ShrinkWrapped

THE New York Times and (the Fallacy of) Genetic Determinism

The Science section of the Times often has useful articles, but whether it is in the news or the science section, they continue to repeat and embellish a mythological understanding of science that is enough to make one wish that the repetition of certain ideas should be made illegal.

In an article  by Benedict Carey, Some Politics May Be Etched in the Genes, a number of remarkably inane and inaccurate comments are made. (Hat tip: Pejmanesque) 

It starts off with a relatively meaningless and innocuous statement:

Political scientists have long held that people's upbringing and experience determine their political views. A child raised on peace protests and Bush-loathing generally tracks left as an adult, unless derailed by some powerful life experience. One reared on tax protests and a hatred of Kennedys usually lists to the right.

And goes down hill from there:

But on the basis of a new study, a team of political scientists is arguing that people's gut-level reaction to issues like the death penalty, taxes and abortion is strongly influenced by genetic inheritance. The new research builds on a series of studies that indicate that people's general approach to social issues - more conservative or more progressive - is influenced by genes.

There is some superficial description of the study's methodology:

From an extensive battery of surveys on personality traits, religious beliefs and other psychological factors, the researchers selected 28 questions most relevant to political behavior. The questions asked people "to please indicate whether or not you agree with each topic," or are uncertain on issues like property taxes, capitalism, unions and X-rated movies. Most of the twins had a mixture of conservative and progressive views. But over all, they leaned slightly one way or the other.

The researchers then compared dizygotic or fraternal twins, who, like any biological siblings, share 50 percent of their genes, with monozygotic, or identical, twins, who share 100 percent of their genes.

Calculating how often identical twins agree on an issue and subtracting the rate at which fraternal twins agree on the same item provides a rough measure of genes' influence on that attitude. A shared family environment for twins reared together is assumed.

I do not expect people without some minimal knowledge of science and the scientific method to be able to adequately understand how science works.  Furthermore, I don't expect anyone without a minimal knowledge of genetics to understand how genes express themselves.  But I did once expect (and we all should expect) a reporter for our most prominent daily newspaper, the "paper of record", to have a minimum level of competency before going off and writing on a subject like genetics.   This study, as described, is so nonsensical as to be worse than a parody. 

Where do I start?

Books

Neo-neocon has invited me to join in the "Five Books" meme, so here goes:

Total Number Of Books Owned Ever: This in not only unknowable but non-computable.

Last Book Bought:  The Road to Reality : A Complete Guide to the Laws of the Universe, Roger Penrose

Last Book I Read: Market Forces, Richard Morgan

Five Books That Mean A Lot To Me:

Rice in Egypt

NPR's Morning Edition featured an interview by the host, Steve Inskeep, with a WaPo reporter,  Glenn Kessler.  He is traveling with Secretary Rice on her trip through the Middle East. 

Kessler described how Condie has been  actively pressing for Egyptian democratization, while being careful to praise their efforts to help us in the war on terror.   He reported that she was able to restore some communication between the Israelis and the PA to coordinate their efforts in the upcoming Gaza withdrawal.  In an interesting twist, the Israelis are planning to demolish the homes they are leaving behind, but will not clean up the rubble because they would be isolated and vulnerable targets for months of cleanup.  They will pay the Palestinians to do the clean up, instead.  No mention was made of addressing the ongoing terror committed by various Palestinian groups but that is to be expected.

There were two particular moments in the discussion that stood out, one quite serious, the other comic and unintentionally revealing.

First, Inskeep asked Keller about Rice's general reception on the trip; how did the Arab audiences react to her?  Keller replied (the transcript is not available but you can listen to the whole interview here) that she has been coolly received.  At her speech pushing for Democratization in Egypt, she received no applause at all.  However, during the question period, an audience member asked her "isn't it time someone apologized for the desecration of the Koran?"  The question was met with loud applause.  Thus does the evil that Newsweek sewed live on past their retraction that no one in the Muslim Middle East believes. 

