an autodidact meets a dilettante…

‘Rise above yourself and grasp the world’ Archimedes – attribution

Posts Tagged ‘health

The statin controversy

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Never edit your own writing! Brian J Ford.

one thing thing you can be sure of – this claim (posted by a British chiropractor) is meaningless bullshit

I read Ben Goldacre’s quite demanding book Bad pharma some years ago, and that’s where I learned about statins, but I don’t recall much. I do recall that, not long after I read the book, I was at a skeptics meet-up when Dr Goldacre’s name came up. The man next to me started literally spitting chips at the mention – he was eating a massive bowl of chips and was grossly overweight (not that I’m assuming anything from this – just saying, haha). He roolly didn’t like Dr Goldacre. What went through my head was – some people may be really invested in having a magic pill that allows them to live forever and a day no matter what their diet or lifestyle.

I’ve just discovered that Goldacre has a new book out, entirely on this topic, which I intend to read, but my current decision to explore the issue is based on listening to Dr Maryanne Demasi’s talk, ‘statin wars – have we been misled by the evidence?’, available on YouTube. I very much recall the massive Catalyst controversy a few years ago, when a two-part special they did on statins led finally to the demise of the program. Without knowing any details, I thought this was a bit OTT, but when I heard Dr Norman Swann, a valued health professional and presenter of the ABC’s Health report, railing about the irresponsibility of the statin special, I frankly didn’t know what to think.

So statins are lipid-lowering medications that come in various flavours, including atorvastatin, fluvastatin, lovastatin and rosuvastatin. Lipitor, a brand name for atorvastatin manufactured by Pfizer, is the most profitable drug in the history of medicine. I’ve never taken statins myself, and I’m starting this piece as a more or less total beginner on the topic. I’ve read the Wikipedia entry on statins, which is quite comprehensive, with a very long reference list. Of course it’s not entirely comprehensible to a lay person, but that’s not a criticism – immunobiology and related research fields are complex. It’s also clearly pro-statin. It includes this interesting sentence:

 A systematic review co-authored by Ben Goldacre concluded that only a small fraction of side effects reported by people on statins are actually attributable to the statin.[63]

It’s interesting that Goldacre, and nobody else, is mentioned here as a co-author. It makes me wonder…

My only quibble, as a lay person, is that the positive effects of these statins, and their relatively few side-effects, seems almost too good to be true. I speak, admittedly, as a person who’s always been ultra-skeptical of ‘magic bullets’.

Which brings me to issues raised in Dr Demasi’s talk, and not addressed in the Wikipedia article. They include the idea, promoted by an ‘influential group’, that statin use should be prescribed for everyone over 50, regardless of cholesterol levels. Children with high cholesterol levels are being screened for statin use and Pfizer has apparently designed fruit-flavoured statis for use by children and adolescents. Others have suggested using statins as condiments in fast-food burgers, and even adding statins to the public water supply. It’s easy to see how such ‘innovations’ involve making scads of money, but this isn’t to deny that statins are effective in many if not most instances, and we should undoubtedly celebrate the work of the Japanese biochemist Akiro Endo, who pioneered the work on enzyme inhibitors that led to the discovery of mevastatin, produced by the fungus Penicillium citrinum.

But Demasi made some other interesting points, firstly about how drug companies like Pfizer might seek to maximise their profits. One obvious way is to widen the market – for example by lobbying for a lowering of the standard level of cholesterol in the blood considered dangerous. From the early 2000s in the US, ‘high cholesterol’ was officially shifted down from as high as 6.5 down to below 5, moving vast numbers of people onto having a ‘need’ for these cholesterol-lowering drugs. Demasi points out that this lowering wasn’t based on any new science, and that the body responsible for these decisions, the National Cholesterol Education Program (NCEP), was loaded with people with financial ties to the statin industry. To be fair, though, one might expect that doctors and specialists concerned with cholesterol to be invested, financially or otherwise, in ways of lowering it. They might also have felt, for purely scientific reasons, that the level of cholesterol considered dangerous was long overdue for adjustment.

Another change occurred in 2013 when two major heart health associations in the US decided to abandon a single number in terms of risk factors for heart disease/failure. Instead they looked at cholesterol, blood pressure, weight, diabetes and other factors to calculate ‘percentage risk’ of cardiovascular problems. They evaluated this risk so that if it was over 7.5% in the next 10 years, you should be prescribed a statin. A similar percentage risk system was used in the UK, but the statin prescription started at 20%. Why the huge discrepancy? Six months later, the Brits brought their threshold down to 10%. The US change brought almost 13 million people, mostly elderly, onto the radar for immediate statin prescription. The method of calculation in the US was independently analysed, and it was found that they over-estimated the risk, sometimes by over 100%. Erring on the side of caution? Or was there a lot of self-interest involved? It could fairly be a combination. The term for all this is ‘statinisation’, apparently. It’s attributed to John Ioannidis, a Stanford professor of medicine and a noted ‘scourge of sloppy science’. If you look up statinisation, you’ll find a storm of online articles of varying quality and temper on the issue – though most, I notice, are five years old or more. I’m not sure what that signifies, but I will say that, while we’ll always get the anti-science crowd baying against big pharma, vaccinations and GM poison, there’s a clear issue here about vested interests, and the need to, as Demasi says, ‘follow the money’.

