Yup, here are the world's greatest medical advances (poll)

World's Greatest Medical Advancements

World's Greatest Medical Advancements

Date: 7/7/2008
Posted By: Jon Barron

To be sure, over the years, I've tweaked medical doctors in my newsletters and blogs. But truth be told, unlike many in the alternative health community, I'm actually a huge fan of doctors -- not so much the organizations that represent them -- but the doctors themselves. Yes, there are doctors who are incompetent or unethical, but for the most part, the vast majority of medical doctors that I have met in my life are extremely competent, highly dedicated, and often even heroic. And make no mistake, no matter how into alternative health you are, there are times you absolutely need a doctor. If your name is John Wayne Bobbitt, you needed a doctor after your wife "altered" you, not an herbalist.

That said, when it comes to most catastrophic illnesses, medical doctors are clueless. They merely manage symptoms and push test numbers up and down. And when it comes to health and nutrition, for the most part, things are even worse; doctors are often arrogantly ignorant. On average, the typical doctor spends a total of 6-8 hours in their entire medical career studying health and nutrition -- and yet they feel free to dogmatically pronounce on all aspects of diet and supplementation with less knowledge than any lay person who has read two good books on the subject. For shame!

In the developed world, we have grown up trusting our doctors. They are frequently the heroes on our favorite TV shows, and we have largely turned over to them complete responsibility for our health. And yes, modern medical science has made incredible advances and contributions which have alleviated much pain and suffering. Surgical technique (the cutting apart and repairing of the human body) has made remarkable progress. Identification of germs that cause disease and improved sanitation, which aids in preventing that disease, have also seen epic achievements. Burn treatment, trauma, and emergency room care are nothing less than miraculous. When it comes to these areas of medicine, the value doctors bring to us is impossible to measure.

It occurred to me, it might be fun in this issue of the newsletter to examine some of medicine's great achievements and see how they stack up when viewed with a skeptical eye. To do that, however, I needed to identify those discoveries that modern medicine takes the most pride in. It would be nice if there were a list of achievements of which the medical community was most proud of so I didn't have to arbitrarily choose them myself. I cringe when the tables are reversed and the medical community evaluates alternative health supplements or procedures by setting up its own protocols for evaluation, and then dismisses the supplement based on that flawed protocol. An example would be evaluating the cancer benefits of laetrile as an isolated supplement, even though every clinic that claimed success with it used it as just one piece of a multi-faceted health protocol. Testing laetrile out of context, then, is like deciding that heart transplants actually involve two separate procedures:

• Removing the damaged heart
• Then replacing the empty space with the donor heart

And once you've made that false assumption, it would be easy to make another, that since they are separate procedures, you need to test them independently of each other -- like deciding to test laetrile as a standalone supplement. But if you separate the pieces from the whole, it should not be surprising that the outcomes disappoint and that you come to the conclusion that heart removal by itself is 100% fatal and therefore should not be recommended in any circumstances. It's nonsense obviously, as is most medical evaluation of alternative health protocols and supplements. In any case, I did not want to be accused of the same kind of hypocrisy by arbitrarily choosing a list of medical accomplishments that were handpicked by me so that I could trash them. Fortunately, the British Medical Journal solved my problem. Last year, it ran a survey among its readers (mostly doctors) to determine the biggest medical advancements of all time. (Thank you BMJ.) So, based on their list, here, with my comments on them, are the top ten.

1. Sanitation: 1,795 votes. The importance of clean drinking water and waste disposal was recognized in the late 1800s, as diseases began to be linked to impure water. However, the World Health Organization says there is still a long way to go. More than 1.1 billion people now lack access to drinking water from an improved source; 2.6 billion do not have basic sanitation.
   
   I'm not actually sure if this qualifies as a medical breakthrough. It's more of a public health issue. And heck, the people who run most of these operations are bureaucrats and PHDs, not medical doctors. But hey, medical doctors were involved in some of the discoveries, so let's give them credit for what is truly a major advance in health. Then again, if they take the credit for improved sanitation, shouldn't they also take the blame for the proliferation of all of the antibacterial wipes and soaps that have flooded the market -- and all of the problems associated with their indiscriminate use?
   
