As you probably know by now, Dresden bombing survivor and towering literary genius of the later 20th century Kurt Vonnegut died earlier week after suffering a fall. You’ve undoubtedly heard a lot about Vonnegut in the past few days, but here’s something you probably haven’t seen before:

The postcard was sent to Mr. Gregory after he “sent him [Vonnegut] a graduation announcement, with a silly note saying something to the effect that I would not have made it [to graduation] without him.” Besides writing wonderfully quirky novels bathed in dark wit, Vonnegut a generally hilarious human being. Here are some samples of things you may not have known about the Mark Twain of the 20th century:

  • – In an interview in 2003 with In These Times Vonnegut was asked if he had any ideas for a really scary reality TV show. To which he replied: “‘C-students from Yale.’ It would stand your hair on end.”
  • – (From Wikipedia): Vonnegut reportedly smoked Pall Mall cigarettes, unfiltered, which he claimed is a “classy way to commit suicide.”
  • – Cat’s Cradle was accepted as Vonnegut’s thesis earning him a Master of the Arts in Anthropology from the University of Chicago.
  • – (From Wikipedia): In Chapter 18 of his book Palm Sunday “The Sexual Revolution,” Vonnegut grades his own works. He states that the grades “do not place me in literary history” and that he is comparing “myself with myself.” The grades are as follows:
  • – And last but certainly not least is one of my favorite Vonnegut quotes, which is quite apropos: “I tell you, we are here on Earth to fart around, and don’t let anybody tell you different.

Is surgery a placebo?

April 10, 2007

From Martin Hutchison in BBC News:

In the early days of medicine, physicians might diagnose patients using bumps on their head, or dispense a couple of leeches to draw off “ill humours”.
Yet a medieval doctor might give a more confident response than his modern equivalent if a patient asked for the evidence to support their treatment.
These days, it seems many of our “tried and tested” approaches to disease are nothing of the kind.

Researchers writing recently in the British Journal of Surgery concluded the practice of daubing patients with a disinfectant skin gel prior to operations made little or no difference to the rate of infections they suffered afterwards. Simple soap and water was just as effective.

However, despite this, it’s more than likely that, in future, waking up after your operation in many British hospitals, you’ll have that tell-tale orange stain around your wound. You’ll have been given a treatment that doesn’t work.

Read more here. The article goes on to describe a study by Andrew Booth at the School of Health and Related Research in Sheffield that found that 15-20% of health care facilities in Britain used treatments that “did not have a shred of worthwhile evidence to support their use.” There are of course, many unfortunate consequences of this. The first is that patients often aren’t getting the treatment that they need. Second some of the ill-informed treatments are actually harmful. One example mentioned by the piece is the test for prostate specific antigen (PSA) which is done as a screening test for prostate cancer despite the fact that those who have the test performed are just as likely to die from prostate cancer as though who don’t. Moreover the use of the test may end causing someone to have an unnecessary surgery performed.

This last issue, unnecessary surgery, made me wonder. Just how scientific are surgeries in general? After all it’s not so easy to give someone the sugar-pill equivalent of a surgery to really “subtract out” the placebo effect in the standard double-blind fashion. To really test the efficacy of a given surgical procedure you’d have to give some group of people a scar and tell them you’ve actually performed the surgery, and since this enters an ethically gray area (to say the least), it hasn’t to my knowledge, been done. Furthermore if the placebo effect really does have something to do with “the power of suggestion” then one would expect the placebo effect to be extremely high in the case of surgeries since one is literally removing a tumor or repairing a malfunctioning organ, in a very dramatic and immediate fashion. In fact, saline injections are very useful in burn victims when they are told that they’re being given a very strong painkiller. So the invaseiveness of a procedure seems to increase the placebo effect. Another important factor is the niceness of the doctor prescribing the treatment, which also increases the effect of the placebo.

