By Liam Heneghan

“There are tories in science who regard imagination as a faculty to be avoided rather than employed. They observe its actions in weak vessels and are unduly impressed by its disasters” —John Tyndall, 1870

In his 1881 essay on Mental Imagery, Francis Galton noted that few Fellows of the Royal Society or members of the French Institute, when asked to do so, could imagine themselves sitting at the breakfast-table from which presumably they had only recently arisen. Members of the general public, women especially, fared much better, being able to conjure up vivid images of themselves enjoying their morning meal. From this Galton, an anthropologist, noted polymath, and eugenicist, concluded that learned men, bookish men, relying as they do on abstract thought, depend on mental images little, if at all.

In this rejection of the scientific role for the imagination Galton was in disagreement with Irish physicist John Tyndall who in a 1870 address to the British Association in Liverpool entitled The Scientific Use of the Imagination claimed that in explaining sensible phenomena, scientists habitually form mental images of that which is beyond the immediately sensible. “Newton’s passage from a falling apple to a falling moon”, Tyndall wrote, “was, at the outset, a leap of the prepared imagination.” The imagination, Tyndall claimed, is both the source of poetic genius and an instrument of discovery in science.

The role of the imagination is chemistry, is well enough known. In 1890 the German Chemical Society celebrated the discovery by Friedrich August Kekulé von Stradonitz of the structure of benzene, a ring-shaped aromatic hydrocarbon. At this meeting Kekulé related that the structure of benzene came to him as a reverie of a snake seizing its own tail (the ancient symbol called the Ouroboros).

Read more »

by Misha Lepetic

“I never knew I had an inventive talent until phrenology told me so.
I was a stranger to myself until then.”
~Thomas Edison

The question of expertise is a fascinating and vexatious one. Who gets to be an expert? More accurately, who is allowed to be an expert? And what happens when expertise is, for lack of a more polite term, betrayed by one of its own? A recent New Yorker article pillorying Dr. Mehmet Oz provides some interesting lessons in this regard.

Most expertise, it can be reasonably argued, is cultivated and deployed within the context of occupational professions. For the purposes of created a baseline for the following discussion, let’s define a profession as “an organized body of experts who apply esoteric knowledge to particular cases.” This is according to Andrew Abbott, whose The System of Professions (1988) is the current sociological heavyweight when it comes to theorizing about professions.

Abbott contends that, in order to theorize this phenomenon effectively, sociology must look at professions in a holistic manner: prior research, which focused on the structure and function of individual professions, missed the larger point that the success or failure of any given profession was largely contingent upon the results of “interprofessional competition.” That is, when considered in isolation, professions make claims concerning their relevance for addressing social needs through the formation of associations, credentialing, the courting of favourable regulation, and so on. However, when viewed as a larger social phenomenon, it is apparent that these claims are subject to constant contention by other professions. There is, in fact, an ecology of professions.

As an example, while one might consider alcoholism to be an objective phenomenon centered around the over-consumption of drink by an individual, the subjective nature of alcoholism as a social phenomenon has been viewed alternatively as a moral or spiritual problem, a medical disease, a legal matter, and as a mental disorder. Respectively then, the responsibility to treat alcoholics was claimed by the clergy, doctors, lawyers and police, and psychiatrists. What is worth noting is that these professions actively partook in poaching the objective phenomenon at hand from one another. When a particular profession failed to deliver results, an opening was created for another group to take over, thereby adding to its social legitimacy and influence.

Read more »

by Quinn O'Neill

If you were a patient in a hospital, whom would you rather have caring for you: a healthy professional or someone who was febrile, coughing, and struggling to stay awake? If you’re like most people, you’d want to be treated by someone who seemed healthy. It's a no-brainer.

Unfortunately, health care professionals have a tendency to show up to work even when they have the flu or a flu-like illness. According to one study more than 80% of medical practioners and over 60% of nurses, nurse’s aides, allied professionals, and administrative staff do not routinely take sick leave when experiencing influenza-like illness (ILI).

