Monday, January 31, 2005

No wonder I couldn't finish that followup to my post on denial by today!

Take the quiz: "Your Psych-Ward diagnosis"

Attention Deficit Hyperactive Disorder
Diagnosis: (ADHD), formerly called hyperkinesis or minimal brain dysfunction, a chronic, neurologically based syndrome characterized by any or all of three types of behavior: hyperactivity, distractibility, and impulsivity.

It kind of makes sense. Some might speculate that it's probably why I'm wasting ten minutes right now taking the above test and posting this to my blog, rather than finishing that paperwork I need to do today. On the other hand, surgeons generally have to be very good at concentrating on the task at hand; so maybe it's not such a good test after all...

What I was listening to while working on a grant this weekend

I've been holed up critiquing and commenting on my colleague's grant a good chunk of weekend, which is why I haven't finished the longer, medicine-related post I had planned for today. The grant has to go out today; so I'll try to finish the post by Tuesday or Wednesday and maybe even still come up with something for St. Nate for The Skeptics's Corner. (Remember everyone, the deadline is 11:59 PM Wednesday night.) In the meantime, I haven't played music critic in well over a month. I love to have tunes playing when I'm working on grants, so here's the new stuff I was listening to that fueled my work:
  1. Worlds Apart (...And You Will Know Us by the Trail of Dead). My very first CD purchase of 2005. Very odd band name. Very good indie rock, though, with a bit of vaguely Smashing Pumpkins bombast and anthemic orchestration. (I'm a sucker for bombastic rock.) I'm definitely going to start checking out their back catalogue, silly band name or no silly band name.
  2. Bows + Arrows (The Walkmen). Their songs are equally noisy, dreamy, romantic, and angry. Why didn't I discover these guys before?
  3. Desperate Youth, Bloodthirsty Babes (TV on the Radio). Just the title alone of the album should tell you it's probably going to be great. And it is. Haunting, deeper, and darker than their debut EP, their first full-length CD showcases more of their drone-rock, veering from post-punk to harder-edged music and back.
  4. Funeral (The Arcade Fire). My pick for the best CD of 2004. It's still in my CD player. It's going to stay there a long time.
Finally, I recently found out that one of my favorite bands, Doves, is going to release a new CD in March. I can't wait. Their last one, The Last Broadcast, was phenomenal.

OK, no more music critic wannabe for at least a month. I promise.

Post-weekend carnival roundup

Well, it's finally here, the one Carnival I expressed my reservations about. Yesterday, Brent Rasmussen finally released the first edition of The Carnival of the Godless. As you may (or may not) recall, my specific reservations were that it would serve mainly as a forum for religion-bashing posts by militant atheists and thus be of little interest to us non-atheists (even those of us who are not particularly devout or even bordering on agnosticism). Although I haven't read everything there yet, so far it looks as though my fears were unfounded. There's some good pieces on the role of religion in public life and science and in how atheists deal with a theistic world. The religion-bashing I had feared is minimal or nonexistent. Brent even posted my reservations about the whole idea first. It almost makes me think it might be worth sending a piece to PZ Myers, who's hosting the next session. Unfortunately, at this time I don't know which post I've already made would be appropriate or whether I'll be able to write one in time for the deadline. We'll see.

Finally, there's another new carnival, The Carnival of Bad History. (Thanks to PZ for the tip.) The criteria suggested by the creators of this Carnival:
  • Bad presentations of history -This is the easy one. Review bad historical movies, books and teevee. How anachronistic are those uniforms? How improbable is that alternate history novel? Did kindly frontier doctors really talk like that?
  • Bad uses of history - When pundits, politicians, and talking heads get hold of history they often twist it beyond all recognition or justification. Tell us about the mangled metaphors, unjustified parallels, or outright lies you find in the public sphere.
  • Historians behaving badly - Historians manage their share of embarrassing talking head appearances, plagiarism scandals, and corporate sell-outs. We don't want mere unpleasant gossip. Contributions in this category should be of historians behaving badly in their professional capacity as historians.
I wonder if my recent post about my first encounter with online Holocaust deniers would qualify (there's only one way to find out). Holocaust denial certainly is bad history. I also have some interesting ideas for a piece about notorious Holocaust denier David Irving (a piece I've been meaning to write almost since I first started this blog) for the topic of "Historians Behaving Badly," but I worry that they might disqualify it based on the simple fact that David Irving has been utterly discredited as an historian.

