Nerds once again in control of government

And I breathe a sigh of relief. Working nights my schedule is a tad goofy, but I wake up today to see this guy describing the changes in the new budget:


This is Peter Orszag the new director of the Office of Management and Budget. He is a nerd and I instantly like him. I was not surprised to find he used to be a blogger.

It was especially refreshing because for too long our government has been run by this guy:

In particular I agree with their emphasis on health care as a necessary element for creating a viable modern economy. America has to compete with other countries that provide this for their workers, and we have a system that regularly ruins the finances of our citizens. I also agree with it as a moral necessity. Within the last week I’ve admitted several people for whom a hospitalization would result in significant financial stress. I talk about it with them, and they’re terrified. On the one hand, they need help. Sometimes their life depends on it. On the other hand, if they lack insurance a hospitalization can bankrupt them, and they’ll honestly admit, they avoided doing anything about their problems until they become life-threateningly severe because they are they can’t afford the help. This isn’t just stupid system, but immoral.

Additionally the need for reform of redundancy and costs in medicine would be a welcome reform. While the privacy issues with the electronic medical record are significant (I’d love if Chris would comment on this), the obvious need for it is undeniable. I can’t tell you how many times tests, expensive tests, are repeated because of incompatible records systems, delays in record transfer, and, frankly, the fact it’s sometimes just easier to duplicate the test than do the scut to find the answer. The emphasis on evidence based medicine, an attack on redundancy, and improvements in coverage will go a long way towards decreasing the terrible costs to insurers and the government, and terrible financial harm medical care can do to our countrymen. I am excited about seeing how this will be implemented, and relieved that once again we have people in charge who use words like “data” and “evidence” and seem that if there are problems generated by these reforms, they will be receptive to criticism.

Tumors in a (quack) human stem cell therapy

It’s almost like a bad Yakov Smirnoff joke, “In America you test therapies in animals before giving them to humans, in Russia…” All I can do is wonder, what were they thinking? Injecting stem cells into a kid’s spinal fluid to correct a genetic disorder? Are they insane?

Stem cells, in particular embryonic and fetal stem cells, are useful because they represent cells that are less differentiated than the cells that are working at specific functions throughout your body. Another result of being stem cells is that they are able to divide and proliferate without differentiating or undergoing apoptosis and as cells differentiate towards their final fate they tend to divide less and ultimately commit cellular suicide if they are signaled to begin dividing again – a protection against cancerous growth. The downside of this is that stem cells act, in their normal state, a bit like cancerous cells. In fact one of the assays to demonstrate the pluripotency of a cell (the ability of a stem cell to make many kinds of other tissues) is to inject them into an animal where they will make tumors called teratomas which are (usually) benign growths of cells that represent endoderm, mesoderm, and ectoderm – the three germ layers than give rise to all tissues in the body during development.

As a scientist who works with stem cells, both in culture and in vivo I could have told you this therapy was a bad idea. A year ago Jake explained why this was a bad idea. If you had described this therapy to us, we would have told you exactly what would happen based on scientific knowledge of how these cells act in vivo. The therapies offered to stem cell tourists are frank quackery. They are unproven, untested, unstudied, and unmonitored. And to you anti-FDA libertarians out there, this is what you get when you don’t have regulatory oversight of human therapies. You get stupid quackery. The fact that this kid’s cancer was detected is probably just luck – there are likely many more people who have tried these therapies of desperation who suffered side effects, and possibly even death, but we just haven’t heard about it yet.

Ethical human trials require many things. At the very least, the therapy should have been tested extensively for safety in animals and ideally for efficacy in animal models of the disease. The patients should be selected carefully, should have a reasonable expectation of therapeutic benefit, and after the treatment follow-up should be extensive. Further, in the case of such a novel therapy, the bar should have been set higher before attempts in humans were made. In this case we have a child with a rare genetic neurodegenerative disorder that was experimented on without proper oversight, or a reasonable expectation that this therapy should do anything. Ataxia Telangiectasia is an autosomal recessive disorder in which every cell in the child’s body lacks the appropriate gene which is involved in cell cycle regulation and DNA repair. By what mechanism did they think neural stem cells would have an effect on such a disorder? Would the cells replace the child’s entire central nervous system? Would they miraculously repair the genetic defect? Or manage to insert themselves in just the right places to fix symptoms caused by a universal defect in the the hosts genome? This is magical thinking, not scientific thinking, and further I believe it is grossly unethical and stupid.