Though paid sick leave policies aren’t the norm in the US, they can have a huge impact on the spread of disease. A study looking at the 2009 flu pandemic estimated that the absence of paid sick leave could add an additional 5 million cases of ILI in the general population. It's worth noting that ILI may be caused by a wide range of pathogens (in addition to influenza viruses) for which flu vaccination offers no protection.

The issue of sick leave – whether it’s paid or not, and whether or not it’s taken when it should be – is particularly interesting in the context of mandatory vaccination of health care workers. A number of employees were recently fired by an Indiana hospital for refusing the flu shot. This wasn't an isolated incident – 29 hospitals fired unvaccinated workers last year. It seems like a pretty extreme measure. Is it justified? In determining this, we should first consider a couple of other questions.

Read more »

by Tom Jacobs

Nobody knows anyone. Not that well.

~ Miller’s Crossing

The midnight thoughts we have when we are kids are amongst the most profound we will ever have, even if we are not in a position to understand them at the time. How do I know the color I see as red is the same color of red for you? What happens after you die? How do I know that my life is not a dream?

These are ridiculously important and childish questions. The kind of questions that used to keep you up at night and that now seem safely relegated to the category of pointlessness (in part because possibly unanswerable…what evidence could one ever marshal to “prove” or even convincingly argue one’s case one way or the other?). But the heart, and somewhere in the back of one’s mind, the mind too, knows, that these questions matter. They will not go away. But there’s work to do and subways to get and schedules to keep. Whether or not you really exist kinda fades into the shadows, along with one’s fear of ghosts. Hell, it’s not even in the background. It’s offstage, somewhere in the wings, occasionally whispering stage directions. But not much more than that. But still it whispers.

Sometimes the moon appears in the middle of the day, spang in the middle of the cerulean familiar. It’s always seemed a damned strange thing, this midday moon. It’s a nighttime thing, the moon, the sort of thing that draws out freaks and lunatics and people who are up to the devil’s business. And yet, the moon is there, hovering over the horizon, at midday no less, offering a kind of vague threat or prophecy. Geosynchronous with us, never letting us see its ass end. As Pink Floyd pointed out long ago, there’s a dark side to it, even if we never get to see it. And this is what creates and cultivates the notion of mystery. Things we know are there but have never seen. The substance of things hoped for, but have never felt or seen (to paraphrase).

My thumb is more or less exactly the same size as the moon is. My thumb is actually usually bigger than the moon, depending on how far it is from my head when I point it towards the sky. How, then, do I know that the moon is, at least in relation to my thumb, immense? How do I know this?

Faith, mostly, with a bit of reason and textbook understanding of physics and geometry thrown in. Even if I was born yesterday (which I wasn’t…I age, I age, and it fills me with a sense of Gnosticism, the felt sense that something has been lost, something important with the advent of consciousness), but even if I was born yesterday, I would never believe you when you tell me that the moon is a moon, orbiting in some unlikely revolution around our earth. And you tell me the earth is four billion years old? Get outta here. But I do trust people who tell me so and I believe them. Why is this so? Is it worth anyone’s time to try to worry over or try to verify these things? Pragmatism comes to the fore to point our attention to things worth thinking about, even if on some deeper level, questions remain.

Read more »

That's All She Wrote

There sits my self
near a window in the sun
its feet up on a sill

There, beside the begonia
whose rose-tinged leaves are satin,
succulent and still

then, as now, taking down
and making up the tale of itself,
a concocting troubadour
in sight of a star above a pine,
past noon remembering,
telling the story of itself to itself
becoming itself,
spinning its character
from threads of the old and
new seconds it stitches into
its suit of being,
as clear as the nose
on the face of itself
(but strange too as it tells and tells),
who reads between the lines of itself
following the story's lead
back to the start of itself
in the beginning
before which, and beyond the end leaf,
there's nothing to tell itself
of itself —that's all she wrote
more would be as silent
as a song without a note

by Jim Culleny 1/23/13

by Mara Jebsen

In August in Philadelphia, the sun leaks across red bricks and washes them down in foamy hot colors like a peach set on fire. Grown-ups sit barefoot on stoops and kids skip under rainbows of fire hydrant spray, which veil their bare arms in incandescent mist. This happened in 1985, perhaps it happens now. It keeps on happening in the diamond in my mind.