Interesting new blog

I just found a blog over the weekend, Tales of an MD/PhD Student, that has potential to be rather interesting. (Also, it's by a fellow M.D./Ph.D., although still in the first year of medical school.) Check it out.

Sunday, January 30, 2005

The five laws of stupidity

I bet you didn't know that there are laws governing stupidity. Neither did I until an acquaintance e-mailed me this. Around 20 years ago, the late Carlo M. Cipolla, Emeritus Professor of Economics at UC Berkeley, proposed these laws:
  1. Always and inevitably everyone underestimates the number of stupid individuals in circulation.
  2. The probability that a certain person will be stupid is independent of any other characteristic of that person.
  3. A stupid person is a person who causes losses to another person or to a group of persons while himself deriving no gain and even possibly incurring losses.
  4. Non-stupid people always underestimate the damaging power of stupid individuals. In particular non-stupid people constantly forget that at all times and places and under any circumstances to deal and/or associate with stupid people always turns out to be a costly mistake.
  5. A stupid person is the most dangerous type of person.
For a detailed explanation and justification, look here. I find it very hard to argue with his logic.

Our Vice President at Auschwitz

Dick Cheney at Auschwitz

I first saw these pictures of our Vice-President on Friday morning, the day after the commemorations of the 60th anniversary of the liberation of Auschwitz. Since then, I've been debating whether to comment on them, given the large number of bloggers who have already weighed in on the issue. However, given my interest in the Holocaust and Holocaust denial, I thought I had to weigh in.

Cheney certainly deserves a lot of the criticism directed his way for not dressing for the occasion. Particularly offensive was his hat, which was emblazoned with the words "Staff 2001." ("Staff"? At a memorial held at Auschwitz? Didn't someone realize the implication?) Nonetheless, I think many of the bloggers who criticized Cheney for his shabby dress, while correct about his showing a lack of respect for the occasion, missed the more important point. At least Cheney was there. He may have been dressed as though he were planning on going ice-fishing right after the ceremony (for which he does indeed deserve criticism for poor symbolism and giving the appearance of lack of respect for the occasion), but at least he was there. His comments were also measured and entirely appropriate to the occasion, even if his clothing was not.

No, what truly demonstrates a lack of respect for the occasion by our leaders is the fact that President Bush did not see fit to bother to attend the ceremonies himself. Other world leaders, such as Russian President Vladimir Putin and French President Jacques Chirac, somehow found the time to attend the ceremonies in person. They did not delegate appearing at such an important event to their underlings, as our President did. President Bush should have been there.


Saturday, January 29, 2005

My estimated longevity...

There will probably only be light blogging this weekend. I wrote a couple of big posts last week (one of which was a very long and serious meditation about the 60th anniversary of the liberation of Auschwitz). Also, after my own success getting funded, I'm helping a colleague get his grant application finished for February 1. However, there have been bits and pieces of things I've been meaning to post for a few days, and this is the perfect opportunity. It's also the weekend, and time for lighter fare. (Don't worry, the serious stuff will start up again no later than Monday.)

Apparently, I'm going to live a long while more, annoying the hell out of everyone--that is, if you put any stock in this test:

I am going to die at 78. When are you? Click here to find out!

I suppose that this is as good a guess as any other. In any case, if it's true, it gives me nearly 40 more years of irritating everyone with my blog...

This can't be right








OK, here's one more while I'm in the test-taking mood. I still don't believe the results of this one, though. Maybe my sister was right about me being too much of a straight arrow:




I am 15% evil.
Take the test :: koolplace.com


Friday, January 28, 2005

Some sanity in Florida: FSU Chiropractic school voted down

In a strong demonstration of support for evidence-based medicine and against unproven therapies, the Florida State University Board of Governors has voted against a proposed chiropractic college that the legislature had been trying to ram down their throats.

It is heartening to see the Board of Governors show some backbone after the Board of Trustees essentially punted on the question. I had expected them to roll over and let the legislature force this school on them.

(Via Rhosgobel and Confessions of a Quackbuster.)

What a surprise




Your Career Type: Investigative



You are precise, scientific, and intellectual.

Your talents lie in understanding and solving math and science problems.



You would make an excellent:



Architect - Biologist - Chemist

Dentist - Electrical Technician - Mathematician

Medical Technician - Meteorologist - Pharmacist

Physician - Surveyor - Veterinarian



The worst career options for your are enterprising careers, like lawyer or real estate agent.



