Up@dawn 2.0

Friday, March 24, 2017

Quiz Mar 28

1. What does Paul Offit find laughable?

2. How much revenue did the rotavirus vaccine and Lipitor generate, respectively?

3. What did a Nashville woman sell for $50?

4. What did Jacobsen v. Massachussetts (1905) uphold?

5. What 20th century political philosopher does Biss's sister mention, in criticizing "Dr.Bob's" counsel of silence?

6. What paradoxical emotional state does Biss say is induced by citizenship in this country?

7. What "cultural obsession of the moment" do some mothers consider a viable substitute for vaccination? OR, what problematic implication of their obsession do some fail to consider?

8. Whose errant article "Deadly Immunity" was retracted, but only in its corrected version?

9. Who said "a scientist is never certain"? OR, Who advocated "negative capability"?

10. What was the bioethicist who said "it's not a matter of if, but when" referring to?

11. Immunologist Polly Matzinger's _____ Model says the immune system is more responsive to entities that do damage than with those that are merely foreign.

12. Who said "we must cultivate our garden," which for Biss implies recognizing immunity as "a garden we tend together"?

  • Do we have too many childhood vaccines, administered too soon (regardless of however many a child could "theoretically handle")? 110, 113
  • Are there any "vaccine profiteers"? 111 Do you agree that medical researchers (as distinct from pharmaceutical companies, or their Boards and stockholders) are not in it for personal profit? 112  Do you think many private practitioners rejected a life of research mainly for personal-financial reasons? What considerations will guide your own medical-vocational choices?
  • Are people who want their children to get chicken pox "idiots"? 115
  • Should we respect the "conscientious objections" of anti-vaxxers? Does it matter that they "honestly believe" unfounded, unreasonable claims about the hazards of immunization? 119
  • We owe the existence of this nation in part to George Washington's campaign of compulsory smallpox  inoculation, but also "owe some of its present character to resistance" to compulsion. 120 Have we achieved a proper balance between individual rights and the common good? Is balance a reasonable goal? Or would you defend tilting one way (individualism) or the other (the "general will")?
  •  Is conscience easily confused with any other feeling? 122
  • If "the body is such a ready metaphor for the nation," is it best conceived as an independent individual or as part of & dependent on a collective and community?
  • "We have sunshine in us!" 132 Should we be more optimistic about our future health prospects?
  • Is there anything wrong with understanding immune system as reflecting not only immunology but also environmentalism, alternative health, and New Age msyticism? 133
  • "Some prefer to assume health as an identity" 135 and not a fortunate but transient and vulnerable condition. Do you think this attitude leads those who hold it to feel less compassionate towards the sick, or less responsible for participating in behaviors that enhance the health of the whole community? Does it encourage a new and pernicious "social Darwinism"?  137
  • What's your response to those who say that AIDS is a punishment for homosexuality, promiscuity, and addiction? 138
  • Do you ever feel, when doing research - especially online research - that you've fallen down a rabbit hole? 139 How do you climb out? Is science a wonderland mostly in a good way?
  • What's the best way to deal with prevalent misinformation and "sensationalist" misleading headlines that distort science: confront, correct, or ignore? 141 Do you agree that "most published research findings are false"? 142
  • Are you optimistic about our "technologies for reproducing information" and our prospects for conquering the "mysterious unknown" of disease?
  • Are we still in the same predicament as Defoe's narrator, "left to reckon with improbable theories and pure speculation" and fears of mysterious plague? 148  Was San Francisco c.1989 not that different from London c.1665?
  • Can we defuse the "bomb" of antibiotic-resistant bacteria?
  • Is Offit's respect for fear of vaccines but not for decisions not to vaccinate coherent? 150
  • Does Stoicism seem right for our times? Is "apocalypse" an overstatement? 151 If we're too stoic, will we be vigorous enough in challenging those who do not acknowledge a civic responsibility to participate in measures to secure the entire community's health and safety?
  • Is there any rationale for banning gays from giving blood? 157
  • Are there "reasons to vaccinate that transcend medicine"? 158
  • What does "cultivating our garden" mean to you, in either medical or broader contexts? 162
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Science Friday (@scifri)

Is MSG actually bad for your health? (Spoiler: No) scifri.me/ng93mx #SciFriArchivepic.twitter.com/SCNOeYcwgk

How many animals are experimented on in labs?
The bioethics of googling
Press Release | Mar. 24 on FRONTLINE: Should Vaccinating Children Be A Choice? | Press Room | FRONTLINE | PBS 

My sister Kim, a social worker and ER staffer, shared a photo someone posted on her ER Facebook site of a tee-shirt with the message: "Too much emergency medicine prevents natural selection." Hmmm. My comment: Nothing prevents natural selection, but humane healthcare enables the selection of decency and compassion. (Will that fit on a tee-shirt?)
NYT Readers compare America’s for-profit system with that of Finland and other countries with universal, government-run care:

To the Editor:

Re “The Fake Freedom of American Health Care” (Sunday Review, March 19):

Anu Partanen’s observations about the cost and value of American health care are right on target. Very few Americans understand how health care gets paid for. Even fewer know that we in the United States spend about twice as much per capita on health care as other developed nations, yet fewer people are insured and our outcomes tend to be worse. Ignorance of these basic facts is at the root of our stalemate about health care reform.