   
2. Antibiotics: 1,642 votes. Alexander Fleming, a British bacteriologist, discovered penicillin in 1928 by accident when he sloppily left a Petri dish of bacteria unwashed in his lab. He found a substance (later named penicillin) growing on it that killed the bugs, and modern-day antibiotics got its start. Fleming shared the Nobel Prize in 1945 for the discovery.
   
   I'm happy to give doctors the credit for this advancement, as long as you also give them the blame for trashing it. Thanks to overprescribing, overuse, and poor management of patients, the medical community has created a situation even worse than existed before the advent of antibiotics. Welcome to the world of medically created super-bacteria. You don't need a military conspiracy to create Outbreak-like disasters. Medical arrogance works very nicely, thank you.
   
   
3. Anesthesia: 1,574 votes. In 1846, a Boston dentist used ether during surgery, putting an end to much of the pain of operations. Since then, general anesthesia has become a mainstay.
   
   Oh, a big thumbs-up on this one. However, it's not quite the advance you might think it is. The use of opiates and herbs to kill pain before surgery goes back to ancient Rome, and the use of acupuncture and chilling of limbs before surgery goes back even further in time to ancient China. Yes, modern anesthesia is an improvement -- but true credit for this discovery belongs to alternative healers who came along well before the modern medical fraternity was even a glint in its founders' eyes.
   
   
4. Vaccines: 1,337 votes. Vaccines have helped prevent a variety of diseases -- including polio, whooping cough, and measles. The first was Edward Jenner's smallpox vaccine, in 1796.
   
   This too is a nuanced issue. For every positive you can point to when it comes to vaccination, you can point to a corresponding negative. Look, I'm not saying vaccines should be eliminated (besides, that's not going to happen anyway) -- just that we should use a lot more discrimination than we are at the moment in their application. And with that said, I'm not sure they belong in the top 10 medical advances.
   
   
5. Discovery of DNA structure: 1,000 votes. Scientists James Watson and Francis Crick presented the structure of the DNA helix, the molecule responsible for carrying genetic information from one generation to the next, in 1953. It earned them the Nobel Prize in 1962.
   
   It certainly is profound, but I'm not sure you can call it a great medical advance… yet. At the moment, only one disease has actually been cured using gene therapy, and a rather obscure one at that. At this point in time, the benefits of gene therapy are more promise than reality.
   
   But there's another potential benefit to the unraveling of DNA: predicting the likelihood of disease by looking at your genetic code. Billed as a major advance in medicine, it unfortunately has a dark side. First, it can potentially be used to deny people access to insurance, based on the risk factors discovered in their DNA. But more importantly, as is already happening, it can cause a medical overreaction. Consider breast cancer, where after testing positive for the "breast cancer gene," women are opting to have their breasts prophylactically removed rather than risk a future cancer. But studies have shown that diet and lifestyle can turn cancer genes on and off in a matter of days. A recent study of men with prostate cancer found that diet and lifestyle changes could "switch off" some 453 cancer-promoting genes, while simultaneously "switching on" some 48 cancer-fighting genes. If you're going to claim the discovery of DNA as number 5 on the list, then don't you have to list the discovery of alternative health as number 4 or higher because the study proves that diet and lifestyle trump DNA?
   
   
6. Germ theory: 843 votes. In the late 1800s, Louis Pasteur was the first to suggest that disease is caused by exposure to microorganisms. Others furthered the theory, showing that specific diseases are caused by specific "bugs."
   
   Come on! How many times can you take credit for the same discovery? Aren't Sanitation (#1) and Antibiotics (#2) expressions of germ theory? Sanitation reduces exposure to germs, and antibiotics kill germs. It's all based on germ theory.
   
   
7. Oral contraceptive pill: 842 votes. The pill arrived on the U.S. market in 1960. For women who use it correctly, oral contraception can be up to 99% effective at preventing pregnancy.
   
   I'm not sure what to say about this discovery without offending some large segment of my subscribers. Suffice it to say, that for whatever benefits may be ascribed to this discovery, the tremendous increase in female cancers we've seen over the last couple of decades may not be unrelated. Synthetic hormones wreck havoc with the body.
   
   
8. Evidence-based medicine: 636 votes. As the name suggests, evidence-based medicine involves making use of the current best evidence (such as research), combined with a patient's values and a doctor's clinical experience, to make decisions about patient care. The term was coined in the early '90s and the concept has been evolving ever since.
   
