The Fifth Skeptics' Circle

The Fifth Edition of the Skeptics' Circle is now posted at Science and Politics. Go forth and receive your fifth innoculation against the rampant credulity of the blogosphere.

What I'm reading now

As I mentioned yesterday, logging will be light until sometime this weekend or next Monday. There are two reasons. First, my parents are in town, and I won't be spending a lot of time composing those epic posts like the one I did this Monday. The second reason is that I'm gearing up to host Tangled Bank next week. (Did you get your submission in yet? If not, what are you waiting for?) I'll probably manage to post something almost every day, but it's likely to be the short blogging variety of links and brief comments--with the exception of today, for the simple reason that I wrote this a couple of weeks ago and never got around to posting it. What better use for it than right now?

I don't think I've ever done one of these posts since starting Respectful Insolence, but I thought it might be fun to describe the sorts of books Orac likes to read. In the old days (back when I was in high school, college, and medical school), most of my reading fare consisted of science fiction. In those days, I'd devour a book a week on average. Unfortunately, work, and the amount of reading of the medical and scientific literature that I have to do, made reading for pleasure more difficult, and now that I've started bloggin I find that I spend a lot of the timethat I would in the past have spent reading books blogging (and reading magazines like The Atlantic) . Although I still get into science fiction and fantasy, over the last ten years or so as my pace of reading for pleasure slowed down, it seems that those genres have been making up progressively less and less of what I read and history and other topics have been making up more and more. don't get me wrong. I still love science fiction/fantasy, and, in fact, J. R. R. Tolkien's The Lord of the Rings is my favorite work of fiction of all time. (I've read it cover to cover at least five times since I first discovered it 30 years ago, and I often pick it up and just read the occasional chapter that I like.) Nothing even comes close. However, as I've gotten older, I've diversified.

In any case, right now, I'm near the end of reading American Brutus: John Wilkes Booth and the Lincoln Conspiracies by Michael W. Kauffman. I'm a relative newcomer to reading about the Lincoln assassination in any depth; consequently there was a lot in here that I didn't know. What makes this a fascinating read is that Kauffmann has, wherever possible, gone back to the original documents about the investigation, roamed the very paths that Booth took while escaping Washington, stayed at the Booth family home, and even burned down a tobacco shed like the one Booth was ultimately trapped in, to see how fast a fire would be likely to consume such a building. He developed a sophisticated database, into which he entered his primary source documents, and, using this tool, found connections that were not apparent before. I had never realized how much Booth had traveled and how very clever he had been putting together his conspiracy, sometimes even binding his conspirators to him by producing evidence that (he knew) investigators would find and use to tie them to the plot even if they later tried to disavow knowledge. On the other hand, he was a vain man, prone to exaggeration and hyperbole. From all this, he weaves together a history that describes the multiple strands as they happen and, during Booth's flight from Washington, reads almost like an adventure novel, as Booth eludes government troops and is finally cornered on Samuel Garrett's farm.

Before that, believe it or not, I read Harry Potter and the Goblet of Fire. All in all, I found it to be an enjoyable read. As a latecomer to the Harry Potter series (people I know have been bugging me to read it and I finally caved), I've been trying to work my way through it before the next book comes out this summer. Clearly, the books have been getting steadily better, and this was the best yet. After I finish the Lincoln book, I plan on moving on to the fifth Harry Potter book, Harry Potter and the Order of the Phoenix. I've even gotten my wife to start reading the series. She's almost through the second book.

Finally, before these two books, here are some recent reads over the last four or five months or so. I recommend them all:

1. Frederick Taylor, Dresden: Tuesday February 13, 1945. An excellent comprehensive history of the Dresden bombing.
2. Richard J. Evans, The Coming of the Third Reich. The first of a planned three-volume history of the Third Reich. Well-written and detailed, without being dull.
3. Greg Bear, Darwin's Children. The sequel to Darwin's Radio. Greg Bear is one of my favorite science fiction authors. Darwin's Children is not as good as its predecessor, but still a strong example of hard SF from a master of the genre.
4. Antony Beevor, The Fall of Berlin 1945. A little dry for my tastes, but a good history of the last battle for Berlin.
5. Mary Roach, Stiff: The Curious Lives of Human Cadavers. A highly entertaining and informative look at what sorts of things are done with cadavers. Wait. I think I read this a year ago. It doesn't matter. It's so good that I highly recommend it. Consider it a light-hearted look at death...
   

On deck, sitting on my shelf waiting to be read, we have (in no particular order):

1. Sherwin Nuland, The Mysteries Within
2. Norman Davies, Rising '44: The Battle for Warsaw
3. Joe Haldeman, The Forever War
4. Robert J. Sawyer, Calculating God
5. Max Hastings, Armaggedon: The Battle for Germany 1944-1945
6. Gregory Benford, Across the Sea of Suns
7. Robert J. Sawyer, Hominids
8. Victor Klemperer, I Will Bear Witness
   
9. Stephen R. Donaldson, The Runes of the Earth (The Last Chronicles of Thomas Covenant, Book 1). OK, I haven't bought this one yet, but it's on my list of must-buy books. I really liked the first two Thomas Covenant trilogies.)
10. Deborah E. Lipstadt, History on Trial: My Day in Court with David Irving.
    

Hey, this is fun. Maybe I'll do a series of posts about my favorite books over the years.

One week reminder for Tangled Bank

Blogging will be light the rest of this week. There are two reasons. First, my parents are in town, and I won't be spending much time typing. I'll try to post something every day, but, other than a piece I wrote a while ago for just such occasions, posts are likely to be of the Instapundit variety link and comment. (In fact, we're going to leave on a road trip to New York in a couple of hours to hang out and then go and see Spamalot. Maybe I'll play theatre critic and post a review after my parents have left.) Second, as hard as it is to believe, my turn to host the Tangled Bank is only one week away. Good submissions have just started to trickle in, but I need more if I hope to live up to the high standards of previous editions. I can't do it without the help of my fellow bloggers. Submissions on all scientific topics are welcome and encouraged, but, given that I'm a physician-scientist, I tend to have a special interest in posts having to do with medical science or science as it relates to human disease. However, interesting or unusual posts about other areas of science are also highly desirable. I want to learn something putting this together!

So, if you have a blog and have written an article about science that you'd like to promote to a wider readership, send the permalink to either orac_usa AT hotmail DOT com or to host AT tangledbank.net. Please include the words "TANGLED BANK" in all caps in the Subject header. The deadline will be 9 PM, Tuesday, April 5, and my edition will be posted on the morning of April 6. Because of past snafus with hyperactive spam software preventing submissions from making it to the host, I will try to acknowledge all submissions with a return e-mail within 24-48 hours of receiving them. Of course, that means if you happen to be the type who likes to submit things at the last minute (as I have on occasion done myself), there might not be time for you to get one and you'll just have to hope I got your submission.

Oh, and the third reason blogging is likely to be light is that Blogger is acting up again this week. It's driving me crazy and not letting me post. It's not quite as bad as it was a couple of weeks ago, but it's bad. I was completely locked out from my blog earlier this morning. I thought that I wouldn't be able to post until sometime after we got back from the city, which will certainly be after midnight. Fortunately, Blogger started working and hopefully it will actually let me post this. Only one way to find out...

Apple is evil

...but not for the reasons you'd think.

Joy of Tech does it again!

Grand Rounds XXVII

Grand Rounds XXVII has been posted at Over My Med Body. Get thee hence and be educated and edified!

Looking at the Grand Rounds schedule, I see that next week's edition will be at Polite Dissent, the only blog I've ever encountered that combines medical blogging with comic book blogging, dissecting the medical aspects of comic stories; for example, see here. My favorite post so far:

W.W.D.D. (What would Doom do?) Unfortunately, I didn't score more than the maximum score of 20. I must not have been Doom enough to realize that cheating and/or altering the space-time continuum to achieve my ends would both represent perfectly acceptable--nay, laudable--strategies to Doom.

Remind me sometime to blog about my 30 year comic book collecting habit. Given that my obsession started with Fantastic Four (a comic that I've collected more or less continuously since 1975, with occasional brief hiatuses during creative dry spells over the years--times when the comic truly sucked--and that I still read to this day), you can understand why I liked the Dr. Doom quiz.

In fact, I can't wait for the Fantastic Four movie that's scheduled to come out this summer, although I look forward to it with more than a little trepidation. Will it be an entertaining, exciting summer blockbuster, like the Spider-Man movies? Will it be mediocre, like The Hulk? Or will it be an outright turkey, like the Punisher movie (or, just as bad, the 1980's version with Dolph Lundgren) or Daredevil--or, even worse, a major bomb like Howard the Duck?

I guess I'll just have to wait and see.

The smackdown continues

Geez.

I thought Paul at Wizbang had finally realized how deep the hole he had dug for himself was.

I was wrong.

Just when I thought he couldn't spout more pseudoscientific rationalizations for his ignorant position on evolution, he goes and does himself one better!

PZ has once again administered a righteous smackdown; so I don't think I need to add much other than a fervent plea to Paul: Please stop. Your posts on evolution have become a slow motion train wreck, and the more you post the more you embarrass yourself. It's becoming painful to watch, much as it's painful to watch an obviously overmatched fighter who refuses to give up get the crap kicked out of him.

UPDATE: Now the Politburo Diktat has joined in the fun, administering yet another smackdown to poor Paul.

Litmus tests

Jason Rosenhouse over at Evolutionblog posted a nice piece on the litmus tests he uses to determine when he is reading the work of a pseudoscience hack. In this case, he dissects an article by Paul McHugh from the Weekly Standard on the topic of evolution, in which Mr. McHugh pulls out all the deceptive rhetorical tools of creationist (and other pseudoscientific hacks.)

Rosenhouse seems to have listed them all. I can't think of another one; but no doubt others will.

The Galileo Gambit

The appearance of the Herbinator on my blog last week and his sarcastic invocation of Galileo reminded me of a topic I've wanted to write about almost since the beginning of Respectful Insolence. It's a favorite tactic used by alties (not to mention pseudoscientists, pseudohistorians, and other cranks). Alties frequently invoke Galileo and other scientists like Ignaz Semmelweiss, who were at first rejected by the scientific orthodoxy of the time and had to fight to get their ideas accepted. The implication, of course, is that their ideas, whatever they may be (alternative medicine, intelligent design, Holocaust denial, psychic abilities, etc.), are on the same plane as those of Galileo or Semmelweiss. Frequently, they will add a list of famous scientists or experts who made predictions about the impossibility of something or other and were later found wrong, so much so that the statements sound ridiculous today. For example, here's a famous list that's been making the rounds on Usenet for years. Some of these quotes may in fact be urban legends (and, in fact, I'd be grateful to anyone who points out urban legends in here to me), but let's for the moment assume they are all legitimate quotes:

..so many centuries after the Creation it is unlikely that anyone could find hitherto unknown lands of any value. - Committee advising Ferdinand and Isabella regarding Columbus' proposal, 1486

I would sooner believe that two Yankee professors lied, than that stones fell from the sky. - Thomas Jefferson, 1807 on hearing an eyewitness report of falling meteorites.

Drill for oil? You mean drill into the ground to try and find oil? You're crazy. - Drillers who Edwin L. Drake tried to enlist to his project to drill for oil in 1859.

Louis Pasteur's theory of germs is ridiculous fiction. - Pierre Pachet, Professor of Physiology at Toulouse, 1872

[Orac's note: This one is particularly amusing to me, given that so many alties reject Pasteur's theory in favor of Beauchamps. Here, they seem to want to have it both ways. They reject Pasteur when arguing against antibiotics, claiming that bacteria are not the cause of disease, or attacking vaccines as useless and harmful. However, they have no problem invoking this quote. Of course, they don't seem to realize that their use of this quote implicitly acknowledges that Pasteur's theories, although initially quite controversial, were ultimately proven correct.]

The abdomen, the chest, and the brain will forever be shut from the intrusion of the wise and humane surgeon. - Sir John Eric Ericksen, British surgeon, appointed Surgeon-Extraordinary to Queen Victoria 1873.

[Orac's note: As a surgeon, I have to point out that, at the time, this was not an entirely unreasonable statement. Operating in the abdomen was risky in the extreme, with a high rate of death from peritonitis (that is, until the invention of antibiotics). In fact, I sometimes wonder how the great surgeons of 100 years ago managed to operate on anyone's abdomen and have them actually survive the procedure. Operating in the chest was also out of the question, given the problem of reinflating the lung afterward, and certainly the brain was completely off-limits. In any case, there was no way Sir Ericksen (or anyone else) could be faulted for failing to forsee the advancements in anaesthesia, antibiotics, surgical technique, and patient care that would ultimately allow such surgery to succeed (although one does have to point out that surgeons were already operating in the abdomen reasonably successfully at the time).]

Such startling announcements as these should be deprecated as being unworthy of science and mischievious to to its true progress. - Sir William Siemens, 1880, on Edison's announcement of a sucessful light bulb.

We are probably nearing the limit of all we can know about astronomy. - Simon Newcomb, astronomer, 1888

Fooling around with alternating current is just a waste of time. Nobody will use it, ever. - Thomas Edison, 1889

[Orac's note: It's well-known that Thomas Edison wanted to promote the use of direct current rather than alternating current. It was a battle of rival technologies (sometimes called the War of Currents), not unlike the war between Betamax and VHS, but on a much larger scale. Edison ultimately lost.]

The more important fundamental laws and facts of physical science have all been discovered, and these are now so firmly established that the possibility of their ever being supplanted in consequence of new discoveries is exceedingly remote.... Our future discoveries must be looked for in the sixth place of decimals. - physicist Albert. A. Michelson, 1894

Heavier-than-air flying machines are impossible. - Lord Kelvin, president, Royal Society, 1895.

It is apparent to me that the possibilities of the aeroplane, which two or three years ago were thought to hold the solution to the [flying machine] problem, have been exhausted, and that we must turn elsewhere. - Thomas Edison, 1895

The demonstration that no possible combination of known substances, known forms of machinery, and known forms of force can be united in a practicable machine by which men shall fly for long distances through the air, seems to the writer as complete as it is possible for the demonstration of any physical fact to be. - astronomer S. Newcomb, 1906

Airplanes are interesting toys but of no military value. - Marechal Ferdinand Foch, Professor of Strategy, Ecole Superieure de Guerre.

Caterpillar landships are idiotic and useless. Those officers and men are wasting their time and are not pulling their proper weight in the war. - Fourth Lord of the British Admiralty, 1915, in regards to use of tanks in war.

Professor Goddard does not know the relation between action and reaction and the need to have something better than a vacuum against which to react. He seems to lack the basic knowledge ladled out daily in high schools. - 1921 New York Times editorial about Robert Goddard's revolutionary rocket work.

[Orac's note: Why the New York Times would be considered an "expert" in rocketry such that it would be of interest to use it as an example of an "expert" making a statement that is later proven wrong, I have no idea. This quote is at best irrelevant.]

The wireless music box has no imaginable commercial value. Who would pay for a message sent to nobody in particular? - David Sarnoff's associates in response to his urgings for investment in the radio in the 1920s.

"All a trick." "A Mere Mountebank." "Absolute swindler." "Doesn't know what he's about." "What's the good of it?" "What useful purpose will it serve?" - Members of Britain's Royal Society, 1926, after a demonstration of television.

This foolish idea of shooting at the moon is an example of the absurd lengths to which vicious specialisation will carry scientists. -A.W. Bickerton, physicist, NZ, 1926

Who the hell wants to hear actors talk? - H.M. Warner, Warner Brothers, 1927.

Stocks have reached what looks like a permanently high plateau. - Irving Fisher, Professor of Economics, Yale University, 1929.

[Orac's note: Of course, we had the same sort of idiotic statements coming from "experts" during the Internet bubble of the 1990's; for example, this book predicting that the Dow would reach 36,000. How many times did we hear that the Internet "changed everything" and that the stock market had no where to go but continually up?]

There is not the slightest indication that nuclear energy will ever be obtainable. It would mean that the atom would have to be shattered at will. -- Albert Einstein, 1932

The energy produced by the atom is a very poor kind of thing. Anyone who expects a source of power from the transformation of these atoms is talking moonshine. - Ernst Rutherford, 1933

The whole procedure [of shooting rockets into space]...presents difficulties of so fundamental a nature, that we are forced to dismiss the notion as essentially impracticable, in spite of the author's insistent appeal to put aside prejudice and to recollect the supposed impossibility of heavier-than-air flight before it was actually accomplished. Richard van der Riet Wooley, British astronomer, reviewing P.E. Cleator's Rockets in Space, Nature, March 14, 1936

Space travel is utter bilge! -Sir Richard Van Der Riet Wolley, astronomer

I think there is a world market for maybe five computers. - Thomas Watson, chairman of IBM, 1943

Computers in the future may weigh no more than 1.5 tons. - Popular Mechanics, forecasting the relentless march of science, 1949

[Orac's note: Heh heh. This statement isn't an incorrect prediction. Think about it. Most computers don't weigh more than 1.5 tons these days, do they?]

I have traveled the length and breadth of this country and talked with the best people, and I can assure you that data processing is a fad that won't last out the year. - The editor in charge of business books for Prentice Hall, 1957

Space travel is bunk. -Sir Harold Spencer Jones, Astronomer Royal of Britain, 1957, two weeks before the launch of Sputnik

There is practically no chance communications space satellites will be used to provide better telephone, telegraph, television, or radio service inside the United States. -T. Craven, FCC Commissioner, 1961

We don't like their sound, and guitar music is on the way out. - Decca Recording Co. rejecting the Beatles, 1962.

But what... is it good for? - Engineer at the Advanced Computing Systems Division of IBM, 1968, commenting on the microchip.

There is no reason anyone would want a computer in their home. - Ken Olson, President, Chairman and Founder of Digital Equipment Corporation, 1977

The concept is interesting and well-formed, but in order to earn better than a 'C,' the idea must be feasible. - A Yale University management professor in response to Fred Smith's paper proposing reliable overnight delivery service. (Smith went on to found Federal Express Corp.)

I'm just glad it'll be Clark Gable who's falling on his face and not Gary Cooper. - Gary Cooper on his decision not to take the leading role in Gone With The Wind.

A cookie store is a bad idea. Besides, the market research reports say America likes crispy cookies, not soft and chewy cookies like you make. - Response to Debbi Fields' idea of starting Mrs. Fields' Cookies.

If I had thought about it, I wouldn't have done the experiment. The literature was full of examples that said you can't do this. - Spencer Silver on the work that led to the unique adhesives for 3M "Post-It" Notepads.

So we went to Atari and said, 'Hey, we've got this amazing thing, even built with some of your parts, and what do you think about funding us? Or we'll give it to you. We just want to do it. Pay our salary, we'll come work for you.' And they said, 'No.' So then we went to Hewlett-Packard, and they said, 'Hey, we don't need you. You haven't got through college yet.' - Apple Computer Inc. founder Steve Jobs on attempts to get Atari and H-P interested in his and Steve Wozniak's personal computer.

You want to have consistent and uniform muscle development across all of your muscles? It can't be done. It's just a fact of life. You just have to accept inconsistent muscle development as an unalterable condition of weight training. - Response to Arthur Jones, who solved the "unsolvable" problem by inventing Nautilus.

640K ought to be enough for anybody. - Bill Gates, 1981

[Orac's note: Of course, in 1981, Gates was correct. No one really needed more than 640K in a personal computer. There wasn't much you could actually do with more than that in 1981...]

So, again, what's the point of alties or other pseudoscientists invoking Galileo or any of the hideously incorrect prognostications listed above? Again, obviously, this technique seeks to denigrate the experts who reject the altie's claims as not knowing what they're talking about or as close-minded, unable to have the vision that they do. It also deceptively tries to associate the quack, crank, pseudoscientist, or pseudohistorian with the theories and findings of great visionaries that went against conventional wisdom and were thus rejected by the experts of the day--and then later shown to be correct. It's a transparent ploy, about which Michael Shermer once said, "Heresy does not equal correctness."

