The 31st Meeting of The Skeptics' Circle

Welcome to the 31st Meeting of The Skeptics' Circle. Check, check... one, two...is this thing on?

Many advanced degrees but they still can't teach us how to use A/V equipment, eh? Hey, Matt, Pooflinger..whatever, could I trouble you to grab me another Kulmbacher Eisbock while we get going? Uh, and, yes, please do carry mine back with your other hand - I'd like to be certain that the dark color is due to the roasted barley.

The Invocation
Before we get to the proceedings, just a few announcements: Let's raise our glasses to Brothers Orac and Skeptico for their recent coverage in The Financial Times, "Ask the Expert: Should the Old Media Embrace the New?". The fact that the FT questions the relevance of our compatriots speaks volumes about their impact in combatting the international spewage of uncritical blathering. Here's to our brethren and all of y'all who keep on "fighting the good fight for science, skepticism, and critical thinking." And, yes, yes, Tara, "brethren" refers to all genders, by my definition at least.

Speaking of our gratitude for lady writers (hat tip: Mark Knopfler), is there some sort of Skeptics' Circle icon we could pass along to Associated Press writer, Jennifer Loven? Indeed, we are to be an apolitical gathering but her work of last week has nothing to do with the political content of her outstanding article. With the help of Drudge's 10 million readers per day, Jennifer's article pushed the straw man fallacy into the lexicon of the general public. I've tried getting hold of Jennifer to be here to accept this "Straw Man Slapdown" award, but AP has her sequestered a bit due to questions about her motivations. Some may say (<- see, not a straw man since it is attributed to a real source) she wrote an "unvarnished partisan piece" and that "AP is pro-terrorist," but I choose to honor her for bringing critical thinking skills to the mainstream reader.

Lastly, and not at all the least, I'd like to play for you Dr. James Randi's audio message of thanks for everyone's best wishes following his recent cardiac bypass surgery and ongoing recovery. Let the record show that PLittle also sends you his specific note of admiration this week. Wish you were here to join us, sir, but it is fabulous news to learn that you intend to be back at JREF's Swift in the next two months. Here's to your continued good health and speedy recovery!

Okay, in calling the Circle to order, I would like to thank Orac for offering me the podium at such an early point in my blogging career. We've had a great two weeks of skeptical blogging, great publicity, and an abundance of responses from North America, Australia and New Zealand, the UK and Sweden, and even the Philippines. I really appreciate the sacrifices you've made to all be present tonight at the Terra Sigillata Pub.

Skeptics ARE Happy Folk Leading Meaningful Lives
Look at us all - happily enjoying food and grog in a most jovial setting, encouraging and congratulating one another. What a fabulous gathering!

I hereby nominate Skeptic Rant for the most literary, engaging, and uplifting post of this Circle. Let Bygones Be Bygones - these are indeed the days of miracles and wonder.

Heathen Dan of Expletive Deleted, thanks for sharing with us your personal take on the concept of subjective validation. What's this???? Another happy skeptic? From England, no less?? Oh, whoops, the Philippines - a wee bit different, eh? Anyway Dan, here's to you and your girlfriend on her pregnancy - the joy in your life has only just begun!

We've had some technical difficulties, but I truly wish to include the post from EoR on Biomesowoo from The Second Sight because I have never yet heard of this pitch of woo. While we get this worked out (okay, it's now fixed!), take a gander at his touching eulogy for his old friend, Fred. I selected this memorial post to address critics who claim that skeptics are just a bunch of sad, cranky people leading meaningless lives. Our thoughts are with you, EoR, on your loss and we honor and celebrate a well-lived life.


The Realm of the Feet
Clark Bartram of Unintelligent Design deconstructs a home electrical appliance intended to take advantage of reflexology pressure spots. Now, frankly, this ol' boy is man enough to admit his love for a good foot massage (receiving one, of course!). So I really don't care if the person doin' the givin' wants to call it reflexology and invoke all sorts of bodily system connections between my feet and, say, my genitalia. (Insert crude remark here). But take a look at the reflexology map on Clark's post: the right lung/bronchus spots are denoted on both feet, with nary a mention of the left lung and bronchus. Why would such a so-called holistic practice be so discriminating, humiliating, and exclusive of the left lung??? I'm outraged! I need a foot massage!

Ahh, but I see that Martin Rundkvist has just arrived from Stockholm with his mother-in-law's Medicinal Rubber Mallet to help address my troubles in the Realm of the Feet. This is the first I have read of Martin's Salto Sobrius and we look forward to his other posts.


How Should "Experts" Be Defined?
The next order of business relates to the threats on rational thinking, public policy, and all the advances we have made in science and medicine over the last several hundred years. This discussion follows nicely from the FT coverage of Orac and Skeptico, card-carrying experts if I've ever seen them.

Professor Tara Smith, an infectious diseases epidemiologist from the middle of the US heartland, will take the floor now with her analysis of a recent discussion on how to critically evaluate expertise and the weight of authority in arguing a particular issue. Tara is all too familiar with this issue as her blog, Aetiology, has been victimized by rants from commenters of dubious authority or, worse, authoritarians with really poor manners and debating skills. I would have killed to have been able to recruit such an energetic and prolific junior faculty member to my previous academic department - don't let the trolls get you down, Professor.

Mark Chu-Carroll, could you stand up and be noticed? Folks, now here is what they call an expert, and an approachable one at that. Mark is a hot new mathematician blogger with a great post on how AIDS/HIV denialists have been pointing to Professor Rebecca Culshaw's change of heart about the link between HIV and AIDS as evidence for their position. Unfortunately, as Mark explains, Professor Culshaw's explanation of her change of heart is an example of how not to use mathematical models correctly.

Dr Bob? Hey, Dr Bob - I know you've got a lot of books to autograph and inscribe but could I get your attention for a moment? Dr Bob Carroll, author of The Skeptic's Dictionary, has a really nice post in his Mass Media Funk section on the war on science.


Evolve Or Die
JM O'Donnell at Immunoblogging has quite insightfully commented on Nature's analysis late last year on the accuracy of Wikipedia relative to Britannica. As the music recording industry has learned, evolve or die. Joseph has also started a series on bovine tuberculosis and badgers in England that promises to become more skeptical in future installments. BTW, Joseph, did you sneak in any of that great New Zealand Sauvignon Blanc and leg of lamb?

We all continue to be a bit concerned about the prolific output and risk for burnout relapse by Matt at Pooflingers Anonymous. I guess I won't be doing him any favors since he sent me two posts and both are quite spot on: refuting the creationist kneejerk mantra, "But they're still..." and an encore fling o' the poo toward those who insist that Homo sapiens has not yet adapted to eating meat. Pass me the carne asada, wouldja? Uh, yes, with the other hand, please.


