The Chowk Jam! Re: cheeno

``I`m reeeeeally curious about something--would you indulge me? Tell me something: do you really think you have a right to know whether Random and BG are the same person, or are you carrying on just for kicks? I would love to hear an honest answer, although I`m having fun either way!!``

Aha, so the true motivation comes out! And here, we`ve been trying to bury the hatchet!!!

No, I don`t think they are the same person, but beyond that my lips are sealed:)

Anita

The Origin of Life Re: the effect of reproduction on female life span.

Sorry, it wasn`t in Science, it was in Nature. Longevity and the Barren Aristocrat. Nature, vol 396, December 24/31 1998 issue (just in case you were looking Aamina).

Anita

Asian Test Championship Re: RanaRansher,

``This Channel 546 (as it is called) is FANTASTIC. It is ESPN for cricket. COnstant cricket day and night. SO if you are having a sleepless night you can actually tune into some cricket...``

Rana ji, CONSTANT CRICKET DAY AND NIGHT???????????

Why have you visited this abomination upon us?

Anita

The Chowk Jam! Re: Cheeno,

Great start, Cheeno! I`ll now have to go and see what Feroze and Zehra have been saying to each other in the ``Growing Up`` article :)

Anita

The Origin of Life Re: Wasiq

The paradigm of life originating as a set of non-enzymatically assembled, self-replicating polynucleotides, somehow recognized by surrounding amino acids as a primitive genetic code, is as you say - an extraordinarily improbable event. The odds certainly boggle the mind.

To my mind, questions with no easy answers are (its not as simple as saying it was just a chemical reaction that happened under the right conditions - we just have not been able to create the right conditions).

1. Its almost impossible to see how polynucleotides formed spontaneously. A veritable army of chemists have for over 40 years been trying to synthesize nucleotides from elementary molecules (ribose sugars, bases, phosphates) with limited success. It certainly doesn’t happen under the postulated conditions of the ‘hot primordial soup’. For one, nucleotides are unstable in water and tend to dissolve in their component parts. For another, they do not stick together very well under hot conditions - cold would be much better. One would have to postulate extremely high levels of generation of nucleotides and polymerization to overcome these dissociation tendencies. Further, the fact that Miller-Urey and Eigen type experiments yield low levels of amino acids and nucleotides does not support this theorization too well.

2. Even if primitive RNA was able to solve the proverbial which came first, chicken or egg (gene or protein) scenario by having extraordinary self-catalytic activity to function as its own enzyme in the self-replicating process, it would have to contend with very high error rates (in the order of 1 in 100), with no correction mechanism in sight. This limits our postulated primitive RNA nucleotide size to approximately 100 bases to have any fidelity in replication. Primitive RNA would very quickly have to come up with a genetic code and synthesize the necessary error-correcting proteins (enzymes), but it can’t do that with just a 100 bases, it needs more like 500 to a 1000. So its a bad Catch-22 situation for our primitive RNA.

Also, what is life anyway? Are self-replicating polynucleotides alive? Is a piece of DNA alive in a PCR reaction of template, primer, and polymerase? Is life possible without nucleic acid (e.g. prions)? Where do we draw the line?

Unfortunately for us scientist types, if we stick to the line of reasoning that says that the origin of life on Earth was a unique one-time only event, wouldn’t we then have to admit that this is beyond what we would usually think of as scientific theory - since we cannot use this theory to explain 1)observed phenomena, and 2) we cannot test it by further experimentation. We know how evolution happened, and can easily explain it by invoking (what Goga rightly points out) are Bayesian conditional probabilities and natural selection. However, as far as origin of life is concerned, we are on very shaky ground. I think it would be fair to say that at present no theory comes close to adequately explaining how life arose.

So what do you personally think Wasiq - was God playing organic chemist, or are we a configuration of molecules arranged by chance in just the right way - not fundamentally different from non-living matter? Or are you among the ‘I don’t know yet’ crowd?

As for what the sense of deep purpose is, for any organism to replicate itself (Reply #8) - what a fascinating question that is for humans - the only species that can control it, yet continues to replicate itself, albeit, the more in control, the less the replication. Have you seen a recent interesting Science piece (within the last 2 months I think) on what the cost of reproduction may be to women, in terms of years of life lost?

