Pill-Rolling the Dice

There's a report that 9 out of 2000 Parkinson's patients on a dopamine agonist with levodopa engaged in pathological gambling. The rate seems only slightly higher than the general population, and the coincidence of Parkinson's and retirement home casino in the elderly community may be contributing. But the patients were cured once their meds were changed.

Neurology continues to fascinate; while this levodopa/gambling link is not nearly as strange as the Lesch-Nyhan behaviors, it's pretty intriguing. I wish I remembered more about dopamine in assessing rewards and risks.

The study was initiated by a doc who saw two of the nine patients in the same week -- meaning I should get to work on this X-linked deafness / eye-color finding.


Ever since my first outdoor cat, Otis, spent the night outside, I've been wondering about tracking pet whereabouts. Seems like someone else has been, too:

"A Swedish moose hunter has invented a matchbox-sized device that can trace just about anything that moves. Using mobile phone text messages and satellite navigation technology, the surveillance gadget can reveal its location to an accuracy of 10 ft in 140 countries... Called Followit, the £700 device was invented by Olaf Lundberg, a Swede who lost his dog while moose hunting. Mr Lundberg's brainwave was to find a way of squeezing the workings of a GPS satellite navigation receiver and a mobile phone with a battery and two aerials into a box that he could strap to his dog's collar.

Richard McPartland, director of Tel Trak Technologies, based in Winchester, Hants, who developed the device with Mr Lundberg, said that after using it to track his dog, Mr Lundberg decided to sell it to other hunters. 'At first he sold it through hunting magazines, but then he found it was being used by truck companies to monitor the movement of their drivers through Sweden,' he said."

Tracking pets, prey, people, what's the difference? There oughtta be a law, and one day there might be. You can lump it in with the problems that ubiquitous cameraphones present in lockerrooms and private residences ... instantaneous distribution of someone's image or location against one's wishes may not be illegal now, but that's because the average joe hasn't had his whereabouts posted on the web yet.

High-Level Negotiations

Very happy to see new activity in Kim Jong Il (the illmatic)'s Journal. The North Korean "Leader" reprints some transcripts of his instant-messaging sessions with Bush and Cheney. They squabble about spelling, inventions, and whose country is better. It's hilarious, even as everyone comes off stupid and petty.

Someone once said all life is like High School. The Kim Jong Il blog shows that if high school kids were running two nuclear powers, things would be ... just like they are now. See the March 27th entry where Bush proposes multi-lateral talks in Washington. Kim counters: "I kind of thought it would be more fun if it was just us."

Bush replies: "I think that might be wierd [sic]... we could do a group thing."

Kim cancels the nuclear negotiations. And really, when you were 15 and you asked out a girl and she tried to make it "a group thing" -- didn't you just want to recall your ambassador and break off diplomatic relations and engage in nuclear brinkmanship until your sorry ass was appeased?

Kim's blog will be huge.

Time for Work

Well, big changes over the last few weeks. Wrapping up the research, the defense, the Week of Loose Ends, and now my first week of clerkships. I've been impressed by the efficiency on the wards and in the OR; so many notes and forms and labs and charts... Everyone is constantly engaged, pretty much all the time, yet as the nurses and docs go about their routine they can break form long enough to teach me what they're up to, and why. Very different from my lab experience, where everyone ran their own solo show.

Will there be time for writing? Can't imagine free time should be spent any other way than studying right now, but I felt the same way back when I started full-time labwork three years ago.

Roger L. Simon quotes Lileks from the radio: "James described being amused by one of the comments in which someone ... wondered if Lileks would be able to speak as well as he wrote without the contemplative longueurs necessary for literary creation. James pointed out that professional writers didn’t have that kind of luxury—they have to make a living—and must spill out copy at the same speed as they talk anyway. (I identified with that one. Other than dead poets, who has time for writer’s block?)"

Holy crap, I say. If Lileks writes as fast as he talks, well, I'd be embarassed to have a conversation with him. After the organization and research, I spent hours polishing the flow and diction of my handful of pieces. Maybe Lileks or Quindlen or whoever can just bang out eloquence in one or two drafts because they've done this hundreds of times. Kind of like Drs. Spina and Staffier operating together almost telepathically -- they know how the story generally goes, after decades of doing this.

For me, for now -- in writing and in medicine -- I only have a fuzzy idea how to proceed, and all my work needs lots of revision.

Summertime, and the living is easy?

Great Op-Art piece in the New York Times about The Real Risks of Summer:
"For example, dangers that primarily affect children evoke more concern than actions that pose an equal risk to adults. Risks that are man-made, like radiation from a nuclear plant, generally scare us more than natural things that are far more likely to harm us, like radiation from the sun. And something extremely rare that kills in a particularly dreadful way, like a shark attack, evokes more fear than something far more common that kills in a less gruesome manner, like a heart attack.
These subconscious patterns of risk perception also seem to affect the judgments of the people who bring us the news. Between Memorial Day and Labor Day last year, major American newspapers and wire services ran 2,240 articles on West Nile virus, which kills fewer than 300 Americans a year, while there were 257 articles on food poisoning, which will kill more than 5,000 of us (beware that potato salad!). "

There's a wonderful graphic, too, showing the number of injuries and newspaper articles about various threats. It turns out that lawnmower accidents, and falling out of windows, are very common and very under-reported. In contrast, West Nile virus and shark attacks are exceeding rare, but get all the press.

