Why Doctors So Often Get It Wrong

David Leonhardt in the New York Times:

DoctorWith all the tools available to modern medicine — the blood tests and M.R.I.’s and endoscopes — you might think that misdiagnosis has become a rare thing. But you would be wrong. Studies of autopsies have shown that doctors seriously misdiagnose fatal illnesses about 20 percent of the time. So millions of patients are being treated for the wrong disease.

As shocking as that is, the more astonishing fact may be that the rate has not really changed since the 1930’s. “No improvement!” was how an article in the normally exclamation-free Journal of the American Medical Association summarized the situation.

This is the richest country in the world — one where one-seventh of the economy is devoted to health care — and yet misdiagnosis is killing thousands of Americans every year.

How can this be happening? And how is it not a source of national outrage?

A BIG part of the answer is that all of the other medical progress we have made has distracted us from the misdiagnosis crisis.

More here.



Closing the e-Commons, a Tragedy in the Making

In The Nation:

The nation’s largest telephone and cable companies are crafting an alarming set of strategies that would transform the free, open and nondiscriminatory Internet of today to a privately run and branded service that would charge a fee for virtually everything we do online.

Verizon, Comcast, Bell South and other communications giants are developing strategies that would track and store information on our every move in cyberspace in a vast data-collection and marketing system, the scope of which could rival the National Security Agency. According to white papers now being circulated in the cable, telephone and telecommunications industries, those with the deepest pockets–corporations, special-interest groups and major advertisers–would get preferred treatment. Content from these providers would have first priority on our computer and television screens, while information seen as undesirable, such as peer-to-peer communications, could be relegated to a slow lane or simply shut out.

Under the plans they are considering, all of us–from content providers to individual users–would pay more to surf online, stream videos or even send e-mail. Industry planners are mulling new subscription plans that would further limit the online experience, establishing “platinum,” “gold” and “silver” levels of Internet access that would set limits on the number of downloads, media streams or even e-mail messages that could be sent or received.

Wedding Science and Hinduism, shotgun style

Meera Nanda in Economic and Political Weekly:

Rather than bring religion under the limits of scientific reason, India has witnessed a steady co-option of science into the spirit-based cosmology and epistemology of “the Vedas.” …That “the Vedas” are conflated with science as we know it today will hardly come as news to anyone who knows anything about India. This is routine business and has been going on since the very introduction of modern science and technology in India, dating back to the 18th century. (Indian rationalists, in comparison, have never enjoyed the same degree of cultural hegemony. The marginalisation of rationalism in India’s cultural politics is a topic for another day and another essay.)

Most Indians pause to think about this streak of scientism in modern Hinduism, just about as much as fish pause to reflect upon the water they live in – which is not much at all. It has become a part of the commonsense of modern, science-educated, English-speaking Indians to treat the teachings of popular gurus, yogis and swamis as vaguely “scientific,” and therefore modern. Indian scientists, for the most part, have not challenged the religious uses of science: they tend to keep their laboratory lives and their personal lives in separate water-tight compartments. Our public intellectuals and social critics, meanwhile, have been more exercised about the real and imagined scientism of the modern Indian state, than about the scientism that pervades modern Hinduism.

I believe that we need to pay closer attention to Hindu scientism because it is a symptom of the deeper cultural contradictions that afflict India’s modernity.

Reconciliation and Open Discussions in Post-Genocide Rwanda

In The Harvard Human Rights Journal, Chi Mgbako examines a creative but perhaps flawed way of fostering reconciliation in post-genocide Rwanda and stresses the importance of open discussion and criticism.