The second memorable moment came when Inskeep described the question.  As an aside, he commented, presumably for any radio audience members who have recently come out of a two month coma, that the question referred to "prisoners guarding the detainees at Guantanamo who had mistreated the Koran in various ways."  I assume he meant that the guards mistreated the Koran since the sentence is structured that way, which would make the error, of using prisoner instead of guard, a type of "Freudian Slip". 

In a Freudian slip, a person makes an error which reveals how they actually feel without the armor of their unconscious defenses obscuring their meaning.  In this case, it would suggest that the reporter is aware that the abuses at Guantanamo were perpetrated primarily by the prisoners but that the abuse meme being propagated by the MSM (and the Democrats) is the preferred POV.  The truth snuck out past his vigilant internal filters.   

It is always amusing to see people inadvertently speak the truth.

A Letter to my Senator

This morning, I wrote the following letter to my Senator, with a modified version to my junior Senator.  The campaign by the left attacking our military and the present administration long ago left the realm of "loyal opposition" and has become disloyal, irrational, mindless opposition.

Senator Schumer,
I am a life long liberal Democrat; I have donated money to Democrats through the years.  I worked as a volunteer for Allard Lowenstien in 1968 (while in High School) and opposed the Vietnam war from 1965 and I am writing to tell you that I no longer recognize the Democratic party.  [I thought it unecessary to point out my voting pattern in the last election-SW]
On Tuesday, the Democratic whip, Dick Durbin, made reprehensible remarks on the floor of the Senate comparing our military to Nazis, the Gulag, and Pol Pot.  This is outrageous, and instead of apologizing, he makes some weasel comments about being misunderstood.  He was not misunderstood!  He made comments that quite clearly express what too many at the core of the Democratic party believe.
As a Jew who has friends and family who lost relatives in the Holocaust, I am beyond disgust with his comments.
You are in a unique position Senator Schumer.  You will probably never have any opposition in New York to re-election as Senator and are unlikely to ever be able to seek a higher office.  This gives you the luxury of being able to speak the truth. 
If you agree with Senator Durbin, do nothing.  You will never again receive my vote or my money, but I doubt it will harm your chances for re-election.
If you do not agree with Senator Durbin, say so, loudly and emphatically.  He should be ashamed but isn't.  He should resign but won't.  He should be censured by his colleagues, at the least.
We are at war, Senator.  If you do not think we are at war, convince me of your position; otherwise, tell your colleagues to stop impeding our military in their efforts to win this war.
Sincerely,
Perry R Branson, MD

Democratic Delusions

The Democrats held a mock impeachment of President Bush today.  In conjunction with my post from yesterday, their rhetoric demands they try to stop the evil.  Here is a pleasant excerpt from an article by  Dana Milbank, from the WaPo: (hat tip: Dr. Sanity)

The session took an awkward turn when witness Ray McGovern, a former intelligence analyst, declared that the United States went to war in Iraq for oil, Israel and military bases craved by administration "neocons" so "the United States and Israel could dominate that part of the world." He said that Israel should not be considered an ally and that Bush was doing the bidding of Israeli Prime Minister Ariel Sharon.

"Israel is not allowed to be brought up in polite conversation," McGovern said. "The last time I did this, the previous director of Central Intelligence called me anti-Semitic."

Rep. James P. Moran Jr. (D-Va.), who prompted the question by wondering whether the true war motive was Iraq's threat to Israel, thanked McGovern for his "candid answer."

At Democratic headquarters, where an overflow crowd watched the hearing on television, activists handed out documents repeating two accusations -- that an Israeli company had warning of the Sept. 11, 2001, attacks and that there was an "insider trading scam" on 9/11 -- that previously has been used to suggest Israel was behind the attacks.

The event organizer, Democrats.com, distributed stickers saying "Bush lied/100,000 people died." One man's T-shirt proclaimed, "Whether you like Bush or not, he's still an incompetent liar," while a large poster of Uncle Sam announced: "Got kids? I want yours for cannon fodder."