   Ah, one of my favorites. In principle a huge winner. In practice, not so much. First, far less medicine is evidence based than you might believe -- only about 15% as it turns out. And don't forget the practice of off-labeling drugs, which bypasses all testing -- and of which the FDA feels so highly that they've decided to eliminate virtually all restrictions. And then, there's the fact that much of what we think is evidence-based, turns out, on closer examination, to actually be based on very weak evidence and is often contradictory. Bottom line: evidence-based medicine is great in theory, not so much in practice.
   
   
9. Medical imaging: 471 votes. The X-ray was accidentally discovered in 1895. Since then, the field has expanded, giving us computed tomography (CT scans), positron emission (PET scans), magnetic resonance imaging (MRIs), and ultrasound.
   
   What can you say bad about medical imaging? Oh yeah, right -- the fact that continued exposure to X-rays is a contributing factor to cancer. But other than that….
   
   Then again, MRI's certainly avoid that problem.
   
   
10. Computers: 405 votes. From medical records to insurance, to making sure your new medication isn't going to clash with an existing one, computers are now considered as important as their stethoscopes by some doctors. They've been in use in medicine since the early 1960s. Doctors can access information on new drugs and interactions, new medical studies, and clinical trials, and keep patient records stored at their fingertips.
    
    Okay, I'm not sure how this qualifies as an advancement in medicine. It's an advancement in technology that has been incorporated into medicine. You might as well claim automobiles as a major advancement in medical technology since they allow ambulances to reach hospitals more quickly. Or for that matter, what about telephones and fax machines that allowed doctors in different cities to confer about the same patient in real time. I'm sorry, computers are a great advancement, but do not qualify as a medical advancement per se.
    
    Or if they do qualify as a medical advancement, then computers qualify equally as an "alternative health advancement." Think about it. Thanks to computers, I can communicate the principles of alternative health, recommend supplements and therapies, and call government health agencies to task -- and broadcast that information to my subscriber base, which is located in virtually every country in the world (hello, all of you in Iran, Zambia, and Malaysia) with the push of a button.

Conclusion

But enough playing around. Let me list what I consider to be some of medicines greatest advancements… yet to come.

The medical hit parade according to Jonny Nostradamus

1. Stem cell research: Despite a great deal of resistance to stem cell research outside of the medical community, advances have continued -- and in most cases without the need for embryonic stem cells. Tests on mice for treatment of diabetes have shown that stem cell therapy can indeed stimulate the regeneration of lost beta cells to produce insulin. And companies are now gearing up to begin marketing the use of umbilical cord stem cells in the "theoretical" treatment of a whole range of disease. Although more wishful thinking than practical at the moment, stem cell therapy is likely to begin asserting itself as a major medical treatment for a multitude of diseases in the next 10-20 years.
   
   
2. Emergency surgery: It doesn't matter how many supplements you take or how good your diet, after a major accident, you're going to be thankful for all of the great advancements in surgical technique and body part repair that we have witnessed over the last 50 years. Sadly, much of the great advancements in surgical technique have come as the result of treating battlefield wounds and automobile accidents. Truly, there is almost no limit to the types of wounds and injuries that can now be successfully treated by surgeon.
   
   
3. Prosthetics: The advancement in prosthetics is almost mind boggling -- again, something beyond the capability of alternative medicine. In fact, Luke Skywalker's prosthetic arm in The Empire Strikes Back is looking less like science fiction by the day. And it's not just limbs, the vision goggles that allowed the blind Geordi LaForge in Star Trek to see are also becoming reality.
   
   
4. Sub cellular intervention (gene therapy, metabolomics, and metagenomics): Even though I made fun of it earlier, gene therapy is coming. Yes, diet and lifestyle can turn genes on and off, but gene therapy will ultimately be able to replace missing genes and repair defective genes. Again, we're talking 10-20 years down the road before we see any significant number of practical applications, but they're coming.
   
   But gene therapy is just the tip of the iceberg. Metabolomics is the study of all of the byproducts produced by your body's myriad metabolic processes. These metabolites are easily found in the urine and blood and provide a wealth of information as to the state of your health, and more importantly, where your health is headed. Certain patterns of metabolites can easily identify schizophrenia, and more importantly, how a patient is likely to respond to a particular drug when treating that schizophrenia. Metagenomics, on the other hand, is the study of the bacteria that live in and on our body. That's right, we are not alone. Over 1,000 species of bacteria live symbiotically not just in our guts, but in our noses, mouths, urinary tracts, and on our skin (6 different species in the crook of your elbow alone). We now know, for example, that the bacteria on your skin moisturize it and that the bacteria in your gut moderate inflammatory bowel problems and may determine whether or not you become obese.
   
