STORM by Tim Minchin, 2008

An instant classic........Tim Minchins' masterfull performance "Storm" can be heard on his latest DVD... well worth ordering if you are a fan of sublime musicality and awe inspiring comedic irreverence.

Though not doing it justice, here is the transcript of this wonderfully sharp and witty poem....enjoy!

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Storm

Tim Minchin

In a North London top floor flat,
All white walls, white carpet, white cat.
Rice paper partition, Modern art And Ambition

The host's a physician,
Lovely bloke,
Has his own practice,
His girlfriend's an actress -
An old mate of ours from home,
And they're always great fun,
So to dinner we've come -

The fifth guest is an unknown,
The hosts have just thrown us
together for a favour.
The girl's just arrived from Australia,
And she's moved to North London,
And she's a sister of someone.
Or has - some connection.

As we make introductions,
I'm struck by her beauty,
She's irrefutably fair,
With dark eyes and dark hair.
But as she sits, I admit:
I'm a little bit wary,
As I notice the tip,
Of the wing of a fairy,
Tattooed on that popular area,
Just above the derrière,
And when she says "I'm Sagittarius!"

I confess, a pigeonhole starts to form,
And is immediately filled with pigeon,
When she says her name is *Storm*

Conversation is initially bright and light-hearted,
But it's not long before Storm gets started.

"You can't know anything.
Knowledge is merely opinion."

She opines over her Cabernet Sauvignon
Vis-à-vis,
Some unhappily empirical comment made by me.
Not a good start I think,
We're only on pre-dinner drinks,
And across the room my wife widens her eyes,
Silently begging me "Be nice!"

A matrimonial warning,
Not worth ignoring.
So,

I resist the urge to ask Storm,
Whether knowledge is so loose weave,
Of a morning, when deciding whether to leave,
Her apartment by the front door,
Or the window on the second floor.

The food is delicious,
And Storm whilst avoiding all meat,
Happily sits and eats,
As the good doctor slightly pissedly holds court on some anachronistic aspect of medical history.

When Storm suddenly insists:
"But the human body is a mystery
Science just falls in a hole
When it tries to explain the nature of the soul."

My hostess throws me a glance,
She, like my wife, knows there's a chance,
I'll be off on one of my rare, but fun, rants.
But I shan't, My lips are sealed,
I just want to enjoy the meal.

And although Storm is starting to get my goat,
I have no intention of rocking the boat,
Although it's becoming a bit of a wrestle,
Because, like her meteorological namesake,
Storm has no such concerns for our vessel.

Pharmaceutical companies are the enemy,
They promote drug dependency,
At the cost of the natural remedies,
That are all our bodies need,
They're immoral and driven by greed,
Why take drugs when herbs can solve it?
Why do chemicals when
Homeopathic solvents can resolve it?
I think it's time we all return to live,
With natural medical alternatives.

And try as I like,
A small crack appears in my diplomacy dyke.

By definition, (I begin)
Alternative medicine, (I continue)
Is either not been proved to work,
Or been proved, not to work.
Do you know what they call
'Alternative Medicine'
That's been proved to work?

-- Medicine


So you don't believe in any natural remedies?
On the contrary, Storm, actually,
Before we came to tea,
I took a natural remedy,
Derived from the bark of a willow tree.
It's a painkiller, virtually side-effect free.
It's got a, a weird name,
Darling, what was it again?
Maspirin?
Baspirin? Oh, yeah -
Aspirin!
Which I paid about a buck for,
Down at the local drugstore.

The debate briefly abates,
As my hosts collect plates.
But as they return with dessert,
Storm pertly asserts,
Shakespeare said it first:
There are more things in
Heaven and Earth,
Than exist in your philosophy
Science is just how we're trained, to look at reality,
It doesn't explain, Love or spirituality.
How does Science explain
Psychics, auras, the afterlife,
The power of prayer?

I'm becoming aware,
That I'm staring,
I'm like a rabbit suddenly trapped,
In the blinding headlights of vacuous crap.
Maybe it's the Hamlet,
She just misquoted,
Or the fifth glass of wine I just quaffed.
But my diplomacy dyke groans,
And the arsehole held back by its stones.
Could be held back no more.

Look up, Storm, So I don't need to bore ya,
But there's no such thing as an aura,
Reading auras is like reading minds,
Or tea leaves, or star-signs,
Or meridian lines.
These people aren't plying a skill,
They're either lying, or mentally ill.
Same goes for people who claim
To hear God's demands,
Spiritual healers who think
They've got magic hands.
By the way, why do we think it's okay,
For people to pretend they can talk to the dead?
Isn't that totally fucked in the head?
Lying to some crying woman whose child has died,
And telling me you're in touch with the other side?
I think that's fundamentally sick.
Do I need to clairify here,
That there's no such thing as a psychic?

What are we - fucking two?
Do we actually think that
Horton heard a Who?
Do we still believe that Santa brings us gifts,
That Michael Jackson didn't have facelifts?
Or are you still so stunned
by circus tricks,
That we think the dead would,
Wanna talk to pricks like John Edward?

Storm, to her credit,
Despite my derision
Keeps firing off cliches
With startling precision
Like a sniper using
Bollocks for ammunition.

You're so sure of your position,
But you're just close-minded,
I think you'll find that
Your FAITH in science and tests,
Is just as blind as the
faith of any fundamentalists,

Wow, that's a good point,
Let me think for a bit.
Oh wait, my mistake,
That's absolute bullshit.
Science adjusts its views
Based on what's observed.
Faith is the denial of observation,
so that belief can be preserved.

