Archives For health

woman vector

With the media fascinated by Bruce Jenner’s transition from male to female and Laverne Cox’s photo shoot for Allure intended to inspire others struggling with gender identity issues, there’s a rare discussion of what it means to be transgendered. More importantly, if someone decides to transition to another gender, what can science do to make this person feel comfortable in what would basically be a new body after all the hormone therapy and surgeries? And what can the kind of technology still in infancy, but barreling towards clinical testing, offer in the foreseeable future? Could modified viruses for gene therapy turn males into females and vice versa? Could printing new organs produce an entire new reproductive system? In short, would gene therapy and printed organs and tissues make the transition more complete?

Despite offering us a way of manipulating the fundamental building blocks of life, they would be dealing with an entire body which developed not just from reading the genome and translating the codons into proteins, but from environmental cues, triggers, and anomalies. Even using the same homebox genes to define our body plans doesn’t quite get you a full instruction set for a human body so changing these genes after the body is formed is unlikely to have much effect. Such genes are like Lego blocks you get to arrange once. Each gets you a finger, a toe, a foot, or a leg, etc. During development you could use chemical signals to tweak them and assemble them how you want. But after they’re finally locked into place, things are more of less done and the formed structures would need to be modified mechanically, i.e. surgically.

We don’t yet know if it’s possible to change a Y chromosome to an X, only that it’s possible for our modified viral agents to silence or promote gene expression. And even if we could, there’s not going to be a mechanism for a penis to suddenly become a vagina or the other way around because, again, these structures are now in place. Surgery would still be the only way to make this step of the transition until we can figure out some sort of nanotechnology to do this, though we could argue that this will also be a form of surgery, just a much less outwardly invasive one than scalpels and saws. And by now it should really go without saying that we couldn’t naturally induce a different reproductive system to grow. But what if we print one, or grow one, using the patient’s modified stem cells, then implant it? Would this work?

From an engineering standpoint, it seems like it would, and after extensive hormonal therapy, they might work as they should, and allow something as radical as a trans-man to impregnate his partner or a trans-woman to become pregnant or give birth. However, there’s a catch. We know how to make the organs but have no guarantee that such complex organs could grow in the lab and function without a hitch. Creating viable germ cells and supporting a gestation don’t seem so complicated to us at first blush because it seem so natural as to be troublesome and leads us to trying to figure out how to stop both until we want them to happen. But consider the fact that if we knew what’s necessary to support a pregnancy, we could create artificial uteri to allow premature babies to develop fully rather than place them in incubators to support them in development and hope for the best. A uterus grown in a lab would seem like a good shortcut at first blush, what ethics board would permit the necessary experiments for clinical studies?

So what’s the takeaway here? For those struggling with gender identity and wanting to make a transition to another sex, there’s a lot of promise in new medical technologies being developed today and on paper, it looks like a complete biological transition could be in the cards. But this technology is not quite there yet and there are so many questions to answer that it will be more than a decade at the very least before we can even think about using them in clinical practice. I would say though, that helping and studying transgender issues raises so many interesting and widely relevant questions, it would be a disservice to the future of medicine not to explore them because answering them will help us understand that does being male or female mean, as well as offer treatments to many reproductive conditions and anomalies, like infertility, ED, or even replace reproductive systems destroyed by cancerous tumors with a brand new one. In other words, transgender people could be a reproductive researcher’s Rosetta Stone…

metal gear solid surgeon

Remember the big news that an Italian surgeon was dead set on performing a head transplant on a human received an enthusiastic volunteer? Well, that story just got really, really weird this week, and yes, there is something more bizarre than an attempt at putting one person’d head on another person’s body. According to a conspiracy theory born on reddit and investigated by several gaming sites, Dr. Canavero might actually be doing this as a marketing stunt for Metal Gear Solid 5 from Konami. Not the surgery of course, but talking about it and getting the press worked up just so game designer Hideo Kojima can unveil his latest game. Some outlets wrote about this story in their usual fashion, omitting the steak for the sizzle, and missing the fact that people actually did ask Canavero head-on — hey, you try to resist when appropriate puns write themselves — about this, and not only did he deny the rumors, but promised to sue Konami for using his likeness without authorization and use the winnings to fund his research.

