Medical Controversy: Much Ado About Nothing...

No... this is not a post about the placebo effect. That's not the nothing I'm talking about. Well actually I may end up talking about placebos but that's not the nothing I want to start with. The nothing I want to start with is homeopathy.

I mentioned quickly in Anatomy of a Comment about the homeopathy debate going on in the UK. I mentioned one of the groups that is fighting the pseudoscience and quackery of homeopathy is 1023.org.uk. But a much simpler description of homeopathy and the lack of good science behind it is a long comic strip by Darryl Cunningham called simply Homeopathy. Which not only covers the lack of science behind homeopathy but covers some of the reasons it may work. Reasons that have nothing to do with the dilutions themselves. This may be a case of things working but not for the reasons expected by the practitioners. It ends with some scary reasons why homeopathy, and especially its practitioners, may be very bad for people instead of just merely harmless.

Still it seems like reason and evidence is winning this battle. It's getting harder for practitioners to make unproven claims. This makes sense. People who make claims have to be able to show the claims are valid. All the hard science seems to disprove the claims of homeopaths. Most, if not all, of the basic claims as to how homeopathy work have been repeatedly shown to be false.

But even without digging too deeply the pseudoscience behind homeopathy doesn't make any sense. If water could have a memory of what is was in it at one time and later diluted away then how do you delete the memory? How do you reset water to not have the memory of anything? And wouldn't that mean that tap water would have the memory of every chemical used to make it safe? And wouldn't every stream or lake have the memory of every chemical or agent that had been diluted in it?

Of course many people swear by homeopathy. They're convinced it works and they are convinced it helped them in some meaningful way. As I mentioned the cartoon covers some of the reasons it may be helpful to visit a practitioner. It also covers the reasons going to the practitioners may be harmful to your health as well. He gives good examples of how practitioners have been repeatedly shown to not suggest mainstream medicine in conjunction with their homeopathic remedies. The specific case he mentions of Penelope Dingle is very disturbing on several levels.

Alternatives as a supplement to mainstream medicine is one thing. Alternatives that exclude proven medical treatments are another thing altogether.

Yet what also caught my eye in the cartoon was the line:

There have been many attempts to reproduce Benveniste's experiments. But any positive results have been neither consistent or convincing. All evidence points to homeopathic remedies being inert and no more effective than a placebo or just letting the illness run its course.

Which got me thinking about all the intangibles that effect each and every one of us when it comes to illness and health. The placebo effect is one of those. Attitude and outlook are also mentioned repeatedly as being important - even by mainstream medical practitioners. But not every placebo works. Not everyone with the right attitude survives and people who are pessimistic about their chances aren't always proven right. These are effects that are hard to quantify and hard to measure. How do you measure a patient's outlook? How do you tell if they are feeling depressed with their situation or if they have an overall positive feeling instead? How do we begin to quantify and understand the more intangible factors?

And if, for example, you have some sort of measurable sense of how a certain attitude affects outcomes in positive ways for certain diseases... how do you prescribe an attitude?

Toronto Rocked to a Miami Model

The G20 summit has left downtown Toronto. While world leaders met, had discussions, and eventually posed for the obligatory photo op, the protesters were making their voices heard in the streets.

I haven't found a good summary of the protests in town yet. Some were peaceful, some turned violent. Over 900 people were arrested. It looks like the vast majority were released and had charges against them dropped. No real surprises over the weekend. Regardless of whether you support the protesters, the police, or both, things went according to plan.

The police reigned in the violent protesters and stopped things from getting out of hand. They also made arrests and disrupted several peaceful protests. They stopped some of the violence and vandalism and in other cases contained the vandalism but let it continue for a while. The police will defend their actions as necessary while also patting themselves on the back for a job well done.

The protesters were also acting according to expectations. A violent minority completely overshadowed and hid any message a larger number of peaceful protesters may have had. I've found it hard to find out how many peaceful protesters there were around the city. The protests seemed to have little effect on the decisions and actions of the well scripted G20 meetings. The media ended up talking more about the protesters and how they operated instead of what they were actually protesting about.

So all in all things went about as well as they could have. The downtown core survived, the protesters survived, the police survived, and the G20 wasn't disrupted at all as it went about its business. G20 Toronto turned out to be much more peaceful and much less violent than many other international summits around the world.

The only thing missing from the weekend was some sort of protest mascot like Kanellos the Greek protest dog. Though one person told me she saw the same protester at every protest she saw broadcast on TV over the weekend.

The way the police handled protesters in Toronto last weekend is known as the Miami Model. The name comes from the 2003 FTAA meeting in Miami were the individual steps and techniques were put into practice together for the first time. You may disagree with some of the steps and techniques involved but you'll probably agree with others. It seems like this has become the standard handbook for handling protests at gatherings of international leaders or policy makers.

In 2004 Indymedia put together a documentary on the protests around the 2003 FTAA meeting. Called The Miami Model it's available for download from archive.org. Don't expect fair or balanced. That's not the point. This is a documentary with a point of view and it's more powerful because of it.

My biggest questions about the 2003 FTAA protests is how the meeting ended. The meetings were held, according to the documentary, "..to plan the Free Trade Area of the Americas". The documentary ends with:

The FTAA stalled in Miami. The US is now pushing its agenda in smaller regional and bilateral 'free trade' deals, meeting fierce popular resistance every step of the way...

I have some simple sounding questions. Did the FTAA stall because of the protesters in the streets of Miami? Did the protesters have any measurable impact on the meeting or did the FTAA fall apart for other reasons? Did the protesters change public perception of the FTAA they were protesting against or did they change public perception of the protesters themselves?

There may be a better way to effectively protest global summits and global political changes than street protests. The quiet and peaceful protesters are pretty much ignored. The violent minority tearing up cities don't seem to generate much sympathy or action for their underlying cause. Quite the contrary actually. There has to be a more effective way. I'm not sure what that way may be but I'm open to suggestions.

Medical Controversy?: Better Vision Via New Barcodes?

I can still remember what it was like before I knew I needed glasses. Most things were just slightly fuzzy. To see things clearly they had to be very close. Just in front of my face was a good distance. At night every was even fuzzier.

Of course I didn't realize that this wasn't normal. Glasses changed everything. Things weren't vague and smeared. Even now when I get a new set of glasses that are the right strength for my slowly weakening eyes I'm reminded that I can make out leaves on trees when they are across the street. Glasses have made my life much easier. Something as simple as a two pieces of curved glass can change one's world.

There are a number of groups providing eye care and glasses for the third world. Third World Eye Care Society Canada is one group that collects old pair of eyeglasses and sends them to were they are still useful. ORBIS is a group treating preventable blindness around the world. ORBIS is also the group with the flying eye hospital.

One of the problems with delivering optical care in rural and rustic settings is the equipment required. How do you figure out what glasses someone needs. Carry a large box containing lenses and ask someone to stare at an eye chart as you try different strengths over and over? Bring in a complicated and expensive machine that does it with lasers? There should be an easier way.

Maybe there is an easier and cheaper way. The idea and concept behind it came from the idea of using camera blur to display barcodes. Yes barcodes via bokeh.

Bokeh you ask? It's the term for the circles of blur that appear on your camera from out of focus points of light. If you point your camera at a Christmas tree in a darkened room and override the autofocus you get a picture that evokes the whole idea of Christmas.