If you show me that, say,
Homeopathy works,
I will change my mind,
I will spin on a fucking dime.
I'll be as embarassed as hell,
Yet I will run through the streets yelling,
It's a MIRACLE!
Take physics and bin it!
Water has memory!
And whilst its memory
Of a long lost drop of onion juice is infinite,
It somehow forgets all the poo it's had in it.

You show me that it works,
And how it works,
and when I've recovered,
from the shock,
I will take a compass and carve
'Fancy That',
On the side of my cock.

Everyone's just staring now,
But I'm pretty pissed and I've dug this far down.
So I figure.. In for a penny, in for a pound!

Life is full of mystery, yeah,
but,
there are answers out there.
And they won't be found,
By people sitting around,
Looking serious,
And saying: Isn't life mysterious,
Let's sit here and hope,
Let's call up the fucking Pope,
Let's go on Oprah,
And Interview Deepak Chopra.

If you must watch telly,
you should watch Scooby-Doo,
That show was so cool!
Because every time
There was a church with a ghoul,
Or a ghost in a school,
They looked beneath the mask.
And what was inside?
The fucking janitor,
or the dude who ran the water slide!
Because,
throughout history,
every mystery
ever solved,
Has turned out to be -
Not Magic!

Does the idea that
there might be knowledge frighten you?
Does the idea that
one afternoon on Wiki-fucking-pedia
Might enlighten you,
Frighten you?
Does the notion that there might not be a supernatural,
so blow your hippy noodle,
that you'd rather just stand in the fog of your
Inability to google?

Isn't this enough?
Just,
this world?

Just this,
Beautiful,
Complex,
Wonderfully Unfathomable,
Natural World?

How does it so fail to hold our attention
That we have to diminish it
with the invention
of cheap man-made
myths and monsters?
If you're so into your Shakespeare,
Lend me your ear
To gild refined gold,
To paint the lily,
To throw perfume on the violet,
Is just fucking silly
Or something like that.
Or what about Satchmo?
I see trees of green,
Red roses too...

And fine, if you wish to,
Glorify Krishna and Vishnu,
In a post-colonial,
Condescending,
Bottled-up-and-labeled
kind of way,
Whatever, That's okay.

But, here's what gives me a hard-on,
I'm a tiny, insignificant
Ignorant bit of carbon.
I have one life,
And it is short and unimportant,
But thanks to recent scientific advances...

I get to live twice as long,
As my great-great-great-great
uncleses and auntses.

Twice as long!
To live this life of mine,
Twice as long,
To love this wife of mine.
Twice as many years,
Of friends, of wine,
Of sharing curries and getting shitty,
At good looking hippies,
With fairies on their spines,
And butterflies on their titties.

And if perchance, I have offended,
Think but this, and all is mended,

We'd as well be ten minutes back in time
For all the chance you'll change your mind.

On the critical need for an educated populace and transparent government

"A popular government without popular information or the means of acquiring it, is but a Prologue to Farce, or a Tragedy, or perhaps both. Knowledge will forever govern ignorance. And a people who mean to be their own Governors, must arm themselves with the power which knowledge gives."

-James Madison

Vote

Here in colorado we were able to cast our vote a while ago and many of us did.

For those who haven't or couldn't today is THE day. It looks like the country is in for a big turn out and history is in the making whatever your choice.

Hopefully you've considered the issues through all the sophistry and rhetoric.

Hopefully reason, inclusion and clear thinking surface as the new focus for national governance.

Hopefully most of us will excersize our basic civic duty and VOTE.

Treating evidence with contempt

Sad commentary regarding the use of critical thinking by many complemenary and alternative proponents:

"For 15 years I have studied the effectiveness and safety of treatments such as acupuncture and homeopathy. Often, the results were not what the proponents ofthese treatments had hoped for. One would have thought that this might lead to debate, further research, or even health policy changes. Sometimes it has, but recently we have witnessed a new phenomenon.

People or organisations promoting highly questionable treatments are treating the evidence with contempt and flex their legal muscle to have it their way. The New Zealand Journal of Medicine recently published an article showing that most chiropractors use the title "doctor." The argument was that this might mislead patients and cause harm. As a consequence, the chiropractors sought to silence the journal by threatening legal action. (1) Fortunately the attempt failed.

The Guardian was sued for libel by Matthias Rath. The paper had exposed Rath’s strategyof convincing South Africa’s government that his vitamin pills were more effective than antiretroviral drugs for treating AIDS. The Guardian put up a fight, and eventually Rath dropped the libel action and was ordered to pay costs. (2) An editorial in the Guardian (http://www.guardian.co.uk/commentisfree/2008/sep/13/matthiasrath.aids noted that Rath’s activity in South Africa "provides a terrible illustration of thepotential consequences of treating the evidence with contempt."

Science journalist Simon Singh recently condemned the British Chiropractic Association for advocating chiropractic care as a treatment for childhood asthma and a rangeof other paediatric conditions. Instead of arguing their corner publicly, the association filed a libel action against Singh (www.telegraph.co.uk/news/newstopics/mandrake/2570744/Doctors-take-Simon-Singh-to-court.html). The case is likely to come before the courts soon.

When I critically commented on a report that Prince Charles had commissioned on the cost effectiveness of alternative medicine, (3) my university received a letter from the prince’s first private secretary, Sir Michael Peat, to "draw attention"to what he perceived as a "breach of confidence" on my behalf. It took a gruelling 13 months of an internal inquiry at Exeter University to clear my name.