You got that right. I contemplated a job selling one summer when I was in high school, but the very thought of it drove me away. I can spend incredible amounts of time and put in incredible amounts of work doing research and writing grants and papers. I can handle high-pressure situations in the trauma bay, undergoing my thesis defense, or giving a scientific talk to hundreds of people. However, the thought of trying to persuade someone face-to-face to part with their hard-earned cash for a product makes my blood pressure go up at least 20 points.

Of course, writing grants is, in essence, asking people to give you lots of money on the basis of your prior work and what you plan to do. You have to be able to write very persuasively to convince reviewers that your project is worthy. Although there is what is known as "grantsmanship" (techniques--some almost ritualized--to frame your data and proposal to make it more appealing), there isn't nearly as much B.S. and schmoozing as doing sales requires. Unfortunately, I'm not so good at schmoozing. If I were, I might be on a fast track to Division Chief or Department Chair...

The Skeptics' Circle

After pouring my heart out yesterday in a long post about the 60th anniversary of the liberation of Auschwitz (the response to which, by the way, has been quite gratifying), I find it somewhat difficult to get back to the usual topics of this blog. In fact, I had considered not posting anything for a couple of days, (my usual topics seem rather mundane in comparison at the moment), but, given that I had already put today's topic off a day and it is one I'm quite enthusiastic about publicizing as well as my humble blog will permit me to, I didn't want to do that. So, here goes.

St. Nate has finally gone and done it. He's announced the first edition of the Skeptics' Circle. Quoth he (slightly edited by me for length):
And now my personal news: A week after announcing the idea, I have gotten my act together and am ready to start my own round-up.
The Skeptics' Circle will hold its first gathering here on Thursday, February 3, regardless of whether or not Punxsutawney Phil sees his shadow the day before. My vision is to create a carnival for bloggers who'd rather think critically than criticize thinkers. More specifically, some of the things I'm looking for are posts about:

*Urban legends and hoaxes
*Pseudoscience
*Pseudohistory
*Hysteria.
*Quackery

So if you have a story you'd like to contribute to the premiere edition of the Skeptics' Circle, send it to me at saint_nate at hotmail dot com by 11:59 p.m. EST on February 2. Also, please let me know if you're interested in hosting a future Circle so I can set up a schedule.
I enthusiastically supported the idea when St. Nate first proposed it. It's a niche in the blogosphere that could definitely use some filling. I'd also encourage posts about the paranormal, in which it is shown that paranormal phenomena can be explained without resorting to, well, the paranormal. (I haven't decided yet if I'm going to submit one of my previous posts, or whether I'll compose something new before the deadline.)

So, folks, start filling! In fact, I'm hoping St. Nate will sign me up to host the second Skeptics' Circle. I'd also like to ask everyone to help publicize this.

Thursday, January 27, 2005

Political (mis)uses of the Holocaust

Unfortunately, Holocaust deniers are not the only ones who abuse the memory of the murdered for their own political ends. They're not even the most famous ones. Radical animal rights activists have appropriated the term "Holocaust" to push their agenda. Such misguided comparisons to the Holocaust include PETA's "Holocaust on a Plate" campaign, as well as the claims of one Karen Davis, Ph.D., who has written a long and meandering articles equating the deaths of animals with the Holocaust entitled "A Tale of Two Holocausts." Brian O'Connor has taken on the unenviable task of refuting her "logic," such as it is, in great detail.

It is hard to argue that too much of what we do to animals is cruel and that animals should be treated as humanely as possible. However, it is a huge leap to draw a moral equivalence between the use of animals for food and medical research and the enslavement and slaughter of many millions of our fellow human beings.

A survivor's story

Continuing the theme of Holocaust Remembrance Day, here are some reflections on Auschwitz from a survivor contemplating the disappearance of those who can remember firsthand.

Musings on the 60th Anniversary of the Liberation of Auschwitz: How I discovered Holocaust denial

I stared at words on the computer screen, dumbfounded:
They do not want to do it because it would show that at Auschwitz Nazis were conducting ETHICAL medicine and they want to keep the myths of the Holocaust alive!
What the--?? I blinked. Did I read this right? I read it again, gently flickering on the computer screen.
They do not want to do it because it would show that at Auschwitz Nazis were conducting ETHICAL medicine and they want to keep the myths of the Holocaust alive!
No doubt about it, I had read it correctly. It was no mistake, no matter how much I wished it had been. The Usenet poster had just capped off an argument I was having with him by saying that historians and doctors did not want to look into his claims because doing so would show that the doctors at Auschwitz-Birkenau were practicing "ethical" medicine.