It is of no surprise that the careless injection of fetal stem cells into a child would result in tumors. This was a mind-bogglingly stupid act. What’s worse, as we hear more about the damaging quackery being offered in countries without proper regulation and oversight of human therapy we will likely hear more stories like this one.

In the rush to find some dramatic cure for a disease using stem cells it is likely efforts like these will damage the success of legitimate and careful studies in regenerative medicine and stem cell therapies. Injury and deaths from careless stupid quacks using these cells will create and association in people’s minds between stem cell therapies and cancer. We know the obstacles to using these cells in humans. The major one – immune compatibility – may have been solved already. The major remaining obstacles towards implementation of some fairly crude stem cell therapies are going to be (1) differentiating the cells into the appropriate tissues, (2) purifying the cells so that undifferentiated cells aren’t accidentally transplanted into humans, (3) preventing tumorous growth in the transplanted cells (possibly including a lethal gene to reverse the therapy if necessary), and (4) proper anatomic delivery of the cells so they perform a useful function and survive in the host. We know what the problems are. Careful study must include addressing each of these issues and ensuring they are resolved before shoving them into someone’s spinal fluid.

This quackery is not only going to prove harmful to individual human patients, but will likely harm the burgeoning field of regenerative medicine as a whole. For the sake of the patients, and for all future patients that might benefit from well-studied therapies, this quackery must be stopped.

For-Profit Fundraising Fleeces the Charitable

Phillip Reese and Andrew McIntosh of the Sacramento Bee report:

If you give to a charity over the phone, there’s a growing likelihood that most of your donation will go to the telemarketer instead, according to a Bee analysis of state records.

More than a third of California charity telemarketing campaigns sent less than 20 cents on the dollar to the charities during 2007, the most recent year on record. Those campaigns and a smaller number of charity auctions and concerts raised $93 million for commercial fundraisers, and just $3 million for the charities.

There are some eye-popping numbers in the report (PDF) released by the California Attorney General. The Bee points to the American Diabetes Association, where in California alone, commercial fundraisers generated $13,000,000 in donations at a cost of $17,000,000. That organization is an outlier, but other prominent charities had significant negative revenue using telemarketing and other commercially-operated fundraising.

The most effective for-profit fundraising was done on behalf of the Ronald Regan Presidential Foundation, with 92% of a $3,482,100 bounty going to the organization!

Since the creation of the Do-Not-Call Registry, many charitable organizations have resorted to in-person solicitation on the street. Is this more or less invasive than telemarketing? I’m not sure. But I am very skeptical of the eleemosynary nature of these groups. Several of the popular in-person solicitors work for child poverty organizations. I’m not sure about the actual names of these charities, but “Children International” raised $1,275,675 and ended up paying the fundraiser $614,850; and “Save the Children Federation” only kept $997 of $71,811 raised. In dead last for effectiveness is the “Children’s Defense Fund,” which paid the fundraiser $29,676 for raising $2,480.

4 Arrested in Animal Researcher Harassment

The San Francisco Chronicle reports that four young people have been arrested on suspicion that they harassed UCB and UC Santa Cruz animal researchers under the Animal Enterprise Terrorism Act.

It is clear from the reporting that law enforcement is taking this issue seriously. The FBI and seven other law enforcement agencies were involved, and effort was coordinated through the Joint Terrorism Task Force. From the press release and reporting, it looks as though agents were following these activists in public places, and filmed them using publicly-available computer terminals. Even DNA was used to link items in a car used to flee from a harassment incident to the suspects arrested.

The FBI’s press release alleges the following harassment:

On Sunday, October 21, 2007 a group of approximately twenty people, including Mr. Buddenberg, Mr. Pope, and Ms. Stumpo, demonstrated outside a University of California Berkeley professor’s personal residence in El Cerrito, California. The group, some wearing bandanas to hide their faces, trespassed on his front yard, chanted slogans, and accused him of being a murderer because of his use of animals in research. The professor told police he was afraid, and felt harassed and intimidated by the extremists.

On Sunday, January 27, 2008, a group of approximately eleven individuals, including Mr. Buddenberg, Mr. Pope, Ms. Stumpo, and Ms. Khajavi, demonstrated outside the private residences of several University of California Berkeley researchers over the course of the day. At each residence, extremists dressed generally in all black clothing and wearing bandanas to hide their faces marched, chanted, and chalked defamatory comments on the public sidewalks in front of the residences. One of the researchers informed authorities he had been previously harassed and the incident had caused him to fear for his health and safety.