Some call it the Galileo gambit (although in actuality Galileo is probably a bad example for pseudoscientists to use, given that he was persecuted by the Church, and not by his fellow scientists). History is indeed full of tales of the lone scientist working in spite of his peers and flying in the face of the doctrines of the day in his or her field of study. No doubt there are still a fair number of such scientists today. Unfortunately (or fortunately, depending upon your point of view), the vast majority of them turn out to be utterly wrong. They disappear into the mists of history, leaving not even a footnote in the grand history of science. As Shermer so correctly put it in his book Why People Believe Weird Things (a book I highly recommend to anyone interested in improving his or her critical thinking skills):

For every Galileo shown the instruments of torture for advocating scientific truth, there are a thousand (or ten thousand) unknowns whose 'truths' never pass scientific muster with other scientists. The scientific community cannot be expected to test every fanstastic claim that comes along, especially when so many are logically inconsistent.

Precisely.

For every Galileo, Ignaz Semmelweis, Nicolaus Copernicus, Charles Darwin, Louis Pasteur, etc., whose scientific ideas were either ignored, rejected, or vigorously attacked by the scientific community of his time and then later accepted, there are untold numbers of others whose ideas were either ignored or rejected initially and then were never accepted--and never will be accepted. Why? Because they were wrong! The reason the ideas of Galileo, Semmelweis, Copernicus, Darwin, Pasteur, et al, were ultimately accepted as correct by the scientific community is because they turned out to be correct! Their observations and ideas stood up to repeated observation and scientific experimentation by many scientists in many places over many years. The weight of data supporting their ideas was so overwhelming that eventually even the biggest skeptics could no longer stand. That's the way science works. It may be messy, and it may take longer, occasionally even decades or even longer, than we in the business might like to admit, but eventually in science the truth wins out. In fact, the best way for a scientist to become famous and successful in his or her field is to come up with evidence that strongly challenges established theories and concepts and then weave that evidence into a new theory. Albert Einstein didn't end up in the history books by simply reconfirming and recapitulating Newton's Laws. Semmelweis and Pasteur didn't wind up in the history books by confirming the concept that disease was caused by an "imbalance of humours" (although Semmelweis probably did hurt himself by refusing to publish his results for many years; his data was so compelling it remains puzzling why he did not do so). I daresay that none of the Nobel Prize winners won that prestigious award by demonstrating something that the scientific establishment already believed. No! They won it by discovering something new and important!

Unfortunately, to most lay people who don't have a strong background in science, the scientific method, or the history of science, such trickery can sound convincing on the surface. For example, you have a quack like Hulda Clark claiming she has a cure for cancer and AIDS and then claiming that the scientific establishment can't accept it. Add a dash of paranoia about big medicine and big pharma "suppressing" her "cure," and it's a potent brew of deception. This ploy is particularly appealing to Americans, because our whole national psyche has in its core a tendency to root for the outsider, the underdog. Alties, pseudoscientists, and cranks tap into that deep-seated sympathy we tend to have for the persecuted outsider and use it to their advantage. It's the same with creationists, who use every well-deserved debunking they get as evidence that they are a "threat" to the established scientific order. The only way to combat such deceptive comparisons is to point out again and again Shermer's dictum that "heresy does not equal correctness" and try to keep the discussion on the hard evidence.

I think it's appropriate to finish with another Michael Shermer quote: They laughed at Copernicus. They laughed at the Wright brothers. Yes, well, they also laughed at the Marx Brothers. Being laughed at does not mean you are right.

Use it the next time an altie tries to imply that the fact that the scientific establishment mocks their ideas means that they must be on to something. Except do what I do and use the Three Stooges instead of the Marx Brothers.

Especially Curly. Nyuck, nyuck, nyck.

Happy Easter

To everyone who celebrates Easter, have a happy one!

That is all for today. Blogging will resume tomorrow.

Another smackdown to be savored

Heh. For any who've been watching Paul at Wizbang make the huge mistake of taking on PZ (of Pharyngula), andy (of The World Wide Rant) and DarkSyde (of Unscrewing the Inscrutable) on evolution, you should check it out now. Another enjoyable smackdown. Not surprisingly, Paul's just digging himself deeper and deeper into a hole. His closing of the old threads on evolution and the opening up of a new one with his "rules" for how it will be conducted and his deleting of comments he doesn't like won't save him, nor will his dissing of PZ.

Maybe he realizes what a hole he has dug himself into. Quoth he: "This is the last evolution post for a few weeks, they wear me out."

Either that, or Paul's finally realizing his mistake. He just won't admit it.

The most nauseating article on the Schiavo case I have yet seen

....is here. That this guy (Joseph Farah) has the gall to write such tripe on Good Friday is truly nauseating.

Even back when I was a lot more religious than I am now, I would have found his Jesus-Schiavo comparison offensive. In fact, I probably would have found it even more offensive than I do now, because he is comparing a woman in a persistent vegetative state with the Savior. I'm still rather uncomfortable about the means of pulling the plug in this case, because dehydration is such a protracted way to die, but I've slowly and reluctantly come to the conclusion that personal liberty is the main issue here and that, if Mrs. Schiavo truly did say that she didn't want extraordinary means used to keep her alive in such a state with no hope of improvement, then that is that. Her wishes should prevail.

But let's address this on Joseph Farah's own religious terms. I can't help but point out that, if we are to take his own comparison (such as it is) to its logical end using Christian beliefs and doctrine, then we have to point out to him that he conveniently forgot one rather big point. Jesus accepted his fate because it was ordained by God. Jesus didn't want to be "saved" from the cross. Whether or not you believe that Terri Schiavo's fate was ordained by God, courts over the course of more than a decade have looked at the evidence and found that Mrs. Schiavo never would have wanted to live the way she is living now and would have preferred to be allowed to die. So, on those terms, you could probably say that she, too, "accepted" her fate 15 years ago and that her being allowed to die is the culmination of what she accepted.

Friday shuffle on Saturday

Most other bloggers do this particular meme on Fridays. Not Orac. Orac does it on (most) Saturdays. Why? Because Orac feels like doing it that way. Sometimes he even does it on Friday, just like most others.

In any case, to do this meme, all you have to do is to take iTunes (or your MP3 software of choice), select your entire music library, set it to play on random or shuffle play, and then list the first ten songs that get played. This morning, mine was as follows:

1. David Bowie, Conversation Piece
2. Simon & Garfunkel, I Am A Rock
3. Kansas, Magnum Opus
4. Johnny Cash, Oh, What A Dream
5. Low, On The Edge Of
6. Rancid, 1998
7. Elton John, I Can't Keep This From You
8. Violent Femmes, Nightmares
9. Frank Sinatra, Dancing in the Dark
10. Ministry, The Land of Rape and Honey

Hmmm. A rather odd compilation. I'm particularly intrigued by the sandwiching of a Sinatra song between a Violent Femmes song and a Ministry song. Oddly enough, it seemed to work OK.

Looks like I'm in the center-right

Just for yucks, I took the World's Smallest Political Quiz, just to see where I fell:

Not surprisingly, I fell on the centrist-conservative line. More surprisingly, my score wasn't as close to the libertarian range as I thought it would be. I never thought I leaned towards the statist side...

Oh, well, it's just a silly Internet test. I think my results on the Political Compass had me pegged better. Maybe I'll post the results sometime...

Friday dinosaur goodies

PZ over at Pharyngula has blogged about a recent report in Science in which amazingly well-preserved dinosaur soft tissues were found deep within the fossilized bones of Tyrannosaurus rex. Cool. Of particular interest to me is the vascular endothelial structures that were identified. Given that my main research interest is tumor angiogenesis, most of my lab work revolves around endothelial cells. Unfortunately, I haven't received the March 25 issue of Science yet, but I'll definitely check this out when it arrives.

In fact, I can see a new grant proposal from this: Dinosaur angiogenesis, anyone?

A response to the "Herbinator"

My, my, Orac has been in a combative mood this week, hasn't he? (Being on call for six days straight--with three more to go, two weekends in a row--does that to him sometimes, particularly since it also often leaves a lot of "hurry up and wait" time to blog.) First there were the rants about the Schiavo case, then another broadside against a chelationist. What's next? Well, I think it's time for a little more light-hearted fare. Two days ago, an herbal "healer" named J. Mark Taylor somehow found my little blog and left a sarcastic comment. No biggie; I'm used to far worse from alties. I found it more amusing than anything else. However, I thought it might be interesting blog fodder to reply to Mr. Taylor publicly. Don't worry, Orac-philes, I'll be polite. (Aren't I always?)

But don't confuse "polite" with going easy on him. Here goes:


Dear "Herbinator":

I see you've found my humble blog. Your sarcastic little comment about how you've supposedly discovered a "blog dedicated to the celebration of conformity" amused me, but unfortunately that is an incorrect characterization. In fact, Respectful Insolence is a blog dedicated mainly to science, evidence-based medicine, and skepticism (none of which alties like yourself appear to understand or embrace)--plus whatever else the inimitable Orac feels like blogging about at any given time. In actuality, I leave the conformity to alties, too many of whom will defend even quacks like Hulda Clark rather than admit that they might have a problem with quacks among their ranks. They're much better at lockstep conformity and adherence rigid dogma than I. Oh, and before you go accusing me of the same sort of "circle the wagon no matter what" behavior with regard to conventional medicine, I suggest you read this, in which I go after conventional doctors for selling unnecessarily and potentially harmful "screening" MRIs for breast cancer. I am an advocate of evidence-based medicine, and I try to apply the same standards consistently to so-called "alternative" treatments and conventional medical treatments.

Your sarcasm notwithstanding, however, I'm still glad that someone like you discovered my blog. In fact, I even hope you'll stick around. You might actually learn something. You'll also likely find that I'm far more receptive to honest criticism than most alties are. Perhaps, if I have time later, I'll go back to your blog and politely politely on some of the stuff I encountered the first time I visited. Then, we'll find out what your tolerance for honest debate really is.

In fact, let's find out a little right now. How about a little taste of Orac's own special brand of respectful insolence? I'm afraid you're just plain wrong when you assert on your blog that little or no progress has been made against cancer in 50 years. One example: Childhood cancers that were death sentences in 1955 are now, thanks to chemotherapy, anywhere from 75-90% curable. Another example: leukemias and lymphomas that were also death sentences 50 years ago are now treatable, and, depending upon the specific disease, anywhere from 30-80% curable. It is true that we haven't made much progress for certain tumors over the last 30 years or so, but admitting that is a very different thing than saying (as you did) that we've made "little progress or no progress against" cancer in 50 years. Let me put it this way: If you were diagnosed with cancer, would you rather be treated with the methods we have now or the methods that were the standard of care in 1955? I realize it's likely that you would simply say you'd prefer "natural" methods. If so, I wish you good luck and hope you never get cancer, even more so than I hope the same thing for anyone--because if you do get a treatable cancer and opt for the "natural" treatments that you advocate on your blog over conventional therapy, you'll be screwed. And I don't wish death from cancer on anyone. Putting that aside, however, I know what my answer to the question would be (not to mention, I daresay, the answer of anyone capable of critical thinking).

But how about another little taste? In another post, you say, "Cancer treatment is probably no more effective today than it was in the 1930's." Oh really? Can you back up that assertion with, oh, say, some actual facts? Do you have some survival statistics? Have you considered not just mortality, but morbidity as well? For example, if you were a woman with an early stage breast cancer, would you want a radical mastectomy (the standard of care for even small breast cancers in the 1930's) or a lumpectomy with sentinel lymph node biopsy (the standard of care for most early stage cancers today) as your surgical therapy? And, if you were unfortunate enough to have a tumor large enough to require a mastectomy, why bother with breast reconstruction (nonexistent in the 1930's) when you can have a deformed chest? Would you want to increase your odds of long-term survival with chemotherapy or take the lower chance that surgery alone would do the trick? How about hormonal therapy? The standard means of hormonal therapy before Tamoxifen and the newer aromatase inhibitors was to do an oophorectomy to stop the body's natural production of estrogen. Now we have drugs that will do the same thing. The same is true for prostate cancer. Castration used to be the first treatment of choice for metastatic prostate cancer, even as recently as my early residency days in the late 1980's. Now, we have drugs that accomplish the same thing. The list goes on and on.

After that, how can you not want just one last taste? Correct me if I'm interpreting incorrectly, but here, you seem to be implying strongly, if not saying outright, that a "nature-cure approach is at least as effective as Standard medical treatments." You wouldn't happen to have, oh, say, some actual scientific or clinical trial evidence showing that this is so. Any disease will do, but, since I'm primarily a cancer surgeon, I'd be most interested in evidence showing such a result for a cancer, any cancer, for which there is presently effective "conventional treatment." Failing that, how about any disease for which there is presently an effective conventional treatment? Or even diseases for which present treatments leave much to be desired? No testimonials, please, because they do not show any generalizable effect, and are impossible to evaluate to see if the presentation of the case is accurate, nor do they tell us actual success rates. I'm talking hard data from well-designed, controlled clinical trials that show your therapies are as "effective as Standard medical treatments." And, if you don't think your therapies should be subjected to such testing, I would then have to ask: Why not? Why should your therapies be exempt from the same testing that mine are subject to? How do you know that your treatments work? Again, as I explained extensively before, anecdotes don't constitute adequate evidence. I will give you this, however. You said, "In the end, you either believe or you don't." The problem is, nature doesn't work on "belief." You can "believe" anything you want, but that doesn't make it so.

That ought to do it for now. I hope you don't think I was too hard on you. However, if you show up and leave sarcastic comments on my blog, don't expect me to take it lying down (although I do always reserve the right to ignore them). I've dealt with alties for a long time now on Usenet in misc.health.alternative; I highly doubt you can show me anything new, but feel free to give it your best shot, should you be so inclined. I'm always interested in honest discussions with advocates of alternative medicine who might be able to show me that I am wrong. I just haven't found one yet. Be advised, as well, that no one but Orac drives the agenda of this blog and certainly not you; so I will not allow myself to become drawn into prolonged exchanges. Orac, and Orac alone, decides when he will and will not respond. I'm sure you run your own blog the same way, which I may find out if I start leaving some comments.

Finally, don't forget Orac's favorite saying: "A statement of fact cannot be insolent!"

Sincerely,

Orac

P.S. Have a nice Easter weekend.

Revenge of the chelationist

A few weeks ago, I described a flier I received at my office advertising a talk at a local extended care facility. Through the flier, the speaker, a local physician who also employs alternative medicine, touted all sorts of wonderful effects that one could enjoy if one tried chelation therapy. Among other things, the flier claimed chelation therapy was good for aches and pains, hardened or blocked arteries, Alzheimer's disease, elevated blood cholesterol, leg cramp pain (claudication), diabetes, angina pain, osteoporosis, poor circulation, cold extremities, elevated blood pressure, skin ulcers, kidney stones, impaired memory or concentration. This physician even went so far as to characterize chelation therapy as “the most successful method to extend maximum life span.” (In fact, based on the flier, I was beginning to wonder if there was anything that chelation therapy wouldn't cure.) The only problem is, there is no good scientific evidence that chelation therapy does any of these things or is useful for treating anything except for documented cases of iron overload or heavy metal poisoning. I emphasize the word "documented," because alties frequently blame "heavy metal toxicity" for a wide variety of ailments, without ever definitively proving excess of heavy metals. ("Heavy metal toxicity"? I may have suffered some of that in my teen years, when I was very much a fan of Ted Nugent. Just ask my sisters or my parents. It's a wonder I still have my hearing.)

Naturally, as a bona fide member of the Skeptics' Society and advocate of evidence-based medicine (and because I was unable to show up at this event myself due to preexisting obligations), I felt obligated to write to try to set the director of this company straight. Fortunately, I wasn’t the only one, and a flood of letters and e-mails convinced the company to cancel the talk. It was over. Score a small victory for reason and evidence-based medicine. Or so I thought.

About a week ago, I learned that the chelationist is almost certainly going to have his revenge.

That's when another flier arrived in my mailbox at work. It looked very much like the one I had received before and is reproduced below (with addresses, phone numbers, and names obscured, of course).

Damn.

It makes me wonder if the company gave this guy a non-refundable deposit and are trying to get something out of him. Or maybe he's a buddy of someone on the board of directors of the company. Why else, having hurt its own reputation in the local medical community by inviting this guy and sending out advertisements to all the doctors in the area in the first place, would the extended care facility risk compounding the damage to its reputation by re-inviting him? Never mind that this guy offers a veritable cornucopia of unsupported therapies, as described on his own website, including "Intravenous Chelation Therapy, Vitamin C Intravenous Therapy, Hydrogen Peroxide Intravenous Therapy, Mercury Detoxification via DMPS injections and Colon Hydrotherapy," among others, all of which are well-debunked on Quackwatch. Regular readers may recall that I ranted a bit last time about the somewhat weasely letter I got from a company flack apologizing but excusing the invitation with a line about how his company's goal is to "educate, never endorse." A few commented that I was being too harsh on the guy, and I was been beginning to wonder if perhaps I had indeed been too harsh. Now that the company has invited Dr. "GHL" back, despite the fact that they now know that he is an advocate of unproven and scientifically unsupported "therapies" (like chelation therapy for cardiovascular disease or colonic irrigation for other maladies), I now contend that I wasn't harsh enough.

Notice, though, how Dr. GHL is much cleverer this time. He's clearly learned from his first experience. I have a sneaking hunch that he probably didn't know that his first flier would be mailed to physicians. It was clearly designed for the lay public, most of whom don't have the medical knowledge or background to understand why his claims for chelation therapy were so obviously overblown. This time, he knew. The claims listed on this new flier are much less specific and much more innocuous-sounding. However, they are still very much of a kind to the claims alties like to make. "Strengthen the immune system"? Gee, who wouldn't want to strengthen his or her immune system? (The contrarian in me can't help mentioning people autoimmune disorders here.) "Slow the aging process"? Who wouldn't want that as well? (Who knows what that means, though.) What about environmental pollutants or toxins? Of course they must be bad! (Of course, alties rarely tell you which toxins are at fault or show you clear epidemiologic, biochemical, or phsyiological evidence that they are at fault. It's always some general vague "toxicity.") This guy should go on Bill Maher's show, for cryin' out loud!

[A side note: Normally I wouldn't be nearly so hard on someone advertising a talk like this. If this were the first flier I had seen, I probably would have just shrugged it off and tossed it in the old circular file. After all, who can complain too much about someone saying that a bad diet might make you unhealthy? Unfortunately, Dr. GHL had already revealed himself to be someone who buys the exaggerated and unfounded claims for chelation therapy, even for diseases for which there is even less evidence for efficacy than atherosclerotic vascular disease.]

Sadly, the company also got a representative of the local chapter of the American Cancer Society to appear with our altie. Whether this is just another example of a misguided attempt to provide "balance" or whether it's an attempt to cover its behind, I don't know, but I have to wonder if the invited ACS representative is even aware of Dr. GHL's advocacy of dubious therapies like chelation for cardiovascular disease or colonic irrigation. Questionable or bogus cancer therapies are a huge problem, and the ACS has in general wisely tried to maintain a balance between not unduly discouraging the use of complementary therapies that might be helpful, particularly in improving quality of life, but still protecting the patient from quack "cures" of the sort Hulda Clark pushes.

With the Bat-signal thus activated, my alter-ego Orac just had to leap into action. (Too bad he doesn't have as bitchin' ride as the Batman does.) Unfortunately, once again, the date and time of the conference are such (early evening of a clinic day during a week I am on call for the group) that I cannot possibly attend it myself. Disappointed, I did the next best thing to being there and fired off another letter:

Dear Mr. X:

I wrote to you a while back to express my concern about a flyer I received for an event to be hosted at your facility. In my e-mail, I voiced my concerns over the topic of the talk, namely chelation therapy. The flyer contained some highly exaggerated and simply incorrect claims for the supposed benefits of chelation therapy. Presumably, the speaker, Dr. GHL, was planning on touting these dubious benefits in his talk (benefits for which there is no good scientific evidence). As a strong advocate of evidence-based medicine, I pointed out that there is no good scientific evidence or evidence from randomized clinical trials that chelation therapy does any better than placebo.

Your company wisely canceled Dr. GHL's talk on chelation therapy after a number of physicians wrote or called to complain before I got around to doing so. Unfortunately, you appear to have rescheduled Dr. GHL with a different topic. A few days ago I received another flier advertising a talk by Dr. GHL entitled "The Nutrition and Health Link." Putting aside for the moment that Dr. GHL just got burned for openly touting unproven benefits of chelation therapy for cardiovascular disease, Alzheimer's, and a number of other diseases for which there is no evidence of its efficacy (it is also a therapy that he himself administers, as described on his practice's own website), this new flier still manages to raise my concern again, to the point where I feel I must write again.

