SPARKGRASS.COMmunity

Puppy Power

2009-06-06T21:40:00.003-04:00

Billy "Backdoor Classic" Packer out as CBS head douche nozzle

2008-07-14T20:00:00.003-04:00

Surprisingly, google gives me only one response for the search Billy "backdoor classic" Packer, and an unrelated at that, which saddens me. I think he said it during a UNC-UK game a few years back, and always thought that, given all of the inappropriate gay-overtoned quotes he has produced, this should be an unheralded entry into his quote Hall of Fame.

Jesse Helms is dead, and Billy Packer is out at CBS. It's a great year to be a human being.

Bo Cowgill on Prediction Markets

2008-06-21T21:48:00.003-04:00

For feed users, go to post for video.

"It's incentive, nonetheless."

Very good stuff.

Where the entitlement never ends

2008-06-11T10:22:00.003-04:00

Harvard's undergraduate commencement speaker is selected by, according to the NPR article, alumni and parents, people who respect the tradition of the institution with the benefit of added perspective. Apparently selecting someone with a unique, lighter-weighted career didn't sufficiently stroke the egos of a few of the graduates, and some of these quotes remind us of what the hell is wrong with this world.

"I think we could have done better," shrugged computer science major Kevin Bombino. He says Rowling lacks the gravitas a Harvard commencement speaker should have.

"You know, we're Harvard. We're like the most prominent national institution. And I think we should be entitled to … we should be able to get anyone. And in my opinion, we're settling here."

You have to listen to this tool stumbling over his "we should be entitled to" remark. It's like, somewhere in that education, he learned about entitlement, about how maybe he and some of the kids around him are some of the most entitled human beings on the face of the earth, but it never occurred to him that maybe that entitlement had some limits.

Speaking of past speakers:

"It's definitely the 'A' list, and I wouldn't ever associate J.K. Rowling with the people on that list," says senior Andy Vaz. "From the moment we walk through the gates of Harvard Yard, they constantly emphasize that we are the leaders of tomorrow. They should have picked a leader to speak at commencement. Not a children's writer. What does that say to the class of 2008? Are we the joke class?"

Yes, you Tool. If you are graduating from that class, either your class is the joke class, or every class behind you has been as well, and nobody told you. Your $200,000 education obviously dropped in value because one of the most successful human beings who didn't have your background got to speak to you for twenty minutes.

To be fair, I'm betting that a tremendous number of Harvard kids enjoyed having Rowling there, and I bet plenty of them don't take themselves as seriously as bunch of asshole 22-year olds who some how avoided picking up any perspective while hanging out with some of the brightest young people on the planet for the past four years. And NPR might have sought the only naysayers in the whole class in order to write their "look how much better YOUR intellectual snobbery is than this guy's intellectual snobbery, you dashing hipster you!" article. But maybe they didn't.

This tunnelvision of the "we're the University X, bow before our shit which does not stink" mentality probably trickles down to, say, the top 40 undergraduate institutions in U.S. News and World Report and probably 20 of the "liberal arts" colleges that get their own perverse ranking system. And probably the top 25 medical schools, law schools, business schools, speech pathology schools, etc. So it goes.

So, congratulations Kevin Bombino and Andy Vaz, on those pieces of papers that will provide you with all the entitlement you could ever imagine. And, when you become one of those "leaders" you're so worried about, may God have mercy on all of us.

2008-05-03T22:04:00.000-04:00

More U.S. Children Being Diagnosed With Youthful Tendency Disorder

REDLANDS, CA-Nicholas and Beverly Serna's daughter Caitlin was only four years old, but they already knew there was a problem.

Vaccine Smack

2008-04-29T23:39:00.002-04:00

Mostly because I'm sick of seeing that scary Huckabee-Squirrel picture every time I pull up my site for link shortcuts, here's another Slate video, this time with some good old-fashion take-your-autonomy-and-shove-it vaccine cautionary tales.

To be clear, I think people who don't vaccinate their children are about as smart as people who eat their own poop. But I wouldn't kick someone out of my practice for any reason save concerns of personal harm, and I don't think it's particularly responsible for pediatricians to threaten parents that they will no longer be their child's pediatrician just because the parent smokes mercury-laced crack.

Don't punish a child just because the child's parents are idiots. The kid is going to have enough problems surviving 18 years with their anti-vaccine asshat mom and dad without getting fired by their pediatrician.

The day when I'm proud to be a redneck

2008-01-26T13:18:00.000-05:00

So, much of my residency decisions have centered around not only geography, but that personal conception of self. Am I a fly-over country kind of guy, could I fit into the Smooth of the west coast, could I become snotty enough to make it in the Northeast? Those sort of existential questions.

Thankfully, the folks at Slate clarify this for me, with their highly enlightening segment, Can You Eat Squirrels?, in response to Mike Huckabee's claim that rural Americans will relate to him because he cooked squirrel in a popcorn popper while in college.

In point of disclosure, I do not support the eating of any animals, especially not ones that require such a large shotgun blast to hunt. But I'd like to have a better Explainer video: are there really people in this country so ignorant of Upland South culture that they don't know that people eat squirrels?

Seriously, watch these squirmy New Yorkers jaw-drop as they learn about burgoo, about using non-certified appliances for frying food, and the idea, that, oh my god, people eat meat that runs around in a forest when shotgun shells are cheaper than McDonald's. The latter is a little less relevant nowadays, but, yes, I had family that hunted squirrels because it was more accessible than McDonald's.

I've never been hunting in my life, but I had a hard time explaining the significance of Dick Cheney shooting that guy in the face with a 20-gauge while quail, realizing that my coastal city-folk friends couldn't even conceptualize the process of quail hunting, and how Cheney's inability to follow the most basic of safety precautions on a bird hunt was quite the microcosm for the administration's approach to the Iraq war.

But I digress.

If you don't know that people hunt squirrels, or if you couldn't select an appropriate firearm for doing so, then you have as much to learn about America as I do.

The Quotable Evangelical Evolutionist

2007-12-07T12:38:00.000-05:00

Michael Dowd, author of Thank God for Evolution:

God communicates through science. Facts are God's native tongue. Who of us would let a first-century dentist fix our children's teeth? Yet every day we let first-century theologians fill our children's brains.

There's a difference between flat-earth faith and evolutionary faith. In flat-earth Christianity, the core insights -- sin, salvation, heaven and hell -- are understood in the same way as when people first formulated ideas. I still value the same concepts, but interpret them in a radically different way.

Sherwin Nuland on ECT

2007-12-03T00:21:00.000-05:00

Nuland is the author of my favorite medical history text and a bunch of other more famous books I haven't read, a former Yale surgeon, and just an all-around brilliant kinda guy.

Joe Nuxhall, 1928-2007

2007-11-17T15:32:00.000-05:00

Youngest ever player in the major leagues, Cincinnati icon, and the dude that called every baseball game I listened to growing up. Sad.

Nuxhall was just 15 years, 10 months and 11 days old when he pitched for the Reds against the Cardinals on June 10, 1944, in front of about 3,500 fans at Crosley Field.

He died Thursday from cancer, or being left-handed, you never can tell.

I highly recommend

2007-10-27T17:12:00.000-04:00

The Stool Pigeon Memoirs.

Gee, never saw THAT one coming...

2007-10-20T18:44:00.000-04:00

Pfizer said yesterday that it would stop selling Exubera, its inhaled insulin, less than two years after introducing the drug. Despite Pfizer’s heavy promotion, Exubera’s sales were minuscule, with prescriptions amounting to less than 1 percent of the insulin market.

Pfizer will take a charge of $2.8 billion for costs associated with Exubera, making it one of the most expensive failures in the history of the pharmaceutical industry.

Rarely does a pharmaceutical company actually feel such nasty repercussions for producing a more expensive product with little value added to the prior product. Needles may hurt, but so does interstitial lung disease. And you just look silly taking a hit of insulin from a bong.

Link Roundup: Comeback Edition

2007-10-14T09:25:00.000-04:00

Alpha: JJ Abrams is going all kinda crazy on the new Star Trek movie. Brilliant casting movies include: Zachary Quinto (Sylar, from Heroes) as an iteration of Spock, Simon Pegg (Shaun of the Dead!) as Scotty, and John Cho (Harold, not Kumar) as Sulu. Could a Star Trek movie be a date movie? And can a Korean guy really play a Japanese guy in the 23rd century?

Beta: Wii Goodness: Wii Fit will be released in the states in 2008, giving West Virginia law makers something other than DDR to put in schools. I welcome my Nintendo weight-loss overlords, having just played some Wii Sports for the first time last night.

Gamma: Damn you, Jared! Cornell researchers find that folks underestimate the number of calories in a meal from Subway compared to McDonald's, because Subway is "healthier."

"We found that when people go to restaurants claiming to be healthy, such as Subway, they choose additional side items containing up to 131 percent more calories than when they go to restaurants like McDonald's that don't make this claim," said Brian Wansink, Cornell's John S. Dyson professor of marketing and applied economics and director of the Cornell Food and Brand Lab, in a news release.

"In estimating a 1,000 calorie meal, I've found that people on average underestimate by 159 calories if the meal was bought at Subway than at McDonald's," said Wansink.

That extra 159 calories could lead to an almost five-pound weight gain over a year for people eating at Subway twice a week compared to choosing a comparable meal at McDonald's with the same frequency, he said.

Delta: File under "study that has lots of data but no useful or surprising information ." The Office of Substance Abuse and Mental Health Statistics issued a report stating that "personal care," "food preparation and serving," "community and social services," and "health care" workers have the highest rates of depression (and women are about twice as depressed in most of those fields as men). "Installation, maintenance and repair" and "engineering, architecture, and surveyors" have the lowest rates of depression. Self-selection much?

Epsilon: File under "stuff people didn't pay nearly as much attention to as they should have." A Pittsburgh physician (NOT associated with WPIC) was finally charged in August with involuntary manslaughter after a boy died of cardiac arresting while receiving chelation therapy for autism. It looks like the kid died from a possible mix-up:

The Centers for Disease Control and Prevention found that the boy was given a synthetic amino acid to rid his body of heavy metals, instead of a similar chemical with a calcium additive. Both are odorless, colorless liquids and may have been confused, the CDC found.

When you make a mistake giving real medical care, it's a tragedy, but bad things do happen to good people. When you kill someone with fake medical care that preys upon the hopes and vulnerability of loving parents, you deserve criminal charges, and a firm kick in the nuts.

Blogging Vacation

2007-10-13T09:52:00.000-04:00

So, as I went back to full-time med school after finishing my master's, and finished up my residency application, I listed this blog as one of my "hobbies." Apparently something about claiming "ownership" freaked me out, or I was just busy, and I entirely got out of the habit of blogging. I kept bookmarking links and sticking them in a "bloggables" folder on my Firefox toolbar (and even opened a "bloggables2" folder, since the first one was so full), but I could never convince myself to actually sit down for the handful of minutes it might take to throw together something. The longer I took off, the more obligated I felt that my posts had to be really good, and few bloggers with real lives have time to make every post really good.

So, I tossed and turned, and almost decided to throw Sparkgrass to the wolves. It's hardly a community anymore, as Zuck, Pepper, and Geoff are swamped interns, and Kyle has finished up his Oxford thesis, and, while his personal blog is wonderful, he's just not as interested in the sorts of things that fit here. So, it's just me. And applying for residencies has brought, front and center, the idea that some day pretty soon, folks are going to be calling me doctor. That nauseates me, in an appropriate way. As a med student, your goal is to learn, and make the lives of the people in front of you feel better as they navigate the system. You learn how to be a decent colleague, and learn a very special kind of responsibility. At least, you're supposed to learn a special kind of responsibility, and I think I am doing so, but some of your colleagues make you wonder if they ever did. As a person that someone calls doctor, you're somebody who makes binding decisions for somebody's daily health. If someone feels like they're going to throw up, or sedated, or agitated, that might be because of the meds I proposed as their best bet. If you give a shit about the lives of the folks in front of you (and I certainly do), that's a huge deal.

I'll have patients googling me someday soon, and they'll find this site. That's weird.

I've missed a lot of world-changing events in my vacation from blogging; S-CHIP, Larry Craig, and a new Radiohead album all come immediately to mind. I'm not sure I had anything intelligent to say about any of these things that Ezra Klein or Matt Yglesias didn't say before I even heard the stories.

So, Sparkgrass is here to stay. But I have to acknowledge its limitations, and my limitations. I'm probably going to find a new, more anonymous blogging home sometime soon (a few offers on the table) where I'll get much more exposure than a personal, blogger-run site can offer. But I have to wait for S-CHIP to blow over. There are way too many people who either a) know more about health policy than I do, or b) simply THINK they know more about health policy than I do, but blather on and on and on, for me to hop in the debate there.

To offset the cute puppy

2007-08-28T22:25:00.000-04:00

Lunetta P, Ohberg A, Sajantila A. Suicide by intracerebellar ballpoint pen. Am J Forensic Med Pathol. 2002 Dec;23(4):334-7.

Picture stolen from and explanation at Retrospectacle, one of the SEED Science Blogs written by UofM cochlear implant ninja Shelly Batts.

Not mine, but I'd take it

2007-08-28T19:34:00.000-04:00

Cute Overload. Seriously.

The War on VBACs

2007-08-26T12:13:00.000-04:00

For those who haven't stayed up all night checking to see if mom's ready to push, a VBAC is a Vaginal Birth After a C-section. During a Caesarian, besides cutting through mommy's belly, mommy's uterus gets cut as well. When a woman has another child, the worry is that since the uterus has already been cut before, the spot of healing isn't as structurally sound as the original uterine wall, thus the pressure placed on the uterine wall during subsequent pregnancies would then result in uterine rupture, and the need for emergent surgery. Emergent surgeries carry a multitude of greater risks than elective procedures.

But then some studies cited in this NPR story mention that the actual rate of uterine rupture in VBACs isn't that large, but when a uterine rupture DOES occur during a VBAC, outcomes are comparably terrible. This lead ACOG to recommend that adequate surgical faculty be available when a woman was attempting a VBAC. The problem arises when smaller hospitals simply don't have the resources to ensure those adequate surgical backups are at hand, and hospitals then ban VBACs because they simply can't afford to keep a full back up team on call.

Which creates the interesting public health versus personal autonomy dilemma we've all come to know and love. Women absolutely have a right to attempt a VBAC (and yes, "attempt" is the correct terminology) with a fairly low threshold for proceeding to a repeat caesarian should complications arise. And hospitals have a right to not offer services they simply can't afford to offer when medically acceptable alternatives exist. "Medically acceptable" and "personally acceptable" are, of course, not always in agreement.