My mother and I encountered the city of Brotherly Love in 1983. It did not begin well. That year, her father, a splendid Norwegian gentleman who carried great mischief and light inside him; whose dark hair bristled around his bald pate like Caesar’s wreath, died on a tennis court. He was not yet sixty. This catastrophe blew the universe into grayness, into a sort of deep ash-color that billowed and swallowed even my mother’s golden head.

We’d been living in Benin, in West Africa. When we arrived in Philly I was six; she was thirty-one. We’d just spent two years being jolly and tropical and adventurous. There had been sand castles and palm trees and parties and villages, and chickens to chase. There had been hundreds of friends for both of us, and bright, homemade cotton dresses, paper hats, a parrot, puppet theaters, and my mother had gone dancing under the palm trees to zouk music in her strappy high-heel sandals.

But she was a serious person, basically, and had gotten a spot as a PHD candidate in folklore at the University of Pennsylvania. We took a one-bedroom in the ugliest little stucco building on the last ‘nice’ street between South Philly and Center city, so that I could go to the ‘good’ public school. For two years we were sour and sad and serious.

In 2006, in New York, the poet Philip Levine told me, with that wicked and often charming humor of his, that my poem was “very interesting,” but that he “didn’t want to hear the memoirs of anyone under 40.” He didn’t say it mean. I was 26 and saw his point. I was getting ahead of myself—I wasn’t old enough to look back. Still I have that urge, because of the colors and the gemstone-feeling.

In 1986 these ‘colors’ came. I suppose this is acculturation? It really was as if the first two years were a muddy black and white, a dour Kansas, but 1986 was Oz. My mother got a part-time job as a delivery person for a florist. We drove every street in Philadelphia in a silver van crammed with Birds of Paradise. From about this moment my memories begin to form like a series of complicated kaleidoscopes, the red and yellow and green diamonds spinning

I am not sure that this is entirely a trick of memory.

Read more »

by Omar Ali

“Men make their own history, but they do not make it as they please; they do not make it under self-selected circumstances, but under circumstances existing already, given and transmitted from the past. The tradition of all dead generations weighs like a nightmare on the brains of the living.” (Karl Marx)

Shia killing in Pakistan started in earnest in the 1980s and proximate causes include the CIA’s Afghan project, the Pakistani state’s use of that project to prepare Jihadi cadres for other uses, the influence of Saudi Arabia and modern Takfiri-Salafist movements, the rivalry between Iran and its Arab neighbors and so on. Some aspects of this (especially in light of the history of Pakistan) are covered in an article I wrote earlier . Here I want to discuss a little more about the historical background to this conflict. The aim is to provide a brief overview of how this conflict has played out at some points in Islamic history and to argue that if both Shias and Sunnis are to live amicably within the same state, the state needs to be secular. The alternatives are oppression of one sect or endless conflict.

The origins of the Arab empire lie in the first Islamic state established in Medina under the leadership of the prophet Mohammed (this historical narrative has been criticized as being too quick to accept the various histories generated a century or more later in the Ummayad and Abbasid empires; skeptics claim that the early origins of the Ummayad empire and its dominant religion may be very different from what its own mythmakers later claimed. But this is a minority view and is not a concern of this article). The succession to the prophet became a matter of some controversy (primarily on the issue of Ali’s claim to the caliphate) and tensions between prominent companions of the Prophet eventually spilled over into open warfare (the first civil war). This civil war had not yet been finally settled when Ali was assassinated and Muavia, the Ummayad governor of Syria, managed to consolidate his rule over most of the nascent Arab empire. Ali’s elder son Hassan, eventually renounced his claim and settled terms with Muavia, leading to a period of relative peace. But when Muavia died and his son Yazid took over in the Ummayad capital of Damascus, there was a challenge from Ali’s younger son Hussain. This ended with the famous events at Karbala, where Hussain and most male members of his extended famly were brutally killed by a large Umayyad force. Supporters of Ali and opponents of the Ummayads (the two categories were not always synonymous) launched a series of revolts against various Ummayad rulers, including several led by different members of the extended family of Ali (and by extension, by Hashemites; since in tribal Arab terms, this was also a struggle between the Hashemite clan and the Ummayad clan). During this time the supporters of Ali and his family (Shia means partisan, as in partisan of Ali) developed their own version of Islamic history in which Ali was the rightful successor to the prophet and his right was usurped by the first three caliphs. They also developed various notions about the special status of Ali and his family. Yazid and his Ummayad successors were thus (with varying intensity) regarded as illegitimate rulers and various Shia groups formed natural foci of opposition to Ummayad rule.