Skeptics Protect Society From Dubious Products and Practices
Liz Ditz was kind enough to nominate a special ed teacher's The Life That Chose Me and his post on The Fleecing of the Autism Community.

While we're on the topic of autism, Kevin Leitch of Left Brain/Right Brain will tell us about DAN! Protocol for Dummies. Kevin, is this right? You don't have to be a doctor to be a DAN! Doctor?

Professor Bleen of Look Out, It's Evil!, you've raised some very crucial issues on the marketing of direct-to-consumer genetic testing kits, drawing parallels to the Wild West mentality that permeates much of the dietary supplement industry.

Moving closer to my area of scientific expertise, The Saga of Runolfr's, Lord Runolfr has a few words to say about Hoodia gordonii, an African cactus-based herbal medicine with purported appetite-supressing and weight-loss activities. When I read his e-mail, I was linked to an advert for a transdermal dosage form for Hoodia (note to marketers: transdermal dosage forms of dietary supplements are in violation of the US DSHEA laws - be checking your mailbox for a letter from the FDA, FTC, or both). I won't ruin his punchline, but I need this stuff like I need a hole in my head.

By the way, barley, hops, and alcohol are natural products - would someone ask the beer mistress to get me a Duck Rabbit Porter, please?


Skeptics Preserve Medical Integrity and Information
Okay, So I'm Not Really A Cowboy holds forth with a primer on stem cell research.

Skeptico, we know you've been a bit bogged down as of late with non-blogging issues, but appreciate that you still had the time to submit a post on the fallacy that we only use 10% of our brain, as brought to us by the Shell Oil Corporation. (Insert oil company executive/politician joke here.).

I should note to those gathered that Skeptico also nominated this outstanding letter to a concerned parent by Dr Flea. Flea is a fabulous new medblogger cited often by Skeptico and Orac. Heck, I played bass in a rock band with several MDs, so Flea gets my vote for all-around kool and smart dude. Dr Flea, you rock, bro!


I'm Sensing Some Unusual Energy...
Oh, sorry, it's just gas.

Adam at Daylight Atheism, you've raised the oft-considered question on why self-proclaimed psychics don't use their powers to win lotteries and such. I am seeing...uh.....mmm...I'm seeing your post appearing somewhere...somewhere with wide readership...I see other like-minded critical thinkers...do the letters "SC" mean anything to you?.

Thursday at Polite Company has his own take on the whole psychic business, part 3 in a series initiated when Lord Runolfr was host. Your post is great but, to be honest, I was so distracted looking at pictures of your stunningly beautiful homeland in British Columbia. Plus, you dig Lou Reed and Tom Waits - welcome!

Rounding out this triad on psychics, BigHeathenMike of Mike's Weekly Skeptic Rant tells us, "I was watching television yesterday for the sole purpose of getting myself pissed off enough to write a blog entry." Okay, so maybe not all skeptics are happy all the time. You Seem to Have a Dent in Your Brain Chakra is a post about a recent Unexplained Mysteries program. Mike, you're Canadian, eh? I'll try to do my best Dan Aykroyd impression: "Hello, Tele-Psychic?" Alright, alright, that's why I'm not a professional comedian...could the bartender send down a Paulaner Salvator, please?

Oh, and I almost forgot another discussion of unusual energy that's not exactly psychic. PLittle of Aurora Walking Vacation, could we impose on you to discuss the principles underlying the appearance of ectoplasm and other ghostly images in photographs?


The Value of Skepticism in Teaching, Learning, and Living
This goes without saying, right? If you can't think critically, you're going to have more problems in life than the damage done by thinking the world is 6 000 years old. If kids can't think critically, they will fall prey to all sorts of hucksters, from used car salesmen to late-night infomercials.

Calladus gets my vote this Circle for "engineering" the best narrative on leading on an altie. As I read, I honestly thought that he was going to take the young lady home to discuss his "energy vortex" (the setting was Las Vegas, after all), only to learn that he was happily married. However, among the Google ads in the side bar of our e-mail exchange: you guessed it, travel to Sedona, Arizona, new age home to one of the world's most powerful energy vortices.

Chemjerk has set up an interesting experiment with his high school students to learn whether atheists are indeed, "seen as a threat to the American way of life by a large portion of the American public." His experiment is remeniscent of the 1956 Horace Miner anthropological study of cultural practices of the Nacirema people. We all eagerly anticipate the results of Chemjerk's informal exercise.


Skeptics Appreciate Thoughtful Input
Orac, you were kind enough to submit two posts, but I really think we need to concentrate on this one, Out of Work Due to Woo, and I don't mean because you're home with your significant other enjoying each others' "company." Following from EoR's tip that Australian employers are now able to accept work absence notices from alternative practitioners, Orac had tried to collect submissions of the most witty excuses. The comments got off topic and I'd really like to appeal to the creativity of those gathered here today, with the intellectual fueling of these fine pub offerings, to revisit Orac's post and suggest your own alt med certificate of absence from work. My own was, "My karma ran over my dogma," but then again, you see what kind of comedic talent I (don't) have.

Mark at Be Lambic or Green offers a similar request, in this case for old wives' tales and their truth or not. Aye, Mark, your site while English reminds me of my honeymoon with PharmGirl in Paris, enjoying an incredible selection of lambics at La Gueuze, just down the street from the Pantheon near the Sorbonne. I'm also an oenophile, but this was by far the drinking highlight of our honeymoon.


Now, there were a couple of very nice submissions not presented this evening, but they were a bit more political than were comfortable with at this gathering. However, there's some great writing out there and those who didn't make it to the Circle for one reason or another should definitely submit to other political carnivals. If I missed anyone who thinks should have been posted here, please let me know ASAP and I'll fix any omissions.

Alright, alright - now does everyone have a designated driver? Y'all are free to crash here but I know we've got work to do. I hereby hand the gavel to Matt at Pooflingers Anonymous who will be the next host for The 32nd Meeting of The Skeptics' Circle on 13 April 2006. Remember to check the schedule and guidelines.

Take care and travel safely!

The case for promoting women's sports and the ugliness of entitlement

This post has been moved to my new local-interest blog, Bull City Booster.

Still accepting submissions for The 31st Meeting of The Skeptics' Circle/Sceptics' Circle

Yours truly is still accepting submissions for The 31st Meeting of The Skeptics' Circle, that biweekly blog carnival of critical thinking, debunking, and deboning of questionable stories anywhere in the scientific and historical realm. In fact, we'll pretty much consider any well-reasoned piece that is apolitical, as the Circle is not meant to advance any one political agenda. More on the schedule, archives, and guidelines can be found here.

