What if this was your last Christmas? What if this was your last chance at Christmas Eve, Christmas morning, and Christmas dinner? Would you make the effort to go home for the holidays? Would you make time to take the kiddos to drink hot chocolate and look at the lights?

Would you still go to the mall?

That’s what Mary Kate Campbell did, and she and her shiny new husband had a great time.

“The best Christmas I had, we went to the mall and only had $100. He got a pair of Ray Bans, I got a sweater from J. Crew. We could afford these things, and we enjoyed our time together,” she said.

That was a couple years ago. She’s not sure where she’s going to spend Christmas this year. “That actually depends on whether I get into a clinical trial I got kicked out of last week,” she said from the Seattle hospital where she’s got a real bad case of relapsed, refractory Acute Myelogenous Leukemia. “Or I will go home to Virginia and have a nice quiet little Christmas like I did last year,” she said. “It all depends on whether I get this new drug.”

The bone marrow registry had two matches, but the doctors found cancer cells after the operation. When I asked if she’d been given a prognosis, she said, “I should be dead already,” and shortly after that she had to get off the phone to have a tube taken out of her chest. She’s 29 and has been married for a year and a half. But when she gets sad this Christmas, don’t assume you know why.

“Christmas is sadder for me now, and it’s for reasons that I think are not the most predictable because I see wonderful, well-intentioned people who love me and care about me and would do anything that they could do to save me, but they cannot save me,” she said. “I see them buying objects for me and for others to distract themselves from the pain for a little while, the pain that they’re going to lose me.”

And you think your mother is hard to shop for?

From her hospital room, Campbell watches endless commercials for Black Friday, door busters, and 24-hour sales, all screaming at us to buy things that will be forgotten by the New Year. If she had her way—and just this once, maybe she should—we’d handle Christmas more purposefully.

“Buy something you can afford that speaks to you about the person you’re buying it for. Surround yourself with people who don’t expect you to buy them things,” she said. “Every Christmas, we present the people we love with a glut of objects. We don’t necessarily present them with our love, we present them with objects.”

Life doesn’t have to be so fraught to give Christmas urgency. My cousin George Stanford, a singer-songwriter based in LA, just recorded a song called “Christmas For Two”. The video—it’s up on YouTube—features his lovely and pregnant wife, Nikole, as they prepare for their last Christmas before the baby comes. It is unspeakably adorable.

“Next year, there’ll be three, around our Christmas tree. You and I have just begun to write our legacy/Our gift will be here soon, a little me, a little you, so let’s celebrate our last Christmas for two,” sings George.

For better or worse, we don’t know who is going to be around the Christmas tree next year. So I’ll put it to you again: If you knew that everything would change next year, how would you spend Christmas? Would you judge Christmas on how high the pile of presents under the tree is? Would you worry that everything looked just so? Would you put a plastic toy on a plastic card because Suzy had to open the same number of wrapped boxes as Johnny?

What would you do?

Battle Looms Over Restriction On Cold Medicine Used For Meth

Published with permission from Indiana Lawyer Daily

Indiana lawmakers have yet to gather for the 2016 legislative session, but already the multibillion-dollar pharmaceutical industry has clashed with influential law enforcement organizations over a proposed law that would require a prescription to buy a common cold medicine also used to make methamphetamine.

Advocates, including county prosecutors, say something needs to be done to rollback Indiana’s dubious distinction as a leading state in yearly meth lab discoveries, and have previously tried — and failed — to make it the third state requiring residents to get a doctor’s prescription for cold medicines containing pseudoephedrine.

This year, they have a powerful advocate in GOP House Speaker Brian Bosma, who has made passing the law a priority.

Here are some things to keep in mind:

Top in meth labs

Meth lab discoveries have dropped across much of the U.S. since a national peak in 2004. That trend has mostly skipped Indiana. State police report 1,242 meth lab “incidents” as of Oct. 31 of this year, only slightly below the 1,384 labs that federal officials reported for Indiana at the national peak.

A 2013 report by the U.S. Government Accountability Office credited crafty meth makers for developing new cooking techniques, as well as the use of groups of straw buyers who fan out to purchase the needed quantities of cold medicine.

But unlike the image of ad hoc meth lab facilities popularized by TV shows like “Breaking Bad,” authorities say 93 percent of the labs discovered in 2015 were much smaller in scale, sometimes involving little more than a one-liter soda bottle

The law would certainly inconvenience consumers, said Jonathan Woodruff, an attorney for the National Alliance for Model State Drug Laws. But decreasing access to cold medicine, he said, can’t hurt “because it makes it harder for people to buy it for illegal purposes.”

MADE IN MEXICO

Opponents of the proposal say it is a dated solution to an evolving problem. Increasingly, authorities say, the meth trade is in the control of foreign drug cartels that can produce large quantities and have a vast distribution network.

“It’s less of an issue of what’s being purchased at the drugstore and more an issue of what is coming into the country,” said Alex Brill, a health care policy researcher at the conservative American Enterprise Institute. “The marketplace here in the U.S. for meth has definitely evolved over the last four years.”

Authorities concede that meth from Mexico is increasingly a problem, but they contend that tightly regulating the sale of cold medicine will free up the resources to focus on drug cartels.

“It won’t solve the meth-taking problem in our state, but we believe it will solve the meth-making problem,” said Washington County Prosecutor Dustin Houchin, who serves an area with substantial meth use.

Advertising campaigns

The proposal is running into a well-financed campaign from industry groups, including the Consumer Healthcare Products Association, which represent interests that stand to lose financially if the law is passed. Already, TV ads are airing across the state highlighting the inconvenience it would cause for consumers, as well as the cost, which could fall on government programs like Medicare and Medicaid.

Former state health Commissioner Richard Feldman says the popularity of meth presents a vexing challenge for law enforcement.

“But flooding the medical system and clogging it up with patients with a common cold? The added cost to government individuals and families is not justified,” said Feldman, who served under former Democratic Gov. Frank O’Bannon.

Surrounding states

Critics and proponents both agree a prescription requirement will likely lead enterprising meth cooks to get their cold medicine in neighboring states, none of which have a prescription requirement for pseudoephedrine.

“But the harder it makes it for them, the better,” said David Powell, executive director of the Indiana Prosecuting Attorneys Council.

While many states, including Indiana, track pseudoephedrine sales through a national sales database called NPLEx, Ohio authorities do not.

Those factors could all lead to the creation of a black market, said Feldman, who is currently the director of Family Medicine Residency for St. Francis Health.  “What did prescription status do for opiates? Nothing. It’s the easiest drug to get on the street,” he said. “Why is it going to be any different for pseudoephedrine?”