Read more »

BETTER A DOG THAN YOUNGER BROTHER

—Persian proverb

When did I start seeing him father-figure?
It wasn’t an endearment shining shoes
for my older brother. Himalayas
shaped his character. I couldn’t call out

his name. “We don’t address our father
using first name, Harry the shrink said.
“He can’t help but see you as kid brother
but, remember, he gets into his pants
as all men do, one leg follows the other.
Banish imaginary gods. Demolish

the ego, for a seed mingles into dust
before blooming. The world is vast. Plumb
your own universe. Forgive your father
for new wife younger than his daughter.”

More poems by Rafiq Kathwari here.

by Randolyn Zinn

Last week Martin Moran performed a private run-thru of All The Rage at a midtown rehearsal room for his director Seth Barrish, stage managers, assistants, a friend, and — me.

Photo by M. Sussman

Moran is a well-known actor and memoirist who goes public with his private musings, seeking where the disparate threads of his life intersect, especially the doubts, guilts and misdeeds that trouble him. He discerns patterns and consequences and then presents them as questions in performance, checking in with the wider world beyond his personal preoccupations.

His latest solo performance piece All The Rage is now in previews at the Peter Jay Sharp Theatre in New York City. Moran has done this sort of thing before. In 2004 he brought his Obie© award-winning The Tricky Part: A Boy’s Story of Sexual Trespass, A Man’s Journey to Forgiveness to the stage before it was published as a book.

After the run-thru (a compact 70-minutes), Martin and I walked to a nearby restaurant to chat about his process.

Randolyn Zinn: I was so moved by your story and how you tell it, the ease with which you make an audience feel focused and connected to your world. I suspect that your theatrical presence, while casual and charming, belies a highly sophisticated set of skills you've developed as an actor. And then there’s your terrific script. The piece moves effortlessly from topic to topic and locale to locale: from Manhattan to Denver to South Africa and back. How did the idea first present itself?

MARTIN MORAN: Every time I make a piece as a storyteller, it’s an imperative, like a knocking in my chest.

It all began with my stepmother. I started writing about my relationship with her because it’s the first time in my life that I actually felt such an outrageous hatred for another human being. That feeling frightened me. Around the same time, my home town newspaper ran a review of my book, The Tricky Part, and it felt like the village elder was saying Martin Moran has no testosterone, why does he not blame his abuser, why is he so mellow, how will this boy ever move on??? And that really threw me for a loop. When I handed my book to a radical feminist to blurb, she said something like Oh Marty your book is so beautiful but where is your anger? And audience members would say in talk-backs after that show, Where is your anger? It all really freaked me out. I thought I had explored my subject, but maybe, I thought, I’m not finished after all, because I skipped an entire realm of human emotion.

RZ: So this piece is a quest to understand anger, your anger…

MARTIN MORAN: Yes. And how anger and compassion can live side by side, like a dance. Of course, there are things worth being angry about and, in a strange way, anger can fuel understanding for how we’re one, connected. We’ve all been wounded somehow. Siba, the man seeking asylum I translated for, was a torture victim. I was abused as a kid. Everyone has something that has sliced through them. So that wound calls us to examine what it is to embrace the reality of why is it we hurt each other and/or why we reach a sublime place of understanding. Perhaps in this piece I’m trying to forgive myself for forgiving.