This brings up the issue of how trials of these drugs are conducted, who pays for them, and who reviews them. According to Demasi, the vast majority of statin trials are funded by manufacturers. Clearly this is a vested interest, so trial results would need to be independently verified. But, again according to Demasi (and others such as Ioannidis and Peter Gotzsche, founder of the nordic Cochrane Collaboration) this is not happening, and ‘the raw data on statin side-effects has never been released to the public’ (Demasi, 2018). This data is held by the Cholesterol Treatment Triallists’ (CTT) collaboration, under the Clinical Trial Service Unit (CTSU) at Oxford Uni. According to Demasi, who takes a dim view of the CTT collaboration, they regularly release meta-analyses of data on statins which advocate for a widening of their use, and they’ve signed agreements with drug companies to prevent independent examination of research findings. All of this is described as egregious, which might seem fair enough, but Elizabeth Finkel, in a long-form article for Cosmos magazine in December 2014, takes a different view:

.. [the CTT] are a collaboration of academics and they do have access to the raw data. It is true that they do not share that data outside their collaboration and are criticised by other researchers who would like to be able to check their calculations. But the trialists fear mischief, especially from drug companies seeking to discredit the data of their rivals or from other people with vested interests. Explains [Professor Anthony] Keech, “the problem with ad hoc analyses are that they can use methods to produce a particular result. The most reliable analyses are the ones done using the methods we published in 1995. The rules were set out before we started.” And he points out these analyses are cross-checked by the academic collaborators: “Everything is replicated.”

As a regular reader of Cosmos I’m familiar with Finkel’s writings and find her eminently reliable, which of course leaves me more nonplussed than ever. I’m particularly disturbed that anyone would seriously claim that everyone over fifty (and will it be over forty in the future?) should be on these medications. I’m 63 and I take no medications at all, which I find a great relief, especially when I look at others my age who have mini-pharmacies in their homes. But then I’m one of those males who doesn’t visit doctors much and I have little idea about my cholesterol levels (well yes, they’ve been checked and doctors haven’t raised them to me as an issue). When you get examined, they usually find something wrong….

In her talk, Demasi made a comparison with the research on Tamiflu a few years ago, when Cochrane Collaboration researchers lobbied hard to be allowed to review trial data, and it was finally revealed, apparently, that it was certainly not as effective and side-effect free as its makers, Roche, claimed it to be. The jury is still out on Tamiflu, apparently. Whether it’s fair to compare the Tamiflu issue with the statin issue is a matter I can’t really adjudicate on, but if Finkel is to be believed, the CTT data is more solid.

There’s also an issue about more side effects being complained of by general users of statins – complaints made to their doctors – than side effects found in trials. This has already been referred to above, and is also described in Finkel’s article. Many of these complaints of side-effects haven’t been able to be sheeted home to statins, which suggests there’s possibly/probably a nocebo effect at play here. But Demasi suggests something more disturbing – that many subjects are eliminated from trials during a run-in period precisely because the drug disagrees with them, and so the trial proper begins only when many people suffering from side-effects are excluded. She also notes, I think effectively, that there is a lot of play with statistics in the advertising of statins (and other drugs of course) – for example a study which found that the risk of having a heart attack on statins was about 2% compared to 3% on placebos was being advertised as proving that your heart-attack risk on statins is reduced by a third. This appears to be dodgy – the absolute percentage difference is very small, and how is risk actually assessed? By the number of actual heart attacks over period x? I don’t know. And how many subjects were in the study? Were there other side-effects? But of course we shouldn’t judge the value of statins by advertising guff.

Another interesting attack on those expressing doubts about the mass prescription of statins has been to call them grossly irresponsible and even murderers. This seems strange to me. Of course doctors should be all about saving lives, but they should first of all be looking at prevention before cure as the best way of saving lives. Exercise (mental and physical) really is a great form of medicine, though of course not a cure-all, and diet comes second after exercise. Why the rush to medicalise? And none of the writers and clinicians supporting statins are willing to mention the financial bonanza accruing to their manufacturers and those who invest in them. Skepticism is the lifeblood of science, and the cheerleaders for statins should be willing to accept that.

Having said that, consider all the life-saving medications and procedures that have preceded statins, from antibiotics to vaccines to all the procedures that have made childbirth vastly safer for women – who cares now about the pharmaceutical and other companies and patentees who’ve made their fortunes from them? They’re surely more deserving of their wealth than the Donnie Trumps of the world.

So, that’s my initial foray into statins, and I’m sure the story has a way to go. In my next post I want to look at how statins work. I’ve read a couple of pieces on the subject, and they’ve made my head hurt, so in order to prevent Alzheimer’s I’m going to try an explanation in my own words – to teach myself. George Bernard Shaw wrote ‘those who can, do, those who can’t teach (it’s in Man and Superman). It’s one of those irritating memes, but I prefer the idea that people teach to learn, and learn to teach. That’s why I love teaching, and learning…

By the way, the quote at the top of this post seems irrelevant, but I keep meaning to begin my posts with quotes (it looks cool), so I’m starting now. To explain the quote – it was from a semi-rant by Ford in his introduction to the controversial dinosaur book Too big to walk (I’ve just started reading it), about writers not getting their work edited, peer reviewed and the like, and being proud or happy about this situation. This, he argues, helps account for all the rubbish on the net. It tickled me. I, of course, have no editor. It’s hard enough getting readers, let alone anyone willing to trawl through my dribblings for faults of fact or expression. Of course, I’m acutely aware of this, being at least as aware of my ignorance as Socrates, so I’ve tried to highlight my dilettantism and my indebtedness to others. I’m only here to learn. So Mr Ford, guilty as charged.

References

Dr Maryanne Demasi – Statin wars: Have we been misled by the evidence?

https://en.wikipedia.org/wiki/Statin

https://cosmosmagazine.com/society/will-statin-day-really-keep-doctor-away

https://en.wikipedia.org/wiki/John_Ioannidis

https://www.smithsonianmag.com/science-nature/what-is-the-nocebo-effect-5451823/

http://www.center4research.org/tamiflu-not-tamiflu/

Written by stewart henderson

September 9, 2019 at 9:44 pm

bronchiectasis once more – resistance, viruses, treatment

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Having fallen ill again, for the first time really in a few years, with debilitating dry coughing, breathing problems and fatigue, and having had no great relief from a first course of broad-spectrum antibiotics, I think it’s a good time to review the condition I suffer from – bronchiectasis.

