Tuesday, May 30, 2006

Politics: The Conscience of a Carnivore

William Saletan likes meat, but he recognizes the moral conundra it poses:

Shrinks call this "cognitive dissonance." You munch a strip of bacon then pet your dog. You wince at the sight of a crippled horse but continue chewing your burger. Three weeks ago, I took my kids to a sheep and wool festival. They petted lambs; I nibbled a lamb sausage. That's the thing about humans: We're half-evolved beasts. We love animals, but we love meat, too. We don't want to have to choose. And maybe we don't have to. Maybe, thanks to biotechnology, we can now grow meat instead of butchering it.
Saletan's solution? We're close to being able to grow meat instead of killing it.
By growing meat in labs, the way we grow tissue from stem cells. That's the great thing about cells: They're programmed to multiply. You just have to figure out what chemical and structural environment they need to do their thing. Researchers in Holland and the United States are working on the problem. They've grown and sautéed fish that smelled like dinner, though FDA rules didn't allow them to taste it. Now they're working on pork. The short-term goal is sausage, ground beef, and chicken nuggets. Steaks will be more difficult. Three Dutch universities and a nonprofit consortium called New Harvest are involved. They need money. A fraction of what we spend on cattle subsidies would help.

Growing meat like this will be good for us in lots of ways. We'll be able to make beef with no fat, or with good fat transplanted from fish. We'll avoid bird flu, mad-cow disease, and salmonella. We'll scale back the land consumption and pollution involved in cattle farming. But 300 years from now, when our descendants look back at slaughterhouses the way we look back at slavery, they won't remember the benefits to us, any more than they'll remember our dried-up tears for a horse. They'll want to know whether we saw the moral calling of our age. If we do, it's time to pony up.
Of course, Saletan doesn't particularly explore the fact that most people would probably be freaked out by lab-grown meat, even though it doesn't pose near the ecological difficulties that biotechnology agriculture does. And I can't see the ingredients on the side of a lab-grown beef package reading merely: beef. There are a few zillion chemicals that will probably sneak in there as well, not that real beef probably doesn't contain a zillion environmental toxins anyway.

I don't think the evangelicals would freak out too badly; I don't recall anything in Revelations that would suggest that lab-grown chicken nuggets signal the end-times.

I'm not holding my breath, but I'll cross my fingers. I do sorta miss barbecue ribs.

Film: Blade Runner to get 'final cut' re-release

For those with taste for fine sci-fi, any news of Ridley Scott's 1982 adaptation of Philip K. Dick's Do Androids Dream of Electric Sheep? is certainly blogworthy.

Saturday, May 27, 2006

You Are Bert

Extremely serious and a little eccentric, people find you loveable - even if you don't love them!

You are usually feeling: Logical - you rarely let your emotions rule you

You are famous for: Being smart, a total neat freak, and maybe just a little evil

How you life your life: With passion, even if your odd passions (like bottle caps and pigeons) are baffling to others

Thursday, May 25, 2006

MedPol: Status of OTC PlanB

A decision on the provision of emergency contraception over the counter has been stalled by the FDA (originally due Jan 2005), which is currently being sued by the Center for Reproductive Rights. There's a lot of politics, religion, morality, and stigma involved, but a recent article in the Annals of Emergency Medicine does a good job of covering the pro's, con's, history, and possible impact on ED's. Right now many people who have condom breakages, etc. have to visit ED's for PlanB prescriptions. Making it over the counter might reduce these visits and help with the incredibly crowded state of our ED's.

Wednesday, May 24, 2006

You are a

Social Liberal
(68% permissive)

and an...

Economic Liberal
(25% permissive)

You are best described as a:


Link: The Politics Test on OkCupid Free Online Dating
Also: The OkCupid Dating Persona Test

Tuesday, May 23, 2006

Cartoon from Clay Jones, from Slate's cartoons.