"Ethical" medicine? At Auschwitz-Birkenau? Could he possibly be referring to the same Auschwitz where well over 1 million people had been killed either by gassing, starvation, disease, or even twisted "medical" experiments? The same Auschwitz, where untold thousands were subjected to starvation, overwork, and disease, with the intent of getting as much work as possible out of them before they died, while expending as little as possible in the way of food and other resources?

"Ethical medicine"? At Auschwitz, the very place where doctors--my profession, to our eternal shame!--did not merely passively acquiesce to the horrors of the camp. No, physicians were integral cogs in the machinery of death. At Auschwitz, doctors, who had taken an oath to preserve life, greeted each new transport of Jews and other prisoners and oversaw the brutal process of selection. They would take a perfunctory look at each new inmate and immediately decide his fate based on how "healthy"--and thus able to work--he appeared. These doctors directed babies, children, the old, the sick, and infirm to one line leading straight to the gas chambers at Birkenau and the young and healthy to another line leading to the camp. Those who were chosen for the concentration camp (Auschwitz) would be subjected to brutal overwork and starvation until they either succumbed or became too debilitated to work and thus candidates for the gas chambers. No doubt some of them came to envy those who went straight to the gas.

"Ethical medicine"? I had to remind myself that this was the very same place where doctors like Josef Mengele and like-minded doctors (Drs. Weber, Schumann, Wirth, and Kremer) performed cruel and scientifically useless experiments on the hapless prisoners, examples of which included (among many others):
  • Subjecting prisoners to low pressure chambers designed to simulate high altitude until they developed pulmonary edema and died
  • Immersing prisoners in ice-cold water to simulate the conditions that downed Nazi pilots encountered in the North Sea
  • Irradiating women's pelvises in order to sterilize them, leading to horrific complications of radiation enteritis, leading to bowel obstructions and fistulae
  • Killing and dissecting of prisoners for anatomic experiments to determine the effects of starvation and the "biologic basis" of racial differences
  • Injecting various chemicals into prisoner's eyes to change their color (this was one of Dr. Mengele's special interests, along with his studies of twins), leading to infection and sometimes blindness
  • Performed "euthanasia" of ill patients by direct injection of phenol into their hearts (because injecting it into peripheral veins took too long to kill the prisoner)
I knew at that point that further argument was pointless. I had just been slapped in the face by Holocaust denial. The only reason this anonymous Usenet denizen could possibly say such things is because he did not believe that the Nazis intentionally did their best to wipe out European Jewry. So eager was he to deny the crimes of the Nazi regime that he was willing to attribute "ethical" medicine to butchers like Dr. Mengele.

Sixty years ago today, the Red Army entered Auschwitz-Birkenau, liberating it from the Nazis and at the same time revealing for the world to see the dark heart of the Holocaust, the camp that has come to symbolize the Nazis' homicidal hatred and fear of the Jews. Only around 7,000 thousand pathetic souls remained, a mere fraction of the number that used to be imprisoned there, all starving, many diseased, many dying. The Soviets also discovered hundreds of thousands of women's coats and dresses and men's suits, and tons of human hair; that, and piles upon piles of rotting corpses. Over the month of January, seeing the rapid advance of the Soviet Army west through Poland, the SS at Auschwitz-Birkenau had come to realize that the war was lost and the Soviets would soon be at their very gates. They had scrambled to hide the evidence of their crimes and escape to Germany. They had burned files and destroyed the gas chambers. Nine days before, they had begun removing as many prisoners as they could, forcing them to march west, to Germany and to other camps. Tens of thousands of prisoners were forced to march on foot in brutal winter weather, without adequate clothing, food, or shelter. Those who were too weak to march or who committed any infraction during the forced march were shot and left at the side of the road. Those not taken on the march were left to die. Seven days earlier, guards shot 4,200 of the remaining camp survivors.

As I thought about what to write today, it occurred to me that, although I have written about my interest in the Holocaust and Holocaust denial right from the blog's beginning (and again more recently), I had not yet written about how that interest began. Today, the 60th anniversary of the liberation of the epicenter of the Holocaust, Auschwitz-Birkenau, is the perfect day to do so. You may think the example I described above is extreme, and so it is. However, sadly, the beliefs of many Holocaust deniers are not all that far removed from a belief in the "ethical medicine" of Auschwitz. I first learned that nearly eight years ago.