Anita

The Never-Ending Story Re: Godot

``...you are wasting your time with a couple of people. Save your energy for those whose ideas do not border on lunacy.``

You know Godot - I think I`ll take your advice!!

Anita

The Never-Ending Story Re: Bad Girl,

In case I still haven`t made my point clear -

You deny hostility, but I feel that this hostility is expressed through Random. You refuse to admit or deny a relationship. If you did, we could talk about it like adults, resolve this once and for all, and move on.

Anita

The Never-Ending Story Oh, and Random,

I am still waiting for that Gary Null data you were going to edify us with.

Anita

The Never-Ending Story Re: Bad Girl

Thank you for your response. I wasn`t really expecting you to be candid.

I am glad that Random was conveniently able to speak for himself just at the right time.

So long,

Anita

The Never-Ending Story Re: Random

``One of the main limitations to our science is a closed mind. The person who brings about a `paradigm shift` is not merely brilliant, but is willing to step outside the prevailing set of beliefs --- to open her mind to regimes that may not be definable by current science.. The danger arises when scientists resist this, convinced about the completeness and internal consistency of the ACCEPTED FRAMEWORK, and worse - slander those that propose ALTERNATIVE FRAMEWORKS``

You have made some very valid comments about keeping an open mind. That is undoubtedly the road to progress. And scientists have kept an open mind about alternative therapies. There is much activity here, in the scientific world, in an effort to finally resolve which, if any, of the thousands of alternative therapies in vogue work. Unfortunately, the overwhelming majority investigated so far do not.

You say:
``Double-blind studies invariably involve a continuous curve with arbitrarily defined confidence intervals. Researchers have decided that for placebo studies they feel comfortable with an alpha of 5%, or 1% or 0.1%. This may be reasonable, but the objective is to ascertain a binary result from a continuous data set, e.g., Ibuprofen measurably reduces the sensation of pain. For the purposes of establishing reasonable causality, this may suffice, but to cling to such body of studies as the holy grail is hubris.``

There is a lot of poorly conceptualized misinformation here.

1) double-blind studies DO NOT INVARIABLY involve continous curves. It depends on the parameter of interest under study. Examples include cancer cured versus not cured, patient lived versus died, number of colds reduced versus not reduced. In pain studies, the patients own subjective assessment of pain is often used - i.e if the patient says pain was reduced, we`ll accept that.

2) An alpha level indicates the probability that the same result would be obtained if the experiment was repeated multiple times. An alpha level of 1% for example means that if an experiment was repeated 100 times, 99 times the same result would be obtained - a pretty exacting standard. This prinicple is the basis of interpreting epidemiological studies. But no scientist accepts this as proving causality. The bar for proving causality is set much higher, and has to do with showing biological plausibility and coherence, strength of an association, consistency of the association from population to population, temporality of cause and effect, existence of biological gradients, results from animal experiments, and much more.

3) Keeping an open mind should apply equally to you. If experimental data go against your alternative framework, at least have the intellectual honesty to accept it as such, and move on, instead of stubbornly clinging to your alternative worldview.

Btw, nicely timed response with Bad Girl to my ``falsely malign`` statement!!

Anita

Jaya: Chronicle of an Anonymous Death This, Jawahara, is the most beautiful piece of prose I`ve seen on Chowk. The envy is killing me. If only I could write like this.

Keep the words coming...

Anita

The Never-Ending Story Re: Saima Shah

Saima, as usual interesting comments.

You say: ``Let`s jsut get the point of view across that relegating control to others is not the best way to deal with disease``

Agreed. I have addressed this some in an earlier comment to BG (#107).

You say: ``That disease is not just the effect of a few germs which must be killed. Those germs are a part of this great eco system we inhabit and killing these may not be the best long-term answer``

Absolutely agreed! Ninety percent of the antibiotics currently used are unnecessary. This is especially true in animal husbandry. The problem is of mega proportions, and will come back to haunt us - in fact is already haunting us.

