I'm sorry

To all the people of Louisiana, I would like to apologize to them for causing the recent hurricane. Silly me, I thought that hurricanes had something to do with warm equatorial waters during summertime. It turns out all this time that hurricane season is just God's way of shutting down Southern Decadence. I'm sure that the families of the thousands of dead will be comforted to know that their loved ones did not die in vain: Southern Decadence has been thwarted.

It makes you wonder what all the Texas queers were doing in Galveston back in 1900 to anger God so greatly, as well. (Via Americablog.)

Here's something to consider

Continuing the obesity theme from the other day, Americablog goes on a bit of a mild rant about sodas in schools, and how they should be replaced by healthier choices like juice. This is in response to the American Beverage Association's release of new rules that would decrease the sodas sold in middle schools and eliminate their sale in elementary schools. The NY Times says the that the entirely voluntary policy will make no changes applicable to high schools, which is where most of the sodas are sold anyway. It also points out that Coca-Cola and Pepsi already have policies against selling sodas in elementary schools.

So is replacing sugary sodas with juice a good move to reduce childhood obesity? I looked at some quick numbers:

Drink	Calories, 12 oz.
Apple juice	180
Grapeade Snapple (*)	180
Milk, 2%	180
Coke	160
Orange juice	150
Pepsi	150
Milk, skim	130
Powerade	105
Gatorade	75

(*) Note that a Snapple container is 16 oz.

So on a strictly per-calorie basis, juice is just as fattening, if not more so, than Coke and Pepsi. Sure, there are some vitamins in real juice that aren't in sodas, but how many of these kids are really lacking vitamins in their diets? I'll buy that some very disadvantaged kids don't have a good diet, but I haven't heard of a scurvy outbreak in the suburbs lately.

The Little General speaks

A doctor friend wrote this. With permission, I'm reposting it here. The referenced article is about a doctor being investigated by the medical board and attorney general for telling an obese patient she was obese. This is definetly making the rounds; I've seen this doctor giving interviews on CNN, NBC, and ABC just in the past two days.

This article saddens me. Unfortunately it doesn't surprise me. As a doctor I hoped that what I was experiencing was a local phenomena, apparently I was overly optimistic.

We are encouraged not to call fat people fat. They're large, they're overweight, not fat. Fat might offend people. Our CT scanner has both a weight limit (the table can't move more than 350 lbs) and a girth limit (you can't be more than 70 inches around). I have to explain to a patient at least once a week that their "habitus prevents us from doing a CT scan." Their habitus...not the fact that they are significantly larger around than I am tall. Other technologies aren't any better. "I'm sorry Mr. Smith, the ultrasound was non-diagnostic -- the surrounding tissue prevented an accurate assessment of your gallbladder." In other words, you're too fat for sound waves to penetrate.

We're encouraged NOT to tell people to lose weight. ED docs can suggest that they cut back on foods that are high in fat and cholesterol and tell them that they should make healthy lifestyle changes, but telling someone that they should lose weight is verboten. It's more appropriately done by their primary care doctors. Except, as the article illustrates, it's not.

This is not a cosmetic issue. This is not because I think they would look better in a bathing suit if they didn't have a spare tire. This is my trying to explain to a 600lb woman why her knees hurt without mentioning her weight and without admitting I can't find the bones of her knee to do a good exam. This is trying to provide care to a 900 pounder when standard drug doses are based on a 70kg patient. This is trying to clean a diabetic ulcer in a 450lb man when the ulcer is hidden under folds of fat...and he's dropping crumbs from the moon pie he's eating on my head. This is trying to intubate a 375lb man who is losing his airway and finding out I don't have enough upper body strength to lift his jaw with the laryngoscope. This is trying to achieve adequate sedation using pediatric-approved doses while setting the broken femur on a 62 pound TWO YEAR OLD.

Fat is killing these people. More importantly from my perspective, it's a huge drain on the health care system. Their fat is causing them huge amounts of morbidity while we pick up the tab in high insurance premiums or lower wages to keep insurance. Fat people cost more to take care of. They require zoo-sized scanners, special operating tables, special elevators, three people to put in a foley catheter instead of one, a vein finder to put in a simple IV; they don't fit in standard sized wheelchairs or standard sized hospital beds or standard sized hospital bathrooms. So health care costs more for everyone who uses the hospital.

Somewhere along the line grossly morbid obesity became acceptable and sanctioned and it is interfering with my job. I can not physically, with the limitations of our technology and the hospital, give these people adequate care, I am not, however, allowed to give them less than the basic standard of care (regardless that the standard was based on a 145lb patient) and now it appears that I am not allowed to tell them how to change their life so that I can give them good care.

Why have we allowed this to happen? When did my patient's ego become more important than their health habits?

The PCness is spreading: a few months ago I was yelled at by a patient for counseling him to quit smoking. He said it was none of my business....and the head of the ED that day backed him up. Mind you, he was there for an asthma attack.

