Burlington Free Press obituary: http://bit.ly/6DlMLn
Los Angeles Times obituary: http://bit.ly/7E3wAe
In the United States, Lego’s biggest market and the biggest toy market in the world, games with themes like “Star Wars” and “Indiana Jones” were among the reasons Lego sales jumped 32 percent last year, well above the global pace. But experts like Dr. Jonathan Sinowitz, a New York psychologist who also runs a psychological services company, Diagnostics, wonders at what price these sales come.
“What Lego loses is what makes it so special,” he says. “When you have a less structured, less themed set, kids have the ability to start from scratch. When you have kids playing out Indiana Jones, they’re playing out Hollywood’s imagination, not their own.”
Even toy analysts who admire the company and its recent success acknowledge a broad shift. “I would like to see more open-ended play like when we were kids,” says Gerrick Johnson, a toy analyst at BMO Capital Markets in New York. “The vast majority is theme-based, and when you go into Toys “R” Us, you’d really be challenged to find a simple box of bricks.”(via Kottke)
When Gawande began writing for the New Yorker, the Brigham’s public affairs department wanted to see each piece before it was submitted. “No way was the New Yorker going to allow that,” he says. “[Michael Zinner, Brighman and Women's chief of surgery] stepped in and said, ‘I’ll take responsibility.’ Then he said, ‘You don’t have to show it to me.’ ”
The two men share a fervent belief that pulling back the veil on medicine will do more good than harm, even if it means pushing transparency’s limits right up to the edge of lawsuit territory. “What is the alternative to understanding the complexity of the world?” Gawande asks. “It’s denying it. There’s no way that’s a successful strategy.”
Because the statistical concept of placebo is drawn from the study data, the study itself has an effect.
For example, the strength of the placebo effect is measured relative to the active treatment. The Wired article says that placebo is getting stronger, which is another way of saying that the difference between placebo and the drug is getting smaller.
It turns out that the more rigorous the study the less strong the drug effect is, or, in other words, the stronger the placebo effect.
For example, we know that better designed and higher quality studies show smaller drug effects. This includes things as simple as randomisation. If your method for randomly allocating people to groups is more susceptible to bias, it's more likely to produced biased results. Better randomisation improves the placebo effect, again, nothing to do with expectancy or belief.
So one reason why the placebo effect might be increasing is that studies are just more rigorous these days.A bit of a long clip, but there's more there if this subject interests you.
“I’m still here,” Mr. Kennedy would call colleagues out of the blue to say, as if to refute suggestions to the contrary. “Every day is a gift,” was his mantra to begin conversations, said Peter Meade, a friend who met Mr. Kennedy as a 14-year-old volunteer on Mr. Kennedy’s first Senate campaign.
Some patients given a fatal diagnosis succumb to bitterness and self-pity; others try to cram in everything they have always wanted to do (sky-diving, a trip to China). Mr. Kennedy wanted to project vigor and a determination to keep on going. He chose what he called “prudently aggressive” treatments.
As someone who has written an entire book about the difficulties of caring well for the dying, I find all the fury aimed at halting support of end-of-life care discussions more than a little ironic. Why? Because the truth is that most of us need all the help we can get to start these difficult conversations. The truth is that we never talk or even want to think about talking about dying because we are afraid of dashing our loved one’s or our patient’s hopes. The truth is that we fear — even abhor — these discussions because we believe that by talking about dying we are giving up.Chen also describes some research findings alluded to here that I still find shocking: Only about one-third of terminally ill patients have discussed end-of-life care with their doctors.
His coolness is his armor. “I do not feel obligated to be sort of eternally involved with the experience of death,” Dr. O’Mahony said. “It’s not healthy to be there all the time.”But the danger is that “death gets to be banal,” he said.“Do you know that poem by Dylan Thomas?” Dr. O’Mahony asked with a faint smile. “After the first death, there is no other.”
*There are more than 6,500 cancer clinical trials seeking adult patients, according to clinicaltrials.gov, a trials registry. But many will be abandoned along the way. More than one trial in five sponsored by the National Cancer Institute failed to enroll a single subject, and only half reached the minimum needed for a meaningful result, Dr. Ramsey and his colleague John Scoggins reported in a recent review in The Oncologist.Even worse, many that do get under way are pretty much useless, even as they suck up the few patients willing to participate. These trials tend to be small ones, at single medical centers. They may be aimed at polishing a doctor’s résumé or making a center seem at the vanguard of cancer care. But they are designed only to be “exploratory,” meaning that there are too few patients to draw conclusions or that their design is less than rigorous.“Unfortunately, many patients who are well intentioned are in trials that really don’t advance the field very much,” said Dr. Richard Schilsky, an oncologist at the University of Chicago and immediate past president of the American Society of Clinical Oncology.
Julia Child wants you -- that's right, you, the one living in the tract house in sprawling suburbia with a dead-end secretarial job and nothing but a Stop-n-Shop for miles around -- to master the art of french cooking. (No caps, please.) She wants you to know how to make good pastry, and also how to make those canned green beans taste alright. She wants you to remember that you are human, and as such are entitled to that most basic of human rights, the right to eat well and enjoy life.