Where I've trained, the VBAC was always an option, mostly because the hospital is equipped with the staff to handle any complication that could arise because patient volume and the high-risk patient population justify their use. On a population level, the risk is astronomical. On a personal level, the risk is miniscule.

Of course, the naturalist spin is that obstetricians are evil bastards who want to cut so they can go home and get some sleep so they'll have time to wake up early enough to spend their hefty salaries. Actually, obstetricians, like other physicians, don't like the idea of folks dying during an emergency from a partially preventable incident.

The woman in the NPR story gives the most revealing quote, however. She is rightfully upset that she is being forced to have a VBAC. When presented with the rationale for why this is so, she replies:

"That's what they hospital is there for, to handle emergencies. And so, in that respect, the policy never made sense to me."

No, emergency rooms are there to handle emergencies, as long as by "handle," you mean do the best that anyone can to stabilize an unstable situation, recognizing that some unstable situations simply cannot be stabilized, and should be avoided if possible.

Hospitals exist to provide inpatient medical care following complicated medical algorithms in which physicians and patients take action to minimize the risks associated with illness and treatment. If a particular hospital can't handle a particular risk, it shouldn't try to do so. It should refer to a tertiary care center, and it should be blatantly honest with its patients about local limitations.

We don't send burn victims or trauma victims to any old hospital and expect that hospital to be staffed to handle those emergencies. We have regional burn centers and a tiered-trauma centers so that patients can receive quality care, and our society can afford to provide that quality care.

A woman has every right to demand an attempt at a vaginal delivery after a caesarian section for a prior pregnancy. Heck, I imagine if I were a woman on my second pregnancy after having a C-section the first time, I would almost certainly demand a VBAC. However, no hospital can be expected to offer a service it simply can't afford to offer. If I want the VBAC, I have to go find a facility that does offer that service, since I'm probably unwilling to spend the extra zillion dollars required to keep sufficient surgical staff available during my delivery. And my current providers have an obligation to help me find that facility.

For the most part, Starbucks has an obligation to give you precisely what you want, because coffee isn't dangerous, and they can charge you whatever that coffee is worth to them.

For the most part, your medical provider has an obligation to give you precisely what you want, as long as what you want is reasonably safe, economically viable, and consistent with what can comfortably be called standard of care. For example, elective abortions and emergency contraception meet each of those criteria, and thus each woman has a right to receive them. In some contexts, a VBAC doesn't meet those criteria (according to ACOG... that's certainly up for further debate). Thus, the provider's obligation is limited to directing the patient to a context in which the patient's preferences do meet those criteria.

Update: The Onion offers the proper supplement to this story:

Woman Overjoyed By Giant Uterine Parasite

NEW BRIGHTON, MN— "I'm so happy!" Crowley said of the golf ball–sized, nutrient-sapping organism that will eventually require hospitalization in order to be removed.

Health Policy: SCHIP in danger

2007-08-24T11:10:00.000-04:00

Recently, congress passed an expansion of the State Children's Health Insurance Program (SCHIP) to allow more children to enroll. Yay, for the kids. The Bush Administration threatened a veto claiming fears of socialized medicine. But going beyond this, the Bush Administration has issued a set of "rules" that would prevent any state from increasing their enrollment unless a slew of requirements are met:

Under the requirements, children must be without insurance for a year before they can be enrolled, and families of children in the program must pay fees for care similar to those paid by families with private insurance. In addition, the state must show that it has enrolled at least 95 percent of children below 200 percent of poverty and that the number of children insured through private companies has not dropped more than 2 percentage points over five years. The latter requirement is supposed to ensure that employers aren't dropping family coverage.

This is outrageous on a number of points. Firstly, it requires children to be without health insurance for a year in order to qualify. A lot can happen in a year (vaccinations, checkups, broken bones). Why would this Administration claim that the best way to insure children is to require them to be uninsured. Additionally, the 95% requirement is ridiculous, since most states simply can't achieve that level of enrollment. And finally, the whole point of these rules is to subvert a law passed by the legislative branch. The constitutional role of the executive is to enforce the law, not subvert it. If Bush wants to threaten a veto, then he's just a jerk who doesn't care about children, but when he continues to trample on the federal constitution then he's a criminal.

Rilo Kiley does 1973?

2007-08-21T21:41:00.000-04:00

Under the Blacklight looked like a possible bright spot in a really boring music summer (I kinda grooved the new DadRock version of Wilco, and the new Rufus sounded very promising and tightly written, even if I can never make myself care enough to listen to more than three tracks. It's like, dude, I get it. You're really really gay.).

The reviews I can find online fall into two categories: a) Rilo Kiley without crunch guitar sucks, and b) hahaha omg watch the indie kidz squirm lol stfu!!1!

I can understand how pop critics would mess their pants anytime an indie band sells out whatever sound put them on the map. If you like pop music, this album is probably a really great pop album. But if you've bought a Rilo Kiley album before, it's probably because pop music bores you to tears. Call us pretentious, and we'll call you just plain bland.

I'd say there's a 35% chance this album will grow on me. But on first listen, this thing is 90% Sucks Ass. Even tracks I want to like figure out a way to push me away.

Jenny Lewis is Bob Dylan with good fashion sense. And even Bob Dylan shat out some incredibly terrible albums in the spirit of "experimentation." Rilo Kiley will probably sell more albums than ever before, but that's only because you can't take back an opened CD.

Update: EW's review is fair, if a bit forgiving. I just have to deal with the fact that this might be a good album, but a terrible Rilo Kiley album.

Hometown Pride Update

2007-08-19T10:13:00.000-04:00

Welcome to 1997, cultural center of Northeastern Kentucky!

First Ashland Starbucks opening Monday

Friday Afternoon Vocabulary Expansion

2007-08-17T15:36:00.000-04:00

I've recently run across two words that have instantly found a home in my "that's just a cool word" mental bin. So I must share.

First, steampunk.

Second, and much better for a general audience, crank bug. (4th paragraph)

To be clear, I claim the latter for the totally awesome indie grass band I will someday assemble.

Hometown Pride! The Duct Tape Bandit Strikes

2007-08-15T21:28:00.000-04:00

You OWE IT TO YOURSELF to go watch the video. By the way, the hospital in the 15-second commercial prior the clip is the one in which I was born. And I graduated high school with the liquor store employee.

So apparently this was on the Today Show this morning. I saw it on Fark as well, so it must be a big deal, right? And Yahoo! news. Problem was, I heard it the night before from my mother, since this occurred about two miles away from my parent's house.

Without further ado, the Duct Tape Bandit!
This guy is obviously in need of a good forensic psychiatrist.

Restore the Draft? What a Bad Idea

2007-08-14T11:48:00.001-04:00

Steve Levitt, of Freakonomics fame, hits one out of the park:

If the problem is that not enough young people are volunteering to fight in Iraq, there are two reasonable solutions: 1) take the troops out of Iraq; or 2) compensate soldiers well enough that they are willing to enlist.

The idea that a draft presents a reasonable solution is completely backwards. First, it puts the “wrong” people in the military — people who are either uninterested in a military life, not well equipped for one, or who put a very high value on doing something else. From an economic perspective, those are all decent reasons for not wanting to be in the military. (I understand that there are other perspectives — for example, a sense of debt or duty to one’s country — but if a person feels that way, it will be factored into his or her interest in military life.)

One thing markets are good at is allocating people to tasks. They accomplish this through wages. As such, we should pay U.S. soldiers a fair wage to compensate them for the risks they take! A draft is essentially a large, very concentrated tax on those who are drafted. Economic theory tells us that is an extremely inefficient way to accomplish our goal.

Critics might argue that sending less economically-advantaged kids to die in Iraq is inherently unfair. While I wouldn’t disagree that it’s unfair that some people are born rich and others poor, given that income disparity exists in this country, you’d have to possess a low opinion of the decision-making ability of military enlistees to say that a draft makes more sense than a volunteer army. Given the options they face, the men and women joining the military are choosing that option over the others available to them. A draft may make sense as an attempt to reduce inequality; but in a world filled with inequality, letting people choose their own paths is better than dictating one for them.

What a Difference a Decade Makes

2007-08-13T06:47:00.000-04:00

In this video, Dick Cheney explains (in 1994) why the invasion of Baghdad just doesn't make sense...

h/t: Gladly Suffering Fools

The More You Know, Nasonex Spanish Bee edition

2007-08-12T08:01:00.000-04:00

So I tried to earn my "not worst husband ever" stripes by making Courtney breakfast this morning before she drudges off to work. While the Food network (since my cooking was obviously not enough to hold our attention), this uber-strange ad pops on the screen:

Courtney: Wtf? Why is the bee Hispanic? It sounded like Antonio Banderas or something.

Garrett: (grumpily) He's not Hispanic, I think the bee is Spanish.

Courtney: (knowingly) That's where you are wrong, pitiful derelict intellect!

And she's right, on so many accounts. First: (thank you, Dictionary.com)

Usage Note: Though often used interchangeably in American English, Hispanic and Latino are not identical terms, and in certain contexts the choice between them can be significant. Hispanic, from the Latin word for "Spain," has the broader reference, potentially encompassing all Spanish-speaking peoples in both hemispheres and emphasizing the common denominator of language among communities that sometimes have little else in common. Latino—which in Spanish means "Latin" but which as an English word is probably a shortening of the Spanish word latinoamericano—refers more exclusively to persons or communities of Latin American origin. Of the two, only Hispanic can be used in referring to Spain and its history and culture; a native of Spain residing in the United States is a Hispanic, not a Latino, and one cannot substitute Latino in the phrase the Hispanic influence on native Mexican cultures without garbling the meaning. In practice, however, this distinction is of little significance when referring to residents of the United States, most of whom are of Latin American origin and can theoretically be called by either word. · A more important distinction concerns the sociopolitical rift that has opened between Latino and Hispanic in American usage. For a certain segment of the Spanish-speaking population, Latino is a term of ethnic pride and Hispanic a label that borders on the offensive. According to this view, Hispanic lacks the authenticity and cultural resonance of Latino, with its Spanish sound and its ability to show the feminine form Latina when used of women. Furthermore, Hispanic—the term used by the U.S. Census Bureau and other government agencies—is said to bear the stamp of an Anglo establishment far removed from the concerns of the Spanish-speaking community. While these views are strongly held by some, they are by no means universal, and the division in usage seems as related to geography as it is to politics, with Latino widely preferred in California and Hispanic the more usual term in Florida and Texas. Even in these regions, however, usage is often mixed, and it is not uncommon to find both terms used by the same writer or speaker. See Usage Note at Chicano.

To add insult to injury, the bee really was Antonio Banderas!

So there you go. Don't a) question your wife, b) muddle the distinction between Hispanic and Latino, which the standard OMB demographic form seems to do, and c) mistake Antonio Banderas for a common Hispanic bee voice.

Which doesn't answer the greatest existential crisis evoked by the commercial. Why the hell is Antonio Banderas the voice of the Nasonex Bee? Only celebrity willing to humiliate himself as a bee besides Jerry Seinfeld? A well-meaning (but totally failing) attempt to be more inclusive, the way that every picture in every textbook or academic brochure that has three people must include two women and two African American, Hispanic, and/or Asian folk, despite the fact that the random probability of those three people actually hanging out is like 1 in 3 trillion? Or does Antonio Banderas only voice Puss-n-Boots after spiking some Nasonex?

Best Cross Promotion Ever?

2007-08-11T22:31:00.000-04:00

The blood drive will coincide with the Halloween premiere of the latest title in Lionsgate and Twisted Pictures' "Saw" franchise, Saw IV, which opens nationwide on October 26, 2007.

The Saw "Give Til It Hurts" blood drive has become a key element of the "Saw" franchise, as much a part of the horror hit's annual rituals as its Halloween premiere date. Since the first SAW blood drive in 2004, "Saw" filmgoers have donated nearly 38,000 pints of blood to help save as many as 112,500 lives.

The Saw films are dropping off in quality exponentially, and I found Saw III mostly unwatchable. But this certainly demonstrates that marketing schemes can have a little social conscience.

Quickie Posts expand! the real world economics of cheating at video games, plus Superbad fun

2007-08-10T13:24:00.000-04:00

Hopefully this post will evolve. I think it might just be best to start posting crap as I find what I want to post, and then commentate later if I ever get a chance. I have high faith in my taste in postable articles.

Remember when cheating at video games was fun? Ah, the sentimentality of the Contra code. The most interesting additional piece of information here relates to Asian WoW players who apparently spend lots of time doing nothing but mining gold, and then selling that gold (like really selling, as in legal currency, not fake WoW money) to lazy Americans who want to, well, act like globalizing Americans, and outsource their own video game playing efforts. Libertarian economists may find this as clever as they find ticket scalping. But apparently there are vigilante WoW players who just go around killing these gold-whores to preserve the integrity of the online community. How much integrity an online community can really have is up to you.

And more Seth Rogen! An EW Superbad Roundtable discussion. Too many notable quotes, so I'll just pull my favorite:

MICHAEL CERA: Same thing with Arrested Development. One of the writers, Jim Vallely, said if we got picked up on Showtime, the first shot he would want of season 4 of Arrested Development would be a shot of Will Arnett having a sex with a girl from behind. Just to kick it off.

Sounds evil, until you keep reading...

2007-08-09T16:33:00.000-04:00

So there's this headline:

Johnson & Johnson Sues Red Cross Over Symbol

Sounds evil, right? I salivate at the opportunity to rip J&J for corporate greed and evil, picking on a little non-profit like that. But, then there's the rest of the article:

The two had shared the symbol amicably for more than 100 years — Johnson & Johnson on its commercial products and the American Red Cross as a symbol of its relief efforts on foreign battlefields and in disasters like floods and tornadoes.

From time to time, the American Red Cross sold products bearing the symbol as fund-raising efforts. Jeffrey J. Leebaw, a spokesman for Johnson & Johnson, said the company had no objection to that.

But in 2004, the American Red Cross began licensing the symbol to commercial partners selling products at retail establishments. According to the lawsuit, those products include humidifiers, medical examination gloves, nail clippers, combs and toothbrushes.

Sorry, J&J. And more:

Mr. Crisan said it was not clear how far the American Red Cross wanted to go in licensing the symbol for commercial purposes, noting that the red cross was a trademark of Johnson & Johnson before the American Red Cross was officially chartered. Mr. Crisan said that some of the items being sold under licensing agreements by the American Red Cross seemed to compete directly with products sold by J.& J.