At MIT researchers realized that you could put an illuminated barcode behind a lens to make a small glowing red dot. When a camera takes an in focus picture all you see is a small glowing dot. When the camera is out of focus a pattern or barcode emerges in the blur. The researchers called it a Bokode.

One of the researchers demonstrated bokodes to his wife and realized that it might be possible to use the idea behind bokodes to develop an eye tester. The Near-Eye Tool for Refractive Assessment or NETRA may be the solution to providing eye tests almost anywhere for almost no cost.

I'd never have guessed that high tech barcodes for cameras would lead to inexpensive eye testing. If a device like this was available when I was younger I may have ended up with glasses years earlier. Which would have made life a little less fuzzy when I was growing up.

Anatomy of a Comment

Just over a week ago I wrote Why Haven't We Beaten Cancer Yet?. In which I concluded that the war on cancer won't be over soon. Someone named Dr. Ian Clements left a comment on my short blog post. The comment leaves me a little bewildered so I'd like to go through Dr. Clements points one at a time.

I am only going on your comments, rather than Dr Coussens.

Fair enough. I quoted from an article by Dr. Gorski where he talks about a presentation by Dr. Coussens. So I can't speak for or against Dr. Coussens with any authority. As I say in my Longer Web Manifesto I like reading and considering opinions and ideas that I don't agree with. I may agree with Dr. Coussens but I'm not sure. I haven't read any of his work, I haven't seen his presentation, and I certainly am not in a position to defend or attack what Dr. Coussens has said. So it makes sense to comment on what I've said instead.

There are several things wrong with this. Firstly, orthodox medicine makes similar misleading claims as CAM - but generally with far worse side-effects.

I'll assume that by CAM Dr. Clement is referring to Complementary and Alternative Medicine. As for "similar misleading claims" I'm not sure what he's getting at. The problem with most quacks and unproven alternative medicine claims is not just that they are misleading but also that they don't stop making claims when there is evidence proving them wrong. The struggle against homeopathy going on in Britain and around the world is a case in point. It doesn't seem to matter how much evidence is weighed against the quacks. In many cases they keep promoting useless or dangerous "cures".

I'll give the British chiropractors some credit compared to the homeopaths. When the evidence against chiropractic claims to cure various diseases started to make headlines the chiropractic association quickly told practitioners to remove these claims from websites and ads. Of course they shouldn't have made many of these claims in the first place but at least they pulled back to what they still think is a defensible position.

Is orthodox medicine incapable of making misleading claims? Of course not. Does orthodox medicine correct itself when a claim it makes is shown to be unproven, unfounded, or wrong? Do the claims and techniques change as new research is done and new treatments are found? Yes and yes. It may take a long time for change to take place but it happens eventually. Otherwise we'd still be treating cancer with the tools and techniques that existed in 1970. Or 1900. Or even before.

Is orthodox medicine capable of making claims that are known to be flat out wrong and dangerous? I'm sure it has happened. The fact that medical associations have removed doctor's licenses and that there are cases of true malpractice shows that. But you'll notice that orthodox medicine is at least trying to police and correct those people who are licensed to be doctors. What qualifications do I need to be a quack? Some alternative medicine groups have created associations and they do provide credentials and codes of conduct. The true quacks are the ones that don't think any monitoring or checking is necessary. And what, aside from the courts of law, will stop them from making malicious and dangerous mistakes?

Secondly, if orthodox cancer has improved so much, why are more people getting cancer and dieing of it?

I never said the war on cancer had been a complete success. The whole point of my post was that cancer is a more complex problem then was once thought. Research is ongoing. I don't think I ever said we'd won this war. I only said there have been advances in treatment over the last 40 years. So this doesn't even apply to what I wrote.

Yes, perhaps boosting the immune system may not always be good (tho; one can say that even more about chemo, radiation and surgery), by and large enhancing the immune system is helpful. Hence the huge increase attention to anti-cancer vaccines, which are inherently immune-boosting.

Dr. Gorski's quote warned against over simplifications. When it comes to boosting the immune system Dr. Gorski wrote that "As we’ve said before here, it’s a meaningless claim, because sometimes boosting the immune system is bad, as in autoimmune diseases." Neither in my post nor in the quote from Dr. Gorski's article did either of us say that boosting the immune system may not be useful in some cases. He was warning against overly simple claims.

Dr. Clement may be correct that there are times in which enhancing the immune system is useful. Many cancer treatments (chemo, radiation, etc) are very hard on the patient. Hopefully harder on the cancer of course. Even so my point is still valid. Oversimplifications aren't always useful and can be dangerous.

As to 'great advances in cancer treatment', see above. Many cancer survival rates are worse (bladder cancer, for instance); only a few rarer cancers have longer survival rates; and much increased survival rates are often due to earlier diagnosis rather than better treatments anyway.

 Now we have something I can check with numbers and statistics. Just before the numbers let me make a couple of points:

1. If a survival rate is better due to "earlier diagnosis rather than better treatments" it is still a better survival rate. And it's orthodox medicine that promotes testing and techniques to make earlier diagnosis. If medicine catches more cancers early when they can be treated effectively that may well make the survival rates lower for the cases that aren't discovered until they have progressed further .
2. Survival rates are different than determining how effective individual treatments are. Dr. Clements isn't claiming that treatments are less effective. He claims that "cancer survival rates are worse (vladder cancer, for instance)."
3. I'm Canadian, I live in Canada, and since I don't know where Dr. Clements lives I'm using Canadian numbers where possible. (As an aside... I love the Public Health Agency of Canada. Numbers everywhere!).

So now on with the show. Let's look at some numbers. Rates are in deaths per 100,000 Canadians. The links go to graphs were the trends just pop out at you. These are population wide mortality numbers they are not survival rates. I'll get to those later. For most of us we'd like to know our chances of dying from a certain cancer. Or cancer in general.

Canadian bladder cancer mortality rates from 1984 to 2004. Males went from 8.06 to only 7.02. Women from 2.41 down to 2.01. Seems like it's more survivable now. So let's keep looking.

Canadian breast cancer mortality rates from 1984 to 2004. Males are staying close to constant. Women went from 30.73 to 23.11 deaths. Need more?

How about an example of why things aren't simple? Canadian lung cancer mortality rates from 1984 to 2004. Males from 80.16 down to 60.61 while females went 22.14 up to 36.09. Graphs can show trends but they don't tell the whole story. Why is the mortality rate for lung cancer in women going up? More female smokers? Unequal application of testing and treatment? (Though I point out men are still dying in larger numbers). If you look at the combined rate for men and women then it does look like the overall mortality rate hasn't changed over twenty years.

That unchanged lung cancer mortality rate does take into account earlier diagnosis and better treatments. Hence my point that the war on cancer isn't over yet.

You're chance of dying in Canada (the overall cancer mortality rate) has remained the almost the same for women (151.84 down to 146.96) and has gone down for men (248.09 down to 212.06). That's the number of due to cancer for each 100,000 Canadians. 

What about survival rates? After all mortality rates are the combination of the number of cases of a cancer and the survival rate of those they get the cancer. Survival rates tells us how many people who actually get the cancer go on to survive.

The best source of bladder cancer survival rates I found was from the American National Cancer Institute. I searched for (deep breath): 5-Year Relative Survival by Year DX, By Cancer Site (Urinary Bladder [Invasive & In Situ]), All Ages, All Races, Both Sexes, 1975-2002.  I don't have a permanent link to the resulting table but you can generate a graph or a table starting from this page.