It would appear that Dr. GHL has learned from the previous incident. He is not making claims as easily debunked as the ones he made for chelation therapy. Instead, he has restrained himself. Dr. GHL's claims are now harder to debunk, not because they are more any more founded in science than his claims about chelation therapy were, but rather because they are so vague and undefined. What, precisely, does "boosting the immune system" mean? Will he tell his audience specifically which functions of the immune system is boosted by his methods and how? Is it T cell-mediated immunity or antibody-mediated immunity, and what peer-reviewed scientific studies support his position? Exactly what does he mean by "slow down the aging process"? All of these are buzzwords often used by purveyors of unproven therapies, and none of them appear to have any defined meaning. Indeed, "boosting the immune system" is not unlike the "improving the vital force" that is so commonly used in various alternative medicine claims. Also, he seems to subscribe to the "toxicity" concept of disease. Unfortunately, rarely do alternative medicine advocates define exactly what these "toxins" are that are supposedly making us sick. The only thing he appears to be saying that is hard to argue with is that a bad diet can hurt your health. I am also disappointed to see that Mr. X, the Regional Executive of the American Cancer Society, will be participating in this talk as well. I have to wonder if Mr. X was aware of Dr. GHL's advocacy of an unproven therapy like chelation therapy when he agreed to appear with him. Certainly, the use of unproven and ineffective "alternative" cancer therapies are a big problem, one I would think that the American Cancer Society would not want to support. I am therefore sorry to see Mr. X lending the prestige of the American Cancer Society to this event. Given that Dr. GHL himself offers a veritable cornucopia of unproven "alternative" therapies, including (quoted from his entry on his company's own website): "Intravenous Chelation Therapy, Vitamin C Intravenous Therapy, Hydrogen Peroxide Intravenous Therapy, Mercury Detoxification via DMPS injections and Colon Hydrotherapy," among others, I find his repeat invitation by your company even more disturbing. All of these are debunked quite well on Quackwatch.org and other sites I can suggest to you, if you are so interested.

Be assured that I do not have any objections in principle to combining alternative and complementary medicine with conventional medicine, as Dr. GHL appears to advocate. Such a combination may indeed ultimately be shown to improve patient care. However, as an advocate for evidence-based medicine, I cannot support combining specific alternative and complementary medical techniques that are scientifically unproven, some of which may be potentially dangerous (like chelation therapy, which can cause cardiac arrhythmias, or colon irrigation, which can cause dangerous electrolyte imbalances), and sending any of my patients to such an institution would make me uncomfortable. I have little doubt that Dr. GHL is probably a competent physician when confining himself to conventional medicine and most likely sincerely believes that the "alternative" methods he is combining with his conventional medical practice benefit his patients. Unfortunately the hard evidence available at this time does not support such a belief, at least not with respect to the "alternative" medical therapies of chelation therapy, colonic irrigation, intravenous vitamin therapy, or intravenous hydrogen peroxide therapy. I hope that your company is more careful in the future in picking its speakers for public education events and more careful still in issuing repeat invitations.

Sincerely


Orac

I'll report back on the response (if any) I receive. I'm guessing I probably won't get a response this time.

One more thing. If they do this again and stick to the same sort of schedule in the future, I might actually be able to make a personal appearance, as my clinic schedule will soon be changing. Of course, given my only just competent public speaking skills, I may have to be careful, or I take the risk of embarrassing myself, regardless of the strength of my position. Perhaps Peter Bowditch would give me some pointers...

Tangled Bank XXIV is here

It's amazing how fast two weeks have gone by. It's already time for the 24th edition of the Tangled Bank, this time hosted by Syaffolee. Once more, great scientific blogging is all gathered into one place for your edification. Enjoy!

Once you've finished being edified and enlightened by Syaffolee's fine compendium of the best of the science blogosphere from the last two weeks, consider this: Believe it or not, I'm hosting the next edition, two weeks from now, on April 6. (Man, time really flies!) Somehow, I seem to have acquired a reputation for creative (or bizarre--you be the judge) ways of hosting other blog carnivals, as seen when I hosted the Second Skeptics' Circle in February and Grand Rounds XXV just last week. I really can't imagine why I might have gotten such a reputation...

The question is, can I possibly top my last two hosting gigs? Am I out of ideas? Will I resort to Tolkienesque meanderings? Or will I opt for a more conventional blog carnival approach? Who knows? In fact, as of this moment, I don't even know myself. There's only one way to find out, though. First, you can help me by submitting the best of your science blogging to orac_usa AT hotmail DOT com or host@tangledbank.net by 9 PM EDST, Tuesday, April 5. (Yes, time's going by so fast that we'll actually be on Daylight Savings Time by then.) The better the blogging that's submitted, the more it'll get my creative juices flowing, you know. Second, you can join me on April 6 for Tangled Bank XXV, where I hope to continue the Tangled Bank's tradition of presenting only the best science blogging, as exemplified by this week's edition.

Birthday wishes

I'd just like to take this opportunity to wish my Dad a very happy birthday! In fact, he and my Mom are coming out to visit next week, and I can't wait. It's been a while...

Yes, I got one of these e-mails too

The Bioethics Dude got an e-mail that was represented as having come from a law firm asking for affadavits from or testimonies by physicians about the Terri Schiavo case.

I got the same e-mail too. I'd like to know who else got it. Please comment on this post if you got one of these.

I really have to wonder what's going on, for a law firm to be soliciting bloggers who post under 'nyms, like me and the Bioethics Dude, for affadavits. They have no way of even knowing if we are doctors or not. Why is it a California law firm? Why bother soliciting affadavits from anonymous bloggers? It seems like a lot of effort for minimal payoff, trolling medical blogs for affadavits of doctors who have no personal knowledge of the case and have not reviewed any medical records or tests and, although I have some experience in caring for brain-injured patients from my trauma days and can do a serviceable job of interpreting head CTs, I am not an expert in that area. In fact, I don't even recall leaving any comments on CodeBlueBlog recently, which makes me think the only reason I got this is because of CodeBlue's link to my recent turn at hosting Grand Rounds.

It could be a monumentally bad idea on the part of the law firm, but I can't rule out a trick by someone trying to discredit or harass the law firm or even personally harass the Tracy Jackson who signed the e-mail. (For all I know, it could be the work of her disgruntled boyfriend.) I'm still looking at the e-mail headers, trying to tell if this truly came from where it appears on the surface to have come from.

In any case, it's just another measure of just how utterly bizarre this case has become.

Grand Rounds XXVI

Grand Rounds XXVI has been posted at the Well-Timed Period. Once again, medical blogging goodness from throughout the blogosphere is gathered into one nice, compact package. Check it out.

Cartoonists on Schiavo

I've resisted the urge to blog on Terri Schiavo thus far. Although I've always supported patient autonomy and the right to pull the plug, I've also always been uncomfortable with dehydration and starvation as the means of "pulling the plug." I don't know if I would have made the same decision as her husband. I don't know whether, like the parents, denial would lead me to continue to hold out hope, no matter how much the objective evidence indicates that there is no hope of significant neurologic recovery. They have my sympathies, and I have a hard time blaming them for pursuing their quest to keep their daughter alive, even though I think it's misguided.

However, regardless of one's position on the Schiavo case, it doesn't take much to realize that the the political gamesmanship going on over her plight is utterly disgusting. I think Pat Oliphant gets it pretty close to correct here...

But Tom Toles nails it right on the head here...

As does Jeff Danziger here...

Wearing two hats, part 2

A while back, I wrote about the difficulties of wearing two hats, that of the basic scientist and that of the clinician. In that post, I wrote more in general about the problems of having dual roles and the perceptions of those around me as to my credibility and competence in each role. Having allegedly "made it" now by producing compelling enough evidence coupled to a persuasive enough case for my planned research to convince the NIH to fund my research proposal (not to mention having published a few papers on my own in good journals), I can correctly say that I have joined the ranks of credible basic scientists. (Whether I am an outstanding--or even a good--scientist or not remains to be seen). In any case, somehow I've now built a reasonably well-funded laboratory and can afford to have a few people working for me to grind out data. On the other hand, I'm still a clinician. I also happen to be on call this week, and when that happens, the practicalities of wearing two hats start to weigh on me more than at other times, because it is at these times that my clinical responsibilities increase to the point where they put more pressure on my research responsibilities.

As I mentioned before, one of the biggest difficulties in combining a research with a clinical career is finding the time to do the necessary work to get a credible research program going. This includes doing the background reading and developing the research plan, doing the research, writing grant applications to get funding to support the research, and writing up the research to submit to peer-reviewed scientific journals. Several "pure basic scientists" pointed out that they have problems with this, too, because administrative and teaching responsibilities eat into their research time. No doubt this is true. I have little doubt that basic science departments pile on teaching and/or administrative responsibilities in a quantity that makes it difficult for young basic science faculty to succeed in getting a research program off the ground, getting funded, and publishing enough to prove themselves to be credible scientists and thus build a reputation for themselves. For a moment, however, I would still like to address why their situation is not and cannot be the same:

If a basic scientist fails to fulfill his teaching or administrative duties or doesn't fulfill them well, no one is going to die. Nor is anyone going to suffer a complication or additional pain. Patient care often can't be put off, at least not for long. Unlike teaching, it can't always be scheduled or predicted.

It's that simple. And that stark.

That'sthe difference. It's possible to succeed as basic science faculty while being not so good at other responsibilities, like teaching. My own experience with several professors during graduate school bears this observation out. There were a few professors who were highly successful in their research, with many publications, international reputations, and oodles of grant money. Unfortunately, they were awful in the classroom. There were even more faculty who were just OK in the classroom, but--again--ran successful laboratories.

I realize that what I said may sound arrogant to some or as though I am denigrating the difficulties basic science faculty face. I assure you that it is not and I am not. Not having much experience in teaching classes, I would probably have an absolutely hellacious time at first learning to become a competent classroom teacher (as opposed to a clinical teacher, which is different) if I ever tried to be straight basic science faculty. However, it's just the nature of the beast. You can't be bad or even mediocre as a physician, regardless of whether or not you are a scientist as well. You just can't. If you are, you have no business treating patients. You have to be at least competent as a physician or surgeon, and preferably you should be excellent. It's also more difficult in a highly technical specialty, like surgery. Practice makes a difference in highly technical skills, unless you happen to be one of those lucky surgeons who is just naturally gifted.

Maintaining one's medical and surgical skills as a part-time physician is perhaps the most difficult challenge facing the surgeon-scientist or the clinician scientist. The only way most of us manage it is to focus their clinical practice like a laser very tightly on one specialized area. That's the practicality of it. The necessity for competence when you don't get as much experience and practice as a straight clinical surgeon usually mandates focus. Even then, it's difficult. As a part-time surgeon, I don't do nearly as many cases as a full-time surgeon, and, as long as I am doing research, I never will. That is another reason by my practice has to be tightly focused if I want to do right by my patients and still have the opportunity to do research.

It cuts both ways, too, although that's usually less of a consideration compared to the basic science faculty with significant teaching responsibilities. I'm in essence a part-time scientist as well. I can't devote the same amount of time to writing grants, papers, supervising the lab, or even doing experiments that most basic science faculty can and do. But perhaps the biggest issue that cuts both ways is the literature. In essence, physician-scientists have twice as much scientific/medical literature to deal try to keep up with. We have to keep up with the medical literature involving our specialties and the scientific literature involving our research, and we have less time to do it, to boot. No wonder I never feel as though I'm on top of the surgical literature. No wonder every so often I get blindsided by a paper related to my research that I never noticed, probably more so than basic scinetists do. That's why another essential practical necessity for success is to have good people working for you and good collaborators working with you. One bad hire can destroy your lab's productivity and even ultimately your lab. You need people who can work with little supervision, and you need collaborators who can help you out with the more arcane basic science that you aren't trained in. In return, you offer your collaborators your clinical understanding of the disease process and, if you happen to be a surgeon, one of the most precious resources of all for biomedical research: access to human tissues.

Finally, perhaps the key difference between being a basic scientist and a clinician-scientist is predictability. The basic scientist, even the one who has significant teaching responsibilities that take up a big chunk of his schedule, has a much more predictable schedule. Patient care can be made somewhat predictable, but emergencies will always occur, the number and frequency of which depend upon the specific specialty. There will always be calls on weekends or in the middle of the night. Disease doesn't respect weekends or nights. Moreover, the natural tendency is for patient care responsibilities to grow slowly and inexorably. In essence, you can be a victim of your own clinical success, and your success in the clinical realm can negatively impact your success in the scientific realm. I know one surgeon who has become so popular that he just can't cut back his clinical practice without risking a backlash from his referring physicians. It can go the other way, too, but when that happens the usual solution is to give up clinical practice.

Let's look at a few real-life scenarios that illustrate the conflict. Scenario number one: You are in the middle of a big experiment when the E.R. calls about a patient you recently operated on, who has returned intrabdominal sepsis. It turns out that your anastomosis has broken down, and the patient needs urgent surgery to fix the problem. However, if you take off to do the surgery, your experiment will be ruined, wasting days of work and hundreds of dollars worth of reagents. The choice is really no choice at all; you take care of the patient and trash your experiment. You could ask one of your partners to deal with it, but they have patients of their own to deal with; they're all either in clinic or in the operating room. Besides, it's your complication. You need to deal with it, because that's what surgeons do.

Scenario number two: You have a grant due in a few days. You thought you had planned well, canceling your clinic that week several months prior and telling the schedulers not to schedule any operations that week, to allow maximal time to finish the grant. However, there is a patient that your boss tells you that you must see and take care of now. (Hopefully, you don't have a boss that does this to you on a regular basis. Fortunately, mine don't and even bend over backwards sometimes to prevent such things from happening.)

Scenario number three: You have a grant due in a few days. The day before your grant is due just happens to be your clinic day. It would inconvenience 20-30 patients if you were to cancel your clinic, and you're so busy anyway that it would be hard to find spots for them in a short period of time; so you don't cancel the clinic and resolve to have the grant ready a day early. Unfortunately, a couple of emergencies (like scenario one) keep you from having it quite ready. Do you cancel clinic and inconvenience all those patients so that you can get your grant done?

Scenario number four (perhaps the most common scenario): Your clinical load has been slowly growing. Almost without your realizing it, you find yourself spending less and less time in the laboratory doing experiments until you are no longer doing benchwork at all. This alone would not necessarily be a problem, because senior basic science faculty often find themselves no longer doing benchwork after a certain period of time. However, over time, your patient load continues to increase and you now find yourself spending less and less time even meeting with your lab personnel. You find that you are no longer even sure of what is going on in your lab on a day-to-day basis. There are a pile of manuscripts that need to be finished, but you can't get to them because you're always in the clinic or in the O.R.. You try to work on them at home, but your wife and children demand their fair share of your attention when you manage to make it home for a while. You'll soon be due to try to renew your grant, something you have no idea if you'll be able to do now. You could try to cut back on your clinic time, but that would mean that patients' waiting time to be seen would increase. Patients with cancer would be forced to wait longer. Also, if you cut back your clinical productivity, your department would not like it, because you would no longer be supporting your salary and overhead with clinical revenue. Your referring physicians will also not be pleased.

These are just a few examples, but in the end the conflicts all come down to the tension between two worlds which are very different, the world of the scientist and the world of the clinician. The world of the scientist values inquisitiveness and intellectually stimulation. It is also less interested in practicality and more interested in intellectual pursuits, in answering questions that have never been asked or answered before. In constrast, the world of the clinician is almost purely practical. It tends to be task- and action-oriented, and protocol-driven. Asking and answering questions are valued, but only insofar as the questions and answers pertain to diagnosing and treating disease or overcoming problems that get in the way of good patient care. It is also much more emeshed in human contact and human relations that the world of the scientist in a way that the world of basic science. It is much less possible than it used to be for the lone scientist to labor with little human contact, but it is still possible for a scientist to labor with little human contact outside of the coccooned world of his department. It is not possible for a clinician (other than a pathologist) to do his job without dealing with many, many people every day, often at their most vulnerable or difficult to deal with. The clinician is always dealing with new patients and new people, and it's hard to succeed as a doctor without being able to deal with people. (Yes, I know that a fair number manage.)

The clinician-scientist tries to bridge the gap between these two worlds. Clinician-scientists bring a unique perspective to the study of human disease that neither a pure clinician or a pure scientist alone can. Nothing is as satisfying as making a clinical observation, taking it to the laboratory, developing a treatment based on my laboratory observations, and then testing that in patients and seeing it work.

I hope to pull that off one day.

In fact, I'm beginning to think that clinician-scientists represent an eminently practical way of doing translational research.

[Note: I may have to write a third part of this series some day on the ethical issues of wearing two hats and doing clinical research involving human subjects, as mentioned by Dr. Maurice Bernstein in a comment in my previous post on the matter.]

Hospitalization

A humorous take on the pros and cons of being hospitalized is here.

The Bull Moose is right

The Bull Moose is right. Conservatism is dead.

What is a theory?

I've been meaning to blog on this very topic for a long time, but, via Pharyngula, I've found an article by Steve Olson published in The Washington Post that explains this point better than I probably could do myself. One of the most frequent canards that creationists use is that evolution is "just a theory." In fact, a lot of those idiotic warning stickers required on biology textbooks by various school districts say this very thing. The problem is, the word "theory" has a very different meaning in science from its meaning in colloquial use. But just let Olson explain:

If you want to know one reason why the debate over teaching evolution remains so contentious, consider the stickers some school boards have wanted to paste in high school biology textbooks. They label evolution a "theory, not a fact," suggesting that an alternative explanation is possible.

It's a clever strategy. Even people sympathetic to evolution often don't know how to respond to the assertion that evolution is "just a theory." And the opposite claim -- that evolution is a fact -- can generate skepticism among those who don't like to be told what to think.

But these stickers use the words "theory" and "fact" in a very misleading way. The biggest problem is that "theory" has two separate meanings. In common usage, "theory" means an idea or a hunch: "I have a theory about why she left him." No one really knows what the reasons were, but we can guess.

That's not what "theory" means within science. When scientists speak of the theory of gravitation, cell theory or evolutionary theory, they are talking about scientific concepts that have been so thoroughly tested that they are very unlikely to change. Theories are the results of decades or centuries of scientific effort. They draw on many interconnected observations and ideas. They are the end products of science, not stages on the way to the truth.

In science, a hunch or conjecture is called a hypothesis, not a theory. When Copernicus proposed in the early 16th century that the Earth revolves around the sun rather than vice versa, his idea was a hypothesis. But four centuries of observation and thinking have convinced us that heliocentrism is a theory, not just an intriguing idea. It is compatible with everything we know about the solar system and explains observations that cannot be explained in other ways.

Ideally, English would have a different word for these comprehensive organizing concepts in science. But for now, "theory" is doing double duty. So calling evolution a theory may seem to denigrate it in everyday terms, but in scientific terms that's high praise.

Precisely. The Theory of Evolution is just as rich and based in evidence as the Theory of Relativity or any of the other major theories in science, and the reason scientists won't take creationists seriously is because they challenge a well-founded and accepted theory without presenting strong evidence contradicting evolution and/or supporting their ideas. (Alties frequently do the same thing.) My only quibble with the article is that Olson doesn't really explain how old theories are usually incorporated into new theories at some level, mainly because theories by scientific definition represent the best explanations for a scientific phenomenon that presently exists. (The contrarian in me wants to use this simple observation to illustrate that the advancement of scientific knowledge is usually evolutionary, not revolutionary.) For example, the theories behind Newton's Laws of Motion were not disproven by the Theory of Relativity. Instead, Einstein showed that Newton's Laws were a special case of relativity for situations in which the velocity is much less than the speed of light, so that the factor v/c approaches zero and Einstein's equations reduce to Newton's Laws. Given that such slow velocities were all that Newton could observe in his time, he was absolutely correct to derive the laws that he did.

