NPR on James Holsinger

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

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

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

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?

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

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

Why does rape or incest matter?

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)

1. Spend all day trying to clean your registry, update antivirus software, get rid of spyware, defrag, etc.
2. Turn it off for a few hours.
3. Turn it back on and cry when it only runs at a reasonable speed for the first five minutes.
4. Stay up until 2 in the morning googling why the fan keeps making that really strange noise.
5. 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.
6. Turn it off and take the whole thing apart.
7. Put it back together, counting your blessings that the number of screws equals the number of holes that seem to require screws.
   
8. Blow on it like it's a NES game in 1987.
9. 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

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

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

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.

1. 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.
2. Fresh Air turns 20: listen to Oliver Sacks and Tom Wolfe.
3. 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.
4. 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.
   
5. 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?"
   
6. 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.
7. 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

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

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

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.

1. 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.
2. 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.
3. 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.
   
4. 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.
5. 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.
6. 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.
   
7. 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

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?

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.