The result? 74.3% 5-year survival rate in 1975 increased to 81.4% in 2002. Bladder cancer survival rates have increased over time!

There is much wrong with cancer research, not least that any new treatment takes decades to see whether there is an improvement. And if not, tough; but if there is, the alternatives meanwhile have continued wrongly. And during all this time most cancer sufferers have died (the average time between diagnosis and death is less than 5 years)

There's something wrong with waiting decades to see if there is an improvement? Do all clinical trials take that long? Do new treatments have to wait decades before being put into use if they are shown to be effective more quickly? Don't you want researchers to constantly look at years of data to determine what is working and what isn't? Aren't the treatments that are offered to patients constantly changing based on long term survival rate information, additional research, and all sorts of other numbers as well?

As for "And during this time most cancer sufferers have died (the average time between diagnosis and death is less that 5 years)" I think Dr. Clements' information is over 30 years out of date. Back at the National Cancer Institute I search for (deeper breath): 5-Year Relative Survival by Year DX, By Cancer Site (all sites combined), All Ages, All Races, Both Sexes, 1975-2002. The results?

• In 1975 50.1% of people survived 5 years after diagnosis.
• In 2002 68.5% of people survived 5 years after diagnosis.

Dr. Clements continues:

"There aren't necessarily simple and easy answers." There are well documented, but otherwise inexplicable, successes following simple treatments - at least as good as those of the orthodox treatments.

I'd like to know about those treatments he mentions. The ones that give "well documented, but otherwise inexplicable, successes following simple treatments...". I'm not being facetious. I'm being serious. I'd like to know what simple treatments work as well as orthodox medicine. If those treatments are as useful as current medical practice, if they have fewer side effects, and if they have been shown to work (in properly held clinical trials) I'd like to know why they aren't in use at the moment. Denying proven treatments to patients is scandalous and something we should investigate and uncover.

If those simple treatments haven't been shown to work effectively in clinical trials yet there is still hope. Proper clinical trials performed under supervision and with done with all the ethical standards required when working with real patients should be considered for any treatment that shows promise. Of course validating treatments takes time. Studies have to be carefully designed, properly funded, and well run. And clinical trials are expensive and only so many can be done at any time. Funding isn't unlimited. So treatments and therapies that have been shown to work in animal tests, or that are based on extensions of already proven research may end up getting priority over unproven and otherwise inexplicable treatments. Maybe effort should be placed into trying to explain those treatments so they will be taken seriously be the medical establishment that is trying to cure cancer.

Dr. Clements ends with:

I could go on (such as there are many cases of spontaneous remissions which are never investigated) about the purblindedness of the orthodox medical profession, hostile to anything from without.

Has no research been done into remission? There has been absolutely no work done on this topic? A quick search found that at Ovarian Cancer Canada's page on chemotherapy they say: Chemotherapy can stop cancer from spreading and dramatically slow the growth of cancer cells. This can help put cancer into remission enabling you to prolong your life. So treatment regimes can and do use the mechanisms of remission to help patients. 


Forgive me if at this point I don't spend too much time finding out if there has been research into "spontaneous remissions which are never investigated". Just a quick search found an article from Discover magazine in 2007 called The Body Can Beat Terminal Cancer - Sometimes. Which contains the following:

• Call it remarkable, call it miraculous—such spontaneous remissions are as fascinating to physicians and scientists as they are rare. Doctors would like to understand cases like Matzke’s, who was given just 18 months to live but would survive another 18 years. And although a recurrence of the cancer—this time in his brain—would eventually claim his life on November 8, 1991, the fact that his lung tumor disappeared completely begs for an explanation.

Followed by this sensible statement about how hard it is to study spontaneous remissions:

• Pinning down spontaneous remissions has been a little like chasing rainbows. It’s not even possible to say just how frequently such cases occur—estimates generally range from 1 in 60,000 to 1 in 100,000 patients. Many cases, when subjected to close scrutiny, prove not to have been remissions at all.

The article goes on at length on the subject. Remission, spontaneous or otherwise, is a part of ongoing medical research. As with many things being looked at it's more complicated than it initially appears.

As for the "purblindedness of the orthodox medical profession" may I point out that every current orthodox treatment started as an alternative to existing medical practice. Medicine is constantly changing with alternative views becoming current best practice. Anyone who has an alternative approach or treatment that can hold up to study and analysis, and which is shown to by more effective and less dangerous can be the person who helps create the new orthodoxy.


Let me summarize the highlights from the Canadian Cancer Society Fact Sheet for 2008:

• For Canadian men:
• Since 1988 the overall cancer death rate has been declining
• The overall cancer incidence rate rose in the early 1990s then declined sharply
• Incidence rates:
• are up for thyroid and liver cancers
• are down for lung, stomach, and larynx cancers
• Death rates:
• are up for liver cancer
• are down for stomach, larynx, prostate, oral, and lung cancer
• For Canadian women:
• The overall death rate has been essentially stable since 1979. If lung cancer is excluded a major decline of 20% has occurred over the last 30 years
• The overall cancer incidence rate has been increasing slowly (due to increasing incidence of lung cancer)
• Incidence rates:
• are up for lung and thyroid cancer
• are down for brain, larynx, cervical, and stomach cancer
• Death rates:
• are down for Hodgkin lymphona, stomach, and cervical cancer
• Overall in Canada in 2008:
• 39% of women and 45% of men will develop cancer in their lifetimes
• 24% of women and 29% of men will die from cancer

Orthodox medical science has made progress and yet, as my original post said, the war on cancer isn't over. It isn't as simple as "we are winning" or "we are losing".

Let me end with a quote I unfortunately can't find on the web because I heard it offline years ago. A cancer researcher was talking about the slow change in the level of fear brought on by a diagnosis of cancer. How patients still react strongly when they hear the word cancer but in many cases breathe easier when they learn what their chances are and what treatments are available. He summed up the slowly changing attitude society has about cancer by saying:

"Years ago we all knew someone who died of cancer. Today we all know someone who survived."

Follow Up Again: Even More Scripts

There's something beautiful about the writing systems of the world. I find them all fascinating. I followed up a post on how difficult the Chinese language is to learn with one in which the scripts of the world are described and explained.

Not all the writing systems of the world of course. Just a few of them. Now Smashing Magazine has published another article by Jessica Bordeau The Beauty Of Typography: Writing Systems And Calligraphy, Part 2. This part covers Hebrew, Cyrillic, and Inuktitut among others. Considering the number of writing systems in the world this could be an ongoing series.

I certainly hope so.

Medical Controversy: Denying the Evidence...

Why is it that overwhelming evidence and research are denied? Why does it seem that the more certain science is of something the harder the cranks and crackpots fight back?

What happens when unsupported theories and ideas endanger lives? Should those who deny care, treatment, and medicine in spite of evidence be held responsible? Even criminally responsible?

These aren't just vague questions.

AIDS denialism in South Africa upped the death toll by over 300,000. That's 300,000 thousands deaths that could have been avoided. A random quack may only affect the lives of a small group of people. When a government makes bad decisions hundreds of thousands of people can be affected. The documentary The Price of Denial produced by the news agency Health-e gives the startling details of what happened.

