Dr. Paul Offit on NPR's Talk of the Nation

Dr. Paul Offit was a guest on Talk of the Nation last week to talk about vaccines.  He talked about his new book, Deadly Choices, which discusses the anti-vaccine movement.  I've already ordered it on my Kindle, but I haven't read it yet.  I'm hoping I can use it as a break from GRRM's A Song of Ice and Fire series soon (I'm ~65% through the 3rd book, A Storm of Swords). 

I had a chance to listen to the podcast while I was at the gym today, and it was enjoyable but immensely frustrating.  I think what people forget is that sometimes medicine doesn't make logical sense until you spend years studying the subject.  One of the callers refused to accept Offit's argument that having 5 vaccines in a single doctor's visit still isn't even a blip in the radar compared to what your immune system (or a child's) encounters every day.  When you see a child scream while getting stuck with a needle a few times, I can understand how it would seem that it's a bigger deal to your immune system, but factually it simply is not.

I could spend hours talking about vaccines and the anti-vaccine movement, but instead I'll have you check out the podcast yourself.  It's ~18 minutes long so you can listen to it while you're driving to class/work or while you're at the gym.  If you have a podcast application on your phone, you can subscribe to Talk of the Nation as well, which makes finding and listening to stuff like this much easier.  Hopefully I'll find some time to read Deadly Choices soon.  Based on what I heard on the podcast, I'm sure it'll be worth the time!

College upperclassman fail at scientific reasoning

Ars Technica has a nice article on how many college upperclassman in science majors still suck when it comes to scientific and/or formal reasoning.  When we're children, we come up with simplified explanations for observed events that fit our experiences and/or expectations, but those explanations are often incorrect.  But hey, nothing against our 5-year-old selves, what else can you expect without a more formal science education!  The hope is that we'd shrug off these inaccurate, inadequate explanations as we progress through our science education.  Unfortunately, that's not happening nearly as often as we'd like.

I'll let you read the article on Ars for some of the details, but one thing in particular caught my eye (emphasis mine):

What's the root of this problem? The authors ascribe a lot of it to language. It's quite common to hear people describe fat as just melting away or vanishing, which doesn't encourage anyone to try to balance the books on where all those atoms actually go to, much less get them thinking in terms of their release as carbon dioxide and water vapor. The same problem persists in the language commonly used by biologists. We frequently refer to energy as "lost" when it's no longer available to an organism, but that doesn't mean it's not still there, typically in the form of heat.

Very similar to what I discussed about Cryolipolysis, right?  I've heard cryolipolysis's effects described as "melting away" the fat, but melting it away in one area doesn't do anything if it only comes back to the same area or somewhere else to take up residence again!  Some scientific reasoning is all that is needed to know that cryolipolysis can't deliver on all of the promises described by some of its proponents.  Better scientific reasoning skills could save people a lot of money and disappointment on procedures like that!

Sloppy Research Regarding GM Crops

I've come to the conclusion that I'm too busy and far too easily distracted to post to Verbatio with any sort of regularity right now.  (That may change if/when SkepSIG starts up though).  I'll still post when something is on my mind, but in general, I won't beat myself up for not posting regularly.  So if I don't post for a few weeks at a time (like now), don't think that I've completely abandoned Verbatio.  Rather, it's likely that I've just been busy or haven't thought of something to post about lately.  But when something comes up, or when I feel like procrastinating instead of studying for an exam (like I'm doing now), I'll be sure to blog about it.

But I digress, onto the matter at hand: those evil genetically modified (GM) crops!  A classmate of mine linked this study, which compared the effects of 3 different GM maize/corn varieties on mice.  What caught my eye from the beginning is that the authors consistently use the term "toxic" or "toxicity" instead of simply "different."  A change in metabolite concentration in the serum or urine is a sign of hepatorenal toxicity rather than just being statistically different from the control.  Rather than state what their hypothesis was (that the GM crops would just be statistically different, or that certain concentrations would be decreased or elevated), they took any change from the control to be a sign of toxicity, rather than simply a difference.  Sloppy science.