Ms. Partanen is right to call out the bogus freedom being peddled by the current administration. The only freedom the current proposal protects is freedom of the market. That kind of freedom may be appropriate for buying a new toaster, but it is not appropriate for health care.


The writer is senior director, theology and ethics, Catholic Health Association.

To the Editor:

The chief problem with President Drumpf’s and most Republicans’ approach to health care is that it lacks a conscience. So-called free-market health care really just means profit-based health care. Such a system has no qualms about letting someone who lacks access to health care die and is indifferent if someone hesitates to seek treatment because it’s too expensive. The only value is the bottom line, assessed annually at stockholders’ meetings.

Thankfully, since Franklin Delano Roosevelt, Democrats (primarily) have stepped in to provide a collective conscience to supplant the profit motive; that collective conscience has demanded that old people have a minimum income, hence Social Security; that old people have health care, hence Medicare; that poor people should have some health care, hence Medicaid and the Affordable Care Act.

The American people are gambling with their lives if they put their health in the hands of Mr. Drumpf, other Republicans and big business.


To the Editor:

Anu Partanen makes a cogent case for universal health care. This would be a no-brainer if it weren’t for the fact that Republicans are worried that without the huge contributions they receive from pharmaceutical and health insurance interests, their re-election prospects would be dimmed. It’s always disturbing to see how they rationalize their support for “free market” solutions in an industry devoid of meaningful competition and rife with inherent conflicts of interest.


To the Editor:

Thank you for a very informative, first-person account of the differences between our slapdash corporate for-profit health care system and the Scandinavian model. As someone who has spent a lot of time in Northern Europe and has friends who work in the Swedish health care system, I found the essay spot on. I received medical attention free of charge when I needed it, even though I was not a resident, and the hospitals there are just as competent as ours here in the New York area.

All this political posturing about “socialism” as a dirty word shows how uninformed our leaders are. The social democratic societies have the best interests of their citizens as a priority. How do they pay for it? Payroll taxes and high taxes on alcohol and cigarettes, the very root of many of our health problems.

I wonder how many of our representatives in Washington have actually visited Scandinavia? Perhaps a field trip to spend at least two weeks in a Nordic country could open some eyes for our tunnel-visioned members of Congress.


To the Editor:

You don’t have to go so far afield as Finland to find a more efficient health care system than that of the United States. I can speak from experience about the much-derided Canadian system.

Since coming to Canada in 1974, I have probably seen my family doctor 50 times (with no co-payment). I have been to the emergency room at least 20 times; I have had several M.R.I.s, X-rays, sonograms and stress tests; and I’ve had a stent put in and cataract surgery in both eyes.

And what have I had to do for all this? Pay my taxes and show my health card. No voluminous forms to fill out or invasive questions to answer. For us the vocabulary of health care in the United States — co-payments, deductibles, pre-existing conditions — is as foreign as that of those aliens in “Arrival.”

Of course our system is not perfect. But I’ll take ours over the American nightmare of choices any day.


To the Editor:

There are many differences between the United States and Finland. Finland has a population of about 5.5 million, while that of the United States is about 325 million. So the size of a bureaucracy to support a centralized health care system in the United States would be staggeringly large. And there is nothing in our current centralized medical care systems (Veterans Affairs, Medicaid) that would inspire confidence in the efficiency or lack of fraud.

Another difference is that Finland is very homogeneous; the United States is not. According to a 2007 study by Steffen Mau of the University of Bremen, the more mixed the population, the less the people trust or support state welfare. And all this is aside from questions of freedom or rights.


To the Editor:

The free market has a way of working itself out for most products and services. A person of means can shop for a Cadillac Escalade and not worry much about the cost. Others who are struggling to find a way to get to work can shop for a used Toyota. The wealthy suburbanite can hire a landscaper to tend to the yard, while others will mow the lawn themselves.

The free market does not work as well with medical care. While a wealthy person may be in great health and use medical services for nothing more serious than a tummy tuck, the struggling family across town might be seeking treatment for a sickly child without the means to do so.

When Paul Ryan says, “Freedom is the ability to buy what you want to fit what you need,” this may apply when buying a home entertainment system, but it fails to meet many needs for health care.


To the Editor:

Anu Partanen is correct that the Republican idea of health care is grounded in “fake freedom.” For women, this pretense of freedom is especially offensive. The “freedom” and “choice” that Representative Paul Ryan and his male Republican colleagues highlight as the greatest pillars of their plan do not extend to women seeking reproductive freedom and reproductive choice.

Instead, the G.O.P. bill seeks to eliminate funding for Planned Parenthood, and to prevent the use of tax credits to purchase health plans that include abortion coverage. Beyond fake, the G.O.P. “freedom” is sexist hypocrisy.