What planet does the Red Cross live on that it thinks this is a legitimate practice? And Mark Emerson, president of the ARC says:

“The Red Cross products that J.& J. wants to take away from consumers and have destroyed are those that help Americans get prepared for life’s emergencies,” Mr. Everson said. “I hope that the courts and Congress will not allow Johnson & Johnson to bully the American Red Cross.”

Yes, Mr. Emerson. Nobody else makes disaster kits except for the companies to which you license J&J's commercial logo. Americans are gonna die because they can't buy products with your license. Right.

Seth Rogen + Simon Pegg = Sparkgrass Post

2007-08-09T11:14:00.000-04:00

h/t to the Pot. Feel free to mock my mancrushes, but I guess it's okay if my wife is directing me to the links.

Actor Seth Rogen is in awe of British funnyman Simon Pegg - because he can't believe how good his movie Shaun Of The Dead is. The Knocked Up comedian had a similar movie idea to Pegg's 2004 zombie comedy, but was pleasantly surprised when he found out he had been beaten to the big screen by the Hot Fuzz star. He says, "When I first saw Shaun Of The Dead, I thought, 'F**k! F**k those guys!' I'd been thinking of writing a zombie movie about two dudes, and then that came along. I couldn't believe it! Not only are these guys quicker, they're better than me, too!"

I wish Hot Fuzz would come off the LONG WAIT list on my Netflix queue.

"Ain't got no sweat tea"

2007-08-08T15:15:00.000-04:00

Fellow Southern expatriate Jeff Klineman's celebration of true Southern Sweet Tea deserves your anthropological attention. I've always gravely lamented my own lack of Sweet Tea experience, and I'm actually working on developing a taste for iced tea. The problem, of course, isn't with the beverage, but my unwillingness to knowingly put that much sugar in a glass and drink it. Thank you, Splenda, for letting me re-explore my heritage without further increasing my chance of diabetes. Courtney assures me that it's my grandmother's fault, since her grandmother always had a pitcher of the prototypical Pitcher of Sugar Flavored with a Pinch of Tea ready in the refrigerator. I was too busy drinking chocolate milk and my grandfather's special recipe root beer floats, I guess.

Kurt Vonnegut on Barry Bonds

2007-08-04T23:48:00.000-04:00

Kurt understood the significance of the asterisk after whatever number of home runs Bonds steals away from the forces of good:
Picture stolen from this website, a collection of author self-portraits. Copyright somebody who's not me.

2007-08-03T15:49:00.000-04:00

Courtney and I turned off our DVR-ed Jeopardy episode last night, only to see this ridiculously painful crash on the X-games. 720 into a 540 turns into a 720 into SPLAT! I thought the dude was dead, since I don't think I could personally survive a fall down a flight of stair, but you can't kill people stupid enough to ride skateboards 50 feet into the air. So it's worth the watch, if only to hear the stoner announcer's reaction: "Ah, man, that was... that was the heaviest slam we've ever seen... Oh, my God. Wow, I can't believe he nailed that 720."

2007-08-03T15:36:00.000-04:00

I don't shill for CuteOverload nearly enough.

Is there something the matter with me

2007-08-01T10:46:00.000-04:00

since I'm more comfortable with John Roberts now that he carries a diagnosis of epilepsy? Am I becoming a psychiatrist because I'm somehow naturally more comfortable with folks who have Tegretol or Lamictal in their blood stream?

Stranger things have happened.

Fables of the Reconstruction of the...

2007-08-01T09:46:00.000-04:00

All-white church may hire black pastor

ASHLAND — First Baptist Church in Ashland may soon lay claim to a first: The all-white church is on track to hire a black minister full time.

The Good: My hometown has just modernized itself out of the 19th century!

The Bad: The newspaper has to run an article with such a headline. Why would the race of the pastoral candidate be worth more than a passing mention if the expectation wasn't that such outdated racism still would figure prominently in the church's decision making.

Towler said race wasn’t an issue in the church’s relationship with Moore, either in a positive or a negative way.

“It wasn’t an issue at all,” he said. “Although we don’t have black members now, we have had black members in the past. ...I can honestly tell you (race) was never an issue in any form or fashion. We think Harold is filled with the spirit and preaches the Bible and that’s what we’re looking for.”

Note to all: the church representative just used the "I'm not racist, I have black friends" argument.

The Ugly: The article ends on an uncomfortable Uncle Tom note:

“We’re just lifting up Jesus,” he said. “We’re not looking for current events, we’re just spreading the gospel.”

Be clear, I'm not criticizing Moore's statement or sentiment. Moore is saying a noble thing, that the Gospel should be studied apolitically. I'm criticizing the article's positioning and use of the quote, as if to say, "Don't worry, Mas'r! Uncle Tom be good, and won't go stirrin' up no troubles for da white folk." You can't end an article whose theme is institutional racism with a statement of submission without making folks like me shake our heads at how far race relations still have to go in the South.

Religious doctors not more likely to care for poor

2007-07-31T17:30:00.000-04:00

That's no surprise, and not even the reason why I would draw attention to it. Here's the real reason this study is significant:

He and colleagues at Yale New Haven Hospital in Connecticut mailed surveys to 1,820 practicing doctors. Of those, 63 percent responded.

What is it about a study on religiosity that would inspire a 63% response rate? Physician survey studies typically consider themselves sterling successes if they achieve anything above a 20% response rate.

Sparky Harry Potter theories Redux

2007-07-22T15:32:00.000-04:00

0/2.

All is well.

Sparky Harry Potter theories

2007-07-19T16:27:00.000-04:00

31 hours until the Deathly Hallows are unleashed upon the Eastern time zone, so here's my last chance to divulge my newest theories before all such theories are useless. I haven't heard anything like this from anybody else, so if I'm right, I want mass love. If I'm wrong, well, I still want mass love, but ya know.

Why does Dumbledore trust Snape?

What experience do Dumbledore and Snape share that no others do? That's right, kids. Only they heard Trelawney's prophesy. Nobody else. Not Harry, not He-Who-Has-No-Nose-On-Screen, and not even Trelawney herself. So how do we know the contents of the prophesy? Dumbledore tells Harry what it said in book five. In book six he tells Harry that the only reason the prophecy applies to reality is because Voldy is obsessed with its contents. Voldy marked Harry by trying to kill him. If Snape never told Voldy its contents (or partial contents, as I propose), said prophecy would be just another blob in the bottom of a tea cup.

So, if Snape and Dumbledore are the only two to ever actually hear the prophecy, if the prophecy was broken in the final battle of OoTP, then who's to say that Dumbledore and Snape heard a version of the prophecy decidedly different than the one presented to Harry? Or, more complete than the one heard by Harry, at least.

When Malfoy attempts to fulfill Voldy's commands, he fails, and Dumbledore offers the Malfoys protection. Did Dumbledore make a similar offer to Snape, allowing Snape to maintain his cover with Voldemort while gaining a valuable mole into the Death Eater camp? Harry tries to explain to the others after Dumbledore's death in H-BP that Dumbly trusted Snape because Snape was sorry that James and Lily were the ones killed after he revealed the prophecy to Voldemort. Could it be that this is a regret that Dumbledore's plan to disseminate false information resulted in collateral deaths? Dumbledore and Snape would have shared this particular regret. So, Did Dumbledore kill James and Lily, in much the same way that Kreacher's self-serving deceptions resulted in Sirius' death? Odd justice, but the sort of twist Rowling does not seem incapable of.

For Vonnegut fans, Snape is the ultimate Howard W. Campbell, Jr. You either get the reference, or you don't. If you don't, Mother Night is a great place to start.

Is Dumbledore dead?

Why we're not obsessing about Dumbledore's relationship to his phoenix, Fawkes, I can't understand. Someone who shares an office with a loyal phoenix isn't gone for good. He's not even out of control. Much of the series has focused on Voldemort's attempts at immortality, while Dumbledore has smiled knowingly that 'love' his so much a greater power than Voldy's dark magic. Maybe 'love' isn't just 'love.' Maybe 'love' connects Dumbledore to Fawkes and to the magic of immortality that doesn't require murder and splitting your soul into destroyable objects. Book five contained two armies: the Order of the Phoenix, and Dumbledore's Army. But it wasn't the Order of Fawkes, it was the Order of Dumbledore, obviously. Dumbledore has achieved immortality, but a phoenix has to die ever so often in order to renew itself.

Snape didn't kill Dumbledore. Snape facilitated the rebirth of a phoenix. Think more Obi-Wan Kenobi than Gandalf, but a rebirth nonetheless. Snape's murder of Dumbledore seems intimately linked to some sort of over-arching plan developed between Snape and Dumbledore right about the same time that Harry's parents were killed. Conquering Voldemort may just require a 17-year plan, and a plan that depends so much on the willing participation of an unwitting kid. No wonder Dumbledore puts so much emphasis on supposed free will.

That's J.K. Rowling's form of destiny. Rowling is a pitcher that sticks a single finger into the air to signify to the batter that a fastball is coming, and you better hit it if you dare. If you don't, you'll strike out. You might need a little bit of luck, and the pitch may come in high and tight, but the swing is still yours to take. And that's why Dumbledore's Army will be lining up outside bookstores Friday night.

Turn Yourself Into a Simpsons Character

2007-07-18T17:34:00.000-04:00

Go to simpsonizeme.com, upload a photo of yourself and the application analyzes your face, turning you into an honorary Springfield resident.

Can't wait to get home and try this thing out.

Update: hehehe...

My Quality Adjusted Life Year may be different than your Quality Adjustment Life Year

2007-07-18T08:47:00.000-04:00

Slate's Darshak Sanghavi discusses some of the problems with the way health care economists judge the cost-effectiveness of various health treatments, within our culture and across cultures. Paul Farmer's Partners-in-Health group is used as anecdotal evidence (as Sanghavi's critique is almost verbatim the one that Paul Farmer gives in his lectures), and Farmer's infamous "before-HAART" picture is included in the article. Farmer hates the QALY (quality adjusted life year) metric, mainly because the QALY assumptions break down the more unlike the treatments are in their target population, and easily damns treating anyone in an impoverished nation with anything more expensive than penicillin and a mosquito net. Despite being an excellent primer in global cost-effectiveness, the article does a great job exploring the extent to which the assumptions of economics, like any statistical science, greatly limit our ability to generalize the results it produces to real policy decisions.

James Holsinger, a simple prop to occupy our time

2007-07-12T00:41:00.000-04:00

The American Public Health Association, founded in 1872 and made up of 50,000 U.S. public health professionals, said it is "very concerned with Dr. Holsinger's past writings regarding his views of homosexuality, which put his political and religious ideology before established medical science."

It was the second time ever, and the first in 26 years, that the group has opposed a U.S. surgeon general nominee.

Funny, the headline reads "Health group opposes Bush surgeon general pick." As if the APHA is just a 'health group.' That's like saying "Book opposes money lending," when said book is the Bible.

Corpus Callosum et al. document well the recent controversy stirred by Richard Carmona's obvious-but-gutsy admission that the Bush administration places politics above science, as well as Holsinger's own personal failings, i.e., being willing to write an article named "Pathophysiology of Male Homosexuality." I initially gave the guy a bit of slack, partially out of pure Kentucky hopeful nostalgia, and because I do earnestly believe that evangelicals could have particular insane political beliefs, and yet place them in proper context when formulating opinions about policy. Alas, James Holsinger will never be my insane-but-straight-shooting evangelical.

I'd be thrilled for this guy to prove us all wrong. But, if confirmed, Carmona's testimony suggests that Holsinger wouldn't have a shot at making any real decisions anyway.

I believe this post completes the R.E.M. trifecta, for those following along at home.

"By jingo, buy America"

2007-07-06T23:38:00.000-04:00

Kyle on "Mindless, Anti-Christian Jingoism" deserves your attention.

Good to hear "R.E.M.," "guitar-heavy," and "new album" in the same paragraph

2007-07-06T16:23:00.000-04:00

Apparently Michael Stipe was editing lyrics onstage during their "working rehearsal" show while finishing up studio album 14.

Doctor Terrorists

2007-07-05T23:44:00.000-04:00

Howard Markel on NPR, exploring the Hippocratic Oath and the recent news of physician involvement with terrorism in Britain. Markel is one of a handful of history-of-medicine ninjas at the University of Michigan.

Samoas versus Caramel Delites

2007-07-04T15:49:00.000-04:00

If you've ever had the Girl Scout Cookie Talk with friends who grew up in various parts of the country, you'll argue about some of the names. Samoas versus Caramel Delites. Tagalongs? That's my Peanut Butter Patties. Take your fancy Dosidos and shove them down your Peanut Butter Sandwich hole. Courtney and I have the debate often. She maligns my insistence on calling her Samoas the much less exciting Caramel Delites.

Apparently the different names are made at different bakeries, and actually have slightly different formulae. Not sure why certain areas get certain variations, but they're NOT the same. Happy 4th of July. Can't get much more patriotic than Girl Scout Cookies.

Maybe I'll blog about something that matters again sometime soon.

Is Ratatouille the best animated movie ever?

2007-07-02T10:38:00.000-04:00

Check out Metacritic's top movies. Ratatouille falls right between Dr. Strangelove and The Manchurian Candidate.

1.	Godfather, The	1972	100
2.	Superman II	1981	99
3.	Army of Shadows	2006	99
4.	Pan's Labyrinth	2006	98
5.	Dr. Strangelove or: How I Learned to Stop Worrying and Love the Bomb	1964	96
6.	Ratatouille	2007	95
7.	Manchurian Candidate, The	1962	94
8.	Pulp Fiction	1994	94
9.	Spirited Away	2002	94
10.	Lord of the Rings: The Return of the King, The	2003	94

Even grumpy A.O. Scott gushes:

A nearly flawless piece of popular art, as well as one of the most persuasive portraits of an artist ever committed to film. It provides the kind of deep, transporting pleasure, at once simple and sophisticated, that movies at their best have always promised.

Courtney made lots of fun of me for being so excited to see this thing. But it's really that good.

2007-06-28T09:40:00.000-04:00

Since I'm in Tennessee/Kentucky, I'll continue along the theme of not posting real content until I'm back in A2. Found this on Feministing, which receives the much more exciting NC-17 tag. I'm not working hard enough. Someone should make fun of Kyle, since Vindicated gets a G. Come on, it's an Anglican blog. That should be at least PG-13 if done right and with significant restraint.

2007-06-26T23:54:00.000-04:00

Political quizzes usually tend to fail me (everybody?) miserably, but I found taking both the "How to Win a Fight with a Conservative" and the "How to Win a Fight with a Liberal" quizzes in combination actually meant something to me.

My Liberal Identity:

You are a Reality-Based Intellectualist, also known as the liberal elite. You are a proud member of what’s known as the reality-based community, where science, reason, and non-Jesus-based thought reign supreme.

