For you who face Irene

Be as safe and careful as you can.  Many of us will be watching as much as we can and hoping for good outcomes.  I suppose a few of us may pray, but you know what philosophers are like.

I  saw my second home town, Galveston, on CNN today as an example of what a hurricane can do.  Ike was so very destructive, and it sounds as though you may have something similar or even worse.  It is frightening, and the devastation you see afterwards can be very depressing.  Houston was without electricity for about 8 or 9 days.  We weren’t even allowed on Galveston; I went there on the second day we could get on the island.  Driving down the main street was like being in a funeral procession.  You may be in for something not easy to imagine.  I was in tears; it was hard not to be.

I hope you have read all the standard advice, and followed what you could.  The only advice I hadn’t seen, and wished I had, was to charge up fully everything that you can.  There are few things more vexing than to finally turn on one’s computer and see that you have little power left and no source of power anywhere near.

Colleges and universities may get power early; ours did.  In addition, of course, you may be able to charge things while you drive about.    It turns out that ipads are not entirely easy to charge, and yours may well require more power than a car can offer.   Well, there have to be some drawbacks, in addition to the name.

If you are in an area that is not used to hurricanes and floods, do be prepared to discover that a lot of retrospectively stupid decisions were made, such as not providing for sealing off the elevator mechanisms.  Or putting the generators in the basement.  Builders who skimped may be revealed, as sides and roofs of new houses come off.  You or other people in your area may be visited with equal stupidity such as, for example, being refused aid for homelessness because their second floor or higher apartment is in tact.  This despite the fact that the elevators do not work and they have to use a wheelchair.

So we will watch and hope.

o

Breast cancer: some psychological questions

I hope for this series to be helpful to others.   Some of the stuff I am encountering, though, has got to be less than common.  

I mentioned last time that there is far more in the way of options than you are likely to hear about from your surgeon(s). And while you might well think a female breast surgeon is the best choice, there is at least one possible downside. You may have very different values. I have, for example, come to think that the cosmetic aspects of her breasts are an extremely big deal to my surgeon.  I value non-intrusive surgery much more than she does (duh!).

So one problematic situation I am in is that I have two really world class surgeons – one the breast surgeon (BS) and the other the plastic surgeon (PS) who think I’m making a huge cosmetic mistake in insisting on a lumpectomy over a mastectomy (plus reconstruction), AND for them, a huge cosmetic mistake is a huge mistake.  Everyone is clear that the medical benefits are too close to choose between them. 

I’ve spoken to another doctor, totally separate from this, and he’s said there’s all this stress on cosmetics because they just haven’t had the time to explain why it is really medically important. But they’ve had plenty of time to tell me and I am pretty sure that with the whole crew cosmetics is a very big deal.  They record the amount of time we discuss things as I think we’re at about 3 hours now.

It may be that they would benefit in some way I can’t see yet, but it may also be the culture.  According to Wiki, for comparable cancers, the percentage of mastectomies over lumpectomies is 76% in Eastern Europe, 54% in the US, 42-44% in No. and So. Europe and 36% in New Zealand and Australia.  (I’m relying on memory so I might be a point or two off.)

Further, to say that I have had to go to some effort to get the surgery I want is an understatement, if one counts enduring highly stressful situations as work.  When I had my consultations with the PS, he simply went beserk.  It really was awful.  My spouse compared him to a famously nasty academic.  I’ve seen people turned red and say angry things when I’ve said “I understand that that is your position, but I disagree for the following reasons.”  But this quickly became uncivil, and I couldn’t even finish a sentence before he rushed in to say it was a stupid question or to jeer at me.  

So I am putting in a lot of effort to do avoid a highly invasive surgery, and I may well fail.  The surgeon needs to get “clean margins,” which is a cm at least of tissue without any malignancy; if she can’t, it is bad news for the breast.   But I think putting in the huge effort will make me feel better if I do fail.  And I’m wondering about whether this sense is fairly idiosyncratic or whether it might even be a general human psychological characteristic.  That is, other things being equal, would putting in a lot of effort even though you eventually fail make the failure easier to endure?