There is a certain symmetry to the events of this week.  On Tuesday, the number two man in the Democratic Senate, Dick Durbin, likened our efforts in Guantanamo to the Nazis, the Gulag, and Pol Pot.  Today, the Democrats in the House hold hearings to stop the evil, and manage to bring paranoid anti-Semitism into the mix.  It is amazing how much the rhetoric of the left resembles the rhetoric of those who hate America.

As the left descends into paranoia and suicidal self loathing, it is inescapable to recognize that the core of the Democratic party must either agree with the charges that are being bandied about, or is cynically acquiescing in some misguided thought that it will help them politically.  Either prospect is chilling.

The prospect of violence grows. 

I repeat:

If the Bush administration is the equivalent of Pol Pot, the Nazis, and the Soviets, all right thinking Americans must oppose the evil, even with violence.  In fact, violence against such a state would be a moral necessity.

If they do not believe this, then it is time for them to start acting like responsible adults.  And how likely is that?

Dangerous Portents II

I had planned to continue, and perhaps complete, my series on The Doctor's Dilemma: Risks, benefits, and liabilities (which started here) but, as often happens, reality intruded.

About 6 weeks ago, I wrote a post, Dangerous Portents, in which I expressed my concerns that the rhetorical excesses of the left, given legitimacy by the MSM (especially the New York Times and its derivatives) and the Democratic Party, would lead to violence.

When your enemies are evil, dangerous fascists who are dedicated to destroying your country, your civil rights, and enslaving and/or killing various innocents, it becomes incumbent on right minded people to act to prevent further horrors.  This is the logic of the left, aided and abetted by large parts of the MSM, Academia, and the Democratic Party.  While they will accuse the Republicans and Bush of doing exactly what I just described, their logic fails when it can not encompass 9/11, Afghanistan and Iraq elections, 3/11, the Cedar revolution, and so much more, but much of the left is beyond the touch of reason; will violence follow?

Yesterday, Senator Dick Durbin, Democrat from Illinois, took the rhetoric to a new level of irrationality. After describing how an al Qaeda member was subjected to such "tortures" as having his air conditioning turned down to  a low temperature, and later turned off so that the room became extremely hot (the horror was compounded by playing loud rap music while the prisoner was chained on the floor, Senator Durbin made the following claim:

If I read this to you and did not tell you that it was an FBI agent describing what Americans had done to prisoners in their control, you would most certainly believe this must have been done by Nazis, Soviets in their gulags, or some mad regime—Pol Pot or others—that had no concern for human beings. Sadly, that is not the case. This was the action of Americans in the treatment of their prisoners.

I have no doubt that the prisoner was very uncomfortable but to assert that this was torture on the level of the Nazis, or the Gulags, or Pol Pot, is not only wrong, but suggests the speaker has taken leave of his senses.  The Jawa Report has some descriptions of real torture, as provided by Saddam Hussein.  It is graphic and disturbing, and impossible to confuse with what our people were doing, even at their worst, in Guantanamo or Abu Graib.

It raises concerns and questions:

Durbin, et al, who assert that that Gitmo and Abu Graib have rendered us indistinguishable form Pol Pot, the Nazis and the Soviets, are objectively wrong.  There is, in fact, no resemblance of what we are doing in Gitmo to what constitutes actual torture. 

If Durbin, et al, actually believe in the literal truth of their statement, then, at best, they have lost the ability to differentiate their own fantasied elaboration of reality and reality.  This is to be expected in the fever swamps of DU, but is frightening coming from a United States Senator.

If Durbin, et al, know they are making outrageously exaggerated statements, then they either are overtly opposed to their own country and are willing to risk the death of Americans in Iraq and at home in order to damage an evil administration that has plunged us into a horribly immoral adventure for reasons hidden to most of us, or they are cynically risking the deaths of American military people abroad and innocents in Iraq and elsewhere, in the service of their corrupt needs, for power and narcissistic gratification.

In the former case, their stupidity is dangerous.  These statements offer reinforcements to our enemies in the information war, convince the Jihadists they can win if they persist long enough, and give impetus to the more radical elements on the left.  Further, the risk of violence increases with every statement that legitimizes the kind of paranoid fantasies that are being supported by such talk. 

