BEST NOT TO OVER DO IT

WHY are doctors so arrogant and uncaring !!!

“They just speak to you about your symptoms for 5 seconds then prescribe you medication for the wrong diagnosis without first checking you out!!! I’M SICK OF THEM, then they complain that you’re a hypochondriac because they weren’t able to treat you for the same problem in the first place!!! 
They ignore your real symptoms and only derive what they wrongly think is causing your troubles.”   – from a Yahoo Pain Management forum

IS YOUR DOCTOR TOO “COLD”?

Doctors should be “caring”.

Every day. Every minute.

Does it really matter if it’s been a long horrible day for the doctor? Isn’t a patient entitled to a dose of sympathy along with whatever treatment is prescribed?

Once upon a time, when doctors carried black bags, they clucked over you constantly. They were sympathy machines.

“My, my. That looks just terrible!,” they would say.

In those day, doctors were your best friend. They knew all the kids. they knew you before you got married. They knew your secrets. They were very wise.

Why did they cluck over you so much?

What else would he or she (oh let’s stop this she crap – it was always a he) do? A stem cell transplant? I don’t think so. They offered sympathy because, often,  it’s all they had to give.

I have to ask. Does this  still make sense?

You’re talking to a stranger. A busy, busy stranger. You’re the 18th patient and there are two waiting in other rooms while you get seen. I know you feel bad. I know a little sympathy would be nice. But can we be realistic for a minute? That guy doesn’t even like you. You’re not his friend. He’s trying to fix what’s wrong with you, okay? Isn’t that what should matter?

I’m just asking.

Evidently, doctors buy into this emotional fraud because I’m looking at an article from the journal Health Expectations which aims to teach doctors how to speak the language of compassion.

Oh boy! The language of compassion! If you don’t feel it, at least learn to sound like you do.

Ronald Epstein, M.D.( University of Rochester, Center for Communication and Disparities Research) was the lead guy.  He worked with a group of oncologists, studying how they interacted with  some very sick patients.  They  worked on tone of voice, ways of expressing tenderness and understanding, and so on. Non-verbal communication too. Were the pauses and sighs right? The pitch? The tone? Metaphorical language? You really don’t want to choose a clumsy metaphor.

Here’s the thing.

The physicians who are involved in this stuff ARE  caring. They’re putting themselves through all this because they want things to be good for their patients. They know it sucks to be sick and they want, somehow, to be more comforting.

But there’s a risk.

“Getting the script right” can be dangerous. People sense it when you aren’t “real”. It can backfire. I’ve worked with doctors most of my professional life and, honestly? I think they’re great. Not one real clunker among the many I know.

MISTER ScienceAintSoBad thinks the emoting can be overdone.

Fix the disease.

That’s good enough for me.

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The drawing is mine.

To leave a comment, click “comments” which can be found at the top right of each article just beneath the headline.

SOUL? WHAT SOUL?

IS THERE A HUMAN SOUL?

Dr. Duncan MacDougall weighed his patients just before they died. After they died, he did it again.

If the soul had slipped quietly away, there would have been a very slight difference. Which is exactly what he found. A few grams . The average weight of the human soul. The soul was the spiritual heart of “man”. Everyone had one. Everyone knew it was there. Even now in the 21st century, most people believe there is a soul. The body dies. The soul doesn’t.

Why don’t surgeons ever see souls during an abdominal operation?

Well MacDougall was wrong apparently. When others tried to get the same results, they couldn’t . MacDougall got fooled by the fact that his equipment simply wasn’t accurate enough to measure such a small difference in weight.

Still.

MacDougall took an idea that lots of people believed and then he tried, scientifically, to prove it. That’s a good thing.

Silly?

Maybe it sounds that way to you, okay? But he was trying to use the best tools he had to collect evidence about something that was poorly understood.

We like that.

MISTER ScienceAintSoBad has talked about faith in the past.

Faith is faith. It isn’t scientific. But it means so much to so many that MISTER ScienceAintSoBad keeps his head down. Most people manage to have room for discordant ideas about religion and science. Maybe it’s crazy. But we’re the planet’s humans, right? We get to do things our way. We’re inconsistent but that’s who we are.

It’s hard to say what people mean when they talk about the soul. On what level do they believe in this elusive unfleshy thing? Are they being metaphorical? Are they being completely literal? Do they think it’s in there under the spleen? Could trauma, like  a crushing injury to the abdomen in a car accident, do something bad to the soul?

MISTER ScienceAintSoBad has come to appreciate the exquisite and beautiful contradictions in our world. We don’t necessarily shed all of our old ideas; we just add a layer of new stuff. Most Americans believe in the existence of a “Higher Being”. And pray at least occasionally. And believe there’s a “better place” to pass on to. But most also believe the evidence of their own eyes and respect scientific achievements.