Since I published a book with Simon Singh that evaluated the evidence for or against homoeopathy and other alternative treatments, (4) UK homoeopaths have been engaging in an elaborate campaign of multiple letter writing, repeatedly invoking the Freedom of Information Act to harass and silence me. This letter shows that they have failed. All of this "is not just unpleasant, it is also unhealthy," commented Ben Goldacre. (5)

I would add that the frequency of these events in recent months is downright scary. People who use legal muscle and power, rather than reason and debate, are a danger to reason and progress. What is at stake here is our right, I would argue our duty, to speak out against misleading claims and dangerous concepts. We should find ways of protecting ourselves against such enemies of reason. "

Cite this as: BMJ 2008;337:a2063 Edzard Ernst, Laing chair of complementary medicine"

Gilbey A. Use of inappropriate titles by New Zealand practitioners of acupuncture,chiropractic, and osteopathy.

N Z Med J 2008;121(1278):15-20Boseley S. Matthias Rath drops libel action against Guardian.

BMJ 2008;337:a1710(18 September.)Henderson M. Prince plots alternative treatments for the NHS.

Times 2005 Aug 24:1.Singh S, Ernst E. Trick or treatment? Alternative medicine on trial. London: BantamPress, 2008. Goldacre B. With their money, myopia and abuses, these pill makers match big pharma.Guardian 2008 Sep 13:34.

The science of economy

The process of learning necessarily implies that any held opinions and concepts need to be continually examined, re-examined and -in light of new information- often modified or expanded upon to better fit a larger picture of understanding. This takes time, leads to many twists & turns and can frustrate a lot of people!

For example, it can put one at complete odds with a "faction" of people and yet alternatively, at other times, in solid agreement with that same crowd. This goes for a plethora of 'categorized' groups- many of whom are polar opposites of each other! Granted, there are always those folks with whom the only thing you ever find in common with is the air that’s breathed!

On the one hand, we need to acknowledge and consider solid reasoning while, on the other hand, take issue with hubris & bullshit no matter the origin- be they liberals, conservatives, independents....neocons, neosocialists, neoluddites, isolationists, consumerists, comunalists,...theocons, fundies, dogmatists, apologists... bioluddites, nihilists, primitivists, anarchists, globalists, anti-globalists, corporatists, anti-corporates...yadda… yadda…

Obviously, categorizing ourselves in these ways is quite arbitrary anyway and is really only marginally useful if you think about it a while. In fact, I find even the most stalwart extremists I know succeed only in fooling themselves much of the time.

The reality is we are quite schizophrenic when it comes down to it and can be described -at one moment or another in varying degrees- with any of the spectrum of descriptive adjectives we've come up with so far. We are Narcissus and Goldmund blended -a bizarre fusion of tangled humanity. On the other hand, many of us strive to reach out for that “candle in the night” in a search for the truer nature of things.

In that vein, I've been following a variety of economic topic threads with the goal of trying to understand the bigger economics conversation a little better…Short take so far is nothing new. That is, 'purism' of any sort doesn't work and striving for a smeared and messy, yet transparent and educated participatory "middle" seems most realistic -even with its concurrent complexities. Here the gorilla in the room -whatever it is for you- becomes a more benign presence and allows for more 'humane' versions of free market (& capitalist) economies of scale.

Anyway, thought you might be intrigued with this economics book list I'm building up. It's proving useful as a data base for the so called "dismal science" and offers tools to differentiate between the "wheat & the chaff" and what's already right & what's not.

Though my keenest interests lie elsewhere -actually waaaay elsewhere- I guess it's important to have some working awareness of a topic that so affects us all. If you have any favorite economy book, lectures, or other suggestions, please send them along!

Economics book list (partial):

Game Theory: Analysis of Conflict

Economics and the Theory of Games

The Worldly Philosophers

Nudge

New Ideas from Dead Economists

Naked Economics: Undressing the Dismal Science

The Undercover Economist

The Race Between Education and Technology

The Mind of the Market

Poverty Traps

Inequality in America

Social Movements: Identity, Culture and the State

Astronomy lectures and climate change

From the Silicon Valley Astronomy Lectures...a very interesting talk:

Take an entertaining and enlighting journey with astronomer and popular author Dr. David Grinspoon through the history of our solar system, discovering run away greenhouses and snowball planets. Compare the evolution of Venus, Earth, and Mars over the years and learn how studying the evolution of other planets can help us understand and predict climate change on Earth.

Labrador love

Doesn't get much better...

On occasion, I will be passing previous posts relating to evidence and science based veterinary medicine, complementary and alternative veterinary medicine and other pertinent skeptical issues to the Vetskeptics blog.

This is an attempt at consolidating veterinary & other medical information relating to skeptical information about CAM/CAVM that may prove useful and interesting in a more focused venue. Time permitting, some of these posts will be expanded upon. As always, posts from anyone interested in contributing (see vetskeptic blog) are welcome.

The Beyond the illusion post touches on some of the factors that confound and fool practitioners and others into thinking ineffective therapies work when they really don't.

End of life: Jasper and Karen

How does one walk in a world where joy and pain are inseparable...where fullfillment and utter despair embrace in an impossible trist...and where saying goodbye becomes confused with saying hello...?

The relationship between Jasper (the dog) and Karen (the human) reflects an authenticity and profound acknowledgement of life as it is....brief, harsh, contradicting, brief, beautiful, resonant, incredible, brief.

For a veterinarian, walking down the path between life and death with a person and their beloved companion is always different. Jasper had an untreatable malignancy (throat cancer) that was literally and quickly choking away his life...what he needed and what I could give him was a good death...

