Category: Health

What’s up with this, Pete?

Pete's truck-350

A diesel-powered Pete’s Frootique truck idles unattended on Doyle Street in Halifax Saturday morning, needlessly spilling volatile organic compounds into the crisp spring air.

Big Mac v. salad – feedback (updated)

Contrarian reader Ken Clare thinks Contrarian’s standards slipped with our post of a chart comparing US food subsidies:

edward-tufte-head-c

Edward Tufte, the “Galileo of Graphics” you introduced us to back in June, refers to images like these as “chartjunk.”

I haven’t taken the time to measure the images you copied (from a committee of physicians who may have had a passing relationship with math sometime in their pasts), but the subsidies pyramid eyeballs closer to a 100-to-1 ratio than the 75-to-25 ratio it is labeled.

Update: A Diligent Reader award goes to Contrarian’s insomniac friend Alistair Watt, who spent time with a ruler and a spreadsheet before concluding that the front faces of the pyramid graphs were a nearly perfect match for the data they purported to represent, but their transformation into three-dimensional pyramids distorted the data severely.

In other words, had this been presented as a column chart or a pie chart, it would have been reasonable. However, when I laboriously calculated the volumes implied by each subsection, the results were dramatically different.

Why a [U.S.] Big Mac costs less than a salad

Big Mac v Salad
This comparison, from the Physicians Committee for Responsible Medicine, is, of course, based on U.S. farm subsidies and U.S. dietary guidelines. Any data geeks out there want to take a stab at Canadian pyramids?

Can Down syndrome cure cancer?

This winter, Contrarian hosted an interesting discussion about whether Down syndrome needs a cure. Now reader Denis Falvy offers an intriguing footnote. It seems that people with Down syndrome rarely get tumors.

Recent research at Children’s Hospital in Boston, reported in the journal Nature, suggests that a gene (gene 231) on the extra chromosome (chromosome 21) carried by people with DS may inhibit cancer by blocking the activity of a protein tumors need to grow. Money quote:

The gene suppresses the growth of new blood vessels that cancers need by blocking the activity of the protein calcineurin, suggesting a new target for future cancer drugs. The investigators… add that chromosome 21 might possess four or five anti-angiogenesis genes.

Homeopathic overdose – rebuttal

Contrarian would not have thought it possible for a defense of quackery to set me chuckling and nodding my head, but my old pal Warren Reed has done it. [Previous installments here and here.] Knowing that the best defense is a good offense, Reed began by catching me in the act of scientific error:

avogad

Amedeo Avogadro

One of the few things I remember from Nat. Sci. 3 is Avogadro’s Number — 6.023 x 10**23.  So it isn’t roughly 10**23 as you state — it’s actually 6 times that.  Six is called The Republican Constant – any Republican can stretch the truth by a factor of six without raising an eyebrow on Fox News.  Journalists often get the same exemption.

But we don’t read Contrarian just for the science.  More puzzling is the notion that a group of pub-crawling Brits is claiming to know what constitutes “proper medical assistance.”  Of the reasons for healing—the passage of time, the placebo effect, natural defenses—”proper medical assistance” is on the list, but is an evanescent concept at best.  It depends on many of the same principles for success as Homeopathy.  Take two aspirin and call me in the morning.

More after the jump.

Read more »

Homeopathic overdose – (cont.)

Contrarian reader Andrew Bourke points us to this trenchant sketch on the plausibility of homeopathy from the British comedy duo Mitchell and Webb:

UK skeptics plan mass homeopathic overdose

10-23rdA British group calling itself 10-23* will stage a mass self-inflicted overdose of homeopathic remedies to protest the Boots pharmacy chain’s continued sale of the worthless** nostrums. At 10:23 a.m., January 30, 300 protesters will down a whole bottle of homeopathic pills each. The joke is that homeopathic mixtures have been diluted so many times, they no longer contain any of the original putative active ingredient.

From an open letter to the Boots chain:

The majority of people do not have the time or inclination to check whether the scientific literature supports the claims of efficacy made by products such as homeopathy. We trust brands such as Boots to check the facts for us, to provide sound medical advice that is in our interest and supply only those products with a demonstrable medical benefit.

We don’t expect to find products on the shelf at our local pharmacy which do not work.