Of course this lawsuit is unlikely to go anywhere because according to a Belgian site for MGS, the doctor in the game bearing an uncanny resemblance to Canavero is actually Ian Moore, a UK-born actor based in Japan, who was definitely aware of the game, and was more than likely compensated for his appearance. That Moore and Canavero look so similar that they could be mistaken for brothers, surely wouldn’t be Konami’s concern according to the courts. Likewise, according to the gamers who spotted the similarity, MGS features a plot line about a surgeon performing a head transplant on Snake, but there’s no official word on whether this is the case, just a teaser in which some fans concluded this is what they were glimpsing. Kojima, known for teasing his fans, has only doused the flames in kerosine with a tweet of headless Snake bodies widely open to interpretation, and saying that the game deals with “taboo” topics.

Here’s my guess at what may be happening. One scenario is that Kojima was very aware of the controversial surgeon and is basically trolling the living hell out of Metal Gear Solid fans with all this teasing in which he winks, nudges, but never provides any real specifics, and wanted to do that from the start. The other possibility I see is very similar to it, but in which Kojima caught the TED talk by Canavero, made the connection between something important in his game, like say the question of giving Snake a robot body or whatnot, and decided to run with it to get free viral marketing done by game reporters. Finally, he could have changed a plot point in development and if there were no head transplants in MGS, there will be now. It wouldn’t be the first time the web ceased on some coincidence, spun an elaborate conspiracy theory, and inspired some big changes. But the bottom line is that Kojima definitely knows how to market games and if even a little pop sci blog like this is talking about his latest creation, that’s just proof of his talent…

cape verde

Despite the constant political challenges and bean counting nihilism, human spaceflight is still a routine event and no matter how much some want to relegate space exploration to robots, any way we look at it, the domain of space travel is not a human or robot proposition, but will always need to be a partnership. Ultimately, monetary considerations be damned, we want to explore and discover. It’s what made us who we are today and we’ll do it even if we have to merge with machines to do it, even if those modifications are almost inhumanly extreme, as long as they’re within the realm of plausibility. But as long as human explorers’ bodies will have organic tissues there will always be the specter of medical emergencies and the need for treatments, surgeries in extreme environments, and dealing with damage from radiation. Right now, if an astronaut is in dire need of emergency treatment the plan is to evacuate him or her and perform whatever procedures are necessary on Earth. Beyond our planet’s orbit, this will not be an option.

Considering the current plans to send humans to asteroids, back to the Moon, and eventually, towards Mars, NASA has been hard at work soliciting ideas for how to do everything from robot surgery, harness ultrasonic devices to help with treatment and diagnosis, and extreme ways of approaching treatment of radiation sickness and long term effects of elevated exposure to both cosmic rays and mutagenic solar particles. This is great news not just for space exploration, but for humanity in general, because radically new approaches to medical treatments will let us live longer and healthier lives. With surgery being a last resort replaced by high tech scanners and ultrasonic devices, lasers, and genetically engineered viruses tested through the rigors of life in radioactive vacuum of space, and what surgeries are performed meant for minimum collateral damage and rapid healing, we could treat more issues, and use far fewer antibiotics.

Imagine a world in which superbugs evolve slower, people would live longer and healthier, and we can fix conditions currently treated by a constant dose of doctors gravely nodding and back pats for enduring them. And of course, since many of these treatments would be designed for maximum effect with minimal or even nonexistent infrastructure, we could deploy them to help developed nations. But hold on, you may ask, why not help developed nations first since that’s your goal along with just better medical technology? Because helping developed nations is not the kind of simple proposition it’s often portrayed to be. It’s become a sport to castigate those who spend their wealth on humanity’s distant future instead of its poorest members and it’s an extremely safe bet to do so. But the reality of the situation is that pouring billions of dollars into unstable regimes with no accountability and perverse incentives solves little. Designing for the rigors of space frees us from the political constraints and forces us to be more creative.

When we know no help will come, ever, not just late, there will be no infrastructure other than a spacecraft around us, and failure to meet the challenge is certain death, evolutionary, halfway, compromised designs are not an option. Being able to then package the successful fruits of all that hard work and ship them into even the most remote wilderness would be huge, a massive game changer that could help billions live a better life. As bizarre as it sounds, basic research, driven purely by the need to accomplish something that by definition has to be efficient, quick, and effective in practice, not beholden to profit margins, shareholders, or patent wars may be much cheaper and exactly what we need to finally capitalize on the bleeding edge research we find being nurtured in startup and university labs today. The space program provided the case for integrated electronics and countless materials that make our modern world what it is, and it can also provide the know-how to drastically improve our lives here on Earth and in space.