I've already received about 11 submissions from all around the world, but the submissions have been dominated by North American bloggers. So as to appeal to our colleagues overseas, I have also included the Queen's spelling of skeptic, "sceptic." (In fact, I should probably use the continental style of quotation when I refer to "sceptic". I do own a copy of Eats, Shoots & Leaves and you can even play the punctuation game here to make sure I'm right.).

Unfortunately, I am pretty challenged in most other languages, and some would say English isn't my best either. Although I can struggle with Spanish and German and PharmGirl, MD, can cover French and Portuguese. I have anthropological experience with Joisey, Noo Yawk, Lawngoylund, and Cahlinuh, and could get some help from folks in my lab with Japanese, Mandarin, and Arabic. I can even do a decent job with Gullah (seriously) and was pleased to see last week's editorial by Charleston's Charles Rowe in the Wall Street Journal.

But, you know what?...some form of English would really be best.

Submit your entries via e-mail here by the evening of Wednesday, 29 March 2006, at 7 PM in your time zone, to be fair to everyone. It would help me if you put "Skeptics' Circle 31" in the subject line.

The carnival will appear here on Thursday, 30 March 2006.

Once again, general guidelines, archives and schedules are here. Initiated by founder, Saint Nate, the carnival is now administered by our sage and colleague, Orac, at Respectful Insolence.

The need for study of rare cancers

Part of why I started this blog was to give myself practice in writing on science topics for a general audience. As I learned professional technical writing during my graduate studies, several mentors suggested that I examine writers whose papers I enjoyed reading. My own favorite is Bob Eisenman at the Univ of Washington - his early 90s Cell papers on Myc, Mad, and Max in oncogenesis still make for engaging reading of great clarity.

So, when I started experimenting with medical journalism, I chose Amy Dockser Marcus as my role model. Based in Boston for the Wall Street Journal, Amy was awarded the 2005 Pulitzer Prize for beat reporting, stemming from a series of articles on cancer survivors.

What I love most about Amy is that she writes in both understandable and scientifically-accurate technical detail, while also bringing an emotional component to the subject matter that makes me proud to be a scientist. In 2004, Amy brought to our attention Andy Martin, a Tulane medical student diagnosed with a very rare cancer, SNUC, or sinonasal undifferentiated carcinoma. I urge you to read her chronicle of Andy's struggle to grow his own tumor cells in the laboratory under the guidance of Dr Tyler Curiel. (Tyler and his wife, Ruth Berggren, MD, deserve their own separate post for their heroic treatment of patients in New Orleans in the aftermath of Hurricane Katrina.). Following Amy's story, NPR's Robert Siegel did a lovely interview with Andy - Andy is no longer with us, but Amy also reported on Tyler's successful post-Katrina rescue of Andy's SNUC cell lines.

As with many of us, cancer has come to roost in Amy's family. Amy's Mom, Golda Dockser, had her gall bladder removed about a year ago and learned it was cancerous. You probably haven't heard much about gall bladder cancer - no green ribbons, races for the cure, etc. - simply because it afflicts just under 7 500 Americans a year, as compared with over 200 000 each for breast and prostate cancer. Amy's account of her journey with her mother, A Cry in the Dark, appeared in this past Monday's WSJ (subscription req'd). However, I'd be happy to send you a 7-day free access invitation to read it if you send me an e-mail request. Her editor, Lawrence Rout, introduced it best:

"Amy Dockser Marcus writes about a different uncomfortable truth: If you have a rare cancer, you have few places to turn. When Amy's mother was diagnosed with gallbladder cancer, Amy, who won a Pulitzer Prize for her reporting on cancer, set out to help her mother learn about the best, and latest, treatments. She quickly saw there was little to learn."

"Amy's essay lays out the frustration of having few options. But it's also a daughter's plea for help, and a reminder that behind every faceless patient is a mother, a brother, a daughter, a friend. And you can't get a truth more simple than that."

Frankly, I can't tell you how many times I've heard on NIH grant review panels, "Why are they studying X cancer since it affects so few people?" But Amy's article got me thinking about why we should study rare cancers. Certainly, government research budgets are limited to the point that we must fund the best-designed studies that have the greatest potential to help the largest number of people.

However, I'm not terribly certain that the increased funding, say, of breast cancer research, has led to advances in treatment in proportional magnitude to the much higher investment. Once the US Dept of Defense started funding breast cancer research in the early 1990s, dozens of my colleagues suddenly started working with breast cancer cell lines - not because they were interested in breast cancer, but because it was a way to get funding to maintain their laboratories and support trainees.

In fact, most advances in cancer biology and treatment come from the least likely sources. The widely heralded anticancer drug, cisplatin, credited with saving Lance Armstrong and revolutionizing the treatment of testicular cancer, was not a result of directed study of testicular cancer. Instead, cisplatin was discovered serendpitously as a by-product of testing the effects of electric fields on bacterial growth. (Cisplatin was then identified from some careful control experiments as an electrochemical product of the platinum electrodes and the amine-containing buffer to which the bacteria were exposed; in fact, cisplatin had been synthesized as early as 1844 when it was named Peyrone's chloride).

In the couple of days since Amy's essay appeared, I've been looking for evidence to support why the study of rare cancers is not only good for those people afflicted with rare malignancies, but because such study might reveal truths and targets of relevance to other more common cancers. For example, exactly why is gall bladder cancer so rare relative to breast cancer? Might study of the gall bladder tell us something about why its cells so rarely undergo transformation? How could those pathways could be turned on in more common cancers?

I'm sure that this topic has been discussed and studied, and I'm aware that the US NCI has a special office on the study of rare cancers. However, I turn to you, o faithful readers, many of whom might have experience in studying rare cancers. For those of you that do, what are your reasons for studying rare cancers? How do you write the "significance" section of your grant applications to convince reviewers of the broad significance of your work?

I can close this post no better than did Amy and our mutual friend, Dr Curiel:

"After my mother's diagnosis, I called Tyler Curiel, the head of the hematology and medical oncology program at Tulane University. I knew that Dr. Curiel's lab had done work on several rare cancers. But that day, I was searching for comfort, not answers.

"A cancer is only rare until you know someone who has it," he told me.

"As my mother undergoes another round of chemotherapy, I cling to this idea. It offers the possibility of what I was searching for all along, an avenue of hope. So consider these words an introduction to my mother, Golda Dockser. Now you know someone with gallbladder cancer."

A small lesson for alternative medicine in the TGN1412 tragedy

By now, you've probably already heard about the young, previously healthy British volunteers for a Phase I clinical trial now fighting for their lives after receiving a monoclonal antibody therapeutic, TeGenero's TGN1412. New Scientist has a concise overview, but I also refer you to Insider at PharmaGossip Derek Lowe's In the Pipeline and Anthony Cox's excellent Blacktriangle for viewpoints from three different disciplines.