Take the quiz at www.fightconservatives.com

My Conservative Identity:

You are a Free Marketeer, also known as a fiscal conservative. You believe in free-market capitalism, tax cuts, and protecting your hard-earned cash from pick-pocketing liberal socialists.

Take the quiz at www.fightliberals.com

This is a big improvement over other quizzes I've taken which always label me a socialist. Come on, just because Courtney and I really want to get two twin German dogs (debating between giant schnauzers and standard poodles) some day and name them Marx and Engels doesn't mean I don't like the free market.

Would you like some loss of sensation with that lopping of your foreskin?

2007-06-21T14:11:00.000-04:00

Male infant circumcision is the most common medical procedure performed in the US (although an article I ran across last week said rates were dropping, and most of that rate drop was due to the assimilation of folk from non-penis-disfiguring cultures). Matz and I spent way too many arguments (according to him, I always enjoyed them) in med school over whether circumcsion was Matz: a benign procedure, culturally significant, and good for hygiene, or Garrett: medical barbarism fueled by the inability of American parents to ask why they should be attacking their male children so they can "look like Dad."

So yeah, I don't like circumcision, and I want my foreskin back, despite the marginal improvements in hygiene suggested in a shoddy body of medical literature, although I'm intrigued by literature suggesting that circumcision may have some role in preventing HIV transmission in Africa.

One of the high points of our arguments was always whether circumcision created a differential in sexual pleasure between the lopped and the non-lopped. This study doesn't answer that question, but it's a great demonstration from which we can extrapolate future work:

Adult male volunteers were evaluated with a 19 point Semmes-Weinstein monofilament touch-test to map fine-touch pressure thresholds of the penis. Circumcised and uncircumcised men were compared using mixed models for repeated data, controlling for age, type of underwear worn, time since test ejaculation, ethnicity, country of birth, and level of education.

Analysis of results showed the glans of the uncircumcised men had significantly lower thresholds than that of circumcised men (P = 0.040). There were also significant differences in pressure thresholds by location on the penis

This study suggests that the transitional region from the external to the internal prepuce is the most sensitive region of the uncircumcised penis and more sensitive than the most sensitive region of the circumcised penis. It appears that circumcision ablates the most sensitive parts of the penis.

I repeat, this study does not adequately address the magnitude of sexual pleasure experienced either way. Circumcision occurs when the brain is still markedly plastic, and it's certainly reasonable to think that some rewiring could compensate for the loss of sensation caused by circumcision. But, the results do suggest that the anti-circumcision crowd may be correct: a foreskin is a terrible thing to waste.

During my third year pediatrics rotation, our attending (Matz and I were actually on the same service that month) brought us to the procedure room to assist in a circumcision. Matz was kind enough to speak up for me, that I had some moral cat in the fight, so as to save some face for me and make me not look like a disinterested medical student who didn't want to learn how to do "procedures." The attending asked me about my objection, and I remember replying earnestly that I didn't see any evidence for a benefit to performing the procedure, and I did see evidence for harm. Her reaction was markedly benevolent (she could have destroyed me for daring to openly question an attending's judgment), and assigned me to my greatest role as a medical student: she handed me a pacifier and a packet of sugar, and suggested I keep the little guy as happy as possible while she and the resident elegantly lopped off the poor little guy's foreskin.

Hopefully our lives never depend on our performance on a penile sensation microfilament test.

Cosmic blogging coincidences

2007-06-17T19:58:00.000-04:00

Back in September of last year, I declared I would never go back to the Briarwood Dollar Movies after a series of terrible experiences with rude employees, disgusting bathrooms, and just general poor quality. But I never got around to seeing 300 on a large screen (and that seemed like the sort of movie that would benefit from being seen in a theater), so today Courtney and I sucked up and decided to give the place another try. We stayed away from the folks at the concession stand, held our urine in our bladders, and beside having to strain to understand some of the dialogue, overall we got our two bucks worth.

And then I come home to get the first comment on said post from back in 2006:

GO WIPE YOUR ASS WITH YOUR 9 DOLLAR TICKETS
DUSCHEBAG!

Awesome. Mr "IP Address 76.226.104.83" thoroughly made my day with that one, and wins the "best alternate spelling of a mainstream cutdown" Award.

Ritalin use doubles after divorce

2007-06-12T08:26:00.000-04:00

Which of course means that divorce is a disaster for kids and parents and doctors just want to shove pills down their throats to shut them up. Or, at least that's about what the headline and the article want you to believe.

Children from broken marriages are twice as likely to be attention-deficit drugs as children whose parents stay together, a Canadian researcher said on Monday, and she said the reasons should be investigated...

"So the question was, 'is it possible that divorce acts a stressful life event that creates adjustment problems for children, which might increase acting out behavior, leading to a prescription for Ritalin?'" Strohschein said in a statement.

"On the other hand, there is also the very public perception that divorce is always bad for kids and so when children of divorce come to the attention of the health-care system -- possibly because parents anticipate their child must be going through adjustment problems -- doctors may be more likely to diagnose a problem and prescribe Ritalin."...

Her study was not designed to find out why the children were prescribed the drug.

I try to be slightly cautious of criticizing research on days when I'm far too lazy to go read the original study, but it's always easy to criticize how studies are presented to the people who are paying for them through tax dollars (yeah, it's a Canadian study, but still).

I won't entirely dismiss the mechanisms of increased stimulant prescription proposed by the study, as they're narratively compelling and probably are true on at least a limited scale. But why do children become children in a divorced household? Probably because mom and dad can't make things work. What's one reason that's often true? Mental illness, and given the prevalence of adult ADHD (that thing that was childhood ADHD before the child became an adult), we could imagine that folks who get divorced have a much higher prevalence of ADHD. What has a heritable component? ADHD.

So, I'd be shocked if diagnoses of ADHD, and psychostimulant prescriptions, didn't go up after divorce. Not because parents or doctors are seeing children any differently (although they probably are), and not even necessarily because divorce, even one that's best for all parties involved, is a stressful event for a child, which it most certainly is. As a cohort, children from divorced households would be expected to have much higher rates of ADHD from a purely genetic standpoint.

The fact that the risk of receiving a stimulant prescription only increases by a factor of two may be the most surprising result of the study, and might even suggest the opposite of what the article suggests: that doctors and parents view attention-deficit and impulsivity symptoms in a child in such a stressful situation as a transient phenomenon, and thus fail to prescribe in some instances.

Maybe, and maybe not. But the last thing we need is more articles in the media that suggest that a neurological condition is nothing but a result of an unfortunate but statistically normal childhood experience for many children, and the impatient parents (probably mothers) and physicians who want to chemically lobotomize children who display problem behaviors.

Resquiescat in Pace

2007-06-05T11:03:00.000-04:00

R.I.P. gets thrown around a lot when people and their lives are separated from one another, and the translation most commonly used by English speakers sounds like a direct command. "Rest in peace, because I said so!" Now, 94% of my Latin is gone, and my wife is at work expecting me to be showering right now, but if Romans were commanding people to rest in peace, I believe that ending would be an -e, (don't quote me on that).

The only reason I mention the academic difference for English speakers is because that -at meaning denotes an exhortation, a plea. It's the same as "Let them eat cake." It's a "Let this person rest in peace." It's a request, it's a hope, it's a prayer. We are actually begging our lost to rest in peace, because we can't unless they do. The imperative mood suggests we have control, certainty. But make no mistake, the proper subjunctive contains its own meditation on the human condition and death. We are the impotent victims of either fate or statistics, two things that we have only tiny means of influencing overall.

No Survivors of UofM Jet Crash. Let them rest in peace. May they rest in peace. Please, for our sake as much as yours, we beg you to rest in peace.

For those of you reading from outside the UofM or Southeastern Michigan area, the plane contained a transplant team. Two crew members, an attending, a fellow, and two other members of the transplant team.

Different services at different hospitals have different reputations. The transplant service at UofM had the best kind of reputation: "we work you until you pass out, but we'll treat you like real live human beings the whole time." That's a medical student dream (well, less the first part, but medical students actually enjoy being worked hard when they, their educations, and the use of their time is being respected.) I've heard from at least one friend that the attending physician on this flight made excellent contributions towards the above reputation of goodness. I didn't have a month on transplant, as only about 20-30 people do each year out of a class of 170, but I know way too many people who are probably very personally effected by this to not be sad for them, including a friend who is on the service right now, and who I'm very thankful was not included on this flight.

Tragedies are often tragic, and this one is no exception. And if tragedies happening to good people are doubly tragic, then his one is also no exception.

Ezra on the politics of Knocked Up

2007-06-04T12:37:00.000-04:00

Apparently a few bloggers on either side have deemed Knocked Up to be a pro-life movie since Katherine Heigl's character makes a choice not to have an abortion. Ezra volleys masterfully:

The flick is pro-choice in the most literal sense of the term. Katherine Heigl's character receives advice in both directions, and then makes a decision -- a decision the audience may very well conclude is the wrong one. But she has a choice; nothing is forced on her, and the most explicit scene on abortion features an eloquent speech by her mother advising her to end the pregnancy because, at this point, she's not ready, and these are not the right circumstances. Heigl, it turns out, disagrees, but that's a perfectly allowable, and indeed respectable, decision within the choice framework.

Due to my eerily busy travel schedule, it'll probably take a week or two to get to the twilight showing at Quality 16 (the only theater in Ann Arbor I step foot in, for appropriately complicated reasons), but I'm pumped. You see, as my wife can embarrassingly confirm, I was a massively strange fan of Seth Rogen's character on Freaks and Geeks. His appearance in The 40-Year Old Virgin made the movie for me, and now, Judd Apatow gives him his own movie? Beyond my wildest Freaks and Geeks dreams.

I had a huge crush on the quasi-nerd version of Linda Cardellini, completely unable to predict that she'd turn into the hot nurse on ER, the sort of neo-Abby of emergency resident dreams. Lindsay Weir was the archetypal cute high school brunette smart-girl nobody noticed in their apoplectic fit of adolescent tunnelvision, not the Ennis-seducing blonde saloon girl from Brokeback Mountain. So Cardellini's ascent into mainstream hotness makes me uncomfortable in that pimply, meso-pubescent sort of way. I might have been able to manage a coffee date with Lindsay Weir, but Samantha Taggart would be making fun of the awkward medical student to her fellow nurses by the fridge in the conference room. So that paves the clear path for Seth Rogen to be my official favorite Freaks and Geeks alum (a venerable position, indeed). All hail Seth Rogen!

NPR on James Holsinger

2007-05-27T14:50:00.000-04:00

James Holsinger, University of Kentucky cardiologist and public health professor recently nominated for the Surgeon General position, gets some positive treatment from NPR. He has his conservative credentials: a theology degree from the conservative (but not really in that nasty Falwell/Dobson sort of way) Asbury Theological Seminary, and a history of serving on the judicial council of the United Methodist Church which supported a ban on homosexual clergy (at least according to a questionable reference on his Wikipedia site).

Buzzflash, which I'm not familiar with, but looks like a potentially very fringy far-left sort of source, has an article expressing its mass unhappiness with Holsinger's nomination. I don't necessarily trust the claims of malfeasance and malpractice, but it's always interesting to see what sort of dirt is being thrown at someone from either side of the wingnutsphere.

For example, while I find it personally unacceptable that homosexuals be excluded from clergy positions, I also don't think that someone who disagrees with that position would necessarily discriminate against homosexual persons in health policy. The latter is the question to be asked, not the former. He's being nominated for Surgeon General, not National Chaplain. If that's the most damning criticism a far-left source can expose towards a public health official's treatment towards the LGBT community, then concern over his policy positions towards the LGBT community may be a general non-starter.

Here's hoping that Holsinger at least represents the best of what we could expect from the Bush administration. I wouldn't anticipate a nominee wholesale interested in the best available evidence outside the realm of a conservative, fundamentalist world-view. So if Holsinger is a nominee who stands on the side of medical evidence, we may have a much better nominee than we ever would have anticipated.

Psychiatry and Pooh

2007-05-25T18:20:00.000-04:00

One of my friends sent me an article on whether or not Anakin Skywalker has a DSM-IV psychiatric disorder (long story short, he probably does and in all likelihood, more than one). Since I absolutely detest the new Star Wars and only moderately like the old ones at best, I thought I would instead follow the link to a more interesting and humorous study on fictional characters: "Pathology in the Hundred Acre Wood". And you thought Pooh's honey-lust was endearing, not a cry for help. My favorite line: "This unfortunate bear embodies the concept of comorbidity."

To be honest, as much as I enjoy making fun of childhood classics, it's not really surprising that so many fictional characters would display traits consistent with a psychiatric disorder. When you think about it, many psychiatric disorders contain traits that we all experience at one time or another, but to such an extreme degree as to cause significant disruptions to life. All of us are have been happy or sad or irritable or excited at one time or another. Fortunately, not everyone has a major depressive or manic episode. Considering that good stories usually require something unusual happen, it seems reasonable to give some of these traits to characters. After all, do you want to read a fictional tale of an average guy doing average stuff? No thank you; I'll take the OCD bear and his gender-identity disorder pal.

WTF? Paris to pay immigrants to return

2007-05-23T23:04:00.000-04:00

While the US polarizes itself with talk of big fences, "Amnesty", and a complex array of temporary-guest-workers (aka indentured servants) and visas, other countries are thinking "outside the box". Have too many immigrants? Why not pay them to go home? That's what France is doing.

New Immigration Minister Brice Hortefeux said a family with two children would be paid 6,000 euros (£4,068) to return to their country.

Gotta love those French.

Maybe Boehner should just write for SNL

2007-05-23T09:47:00.000-04:00

From Political Wire:

Quote of the Day
"I promised the President today that I wouldn't say anything bad about... this piece of shit bill."

-- House Minority Leader John Boehner (R-OH), quoted by The Hotline, on the immigration bill.

I generally stay out of immigration debates, as I really just don't know what to say about them. I have no idea what actually does the most good for the least harm in these cases. Some of the reason for that is Eric Schlosser's excellent chapter in Reefer Madness that details illegal immigrant labor in California strawberry fields. Schlosser, who you probably remember better from Fast Food Nation, adequately dissects similar policy propositions as what are being debated now, and they all come up pretty sour. I don't even know what extremists on either side would really propose, short of "close the borders and shoot all the Mexicans" and "open up the borders and let everybody in."

See Zombie Run?

2007-05-22T23:54:00.000-04:00

Josh Levin ponders one of the essential questions of life: why, all the sudden, do movie zombies run instead of drag after their victims? Non-canonical heresy, or Darwin at work?

