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Dr Oz Defended, and Attacked Again

April 25, 2015

There has appeared, in the New York Times, an opinion piece by Bill Gifford, titled “Dr Oz is no Wizard, but no Quack, Either.”  I didn’t know who Bill Gifford was, but since he has written a book (or maybe several) and gets published in the NYT,  I assume he’s more important than me.  As another “voice crying out in the wilderness” however, I have to disagree with Bill.  He does make short work of the recent British Medical Journal article about Dr Oz; it’s impossible to evaluate the article’s claims without reading specifically which eighty health claims or statements were “randomly” chosen for analysis.  As Bill says, “only nine” of the eighty claims were specifically disproven; the rest were just open to question.

Here are my three big issues with Dr Oz:

First, there is the issue of Dr Oz’s promotion of, for example, homeopathy and reiki.  We know, from scientific study, that both these therapies are worthless.  Dr Oz is lucky that they are harmless as well, because Heaven only knows how many people are assiduously attempting to use these therapies to better their health on the basis of his recommendations.

Second, there is the issue of his “partnerships”– or are these endorsement deals, a particularly odious way for a man who trades on his charisma, rather than his sports talent, to make a living?  Surely, if he is promoting “alternative” medicines or treatments by attaching his name to them, and is getting something out of the arrangement, he is committing health care fraud.

Third, there is the odd specter of a cardiovascular surgeon who spends most of his time in front of a TV camera talking.  Does he really think that he is better qualified than the other 10,000 family practicioners, internal medicine specialists, public health experts, nutritionists, and professors of sociology to give general health advice to random patients?  Would he allow any of these various and sundry other individuals who are trained in public health to practice cardiovascular surgery to make up for the time he doesn’t spend in the operating room or the laboratory?

After all, if he is so talented at providing health advice of a general nature to TV audiences, perhaps he should abandon his surgical practice and go full time on TV.  That’s all I’m suggesting.  While he’s at it, he should resign his position as assistant head of surgery and stop making skeptical patients wonder just how good of a surgeon (and supervisor of surgeons) he really is.  His continuing in this faculty position makes it look as if the average assistant chief of surgery can just phone it in and continue to collect his salary.

This is my basic objection to the way Dr Oz makes his living: he continues to hold down a supposedly serious job at an institution where people are trying to do serious work, while at the same time making money as an entertainer with no serious controls as to what he promotes on a supposedly serious topic.  He brings down shame on the institution that continues to carry him on its books as a supposedly serious-minded person.

Rahm Emanuel is no Better than Richard Daley

April 24, 2015

From an article in VICE about lying by police officers that is already two years old:

“In November 2012, a federal judge in Chicago held the city responsible for the pervasive deception of its police department after its officers refused to properly investigate the complaint of a bartender who was severely beaten by a drunk off-duty cop to whom she had denied service. The arresting officers went to great lengths to protect their coworker, and another city employee attempted to bribe the victim into silence. The city is appealing the ruling and Chicago Mayor Rahm Emanuel filed legal papers suggesting that there should be a code of silence about the code of silence.

[Vice, February 3, 2013, by Nick Malinowski]

Comment of the Day

April 23, 2015

There were a fairly large number of comments to a NYT article on the war in Yemen (348 so far) but this one stood out:

 

Chump

Hemlock NY Yesterday

Other than the notice of a byline “OBOCK, Djibouti” there is no indication of western involvement in this story. But between the lines: there is a US Marine base in Djibouti and American drones are launched from there. The “warplanes” of the Emirates and the Saudis are made in the US. The Marines protect the Djibouti airport, the drones provide intel for the proxies flying American planes. So though the article doesn’t say so, we’re in it thick as thieves– which everyone knows without the article saying so.

First Automobile, part three

April 23, 2015

When I started the residency program at Glendale Adventist Medical Center, I didn’t have a car, just a bicycle.  I saved my salary for four months to raise a down payment on a car– $1500.  A friend from the hospital, a girl who was an ultrasound technician, took me to a Subaru dealer in Pasadena; she had a car from them, and they had treated her well.

However, the first thing I noticed at the Subaru dealership was a used Alfa Romeo Spyder, with a new convertible top.  It was cream-colored and understated.  The dealer allowed us to drive it around the block but said not to take it on the freeway.  It had 48,000 miles on it.