On February 24, 2008, five to six individuals including Mr. Pope, Ms. Stumpo, and Ms. Khajavi, attempted to forcibly enter the private home of a University of California researcher in Santa Cruz. When her husband opened the door, a struggle ensued and he was hit by an object. As the individuals fled, one yelled, “We’re gonna get you.” The professor and her husband both told the FBI they were terrified by the incident.

On July 29, 2008, a stack of flyers titled “Murderers and torturers alive & well in Santa Cruz July 2008 edition” was found at the Café Pergolesi in Santa Cruz. The fliers listed the names, addresses, and telephone numbers of several University of California researchers and stated “animal abusers everywhere beware we know where you live we know where you work we will never back down until you end your abuse.” The investigation connected Mr. Buddenberg, Mr. Pope, and Ms. Stumpo to the production and distribution of the fliers. Distribution of the fliers preceded two firebomb attacks outside researchers’ Santa Cruz homes, both of which are still under investigation by the FBI.

I’m willing to bet that local and federal police have people in every one of the area animal rights groups, in light of this pattern of harassment. This effort is likely to deflate this type of criminal behavior, because violations of the Animal Enterprise Terrorism Act can result in up to 5 years in prison. Whether guilty or innocent, a federal investigation and prosecution will turn one’s life upside down. And if guilty, the government will be seeking maximum prison stays.

George Will – We must not allow his dishonesty to be ignored

I’m heartened to see a broad disgust with George Will’s lies about climate science. After all it’s pretty extraordinary when a major syndicated columnist repeats a lie about science, not once, not twice but three times despite being corrected.

PZ wishes he too could just make up his own facts, and Mike too is pleased the disgust is moving beyond the scientific community. Carl Zimmer at the Loom covers the broad mistakes made in the essay, and TPM documents how it was almost all lies. Mark Kleimen has caught on to the fact that in the end, this is just another conspiracy theory on par with HIV/AIDS denialism ( would add anti-vax denialism, 9/11 trooferism, or evolution denialism and every other kind – they’re all ultimately the same).

It’s reassuring to me to see that people are catching on. When we hear pseudoscience drivel, it’s never unique. It always follows a specific method – the pseudoscientific method. We happen to call that method denialism.

Bank Secrecy on Life Support

If you are socking money away in offshore banks, pay attention to this man’s expression. He’s saying, you’re screwed.

Yes, taxpaying citizens, you can rejoice, because tax cheats across the country are having panic attacks. They’re thinking about refiling their tax returns, or going to the IRS to beg forgiveness with a check to cover past taxes and potential fines. Some are evening thinking about sailing away from this great country. Good riddance.

As part of a 9/11 trend that requires banks to collect more information about their clients, and the fact that our government needs money, bank secrecy is on life support. Governments are willing to share information nowadays, and as the Times reports, the US government is going after 52,000 customers of UBS bank. (If you’re a customer, call your lawyer, today.)

When rich and powerful people have their privacy invaded, it oftentimes results in new privacy laws. Maybe the long-term result of this will be less privacy for the ultra tax cheating rich, and more for us. Maybe.


What to say about psychiatry that isn’t already completely covered by television and movies? It’s unique among the specialties for its coverage in the media. Maybe because we’re such social animals, or maybe because such shows about psychiatry or therapy appeal to a voyeuristic impulse in us to peer into people’s most private thoughts and feelings.