Cats for Pistons

2007-05-19T14:14:00.000-04:00

Matt Jones explains how Tayshaun Prince singlehandedly gave the commonwealth its NBA team.

Why does rape or incest matter?

2007-05-18T13:16:00.000-04:00

Samhita at Feministing (one of the greatest blogs in the sphere) takes Sam Brownback to task for his comments on abortion and rape and incest the other night:

Yeah you heard it right. Senator Sam Brownback actually argued on Wednesday that, "We talk about abortion, but abortion is a procedure. This is a life that we’re talking about. And it’s a terrible situation where there’s a rape that’s involved or incest. But it nonetheless remains that this is a child that we’re talking about doing this to, of ending the life of this child."

Now, I grew up in a fundamentalist household, and I've simply never understood the rape-and-incest line of argument, as if somehow whether the fetus is a product of rape or incest changes the fundamental facts of the abortion question.

I feel like I do a better job than most really breaking down the debate, but we'll see.

A fetus is one of two things:

A) A human being, and should thus have full protection under whatever laws we could scrounge together to protect it, or
B) A clump of cells living in a woman's uterus that, if given the opportunity, would likely somehow escape the uterus and begin development as a human being.

By tone of writing, its readily apparent that I support the latter definition.

From B), two options seem reasonable to me:

1) Mother decides that the clump of cells living in her uterus represents a future human being that should develop as her child. She wants that child, and she wishes for that child to escape her uterus and begin development, and from this point has a legal obligation to protect the child.
2) Mother decides that the clump of cells living in her uterus does not represent a future human being that should develop as her child. She thus decides to have abortion to have an unwanted mass of cells removed from her body.

So, where does rape or incest fit into ANY of this paradigm? I see no morally defensible middle ground between A) and B) or between 1) and 2).

Between A) and B), we could insert these notions:

i) A fetus is a human being but does not enjoy the rights of a human being outside the womb.
ii) At some arbitrary point during gestation the fetus changes from being a clump of cells to a human being, irrespective of a mother's wishes.

But neither make any sense to me. i) requires arbitrary notion of a second-class citizen. ii) requires that there's something magical about a cellular process independent of a social construct. I reject both of these outright as absurdities, although I find these are two popularly held beliefs. They're convenient, and let people make decisions about abortion de facto (and set silly regulations about so-called partial birth abortions or legislate abortion regulations differently depending on trimester of gestation) without actually considering any consistency with other moral beliefs. These notions might be useful shortcuts, but they don't seem logically defensible.

So I only see two morally defensible takes on abortion:

A*) Abortion is wrong because a fetus is a human being who deserves all the rights and protections of law, except possibly in the case of a mother's life being in danger, where all of this paradigm breaks down, and more subheadings would be required.
B*) Abortion is on average morally neutral and a decision left to a woman who has the right to make decisions about her own reproductive health regarding a pregnancy at any point prior to its termination through abortion or delivery.

Again, by tone of writing, its readily apparent that I support the latter definition.

I just don't see how rape and incest fit into this paradigm. Either a fetus is a human being, and killing it is murder, or a fetus is a prospective human being, and killing it is not murder.

I'm a firm believer in B*, but I do believe that A* is morally defensible, even if I absolutely reject it, because I know of no absolute way to differentiate between A and B. Now, in some cases, such as when Sam Brownback starts talking, A seems flat out hateful and ignorant. "You got raped and became pregnant? Tough shit! Go to church, you filthy harlot! They have free nursery during services!"

But I know a handful of rational, pro-women pro-lifers who subscribe to A and A*, and they are intelligent and thoughtful enough for me not to reject their ideas as ignorant. A and A* can certainly be included in a rational progressive agenda that supports women in poverty, provides unfettered access to proper contraceptive and reproductive health resources, and punishes perpetrators of violence on women. But give me B and B* any day, because they simply make more sense to me, and allow women more control over their lives.

I'm actually asking for answers here, and I know of at least a few regular readers that have the backgrounds to make reasoned comments. Why does rape or incest matter when determining whether an abortion should be permitted?

How to fix a laptop (that isn't really broken)

2007-05-17T01:40:00.000-04:00

Spend all day trying to clean your registry, update antivirus software, get rid of spyware, defrag, etc.
Turn it off for a few hours.
Turn it back on and cry when it only runs at a reasonable speed for the first five minutes.
Stay up until 2 in the morning googling why the fan keeps making that really strange noise.
Find out that a legion of geeks have encountered similar problems before, and even written software that lets someone like me highjack my computer fans, which will probably on result in me setting my apartment on fire.
Turn it off and take the whole thing apart.
Put it back together, counting your blessings that the number of screws equals the number of holes that seem to require screws.
Blow on it like it's a NES game in 1987.
Enjoy a computer that works again (and may continue to do so for hours, maybe even days, maybe even weeks).

I really enjoy the fact that the most likely intervention of any consequence was blowing really hard to clean some of the lint and dust from around the fans. My CPU is at a cool 136 degrees at 1.2 mhz (why not at 1.7 like it was a few minutes ago, and is rated for, I have no clue). Great success! (until tomorrow)

Confessions of a Show Killer

2007-05-16T18:15:00.000-04:00

Okay, I know it's been forever and a day since I've posted. I wish I could say that I have been waiting for a really great topic to blog about, some sort of earth-shattering event which I've uncovered or have remarkable insight on. Alas, I cannot. No, what pushes me take up the pen...er...keyboard again is actually a guilty conscience. You see, folks, I'm a killer. As you may have read, CBS has just announced the cancellation of "Jericho" and I'm afraid that it's all my fault.

What's that you say? You've never even heard of Jericho? The show sounds stupid? You didn't think Skeet Ulrich was still around? I understand where you're coming from. But you see, I liked the show. Sure, a post-apocalyptic small-town Kansas might not be the most relatable of locations for someone like me. And sure, having a nuclear bomb detonate in America may not be the most PC image in this post-9/11 world (a phrase I would retire if I had the authority), despite 24's outright theft of the idea. Nevertheless, the show was entertaining. It made some interesting statements about small towns and the way Americans would act if they were suddenly isolated from the rest of the country and world. Throw in a few good mysteries about who even bombed us in the first place (and the somewhat predictable "can we trust any new people who've come around lately?") and there was a reason to come back week after week. Plus it stayed away from the mistakes of one of my other favorite shows, LOST, and you know, wouldn't just make shit up for the sake of having more mysteries.

And then the show went on mid-season hiatus. I forgot about it. I figured out other things to do on Wednesday nights. I don't watch anything else on CBS so I never bothered to figure out when the show came back. Apparently no one else did either. The show that once had an article on CNN about how a post-apocalyptic drama would ironically be the hot new star of the season died a painful and viewer-less death. It's amazing the difference 5 months makes.

Of course, if I really had cared that much about the show, I could have paid attention to it. I could have made an effort to figure out when it was on and actually watched. I could have stopped rationalizing that if I ever wanted to get back into it, I could always just watch the episodes online for free. But the show's passing begs the question, "Is a mid-season hiatus really that necessary???"

Witness, if you will, Heroes, my new favorite, and the only show on NBC that is actually watched by someone who isn't an NBC exec. Despite being one of the strongest series on the network, even it took a tremendous nose-dive following it's 6 week hiatus. It took until the penultimate episode of the season to even start to regain it's coveted viewership. LOST too has taken it's biggest hits in audience numbers during the long-midseason breaks; granted LOST has plenty of other problems.

In the end, though, is the midseason break really necessary? I understand wanting to save your best stuff for sweeps, or wanting to limit production costs by ordering a few less episodes each season. If the audience stays away though, is it really that cost effective? I think I'd honestly prefer to have all the episodes shown in a row. Then just do repeats until the new season. Who wouldn't prefer that to having to look up each week whether the show is on or off again, eventually just deciding maybe it isn't worth watching?

You hear that, Heroes? Spinoffs aren't going to prevent a dive in your ratings. Midseason breaks aren't going to shore up that advertising revenue. Networks, just give us the new stuff in order and we'll promise to stay with you until the end.

Otherwise, I may be forced to kill again.

Patrick Patterson a Wildcat

2007-05-16T15:49:00.000-04:00

My first ever blog post dealt with Randolph Morris presser announcing his decision to come to Kentucky over Georgia Tech. Kentucky fans can certainly debate the disappointment of the "greatest recruiting class" of Rondo, Crawford, Morris, and Bradley, but the Billy Clyde era is here, and there will be no Lot's wife pillar-of-salt action going on here. There's momentum to match the tradition.

KentuckySportsRadio is farked right now, but Matt Jones and company streamed the press conference via cell phone (beautifully low tech), and PPat's barely discernible garble of "University of Kentucky" brought appropriate Kentucky screams in the Huntington High gym, about thirty minutes from the house where I grew up. Now if the kid even remotely lives up to the hype...

Eat shit, Florida. Eat shit, Billy Donovan. Long live Billy Clyde!

Link Roundup, my computer is making angry sounds at me edition

2007-05-15T22:20:00.000-04:00

I'm somehow surprised everyday that goes by that my old Inspiron 8200 doesn't burst into flames. Blogging and other work has taken a backseat to research and more board exam prep, but these links are burning holes in my Firefox pocket.

Sweden's #1 tobacco product, Snus, is getting headlines all the sudden because a recent study found an increased rate of pancreatic cancer for users, even though that rate is still well below that of smoking. The Swedish figured out a long time ago that smokeless tobacco, stored properly with very specific manufacturing techniques, is so much less dangerous than cigarette smoking that converting all smokers to chewers would have health benefits far outweighing our current methods of offering smoking cessation to an unwilling population. But that's the Swedish for you.
Fresh Air turns 20: listen to Oliver Sacks and Tom Wolfe.
Fruit juice doesn't make kids fat? Haven't seen the actual paper, but can't help feeling suspicious that this study didn't do a very good job controlling for other family health habits. We would expect parents who give their kids a lot of fruit juice to be a little more health conscious overall, and might not be surprised to see that kids who get their calories from fruit juice don't get excess calories from other poor diet choices. For some reason I just doubt that fruit juice calories don't count, which is the latent message in the press release.
Parody abounds: Microsoft Firefox ("where am I today?") and the Onion's anti-abortion pill, UR-86, that kills the mother and saves the fetus.
Oral sex increases the risk of a certain throat cancer from ultra-low to slightly-less-ultra-low:
And those people who had had more than six oral sex partners were 8.6 times more likely to develop the HPV-linked cancer.
Hear that, kids? You only get to have oral sex with five partners! Choose them wisely. Seems like an interesting take on those cellphone commercials. "Who's in your five?"
Cervical cancer vaccine less effective in sexually active. I'd hope this would come from the "no shit" research files, but sadly, the obvious does need to be stated for the anti-Gardasil crew who don't want their daughters turning into sluts because their risk of dying of a preventable cancer might be reduced.
Psychiatrists are evil and give your kids deadly medications because the drug companies pay them off in smoky, dimly lit rooms! MWAHAHAHA! This is one of the most manipulative, poorly written anti-psychiatry articles (even in the NYT, which manages to run plenty of anti-psychiatry drivel) I've seen in awhile, and I just can't bring myself to fisk it. If you're reading this, you probably already have the cognitive function available to see the gaping holes in the story.

Jerry Falwell, dead at 73

2007-05-15T19:06:00.000-04:00

The Carpetbagger Report tackles the difficult position of discussing Falwell just hours after his death by recounting the events of his life.

I'm always quick to talk about my experiences spending two summers at Baptist boot camp at Falwell's Liberty University, because a lot of who I am today really traces back to those experiences, how disingenuous and manipulative they were. Most of what I really found important spiritually growing up just never felt legitimate again. I don't have a personal beef with Pat Robertson or James Dobson, although I do think they are bad people. But Jerry Falwell, I shook that guy's hand. And he shook my faith. And I hate him for it.

Falwell and his evangelical cronies have done a lot of emotional and psychological damage to a lot of people under an umbrella of an extremely hateful reading of a sacred text. He was a bad person. I can't imagine the good things he might have done could possibly surpass the bad things he did.

To quote Death Cab for Cutie, "Styrofoam Plates":

I won't join the procession that's speaking their peace
using five dollar words while praising his integrity
and just because he's gone, it doesn't change the fact
he was a bastard in life, thus a bastard in death.

Update: Here is the particular camp I'm talking about. I guess that would have been the summers of 1996 and 1997 for me. Looks like they still hold camps at Liberty even today.

Update 2: Some indefensible Falwell quotes.

"AIDS is the wrath of a just God against homosexuals. To oppose it would be like an Israelite jumping in the Red Sea to save one of Pharaoh's charioteers ... AIDS is not just God's punishment for homosexuals; it is God's punishment for the society that tolerates homosexuals."

"The abortionists have got to bear some burden for this because God will not be mocked. And when we destroy 40 million little innocent babies, we make God mad. I really believe that the pagans, and the abortionists, and the feminists, and the gays and the lesbians who are actively trying to make that an alternative lifestyle, the ACLU, People for the American Way -- all of them who have tried to secularize America -- I point the finger in their face and say 'you helped this happen.'"

Update 3: Tim Noah includes some more quotes, including those denouncing feminists, Jews, and Martin Luther King, as well as a fit epitaph: "Rest in peace, you blowhard."

When you're looking for a chocolate-covered black hole

2007-05-09T00:06:00.000-04:00

I've found that whenever I have that sort of gut-gripping hopelessness in my head that I just can't quite shake, turning to Uncyclopedia's list of weapons that don't exist, but should is strangely therapeutic. For example:

Radioactive vegetables

Your parents lied to you.

Especially good for killing off large amounts of hippies or vegetarians. As the unsuspecting victim bites into the vegetable, large amounts of radioactive isotopes are injected into their bloodstream, killing them in a matter of seconds. Just don't try to plant them in your backyard.

Note that even if you have not eaten enough vegetables to fulfill the requirements of the Food pyramid, you should never eat vegetables that you know to be radioactive. The Surgeon General has said that the health benefits natural to vegetables do not outweigh the costs of rapid death. Radioactive vegetable producers have started an advertisement campaign claiming that eating vegetables will not affect your health in any way, however there is an asterisk on the end which links to the statement "if you were going to die anyways." written in a very small font.

Link Roundup, listening to Nirvana edition

2007-05-05T09:12:00.000-04:00

I fail miserably every time I try to expand my listening tastes into Nirvana's whole catalog. Back in my Baptist brainwashing days, I wasn't allowed to listen to the band with the baby dick on the cover, so I missed the boat the first time around, and in 8th grade when Kurt did his thing, I was largely confused. God, those t-shirts everybody wore were just ugly as hell, and the people that wore them, on average, wore nothing else and stunk of patchouli oil, like about 40% of my high school did anyway.