....this is a part of our world.

Never let them see your fear...

A tale -in some version or another- most veterinarians have lived through...

Integrative medicine and hat tricks

So many times the devil really is in the details. So it seems, time after time,
I and many others find ourselves confronted with the same tired and increasingly tenuous arguments from Complementary and Alternative Medicine proponents.

Sadly, it doesn't seem to slow the creep of medicine back towards a far more
dangerous era -one of "curative anarchy"- that society wisely decided
to collectively walk away from a hundred years ago.

How quickly we forget...

These modalities continue to find fertile ground with the credulous by insiduously blanketing and confounding themselves with a false legitimacy. By appropriating and altering innocuous sounding concepts such as 'freedom of choice', 'teaching the controversy' and having a 'balanced' discussion (where none exists) -all for the sake of an ideology- many CAM supporters succeed only in weakening and degrading the pillars of reason and critical thought.

A colleague, Dr. Novella writes a sharp and clear post regarding one of CAMs
more succesful hat tricks...the bait & switch.

Excellent reading.

Carl Sagan: A thousand years of darkness

The importance of questioning not just the permanence of the stars, but also the justice of slavery can not be overstated...

...only then will history not -once again- be damned to repeat itself.

Carl at his best.

on choosing humanity over magic

Good article on how taking into account 'provenance' helps us ellucidate -even with our limited capacity - truer realities. Though we can never completely escape our biases nor should we (pattern seeking social primates that we are), we can sure strive for balance between -not magic and reality- but humanity and reality.

The article talks about 'woo' which is a catch phrase -as most of you are aware- for a broad collection of credulous mind sets. Here is a brief primer of what 'woo' is (thanks Orac):

Beliefs that clearly demonstrate magical thinking, uncritical acceptance of things for which no good evidence exists. This includes, but is not limited to, psychic phenomenon, ghosts, the paranormal, "energy healing" and a wide variety of other mystical and pseudoscientific beliefs.

Woo is resistant to reason. Indeed, woo has a double standard when it comes to what it considers to be good evidence. It is very accepting of a wide variety of fuzzy, mystical ideas, but is often incredibly distrustful and skeptical of anything having to do with "conventional" science or "conventional" medicine. Woos tend to be very quick to react to defend their particular brand of woo and very unforgiving of its being questioned.

StevenPinker: on the decline of violence

....or it helps to continually learn, listen & understand -as best we can- when trying to affect change in the ways of the world.

In that regard here is an interesting review of Steven Pinkers lecture (& upcoming book) with respect to the study of human violence from a historical perspective...important to "consider as one considers".

Of course regarding violence, things can easily go to hell in a hand basket -and often do- for a variety of reasons...still, teasing out these observable phenomena can prove very useful in understanding human collaboration.

Steven Pinker on the decline of violence

"Steven Pinker, a professor of psychology at Harvard, begins his presentation with an image of corpses on a truck, being taken from Auschwitz concentration camp. The image is one of many characteristic of the 20th century, a century that included brutality under Stalin, Hitler, Pol Pot and the genocide in Rwanda. The 21st century, which has barely started, already includes the brutality of Darfur and the daily destruction in Iraq.

These sorts of images can lead us to thinking that modernity brings terrible violence. Perhaps native people lived in a state of harmony that we’ve departed from.

This, Pinker tells us, is bullshit. “Our ancestors were far more violent than we are.” We’re probably living in the most peaceful time of our species’s existence, a statement that seems almost obscene in light of Darfur and Iraq.

The decline of violence, he tells us, is a fractal phenomenon - we see it over the centuries, the decades and the years. That said, we see a tipping point in the 16th century - the age of reason - particularly in England and Holland.

Until 10,000 years ago, all humans were hunter gatherers. This is the group that some believe lived in primordial harmony - there’s no evidence of this. Studying current hunter-gatherer tribes, the percent of male adults who die in violence is extraordinary - from 20 to 60% of all males. Even during the violent 20th century, with two world wars, less than 2% of males worldwide died in warfare.

Moving slightly further forward, we can see that violent punishment was common in the Bible - Moses tells his followers to kill all the men and married women of a village and rape the virgins. The death penalty was used for murder, idolatry, disrespecting your parents and “collecting sticks on the sabbath”.

The Middle Ages were filled with mutilation and torture as routine punishments for trangressions we’d punish with fines today. This was merely another charming feature of a time that featured passtimes like “cat burning”, dropping cats into a fire for entertainment puposes… Some of the most creative inventions of the Middle Ages were fantastically cruel forms of corporal punishment.

One on one death has plummeted through the middle ages, with an “elbow” of the curve in the 16th century. Despite a slight uptick in the 1960s - “perhaps those who thought that rock and roll would lead to a decline in moral values had it right” (joking) - we’ve seen two orders of magnitude fall in one on one violence from the middle ages to today. State sponsored violence has also fallen sharply - we’ve seen a 90% reduction in genocide since the end of the cold war. State on state conflicts are dropping every decade.

So why do we so mispercieve the violence of our society? For one thing, our reporting is better. AP is more likely to cover a war somewhere on the planet than a 16th century monk. We’re subject to a cognitive illusion - memorable events (brutal murder) are judged to be more probable than they actually are. Finally, our standards tend to change faster than our behavior. We may be offended by capital punishment today because it no longer fits with our vision of ourselves, but it’s worth remembering that not long ago, that sort of punishment was exceedingly common and there wasn’t strong protection of rights in the courts to prevent it from taking place.

