Kevin Drum

Quick Treatment Update - And Thanks

| Sat Oct. 25, 2014 9:09 PM EDT

I had my first round of chemo about six hours ago, and I had no reaction at all. No nausea, no vomiting, no nothing. I ate lunch an hour afterward. Obviously this may change as things progress, but so far I seem to be tolerating the treatment regimen well. That's good news. And my back continues to slowly get stronger and less painful.

The outpouring of prayers and good wishes has been genuinely heartening. Thank you to everyone for all the comments, tweets, and emails. They truly mean a lot to me. And to Nora and Jason from Chicago: Thanks for the flowers! They're lovely.

On a related note, several people have asked if I need any financial help. As it happens, MoJo provides excellent health coverage (mine is through Kaiser), so I'm well covered on that front. Beyond that, as many of you know, my previous career has left me in very good financial shape. So I'm one of the lucky ones: All I have to do is worry about following my treatment plan and getting better. I have no money worries, and plenty of family and friends (and cats!) rooting for me and ready to take care of me when I need help.

That's the latest. And here's the best news: Depending on how things go tonight, I may be able to go home tomorrow. Hooray!

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Amazon Must Be Stopped - Sort Of

| Sat Oct. 25, 2014 12:44 PM EDT

Enough of this cancer nonsense. Let's agree and disagree with Matt Yglesias today (not that I'm comparing him with cancer, mind you).

First off, the disagreement. In the current issue of the New Republic, Franklin Foer pens a righteous rant against Amazon as an evil, marauding monopoly that needs to be crushed. It warmed the cockles of my heart, since Amazon's almost Luthor-like predatory strategies against startup competitors leave me cold. That's one reason I choose not to do much business with them. But legally? I may not like the way Amazon went after Diapers.com, but let's face it: they're nothing close to a monopolist in that space. Yglesias is right that in most of their business lines they should be left alone. Walmart and Target and Google and a tsunami of aggressive startups will keep them plenty busy.

However, there's an exception: e-books. Yglesias has no sympathy for big book publishers, and he has a point. These are pretty gigantic companies in their own right, and although I suspect he gives their business practices short shrift in some important ways, there's not much question they often seem pretty antediluvian. But this goes too far:

It is undeniably true that Amazon has a very large share of the market for e-books. What is not true is that Amazon faces a lack of competition in the digital book market. Barnes & Noble — a company that knows something about books — sells e-books, and does so in partnership with a small outfit called Microsoft. Apple sells e-books and so does Google.

Amazon has a huge share of the e-book market, and pretty much everyone—including Yglesias, I think—believes that Barnes & Noble is only a few steps from the grave. Unsurprisingly, Nook funding is in free fall. Sony has exited the e-book market and Kobo isn't far behind. Even Apple, as mighty as it is, has only a tiny market share after several years of trying.

In theory, this is a great opportunity for an innovative startup. Startup costs are modest since there's no physical inventory to worry about. Publishers are eager for new entrants. Maybe a smart startup could appeal to consumers with a great new e-reader concept. Or a better recommendation engine. Who knows? There are loads of possibilities. The problem is that no startup can possibly compete with a huge incumbent that's willing to sell e-books at a loss. There's no VC on the planet willing to fund a trench war like that.

So Amazon really does have a monopoly position in this market that it sustains via predatory pricing and heavy-handed business practices—against publishers both big and small—that might make John D. Rockefeller blush. Tim Lee pinpoints a big part of the problem:

I mostly agree with my colleague Matt Yglesias's argument that Amazon is doing the world a favor by crushing book publishers. But there's at least one way US law gives Amazon excessive power, to the detriment of publishers, authors, and the reading public: ill-conceived copyright regulations lock consumers into Kindle's book platform, making it hard for new e-book platforms to gain traction.

....In 1998 [music publishers] got Congress to pass the Digital Millennium Copyright Act, which made it a federal crime to unscramble encrypted content without the permission of copyright holders.

....While the law was passed at the behest of content creators, it also gave a lot of power to platform owners. If you buy a movie on iTunes, you're effectively forced to continue buying Apple devices if you want to keep watching the movie. Tools to transfer copy-protected movies you've purchased from iTunes onto another platform exist, but they're illegal and, accordingly, not very user-friendly.