On the way home (on the freeway) my friend noticed that my new Alfa was smoking a little, every time I accelerated.  That was on Saturday.  By Monday, the car would barely run at all.  I took it back to the dealer, and they gave me a “loaner.”  The next I heard from them was three weeks later, and they said it was fixed, to come pick it up.

In the meantime, someone had rear-ended me in the loaner, leaving the car a foot shorter but still driveable after I unbent the exhaust time.  That was only a few days before they called me back.  I took the car in and gave them a copy of the accident report: I had been rear-ended at a stop light by someone who claimed not to have seen me.

When I got the Alfa back, it was literally gushing oil, using a quart every thirty miles and spraying all over the engine compartment.  Again, I had to wait over the weekend to take it back to the dealer.  When I did take it back, they apologized and said they had left a bolt off the engine when they put it back together.   They replaced the bolt and cleaned out the engine compartment.

After that, it ran fine, and I managed to put six thousand miles on it, mostly with the top down, from December to June.  I would get an afternoon off and spend it driving around the curvy little roads in the hills behind Glendale.  One of the nurses remarked that I had a nice suntan for February; I told her it was because I drove around with the top down on my car all the time.

Once they got it running, the only problem I had with it was that the top leaked when it rained.  Once, after a night of being on call and a heavy rainstorm, I came back to my car to find an inch of water on the floorboards.

There was something just really fun about driving around the freeways of Los Angeles in a tiny convertible car.

After a while, though, I gave it up to go into the Indian Health Service.  That’s another story.

Years later, I came back to LA and bought a new Mustang convertible that was the same color as that Alfa.  It’s still fun, and I’d do it again  in a minute.  But after that, I gave up buying used cars.

First Automobile, Part Two

April 21, 2015

The VW dealer in Des Moines fixed the engine and I was back on the road after five days.

The van drove much better after getting a new “short block” (the top of the engine, including the cylinders.) It accelerated much better, and made it up to top speed readily. According to the manual, my top speed, never to be exceeded, was 65 mph.

Over the miles to California, I replaced one worn out item after another. At a gas station in Arizona, I had new shocks put in. At a relative’s house in Denver, I replaced the worn rear brake pads.
After I got to my girlfriend’s apartment in Livermore, I started working on the axle. I put on a new axle and wheel nut, with the proper cotter pin. I had new tires installed– Vredestein steel belted radials with aggressive tread.
My girlfriend had been working a summer job at Lawrence Livermore National Laboratory, the place where they study plutonium and other highly toxic things. She was a chemistry major, and she eventually went to graduate school to become a chemist. We stayed in an apartment in Livermore, which was a small town then, out in the desert east of Oakland. We rented bicycles and rode all over town and into the country on weekends.
We only went to the beach a couple of times, it seemed, but we did get to go bicycling in Golden Gate Park, a memory that will last a lifetime. We went with our room-mates, a pair of chemistry graduate students; he had been injured in an auto accident and had no sense of smell.
Which was fine with me because I smoked marijuana in the bathroom with the ventilator fan on and I didn’t want anyone to smell it. In those days, there was no restriction or thought of banishment of cigarette smoking from indoors, and I think I may have smoked cigarettes in the living room too.

At any rate, we packed all four of our rented bicycles into the back of the VW van; two people sat up front, in the seats that remained, and two people sat on the hump in the very back, over the engine. This snug group drove from Livermore, over the Bay Bridge, in to San Francisco, and then to the Golden Gate Park, where we disembarked. We rode all over the park and had a wonderful time. The sun was out, it was warm for San Francisco in the summer, and we stripped down to our t-shirts to ride.
We went down to the the beach at the west end of the park, and back around the twisting lanes to the east end. I had parked along a side street just a block from the park, and I left the keys in the ignition. An hour later, when I remembered the keys and returned, the window was still rolled all the way down and the keys were still in the ignition.

At the end of two months, I packed up everything I and my girlfriend had brought for the summer and my stereo system in to the van, filling it up to the level of the backs of the seats. We came close to the nominal maximum payload of the van: 1500 lb. Above the luggage and boxes, I laid a six inch thick foam mattress I had picked up somewhere. We slept inside the van each night as we drove, back to Chicago first, then on to Boston. My girlfriend drove as much as I did, and she was a good driver, but it still took us a week of driving to get across.

I took my girlfriend to her parents’ house in upstate New York, and visited with them. Her father was a WW II veteran; she said he wouldn’t talk about it, even if pressed, because he said the memories of combat were too painful. We drove on to New Haven, Connecticut, where my stepmother Vicki lived, then to my girlfriend’s college, Wellesley, in a suburb of Boston.