So why is violence becoming less common? He offers four explanations:

1) Hobbes got it right. “Life in the state of nature is solitary, poor, nasty, brutish and short.” In anarchy, there’s a temptation towards pre-emptive violence, hurting the other guy before he hurts you. But with the rise of the Leviathan - the State - there’s a monopoly on violence. This helps explain why we still see violence in the absence of the state - zones of anarchy, failed states, street gangs.

2) In the past, we had a widespread sentiment that life was cheap. As we’ve gotten better at prolonging life, we take life more seriously and are more reluctant to take life.

3) We’re seeing more non-zero sum games, as people discover forms of cooperation that can benefit both parties, like trade and shared peace dividends. These zero-sum games come with technology, because it allows us to trade with more people. People become more valuable live than dead - “We shouldn’t bomb the Japanese because they built my minivan.”

4) Finally, Pinker leans on Peter Singer to speculate about “the expanding circle”. By default, we empathize with a small group of people, our friends and family. Everyone else is subhuman. But over time, we’ve seen this circle expand, from village to clan to tribe to nation to other races, both sexes and eventually other species. As we learn to expand our circles wider and wider, perhaps violence becomes increasingly unacceptable."

A non-zero sum game of human to human interaction makes the most intuitive sense to me and is reminiscent of aspects of evolutionary game theory, though the "expanding circles" notion is intriguing. However, Peter Singer goes way too far in other writings where he or at least some of his readers manage to confound unrelated ideas into a bizzaro house of cards version of 'animal rights' mindlessly parroted, overused and abused by 'animal rights' activists.

It’s likely, that a combination of Pinkers’ hypotheticals blend together –possibly along with other intangibles- to affect this fascinating fractal phenomenon observed as a general reduction in human on human violence.

What is going on that is right is as important to know as all that is going wrong. All in all this presentation offers some interesting food for thought.

Acupuncture: still no point to the point...

This has been a summer full of distractions and challenges needing a lot of attention. Add to that a touch of blog writer “blues” and you get a dry spell regarding postings. Consequently, this blog –not to mention the new blog baby - has been neglected and hungry for forward movement and novel discussion.

Hopefully, this little post will get things going again. All in all, this is a fun and gratifying way of expressing ideas and thoughts and helps to keep the mind sharp and attentive.

The following is a comment on my “Veterinary acupuncture” post that, although friendly and thoughtful, latches on to a few canards and fallacies in order to defend the concept of acupuncture as a viable medical therapy. Obviously, I disagree and felt compelled to write a quick response which follows the commentators blurb.

"Unfortunately there are far too many veterinarians, physicians and researchers who dismiss acupuncture as a hoax or as in this case lacking adequate scientific and clinical proof to warrant its use. Clearly the problem has been that clinical and scientific studies of acupuncture have lacked adequate controls. Without proper controls study results are nothing more than hearsay. However more recent scientifically controlled studies would argue that perhaps acupuncture therapy has merit. In this regard recent studies using microarray technology to examine acupuncture effects on gene expression in peripheral blood are no less than fascinating. For example Shiue et al (2008) have shown that acupuncture therapy significantly reduced allergic rhinitis symptoms, including nasal symptoms, non-hay fever symptoms, and sleep in human patients and this was accompanied by and alteration in the balance between T-helper 1 and T-helper 2 cell-derived proinflammatory versus anti-inflammatory cytokines in the blood. Such studies are paving the way for a more scientific explanation of acupuncture's effects. One only has to examine the recent fMRI studies of acupuncture effects on brain activity in humans and animals to conclude that acupuncture point stimulation has remarkable effects on brain activity compared to non-acupoint stimulation (see for example Napadow et al., Hum Brain Mapp, 2005). These are real effects and whether they underlie the ability of acupuncture to alter pain sensation in humans and animals remains to be proven with certainty, but nonetheless acupuncture has the capability to change brain activity. In our own studies we have found that acupuncture can prevent tumor growth if given at the very early stages of tumor cell proliferation. Conversely if acupuncture is applied later on after a tumor begins to grow, it significantly enhances tumor growth, which is why acupuncture is typically not recommended as a treatment for cancer. On the other hand acupuncture provides clear relief of pain in animal models of neuropathic pain and inflammatory pain. These effects are real folks and I have seen them first hand, so I refuse to believe that acupuncture is of no value in the medical community, be it veterinary or human medicine. There is evidence that acupuncture does not work in certain individuals and works well in others, so there is clearly individual variation in the ability of acupuncture therapy to work effectively. Taking all of this into account, I would argue that you shouldn't dismiss acupuncture until you have tried it!”

The real unfortunate issue is not that acupuncture is dismissed as a hoax, but that – even with a preponderance of disappointing evidence- this modality continues to expect unearned acceptance.

Though plagued with poorly designed studies that are often replete with equivocal results or laced with regional geographic bias, better designed acupuncture studies are out there. However, the news is not good for any real acupuncture effect. The infamous placebo –among other problems (i.e.; expectation, suggestion, counter-irritation, operant conditioning, and other psychological mechanisms) - continue to confound even “modern” acupuncture technique (that is to say; those acupuncture practices that use needling and claim no association with the ‘elam vital’, points, or meridians).

The studies you mention do not address a critical issue with respect to acupuncture- whether or not its putative effects exist. The attempt to correlate a claimed acupuncture effect to epigenetic influence puts the cart before the horse (and is reminiscent of what ‘nutritional supplement support’ advocates claim for a favorite herb, vitamin, or tonic du jour) and purported brain responses apparently observed by fMRI are interesting but it seems apparent that any mechanical puncturing of the dermis –on points or no points, shallow or deep- will effect changes.