Fiddling with the immune system is tricky business, and even highly experienced scientists are having difficulties understanding the intended use of TGN1412 in autoimmune disorders like rheumatoid arthritis and "cancer-related immune deficiencies" [from TeGenero's website].

As I understand it, the antibody therapeutic was designed to bind the CD28 receptor on regulatory T cells and act as a superagonist, overriding the body's normal requirement for a second, antigen-specific signal to activate the T cells. This nonspecific, super "immune boosting" effect (ever heard of that term before?) has now put two of six volunteers into multiple organ failure.

I'm reminded of the "immune system boosting" claims of many alternative therapy hucksters. Even if such a remedy existed, the immune system is far too complex to regulate with a single, myopic approach due to its multiple checks and balances, feedback loops, and other regulatory process that normally keep us from attacking our own tissue while recognizing and mounting responses against invading organisms. Even the most clever cancer immunologists have only made incremental headway in harnessing immune responses to treat cancer.

However, alternative therapy advocates prey on the public's misunderstanding of the immune system - it's a struggle for many scientists to understand, just like how homeopaths throw around terms from quantum physics. I'm reminded of my brush with fame on an AM radio talk show a few years ago where a woman who was taking Echinacea noted that her rheumatoid arthritis got worse everyone she took the herb. My simple response was that even if Echinacea was "immune boosting," the non-specific release of cytokines could make autoimmune disorders like RA much worse. (Recent data are indeed suggestive that some Echinacea compounds may indeed have potent immunomodulatory effects.). The same goes for asthma and why I always worry about folks using Echinacea supplements whose asthma has a strong immmune component. Fortunately, most Echinacea products on the market are of such inferior quality that they only occasionally pose a threat.

But the next time some CAM huckster tries to sell you a remedy that will "boost your immune system," ask them how they can be certain you won't end up in the hospital like the unfortunate Phase I volunteers in London.

Proud moment for feminist Dad during NCAA basketball tournament

Being the father of a 3 1/2-year-old girl who is likely to be an only child, I have a unique opportunity in our rich academic and athletic community to provide PharmPreSchooler with superb role models who just happen to be women.

So, we got season tickets this year for one of our local university women's basketball teams. My closest research colleague and I have a had a blast taking our little daughters to the games.

I knew I was doing okay last night when we were watching the first round of the men's NCAA tournament:

PharmPreSchooler to PharmGirl, MD:

"Mommy, why are there boys playing basketball on the TV???"

I think I even scored points with my wife, too.

The 3,000-Hit Club

Getting 3,000 hits is a major milestone in the career of any baseball player. My own favorite all-time 3,000-Hit Club member from my childhood is the late Roberto Clemente. In 1972, in his last at-bat of the season - also to be the last at-bat of his career - the great Pittsburgh Pirates right-fielder smacked a double off of New York Mets pitcher, Jon Matlack. Clemente, an understated humanitarian, was to perish in an overloaded airplane that crashed 31 Dec 1972 on its way to Nicaragua carrying supplies to aid survivors in the wake of a Christmas holiday earthquake.


Clemente is shown here with fellow Hall-of-Famers and immediate predecessors in The 3,000-Hit Club, Willie Mays and Hank Aaron.

"Anytime you have an opportunity to make things better and you don't, then you are wasting your time on this Earth" - Roberto Walker Clemente

For most of us, blogging is not quite such a noble act, although many of us get into it to make things better. However, a great many bloggers would sob and cry if they only got 3,000 hits in a single day.

Well, I am bursting with pride at getting my 3,000th hit today - my "lifetime" accumulation since starting the blog on 15 December 2005. As my luck would have it, I can't thank anyone for this particular hit since it came across SiteMeter this evening as from an unknown location, but at least left their mark as coming over from Skeptico's referral to my recent post on Isaac Hayes quitting South Park.

What's kind of cool for me is that the blog has reached this milestone without announcing it to any of my family or co-workers. Oh, of course, the highlight for me so far has been the tremendous accidental traffic from British crossword enthusiasts. As a result, I am proudly one of few Americans whose Google share from the UK search engine outranks that from Google.com.

I've also gotten a fair bit of traffic from clay crafters trying to work with terra sigillata, recreational drug enthusiasts looking for information on hallucinating with traditional plants like Hoasca/Ayahuasca, and people researching Dr Akira Endo, the Japanese natural product scientist who discovered the first cholesterol-lowering statin.

I've actually been so burned out on science from work lately that my pharmaceutical/herbal posts have been pretty infrequent. As I regain balance in my life, I intend to change that because there are some great new natural products stories out there.

Most of my support has come from fellow bloggers and you folks who check in regularly to see if I'm going to say anything of benefit. My biggest referrals have come from friends around the world who have hosted my posts in Grand Rounds or The Skeptics' Circle. This is a remarkable community in which I've made a great many e-friends in medicine, nursing, and all aspects of academia from undergrads to full professors.

Okay, so this is almost as bad as an Oscar's acceptance speech (cue music now).

So, many thanks to Barbados Butterfly, A Chance to Cut is a Chance to Cure, Paige's Page, and Unused and Probably Unusable for hosting my carnival posts. Of course, I would be remiss if not for Orac, who made the suggestion that I submit as early and as often as possible to blog carnivals. Finally, special thanks to blogger-in-absentia, BotanicalGirl, and all of the graduate students and postdocs who I always hold in the highest regard for studying what they love no matter how cynical we older farts get about this crazy business.

Last ditch effort for US cancer research funding

I spent part of the day over at Orac's place, bitching about our NIH grants being cut even more than they were originally cut when we each got ours. Well, one of my primary scientific organizations, the American Association for Cancer Research (AACR), just came across with the following e-mail alert.

You can be sure I'll be calling our US Senators tonight and tomorrow. Feel free to join in from your own state should you care to support your local, hardworking cancer researchers:

To: All AACR Members

From: Dr. Margaret Foti, Chief Executive Officer; Dr. William G. Nelson V, Chairperson, Science Policy & Legislative Affairs Committee

Date: Wednesday, March 15, 2006 by e-mail

Re: Please Contact Your Senators TODAY or TOMORROW in Support of the Specter-Harkin Budget Amendment and the Feinstein-Mikulski Amendment
- MAKE CONTACT BY 4:00 p.m. ET on Thursday, March 16

The President's FY 2007 budget proposal calls for no increase for the National Institutes of Health (which was cut by 0.1% in FY 2006) and for a cut of $40 million for the National Cancer Institute (which was cut 0.7% in FY 2006).

The Senate is taking up the FY 2007 budget today (March 15) and is expected to vote on it by tomorrow afternoon.