Read more »

by Dave Maier

Belief, as Aristotle might say, is said in many ways. This would be okay, except it can lead to some annoying, and I think avoidable, muddles. Here I try to pick a way through the minefield.

Let's jump right in. When I say

(1) I believe/don't believe in Bigfoot.

I express my view on whether the “footprints” are fake, the famous film clip is a hoax, etc. For the negative form at least, we might say instead

(1a) I don't believe that there is such a creature as Bigfoot is supposed to be.

This is a statement of the form “I don't believe that P”, where P is some proposition with a truth value. I would say this is true for the positive form as well, but it sounds funny to say

(1b) I believe that there is such a creature as Bigfoot is supposed to be.

even if that is in fact what you believe. In any case I will mostly use the positive and negative forms arbitrarily, unless the difference really seems relevant.

How about this one?

(2) I believe/don't believe in God.

Taken in one way, this sounds like (1). Its negative form can be paraphrased in the same way:

(2a) I don't believe that there is such a being as God is supposed to be.

The context for this reading of (2) might be a conversation in which we were trying to decide whether the force of moral principles derives from divine command. If there exists no divine being to issue these commands, then whatever force morality has cannot come from divine command.

But (2), unlike (1), can also be used to mean

(2b) I am a religious believer; in particular, an adherent of a monotheistic religion such as Christianity.

Here I don't simply assert the existence of some entity, but also indicate the nature of my attitude toward it, which amounts in this case to, among other things, an existential commitment to be a certain type of person. In fact (if I am not particularly orthodox) I may not care very much if “God” is taken to refer to an entity at all, existent or not.

Read more »

Who made you? ,,,…………….,, God.
What else did God make? …… God made all things.
Why did God make you and all things?
………………. —Catholic Catechism for Small Children

Catechism

God made the world
as much an open sewer
as a blazing emerald
in space

Why did god
make the world
whirl, was it
grace?

And why me,
part dark
part bright

Why did god
concoct schism
emeralds and sewers
shade and light
television

Why did god so diddle
make two poles?
Ah! —no ends, no middle

Apprehending the corona
of an eclipse: grabbing the
ring of fire round a vacant gate

Here a veined leaf,
there scorched earth
upon an earthen plate

bitterness unbounded
unbounded love

weightlessness and weight
decision, indecision

Are we made to love and serve
or to send hate off on a roll
to suck the us from we?

But to suck the us from we
leaves just me
with no god above
.

by Jim Culleny
12/28/12

by James McGirk

Before we had any idea how dangerous it was to bolt human beings to exploding tubes and launch them into space, when inventions like the lightbulb and airplane and telephone were warping the planet at a ferocious pace and escaping the earth’s gravity well suddenly seemed possible —we imagined that exploring the Universe would be a lot like the famous expeditions we had seen before. Compare Jules Verne or sci-fi serials of the 1950s to Marco Polo’s Travels: worlds squirming with life and adventure, with bizarre wildernesses to traverse, silver cities that gleamed like sunlit crystal, galactic emperors and perfidious foes and glamorous green heartthrobs who wore togas and served slithering banquets and summoned lightning bolts from buttons on their belts.

It seemed natural our future would come to look like this too. Rocketships and sleek shapes seized our imaginations and seeped into our culture. The centerpiece of the 1939 World’s Fair was the Trylon and Perisphere, a 600-foot tall spire that stood beside an enormous sphere while klieg lights roamed the sky. Architects added ringed spines to radio towers, engineers built trains that looked like gleaming bullets; cars became swoopy and streamlined and eventually grew fins. Anything futuristic was swaddled with chrome and extraneous antennae. By day the movie theatres, airports, motels and diners lining the brand new superhighways looked like docking spacecraft, by night their neon blazed until it blotted out the stars.

Literature absorbed and was mutated by this great swell of imagination. The slender prose of Hemingway and F. Scott Fitzgerald was replaced with huge tomes and colossal egos who tried to devour all of postwar America and regurgitate it into a single tome. This was the era of Norman Mailer, of Saul Bellow and William Burroughs and John Updike and Joseph Heller and Thomas Pynchon and Alan Ginsberg. Their work was as larded with glittering things—with extraneous information, details about objects and history and revolution—as the glorious motels and gleaming theatres had been a generation before.