The year was 1997. I had recently rediscovered the joys of the mass of online squabbling that is known as Usenet after an absence of four years, during which time the rigors of residency had kept me from any online activity more involved than perfunctory responses to e-mail. While perusing the political newsgroups, I had come across a rather bizarre post referring to the "Holohoax," which had been crossposted to several other newsgroups, including alt.revisionism. I didn't know it at the time, but alt.revisionism is the newsgroup dedicated to the discussion of Holocaust "revisionism" (which, in actuality, is almost always Holocaust denial). I lurked there for several weeks, hardly believing what I was reading. Over that time, I learned some of the techniques deniers used to downplay the Holocaust, deflect blame from its perpetrators, or portray "exaggeration" of the Holocaust as a Jewish plot. I also learned that, without exception (at least, without any exception I've yet seen), Holocaust denial derived from anti-Semitism and/or an admiration for the fascist regime of Adolf Hitler.

My move from lurking to more active involvement in debunking Holocaust denial started, oddly enough, with an admittedly arrogant eagerness to flaunt my medical knowledge. I did not know it at the time, but this precipitous leap into a discussion thread full of Holocaust denial was the beginning of my odyssey. A man who posted under the name Joe Pawlikowski, claiming to represent a group called the Polish Historical Society, had been making the claim that all the dead at Auschwitz were due not to intentional killing, to the gas chambers, but rather to starvation and diarrhea. I had recently learned that this was a standard canard of Holocaust deniers. Not wanting to admit that the Nazis had indeed intentionally sent millions to the gas chambers, Holocaust deniers will concede that there were thousands upon thousands dead in the camps, but will then claim the deaths were due to starvation and disease, not to intentional killing or gassing. They would then claim that the starvation was due to disruption of the supply lines by Allied bombing (never mind that the guards and the people in the nearby towns showed no evidence of deprivation when the Soviets arrived and that it was the explicit policy in the camps to underfeed the inmates and get as much work as possible out of them before they died of starvation). The specific bizarre claims that Pawlikowski was making, to my mind, demanded medical debunking, and, in my hubris, I thought that I could provide knowledge that none of the other debunkers of Holocaust denial could.

What were those claims? Besides the standard claims I mentioned above, which were actually better debunked by those more knowledgeable in Holocaust history than I, Pawlikowski claimed (spelling errors left intact to give you the full flavor of his ranting):
If an occasional prisoner developed oncotic edema (because SS administration was selling meat on the black market), while overfed them with patatos, they would immediately pull off the prisoner from the work detail and send him/her to Lazaret where he/she would be FORCED to drink one gallon of milk (4L) over the next two days and on the third day such survivors reported that they were ready for work with no trace of edema.
A brief explanation is in order here. Protein malnutrition (kwashiorkor) results from inadequate protein intake in the presence of relatively good overall calorie intake. These are the people who have the large protruberant bellies due to the edema caused by lack of protein. This is in contrast to the other major form of malnutrition, marasmus, in which there is both protein and total calorie malnutrition. These patients appear cachexic, and do not have prominent edema. In fact, they usually appear to be wasting away. I pointed out first that the vast majority of the starving at Auschwitz and other camps did not suffer from kwashiokor, but rather marasmus (a diagnosis that one can make just by looking at photos of camp survivors). I then pointed out that, even if it were a case of kwashiorkor, it takes a very prolonged period of time to develop malnutrition that severe. It cannot be reversed by two or three days of refeeding. I pointed out that 4 L of milk would not even come close to correcting such a nutritional deficit. In fact, feeding milk to patients with kwashiorkor can be counterproductive, because they often develop lactose intolerance.

None of these arguments affected Pawlikowski in the least. The argument went back and forth over several days. I calmly stated the medical facts that made his claims ridiculous. He then shifted gears, and the discussion moved towards typhus and his claims that typhus (which he seemed to be confusing with typhoid), not gas chambers, had caused most of the deaths. In Pawlikowski's world, there were no gas chambers at Auschwitz-Birkenau, and the crematoria there existed only for hygienic purposes, to dispose of corpses and prevent the spread of epidemic disease. His responses got longer and longer. And, then, buried in one of his rants:
They do not want to do it because it would show that at Auschwitz Nazis were conducting ETHICAL medicine and they want to keep the myths of the Holocaust alive!
At that point, I hit the wall. I remember going off on him. I remember going on and on about the crimes committed by doctors at Auschwitz. He started harping on my name, asking me insistently if I were Jewish. Eventually I gave up. There was no point. A few weeks later, he reappeared. He even e-mailed me. I made the mistake of replying. He posted my e-mail to Usenet, teaching me an important lesson: Never reply to a Holocaust denier with anything I do not wish to be publicized. I even gave him the opportunity to renounce his previous claim that the Nazis practiced "ethical" medicine. His response:
I confirm that Nazis practiced ethical medicine at Auschwitz. I repeat that stories about Mengele are fantasmagoric.
But enough of Pawlikowski. Even now, thinking about him disgusts me.