Senators Specter and Harkin have proposed an amendment to the Senate Budget Resolution (S. Con. Res. 83) which would add $7 billion above the President's budget request in order to restore funding for the NIH and NCI to FY 2005 levels.

According to Senator Harkin, "This is the decisive vote . . . this is our best, maybe our last real opportunity to change our budget priorities, and if we fail to act we will indeed be cutting into the bone and marrow of our most important programs."

Senators Feinstein and Mikulski have now also introduced a cancer-specific amendment that would increase funding for cancer research and programs by $390 million.

Without an increase in funding by the Budget Committees, the Appropriations Committees will simply be unable to provide more funding for the NIH and NCI than is provided in the President's woefully inadequate FY 2007 budget

ACTION REQUESTED
AACR urges you to call your Senators between now and Thursday afternoon, March 16th and take the following steps:

Call (202) 225-3121 and ask to be connected to your Senators.

Once connected to the offices, ask to speak with the legislative assistant who handles health care issues (or leave a message).

Request that the Senator vote FOR the SPECTER-HARKIN budget amendment to increase funding for health and education by $7 billion.

Request that the Senator vote FOR the Feinstein-Mikulski budget amendment to increase funding for cancer research and programs by $390 million.

Make it clear that there is no excuse, rationale, or explanation to justify voting against their constituents and approximately 1.5 million Americans who will be diagnosed with cancer this year and the nearly 10 million Americans living with and beyond cancer.

Let them know you will be following the budget process closely and ask them to keep you up to date on what actions they take.

Please ACT by March 16. Thank you for your ACTION to support cancer research.

Grand Rounds vol. 2 no. 25

Got a little insominia right now and I think I know the cause:

I neglected to post a link yesterday to the week's best of the medical blogosphere, Grand Rounds, hosted by yet another Down-Under-and-to-the East colleague, PICU nurse Geek Nurse. (Saying "PICU" gets me out of the conundrum of using "Peds" vs. "Paeds.").

Beyond the usual scads of incredibly moving and insightful posts, recent Grand Rounds have brought my attention to two of my new favorites, Kim at Emergiblog and Dr. Michael Hebert at his Medical Gumbo.

I'm just a lab dude - I am ever so impressed with what you nurses and docs do every single day.

I'm also really enjoying Dr. Nick's weekly interviews with each host at Medscape.

Submit now for The 30th meeting of The Skeptics' Circle

Paige's Page is still accepting submissions for The 30th Meeting of The Skeptics' Circle, that biweekly blog carnival of critical thinking, debunking, and deboning of questionable stories anywhere in the scientific realm.

Submit your entries here by tomorrow evening, or thereabouts. The carnival will appear on Thursday, 16 March 2006.

General guidelines, archives and schedules are here. Initiated by founder, Saint Nate, the carnival is now administered by our sage and colleague, Orac, at Respectful Insolence.

Why, you ask, am I being so kind in promoting dear Paige? Well, yours truly has volunteered as host for The 31st Meeting of The Skeptics' Circle on 30 March 2006, my very first attempt at carnival hosting.

Just trying to create good karma in advance.

Say it ain't so, Chef!

No amount of higher education could take away the fact that I sometimes behave like a juvenile teenage boy. Hence, my reverence for the animated South Park series. I've often visited the real place, the windswept high mountain valley town of Fairplay, Colorado, and the surrounding area that played host to miles of trail running and several lab outings for hikes and rafting down the Arkansas River. The real South Park isn't actually a town but rather a geographical region where the mountains give way to a huge, sprawling, high-altitude grassland. If you're taking Spring Break to ski in Breckenridge and are tiring of the great food and mass of people, you can drive 25-30 miles south over Hoosier Pass to the far less commercial real Colorado.

Co-creators, Matt Stone and Trey Parker, are some of the most controversial figures to come out of the University of Colorado system until Ward Churchill. But they have always been even-handed in ridiculing virtually every religion, racial and ethnic group, and boastful celebrity - and if you pay attention, there is usually a moment of clarity in each episode where some real truth about our culture is revealed, most often by Stan or Kyle.

So why, after ten years and 150 episodes does singer Isaac Hayes leave the show on religious grounds? He was somehow able to reconcile his 40 years of work as a civil rights activist and collect paychecks from shows poking fun at all manner of minorities and religions.

Well, as Reuters reported yesterday, they made fun of his religion, the Church of Scientology.

The only reason I make this point on this blog is that Scientology is well-known for avoiding the use of drugs, particularly psychiatric medications. Tom Cruise's famous admonition of Today Show's, Matt Lauer, "You don't know the history of psychiatry. I do," reveals just one frightful aspect of this group's unusual concoction of pseudoscience and religion.

Those of us associated with health care spend a tremendous amount of time trying to erase the stigma associated with mental illness and get diagnosis and proper treatment, that sometimes includes drugs, to the people who can best benefit. To me, depression and psychoses are as life-threatening as hypertension or cancer and are a result of clear biochemical disturbances in neurotransmitters and neurosteroids. Scientology would have it otherwise, as they do not believe in chemical imbalances or altered physiology in the brain. But they will sell you on various sessions to rid you of what's in your mind...and your wallet.

I still take Rolling Stone magazine in an attempt to stay updated on music and cultural trends among the younger folks - last week's issue had one of the most extensive recent reports on the Church of Scientology. Cult expert, Rick Ross, has a nice review of the article if you can't get through the entire 13,000-word text.

As for Mr. Hayes, I can only wish him well out of respect for his musical career, civil rights work, and ten years of hilarious satire. But, for me, a return to his roots as a Southern Baptist would be far more palatable than his embracing of $cientology.

ADDENDUM: If you got here via Paige's Page, just another reminder that I'm the next host for The Skeptics' Circle. Please send entries for The 31st Meeting of the Skeptics' Circle to me here by 11 PM EST on Wed 29 March 2006 and put "Skeptics' Circle 31" in the subject line. Many thanks!

What kind of beer are you?

Beer is a natural product, representing the best of botany (barley and hops), biochemistry (the conversion of starches to fermentable monosaccharides by enzymes in germinated barley), and the unusual pathways of a genetically-tractable model organism (the yeast, Saccharomyces cerevisiae, can make ethanol from sugars).

My new home state just celebrated 6 months since the passage of new legislation permitting the sale of craft beers possessing greater than 6% ethyl alcohol per volume. I donated more money to this cause than I did to any political candidate in the 2004 elections. That should tell you how I was going to score on the blogthing below (BTW, I'm currently enjoying a Sierra Nevada 2006 Bigfoot Barleywine Style Ale.).

You Are Guinness

You know beer well, and you'll only drink the best beers in the world. Watered down beers disgust you, as do the people who drink them. When you drink, you tend to become a bit of a know it all - especially about subjects you don't know well. But your friends tolerate your drunken ways, because you introduce them to the best beers around.