Our exposure to psychiatry in medical school, however, is primarily with inpatient psychiatry – people who for whatever reason require hospitalization to deal with their mental illnesses. Reasons may range from soul-crushing anxiety attacks, to addiction, to suicidal ideation, to frank psychosis from schizophrenia, depression or bipolar disorder. I’ll also say it’s very upsetting at first to treat the subset of patients who are being held against their will due to court orders. One of the most basic tenets of medicine is that a physician must respect the autonomy of their patients, and psychiatric patients have often had a court take this autonomy away from them because of their actions or behavior. Not surprisingly, many patients are not happy about this. They may not be willing to accept they have a problem, or be very reasonably upset about the financial, social, or legal consequences of a hospital stay, or occasionally they don’t necessarily feel that their delusions regarding their absolute dictatorial control of the US government and their need to evade agents of foreign nations by breaking into a pet store are actually a problem. However, others necessarily are disturbed by such things, often resulting in a temporary detention order, or TDO, to assess their need for psychiatric treatment. I’m not making light of mental illness, but psychotic states result in behaviors that are frankly bizarre, and the self-reinforcing nature of delusions often put patients into a state that makes them feel you are part of a plot designed to persecute them. Worse, there are times when a TDO can be devastating to a patient’s life. An inpatient admission for psychiatric, alcohol or drug treatment is not a benign intervention and often has pretty major accompanying legal and social consequences. Patients are often facing criminal charges for DUIs, violence, or other behavior that has finally come to a head, and cost of treatments is often a huge burden.

The two major things I learned as a part of this process are that (1) the state of Virginia drastically underfunds the treatment of mental illness relative to other medical illnesses (and this is a very bad thing) and (2) anti-psychotic medications are amazing drugs. Let’s start with a case – details, of necessity, are highly altered due to the sensitivity of psychiatric treatment but the fundamentals are real.

A 22 year-old-male is admitted to the inpatient psychiatric unit at a private hospital after his family brings him to the ER for bizarre and uncontrollable behavior…
Continue reading “Psychiatry”

Should IQ and Race be studied and what is Lysenkoism anyway?

Dan MacArthur has started a big discussion on whether or not the relationship between IQ and race should be studied. Inspired by a pair of essays for and against the idea it has created a pretty healthy debate among the sciencebloggers including Razib with whom I will likely never agree on this issue. For the record, I’m on the side of those like Richard Nisbett (for a good review of his analysis of race and the black white divide see here PDF) that genetics are a poor explanation for the divide.

But this issue aside, why do I believe this is a still a bad idea to expend resources to evaluate the role of race and IQ? After all, that’s just what Nisbett has done in the paper cited above.
Continue reading “Should IQ and Race be studied and what is Lysenkoism anyway?”

Scientologists blame psychiatry for 9/11

We’ll have to add Scientology to Pal’s list of disease-promoting groups. Via Screw Loose Change I learn that as part of their bizarre hatred of psychiatry, they’ve now taken to saying that 9/11 was caused by psychiatrists in addition to the holocaust. Apparently, Osama was just a regular guy until al-Zawahiri, a psychiatrist, got to him. Strange considering al Zawahiri was not a psychiatrist at all.

Scientologists Try to Explain how Psychiatrists caused 9/11 and the Holocaust from Chris Doyle on Vimeo.

Anyway, watch the crazy!

I’ll have a post up on my experience on my psych clerkship soon.

The Global Warming Cranks – George Will officially in their ranks

One would think given recent findings that antarctic warming is robust for instance, that the canard of antarctic cooling would go away. Or, that based on the round dismissal of the myth of 1970s global cooling warnings we’d stop hearing about that in the media too. But instead I’m watching TV last night and there’s all these unbelievable crank ads sponsored by the anti-regulation ideologues the Americans for Prosperity featuring fake expert John Coleman. His senseless rant against the stimulus and the evils of regulation is accompanied by text on the bottom of the screen declaring “global warming it is the hoax” and “it is the greatest scam in history”. It is amazing in this day and age that this shameless conspiracy theory is being broadcast on national television. There is no way that one can on the one hand describe anti-AGW denialism as skepticism, and at the same time be a proponent of such an absurd conspiracy that thousands of scientists around the world, and journals, and editors, and politicians are all in cahoots to falsify data about climate.

But if there is a truism about crankery that I can come up with to explain the persistence of debunked arguments, it is that good ideas may come and go, but we’re stuck with the bad ones forever. For instance, we saw this weekend that George will still thinks there were predictions of global cooling in the 1970s. Scibling James decries George Will’s inability to read what he cites, but this is nothing new. George’s Willful Ignorance on this topic has persisted for years this isn’t the first time he’s misquoted that exact same article, or the second time either despite being corrected by others. His incompetence at judging sources, and his inability to stop citing false information shows he’s simply unwilling or unable to differentiate between legitimate and false information, or even read for comprehension for that matter.

What can be our response to this consistent dishonesty from Will? A repeat of a cherry-pick not once, or twice, but three times despite this being clearly false? I think the only thing you can say about someone like this, a man who can’t be turned, is that they’re a crank.