I continued to date her for a couple of years after that; she even came out to Chicago for graduate school. Later on, she dropped out of graduate school to get married and have kids. I don’t know what happened to her after that, but I thought she was one of the most beautiful girls I have ever known, in mind and body, and she wore a mean bikini.

Finally, I drove back to Chicago, and that was difficult. I picked up a hitch-hiker in New York state and drove him back to his college in western New York State.
Leaving there, I drove overnight to Chicago and arrived at the beginning of the morning rush hour. I seemed to be driving eternally on a packed four lane highway with trucks and speeding cars, from western Indiana across southern Chicago, through downtown, and then outwards west on I-80 to Forest Park. There my erstwhile room-mate from medical school had rented a three bedroom student special next to the subway line, across from a factory that made cinnamon-scented candy on Tuesdays.

During my first semester, second year of medical school, among other difficulties which I honestly could not tolerate, the brakes went out on the van. I tried to stop at a stop sign, going fifteen miles an hour, and slid halfway into the intersection. It seems that all the brake fluid had leaked out through a ruptured gasket in the brakes master cylinder, around the rod that pushes hydraulic fluid down the lines when you step on the brake. I filled up the brake fluid reservoir, but it was obviously going down every time I stepped on the brakes. After limping home, I disassembled the brake cylinder and looked for a replacement.
Unfortunately, the specifications for the brake master cylinder had changed over the years since the vehicle had been manufactured. There were two fewer connections on the outside of the master cylinder, because a warning light connection had been discontinued. Apparently, it was no longer thought necessary to enable the brake fluid warning light that sat on the dashboard and had a special “test” button to make sure the light still worked. Some law had been passed making it unnecessary, or that’s what I had heard at the time.

As a result, every replacement master brake cylinder I was offered at the various parts departments I visited failed to match the master brake cylinder that I had in my hand and wanted a replacement for. After a couple of failures like this, I became deeply depressed and began to neglect my schoolwork. For several months, the van couldn’t be driven because of the brakes were out; it sat in the parking lot behind the church down the street, the same parking lot where they had held a fall carnival with some of those portable amusement rides.

I was particularly annoyed because the school, and the government, had reneged on some of their promises and, for example, made the scholarship taxable as if it were a regular job. That seemed inefficient, to tax the funds one had just distributed as a government grant. The Congress passed a temporary exemption to this taxation every year at the very end of the year, so we never knew for sure from one year to the next whether the grant was taxable.

Then I had given the government the address of the Dean’s office to send my monthly checks because I didn’t know what my address in Forest Park was going to be; for months I had to go down to the dean’s office every month and explain why they were getting my check; the secretaries seemed to think that I didn’t deserve the money, since it was addressed to them.

Then there was my room-mate. Actually, I had two room-mates, but only one was a problem. He was a fellow medical student in my class, and we had to study the same things. He had been blessed with an ability to learn quickly, but he preferred drinking and chasing girls to studying.

He was a “serial seducer”, that is, every time he met a potentially date-able girl, he would start to speak to her in a peculiar fashion, as if he had just fallen in love with her, that I couldn’t stand. His intent was, in every case, to get the girl to go to bed with him. His technique, I will admit, was pretty good; where he had the advantage he usually was able to accomplish his goal. Once he had a few sexual encounters with the girl, however, he lost interest and soon began to treat them badly. Usually, the girl would get the hint quickly, but I saw some girls become really hurt by his “wham bam thank you ma’am” approach.

His behavior, at first entertaining, quickly became offensive to me, particularly when he tried to seduce a girl who was, I thought, a good friend of mine. She was the girlfriend of a connection that I knew of, but she went to school with us and I was friendly (in a good friends sort of way) with her. When he met her, he immediately started to approach her, with his, for him, subtle approach.

He played the guitar and had been part of a rock group, so he wrote a song in which he plainly meant to seduce her. He compared her eyes to those of a cow, which I thought was funny; he seemed to think that she was a hick because she came from downstate Illinois. When she realized what he was trying to do, she became offended, which I thought was reasonable. To me, his approach was disingenuous.

The second room-mate was a pharmacy school student, a sophomore like us, who was a native of the South Side of Chicago, prejudiced against blacks but friendly to other white people. He looked up to us since we were medical students. He was a good natured sort, and he liked to party with his fellow pharmacy students.