[ illustration from Erik Wernquist’s Wanderers ]

futurama heads in jars

Italian surgeon Sergio Canavero has been planning to do something that sounds like a scene straight out of Frankenstein: transplanting a head onto a new body. He’s been trying to figure out how to do it for many years, publishing a paper detailing how he sees the procedure could work a bit over a year ago, and making his case to the medical community since then. As of a few days ago, however, his work has exploded into the mainstream because there is a public volunteer for this radical surgery, Valery Spiridonov, a Russian programmer suffering from a rare genetic condition which rendered him unable to walk and take care of himself. As he sees his options, a head transplant is the only chance he has to ever live a normal life, and there’s someone who says he will be ready to perform the procedure in two years. However, despite Canavero’s enthusiasm, much of the science he presents as settled is still not ready for prime time, and the procedure is more likely to kill the patient than give him a new body.

Basically, as the history of head transplant experiments shows, connecting a head to a brand new body is the easy part. Giving it control of this new body and avoiding rejection is the real struggle, and this is where Canavero and the majority of the medical community aren’t seeing eye to eye. Most surgeons have little doubt that Spiridonov would survive the surgery, it’s the subsequent inability to join the spinal cords and the tissue rejection that worries them. They’re not really concerned as to whether he would be able to walk or have a normal life afterwards, believing these questions to be irrelevant since they’re not sure he’ll survive more than a few days after the procedure. In fact, they’re betting that the whole idea will be dropped since the odds of Canavero actually being ready to do a head transplant in 2017 are virtually nil. And if we’d look at the broader medical context, this might never be a viable procedure anyway.

Here’s the problem. Patients already wait for years to get organ transplants. Can you imagine how long someone would have to wait for an entire donor body suitable for the operation? On top of being intact, it also has to be that of an otherwise healthy person compatible enough to reduce the risk of rejection, otherwise whatever organ failure, trauma, or illness that ended the donor’s life would kill the patient as well. We would have to be able to quickly and easily get the body into a healthy state, limiting potential donors to solely head trauma or stroke victims who are otherwise young and healthy. But as they get the body ready to receive a new head, there will be a different calculus to consider. Yes, they can give this body to a patient for a very risky experimental procedure unlikely to end well, or they could use the body for parts to give new organs and tissues to dozens of people, doing far less risky surgeries with high success rates and adding many quality years to those patients’ lives. Its a sad but clear choice.

Still, there is a reason why head transplants even came up as an idea. Some people basically need a new, well, body because nothing short of that would help them. Sadly, there is nothing medical science can do today for Spiridonov. We’re making strides towards 3D printed organs and implantable devices that can bypass damaged sections of spinal cords to allow paralyzed patients to walk again under their own power, as well as honing genetic engineering to treat a host of powerful cancers and some genetic diseases. But while there is light at the end of the proverbial tunnel for patients who could benefit from these advancements, they’re still several decades away from being new standards of care and will require countless trials and hundreds of billions of dollars from government grants and private companies to be readily available. It’s awful to say this, but for patients like Spiridonov, these potential cures will come too late and a lot of patients like him will succumb to their ailments before medical science can help.

Canavero is trying to help people and Spiridonov is trying to aid him in pioneering a hope for a normal life for those to whom nature didn’t give a fighting chance. Unfortunately, we’re still just now making a few baby steps towards the technologies they would need to be successful, and it’s our sad duty as scientific skeptics to point out that while all death is awful, some ways to die are far, far worse than others, and it would be more humane not to try head transplants. In the future, when we can rebuild bodies with advanced robotics, harmless viruses that can purge a genome of life-threatening defects, and 3D printed tissues, it may be possible for many would-be volunteers for a head transplant to end up living healthy, happy lives. But today, we are just too far away from making this a reality, and while volunteering to advance medicine should be praised, there are some cases where allowing an experiment to go forward, even when all the participants involved know the risks, would still be cruel. And that’s the bad thing about the real world. Sometimes, no matter how hard you try, you still won’t get a happy ending…

quantified self

With the explosion in fitness trackers and mobile apps that want to help manage everything from weight loss to pregnancy, there’s already a small panic brewing as technology critics worry that insurance companies will require you to wear devices that track your health, playing around with your premiums based on how well or how badly you take care of yourself. As the current leader of the reverse Singularitarians, Evgeny Morozov, argues, the new idea of the quantified self is a minefield being created with little thought about the consequences. Certainly there is a potential for abuse of very personal health metrics and Morozov is at his best when he explains how naive techno-utopians don’t understand how they come off, and how the reality of how their tools have been used in the wild differs drastically from their vision, so his fear is not completely unfounded or downright reflexive, like some of his latest pieces have been. But in the case of the quantified self idea being applied to our healthcare, the benefits are more likely to outweigh the risks.