I tried to come up with some kind of morbid formula for this back in February, after the RI nightclub fire... The arbiter of publicity is probably Lexis-Nexis citations, number of newspaper articles, etc. I figured one of the biggest factors would be identification with the victims -- "that could have been me". It certainly was the case for 9/11 and the nightclub fires, and explains why an earthquake in Kyrgystan got scant coverage.

But it's not that simple. I think publicity is propelled by a combination of "that could have been me" and "I'd be helpless to stop it" -- which explains why shark attacks get coverage, and window falls don't. People aren't going to stop going to beaches or nightclubs, but they're going to do these things with the notion in the back of their mind that they could suddenly, powerlessly, suffer a horrifying death.

It's what they want to read about, at least.

Trans-human Factors

Glenn Reynolds asks : "Would I like to be smarter? Yes, and I'd be willing to do it via a chip in my brain, or a direct computer interface. (Actually, that's already prefigured a bit in ordinary life, too, as things like Google and wi-fi give us access to a degree of knowledge that would have seemed almost spooky not long ago, but that everyone takes for granted now). And I'd certainly like to be immune to cancer, or AIDS, or aging. But these ideas threaten some people, who feel that our physical and intellectual limitations are what make us human.

I don't know whether I believe this. Which limitations, exactly? Would humanity no longer be human if AIDS ceased to exist? What about Irritable Bowel Syndrome? Was Einstein less human? If not, then why would humanity be less human if everyone were that smart? It may be true, as Dirty Harry said, that 'A man's got to know his limitations.' But does that mean that a man is his limitations? Some people think so, but I'm not so sure. Others think that overcoming limitations is what's central to being human. I have to say that find that approach more persuasive.

These topics (well, probably not the Irritable Bowel Syndrome) were the subject of a conference at Yale on transhumanism and ethics. The conference was the subject of a rather good article in The Village Voice, which reports that many in the pro-transhumanist community expect to encounter considerable opposition from Luddites -- and, judging by the works of anti-technologists like Francis Fukuyama and Bill McKibben, that's probably true."

It's easy to tie this in with history of science stuff. Glasses, wristwatches, medications are all attempts at improving our limitations. Reynolds writes about gene doping for the beijing olympics -- not sure what that is but it prompts: how can you penalize someone who was bred to compete?

Reynold's conclusion is that the forces of human improvement will win out over the luddites, like always. But if the pace of improvement is too fast there could be a big backlash. At least, until the fearful realize they're falling behind.

Against the Grain

For those of us without older brothers, or talkative fathers, the Straight Dope weighs in on shaving styles:

"I get accused of giving very long answers, so here's a short one. Shaving against the direction of hair growth gives a closer shave, but has two drawbacks:
It's a good way to donate blood, and you run a high risk of cutting off a hair below skin level, causing an ingrown hair--the whisker grows into the surrounding tissue instead of out of the pore, resulting in inflammation and possible infection.
To avoid these problems, shave 'with the grain' (that is, in the direction your hair grows.) Each person's facial hair has its own growth pattern. If you are unsure of the direction of your beard, let it grow for a day or two and you'll see it.

Professional barbers, by the way, usually first shave with the grain, and then re-shave going sideways. I asked Cecil if there was enough money in the Straight Dope Research & Entertainment Fund for me to go to a barber so I could report back firsthand, but no dice."

Nick says: It's crazy to me that I can become something of an authority on chondrocyte mechanotransduction, information which may never come in handy again... Yet the basics of shaving, which I do (nearly) every day, remains a mystery. Where are the priorities? More echoes of Dusty, who likes to investigate his groceries and other purchases. Why know about esoteric medical facts if you don't know what you're eating, why you're shaving against the grain?

So, more trivia: "Facial hair grows about 15/1000ths of an inch each day, or almost 6 inches a year. Shaving removes about 65 mg of whiskers daily, per male (on average). If you prefer, that's about a pound every 16 years. In the U.S., sales of razors (as distinct from blades, replacement cartridges, etc.) is around $90 million annually, of which about a third is for electric razors. . More than half of wet-shave razors that are sold are disposables. Total sales of replacement blades is in excess of $900 million, which is why the razor blade companies sometimes give away the razor. Who cares about the razor? They want to get you hooked on the blades."

blog blog blog

The thesis will be defended in less than a week. Correctins and changes have got to be done by the 18th. Then... clerkships! Editing for worcester medicine magazine! I should be using my free time to re-learn medicine or work on other people's articles... will there ever be time to write my own stuff?

My best bet is to make all kinds of short observations here, and then when the opportunity presents itself (sometime in 2004, it would seem) to try to gather it up and write some articles... on the patient interaction, new technology, whatever else I find kind of interesting.