Suppose there’s a job possibility or a grant available and you put in a great deal of effort to get it.  Will the effort  make you feel better about not getting the job or not getting the grant?  Or perhaps the actual effort has secondary effects that make it worth it?  Or is it that some of us don’t want to be the sort of people who approach important things carelessly?  And why?

The second question is about the stigma of not being a good patient.  Are there things, such as people’s efforts to help you, that really you cannot complain about without a big social cost?  I was brought up short by someone’s saying to me last night, “Remember these people are all trying to help you.” 

At the risk of showing myself to be very ungrateful, I will mention the the physician’s assistant, who stood between me and the BS. She is a very sweet and nice young woman who obviously takes it as her mission to explain why the BS is right. She’s also the first line of defense, so she’s supposed to answer one’s questions. One day I said that I wanted to find out the grade of my cancer.   Grade is important in finding out how aggressive it is.  She looked at the chart, saw it wasn’t there and appears to have inferred that the pathology people couldn’t determine it.  So she explained to me that they couldn’t grade the cancer since there weren’t enought cells to test.

Even I could see that couldn’t be right.  And in fact the initial grading showed up in the system a few days later.

And then there was the psych consult, which I should have refused. Having happily, but with faulty statistics, explained which behavior of mine caused the cancer, the social worker decided to show me how to change my behavior. We started with a big circle to cover all aknowledge. I knew this was not going to go well, but to my credit, I think, I remained very polite though it all.  The kind of cancer I have is very rare and no one knows what causes it, btw.

My hair guy would disagree that they are all trying to help me.  He thinks they are part of a conspiracy to make money.  He holds that cancer is a fungus and is best treated with baking soda.  And there are people on cancer discussion boards who say they believe this theory.  And that’s how they will act.  This is American, after all, when people apparently learn so little in school that they actually believe a lot of stuff that seems really clearly  loony.

August 26: Women’s Equality Day

What is Women’s Equality Day?

At the behest of Rep. Bella Abzug (D-NY), in 1971 the U.S. Congress designated August 26 as “Women’s Equality Day.”

The date was selected to commemorate the 1920 passage of the 19th Amendment to the Constitution, granting women the right to vote. This was the culmination of a massive, peaceful civil rights movement by women that had its formal beginnings in 1848 at the world’s first women’s rights convention, in Seneca Falls, New York.

The observance of Women’s Equality Day not only commemorates the passage of the 19th Amendment, but also calls attention to women’s continuing efforts toward full equality. Workplaces, libraries, organizations, and public facilities now participate with Women’s Equality Day programs, displays, video showings, or other activities.

And, as we have noted before, it is also Dogs’ Day!

 

Racism in US Academia?

Grant applications at NIH and NSF are peer-reviewed; there is a serious worry, substantiated by research recently reported in Science,  that the peer-reviewing at NIH either is racially tainted or reflects a disadvantageous racism in African-American scientists’ careers:

It takes no more than a visit to a few labs or a glance at the crowd at a scientific meeting to know that African-American scientists are rare in biomedical research. But an in-depth analysis of grant data from the U.S. National Institutes of Health (NIH) on page 1015 in this issue of Science finds that the problem goes much deeper than impressions. Black Ph.D. scientists—and not other minorities—were far less likely to receive NIH funding for a research idea than a white scientist from a similar institution with the same research record. The gap was large: A black scientist’s chance of winning NIH funding was 10 percentage points lower than that of a white scientist.

The NIH-commissioned analysis, which lifts the lid on confidential grant data, may reflect a series of slight advantages white scientists accumulate over the course of a career, the authors suggest. But the gap could also result from “insidious” bias favoring whites in a peer-review system that supposedly ranks applications only on scientific merit, NIH officials say.

As far as I know, there isn’t any comparable data for NSF.

 

Do note that the concern that the grant applications from African Americans were less good is recognized, but no one doing the study thinks they have good grounds for saying that.  Nonetheless, the “series of slight advantages” covers factors that could well affect the quality of grant applications, such as strong mentoring.  Further research is being divised to isolate some of the causes of the award gap.

 

The original article, linked to in the post, has a lot of information and some useful references.