I’ve tried to put it in the back of mind and have been mostly successful, except now and then to marvel that it hasn’t come roaring back for a year, then two years, then three years. Still, I’ve never quite gotten rid of a niggling cough, and every time I have a sneezing fit my mind turns, however briefly to what might finally await me…

Bronchiectasis literally means ‘widened or widening airways’. The airways leading to the lungs have become permanently distended and develop ‘cul de sacs’ in which bacteria gather as in a stagnant backwater. The increased bacterial load means that those with the condition are easier prey for bacterial and viral pathogens. The causes of this condition are various, including genetic conditions such as cystic fibrosis, or a general immunodeficiency. In my case it was most likely an early childhood infection, the cause in about a third of all adult cases. The sad thing is that with each new flare-up the damage to the airways is increased, the condition worsens, and there’s no cure, but it can be contained through specific exercises designed to clear the airways, postural drainage and other techniques. Above all (he adonishes himself) always get regular flu and pneumococcal jabs. I was diagnosed with this condition about four and a half years ago, but I think I’ve been suffering from it for much longer. Like many stupid men I’ve tended not to go to the doctor till I’m at death’s door. I’ve improved a little in that area in recent years, but not enough.

The recent flare-up has been traced to a relatively common virus, called respiratory syncytial virus (RSV). My doctor sent me for a virology swab after my second visit. On my first visit I presented with my severe cough, and I explained my bronchiectasis, which he knew something about as I’d had my records transferred to him from a previous establishment. Although I expressed concern about antibiotics, having experienced what I presumed to be resistance to erythromycin previously, I was prescribed a broad-spectrum antibiotic called roxithromycin GH. Desperately wanting to get rid of this debilitating and spirit-weakening cough, I got the set of ten tablets – a five-day dose – together with a repeat dosage. I’m currently two tablets away from finishing the repeat. It was also recommended that I get a bottle of Bisolvon®, which ‘thins, loosens, clears mucus from the chest’ and ‘helps clear stubborn chest congestion’.

This first consultation was on a Friday. I was contracted for a two-day work week at Eynesbury College starting the following Thursday, and I really wanted to be fit by then. However, by Monday-Tuesday I was worried. The antibiotics, I felt, had been initially successful but then my condition seemed to deteriorate. On Wednesday I had my second consultation. I explained my amateur theory that the antibiotics had an immediate impact, but then the resistant strain of the bacteria continued to multiply, took over the territory of the non-resistants, and the illness came sweeping back. Classic evolution, in a sense: from random variation the environment of my body selects the stronger, resistant strain. The doctor agreed, or said he did, but pointed out that the problem was that my infection was probably viral rather than bacterial. In my enthusiasm for my own cleverness I hadn’t thought of this. And this probably explained the ineffectiveness of the erithromycin in the past. Maybe I’m not resistant at all.

So I was sent to the nearest Clinical Labs testing centre for a swab. I was also advised to continue with the antibiotics. The swab is applied by means of a long needle-like instrument wrapped in something like cotton wool at one end. This material is soaked in a virus-detecting solution and inserted fairly deeply into the nasal cavity. I visited the testing centre more or less immediately after the consultation, and received word the next day that the results were out. On Friday, I think, I attended my third consultation and was given the read-out. Ten viruses tested for were presented, including influenza A and B, and types 1 to 4 paraainfluenza, all undetected. The other undetected viruses were adenovirus, rhinovirus and metapneumovirus. RSV, an RNA virus (as are most viruses), was the only one detected.

So, progress has been made, and I was prescribed one more medication, a Turbuhaler® called Symbicort®, often used for symptomatic treatment of asthma. Instructions are to inhale two doses a day of the oral powder, which consists of budesonide and eformoterol fumarate dihydrate. There are 120 doses in my inhaler.

Budesonide is a corticosteroid, commonly used in this inhaled form for long-term treatment or management of asthma and COPD. It’s been around for a while, having been patented in 1973, and in commercial use as an asthma medication since 1981. It’s also on the WHO list of essential medicines. According to Wikipedia, ‘common side effects with the inhaled form include respiratory infections, cough, and headaches’, and at the moment I have a headache, and have suffered from severe coughing fits.  I’m also producing quite a lot of mostly clear mucus, through the nose. I’ve attributed these symptoms to the virus, not the medication, but who knows?

Eformoterol is a more recent addition to the arsenal of anti-asthma type medications. This 1997 article in Australian Prescriber describes it as ‘a long-acting beta2 adrenoceptor agonist’ – a type of beta-blocker. Here’s some further interesting info from this site:

After inhalation of eformoterol powder, bronchodilatation begins within 3 minutes. This effect lasts for 12 hours with a peak effect within two hours of inhalation. These properties make eformoterol suitable for twice daily inhalation in patients who require regular, long-term treatment of reversible airways obstruction. It is not recommended for use in acute asthma. Patients should have a short-acting agonist, such as salbutamol, available to help deal with acute attacks.

Unfortunately my airways problems aren’t reversible, though particular obstructions and their causes may be treated effectively.

So what I have in my little Turbuhaler is a combo of a corticosteroid and a long-acting betaagonist (i.e. a bronchodilator). According to Wikipedia ‘combinations of inhaled steroids and long-acting bronchodilators are becoming more widespread’.

It doesn’t seem as if there’s much I can do but wait for my condition to slowly improve. It’s been nine days since my first consultation, and I’ll be revisiting my doctor in a day or two. Mucus still flows freely and the distinctive, whistling wheeze I developed about a week ago is still present (I’ve never experienced this before). Physical exertion quickly makes me exhausted, but I’m hoping I can soon be sufficiently recovered to consider specific exercises to improve my condition and support me against further setbacks. Don’t want to end up slowly drowning in my own phlegm.

Written by stewart henderson

July 30, 2018 at 3:13 pm

what to do with a serious problem like Trump: part one

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When I first encountered Trump, I suppose a couple of decades ago now, I quickly felt an intense, visceral loathing and disgust. He struck me as tasteless, vulgar, ignorant, vain, an exemplar of the absence of all humane values. A boorish, blustering, bigoted, bragging blundering, bullying, bullshitting buffoon, not to put too fine a point on it. And then, when those he demeaned and belittled began acting as if they deserved it, I began to wonder – who is worthy of more contempt, Trump, or those who take him seriously for more than a second? How could anyone with an ounce of sense not see that he was a walking advertisement for abortion?