Andrew Sullivan warns: "I think bloggers do well to take time out. We can lose perspective, stop thinking in longer form, and also get exhausted. "

Eh. Thinking in 'longer form' has never come naturally, and my randomly scheduled blog entries are never exhausting. I do wonder, though, if opinion writing is even something I should aspire to. Maybe I can make a career out of just pointing to the latest David Brooks piece in the Atlantic and saying "Look! Read this! It's sparkling, well-researched, well-written, and makes a provocative point! Damn, he's good."

If you can't join 'em, cite 'em?

Smart Mobs vs. Silly Mobs

Some stories on internet-directed gatherings:

Using mass e-mailing, the organisers bring together what their invitations describe as 'inexplicable mobs' - large crowds that materialise in public places and suddenly dissipate 10 minutes later.

"It's a spectacle for spectacle's sake - which is silly, but is also, as I've discovered somewhat to my surprise, genuinely transgressive, which is part of its appeal, I think," said the mysterious Bill in an e-mail exchange. "People feel like there's nothing but order everywhere, and so they love to be a part of just one thing that nobody was expecting."

San Francisco, Minneapolis and Phoenix have all staged their own events, while the first European mob took place this week in Rome, when 300 people entered a music and bookstore and asked for non-existent titles. The idea has also been adopted and given a more political agenda by other groups.

In Detroit, a group of gays and lesbians organise the 'Detroit Guerrilla Queer Bar', which targets a local straight restaurant or bar for 'swarming' on a designated night. And in Boston, Reggie Cummings, a black software developer, coordinates 'friendly takeovers' by crowds of black yuppies of downtown bars with a traditionally white clientele.

http://www.azcentral.com/business/articles/0801oddpranks-ON.html :
So far, flash mobs have claimed to be apolitical, but that could soon change. What started as a prank could blossom into a social revolution, according to Internet watcher Harold Rheingold, author of "Smart Mobs: The Next Social Revolution."

Rheingold's book outlined the use of wireless technology in helping people around the world organize. As an example, he cited the use of cell phones and pagers by activists who demonstrated against the World Trade Organization in Seattle in 1999.

Seems to me that this fits in along with the success of meetup.com in organizing Dean rallies and other events. And of course, the dating sites are doing well. The internet and email, long accused of encouraging antisocial / anonymous / secluded behavior, is now bringing the masses together, face-to-face, for fun and social causes.

It's one thing to find a discussion board for fans of Marlin Fitzwater or some other underground cult hero. Those are far-flung groups that need the internet to organize, because you've only got a few fans per city. These new mobs are different -- there are plenty of people who want to do something silly, they just need a coordinator and one happens to be online.

They could've just joined a frat, though. Or a fight club.

Levitt's cleverness

In the New York Times magazine section, Stephen Dubner describes a Chicago economist who thinks of clever ways to measure previously unmeasurable things.

Are real estate agents encouraging lowball offers, because their take doesn't change much and they just want to make a deal? He answered this by looking at how agents sell their own homes (those houses stay on the market longer, and go for more).

How much does money matter in elections? Hard to say, because the challengers don't get a lot of money unless there's a good chance they'll win, and incumbents don't spend a lot unless there's a good chance they'll lose. So Levitt looked at repeat matchups -- same people, different races. It's kind of like how scientists trying to tease nature vs. nurture look at separated twins. Levitt found that money mattered a lot less than expected.

Levitt's big take home message: the data is out there, the hunches are out there, you just have to find an interesting way to prove your point, and publish it.

Ancient Brains

For the second time, I've stumbled upon a reference that Homer, and possibly his audience, was colorblind. Sacks cites the Odyssey's "wine-dark sea" and other lines as evidence. Where did I see this before? Maybe in "The Future of Man", where Medawar discusses recent evolution trends.

It's neat to think that something so basic to our worldview -- true color perception -- might only be a few thousand years old. And our decendents will marvel that we couldn't see into the UV spectrum.

But I'm also reminded of reports about ancient thinking. I wish I had this blog a few years ago, when I was reading interesting books. I recall the notion that ancient Greeks and Romans didn't believe they could think -- as we do -- but rather, that the gods put notions into their heads. This might be Sacks as well, one of his footnotes?

Googling on this leads to http://www.thymos.com/tat/dreams.html:
It is likely that millions of years ago our waking life was not too different from our dreaming life. Consciousness in dreams is a series of flashes which are fragmented and very emotional... Today our consciousness has acquired a different profile: it has evolved to a more or less smooth flow of thoughts, in which strong emotions don't normally figure prominently... One could argue that ancient gods simply represent concepts. As concepts were forming in human minds, human minds expressed them as concepts. And their interaction yielded religions.

Not quite what I was going for, but this is closer (http://www.horuspublications.com/guide/ac10.html):
Everywhere else in the Mediterranean and Near Eastern area, knowledge was still based on the assumptions that nature and man's history, and much of what men thought, were ruled by Gods.

Where to go with this? Well, it's easy to imagine prehistoric and early historic people as being just like us, but without education or the security and convenience of civilization. It's more compelling to think that education isn't just learning facts but is necessary for an ordered consciousness, for making sense of the world.

One site points to: The Origins of Consciousness in the Breakdown of the Bi-cameral Mind by Julian Jaynes.