I agree with PZ. We should never, ever refer to creationism or intelligent design as "theories." They are not. They don't even rise to the level of hypotheses. It's also important to remember that science is not logic. Logic is an important part of the scientific method but does not necessarily have much to do with how natural phenomena operate. Many are the scientists who have been misled by an idea of how they thought nature should be, based on logic, as opposed to how nature actually IS, based on evidence and experimentation. (After all, Lamarckian evolution is a wonderfully logical concept--logical and wrong, not the way nature operates.) "Intelligent design" creationists frequently use logic (usually bad logic, but logic nonetheless) to justify their "hypotheses." However, logic alone is not enough. Science is about evidence, experimentation, hypotheses, and reasoning. They all have to be consistent with each other for a principle to be considered valid. Creationism and its deceptive offspring intelligent design fail on all these counts.

Sunday afternoon history lesson

Regular readers of this weblog know that I have an interest in history, particularly World War II and Holocaust history. I've posted about the 60th anniversary of the liberation of Auschwitz and how I discovered Holocaust denial. I've blogged about the bombings of Dresden and Tokyo, as well as the flag-raising at Iwo Jima. However, although this blog is now over three months old, I haven't talked much about Holocaust denial today and how Holocaust deniers seek to silence those who would refute their lies.

The most famous case of this is the David Irving trial. This trial took place in 2000 in response to David Irving's lawsuit against historian Deborah Lipstadt for her characterization of him as a Holocaust denier in her 1993 book Denying the Holocaust: The Growing Assault on Truth and Memory. Lipstadt's characterization was based on copious evidence, including statements by Irving such as "more women died on the back seat of Edward Kennedy's car at Chappaquiddick than ever died in a gas chamber in Auschwitz," among others. In response, David Irving sued Dr. Lipstadt and her British publisher, Penguin Books, for libel in a trial that made headlines around the world. The reason Irving chose to sue Professor Lipstadt in Britain is because British libel laws are among the most lenient in the world for plaintiffs, forcing the defendant accused of libel to prove that what he or she wrote is true, rather than, as is the case in the U.S. (for example), putting the burden of proof on the plaintiff to prove that what was written was false or written with a "reckless disregard for what is true."

Fortunately, Professor Lipstadt prevailed, dealing a crushing legal and moral blow to the Holocaust denier David Irving. (Unfortunately, however, despite the judgment against him for court costs, somehow David Irving manages to travel around the world giving talks and avoid paying the judgment.) At least, however, forever after now, the label of "Holocaust denier" will follow Irving, based on a verdict by a British court.

The reason this whole issue has come up again is twofold. First, Professor Lipstadt is finally getting to tell her side of the story. She has written a book entitled History on Trial: My Day in Court with David Irving. I haven't yet had the opportunity to read it, but I'm definitely going to order it from Amazon.com. The excerpts I've read from it, plus having read Professor Lipstadt's previous work, lead me to predict that it will be a detailed account of how Holocaust deniers will try to use to silence their critics, all the while claiming the mantle of free speech martyrs for themselves. Second, recently C-Span's Book TV made a very bad mistake, the same sort of mistake news organizations make when covering evolution. Book TV wanted to do a segment on Lipstadt's book. However, in order to provide "balance," they wanted to invite David Irving to speak as well. (Does this sound familiar to those of you who are involved in debunking creationism?) Professor Lipstadt's pleas that including a blatant Holocaust denier like David Irving would hurt C-Span's credibility fell on deaf ears, leading her to withdraw from the show.

Lipstadt had a ready response and Amy Roach, the C-Span producer handling the show: “Would you put on someone who says slavery did not happen?” “No,” Roach assured Lipstadt. Then why a Holocaust denier, Lipstadt asked. “Oh,” she said quite breezily, “He’s not going to talk about Holocaust denial. He’s going to talk about the trial.” Given that the trial was entirely about Holocaust denial and whether Lipstadt was correct in characterizing Irving as a Holocaust denier in her book, this quite understandably struck Professor Lipstadt as "wacko."

It's depressingly the same, whether the issue is pseudoscience (creationism being the prime example), pseudohistory (Holocaust denial being the prime example), paranormal phenomenon, or quack medicine. The media consistently confuse "balance" with letting the unsupported crank appear on the air or in print as an equal to the true expert. This puts the true expert in a bind. If, she doesn't go on the air with the crank, then the crank will get time to spout his crankery without rebuttal or debunking. On the other hand, if she does go on the air with the crank, she risks giving him credibility as an "alternative opinion." I don't know what I would have decided if I were Lipstadt, but the very fact that she had to make the choice shows how "balance" isn't really balance at all.

How do you "prove" photography to a blind man?

One analogy psychics sometimes use to claim that we "normal" people can't understand their abilities is to ask a question like: How would you prove to a blind man that photography exists?

The implication, of course, is that psychics have a sense that you do not, just as you have a sense (sight) that a blind man does not. Skeptico tells us exactly how you could prove the existence of photography to a blind man using the scientific method. Even better, he completely turns the question around on the questioner to show why the "evidence" supposedly used to "prove" psychic phenomenon is so weak and unconvincing.

Beautiful. No wonder Skeptico is rapidly becoming one of my favorite skeptics' blogs.

Friday morning shuffle done on Saturday

It occurred to me that I haven't done this blogger meme in a while, but people seem to do it usually on Friday. Well, not Orac. In any case, basically, you take iTunes (or whatever MP3 player you use), set it to shuffle or random play for your entire music library, and then list the first ten songs it plays. Here goes:

1. Eric Clapton, Love in Vain
2. The Zombies, Beechwood Park
3. R. E. M., I Am Superman
4. Peter Gabriel, Washing of the Water
5. The White Stripes, Seven Nation Army
6. The Modern Lovers, Pablo Picasso
7. The Ohio Players, Fire
   
8. John Mellencamp, The End of the World
9. The Beta Band, Dry the Rain
   
10. Queen, Good Old Fashioned Lover Boy

Interesting mix. Perhaps iTunes is reminding me to listen to the Zombies. Odessey and Oracle is their greatest album, a true 1960's psychedelic masterpiece...wow, man...

The deadly power of denial, part 4: Denial isn't just for patients

I thought I wouldn't be continuing this series any more, having more or less mined my thoughts about patient denial of a diagnosis of cancer until (I thought) nothing was left. In my first post on the topic, I described breast cancer patients who presented very late, with huge, bleeding, fungating tumors, yet had somehow managed to hide them from their family, sometimes for years. (Update: Sadly, one of the patients described in this post, unfortunately, has large volume metastatic disease in her bones.) In the second post, I described a patient for whom denial was really a way of "not wanting to be a burden" on anyone. Finally, in my most recent post on the subject, I described how what seems to be denial can in reality be fear of surgery or other necessary treatments. (Update: This patient in this anecdote underwent surgery and has done quite well. She is now preparing to undergo radiation therapy.) After that, I didn't see any further purpose in beating this topic to death, and I didn't want to risk my commentary degenerating into the trite or even into the realm of self-parody. I thought it was finished. Done. Time to move on to other topics.

Then, as Michael Corleone said in the Godfather, Part III, "Just when I thought I was out, they pull me back in." ("They" being patients, of course.) [As always, details about patients and how these events happened that don't affect the core of the story have been altered.]

It all started when I got a phone call from the nurse practitioner who worked with one of the oncologists. It was about patient whom I had operated on nearly three years ago for an early stage breast cancer and hadn't seen in about 18 months. This patient was a relatively young woman (under 40) who had had multifocal node-negative disease that had required a mastectomy with immediate reconstruction. She had undergone postoperative adjuvant chemotherapy without too much difficulty and had been doing well. From what I could gather, this patient had called the oncologist and was very concerned about a palpable "gland" that had popped up in her neck. Normally, in a cancer patient, such an observation would make us all think, "Uh-oh," but the story was complicated by the additional history that she had recently had an upper respiratory infection and not long before that, dental work. Neither the nurse, nor the oncologist, nor I was particularly concerned (at least not yet), although the nurse was asking me if I could see the patient that day. I told her that, unless it was an emergency (which it clearly wasn't), I couldn't see the patient because it wasn't my clinic day and I had surgeries scheduled later. In fact, I even suggested that, given the upper respiratory infection, this could easily be a reactive node and that she should perhaps wait a couple of weeks to see if it resolved as her infection resolved. None of the medical staff seemed to have any problem with that recommendation, as it was medically appropriate, and the patient was told that we would see her next week.

That was all very well and good. Very reasonable and medically appropriate. But we sometimes forget that, if you're a patient who has survived cancer, lurking in the back of your mind is a dark fear, fear that the monster that you had thought banished from your body may in fact have never left and may one day return from the hidden places in your body where it has been lurking, biding its time and waiting for a chance to re-emerge and strike again. That fear is always in the back of a cancer patient's mind. Time may diminish it, but it never goes away completely. Cancer patients, even the ones who are fortunate enough never to recur, carry that fear to their graves. Whether the monster is truly gone or not, fear of the monster remains. As health care professionals, intellectually, we may know that this feeling exists in our patients, but we don't feel it viscerally as the patient does. It doesn't wake us up at night in the dark hours late at night when we are alone. We don't worry about who is going to take care of our children if the monster returns.

You can probably see where this is going. The patient was persistent. I, of course, gave in, and saw her early on a Monday. I went into the exam room still thinking that this was probably just a reactive lymph node from her upper respiratory infection, that I could reassure the patient by doing a fine needle aspiration to show that there were only lymphocytes in the node, no tumor.

Then I examined her.

She had a rock-hard, 2 cm supraclavicular lymph node on the side of her mastectomy. It wasn't soft and rubbery, as reactive nodes, even very large ones, usually are. No doubt the doctors who frequent this blog know what that means, but for those of you who don't it means (almost certainly) a tumor recurrence in the lymph node in her neck. It means metastatic disease. It means the tumor has recurred as metastatic disease.

It means death, because metastatic breast cancer, although treatable, is not curable. And she isn't even 40 yet.

I'm afraid my reassuring facade must have slipped for a second when I felt the node, because I briefly met her eyes and her eyes widened. She knew. In retrospect, I think that had known all along, from the moment she had first felt it in her neck. I did a fine needle aspiration of the node (which ultimately proved the diagnosis I had feared) and called the oncologist, who saw her and concurred that the node was very suspicious. Tests were ordered, and, once again, the patient's life could never be what it was before. Why had I not accepted more rapidly what the patient had been trying to tell all of us? Why had the nurse been so willing to agree with me? I can't speak for anyone else but me, but I suspect it was because neither of us wanted to believe that a young woman who had been apparently successfully treated for a "curable" cancer was not, in fact, cured.

Denial isn't just for patients, you know. Doctors can feel its power as well. I'm not sure if that's what was going on in this case, but in retrospect there probably was an element of denial in my initial reaction. I just didn't want to consider, at least not as the first explanation, that my patient's cancer had recurred, and that I was powerless to do anything about it. The surgery had gone so well; she had had an early stage cancer. She had tolerated the adjuvant chemotherapy quite well. By all expectations, she should have had a very high chance of living to a ripe old age. Also, the most likely explanation was that this was a reactive node, given her upper respiratory infection, and treating it as though that's what it probably was was not wrong. Waiting was not the wrong thing to do, and, in reality, even if we had waited two weeks to make the diagnosis, it would not have made any difference in her medical prognosis. In fact, part of me almost thinks that it might have been better for her if she had let us persuade her to wait.

At least then she would have had two more weeks during which she could at least have the hope that the monster hadn't returned.

In this case, though, the patient knew better. Now I know better as well. The patient may not always be right about her disease, but she often is. In the future, I will try to listen better.

Curse you, Blogger! Part II: At least the Skeptics' Circle is up!

Blogger is really irritating me today again. During my brief lunch break at clinic, I had hoped to run up to my office and post a brief plug for the Skeptics Circle, the latest edition of which was posted this morning, but Blogger wouldn't let me do it in the brief time I had. It kept trying to load and never quite made it.

After having immersed myself in the credulousness that made up too much of the Science and Christianity Showcase, I needed a dose of critical thinking and good old-fashioned skepticism, and I needed it bad. Fortunately, the Two Percent Company had just what I needed and wanted, having compiled an excellent Fourth Skeptics' Circle. In fact, to prime the pump and fire up their readers for the skeptical blogging that was to appear today, the boys at the Two Percent Company even dedicated this entire week to a multipart debunking of the "psychic" Allison DuBois!

How's that for service?

Well, what are you waiting for? Go check it out!

(Now, let's see if Blogger lets me post this. If you don't see any activity on this blog for a couple of days, you'll know it's because I've gotten so fed up with Blogger that I had to take a break or risk trashing my computer in a fit of frustration.)

Curse you, Blogger!

Blogger is driving me nuts this week.

Yet another brilliant pearl from the keyboard of Orac was in production last night (medically related as promised), and Blogger was so incredibly slow that it was intolerable. I learned early on that it's highly advisable to hit "Save as Draft" every so often or risk losing the post I'm working on. For long or very important posts (like Grand Rounds), I'm very careful to write it in Microsoft Word first, then transfer it to Blogger to add the formatting and links and do the final editing. So, halfway through what was to be today's post, I saved my draft. No problem. I then went on to write the rest of it, after which I hit "Save as Draft."

Nothing happened for several seconds. Then several minutes. Then what seemed like a very long time. I waited. And waited. Then waited some more. It was getting late. I finally gave up. Finally, I went to bed, leaving the browser chugging away, trying to save the post. (I have seen Blogger on occasion take an hour to save a post or republish my blog; so I was not worried. I figured it would be saved, and I could post it before going to work.)

When I got up, what was there? Nothing except a "Document contains no data" error message. Where was my post? Gone. Fortunately, I had started it in Word and had part of it to work from, but it still means that I have to reconstruct it, and there's no time to do it until tonight or over the weekend. It will appear, but I fear it may not be as good as it might have been.

I have to ask the experienced bloggers around here: Are you having the same problems with Blogger? Should I pay the money and move my blog to Typepad? What are the advantages of Typepad over Blogger?

Now, fortunately, I usually have some miscellaneous posts lying around unused for just this sort of situation (or for when Orac has a case of writer's block or has no time to post); so I appropriated a backup today. As you may know, I've mentioned the Carnival of the Godless before, in which the articles tend to be critical of religion. Although I seem to be slowly drifting towards agnosticism, I haven't become a complete heathen yet, likely much to the disappointment of a few of the atheists who frequent my blog. (I still even go to Mass occasionally.) The other day, I stumbled across the Science and Christianity Showcase, a new blog carnival. I wondered: Can it tell us how one can reconcile religion with a life dedicated to science? (I never really understood how the conflict between science and religion got so out of hand, anyway. Many prominent scientists throughout history have been religious and could reconcile their observations of the natural world with their religion. Louis Pasteur, for example, was a devout Catholic and was reported to have died with his Crucifix in his hand after having requested that the story of the life of St. Vincent de Paul be read to him.)

Unfortunately, this new blog carnival (at least its first edition) is a very mixed bag. A couple of the articles in the Science and Christianity Showcase are of the simplistic and embarrassingly anti-intellectual "Why does the grass grow--because God makes it grow" variety, making me wonder if the persons writing them are truly scientists. Others are more thoughtful and nuanced, such as this article on quantum physics or this one on why science can't prove or disprove the existence of God. Most are in-between. Shockingly, there wasn't a single post primarily about evolution, which is the flash-point for the conflict between science and fundamentalist religion in the U.S. today. In fact, evolution was hardly mentioned. I have to wonder why, given its prominence in the conflict between science and religion. I might keep an eye on this carnival, to see how it goes, as I have been with the Carnival of the Godless, which has been generally good quality, even though I often don't agree with the content of some of the posts. It will probably get better.

I just hope that the two carnivals never come in contact with each other; they might annihilate each other, like matter and antimatter...

Last call for skeptics!

It just occurred to me a few minutes ago. In all my concern about putting together Grand Rounds, I forgot about my other favorite blog carnival, The Skeptics' Circle, which I myself hosted a month ago. But it's almost here; the fourth Skeptics' Circle is slated to appear at The Two Percent Company tomorrow! The Amazing Randi has taken notice of this carnival, guaranteeing that the profile of the Skeptics' Circle in the blogosphere will continue to rise.

Given that, I thought I'd take this opportunity to utilize the tail end of the huge traffic spike I got for Grand Rounds (generated by Instapundit, Dean Esmay, Accidental Verbosity, and most of the medical blogosphere) to plug the Skeptics' Circle. So, if you're a blogger and like to flaunt your critical thinking skills, get your best skeptical blogging submitted by 11 PM EST--and then join us for the Skeptics' Circle tomorrow!

Aftermath II: Tunes to do Grand Rounds by

Grand Rounds XXV is now in the history books, and I'm glad it was as well-received as it was. Hopefully my frivolous way of arranging the posts didn't distract anyone from the quality of the posts submitted (and, in a couple of cases, appropriated by me). My only regret about how it came together is that I just couldn't think of a good way to work in my two favorite shows: Deadwood (given that this is more or less a PG-13 blog at its worst, the unbelievable level of profanity in the show would have made it difficult to give those of you not familiar with the show a flavor of what it is like--although it would have made it fairly easy to parody); and, of course, 24 (discussed previously here), which I was actually watching as I was putting this together Monday night. Unfortunately, this week 24 irritated me for the first time this season with a clumsily inserted subplot about Arab shopkeepers who patriotically risk their lives to help Jack Bauer and prove that not all Arabs are terrorists. It was so obviously and unsubtly designed to blunt criticism that the show was unfairly portraying Arabs as terrorists this year and so badly written (I've never seen such cheesy dialogue on 24, even for Kim Bauer in previous seasons) that it landed with a big thud. Fortunately, CSI:Miami, which followed on CBS, was suitably over-the-top and cheesy to get me inspired again. (It's one of my guilty pleasures, a show with really corny dialogue that's still hard to resist.)

After all the work it took to put Grand Rounds together (including trying to figure out how to work in a couple of last-minute submissions and one late submission), my brain is a bit fried; consequently there will be no substantive posts on medicine today. Since it's been a while since I've played music critic, I thought I'd mention some new music that was playing as I was starting to put Grand Rounds together this weekend:

1. Some Cities (Doves). I love Doves. Not the bird, the band. I first discovered them in 2002, when their last album, The Last Broadcast, took up residence in my CD player for several months. Their music is lushly produced, Brit-pop-sounding rock, and they have a knack for very catchy tunes that build to a satisfying crescendo. Now they've released a new CD, Some Cities. The first time I listened to it, I was taken aback. The first song, Some Cities, is more stripped down than their previous efforts, and more muscular-sounding, with a heavier backbeat. However, the more I listened to the album, the more I realized that it was evolutionary, not revolutionary. The sound is just slightly more stripped down than their previous efforts, but the tunes are tighter, shorter, and more focused. Several are just as compelling as anything on The Last Broadcast or Lost Souls (their debut album), and a couple may be their very best work ever. This one is really growing on me. It looks like Doves will be taking up residence in my CD player again for several months in 2005. These guys deserve to be the next breakout band. If The Killers and Franz Ferdinand can hit it big in 2004, Doves deserve to hit it big in 2005.

2. Frances the Mute (The Mars Volta). I had never heard of these guys until a couple of weeks ago. After hearing samples of their stuff, I took a chance and bought their latest, Frances the Mute. As much as I like punk and other stripped-down rock, I still have a weakness for prog, and Frances the Mute is prog rock just the way I like it: bombastic and pretentious, with long, oddly-named multimovement suites of songs that nearly fill the 80 minute CD. It reminds me of Jethro Tull's Thick as a Brick and Passion Play or perhaps early 1970's Emerson, Lake, and Palmer or Yes, perhaps with a little Dream Theater thrown in for good measure. Heck, a couple of the songs are even in Spanish! But they also have the chops and imagination to pull it off without degenerating into Spinal Tap territory. As in my comments on Comets on Fire's Blue Cathedral and their mind- and speaker-melting acid rock, I didn't think there were any bands that made music that channeled the early 1970's in such a satisfying way, but Mars Volta takes early 1970's prog and updates it for 2005, just as Comets on Fire did for acid rock. I'm going to have to check out these guys' back catalogue...

There's more, but I haven't listened to the entire CDs yet, which means I can't review them properly yet: The Great Destroyer by Low, which is awesome, as far as I can tell so far; and Who Killed...The Zutons by the Zutons, which sounds lightweight but fun. (One of the Zutons' songs, Pressure Point, was featured in a Levi's ad.)

