Seth’s blog

For most of its existence, there was no letters section in The New Yorker. A big mistake, which Spy pointed out and made fun of by running Letters to the Editor of The New Yorker. The current version of The New Yorker has letters, of course, but no comments on the web. Another big mistake.

Because those comments can be incredibly good. In its Health Blog, the Wall Street Journal website recently posted news about Charles Nemeroff, the Emory University psychiatry professor who failed to disclose about a million dollars from drug companies. The news itself wasn’t anything special but the comments told me important stuff I hadn’t known:

• What his defenders say. (Not easily summarized.)
• The nature and quality of his research. “Regarding Dr. Nemeroff’s contributions to science, although he has published many papers, a large proportion have dealt with the hypothesis that the adrenal hormone cortisol plays a major role in the etiology of depression. This hypothesis has its proponents, but has not gained widespread support from experimental or clinical data. Drugs designed to inhibit cortisol have been disappointing as treatments for depression. Hence, regardless of any ethical issues surrounding his career, his publications have been numerous, but with low impact on advancing science and on actual clinical outcomes. Actually, it’s a sad commentary on how really difficult it is to understand the biology of mental illness that individuals such as Dr. Nemeroff who conduct rather mediocre scientific work are considered major contributors to the field.” You can read a thousand outraged editorials and blog posts about Nemeroff and not find something this revealing. Without anonymity, it is very hard to say something like this.
• Complete refutation of one of Emory University’s comments. “Emory said its review supports Nemeroff’s contention his lectures weren’t product specific.” WHAT….I worked in pharma sales years ago specifically selling SSRI’s. Nemeroff was WELL known for SPECIFICALLY selling Paxil in his presentations. He was GSK’s Paxil hit man.” So much for Emory’s credibility.
• A surprising suggestion. “Disclosure alone is not going to do that. These are amounts of money that even if Nemeroff had properly disclosed would be unethical -it can’t be right that a Prof is paid 300 K a year for a full time job and get 500 K in addition from drug companies - even IF it was disclosed. Patients will do well in asking their physician to post or tell them about such additional moneys - and should vote with their feet since there are many honest people, though less powerful, in the field as well.”
• A comment on the real cost of people like Nemeroff. “Anon asks, “Who among the bloggers is familiar with his work, conversant with his research, actually read his papers?” I have, and I don’t trust much about what he says in any of his pharma-related articles. Indeed, I have challenged his findings in letters to the editor. The saddest part of this entire scenario (Nemeroff and others) is the wreckage they have strewn throughout our scientific literature in the past 10-15 years.”

Supporting what I said about letters to the editor. The truth about Nemeroff’s research (and by extension a vast swath of psychiatric research) was in the letters to the editor. But a letter to the editor is just one person — and usually these letters can’t be anonymous. This discussion is many people, it’s a discussion, it’s anonymous, and it’s easily available. The emotion expressed — because people can comment quickly and informally — makes the whole thing easy to read.

This is a wonderful age we are living in, that so much nuanced and well-informed comment is available. Never before, not even close. Merry Christmas!

In a wonderful profile of master diagnostician Dr. Thomas Bolte, this especially pleased me:

Many of the patients Bolte sees are victims of iatrogenic, or doctor-caused, illness. Simply put, they have been misdiagnosed, overmedicated to the point of sickness, or given treatment inappropriate to their conditions. On occasion, this has led to shouting matches with more conventional docs, like the dermatologist colleague who burst into Bolte’s office one day and harangued him—in front of another patient—for telling the mom of an acne-ridden teen to stop feeding her child so much junk food. There’s no evidence that diet has anything to do with acne, the dermatologist shouted. Bolte begged to differ and cited the literature. “The pharmaceutical industry has trained even doctors to believe that there’s a pharmaceutical answer to everything,” he says, shrugging.

A large fraction of Bolte’s patients have been poisoned. They get better when the poison is stopped. The mother of a friend of mine was near death — so near that her children decided to put her in a hospice. By mistake her six or seven medicines were stopped. And she recovered! Her medicines were what had been killing her.

The technical term for such horrors is drug interaction.
Thanks to Dave Lull.

Alana Taylor, a journalism student at NYU, blogged about one of her classes:

Quigley [the teacher] tells us we have to remember to bring in the hard copy of the New York Times every week. I take a deep sigh. Every single journalism class at NYU has required me to bring the bulky newspaper. I don’t understand why they don’t let us access the online version, get our current events news from other outlets, or even use our NYTimes app on the iPhone. Bringing the New York Times pains me because I refuse to believe that it’s the only source for credible news or Pulitzer Prize-winning journalism and it’s a big waste of trees. . . I am taking the only old-but-new-but-still-old media class in the country.

Yeah. The same thing goes on all over campus where students are required to buy a heavy glossy textbook that costs about a semester of paper New York Times. As if the same info wasn’t free on the Web.

Long ago, textbooks were a fantastic bargain because they cost so much less than private tutors. And private tutors disappeared.

After Taylor’s unflattering piece, her thin-skinned professor, who had said “it’s essential for journalists to blog”, banned blogging about the class.

These glasses can help everyone, not just the poor:

The wearer adjusts a dial on the syringe to add or reduce amount of fluid in the membrane, thus changing the power of the lens. When the wearer is happy with the strength of each lens the membrane is sealed by twisting a small screw, and the syringes removed. The principle is so simple, the team has discovered, that with very little guidance people are perfectly capable of creating glasses to their own prescription.

[Josh] Silver [a retired professor of physics] calls his flash of insight a “tremendous glimpse of the obvious” - namely that opticians weren’t necessary to provide glasses

Speaking of not needing opticians and making glasses more affordable, a year ago I discovered by accident something extremely useful: Wearing one contact lens is better than wearing two.

Wearing just one contact lens, I get good distance vision from the lensed eye and and good close-up vision from the unlensed eye. Wearing two contact lenses, I have poor close-up vision. Another benefit of one rather than two contact lenses is that one eye is contact-lens-free for a long time. And I go through contact lenses half as fast. I wear lenses that last one month so I switch monthly which eye has the lens.

No optician told me this. No optician has even figured this out, as far as I know.

By which I mean journalism that involves doing an experiment. In this example, two New York journalists measured reaction to two versions of strawberry milk. The low-rent version did surprisingly well.

A friend and I were once thinking of writing newspaper articles about parking illegally in various places in San Francisco and measuring how long until we got a ticket. News you can use.