One evening that fall, we held a dinner party, six of us; the pharmacy student fancied himself a cook, and he did pretty well, so he cooked a turkey. We got all the preparations together and sat down in the living room to chat and drink. We broke out some whiskey and mixed up some drinks. The medical student room-mate drank heavily.

He became thoroughly intoxicated within the hour that we sat in the living room waiting for the turkey to be done. When we got up and started putting the food on the table, I noticed that he went into his room and fell on his bed.
He lay that way without moving while we sat down to eat, and ate a full dinner of turkey, stuffing, corn, mashed potatoes, cranberry sauce, and wine. He didn’t wake up until we had finished the meal and cleared away the dishes.
He got up as if nothing had happened and started to drink again. This time he stayed awake long enough to ask one of us to drive his date home. I was thankful that he didn’t try to drive.

He often did drive drunk, and by our junior year he did have a crash, but got away with not too serious injuries. The oddest part, I thought, was that he was dating a schizophrenic girl (her father was a professor at the medical school) who reacted badly when he dumped her. She seduced me in revenge for his behavior towards her.

By November of my sophomore year, I had visited the doctor four times complaining of pain in my neck and back. I didn’t know that it was a residual effect of the bicycle crash I had suffered when I was a junior in college. In that accident, I had struck my lower back between the first and second lumbar vertebrae on the front edge of the roof of the car that hit me.
It was a small car, and I smashed in the windshield glass with my buttocks. The impact of the edge of the roof with my lumbar spine caused a rupture of the anterior ligaments that held my spine together and pushed out (herniated) the intervertebral disks at two segments. Fortunately, there was no direct nerve injury during that accident, so I had recovered quickly. Or so it seemed.

I complained to the doctor that my neck and back would hurt, especially at night, and early in the morning. Each time, he noticed that I was getting thinner; my normal weight of about 205 pounds had dwindled to 175 by the time he referred me to a psychiatrist. I admitted that I couldn’t sleep and I felt very depressed because of several problems that I ruminated over. I certainly didn’t think taking antidepressant tablets would help, but I was willing to try anything they wanted to try on me.

The tablets, Elavil (amitriptyline) certainly helped me sleep; they also made me drowsy and constipated. I had a terrible dry mouth. Nonetheless, I took them as directed. At the two week point, which happened to be Thanksgiving weekend, I felt a feeling of– something– a good feeling. At that moment, I happened to be driving to a shopping mall to escort my current girlfriend on a shopping trip.
I felt a slightly electric feeling, a buzzing that was inaudible but nonetheless reassuring. I decided that this was a sign of improvement, and further decided to continue taking the tablets as long as they told me to. That turned out to be indefinitely, or at least “six months to a year” according to the psychiatrist.

The buzzing went away and I only felt it intermittently after that. The constipation improved with Metamucil, the dry mouth with chewing gum. I could no longer smoke marijuana because the combination of the amitriptyline and the marijuana together made my mouth so dry that I couldn’t eat or spit, and I got hoarse.

The problem was that I was still depressed, although I denied that to myself. I didn’t want to go to classes, and frequently failed to go. I couldn’t study, although I should have studied two hours every night. I couldn’t look at the slides under the microscope which I hadn’t rented. I had intended to buy a binocular microscope when I got back to school in the fall, but as a result of the many repair bills I didn’t have the cash needed.

I dated several girls who turned out to be complete disasters, including one who was schizophrenic (she was a talented artist).

Finally, I gave up on the van. I went back to visit Vicki over Christmas, and she offered to loan me the money to buy a better car. The cheapest/best alternative was a new VW Rabbit, a small boxy car that had a front engine, front wheel drive combination that gave it excellent cornering ability and traction. It was $4500. After I drove back to Chicago instead of flying, I sold the VW van through an ad in the newspaper. It went to a kid who wanted to buy some pot from me too. Unfortunately, I didn’t have any to sell him, having lost my ability to smoke it.

That was the end of my first automobile and my gay abandon in medical school. I stopped smoking marijuana, stayed depressed, and didn’t study enough. I hated my classes, especially the clinical courses. It seemed as if marijuana had tranquilized me and kept me from realizing how degrading the medical school was.

I continued to take the Elavil until the following year. I gained seventy five pounds during that period and ended up at 250 pounds. After stopping the Elavil, I lost weight and ended up at 225 pounds, a much more reasonable weight for my height (at the time) of six feet seven inches.