If the Bush administration is the equivalent of Pol Pot, the Nazis, and the Soviets, all right thinking Americans must oppose the evil, even with violence.  In fact, violence against such a state would be a moral necessity.

If they do not believe their own rhetoric, and recognize the hyperbolic nature of their assertions, their opportunism puts people in danger in the same way as above, but with even less justification; it is, if anything, more despicable.

Sadly, the Bush administration, even accepting that they are terribly handicapped by the opposition of the MSM, continues to do a poor job of articulating the connections between the Iraq theater and the over all war on Islamic fascism, though there are some signs that they are beginning to mobilize their resources. 

It remains a remarkable testament to our country that we can tolerate this kind of dangerous and violent nonsense in the service of freedom, but the air is charged and physical violence is not far from the surface.

The Doctor's Dilemma: Risks, benefits, and liabilities.

Placebo Effects: A Double Edged Sword

Yesterday I described some of the advantages and risks of using Zyprexa, a powerful medication with great value in treating our sickest patients. 

I would add that Zyprexa, and the other Atypical Anti-psychotics, have tremendous utility in other cases, as well.  There are many people who have a tendency to develop disorganized thinking when stressed.  Some develop a "Brief Reactive Psychosis"; others are diagnosed with "Borderline Personality Disorder."  I do not want to go into any detail on these diagnostic entities at this point, but for people who have these diagnoses, they can develop psychotic states that can appear indistinguishable from a Schizophrenic decompensation (but tend to be short lived states and they have full recoveries without any inter-episode residual symptoms.)  Further, there are many people (and there is significant overlap) who have affective (emotional) instability.  That is, their moods are highly reactive; when pleased, they  may be nearly manic in response, and when sad, they may become profoundly depressed, without meeting criteria for a major depression. 

Clinical experience with these patients has shown that effective treatments often require long term psychotherapy and the ability of all concerned to weather "affect storms" which can severely disrupt lives.  Past attempts to regulate their affective lives with medications have been disappointing.  For many of these people, Zyprexa has been a life saver, keeping them on an emotional "even keel" (often in conjunction with an anti-depressant).

So, what is the problem?  There are two main problems, beyond the obvious risk of developing diabetes.

The Doctor's Dilemma: Risks, benefits, and liabilities.

Zyprexa

The excitement in the field when Clozaril first became available was only matched by the disappointment when we discovered it had such serious side effects that its use would have to be extremely limited.  A typical protocol for Clozaril use requires blood tests every two weeks, with only two week supplies of the medicine given at any one time, in order to catch the drop in white blood cell count before it became deadly.  Bedsides the unpleasant need for blood tests on such a frequent basis, it was clear this medicine could only be offered to the rare patient with Schizophrenia who was also extremely reliable.  It is used these days as a last resort, for intractable symptoms. 

Zyprexa was introduced in 1996 and seemed to have none of the serous drawbacks of Clozaril or any of the other, older medications; plus, it was more effective than Risperdal.  Its main drawback appeared to be sedation, a side effect that could be turned to our advantage since so many patients when they are acutely ill have trouble sleeping.  Zyprexa became the drug of choice for psychotic episodes of all causes. 

A digression: There are numerous psychiatric conditions which involve psychotic symptoms, including certain types of Major Depressions, Bipolar Disorders, certain types of personality disorders, drug induced states, etc.  Zyprexa was effective at alleviating psychotic symptoms for all these patients.  It was safe, effective, and left the patients able to feel the full range of human emotions.

Not unexpectedly, once the drug was in use by millions, rather than a few thousand in clinical trials, the treatment emergent side effects appeared.

The Doctor's Dilemma: Risks, benefits, and liabilities.

Introduction

On Saturday, the news broke that Ibuprofen, a painkiller used by millions everyday, had been linked to an increased risk of heart attacks. As reported in The Scotsman, "Ibuprofen increases risk of heart attacks":

COMMON painkillers such as ibuprofen could significantly increase the risk of a heart attack, research warned yesterday.