You say: ``I want to know whether the human race will ever develop beyond the scientific method as its greatest thought system. Reason is a product of centuries of fumblings and searchings, It is not the end of thought; rationality as we know it is not the last end of this continuum``

Hmmm. Scientific method is the best we’ve got so far. Right now I cannot conceive of much beyond rational thought, but I am tired and hungry, and it is past one am :) But at least let’s not go backwards into the pre-reason era.

You say: ``Our ignorance in the face of evolving and new diseases is heartening. It means we may have more time with the the forests and flaura and fauna which our continued procreation and plunder is depleting at a rapid pace``

To me, it is scary. In fact, Saima, I am shocked !!!Are you really saying that you’d welcome some new bug that will come and decimate people to reduce their numbers. Surely, there are other ways to preserve the environment and reduce population growth rates which are not so painful, and patently unjust (remember, its the poor that always die). How about more equitable sharing of environmentally-friendly resources between the rich and poor countries, education, poverty alleviation, and so on.

You say: ``Why don`t doctors look at the entire ecosystem?``

An entire branch of public health, called Environmental Health/Medicine is devoted to this field. These are the guys/gals who describe all the environmentally-toxic health substances that you hear about.

You say: ``What is wrong with holistic as a concept?``

Nothing. That is why I love Infectious Disease. It looks at the whole person (their immune system, their nutritional status, their general health), the germ, the environment, how they come together …only I do it keeping scientific principles in mind, instead of mumbo jumbo.

You say: ``what is so mumbo jumbo about herbal cures or methods? it does not kill fishes and is not a by-product of petroleum and gets the job done in many many cases.

If they are proven to work, then of course they are not mumbo jumbo, but the problem is that most, when studied scientifically work no better than placebo (see earlier reply to BG). Many are probably harmless to health, especially if cost is not a big factor. The problems occur when, they include substances that are good in the short-term, but harmful in the long-term (example many homeopathic medicines include steroids), when they have interactions with other allopathic drugs a patient might be on, since many herbal medicines have patented and secret recipes (several deaths have occurred due to fatal interactions), and when a person such as BG might choose them to treat breast cancer, over conventional, proven methods of treatment, in the mistaken belief that the alternative is better.

You say: ``Your views are edifying, but then what`s next in terms of optimum solutions rather than cures``

The answer is to keep searching …

Regards,

Anita

Re: Umair

``To the inequity of death (Hakim Said dies, Zardari lives) and of birth, may we add the inequity of retribution for intelligence as the third biggest irony of life?``

So true...

Anita

The Never-Ending Story Bad Girl,

In response to your request for data some quick info on alternative therapies. This is only the data I have at home. There is much more, may be I’ll write an article.

1. Acupuncture versus sham control procedure for nicotine withdrawal (patients didn’t know what they were getting)- no difference in results (Archives of Internal Medicine Nov 9, 1998).

2. Acupuncture versus sham control procedure for low back pain - no difference in results (ibid).

3. Garlic extract versus placebo for cardiovascular risk - no difference in results (Archives of Pediatric and Adolescent Medicine - Nov 1998).

4. Echinacea extracts versus placebo for boosting immunity against colds - no difference in results (Archives of Family Medicine, Dec 1998).


Bad Girl, despite the underlying hostility on both sides, I think this has been a useful discussion. An important underlying message can be gleaned from your comments such as (probably slightly paraphrased, but the essence I think stands), ``modern medicine disempowers patients``, ``patients feel powerlessness``, ``the distant expert in the white coat``, ``science is too focused on lab experiments and quantification rather than on people…etc``

The message is that science has become too complex to understand and decipher for many lay people so that they increasingly feel alienated and disempowered. Physicians and medical scientists clearly should accept much of the responsibility for the creation of this huge‘information failure’. However, from a lay person’s health perspective this is a very dangerous pit to fall in, if its leads them towards finding simple solutions to very complicated problems, when no simple solutions in fact exist. Charlatans have exploited this need of people to understand their physiologic and pathologic processes by convincing them into thinking they have easy solutions when the reality is far different. Therefore, some members of the lay public are doing themselves a huge disservice by shunning a scientific understanding of their health, instead of spending time understanding the complexities.