There is little or no evidence that acupuncture is effective for any real medical disease (i.e.; neoplasm) nor, for that matter, for less well defined symptoms (including chronic pain, depression, allergies, asthma, arthritis, bladder and kidney problems, constipation, diarrhea, colds, flu, bronchitis, dizziness, smoking, fatigue, gynecologic disorders, headaches, migraines, paralysis, high blood pressure, PMS, sciatica, sexual dysfunction, stress, stroke, tendonitis and vision problems). Interestingly, promising and plausible mechanisms –if any- seem associated with completely different modalities that are confused with acupuncture (i.e.; TENS, psychosomatic, placebo).

Seeing acupuncture effects “first hand”, no matter how impressive, is simply anecdotal testimony and adds nothing to a scant evidence and science based foundation supporting acupuncture. In short, the accumulating evidence suggests most of the perceived beneficial effects of acupuncture are probably due to the power of suggestion and forms of the ‘placebo effect’.

Whether or not acupuncture is of any value to the medical community might be better discussed in a philosophy of science course. For example, acupunctures place might be better off in the realm of personal belief or preference (i.e.; priest or shaman) and well outside of medicine (If you believe in it, it will make you think you feel better – that’s your business).

As for having tried acupuncture…been there done that. I’ve also extensively observed its use in animals by certified veterinary acupuncturists.

Not impressed.

Science

(hat tip to Orac)

leading forward

One of the goals when teaching is to "lead forward'; that is create an
environment that sparks interest and wonder. If a teacher can manage to provide
a glimpse into the breathtaking world of life long learnig they are doing their
job.

The "thousand year model" is a great way to introduce astronomy to just
about any one and is an especially good "mini" field trip set up for school
kids. It creates an experiential excersize of our own solar system that seems to
stick with them.

Maybe you know some teachers who might be interested in it if they aren't already aware of it, but try it yourselves if you ever have some time to take a long walk -it's amazing!

non sequitor

A nice statement ...

No matter where one stands on the spectrum of perception and worldviews…the “state of being” these words reflect serve as a sound guide...they fly sound and true.

I believe in time,
matter, and energy,
which make up the whole of the world.

I believe in reason, evidence and the human mind,
the only tools we have;
they are the product of natural forces
in a majestic but impersonal universe,
grander and richer than we can imagine,
a source of endless opportunities for discovery.

I believe in the power of doubt;
I do not seek out reassurances,
but embrace the question,
and strive to challenge my own beliefs.

I accept human mortality.

We have but one life,
brief and full of struggle,
leavened with love and community,
learning and exploration,
beauty and the creation of
new life, new art, and new ideas.

I rejoice in this life that I have,
and in the grandeur of a world that preceded me,
and an earth that will abide without me.

(hat tip to Pharyngula)

Vetskeptics blog

A blog baby!
This little blog project at wanderingprimate has always been about pondering on a rather wide breath of topics. Hopefully regular readers- if any- have enjoyed some of these posts as I have meandered- or wandered- about from topics in physics, medicine and other science related themes that have caught my fancy. As long as it is enjoyable, I plan to continue writing and perhaps broaden the scope a bit- touching more on other sciences and philosophy from time to time.

Along the way, I have managed to build up a fairly significant body of veterinary posts that have proven useful and may be of some use to others. With that in mind, I’ve decided to create a new veterinary specific blog site -Vetskeptics- with the goal of collecting these posts into an easier to access format and, at the same time, initiate a veterinary specific site that promotes critical thinking and skepticism.

My goal is to add to the scarce resources on the "ether" net for veterinary skeptics, or any animal lover tired of the pseudo-scientific blather out there. I hope to improve on some of the old posts and have new authors send in their own quality posts in an effort to put together a more collaborative site of like minded veterinarians, veterinary technicians, animal care-givers or any animal lover interested in sharing their thoughts.

If nothing else, it will be a nice skeptical reference blog. If you are interested in helping out, please have a gander at the site and drop me a line at (drg at vetskeptics dot com).

It could be a lot of fun!

Prions: mysterious shape shifters

Everywhere and nowhere

It is the strangest thing to see a vibrant and healthy Colorado bred elk begin to shrivel and waste away before your eyes. It is even more frustrating to feel that old familiar tinge of complete helplessness when the realization comes to you that chronic wasting disease has taken (CWD) hold of another victim. No matter how aggressive and careful you are there is literally nothing that can be done once this mysterious disease takes hold.

Thankfully, the incidence of this prion based sickness is relatively rare and slow to ravage whole herds. This is good as the best we can do to control CWD is to monitor it by testing the tissues of captive adult animals that have died or researching “test and cull” methods for eradicating it from wild herds.

The mechanisms that make this disease so bizarre and counter intuitive starts with the causative agent – a prion- a small protein structure without any nucleic acid. They are described as “small proteinaceous infectious particles which resist inactivation by procedures that modify nucleic acids.”

This is indeed beyond strange. The idea that a protein structure by itself can cause disease defied a lot of what was known about infectious disease. The infected animals are usually neurological and the disease is now classified into a family of “spongiform encephalopathies” based on the post mortem lesions found in affected mammals¹- of which most seem to have some version of this thing (table 1). They are all characterized by varying degrees of loss of motor control, dementia, wasting (paralysis) and eventually death.