Roger Simon linked to a version of the story and an interesting discussion ensued on his site. Since the commenters at Roger's site tend to be exceptionally erudite and rational (and I am not saying that just because I often comment there), a number of aspects of the situation drew my attention. It strikes me that even for smart, educated people, determining the acceptable level of risk of a medication is a nearly impossible task, especially if they are forced to rely on the media to report the latest scientific research. In light of the difficulty involved, I thought it might be interesting to describe the various processes one particular doctor goes through in determining what medication to use for particular medical conditions (in my case, psychiatric), how I decide when to try a new medication, and how I talk about the risks and benefits of any medication I offer to my patient. 

I spend about half my time in my private practice, primarily doing Psychotherapy and psychoanalysis; the other half of my time is spent in a Community Mental Health clinic where I supervise therapists and assess patients, and where indicated, prescribe medications for various psychiatric conditions. I will limit myself to a discussion of a particular medication, Zyprexa, for a number of reasons. First it offers the opportunity to be fairly specific in describing the pros and cons of a particular drug. Second, Zyprexa is a fairly unique medication, with a high level of effectiveness, and some significant side effects as well. Third, Zyprexa, because of its efficacy and safety profile, is commonly used "off-label" which presents numerous medico-legal issues.

Hopeful signs

MEMRI today has excerpts from three articles by Arab moderates that are heartening but also troubling.  Arab Criticism of Muslim Extremist Activities in the West:

Extremist Muslims in Western countries have come under increasing criticism by moderate Muslims who are familiar with the West through living in America or Europe, either temporarily or permanently. In three recently published articles, Arab academic and intellectuals harshly criticized their extremist activities.

In his article on the reformist website www.elaph.com, Dr. Ahmad Abu Matar, a Palestinian academic residing in Oslo, stated that Muslims in Europe foster conflict instead of coexistence. Muslims in Europe, he explained, are influenced by an extremist fundamentalist brand of Islam – and moderate Muslims are not speaking out adequately against this activity.

In the UAE daily Al-Itihad, Saudi journalist Turki Al-Dakhil, whose popular interview program on Al-Arabiyya television frequently hosts reformist Muslims, wrote about the hatred of the West that is spread by Muslims in the U.S., sharing his personal experience during his studies in the U.S. around the time of 9/11.

In the wake of Al-Dakhil's article, Tarek Hamo, a Kurdish journalist living in Germany, also criticized the actives of extremist Muslims in the West. In his article in www.elaph.com, Hamo accused Arab and Muslim states that seek to appease the extremists and to keep them away from political activity in their own countries, as well as the European host countries that are turning a blind eye to extremist activity – on grounds of "tolerance" and "religious freedom," and more recently, on grounds of a "dialogue of civilizations."

What is heartening about the report is that if we are ever to live in a world where Muslims, Christians, Jews, et al, can live together as peaceful neighbors, the voice of moderate Islam must grow louder and louder and eventually drown out the voices of Islamic fascism.  We hear very little from moderate Islam, though many Islamic spokesmen in the West are adept at speaking in the terms of peace and moderation, in English, while speaking in the privacy of their own centers to their followers of Jihad and death tot he infidels.  CAIR, a leading Islamic American group, has had numerous officers arrested for aiding and abetting terrorism all the while professing to be a peace loving group.  This has been the pattern for the Jihadists, perfected by the Palestinians, for decades. Jihad Watch has lots about them, as does Daniel Pipes.

What is troubling about the report is that while most would agree that we should be doing everything we can to support the moderates in Islam, our media, and some of our politicians, insist on making irresponsible charges and focusing on every possible set back, in order to tarnish our efforts in Iraq and the war on terror.

Everyday I wait for some sign that the MSM and the Democrats (they seem increasingly indistinguishable these days) appreciate how they damage our chances of defusing the catastrophic war our enemies wish for.  They instead insist on keeping the fuse lit.