Read more »

by Maniza Naqvi

It’s rotten! Completely, eaten through! Take this out immediately throw it away—When was the last time you bothered even to clean in here? Didn’t you see this? No—stop! First take your shoes off—they are filthy!—Beta—how many times have I told you not to come in here with your shoes on! Why can’t you do as I say? No! I don’t want to hear a word from you! Don’t answer back! Look at this! When was the last time you cleaned this closet? Before the rains I am sure of it! Now look at this outfit! Ruined, infested—eaten through—crawling with insects! Just lazy! Plain careless! Beta you aren’t a child—you are twelve years old, you should know your responsibilities. I told the sweeper not to throw it out until you had seen it for yourself! I’ve been waiting for you to get home so that I can show it to you! I wore this only once on my last trip abroad for my speech at the conference and everyone complimented me! Now it’s ruined! A waste! No, don’t talk! That is another unending problem with you! You always have an excuse! You never listen. Why are you so late today? Your classes finish at noon and it’s now gone past one! This is what I get in return for sending you to Koran school! It’s just around the corner and you’ve taken so long in walking back. I should have never decided to educate you and send you to school! I thought that getting an education would make you smarter and that this would help you in the future to get married to a decent man–but no—you remain as lazy as ever! I’m going to tell your parents that I can’t send you all the way back to your home for Eid if this is the thanks I get in return for keeping you in my house, giving you a job and educating you. I have been telling all my friends, that they should follow my example. If we don’t do this who will! But you make me ashamed. I will have to tell everyone that I made a mistake and that it is simply no good sending you to school! I mean, if nothing else, if you don’t care about anything else, our reputation, our trust, our generosity, then at least, for the sake of Allah, you must take into account that money doesn’t grow on trees, I’m not made of money. I am generous I know that and maybe that is my sin but please don’t skin me alive for being kind! I am sad to see how ungrateful you are —Beta—we try so hard to make it clear that you are part of the family. Now be quiet—Silence! Let me listen to the news, get out of the way so I can see the breaking news. Oh Allah! Save us, not again! Tsk! Tsk! What is to become of us! I must update my status on Facebook. What we have to endure on TV, the things we suffer on TV. When will the real moral and good leader appear on this blasted TV? I pray and I pray for it. Always these ugly scarey looking crazy mullahs! Where are the decent looking ones? There must be someone we can say we can have over for dinner–sit with at a party—socialize with? —-Hand me my IPAD—no not that that’s my IPhone—over there—bring it here! Get the remote, switch the channel to Al Jazeera—No that’s BBC—okay stop let me watch CNN! What are you sniffling about? Are you getting a cold? I can’t afford for you to fall sick! Move the heater closer to me. There is so much work to be done and I have thirty people coming to dinner tomorrow night, to celebrate Fahad Rizwan’s award for his documentary, you know this very well, you have spent all of yesterday afternoon taking out and washing all the crockery and polishing the cutlery! And tomorrow before you got to school we have to rearrange the dining room. Go change out of your school uniform at once, wash up and make sure the cook gives you lunch—fatafat—be quick–eat in five minutes and then lay out the lunch on the table for Zohra and Tahir–Go check with the guard at the gate–has the Pizza Hut delivery arrived–I ordered it an hour ago, it must have—the children will be getting in any moment now from school. Zohra had a mathematics and physics exam today—you know that! She is going to be so tired! And both Tahir and Zohra have to get to their tutors for their after school tuition for chemistry, math and English by three. Here take this—put it on the dining table–Make sure they take these vitamins! These children, my God, Alhamdolillah! Mashallah, mashallah!! Inshallah they will do well in their O levels. Mashallah they are all so hardworking! Jazakallah!! Now go! There’s no time to waste. Get going! I have to say my prayers. And oh yes, iron the outfit I’ve hung up in my dressing room! It’s brand new. Be careful, if you burn it I’ll skin you alive!! I’m going to wear it tonight to the fund raiser for schools in Swat. It’s the last charity ball of the season. I’m tired. So tired of all that I have to do!! We are going to be late tonight so make sure you stay awake till we get home. You can watch TV in the lounge downstairs. And here, take this, don’t put on that stinking outfit that you’ve worn all week. Take this, I’ve made a pile of clothes for you, these don’t fit Zohra anymore—now go! Go quickly and change. And say your prayers! And take these two dupattas as well—they are white so you can cut them up in half for making at least four hijab scarfs for your school uniform. I can’t have you wearing the same thing on your head every day—it is filthy and what would people say, after all you are associated with the respectability and honor of this family! And stop scratching your head—if you get lice—I’m warning you—I’ll have your hide! Now, quickly tell me: What did you learn today—have you finished memorizing the twenty first Siparah? No! Not now!—I don’t have time to listen right now! Oh for the sake of Allah!!! I’ll listen to you later when I have a moment’s peace. But recite it all the time to yourself today– I will test you later. And remember to mention my parents by name each time you finish reciting it. And after we leave tonight, make sure you mop the corridors on the second floor; Zohra spilled Pepsi there this morning. If I had time I’d ask you to massage my feet but I have no time at all right now, maybe when I get back tonight, the high heels I’m planning to wear I know will kill me. Now go get me a cup of tea.