The evidence for HIV and AIDS is immense. Yet sites like AIDSTruth.org have to have detailed counter evidence against denialist myths. And that long page is just a summary of the myths with links to more detailed information.

What's depressing is the amount of effort and energy required to fight these myths. If a fraction of the energy put forth by those spreading the myths and those countering them was put into prevention programs that work, into treatment projects with proven drugs and therapies, and into basic research we might be much closer to finding an effective way of dealing with AIDS. Maybe even finding a cure.

In case you think that medical science isn't trying new approaches and looking at radical (yet plausible, and testable) ways of dealing with AIDS then the article Can AIDS be Cured? is a wake up call. There are many different approaches being tried. Some are more promising than others. Keep in mind that as the article says:

There is no cure for polio, hepatitis B, measles, chicken pox, influenza, and a long list of other viruses. Though the immune system and drugs can ultimately defeat many viruses, they are notoriously difficult to stop before they cause damage--especially a virus that integrates itself into chromosomes and can lie dormant for years.

Maybe there isn't a complete cure on the horizon in the short term. Maybe prevention of transmission and better treatment for those who are infected is the best plan for now. I'm just glad researchers are working on the problem from many different angles and with many different approaches. All without denying the underlying science.

The Internet Protects What it Finds Interesting

On the Internet it helps to be good at what you do but that isn't enough. Many people are funny or have an interesting outlook on life and still manage to disappear in the vast sea of people online. If you also happen to catch people's attention, well, then you're set.

One young man certainly has caught people's attention. Oprah Winfrey is holding a competition called "Your Own Show". It's a talent and popularity search for the "the next TV star". Zach Anner from Austin Texas submitted an audition tape to try and become that next TV star. Go watch it. It's a site to behold. What happened next is a classic example of the Internet's new attention economy.

Zach's audition was picked up by various sites that started to put in place vote getting campaigns. Some are simple "tell everyone you know to vote for Zach" affairs. Others simply said "go look and do what you know you must" and people did. I don't know if any sites tried to automate the voting to put Zach ahead. I don't think anyone needed to automate the process. How could you not vote for Zach after watching his video? Plus you'd hope by now online polls and votes are relatively immune to that sort of mass auto-voting. It shouldn't be possible to fix the vote from afar.

Zach's audition started getting mentioned in all sorts of places you wouldn't expect. The musician John Mayer did a "go watch this" blog post. All the attention from all those various corners of the Internet paid off and Zach stormed to the top of the voting. Even he didn't expect it. Here's how he reacted when he found out just how well he was doing. He even thanked John Mayer. Which lead to John offering musical support. If Zach wins hewon't have to worry about his show having a theme song.

But in the last day or so something happened to the voting. The second place contestant made a completely improbable run ahead. Something wasn't right. It seemed fishy. So the Internet that loves Zach for his outlook and humour decided to investigate and make sure everything was still on the up and up.

Never underestimate the collective investigative power of the Internet.

The investigation already has details of the source code on the voting page, graphs with the rates of changes of votes, and all sorts of technical details. People are going to get to the bottom of this. People want Zach to win. They had voted him into first place. They didn't want some chicanery to remove him from top stop. Especially if the chicanery seems to be going on in the site running the voting. The Internet protects what it finds interesting or finds out what's going on. In excruciating detail. Read the investigation if you don't believe me.

Whether Zach wins or not, whether he gets a show via Oprah or not, Zach is too much of a character and too much of a personality to just disappear. Zach will get a place to shine and many people, myself included, will tune in to watch. He'd do a great travel show. Remember, no Atlantis is too underwater or fictional.

Medical Controversy: Anecdotes are Important Too

I'm sure that we all have personal medical stories to share. Hopefully good stories and not just bad ones. Did your uncle survive into his 90s while smoking a cigar a day? Did that young doctor in town do something awful to Elizabeth in accounting? We all have a collection of tales.

When it comes to determining what is right or wrong with medicine anecdotal evidence is considered weak. Mainly because the more evidence and the more cases and the more numbers involved the stronger any correlations and links you can find. Smoking is linked to certain cancers and diseases. Not everyone who smokes will get those diseases. They're just much more likely to get them.

But anecdotes aren't unimportant. Every trend starts with the first observation. A few anecdotes may lead to the collection of much stronger evidence.

Plus anecdotes can be incredibly moving, personal, and powerful. Empathy is a powerful force.

My Brain Forgot... by Lucy Ambrose is her story of a back injury that spiraled out of control. It describes how a 'simple' injury turned into a dark nightmare and how she eventually got help that worked. Stories like Lucy's may not be representative. Her story may not reflect what happens to most people. It does however tell you what happened to her specifically.

For even though a single anecdote is not a sound basis for changing medical policy it may help to remember that each person will end up with their own story. We are going through our own story of illnesses and issues and of diagnoses and treatments.

Each of us is an anecdote in the making.

My New Word of the Day: Metaignorance

Some people think they know everything. They aren't aware of the vast numbers of things they are unaware of.

According to Jeffrey Ellis that makes them metaignorant.

My new favourite word. Help spread the word. Any candidates for who we should apply the word to?

Medical Controversy: Why Haven't We Beaten Cancer Yet?

In 1971 President Nixon initiated what was called The War on Cancer. The hope was that with more research the cause and cure for cancer would soon be discovered. Almost 40 years later the war is still being fought. Why haven't we beaten cancer?

War against cancer has more than one target in the Washington Post gives an overview.  Cancer is more complicated than we thought. Dr. David Gorski gives a more detailed look into the problem in The complexity of cancer: a science based view.

Dr. Gorski's article gives an overview of some of the talks at the annual meeting of the American Association for Cancer Research (AACR). At times Dr. Gorski gets into technical details but don't let that deter you. There are a few take home lessons. One is how complex the problems really are. There aren't necessarily simple and easy answers. He specifically points out the difference between science's approach to the problem and the easy (and wrong) answers given by quacks and practitioners of unscientific medicine. So much of what's peddled as miracle treatments and simple approaches is just plain wrong. What may sound good at first may not actually make much sense when looked at in detail. For example he writes:

Dr. Coussens’ talk is fascinating for what it revealed about the immune system and cancer. How many times have you heard “alternative medicine” believers and promoters brag that this nostrum or that potion “boosts the immune system”? As we’ve said before here, it’s a meaningless claim, because sometimes boosting the immune system is bad, as in autoimmune diseases. In cancer, it’s long been known that inflammation, particularly chronic inflammation, can lead to cancer.

There has been great advances in cancer treatment over the last 40 years. Our understanding of cancer has grown as well. For all the advances and new knowledge it now looks like the war on cancer will not be over soon.

Magnificent Obsessions: When One Script isn't Enough

Sometimes things just all fall into place. First I wrote about how Chinese is a hard language to learn. Next came a follow up on various writing and calligraphy systems of the world including Chinese. On a completely unrelated note I wrote about how I don't like The Lord of the Rings.

And then out of the ether a webpage start making the rounds. Write Your Name in Elvish in Ten Minutes by Ned Gulley gives directions on how to take an English word and write it in an elvish script. I can imagine many tattoo artists using this page as a howto manual.

But there's more to Tolkien's various created languages then directly writing english in a new font. Much more. Books have been written on the languages and scripts Tolkien created. A short introduction to Tengwar, one of his languages, is on Omniglot.