Table 1 some prion diseases:

• Scrapie: sheep
• TME (transmissible mink encephalopathy): mink
• CWD (chronic wasting disease): muledeer, elk
• BSE (bovine spongiform encephalopathy): cows
• CJD: Creutzfeld-Jacob Disease: human
• GSS: Gerstmann-Straussler-Scheinker syndrome: human
• FFI: Fatal familial Insomnia: human
• Kuru : human
• Alpers Syndrome: human

An interesting historical anecdote regarding early prion research is touched on by Dr Shaun Heaphy lecturer at the University of Leicester “Kuru is the condition which first brought prion diseases to prominence in the 1950s. Found in geographically isolated tribes in the Fore highlands of New Guinea. Established that ingesting brain tissue of dead relatives for religious reasons was likely to be the route of transmission. They ground up the brain into a pale grey soup, heated it and ate it. Clinically, the disease resembles CJD. Other tribes in the vicinity with same religious habit did not develop the disease. It is speculated that at some point in the past a tribe member developed CJD, and as brain tissue is highly infectious this allowed the disease to spread. Afflicted tribes were encouraged not to ingest brain tissue and the incidence of disease rapidly declined and is now almost unknown.” This rather macabre custom did illustrate how this strange infection behaved and how it might work through a population of people.

Even more intriguing, these prions seem to be related to a normal and abundant cellular protein (PrPc) located on the membrane on run of the mill neural cells. These prion like structures have a different structural shape than infectious prions and are perhaps functionally linked with normal neural transmission, though no one really knows for sure.

Prions and these PrPc proteins seem to have species specific structures but these configurations are fairly similar across the board. This species specificity dramatically slows down cross species infections and makes such jumps far less probable, but not impossible- especially if there is a susceptible individual on the other end.

The prion varies in its structural three dimensional forms from the normal PrPc protein and it’s this structural difference that seems to make them so insidiously pathological. To make matters worse, it seems there may be genetically susceptible individuals that are more prone to having their own PrPc proteins “shape shift” into the pathological infectious prion by coming into contact with a prion (by the way, not all shape shifted prions are lethal).

Interestingly, that it is possible to eventually “transform” an infectious prion from one species to another susceptible species is a prime example of witnessing evolution “unplugged” right before our eyes. The ability of these prions to evolve structurally and in time come up with the right configuration to cross species without any genetic elements is remarkable.

As ERV puts it “How does something with the same amino acid sequence evolve??”. With respect to prion research being done by Dr Bartz she adds “The idea I pitched to Dr. Bartz (the idea he was already planning on pitching to the scientific community hehe, I iz smrt) is that prions operate like HIV-1. But instead of exploring sequence space like my HIV, his prions explore structure space. One protein exploring all possible structural configurations. It has an optimal configuration for minks, but needs to explore and find a more optimal configuration for ferrets.” Amazing stuff!

What does a normal PrPc do? What makes its shapeshifted version so lethal? According to the Prion Institute “Studying how and why proteins misfold and the genetics, diagnoses and treatments of prion diseases will have positive implications for both animal and human health issues.”

Indeed, the possible breakthroughs for understanding the prion phenomenon may have staggering implications towards not just understanding the spongiform encephalopathies, but other degenerative neural diseases (i.e.; Alzheimer) as well as shed light on normal brain physiology. All this from a tiny inert blob of protein- reality is indeed far stranger than fiction.

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1) Visible end results at post-mortem are non-inflammatory lesions, vacuoles, amyloid protein deposits and astrogliosis.

Killing fields of Darfur, Chad and beyond

From people to endangered species: the travesty grows

The unending specters of misery and death so ubiquitous to the killing fields of Darfur have set their gaze to distant riches beyond the borders of Sudan. They have stirred and moved in the name of money on easy prey and this time it is the animals that suffer. According to Sharon Begley of Newsweek, the sad tale of this human travesty has now reached the world of Africa’s endangered species- and it’s killing them at near industrial scales.

As if a child’s dying cry wasn’t enough for the hungry hordes of the Janjaweed (nomadic proxies in a terrible struggle between Sudanese powers that be), they now spread their bloody reach into Chad’s Zakouma National park ; a refuge of endangered species and a tantalizing source of blood money for these killers. However, they aren’t the only "armies" in need of Chad’s treasures in a continent choked by desperation and greed. The endless quest to feed bloody struggles for power and domination can be seen in ever more brazen poacher raids like those supported by Somali warlords and demonstrate the perils of trying to defend the defenseless.

Once rebounding populations of elephants and rhinos among many other endangered species are now being decimated to fuel the ongoing human tragedy in Darfur, Somalia, and who knows where else. Begley notes that this “signals a terrifying turn in the world's efforts to save vanishing species. The battle is no longer just about the elephant's trumpet never again echoing over the African savanna, or the Bengal tiger's roar being heard only in memory. The threat posed by the contraband wildlife trade is now also about the money it generates—wave upon wave of it—that is being used by very bad people to do very bad things.”

Chadian park rangers are caught in the middle of a newer more vicious illegal animal trade whose endgame appears to be the very extinction of the animals they defend. The problem of course extends far beyond the borders of Sudan or Chad and reaches into the depths of India, Asia and North America. Part of the problem is the shear idiocy and ignorance of people who create a market demand for these animals in pieces and parts that end up as ivory statues or in "magical" aphrodisiac powders. By doing so, whether they know it or not, these buyers aid and abet in an unfolding human tragedy.