I Almost Forgot I'm Going to be a Doctor

A strange thing seems to happen throughout your 1st year in medical school: you forget you're actually going to be a doctor at some point.  You get so caught up in studying anatomy, biochemistry, histology, cell biology, etc. that you lose sight of WHY you're studying all of that stuff.  Instead, you spend all of your time studying (or, if you're me, you spend all of your time reading skeptical blogs and books about the financial collapse, and playing Halo or Call of Duty until 2-3 days before an exam).  You don't really experience much outside of the classroom.

However, you really need to have a lot of that basic medical science down before you can even approach anything clinically-oriented.  In my yearly meeting with a faculty member the other day, I explained how utterly useless most 1st year medical students are when they attempt to give us some amount of clinical exposure.  Sure, they can take 1st years into the hospital to interview patients and get a history, but the patients tend to know more about their disease than we do.  I've joked a few times that at this stage in my medical career, I'm a lot like my uncle when it comes to computers -- I [think I] know just enough to be dangerous.  Some schools brag about offering clinical exposure in the first year, but realistically, it's basically like show & tell back in kindergarten.  You get to see some pretty machines, neat disease processes that you still don't understand, and meet some interesting people.  But don't plan on the encounters changing your life or enhancing your understanding of the science you're trying to learn.

But a funny thing happened at the beginning of this semester.  The professors snuck up on me and reminded me that I'm actually going to be a doctor.  This year, I get to do some exciting things.  I see at least one patient every week to work on history-taking and physical exam skills.  More often than not I even have a clue as to what's going on with them and how that disease has progressed.  Each week we have a special session about a particular specialty where we learn about the specialty and have some sort of clinically-oriented experience.  For example, when we had the session for plastic surgery, I got to practice my suturing skills (on a pig's foot).  It was comforting to know that after spending a semester dissecting a cadaver last year, I actually did pretty well in stitching skin back together.  It was too little too late for the pig though.

So, since my medical school did me the kindness of reminding me that I'm in medical school to do more than just learn neuroanatomy and pathology this year, I'm going to follow suit and try to post a little more often about medically relevant topics.  I'm sure I have a few readers who are interested in the medical school perspective on more than just science topics, so I'll try to include some of that when I can.  Considering my ADHD nature, however, I'm confident I'll still bounce around quite a bit between that, skepticism, what I'm reading on my Kindle, and whatever else happens to hold my attention while I'm at the computer.  I hope you enjoy it!

To Start a New Student Interest Group?

I'm debating starting a new Student Interest Group (SIG) at my med school.  We have all kinds of them for various specialties (dermatology, orthopedic surgery, family medicine, etc.), cultures/beliefs (LGBT, Christian Medical Association, Spanish language), and other commonalities.  I tried to get involved with one SIG last year that presents 1 hr presentations about science/medicine to students at a local junior high school to get them interested in the topic, but unfortunately the date I was scheduled to present was rescheduled.  But aside from that particular SIG, I haven't found one that really speaks to my interests.  I don't just want to be in some SIG that will sound good on a residency application; rather, I'd like to be a part of something that will have a lasting effect on myself and my peers by preparing us to deal with the challenges that lie ahead.

This led me to an idea for a new SIG, which I would call SkepSIG.  Catchy, I know.  It would basically be a way for medical students to get together to discuss science and medicine and how to effectively communicate these topics to patients.  When I read about how people respond when the scientific evidence contradicts their own beliefs, or when I observe such political and public outcry when it is recommended that an ineffective breast cancer drug have its FDA approval revoked, I can't help but consider how the scientific attitudes of physicians, patients, public officials, and the general public will affect my ability to help my patients in the future.

Changes to Student Loans

Something that went relatively unnoticed (untiland whatnot recently) amidst all the healthcare news lately are the changes made to student loans.  It's absolutely ridiculous how some people are so up in arms about this, screaming about another "government takeover" that's killing freedom and whatnot.  Oddly enough, this one actually is a government takeover, but one that I think most people should be happy about!

Basically, until this new law the government was lending money to private lenders so they could lend money to students, while the government (AKA: taxpayers) assumed all of the risk.  This meant that private lenders were able to make profits off of the interest they charged on student loans without having to worry about whether or not the student would actually pay the full amount back.  If the student failed to do so, no problem, the government would pay the private lender instead!  Talk about a government handout!