The second automobile was faster and handled better than the first. A small, simple front wheel drive car, the Rabbit handled well. It was green, which was an ugly color, but that was what they had on the lot the day I bought it. It seated two in the front seats and three in the rear with a squeeze, and there was a little room for luggage behind them. The engine and transaxle fitted neatly in the front of the car, right over the front wheels, so traction was excellent in forward (although only fair in reverse.) It had a stick shift on the floor and four speeds. According to the driver’s manual, it had a rated top speed of 100 mph (which was precisely how high the speedometer read.) The reason this information was in the driver’s manual, apparently, was that in Germany there are certain roads where there is no maximum speed (unless conditions would compel a prudent driver to slow down.) At that time, of course, the maximum allowed speed (when the police were paying attention) anywhere in the US was fifty-five miles an hour.

I eventually did graduate from medical school and became a doctor. The Public Health Service scholarship kept body and soul together for four years; after that I was an intern making hardly any more money. I joined up with the Indian Health Service in July 1980, doubling the salary I had received as an intern.

2014 Was the Warmest Year in Recorded History (Since 1880)

April 18, 2015

 

The Warmest Year on Record

Parts of the eastern United States were cooler than average last year, but globally 2014 was the warmest year in recorded history.

 

Surface Temperature Anomalies

2014 temperature anomaly

Relative to the 1951–80 average

Global surface air temperature

Relative to the 1951–80 average

Inheritance: Not Just DNA

April 18, 2015

Recent research has shown a second aspect to the cell’s system of genetic control.  Most of us have heard of DNA– and know that it contains “the code of life”, the instructions for all the proteins that the body makes, in every cell.

What most of us have not, until now, heard about, are histone proteins. These proteins carry the strands of DNA like spools holding coils of wire; the six or so feet of DNA contained in a person’s each and every cell (except for red blood cells) is completely wound around thousands of these histone proteins so that it fits inside a cell that is too small to see with the naked eye.  Variations in the histone proteins control the activity of the genes, so that some will not be transcribed to RNA to be manufactured into proteins, while others will actively translate into RNA and then protein.  There are many variations, and it seems that it some cases changes in a single amino acid will change the character of the entire histone protein, enabling highly discrete changes in translation activity and protein production.

The changes in histone proteins cause inheritable changes during an individual’s lifetime, unlike DNA, which is unable to respond in this way.  In a sense, it verifies a previously discredited theory of evolution that was known as LaMarckian evolution and was party doctrine in the Soviet Union for a long time (called Lysenkoism.)  The epigenetic changes behave exactly as a Lysenkoist  theoretician would predict.

So in fact, evolution proceeds by two pathways: the set of instructions, and the code for turning them on and off.  Changes in histone proteins cause changes in the expression of DNA.  Unlike DNA, histone proteins can change a cell’s behavior during the lifetime of an individual organism.  DNA is changed by mutations, which occur almost randomly in single cells.  The change is not passed on to an individual’s descendants unless the DNA in sperm and ova is changed.

Changes in histone proteins seem to occur in tandem in all cells of an individual’s body, in response to changes in the environment.  Histone changes cause changes in the amount of protein that the cells produce, not in the character of the protein that is produced.

Histone changes also seem to cause cells to differentiate into the types of cells that make up different organs.  All the cells in the body carry essentially the same DNA, but cells in different organs produce different types and quantities of proteins.  This organ specificity of protein production seems to be controlled by differences in histones.  Early in the growth of the embryo, cells differentiate into distinct types that eventually go on to produce different organs; this starts with the distinction of front from back and top from bottom, then proceeds to inside from outside, solid organ from muscle from nerve cell from skin cell from intestinal surface cell, and so on.  All these differences appear to be caused by changes in histones that are responsive to the location of the cell within the embryo.

Other histone changes relate to responses to the environment of the individual as a whole; some appear to respond to the level of stress that is placed on the organism, for example.  People and animals who are exposed to various types and degrees of stress during early development appear to respond with permanent changes in nerve responsiveness as well as changes in the levels of stress hormones in the blood.  These changes are inheritable, a contradiction to earlier, simpler “Darwinian” theories of evolution.

More advances in biology are on the horizon.  There are still many mysteries that we have not solved.  But we are making progress.  Now, if we can just avoid slipping backwards, we may eventually get somewhere.

Next: genetically modified organisms.

 

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