   
5. Crisis intervention and options for those who won't take care of themselves: Even though we know that diet and lifestyle can prevent and/or reverse much of the catastrophic illness we see in the world today, that doesn't matter to huge segments of the population. Heck, everyone knows smoking is unhealthy, and yet vast numbers of people throughout the world still choose to smoke. The bottom line is that we need options for those people who are too undisciplined or unwilling to take control of their own health. And we need options for those people who need to buy time while pursing an alternative option when their condition is discovered late in the game. Medicine can play an essential role in buying time in times of crisis and in providing options for people who won't take care of themselves.

The role of medicine

As we look back, it is easy to see that modern medical science has indeed made incredible advances and contributions which have alleviated much pain and suffering -- and will likely continue to do so as humanity stumbles into the future. However, in our exploration, we we have seen glimpses of medicine's darker side-- chinks in the armor of its accomplishments if you will. For now, though, let's give medicine its due and leave on a high note. Congratulations to doctors and all they have done!

In our next issue, however, we will explore some of the less positive aspects of modern medicine's "achievements."

Peak Civilization and the Winter of our Disconnect: Carolyn Baker

PEAK CIVILIZATION AND THE WINTER OF OUR DISCONNECT, By Carolyn Baker

Thursday, 24 April 2008

To be interested in the changing seasons is a happier state of mind than to be hopelessly in love with spring. ~George Santayana~ The appearance of springtime in North America may be more welcome this year than at anytime in recent history. The winter has been long, cold, and dreary-particularly in the Rust Belt where the devastations of housing foreclosures, unemployment, and the resultant blight have left a trail of human misery and degradation not seen since the Great Depression. Ten percent of the population of Ohio now relies on food stamps while hordes of domestic animals abandoned in foreclosed homes endure long and grotesque deaths from starvation. For countless Americans across the nation, this winter has brought with it something far more distressing than brutal, bone-chilling temperatures-horrific, traumatic revelations that the American dream, neatly packaged and sold for decades, has become their worst possible nightmare. Should they happen to see on TV the guy from the Countrywide commercial greeting them with "Homeowners...", they are probably wondering why he hasn't been assassinated and at the very least wondering why Countrywide is still in business. Something is festering in the psyches of the formerly middle class of this nation-something far more ominous than burgeoning public assistance and food stamp applications or mushrooming meth labs. If the subprime mortgage massacre had occurred in a vacuum, the dirty little secret might have been kept a bit longer, but juxtaposing it with Peak Oil, skyrocketing food prices, wacky weather and debilitating droughts, not to mention proliferating pink slips, it daily becomes embarrassingly obvious that Jim Kunstler was spot-on when he uttered his infamous declaration in the documentary, "The End Of Suburbia" that "the entire suburban project is the greatest misallocation of resources in the history of the world." And yet during this "winter of disconnect" we have heard delusional economists and the President himself describe the current horrors in terms of "a soft patch" or the need to "ride this one out until things bounce back." And overall, the human race is virtually ignoring climate change and perseverating in the madness of the ethanol panacea. And speaking of insanity, Europe is rapidly returning to coal-fired power plants, while in China, coal "remains the major source of fuel for two billion people"-nightmare scenarios with respect to global warming and climate change. Meanwhile, Monsanto and other genocidal monsters of food and population control, tout ethanol as an energy panacea--the only tangible result of their hype being mass starvation and astronomical food prices. Or as a friend recently commented: Ethanol is a fabulous solution to our energy dilemma because it will provide more fuel for us to drive around and look for food. The Four Seasons Of Civilization Duane Elgin, author of numerous books including Voluntary Simplicity, postulated fifteen years ago that civilizations evolve through specific stages which ironically follow the shape of a bell curve, similar to the Peak Oil curve, in their development and to which Elgin refers as the "four seasons" of growth. This was long before the bell curve of Peak Oil was familiar to many other individuals besides M. King Hubbert, father of the Peak Oil theory, who died four years before Elgin's book was published. According to Elgin, Stage I of the development of a civilization, "Springtime" is characterized by high growth and an era of faith in future potential. During springtime, there is little bureaucratic complexity, and activities are largely self-regulating. Stage II or "Summer", is an era of reason where social consensus begins to weaken and bureaucratic complexity increases with less self-regulation and more external regulation. "Autumn" follows, ushering in an era of cynicism