One of the reasons why healthcare in the United States is so incredibly expensive is the lack of focus on preventitive medicine. Health problems are allowed to fester until they become simply too bothersome to ignore, a battery of expensive tests is ordered, and usually expensive acute treatments are administered. Had they been caught in time, the treatments would not have to be so intensive, and if there was ample, trustworthy biometric information available to the attending doctors, there wouldn’t need to be as much testing to arrive at an accurate diagnosis. As many doctors grumble about oceans of paperwork, logistics of testing, and the inability to really talk to patients in the standard 15 minute visit, why not use devices that would help with the paperwork and do a great deal of preliminary research for them before they ever see the patient? And yes, the devices would have to be able to gather data by themselves because we often tell little white lies about how active we are and how well we eat, even when both we and our doctors know that we’re lying. And this only hurts us in the end by making the doctors’ work more difficult.

That brings us full circle to health insurance premiums and requirements to wear these devices to keep our coverage. Certainly it’s kind of creepy that there would be so much data about us so readily available to insurance companies, but here’s the thing. They already have this data from your doctors and can access it whenever they want in the course of processing your claim. With biometric trackers and loggers, they could do the smart and profitable thing and instead of using a statistical model generated from a hodgepodge of claim notes, take advantage of the real time data coming in to send you to the doctor when a health problem is detected. They pay less for a less acute treatment plan, you feel healthier and have some piece of mind that you’re now less likely to be caught by surprise by some nasty disease or condition, and your premiums won’t be hiked as much since the insurers now have higher margins and stave off rebellions from big and small companies who’ll now have more coverage choices built around smart health data. And all this isn’t even mentioning the bonanza for researchers and policy experts who can now get a big picture view from what would be the most massive health study ever conducted.

How many times have you read a study purporting the health benefits of eating berries and jogs one week only to read another one that promotes eating nuts and saying that jogs are pointless with the different conclusions coming as a result of different sample sizes and subjects involved in the studies? Well, here, scientists could collect tens of millions of anonymized records and do very thorough modeling based on uniform data sets from real people, and find out what actually works and for whom when it comes to achieving their fitness and weight loss goals. Couple more data and more intelligent policy with the potential for economic gain and the gamification offered by fitness trackers, and you end up with saner healthcare costs, a new focus on preventing and maintaining rather than diagnosing and treating, fewer sick days, and longer average lifespans as the side effect of being sick less often and encouraged to stay active and fit, and you have a very compelling argument for letting insurance companies put medical trackers on you and build a new business model around them and the data they collect. It will pay off in the long run.

magazine kiosk

When an expansive article on GMOs became the lead story in Elle Magazine, it wasn’t exactly a shocker that the story got its science wrong and horribly abused quotes to create a controversy where one didn’t exist. In fact, it’s par for the course when GMOs are mentioned in publications not known for their scientific reporting. Just like conservative political outlets go out of their way to deny global warming and denigrate the scientists involved in climate modeling, generally left-leaning lifestyle magazines do whatever they can to cast some doubt on the viability of GMOs in a noxious mix of conspiracy-mongering and double standards. No matter how many tests looking for potential allergens or toxins are done over decades, the anti-GMO pundits declare that there aren’t enough studies of the modified crops’ safety and surely this means that Monsanto turned millions of people into their unwitting guinea pigs for the sake of profit.

Meanwhile, even a single experiment which claims to find some sort of a problem with GMOs, no matter how horribly done and how much the researchers conduct it threaten reporters who want a second opinion or ask questions, has to be held up as the definitive proof that we’re all being slowly poisoned by greedy tycoons. The reality is quite different, of course. GMOs are actually strictly regulated, unlike organic food, since each new protein or genetic modification is treated as a food additive and has to be cleared by an independent panel of experts and by the FDA to ever hit the market. By contrast, anything described as "natural" and used in organic food does not have to be subject to any studies thanks to the codification of the naturalistic fallacy into law and despite the fact that nature can be very, very deadly. However, it’s not all regulations, good science, and securing the food supply. GMO makers use and abuse the patent system to milk a hefty profit from every stage of their products’ lifecycles and bilk farmers.