So sometimes placebos are useful. But not all of the time of course. A Danish study of placebos found that 48% of general practitioners had prescribed a placebo in the last year. The placebo prescriptions range from vitamins for fatigue, to antibiotics for viral infections (even though antibiotics only kill bacteria, not viruses) which is certainly not a good thing since natural selection will give rise to ever nastier antibiotic resistant super-bacteria! So I’m more or less on the pro-placebo side of the debate, but only if those Danish doctors switch to a more inert placebo for viral infections. So Danes, if you’re reading, here are some suggestions for harmless placebos: vitamins(!), eat more vegetables, vote for Bill Richardson for President, comment on ..dotted and undotted dotterings.., and of course more ice cream from Scoops!

So I’ll spare the blogosphere any additional, ill-formed pontifications for the day and simply share with you my top seven physics cartoons. Why seven you ask, as opposed to the canonical 10? Well the short answer is, I couldn’t find 10 that were notable enough. The long answer is too long, but suffice it to say that seven has lots of nice features. Not only has its glyph stayed relatively constant since it was first used by the Hindus, but it’s also the number of spots found on a common ladybug.


The solution to failing schools…?

How (more than) half of all theoretical high-energy particle physicists end up:

In typically Gary Larson fashion, this one speaks for itself:

Yet another reason why not to trust an experimentalist with a cat (or anything else that breathes):

Alex Kusenko ended his talk at UC Irvine on sterile neutrinos with this very apropos cartoon:

And of course, a very elegant and general method for solving any physics problem:

Okay, the last one isn’t really a cartoon, but it’s just too amusing not to put on the list. Someone actually put that on an exam! Zero points is a little harsh though. They should get a a point or two at least for having such an elegant and creative solution.

I tend to view science in terms of the larger cultural context of human institutions. As I wrote in an earlier post, I think culture is best understood as a complex network of symbols. I’m not pretending that this is an especially unique perspective, since it’s largely borrowed from the preeminent cultural anthropologist of the late 20th century, Clifford Geertz, who, incidentally borrowed it from Max Weber. For example, Weber was famous for saying that man was caught in “webs of significance that he himself has spun.” Symbols are, in a sense, the units out of which culture is built. Viewing culture as symbol is nice, because it encompases an important aspect of human interaction: it is fundamentally interpretational. Is my wink an indication of a secret understanding between the two of us, or is it a half-joking bursleque wink? Or am I pretending it to be a half-joking burlesque wink? As Geertz himself put it, culture is a series of “winks, upon winks, upon winks!” Symbols, and subsequently culture, are contested territories of meaning. The realm of the beaten path of meanings constitutes the mainstream of a given culture. Why do we as a species gravitate to a unified, shared system of meanings? Well the honest answer is, yeah right! no one knows. A more exciting, and therefore probably wrong answer, is that we strive for consistency of intepretation because it simplifies matters. The behavior of humans, to far higher degree than probably any other animal, are not as dependent on their genes. When we are faced with a difficult decision, be it behavorial or interpretational, we filter it through a culural complex of meaning to arrive at the conclusion.

Now what does this have to do with good ol’ hard-nosed science? Science, it is (perhaps) often said, is above the relatively banal matters of culture. In it’s most arrogant formulation it is said that science is trans-cultural. Poppycock. Science is another cultural system in just the sense discussed above. True, science does cherish falsifiability and predictability, but these are just particular ideals that a subculture of Western civilization has chosen to venerate, albeit ideals that I happen to enjoy. That being said, science is indeed unique as a cultural form. It has enjoyed unparalleled success in its application to technological improvement and the expansion of a falsifiable system of knowledge. Certainly, all cultures are dynamic, ever-changing institutions, but only in science I think is change the name of the game. As far as I know, science is the only cultural form to paradoxically, institutionalize revolution. This leads to what I’d offer as the natural definition of science (see the earlier post on definitions too):

A particular cultural form which has uniquely institutionalized revolution. The status of these revolutions are formalized by experimental confirmation of a parsimonious theory.

In science, all knowledge is built on sand, and the whole goal is knock down the previously exisiting sand castle and build one that’s more stable!

I know definitions usually come at the beginning rather than the end, but hey, every exit is an entrance and versa vice, right?