Want to Know How Medical Research REALLY Works?

Read about it in The New Yorker -
I was sifting through all of these data, and I said to myself, ‘It can’t be this obvious,’ ” he recalled. “ ‘It can’t be the predominant factor in preeclampsia, because people would have discovered it by now.’ This couldn’t be just waiting for me.”
It's an article about the potentially very serious pregnancy disease, preeclampsia and a young non-obstetrician medical researcher, Ananth Karumanchi.

Classify These As Good Times

Well, for me anyway. The rest of the world isn’t having it so good at the moment.
And the classification was at its strongest 2 weeks when I blogged my last post and went on holidays.
And now after spending 47 hours out of the last 60 hours at work – and I started work on Monday 8am and went straight from my front door to my bed last night for 9 hours sleep - I’m classifying my current mood as “about to fall over” (I’m home 90 minutes and have yet to move from my sofa – the laptop is, for the first time, actually on my lap). The thing is, I’ve 2 more full days of work – which is another 23-24 hours at least, that brings my weekly total to 80 hours approx (I actually had to use calculator function to figure that out!) in 5 days.
Enough whinging about the sad life of a NCHD – because the bizarre thing (and I mean this is really really bizarre as I kinda hated studying medicine) I love my work. While I posted sympathetically about IVDU (intravenous drug users) here before, I am becoming a little more cynical – for example – I was called at 5am to re-site a cannula in a patient who has no veins left anywhere – except the side of her foot where she can’t reach to inject – so I spend ages putting it in for her urgent antibiotics – at 10am I walk by – see security removing a man from the ward – turns out he’s the boyfriend, he brought her in heroin – she shot up through MY line in the toilet and then proceeded to have rather noisy intercourse with him in same eerily blue lit toilet before being interrupted by security. Thankfully I was off call and did not have site another cannula at that stage – I might have self-combusted at that point.
Vienna, where I was last week, is fantastically beautiful sunny, edifying, expensive for ice and lemon (2.40 for tap water!) and has a marvellous array of audioguides. I’m a bit of an audio guide demon – I insist on listening to all pieces about every single painting/sculpture/side door/staff toilet that is on them. I did the really really cool “Mozart was here” audio-walk – everything was great – I meant to post properly – and my hotel (the very brill K+K Maria Theresa which is now my favourite hotel chain) had free internet so I had no excuse for not posting, especially when I did check in occasionally on other blogs.
There’s a load of other posts I want to comment on or flag but given I spelt “or” “r” and couldn’t understand why it looked funny, I might go to bed now and do it tomorrow!

I’m Just A Blogger

I was originally posting this as a comment to my post below but it got too long.

Do I believe that the opposition have policies? Yes.  Do I believe they’ve good policies? Some, I’m sure. Are those policies enough to convince me to vote for them? No.
I apologise to those who expect flawless use of the English language in every sentence I write – it may have been intemperate and fuzzy to say Voting for change is not enough – we must be voting for something, for an approach based on more than “not being the government”. From what I can see Labour/FG have been pulling shapes** about these issues rather than offering constructive alternatives – and in reality there aren’t always alternatives.
And as tedious as it is to repeat myself, I basically meant that MY intertreptation (as far as I can see) from watching Q&A, The Week in Politics and reading the papers like any other average Irish voter is that there seems to be more emphasis on being not-FF/PD than carving out distinct policy identities. That is not to say that they don’t have policies, just that one gets the impression they don’t matter as much when one is urged to “voting for change”. As for copernicus’s assertion that I have not fully engaged with those policies  - depending on his definition, I might not have –– I haven’t sat down and read all their press releases and policy documents. I did attend one of Enda Kenny’s meeting-the-people public meetings and while Enda isn’t all that engaging, I was attentive.
I’m just a blogger, I write this crap because I enjoy it. I don’t pretend I’m Gene Kerrigan or a political philosopher. Correct when I’m wrong, argue with me ‘til the cows come home, but please don’t expect me to know everything about all political parties in Ireland. This is not a cop-out, but how I use my vote is not contigent on indepth knowledge of the footnotes of  Sinn Fein’s economics documents.
As I stated below I’m not voting for change because “I simply do not trust Enda Kenny or  Pat Rabbit to not make any more bad decisions or to improve on what we already have.”