But then, when you start thinking everyone’s a fuckwit except yourself, you know something’s going wrong. Okay, you do start listening around and find that in many circles Trump’s a laughing-stock. But then he’s somehow super-rich, and people like to hob-nob and ingratiate themselves with the super-rich no matter how obnoxious and boring they are.

So why was Trump super-rich? I have to say that, having lived mostly below the poverty line in one of the world’s richest countries (that’s to say I’ve rarely come close to going hungry), I’ve never really associated with rich people, never mind the super-rich. They’re like alien beings to me. But it stands to reason that there are two types of super-rich people; those who inherited wealth, or those who gained it by their own talents and efforts – legitimate or illegitimate.

So which of these was Trump? He struck me as flamboyantly imbecilic, far removed from the Bill Gates and Steve Jobs types. And I have to say it wasn’t a burning question for me. Naturally I was far too superior to concern myself with such riff-raff, and yet…

Information fell into my lap over the years. He’d inherited oodles of wealth from his father, a ‘business tycoon’. He’d never done a day’s work, in the general sense, in his life. He’d been bankrupted many times. His net worth was anything from negative infinity to positive infinity. His principal business was real estate, which was as hazy to me as scalar field theory. But his principal interest was self-promotion, which I felt a bit more cluey about. It seemed he was little more than a ‘big noise’.

So that was it, until he began to run for President, and shocked almost all pundits, including this pseudo-pundit, by winning quite well on an electoral college basis, though losing the popular vote.

Of course during the run-up to these ludicrously long US presidential elections, especially in the final months of 2016, we were pretty well forced to learn more about Trump than many of us ever wanted to know, and it’s been an ongoing ‘reveal’ throughout the last eighteen months or so. But I return to my initial response to Trump, and my feelings of contempt, and easy superiority.

How did Trump become what he is? How did I become what I am?

How free are we to form ourselves?

I think the answer is clear, though clearer when we look at others than when we look at ourselves. We didn’t get to choose our parents, our genes or our upbringing, we didn’t get to choose or influence our experience in the womb and in our earliest formative years, which the Dunedin study, inter alia, reveals as more character-forming than any other period in our lives.

More questionably I didn’t get to choose a character that loathes someone like Trump, any more than Sean Hannity and many others got to choose a character that finds Trump appealing, refreshing and admirable, assuming that I’m reading more or less accurately Hannity’s mind.

So am I saying we’re all blameless when it comes to our flaws, and unpraiseworthy when it comes to our virtues? Further, am I saying that moral judgment is inappropriate?

I hope not. After all, humans are the most social of all creatures – vertebrate creatures at least. We’re interested in getting along, in minimising harm and maximising advantage, for us all. We shouldn’t turn a blind eye to any person, or policy, or activity, that threatens that well-being. So we should discourage, and sometimes punish behaviour that harms or demeans others, while at the same time recognising that the bully or aggressor is acting under the sway of traits she has less control over than we might think.

So we should judge behaviour as immoral when it damages others or damages the institutions or activities that tend towards the general well-being. And we should check or punish those who commit those faux pas, which we might call crimes, misdemeanours, or bad behaviour, to the extent that they understand that resistance of the general will is futile – that’s to say, that continual commission of those faux pas will be counter-productive to their own well-being.

Let me return then to the case of Trump. In watching and listening to him, I find him, as President, consistent with the person I loathed decades before, though I also realise, as I did then, that there is something unfair and slightly unseemly about my contempt, for reasons described above. Trump is the product of a background and influences which are clearly far removed from mine. I was also, like many, somewhat fascinated by him as a specimen who revealed, more effectively than most, how infinitely variable human experience and character can be.

However, though I recognise that he is what he is and can’t help but be, I’m also alert and alarmed that he is now the President of the USA – a shocking development, considering the man’s character.

For, though nobody should be blamed for his own character, there are some characters that the general society needs to be protected from, because of the damage they are capable of doing, or incapable of not doing, given certain powers and opportunities.

Trump came to his current position with a reputation which, I feel, was deserved, given everything I observed of him, and everything I learned. That reputation was one of dishonesty, self-aggrandisement, wilful ignorance and anti-intellectualism, and indifference to the feeling and suffering of others, with possibly a few exceptions, and leaving aside his children, whom he would see as extensions of himself to a large degree.

There are some characters who are so pathological, so damaging to themselves and/or others that society needs to be protected from them, unless of course their pathology can be identified, treated and cured. In the case of Trump, the terms psychopath, sociopath, malignant narcissism and narcissistic personality disorder have been given an airing. It’s surely not coincidental that these claims about Trump have been much more frequent since he has become President. His power to damage the wider society is at its zenith.

When I first heard the term narcissistic personality disorder directed at Trump, it was in a discussion with a mental health professional, early in the Presidency. That professional was critical, even angry, that the term was used to describe Trump, because, he felt, this term described a real and debilitating pathological condition which was far too serious to be used for political purposes against Trump. His words gave me pause, but now I think it’s time to look at this matter more closely.

First, before actually looking more closely at the ‘mental disability’ terms described above, I should say this. As Stormy Daniels’ impressive attorney Michael Avenatti has said, Trump’s behaviour, especially his constant self-promoting and self-protecting lies, should concern all Americans regardless of their political persuasion. Trump’s behaviour in office is essentially not a political issue, in spite of its massive political consequences. One pundit recently described Trump as a ‘lifelong Democrat’ before switching to the Republican party a few years ago. It’s my contention however that Trump was never a Democrat and has never been a Republican. He has never been interested in politics in the usual sense – that of believing in and promoting policies and practices for the most effective running of a state. He has little interest in or knowledge of political history, political philosophy or international affairs, and no knowledge whatever of science, or history in general. He doesn’t read or have anything like an enquiring mind. He has expressed very little compassion for others, except when it may benefit himself, and his concept of truth is not something that anybody seems to be capable of recognising or describing.