There are days I think I should be a bookstore owner.

Talk about having a thick skull!

I don't normally watch Larry King, because I think his show is generally just a bunch of puff pieces for trivial news stories that probably should have been permitted to die a natural death. (Can you say Natalee Holloway, kids?) I guess we have to have our nightly update on all the missing white women, though.

Today, however, he had Marc Cohn on, so I watched. I've always been a really big fan of his music, and it's a shame that he hasn't put out more albums. Burning the Daze dates back to 1998, and he's only put out a five-song retrospective since then. The good news is that another is coming out this year.

I didn't know this, but Cohn was shot in the head during a carjacking about two weeks ago. After passing through the windshield, and possibly grazing his road manager's chin, the bullet lodged in his skull. It was removed at the hospital, and it sounds like he's going to be fine. Wow, lucky.

I'm still up

Yay for insomnia.

That Blogger flag

You'll notice a new button in the Blogger title bar up top. They've instituted a "Flag as Objectionble" option for all the splogs (spam logs) that are filling up Blogspot. The number of these damn things is incredible. Just click on "Next Blog" a few times and you'll see what I mean. Here's one dedicated to kitchen cabinets. I especially love how that one has been hit by a spammer in the comments.

Google is also instituting a captcha to stop spam comments. I've never had a problem with those here, so I have intention no turn it on.

Dealing with the splogs is a good idea. It's in Google's own best interest, of course, too. These things dilute the Blogger brand and poison their own search index.

This phenomenon is just another example of how a few spamming parasites can make life a little more difficult for everyone else.

When will I learn?

Somehow I need to get it through my thick skull that going grocery shopping on the Sunday of the weekend before classes start is not a good idea.

On a related note, it turns out that is possible to be more annoying that talking all the time on your cell phone in a public place: use your cell phone as a walkie talkie so everyone can hear both sides of your conversation.

We, the important people...

Dave over at Davenetics (formerly Electablog) points out:

We’ve seen how the Sheehan story has pushed Iraq back into the headlines and stirred up unanswered questions. But you have to wonder, how can we be in a war and not have really been that focused on it during the pre-Sheehan months?

Quick, name the top issues being debated when it comes to the Iraqi Constitution…

We’ve grown bored with what is supposedly the struggle of an era.

You would have a hard time disagreeing with him looking at the news. CNN, FOX News, and MSNBC all have as their top story right now the Northwest mechanics' strike.

There's an AP story this morning that says the US may be softening to the idea of enshrining in the forming Iraq constitution that the Koran as the final arbiter of their law. In other words, that Sharia or at best some form of Sharia-lite will be the law of the land.

I asked before, what will we do if the Iraqis elect another Taliban to power? What will we do if women become second class citizens and gay teens are executed in the public square? I fear all we will do is pat ourselves on the back and pull our troops out.

Yes, Virginia, the universe does behave rationally

I came across P. Z. Myers's excellent Pharyngula a while ago, but lost it. I remembered the name of his blog, but couldn't get the spelling right (even in the Google spell check), and so couldn't get back to it. Thanks to Squire for his post and the link.

Myers also links to an article by Kevin Drum that pretty much sums up the recent kerfluffle about Intelligent Design:

Look, this controversy isn't really about ID vs. evolution. It's about who gets to decide what's science and what isn't — and in that sense the radical Christian right understands the stakes better than much of the evolution crowd. After all, once you concede that the revealed wisdom of a millennia-old text is a legitimate substitute for empirically based science, creationism is only the start. The book of Genesis expresses opinions on much more than simply the creation of Adam and Eve.

That's why this issue is being debated at school board meetings and on newspaper editoral pages: creationists can not win the argument (and, in fact, lost it a long time ago) in the peer-reviewed pages of scientific journals.

Humanity began a new phase in its development with the Enlightenment. In some ways, creationists are trying to turn back that clock of Reason that began back in the 17th century and return us to the Dark Ages. We must rage against the dying of this light; as a people, a society, and a species, we can not afford not to.

Marines are such wusses

If you weren't paying attention to the political blogosphere, a week and a half ago there was a special election in Ohio. Paul Hackett was the Democrat running against Jean Schmidt in a district that tends to go heavily Republican (it went for Bush by 26 points in 2004). Hackett was a recently returned Iraqi veteran, and was actually criticized for it by his opponent. There was a big push of support for Hackett in the liberal blogs in the last week of the election, but it wasn't enough. The good news is that it was an astonishingly close margin of only 4%, which bodes well for 2006.

But what was most shocking was that Rush "Support the Troops or You're a Terrorist" Limbaugh treated him, an American veteran, with an astonishing degree of disrespect. Here is one exchange he had with a caller:

RUSH: He was in the Civilian Affairs Unit, and this is a Washington Post story (it says here) from July 30th. "A lawyer and a major in the Marine reserves, Hackett volunteered last year to serve in Iraq and spent seven months there in the civilian affairs job, including service around Ramadi and Fallujah...So he volunteered to serve, spent seven months in a civilian affairs job... Okay, call him a staff puke if that's what you want, but civilian affairs, staff puke.