Amazon has taken advantage of the DMCA too. Kindle books come copy-protected so that only Amazon-approved software can read it without breaking the law. Of course, software to convert it to other formats exists, but it's illegal and accordingly isn't very convenient or user-friendly.

And that creates a huge barrier to entry.

Aside from my general distaste for Amazon, I happen to think the Kindle app is kind of sucky. The Nook app is better, so I buy my e-books via Barnes & Noble. But the Nook app has its own problems, and you may prefer Kindle. That's great! Competition! But I'm keenly aware that B&N is likely on its last legs, and then what? Amazon will have even less incentive to improve its reader, especially on less popular platforms.

I like competition. And it can't be emphasized too much that the DRM issue is driven heavily by publishers, not just by Amazon. Nor is there a simple solution. Arguments of the techno-utopian "information wants to be free" crowd aside, there are pretty self-evident reasons why authors and publishers don't want their books to be instantly available for free within a week of being published.

Nonetheless, this is a problem that begs for a solution. Partly it's driven by DMCA restrictions. Partly it's driven by those antediluvian publishers. And partly it's driven by Amazon's genuine monopoly position in the e-book market, which stifles innovation and promises to get even worse in the future.

So sure, leave Amazon alone in most of its business lines. But in e-books? Nope. They're a monopoly in every sense of the word, and they use predatory practices to stay that way. They may offer cheap books, but in the long run it's vibrant competition that truly benefits consumers. Regulating Amazon would hardly solve all our e-book problems—far from it—but it would be a start.

Friday Cancer Blogging - 24 October 2014

| Fri Oct. 24, 2014 5:27 PM EDT

A few of you have probably cottoned onto the fact that people don't usually spend a week in the hospital for a broken bone, even a backbone. So in the long tradition of releasing bad news on Friday afternoon, here's my first-ever Friday news dump.

When I checked in to the hospital Saturday morning, the first thing they did was take a bunch of X-rays followed by a CT scan. These revealed not just a fractured L3, but a spine and pelvis dotted with lytic lesions that had badly degraded my bones. That's why a mere cough was enough to send me to the ER. It was just the straw that broke an already-weakened camel's back. Later tests showed that I also had lesions in my upper arm, my rib cage, and my skull—which means that my conservative friends are now correct when they call me soft-headed.

The obvious cause of widespread lytic lesions is multiple myeloma, a cancer of blood plasma cells, and further tests have confirmed this. (The painful bedside procedure on Tuesday was a bone marrow biopsy. Bone marrow is where the cancerous plasma cells accumulate.)

I know from experience that a lot of people, especially those who have been through this or know a family member who's been through this, will want to know all the details about the treatment I'm getting. I'll put that below the fold for those who are interested. For the rest of you, here's the short version: I'm young, I'm not displaying either anemia or kidney problems, and treatments have improved a lot over the past decade. So my short-term prognosis is pretty positive. Treatment involves two to three months of fairly mild chemotherapy, which has already started, followed by a bone marrow transplant. My oncologist thinks I have a very good chance of complete remission.

The longer-term prognosis is less positive, and depends a lot on how treatments improve over the next few years. But I figure there's not too much point in worrying about that right now. Better to stay focused on the current regimen and see how I respond to that. Wish me well.

Friday Cat Blogging - 24 October 2014

| Fri Oct. 24, 2014 12:55 PM EDT

We're a little late with catblogging today, but that's not bad under the circumstances—which partly include all those meddling doctors with their tests and pills and questions, but are actually mostly technological. For the most part, the Windows tablet and the new phone have been godsends in the hospital. The Windows tablet, running standard—and fully synced—Firefox, allows me to blog with no trouble, unlike either my iPad or Android tabs. Windows OneDrive gives me access to every picture I've ever taken of the cats. And the hotspot on the phone is fast and reliable, unlike the hospital WiFi system.

Unfortunately, I don't have Photoshop installed, and probably never will since it's now astronomically expensive and available only by subscription. Even the simplest image editing is a trial with only MS Paint to work with, so any post with a picture is sort of torturous to publish.

But I'm a professional, and nothing is too much work for my loyal readers. So here you go. Hopper is the blurry one on the right, grooming a slightly bemused Hilbert, who joined in a few seconds later and turned both cats into blurs.

Final Housekeeping Update

| Fri Oct. 24, 2014 11:09 AM EDT

According to my surgeon, yesterday's kyphoplasty went swimmingly well. I needed to be prepared for normal post-op recovery pain, but once I was through that my back would be in good shape.