This description of Trump is not a political one. It’s a description which most sensible people would broadly agree with. It’s a description of a person so singularly ill-equipped to be the President of the world’s most powerful military and economy, that the question of how he came to be in that position and how he can be removed from it before further damage can be done, should be paramount.

Before I go on, I should address those outliers who say that Trump has been a successful and impressive President. They would cite the booming economy and the administration’s tax legislation, the only major piece of legislation enacted thus far. On the tax legislation, I will not consider its fairness or unfairness, or the effect it has had on the US economy. I will simply say that Trump recently claimed more or less sole responsibility for this legislation, a claim that was demonstrably false. Trump did not participate in the writing of this legislation, and he most certainly hasn’t read it. He simply presided over a Republican congressional majority responsible for its production. As to the US economy, that is a massively complex area, full of winners and losers, which, of course, I’m not competent to comment on, any more than Trump would be. Suffice to say that the reasons for an economy’s success are manifold and generally historical.

So there is a problem with Trump as President. In my next post I will go into more detail about what the problem is, and why there is no easy solution.

Written by stewart henderson

May 5, 2018 at 11:33 am

Why science?

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why is it so?

Ever since I was a kid I was an avid reader. It was my escape from a difficult family situation and a hatred or fear of most of my teachers. I became something of a quiet rebel, rarely reading what I was supposed to read but always trying to bite off more than I could chew in terms of literature, history, and occasionally science. I did find, though, that I could chew almost anything – especially in literature and history. And I loved the taste. Science, though, was different. It certainly didn’t come naturally to me. I didn’t know any science buffs and in fact I had no mentors for any of my reading activities. We did have encyclopaedias, though, and my random reading turned up the likes of Einstein, Newton, Darwin, Pasteur and other Big Names in science. Of course I was more interested in their bios than in the nature of their exotic researches, but in my idealised view they seemed very pure in their quest for greater understanding of the material world. I sometimes wished I could be like them but mostly I just dived into ‘literature’, a more comfortable world in which ordinary lives were anatomised by high-brow authors like Austen, Eliot and James (I had a fetish for 19th century lit in my teens). I took silent pride in my critical understanding of these texts, it surely set me above my classmates, though I remember one day walking home with one of the smartest kids in my class, who regaled me with his exploration of the electronics of a transistor radio he was pulling apart at home. I remember trying to listen, half ashamed of my ignorance, half hoping to change the subject to something I could sound off about.

Later, having dropped out of my much-loathed school, I started hanging out, or trying to, with other school drop-outs in my working-class neighbourhood. I didn’t fit in with them to say the least, but the situation worsened when they began tinkering with or talking about cars, which held no interest for me. I was annoyed and impressed at how articulate they were about carbies, distributors and camshafts, and wondered if I was somehow wasting my life.

Into my twenties, living la vie boheme in punk-fashionable poverty among art students and amateur philosophers, I read and was definitely intrigued by Alan Chalmers’ unlikely best-seller What is this thing called science? It sparked a brief interest in the philosophy of science rather than science itself, but interestingly it was a novel that really set me to reading and trying to get my head around science – a big topic! – on a more or less daily basis. I was about 25 when I read Thomas Mann’s The Magic Mountain, in which Hans Castorp, a young man of about my age at the time, was sent off to an alpine sanatorium to be cured of tuberculosis. Thus began a great intellectual adventure, but it was the scientific explorations that most spoke to me. Wrapped up in his loggia, reading various scientific texts, Castorp took the reader on a wondering tour of the origin of life, and of matter itself, and it struck me that these were the key questions – if you want to understand yourself, you need to understand humanity, and if you want to understand humanity you need to understand life itself, and if you want to understand life, you need to understand the matter that life is organised from, and if you need to understand matter…

I made a decision to inform myself about science in general, via the monthly magazine, Scientific American, where I learned at least something about oncogenes, neutrinos and the coming AIDS epidemic, inter alia. I read my first wholly scientific book, Dawkins’ The Selfish Gene, and, as I was still living la vie boheme, I enjoyed the occasional lively argument with housemates or pub philosophers about the Nature of the Universe and related topics. In the years since I’ve read and half-digested books on astronomy, cosmology, palaeontology and of course the history of science in general. I’ve read The origin of species, Darwin’s Voyage of the Beagle and at least four biographies of Darwin, including the monumental biography by Adrian Desmond and James Moore. I’ve also read a biography of Alfred Russell Wallace, and more recently, Siddhartha Mukherjee’s The Gene, which traces the search for the cause of the random variation essential to the Darwin-Wallace theory. And I still read science magazines like Cosmos on a more or less daily basis.

These readings have afforded me some of the greatest pleasures of my life, which would, I suppose, be enough to justify them. But I should try to answer the why question. Why is science so thrilling? The answer, I hope, is obvious. It isn’t science that’s thrilling, it’s our world. I’m not a science geek, it doesn’t come easily to me. When, for example, a tech-head explains how an electronic circuit works, I have to watch the video many times over, look up terms, refer to related videos, etc, in order to fix it in my head, and then, like most people, I forget the vast majority of what I read, watch or listen to. But what keeps me going is a fascination for the world – and the questions raised. How did the Earth form? Where did the water come from? How is it that matter is electrical, full of charge? How did language evolve? How has our Earth’s atmosphere evolved? How are we related to bananas, fruit flies, australopithecines and bats? How does our microbiome relate to obesity? What can we expect from CRISPR/Cas9 editing technology? What’s the future for autonomous vehicles, brain-controlled drones and new-era smart phones?

This all might sound like gaga adolescent optimism, but I’m only cautiously optimistic, or maybe not optimistic at all, just fascinated about what might happen, on the upside and the downside. And I’m endlessly impressed by human ingenuity in discovering new things and using those discoveries in innovative ways. I’m also fascinated, in a less positive way, by the anti-scientific tendencies of conspiracy theorists, religionists, new-agers and those who identify with and seem trapped by ‘heavy culture’. Podcasts such as The Skeptics’ Guide to the Universe, Skeptoid and Australia’s The Skeptic Zone, as well as various science-based blogs like Why Evolution is True and Skeptical Science are fighting a seemingly never-ending fight against the misinformation churned out by passionate supporters of fixed non-evidence-based positions. But spending too much time arguing with such types does your head in, and I prefer trying to accentuate the positive than trying to eliminate the negative.