From the medical scientists and physicians perspective, clearly if they are to help people they must become better at communicating with the lay public about their health in a language they can understand. For me personally this has meant that I see fewer patients so that I can spend an hour with each one going over all their concerns/questions. I make it a point to mail the parent/s a copy of my extensive typed note, sharing all my thoughts that went into caring for their child. For a particularly challenging health problem, I also mail up to date reviews/latest scientific info, along with a lay summary. In addition, I give them my e-mail and pager number for follow-up questions. I find that these extra steps go a long way in informing my patients about their health and making them active participants and decision-makers, and we all benefit in the process.

One hopes that as people become more knowledgeable about their health, it will force the physician-patient relationship to become less passive. Only by this process can patients make INFORMED decisions about their health that are rational, based on scientific principles, health-promoting, and take into account their own preferences.

In the end, an explanation and an apology. In examining my own reactions, I realize that I have been unnecessarily harsh in addressing you. While I would like to attribute these negative reactions to a) thinking that you have used Random to falsely malign me, and b) irritation at your inaccurate statements regarding scientific medicine, that is in fact no excuse for my insulting tone. I sincerely apologize if I have hurt your feelings.

Anita

Re: Iconoclast and my preachiness.

I stand reprimanded! I know the above is also terribly preachy. I suppose it has something to do with being the eldest of 5 siblings, the eldest of 18 cousins, many years of teaching, and being a mother!! Count it among my biggest faults.

Anita

The Never-Ending Story Re: Bad Girl

``…as a lay person, with no interest in medical journals, or knowledge of ‘exciting’ discoveries this is the bottom line for me: there is…NO cure for cancer and AIDS offered by modern western medicine.``

Bad Girl, since you by your own admission have NO SCIENTIFIC KNOWLEDGE in this area - how can you come up with a bottom line? This is just another one of your false statements. The vast majority of leukemias, lymphomas, breast cancers, and many other types of cancers are now curable. There have been tremendous advances in HIV treatment, with several years of disease-free survival, and for the first time, the potential for cure.

You say:

``I WOULD NOT HAVE MY BREAST REMOVED. I happen to like all parts of my body, thank you, and will try anything else (excluding chemo, radiation etc.) to keep them intact.

This is an interesting stance. Let’s explore it a bit further.

What else will you try to boost your immune system to get rid of the cancer? Please provide name of agent/procedure, and figures on cure rates from controlled trials. Tell you what, I’ll even accept a large series of observational data for a start.

You say: ``I don’t see why I have to provide any scientific research studies on alternative medicine. Europe and china are both places where modern and traditional medicine practitioners are involved in working together``

Okay, so show us the European and Chinese data. (Huge sigh).

You say ``Traditional medicine systems have been developed over thousands of years, without labs and control experimentation. But they have worked. That’s why they have survived…"

This statement is no different from what any fundo might make, when defending religion!!

And then you advise me ``if you are truly interested, seek out research on alternative medicine yourself``

My dear Bad Girl, unlike your limited understanding of modern scientific principles, my understanding of alternative medical therapies is very good. I have a Masters in International Health.

And one last thing - may be its time to move to a new pcp who remembers to talk to you about nutrition at every visit, and makes sure you go to bed every night at the right time.

Anita

The Never-Ending Story Bad Girl,

Regarding Random, you say:

``hello? am i random`s mommy or nanny? anita, L E T I T G O. trust me, its really simple and you`ll eventually feel better.``

Why should I let go when it is so much fun to bring him up. And who said he was your mommy or nanny? Lackey would be a better term:)

I am glad that you admit your understanding of science and the scientific process is limited. Allow me to elucidate each one of your statements point by point, although I am wasting precious time doing this. In my case it wasn’t standard sexist dismissal of your arguments. It was that I am simply a very busy woman.