Fair warning. Omniglot is a dangerous wonderful website for anyone who loves languages and writing. There are examples of many ancient and modern scripts. A section on fictional alphabets and undeciphered scripts. And it goes on and on and on. All with links to other resources and sites. Omniglot certainly qualifies as a magnificent obsession.

Defining New Words?

English is a remarkable language. It absorbs words and ideas from any source and keeps growing through osmosis. Some words come from other languages, some are made up and created along the way, and still others move from specific technical disciplines and become part of everyday use.

After all twenty years ago not many of us emailed, none of us texted, and surfing usually required water.

As new terms and ideas get absorbed into the language a wonderful process happens. Collectively all English speakers determine how new words should be used and what is now considered grammatically correct.

Along the way there are bound to be disputes and arguments. I find it refreshing that the answer isn't dictated by formal rules or scholarly grammarians. Instead we end up just doing what sounds right. Even on the path to what sounds right there are disagreements and people who want to make sure that we don't reach the 'wrong' conclusion. Don't think these disputes about language are minor affairs. The term "grammar nazi" was coined for a reason.

Still I have to admire the passion and drive of someone who's convinced many people are making a mistake with the language. If that person also documents the specifics in great detail then I admire then even more. Which leads me to "Login" is not a verb (www.loginisnotaverb.com). Mark Pettit shows us all in great detail that we should not say "I will login to the system" but instead "I will log in to the system". He shows in which cases the attempt to make login a verb fails (including "I logined to the system").

Don't think this is just about "Login". Oh no. He has a list of computer terms we shouldn't turn into verbs. Each with its dedicated webpage explaining why.

What words and phrases are cropping up that you don't like? And would you build a website around them?

Medical Controversy?: Everything has a Support Group...

I know there are support groups for everything. I expect that there are groups and organizations for various maladies, syndromes, diseases, and afflictions. I understand that the Internet makes it easier to find people who are going through what you are going through. I completely grok the idea of sharing stories, getting help, and gathering strength from shared experiences.

But even that didn't prepare me for coccyx.org. Which includes a long page with links to stories from people who have had a coccygectomy. Which means they've had their tailbone removed for one reason or another. I may have suspected that many people suffer from tailbone pain but I never thought enough people had their tailbone removed to fill a page with many personal experiences. Who knew? Not me.

In case you're wondering here's a short article to help you determine if you need to have your tailbone removed.

Can we Feed the World?

It doesn't seem like a simple question. Can we feed everyone on the planet? All 6 billion people?

There may be a more difficult question. Can we feed the 9 billion who will be on the planet? The population of the globe is still increasing but it looks like the growth is slowing. We'll hit a peak and then the population will actually drop. The number for the predicted population peak keeps changing depending on who's doing the math. Let's stick with 9 billion in the middle of this century.

Can we feed them all?

One thought is that we may be able to. Especially if we want to do it in a sustained and fossil fuel limited manner. Can We Feed the World? More Importantly Will We Choose To? is an excerpt from the book A Nation of Farmers.

Another thought is that we aren't feeding people now and we may not be able to feed the upcoming 9 billion. Jules Pretty's article in the National Review Can Ecological Agriculture Feed Nine Billion People? strongly tends towards us not being able to feed everybody without massive changes to food production.

Yet another thought is that we already can feed people. Not just the current population but also the 9 billion of the future. Josh Viertel's article in The Atlantic Why Big Ag Won't Feed the World tells us we already produce enough to feed 11 billion.

If the world is truly producing enough food then the problem is that it isn't getting distributed well. To quote Josh Viertel "it's a global justice problem". In which case the profit motive isn't going to help much. Profits and other corporate concerns tend not to align with problems of justice or fairness.

If it is a global justice problem that leads me to another thought. In more and more countries it is been decided that health care is a right of the citizen. Even the U.S.A. is slowly moving towards providing basic healthcare to all Americans. Most of the rest of the world has decided that being healthy is a right of citizenship and that healthcare shouldn't be dependent on earnings or net worth.

What if we slowly move towards the idea of every citizen having the right to enough food to live? I'm not advocating this. Yet. I'll admit that it's an intriguing idea. How can one have life, liberty, or the pursuit of happiness if one is starving?

Think that's a deluded dream of a utopia that can't be reached? It may not be as farfetched as you think. In fact it is already happening. The City That Ended Hunger by Frances Moore Lappe tells of the Brazilian city of Belo Horizonte where food is a right of citizenship. It's not just about providing food for those who don't have any. It's also about restructuring how food is distributed to give people the ability to buy fresh local produce and help local farmers where possible.

Maybe one way to help end hunger and help put in place sustainable agriculture is to guarantee people the right not to go hungry. Is that idea so crazy it just might work?

Medical Controversy: Fructose Followup...

On Monday I wrote about a video where Dr. Robert Lustig talked about the link between fructose and obesity. The video certainly made the rounds and was used as a call to arms.

For some the call was to blunt Dr. Lustig's call to arms. Alan Aragorn wrote the bitter truth about fructose alarmism. The article simultaneously commends Dr. Lustig when his research and numbers hold up to scrutiny and pokes holes into Dr. Lustig's folly when the research doesn't match his statements. Who's right? Dr. Lustig? Alan Aragorn? Both? This is one of the cases where they may both make valid points and so neither may be completely wrong. Welcome to the world of scientific controversies.

Regardless of whether the scientific community is completely onboard with Dr. Lustig or whether the jury is still out there is the beginning of a backlash against fructose. Companies are moving away from using fructose sweeteners mainly due to the new bad publicity. The public at large has discovered the controversy over fructose and run with it. From Facebook groups to online activism the anti-fructose movement has begun in force. Even before the science is settled people are reacting to the latest reason why they aren't slim.

Meanwhile the science goes on. It's easy to predict what will happen next. As each new study about fructose comes along people on both sides of the argument will be looking for the single smoking gun that proves their side of the controversy. Each fat rat will cause activists to scream for changes to the food supply. Every discovery of other reasons creatures gain weight will be used to try and vindicate the producers of fructose who are beset by enemies from all sides. New products will be formulated and sold (how long until 'fructose-free' is on packages as often as 'fat-free'?). People will publish books guaranteeing weight loss if you fructose. And over time something else will be implicated as science moves forward and keeps digging into obesity.

What I can't predict is whether people will become more obese over time or whether we'll finally figure out how to handle this epidemic.

Magnificent Obsessions: "Life is like a ten speed bicycle..."

Life is like a ten speed bicycle. Most of us have gears we never use. - Charles M. Schultz

As often as I can I walk home from work. Usually with an mp3 player blasting music of any and all types - heavy metal included. Occasionally I consider getting myself a bike and sparing some wear and tear on my shoes. The idea quickly goes away for two reasons. One is that I'm barely awake in the morning so I'm not sure I would be aware enough to avoid the idiotic drivers on the road. Second - I do like to lose myself in audiobooks, audiodramas, or music for ninety minutes during my walks home. A bike would get me home too quickly.

If I ever do seriously think of buying a bike I'll do a lot of my research for buying using Ken Kifer's Bike Pages. I stumbled across Ken's website with a link to his article on Cycling Cadence and Bicycle Gearing. Math, physics, and the quest for the easiest ride up the hills. What's not to like? The entire website is full of useful articles. From tips on touring to how to perform basic repairs. From traffic safety to humour. Ken was passionate about bicycles and the bicycle lifestyle.