And on that positive side, exciting things are always happening, whether it’s battery technology, cancer research, exoplanetary discoveries, robotics or brain implants, more developments are occurring than any one person can keep abreast of.

So I’ll end with some positive and reassuring remarks about science. It’s not some esoteric activity to be suspicious of, but neither is it something easily definable. It’s not a search for the truth, it’s more a search for the best, most comprehensive, most consistent and productive explanation for phenomena. I don’t believe there’s such a thing as the scientific method – the methods of Einstein can’t easily be compared with those of Darwin. Methods necessarily differ with the often vast differences between the phenomena under investigation. Conspiracy theories such as the moon landings ‘hoax’ or the climate science ‘fraud’ would require that scientists and their ancillaries are incredibly disciplined, virtually robotic collaborators in sinister plots, rather than normal, questing, competitive, collaborative, inspired and inspiring individuals, struggling desperately to make sense and make breakthroughs. In the field of human health, scientists are faced with explaining the most complex organism we know of – the human body with its often perverse human mind. It’s not at all surprising that pseudo-science and quackery is so common in this field, in which everyone wants to live and thrive as long as possible. But we need to be aware that with such complexity we will encounter many false hopes and only partial solutions. The overall story, though, is positive – we’re living longer and healthier, in statistical terms, than ever before. The past, for the most part, is another country which we might like to briefly visit, but we wouldn’t want to live there. And science is largely to be thanked for that. So, why not science? The alternatives do nothing for me.

The SGU team – science nerds fighting the good fight

Written by stewart henderson

October 7, 2017 at 6:18 am

on dresses, marriage and patriarchy

with 2 comments

the spice of life

Canto: It seems some schools are still intent on having girls wear dresses to their classes. Why?

Jacinta: Because that’s what girls have traditionally worn. Because some schools insist on an absolute distinction between girls and boys.

Canto: Yes but they must be able to come up with good reasons for that, otherwise they’ll look foolish.

Jacinta: Well girls are girls and boys are boys, aren’t they? How can they be treated equally or identically? It’s obvious.

Canto: Ah, the obvious argument. Like Cook obviously discovered Australia. But this absolute differentiation between males and females has always been a horrible thing to behold. When such absolute differences are insisted on, it’s always accompanied by a sense of the superiority of one side of the differential.

Jacinta: Indeed, as one schoolteacher put it in an interview I saw recently, the dress thing in schools is essentially an insistence that girls should dress more for decoration than for practicality.

Canto: Yes, though there are conditions in which dresses are more practical, in which case they should be allowed for all genders. I’d still like to buy one of those kilts I saw advertised on Facebook a while ago.

Jacinta: It’s amazing that this gendered stuff hasn’t been questioned, or raged against, more vigorously before now, but the dress thing could be a wedge to open up a pack of gender issues.

Canto: And research has found that girls exercise less than boys, to a significant degree, and dresses undoubtedly contribute to that. It’s being pointed out that making simple changes to uniform policies might be a much cheaper way to address the problem than a ‘girls be active’ campaign.

Jacinta: And it requires leadership from, well, the leaders. Girls aren’t likely to go it alone and risk being mocked by their peers for being different. And it looks like if senior teachers or principals don’t engage in the exercise of change – at last! – then parents will have to make the move, possibly via legal action.

Canto: Yes, the refusal to allow girls to wear clothes appropriate for tree-climbing, mud-wrestling and other typical schoolyard activities is clearly discriminatory. Bring it on!

Jacinta: Seriously we know that both girls and boys, in terms of their mental and physical activities, cover the whole range. Forcing them into specific, gendered outfits inhibits that range. That’s the last thing the wider society wants. So now, due to the same-sex marriage issue and some silly remark from the no campaign about boys wearing dresses, the issue of girls’ uniforms is grabbing a moment’s attention, but will it die down again with no action taken? Our society’s inertia is lamentable, methinks.

Canto: Maybe we should take it upon ourselves to keep the issue alive after the marriage issue gets dealt with – letters to arch-Catholic schools, veiled threats, dress-burnings outside the railings.

Jacinta: Railings and wailings outside the railings. But not outside of individual schools, that would take forever. We need national action. Federal parliament needs a dressing down. But speaking of marriage, I just heard a sound-bite about a woman from Israel, a parliamentarian, who’s calling for a cancellation of marriage. She wants to get rid of it, apparently. Now that takes me back to the old days.

Canto: Is this a feminist issue? I mean, lots of people aren’t keen on marriage, including myself, but I never thought of it as a feminist issue, though of course it would be in more patriarchal cultures.

Jacinta: Well the ‘cancel marriage’ advocate is Merav Michaeli, who worked mainly as a journalist before entering the Israeli parliament, and in her TEDx talk she clearly sees it as a feminist issue and makes a number of valid points…

Canto: But how can this be relevant to gay marriage?

Jacinta: Yes, that could be an argument against her – marriage can evolve rather than be cancelled. She’s right about the history of the marriage arrangement and how it has disadvantaged women, quite massively in fact, but marriage is what we make of it and we can do a better job of the arrangement in the future. Having said that, I’d be quite happy for it to be scrapped.

Canto: I’ve always been interested in different arrangements for rearing kids, other than the two-parent thing. But let’s return to the small issue of dresses. The Western Australian labor government has upped the ante by making it mandatory for schools to offer girls the choice of wearing pants or a dress.

Jacinta: That’s great. I presume this is for primary school. And maybe high school, Though I recall in my high school, a long long time ago, the senior students were weaned off uniforms, in preparation for sensible adult life when they could at last wear what they wanted.