Grand Rounds XXV: What to watch this week

As a child of television, I had to wonder what Grand Rounds would look like if it were TV, presented by a TV critic from a magazine known for its somewhat snarky TV reviews. Well, it might look something like this...

WHAT TO WATCH: GRAND ROUNDS EDITION

A day-to-day guide to notable programs by ORAC Wheat (with apologies to Entertainment Weekly)

This week, Orac has decided to focus on medical-themed shows, and there's some good ones this week, and in some unexpected places! So, let Orac dig out the gold from all that dirt.

(All times are Eastern Standard Time.)

MONDAY

9-10 PM
Hannity and Colmes (Fox News, TV-G). Sean Hannity interviews the CodeBlue doc (famed creator of CSI:Medblogs and winner of various medblogging awards) on as their guest. CodeBlue presents the controversial results of his personal investigation into the recent complications of former President Bill Clinton’s bypass surgery. Based on his findings, at first, he wonders what the heck is really wrong with Clinton that surgery is mandated to fix it, even going so far as to wonder whether he has AIDS or cancer, and then he speculates that it may actually have been a complication from internal mammary artery harvesting. He then takes Clinton’s doctors to task for not recognizing the complication sooner. Hannity eats it up and bullies Colmes; Colmes just lays down and takes it. Like always. Formerly skeptical guest Nick (invited to rebut CodeBlue) is almost won over by this line of thinking. James Carville denies everything.

10-11 PM
CSI:Miami (CBS, TV-14). Evidence of Things Unseen. Horatio Caine (David Caruso) is invited by his old buddy Dr. Emer to help investigate the mysterious deaths of schoolchildren in the Phillipines. Naturally, Horatio brings his flaming red hair and his crew of attractive young forensic scientists and pathologists to do all sorts of disgusting tests on the corpses and cool-looking chemical assays on the cassava fruits implicated in the deaths (all with lots of multi-colored Eppendorf tubes--most regular scientists like Orac use plain tubes--and rock music, of course). Unfortunately, there are no shootouts (good thing it’s not a sweeps month); it turns out that it was probably organophosphate poisoning of the fruit. Horatio is frustrated because there is no villain at whom he can narrow his eyes menacingly and fire off one of his patented sarcastic lines that he likes to use before busting the bad guy. Bummer.


TUESDAY

8-9 PM
Nova (PBS, TV-G). Marvels of the Brain. In honor of Brain Awareness Week, Nate takes the viewer on a tour of the brain and investigates with Doctor-squared-to be MudFud how neuromarketing may represent the new frontier in advertising. Maria explains how treating mental diseases is different than treating physical disease.

9-9:30 PM
Scrubs (NBC, TV-PG). My Best Laid Plans. Madhouse Madman guest stars as a new intern. Hilarity ensues when Dr. Cox (John McGinley) and Madhouse Madman have to adjust to a hostile takeover by the new chief of medicine. (Congrats, Madman!) And, as if that isn’t enough, a beautiful new drug rep tempts intern Scott with her tricks.

9-10 PM
House, M.D. (Fox, TV-14). A Bird in the Hand. A patient who happens to be a newcomer to Grand Rounds (Grrlscientist) comes in with flu-like symptom, and, naturally, Dr. House (Hugh Laurie) can’t figure out what’s wrong with her, even though all of his young apprentices tell him it’s the avian flu. As usual, Dr. House makes several dangerous and incorrect (not to mention unethical) attempts at diagnosis and cure before, just as it looks as she is about to die (although it's not clear if from the flu or from Dr. House's interventions), he manages to pull out the real diagnosis and save the patient’s life, with only two minutes to go in the show. He is sorely disappointed, because he suddenly realizes that the avian flu may not have been all that deadly. In fact, he’s so disappointed that he allows Grrlscientist to pontificate on how vaccines are made, something he would normally never allow, because no one can ever be allowed to show that she knows more than him. In the meantime, as a subplot, an anaesthesiologist is told by a patient that if he’s wrong, she’ll sue him. Too bad no patients ever seem to say that to Dr. House. Of course, Dr. House is never wrong; so it’s a moot point anyway.

10-11 PM
Queer Eye for the Straight Guy (BRAVO, TV-PG). The Fab Five have a real challenge, when straight guy Orac, on the verge of a mid-life crisis and crazed because he’s just realized that he’ll never be able to afford that Italian sports car he dreams of, seeks Carson’s help to stop looking like such a total geek in preparation for presenting his data to a national audience.


WEDNESDAY

Check local listings for times.
The Oprah Winfrey Show (Check local listings for station, TV-G). Oprah discusses obesity (as she has so many times before). First, Aaron sets the stage by describing evidence showing that obesity is not just a problem in the cities, but also in rural areas. Yoshi, who has undergone laparoscopic gastric bypass surgery, discusses his battle with obesity and ultimate decision to undergo surgery. Dr. Phil then makes a rare appearance (since he got his own show, at least), after which there is a roundtable discussion with obesity experts.

10-11 PM
CSI:New York (CBS, TV-14). Top, this, Horatio! Not to be outdone by Horatio Caine, Mac Taylor (Gary Sinise) and the CSI:NY crew become embroiled in a murder mystery thousands of years old when old buddy (ever notice how old buddies always get you in trouble?) Dr. Sethi asks him to look at King Tut. Unfortunately, much to Mac’s disappointment, the CT scan shows that Tut didn’t die a violent death. Much subdued emoting in shadowy lighting follows, as Mac realizes he won't be famous after all. Also, as is de rigeur for all CSI shows, many scenes of unusually attractive scientists in clothes that are tighter-fitting than what most scientists wear making even the most boring chemical assays seem exciting follow.


THURSDAY

10-11 PM
E.R. (NBC, TV-PG). One Day There Will Be Something New. Dr. Charles, a new attending in the E.R., agonizes over a patient with a mysterious and painful problem, while a new anaesthesiologist must deal with a failure of anesthesia. In the meantime, Carrie Weaver (Laura Innes) wrestles over bed issues (you know, the ones that keep patients on ventilators in her E.R. for days, forcing the E.R. docs to have to wean patients who've become chronically ventilator-dependent because they've been in the E.R. so long) and goes to Tim for help, before going to Dr. Andy for help with the new electronic order entry system. (OK, it’s a slow day in the E.R., and the writers ran out of ideas—come on, the show’s almost 11 years old, fer cryin’ out loud!) In the meantime, called to the E.R. to see a smoker, the Cheerful Oncologist must make an unpleasant diagnosis, threatening his until now indestructible cheerfulness.

10-10:30 PM
Bullsh!t (SHOWTIME, TV-MA). Alternative Medicine and Antivaccination Quacks. Penn & Teller, in their usual hilarious and foul-mouthed style, trash chiropractic medicine (with the help of guest Paul Lee), find heavy metal contamination of Ayurvedic medicines (with the help of Skeptico, who also gleefully takes on alternative medicine in general), Organon (with the help of Quackblog). Finally, they take on an antivaccination nurse (and here)with the help of Peter Bowditch and Dr. Henochowicz, who utterly demolish the myths of the antivaccination movement. To put it all together, Anne tells the boys the signs you’re dealing with health fraud.


FRIDAY

8-9 PM
Fear Factor (NBC, TV-PG). Fear Factor moves to a special night and time because….because, well, even Orac, as disgusting as he can be at times, was too squeamish to lead off Grand Rounds with this, which is what he would have had to do if he put Fear Factor in its usual time at 8 PM on Monday nights—so just deal with it, OK? In any case, in this episode, contestants must face ear wax and smegma, courtesy of guest-host PZ Myers. Not for the faint of heart.

10-11 PM
Comedy Central Presents (Comedy Central, TV-PG). Comedy Central Presents...Nick Genes. Nick brings his standup act to the medical sphere, with his playful take on medical acronyms.

10-11 PM
Battlestar Galactica (SCIFI, TV-14). Flesh and Bone. President Laura Roslin (Mary McDonald) undergoes TomoTherapy by Medgadget for her advanced cancer. Desperate for a reliable means of identifying Cylons disguised as humans, Starbuck approaches Dr. Tony about using nanobots, developed in 2030 to cure human diseases, to tell the difference. (Actually, it just occurred to me while I was writing this: Why use TomoTherapy on President Roslin if nanobots could cure her? Is there something that's--oh--ominous about them? Or have the writers screwed up this time?) Meanwhile, the Cylons plot a final strike against the fleet. (Aren’t they always doing that?)

10-11 PM
20/20 (ABC, TV-PG). 20/20 reports on issues in medical ethics, introduced by a discussion by Dr. Bernstein on just what is an ethical dilemma. Segments include: 1. Behave or Die. Editors of The American Journal of Bioethics examine how AIDS policy is more moralistic than effective. 2. Infanticide. Different River reports on how the stigma appears to be lessening for infanticide and discusses the Groningen protocol. 3. Is it possible to be too honest? The Anonymous Clerk reports on the ethics of transference in psychological treatment and discusses the boundaries. 4. Not in my pharmacy you don’t! The Bioethics Dude reports on a pharmacist who won’t fill prescriptions for birth control pills and asks: Is that ethical?


SATURDAY

Nothing good on Saturday this week. Sorry. Saturday Night Live has Ashton Kutcher as host. Rent a movie. Or go see a movie. Except that this time of year is a wasteland for movies. I'm on call this weekend anyway. I can't go, because I hate it when my pager goes off while I'm in a movie. Damn. Maybe a DVD and hope that the pager doesn't go off too much...


SUNDAY

7-8 PM
60 Minutes (CBS, TV-G). Stories focused on the crisis in health care. This week, DB reports on long hours and the doctor shortage. Kevin, M.D. reports on the dim-looking future of primary care. Finally, the Thinking Nurse reports on a nurse who uses blogging as therapy. Finally, Morley Safer interviews Dr. Sydney Smith about the problems inherent in pay for performance. Interested Participant substitutes for Andy Rooney and asks why prescription drug information labels have to be so long and obtuse.


10-11 PM
Boston Legal (ABC, TV-PG). The Whistleblower. Denny Crane (William Shatner) and Alan Shore (James Spader) are recruited by Matthew Holt to defend a woman fired by a big HMO of whistleblowing because the company had apparently compromised patient confidentiality. In the meantime, Pearls and Dreams defends a doctor sued by a patient for forcing her to reschedule because she was 30 minutes late for an appointment. Gruntdoc defends doctors against the rapacious greed of Crane and Shore, explaining why lawyers’ claims that tort reform won’t reduce malpractice rates are flawed. All the while, everyone in the office either has sex. or spends a lot of time delivering quirky dialog. (This is a David E. Kelly production, after all.) And William Shatner overacts, muttering "Denny Crane" constantly. Which is one reason why I still love him, 36 years after Star Trek.

Well, that's it. It's been an honor and a blast to host Grand Rounds. I hope you enjoyed it and that you didn't consider my attempt at humorous take on Grand Rounds to be hack. (If it is hack, then perhaps I could get a few free lessons from The Cranky Badger. There has to be some benefit to having a relative who taught comedy writing...)

The next session of Grand Rounds will be hosted by the Well-Timed Period on March 22; so don't hesitate to send your submissions there for next week. I know I will. And, finally, thanks to Nick for organizing Grand Rounds.

Last call for Grand Rounds!

I'm honored to be hosting Grand Rounds tomorrow here at my humble blog. I've gotten some really good submissions so far (but I've also have seen a few really good ones that I'd really like to include--hint, hint!), but there's always room for more and still time to get more. Send your entries to orac_usa AT hotmail DOT com today. The deadline will be 9 PM EST.

Zombie update (OK, I lied)

Remember how I said that I wouldn't comment on the Kentucky zombie story anymore?

I lied.

Actually, I didn't lie, because I did leave myself the out that if anything else came up I might still comment. But wouldn't you know it that I couldn't go more than a few days without commenting on this incident again. As a followup to my last rant about this story, I've found a few other bloggers who are of the same opinion that I am: That the Kentucky law against "terroristic threatening" is a bad law and that the police are using a frighteningly (to free speech advocates, at least) loose interpretation of the definition of "terroristic threatening."

James Bow says: The possibility that this was an attack on free speech weighed heavy on me.

Matthew Rossi says: More unfortunate is the society that thinks that they can stop these awful things by declaring criminal everyone who suggests openly that they might have a dark side. It's in these societies that mental illness festers and grows, that people who truly are sick don't seek help for fear that they will be declared enemies of society.

M. Valdemar says: Call me a cynic, but I think the most likely truth in this story is that Poole is lying and the courts are overreaching. What we've got here is real Clash of the Titans, bluegrass-style.

Bottom line: The Kentucky law, in my opinion, is a bad, bad law. It is a threat to the First Amendment and should be repealed or overturned.

OK, now no more posts on this topic for a while.

Also, I promise that my first decent-sized post after Grand Rounds tomorrow will be medicine- or science-related. It may even be on par with some of my best (as seen in Essential Orac on the sidebar), but I'll leave that to the reader to judge...

Iwo Jima remembered

As a followup to my commemoration of the flag-raising at Mt. Suribachi, here is a New York Times article on the 60th anniversary commemoration of the battle for Iwo Jima by U.S. veterans and Japanese government officials. The article is also interesting because of its brief discussion of the differences in perception between Americans and Japanese on the battle, particularly in relationship to the Tokyo firebombing.

In honor of Kentucky zombies...

No blogging today (at least not anything big). Speaking of "pieces," however, in honor of the rather prolonged attention to the Kentucky zombie story I've shown over the last week and a half (with concomitant neglect of my usual medical and science blogging--fear not, after Grand Rounds I'll return to the usual topics, which have been building up during this diversion), I want everyone to check out this.

Just be careful.

And, no more zombie posts for a while, unless something happens in the William Poole case that compels me to comment.

Weekend fluff, part 8

Blogging will be light or nonexistent until Tuesday, when I host Grand Rounds. (Medbloggers: Have you sent in your submission yet? Well, what are you waiting for?)

However, that never stopped me from taking five or ten minutes to post a little weekend linkage fluff, while seeking inspiration about how to construct this week's Grand Rounds:

1. Here's an amusing photoblog that specializes in catching public figures in mid-blink.
2. Go Fug Yourself!
   
3. Here's a site that claims to have gathered actual quotes from high school history reports written by students. If these quotes are legit, it does confirm my belief that most Americans have a screwed-up understanding of history. On the other hand, it could just be an urban legend or a typical Internet joke.
   
4. Want some beautiful photos? Go here.
5. Time to head to Daytona Beach.
6. Mullets rule.
7. Even as a center-conservative type (or maybe because I am a center-conservative type), I have to admit that Republican Jesus cuts close to the bone and has done so for a while now.
   

Less than four days until Grand Rounds XXV

I've already plugged The Skeptics' Circle, even though I'm not even hosting it. Then, last night it occurred to me that I should be much more concerned--at least this week--with the blog carnival I am hosting rather than the one that I'm not, particularly since there are less than four days until Grand Rounds XXV is scheduled to appear at Respectful Insolence on Tuesday, March 15. Given that the weekend is almost upon us, I thought that this would be a good time to put out a second call to the medical blogosphere for submissions, knowing as I do (mainly because I've been a frequent contributor to Grand Rounds since I first discovered it a couple of months ago) that many, if not most, contributors probably don't even think about what to submit to Grand Rounds until the weekend before the deadline, meaning that a strategically timed reminder can't hurt.

Soooo.....

Please send your submissions to me at orac_usa AT hotmail DOT com. The deadline will be Monday, March 14, at 9 PM EST (mainly because I want to post this puppy by the early morning hours and then get some sleep). Please include the words "Grand Rounds" in the Subject: header of your e-mail. Because of what has happened with another carnival because of an overly sensitive spam filter, I will acknowledge all submissions with an e-mail; if you don't get an acknowledgment within a day or so, please e-mail me again or leave a comment here for me to contact you.

I'm really hoping to make Grand Rounds XXV a great one, but I don't have a prayer of succeeding without you and your best medical blogging.

I never realized

Apparently, I'm way richer than I ever thought I was. Or, at least that's what some car dealers seem to think. Someone seems to think I might be in the market for a new Ferrari or Maserati.

I got a letter in the mail yesterday advertising a new Ferrari/Maserati dealership in the area. Now I'm guessing that they don't just mail those things out to everyone, as a Ford or Chevy dealer might. That's why I'm puzzled. Why did I get one? What made the marketing gurus think I might want to own a new Maserati or Ferrari? On second thought, of course I'd love to own a new Maserati or Ferrari! What middle-aged guy who's probably only a few years at most from a raging mid-life crisis wouldn't want to own one? Perhaps a better question is: What made the marketing gurus think that I might actually be able to afford to buy one? These cars range from around $90,000 (the entry price for a Maserati Spyder) to well in excess of $125,000 (the prices for some of the Ferraris). What made them think that I could afford to spend that kind of loot on a car or that I would even want to spend that money (if I had it) on such a car, particularly a two-seater sports car with no trunk space that could only function as a secondary car? After all, the car payments would be almost the size of a mortgage payment for a fairly nice house in some of the less expensive parts of the country.

My best guess is that it's because I'm a doctor, and the common perception that doctors are all rich still persists.

That's it.

That's the only reason I can think of. The dealer probably purchased the list of all the doctors in the state and mass-mailed us all. This explanation seems particularly likely because the letter and brochure were mailed to my office, not my home, and my office is my address of record for the medical board of my state. Certainly it's not because I've ever made extravagant purchases that somehow landed me on a mailing list of the ridiculously affluent, like a yacht or something.

I realize that some doctors might be affluent enough to have the excess income to indulge in such expensive and impractical (although undeniably attractive) toys, but not the ones I know. Of course, I do happen to work in academia, and that automatically means that I make considerably less than most other surgeons. Certainly, to me at least, the rewards of an academic career far outweigh the loss of potential income and the much longer training I underwent (I didn't get my first "real" job until I was 37, for example), but accepting a lower salary is inevitable in academics. It just comes with the territory. I could easily increase my income by 50-100% or even more if I went into private practice, but I doubt even that would be enough for me to afford one of these machines as a second (or even first) car. Perhaps a few of the private practice guys would be in the market for one of these gorgeous machines.

No, I can't picture even the private practice docs I know (with the possible exception of a couple of plastic surgeons in the area) having the excess income to spend on cars like these.

Don't get me wrong. I'm not claiming any sort of poverty, my remaining student loan debt notwithstanding, nor am I asking for sympathy, nor am I indulging in self-pity. (Most of my readers, I daresay, would take me to task if I did, and I would probably deserve it.) I make a comfortable living, and, like most academic surgeons, because a portion of my salary comes from clinical income, I make more than most nonmedical faculty of equivalent rank, as I have mentioned before. Even in a state with a ridiculously high cost of living and stratospheric real estate values, it's more than enough. Indeed, for the first time in my life, I have nothing to complain about, at least as far as my income goes.

Even so, I don't make nearly enough to afford one of these cars, nor can I imagine my salary ever being sufficient to let me purchase one. In fact, even if I were some sort of businessperson making millions of dollars a year, such that a car like one of the Maseratis in the brochure would not be that difficult to afford, I still don't think that I'd be able to bring myself to pull the trigger and buy one. Why? Perhaps it's because I come from a modest, solidly middle-class background. We weren't poor, but we certainly weren't rich. Until relatively recently in my life, I've always lived on modest incomes--because I had to. Through college, medical school, and even well into residency, I've always had to live fairly modestly, for the most part, all while watching my student loan debts mount, awaiting some day in the seemingly distant future, when I would have the means to repay them. My one big vice was music, but I never let even that get out of control. No, unlike many of you, I was never poor, but I do know what it's like to live within a fairly tight budget, a skill that has served me well.