Yes... was. Ken was killed in 2003 by a drunk driver in pickup truck who hit him while he was riding his bicycle. The website is being kept online because of how much it meant to Ken. Ken's website covers more than just bikes. He was passionate about many things and he poured his energy into his website. There isn't a more fitting tribute than just leaving his website running for people like me to come across. Ken certainly used most of his gears.

Medical Controversy: It's Fructose's Turn...

Obesity rates in America continue to grow. While the best advice to maintain weight may be to eat less and move more that isn't a quick fix and doesn't lay blame somewhere else.

What I'm interested in is the latest place to lay blame. The current subject of the blame game is sugar. More specifically the sugar fructose. Robert Lustig's presentation Sugar: The Bitter Truth was one of the first large scale public attacks on fructose being the cause of the obesity epidemic.

For now just listen and watch Dr. Lustig's presentation. I'll leave whether or not he's correct for another day.

Follow Up: That's not Jazz...

The history of Jazz is a complex and rich story. From founding fathers to people who pushed and pulled the boundaries of what Jazz can be.

Jazz can be a lot of things. Many styles, many forms, many musicians. Most people would not consider Kenny G a Jazz musician or even much of a musician. He's more of a showman than a musician. In the world of music styles approaches are different. There is an amazing amount of tolerance and even respect for musicians that take different approaches to success. More respect is given when the person is technically and musically competent of course. So while many may consider Kenny G's wailings bothersome they don't take too much offense and even begrudgingly be happy for his success.

That is until his wailings and warblings go beyond his own realm of cheesy music and tread on the legacy of one of those founding fathers of Jazz.

Pat Metheny on Kenny G is a good read. At first because it's a valid musical critique of Kenny G's music but later because it shows how vehement people can get when certain lines and boundaries are crossed. Stay in your own world and you can have all the excess success you can claim from popular culture. Mess with things that are close to sacred and watch out. People will no longer congratulate you on your success. People will start telling the world what they think of your actual ability.

Not that the opinion of a really talented musician will change Kenny G's success of course. It will however remind me of why I can't stand Kenny G's version of 'music'.

Medical Controversy: Shouldn't Gender be Simple?

I'm not one to wax nostalgic about how things were simpler long ago. I don't yearn for a simpler time when men were real men and women were real women. Most of the time the mythical golden age wasn't as nice and quaint as a backward glance would leave you to believe.

Things were never that simple when it comes to men and women. It turns out that in some cases gender itself isn't simple. Science helps us understand why things are so complicated.

You may remember that last summer a South African, Caster Semenya, ended up in the middle of a controversy over gender in sports. So far no results from the testing have been released and the matter is still up in the air. One reason may be that in some cases gender isn't simple.

The Androgen Insensitivity Syndrome Support Group (AISSG) put online Maria's Story. The story of Maria Patino is another case in which gender is in question. There's even a term for the various congenital conditions that cause atypical genders - Intersex. Biology is more complicated then we're taught in grade school. Turns out all sorts of conditions may occur. Some of the complexities when in comes to testing in sport are shown in Howard Hughes Medical Institute's Gender Testing of Female Athletes. Click along and see if you come to the same conclusion the medical tests do.

The term Intersex replaced the term hermaphrodite. Over time the term Intersex is being steadily replaced with DSD (disorders of sex development). Resources such as the Accord Alliance have lots of information on DSD. Changing a name can be good, bad, or both. In this case the change from Intersex to DSD may be a change for the better even though the new term has the word 'disorder' in it. Whether it is an improvement depends on who you ask. Emi Koyama's 2006 keynote from the Translating Identity conference makes for interesting reading. However I can't comment on her views on what constitutes a disability and extending that definition towards the Intersex community. I'll leave that to others who are more versed in the field. Emi's website eminism.org has a lot more of her views on all sorts of topics. How often does one come across someone who identifies themselves as:

Emi Koyama is a multi-issue social justice slut synthesizing feminist, Asian, survivor, dyke, queer, sex worker, intersex, genderqueer, and crip politics, as these factors, while not a complete descriptor of who she is, all impacted her life. Emi is currently the director of Intersex Initiative. Emi lives in Portland, Oregon and is putting the emi back in feminism since 1975. 

Short to Long: The Beautiful Game

For any football fan the next month is going to be special. The World Cup starts tomorrow. Has it really been four years? Living in Toronto is a treat since there are dedicated lifelong fans of each and every team residing here. In the next month there will also be new fans of every powerhouse that plays well and every underdog that performs much better than expected. This is modern cross-multiculturalism at its finest.

The flags that are already displayed out of car windows will constantly change over the next month as allegiances change to follow those teams that are successful. My early unofficial poll shows Brazil winning the flag battle. So with fans primed and ready it's time to settle down and watch the beautiful game being played by the world's best.

The Short

Need a way to follow what's going on? Trying to keep up with the various groups or your favourite team? The Spanish magazine Marca has a flash app (why do I feel tempted to type the full word 'application'?) that allows you to view the results by day, team, group and stage, and even by host city. Just keep the World Cup calendar open in a browser window and you can stay on top of developments.

The Medium

If you just need a recap of the previous World Cups so you know who won what and when... then Dzinepress has The Ultimate Resource About Football World Cup History. But... while it gives details on who won the various groups or stages it isn't really the ultimate resource.

The Long

The award for most stats and details of World Cups goes to worldcup-history. Pick a World Cup... I'm going back to Uruguay in 1930. On July 13th France played Mexico in Pocitos stadium. One thousand people watched France beat Mexico 4-1 in the first World Cup game played.

Want to know who played on the French side? It's there. Want to know who scored for Mexico? It's there. Did you know that Lucien Laurent scored the first World Cup goal? Or that in that same game Andre Maschinot became the first player to score twice in a World Cup game? When it comes to the level of detail worldcup-history is the best site I've found so far. The only stat it doesn't seem to have is who should have received the equivalent of an Oscar for the best acting that drew an unnecessary red card, or which announcer had the most colourful and excited delivery.

There you go. Now you can follow the matches, check up on history, and end up with stories and memories to last another four years.

Medical Controversy: Who are you Calling a Crazy Cat Lady?

Sometimes I stumble across someone who's inherently fascinating. A person who throws ideas out that make you stop and think and yet makes it seem like there's nothing to it. In the last few months I've stumbled across a couple of videos of one such individual - Robert Sapolsky.

First I came across a lecture he gave for Class Day 2009 at Stanford on the Uniqueness of Humans. Don't let the idea that he spoke at Stanford put you off of watching. It's aimed at a general audience and well worth it.

Then I went looking for some other videos and came across a couple where he discusses some ideas on where religion may have come from. My university lecturers weren't anywhere near as interesting. Professor Sapolsky Explains the Origins of Religion part 1, and part 2.

But back to the topic of today's symposium... here's an interview from Edge.org where he talks about the Toxoplasma parasite in rats and then in humans. (with detours to a few other areas of research). It turns out that Toxo does affect us humans. It may not be as specifically directed an effect as the one found in rats. Mammalian chemistry is similar enough so there are changes to the brains of humans who are infected.

