Cost externalization or externalized costs usually refers to producers [often corporations] that off-loads indirect costs, called negative externalities, to a third party [often all of us] in order to maximize their profits. An example would be a corporation not taking financial responsibility for the polution that they produce or paying their employees low wages and thus requiring them to use food stamps and other forms of public assistance that we all pay for through our taxes. The UN is currently studying the cost of polution and other environmental damage by the world's top 3,000 corporations. The price tag is $2.2 trillion. That represents 1/3 of the profits for these corporations. So, for the sake of more profit, these corporations are willing to contribute to the end of our planet as they put the burdon of this pollution on the rest of the world. Does it seem right that a very small percent of the world's population gets money at the expense of the rest of us. I believe that everbody would agree that this is very wrong. It is not part of a fair capitalistic system as externalizing costs can allow a corporation to lower the cost of their products giving them an unfair advantage over other corporations making the same type of product. It is not right. It is morally wrong and all of us know this. So why do we tolerate this? It may be because we are also guilty of externalizing our costs by: purchasing things that are cheap because of the manufacturer externalizing costs; by polluting [not carbon neutral, not recycling, etc.]; buying stocks of corporations that externalize costs; by electing people who promote externalization of costs; etc. So, many of us externalize costs. If we want those corporations to stop externalizing costs then it might be helpful for all of us to do likewise. This might increase our awareness and sensitivity to this problem and help all of us to work together to treat each other with more respect as we take responsibility for our own problems and help others to take responsibility for theirs.

Does this make sense?



I've read that the ancient Greek democracy failed because it did not protect the individual from the majority. If we believe that all life is sacred [precious, etc.] then we must protect the rights of the individual from the majority. So, something being good for most people does not justify it being imposed on the individual. Or does it? If we see that the right to life is being taken away from some people by individuals with assault style weapons then does any individual have the right to those weapons when exercising their right can take away the right to live for innocent people? So where do our individual rights end and the majority's rights begin? 

We as individuals are guaranteed by our constitution to be free to pursue our lives. So, any thing that interferes with our ability to pursue our lives interferes with our individual rights. But what about the rights of others, such as the rights of children and adults to not be killed by a male with an assault rifle. Their right to pursue their lives is over. So, is it right to pursue our lives if it can result in the right of others to pursue their lives be taken from them? It has been argued that it is wrong to take assault rifles from people who have not killed anyone and yet the fact of and availability of these weapons has taken the right of many to be alive to pursue their lives. I believe that it is our responsibility to protect the lives of those innocent people.  If this is true regarding guns then it must be true for protecting those innocent people from the hate being promoted on line or anywhere else. We are free to speak what we believe but not free to take away the rights of others to pursue their lives.

What do you think?



Questions are sometimes raised about exceeding the maximum recommended doses of medications used to treat ADHD. I have reviewed the research studies for these medications and it is clear that the studies were to determine efficacy and were not dosing studies.  Specific doses were chosen to assess the benefit and minimize risk of side-effects.  Once efficacy was determined the study ended and there was no motivation to do further studies addressing the range of doses that were therapeutic. Thus, doses involved in efficacy studies can be mistakenly seen as being studies to determine limits of what is therapeutic. The studies could not recommend a different dose because they did not assess different [higher] doses.  Also, each person is unique and this uniqueness can include how they respond to medications with some people responding to higher doses and others to lower doses. The U.S. Food and Drug Administration recognizes this when they state “the dosing regimen [for stimulant and related medications] is adjusted according to a patient’s individual response to pharmacotherapy."

I believe that it is important to work with my patients to assess their response to medications and in collaboration with them determine an optimal dose. At times this dose may be higher than is “recommended.”  I hope that it is clearer now why this is the case and why it is necessary to prescribe higher doses for these patients.




It is so sad that Whites continue to be priviledged at the expense of others, mostly African-Americans. The priviledge is a weight on whites as we suffer from the abuse that is perpetrated in our name whether we agree with it or not. Our country grew up supporting racism and white priviledge and it is woven into our culture and to change this we must choose to see the priviledge for the abuse that it represents whether by financial institutions refusing loans or having higher interst rates, maintaining segregation through realestate practices or by promoting Whites only charter schools. According to Resmaa Menakem [My Grandmother's Hands] Whites suffer in their bodies from a long pattern of reacting to African-Americans as a threat and yet are also frequently dependent on them. Mr. Menakem feels that Whites need to become aware of their bodies response to African-Americans and change it so that they can process and then dismiss their emotional reactions and begin to see them as like themselves and not a threat. Mr. Menakem sees the police as needing a lot of support to overcome their frequent automatic response as if African-Americans are dangerous with the increased risk that lethal force will be used inappropriately.  Support to help the police to manage traumatic experiences that they have as well as help people they are responsible for keeping safe to resolve any traumatic experiences that they might have. Finally, Menakem also sees African-Americans as needing to stop their automatic response of defering to Whites and feeling responsible for them. If we all can overcome our rapid, automatic and destructive body responses to others we will be free to experience our common humanity and not need to live in fear or with the weight of prejudice and judging others. 

I believe that what Menakem is describing is similar to patterns of behavior that develop related to our automatically perceiving people or situations to be dangerous because of past traumatic experiences. Our behaviors are meant to protect us from the danger that we [or our ancestors?] had experienced in the past . The human brain is capable of storing patterns of behavior and accessing them instantly [in a nanosecond which is a billionth of a second] to protect us. We are reacting before we are even aware that we are. This makes changing these patterns of behavior much more difficult, even if we actually no longer need to be afraid or react to what is no longer a threat to us. According to Menakem, we all need to be aware of changes in our bodies that indicate we are recalling past threats and need to calm ourselves down to avoid reacting. This is especially important if we by the nature of our work, carry guns. Menakem recommends therapeutic support for police officers who are exposed to violence or participate in violence. It is important for all of us to develop this awareness of changes in our bodies that can activate old patterns of behavior that we no longer need and can lead to conflicts in our relationships with others. Then we need to learn ways to diffuse these reactions so we do not get triggered and thus do not react to them.

What do you think?



Zero sum refers to any exchange where whatever is gained by someone is lost by another person. An example would be where two people or two groups of people [like in a company] are both competing for something where if one person or group gets that something the other person or group will get less. Zero sum refers to the fact that when you have a limited amount of something that two or more want, how much each individual changes but the total never does and there is always no [zero] change in the overall amount that does not change. So the possibility of a win, win situation does not exist if the total amount is fixed or the value of the something is fixed. Thus, a way where both benefit is not possible. It seems to me that any kind of competition is always zero sum, so that whenever you have winners and losers you are dealing with zero sum. Win-lose outcomes are common and result in one side gaining and the other losing. This can lead to some benefit in the short run but significant losses in the long run. It is the problem of competition [zero sum] vs cooperation [non zero sum or win-win].

Well, what then is not zero sum? It requires that both persons, parties, groups, entities benefit from the exchange or interaction. How does this happen? It can be called a "win-win" outcome where both sides benefit. Examples of this include: all human relationships have the potential to be win-win [right?!]; selling and buying interactions where it is by choice and the seller benefits by the sale and the buyer by what is purchased; and where there is a direct benefit and an indirect benefit such as an employer relaxing work schedules to allow more choice by employees and this increases employee satisfaction and morale and productivity that then benefits the employer.

I mentoned above that human relationships can be win-win and ideally are. Actualy, I believe that human relationships are win-win or they are not human relationships. But, what would they be called if not human? Maybe it is the relationship aspect that requires that it be win-win? Aren't human relationships supposed to be mutually beneficial?

What do you think?