Thursday, June 28, 2007

Online Dating
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.

Tuesday, June 26, 2007

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.

How to Win a Fight With a Conservative is the ultimate survival guide for political arguments

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.

How to Win a Fight With a Liberal is the ultimate survival guide for political arguments

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

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.

Thursday, June 21, 2007

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

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.

Sunday, June 17, 2007

Cosmic blogging coincidences

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:

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

Tuesday, June 12, 2007

Ritalin use doubles after divorce

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.

Tuesday, June 5, 2007

Resquiescat in Pace

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.

Monday, June 4, 2007

Ezra on the politics of Knocked Up

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!