Now that I'm making more money than I've ever made before and actually paying down my student loans, however, it's hard to escape a vague feeling that I don't really deserve my success, that I won't be able to sustain it, that it could all disappear at any time, or that I'm just one failure or illness away from the poorhouse, my disability insurance notwithstanding. I've heard of this sort of feeling--the "imposter syndrome"--among successful people, but I never really much believed it possible until recently. (I had always considered it rather unbelievable when I was in the midst of my long struggle to get where I am now that I might not think I deserved every bit of what has come my way.) It may also be a dash of good old-fashioned Catholic guilt from my upbringing that prevents me from indulging in any sort of major conspicuous consumption beyond a nice new Macintosh computer every three or four years (I have my eye on the Macintosh Dual Processor Power Mac G5 right now, in fact, but, alas, it's too soon since my last computer purchase) and a very nice car that I bought a year ago. Or maybe it's the fact that my wife would probably divorce me if I ever spent $125,000 on a sports car, never mind whether I could come up with the cash or credit. It may even be the liberal politics the vast majority of my family (other than me) subscribes to that permeated my upbringing but apparently failed to stick to me, with the exception of my dislike of our current President. Possibly it's your basic Midwestern practicality. Or maybe it's a combination of all of the above. Certainly, whatever it is, I find it amusing at best and appalling at worst that some dealer of very expensive, very impractical sports cars has somehow targeted me as a potential client, most likely only because I happen a doctor.

On the other hand, that Maserati Spyder is really nice-looking, isn't it, with its open top and sleek styling? And wouldn't it be cool to fire up the 400 hp V8 engine to go 0 to 60 MPH in 5 seconds and reach a top speed of 180 MPH?

A guy can still dream, can't he?

One week to go

It's hard to believe, but there's less than one week to go until the fourth installment of the Skeptics' Circle, the biweekly blog carnival in which bloggers get to strut their stuff as far as their critical thinking skills go, answering myth with fact, countering pseudoscience with evidence, and quackery with science. This time it's being hosted at the Two Percent Company. Their call for submissions is here, and the deadline is Wednesday, March 16, at 11 PM EST. With the weekend fast approaching, perhaps my fellow bloggers will consider using the weekend to write up some good skeptical blogging to submit to the Two Percent Company next week. If you're not familiar with the Skeptics' Circle, in a way I'm a bit envious, because you have some fine blogging to experience for the first time. Check out the first, second, and third editions of the Skeptics' Circle for inspiration and examples of how it's done (not to mention for the education and entertainment value, as well). And, if you want to host someday, contact St. Nate, and he'll get you on the schedule of upcoming hosts.

Kentucky Zombie update

Last week, I commented on a story, first credulously (perhaps because the story hit a nerve personally) and then in the addendum/update more skeptically. It was a story in which a young man from Kentucky, William Poole, was arrested for making “terroristic threats,” based on his writings. In the first story that I encountered about this, Poole claimed it was because of a story he had written about zombies taking over a school. This story got wide play in the blogosphere, but a little more digging showed that it was more complex than I had first realized. Besides blaming myself for lack of skepticism, I still find it disturbing that the story was so easy to believe. If there weren’t such a post-Columbine paranoid climate of fear and “zero tolerance” in our schools, no doubt my B.S. detector would have immediately told me not to take this story at face value.

Having been burned once, I promised to try to keep up with new developments. Well, there’s been one, although I’m a couple of days late noticing it. (I'm rather surprised the anonymous commentor who had been so vocal in my previous post didn't remind me.) Mr. Poole has finally been arraigned, as described here and here.

Here's an excerpt:

William Poole, 18, was arrested February 22. In a jailhouse interview with LEX 18 News shortly after his arrest, Poole said that the writings that got him arrested are being taken out of context. Investigators say they discovered materials at Poole's home that outline possible acts of violence aimed at students, teachers, and police.

In court Tuesday, police released some of Poole's writings, and they contradict some of what he told LEX 18 in his interview. Poole says he wrote the short story for English class. Not so, according to police. They say his teachers deny knowing about such writings, and add if they did, the teachers would have reported their concerns about the contents to school officials.

Some of the details Poole wrote about included wanting to assemble a group of boys he called "True Soldiers and "No Limit Soldiers" to take over a high school.

Police say they've interviewed seven George Rogers Clark High School students who say Poole tried to recruit them into his group.

Investigators add that Poole wrote about bringing weapons and tools into a school. And, perhaps most disturbing, they say Poole wrote down what he called "Dates of Death", which happened to be February 19 and 20 of 2005 - dates mentioned that were just two days before police arrested Poole.

OK, so it looks as though the police account is probably closer to the truth than I had wanted to believe. However, one thing the police involved in the case keep saying still disturbs me:

Even so, police say the nature of the story makes it a felony. "Anytime you make any threat or possess matter involving a school or function it's a felony in the state of Kentucky," said Winchester Police detective Steven Caudill.

Let’s get this straight. ANY time? “Possess matter involving a school”? What does he mean by that? Does “matter involving a school” include possessing a school yearbook maybe? I may have been wrong to swallow Poole’s story so uncritically at first, but this story still suggests to me that the police in Kentucky have gone off the deep end a bit and that their law against “terroristic threatening” is way too vague. In the end, after having learned a lot more, what scares me the most about this incident is the "nature of the story makes it a felony" statement by the police. Does it bother you? If it doesn't, it should. It sounds like censorship and violation of my free speech. That’s way scarier than Poole, in my book, given that Poole is looking more and more like a disturbed young man who got busted for having fantasies that disturbed young men often have.

Let’s assume, however, that Poole wrote exactly what the police claim he wrote (although we may never know now if that’s the case, because the judge ordered his writings sealed—which makes me suspect that the end result of this case will be a plea deal in which Poole’s writings are permanently sealed, thus sparing the police any embarrassment if the writings turn out not to be as threatening as claimed). The police have never stated that what Poole wrote wasn’t a story, as Poole claimed, at least not as far as I can tell from the news reports. So, in essence, the police are saying that writing a story whose content sounds like a threat against a school is a felony in and of itself.

A felony? What about the First Amendment? Try to convince me that this sort of law and reaction aren’t a danger to free speech. But, before you do, consider the law itself, as quoted here:

Under Kentucky law, a person is guilty of terroristic threatening in the second degree when they threaten to "commit any act likely to result in death or serious physical injury" to students, teachers or employees of a school.

Now consider what little we actually do know about what Poole wrote, as described in court testimony and reported. Here is an excerpt from the writings, the only one quoted verbatim thus far (descriptions of other parts are here and here, but no other direct quotes):

They stood at the yard carrying bags full of weapons and tools. They yelled kill them. All of soldiers of zone two started shooting. They are dropping every one of them. After five minutes all the people were laying on the ground dead. [Note: According to the cited stories, Poole's fictional organization was broken up into four zones. Zone One was in Barbourville, Kentucky; Zone Two was Clark County; Zone Three was in South Carolina; and Zone Four was in New York City.]

Is the above quote disturbing, coming, as it does, from a high school student? Sure. Poorly written? Definitely. But it still sounds like a piece of a story to me, albeit a bad one. I’m not sure how this constitutes “terroristic threatening” or whether Poole is actually “threatening” to actually do what is described. It’s hard to tell for sure, given how little was revealed in the news reports of the court testimony. However, if what is described in the court testimony as described in the news stories is the most threatening of Poole’s writings (not an unreasonable assumption, given that the police knew they were under the microscope and that they wanted to get an indictment), then I don’t see how Poole’s writing should be criminalized even under the disturbingly vague criteria of the Kentucky terroristic threatening law, even if the police have represented it accurately. It should not be against the law for even a minor to write something like that just because it was written about a school. I hope that even those who have commented on my first post about this incident so vociferously in favor of Poole’s being arrested can understand why I find the law under which Poole was arrested and charged very disturbing as far as our First Amendment rights go. (And, no, Poole's story is not like yelling “fire” in a crowded theater or inciting a mob to violence. It appears to be far too vague to meet the criteria for presently accepted exceptions to the First Amendment of incitement, threats, or imminent danger.)

Don’t get me wrong. Don’t jump to the conclusion that I don’t care about the contents of the story. I’m not saying that teachers or police should ignore such a violent story if they come across it or that they should not be concerned enough about it to report it to the authorities. However, the state doesn’t need to criminalize speech to prevent a disturbed student from violent acts. For example, the story could certainly serve as reasonable grounds to search Poole’s house, locker, and anywhere else the police could think of for weapons. It’s not necessary to make writing the story itself into a felony, especially since there are no specific threats or people mentioned in it. (Remember, as far as I can tell, the only crime Poole has so far been charged with is “terroristic threatening.”) Similarly, the police claim that Poole tried to recruit others to his “group” to help him take over the school. If that’s actually the case, then I’d be willing to bet that there are plenty of laws against conspiracies that could have be used to prosecute him. But that’s not the law the prosecutor chose. He chose the terroristic threatening law. Finally, I tend agree with Poole’s grandparents. He probably needs counseling and psychological help, not jail.

So, while I was disturbed about the arrest of Poole when I first read about it, it turns out that I had gotten myself all worked up for the wrong reason. I now correct my mistake. Now I’m getting myself all worked up about this incident for what I believe to be the right reason—its negative implications for free speech. Under Kentucky’s “terroristic threatening” law as it was interpreted in this case, I would have to be afraid that writing any violent story set in a school or anything involving a school that could be remotely perceived by someone as threatening might potentially be considered a felony in Kentucky. If I lived in Kentucky and were a writer, I’d be very afraid of writing any sort of fiction in which anything worse than a bad case of acne happens in a school.

Perhaps you think that's no great loss. I disagree. As Benjamin Franklin once famously said:

They that can give up essential liberty to obtain a little temporary safety deserve neither liberty nor safety.

Tangled Bank, Issue #23, The Birdday Edition

Issue #23 of Tangled Bank has been posted at Living the Scientific Life. This edition happens to be dedicated to the birthday of the founder of Tangled Bank, PZ Myers of Pharyngula fame, and, as usual, features the finest science blogging from the last couple of weeks. Check it out.

60 years ago tonight: The Firebombing of Tokyo

Sixty years ago tonight, American forces bombed Tokyo.

This is an attack that is rarely discussed, at least in comparison to the debate and controversy the bombings of Dresden and Hamburg engendered, even though the firebombing of Tokyo killed far more people in one night than both of those bombings combined, an estimated 80,000 to 100,000. The attack on Tokyo is also rarely discussed even in the context of the atomic bombings of Hiroshima and Nagasaki, even though more people died 60 years ago tonight in Tokyo than died as a result of the atomic bombing of Nagasaki. In 2005, as for several decades before, the firebombing of Tokyo, indeed, the entire bombing campaign against the Japanese mainland, remains obscure in comparison to the bombing campaigns against Germany. Few Americans are even aware that it occurred, or of the magnitude of the bombing, and most Japanese don't want to discuss it.

Just after midnight on the night of March 9-10, 1945, 334 heavy B-29 bombers began dropping 1,665 tons of incendiary bombs on Tokyo, where the vast majority of buildings were made of wood and easily flammable materials. By the time the bombing was complete, over 15 square kilometers of Tokyo were leveled, and over 1 million were left homeless. This was just the opening salvo in a bombing campaign that equalled or rivaled the campaign against Germany.

Witness Saotome Katsumoto was 12 at the time of the raid and later reported:

It was a midnight air raid, but unlike anything we had experienced before. The planes flew in very low, so low you could see the fires reflected in their undercarriages, and they dropped mostly incendiaries. The fires started everywhere and we tried to fight them, but there was a strong, northerly wind fanning the flames. All around me people were on fire, writhing in agony.

Although I've tried to debunk a lot of the myths about the Dresden bombing, putting it into historical context and explaining that Dresden was indeed a military target, I have a harder time explaining our firebombing of Tokyo. For one thing, as much as one could question the morality of the bombing of Dresden, it was not done with primarily incendiaries and was targeted at railway stations, industrial targets, and infrastructure, not primarily at civilians. Dresden was to be a strongpoing in the defense against the advancing Soviet Army. True, Tokyo was the capital and therefore the nerve center of the Japanese war machine, and, by the logic that had prevailed by the end of the war, certainly the governmental and military complexes in the city were legitimate targets. However, the very design of the bombing was morally worrisome. Major General Curtis LeMay, the architect of the attack, intentionally targeted civilians with incendiaries in an attack plan designed to cause the maximum possible destruction and casualties. As he himself later said, victims were "scorched, boiled, and baked to death," and as victims themselves described, even the river was no protection from the wall of fire that engulfed the city. The rationale of the bombing campaign was to destroy Japanese industry, but more importantly to break the will of its people. It is hard not to speculate that the punishment meted out to Tokyo and then to other Japanese cities in the final months of the war was not at least in some measure revenge for Pearl Harbor and the atrocities committed by the Japanese during its invasion of the Phillipines (such as the Bataan Death March) and in the Rape of Nanjing and the relentless bombing of Shanghai. (Indeed, there was a widespread belief among the American military and public that the Japanese "deserved" what they were getting.) It is also true that nowadays it is very hard indeed to imagine a time of "total war" against a foe that was clearly fanatically committed to winning at all costs or dying in the attempt, who launched suicidal Kamikaze attacks against the U.S. Navy. (Al Qaeda, as fanatically dedicated to harming the U.S. as its members are, does not pose the same threat. Certainly, given that we have not even instituted a draft or in any real way mobilized the civilian population for this conflict, the present "war against terror" is by no means a "total war.") One also has to remember that there was a great fear of up to a half-million American casualties predicted for an invasion of the Japanese mainland, which was another reason used to justify "softening them up." Nonetheless, even at the time, there were those who hesitated at the magnitude of the payback, those who feared we were losing the moral high ground. They had a point.

Today, there is little evidence in Tokyo of the destruction visited upon the city 60 years ago. Gleaming skyscrapers rise from what once were ashes, and Japan is now one of our closest allies. Of more concern is that the generation who can remember firsthand the horrors of the last World War, including the Holocaust and the Rape of Nanjing, as well as the bombings of Dresden, Hamburg, London, Coventry, Shanghai, Stalingrad, and Tokyo, are rapidly aging and dying off. As that happens, I have to be concerned that it will once again become possible for such carnage to be inflicted in a future war. As Jonathan Rauch put it three years ago:

It is true that the United States in 1945, in marked and important contrast with, say, al Qaeda in 2001, viewed the targeting of civilians as a last rather than a first resort; and it is true that throughout history even the virtuous have wound up fighting dirty if fighting clean failed; and it is true that sometimes the good must do terrible things to destroy a great evil. But it is also true that if the good find themselves driven to barbarism, they own up afterward and search their souls.

America is better at reforming than at repenting, which is probably just as well. Perhaps America's quiet way of paying its debt to the dead of Tokyo has been to take unprecedented pains, far beyond anything done by any other great power, to design and deploy weapons and tactics that spare civilian lives. A lot of innocent people in Yugoslavia and Afghanistan are alive today as a result. Still, the erasure of the Tokyo firebombing from Americans' collective memory is not a noble thing.

Indeed, it is not. But it is, unfortunately, inevitable, given our inevitable mortality. Even now, some have criticized America's great reluctance to inflict civilian casualties as "tying our hands" (see the discussions that preceded our incursion into Fallujah last year), but I, like Mr. Rauch, view this reluctance to kill civilians and great effort to develop "smart weapons" and tactics that minimize "collateral damage" as a noble thing. Perhaps it is a result of the massive destruction and killing we inflicted to win the last World War. If true, it would show that, to some extent at least, we have learned from our previous conflicts. However, we must also still remember that even the "smartest" weapon is a blunt instrument that, when used in war, will inevitably result in the deaths of those who were no its target.

More on this topic:

The night hell fell from the sky
100,000 people perished, but who remembers?
Firebombs over Tokyo
Museum recalls Tokyo firebombing

Grand Rounds XXIV

And now for something that (mercifully, my readers are no doubt thinking) has nothing to do with Bill Maher or his idiotic statements about Pasteur and is far more important than the blatherings of a windbag comedian who thinks he knows more than he actually does:

Grand Rounds XXIV is now available at Hospice Blog. The Hospice Guy has taken his turn at gathering the best of the medical blogosphere and boiling it down into one nice, neat package. They should give those of us with M.D.'s CME credits for this stuff. It's that good.

Next week is my turn to host. I just realized as I type this that, through some quirk of fate, I've somehow landed the honor of hosting the 25th edition of Grand Rounds at Respectful Insolence. Wow. That's a lot of pressure and expectation, given the routinely high quality of preceding Grand Rounds. (I may not have known what I was in for when I volunteered to do it a couple of months ago.) I realize that some of my readers may be expecting me to try to top my last turn at hosting a blog carnival, The Second Skeptics' Circle, in which I integrated the articles into a story in which a raucous bunch of skeptical free-thinkers were having a loud discussion of various issues in the back meeting room of a bar. Certainly, I was inspired by the Madhouse Madman's take on Grand rounds in January. I was also very impressed by Maria's use of the menu as a means of organizing the posts last week (although some were a little taken aback by the food analogies to various body parts not normally associated with food).

After such great examples, I'm finding it harder to think of creative ways of doing a blog carnival that don't just copy someone else's idea or repeat what I've done once before. I have a couple of ideas about how this time around I might accomplish this. However, I'm not yet sure if Grand Rounds will lend itself to what I have in mind all that well; so the "creativity" (which some no doubt consider weirdness, given my warped mind) might actually have to wait until my turn to host Tangled Bank in April. Right now, though, I'll try to lower expectations a bit. I may well end up using a more conventional method of presenting the posts if I don't like the results of my more out-there ideas. Not that that should be a problem. The posts submitted to Grand Rounds are almost always of such high quality that they probably don't need the host (me) to be messing with them too much by weaving them into a story or menu (although such devices can certainly add to the entertainment value of Grand Rounds or other blog carnivals when done with suitable panache). I expect that the submissions to this week's Grand Rounds will be no different in terms of high quality; so it may not be such a bad thing if I end up being a bit more conventional in my presentation.

But, then again, I may not end up being conventional. I'm unpredictable that way. You'll just have to wait until next week to see.

Enough of my long-windedness. After you're done checking out this week's edition of Grand Rounds, it's never too early to think about next week. So, without further ado, here's the official call for submissions to next week's Grand Rounds. Please send them to me, Orac, at orac_usa at hotmail dot com. The deadline is Monday, March 14, at 9 PM EST (but if you can get them to me by the end of this weekend, I'd be very appreciative). Please be sure to put the words "GRAND ROUNDS" in all caps in the Subject: header and include the URL for the permalink to your post in your e-mail. As a surgeon/scientist, I'm particularly interested in articles having to do with surgery or medical research (but, as always, articles on all medical topics are welcome), and articles on these topics will probably get priority for being listed near the beginning. I will also acknowledge each submission with an e-mail; so if you don't hear from me within 24-48 hours after e-mailing me, contact me again or leave a comment after this post. (I don't want any hyperactive spam filters to prevent anyone's submission from being included, which is unfortunately what happened to the last edition of Tangled Bank.)

Maher redux

This will be the last I mention this for a while, after my last post. I promise. Really, I do (unless, of course, something new comes up that gives me a new angle).

Oddly enough, I was flipping through radio stations on Monday and I noticed the right-wing talkers ranting about the very same Real Time with Bill Maher show I had criticized for Maher's idiotic statements about vaccines and Pasteur. But they were doing it for a very different reason. They were all in a lather because, in the same show, Maher apparently sucked up to Ward Churchill, he of the "chickens coming home to roost" post-9/11 fame. The clips they played were rather embarrassing--to Maher. For example, Maher sympathized with Ward Churchill about being "taken out of context." (The problem for Ward Churchill was that he was taken in context. Indeed, having read his entire essay, I don't see how labeling the employees in the World Trade Center as "little Eichmanns" could be less damning in context.) It reminds me. I've been meaning to do a little comparison between Churchill's writings and a little article to which it sounded eerily similar, one that my readers may not be as familiar with (although my old fellow travellers on alt.revisionism will probably figure out which infamous post I'm referring to). I'll try to get to it later this week; I just have to dig the text file containing the original article out of my archives. I hadn't done it yet because I thought the whole Ward Churchill thing was so over. But maybe it's not, at least not yet.

Is Bill Maher really that ignorant? Part 2

The short answer is: Yes. The long answer is below.