What's Your Beer Personality?

Women in Science and Medicine - request for comments

I'm looking for a little insight here from my dear readers, especially my regular lurkers and women with careers in science and/or medicine. What I'm not looking for is validation, just some understanding as to where I might be going wrong as a mentor of female scientists.

As many of you know, 8 March of this week was decreed Blog Against Sexism Day. I'm pretty proud of the fact that, on average, 3 out of 4 of my trainees have been women, and many have gone on to outstanding programs and faculty positions. One of my all-time idols in cancer chemotherapy is the late Gertrude Elion, co-inventor of several antimetabolite anticancer drugs and 1988 Nobel Laureate in Medicine or Physiology - all of which was accomplished without a Ph.D.!

In registering my pride in my incremental contributions, particularly in the comments section of Dr Janet Stemwedel's post on Adventures in Science and Ethics, I encountered some resistance to a commenter who found me to be back-patting and simply molding young women into becoming subserviant to the patriarchal science machine.

For the first time in the four-month infancy of this blog, I've been taken to the carpet to question and reevaluate how I approach mentoring and counseling female trainees in my research group.

My approach has always been to create an environment where all of my trainees can succeed in the way that suits them, personally and professionally. I started my career thinking I'd go to grad school to end up as a drug development researcher in big pharma, but fell in love with academia and teaching, warts and all. However, not everyone is me (thank god), and not everyone who walks through the doors of my lab wants the same thing from science. I try to respect that, regardless of gender, and help guide the trainee toward a career that suits them.

However, Polly Anna took issue with my approach. I guess that I am just puzzled as to what I should be doing differently, as most of her comments were critical without suggesting a solution to my behavior.

With apologies to Janet, let me reproduce some of the exchange I had with Polly Anna. First, from me, comments on Janet's post that the situation for women in science is improving, at least from my little view of the world:

"Janet, I pray that it's getting better with my generation (born '64, PhD '89). Women outnumber men in most of our grad program in biomedical disciplines and all of my Ph.D. graduates have been women. My lab has generally run 3:1 women to men and two of my former postdocs, the best I've ver had, have just gotten tenure track faculty positions this year - both women."

"I was raised by a strong Mom (and grandmother, too) who was encouraged by my Dad to go to nursing school when I was 10 - not a grad program, but certainly better than being a secretary for a Pfizer salesperson. I never knew anything about a gender disparity until I got to university, although my highly-technical, chemistry-heavy program had women kicking our asses most of the time and our valedictorian was a woman. The most successful person from my pharmacology grad program is a woman who had such high aspirations that she leads a $30 million/yr health consulting business in NYC - lab was too 'small potatoes' for her. One of my best friends as a postdoc had Science papers and was recruited by Duke and Cornell but preferred a large Midwest state school where her first R01 has been renewed."

"Mine are all anecdotes, of course, but I have grown up with excellence among women my entire life and career. Hell, I married one of the smartest people I know, who went to schools that would've laughed at my applications if I had the guts to apply. Now that we have a 3.5 y.o. daughter, I'll do all I can to be sure a similar culture exists for her. And, as for the one open slot I'll be having this summer due to my postdoc getting a tenure-track faculty position, well, we're always accepting applications...and my history tells me 3 to 1 that a woman will be my top candidate."


My personal experiences with female colleagues in science and medicine have been nothing short of outstanding. I'm incredibly proud of the accomplishments not only of my own students (in pharmacy, medicine, nursing, physical therapy, and physician's assistant programs), but the people I trained with who also just happen to be women.

But my bubble of pride was then deflated somewhat by the following from Polly Anna:

"Oh, my! It all sounds so simple."

"According to fellow polyannas, stat-quoting (got my Science paper, got my R01), back-patting Able Farmboy [sic] and BotoxicalGirl [sic; BotanicalGirl, who had commented on the abundance of women in the grad student interview pool in her program], all this is much ado about nothing; we are there, or soon to be there."

"Yet I hear some grad exec committees (mostly male of course) are attributing the increasing female composition of graduate programs to the same forces that have increased the composition of Asians."

"1. The increasingly thoughtless assembly line, high throughput technical data production nature of science at the expense of deep thinking hypothesis driven science (women and Asians are better at repetitive mass production and have "more precise hands" as techicians [sic])."

"2. The loss of "high quality" domestic male applicants to other "softer," but higher paying disciplines better suited for fulfillment of the "food gathering" gene cluster. All associated with the decline of American scientific education in grades K1-12 in general."


I then responded:

"Polly, not back-patting at all. Just saying that there are some of us out here trying to make a difference starting in our own labs. Moreover, none of my statement cites either of your points, especially the "thoughtless assembly line." The women who've trained with us are also the most experimentally creative and best writers I've ever worked with."

"But I continue to be deeply concerned about what needs to be done and live everyday with a physician-scientist-mother who is struggling to make it work in a so-called Research-1 paternalistic empire. I'm not asking for credit, but rather registering one anecdote of an XY who has many female colleagues making it work for them."


This caused Polly to take issue with my then-current and previous comments:

"Oh, my! Sorry for the misspelling, Abel."

[.....such high aspirations that she leads a $30 million/yr health consulting business in NYC.....best friends as a postdoc had Science papers and was recruited by Duke and Cornell but preferred a large Midwest state school where her first R01 has been renewed......postdoc getting a tenure-track faculty position.... misled me.]

"Owww, "the Midwest state school" putdown while going gaaa-gaaa over Duke and Cornell fooled me."

"Please forgive me for suspecting that you might be encouraging those girls to play copycat in pursuit of batting averages like the majority of their male counterparts."

"At the expense of learning to enjoy playing the game, following their ideas, making great conceptual advances, and to be excellent for its own reward."

"Oh, goodness! I can't resist copying a post of mine from another site in response to the same general topic:

"Oh, my! It all seems so simple. The honest, open and altruistic practice of science, the search for truth by a method that all must eventually agree upon and reproduce, is its own reward. The high E/A members of the species will always be at a disadvantage in inverse proportion to which this "raison de etre" can be achieved (E=estrogen; A=androgen)."


At this point, what got me thinking, and admittedly defensive, was her argument that I am merely encouraging my "girls" (her word) to play copycat with men in science.

Here's what I said next, trying at least to solicit what she thinks needs to be done instead:

"Polly, no good deed goes unpunished, eh? I fear you may be reading into my comments whatever supports your anger. For this, I apologize. But I would certainly welcome constructive comments on how you think I could modify my behavior in a way that would help the trainees who I am honored to guide."