Is this bad?

In this country where approximately 85% of the people believe in “something or other”, rapid developments in science and technology are the norm and – you know what? – us poor bloggers can’t even keep up with the flow of new stuff.

If this is how religion impedes science, I would hate to see the unimpeded version.

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The drawing is mine.

To leave a comment, click “comments” which can be found at the top right of each article just beneath the headline.

Turn Off Climate Change

DON’T FREAK, TWEAK

The planet you were born on is in trouble. When we take its temperature, we walk away shaking our heads.  The patient is burning up with a fever.

No matter who’s at fault (some say it’s not us humans), the seas keep rising and the storms keep getting nastier.

What to do?

Getting emissions cut back to neutral is a pipe dream.

And pointing fingers is a waste of time. It’s too late anyway.  The horse is out.

So some are asking if we can’t take a few risks.  What about all that scientific know-how we supposedly have? Could we engineer our way out of this mess? Maybe do something to the oceans so that more carbon gets captured by plankton? Change the clouds so that more sunlight gets reflected? Would  it be ethical to do stuff like that? Could we get all the countries in this huge world to go along with it?

Most of all, would such crazy and unprecedented projects work or would they blow up in our faces?

The Journal Of Climate Change thought this would be the right time to figure it out. Its December issue is a “special”. Twelve papers on the subject of geoengineering.

Maybe getting so many ideas under one cover and so many authors in one room (for a separate conference) could start the process of thrashing out some of the differences. At least, that’s the hope.  Ethicists and political scientists are in the mix. They’re supposed to help the techies to see the bigger picture. These aren’t, after all, exactly backyard experiments. If one or more of them actually gets the go ahead, it would be the first time anyone had the goobers to deliberately tamper with the planet in that way.

If it makes you feel better, a set of guiding principles (the Oxford Principles) has already been worked out to, maybe, guide the hand of future world wide climate experiments.

Just in case.

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The drawing is my own.

To leave a comment, click “comments” which can be found at the top right of each article just beneath the headline.

AS GOOD AS STATINS

HEALTH (AGAIN)

Science has lots of busy corners. Technology, even more. I can’t use up all my blog time on health related stuff. It wouldn’t be fair to physics, chemistry, biology, and North Korean tablets. But I  would be a b-a-d science blogger if I didn’t tell you about apples.

Seriously.

You know about statins? They’re drugs that  lower cholesterol. Doctor’s love them. Pitivistatin, lovostatin, atorvastatin, , zocor are statins. Others too. Long list.

Statins are amazing. They don’t just  lower cholesterol, it seems they do other good stuff. They help with cataracts and dementia, and gum inflammation. They also reduce the incidence of  heart attacks and strokes, and one study even says that statins might slow aging by protecting your telomeres. Supposedly they can cause some problems with muscles but, for most people, that shouldn’t be a problem.

I’ve seriously toyed with  trying to talk my way on to statins, myself.

Well here’s the thing.

Dr Adam Briggs (BHF Health Promotion Research Group at Oxford University)  looked at the effect of eating a single apple each day (that’s right – “an apple a day”) vs statins. The results, cardiovascular wise, were about the same for apples as statin drugs. Dr. Briggs’ conclusion was that you could do as good a job for yourself eating apples as taking statins (probably because apples contain pectin which has similar effects on cholesterol to statins).

If you can lower your cholesterol and lower your heart risk without taking drugs, who am I to say you shouldn’t?

This report didn’t get into whether apples did all  the good stuff that statins do.

Still.

Apples? Hot dang!

A final point:  Statins, like anything, have pluses and minuses. Don’t rush off and stuff yourself full of statins on my account. First go over the particulars with your doctor. Better yet? Try fruit.

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A reader left a comment (see comments) suggesting that this study from the BMJ is less than serious. Perhaps so. But you’ve gone out and bought all those apples, right? You might as well eat them.

What could it hurt?

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I drew that apple!

To leave a comment, click “comments” which can be found at the top right of each article just beneath the headline.

HAYWIRE HEALTH PLAN

OVERCHARGING YOURSELF

Most Consumer’s Pay Too Much, Pick Wrong Plans 

We’re trying.

This healthcare stuff is confusing.

Dr. Eric Johnson (Decision Sciences, Columbia Business School) observed test subjects “enrolling” in simulated health plans. The testing was modeled on what people find when they use the major exchanges. He and his colleagues watched people sweat through the choices as they  clicked through possible health plans.

Scary.

The great majority  chose stuff that they didn’t need and couldn’t afford.

Dr. Johnson is a specialist in consumer behavior. He’s helped in the design of health care plan systems for several states. According to him, 80% of consumers are paying too much.  $611 a week, he says, for a family making $42,000 a year. Painful!

You know what? I’m buying stock in a company that sells healthcare insurance.

Here’s the thing.