Unfortunately, "normal post-op recovery pain" turned out to be hours of excruciating, mind-numbing agony. At one point I was on four separate pain killers and they still weren't doing the job. I finally got a second dose of the most powerful one, and that made things barely tolerable—though at the medium-term expense of my stomach, I suspect.

But that was yesterday. Today I feel OK, and this morning I got out of bed and hobbled around the room without any significant pain So, success!

This is the last post that can fairly be called "housekeeping," but not the end of the story. I'll have more news later.

Yet More Housekeeping

| Thu Oct. 23, 2014 12:00 PM EDT

How much detail do you want about my medical woes? Well, I'm bored, so you're going to get more.

By the time you read this, I should be sedated and ready for a something-plasty, a procedure that injects bone cement into my fractured L3 lumbar vertebra. In other words, I will become a low-grade Wolverine in one teeny-tiny part of my body. According to the doctors, the cement dries instantly and should relieve my back pain almost completely. It sounds too good to be true, and of course it's always possible that I have some other source of back pain in addition to the compression fracture. But this should help a lot.

There is more to this story, and hopefully tomorrow will wrap everything up as all the rest of the test results come back. I'll keep you posted.

On a related subject, I have to say that the Irvine Kaiser hospital is excellent. I have a very nice little single room with good visiting accommodations. It features all the usual annoyances of a hospital, some of which have made me grumpy, but everyone has been very nice and professional. They've made my stay about as nice as it could be under the circumstances.

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Housekeeping Update

| Wed Oct. 22, 2014 10:58 AM EDT

Just a quick update. Yesterday my doctor decided to do a "little bedside test" to get a better reading on the state of my bones. It was indeed bedside, and it was indeed done with just a local anesthetic, but I guess it wasn't a very powerful one. Hoo boy, did that hurt, and naturally I was a total baby about it. In any case, they want to keep me here for at least another day to make sure I didn't get infected etc. Also, today I get my first monthly dose of some bone-strengthening med whose name escapes me. So it looks like it'll be tomorrow at the earliest before I go home. It depends on how I'm doing and what the doctor gods decree. But I walked 300 feet this morning without too much trouble, so that has to be a positive sign, doesn't it?

When will blogging recommence? I'm not sure. In the meantime, though, enjoy a bonus cat.

Housekeeping Note

| Mon Oct. 20, 2014 8:00 AM EDT

No blogging today, I'm afraid. I've been having lower back problems for several months, and on Friday night it got a lot worse. Saturday morning I couldn't get out of bed, and had to be transported to the ER. It turns out that I had a compression fracture of one of my lumbar bones. I've been in the hospital ever since.

I can walk again, but I'm pretty much bedbound for a while. Beyond that, further tests will tell us what's going on here. Without either oversharing or being coy, there's a chance this could turn out to be pretty serious. We'll know more by the end of the week. In the meantime, blogging will obviously be pretty limited.

Friday Cat Blogging - 17 October 2014

| Fri Oct. 17, 2014 2:15 PM EDT

I don't know about you, but I could stand to have catblogging a little earlier than usual this week. What you see here is one of the many cat TVs now installed in our home. This is the dining room TV. There are also cat TVs in the kitchen and the study. The kitchen TV apparently has most of its good shows at night, and it's not clear what those shows are about. But they are extremely entrancing.

The dining room TV, by contrast, is sort of our workhorse cat TV. They both love it all day long. Needless to say, this is something new for both Hopper and Hilbert, since they spent the first ten months of their lives in a shelter, where cat TV mostly just starred other cats. Who knew there were so many other channels to choose from?

What World Leader Has Done the Most Damage to the Global Economy?

| Fri Oct. 17, 2014 1:57 PM EDT

Who's worse: Amity Shlaes or Angela Merkel? You have to give the nod to Merkel, of course. Unlike Shlaes, who is limited to cheering on horrifically bad ideas that would immiserate millions, Merkel has the power to actually implement horrifically bad ideas that immiserate millions. And she has. So Merkel it is.

Now, if instead the question were how Merkel compares to, say, John Boehner and Paul Ryan, then it would be a tougher choice. I think Merkel would still win, though. When it comes to bullheaded insistence on terrible economic policy, she's hard to top.