"No put-down intended about the Midwestern state school which, in my opinion, is one of the top 3 state research universities in the country. Moreover, I aggressively counseled this colleague against Duke in particular since I knew personally at the time that they ate their own young and, until recently, had a poor record of junior faculty development regardless of E/A ratios. In her current position, she is an internationally well-respected scientist with a loving home life as well. I have never seen her happier or more fulfilled."

"I'm also sorry that I have to balance my mentoring with the actual, fact-based performance metrics required to survive in this increasingly competitive funding environment and with outcomes-driven promotion and tenure committees. I don't consider it solely as, "At the expense of learning to enjoy playing the game, following their ideas, making great conceptual advances, and to be excellent for its own reward." If they can't stay funded, they no longer will have the luxury of pursuing their dreams and making conceptual advances because they will be out of a job. Assuming that they want to stay in this business, pretending these metrics don't exist is a disservice to them. If they wish to pursue science in another paradigm that suits them, I still continue to support them. If they choose to leave science altogether, I support them equally in whatever endeavor they choose."

"Lest you think me an androgen-raged misogynist, I will also note that two of my three Ph.D. grads are happily pursuing their family lives prior to getting back into science full-time - I heartily supported their choices to do what was right for them, not me. When, and even if, they choose to return to science, they will receive my highest level of endorsement as they pursue their own happiness and balance in their love for science and their families."

"If this doesn't satisfy you, rest assured that I am not a terribly successful scientist by low E/A ratios: I have never had more than five people in my group and am struggling with one R01 to keep the two people I have. I am only making a small dent in gender inequality issues but, IMHO, in the correct direction."



I have yet to get a reply, but I suspect one will be coming. I guess my level of discomfort comes from the supposition that I am minimizing the problem of gender inequality in the sciences and that, as a man, I am somehow brainwashing my female trainees into succeeding via the male definition of success. I alone cannot change the system, so my approach has been to help my trainees develop the tools to succeed in the system, all while respecting their personal decisions for a life outside of the lab.

Using another analogy, I hate departmental politics. But, to succeed, I've learned how to be more politically astute if for nothing than to protect my own resources and people. I don't really like the energy I waste on political manuevering, but to pretend politics doesn't exist would be the demise of my program.

What do you think? Am I deluding myself? Is it wrong for me to encourage women, women who expressly wish to, to compete for R01 grants, high-impact papers, and tenure-track positions.

More broadly, what can be done to prevent what some have called the "leaky pipeline" for women in science and engineering?

Sports, supplements, and steroids

Let me ask this question: who should be responsible for assuring the content and purity of dietary supplements in this country???

One might think the US Food and Drug Administration would have this task within its bailiwick. However, the 1994 Dietary Supplement Health and Education Act essentially prevents the FDA from acting until adverse events due to supplements are detected.

In no way do I blame FDA for this situation - they can only enact what Congress legislates them to do.

But, when Major League Baseball players claim that their positive steroid tests are due to some supplement given to them by someone else, what is the response? MLB commissions a private lab to certify supplements for use among players, with the assurance that none contain illegal, performance-enhancing steroids.

Great...lovely...how 'bout a little quality control for the rest of us whose multimillion-dollar-a-year jobs aren't jeopardized by a positive steroid test?

How about protecting....oh...I don't know...young high school athletes from steroid-containing supplements that are still making it to the market, as announced by the FDA only a day after MLB launched their quality-control program? And no excuses here about the supplements coming from some far off country with substandard manufacturing practices. Today's FDA warning letters have been issued to:

Anabolic Xtreme Superdrol, manufactured for Anabolic Resources LLC of Gilbert, Ariz., and distributed by Supplements To Go of Cincinnati.

Methyl-1-P, manufactured for Legal Gear of Brighton, Mich., and distributed by Affordable Supplements of Wichita, Kan.


When will the US adopt a proper testing and registration program for dietary supplements like Canada's Natural Health Products Directorate?

What is so hard about offering the following system?:

"Through the Natural Health Products Directorate, Health Canada ensures that all Canadians have ready access to natural health products that are safe, effective and of high quality, while respecting freedom of choice and philosophical and cultural diversity."


Oh yeah, I forgot, we need to have the freedom in the US to buy poorly studied supplements developed by a schoolteacher, but touted on Oprah.

The Holocaust History Project (THHP) terrorized

If you've gone anywhere on my blogroll, you'll have learned already that the San Antonio office of the The Holocaust History Project (THHP) was damaged extensively by arson this past Sunday, along with several businesses in a warehouse complex near the San Antonio International Airport.

The complete THHP press release details the incident as well as past criminal efforts to try and silence this important group of dedicated individuals.

Bora/Coturnix and Orac have written extensively about the incident, with links to their posts on their personal interests in combating Holocaust deniers.

In particular, Orac really spearheaded this blog campaign to turn another silencing attempt into greater publicity for THHP because of his longstanding interest in and support of Holocaust historians. I've come to know the good Doctor a fair bit due to our overlapping professional interests and I'm pretty sure he's not even Jewish, but rather a recovering Catholic. What Orac has taught me is that pseudoscience and pseudohistory make use of many of the same manipulative tools. Hence, rational thought, logic, and skepticism can go a long way in combatting all kinds of offensive, dangerous, and downright criminal practices.

His own narrative provides great insight on how he became interested in combatting Holocaust revisionism, at first using his medical knowledge to respond to the offensiveness of those who would minimize or dismiss the deaths of 6,000,000 Jews and millions of others around the world.

It makes the intellectual battle against dietary supplement hucksters pale in comparison.

So, this is why you'll often see the scientific discussion here interspersed with my support for those who fight injustice, as with my admiration for Stetson Kennedy, or Morris Dees, co-founder of the Southern Poverty Law Center.

Sitting in my comfy little house with my happy little family and working in my buzzing little government-supported laboratory leaves me awestruck by those who choose to dedicate their lives to standing up for the rights of others, to prevent past injustices from being revisited.

Modern Skirts my pick for SXSW

Another non-pharmacology post:

Mark my words: The "biggest new thing" to come out of the upcoming SXSW Music Festival in Austin next week will be another band from Athens, GA, called Modern Skirts.

Since I'm an old(er) fart, my exposure to new music comes either from postdocs in the lab or the various music rags I get. Frankly, Orac's Random Ten the other day really spanked me because the guy is about my age and I only knew six of the artists on his shuffle from the venerable iPod (which I do not yet own). Fortunately, I got turned on to Paste, a superb new magazine (actually, a merger with "Tracks") which provides a CD sampler with every issue. Great new stuff by Kinks god, Ray Davies, a New Orleans tribute from former military dude and troubadour Shawn Mullins, etc.