In the immediate aftermath of the genocide, the infrastructure and social fabric of Rwanda lay in complete ruin. Although the government, remarkably, has restored the physical infrastructure of the country, post-genocide Rwanda continues to grapple with a desperate need for reconciliation. Reconciliation mechanisms designed to respond to atrocities such as genocide, however bold, are inevitably inadequate. Nevertheless, despite these limitations, societies need to establish such mechanisms to come to terms with the legacies of mass atrocity. The RPF-dominated government has employed ingando, or solidarity camps, both to plant the seeds of reconciliation, and to disseminate pro-RPF ideology through political indoctrination. The government encourages or requires Rwandan citizens from diverse walks of life—students, politicians, church leaders, prostitutes, ex-soldiers, ex-combatants, genocidaires, gacaca judges, and others—to attend ingando for periods ranging from days to several months, to study government programs, Rwandan history, and unity and reconciliation.

This Note, based primarily on interviews with ingando participants, government officials, journalists, and genocide survivors conducted in Rwanda in January 2004, evaluates the merits and limits of ingando as a means of fostering reconciliation in the complicated social landscape of post-genocide Rwanda. Focusing on ingando for ex-combatants, ex-soldiers, students, and released genocidaires, this Note argues that much of the ingando project is focused on the dissemination of pro-RPF ideology, a dangerous undertaking in a country in which political indoctrination and government-controlled information were essential in sparking and sustaining the genocide. Furthermore, a successful reconciliation program must take place in a society that values human rights; therefore, we cannot evaluate ingando in isolation from human rights developments in Rwanda. This Note argues that ingando will fail as a reconciliation mechanism so long as the Rwandan government continues to attack public spheres of independent thought and criticism.

rodchenko

Rod

In the 1920s, Alexandr Rodchenko built finely detailed, free-floating, geometric cardboard models and massive sculptures made from squared-timber pieces. His interest lay in spatial investigation rather than completed objects, however, so he destroyed these works immediately after photographing them. Now his grandson, Alexander Lavrentiev, has rebuilt some of these models and is exhibiting them for the first time, along with an extremely varied assortment of hitherto unseen sketches and architectural designs by his grandfather. The work includes free forms, studies for a tea set, cover designs for magazines and books, sketches for a multistory building, a newspaper kiosk, and a lectern at a workers’ club. Particularly striking are The Town, 1912, and Concept for a Terminal, 1919, unusually colorful drawings. This diminutive yet very impressive exhibition in the basement gallery of the MAK makes it clear that, in Rodchenko’s work, space is not a matter of architectural perception but rather a promise of social possibility, a proposition as valuable today as when he first made it.

from Artforum.

The Happiness problem

“bad is stronger than good” is an important principle of design by evolution. “Responses to threats and unpleasantness are faster, stronger, and harder to inhibit than responses to opportunities and pleasures.” This is a matter of how our brains are wired: most sense data pass through the amygdala, which helps control our fight-or-flight response, before being processed by other parts of our cerebral cortex. The feeling that a fright can make us “jump half out of our skin” is based on this physical reality—we’re reacting long before we know what it is that we’re reacting to.

This is one of the reasons that human beings make heavy weather of being happy. We have been hardwired to emphasize the negative, and, for most of human history, there has been a lot of the negative to emphasize. Hobbes’s description of life in the state of nature as “nasty, brutish and short” is so familiar we can forget that, for most of the people who have ever lived, it was objectively true. Most humans have had little control over their fate; a sniffle, a graze, or a bad piece of meat, let alone a major emergency such as having a baby—all were, for most of our ancestors, potentially lethal. One of the first people to be given penicillin was an Oxford policeman named Albert Alexander, who, in 1940, had scratched himself on a rose thorn and developed septicemia. After he was given the experimental drug, he began to recover, but the supply ran out after five days, and he relapsed and died. That was the world before modern medicine, and it would have been familiar to Ig and Og in a crucial respect: one false move and you were dead.

more from The New Yorker here.

ENIAC Turns 60

From The National Academy of Science:

Eniac_today The world’s first large-scale electronic computer, ENIAC — shorthand for Electronic Numerical Integrator and Computer — just turned 60. ENIAC was developed and built for the U.S. Army to calculate ballistic firing tables. It was unveiled on Feb. 14, 1946, at the University of Pennsylvania.