When I first posted on this yesterday, I had hoped things weren't as they appeared. Although representing himself as a free-thinking skeptic who proudly trumpets his atheism and calls religion a "neurologic disorder," Bill Maher has, sadly, apparently officially passed from the realm of "smug but entertaining curmudgeon that I usually disagree with but sometimes find entertaining anyway" to full-fledged fruitloop, maybe even an altie. I base this judgment on statements he made on Real Time with Bill Maher on Friday, March 4. On that show, he stated that he doesn't believe in vaccination:

I don't believe in vaccination either. That's a... well, that's a... what? That's another theory that I think is flawed, that we go by the Louis Pasteur theory, even though Louis Pasteur renounced it on his own deathbed and said that Beauchamp(s) was right: it's not the invading germs, it's the terrain. It's not the mosquitoes, it's the swamp that they are breeding in.

Sources: Here and here. There's also some very scary misinformation on his message boards from last year. (I realize that Maher probably has no idea what sorts of things people are saying on his message boards, but nonetheless the anti-vaccination fruitloops are out in full force there.) Once again, there is no evidence whatsoever that Pasteur ever "recanted" on his deathbed and good evidence that he did not, as explained by Peter Bowditch. He certainly never said that Beauchamps was correct. This story is a myth promulgated by alties, plain and simple. I'm speculating that, as an atheist himself, Maher probably doesn't buy the rumors by some fundamentalists that controversial atheist activist Madalyn Murray O'Hair recanted before her death and said that there is a god. He would quite rightly point out that there is no evidence that she ever did any such thing. (Such stories are also highly implausible because the only persons who could have witnessed such a conversion would be her kidnappers and killers.) Similar myths of deathbed recantations exist for Darwin, in which it is rumored that he renounced evolution before dying. Even most creationists do not believe these myths about Darwin's supposed "conversion" now, so ungrounded in any evidence are they. Yet, for all his self-proclaimed "skepticism" or "cynicism," Maher swallowed second-hand, unsubstantiated rumors and myths that Pasteur recanted on his deathbed and has now repeated these myths on HBO, despite the fact that there is no more evidence for them than there are for the myths of O'Hair's or Darwin's recantations.

What disappointed me, however, is that Dr. Bernardine Healy, former Director of the NIH, was a guest and that she didn't slap Maher down hard for his idiotic statements about vaccines and Pasteur. (It's possible that she was so taken aback by the ignorance revealed in his assertions that she was at a loss for words other than "Oh, dear," but that's no excuse.) Only Dave Foley-- of all people!--took Maher on, but then just mildly:

You gotta say, the polio vaccine turned out well. You know...

In fact, Maher even had the chutzpah to say this to Dr. Healy:

You're in denial, about I think is a key fact, which is it is the at... people get sick because of an aggregate toxicity, because their body has so much poison in it, from the air, the water... Yes, much of it is not our fault and we can't control it. But a lot of it we can and even the food people think is good for them, is bad, and I'm not presenting myself as a paradigm. I do cruddy things to my body too and I enjoy them. But when I do them, I'm not in denial. I'm not eating fat free cheese and saying: "You know what, I'm healthy for eating this." I'm saying: "Oh yeah, this is chemical goop and this is killing me.

"Aggregate toxicity"? Hulda Clark (also here, here, here, and here) or the chelationist about whom I complained couldn't have said it better. From this sort of scientifically and biologically flawed thinking, it's only a short step to advocating colon flushes or chelation therapy to eliminate vague and undefined "aggregate toxins" or "heavy metal poisoning." No, I am not saying that diet and environment don't matter as far as your health is concerned and that there are not substances to which we are exposed that are bad for us. What I am saying is that alties frequently blame some vague "toxins" or "aggregate toxicity" for a wide variety of ailments without ever specifying what the "toxins" are that are supposedly causing the disease in question. It appears that Maher has fallen into this mindset of lumping environmental factors we can control (diet, smoking) with ones we can't, and then attributing to them all some sort of vague "aggregate toxicity" (conveniently undefined or only very vaguely defined) as the root cause of disease. Alties make these sorts of assertions all the time. Indeed, they seem to be obsessed with "impurities" in their bodies, livers, colon, or blood, and many of their "cures" are purported to purge the body of these "toxins." (Sometimes their obsession with "toxins" reminds me of General Jack D. Ripper from Dr. Strangelove, Or How I Stopped Worrying and Learned to Love the Bomb and his obsession with the purity of his--as he put it--"precious bodily fluids" and maintaining his "purity of essence.") Unfortunately, alties almost never identify which specific toxins they are talking about, provide scientific evidence that these undefined "toxins" cause disease, or demonstrate that their favored remedies actually remove these "toxins" and cure the disease in question. Certainly, Maher's comments are consistent with this sort of mindset that "toxins" are to blame for all disease. He is at once seemingly skeptical of conventional medicine (but in reality it's only a knee-jerk distrust) yet at the same time very credulous when it comes to claims made by alties and apparently also to intimations of vast corporate conspiracies to suppress what he views as the "truth."

Thanks again to Skeptico, for giving me the heads up. I also suggest contacting Bill Maher through his show's website and asking him if, as such a "rational" and "skeptical" person, he feels any responsibility for peddling false information about vaccines and Pasteur. Suggest that he should revisit the issue on a future show and provide actual evidence for his assertion about Pasteur or his "not believing" in vaccines. Perhaps he could even invite someone who is capable of providing a strong rebuttal to his claims, someone who knows a thing or two about the myths promulgated by anti-vaccine activists and how they are fallacious.

Peter Bowditch, perhaps--by satellite from Australia?

UPDATE/ADDENDUM 03/08/2005: The official transcript of the show in question has been posted here. As you can see, the original first attempt at transcription I cited above was quite accurate.

A field guide to biomedical meeting creatures, part 1: Any questions?

I'm back at home. The meeting went fairly well and my talk was well-received.

Surgical meetings are odd beasts. Although they are similar in some ways to other medical and basic scientific meetings, they tend to be much more formal. For example, all the men wear suits and ties (or at least a tie and a good sportsjacket) and the women all wear business suits. You'd never see that at a basic science meeting, where even many of the speakers don't dress up all that much. (Heck, I once speculated that, if I were to wear a suit to a basic science meeting, people would probably think I was the concierge or something.) I doubt even internal medicine meetings are so formal, although I've never been to a medical meeting that wasn't surgical, with the exception of the AACR, which is in reality a hybrid medical-basic science meeting. Everything else about surgical meetings tends to be formalized, as well.

In any case, in observing a number of talks and in giving my own, it occurred to me that a little-appreciated art is that of dealing with people who will inevitably ask questions after you're done with your talk. It's a tough thing, as the people who come up to the microphone to ask questions sometimes have agendas that aren't always immediately apparent, agendas that often don't include simple curiosity about your results. You must also realize that, while you can and should control the content and delivery of your talk, you cannot control what comes after. You can only try to be prepared for it. I'm guessing my observations will not be unique to just surgical or medical meetings (although I suspect the distribution of types of questioners will vary between basic scientific meetings and medical meetings).

In my experience, I have noticed that there are several distinct subspecies of questioners who will come up to the microphone to grille you after you've given a scientific or medical talk. I have not experienced them all personally at my talks, but I have observed them all over years of going to such meetings. So, I introduce here part 1 of an occasional series on going to biomedical meetings and the creatures you might encounter here. I'll probably add another followup (or two) to the series after I go to the AACR meeting in April...

So, without further ado, here they are, the questioners:

1. Moderator. It's the Moderator's job to be sure to come up with a question or two to ask the speaker, to prevent embarrassment if no one from the audience is sufficiently interested to ask questions. As such, the questions that come from the Moderator will be highly variable in quality, ranging from uninterested and ill-informed to nice softball questions that you can hit out of the park to very inciteful. If you only get questions from the Moderator, you have to worry that no one was sufficiently interested in your talk to ask questions. Either that, or you can reassure yourself that your work was so far above the audience that no one understood it. It might even be true--but probably not.
   
2. Sycophant. Sometimes a plant (or, at least, I sometimes suspect they're plants), the Sycophant is someone who will come up to the microphone, and, before asking a softball question, effusively praise the quality of the work just presented. I have actually seen a talk by a colleague of mine in which a Sycophant was so extreme in his praise that it embarrassed the hell out of the speaker. (I need to arrange for one of these for myself someday.)
3. Pontificator. Whenever you see someone come up to the microphone and say something like, "I have two comments and three questions," chances are very high that you're dealing with a Pontificator. The Pontificator will generally blather on about the topic for a long time, sometimes even to the point where the moderator will, in the interests of keeping the session on schedule, sometimes feel compelled to cut him off and ask him what his question is. You see, the Pontificator isn't really interested in asking a question about the research. He is interested in making his point about this particular topic to the large audience afforded him by the scientific talk. Often he is an opinionated senior scientist or surgeon, but not always. Sometimes he is an opinionated junior faculty looking to become an opinionated senior scientist or surgeon. If the Moderator will not intervene, there's really nothing you can do about a Pontificator, other than wait for him to blow over and then thank him for his comments. (Try not to let your clenched teeth alter your voice too much.)
   
4. Show-Off. Closely related to the Pontificator, the Show-Off is not so much interested in getting his opinion out but rather in showing the audience just how knowledgeable he is about the topic at hand. The Show-Off will therefore quote obscure journal articles (sometimes intentionally making the speaker look foolish for not being familiar with them) and ask very detailed, but often largely irrelevant, questions. The best tactic for dealing with the Show-Off is to thank him for making you aware of that article in the Uzbekistan Journal of Applied Dermatology and promise that you will look it up right away.
   
5. Rival.If your talk was about a topic that is hotly debated in the medical world, you'd best be prepared for this species of questioner. The Rival's goal is not so much to shed light on the topic, but rather heat. Usually, he has done research on the same question you have and quite often he has come up with a very different conclusion. It's possible that he had another talk at the meeting. It's also possible that his abstract didn't get accepted for a talk and he is pissed off about it. The Rival's goal is to pick your work apart. He will frequently ask confrontational questions and attack any perceived weakness in your study, although sometimes he will take the unctuous route, praising your work before sticking the knife in your back. If you see several Rivals lining up at the microphone after your talk, it's definitely a badge of honor in that they took your work seriously enough to feel challenged (and therefore the need to respond). However, it's also a sign that you'll be in for a rough question-and-answer session. This is the one time when it's OK to do what it takes to hold your own, even if it occasionally means being a bit bellicose yourself (although the suave, smooth put-down is way more effective, if you are able to pull it off). Just try not to sink to their level.
   
6. Conniver.Closely related to the Rival (and in fact, often a Rival using a different tactic or an ally of a Rival), the Conniver is interested in finding out how much further you've gotten with your research than what you've presented and what you are doing now. He is not interested in this because he is curious, but rather because he or his friend/ally is working on the same thing. The Conniver is looking for an edge. He wants to know your research strategy and if you are on the verge of scooping him. (Either that, or he has a bigger lab than yours and could, with sufficient information, take your results and beat you in publishing the next study.) Consequently, he will often ask highly detailed and technical questions far outside the understanding of the majority of the audience and try to find out what new findings you've made since submitting your abstract for consideration. The best way to deal with a Conniver is to be as vague as possible in your answers. Don't give him too much information.
   
7. Me-Too.This beast is probably more common at the more clinical meetings than at basic science meetings, in my experience, mainly because there are often multiple clinical trials and studies going on that examine the same topic. Also closely related to (or the same as) the rival, the Me-Too will get up after the presentation of the results of a clinical trial and ask questions in which he is very obviously trumpeting the results of his own clinical trial on the same or a related question. He will take particular care to try to show how his methodology was superior to yours or how his conclusions more valid. If his results disagree with yours, he will ask you why your results differ from his. If his results largely agree, he will still manage to find flaws in your methodology or question some of your subsidiary findings. He will be very upset if you are not familiar with his work. (He may already be upset that his abstract was not accepted and yours was.) It's therefore very important to be aware of all the other clinical trials that have been done or are under way in your area and to know why yours is better (if it is better, that is).
   
8. Clueless Wonder. I never understand why these people get up and ask questions. The clueless wonder is someone who is very obviously not knowledgeable at all about the topic of the talk. However, Clueless Wonder will still get up and ask either a question so basic that everyone in the audience knows the answer to it or a question that obviously has nothing whatsoever to do with the topic at hand. I remember one example of such a questioner who used to attend Grand Rounds every week when I was a resident. (I realize that Grand Rounds is not really a scientific meeting, but the Clueless Wonder is--alas!--not limited to just national scientific meetings.) He was a very old surgeon (I guessed he was at least in his 80's) and retired. I suspected that he went to Grand Rounds just to help keep his mind active and to be social, a very laudable thing to do, as far as I'm concerned. (If I make it to my 80's, I hope to do the same thing someday.) He seemed very sharp mentally if you engaged him one-on-one in conversation. What wasn't so laudable is that he would almost always stand up after each Grand Rounds and, in a very proper British accent, ask the most inane questions imaginable, often at great length. The goal here is to try to answer the question without looking as though you are making fun of the Clueless Wonder--sometimes a difficult task indeed.
   
9. Nonsequitur.Distinguished from the clueless wonder by the fact that he actually appears to understand the material somewhat, Nonsequitur will nonetheless ask questions that have little or nothing to do with the talk just given. The best tactic is to try to answer the question, but there are times when you might be forced to confess (politely, of course) that you don't see what he's driving at.
   
10. Oh Shit!This is the most dreaded questioner of all, and the reason for his name will become obvious. Oh Shit! will ask a question that unerringly and devastatingly reveals a huge flaw in your experimental or clinical trial methodology (often this flaw is that you forgot what should have been a very obvious control in your experiment or a very obvious control group in your clinical trial), a huge deficiency in your data or statistical analysis, or a gaping hole in your argument. Worse, it's usually a huge flaw that you never thought of or thought you had papered over successfully. There is no way to deal with Oh Shit! gracefully. Preemption is the only strategy that works, because if Oh Shit! successfully holes your talk below the waterline, there is no recovery. It will sink. You must therefore make sure your study or experiments don't have any flaws that Oh Shit! can point out, and you must be completely familiar with every weakness in your study design and data, so that you can explain or justify it if necessary.
11. Appropriate. This is perhaps the most uncommon questioner of all. Appropriate asks an entirely appropriate, interesting question about your data, one that does not insult the intelligence of the audience or speaker and--better yet--one that you can answer well. It may be a challenging (but not too challenging) question, or it may be an interesting take on your data that leads you to think of cool new experiments or studies to do. Be grateful when Appropriate appears.
    

As you can see, there is more to giving a scientific talk than just giving the talk. As always, hope for the best (the Sycophant or Appropriate) but prepare for the worst (Rival or Oh Shit!), and you will be able to make the most of the opportunity (or at least minimize the damage if you are unfortunate enough to attract the worst).

I wonder how many of my colleagues will recognize these creatures and whether they can suggest more. The floor is open!

Weekend fluff, part 7: At least I'm not Pius XII

You are Pope John Paul II. You are a force to be
reckoned with.

Which Twentieth Century Pope Are You?
brought to you by Quizilla

Odd that I turned out to be Polish, just like in real life.

Weekend fluff, part 6: I knew it!

I knew it, only I thought I acted even younger than that....

You Are 33 Years Old

33 Under 12: You are a kid at heart. You still have an optimistic life view - and you look at the world with awe. 13-19: You are a teenager at heart. You question authority and are still trying to find your place in this world. 20-29: You are a twentysomething at heart. You feel excited about what's to come... love, work, and new experiences. 30-39: You are a thirtysomething at heart. You've had a taste of success and true love, but you want more! 40+: You are a mature adult. You've been through most of the ups and downs of life already. Now you get to sit back and relax.

What Age Do You Act?

Is Bill Maher really that ignorant?

Via Skeptico.

I missed Bill Maher's HBO show Real Time with Bill Maher because I was away at my meeting. However, I have heard that he said that vaccines don't prevent disease and that Pasteur recanted on his deathbed. I'd like to see what he actually said before going off on him too much, but unfortunately the transcript for the show doesn't appear to be up yet, assuming it was the March 4 show. Did anyone else see the show? Did he say this? Was he being ironic or serious? Is there any way Skeptico could have misinterpreted what he said? Inquiring minds (like mine) want to know!

In any case, I've always found Bill Maher to be a bit too smug a bastard for my tastes, even back when he did his Politically Incorrect show, although he is at times quite entertaining. However, if he did actually say that vaccines don't prevent disease, I will have to move him from the category of "smug but entertaining curmudgeon that I usually disagree with but sometimes find entertaining anyway" to just plain "crank." Anyone who can seriously believe that vaccines don't prevent disease and actually say so to a national audience has moved from the realm of curmudgeonly skeptic into the realm of the fruitloop, as far as I'm concerned. If, further, Maher truly believes the myth that Pasteur recanted on his deathbead (a common myth promulgated by credulous alties to make it seem as though the father of germ theory decided before he died that he had been incorrect), I don't think I can watch his show any more. (Peter Bowditch did a fine job of debunking this particular myth about Pasteur last year.)

For someone who bills himself as being so rational and skeptical, proudly trumpeting his atheism and claiming that religious people have a "neurologic disorder" because of their belief in things that can't be proven, Maher certainly seems to be rather credulous about other things that fit into his own world-view. Certainly, his close affiliation with PETA and his rather uncritical acceptance of its claims argues for this. Money quote from an interview from a few years ago:

To those people who say, "My father is alive because of animal experimentation," I say "Yeah, well, good for you. This dog died so your father could live." Sorry, but I am just not behind that kind of trade off.

I will wait until the full transcript is out to see if Bill Maher really is that credulous about the lies of the anti-vaccination movement, but it's disappointing to see a self-proclaimed rationalist and "politically incorrect" skeptic spew such nonsense, if spew it he did.

"Short scientific talks for dummies"

As readers know, I had to give a rather big talk at a national meeting (big for me, anyway). Fortunately, it went well. In fact, I was inspired to write rare brief followup to my career advice to young scientists (not rare for being a followup but rare for my actually being brief), in which I recommended doing whatever it takes to get good at public speaking. So, without further ado, here are a few words of wisdom for giving 10-15 minute scientific presentations, learned over 15 years of giving these presentations. (As I'm still at the meeting, the very fact that I'm blogging should be an indication that there isn't much to do around here, and for some reason, none of my friends here wanted to do anything tonight--leaving me in the hotel room to write this.) So, here it are some of my tips:

1. Pace yourself for approximately one slide per minute. This is not a hard-and-fast rule and depends on the content of the slide. If, for example, the slide is a one-liner or just a picture that needs little comment, then you don't need a minute (or even 15 seconds). However, if it's a data-dense, information-dense slide you might need way more than a minute to march through it. However, in general, a good rule of thumb is that it all averages out to around one minute per slide. So, if you have 30 slides for a 12-minute talk, you have a problem.
2. Be utterly brutal in editing your slides. There should be no more than two figures or five lines of text on a slide. Any slide that is not absolutely essential to telling your story should be eliminated with prejudice.
   
3. Don't just read off of your slides. The audience can read them well enough and doesn't need you to do it for them. Use them as a guide? Yes. Read them verbatim? No.
   
4. Control yourself and don't speak too fast. If you're afraid of public speaking, or very nervous, there is a natural tendency to talk faster in order to get it over with faster. Avoid this temptation. You don't want to sound rushed or nervous, even if you are nervous and do want to rush. (This was one of the most difficult tendencies I had to overcome; I still do it occasionally--but fortunately not at this talk.)
   
5. On the other hand, don't talk too slowly, or you may find yourself coming up against the time clock and risking having your microphone turned off (unless, of course, you are an influential member of the society, in which case you can drone on as long as you want). Either that, or you may put your audience to sleep. What you want to aim for is a nice, natural, conversational pace.
6. Practice your talk. Practice it at least 5 times, paying special attention to whether or not you can finish it in the time allotted. (It's very difficult to summarize many months--or even a couple of years--of your life's work in 10 minutes.) Practicing it 10 times is better. It's only a 10 minute talk, so you should be able to practice it 10 times in 2-3 hours easily. A lot of practice will assure that you won't freeze or have a brain fart and forget what you wanted to day. It will also make it easier to recover from equipment malfunctions, should they occur, as you will be so familiar with your material that you can continue even without the slides as the AV tech guys scramble to fix the problem.
7. No jokes. There's almost never time for them in a 10-15 minute talk anyway; every minute spent telling a joke is a minute you can't present your data. (If you're giving a 45-60 minute talk, that's another thing entirely.)
   