But don’t expect a discussion about the patent system and biology in Elle because the story isn’t so much about GMOs as about the author and her quest to rid herself of allergies, transitioning into a standard storyline of a woman in search of truth. Though by truth what I really mean is an exploratory trip into the land of conspiracy theories because that’s what the readers want. It’s a story written for the magazine’s target demographic, which is why it’s first person and focuses on vague, scary-sounding concerns to keep readers hooked. And this is why the admonition given to this article after a fact check sounds a bit silly to put it mildly, as it laments the science abuse and rampant misquotes to create a controversy for the sake of eyeballs…

It represents a major setback for science journalism, and for consumers who rely on hugely popular lifestyle publications to make their way through complicated issues. Is GMO corn causing allergies or other disorders? Are GMOs a threat? Elle perpetuates a “controversy” that just doesn’t exist in the mainstream science or medical communities. Worse, it fans the flames of doubt and distrust that fuel unilateral opposition to a sophisticated technology that could improve global food security.

Here’s the thing. If people are getting their science information from the same magazines which tell them what shoes are in this season, or what celebrity is working on what new movie, we have much bigger problems than are being highlighted here. Why would anyone think that relying on the latest edition of Vanity Fair, or Esquire, or, yes, Elle, for the latest and greatest in important, everyday science is a good idea? Certainly, one doesn’t expect fashion tips and celebrity gossip in their edition of National Geographic. Likewise, why would people rely on fashion magazines to navigate important policy debates? The really scary thing is that despite most people singing all manner of praises to science and a STEM education in popular surveys, they by in large do not care about the science that actually gets done or why, and even worse, don’t want to care. And considering that, is it any wonder that publications that cater to people who only say they care to be scientifically literate focus on creating controversy, peddling conspiracies, and moving copies to charge advertisers more? The Elle story is just one symptom of a much bigger issue…

[ photo illustration of news kiosk in Zurich via Wikimedia Commons ]

noodly_horror_600

While we’re talking about chemophobia, here’s another area where a selective focus on health isn’t helping in the big picture: food. The cover story for the current edition of The Atlantic is an expansive, New Yorker style, 10,500 word case against chemophobic foodism that’s currently in vogue in many metropolitan cities. David Freedman’s thesis basically boils down to calling out foodies on their caloric hypocrisy while noting that the companies they demonize are working to cut down on calories in their most popular offerings, which could have huge downstream effects for tens of millions of people. And with obesity arguably being America’s biggest health problem, combating it could shave trillions off our healthcare expenditures. That’s a big deal, so focusing on only "wholesome, natural, farm-to-table" fare while relegating food conglomerates to the role of the foodie movement’s sworn enemies is shortsighted and naive. As you can imagine, there’s no shortage of detractors to Freedman’s indictment and many of them base their opposition on the very chemophobia he sites, recycling the same arguments he tries to dispel.

Of course the article itself isn’t without flaws, but arguing with its focus on noting out how foodie idols aren’t helping to reduce caloric intake, but instead jack up the price in the name of style or ideology misses an important point. You see, the foodies aren’t actually helping people lose any heft by substituting fast, cheap, fattening food with wholesome, fresh, simple dishes that are so aesthetically pleasing they’re bordering on gastronomic pornography, yet every bit as bad as all those Big Macs and fries. Their excuse? It’s better for you because it’s all wholesome! Disregard the terrifying amount of flour, butter, bacon, and sugar going into these recipes. They’re labeled organic and they’re not — gasp! — processed with chemicals. Oh and if you want to lose weight, don’t eat this often and stay active; because all this stuff is natural and organic it will burn off all the faster. But the fact of the matter is that it won’t. Remember the craze about the high fructose corn syrup and the call to replace it with natural sugar? There’s a reason why it died down. The science says that sugar is sugar and both HFCS and cane sugar are equally dangerous.

Couple this almost religious faith in the power of "wholesome and natural food" with a big dollop of affluence and advice like "don’t eat something with more than five ingredients or containing chemicals you don’t immediately recognize," and you get a classic situation in which a little bit of knowledge is a dangerous thing. Not only are foodies disregarding food that’s more immune to being left out unrefrigerated for a few hours and safer from germs and spoilage (that’s what the vast majority of those strange sounding chemicals in processed food do by the way), but they’re also paying premiums for what they do find acceptable. This is great for Whole Foods, or as it’s known in some places Whole Paycheck, but not so great for John and Jane Public who are now thinking that they’re priced out of eating healthy. Fresh, more local food that travels from farms to supermarkets and forks faster is actually a good thing. It’s less resource intensive and helps the food stay edible longer. But it’s also being sold at a premium instead of being the default for markets. Why? Because foodies are willing to pay extra and margins in the grocery business are slim to put it mildly. Like many "green, eco-friendly" products, food is being upmarketed.