The only band I'd really effectively sneaked through the decency barrier was R.E.M., just because my parents couldn't understand most of the curse words on Automatic for the People, and if you didn't listen to Nirvana or Pearl Jam in middle school, you just weren't cool (and thus, I wasn't). I only ever bought "Ten" because the girl I wanted in middle school couldn't stop talking about it.

For some reason, R.E.M, Weezer, and Radiohead, the bands I preferred instead, just weren't cool. A friend of mine who went to a local county school was called 'gay' every time he wore an R.E.M. shirt, as we'd largely found the band together (in that, ya know, heterosexual sorta way). So it goes.

So Nirvana is just weird for me. I could probably mention about 15 songs that I thought were all genius, and then anything else I ever hear by them sounds like cats scratching a chalk board. Usually there's some middle ground, but Nirvana for me is either rock-out or suck-out.

If benzylpiperazine is going to be the next ecstasy, its really going to have to work on some new nicknames. 'The piper' seems cute. Has anybody heard what this stuff is called on the street? The wiki articles says it's called "The Lovely" or something stupid like that in Canada. They would.
Stuff Medicare won't cover: carotid artery stents and vagus nerve stimulators for chronic depression. The article for the latter mentions quite a few reasons why vagus nerve stimulators aren't trusted by the psychiatry community, although its hard to think that the "implantable psychiatrist" approach might not be a valid approach someday.
This article suggests that girls abuse prescription drugs more than boys, and then mentions tranquilizers and antidepressants. How the hell do you abuse an antidepressant? It's like trying to abuse bread. Sure, you can make yourself sick by taking a bunch of them, and in the case of TCAs, which are rarely prescribed for adolescents, you could really hurt yourself. But chewing a pencil would be more exhilarating than dropping Prozac on the weekend. Note: I only post this article because it's a great example of the way the media can write something without actually conveying any actual information.
Penn folk say that psychotherapy can't extend the life of cancer patients. If I track down the pdf, I might plunge into this in a post on its own, since the review flies in the face of about 15 years of assumed truth.
Gulf War Syndrome patients have some pretty weird findings on neuroimaging compared to other Gulf War vets without symptoms. Corpus Callosum posts a quote from one of the authors being a good neurologist by frankly criticizing psychiatric illness in general:
Study coauthor Dr. Ronald Killiany, PhD, from Boston University School of Medicine, told Medscape that these data are an "important first step for Gulf War veterans as well as the scientific community in validating the fact that so-called 'soft' neurological conditions can have a pathological basis."
Can have a pathologic basis? Those are fighting words.
Oxytocin for autism? Stranger things have happened. Here's one of the best quotes I've seen in a long time from a medical journalism article:
While it is hardly implausible that a hormone involved in orgasm would have positive effects on anyone, these findings of improvement in adults with autism given oxytocin are based on measurable changes in behavior as well as visible changes in their brains as seen through functional magnetic resonance imaging.
Can't argue with that logic. At least, not without giggling.
Just a brief overview of bipolar disorder in kids, which may be much more common that thought, especially in those mistakenly diagnosed as ADHD.

So I finally got around to watching an episode of House

2007-05-03T23:55:00.000-04:00

I've always wanted to start at the beginning with the DVDs, as I really hate jumping into a series anywhere other than at the beginning. But my in-laws have been visiting this week, and because of them, I've now seen my first episodes of American Idol (strangely addicting, although I think the methadone is already working) and House.

I had high hopes for House. I remember Chris Scipione (soon to be a surgical intern at UofM) recounting how he was watching an episode with his parents back during M1 or M2 year, and Chris' guess early on that the patient suffered from SSPE turned out correct, and everyone in the room was thoroughly impressed with their genius boy medical student. Skip was like that. If anybody could vouch for House, it would be Skip. If anybody could wind up "bored-certified" in nephrology and infectious disease while developing his own radiographs and performing brain biopsies in his spare time, it'd be Skip.

But my God, I've never watched such a painful show in my life. Hey, this kid has histo, and this kid has leukemia. His balls are swollen, and we won't do an ultrasound of his sack, we'll just suck out his white cells! Woohoo!

I'm not sure if it's any worse than Grey's, which I only watched for a few episodes during my OB rotation so I'd have something to talk about with the residents. If ever there was a case of stereotypes ringing true, it was OB residents and nurses talking about Grey's.

Courtney's in the other room watching something from a season 6 DVD of ER. ER flubs here and there, but at least it smells like real medicine. ER takes itself way too seriously, but it's a television drama. At least they put some drama into it.

Grey's and, now House? WTF is this crap? They're not about medicine. They could be about Martian ferret farming, and use most of the same back stories, and nobody would know the difference.

And sure, you're going to say it's just entertainment. But dude, that's like saying that Jerry Falwell is just a preacher. Or that Nostradamus was just a hot dog vendor. I mean, maybe he sold good hot dogs, but somehow that whole predicting the murder of kings thing sorta went further, right?

Okay, not even I understand what the hell I meant in that previous paragraph. Bed time. House sucks, although I will probably give it another shot when Courtney starts getting the DVDs from Netflix, starting at episode one.

Are white NBA refs really racist?

2007-05-02T13:51:00.000-04:00

A coming paper by a University of Pennsylvania professor and a Cornell University graduate student says that, during the 13 seasons from 1991 through 2004, white referees called fouls at a greater rate against black players than against white players.

Except that it really doesn't say that at all. This isn't a bullshit study by any means. I've read that the authors do a great job of considering a multitude of potential confounders, and that the authors do mention alternative hypotheses that their data cannot distinguish between, and that's heartening.

But the paper (or at least those interpreting it in the media and blogosphere) seems to be making a fundamental ecological error of attributing community level behavior to individuals. The study suggests that having more white refs on a three-man referee team leads to more fouls on black players, but it has no means by which to imply that white referees call more fouls on black players.

While not as elegant an explanation, a black referee with two white referees in his group might be more likely to call a foul on a black player, and the white referees might make no distinction.

The proper conclusion of the study is that a community-level effect exists, and another study needs to be performed addressing which of the individuals makes the call to create strong evidence for any individual level bias hypothesis. As the NBA has that data and will not release it, and no grad student probably has the time to watch 1500 basketball games a year to generate the data, I doubt we're going to get an answer.

Iowa a safe place for gays?

2007-04-26T09:04:00.000-04:00

Iowa is positioned to become the most recent state to provide some protection to LGBT individuals. A bill that adds sexual orientation to the list under the anti-discrimination policy was passed by the senate and will head to the house for final approval. If is passes the upper house, it will go to the governor's desk - and he's already committed to signing it.

Who knows Iowa would be a good place to work as a gay individual? Or better yet, why are there still 31 states that don't provide anti-discrimination protection to LGBT people? Come on - let's get this party rolling!

The Farm Bill as Government Subsidized Obesity

2007-04-23T08:42:00.000-04:00

Michael Pollan, author of The Omnivore's Dilemma, writes in the New York Times Magazine:

A public-health researcher from Mars might legitimately wonder why a nation faced with what its surgeon general has called “an epidemic” of obesity would at the same time be in the business of subsidizing the production of high-fructose corn syrup. But such is the perversity of the farm bill: the nation’s agricultural policies operate at cross-purposes with its public-health objectives.

Read the rest: "You Are What You Grow" (h/t: Will Samson)

What better to balance vitriol than a puppy video

2007-04-22T13:18:00.000-04:00

Not my puppy.

How could you write any less intelligently about menstruation?

2007-04-22T10:32:00.000-04:00

I know nothing about Stephanie Saul, and I don't know anything about having a period. I know a lot about living with someone who has them and constantly complains about them, and yet doesn't really have any interest in not having them. I can accept that sort of doublethink just fine. God knows I probably exhibit behavior and attitudes at least that discordant.

Let me be absolutely clear: If a woman has a complicated relationship with her menstrual cycle that relates to her identity and personal relationship with her body, that's great. Seriously. I don't bleed. I don't know what it's like. If there's something symbolic about it for you, that's cool. If it helps you understand your relationship to your body, awesome. I can at least imagine it on a literary level. I can't think of any exact analog for a guy's relationship with his sexual anatomy, but if there was one, I bet I'd have a complicated relationship with it too.

But if a woman doesn't have a complicated relationship with her menstrual cycle, then my God, why does she have to bleed if she doesn't want to? Since when has feminism become about limiting a woman's choice?

So here's a brutal jump-around fisking of Ms. Saul's pseudofeminist drollery.

For many women, a birth control pill that eliminates monthly menstruation might seem a welcome milestone. But others view their periods as fundamental symbols of fertility and health, researchers have found. Rather than loathing their periods, women evidently carry on complex love-hate relationships with them.

Oh my God! Women don't agree on everything! Holy shit, there's more than one valid opinion on a matter in this world! How will we ever survive until next week without our unity?

This ambivalence is one reason that a decision expected next month by the Food and Drug Administration has engendered controversy. The agency is expected to approve the first contraceptive pill that is designed to eliminate periods as long as a woman takes it.

Alberto Gonzales: controversy. Gun control on college campuses: controversy. Approving a new birth control pill that ruins the old misogynistic proverb "never trust something that bleeds for a week and doesn't die?": Yawn.

“My concern is that the menstrual cycle is an outward sign of something that’s going on hormonally in the body,” said Christine L. Hitchcock, a researcher at the University of British Columbia. Ms. Hitchcock said she worries about “the idea that you can turn your body on and off like a tap.”

Two points here. The first one, valid. Amenorrhea is an outward sign that something isn't working quite right, and this pill would mask that. Valid point. The second one, the "turning your body on and off like a tap" thing, is this woman for real? Who cares? If people want to contemplate the symbolic nature of their own menstrual cycle (which I certainly do not oppose), that's cool. But to unilaterally say that every woman out there, whether she finds her cycle to be something personally important to her or not, should necessarily have to have the thing, with only poetry to back you up, is pretty dumb.

That viewpoint is apparently one reason some already available birth control pills that can enable women to have only four periods a year have not captured a larger share of the oral contraceptive market.

Oh my God! The market can handle a diversity of goods!

“It’s not an easy decision for a woman to give up her monthly menses,” said Ronny Gal, an analyst at Sanford C. Bernstein & Company.

Or its just not a necessary decision. If a woman is on a birth control regimen that works for her, and the benefit of not having a period isn't worth having to fiddle with that regimen, that seems pretty reasonable to me.

Doctors say they know of no medical reason women taking birth control pills need to have a period. The monthly bleeding that women on pills experience is not a real period, in fact.

Okay, this is when Ms. Saul really loses my vote. "Hey birth control pill users, you phonies, you don't even have real periods!!! That's not blood dripping from you for five days every month, that's really just cherry slurpee the drug company implanted in you while you were asleep! Fooled you!"

What the hell? No, you don't have an egg to shed when you're on the pill, because you don't ovulate. But you still shed some endometrial tissue, and unless I just totally failed my GYN rotation, I'm pretty sure that constitutes a "real" period. Labeling an on-the-pill period as "fake" seems a little, well, nutty? To make such a claim, you either a) have a really bad understanding of science, b) believe everything you're told, or c) have a very specific agenda.

And studies have found no extra health risks associated with pills that stop menstruation, although some doctors caution that little research has been conducted on long-term effects.

Welcome to drug research. How do you conduct research on long-term effects if people don't take the medication for long periods of time? It's not like we have a colony of research-people on the moon we can feed Seasonale for the next fifty years to see if they grow an extra arm on their head or something, and then get back in our space ship-time machine to come back to 2007 to tell everybody that it's totally safe, except for that arm-growing-out-of-your-head thing. We don't have long-term research on most of the birth control regimens in existence now, as most research I've seen just lumps OCPs into one big catch-all category. That might be totally appropriate, but maybe this progestin analog causes arms to grow out your head, and another one doesn't. We won't know for fifty years.

The topic has, however, inspired an hourlong documentary by Giovanna Chesler, “Period: The End of Menstruation?,” currently screening on college campuses and among feminist groups.

Ms. Chesler, who teaches documentary making at the University of California, San Diego, said she became concerned about efforts to eliminate menstruation when she first heard about the idea several years ago.

“Women are not sick,” she said. “They don’t need to control their periods for 30 or 40 years.”

Geez, and I thought the "Left Behind" people needed to get a life. No, women are not sick, but they take birth control pills because they'd like to actually be able to enjoy sex without having seventeen children. If stopping ovulation with pills is okay, why is stopping menstruation with pills somehow worse? At least, medically.

There has also been a backlash among groups that celebrate the period as a spiritual or natural process, like the California-based Red Web Foundation. “The focus of our group is to create positive attitudes toward the menstrual cycle; suppressing it wouldn’t be positive,” said Anna C. Yang, a holistic nurse and executive director of the organization.

What a bunch of hippies. Nobody's FORCING this stuff down your throat. If you love your menstrual cycle, knock yourself out. If you want to celebrate your menstrual cycle as a central theme of womanhood, have fun. But leave women alone who don't think it's fun to bleed 20% of the time for thirty years.

Eliminating menstruation is not a completely new concept. Women who take any kind of oral contraceptive do not have real periods.

Because the hormones in pills stop the monthly release of an egg and the buildup of the uterine lining, there is no need for the lining to shed — as occurs during true menstruation.

Not again. Space cadet.

At the alternative Bluestockings Bookstore on the Lower East Side of Manhattan early this month, several dozen women gathered for the New York premiere of “Period: The End of Menstruation?,” Ms. Chesler’s hourlong documentary. It explores the idea of suppressing the menstrual period but leaves the viewer to make up her own mind.

One who attended the screening, Aviva Bergman, a 22-year-old student at Goucher College in Maryland, said she would not use products that suppressed her period because it seemed unnatural.

You know what else is unnatural? Being able to have sex without worrying about getting pregnant. Injecting yourself with insulin because your pancreas doesn't work. Getting a heart transplant. Nuclear bombs. Soy milk.

You know what's perfectly natural? Earthquakes. Floods. Hurricanes. Puppies. Rainbows.

Natural doesn't seem like the best proxy of goodness. Seems like most of us evolved with intellects that can stomach a bit of nuance and context here and there.

“I just feel that there’s a reason you’re getting it every month,” she said.

Feel away! It's your menstrual cycle. Do what you want with it. But it's your menstrual cycle, and not that of the woman sitting next to you. Make your own decisions, and leave other people alone.