8. No cutesy slides or cutesy pictures on data slides.
9. Thank the audience and/or the society hosting the meeting.
   
10. Thank your mentors/collaborators, the workers in your lab, etc.
11. Don't clutch the podium as though you are on a ship in a hurricane
12. Look at your audience as much as possible. Minimize your looking at the slides or the monitors. At national meetings these days, there is usually a monitor for you to see your slides, and the actual screens are parallel to you, so that you can't see them very well even if you try.
13. If there's a spotlight on you (as there was on me), it's disconcerting to realize that you can't really see the audience very well at all. In these cases, just look in the direction of the audience and scan over where you think they are.
14. Avoid the temptation to keep revising at the last minute. Get the slides ready to your satisfaction at least the night before, if not sooner. Fiddling with them too late will only mess you up.

All of these are simply tips I've found useful. I'm sure my readers can provide more if they're so inspired. In fact, I may submit these to Tangled Bank.

The Skeptics' Circle #3

Meeting or no meeting interfering with my blogging, I have to mention that the Third Edition of the Skeptics' Circle has been posted at Rhosgobel: Radagast's Home. I apologize to Radagast for being so late in linking to it, but I've been in meetings all day and--wouldn't you know it?--during the one chance I got to get back to my hotel room during the afternoon, Blogger wouldn't load. In any case, once again, skeptical bloggers have done their best to fight misinformation, pseudoscience, and quackery with facts, reason, and science. Radagast has eschewed my rather amusing style of organizing the posts in favor of a lean, mean, tight listing of skeptical blogging grouped by category, with brief descriptions of each post. Just the facts and right to the point, with a number of excellent contributions. No muss, no fuss.

I like it.

I do, however, wonder what his first version would have looked like, in which he had been planning on weaving the posts into a Tolkienesque narrative. It sounds like it would have been fun--either that, or incomprehensible. (Damn, now that he's mentioned that idea as a possiblity, I can't do it when I host Grand Rounds on March 15 or Tangled Bank on April 6. But don't worry, Oracphiles. I have other ideas in mind for unusual ways to organize the posts for these upcoming blog carnivals--although I'm not sure if I have the guts to use them. I'm just kicking myself, however, for not having thought of the idea of organizing them into a menu, as Maria did with this week's Grand Rounds.)

If you're new to the Circle, check out the First and Second Editions as well. If you're a blogger, consider contributing to the next edition. Heck, think about hosting a session yourself! It's fun!

A schedule of hosts and upcoming editions is here.

Public speaking

Blogging is likely to be light or nonexistent between now and Monday. I'm now at a surgical meeting, where I'm scheduled to give a talk, and I don't know if I'll have much time to blog or not. (Of course, if the meeting is boring, it is conceivable that I'll blog a lot. There are few things more dull than being cooped up in a hotel room in a strange city.) In any case, my impending talk reminds me of a topic I have been meaning to write about for a while now.

Public speaking.

Yes, public speaking. Most people are terrified of it. Certainly there was a time in my life when I was. Yet, here I am, doing the final tweaking of the PowerPoint slides for one of the bigger talks in my life, a talk to hundreds of people, with my face projected on a big screen in a cavernous hotel ballroom, and right now I'm only mildly nervous about it. True, I'll be more nervous the morning of the talk, but 15 years ago I wouldn't have even been able to imagine myself giving such a talk. In fact, it's even worse than that. I was so afraid of public speaking that I couldn't possibly imagine myself defending a Ph.D. thesis and hence was afraid of entering my Ph.D. program.

One thing many aspiring scientists don't appreciate is just how vitally important public speaking is to their success. True, it's certainly important to be able to write clearly and compellingly about your work. That's how you get your work published in the best possible journals. My Ph.D. thesis advisor once told me that putting together a scientific paper is just like telling a story. You have to provide a framework for your data and write a compelling case for why it means what you think it means and why that's important. That's also how you get grants, because, in essence, you are using nothing but your data and your writing skill to persuade the government, foundations, or industry to give you thousands, sometimes hundreds of thousands or even millions of dollars to support your work.

But it's not enough just to be a good scientist and a good writer. Sooner or later, you are going to have to present your work face-to-face to your peers. The venue can be at scientific meetings. Or, if your work gets noticed, you will get invitations to speak, perhaps as a visiting professor. Making a good impression through public speaking gets you noticed by the higher-ups in your field. It gives you the chance to see potential flaws in your work, because at the question session at the end of your talk your peers will point them out (and sometimes point out ones that don't exist). It gives you the chance to meet potential collaborators who can help you (and whom you can hopefully help in return). It can lead to invitations to join study sections and thus the opportunity for further networking. You could be the greatest scientist in the world, but if you don't present your work at national meetings, unless you happen to publish in very high visibility journals you may not be noticed. Certainly, you will not be as widely noticed as you might otherwise be. No one who matters will be able to put a face with a name. Finally, although this may seem obvious, public speaking skill is also important for teaching, which nearly all academic scientists have to do to some extent or another, varying from very little to quite a lot.

Unfortunately, public speaking is a stress-provoking activity. My first memory of the stress that public speaking can cause was from second grade, believe it or not. I was attending Catholic school, and a class assignment in religion was to compose a prayer. The students writing the best prayers would be given the honor of reading them in church. I happened to be so honored. My memory of the whole event is rather sketchy, as most memories people have from when they were six or seven years old tend to be. However, what I do remember is utter, sheer terror at the prospect. I don't remember how I managed to do it, but I did. Some of the atheists who frequent my weblog will no doubt see fit to blame the Catholic Church for instilling a terror of public speaking in me, but I don't. After all, having students give oral book reports is not uncommon in grade school. (In fact, we did that, too.) No, I rather suspect it was my innate shyness.

Years went by, and I avoided public speaking when I could and sweat bullets doing it when I couldn't avoid it. Oddly enough, when I got to college, public speaking was no longer necessary in the vast majority of classes I took. I rarely had to do it; so I never really learned how to do it well and bad habits hardened as I journeyed further into adulthood. Medical school was no different. Certainly, there were many uncomfortable tasks to learn (physical examinations, asking patients sensitive questions, etc.), but no real public speaking. I passed quite happily through medical school only rarely having to make any public speeches.

Then I started graduate school. After having struggled through my turn to present at a couple of lab meetings and journal clubs I realized that I needed to do something in this area. So how did I overcome my fear of public speaking and become a competent (if not particularly scintillating) speaker?

Well, the way to learn public speaking is by doing it. The way I forced myself to do that was by taking a Dale Carnegie Course, specifically this one. It wasn't cheap, but I felt that I had to do something or I'd never make it through my thesis defense; so I ponied up and I went.

Laugh if you will, but it worked. In the DCC, everyone has to speak in public at least once every session. There's no escape and no excuse. There were speaking exercises on a wide variety of topics and situations, and there were interpersonal exercises designed to teach and reinforce basic social skills. As silly as it sounds, there was one session I remember in particular in which we were specifically taught how to introduce a speaker. You'd think it would be common sense, but it's not.

At the first class, I was terrified, but as time went on I became more and more comfortable giving the little three minute speeches required at the end of every class. After each of these sessions, the class would vote on who gave the best speech, and damned if near the end of the 12-week class I didn't win. The prize was a Dale Carnegie pen. Again, as silly as it sounds, I still have that pen fourteen years later. It is evidence of how I overcame my fear.

So, if you're an aspiring scientist, the most important thing is to learn the science and how to apply the scientific method. However, coming tied for second are two things: writing skills and public speaking skills. Most graduate programs do a pretty good job teaching scientific writing skills, usually through requiring the students to write a mock NIH grant application, but most do a rather poor job teaching public speaking skills, mainly because they don't teach them at all. Even my thesis advisor, who was fantastic when it came to letting me write papers and then critiquing them, did close to nothing to teach me my how to give scientific talks. Fortunately, I took matters into my own hands.

Also remember that there are many more ways than simply taking the Dale Carnegie Course to get better at public speaking, and that the Course may not be for everyone (for one thing, it's pretty expensive, costing me around $800 fifteen years ago). For example, there is Toastmasters International, a group dedicated to teaching and practicing public speaking. They have clubs and chapters all over the country, and the sole purpose of these clubs is to teach public speaking and meeting skills. Better yet, their dues are quite affordable.

I'll probably never be a great public speaker, the kind who can spellbind you and have you hanging on every word. However, through a combination of hard work, practice, and a little help from the Dale Carnegie Course, I have become a competent (although not exciting) one. More importantly, the thought of having to give a speech. If you're an aspiring scientist (or in any career that requires public speaking skills), it's well worth it to improve your abilities in this area.

I still keep that silly Dale Carnegie pen to remind me of this.

The Queen doesn't recognize some of my favorite guitarists

Brian May, Jimmy Page, Eric Clapton, and Jeff Beck were all guests at a Buckingham Palace party to honor the British music industry. Unfortunately, the Queen didn't recognize them, asking them, "What do you do?"

Quoth Eric Clapton: "It's great to meet her and it doesn't matter at all that she did not know who we are or what we do," Clapton said. "I wouldn't expect her to."

Carnival of the Vanities #128

The Carnival of the Vanities #128 has been posted at Belief Seeking Understanding.

Another cool World War II site

I'm being made aware of interesting World War II sites fast and furious now. This time it's Wartime Images. The webmaster says:

In the Second World War people at home with loved ones spread far away around the world with the forces were fed a diet, often government backed, of "how it works" or "how we will win" technical information leaflets. Very often these would have contained superb cut away and sectioned diagrams, showing the "insides" or as was said at the time "the works!" of the machines that were winning the war for us!

And there are indeed some very cool cutaway and sectioned diagrams. I'm adding this one to my sidebar as well, as I did for World War II in Color a couple of days ago.

"Zero tolerance" = "Zero common sense"

Here's more evidence that Columbine and other fears have unhinged some people's brains.

An 18-year-old high school student in Kentucky named William Poole has been charged with "making terrorist threats" for having written in his private journal a story in which zombies overrun a high school. He did not name the school, anyone who goes to or works at his high school, or anyone in Clark County. It appears his nosy grandparents read his journal and turned him in.

Most disturbing money quote:

Even so, police say the nature of the story makes it a felony. "Anytime you make any threat or possess matter involving a school or function it's a felony in the state of Kentucky," said Winchester Police detective Steven Caudill.

Let's get this straight. Any matter involving a school or function is a felony? Someone pointed out that, by that criterion, keeping your high school yearbook could be considered a felony. It's possible that Mr. Caudill misspoke, but it's also clear that he's brain dead, and so is are the prosecutors and judge:

On Thursday, a judge raised Poole's bond from one to five thousand dollars after prosecutors requested it, citing the seriousness of the charge.

Thank heaven I don't live in Clark County in Kentucky. Perhaps we should send Mr. Caudill and this judge The Zombie Survival Guide. It might actually educate him.

Also, thank heaven I went through high school in the late 1970's, rather than now. If I were a high school student today and behaved today the way I did then, no doubt some ignorant paranoid twit like Mr. Caudill would want to lock me up. Why? Well, for one thing, I used to play a lot of Dungeons & Dragons, and we all used to revel in slaughtering (imaginarily speaking, of course) huge numbers of imaginary enemies. (In fact, during my senior year, my friends and I used to play D & D at lunch or on breaks at school--and I went to a Catholic high school. The priests never stopped us or even seemed the least bit concerned.) For another thing, I used to decorate my notebooks with amateurish drawings of Conan-like warriors wielding huge swords and battling various monsters, as well as one rather disturbing image that represented my concept of what Sauron looked like.

In other words, I was a fairly typical geeky teenaged male who read a lot of science fiction and and fantasy, collected comics like a fiend, and played games that let my imagination go wild. Despite all that (or perhaps because of it), I turned out OK, having made it through graduate school and medical school and now taking care of patients while running a fairly productive cancer research laboratory. Personally, I attribute a lot of my imagination and writing skills to my geeky past, but schools don't seem to see it that way these days. I really pity kids in high school now who are like I was then. Not only do they have to deal with the usual problems of being a nerd or geek or whatever they're calling it these days, but now they have to worry that the school administration will think they are early stage mass murderers.

More on this here, here and here.

Via rec.arts.sf.written.

UPDATE: Based on OutEast's comment (and the fact that my B.S./urban legend detector, like OutEast's, had indeed twitched a little bit about this story--although apparently not strongly enough), I did a little more digging between meetings this morning. As mentioned by OutEast, blogger a.r. reports an anonymous source who claims Poole had been in trouble before and that the story had nothing to do with zombies, but rather contained a plan to take over the school, with weapons lists, recruits, and instructions how to breach security. Normally, I would take an "anonymous source" about as seriously as the aforementioned story about zombies, but another story in a local paper reports the story in this light as well. One thing I've noticed in looking at this again is that there appears to be at least one person, maybe more, commenting anonymously on blogs defending the school, for example in a.r.'s post and also here. (Perhaps one of them will find my blog and actually post a comment here with verifiable information. I would be most grateful for that.) Others have pointed out the other side of the story.

In my defense, I did do a couple Google searches on this before posting (probably because of the light tingling of my B.S. antennae), and was unable to find much more. However, now, after refining my search terms, I was able to find additional information. Also, it was late at night when I wrote this. I didn't read all the comments from the bloggers' posts I referenced, which, if I had seen them, might have set off my B.S. detector a little more strongly. Oh, well. At least I always try to clear things up when it is pointed out to me that I might have screwed up.

BOTTOM LINE (for now): This story is very likely more complex than I led you to believe. Deep down, I had suspected that it might be, but perhaps my memories of high school geekiness led me to jump too rapidly to conclusions. (Geez, this time Nate really will take away my super-secret Skeptics' Circle decoder ring, as I feared in the past--based on a previous incident of insufficient skepticism--and never let me host again...) On the other hand, if the other version of the story does turn out to be correct, I can't understand how this kid's lawyer would have coached him to or let him make these sorts of statements to the media (or even let the kid speak to the media in the first place before the court hearing). Such statements could only hurt Poole in court. It's possible that the kid talked to the media without consulting his lawyer, but I tend to doubt it, given that he was in the juvenile detention center at the time of the interview and would have had to go through channels to receive any phone calls or visits from reporters. I also can't understand why the police wouldn't have simply issued a brief statement that gave a little more information about what was in the story, not enough to undermine their case but rather enough to refute Poole's claims.

I'm also very puzzled by the lack of followup on this story by the local media. I know that if something like this happened near where I live, it'd be all over the news for days, even though, being near a large city, there would be plenty of other news to crowd it out. In fact, I'm puzzled that this isn't a national story, as it's just the sort of story that usually gets picked up by the national press, at least since Columbine. Yet, here, in this small town in Kentucky, where presumably life is more tranquil and stuff like this presumably rarely happens, there doesn't appear to be a single followup story after the kid's interview--even though the arrest happened a week ago. (At least, I can't find any legitimate news stories more recent than the one I originally cited.) Such a lack of followup sometimes indicates that the story may, in fact, be an urban legend, but I don't think so in this case. The news accounts appear to be too specific and too easy to verify through the police and courts. I also searched Snopes.com and couldn't find anything about it.

It may very well be (as it often is in these cases) that the true story is somewhere between the two competing stories. Whether it will turn out to be closer to the police account or Mr. Poole's account, however, I have no idea at this time. Perhaps the police did over-react to a story, or perhaps this kid really did make specific threats. I'm beginning to suspect that the zombie story might be a red herring. Poole stated that the police had reacted to "one of my stories" and then mentioned the zombie story. Perhaps there were other stories in his notebook, and it was to one of those that the grandparents and police reacted.

I guess all I can do is to promise to try to keep an eye on this story as it develops. When the kid is arraigned in court, the prosecutor will have to produce some sort evidence to justify trial. Sooner or later, the entire text of the story will have to be made public. The truth will out, and we'll find out if this really is a case of an overzealous police department and prosecutor overreacting to a kid's flights of fantasy (as Poole claims) or if Poole really is a Dylan Klebold in the making, as the prosecutors seem to be claiming.

Finally, I stand by my criticism of Mr. Caudill, for saying what he did. By the criteria he listed, writing a story about school (or, as some have pointed out, having a school yearbook might be grounds for being charged). If that's not what he meant to say, he should retract it now. If that is what he meant to say, he is indeed a moron. I also still think that "zero tolerance" = "zero common sense," as there plenty of other examples that are much better documented (for example, the recent incident of a 6-year-old girl busted by a teacher for giving her friend a plastic bag full of dirt and clovers because the poor girl's idiotic teacher couldn't tell the difference between dirt and marijuana), even if this particular incident ultimately turns out to be a bad example.

ONE MORE SOURCE:

I found this. Dated Februrary 25, it states:

A junior at George Rogers Clark High School has been charged with terroristic threatening, a felony, after notes outlining possible acts of violence against students, teachers and security guards were found. No direct threats were made against named people, Winchester police Detective Steven Caudill said. William Poole, 18, of 426 East Broadway was being held on $5,000 bond yesterdayy at the Clark County jail. Caudill said Poole's family was cooperating with police. Principal John Atkins said he received a dozen or so calls from concerned parents yesterday.

ADDENDUM/UPDATE 03/10/05: Still more information can be found here, as Poole was arraigned.

The Supreme Court gets it right

The Supreme Court ruled today on the Constitutionality of imposing the death penalty on juveniles. Fortunately, although I had feared it would be otherwise, this time they actually got it right, banning the imposition of the death penalty for crimes committed by minors:

"The age of 18 is the point where society draws the line for many purposes between childhood and adulthood. It is, we conclude, the age at which the line for death eligibility ought to rest," Justice Anthony Kennedy wrote.

Personally, I don't understand why this issue should be in dispute or how even death penalty advocates could support the death penalty for minors, much less why the Court's vote would be so close (5-4). Even before my conservativism became more libertarian in nature, leading me to seriously question my previous support for the death penalty, I was always strongly opposed to imposing the death penalty on minors. Yes, 18 is a somewhat arbitrary age, but it's the age our society has chosen at which full rights and responsibilities of adulthood--other than drinking alcohol (but that's a topic for another post)--are granted and expected. As such, it is also a reasonable cutoff for death penalty eligibility. The only thing that bothers me about the ruling is the Court's invocation of international standards. It shouldn't have needed to do that. Defining the execution of children as "cruel and unusual punishment" under the Eighth Amendment should have sufficed.

Grand Rounds XXIII

Grand Rounds XXIII has been posted at Intueri. Maria has served up a tantalizing menu of dishes made from the finest medical blogosphere ingredients by the finest blogging chefs, full of delectable morsels of blogging goodness. (Damn. I wish I had thought of the format she used, as it will be my turn to host Grand Rounds two weeks from now. Excellent work, Maria!)

And, for those of you who have found their way here via Grand Rounds, if you like blog carnivals, The Skeptics' Circle is coming up this Thursday at Rhosgobel: Radagast's Home. The Skeptics' Circle is a biweekly carnival for bloggers who apply critical thought to questionable stories. Subjects include frequently repeated urban legends, quackery, pseudoscience, misinterpreted or denied history, analyses of misleading media, and any other articles or essays that fight misinformation with facts. I hosted it two weeks ago (using a creative format to organize the posts that was different from, but--I hope--as entertaining to the reader as Maria's) and St. Nate did the very heavy lifting of putting together the inaugural edition four weeks ago.

The deadline for submissions is tomorrow. Send Radagast your best skeptical blogging before 11 PM PST tomorrow night and help make this the best Skeptics' Circle yet!

ADDENDUM:

I just found out that the very first Carnival of Bad History has been posted at archy. It's a blog carnival in which examples of poor historical understanding or of the misuse of history are dissected and bisected. As such, it could be viewed as a specialized version of The Skeptics' Circle tightly focused on pseudohistory.

It's that time of month again

March 2005

March 2002

Yes, it's the first of the month again, and regular readers of Respectful Insolence know that that means it's the time for Orac to indulge one of his stranger obsessions, as originally explained here, here, and here. So, without further ado...EneMan for March!

(For those who do not find EneMan as strangely compelling and amusing as Orac does, feel free to skip this post and take comfort in the fact that Orac does not post these sorts of pictures more than once every month. For those of you who've found their way here from Grand Rounds, please check out other posts in Essential ORAC on the sidebar before you dismiss Orac as a flake. Or just dismiss Orac as a flake if you like. Orac is indeed rather strange. But he is also a pretty good blogger.)