Worst of all, a great deal of the foodie motivation behind spending more money and avoiding a gret swath of basic chemistry to keep food fresh and safe longer is useless when it comes to the big goal of fighting obesity. The chemicals are not making people fat. The tomato from a frozen warehouse and the tomato from a local farm won’t break down differently in someone’s stomach and fuel the body with different calories. Obesity is so much more complex than that. When you want to tackle the question of why people gain weight you have to also look past exercise and a sum total of calories. You also have to consider that Americans work too much, sit too much for their jobs, don’t get exercise breaks in their routine, try to cram some 20 hours of tasks into a 16 or an 18 hour day, have to drive everywhere, some have genetic predispositions for weight gain, and others have emotional problems that drive them to food, etc. If you want to tackle the country’s weight problem holistically, you don’t do it with bad science, throw money at it, or try to shame people who can’t afford to eat like a foodie to do so. You have to do a lot more.

People eat fast food because it’s convenient and yes, cooking it with higher quality ingredients while cutting out calories and improving flavor with judicious use of benign and helpful chemicals would go a long way. But we also need to encourage more mass transit, more urban lifestyles in growing cities to get more people walking, jobs that allow for more flexible schedules to get a bit of exercise into the day and break up the monotony of being chained to desks and office chairs, and teach coping strategies for an insane workload both at the office and at home. Fighting the scourge of obesity and its attendant health problems requires many years of work and we have good studies showing us how we can start doing it. Demonizing processed foods with naturalism and pseudoscience with an irrational fear of chemistry isn’t going to help. It’s just going to make some foodies feel like they’re doing good things for their health. A number of whom, I might add, flip out in terror if their food contains half a gram of aspartame, but think nothing of having botox injections. You know, injections of the deadliest toxin know to humans to paralyze their faces so they look younger by poisoning their muscles into submission until their crow’s feet are gone…

sara jean underwood

The city where I live, the college town/aspiring big city of Columbus, OH, the weather isn’t really known for being nice. And we’ll tell you how much the weather sucks when you ask what it’s like to live here. It will be either our opening line or the caveat we sneak in at the end. Right now, it’s hot and incredibly humid, which makes walking outside feel like stepping into a blast furnace that cooks you in your own juices. This means that if you want to work out, it’s best to get indoors to the treadmill. Unfortunately, some of my wife’s and my mutual friends seem to disagree because lately, they’ve gone granola on us and ascribe to the trend that exercising in hot, humid weather is perfect to sweat out toxins. Ah, yes, the t-word, used as the magical justification for just about every New Age lifestyle trend, much like the word quantum is used as an automatic free pass for them to say whatever they want about science. Now, trust me, I know it sounds compelling to go out there and sweat out all your toxins, but what you’ll really be doing is getting heat stroke and putting your body in danger so for the love of all things cute and fluffy, don’t do it.

Here are the two big problems with this idea. First and foremost, there’s a reason why it feels so miserable to run around in 90+ degree weather and high humidity. Your body needs to transfer heat to the outside environment to cool down and if the temperature is close to, or exceeds your body heat, that transfer is very much inhibited. Sweat doesn’t evaporate cooling you off, it’s just stuck to you and your clothing, keeping you uncomfortably warm. According to research by the people who created the mantra "pain is weakness leaving your body," the U.S. Army, — probably the absolute last institution you could accuse of not knowing enough about fitness and physical training — the optimal ambient temperature during your workout should be about 65° F. It’s not so cold that your body tries to hold on to heat and interferes with your muscles, and not nearly hot enough to get in the way of sweat giving off excess heat efficiently so you could work much harder and train a lot longer than you would otherwise. This is why many gyms have thermostats set to the mid to low 60s, we know it’s good for your body as you’re exercising.