Dr. Johnson – did I mention the rest of his team, Ran Hassin, Allison Baiger, and Galen Treuer? – went further. He didn’t just expose the flaws. He made constructive suggestions. Among them:

1. Don’t choose a plan until you’ve looked at the services you think you need.

2.  Gussy up the software with more pop ups to explain terms that tend to confuse the uninitiated. Not everyone understand what a “deductible” is.

3.  Include relevant “tools”. Just adding a calculator saved money.

4. Default to the most cost effective plan. A simple step like that saved lots of $.

5. Lots of choices overwhelm and confuse people. Easy does it with the choices.

The report, Can Consumers Make Affordable Care Affordable?, was published in PLOS ONE.

BY THE WAY

This study wasn’t a dig at Obamacare. The authors were explicit about that. These problems weren’t caused by the affordable care act. They were caused by the fact that choosing a healthcare plan is just bloody complicated no matter who’s behind it.

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The drawing is mine.

To leave a comment, click “comments” which can be found at the top right of each article just beneath the headline.

HOPELESS!

 A POSSIBLE FIX FOR TOURETTE’S SYNDROME

The  headline was originally KIDS WITH TICKS.

I changed it. I didn’t want to sound like a jerk.

A jerk? That’s what we call an insensitive clod? Jerk?

We bad.

Kids with Tourette Syndrome get “tics”. They are are caused by nerves that are too sensitive – hyperexcitable. Tourette’s kids can’t keep hands, feet, arms, legs, head from twitching or jerking. Sometimes Tourette’s causes vocal tics which can result in embarrassing noises or even in saying things that piss people off. Sometimes strings of profanity pop up.

Shit, shit, shit! (Imagine the consequences!)

The exact science behind Tourette’s has been elusive.  But researchers at The University of Nottingham (Journal of Neuropsychology) are tracking it down. They find that a particular piece of the brain, the “striatum”, is in overdrive in these kids which causes the  brain’s cortex to be bombarded with too many signals and too much stimulation. Their work has lead to the idea of using an electromagnetic stimulation device (Transcranial Direct Current Stimulation ) to suppress the excess excitation.

WHAT’S GOOD

The good thing is that this basic approach to the science behind Tourette’s seems to be unearthing the mechanism behind it. And, if all goes well, kids with Tourrette’s might be able to get fixed up without drugs. Just by applying an electromagnetic device to their heads for a few minutes a day.

This is all very exciting.

WHAT’S BAD

What’s bad is that we’re not there yet. This work is ongoing. More to be done. Maybe a device has to get approved by regulatory agencies. And kids don’t stay kids forever. We need this thing. MISTER ScienceAintSoBad is hoping for fast progress.

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That drawing is mine.

To leave a comment, click “comments” which can be found at the top right of each article just beneath the headline.

PUT A CORK IN IT

THE SEA

You’re not going to like this. Not if you live in New Jersey.

Scientists from Tufts and Rutgers say sea levels are headed higher at maybe 1/2 an inch a year. 18 inches higher higher by 2050 and 40 inches by 2100.

By that time, you’ll be old even if you’re just a little kid now.

And I will be world famous.

160  years old and still blogging. People will want autographed pictures of me at my old, cracked PC.

I  hope I wont find myself writing about the misery in Atlantic City. Ken Miller, Robert Kopp, Benjamin Horton and James Browning of Rutgers and Andrew Kemp of Tufts did the work which appears in the journal Earth’s Future. It’s partly based on the recently constructed 25,000 year record of sea levels in the mid-Atlantic.  The projected rise is only partly due to rising temperatures. There’s other stuff too. Anyway, they’re not even confident in these horrendous numbers. It could turn out even worse. Maybe 28 inches by 2050. And – you know what? – they better be wrong because I like the Jersey coast.

Here’s the thing.

Mister ScienceAintSoBad is leery of being a “climate denier”. Nobody likes a climate denier. I have great respect for the researchers behind this report.

But MISTER ScienceAintSoBad is an optimist. No matter how bad the news, some part of me looks for a way out. Smart as they are, maybe they missed something. Maybe society will dare to intervene in a reckless, massive way and, somehow, get away with it. Maybe there actually is a benevolent being out there who will bail us, literally, out at the last moment.

What do I know?

In the meantime, will I be buying oceanfront property in New Jersey?

I won’t. But please don’t let my individual choice undermine property values. I never planned to in the first place.

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I drew that.

 BRAINS ARE SENSITIVE

You would be surprised how easy it is to hurt a brain.  It doesn’t take much. With babies, just a little shaking. With grownups, a single rough football game or a minor motorcycle accident with the helmet still nicely attached to the rack.

Who wears a helmet when it’s this nice, right?

The men and women who fight our wars for us know about brain injuries. A handmade explosive can rip away a soldier’s future permanently. Happens all the time.