Medicine: Lexapro goes generic

Apparently Lexapro was the number 2 seller behind Zoloft, which is quasi-shocking to me. I'm wondering if this actually represents the number of prescriptions for escitalopram versus sertraline, or Lexapro versus Zoloft, i.e. what "brand name" drugs are being sold the most. I'd imagine that generic sertraline (Zoloft) and citalopram (Celexa, and the racemic mixture of Lexapro), would blow the more-expensive and probably-no-better-tolerated Lexapro out of the water.

For those not in the know, among the class of drugs wrongfully called SSRIs, since the fact that they are SSRIs probably has nothing to do with their efficacy, sertraline and citalopram are the two antidepressants that play most nicely with other drugs, which of course becomes important for folks taking 20 other meds.

Monday, May 22, 2006

Medicine: Vegan diet lowers odds of having twins

Fact or fiction?

Women who eat a vegan diet -- a strict vegetarian diet that excludes all animal
products including milk -- are one-fifth as likely as other women to have twins, a U.S. researcher reported on Saturday.

The reason may be hormones given to cattle to boost their milk and meat production, said Dr. Gary Steinman, an obstetrician specializing in multiple-birth pregnancies at Long Island Jewish Medical Center in New Hyde Park, New York.
This might, at first, seem like a semi-condemnation of veganism, and is of course the way that the general public would take a headline like that, thinking "oh, vegans aren't healthy enough to carry twins, which are obviously cooler than singles!"

Except that's of course a load of crap, since a twin pregnancy is, by definition, a high-risk pregnancy. But regardless, this entirely retrospective, correlational study can't a) prove causation, or b) figure out if it's because milk is healthy, or because we're doping cows up with exogenous hormone, IGF, to make them produce more milk. Now, milk would of course contain some cow IGF anyway, which might be stimulating human ovaries. Or, maybe it's the crap we throw into milk. I'm wondering, for example, if there would be enough of an organic milk drinker subset to hash this out. Doubtful, since widespread availability of organic milk is a little on the new side.

Twins are cute, but do you really want them to moo at you?

Well, sure, that'd be awfully cute. If the kids would really moo at you, that'd be awesome. But they wouldn't really. Not to say that there's even anything particularly dangerous about exogenous IGF transferred from moo cows, but there's obviously a slight creepy factor.

Unfortunately, articles likes this would undermine a slightly more serious matter, that of vegan mothers receiving proper nutrition throughout their pregnancies. Proper nutrition for vegans is not a given, but certainly very possible (and, if done properly, probably beneficial) for a pregnant mom and her baby. But no, we'll have to have fights of Silk vs. milk, because its more fun to bash vegans. That's great public health. Sure.

Sunday, May 21, 2006

Internet: Top local for googling "porn"

Ever wondered who spends the most time on the internet googling terms like "porn" or "vibrator"? Well, now we have an answer: Elmhurst, IL!!

All I can say is keep up the good work!!!

Wednesday, May 17, 2006

The "new" Flight 77 video.

So this is supposed to be the video that puts all 9/11 conspiracy theories to rest, the media is reporting. The addition of a mere, blurry frame offers absolute proof of the events on the Pentagon lawn. Watch it. Stare at it for hours like one of those flash-in-the-pan popular stereograms. Why can't we see the other videos taken from the nearby gas station and hotel which were confiscated immediately following the attack? The people at Flight77.info are trying to obtain these, but I think they may just be wasting their time.


Here is a link to the photo of the single frame everyone is buzzing about.

Monday, May 15, 2006

Grey's Anatomy is the worst thing that has happened to television or medicine in, well, the past two seasons

Post rated PG-13 for mature themes, baseless anger, dirty words, and the desecration of all humanity by Seattle Grace

If only my wife would quit watching it and exiling me from the living room into the bedroom or computer room, where I can't help but listen to its inane bullshit.

"They always say that transplant patients bounce back quick, but wow!"

No, they don't. Transplants, especially heart transplants, are hellacious ordeals. What the HELL are these overly made-up dufus bitch doctors talking about? I think the University of Washington should sue the shit out of the producers of this show for even associating the piss-poor dickheaded medical melodrama of Grey's with the Seattle area. Hell, Starbucks should bring out a drink, the "We have nothing to do with that piece of shit show" Mocha.