The second big problem is this. What toxins are you trying to sweat out? Chemophobes can get tests to determine what sort of residue can linger in their tissues and hyperventilate about every chemical under the sun on the basis of the results. Whatever chemical name they don’t readily recognize or the nature of which they don’t understand, they call a toxin and proceed to spend a good deal of time and effort "detoxing." For example, formaldehyde is a commonly cited toxin but it actually occurs naturally as a byproduct of your metabolism and is used to help chain together amino acids into proteins. The problem is that if you’re exposed to industrial quantities of it, the excess formaldehyde is converted into formic acid which could cause nerve and kidney damage in sufficient quantities. So where do our New Agey chemophobes go wrong? Well, they assume having a few parts per million of it in our bodies is dangerous and must be the result of pollution, despite the fact that it naturally occurs in our tissues and their concentrations of it are orders of magnitude lower than what it would take to even raise a yellow flag. Dose makes the poison, but the granola crowd assumes that if it can be a poison, it’s just a matter of time before it is.

And so they go out in the blazing heat to sweat out chemicals that aren’t going to harm them just to overheat their bodies to the point of exhaustion, and take how miserable they feel as a detox regimen working as designed. In reality, however, the headaches, weakness, and nausea aren’t toxins leaving the body. They’re your body’s way of telling you "don’t pull this shit on me again, I mean it!" Having less and less discomfort after working out in the heat for a while isn’t a coup for the detox protocol either, it’s your body begrudgingly accepting its fate and getting used to the stress at the expense of overworking the heart and the kidneys. While heat stroke and its milder precursors will generally go away after a brief rest without doing permanent damage, repeated exertions can take their toll in the form of cramps and muscle pain. Really, if the workout in the air-conditioned gym and the miserable routine in the sticky heat won’t actually rid your of all the chemicals that are actually not harmful to you in the amounts everyone carries, why run the risk of heat exhaustion? Why not just keep yourself in shape safely and using real science?

smiley death grafitti

It started almost immediately after Sandy Hook. The reliably shrill alt med ignoramus who hasn’t read about a conspiracy theory he didn’t immediately love, Mike Adams, penned a fiery screed accusing psychoactive drugs of creating mass murderers and using a seemingly long list of very grizzly events to support his point. Since he’s Alex Jones’ best buddy and fills in on the Coast to Coast radio show, the meme has spread like wildfire among conspiracy theorists, and even the pundits of World Net Daily — known as World Nut Daily for some very good reasons — are now spouting the dogma of antidepressants turning people into a homicidal frenzy, all so Big Pharma can profit from untested drugs while the government covers up the dark truth. Although that last part there could’ve been from the Sandy Hook Truther conspiracy. It’s kind of hard to keep all of the overlapping conspiracies straight sometimes, though it’s usually a safe bet that there’s some mention of the government covering up something for someone nefarious so the bigwigs of the New World Order can keep their sex slaves and appease their alien overlords.

Here’s the immediate problem with the psychoactive drug-induced mass murders theory. It fails the statistical significance test. Tens of millions of people have taken what’s known as selective serotonin reuptake inhibitors, or SSRIs, to treat mild to severe depression, and social disorders like anxiety and OCD. Virtually all the brand names given by Adams and his friends and fans are from the same family of SSRIs, and we can safely ask why just a few dozen examples of violent crime out of a population of tens of millions of patients mean that SSRIs turn people into crazed gunmen. After all, if your study population is, say, 20 million and your sample time period goes back decades, having some mass murderers, serial killers, and short tempered violent criminals is pretty much statistically inevitable. Plus, what about the other tens of millions of patients who didn’t commit any crimes? How can you argue for a causative effect between SSRIs and murder when the murderers are so few and far between as to be a tiny blip on the radar? And that’s not to mention that SSRIs don’t have any known side effects that increase one’s aggression.

In fact, patients on SSRIs with the most extreme side effects and conditions are likely to commit suicide, not homicide. A quick reading of the list presented by Adams and company mentions a number of suicides quite prominently, as well as changing the definition of mass murder to "any violent crime in which more then one person died," further weakening their own case. Yes, a lot of gunmen commit suicide after their massacres, true. But the problem is that it’s very difficult to make any definitive causative link between SSRIs and suicide. Considering that patients with an extreme case of depression may commit suicide in spite of the drug rather than because of it, as well as the fact that for patients with a history of abuse and trauma SSRIs might not really do all that much more than a placebo, the connection is very murky. While we can say that gunmen in the headlines today were taking SSRIs and other similar medications, we can make a stronger case that the medications failed to do their job than Adams can that their medication pushed all, or nearly all of them, them towards violence, because the former explanation better fits with the fact that tens of millions of SSRI-using patients aren’t violent, and the relevant scientific work.