Until now, the options were very limited for brain injured patients. But researchers from Case Western Reserve University/University of Kansas Medical Center have come up with something amazing.

WOW!

Dr. Pedram Mohseni (Case Western Reserve) developed a “brain prosthesis” . A brain prosthesis is  an artificial thing which helps a brain work right. Dr. Mohensi’s device is a very small computer which can connect up parts of the brain that got disconnected because of an injury. It’s a bridge for the signals between the separated parts. The device uses powerful signal processing techniques to extract useful signals and then injects them where needed to “complete the circuit”. Although this may sound simple to an electronic hobbyist, this is several levels above “miracle” as far as medical science is concerned. It is amazing and startling and shocking and wonderful.

I’m not exaggerating.

Except – (good guess) – it’s the damn rats again. They have all the luck, don’t they? This has so far only been demonstrated on lab vermin. Experiments on lab animals are very important (although sometimes morally repugnant) but MISTER ScienceAintSoBad tries to “keep it real” with articles about things that are closer to the clinic or the drugstore. This research is remarkable though. How could I deny it mention? And a cartoon of its own.

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The drawing is mine. The kid, hopefully, is not.

COMMENTS: To leave a comment, click on “comments”. It’s just under this article’s headline (toward the right).

EXCEPTION TO THE RULE?

DON’T DO IT

The kids are out of control,  right?  Maybe a good smack would do the trick. It worked for you, didn’t it? Back in the day?

Dr. Murray Straus (Sociology Dept. , University of New Hampshire) says physical punishment isn’t a good idea. Neither is giving the kids to the next door neighbor, by the way. His new book “The Primordial Violence” examines the evidence from 32 different countries and 7,000 kids in the US.

Does spanking work?

It does. – If you’re goal is to get the kids to shut up and stop being a pest. You can modify behavior, using force. It doesn’t take a genius. But don’t go there, okay? Here’s why.

There are other ways to get kids to behave that are just as good as spanking without the negatives.  Spanking can mess up the bond between you and your children as well as affect their self esteem. Before you dismiss that as a lot of hooey, here’s what Straus saw from looking at what worked and what didn’t work with the thousands of kids he looked at. Kids that were spanked became “hitters” themselves. They struck out at other kids and even at their parents. When they grew up, they became physically abusive to their partners.  Kids who were spanked developed slower mentally and they did worse at school.

That’s a lot of bad stuff considering that you can do just as well by just holding back on privileges or using “time outs” to get the same result.

NO LONGER AN EXCUSE?

ARTHRITIS

You can count on your joints hurting as you get old. Degenerative changes in joints (osteoarthritis) is the result of the fact that joints and cartilage lose their baby smoothness. It doesn’t feel too good but you get used to it.

There’s another kind of arthritis –  rheumatoid arthritis. Personally, MISTER ScienceAintSoBad thinks it should be called something else. It’s not like regular arthritis except for the joint part. The rheumatoid stuff is an immune system disease – another one of those stupid, stupid things where the immune system goes haywire. In rheumatoid arthritis,  cells of the immune system attack the lining of the joints which,  then,  gets inflamed. The inflammation can cause damage to the joint – especially if the disease started early in life or is a particularly nasty form of the disease. In bad cases, joints can be deformed. Sometimes, surgery is even needed. There can even be organ damage.

What to do.

Well. There are treatments.

Diet modification and physical therapy are often on the menu along with nonsteroidal anti-inflammatory drugs (Aleve, Advil, etc) for inflammation and pain. Steroids are very common too.  The newer stuff includes  “biological” drugs which are designed to “make it go away” instead of just managing swelling and pain. Methotrexate or hydroxychloroquine are used for this.

NOT A PERFECT WORLD

NSAIDs and steroids reduce the pain and swelling but they can be a challenge for long term use. You’re always dancing with the side effects. The biologicals can be effective but their trick is based on dialing back the immune system. You have an immune system  for a reason, right? People with suppressed immune systems can get infections and other stuff.

GOOD NEWS

Why would I put you through this if I didn’t have some good news?

Dr. Patrick R. Griffin  (The Scripps Research Institute) just published a study in Arthritis & Rheumatism. The drug is called SR2211 . It blocked all symptoms of rheumatoid arthritis in mice within 10 days and their joints did way better as far as bone loss is concerned. This drug aims for only the part of the immune system that releases “inflammatory mediators” .  And since it’s an oral drug (the other biologicals are injected) if  you think you’re getting an infection, you can skip a few pills til things settle down.

That’s the theory.

There’s no mention of when this stuff goes to clinical trials. MISTER ScienceAintSoBad, sympathetic, as ever, to our mouse friends, has a strong bias toward getting this stuff out and into human hands.  Can we get cracking on this please?

Thank you.

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The drawing is mine