I'm truly appalled of the medical folks who actually watch this show with some sort of forgiveness for its atrocious crap. All female medical students, that I know of. And the entire OBGYN staff. I pretended that I liked the show on OBGYN, I admit, so I'd have something to talk about with some of the residents. True, I had been forced to listen to the "Code Black" episode, and by unwilling osmosis, I did know some of the plot twists that a few of the residents were dying to get to their Tivo's to watch.

I think all of my other postings outline very well my feminist nature, but feminism doesn't say anything about taste. Guys still like a lot of shitty action movies that aren't any good. And Girls still like a lot of shitty romance melodramas that aren't any good. And sure, there's overlap, but society is one strong monkey, and the gender monkey isn't getting off our backs any time soon.

So here it is: I blame heterosexual female medical students for allowing Grey's Anatomy to exist!!! Curse you all!!!

I'm glad Courtney doesn't watch House.

And what's worst, poor ER, still a good show, has to share the small screen with this crap.

It's a commercial. Courtney has the TV on mute. My blood pressure slowly drifts downwards... must... hit... publish... post... now.

Update: Grey's has been moved to Thursday nights at 9:00, against CSI and the O.C. and some new big deal thing from NBC. Since nobody watches TV except on Thursdays, and nobody wants to watch more than show.

Sunday, May 14, 2006

Mental Health: Support Our Troops (unless they fulfill DSM-IV criteria)

A pair of CNN military mental health articles have come out over the past few days:

Report: Mentally ill troops forced into combat:
Military not following own rules on deployment, paper says

More veterans may need extra help for post-combat stress:
Fewer than a quarter of returning troops get mental health referrals
The articles detail several dangerous situations, including troops being pulled out only briefly, slapped on an antidepressant, and thrown back into combat without any sort of therapy or even further evaluation--this for a population in which everyone has ready access to firearms. Apparently suicides have accounted for about one-fifth of the total noncombat deaths in the current conflict.

Some of the problem seems to stem from the fact that military commanders, rather than medical personnel, make the decision as to whether someone is fit for duty. And since "be all you can be" doesn't allow room for being depressed, unfit soldiers are stigmatized and placed back into positions where they are dangerous to themselves and others.

Of course, difficulties with keeping military enrollment at desired levels produces undue stress on commanders to keep their troops in the field, crossing their fingers that the ship holds.

And after watching Jarhead this past weekend, all of this seems perfectly in place.

Tuesday, May 9, 2006

Short, terse, unfriendly,
Yet sometimes quite emotive;
I am the Haiku.
What Poetry Form Are You?

What Video Game Character Are You? I am a Scorched Earth Tank.I am a Scorched Earth Tank.

When I have a mission, it consumes me; I will not be satisfied until the job is done. I have a strong sense of duty, and a strong sense of direction. Changes in the tide don't phase me - I always know which way the wind blows, and I know how to compensate for it. I get on poorly with people like myself. What Video Game Character Are You?

Monday, May 8, 2006

MedLaw: The Un-insured soon to become The Under-insured

I've been worried recently about so called "conscience clauses" that allow insurers to refuse to cover services they find ethically objectionable--abortion, birth control, in vitro for gay couples. You might ask, why can't insurers do that already when they setup a plan? Well, most states have laws (and under the federal rubric of division of powers states get to regulate insurance) that mandate minimum coverage. Well, now Congress has decided that states aren't acting fast enough to undermine citizen protections and have proposed legislation to allow businesses and insurers to refuse to cover services for pretty much any damn reason they want (who needs religious outrage?). And their argument: By lowering what insurers can offer, more people will be insured.

Sponsor Sen. Mike Enzi R-Wyo. predicts that most businesses will stick with the policies they currently offer rather than switch to a less comprehensive benefit and only those businesses without any coverage would choose to add the crappy coverage. (Remember to downplay the number of employees that are being screwed and the number of businesses that will make money off this act of betrayal whenever you are proposing legislation to allow businesses to screw their employees.)

And the best part is, this bill is merely an attempt to cover the uninsured: "They have no insurance right now, so this would be an improvement," Enzi said. This is a great solution, when presented with a huge number of people who don't have health insurance (and thus don't have access to basic services) just redefine what constitutes a basic service.