Canto: I’d love to hear the rationale of those schools who don’t allow girls to wear trousers or shorts. And I don’t think just offering the option of shorts for girls is enough – no girl wants to be the only girl in her class to not be wearing a dress. If shorts and trousers really do encourage girls to engage in more play – and they clearly do, then they should be encouraged, for their health’s sake.

Jacinta: It really is discriminatory, as many experts say. And it doesn’t reflect what grown-up women wear. I teach in a college with predominantly female colleagues. Not one of them wears a dress on a regular basis. Most of them have never worn a dress at work, as far as I can recall.

Canto: Which makes me wonder about the female teachers at these hold-out schools. Do they all wear dresses? Imagine a trousered teacher dictating the dress-only-dress code to her female charges. Wouldn’t be surprised if that hasn’t happened somewhere. It’s a weird weird world.

Jacinta: In some ways it might seem a trivial subject, given all the issues about clean energy and so on, things that we’ve been focusing on lately, but these apparently minor issues of dress go to the heart of patriarchy in many ways. After all, these rules are being forced on girls quite often, and they’re telling them something at a very impressionable age, and that’s not a good thing.

Canto: We must try to keep this one in mind, as the issue is likely to go off the boil again and may take decades to fix. I’d also like to know which schools are enforcing these rules. We might try to shame them.

Jacinta: I hear it’s often the parents that insist on it. They’ve sent their kids to a conservative school for a reason. In any case they should be forced to justify their attitudes. I’d like to see them try.

References

http://www.adelaidenow.com.au/news/south-australia/most-public-school-parents-say-girls-should-not-have-to-wear-skirts-and-dresses-survey-finds/news-story/f9556be30c4251b75a379705ae370f9b

http://www.illawarramercury.com.au/story/4904291/yep-boys-shouldnt-wear-dresses-neither-should-girls/

https://theconversation.com/why-do-we-still-make-girls-wear-skirts-and-dresses-as-school-uniform-69280

http://www.abc.net.au/news/2017-09-08/should-australian-schools-force-girls-to-wear-skirts/8879222

http://www.news.com.au/lifestyle/parenting/school-life/girls-will-now-be-able-to-wear-shorts-or-pants-at-public-schools-in-wa/news-story/13bac1b41510144e9b872ec27d36b574

Written by stewart henderson

September 12, 2017 at 8:39 am

some more stuff we’ve learned about vaccines

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Vaccinology, I would say that it’s not rocket science. It’s a lot harder than rocket science.

Alan Schmaljohn, virologist, 2014

 

Canto: So, reading The Vaccine Race, by Meredith Wadman – maybe we should just do book reviews? – I find myself getting excited, or confused, by a passage, and wanting to do more research, and then forgetting about it…

Jacinta: It’s probably pretty normal to forget 95% of what you read within a week or so of having read it. You just hope the things you retain are the principal things.

Canto: Yeah well, I was probably hoping the book would help me get my head around how vaccines work, as well as providing juicy and inspiring tales of heroism and malpractice in the history of vaccine development, and it has helped, but I think I’d need to read half a dozen such books and watch a dozen videos before it penetrated my thick skull…

Jacinta: Yes, for example, when I found myself reading, well into the book, about Leonard Hayflick’s human diploid cells, taken from the lungs of an aborted foetus, which were used to provide a sort of base for creating vaccines against all sorts of diseases, most notably rubella, I thought ‘obviously the author has explained human diploid cells, probably in great detail, before, but I can’t recall a whit’…

Canto: That’s what comes of reading too many books at once, and spreading your focus. You know it’s a myth that women can multi-task better than men, but the major finding of research is that multi-tasking is bad for everyone. Let’s resolve to read books one at a time, from start to finish.

Jacinta: Resolved. Anyway, diploid cells are just standard human cells, with 23 pairs of chromosomes. The only other human cells are haploid sperm and eggs, with 23 unpaired chromosomes. Hayflick’s cell line, gathered in the fifties, was ‘cleaner’ than the cells previously used from other animals, such as monkey kidney cells, which contained many viruses. I used the index.

Canto: So these cells were taken from the lungs of a foetus, and Hayflick was able to produce a cell line from them, that’s to say a line of almost endlessly reproducing cells, I’m not sure how that worked, but these cells, which had to be free of every virus or pathogen, would then be somehow injected with, say, the rubella virus, in some sort of reduced form, so as to produce antibodies in those who are vaccinated. The trick with vaccinology, it seems, is to produce a safe vaccine with no side effects, or minimal side effects, but with enough potency to produce a reaction, thus producing antibodies to the antigens in the vaccine. The vaccine must contain antigens, must have some potency, otherwise it’s useless. And every immune system is subtly different, so producing a one-size-fits-all vaccine is in many respects a monumental undertaking. I may have this completely wrong by the way.

Jacinta: Probably only partially wrong, let’s not be absolutists. What about this difference between killed vaccines and live vaccines. Can we talk about that?

Canto: Well first I want to understand how a ‘cell line’ is produced. How were Hayflick’s famous WI-38 (human diploid) cells produced in a constant stream from the lungs of a single legally aborted foetus in 1962?

Jacinta: Let me try to summarise Wadman’s description of the process from this online article. The tiny lungs were minced up and then placed in a container with a mix of enzymes that separated them into individual cells. These cells were separated again into small glass bottles, and a ‘nutrient broth’ was added, causing the cells to divide. thus began the most thoroughly described, studied and utilised human cell line to date, from which was created vaccines for rubella, rabies, adenovirus, measles, polio, chicken pox and shingles.

Canto: A nutrient both? You mean ‘at this point a miracle happens’?

Jacinta: Well, this was a well-established miracle, only previously it was done with non-human cells, and still is. Monkey and canine kidney cells, chicken embryo fibroblasts, hamster ovary cells… Of course using human cells was bound to be controversial.

Canto: So – obviously the cells in these tiny lungs would’ve gone on dividing had the foetus survived, so microbiologists had worked out a way, of making this happen – mitosis, isn’t it? – outside the host. How long have they been able to do this?

