Archive for: February, 2009

PalCast 6

Feb 28 2009 Published by under PalCast

It's up and ready! It's maybe not my best, but I'm getting used to my new equipment and I've been out of the podcasting biz for a while.
Feel free to come back here and discuss.

4 responses so far

If you're an entertainer, it's OK to beat your wife

Feb 27 2009 Published by under Narcissistic self-involvement

MTV news is reporting that Bow Wow is coming to Chris Brown's defense. For those of you who have been too busy worrying about the economy to follow the personal lives of celebrities, Chris Brown is a young singer who beat the shit out of his girlfriend Rihanna, another young singer (I'm sorry--"allegedly" beat the shit out of). The up side of this is that it may actually affect his livelihood---he has reportedly lost some advertising deals. But as Kobe Bryant showed us, if you're a celebrity you can rape whomever you wish and you will probably not end up in jail or the poor house.
So another entertainer, Bow Wow, is asking us to pray for Chris. You see, apparently singers are only human:

"We're not perfect," Bow said. "We put our pants on the same way everybody else puts their pants on."

Except that after Brown puts on his pants, he beats up his girlfriend. Is Bow saying that we should cut him some slack because domestic violence is just like any other "normal" behavior?
Maybe it's time to stop worrying about how this will affect Brown's career and talk about how it affects Rihanna's, and what larger message it sends the public. Perhaps if Bow were to use is hight-priced mouth to denounce domestic violence instead of telling us that it's just part of being human, then he could actually do some good. Otherwise, he's just another famous, misogynist prick.

11 responses so far

Good bye, Henry

Feb 26 2009 Published by under Medical Musings, Medicine

Yesterday, a fellow medical blogger suffered a blow most of us cannot imagine. She goes by the name "drsmak" and was a great writer before her son fell ill, but when her son fell ill, her document of the struggle showed us how good the blogosphere can be. She allowed us a view of what it is like to love, and how that love is sometimes distilled into a painfully small elixir.
Drsmak did us all a great favor---she showed us how it is possible to survive the unsurvivable, and she has done it with great dignity and art. The blogosphere owes her a debt.
And you can help memorialize Henry, and show your respect for drsmak. The family has specified some charities to donate in his name. These charities benefit children with cancer, and some of them rely on large numbers of small donations.
I've never given a shout-out to a cause before, but kids with cancer---that's a big deal. And drsmak is a seriously important netizen. Go over to her blog (linked above) and read some of the pieces about her son. Then scoot on over and give a even a little bit in memory of Henry. It's the least we can do.

3 responses so far

Sleepless

Feb 26 2009 Published by under Narcissistic self-involvement

It's really early, but I've been up for a while. The leg pain caused by the disk pushing into my L5 nerve root is turning me into a cranky insomniac. So this morning I'm giving in. I'm giving up on tossing and turning, grinding some good coffee beans, boiling some water, combining them in a coffee press, and sitting by the computer. My wife's office downstairs is a peaceful room. (Hold on, time to press the coffee---that reminds me. A couple of years ago, I was pressing the coffee and I accidentally sent the press flying, coffee and grounds painting the family room. My 4 year old still remembers it. OK, done.)
My wife's office is sort of isolated from the rest of the house, so it's a good place to do a little writing without bothering anyone, or being bothered in turn. And of course, early mornings are a time of forced introspection and contemplation. You see, it's been a helluva winter here at Casa Pal, so sleep doesn't always come easy. (Damn, that's some good coffee. Yes, I know, there is irony in my complaining about insomnia while drinking coffee---deal with it.)
Anyone who lives in the midwest knows it's been a long, cold, dark winter (oh, and to you global warming denialists---please remember that weather does not equal climate, idiot). Back around Thanksgiving, my father-in-law developed severe weakness, and was found to have a cervical spinal cord compression. He was not a well man, spent several weeks in the hospital, and finally died. As anyone who has ever lost someone knows, even when you're feeling a little better, it can come back to overwhelm you. My wife called her mom's cell phone the other day, and it went to voice mail. Her dad's voice asked her to leave a message. She called back about five more times.
His death has really been the dominating color this winter, but other crises have arisen. I've lost several of my oldest patients. Ice damming caused flooding in our house (you know something isn't right when you hear running water in a room without a sink), my computer died (horror to a writer, but they're sending me a new one), and my own back is becoming a real problem. As I hobble down the hall at the hospital, the House jokes are becoming more frequent.
But of course, it's hard not to realize how good I really have it. My wife is a remarkable woman, and my daughter is my heart. When I came home last night from work, I lay next to her for a few minutes just to watch her sleep. My wife says that when she sleeps, she looks exactly like me, but to me she is joy incarnate. (And smart---did I mention she's smart? Apparently, one of the kids at her preschool told his mom, "I want to be able to read like PalKid.")
And of course, I have a job. Back in December, I received a nice pay cut due to the economy, but compared to most Michiganders, I'm doing great. The pervading sense of doom is hard to convey to anyone who doesn't live here. People aren't just hurting a little; they are losing their homes, their cars, their jobs, their marriages, their lives.
So I've got it pretty damned good. Still, it would be just that much better if I could get a little sleep.