Yeah, there's a reason "you're getting it" every month. It's because (oh hell, you can look it up on wikipedia, if you're that interested in reproductive endocrinology). I'm pretty sure there's nothing magical about pulses of GnRH, although I'm not a medical student at Hogwarts, and may be out of my league on this one.

I don't anticipate that anyone is actually going to read down this far. If you did, please keep all these comments in focus with the overriding thesis.

Women should get to decide what they do with their own bodies.
There's nothing feminist about trying to limit the choice of other women for poetic reasons.
We don't know much about the long term effects of suppressing periods indefinitely. but we also don't have much medical reason to think that regimens that suppress periods indefinitely will really be much of a problem in comparison to contraceptive regimens already available.
There's nothing magic about things that are natural. Cancer is natural. Air conditioning is unnatural.
I've never had a period. I'm only qualified to speak about the medical and political implications of this stuff. I do not question anyone's personal experience with menstruation.

What do 5 members of the SCOTUS and near-sighted gynecologists have in common?

2007-04-19T13:35:00.000-04:00

They all have wet noses! (Apologies to the 98% of you that don't get the reference)*

I held off posting on the Supreme Court's decision to be supremely retarded, figuring someone else would write something more measured and that would hit all the points I wanted to hit. Lynn Harris at Salon did a pretty good job.

In general, critics of "partial-birth abortion" bans -- which are also on the books in 26 states (though enjoined in 18) -- have long argued that not only is there no such medical term as "partial-birth abortion," but that such laws define it so as to appear to also include a variation of dilation and evacuation (D&E), by far the most common -- and safest -- method of second-trimester abortion (which is relatively rare itself; at least 85 percent of abortions take place in the first trimester). In other words, the ban could be interpreted to outlaw abortion procedures used very early in the second trimester (not to mention those used for women who have learned via amniocentesis, as late as 20 weeks or more, that they're carrying a fatally abnormal fetus).

And even better:

Make no mistake: "This ban is not just about later-term abortion," says Janet Crepps of the Center for Reproductive Rights, who argued Gonzales v. Carhart. "The options for all women -- particularly women facing serious medical conditions -- have been dramatically reduced. No longer can women and their physicians decide what's in their best interest. Now there's the added concern about whether what's in their best interest will be in violation of federal criminal statutes." Among opponents of the ban, gallows humor was the order of the day. As in: "I'd like to give you the best possible care," your doctor might say, "but first let me check with my lawyer."

*The UMMS 2007 Smoker included the joke "What does my dog Winston have in common with a near-sighted gynecologist? They both have wet noses!"

NB: My dog is not named Winston.

Civil Units in New Hampshire

2007-04-19T11:47:00.000-04:00

NH's govenor has finally weighed in and will sign legislation creating Civil Unions in the state starting next year. I applaud him for making this move. But it begs the question, why are all the states that are making it a safe and semi-equal place for lesbians and gays to live in the North East? Come on, can't the rest of the country catch up? Even California, Oregon or Washington? I know it's not likely in South Carolina, Texas or even Michigan, but we've got to see this breaking out somewhere else in the country.

Link Roundup, random med news buffet edition

2007-04-17T11:24:00.000-04:00

Do fictional diseases increase the risk of cardiovascular disease. Probably not. So Restless Leg Syndrome probably isn't a fictional disease. I get so tired of the "nobody'd ever heard of RLS until just a few years ago, but now because some drug company can make money, everybody has it!" argument. That's not to say that I don't think problems like this get over diagnosed after physicians and patients are suddenly inundated with a new possible answer to old problems, but that doesn't mean RLS isn't a real entity.
The NHS has just NOW apparently figured out that it's not a good idea for patients and doctors to be inserting probes into one another for procedures that they can't bill for.
Alpha-blockers for nightmares in PTSD? Will urological psychiatry become a new fellowship?
Glucosamine/Chondroitin Sulfate still doesn't do shit except take your money.
Jonathan Cohn Jonathan Cohn Jonathan Cohn. I'm going to have to read his stupid book before I go nuts hearing something new about it three times a day. He sounds sensible enough on NPR.

Fox News pisses on Kurt Vonnegut's grave

2007-04-17T09:44:00.000-04:00

I always knew there would be a special level of hell for the folks at Fox News, but I didn't know they were going to work towards pushing that level further and further down.

Disgusting. After calling Vonnegut "irrelevant," the final lines of the obituary take the cake:

Vonnegut, who failed at suicide 23 years ago, said 34 year ago that he hoped his children wouldn't say of him when he was gone, "He made wonderful jokes, but he was such an unhappy man." So, I'll say it for them. Kurt Vonnegut was 84. In Washington, James Rosen, Fox News.

What a stupid fuck of a man.

Sympathy for Hokies

2007-04-16T17:08:00.000-04:00

I've only been through Blacksburg once, to pick up a friend at VT on the way to church camp back in my Falwell-brainwash days, but I remember seeing a beautiful campus on a very beautiful day.

Here's hoping folks there can get back to enjoying how beautiful it is very soon. Tragedies suck. Hard.

Men do just as much work as women do (just maybe)

2007-04-16T14:00:00.000-04:00

Joel Waldfogel tries his best to suppress some latent misogyny on his review of a survey by some economists of 25 nations measuring how much combined work, "market" work and "house" work, men and women do. The study finds, popular to common belief in sociological circles, that men and women, at least on average, and in richer nations, tend to do the same amount of work each day. The end-article caveat seems spot-on, though:

Many women with demanding careers tell me that it is women working full-time in the market, not women overall, who work more than comparable men. This study cannot settle that question because it does not report work time separately for people with and without market jobs. But if women with careers work more than men, while women overall work the same amount as men, then women without market jobs must work less than men. Men can use that argument to hit the couch in the afternoon. Or to end up there at night.

Something tells me that Waldfogel might be looking at some nights on the couch for writing this article.

It's a little disappointing that we don't get some nice reported sub-group analysis, since the research question becomes most interesting in the context of couples who work roughly equally outside the home.

Given the massive pile of laundry in the hallway, the overflowing trash can in the bathroom, and the wads of unvacuumed puppy hair on the floor, I think you can safely assume that Courtney and I do equivalent housework: not much.

Tax Returns Rise for Immigrants in U.S. Illegally

2007-04-16T09:58:00.000-04:00

Thought this was an interesting article in the NY Times about an increase in the number of undocumented aliens paying income taxes. A lot of Americans assume that these people don't pay any taxes and just sponge off of society, but they forget that they all pay sales tax, and with the use of individual taxpayer numbers they can pay income taxes. People also forget that many of the services these populations utilize are for health care and schooling, which (in my eyes) takes a pretty big asshole to deny someone. Apparently, some link the rise to possible amnesty and other roads to citizenship that will require payment of taxes and back taxes. It's nice that when people see a road to citizenship they are encouraged to participate in the larger society.

In 2005 alone, more than $5 billion in tax liability — the total owed, including money withheld from paychecks during the year — was reported in the 2.9 million returns that listed at least one person with an ITIN, she said. And between 1996 and 2003, such filers reported nearly $50 billion of tax liability.

Sorry Zombie lovers, the McCoys were not infected with rage

2007-04-15T11:08:00.000-04:00

Despite the fact that I'm currently reading Max Brook's oral history of the coming Zombie war, I was a bit put off by the misleading headlines last week. Imagine that, misleading headlines about medical research. The media went haywire about a report that a genetic disorder in the McCoy side of the Hatfield-McCoy might have caused all that hillbilly rage. You know, like in 28 Days Later.

Mostly for the non-medical folk who read this blog:

McCoy descendants have been found to have a high number of cases of Von Hippel-Lindau Syndrome (VHL). On my week of neurosurgery last year, I met a patient with VHL, and believe me, they weren't chasing me around the table, infected with rage. VHL doesn't cause rage. It causes tumors in lots of places, usually around rich vascular supplies, because of an autosomal dominant lack of a certain binding protein. One of the tumors that are common in certain subtypes of VHL are pheochromocytomas, adrenal gland tumors. Pheos present clinically with sudden episodes of sweating, crazy high blood pressure, etc., from basically a big dumping of catecholamines (like adrenaline) into the blood stream. Anyone who's watching 24 this season knows what happens when you inject people, like presidents, with shots of adrenaline. They start pretending to drop nuclear bombs on unnamed Arabic nations.

Pheochromocytomas are rare, but for some reason are classically represented on boards exams, so every medical student on earth can pick out a pheo on a standardized test from 20 miles away. But because they're so rare, and typically not as interesting as in the above test, non-medical folk just don't know anything about them.

Pheochromocytomas are also most commonly not related to VHL, although they are a hallmark of several of the multiple endocrine neoplasia syndromes. Again, boards questions for medical students, rarely obscure for non-medical folks.

Of course, my question immediately becomes, has there been an episode of CSI about a pheochromocytoma? Has there been an episode of House? If not, I bet you won't have to wait much longer.

Lithium cuts suicide risk in recurrent depression

2007-04-13T16:36:00.000-04:00

The overall rate of suicidal acts was 1.48 percent annually among those not given lithium compared with 0.17 percent per year among those treated with lithium -- an 88.5 percent reduction in risk.

For better or worse, current thought among the medical community is that SSRIs are so safe, a monkey could prescribe them. Just above monkeys, of course, are psychiatrists, family docs, and nurse practitioners. Psychologists typically gain the most support for their petitions for prescribing rights on the safety of SSRIs.

But lithium is something altogether scarier, again, for better or worse. Psychiatrists prescribe lithium. Nobody else does. And now there's evidence that, at least in the population defined in this study, the attributable benefit of lithium could be about 8/9 for suicide prevention. So some questions immediately arise (some maybe because I just haven't got around to looking at the original article yet):

1) What patients with depression (since most depression is undoubtedly recurrent depression) would benefit from lithium? I don't know what it feels like to be on lithium, but from Kay Redfield Jamison's An Unquiet Mind, it doesn't sound like the most benign drug. Thus, balancing the way lithium makes patients feel, in addition to all the long term nephrotoxicity and such, with the benefit of less death by suicide will be quite an important endeavor. Will that be an endeavor for psychiatrists, or for the larger mental health practitioner community?

2) Do all of these patients suddenly need psychiatrists to prescribe their lithium, or would non-psychiatrists become more comfortable prescribing lithium, at least as a depression adjuvant, which would likely be a far less complex endeavor than managing bipolar disorder?

3) Does this strengthen or weaken the case for prescribing rights for psychologists? After all, this paper is proposing a change to our current care model that could cause a dramatic increase in the need for more specialized mental health services. Of course, this assumes that the answer to question 2) is that non-psychiatrists would not become more comfortable prescribing lithium adjuvant therapy for depression.

4) And of course, if one mood stabilizer decreases the risk of death by suicide for folks with recurrent depression, what would the others do? Now that some atypical antipsychotics have been approved as mood stabilizers, where do they fit into this picture?

5) Do SSRIs remain relevant to the treatment of recurrent depression? Not to be too cynical, but all but Lexapro are off patent.

On a parallel note, check out The Last Psychiatrist's take on new evidence that adjuvant SSRI therapy adds nothing to patients with bipolar disorder already on a mood stabilizer. Especially relevant to question 5).

Goodbye, Blue Monday

2007-04-12T11:31:00.000-04:00

When my radio alarm woke me up this morning, I caught "he survived the firebombing of Dresden, and much of his early work dealt with atrocities..."

Holy Shit.

The segment ended, I poked Courtney, and she listened to the last bit with me, still too asleep to process that all the verbs were in the past tense. She ran to the computer and popped up the news, and there it was. Kurt Vonnegut dies at 84.

You're not supposed to cry when people die whom you never met. But damn, I can hardly even type right now. I was okay, until I entered that title above, and then it just broke. Goodbye, Blue Monday. It's like the god damn Velveteen Rabbit all over again.

People either get Vonnegut, or they don't. Few people who get Vonnegut don't have a period of their life where they start voraciously consuming his novels as fast as they can read for at least a few months. You change during those months. I think I was 16. People talk about great writers, but Vonnegut was an important writer. He was important because he's often the first writer that existential dysthymic teenagers run across who is so interested in something that, however nebulously, you have to call truth.

Vonnegut, like the other main artistic force in my personal development, R.E.M., wasn't doing anything nowadays to add to his legacy. A Man Without A Country was a guilty pleasure, and quintessential Vonnegut, but it wasn't a book, and it was clear to all of us that he wasn't going to write another book. Timequake wasn't even supposed to happen, and plenty of people wish it hadn't. But Kurt Vonnegut had a series of seven novels, each of which incrementally dealt further with his time in Dresden, leading to his eventual release from its grasp on his artistic psyche in Breakfast of Champions.

He was old, and the fact that he didn't die of lung cancer might be a small miracle unto itself. But these days come. And these days are devastating.

On the top of one of my bookshelves, every Vonnegut book published (except for a few of the random nonfiction ones that have popped up over the past ten years or so, mostly collections of previous stuff), is lined up in a nice dusty row. Several of them have more than one copy, due to the merging of my and Courtney's book collection. I imagine the two or three that have managed to avoid being read for all these years will find that streak coming to an end very soon.

Funny, I just mentioned to Courtney that we watched Slaughterhouse Five on DVD the night of our first kiss.

Poo-tee-weet.

A well-intentioned white southerner's education on racism

2007-04-10T22:02:00.000-04:00

Please understand that I'm not being sarcastic here, because if I were reading this post, I think I would think it was sarcastic in parts.

I grew up in northeastern Kentucky around a bunch of white people and a handful of Asian doctors' kids. I think there were some black kids in some of the neighboring school systems, but I don't think any stayed at Russell for more than a few years. I didn't really know any of them. So sure, I was ignorant about race in the classical sense. I wasn't exposed to race issues personally in any meaningful way, and the little I knew about race issues came from books and TV and bad jokes.

So stuff I've learned this year:
-The world 'articulate' has some sort of weird history (predating Barry-O) as a derogatory term for well-spoken folks who are African American. Didn't know that.
-Tar-baby from Song of the South, which I knew in its situational context, has a racial context as well. Didn't know that. I remember singing Zip-A-Dee-Do-Da a lot when I was kid, because it was a catchy tune. I knew Brer Rabbit was a rabbit, Brer Bear a bear, Brer Fox a fox, and Uncle Remus, well, somebody's uncle, and a farmer. Black sharecropper didn't really mean anything different than the farmer in the dell. And Song of the South really wasn't something on the forefront of my brain to really reconsider.
-Nappy refers to, according to wiki, the texture of African hair which has not been altered chemically. I knew that nappy hair was similar to hair that was in dreads, and I guess I knew
that dreads had African roots. But I don't think I necessarily understood that there was a necessarily negative connection there. And when I first read the whole Imus thing, I don't think I really understood that his "nappy-headed ho" comment was really any more inflammatory than the entirely disgusting and uncalled-for stuff he says every day.