where consensus weakens considerably, special interest groups surpass the power of a shared social purpose, and bureaucratic complexity mounts faster than the ability to effectively regulate. An era of despair characterizes Stage IV, "Winter", and the collapse of consensus is supplanted by conflicting social purposes. Bureaucratic mechanisms and their complexity become overwhelming, and society begins to break down. Elgin believes that three possible outcomes are likely to emerge from the breakdown of the system. One outcome is collapse as the biosphere is pushed beyond its limits and can no longer support the burden of humanity. Stagnation is another option, in which members of the system expend energy on simply maintaining the status quo. Revitalization is the most desirable option which results from a "period of intense communication and reconciliation that builds a working consensus around a sustainable pathway into the future." The author notes that we get collapse by "perpetuating the status quo and running the biosphere into ruin. We get stagnation when citizens are passive and rely on remote bureaucracies and technological solutions to handle a deteriorating local-to-global situation. We get revitalization only when we directly engage our predicament as individuals, families, communities, and nations." Although Elgin has presented the three options in this particular order, it is clear to me that the current civilization has long since passed through stagnation and is rapidly collapsing. In my opinion, while revitalization may have been possible decades ago when society's elite first learned of Peak Oil, climate change, and numerous renewable energy options, it is now possible only as a consequence of collapse for the simple reason that the progression of collapse has rendered voluntary revitalization extraordinarily problematic, if not impossible. Richard Heinberg's Peak Everything reveals unequivocally that virtually every resource on earth has reached or passed its peak of availability to the human race. Elgin's 1993 theory, however, offers a larger picture in which the likelihood that civilization itself has peaked and is on the downward side of the bell curve is logically plausible. The immediate "winter of our disconnect" (and discontent), described above, has been characterized by an astonishingly rapid unraveling of civilization which appears to accelerate with every passing day. The larger winter is not about specific events such as foreclosures, bankruptcies, food rationing in America, or melting glaciers, but rather the final evolutionary stage of civilization and its eventualities in which we now find ourselves embroiled. In other words, particular occurrences of unraveling indicate irrefutably that we have entered Peak Civilization. It is crucial, in my opinion, to comprehend Peak Civilization so that just as we understand that all of earth's resources have peaked which would prevent us from embracing the chimera of a "return to normalcy", we more astutely grasp the progression of human evolution and its implications in the macrocosm. That is to say that a clear understanding of Peak Oil prevents any rational human being from assuming that a return to cheap and abundant energy is feasible in his/her lifetime. Likewise, recognizing that civilization is in an irreversible trajectory of descent may assist us in conserving our valuable mental, emotional, and spiritual energy so that we do not expend it on phantoms of long-term revitalization. Past-Peak Elections-You Have No Government At this point it becomes necessary to distinguish between long-term and short-term revitalization. From my perspective, as stated above, collapse must occur in order for long-term revitalization to become possible, so attempting to prevent collapse also prevents one from honoring the current stage of civilization now unfolding. One example of understanding civilization's "winter" is to grasp that the only thing more futile than addressing energy depletion with ethanol use is the delusion that legitimate presidential elections actually occur in America offering valid choices between two genuinely opposing candidates who represent two distinct political parties and who are beyond domination, contamination, or exploitation by the transnational corporations that in fact manage the United States. Furthermore, to fully understand Peak Civilization is to understand that the federal government per se does not exist, but rather an elite corporate cartel engaged in the management of citizens-citizens who are now completely on their own in terms of their survival as the pseudo-government continues to implode. Moreover, the cartel's direct intent is the cessation of nation states to be supplanted by corporations and their subsidiaries. Therefore, the task before us is not to perpetuate the status quo by participating in the ersatz federal election debacle, but to, in the words of John Michael Greer "transition to a Third World lifestyle." I believe that any politician who suggests that we can do otherwise and survive as individuals or as a nation, may be committing a crime against humanity. Politicians and centralized systems are incapable of effecting meaningful change. Or as Greer states, "...getting the Federal government to do something constructive about the situation, for instance - [is] a waste of time. That sort of change isn't going to happen. It's not simply a matter of who's currently in