9 responses so far

Dumb and dangerous---Kennedy and Kirby's continued clash with reality

Feb 25 2009 Published by under Absurd medical claims, Medicine, Vaccination inanity

The Autism Omnibus Trial is a conundrum for the infectious disease promotion movement. Still, their ability to pick up the goalposts and run is unmatched, and that is just what David Kirby and Robert Kennedy, Jr. have done in today's Huffington Post.
To review, the recent Omnibus decision looked at a few test cases for the "vaccine causes autism" hypothesis, and tossed them for being inconsistent with reality. This correlates well with what science has to say about the issue.
But of course the overwhelming evidence isn't going to deter these superheroes. They know the answer, and they're strong enough to make any facts fit their hypothesis.
Their answer to the Omnibus findings was, "but look over here---here's a case were a judge said vaccines cause autism." If this is where they are planting their goalpost, then it's going to be another "own goal" for K&K. Let's try to take an organized look at their chaotic ramblings.
What is alleged?
What K&K are alleging in their latest rant is that the Omnibus finding (that vaccines do not cause autism) is not relevant and of little importance, since the "vaccine courts" have already found the connection to be true.
This is, of course, false. Let's review, with a little help from Orac. Here is what the vaccine court is:

Continue Reading »

10 responses so far

Computer update---w00t!

Feb 25 2009 Published by under Narcissistic self-involvement

HP feels really, really bad, and they are sending me a brand new tablet pc, apparently a newer, shinier, happier one. Yea!!

6 responses so far

Do quacks prey on vulnerable groups?

Feb 23 2009 Published by under Absurd medical claims, Medical ethics, Medicine

A while back I wrote about a naturopathic "physician" who was specifically preying on the Latino community. This is troubling for a number of reasons, some of which I mentioned. In my zeal to rant about the quackery, I may have not delved deeply enough into some of the other important issues.
For example, Hispanics have rates of diabetes and stroke well above the white Anglo population. These are conditions for which we have very effective science-based treatment. Proper treatment of high blood pressure in diabetics reduces the rate of heart attack and stroke by 35-50%. Proper foot care, which can be as simple as regular foot exams at the doctor, can prevent amputations by 45-85%. The list goes on---we know how to treat diabetes, and prevent the devastating micro- and macro-vascular complications.
Anything that stands in the way of proper treatment will naturally increase the rates of diabetes-related illnesses. Quacks that encourage "alternatives" to science-based medicine are dangerous no matter whom the prey on, but for American Latinos it is a double hit. By percentages, more Latinos will need diabetes care than Anglos, and they may have less access to proper care, either for cultural, economic, or linguistic reasons.
When I call out the quacks on their unethical behavior, I've had commenters come back with, "but your medicine gave us Tuskegee!" This is of course irrelevant. Unethical behavior is unethical behavior, no matter who perpetrates it. The Tuskegee experiment damaged the lives of hundreds of individuals, and damaged the relationship between the health care system and an entire ethnic group. But that doesn't invalidate the science-based medicine which we strive to practice today.
When they target minority communities, practitioners of cult medicine such as chiropractic and naturopathy are perpetrating a dangerous form of racism. By hanging out a "se habla espanol" sign, they invite Latinos in for a chat, a hug, and a glass of horchata, and then very gently separate them from their money, leaving them no healthier than they were when they walked in. These quacks might believe they are doing good, but then, so did the teachers at the Native American relocation boarding schools. Good intentions do not mitigate the effects of a harmful, racist practice.