To the Editor:

Choosing not to purchase health care coverage when you can afford it is not freedom but rather gross irresponsibility. Everyone is at risk of becoming ill or injured and needing expensive care to recover. To forgo insurance is to leave to others the responsibility of dealing with the costs of your illness or injury — or, worse, to force others to turn a blind eye while you suffer or die without care.

Certainly there are people who foolishly delude themselves into believing they are invincible or choose not to think about the consequences of not having coverage. But the majority of people who fail to purchase health coverage do so not because they don’t want coverage, but because they can’t afford it. Only the most cynical would call this inability to afford coverage freedom.


Deborah Blum (@deborahblum)

No possible acceptable defense: De Niro Defends Screening of Andrew Wakefield Anti-Vaccine Film at Tribeca Festival nyti.ms/1RErxol
Joe Hanson (@jtotheizzoe)

Hey @Tribeca, I fixed some errors in Andrew Wakefield’s bio for you pic.twitter.com/JOMg7SRCuZ
Michael Shermer (@michaelshermer)

There is an Intelligent Designer & his name is J. Craig Venter: "Design and synthesis of a minimal bacterial genome"science.sciencemag.org/content/351/62…
NYT Health (@NYTHealth)

A doctor's memoir is all the more powerful for its frequent uncertainty nyti.ms/1N4XhM0 pic.twitter.com/K1qo4Rj0qt
Saving The Doctor-Patient Relationship
Lifetime M.D. Dr. Nortin Hadler joins us to look at what’s happened to the doctor-patient relationship, and how to save it.
In this photo taken Thursday, Feb. 18, 2016, Doctor Leonid Basovich, left, examines Medi-Cal patient Michael Epps, at the WellSpace Clinic in Sacramento, Calif. (AP Photo/Rich Pedroncelli)
In this photo taken Thursday, Feb. 18, 2016, Doctor Leonid Basovich, left, examines Medi-Cal patient Michael Epps, at the WellSpace Clinic in Sacramento, Calif. (AP Photo/Rich Pedroncelli)
Nortin Hadler, MD, has been doctoring for a long time. He’s old school. Loves a rich doctor-patient relationship, where the whole person – patient – is seen and comprehended. Treated in full. But these days, he says, doctors who care are burning out, retiring early, pulling their hair out. “Today,” he writes, “health is a commodity, disease is a product line and physicians are a sales force in the employ of a predatory enterprise.” Ok! This hour On Point, Dr. Nortin Hadler on how to heal American health care... On Point (listen, read an excerpt of "By the Bedside of the Patient" by Dr. Hadler)


  1. Alternate Quiz
    1.In the vaccine that Biss’s father received for smallpox, what ingredient did it contain more of than it does in vaccines today? (110)

    2.What image makes Paul Offit sound like a madman for the proposition he made about how many vaccinations a human body can take?(113)

    3.(T/F) Vaccination immediately became more popular than variolation and replaced it when the technique was introduced by Edward Jenner. (116)

    4.What term, now primarily associated with war, originally referred to those who refused vaccination? (118)

    5.What is a tendency to take unwise risks when we are protected by insurance called? (123)

    6.Who said, “If thought corrupts language, language can also corrupt thought.”? (127-128)

    7.What became a controversial issue surrounding the cleanup of the great oil spill in the Gulf? What did the EPA do about it? (130)

    8.What was the answer to Anne- Marie Moulin’s question, “Why was the term immune system accepted so widely and so rapidly?” (133)

    9.What does Biss’s dad say causes cancer? What does Siddhartha Mukherjee say are copies of ourselves?(138)

    10.What is an example of a bacteria that is difficult to remove from the body due to the overuse of antibiotics?(149)

    11.During the _________ __________that killed more than half the population of Europe in the fourteenth century, rioters burned Jews alive under the auspices of public health. (156)

    12.What is essential to the health of any ecosystem?(161)

  2. Alternative Quiz Questions:

    1. For what reason has Dr. Paul Offit earned the distinction of being called the “Devil’s servant” and “Dr. Proffit” along with various credible death threats? (111)

    2. The vaccine virus chicken pox and the introduction of New Coke reinforces the idea that we are wary of what, despite they’re offered improvements. (117)

    3. What “empowering advice” did antivaccination activist Lora Little offer? (121)

    4. When Biss’s sister suggests that our bodies are not independent from each other and are reliant upon the choices other people make, she makes the point that there is simply an illusion of what? (124)

    5. Why is the requirement of indivisibility problematic for worms and women and how does this relate to the issues women have in modern western culture? (125)

    6. According to Biss, if our sense of bodily vulnerability can pollute our politics, then what must come of our sense of political powerlessness? (128)

    7. How does the presence of regulation resemble the absence of regulation? (132)

    8. Physician Michael Fitzpatrick says that the imperiled ‘immune system’ is a metaphor regarding what? (133)

    9. What epidemic preceding Biss’s generation left them believing that it was possible to avoid disease by living a cautious life and limiting contact with others? (136)

    10. According to Biss, what is meant when scientists say science is “self-correcting”? (142)