Medicine

I wasn't going to review this book, but the issues that it brought to mind by its conclusion were more than enough to inspire me to write about it.

I could have called this review My Lobotomy, which is the title of the book and which I know is eye catching. But for me, the question that is asked of the author after a groundbreaking NPR story was done on him gets to the heart of why the book is so important and why I am writing this review. "How could this happen?" This is, sadly, a question that can be asked of many aspects of our society and which is too rarely asked.

I was browsing at my local library and saw the title My Lobotomy. When you see a title like that it's like when you hear the screech of brakes and the sound of metal hitting metal. You know there is a car wreck and you know there's something you probably shouldn't want to gawk at but you just can't help yourself. The title of the book is like that. I had no idea what the book was, but I felt compelled to check it out.

It sat around awhile until I had finished a few other books I was working on, but then I picked it up. It is largely the memoirs of Howard Dully who was, at age 12, given a "transorbital lobotomy" by none other than Dr. Walter Freeman, the man who made transoribital lobotomies chic. This is the third memoir I have recently read where it is clear that the author has such a literal mind that you know what you are reading is the solid truth as the author sees it. The first such memoir I read was Grief of my Heart (which I reviewed here), the memoirs of a Chechen physician who lived through the two Chechen wars. The Chechen/Russia conflict has so many twists and turns and distortions that when you read anything about it you have to look for the bias of the author. Yet this book rang true. My wife's comment on this book was that she felt the author was not very imaginative and that he was telling the brutal truth about what he lived through. I felt the same. The power of the story was enhanced by the fact the author seemed so literal. The second memoir I recently read that had that same literal, unvarnished truth feel to it was A Long Way Gone, the memoirs of a child soldier from Sierra Leone who now lives in New York. This is a book I have been meaning to review for months now but haven't gotten up the emotional energy to do so.

Generally when I am criticizing sloppy or bad science, my criticism is aimed at creationists (the Intelligent Deception lobby) or global warming deniers (the Denial Lobby). Sadly, today I have to criticize my fellow research biologists for some really sloppy science.

There is an alarming, if a bit overstated, article on BBC news today. It seems sloppy science may invalidate a chunk of cancer research, setting back treatments for patients with particular types of cancer. To quote the article:

...it comes as a shock to learn that millions of pounds in charitable donations and from taxpayers are being wasted on "worthless" research for lack of good housekeeping practice in the lab.

...many scientists fail to carry out simple and inexpensive checks to ensure that they are working with the right experimental materials - particular forms of human cancer cells.

As a result, thousands of studies are invalid.

First off, let me say that this is slightly overstated. In many cases the basics of these studies will still be valid. But it is true that in many cases the results would need to be re-evaluated and may mean the results do not necessarily apply to the particular kinds of cancer they purported to study. That alone is devastating to science...but it doesn't mean these studies are all completely invalidated.

No-frills space gives docs luxury of time

From the September ACP Observer, copyright © 2007 by the American College of Physicians.

By Ryan DuBosar

Patients walking into general internist Soma Mandal, MD’s, Manhattan office in New York City see her immediately—she’s the only person in the practice. She relies on patients to complete their histories before their visit and she verifies insurance in advance. With all the paperwork addressed, she can then devote anywhere from 20 minutes for a routine visit to 40 minutes for a new patient—all of it clinical time.

The luxury of such long visits is a welcome shift from her previous work at a hurried Lower East Side community health clinic. Treating the underserved was rewarding, but the overhead of a large facility demanded she fit patients into 15-minute slots, leaving only five to seven minutes for clinical work. She moved to a large Brooklyn medical practice, but 40- to 50-hour weeks were similarly frenzied. So she began plotting how to strike out on her own.

“I realized that the only way I could take control would be to start my own practice,” she said. Unable to get a bank loan, she covered the $20,000 in startup costs herself and opened her scaled-down practice in September 2006.

By moving to a tiny office with no staff and minimal equipment, she lowered her overhead costs to an income-to-overhead ratio of 8:1. This allows her to restrict her patient load per week to about 20 patients in four half-day sessions, even while continuing to practice in New York’s Gramercy Park neighborhood.

I almost never watch network TV anymore. There's only a couple of shows I watch on cable and that's it. So it came as a surprise my opportunity to watch ABC News: 'Out of Control: AIDS in Black America'

Black Americans make up 13 percent of the U.S. population but account for over 50 percent of all new cases of HIV, the virus that causes AIDS. That infection rate is eight times the rate of whites. Among women, the numbers are even more shocking%u2014- almost 70 percent of all newly diagnosed HIV-positive women in the United States are black women. Black women are 23 times more likely to be diagnosed with AIDS than white women, with heterosexual contact being the overwhelming method of infection in black America.

I urge you to watch all 6 parts over at You Tube. I have included above part 5, "Failure to Lead". You will be disgusted by the Reverend Jakes. Who shocked me with his cluelessness was Jesse Jackson. He got owned by Terry Moran when he called him on his focus on AIDS in Africa but not in the United States.