Over the next seven years, I made hundreds, perhaps thousands, of posts to alt.revisionism. I learned a great deal about the Holocaust. I learned about how Holocaust deniers misrepresent legitimate debates among historians over the origins and evolution of the Holocaust as "proof" that there was never a plan to exterminate European Jewry. They would claim that there was never a written order from Hitler to exterminate the Jews, neglecting the fact that Hitler was well known to avoid giving written orders, preferring to make his wishes known to his henchmen and let them compete with each other to carry his wishes out and win his favor. I learned the difference between genuine historical revisionism (a legitimate pursuit of historians, who reexamine history in light of new evidence or reinterpretation of old evidence to come to new conclusions about it) and Holocaust denial, which is not, although Holocaust deniers like to call themselves "revisionists" in order to falsely claim the mantle of academic rigor. Although I did not believe it at first, over time I also reluctantly came to the conclusion that every Holocaust denier is an anti-Semite at heart and that the real purpose of Holocaust revisionism is to "make National Socialism an acceptable political alternative again."

Eventually, my crude efforts drew the attention of a like-minded group of people who were doing the same, most of whom are much more knowledgeable than I. I found out about how much some of them had sacrificed for their efforts. Harry Mazal, for instance, makes great sacrifices in time and money to maintain the Holocaust History Project, even in the face of distributed denial of service attacks, and Ken McVay runs the other premier Holocaust education site, Nizkor. One woman in particular, Sara Salzman, suffered serious harassment over several years as a result of her efforts. Her case was the subject of a Hatewatch report, and has been discussed at international meetings on online hate. In time, I suffered a very mild version of what they suffered, when my name was circulated around Usenet as part a list of others who combat Holocaust denial falsely labeled as pedophiles (a standard smear). Fortunately, nothing has ever come of it (although that list still resurfaces from time to time, even years later, a testament to the longevity of Internet smears.) My paltry efforts and sacrifices pale in comparison to theirs.

As I reflect upon the 60th anniversary of the liberation of Auschwitz-Birkenau and the horrors that occurred there over nearly five years, I now realize that it was this initial experience with Holocaust denial that sparked my overall interest in rationalism and skepticism, leading me to do my small part to combat the pseudohistory that is Holocaust denial. The offensiveness of a group of people seeking to deny or minimize the deaths of 6,000,000 Jews and millions of others in order to make the world conform to their anti-Semitism or to whitewash the ideology that committed those murders was the spark that shocked me from my complacency. Before that encounter, I had little interest in promoting evidence-based thinking outside of my own surgical practice and laboratory. I rarely openly questioned pseudohistorical or pseudoscientific claims, even though privately I may have considered them a load of garbage. I now realize that pseudoscience and pseudohistory can contribute to making such atrocities possible, particularly when they fused to despicable ideological belief systems like Nazi-ism. For example, the "science" of racial hygiene (in actuality a perversion of Darwin's theory) touted by Nazi scientists and doctors, served to justify their exaggeration and misrepresentation of racial differences and the classification of races as "superior" or "inferior." Coupled to racial hygiene and pseudohistory (the myth of the "stab-in-the-back" by Communists and Jews leading to Germany's defeat in World War I, of a "time of greatness" 50 years earlier during Bismarck's reign, and of a pan-Aryan culture that needed to be reunited and protected from the Jews), the romantic evocation of Volk and the belief that a lost time of greatness could be reclaimed if certain enemies were defeated, provided a potent ideological brew that the Nazis used to justify their genocidal policies: the exclusion of Jews from political life (the Nuremberg Laws); the relentless expansionism of the Reich in search of Lebensraum in the East; the gassing of the mentally ill and retarded ("life unworthy of life" or "worthless eaters," as Nazi propaganda characterized them); the forcible expulsion of Jews (often compared by Nazi propaganda to "bacilli" or "cancers" that must be cut out) from territory controlled by the Reich; and their later conclusion that expulsion wasn't enough, that they must be exterminated; and, finally, the construction of camps in which to do it, like Auschwitz.