I wonder what other parasites and diseases also alter our behaviour? There may be more than we think. To quote from the beginning of the interview:

In the endless sort of struggle that neurobiologists have — in terms of free will, determinism — my feeling has always been that there's not a whole lot of free will out there, and if there is, it's in the least interesting places and getting more sparse all the time. But there's a whole new realm of neuroscience which I've been thinking about, which I'm starting to do research on, that throws in another element of things going on below the surface affecting our behavior. And it's got to do with this utterly bizarre world of parasites manipulating our behavior.

Bizarre indeed. I may have to have a chat with my three cats. Who knows what else they are carrying around.

Now Appearing on the Gaza Strip: More Tensions...

The Middle East never seems to leave the news. At the moment the big story is the Gaza flotilla. I don't think I've seen so much spinning of a news story in years.

Still it's not as if the basic underlying tensions and problems haven't been predicted for a long time. In 1947  As the Arabs see the Jews appeared in The American Magazine written by King Abdullah bin Al-Hussein of Jordan.

Whether you agree with his point of view or not it's important to realize that even 60 years ago the basic equation of inevitably arising tensions was well understood. King Abdullah ends the article by posing a rhetorical question to the American readers:

I have the most complete confidence in the fair-mindedness and generosity of the American public. We Arabs ask no favours. We ask only that you know the full truth, not half of it. We ask only that when you judge the Palestine question, you put yourselves in our place. 

What would your answer be if some outside agency told you that you must accept in America many millions of utter strangers in your midst—enough to dominate your country—merely because they insisted on going to America, and because their forefathers had once lived there some 2,000 years ago? 

Our answer is the same. 

And what would be your action if, in spite of your refusal, this outside agency began forcing them on you? 

Ours will be the same.

Medical Controversy: If a Disease has Only Symptoms...

Let's perform a simple thought experiment for a moment. Imagine you're a doctor who's faced with patients that are showing symptoms. Symptoms that aren't part of what most of us consider a normal healthy life. They have chronic pain, they have chronic fatigue, they have disturbed sleep and they may have excessive stiffness in their joints. There may be a few other less frequent symptoms in the mix as well.

Now imagine you're that doctor and you start looking into the research. People are suffering but upon further examination there is no obvious source to the problem and there is no obvious physical change independent of the patients pain and suffering that can be tested for. Nothing shows up on X-rays. There doesn't seem to be any unusual pathology. Not only can you not find an underlying cause but it doesn't seem to leave any obvious tissue or nerve damage. It may well be making changes in the patients but medicine hasn't figured out what those changes are yet.

So there are symptoms but no causes. Pain and stiffness but no damage.

Now let me ask you... given that there seems to be no reason for these symptoms and also given that the patients are truly suffering pain you have to answer this question. Is this a disease?

Would it change your answer if I said that between 2 and 4 percent of the population show these symptoms? Would it change your answer if I said that nine out of ten suffers are women?

I don't know about you but my answer would be that this is a disease. Regardless of who's suffering or why. It doesn't matter if women suffer more than men because that fact makes it no less real. It doesn't matter if medicine can't find the cause because people are having the symptoms.

Now given that situation not everyone would come to the same answer. Some doctors would say it's all invented or in the mind's of their patients. Even doctors who would agree that it is a disease wouldn't know what to call it or how to diagnose someone as having it.

Welcome to the mysterious world of fibromyalgia.

A world full of controversy, books, and advice.

Giving the collection of symptoms a name was an important step. Until you have a name it's hard to focus attention on the problem. With a name comes research and some legitimacy. Though the people with fibro don't seem to need physicians to legitimate their suffering.

With a name and a description can come diagnostic criteria. Considering the lack of identified pathology or known agents that may cause fibro it's no wonder the criteria has to be based on the symptoms. If 11 of the 18 spots on the body most often linked to fibro pain are tender when pressed and the patient suffers from chronic (but not constant) pain then there is a diagnosis. (Please note I'm not a doctor and don't use this abbreviated explanation to self diagnose. If you're going to get incorrectly diagnosed I'd prefer it be by a physician with malpractice insurance.)

The criteria may be changing soon. With more research clinicians are coming up with different lists of clinical criteria. I'd expect the entire definition of fibro to change as more is discovered.

Still patients complain that doctors don't take them seriously. There are endless stories online of people who are relieved to finally be diagnosed with something, anything, after being told they didn't have anything.

Pain is nothing? How can you ignore aches and pains in a patient? Am I missing something?

And all the controversy was described, and essentially countered, 15 years ago. In 1995 Don L Goldenberg followed up his 1987 paper Fibromyalgia syndrome: an emerging but controversial condition (abstract only) with the paper Fibromyalgia: why such controversy? (the pdf of the paper is on the linked page).

The paper is very readable. It explains the controversy that has continued to rage for over a decade after its publication. The paper also points out a number of other issues related to fibro. For example the medical community's lack of understanding of chronic conditions:

In many countries, fibromyalgia is a common cause of being categorized as unfit for work and an increasing cause of litigation and compensation. However, this is not a consequence of the fibromyalgia label but rather a consequence of the focus by society on entitlement and the medical professions' inability to deal effectively with chronic physical and psychological pain.

I don't suppose the controversy over fibro will go away soon. More people will be diagnosed. More research will be done. New drugs and treatments will appear even though there seem to be a number of good approaches for self management of fibro. Money will be made offering relief to people with fibro. I'm guessing the controversy over fibro will change. The controversy still seems to be that "many doctors don't accept it as being real". I'd put money on that changing into "why are there still a few doctors who don't accept it".

I'm not going to put any money on whether an underlying cause will be found anytime soon. Pain has to come from somewhere but by what agent or mechanism may take a while to unlock. Without an identified underlying cause there may not be any proposed cures for a while. Still progress is being made. The medical community is more accepting of fibro and more is being done all the time.

Watching the medical community come to grips with fibro isn't much fun for those who have it but at least the progress seems to be in the right direction.

A Topic Ago: The Senses

Now that I've moved from Memoirs and Histories to Medical Controversy it's time to take a look back at the topic before both of those. Hence the name "A Topic Ago".

I started this blog by taking a look at the Senses. I thought I'd start with how we experience the world.

The Senses (March - April 2010)

• Listening and Language: 
• Spirals to Unravel a Mystery
• The New Colours of Summer?: 
• Teal and Orange - Hollywood, Please Stop the Madness
• Memory Colors
• Got Me a Side Job
• I Love the Smell of History in the Morning: 
• Jenne Heise / Jadwiga Zajaczkowa
• Two Genera of Living Earworms: 
• Recording Cher's 'Believe'
• Can I Get An Amen?
• Spices of Life: 
• Gernot Katzer's Spice Pages
• Sailu's Kitchen
• Revising Nonsensical Colour Theory: 
• color vision
• Something Smells Fishy: 
• Olfaction
• Fooling Our Ears: 
• Speaker Wire - A History
• Cables, Interconnects & Other Stuff - The Truth
• The Full Body Sense: 
• The Sense of Touch and How It Affects Development
• Can't Touch This
• "Monkey See Monkey Do" Neurons: 
• The Dancing Mind
• Not Just a Matter of Taste: 
• Tracking a Century of American Eating
• Major Trends in U.S. Food Supply, 1909-1999 (pdf)
• Technical Details: 
• The Physiology of the Senses: Transformations for Perception and Action
• Seeing, Hearing, and Smelling the World
• The One We Don't Want to Feel: 
• The Seated View

Follow Up: Chinese may be Hard....