When I put up a recent tweet saying writer's block was nothing more than an attempt to justify your own laziness (and not recognizing this was simply lying to yourself), I got a number of angry RT's calling me (at best) smug. To those whom I angered I would say, that's a common response when someone takes away a crutch.
If there is a problem with Twitter though, it’s an inability to express nuance (for most of us, anyway, who don’t have the poet’s genius for condensation).
But here I can say, re: writer’s block: This I Believe:
The phrase writer’s block is an excuse that should be used only by the weak and delusional (or as lighthearted slang for “It’s cocktail time somewhere!”). If you must put a tag on your inability to produce, be my guest. We all know what it means.
It has a slightly golden hue, suspended in an oily substance and injected in a needle about half as thick as a telephone wire. I have never been able to jab it suddenly in my hip muscle, as the doctor told me to. Instead, after swabbing a small patch of my rump down with rubbing alcohol, I push the needle in slowly until all three inches of it are submerged. Then I squeeze the liquid in carefully, as the muscle often spasms to absorb it. My skin sticks a little to the syringe as I pull it out, and then an odd mix of oil and blackish blood usually trickles down my hip.
Sick Guy on taking testosterone in 2009:
I pull the largish square envelope from its package, then tear it at its score lines and slip out the flesh-colored disc and set it on my desk. I brace myself as I feel around underneath my clothes for yesterday's patch, then rip it (and sometimes a considerable amount of body hair) away. I take the new disc, puffy in the center with its cargo of synthetic testosterone, and remove its plastic backing. A strong smell of alcohol fills the air as I stick it to my stomach, shoulder or thigh.
The immediate effect for Sullivan:
Because the testosterone is injected every two weeks, and it quickly leaves the bloodstream, I can actually feel its power on almost a daily basis. Within hours, and at most a day, I feel a deep surge of energy. It is less edgy than a double espresso, but just as powerful. My attention span shortens. In the two or three days after my shot, I find it harder to concentrate on writing and feel the need to exercise more. My wit is quicker, my mind faster, but my judgment is more impulsive. It is not unlike the kind of rush I get before talking in front of a large audience, or going on a first date, or getting on an airplane, but it suffuses me in a less abrupt and more consistent way. In a word, I feel braced. For what? It scarcely seems to matter.
For Sick Guy:
I feel nothing, and proceed to knock down the other seven or eight pills I take every evening.
[At the point I started the injections] I weighed around 165 pounds. I now weigh 185 pounds. My collar size went from a 15 to a 17 1/2 in a few months; my chest went from 40 to 44. My appetite in every sense of that word expanded beyond measure. Going from napping two hours a day, I now rarely sleep in the daytime and have enough energy for daily workouts and a hefty work schedule. I can squat more than 400 pounds. Depression, once a regular feature of my life, is now a distant memory. I feel better able to recover from life's curveballs, more persistent, more alive. These are the long-term effects. They are almost as striking as the short-term ones.
Three weeks in, and my weight is stuck stubbornly, tragically, at less than 130 pounds. I once wore XL clothes; now I take smalls. I still nap. I do not work out, not unless Wii Tennis counts. My appetite is fragile -- up, then down. Some days I eat almost nothing, forcing down a couple high-protein drinks and a piece of toast. Other days, like a memorable one a while back, I feel different.
I was reading to little B. about castles and swords and dreams of knighthood, when a primal surge of hunger rose up in me and demanded food. I ate a handful of grapes and a sack of pretzels and emerged only hungrier. I rose shakily to my feet and procured two "whip it's!" (a marshmallow-focused confection that is the pride of Quebec) mainly because the cookie sack was already on the counter. Then a square (OK, two) of rum-caramel-filled chocolate. At this point, L. said something along the lines of, "Jeez, dinner is almost on the table." I subsided briefly, but grabbed another handful of grapes. I then proceeded to eat a Close Encounters-like pile of mashed potatoes and some grilled flank steak and spinach.
Sullivan’s NYT essay on testosterone -- which ranges far beyond the personal anecdotes I recount here -- is worth reading, despite the powerful critiques hurled against it, most memorably by Judith Shulevitz. For Sullivan, at that time, the hormone held huge explanatory power backing up a particular idea of competitive, vigorous masculinity, an idea that, if taken crudely, is not so far from the ass-kicking, NASCAR lovin’ sort of guy-dom I satirized here. Another note: It’s striking to compare the effects of Sullivan’s sudden and presumably higher-dose method of delivery to those of my more gradual approach. Perhaps this change in modality, which I assume is widespread, accounts to the fact that people (except, maybe, Floyd Landis) aren’t talking about T. as a wonder hormone any more. I’m still hopeful that it will stimulate appetite and build muscle, but it’s clear that it’s going to take a while.
Will it make me into a better man -- or at least a more manly man?
I don’t think so.
Note on the title: I don’t wish I were him, Andrew Sullivan. It’s a reference to this song by Ben Lee, which is a tribute to Evan Dando. Lee, who looks like he’s about 11 in the video, actually did get as cool as Dando, dating Clare Danes for several years before marrying Ione Skye. Dando, sadly, is apparently still mired in addiction and has almost destroyed his talent and voice.