Jacinta: Well the first vaccine was created by Edward Jenner in the late eighteenth century, but they weren’t actually culturing cells then. Cell culture is a broad term meaning a process of growing cells – obviously by cell division – outside of their natural environment, usually in a lab. A cell line (e.g. Hayflick’s WI-38 cells) is ‘a population of cells descended from a single cell and containing the same genetic makeup’, to quote Wikipedia. Cell culture started with the maintenance of cell tissue independent of the host animal in the late nineteenth century, but techniques advanced rapidly in the 1940s and 50s to support virology and the manufacture of vaccines. A key event was the growing of poliovirus in monkey kidney cells in 1949, for which John Enders, Tom Weller and Fred Robbins won the Nobel Prize. Their methods were used by Jonas Salk and others to produce the first polio vaccine.

Canto: But the problem with using monkey kidney cells was that they potentially carried their own viruses, right? Which may or may not be harmful to humans, and how would they know? Without using human guinea pigs?

Jacinta: Human subjects, yes. And there’s also the question of the potency of the virus being used, presumably to stimulate the production of antibodies. Is it just a question of stimulating enough antibodies? And isn’t there an obvious danger of infecting subjects with the virus itself? Presumably a killed virus solves that problem, but is it really effective?

Canto: Yes, Wadman’s book has been fascinating on the politics of the vaccine race, but I’m still left much confused – probably due to stupidity or inattentiveness – as to how some vaccines work better than others, and how a cell line – I know it’s essentially about exponential growth – can produce enough material for millions of vaccine doses.

Jacinta: Yes it’s about exponential growth, and it was once thought that, given the right conditions, these cells could go on multiplying ad infinitum, to immortality so to speak, but it was Hayflick who showed this not to be true in a much-cited paper. Even so, the number of replications of individual cells assured a sufficient supply of cells for generations. And since then, much more has been discovered about cell ageing and its causes, what with telomeres and telomerase, but that’s another story. As to why vaccines developed from the WI-38 cells have been so much less problematic than others, it clearly has much to do with their being ‘clean’ human foetal cells, with no other lurgies lurking.

Canto: So let me get this clear. The WI-38 cells are provided to different labs that are wanting to create a vaccine for, say, measles. Or that have already created a vaccine, or at least have isolated the virus – but then of course viruses can’t be isolated, they need cells to survive in. So they get the WI-38 cells, and then they inject them with the virus – killed or attenuated – and then they start trialling it on rats or mice or something, trying out different strengths of the virus, without really having much idea whether the dose will translate to humans, so they must find some willing volunteers (or, in the early days, orphaned or intellectually disabled kids) to experiment on, making sure they err on the conservative side initially, then upping the dosage? I’m no doubt simplifying and speculating wildly here.

Jacinta: yes and I’m no wiser  than you, but it’s a good thing we have people taking these risks, and working so hard in this field –  with clearer ethical guidelines than before – because millions of lives have been saved by vaccines, and so much has been learned about our immune system in the process of developing them.

 

Wadman, Meredith. The Vaccine Race. Doubleday 2017.

https://www.historyofvaccines.org/content/articles/human-cell-strains-vaccine-development

http://www.nature.com/news/medical-research-cell-division-1.13273

https://www.ncbi.nlm.nih.gov/pubmed/25903999

https://en.wikipedia.org/wiki/Cell_culture

Written by stewart henderson

June 11, 2017 at 7:39 pm

More subsequent remarks preliminary to a voyage

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my officially incipient tache - a supposedly fun thing I'll never grow again

my officially incipient tache – a supposedly fun thing I’ll never grow again

So as flight-time draws nigh, it’s hard to describe my tangle of emotions. The first is dread that this is the end [litt ref 3.5, with apologies to the Doors]. I have a micro-fear of flying, and this’ll be the first long haul. I love embracing travellers’ lingo. We’re flying Emirates, stopping over at Dubai, but the thing is, we’re flying all night. I mean, how do the pilots see anything?

OK, I know it’s all ineffably hi-tech and the safest form of transport ever invented and night flights are pushbuttoningly routine, and Mick Jagger’s still alive and dancin after 10 zillion flights, but there have to be exceptions to prove rules perhaps, and when disasters do happen they’re always spectacular. I mean, you don’t get a dose of whiplash from a plane crash. They’re not called prangs. It’s, like, 279 dead, body parts spread over an xx-kilometre zone, so much for safety in numbers, and I’m wondering, as strangely-pathetically I often do, what will be the reaction to my passing…

But enough self-indulgence, I’ll be right on the night. Still the other emotions and stressors are pastel in comparison. In fact, actually, truthfully, the flight’s the only real issue. Money, la langue francaise, communications home, possible tensions with my TC, health concerns (not flu jabbed, tsk tsk), all mere nanothemes. I’m collecting gratis advice – take a KO dose of valium, get drunk, use nasal spray (done), chew gum (will do), sleep, get over it, enough self-indulgence.

The home I leave behind will be tenanted by a sweet young miss of whom I will say no more in the unlikely event that she reads this blog, and I must say I’ll miss the daily watched-kettle-not-boiling progress of the various building sites in my neighbourhood, with, as a neighbour pointed out, possibly lethally ambitious NYC names like the Bowery, the Beeline (or is it the Beehive?) and Park Central. Really. Cafés and R & R areas are proliferating and jackhammers and earth-pounding noise-makers are just starting to shape the projected City Square a few blocks away. How thrilling it’ll be to actually notice a difference come the end of May. I don’t feel at all cynical about it, as a relative newcomer to regular acceptable employment, a parvenu, a bourgeois – but not assez plat, to recall the slicing words of Stendhal [litt ref 4.5]. Besides, I’ve encountered a few of the occupants of the new medium density constructs sprouting around me (I mean sighted them, not met them) and mostly they look just as spivvy as myself. And the enviro-ideas shaping those buildings really are exciting, but I’m too excited – just about to be picked up and driven to the airport – to detail them now. I will survive [musical reference 1 – but then the Doors reference should really be a  musical reference not a half-litt reference – ok no more ref-mentions].

Written by stewart henderson

April 23, 2016 at 6:00 pm