8 responses so far

Computer woes

Feb 23 2009 Published by under Narcissistic self-involvement

So I've been dealing with a sick computer for a while now. It died ungracefully during ScienceOnline09, first giving me the dread blue screen of death, then giving me a black startup screen that said the pc equivalent of "piss off".
My other computer is a mac, but the hospital's system isn't mac-compatible, and my wife needs it, so I'm in a bit of trouble. As far as I know, I don't keep a lot of irreplaceable data on it, so I'm not too worried about that, but I really, really want my computer back.
It's a lovely little hp tc4400 tablet pc. I don't use it in "tablet mode" very often, but the touch screen is very handy at the office. Hp's service is somewhat amusing. When I email them, they respond promptly, but when I try to respond back, I always receive an email that the case cannot be found or is closed. Phoning requires at least 10 minutes of being shifted from person to person (and likely from continent to continent).
Still, they promised to do warranty work on it quickly and efficiently.

Thank you for contacting HP eServices.
As per the information received I see that the LCD latch does not function, the Hinges are loose and also the unit boots up with an error message.
In order to provide you the complete resolution, I will be shipping you the drop box for you to have the notebook serviced in our repair center. A shipping box will be sent to the address provided under this case within the next two business days.
Please ensure that you back up your data prior to shipping the unit in, as our repair facilities may have to image the hard drive as part of the repair service. All passwords should also be removed, including the BIOS and Windows passwords.
Please send the AC Adapter as well as the Battery along with the unit as it needs to be tested in the repair facility.
We request you to read the 'HP Mail-In Repair- Packing and Shipping Procedures or instruction' sheet sent along with the drop box prior to ship the notebook. If you need to schedule a pick up then please call the number included in the Packing sheet. We also request you to ship the notebook within five business days from the box arrival day.
Note: If there is damage that is not covered by the product warranty, there will be an evaluation fee charged if the resulting billable repair is declined. The evaluation fee is $89 and covers the cost of shipping and diagnosis of your HP product.
**Note**
Please do not update this case 3604782943 through Support Case Manager. To check status on the mail-in or for any other assistance in regards to this case, please call HP Support at 1-800-HP-INVENT (1-800-474-6836).
You may shortly receive a survey regarding your experience with us. Kindly provide us with your valuable feedback.
Regards,
Some dude

After sending it back, I heard nothing. I called them several times, and each time, after several transfers I found that they had an incorrect email address listed. Each time they corrected it---and somehow it kept reverting back. Finally, I received some communication:

Hello
We have received an update from our repair facility. The part needed in order to repair you unit is currently on back order , the ETA on this part is 02/20/09 once we have an update we will contact you. Please allow 3 to 5 days for repair and delivery after part/s have arrived
Thank you
(unsigned)

Then:

Hello
We have received an update from our repair facility. The part needed in order to repair you unit is currently on back order , the ETA on this part is 03/02/09 once we have an update we will contact you. Please allow 3 to 5 days for repair and delivery after part/s have arrived
Thank you

I whined, and received the following:

Hello
I apologize about the delay. Your case has been escalated to our Customer Relations team, a case manager will contact you via phone within the next 24 to 48 hours to help you resolve this matter.
Thank you

We shall see.

10 responses so far

Ginsburg likely to live longer than 9 months---Bunning will still be an idiot

Feb 23 2009 Published by under Medicine

If you read the news, you know that Justice Ruth Bader Ginsburg has pancreatic cancer. I am not privy to the details of her illness, but it was apparently amenable to surgery, which gives her a fighting chance, and today, she returned to the Bench. I was going to use her illness to explore the specifics of pancreatic cancer and of cancer screening in general as part of my series on cancer, but some idiot is already using her story for political gain, so my hands are tied.
Senator Jim Bunning (R, KY) issued a god-like pronouncement over the weekend, declaring that:

he supports conservative judges "and that's going to be in place very shortly because Ruth Bader Ginsburg ... has cancer."
"Bad cancer. The kind that you don't get better from," he told a crowd of about 100 at the old State Theater.
"Even though she was operated on, usually, nine months is the longest that anybody would live after (being diagnosed) with pancreatic cancer," he said.

Thanks for playing, asshole. First of all, with Stage I pancreatic cancer, the average 5-year relative survival rate is about 20% (assuming she has an adenocarcinoma rather than a rarer tumor type). Let's remember that these statistics tell us about aggregate data, not about individuals. A particular patient's chances are also influenced by many factors, including their overall level of health.
Bunning has the facts wrong (although he's correct in noting that pancreatic cancer is usually a devastating disease, especially when diagnoses in later stages as is the norm). But then there's the "asshole factor". First, a public official making a general pronouncement on the horrific nature of "cancer" is a bad idea---it takes away hope from cancer patients caught in his crossfire.
Second, the tone is one of gleeful stupidity. He's clearly overjoyed at the prospect of Ginsburg's mortal coil gettin' in the ground, but fast.
Of course, he has now issued his obligatory "nopology":

"I apologize if my comments offended Justice Ginsburg," Bunning, a Kentucky Republican, said in a statement released by his office. "That certainly was not my intent. It is great to see her back at the Supreme Court today and I hope she recovers quickly. My thoughts and prayers are with her and her family."