So let’s review. Mass murdering gunmen on psychoactive drugs are few and far between even when the criteria for mass murder are loosened to include any crime in which two or more have been killed. The link between SSRIs and violence has been studied and shown not to exist. And while patients on SSRIs with a severe diagnosis are more likely to commit suicide, we could very easily make a sound case that suicides are the result of the medication failing to do its job, not driving someone to a suicidal state, much less to killing themselves after leaving a trail of victims in his wake. But none of this bothers the conspiracy theorists. To them, everything has to be a secret plot by those behind the scenes because this the only way they can imagine the world. If they allowed for random chaos to interfere or simplt incompetence to bring down economies and lose wars, why, the world would be an unpredictable place they couldn’t pretend to navigate like sages in the know observing a chess match. They would have to be ordinary shmoes just trying to make sense of events that all too often simply don’t make sense in the big picture…

beaver talc

A feature piece on the Dr. Oz Show and the man behind it is up at the New Yorker, and as most features on a controversial topic in the New Yorker go, it’s long and none too flattering. In it, he’s described as brilliant, charismatic, but profoundly influenced by his wife’s deeply held beliefs in alt med woo, and seeking ratings and publicity to a fault. He may talk about giving patients every bit of information out there and wash his hands of any claims that in retrospect were found to be with little to no medical merit, but the message is clear. He needs drama, ratings, and to give the audience what it really wants: quick, easy, convenient answers to the big three questions. How can I lose weight? How can I live longer? How can I battle cancer if it sneaks up on me? And as numerous quotes from experts in the article show, he goes overboard with his answers…

“Mehmet was always unique, but now he has morphed into a mega-brand. When he tells people the number of sexual encounters they need each year to improve their lives in a specific way, or how to lose weight in three days—this is simply lunacy. The problem is that he is eloquent and talented, and some of what he says clearly provides a service we need. But how are consumers to know what is real and what is magic? Because Mehmet offers both as if they were one… It all seems to be in the service of putting on a show. And, when you add it up, that seems like something other than medicine. It’s more like medutainment.”

No wonder Oz is so popular. Have trouble with weight loss and yo-yoing back and forth, and no doctor can tell you how to keep weight off? Try the raspberry ketones. Then the green coffee beans. Then the blueberries and almonds. What should I do to add a year to my life? Have sex on a regular basis and aim for 200 orgasms a year. These are not exaggerations. I’m not being snarky or sarcastic whatsoever. These are real, honest to goodness Dr. Oz recommendations, his televised answers to complex medical questions we are only now learning how to even try to research thanks to cloud computing and an explosion in bioinformatics. But instead of doing an expansive study using data from millions of real patients whose data was uploaded into secure data centers for medical research use, Dr. Oz is basically telling his viewers "oh, want an extra year added to your lifespan? Why don’t you go out and get laid? Doctor’s orders!"

It’s simple, it’s nice to hear, and it comes with the most minimal amount of evidence. Yes, we do know that sex adds years to your life but we don’t know how well enough to tell someone how many orgasms he or she should have to live longer. Same goes for all the compounds that Oz touts as the miracle fat buster that Big Pharma doesn’t want you to know about, despite being all too able to extract the active ingredient in pill form, patent it, and make billions selling it. It’s all those pesky FDA requirements that the supplement do a better job than a placebo that just get in the way, unlike for health store chains that sell vitamins formulated in Utah, where a senator with deep ties to the supplement lobby fights to keep vitamin sales totally unregulated. Point is, much of what Oz has to offer the public is either common sense or ridiculous hype and eyeball grabbing manufactroversies for the sake of ratings.

Considering that Oz is indeed a brilliant and accomplished surgeon and researcher, he should really know better than to opt for drama and ratings, telling his viewers what they want to hear instead of admitting that we don’t know a lot of things to which they demand instant answers. In the scientific world, nature doesn’t take the attention span and personal desires of patients into account and it makes you fight to find solutions to complex problems like aging and cancer. For someone to step into the role of "America’s doctor" without acknowledging it and sticking to the facts for which we can have solid evidence, is a gross abuse of trust and a position of immense power. He could’ve used his bully pulpit to dispel countless snake oils and get more people on treadmills and committing to a healthy lifestyle. Instead, he gave common sense a node while sending his fans on the hunt for the latest weight/cancer/age-busting fad. For shame…

[ illustration by Glen Southern ]