My wife asked me why I was even writing this post, what I possibly hoped to accomplish by a) painting myself as a dumb hick, b) risking giving the impression that I somehow tolerated things that other folks found hurtful, c) rambling.

A) My thesis is not that white southerners are dumb hicks, but that some aspects of the white southern experience differ meaningfully than that of folks who grew up in relatively progressive urban environments, and can easily include minimal exposure to race issues in a meaningful way. I think it's non-obvious to folks who have only lived in progressive areas that reasonably intelligent and even well-intentioned people can be ignorant about the finer points of race issues due simply to lack of exposure.
B) Each of the three controversial points above could elude a well-intentioned person with minimal exposure to race issues. My initial reaction to all three was generally dismissive until I saw that reasonably mainstream folks with more direct experience with race issues could find the usages undesirable. I'm not convinced that "articulate" and "tar-baby" are inherently racist words, but I am convinced that it's probably not worth using them in these contexts, because there are intelligent folk who could reasonably feel marginalized by their usage.
C) Well, yeah.

Link Roundup, Baseball and Robots edition

2007-04-10T13:07:00.000-04:00

Baseball's "hitting slump" probably isn't due to de-juiced balls or steroid deterrents, but about the ever-widening strike zone. Which makes sense, since the vast majority of baseball hits are not homeruns. And anybody that's watched Barry Bonds work the count has to wonder if anything that doesn't hit Barry's bat would ever be called a strike.

And more on the neuropsychology of hitting a baseball. Nerdy, but essential for the baseball-watching neuro-fan.

Check out the Top 10 80's Robots (We Expected to Exist By Now). Embarrass-your-self-at-work funny for the people who found link 2 interesting.

Darshak Sanghavi takes Jerome Groopman to task in Slate's book club for his focus on the efforts of individuals in improving health care, which has become an inherently systems-based practice. Groopman's been on a handful of NPR segments to blast doctors for being arrogant and tunnelvisioned, but I've struggled to really put my finger on what about Groopman's arguments really bugged me. Sanghavi proves why he gets to write on Slate, and I get to write on Sparkgrass.

And, from the somebody-had-to-do-the-study department, having a gun at home increases the risk for a death by suicide.

For the med student sequel of Harold and Kumar go to White Castle

2007-04-07T10:04:00.000-04:00

Check out Matt (our own Matz) and Kags in Ghana. Matt reads enough Bill Bryson to insure that he's at least familiar with the travelogue genre, with a creative writing degree to boot. Not to say that he's necessarily aiming for his masterpiece under such circumstances, but chances are these guys will make fools of themselves plenty of times.

Matt and Kags will begin residencies in emergency medicine in July, at Brown and UofMichigan, respectively.

Throwing grapes at the Detroit school board

2007-04-06T14:37:00.000-04:00

I don't usually watch local news, but we didn't turn from channel 7 after Lost on Wednesday. The first story was some crazy women chucking grapes from the audience at a school board meeting because Detroit schools are hemorrhaging cash, and some unfortunate closings were necessary.DPS police officers arrested

Agnes Hitchcock, leader of the Call 'Em Out Coalition, a local advocacy group known for harsh political comments. As she was being arrested, she was asked what she had thrown, and Hitchcock yelled, "Grapes! I hit her right here," and pointed to her forehead. It was unclear whether Hitchcock was released from custody Wednesday night.

Hayes-Giles said she was struck in the chest and plans to press charges.

"It was hard. It startled me because quite frankly, I didn't know what it was," Hayes-Giles said of the incident. "It was unacceptable behavior. You can disagree with the vote someone takes, but that gives her no right to assault anyone."

Some things don't even need commentary.

Was the Dharma Initiative a UofM psychology project?

2007-04-06T14:29:00.000-04:00

I knew there was something fishy about this place.

Exiting the panic room

2007-04-06T10:58:00.000-04:00

I've tried to avoid turning Sparkgrass into a basketball blog, as others do that much better, but I'll just state my extreme satisfaction with Billy Gillispie as a super choice to lead the Wildcats helm. He wanted the job as soon as his name was mentioned, and he wins fast. Of course, the latter worries me that a bunch of NCAA violations will pop up, since it's a little unreal that he could turn UTEP and Texas A&M each into strong programs in the twinkle of an eye. But if this guy's for real (and he probably is), we're all in for some fun times. And maybe, just maybe, a Kentucky-Florida rivalry will be restored with the stakes even so much higher.

The Kentucky job is still one of the top 5 in college basketball. But the top 5 jobs in college basketball are no longer so much better than the top 20 jobs in college basketball to expect someone to leave one of those posts. Roy Williams left Kansas for Carolina because he was a Carolina kid at heart, the same reason that Bob Huggins made yet a bigger ass of himself and left KSU for West Virginia. Huggins is a Mountaineer and a douche nozzle at heart, and so he left all of his promises to his #2 recruiting class in the nation to go home. Heck, Ben Howland left a sweet job at Pitt for UCLA not just because the UCLA is a top 5 job, and the Pitt job is a top 25 job, but because he was a UCLA kid at heart.

Billy Donovan wasn't a Wildcat at heart. He was an assistant coach under a former coach, and an assistant coach at the same time as another assistant coach who just got pushed out of his head coach position by the psychotic wing of the Kentucky fanbase. He had a nice link, but growing up in the same conference, he'd had plenty of time for the mystique to weather. Billy Donovan can do no wrong in Florida. He'll pull a Denny Crum or a Bobby Knight. He'll win for a few more years (10-15?), and then spend his twilight years directing a mediocre program. No one will care, because he put Florida on the map. That's special, and good for Billy Donovan. Kentucky should be proud that we had something to do with developing the hottest coach in the nation, even if we can't claim him as our own.

Francis Collins, class act

2007-04-04T17:34:00.000-04:00

Apparently, my first year of medical school was the first year in which Francis Collins didn't teach M1s medical genetics at the University of Michigan, so I never got to meet the guy. He was too firmly entrenched as director of the genome project by then, and while I'm sure lecturing me on genetics would be his second greatest achievement, honing his ninja genetics skillz at NIH makes sense too.

Collins is also famous as an evangelical Christian who makes a lot of sense when he talks. There aren't a lot of those on the national stage, and not a lot of them in the scientific community with voices loud enough to be heard.

So, some have asked, doesn't your brain explode? Can you both pursue an understanding of how life works using the tools of genetics and molecular biology, and worship a creator God? Aren't evolution and faith in God incompatible? Can a scientist believe in miracles like the resurrection?

Actually, I find no conflict here, and neither apparently do the 40 percent of working scientists who claim to be believers. Yes, evolution by descent from a common ancestor is clearly true. If there was any lingering doubt about the evidence from the fossil record, the study of DNA provides the strongest possible proof of our relatedness to all other living things.

This is a guy who is obviously interested in cutting out the bullshit. I'd like to think that it's the bullshit, and not religion itself, that scares away intellectuals and scientists.

As an almost formal rule, I don't really talk about my personal religious beliefs with anyone nowadays. I hadn't really thought about that fact, but the last time I can remember even trying to have a discussion of what I believed was during my first year of medical school.

UofMichigan Sit-In for sweatshop labor

2007-04-03T15:31:00.000-04:00

Back in my freshman year of college at the University of Kentucky, friends of mine holed themselves up in the administration building to protest the use of sweatshop labor by university vendors.

Now, there are kids at UofM doing the same thing.

I'm no economist (even if I sometimes play one in my fantasy life), and I'm ambivalent at best nowadays about globalization (which is a dramatic shift from my extreme anti-globalization views held as recently as just the past few years). The globalization debate is a fertile one, and one in which both sides can make extremely compelling arguments that their policy preferences best serve the interests of the citizens of the world, rich and poor, at least in a long haul. So, I guess I'm not de facto supporting the fact that these motivated kids are anti-globalization, but I will support their willingness to stick out their necks because they think the world can be a better and more equal place. Their message is that, in the globalization debate, we do have to consider the holistic impact of economic policy on both human dignity and the environment. Compelling arguments, albeit slightly counterintuitive ones, assure that both human dignity and the environment will eventually benefit from globalization, even if some short term lapses appear to occur. Those arguments might also be effective only in a theoretical universe, and may fall apart when weasel corporations are involved. Lots of mights and maybes, and I'm just not able to commit to any of them.

But, props to the kids at the UofM Sit-In. They're not doing anything wrong, and they just might be doing something right.

UPDATE: Surprise! They got arrested, as seems to happen at these things. At least they didn't get manhandled, or at least it wasn't reported as such.

Link Roundup, Drug-Withdrawal edition

2007-03-30T13:59:00.000-04:00

Pergolide, dopamine agonist used as an adjunct to L-Dopa and Carbidopa, is withdrawn voluntarily when evidence showing that the drug increases the risk of damage to heart valves puts the drug on tremulous ground. *Rimshot*

In crappier news, IBS pro-motile drug Zelnorm apparently increases the risk of pretty much everything. FDA asks Novartis nicely to please quit selling people heart attacks and strokes.

Some NIH folks figured out that when monkeys concentrate voluntarily, their prefrontal cortex is in charge, while distractions activate the parietal cortex. ADHD neuroscientists start writing new grants furiously, buying extra bananas.

Nature addresses the growth of dichloroacetate sales (for veterinary uses *wink nudge*) on the internet for cancer patients, and how such activity, besides being illegal, throws a huge monkey wrench into the process of actually testing DCA in real clinical trials.

While the FDA hasn't found anything particularly wrong with Pfizer's inhaled insulin formulation Exubera, doctors and insurance companies just aren't impressed.

Kids with ADHD more likely to abuse alcohol

2007-03-28T14:29:00.000-04:00

Strangely enough, from the same research group at WPIC that produced a big chunk of the research I used for term projects in Adolescent Health and Mental Health Policy classes last semester:

The 15- to 17-year-old children in the study with childhood ADHD reported being drunk 14 times, on average, in the previous year, versus only 1.8 times for age-matched teens who did not have childhood ADHD.

Fourteen percent of 15- to 17-year-olds with ADHD were diagnosed with alcohol abuse or dependence compared with none of the similarly aged subjects without ADHD.

My question would then be, how does effective ADHD treatment relate to allaying, if at all, the risk for substance abuse in ADHD teens? I might mail email the study author to see if her group has addressed/wondered about that as well.

And I thought my high school biology teacher was an idiot (not clairvoyant)

2007-03-27T00:20:00.000-04:00

I REALLY wish I had made this story up, rather than being forced to document the sad truth about secondary science education in the Bluegrass State.

Imagine fifteen year old Garrett:

[Biology classroom, fifth period right after lunch. Garrett resumes his daily routine of walking into biology class and promptly falling asleep on his back pack. For some reason, Garrett can't sleep today, and feels a little guilty for being so flippant about a science class. He tries to feign some interest in Ms C's biology lecture]

Ms C: So, you get twins when two sperm fertilize the same egg...

Garrett: [mystified that the state of Kentucky would pay someone to say something like that in a biology class, sits up] Wait, did you just say that twins are caused by two sperm fertilizing the same egg?

Ms C: Yeah, that's how we get twins.

Garrett: [looks around room to other people he knows with IQs over 12, fails to find anyone else even remotely paying attention] But...

[Ms C continues with lecture on nothing, Garrett is able to return to his post-lunch nap with a clear conscience]

But now, Ms C's delusions are newly-minted medical science. Semi-identical twins, produced by the fertilization of one egg with two sperm, have now been documented.

[Cue Fade Music: "It's the End of the World as We Know It (And I Feel Fine)"]

Now if that whole Creationism thing would just pan out, Ms C might win the Nobel Prize.

Drugs Equal Benefits of Artery Stents

2007-03-27T00:12:00.000-04:00

Was it for this my life I sought?
Maybe so and maybe not
-Phish, Stash

I don't really have anything to add to the New York Times article, which explores the study in remarkable detail impressive even for the NYT. Except that this, like any study, isn't the final say in the debate. It's just a really loud and integral portion of the debate.

But this has to be required reading for anyone in medicine or health policy and economics. Or anyone screwed with a load of Boston Scientific stock.

Sunday Link Roundup

2007-03-25T00:39:00.000-04:00

1) Jay Farrar and Son Volt's new album The Search on All Things Considered.

2) Because of some loophole in a new Medicaid rebate law, pharm companies now have no incentive to offer OCPs cheap to universities. Because pregnant college girls are good health policy. Obviously.

3) But maybe that's okay in Texas. State Rep Dan Patrick (R-ealAsshole) wants to offer pregnant women considering abortion 500 bucks not to get abortions. Hey, Texas girls, have twins, and you might be able to pay for your books next semester!

4) Patients really don't give a flip if you wear scrubs, a white coat, or monkey boxer shorts. They do care if you are a douche nozzle. (For a history of the "douche nozzle," Ctl-F the term here.)

5) Docs around the world are calling for a boycott of Reed Elsevier (they publish the Lancet, among other obscure journals to which your EBM searches inevitably lead you), since apparently they have something to do with arms fairs to showcase cluster bombs, or something sketchy like that.

6) Disaster averted: Emma Watson will play Hermione through Film 7. Reports last week said she wanted to bail.

7) Creepy much?

In what is becoming a trend among conservative Christians in the United States, girls as young as nine are pledging to their fathers to remain virgins until they wed, in elaborate ceremonies dubbed "Purity Balls."

"Since I'm just the return on Daddy's investment into Mommy's sperm bank, he owns my hymen until he tells some boy its okay for him to have it." Eww.

Morris heading to the Knicks

2007-03-24T20:45:00.000-04:00

I'm slow on the draw, and every Cat fan knows that RaMo had 1.6 million reasons to leave. Plenty of griping going on, but I just wanted to put my two cents in to the world: good for you, Randolph.

Thanks for all the fish.

Abolishing the Middlemen Won’t Make Health Care a Free Lunch

2007-03-22T18:53:00.000-04:00

Tyler Cowen takes a pot shot at the argument that Medicare's low overhead would still be a good thing in a Medicare-for-all scheme.

Not saying I buy it, or that I've had time to think about it, but Cowen's always at least smart and avoids partisan hackery.

Step 2 awaits Saturday, and I can't really think until after that. Not between Step 2, and Tubby going to Minnesota.

WTF???

2007-03-22T14:44:00.000-04:00

Tubby Smith leaving Kentucky for Minnesota.

Didn't actually see that coming, because I didn't imagine Mitch Barnhardt was that inept as an AD. Does that leave us anywhere with Patterson or Lucas?