Let's all remember what apology really means. The purpose of an apology is to tell someone that you regret causing them harm. When you say that you are sorry that your comments "offended someone", you are blaming them for being overly sensitive rather than expressing actual regret (or perhaps, more properly, you regret getting caught). This is one of the most insulting statements one person can make to another. It's the equivalent of spitting in someone's face and then wondering aloud why anyone would take offense.
I don't expect Bunning to issue a real apology, especially after reading the comments from his constituents. It does give me the idea that I probably wouldn't want to live in Kentucky.

17 responses so far

Friendly Fire

Feb 20 2009 Published by under Medical Musings

This is an essay from several years ago, but with so many WWII vets dying, I thought I'd keep this little bit of oral history around.
About an hour before my patients begin to show up, I sit at my desk and enjoy a cup of coffee while looking over the charts for the day. On my list was a new patient for the 9:00 slot. I opened his computer chart and saw that he was not new to the VA, only to me. He had been to a series of doctors over the years, and was noted to be hostile and dissatisfied with each. This is often how people seeking help become labeled as "bad patients", and are even "fired" by doctors. There are certain code words and phrases in medical charts that help identify "bad" patients; among these are "poorly compliant" and "habitual no-show". From reading the chart, he was all of these, so it was with a bit of dread that I awaited his arrival.
Mr. Williamson showed up in a blue blazer, slacks, and a blue cap adorned with the name of the Navy boat on which he had presumably served. He was a large man, imposing even at 73 years. He sat down, folded his arms, and waited for me to speak.
"So, what brings you in today?"
"Well, it's the same goddamned thing every time! Can't you read what's in that damn computer?"
"Well, I can see what other people say, but I'd like to know what you have to say. Any pain anywhere?"
"Of course I got pain. I'm 73 years old, and the VA fucked me over good, just like the Navy done!"
"Well, I just met you, so I don't know about any of that, but I'll tell you what-why don't you pick one thing that's bothering you the most today, and I'll listen to you, and try to help you with it. No promises beyond that. I can't tell you I'll make it better, but I'll try."
"OK, it's my damn knee. Hurts just as bad as it did the day I hurt it."
"How'd that happen?"
"Well you know how it is. I acted like a damned fool and joined the Navy. Thought I'd have a real job. Not many folks in my town had jobs back then. So I joined up, ready to do whatever it takes, and guess what? Me and all the other coloreds get assigned to manual labor. They didn't care what skills we came in with, and they sure enough weren't going to give us any new ones. They just put us on ships and docks and told us to lift shit all day. And if you complained, there was plenty worse work you could get."
"Did you work out at Port Chicago?"
Port Chicago was a Naval magazine in the San Francisco Bay area where several hundred black seamen were killed while loading live ammunition onto ships. They had complained about the danger, but had been ignored or threatened. After the accident, many refused to go back to work without a change in conditions. They were court martialled, but finally pardoned many years later.
"Just before the accident, which was no accident, most of the guys stationed with me shipped out there, figured it would be better work out west. I stayed here. Most of them's dead now."
"What was it like for you back here?"
"We got treated like slaves. When they'd put us on a train, we'd have to ride in the first car, the one where all the smoke from the engine goes in. The German POWs rode in the good cars. And when we'd stop for meals, the POWs ate in the restaurants, but we had to find sandwiches and eat them on the train."
"We were willing to die fighting. Black men who got combat training went around training with wooden guns. Army's probably afraid they'd use real one's to kill white officers. Fact is, I think the ones who did get to fight got so good at killing Germans 'cause they were killing white people."
None of this was in his medical chart. His eyes stared forward as he spoke. He appeared angry, sad, hurt, and very distant. He had not yet spoken of his injured knee. He never did. His pain was as sharp at that moment as it was 50 years ago. He had volunteered to serve his country, and found the enemy was treated better then he was. Like many soldiers, his memories had him pinned down in the past. When the year is 2001, 1945 is a very lonely place.

11 responses so far

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