Not only are these products ineffective, they can also be dangerous. Patients may delay seeking proper medical assistance because they believe homeopathy can treat their condition. Until recently, the Boots website even went so far as to tell patients that “after taking a homeopathic medicine your symptoms may become slightly worse,” and that this is “a sign that the body’s natural energies have started to counteract the illness”. Advice such as this directly encourages patients to wait before seeking real medical attention, even when their condition deteriorates.

Contrarian has long been astounded that regulatory authorities permit the sale of so-called remedies containing no active ingredients. Homeopathy takes snake oil salesmanship to a new level of fraudulence. The 10-23 website offers a good deconstruction of the theory underlying this persistent quackery.

* The group’s name derives from Avogadro’s constant, roughly 10 to the 23rd power, which, broadly speaking, places an upper limit on the number of molecules in a given volume of liquid or gas. Successive dilutions used in the preparation of homeopathic elixirs reduce the amount of the original ingredient beyond this number, with the result that not a single molecule remains. What’s left in the bottle is literally sugar water.

** In 2005, the respected British journal The Lancet carried out an exhaustive meta-analysis of all reported studies of homeopathic treatments and concluded that any apparent benefits were attributable to the placebo effect. [Free, but registration required.]

Hat tip: C. C.

A father responds to the Down’s ‘cure’ debate

Silas Donham responds to posts on the New York Times Motherlode blog criticizing those who would reject potential chemical treatments intended to improve intellectual function of infants with Down syndrome. This difficult topic provoked a debate here on Contrarian that was remarkably thoughtful and respectful. But when the Times picked up on our discussion, many commenters were incredulous that any parent would hesitate accept such treatments for their children. A few had nasty things to say. Silas responds:

First, the disclosure: I am Jenn Power’s husband, father to Jacob and Josh, and son to contrarian.ca, the blogger who got all this started. Like Jenn, I have spent my adult life living and working intimately with people who have intellectual disabilities.

Many of the contributors to this discussion seem to be imagining a magic pill without risk or side-effect that would remove the intellectual impairment associated with Down Syndrome. Medical treatments like that do not exist. Of course Jenn and I want our children to have every advantage, and the fullness of potential, which is available to them. Our boys have glasses, they have tubes in their ears, they attend school as well as physio-, occupational, and speech therapy, a clinic that focuses on eating difficulties, an adaptive swim program, a youth group, church, friends’ birthday parties, etc. One of my boys had surgery to repair a hole in his heart. I home-schooled them for a year to get ready for regular school. But we would not allow a medical researcher, however sincere and well-meaning, to take a potential chemical blender to their brains in infancy. Thank you, no. In that sense, our boys are just fine the way they are.

Many of you have posed questions from the imagined viewpoint of a person with a disability: if you had Down Syndrome, wouldn’t you want to be “cured”? Can you imagine a person with no legs NOT wanting a treatment that would give him legs? It is a sad observation that the voices of actual people with disabilities are usually absent from discussions of this type (thanks to Ingrid in San Francisco for bucking that trend). In fact, their answers to these questions are often not what you would expect. I first contemplated that idea when I heard a CBC radio piece produced by Dave Hingsburger, a counsellor and disability rights activist in Toronto. Over the course of a two-hour program, Hingsburger talked to many members of the disability community, including people with Down Syndrome, as well as a man who has no legs. At some point in the course of other discussions he asked each person he talked to whether, if presented with a pill that would get rid of their disability, they would take it. Without exception, they all said no.

At the time, this was an earth-shattering notion for me. But the fact is that I know many people who have intellectual disabilities. No-one I know sees themselves as diseased, suffering, or in need of a cure. So who is really imposing their viewpoint here?

Jenn framed her response to this medical research in terms of the benefit she has received from her relationships with people with disabilities, and the benefit society as a whole stands to gain from them. Unfortunately some of you have construed that to mean that people with disabilities should be kept in a limited, suffering state so the rest of us might benefit. Several of you even made the hurtful comparison between our boys and “therapy animals.”

Perhaps it is a symptom of the way people with disabilities are devalued in our society that we so often feel the need to justify them by naming the benefit other people receive from them. No other group in society needs to do this. However, that is not the basis by which we make decisions about our boys’ lives. Everything we do (including the hypothetical rejection of experimental brain treatment) for them is with their best interests at heart. And to respond to other posters, we have not forgotten what might happen to our boys when we are no longer around. That is why our whole lives are devoted to people with intellectual disabilities, from our parenting to our professional lives with L’Arche to our involvement in the local school to our involvement in discussions such as this one. A society that recognizes the gifts of people with disabilities is one that goes beyond inclusion and tolerance to real relationship.