ENIAC was programmed and operated using punch cards, and the machine took up 1,800 square feet, weighed 30 tons, used 150 kilowatts of power, and contained 17,468 vacuum tubes, 7,200 crystal diodes, 1,500 relays, 70,000 resistors, 10,000 capacitors, and around 5 million hand-soldered joints. In one second, it could calculate 357 10-by-10 digit multiplication problems or 35 division or square root problems. It had less memory and processing power than a typical cell phone today.

More here.

Rereading the Renaissance

From Harvard Magazine:Harvard_6

According to Princeton historian Anthony Grafton, one of today’s leading scholars of the Renaissance, “the studia humanitatis, the humanities….encompassed quite a specific range of subjects: grammar, rhetoric, and dialectic, the arts that gave a command of Latin, the language of learning, and oratory, history, poetry, and moral philosophy.” For centuries after, these disciplines were considered indispensable for any well-educated person. Still more important, they helped to define an ethical ideal: they were “forms of thought and writing,” Grafton explains, “that improved the character of the student.” To study the humanities was to grow more independent and intrepid, both intellectually and morally; it was the royal road to becoming a complete human being. In the words of the critic George Steiner, A.M. ’50, modern education has been defined by the principle “that the humanities humanize.”

This tumultuous moment, when the humanities and humanism itself face an uncertain future, is the perfect time to shine a new light on the age when they were invented. That’s why it seems especially fitting that Vergerio’s treatise on education—along with a galaxy of other fascinating, inspiring, and almost wholly unknown texts—is being discovered by a new generation of readers, thanks to the I Tatti Renaissance Library (ITRL; www.hup.harvard.edu/itatti/index.html).

More here.

Wednesday, February 22, 2006

SLAYING LE MONSTRE SACRE

Paul Johnson reviews Tête-à-Tête: The Lives and Loves of Simone de Beauvoir and Jean-Paul Sartre by Hazel Rowley, in Literary Review:

Sartre_1The way in which Sartre became world-famous is itself interesting and shows how useful it is for a writer to operate simultaneously in different fields. A schoolteacher, he had made a study of the phenomenalists, and in 1938 published a novel, La Nausée (a good title, thought up by his publishers: Sartre wanted to call it Mélancolie), based on Heidegger’s principles. It was a deliberate attempt to make a splash, but failed. Then he had a good war. It is amazing he was conscripted at all since he had been virtually blind in one eye since the age of four and his sight became progressively worse; towards the end of his life (he died in 1980) he was virtually blind. As it was, he served in the meteorological section at Army Group HQ, where he tossed balloons of hot air into the atmosphere to test which way the wind was blowing. Taken prisoner during France’s ignominious collapse in June 1940, he was released the following March, having been classified as ‘partially blind’. He got a job in the famous Lycée Condorcet teaching philosophy, gave a wide berth to the active Résistance, and concentrated on promoting himself. As he put it later: ‘We have never been so free as we were under the German occupation.’

An only child, spoilt by his adoring mother, Sartre had never been bothered by consideration for other people. He believed to his dying day that he was the centre of the universe.

More here.

Math as a Language in Its Own Right

Alfred Scharff Goldhaber in American Scientist:

Vtemzruvyad9Robyn Arianrhod’s theme in Einstein’s Heroes: Imagining the World Through the Language of Mathematics is that mathematics is a language, with its own grammar and (implicitly) a number of dialects. Her view implies that mathematics, like more familiar languages, is something characteristically human, an idea appealing to anyone fond of math. The notion of mathematics as a language is not new, but what distinguishes her take on it is that she focuses on a particular, critical event in the use of mathematics, where we can see mathematical language growing in front of our eyes until it reveals a brand-new piece of physics.