You say ``i was surfing the channels when i came across a documentary on pbs a couple of weeks ago. it was about hiv+ survivors of about 16 yrs, who were doing extremely well. the scientists in the documentary said that recently (couple of years ago or less, i think this was 1997) they had started focussing on the immune system of the small number of people who were doing extremely well despite being hiv+. i was shocked. why hadnt these people been studied 10 yrs earlier? i would have thought that`s the first thing they would have done -- focussed on the body`s own natural mechanisms for maintaining health!``

This whole example is a good illustration of your superficial grasp of this very complicated subject. TEN years ago (1989) we did not know about long-term non-progressors because AIDS hadn’t been around that long. In 1989, there were NO long-term non-progressors. Remember, a few years had to pass before we realized that a small minority of people do well, even without therapy. Scientists have been studying this phenomenon for the last SEVEN years. I should know - I take care of two such wonderfully lucky kids -who I hope to send to college one day. And I maintained one of them for as long as I could WITHOUT any drugs - the immune system started showing early signs of decline last year, despite optimizing nutrition, counselling for stress etc. but it was still a very tough and painful decision to make.

You say:
`` obviously, it appears that the disease-fighting medical paradigm does not consider the immune system as the primary focus, but seems to focus on disease-causing agents and drugs that can attack and hopefully destroy these agents. (benefits the pharmaceutical industry)…"

Wrong again!! The disease-fighting medical paradigm DOES consider the immune system as the primary focus - only it does so in a SCIENTIFIC way. Many exciting discoveries are being made daily in this field, and we are developing new insights into why some people get a particular disease and others don’t. Much of it is genetic, with environment, nutrition, and pathogen factors also playing significant roles. The entire branches of Immunology and Vaccination Science are devoted to the study of the immune system and its impact on people`s health. It is one of THE MOST active areas of research in biological sciences. I evaluate countless children every month who are referred to me by their pcps primarily to address the question of whether there is any immune problem that can be addressed to improve their health.

You say:

``alternative medicine, on the other hand, supports the entire body and, in particular its immune system, to restore it to ITS NATURAL STATE OF health and balance. that is true of ayurveda (diet, herbs, meditation) and chinese traditional medicine (herbs, diet, meditation). homeopathy is based on stimulating the body`s immune response to disease…"

Show me the data on which you base these claims. Random ran away at this point too:)

You say:

``i dont have the training and the interest, frankly, to go through medical research journals. as a lay person, i am ultimately interested in results and options…"

Then may be you should consider avoiding to talk about things about which you have little knowledge, or worse, incorrect knowledge.

You say:
``of all the people i know with diabetes, hypertension, arteriosclerosis, psoriassis (sp?), eczema, lupus, rheumatoid arthritis, who are on standard medicine regimens, NONE have been cured in the true sense of the word…"

That is because no cures have as yet been discovered for these ailments. Allopathic medicine doesn’t have them - but the Alternatives certainly don’t have them. If they did, do you not think the medical and pharmaceutical industry would have capitalized on it? Or are you now invoking that scientists know that these diseases can be cured, but are deliberately holding out so that these people are chronically medication-dependent?

You say:
``my understanding of modern medicine is that for the most part, it alleviates or tries to remove the SYMPTOM, not the cause…"

Again, your understanding is incorrect. Modern medicine tries to prevent and cure illnesses (immunizations, dietary advice, exercise, avoidance of drugs and alcohol, antibiotics, chemotherapy, surgery). For those disorders for which there is no cure at present, it attempts to alleviate symptoms, while scientifically searching for a cure.

You say:

``my point about billions of dollars going to research was specifically CANCER research…and given the amount of money that has gone in and the results—if we are left with breast removal as the most effective prevention—I would call it diddly…"

Again, you are simply misinformed. There have been many gains in the field of cancer research. Leukemia, lymphoma, breast cancer are now for the most part curative diseases. Liver cancer can be PREVENTED by immunization against Hepatitis B. Stomach cancer be PREVENTED by adequately treating H. pylori bacteria. We’ve got to keep looking to see if the same can be done for breast cancer. We do know already that heavy alcohol consumption is a risk factor, as is delayed first birth, and not nursing, and a high-fat diet. The results of the huge Breast Cancer Prevention Trial with thousands of high-risk women over the age of 60, using Tamoxifen got published in September 1998 (Journal of the National Cancer Institute). The study was stopped early because Tamoxifen resulted in a highly significant 49% reduction in invasive breast cancer. So a lot has been achieved …but a lot still needs to be done - we cannot let the amount of money spent doing research stop us from trying harder to find even better alternatives.