People are complicated organisms. Tinkering with one aspect affects a host of others. As a society we tend to overvalue independence and intellectual competence. These things do not bear a linear relationship with happiness or quality of life. There are a lot of independent people who lead very lonely lives. In my experience of people with intellectual disabilities, the ones who are more capable and independent are often the ones who have the hardest time finding a place of belonging, and who therefore lead lives of greater suffering. I don’t mean to say that capability is a bad thing; I just mean that it is complicated, and that makes the ramifications of this treatment hard to predict.

We don’t know whether this potential brain treatment will lead to greater quality of life for people with Down Syndrome. We don’t know what its risks and side-effects might be. We do know that people with disabilities are undervalued, insufficiently supported, and too seldom consulted or in control of the decisions that affect their lives. Why don’t we put more work into supporting the weaker members of society, combating bullying and abuse, and discovering and learning from the experience of people who have disabilities, and get less excited about expensive, unproven treatments that may do more harm than good?

Welcome New York Times Motherlode readers

For those who have followed the debate over potential treatments for Down syndrome in the New York Times parenting blog Motherlode to its source here on Contrarian, I have assembled a series of links you might want to follow.

Our discussion of this issue began with this post back in November. Jenn Power elaborated on her concerns here, and Dr. Ahmad Salehi, the Stanford researcher whose work touched off the discussion, responded thoughtfully here. Jenn’s husband Silas Barss Donham, my son, weighed in here.

Other reader commented here, here, and here.

Jenn is the community leader of L’Arche Cape Breton in Iron Mines, Nova Scotia, a community for “people with developmental disabilities and those who choose to share life with them.” It’s one of about 130 L’Arche communities around the world founded by the acclaimed humanitarian and philosopher Jean Vanier. A few links:

You may have gathered that I’m very proud of my daughter-in-law. It was distressing to see so many Motherlode commenters leap to the conclusion that, because Jenn recoiled at the prospect of chemical treatment for her sons’ intellectual impairment, she must be selfish or patronizing. In fact, Jenn is one of the least selfish, most compassionate and giving people I know. My own post on Motherlode elaborates on her admirable work.

NY Times picks up our Down syndrome thread

Motherlode, a New York Times blog on parenting, has picked up on Contrarian’s discussion about potential treatments for the intellectual impairment associated with Down syndrome — and touched off quite a debate of it its own.

Our own discussion began with L’Arche Cape Breton Community Leader Jenn Power’s disquiet at the assumption that Down syndrome constitutes a disease in need of curing. Jenn, who is both the adopted mother of identical twins with Down Syndrome and — disclosure — my daughter-in-law, spoke eloquently of Down traits that don’t need fixing:

[I]ncredible smiles, overflowing affection, stubbornness, great sense of humour, cute toes, love for orange pop and Rita MacNeil, endless capacity to forgive… the list goes on and on.  I am not sure I can articulate why, but I find this article both upsetting (lump in my throat and eyes welled with tears right now) and disturbing.  Why does everything need a “cure?”

david-sThe Times quoted at length from Jenn’s subsequent, more detailed Contrarian post, and from Stanford University researcher Dr. Ahmad Salehi’s thoughtful response here as well. Motherlode’s thread on the subject has now attracted more than 100 comments. Several are thoughtful and constructive, but a shocking number come from people quick to condemn Jenn as “selfish” or “patronizing” for not jumping at the chance to chemically enhance her sons’ cognitive skills.

Many Contrarian readers are familiar enough with Jenn to know her life is the antithesis of selfishness. As I wrote in my own comment on Motherlode:

As the leader of this extraordinary [L'Arche] community, Jenn manages an incredible range of human emotions, trials, joys, and tribulations, along with the myriad practical details required to manage any large group of diverse people. She does this with enormous tact, kindness, generosity, wisdom, humor, firmness, practicality, and love. And immense hard work.

From this I conclude that, despite decades of progress integrating developmentally challenged citizens into society, we have a long way to go in overcoming the kneejerk tendency to view people like my grandsons as less good and less valuable than the rest of us. That’s our loss as much as it is theirs.

In a separate post aimed at New York Times readers, I will include links to all our Down syndrome posts, and to several short videos featuring the extraordinary folks at L’Arche Cape Breton, including my esteemed two grandsons, Josh and Jacob.

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