So, today, as memorials to the murdered are held and speeches made, I urge everyone to take a moment and reflect upon the evil that humans are capable of. But, more importantly, reflect upon what each of us might do to prevent it from happening again, particularly since the march of time will soon lead to the disappearance of those who were there, still remember, and can remind us of what happened. One way that I choose to honor the memory of the dead is by doing what little I can to refute those who would, for their own racist or ideological reasons, deny the crimes of those who killed them. To that end, from time to time, I will post articles here refuting specific distortions and lies of Holocaust deniers and doing my small part to help out the Holocaust History Project. In the grand scheme of things, it is not that much. But it is what I can do.

ADDENDUM (01/31/05): Deborah Lipstadt, Ph.D., Director of the Rabbi Donal A. Tam Institute of Jewish Studies and Dorot Professor of Modern Jewish and Holocaust studies at Emory University, has written an excellent online primer on some of the more common techniques of Holocaust denial. I urge you to read it.

Wednesday, January 26, 2005

The Carnival of the Vanities

The Carnival of the Vanities #123 is now available at The Raving Atheist. I notice a couple of my fellow medical bloggers have contributed. The main theme is religion and atheism (at least those are the posts that are featured first), plus the usual potpourri. Check it out.

Tangled Bank #20

Tangled Bank #20 is now up at JasmineCola. Once again, the best science blogging in the blogosphere over the last couple of weeks is made available in one compact, nicely annotated package for your reading pleasure. Now that I've been plugged into the science blogosphere a few weeks, I've been finding that often I've already read many of the posts aggregated in every Tangled Bank. However, there are always at least one or two excellent posts that I haven't seen, and this edition is no different. (I love it when bloggers who haven't yet contributed send good writing about science in.) Check it out.

I can't wait for my chance to host in April...

More on whole body scans

I've spoken before about the issue of whole body scans and other tests like breast MRI for screening marketed direct to patients (see here and here). Via Kevin, M.D., here's a nice study that shows these studies not only provide a very miniscule benefit in terms of increased life expectancy (6 days, to be precise) but they do so at a very high cost.

I wish I had seen this before my last post on the issue. It would have just been more ammunition.

Weird search that led to my site

OK, I'll admit it.

Like most bloggers (particularly new ones, I'd wager), I can't resist checking out my Sitemeter readings fairly frequently. It's not mainly for the number of hits (which, fortunately, have been steadily rising), although that is of course of great interest to me. No, what most interests me are the links leading to my blog. I've found some great blogs and sites that way. But even more interesting than that to me are the occasional Google searches that lead people to my blog. There are the not unexpected ones, like searches for EneMan (based on my posting of pictures of EneMan just before Christmas), of course. But every so often a truly strange one pops up. Sometimes it'll be a search that just makes me scratch my head and wonder how on earth my blog came up as a result of this search Rarely, it will be a search that disturbs me or angers me. That happened yesterday, when this came up on my Sitemeter listings.

It was a Google search using these terms: Judah Folkman false results 2005 lying. The post by me that came up was this one. (Oddly enough, it no longer appears when I do this search again.) What disturbs me is that my blog, however briefly, came up on a search by someone apparently looking for evidence to support the allegation that Dr. Judah Folkman reported false results or was in some way lying. Happily, my blog gave no support to the apparent intent of the search.

So why did this oddity tick me off? Dr. Folkman is an inspiration to me and other surgeon-scientists. He is one of the rare surgeon-scientists who has been able to excel at both surgery and research over a career spanning more than three decades. He is even rarer still in that he founded an entire area of research, that of tumor angiogenesis and how it might be targeted for therapy, with his discovery of angiostatin in 1994 and endostatin in 1997, and later with his demonstrations that angiogenesis inhibitors could cause tumor dormancy. But it didn't start there. Those discoveries were the culmination of 25 years of research, during much of which his ideas were not taken seriously by large numbers of cancer researchers. But he persevered and ultimately the evidence he produced and the discoveries he made forced his work to be accepted. Yes, there were a few bumps along the way, even in the 1990's. Early on after his description of tumor dormancy, other labs had difficulties replicating his results, but these problems were ultimately demonstrated to be due mainly to methodologic differences and differences in the purity of angiostatin and endostatin preparations. (I'm guessing by this search that a few still harbor these doubts even now, long after Dr. Folkman resolved them to the satisfaction of the vast majority of angiogenesis researchers.) Finally, my area of research is in tumor angiogenesis, and it was Dr. Folkman's work that inspired me to get involved in angigonesis research. That's why I was truly perturbed when I saw this Google search come up on my Sitemeter listings.