It’s also worth remembering that most people don’t vote in favour of 100% of a party’s policies. In the vast array of issues that political parties form positions on, only a few really matter to each individual. If the candidate or party ticks that particular box, less important issues are ignored. As far as I’m concerned voting for the idea of change is not enough – and if the nebulous concept of change is what matters to some voters, it’ll be interesting to see how exactly Labour/FG/etc will harness that as well as presenting unique identities to the rest of us.

As much as I’d love to stay and discuss this more, I’m off for the next week. In the meantime, buy the Pipette’s new album – they’re good fun or see Stacy Earle and Mark Stuart in Whelans on Sunday. .

Update – a few more bloggers on this – Damien Mulley, Richard Waghorne and Colm@InFactAh.

It’s All Black and White for Me, Baby*

Simon McGarr at tuppenceworth.ie has written a summons of sorts, a wail into the greyness of Irish politics - he wants to us to vote for change, to vote for the opposition.
The phrase “vote for change” has been forever sullied for me by Puff-Daddy-Diddy-Combs-Sean (or whatever he calls himself), REM, Bright Eyes, and Bruce Springsteen and their musical rabble-rousing in the run up to the last US election. It now just sounds trite and reminds me of John Kerry windsurfing.
That unfortunate association aside, Simon has a point – not one I agree with, but a point nonetheless – “I don’t have any illusions about the opposition but they have a single shining advantage- they represent a change. They can make new decisions, go in new directions. And they can reverse the bad decisions and wrong directions we’ve taken.”
He takes a number of issues that as a 30 year old aware of the temporal power of some political decisions to outlast his lifespan, he feels quite strongly about: MRSA; “officially sanctioned programme of torture”; road deaths; crooked housing developers; Luas/Metro problems; Bertie’s non-existent Bowl; e-voting and Fianna Fail’s tendency to attract megalomanical sorts that are more loyal to the Executive’s wishes rather than the nation’s need.
I’m not exactly happy with all these things either but I think I will be voting for the coalition again – not because I agree with their sometimes bad decisions, but I simply do not trust Enda Kenny or  Pat Rabbit to not make any more bad decisions or to improve on what we already have.
Voting for change is not enough – we must be voting for something, for an approach based on more than “not being the government”. From what I can see Labour/FG have been pulling shapes** about these issues rather than offering constructive alternatives – and in reality there aren’t always alternatives.
Simon rightly expresses his frustration with those who state that changes in “life and death” areas like MRSA infection rates will come slowly. I’m at a loss though to see what else can be done in hospitals that haven’t already been started – hand and hospital hygiene have been major priorities in any hospital that I have worked in. There are definitely many where this must be improved on, but Liz McManus as health minister is going to change anything, except give us higher tax bills – the changes that still need to be instituted can only come from the bottom. In fact, I had to undergo a 3 hour session on hand hygiene (washing your hands is simply not official enough a term) as part of my induction as a non-consultant hospital doctor, this on top of several such sessions as a medical student. MRSA and other such antibiotic resistant infections are an unfortunate side effect of modern antibiotic use – VRE is equally worrying as is VRSA in the emerging resistance fields. C. Dif, the severe diarrhoeal infection that is killing more than MRSA, is literally a side-effect of life-saving antibiotics that kill off other organisms allowing C. Dif to multiply.
I have absolutely no problem with Shannon airport’s use by American troops or with Luas/Metro issues – again I have yet to be convinced that the opposition can offer anything more.
The road deaths issue is an interesting one to leave at the government and Gay Byrne’s feet – Gaybo’s appointment does seem stupid but is this not an issue about personal responsibility? The government can not sit in our cars with us and tut-tut at crazy overtaking – in fact I nearly feel that we have too many gardai pointing their phallic like speed cameras at us from behind bushes. If I was going to vote on road safety, I would vote for the party who would make all straight roads 100kmh zones instead of just looking at where the road goes to give it a ranking. For example the Ring of Kerry is a 100kmh zone. Those who attempt to kamikaze-drive that very scenic part of our landscape at 100kmh deserve the pile-up that’s coming to them. However, the perfectly safe, straight and wide roads of the midlands that lead you from one small hamlet to the next village need not be passed at a measly 80kmh.
No political party is going to come out and say that speed cameras don’t work and we’d be much better depending on well trained drivers with a strong sense of personal responsibility. But personal responsibility and civic duty can’t be solved by the government; they can’t even be learned by example from our public figures.
I’m not going to go through the rest of Simon’s list – I agree with him that these are important problems – but their existence is not enough of an incentive to vote Bertie and co out of office. Simon wants a discussion – let’s do it. But let the basis of the discussion not be the need for a change of votes, but a change of solutions.