She starts her account with a riff on Remembering Babylon, David Malouf’s novel in which a young English boy has been marooned in an aboriginal community in Australia and suffused with its language and culture. On rejoining British society he feels strange—and seems strange to those around him—having been virtually transformed into an aboriginal thinker by being steeped in that language. With this prelude Arianrhod makes a point of the power of language, which she proceeds to bring home with her mathematical exploration.

Who are the heroes of the title? The first is Isaac Newton, who created the earliest grand vista of mathematically encapsulated physics through his universal theory of gravitation. Then comes Michael Faraday, who replaced Newton’s notion of forces acting instantly between separated objects with a new concept, a field generated by an object in one place, flowing from there throughout space to influence the motion of anything that encounters it. Finally, James Clerk Maxwell reformulated the field concept, which Faraday had conceded was not properly mathematical, by using a new language—(differential) vector calculus. This led to a spectacular deduction, the existence of electromagnetic waves traveling at the speed of light. Maxwell’s reformulation invited scientists to identify light as an electromagnetic wave and also to try generating in the laboratory new waves of much lower frequency. Heinrich Hertz later achieved this feat, and today these waves are that commonplace of daily life, radio.

More here.  [Maxwell’s electromagnetic equations shown on upper right.]

United Nations: U.S. Aligned With Iran in Anti-Gay Vote

From Human Rights Watch:

In a reversal of policy, the United States on Monday backed an Iranian initiative to deny United Nations consultative status to organizations working to protect the rights of lesbian, gay, bisexual, and transgender (LGBT) people. In a letter to Secretary of State Condoleeza Rice, a coalition of 40 organizations, led by the Human Rights Campaign, Human Rights Watch, the International Gay and Lesbian Human Rights Commission, and the National Gay and Lesbian Task Force, called for an explanation of the vote which aligned the United States with governments that have long repressed the rights of sexual minorities.

Screenhunter_1_6In May 2005, the International Lesbian and Gay Association, which is based in Brussels, and the Danish gay rights group Landsforeningen for Bøsser og Lesbiske (LBL) applied for consultative status with the UN Economic and Social Council. Consultative status is the only official means by which non-governmental organizations (NGOs) around the world can influence and participate in discussions among member states at the United Nations. Nearly 3,000 groups enjoy this status.

States opposed to the two groups’ applications moved to have them summarily dismissed, an almost unprecedented move at the UN, where organizations are ordinarily allowed to state their cases. The U.S. abstained on a vote which would have allowed the debate to continue and the groups to be heard. It then voted to reject the applications.

More here.

Spiegelman and Sacco on the Cartoon Controversy

In The Nation, cartoonists Art Spiegelman and Joe Sacco discuss the cartoon controversy.

Should this controversy really be framed as an issue of freedom of speech?

SACCO: All societies have their taboos. Are these editorial cartoonists going to rush to the defense of anti-Semitic cartoons? I doubt it, frankly. There are countries in the so-called West–Germany, Austria–where depiction of Nazi imagery is against the law, and even doing a Hitler salute–you could be imprisoned for something like that. It’s a hot time on this planet, and tempers are going to flare, and people are going to get hurt with these sorts of things. Freedom of the press, or the idea that you can depict anything–we simply don’t subscribe to that when it comes down to it. I mean, child porn is not allowed. There are certain barriers or borders we all sort of agree, or most of us agree, where you are taking things too far. I personally don’t necessarily think that attacking a religion is taking it too far, or even working within the imagery of religion to attack it. But you have to judge each instance, and what it means.

SPIEGELMAN: There has to be a right to insult. You can’t always have polite discourse. Where I’ve had to do my soul-searching is articulating how I feel about the anti-Semitic cartoons that keep coming out of government-supported newspapers in Syria and beyond. And, basically, I am insulted. But so what? These visual insults are the symptom of the problem rather than the cause.

In 1897 politicians in New York State tried to make it a major offense to publish unflattering caricatures of politicians. They were part of a Tweed-like machine who didn’t like insulting drawings published of themselves, so they spent months trying to get a bill passed and to make it punishable by a $1,000 fine and up to a year in prison.