Here is what Wikipedia has to say about these two cities:

Ramadi: Ramadi is considered to be the southwest point of Iraq's Sunni Triangle. It has been a focal point of resistance to the U.S. occupation of Iraq. On April 6, 2004, at least 12 U.S. Marines were killed by guerilla forces in Ramadi, in an apparent effort to relieve the ongoing siege of nearby Fallujah.

Fallujah: Fallujah has become one of the most dangerous areas for coalition military troops during the occupation of Iraq. Since the occupation began, more than 200 Americans have died in Fallujah — more than any city except Baghdad.

Yeah, Hackett must really be a big pussy to hang around Ramadi and Fallujah.

Rush later accused him of going to Iraq with ulterior motives:

The big picture here is they got another liberal Democrat trying to hide behind a military uniform...And it appears that, you know, he goes to Iraq to pad the resume...

Can you just imagine the nuclear screaming hissy fit that Republicans would throw if anyone attacked a conservative Iraqi vet's service? There would be accusations of treason, hating our troops, and everything short of devil worship. Oh wait, that's pretty much standard fare.

It's is a testament to the power of the Right Wing Spin Machine that somehow Bush's minimal service during the Vietnam War became more heroic than Kerry's (which one took a bullet?), that it can effectively question the patriotism of Max Cleland after he lost three limbs in Vietnam, and that it can fearlessly call Paul Hackett a "puke." That last, mind you, coming from a man that didn't serve in Vietnam because he had a cyst on his ass. (It was later reclassified as his head.)

There have long been apocryphal stories of Vietnam vets getting spit on in airports as they returned from the war. (Those dirty hippie liberals, ya know.) I guess we know who's doing the spitting now.

He didn't mean *that* kind of terrorist

(This is a bit of a follow up to this post about Joe Scarborough advocating racial profiling in random bag searches.)

A guy was caught at an Oklahoma City airport today trying to sneak what looks to be a bomb onto an airplane. From his picture, it looks like he's as white as I am.

But something tells me we won't hear much call from the Right about racial profiling of white guys.

Freaky statistic

There's an article over at Yahoo (from PlanetOut) about people not necessarily supporting their loved ones taking part in HIV vaccine trials. I rather think the article makes a bigger deal out of the findings than is justified; just because I don't want someone I care about with cancer to get the placebo in a clinical trial doesn't mean I don't want there to be a cure for cancer.

But this has to be one of the freakier statistics I've ever seen in my life:

One of the most shocking discoveries for pollsters was that several people believe an HIV vaccine already exists and is being kept a secret. Out of those polled, 47 percent of African Americans, 26 percent of Hispanics and 13 percent of MSM said they believed in such a conspiracy theory.

Let's look at that again: HALF of all African Americans believe there exists a working HIV vaccine, but it's being kept secret.

Sometimes I wonder if I live on the same planet as the rest of the world.

Why won't gay.com do something about the spam bots?

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A dozen red Turd Blossoms, please

When asked about Karl "Turd Blossom" Rove on Monday, Dubya said, "Karl's got my complete confidence. He's a valuable member of my team." Now, he's previously backtracked on his promise to fire any leaker in this case, refusing to comment because the investigation is ongoing. It seems almost a foregone conclusion that the investigation will reveal he was definetly at least one of the leakers. If that happens, the reluctance to fire him because the investigation is ongoing will turn into a reluctance to fire him because criminal charges haven't even been fire. If he's indicted by Fitzgerald, the prosecutor, that will then turn into a refusal to fire him because he's "innocent until proven guilty." I'm betting he would hold his office up until an actual conviction, at least, which would likely be after Bush leaves office.

But Bush's "complete confidence" doesn't wash. I can only come up with two possible interpretations of his statement:

• Bush doesn't think Karl was involved in the leak
• Bush actually approves of outing Plame's covert identity and the damage to our national security it caused

I just can't imagine any other way you can parse Bush's continuing "confidence" in Rove. The former possibility would be willfull blindness, at the very least, not to mention a striking lapse of judgement. The latter possibility, however, is almost frightening to contemplate. Is it even possible that Karl revealed her identity with the approval or possibly even under instruction from the President? Remember, this is an administration where even those involved in it have said it has absolutly no policy wing; everything is driven by political considerations.

The sidebar has a new blog, which I've been reading for a while, and I will quote Seeing the Forest where Dave Johnson said:

Rove outed a covert CIA agent working on keeping WMD out of the hands of terrorists. This "rolled up" her network of contacts, possibly getting some killed. And by exposing her he exposed her cover company, possibly causing damage to other agents and networks as well.

Rove did this at a time of war against terrorists. His act exposed all of us to increased danger of attack by those WMDs she was trying to keep away from terrorists.