Priorities

Have I mentioned the webcomic “pictures for sad children” yet? It’s wonderfully horrifying. There is clearly something deeply wrong with its author, John Campbell.

start w/what you can handle

Accidentally Overheard at the Grocery Store

[Customer A]: “That should be fifty-six dollars… if I can do math, that is.”

[Clerk]: (jokingly) “Hmm, how worried should I be?”

[Customer B]: (jokingly) “Well, let’s see… two plus two equals five!”

[Clerk]: “…for sufficiently large values of ‘two’.” (muses) “Y’know, with rounding error, that’s potentially a valid result.”

[Customer A]: “Depends on the algorithm.”

[Customer B]: “I love shopping here!”

More Borgstromancy

More of the informal work of Jenna K. Moran, taken from this rpg.net thread.

The phone call is coming from *inside the house!*

The butler did it.
. . . well, the butler, and Cthulhu.
Cthulhu did most of the butchery.
But the butler let him in.
And held his knife.
And dusted him off afterwards
To help him disguise himself as the Christmas Tree.

He’s actually . . . Luke’s *father*.
But more astonishingly
Luke is *his*.
In episode three Luke warps too fast around the sun
Due to a problem with communication
And winds up in the past.
He builds two robots
And saves some whales
And has sex.
That’s why almost a quarter of his genes are an exact match with his own.
Remember, kids!
Midichlorians measure inbreeding!

The Iron Giant is friendly.
He loves people.
In fact, he loves them too much.
Just like Big Bird.

The owls are not what they seem.
They are luxury sedans with smooth, precise shifting,
High engine rev,
And dynamic performance.
See?
It’s a funky show.

Star Trek is based on the true story
Of Rasputin
And his faithful half-Vulcan companion,
Ivan.

What is the Matrix?
A tissue of false fate
Woven in the Wyld.

Sing, oh muse, of the wrath of Achilles
Sing, oh muse, of the birth of Ganesha
And of Iron John
And of that place
East of the sun, west of the moon.
And of all the old stories
Told by the Wyld
Before they were e’er told by men.

Superman comes back to life
Again
Later on.
Only now,
He’s radioactive.

Dresden Codak: The Sleepwalkers

Mr. Codak has produced another comic!

It’s visually stunning, scientifically intriguing, and – ultimately – humorous character development.

It’s a shame it takes so long to produce new content, but the stylized-painting style is really worth it.

Cheryl Morgan on Gender

See her post on her website, Cheryl’s Mewsings, here.

It’s excellent except for this part:

However, there is a fair amount of evidence that some forms of gendered behavior have a biological component, and that treatment with hormones and similar chemicals, or even neuro-surgery, can cause animals to change their gendered behavior. Presumably the same is possible for humans.

The best available evidence is that it’s not. At least, not in any non-trivial sense – sufficiently advanced neurosurgery could change any behavior, and sufficiently primitive neurosurgery can eliminate any behavior. But that’s not what’s being discussed.

Identity and sexual orientation resist every mode of therapy and attempt to change known. It is possible to destroy cognitive function to the point where unusual concepts of identity and disapproved sexual orientations no longer manifest, certainly. But changing from one to the other? Can’t be done.

The article is definitely worth reading, and clarifies issues many people are confused about to a high degree. With such contentious issues of definition, I’m sure not everyone will agree completely with her usages, but they’re a good starting point for discussion.

[Edit: Clarification] The best available evidence is that orientation and gender identity cannot be changed in humans. I wasn’t trying to suggest that the evidence is against biological components to both those things – quite the opposite.

Balko on Ted Kennedy

See his article here, which demonstrates a far greater patience and restraint that I could manage.

Basically, he sums up most of the things I wish I could say but am not skilled enough to do so properly.

First, Do No Harm (Part 1)

Many years ago, as I read through the July 1998 edition of Discover magazine, I came across a fascinating essay entitled “First, Do No Harm”, by Frank T. Vertosick, Jr. (I later learned he was the author of a number of excellent books, including
When Air Hits Your Brain and Why We Hurt: The Natural History of Pain.) When I started reading it, I was idly curious; when I finished it , I was determined to skeptically examine the way medical decisions were made.

Sadly, I can’t provide a link to the article – although much of the content of Discover is available in various indexing and archival services, that particular commentary isn’t for reasons of copyright. But if you have access to back issues of the magazine, I highly you recommend you take a look at that particular edition; the essay begins on page 106.

What was so powerful about the essay that I remember it vividly more than a decade after I read it? Let me show you the bolded quote prominently displayed on its first page:

In the 1970s neurosurgeons began performing an operation designed to save lives. It actually risked them. But no one bothered to determine that for 20 years.

