Week of March 11, 2024
Open-ended questions to patients often yield unexpected conversational twists. Last week, I found a trend in the responses to my typical exam room entrance question, "What's new and exciting?" Noting media coverage (surrounding the presidential primaries and the State of the Union Address), several patients (representing a wide range of political beliefs) reported significant anxiety about the "news," "state of the country," and "crazy people." During one appointment, we discussed whether political polarization was more intense or just more apparent in an age of endless media. What constitutes care can be so variable. Sometimes, you help support patients as a navigator through chronic illness; sometimes, you quell anxiety by talking about history.
Looking at other periods of history often demonstrates how politics are so messy and anxiety-provoking to those who experience them in real-time. Two examples:
U.S. Election of 1800 – a messy time in U.S. history
Good book on this window of history: https://www.goodreads.com/en/book/show/1216800
and
George Orwell's essay The Lion and The Unicorn - Socialism and the English Genius. "[The essay] expressed his opinion that the outdated British class system was hampering the war effort and that to defeat Nazi Germany, Britain needed a socialist revolution. Therefore, Orwell argued, being a socialist and a patriot were no longer antithetical, but complementary."
About: https://en.wikipedia.org/wiki/The_Lion_and_the_Unicorn:_Socialism_and_the_English_Genius
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Coronavirus rates are still falling based on wastewater RNA levels and hospitalization rates.
The Pandemic Mitigation Collaborative (PMC) website uses wastewater levels to forecast 4-week predictions of COVID rates.
based upon https://biobot.io/data/
The N.Y. Times COVID Tracker reflects only CDC-gathered hospital data. Hospitalization data are a (lagging) indicator.
https://www.nytimes.com/interactive/2023/us/covid-cases.html
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COVID articles
Per the Pew Foundation, the likelihood of receiving the COVID vaccine is now more about age and risk factors and less about political affiliation. Coronavirus is fading from the list of concerns for many Americans (until they get it).
Numerous loyal readers sent me the article about the German individual who claims he received 217 COVID vaccine injections. Only 134 shots are verified (and spawned a fraud investigation by German prosecutors). Researchers were able to obtain blood samples from this person. The Lancet article describing the findings has a disturbingly unironic title - "Adaptive immune responses are larger and functionally preserved in a hypervaccinated individual." The individual suffered no ill effects, had preserved general immunity, and had never had COVID. The author's conclusion ("While we found no signs of SARS-CoV-2 breakthrough infections in [the individual], it cannot be clarified whether this is causally related to the hypervaccination regimen. Importantly, we do not endorse hypervaccination as a strategy to enhance adaptive immunity") fails to explore the most critical question - "WTF?"
https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(24)00134-8/fulltext
https://x.com/erictopol/status/1765130951003410928
Medical Trends and Technology
The FDA chose which strains of influenza to include in the 2024-25 U.S. flu vaccine. While this news is not exciting, the discussion about how the pandemic (specifically the masking and isolation) altered the prevalent influenza variants is—evolution in action.
and
Science blogger Philipp Markolin offers a fantastic discussion about how "scientific truth" is established - "The power of science rarely boils down to a single key experiment; quite the contrary. Science works through triangulation to approximate ever more likely truths." While the article he cites is related to the data supporting that SARS-CoV-2 is a natural phenomenon (i.e., not bioengineered), the logic holds for all scientific data and understanding.
https://twitter.com/PhilippMarkolin/status/1766572001777295523
See the fantastic infographic
https://twitter.com/PhilippMarkolin/status/1766572010732171689/photo/1
Eighteen years ago, my mother bought our children a collection of Baby Mozart CDs, advertised to make them smarter. She was misinformed. The story of how a small study looking at test performance in college students improved after listening to Mozart morphed into "Play Mozart for your baby" is fascinating. Multiple studies later, it turns out that listening to Mozart is just listening to Mozart. Logical fallacies, the media, and the endless desire for an "easy button" to make genius babies are a powerful combination.
https://www.mcgill.ca/oss/article/medical-critical-thinking/mozarts-music-doesnt-make-baby-geniuses
Infographics
I found the "Prosthetic Hands in Fiction" infographic out of context and with no source in a Reddit forum. While the image assembles disparate information (in this case, a collection of famous fictional characters' prostheses), it seems like only a visual list—the image offers no broader understanding. What was going through the author's mind? Under what circumstances does someone think, "The world needs a visual compilation of fictional characters' artificial limbs?"
Instant update! The internet never forgets. Reverse image searching finds that the infographic was the original art for a 2014 USC School of Engineering article entitled "When will we have Luke Skywalker's Prosthetic Hand?" It is still odd.
Things I learned this week
I learned about a perpetual political candidate (for both national and New Hampshire state offices since 2008) and performance artist, Vermin Supreme. While wearing a boot on his head, he espouses absurd political positions like mandatory tooth brushing, harnessing zombies for power (think zombie-powered treadmills), and government-granted ponies for all citizens. And, to the delight of a nephrologist, he donated a kidney to his mother in the early 2000s. He uses his public speaking to encourage others to be living kidney donors. He has participated in several state-level debates with "real" politicians, including glitter-bombing fellow candidates during a 2012 New Hampshire gubernatorial debate.
https://en.wikipedia.org/wiki/Vermin_Supreme
A 2020 interview captures his beliefs:
https://www.youtube.com/watch?v=QZKCi1TXsNs
I learned that McDonald's in Japan is releasing three French fry-scented perfumes - garlic pepper mayo, plum nori seaweed salt, and "traditional" salted French fry. That's it. There is no additional commentary or analysis to enhance the first sentence.
Living with A.I.
JAMA Dermatology published a review of A.I.-driven consumer dermatology apps from the Apple and Android mobile app stores. The authors evaluated the various apps' audiences, evidence-based claims, algorithm details, data availability, clinician input during development, and data usage privacy policies. Their findings were concerning -
"This [review] determined that although A.I. dermatology mobile apps hold promise for improving access to care and patient outcomes, in their current state, they may pose harm due to potential risks, lack of consistent validation, and misleading user communication. Addressing challenges in efficacy, safety, and transparency through effective regulation, validation, and standardized evaluation criteria is essential to harness the benefits of these apps while minimizing risks."
https://jamanetwork.com/journals/jamadermatology/fullarticle/2815800
Like cryptocurrency mining, A.I. requires enormous amounts of energy.
The New Yorker published this article highlighting the very real-world concerns raised by the energy demands of virtual currency and artificial intelligence. "[Estimates are] that if Google were to integrate generative A.I. into every search, its electricity use would rise to something like twenty-nine billion kilowatt-hours per year. This is more than is consumed by many countries, including Kenya, Guatemala, and Croatia."
A.I. art of the week
A man with a boot on his head is listening to classical music using big headphones. His eyes are closed, and he faces a wall of screens, all with different commentators and reporters.
https://drive.google.com/file/d/131jrZ4i-sS53sGNWg8K9KBKMeCAvKdNd/view?usp=sharing
Clean hands and sharp minds,
Adam
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