Begley concludes her article noting "that as the ultimate blame for drug lords who murder the innocent lies with users, so the blame for a wildlife trade that sustains organized crime and genocidal militias lies with the buyers. "There is a vague awareness in America that some things, they shouldn't be buying," says McMurray. "But the psychology seems to be that if it's in a store [or online] it must be OK." Americans who buy ivory carvings (easily available online), Japanese who collect the ivory signature seals called hankos and Chinese who clamor for "medicines" made from tiger bone are not supporting some lone poacher who's trying to feed his family. They're putting money into the coffers of the Janjaweed, warlords and possibly even worse actors. With the new wildlife traffickers, it's not only animals whose lives are at stake.”

Cry the children... and the animals….

Combating Malaria with mosquitoes

A possible novel strategy

There have been a lot of mixed results on the malaria control front. Simple and effective measures such as executing public malaria prevention campaigns, spraying against mosquito larvae, disseminating anti-malarial medications and mosquito netting have been slow to take hold due to a constellation of frustrating problems. The sad scourge of political corruption, extreme poverty and socio-cultural prejudice are but a few of the barriers that impede progress towards bringing down the death toll of this ancient protozoal disease that kills in the area of one million people a year.

This is why it is still worth perusing alternative strategies against the malaria parasite. Any measure that can help impact the effects of this disease should be considered and if found to be effective, added to the existing known strategies. This doesn’t include opening ones mind until your brains fall out and embracing implausible measures that just don’t work such as homeopathy and nutritional supplement “treatments”. Alternative efforts like these reflect -at best- a stunning dissonance between reality and belief or -at worst- complete and utter stupidity and a morbid disregard for human life.

However, among the more interesting possible anti-malarial strategies that might bypass some of the problems of other programs are biological approaches for combating malaria. For example, approaches that could cut its life cycle could dramatically reduce the prevalence of this parasite using a completely novel angle.

Actually, the idea itself isn't really new. Scientists have been trying for years to develop a malaria resistant mosquito that could survive in the wild. Until recently, the idea of combating malaria through biological mechanisms involving its life cycle has been a nice but impractical theory. It made sense but has been very difficult to make work- the devils been in the details. The good news is that recent developments in this area might breathe new life to this approach making it, at the very least, a promising avenue worth pursuing.

An interesting article in the January 2008 issue of Scientific American touches on some of the hopeful developments in this field. In summary, it mentions various lines of research on the malarial parasite life cycle, genetically engineered mosquitoes (Anopheles) and their capacity to survive in the wild that are coming together to perhaps create an viable and effective instrument for combating the malaria organism (Plasmodium falciparum).

In 2007, researchers found that the midgut environment of the anopheline mosquito, where the malaria parasite is transported and becomes infectious, plays an important role in the development of the malaria parasite. By genetically manipulating the mosquito to produce a substance found in Sea Cucmbers (CEL-111) in this midgut region, these researcher have been able to significantly inhibit the sporogenic development of Plasmodium falciparum.

The authors in this study note that “To our knowledge, this is the first demonstration of stably engineered anophelines that affect the Plasmodium transmission dynamics of human malaria. Although our laboratory-based research does not have immediate applications to block natural malaria transmission, these findings have significant implications for the generation of refractory mosquitoes.” These researchers basically have managed to create a viable mosquito resilient to the malaria parasite- an important piece of the puzzle.

Other threads of research are probing alternative mechanisms that alter the parasite life cycle within the mosquito and offer intriguing bits of information adding to the development of a robust data base for discovering more anti-malarial bio-mechanisms. For example, in the same year it was discovered that a capsule protein PbCap380 an ingredient of the malarial oocyst outer wall was critical for malarial survival inside the mosquito. The oocyst stage of the malarial life cycle is key to this parasites ability to infect humans and without this particular protein component the parasites were gradually eliminated from the mosquitoes reducing their capacity to transmit the disease.

Another study found they were able to reduce the adherence of the ookinate stage of the parasite to the lining of the mosquito midgut; an important part of eventual oocyst development by RNA interference. In essence they were able to reduce the level of a “ligand” – a glycoaminoglycans structure on the gut lining- that acts like Velcro.

Having a mechanism or mechanisms to inhibit plasmodium inside altered mosquitoes and maintaining a viable population of these insects are crucial steps toward a larger active bio-engineered anti-malarial program. However, one of the biggest steps in this area is to translate these successes to the field. If one or more of these mechanisms can be spread throughout the wild gene pool of mosquitoes then a whole new front against malaria could be established.

In fact, another recent study offers tantalizing evidence that transgenic malaria resistant mosquitoes can in fact survive in the wild. These authors note that “The introduction of genes that impair Plasmodium development into mosquito populations is a strategy being considered for malaria control. The effect of the transgene on mosquito fitness is a crucial parameter influencing the success of this approach.”

The study found that transgenicaly altered mosquitoes actually had a survival advantage in the lab when compared to non- transgenically altered mosquitoes. The authors conclude that the result of their findings “suggest that when feeding on Plasmodium-infected blood, transgenic malaria-resistant mosquitoes have a selective advantage over non-transgenic mosquitoes. This fitness advantage has important implications for devising malaria control strategies by means of genetic modification of mosquitoes.” On a related note, another important study in fruit flies reveals that it is possible to spread genetically modified insect genes in the wild.

Taken as a whole, one begins to see that several vital steps are being made to close the circle on a novel biological mechanism that can be used to reduce malaria in its natural environment. Each of these studies provides a brick of knowledge that begin to form a wall against malaria transmission. This fascinating activity may indeed be the genesis of a true “bio-weapon” against malaria and add to the greater effort in combating a deadly human disease.