What happened?

SPIEGELMAN:It got killed. We have this thing called the First Amendment that was in better shape, maybe, then than now.

double scotch

Banks1_0066209846

There are always two to a talk, giving and taking, comparing experience and according conclusions,” Robert Louis Stevenson wrote in an 1882 essay. “Talk is fluid, tentative, continually ‘in further search and progress.'” Biographer Claire Harman seizes on this passage from “Talk and Talkers” and appends the rhetorically incomplete response, “To be continued.” The device allows her to underline the vexed sense in which a lack of completeness resides at the core of the life and work of the curious Scottish writer.

“The pleasure in writing the beginnings of stories (natural enough in an apprentice) and a revulsion from the work involved in finishing them would remain the most marked characteristics of Stevenson’s creative life,” Harman writes in Myself and the Other Fellow: A Life of Robert Louis Stevenson. As she sees it, a thoroughgoing sense of unfinishedness goes hand in hand with a theme permeating the writer’s oeuvre—the split self and its familiar counterpart, the double, a leitmotif not just in Stevenson’s best-known tale, that of Dr. Jekyll and Mr. Hyde, but also in any number of his works, especially the nocturnal miscreant of Deacon Brodie, the Raskolnikovian killer in the short story “Markheim,” even the pairing of innocent Lowlander David Balfour and exiled Highlander Alan Breck in Kidnapped.

more from Bookforum here.

tropicália

Suit372

Clark was uncertain if what she did was art, or signal to her own pathology. It was both. She was a true original. A diver’s breathing tube, mirrored goggles to be worn by two people, weird balaclava-like masks with pan-scourer eye-hole, rubber gloves to be used to manipulate small objects, whole body-suits with pregnancy-pouches and umbilical tubing – her work is meant to heighten and destabilise the sense we have of our own bodies. We might feel self-conscious wearing this stuff, or playing her games, but their intention was actually cathartic. Her smaller works may have been entertaining, but they also carried within them a similar kind of threat as Giacometti’s “disagreeable objects”. Why there has never been a proper retrospective in the UK of Clark’s work is beyond me.

For all its flaws, this is a timely exhibition. Whatever else it was or wasn’t, Tropicália was an engine of creativity. It had spirit. It was sensual and intelligent, for all the embarrassments of the period. Sitting watching early concert footage of Gil and Caetano, or excerpts from their short-lived TV series, one gets an impression of a less media- and market-driven age, before culture became an industry. An errant art meant something in the late-1960s. Nowadays there’s only the market, and dictatorships by different names.

more from The Guardian here.

seydou keta: african images

Camhi

The portraits show modernity and tradition entwined in a complex dialogue with no beginning or end. The ghost of Marie Antoinette hovers over the pleated bodices and ruffled blouses of these gay and pensive beauties, some made of “Dutch wax” fabrics imitating colonial Indonesian designs, which were printed in Manchester for export to Africa. Their “aeroplane wing sleeves” and “coat hanger braids” (as the Bamakois called them) turn up in the breeze; they bear the marks of scarification and of Western affluence with equal pride.

Above all, they live. “My wish is that my negatives will survive for a very long time,” Keta remarked in a late interview. “It is true, my negatives breathe like you and me.”

more from The Village Voice here.

The birth and life of the ‘9-11 Truth movement’

From The Village Voice:

Tower William Rodriguez, a janitor at the twin towers credited with saving lives on 9-11, has filed a federal RICO suit against Bush, the president’s father and three brothers, the Republican National Committee, Alan Greenspan, Halliburton, several voting-machine companies, and others. He claims that the president and his administration participated in “approval and sponsorship of the 9-11 attacks, kidnapping, arson, murder, treason” in order to “obtain a ‘blank check’ to conduct wars of aggression, to consolidate economic and political power.”

“The guilt of the defendants,” the suit alleges, “is compellingly suggested by their myriad lies, their thwarting of any proper investigation, and their stonewalling and failure to truly cooperate even with the . . . Commission ‘investigation.’ ”

More here.