[From my recent music listening = *”Black and White” by the Upper Room and **”Pull Shapes” by the Pipettes]

Embryo Custody Case Starts in High Court

But will probably go further.
Here’s a few previous posts about this case –

The More You See The Less You Know
More on the IVF Case (my title-creativity just gets worse and worse)
Never Promised You A Rose Garden (Just about adult vs embryonic stem cells.)

My Metro Crashed – 30 Dead But I’m Grand

Yet another entry in the “text messages you don’t want to get” series. This time from the baby sister on her holidays in Valencia.
My pulse shot up to 500 or thereabouts on receipt of the text. Rang the parents and they had just talked to her and she and all her friends were all grand – this was before it was on the news so it was kinda confused – I think she was on the metro that crashed or was waiting for it on the platform.
Last year my parents and herself were held hostage in our home overnight – my mother sent a similarly short, sweet and to her ears, reassuring text – “Held hostage after break-in. Fine now. Ring when you get a chance”.
I have just instituted a new family rule – no text messages about disasters without my prior permission over a phone call.

Virginity or Death or Same Old Feminist Delusions

Ana Marie Cox of wonkette fame reveiews Katha Pollit's new book, "Virginity or Death! And Other Social and Political Issues of Our Time" in today's The New York Times.
She ends with -
If self-described feminists choose to wear 'excruciatingly high heels' and submit to Botox, Pollitt sees a charade: 'Women have learned to describe everything they do, no matter how apparently conformist, submissive, self-destructive or humiliating, as a personal choice that cannot be criticized because personal choice is what feminism is all about.'
This may be the book's most cogent statement, though a headline in The Onion put it better: 'Women Now Empowered by Everything a Woman Does.' But there's a world of difference between choosing to wear heels that require foot-soaking and choosing to cut your toe to fit your shoe. When women dress up damaging choices as empowerment, it weakens feminist argument. But when feminists start lecturing about wrong choices, it lessens their numbers. I wish I had an easy answer about how to navigate between stridency and submission. Then again, I wish Katha Pollitt did too.

The NYT gives access to the first chapter as well. Pollitt laments the lack of "grassroots" among women who have had abortions - apparently they are unwilling to campaign. Of course that could be that they regret their decision, something Pollitt would never dare factor in, or maybe they just have not fully processed their feelings about it.
She describes the serious business of feminism as daycare, abortion, equal pay as being interlinked with sexual self expression (and darlings, of course we express that through the Vagina Monologues) - How can you see yourself as an active subject, the heroine of your own life, if you think you're an inferior being housed in a shameful, smelly body that might give pleasure to others but not to you?
In honour of EWI's sensibilities, I won't discuss my views on vaginas again, but I find this aging feminist obsession with them interesting. To the casual observer of young women, shame about their bodies is not so much tied up with sexuality as the self image, control and emotional issues of anorexia. Porn has even become mainstream, fun and cool.
Perhaps feminists should worry about their ideaologies and hobby-horses and realise that they will never again regain the conformist "revolution" of the 70s - women will make bad choices and feminists, like the patriarchs of old, simply cannot dictate to a population created by sex, which choices they deem acceptable. Realistically, wearing stilettos is not exactly the worst choice a woman could make.
And to be honest, there are times when I would rather a Victorian "man of the house" who occupied himself with the mundane realities of making money, allowing his wife to devote herself to the exalted domestic sphere to a radical feminist interested in making all women market commodities, trading fertility for abortion, child-rearing for day care and refusing to accept that equal pay is already here.

George Bush sings "Sunday Bloody Sunday"

Honestly.
And it's weird.