Chinese is apparently a hard language to learn but it is also beautiful. So are many other languages. Beautiful, elegant, and yes... different.

The Beauty of Typography: Writing Systems and Calligraphy of the World from Smashing Magazine gives some insight into how various writing systems work. It's more than just a "they look nice" overview. It starts to delve into how and why various writing systems work.

We humans have a remarkable ability with language. Every child learns to listen and speak without formal training. It's a different story when it comes to writing words down. There's a lot of formal training involved. There is no one best way to express oneself in writing. Each language and culture has found its own way of doing it.

Even if I can't read the words of other languages and cultures I can start to appreciate how other writing systems work.

Medical Controversy: What is a Disease Anyway?

Can there be an epidemic of obesity? Should out of shape people be considered sick? Diseased Thinking: dissolving questions about disease from Less Wrong takes a stab at defining what a disease actually is. This isn't a boring list you'd find in a medical textbook. What a medical school may call a disease isn't the issue here. The issue is what do we think about when we use the term disease.

For me the two important points are these. First - giving some things a shared name, like calling them a 'disease', helps us categorize and understand those things. Second - Having a suggested list of criteria helps us classify if things fit into that category. The list is useful even if I don't agree with it completely. Having a starting point for a discussion is important.

Calling something a disease is powerful. It implies that the something is worthy of the attentions of the medical and scientific communities. It implies that it is fair game for research in both the public and corporate spheres. Cures, palliatives, and various concoctions to help with the symptoms can be sold and used. It implies that employers and insurers treat the thing differently simply because it is a disease.

So... is obesity an epidemic? Should people be expected to stay physically fit? Is being a lazy slob and a couch potato be considered a lifestyle choice? I still don't know the complete answer but I have something to base the conversation on. That's a start.

"...not another elf"

Okay. I'll admit it. I suppose some of us who consider ourselves geeks have to say this sooner or later.

My name is David and I've never read Lord of the Rings all the way through. I don't like The Lord of the Rings.

There. I've said it. I feel better now that it's out in the open.

Why? Well... that's harder to pin down. The Hobbit enchanted me though I haven't re-read it in decades. The Lord of the Rings didn't enchant me at all when I tried to read it. Sure Tolkien could build a world... sort of... but I don't need to read a book he essentially only wrote for himself. I've heard complaints about Harry Potter that say that J.K. could have used a good editor to help tighten up some of the later books. When it comes to J.R.R. a good editor wouldn't have left him enough for a single novel let alone a trilogy.

And don't get me started about his world building. Middle Earth is a masterpiece in many ways. From the languages up to the historic details. Did you know Tolkien worked on the Oxford English Dictionary? His love of words and etymology must have helped the OED a great deal. I read once you could see his handwriting on the card for the word walrus for example. Middle Earth is a wonderful achievement but he could have used that world as the backdrop to a story instead of as one of the main characters. I like my mythical histories as much as the next person but enough is enough.

Turns out I'm not the only one with criticisms and complaints. I'm biased because the books never caught my imagination so people who love the books will discount anything I say outright. What happens when they are confronted with a critical review from someone who still loves the books despite the problems?

Andrew Rilstone wrote a critique called Is Tolkien Actually Any Good? and it's fun to watch someone who likes the books also rip them to shreds. Even more fascinating is reading a review of the Peter Jackson movie adaptations by a serious fan of the books:

• “Lord of the Rings: Fellowship of the Ring”—Review
• The Two Towers
• Return of the King (1)
• Return of the King (2)
• Return of the King (3)
• Return of the King (4)
• "Go away and never come back": Return of the King (5)

As I said I'm not a fan of The Lord of the Rings. Even so it's interesting to find out why someone is a fan of the books. I may not see the appeal of the trilogy but at least I now know what others find in it.

P.S. Dig around on Andrew's Arts page for a series of reviews of the Star Wars prequels. Check out Little Orphan Anakin 3: A certain point of view in which he skewers Lucas' history of what he intended the movies to be and Little Orphan Anakin 6: The Hero With at Least Two Faces. The latter shows how the Star Wars movies are completely different when we see them now. When it first came out "Star Wars" was a single movie with an engaging plot and wonderful characters. Now it's "Star Wars IV: A New Hope" is the beginning of the second trilogy of a story that is about Anakin/Vader and not Luke.

Even before the new special effects and other changes to the movie, George Lucas has forever changed how audiences will see what was one of the pivotal films in most geeks' lives.

Medical Controversy: Take Two and Call Me in the Morning

You tend to hear a great deal about how big Pharma manages to get new medicines into widespread use. Targeting doctors with ads and incentives or with detailed studies and suggestions on why a new pill should be used. There's also the time and effort to convince the public to use the new wonder drug to make their lives better. Pills and other treatments are big business.

A completely modern way of doing business right?

Well... maybe it's not modern at all.

Physicians, Fads, and Pharmaceuticals: A History of Aspirin by Anne A.J. Andermann from the McGill Journal of Medicine shows us that none of this is new. In fact it all sounds too familiar.

Moving from Memoirs to Medicine

The number of memoirs and other histories that are online is immense. I could end up just linking to personal recollections and stories for the next year. It's time to change gears. I'll return to the parts of the longer web that involve individuals another time.

The next topic is Medical Controversies. Time to look at disease, basic health, and anything else that the science of medicine can't seem to agree on.

My New Word of the Day: Organoleptically

When writing about the senses I didn't stumble across the term organoleptically. Which is unfortunate because it's a lovely word.

I found it in an article on How to Make Brownies, Pentagon Style. The article details the Pentagon's brownie recipe which is document MIL-C-447072C (pdf). Which as recipes goes is a nightmare that fills 26 pages.

Yes... 26 pages. For brownies. It contains details on the the ingredients:

3.2 Ingredients. All ingredients shall be clean, sound, wholesome, and free from foreign material, evidence of rodent or insect infestation, extraneous material, off-odors, off-flavors, and off-colors.

So remember when cooking brownies for the Pentagon hide any evidence of rodent or insect infestation. The infestation can be there. It just can't be evident.

And details such as the exact steps to prepare the brownies:

3.3.2 Brownie preparation. (NOTE: The contractor is not required to follow the exact procedure shown below provided that the brownies conform to all finished product requirements in 3.4)

And even the details of section 3.4 that tell you how your brownies have to turn out such as:

a. There shall be no foreign material such as, but not limited to, dirt, insect parts, hair, wood, glass, or metal.

b. There shall be no foreign odor or flavor such as, but not limited to, burnt, scorched, stale, sour, rancid, musty, or moldy.

But my new word comes in at section 4.5.1.1 (Ingredient and component examination). In which the instructions say (take a deep breath... this is a big one):

If necessary, each ingredient shall be examined organoleptically or inspected according to generally recognized test methods such as the standard methods described in the Official Methods of Analysis of the Association of Analytical Chemists and in the Approved Methods of the American Association of Cereal Chemists, to determine conformance to the requirements.

Admit it. You didn't even know there was an American Association of Cereal Chemists.

So what ranks as a method along side those of the Association of Analytical Chemists and the American Association of Cereal Chemists? Organoleptically simply means using your senses. Looking, smelling, tasting, and touching (and when it comes to ingredients in brownies I hope we don't need to use hearing too often).

In other words you can inspect them visually or with your other senses.

I'm so glad there's a word for that. Any ideas on how to work the word in during random chit chat at the office?