Unlocking the Secrets of Longevity Genes

From Scientific American:Age_6

You can assume quite a bit about the state of a used car just from its mileage and model year. The wear and tear of heavy driving and the passage of time will have taken an inevitable toll. The same appears to be true of aging in people, but the analogy is flawed because of a crucial difference between inanimate machines and living creatures: deterioration is not inexorable in biological systems, which can respond to their environments and use their own energy to defend and repair themselves.

At one time, scientists believed aging to be not just deterioration but an active continuation of an organism’s genetically programmed development. Once an individual achieved maturity, “aging genes” began to direct its progress toward the grave. This idea has been discredited, and conventional wisdom now holds that aging really is just wearing out over time because the body’s normal maintenance and repair mechanisms simply wane. Evolutionary natural selection, the logic goes, has no reason to keep them working once an organism has passed its reproductive age.

Yet we and other researchers have found that a family of genes involved in an organism’s ability to withstand a stressful environment, such as excessive heat or scarcity of food or water, have the power to keep its natural defense and repair activities going strong regardless of age. By optimizing the body’s functioning for survival, these genes maximize the individual’s chances of getting through the crisis. And if they remain activated long enough, they can also dramatically enhance the organism’s health and extend its life span. In essence, they represent the opposite of aging genes–longevity genes.

More here.

Fukuyama’s revisionism

Helmut at Phronesisaical:

Francis Fukuyama reassesses neoconservatism, distancing himself from the tragedies and grand fiasco that is Bush Administration foreign policy. He does so by repeating neoconservative revisionist mythology. Neoconservatism is not idealism. Strauss was indeed a serious scholar of Greek texts, but his anti-democratic, elitist Platonist and Machiavellian conclusions underride all neocon thought. What we have here is an apologetics where the main figure, Fukuyama himself, reimplicates himself by showing he still doesn’t get it. Indeed, this is a piece of revisionism itself – same old necon approach – since there’s little argument to be made. Let’s take a look at his piece from the NY Times Sunday Magazine

More here.

Leonard Susskind Interview

Greg Ross in American Scientist:

Fullimage_2006112132653_306It’s often noted that the universe seems strangely tailored to support human existence. The cosmological constant, for example, is tiny but not quite zero, producing a delicate cosmic balance without which life could not exist. This unlikely hospitality has given rise to the “anthropic principle,” a controversial concept that invokes the requirement for human existence in seeking to determine the rules of our universe.

The principle is unpopular among physicists, who would prefer to reach a single elegant solution that prescribes values for all the constants of nature without appealing to our own existence. The difficulty is that string theory currently gives rise to an unmanageable number of possible solutions.

In The Cosmic Landscape (Little, Brown, 2005), Leonard Susskind offers a different conception. The Stanford physicist champions the idea of a “megaverse,” a sea of pocket universes whose local environments correspond to the myriad solutions offered by string theory. Rather than seek a unique theory that somehow allows for our existence, he argues, physicists should consider a landscape of parallel universes in which the “local weather” is, here and there, hospitable to life.

Read the interview here.

I Do, I Do, I Do, I Do: The economic case for polygamy

Tim Harford in Slate:

Mammo1A lot of the knee-jerk reactions against polygyny are from people who can’t add up. In a society with equal numbers of men and women, each man with four wives gives women the additional pick of three men—the poor saps whose potential wives decided they’d prefer one-quarter of a billionaire instead. In the Sahel region of Africa, half of all women live in polygynous households. The other half have a good choice of men and a lot more bargaining power.

It’s hardly surprising that in most polygynous societies, the bride’s family gets large payments in exchange for her hand in marriage. If polygyny combined with women’s rights, I bet we’d see more promises to wash the dishes. Not everybody would have to share a husband, but I can think of some who might prefer half of Orlando Bloom to all of Tim Harford—including my wife.

More here.