You say:
``i have noticed that i fall sick when i am over worked and stressed out… when i go see my herbalist, he always asks me if i am sleeping well and eating well. always. he always reminds me that i need rest/relaxation and balance in my life.``

He/she says this because this is ALL he/she can say. If this is what you need, hear it from me and save yourself a lot of money-EATING AND SLEEPING WELL, REST AND RELAXATION AND BALANCE IN YOUR LIFE ARE ALL VERY IMPORTANT FOR GOOD HEALTH.

You say:

``my come around has been,…based on my own experience with both modern medicine and alternative therapies and those of people i know AND through reading and thinking about life in general, including `medicine`, `health` and `healing`. holistic medicine…including modern western medicine``

Again, I would love to see you provide examples of well-done scientific studies from among all that you have read, that show that these alternative therapies work better than just talking to a good friend.

You say:
``…on the question of breast removal as mutilation. as i said, there is a long history of the mutilation of women`s body, be it cosmetic, for hygiene, sexual control or `medicine`. i believe breast removal is a form of mutilation. if the dominant social, political, economic and political paradigm is patriarchal, violent and misogynistic, why would the medical industry be any different?``

Trust me, when physicians remove someone’s diseased body part, they do it as a matter of last resort, for a medical indication. Breast removal for the purposes of preventing or treating cancer cannot be considered mutilation or misogyny. On the other hand, our male counterparts can justifiably claim that circumcision is a form of ritual male mutilation,misoandry if you will, since it serves little, or no medical purpose (Sohail, I absolutely forbid you to go off on this tangent :).

You say:
``If I were diagnosed with cancer, I would ABSOLUTELY seek out a diet, meditation, detox regimen. No question. I will not go for chemo or radiation. ABSOLUTELY NOT.``

The question, Bad Girl, was, ``if you have breast cancer, would you have the cancer surgically removed?``

In the end a few general comments:

1. You seem to be unduly taken in by labels such as ‘ALTERNATIVE’, ‘NATURAL’, and ‘HOLISTIC’. As long as any therapy comes with these labels, you seem to `believe` in their efficacy. So for example, I can easily concoct a mixture of honey, dandylions, some fancy-sounding herbs, put it in a nice bottle, call it ‘ABINA GINGHOSA, - a Natural Tonic to boost your immunity, and get 10 people to swear by how holistic the experience was, and I would have you sold on its merits.

2. It always amazes me, how far mere Anglicization can carry an individual, and what it allows them to get away with. It is I think fair to assume that if person on the Charpai totem pole (see Ikbal Khan’s poem) wrote in support of hikmat as a holistic approach to health, and decried the scientific method in the process, they would be hounded off Chowk by the purveyors of rationality. Sadly, many work under the assumption that if one has the facility to come up with (preposterous) statements like ``the ``conquest of disease`` is a violent paradigm in keeping with ``conquest`` over nature, over women, over brown and black people``, that one can’t possibly be of an irrational mindset. Kudos to Umair, for calling a spade a spade.


Anita

An Evolving Conversation Re: ASK

``Are geneticists now (or will they be in the near future) capable of making such gene-based agents? What are the chances of an existing non-fatal virus naturally mutating into something deadly(how often does this happen)? How many more unknown dangerous viruses may be present in the world(based on the rate at which new viruses are discovered...)?``

The answer to all of these questions is yes, although I can`t directly think of how selling the Icelandic populations genetic information has any bearing on this. You`ll have to give me more details on that.

One far-fetched possibility could be that they identify a specific genetic abnormality in handling a certain pathogen that is common in people of Icelandic descent and attack with that pathogen. For example CCR5 receptor is important in entry of HIV, abnormal gamma interferon pathways/receptors lead to increased susceptibility to TB etc.

Existing non-fatal viruses can naturally mutate into something fatal, although it doesn`t happen very often. The two best examples are the 1918-1919 influenza epidemic, and HIV. In that `flu epidemic, suddenly a very virulent strain of `flu appeared, which had high death rates even among young people. Over 20 million people died the world over, in that epidemic.

There are probably thousands of undiscovered viruses in the tropical rain forests of the world. As humans increasingly destroy wildlife habitats, we will see more and more of them.

Anita