power, although admittedly that doesn't help. The core of the problem is that even proposing changes on a scale that would do any good would be political suicide." Although nothing could be more unpalatable for the American public, transitioning to a Third-World lifestyle is precisely what it is being forced to do. And as Greer comments: There's no way to sugar-coat that very unpalatable reality. Fossil fuels made it possible for most people in the industrial world to have a lifestyle that doesn't depend on hard physical labor, and to wallow in a flood of mostly unnecessary consumer goods and services. As fossil fuels deplete, all that will inevitably go away. How many people would be willing to listen to such a suggestion? More to the point, how many people would vote for a politician or a party who proposed to bring on these changes deliberately, now, in order to prevent total disaster later on? What Peak Civilization Really Looks Like Peak Civilization by definition means the disappearance of public education, healthcare, government-issued currency, commercial food production, public access to regional water supplies, interstate commerce, the North American energy grid, and the very infrastructure of the United States. Yet one need not succumb to fatalism. While long-term revitalization cannot be realized now, its seeds can be and are being planted by the proliferation of vibrant relocalization movements erupting and evolving around the world, many of which have been spotlighted at the Truth To Power website. As Duane Elgin emphasizes: "A revitalizing society is a decentralizing society, with grassroots organizations that are numerous enough, have arisen soon enough, and are effective enough to provide a genuine alternative to more centralized bureaucracies." The first headlines of food rationing in America are buzzing across the internet as I write this article. They underscore the unequivocal reality that collapse is going to compel us to feed ourselves or quite simply, we will perish. I believe that food security is the most urgent, the most immediate issue to which we must attend at this moment of Peak Civilization. For months, this website has been informing readers about food storage and preservation and other aspects of preparedness. It is now time, if you have not already done so, to organize groups of citizens in your neighborhood, schools, churches, and community centers to plant and maintain gardens. In addition, collapse is compelling us to rapidly mobilize our neighborhoods and communities to not only accumulate our own supply of stored water but to organize citizens to work with local public water utilities to ensure that they remain public and are not privatized. Health care professionals reading these words need to consider offering local workshops on a regular basis teaching citizens how to treat injuries and illnesses in the absence of a viable healthcare system. Doctors, nurses, dentists, and all manner of medical personnel are likely to be overwhelmed with patients during and after the full-scale breakdown of the system when hospitals and clinics have closed and almost no one can afford health insurance. A recent CBS News video link emailed to subscribers recently by Truth To Power confirms the imminent, total collapse of America's healthcare system and reveals the extent to which anyone with the slightest bit of training in the field is likely to find her/himself inundated with throngs of sick people desperately seeking care. Seeds Of Revitalization Greer emphatically stresses that "The key to making sense of constructive action in a situation of impending industrial collapse is to look at the community, rather than the individual or society as a whole, as the basic unit." Those familiar with Greer's article, "The Coming Deindustrial Society", recall his three requirements for community: A community must have some degree of local organization; it must have a core of people who know how to live without fossil fuels; and it must have food and a production and distribution system for it. In a future article, Truth To Power will add another requirement, namely, the ability to communicate clearly and compassionately with other community members. Our challenge at this moment in history is to recognize and intentionally connect with the evolutionary season of winter in which Peak Civilization finds itself because as Duane Elgin admonishes us: "It is time to begin the next stage of our human journey." As I witness most of humanity's current "solutions" to its climate-energy-food-water-population-economic dilemmas, I see only myopic, psychotic strategies, and I have to ask myself whether or not it will be necessary for us to annihilate ourselves and the planet in order to transition into a more advanced evolutionary paradigm that will not permit the human race to ever again engage in anything like the current madness. Tragically, I see almost nothing that suggests otherwise. It is crucial that we comprehend that not only have we entered winter, but that that particular season is going to last a long time. As we navigate that winter, we are allowed our discontent, but we dare not permit ourselves to disconnect from current reality. Simultaneously, it is imperative that we hold a vision of revitalization and plant its seeds everywhere at the same time that we honor more the changing of the seasons than our addiction to springtime.

Last Updated ( Thursday, 24 April 2008 )