The human scalp is extremely well-supplied with blood to help keep body temperature under control by radiating away excess heat. In terms of immediate physiological requirements, the scalp doesn’t need anywhere near the total amount of blood that flows through it. Additionally, the peripheral arteries of the face and scalp tend not to become restricted or clogged with fatty deposits, with the result that many older patients have excellent blood flow in all parts of their heads but their brains.

Doctors began to think that redirecting this excess blood supply might be a good way to mitigate the devastating effects of strokes. When the brain wasn’t getting the blood it needed, why not borrow from the scalp? So in 1967, Dr. Gazi Yasargil of Switzerland was the first to conduct an extracranial-intracranial (EC-IC) bypass in humans, threading scalp arteries through the skull and grafting them onto the surface of the brain. Between then and 1976, he offered the surgery to 84 patients with a history of stroke or transient ischemic attacks, temporary blockages of blood in the brain that often warn of later strokes. In that time, only three of the patients had further strokes; based on older studies of similar patients, Yasargil concluded that more than half of his patients would have had strokes if he had not performed the surgeries, and that the EC-IC bypass was a highly effective preventative treatment.

Other neurosurgeons hadn’t waited for even this preliminary study to be concluded before offering the bypass themselves, years before any long-term investigation was possible. Thousands of surgeries were performed before even Yasargil’s results were published. As Vertosick reports:

Microsurgical laboratories sprang up overnight to teach the fine skills required for joining spaghetti-size arteries with sutures invisible to the naked eye. Large hospitals and universities aggressively recruited experienced bypass surgeons. Technically elegant and very lucrative, the operation became the darling of the neurosurgical community.

But technically early studies like Yasargil’s were only suggestive, not definitive. There was no proof that the therapy worked as well as we thought it did – they compared patients treated with surgery in the present with untreated patients from the past. That introduces the potential for biasing the results. Direct evidence would require comparing treated and untreated patients from equivalent populations in the present, with the absence of treating serving as a control.

In 1977, the National Institute of Neurological and Communicative Disorders and Stroke (NINCDS) began a study designed to do exactly that. 71 participating neurosurgical centers randomly assigned high-risk patients to either EC-IC followed by aspirin or aspirin alone. Nearly 1,400 patients had been studied when the trial ended in 1985.

Dr. Vertosick attended the conference at which the results of the study were publically released. Instead of confirming what the physicians believed to be true, the results abolished it. The surgery didn’t reduce the risk of stroke no matter how the data was examined. In fact, when deaths and strokes resulting from the surgery were included, the surgically-treated groups had more strokes with greater mortality than the groups given aspirin alone, averaging 14% more.

In other words, the EC-IC bypass wasn’t just useless, it caused significantly more strokes and deaths than doing nothing.

Yasargil’s beautiful theory died that day, slain by ugly facts. The now-wasted hours I had spent bypassing rat arteries flashed before my eyes. At the conclusion of the Honolulu talk, one of my colleagues approached me, cupped a hand to his ear, and lamented, “Did you hear that noise? The doors to a hundred microsurgical laboratories just slammed shut. For good.” Bypass mavens fought hard to save their operation, but to no avail. After a brief and acrimonious debate over the validity of the NINCDS study, the bypass era finally ended. Insurance companies stopped paying for the operation, halting its use; many surgeons still believed in it, but not enough to do it for free.

Although a minuscule number of bypasses are still performed for two rare, life-threatening brain diseases, the operation no longer has any role in the wholesale prevention of stroke. It now lies buried in the cemetery of dead therapies alongside bloodletting, head irradiation for ringworm, and a host of other harmful “cures”. Yet for nearly two decades, the best brain surgeons on earth inflicted thousands of operations on unsuspecting patients in the mistaken belief that the procedure was helping them. In doing so, they caused more death and destruction than the disease itself.

How could they have been so wrong?

That’s what the next post will be about.

Radley Balko on the “Whole Foods Fiasco”

See here.

The more I read of Balko’s work, the more I like him. And I didn’t even realize at first that he’s a libertarian…

Evaluations Needed

Hey, folks, I could use your help.

I’ve been reading the works of Raoul A. Robinson lately, and his ideas intrigue me. I’ve already formed a variety of opinions of the claims he makes, but I want other judgments.

Take a look at this article discussing some of his ideas, then consider reading his books, which are available for free download. (They’re really quite short – don’t let the high page counts faze you, the PDF pages are tiny.)

Then, please tell me what you think about the validity of his claims, the strengths of his ideas, and their weaknesses.

(Michael Vassar is specifically excluded from this request.)

Thanks.

A Teacup in a Velvet-Gloved Iron Fist

Erfworld had strips with remarkable writing. Hopefully, once the comic returns, it will again.

In the meantime, we’re left with “Summer updates”, which were previously interesting. Lately, however, they’ve become extraordinary.

See this, this, and this.

If you’re not familiar with the story thus far, those events will be moderately opaque. But if you’ve been following along… the complexity of theme and character is remarkable.