PharmPreSchooler and I were riding to work the other day when both of us got jazzed by a little number eminating from the car speakers. Playing it again, I wondered if it was something new from Ben Folds or They Might Be Giants. Instead, the song, "Seventeen Dirty Magazines," comes from this piano-centric guitar quartet from Athens, with a singer possessing a mid-tenor voice. A simple 4-chord progression with a critical key change from E or A major to Am and words, like old R.E.M., meant to provoke emotions rather than tell a story directly (although the words are understandable and not mumbled.). The ditty runs just shy of 2:10, such that the little one can say, "play it again, Daddy," five more times between home and preschool.

With all of the pre-processed posing going on these days, it is a rare and refreshing surprise to have something grab you by the ears the first or second time you hear it. If Modern Skirts aren't going places, they will always have a place in my CD player...until, of course, I join the world and get an iPod.

Grand Rounds vol. 2, no. 24

The best of medblogging this week is up at Kim's Emergiblog. I don't even know where to begin with my picks because the whole dang issue is outstanding.

By the way, kudos to Dr. Nick for getting Pre-Rounds a regular feature on Medscape. I really enjoy the interviews with hosts, like this one with Kim.

Speaking of Kim, her own post, They Called Him 'Mac', is particularly insightful about how difficult it is to get proper medical care for a family member. (Side note: Kim and I also share fathers who were born in 1938 and both passed away this week in 2000 and 1997, respectively.).

Not to be too serious, my own 5-week battle with sinusitis led me also to appreciate the advice on nasal irrigation from Anatomy Notes, written by a University of Vermont anatomy lecturer who is quiiting his job to go to medical school.

At Diabetes Mine, Amy is a newly-diagnosed type I diabetic patient who does an exceptional job reviewing herbal remedies touted for diabetes.

Finally, I have to promote Dr. Andy's submission, Eat Dirt, Prevent Asthma!. The post builds on the hypothesis that our decreased exposure to non-harmful microorganisms is associated with the increasing rates of childhood asthma and allergic rhinitis. Regular readers may recall that Terra Sigillata is also associated the practice of geophagy, sort of.



Just a general observation as well: The other thing I like about blog carnivals is that they tune you in to other bloggers you may not have gotten to yet, especially on subjects you care about that aren't part of your core writing topics. This week, the hilarious piece of satire from Dr. Hebert's Medical Gumbo comes at the same time he has posted a particularly poignant piece on springtime in his New Orleans.

Not like it needs my help now...

Congratulations to everyone involved in "Crash," perhaps the biggest Academy Award Best Picture upset in many years. Kudos especially to director and co-producer, Canadian Paul Haggis.

I mention Crash on this blog only because Hollywood's attempts to make cinema out of natural products pharmacology has often been argued. I did hear that Mark Plotkin was pretty good playing himself in Shaman's Apprentice, but I think that it's considered more of a documentary than a full-length feature film.

Crash has been on my favorites list since starting this blog. Even if you think you are the most tolerant, peace-loving, Dalai Lama-type, this movie will have you questioning your assumptions on race, class, and will have you look at even your most everyday relationships in a very new way.

The little girl jumping onto her father's shoulders as he was shot had me sobbing in bed later that night when I kissed my own little girl goodnight.

Now that's cinema.

Dr Tara Smith interview at Daily Kos

Although I'm not a microbiologist or a public health professional, I do a bit of recreational reading on public health and infectious disease issues. Most of my interest in microorganisms comes instead from the compounds that they make to kill each other and how we might harness them to treat infectious diseases that affect humans. My dabbling in public health issues stems from my reading of two excellent books by Laurie Garrett: The Coming Plague and Betrayal of Trust.

One of my favorite science bloggers, Dr Tara C Smith at Aetiology, does however have the appropriate background on such issues and was just interviewed at Daily Kos in a post entitled, Guns, Germs & the GOP - a clever spoof on Prof Jared Diamond's book. Tara is a remarkably energetic junior faculty member in epidemiology at the University of Iowa's College of Public Health and writes prolifically on infectious diseases and related issues.

The interview is great and quite instructional on infectious diseases as a national and world security risk. Frankly, failings in public health have been a joint effort of both Democrats and Republicans, although never carried out to such a level as under the current administration.

The problem, as Laurie Garrett has pointed out, public health initiatives rarely garner much political support (nor are politicians pressured by their constituents) because no one ever sees the lives that weren't lost because of effective public health measures. Garrett also presents arguments in her books supporting the notion that the growing chasm between rich and poor can contribute to major pandemics, especially in urban areas.

Tara covers some of these issues in her interview - it's definitely worth a read.


ADDENDUM: Tara reminds me that the interview is not new (3 Feb 06), but I still find it highly worthwhile

Grand Rounds vol. 2, no. 23

Well, we're back to the blogosphere after weeks of reading and writing, followed by three days of grant review service to the US federal government and our fellow scientists and physicians.

A very depressing time was had by all, knowing full well that the payline for some NIH institutes will drop below the 10th percentile during the next funding cycle. I've never seen so many scientists, superior in stature to me, so tangibly fearful for the future of their departments, their junior faculty, and, of course, their own research programs.

With that said, you might understand that I've been a bit distracted. So, I completely missed the launch on Tuesday morning of Grand Rounds by surgeon-blogger-Bulldog, Dr "Bard-Parker," over at The Chance to Cut is a Chance to Cure.

Perhaps my study section experience has me waxing philosophic about the state of science and medicine, but I found this edition to be unusually profound in its content. The Doc also did a fabulous job of arranging the posts and providing lovely artistic surgical interludes between sections from surgeon/artist, Joseph Wilder.

An aside
Although I'm a PhD, I did most of my training in medical schools alongside MDs who were doing the research years of their fellowships. I've always been impressed with the diverse skills, education, and interests of physicians, both within and outside of medicine.

Perhaps it's just my perception or the kinds of docs that I end up talking to socially, but most are quite remarkable and engaging individuals. The single-minded geekiness I encountered among about half of my fellow PhD students didn't seem as common among medical students or fellows with whom I've worked, and this perception has continued in the years since. Perhaps it's because I went to grad school at a time when medical school admissions committees began focusing more on recruiting future docs from diverse backgrounds with a broader variety of undergraduate training and more humanistic qualities than your traditional pre-med folks.

Or, maybe I've simply been lucky to have some incredibly engaging friends and colleagues who just happen to be physicians...not to mention a wife who, by her example, sets the bar quite high for anyone who tries to be a doc, a mother, and a best friend.



I was particularly reminded of this by the current week's Grand Rounds posts from The Cheerful Oncologist and Dr. Charles. Both have great reputations as excellent writers and physicians, but even their submissions for this week were a notch above their usual level of literary excellence.

Despite my tardiness, I encourage you to get over to Grand Rounds 2(23) before the next week's carnival and get yourself some good medicine for the soul.