I've actually had the honor of meeting Dr. Folkman on two separate occasions (although I doubt he'd remember me if I were to approach him at a meeting). One time, I even had the pleasure of his sitting in on our lab meeting, evaluating our data, and giving us his input. It was an amazing boost to my ego when, at that meeting, he told me he had read a mansucript I had submitted and very much liked it. It was an even bigger boost to hear him mention the scientific paper that manuscript became during one of his talks and characterizing it as one essential paper to read on angiogenesis inhibition.

Given all that, I figured the least I could do for one of my inspirations in science and surgery was to blog about this incident. In fact, I just had an idea:

Judah Folkman false results lying
Judah Folkman false results lying
Judah Folkman false results lying
Judah Folkman false results lying
Judah Folkman false results lying

There, that ought to do it. Take that, anonymous idiot.

Now, hopefully, if that idiot (or any other) does a Google search looking for evidence that Folkman was lying or reporting false results, this post will come up as the very first result of their search, as a rebuke. And if it doesn't come up first, I'll just keep adding more and more repetitions of the terms above until it does!

Tuesday, January 25, 2005

Grand Rounds #XVIII

Grand Rounds XVIII is now available at A Chance To Cut Is A Chance To Cure. Since this week's host is a fellow surgeon, I feel that, as a member of the brotherhood/sisterhood, I have to go all out to support his efforts. That means I won't be posting any lengthy pieces today, so as not to distract too much from the purity of the message: Check out Grand Rounds. (It's also a chance for me to write a Holocaust piece I've barely started, so that it will be ready in time to post on the 60th anniversary of the liberation of Auschwitz this Thursday. It'll be about my first encounter with Holocaust denial.) For my part, I support Grand Rounds pretty much every week by publicizing it, trying to contribute most weeks, and, in March, by hosting it (not to mention linking to it as many times as possible in my posts, to give it Google-juice). If you happen to have an interest in medical topics and medical blogs, I encourage you to check it out and even consider hosting it someday.

Of course, anyone who ends up here as a result of my humble contribution to this week's Grand Rounds, please check out some of the best of my past work in Essential ORAC (on the sidebar)—only after you've finished perusing the fantastic medical blogging goodness that is Grand Rounds, of course! Hopefully you'll like what you see and add Respectful Insolence to your blogroll. (We surgeons rarely miss a chance for self-promotion, whether at surgery, blogging, or anything else we do; so I'm sure Dr. Bard-Parker—if you get the joke in that name, you are likely to be a surgeon or work in an operating room—will not mind my little self-plug in the least. After all, I did tell everyone to check out Grand Rounds first, before coming back here...)

We're evolving, we're evolving!

Pat Oliphant weighs in on the debate:

Evolution cartoon

Medicaid crisis in Washington

Dr. Bob, of the excellent blog The Doctor Is In, and I have had our occasional differences, but yesterday he posted something that was right on target, a description of the crisis in access to health care for the poor in Washington brought on by low Medicaid reimbursements. He's right. Medicare reimbursements usually barely cover the cost of providing service or, at best, slightly more, and Medicaid reimbursements usually run between 60-75% of Medicare reimbursement for the same services (depending upon the region of the U.S.). That means that doctors who accept Medicaid patients usually lose money on them. Many still accept them, but it is more a matter of charity and a feeling of obligation. Those who do accept them cannot allow them to become too large a percentage of their patients, or their practice will no longer be financially viable. One advantage of being in academics (as I am) is that I'm shielded somewhat from these forces, mainly by state subsidies to our medical school and hospital. Given the budget crunch facing our state currently, those subsidies are bound to decrease soon, and we will likely be in the same boat our private practice colleagues have been in for a while.

I'd like to add just one thing. In medicine, market forces, for the most part, do not determine charges. In effect, the government determines our rates of reimbursement. Most HMO's, insurance companies, and third-party payors start their negotiations over reimbursement rates for doctors, medical practices, and hospitals at the Medicare rate. Usually, the contracts end up being somewhere around 100-130% of Medicare (although occasionally, particularly hard-nosed insurance companies have managed to negotiate rates below Medicare reimbursement). In addition, Medicare rates are not even keeping up with inflation, and fo