Other Writings By Maniza Naqvi

by Carol Westbrook

The Golden Age of cancer research is here. The Human Genome program provided rapid sequencing tools and large databases to be mined, computers are larger and faster than ever, advances in equipment and robotics make high-throughput experiments possible, the info web permits quick literature searches…. and so on. Cancer patients are out there, digitally connected and eager to participate in clinical trials. An increasing amount of private and public monies are going into the research effort. We are poised to make great discoveries at a rapid pace, and bring them rapidly to the clinics.

So then, why are these anticipated advances in cancer treatment so slow in coming? What is wrong with cancer research today? Well, pretty much everything.

Cancer research has two sides to it: the basic science laboratory at the university, where ideas are generated and potential new treatments are designed, and the clinical research program, where these new drugs are tested on patients and developed into bona fide treatments which are then brought to the FDA and eventually the marketplace and clinic. There are inefficiencies and major barriers to productivity in both the basic and clinical arenas.

Laboratory research is terribly expensive, and relies primarily on government funding, though an increasing amount comes from private donations and foundations. Yet only a fraction of these research dollars are truly used for researc, as the university is permitted to keep a large share as “overhead” for its own use. Admittedly, these dollars support the teaching mission of the university and contribute to our country's education, but that's fewer dollars spent on cancer research.

There is intense competition for these research dollars, and the competition itself is costly, requiring large infrastructures merely to submit and review grants. One's success in academics relies on getting the most grant money, rather than on the productivity that results from the grant.

Read more »

by Kevin S. Baldwin

Amidst all the bad news about climate change and emerging diseases it is easy to overlook one of the most successful public health initiatives in recent memory. We are on the verge of exterminating an ancient scourge, the Guinea worm.

Dracunculus medinensis, (literally the little dragon from Medina), is a large nematode, which can reach up to 80cm in length. Humans acquire it by drinking unfiltered water that contains water fleas (copepods of the genus Cyclops) infected with larval nematodes. As the copepods are digested, the worm larvae burrow through the human gut and mature in the body cavity. Male worms die after fertilizing females and gravid females move to subcutaneous areas typically on the lower limb. After about a year of maturation, the female releases compounds that cause the skin to blister and the host goes to water to seek relief from the painful lesion, which then ruptures, releasin g the nematode larvae into the water where they are ingested by copepods to complete the life cycle.

This worm is the fiery serpent of the Old Testament. Its treatment in ancient times (and even today), slowly winding the worm around a stick to extract it from the skin lesion, gave rise to symbols for medicine we use today: The single snake on a club (the Asklepian) and the two snakes on a winged staff (the caduceus).

Read more »