Insurers say the state mandates (such as mammograms, immunizations, and child health exams) are driving up the cost of policies, and the ranks of the uninsured. Additionally, some states have increased the age at which insurers must cover unmarried dependents to 25 and 30 years old. Why are they doing this? Perhaps it's because so many of those unmarried dependents are (you guessed it) uninsured.

Forty-six states also require coverage for treatment and screening of diabetics, as well as the cost of their insulin. First of all, which four states DON'T require coverage for insulin? And, as Lawrence Smith, president of the American Diabetes Association points out, "The need for diabetes care will not diminish simply because coverage shrinks . . . it will be our emergency rooms and Medicaid system that are forced to pay, thus overburdening an already strapped public health infrastructure."

MedEd: Aussie Medical students fail basic anatomy

This is from an Australian Newspaper, but some of the issues are relevant here as well:

TEACHING of basic anatomy in Australia's medical schools is so inadequate that students are increasingly unable to locate important body parts - and in some cases even confuse one vital organ with another.

"Teaching hours for anatomy have been slashed by 80 per cent in some medical schools to make way for "touchy-feely" subjects such as "cultural sensitivity", communication and ethics.

Several senior consultants have told The Weekend Australian they have been "horrified" to encounter final-year medical students who do not know where the prostate gland is, or what a healthy liver feels like.

When asked by a cardiac surgeon during a live operation to identify a part of the heart that he was pointing to, one group of final-year students thought it was the patient's liver.

But many students are also unhappy about core science training. One group of students wrote anonymously to two noted academics last year, saying they were "sick of being asked, 'Didn't you study anatomy?"' by consultants amazed by the gaps in their knowledge. "How can we learn if we are not taught the basics?" they wrote.

"It's part of the new educational dictums - 'don't put any stress on them (students) ... it doesn't matter if they don't know anything'."
Okay, so the article is alarmist and kind of takes things out of context (anyone who has spent several hours retracting during a surgery has had a moment where they looked at what was below them and thought: What the hell is that?). I mean, is it really important to understand what a healthy liver "feels like"? Additionally there's a lot of other stuff to learn that squeezes anatomy out, like new diagnostics, genetics, treatment, etc. And apparently Aussie med schools are pretty cushy because I've never heard anyone say "don't put any stress on them". But when the going get tough, the Aussie med students handle things much like American med students . . . blame the administration and bitch about the curriculum.

Tuesday, May 2, 2006

MedRoundUp: Have your babies in late summer, early fall

Kids born in spring or early summer have a 17% higher chance of committing suicide, says a new study, in contrast to schizophrenic babies, which are born more often in late winter, early spring. Last year, other research found that summer sunlight triggers a seasonal rise in suicides.

Another new study compared a 500-calorie diet vs gastric banding surgery. After six months, both the surgery patients and the low-calorie dieters lost an average of 14% of their starting weight. After two years, the gastric band patients lost 22% of their starting weight. That was about 87% of their excess weight, or roughly 45 pounds. They also showed marked improvement in their health and quality of life. At the end of two years, the dieters had regained much of their lost weight but were still 5.5% below their starting weight. They had lost 22% of their excess weight, or about 12 pounds.

A consumer group wants gatifloxacin banned, because even though Bristol-Squibb discontinued production of the drug, stores that docs could prescribe still exist. The fluoroquinolone reaks havoc on blood sugar levels, but it also is the drug least associated with agranulocytosis, which made it a key portion of the treatment of one of my AIDS patients at the VA this past year. Gati isn't exactly first-line, but with growing fluoroquinolone resistance, I don't know why the FDA would deem it necessary to remove yet another tool from the infectious disease toolbox, especially in the in-patient setting, where blood sugar levels can be closely moniotored.

A UofChicago survey, not surprisingly reported by Fox News, says that physicians really don't mind talking about religion with their patients. Actually, that's not at all what it says, but that's what the headline implies. Really, there's just no consensus on how religion can be appropriately integrated into the therapeutic relationship. I'd like to see a breakdown by specialty.