w i t h o u t  b o u n d . n e t
May 7th, 2009

(Not really, although if I were a neuroscientist [which, I am sure, the professors who made a noble attempt to teach me that subject would agree it's a good thing for everyone that I am not] I think it would be a promising area of research. It’s known that increased use can make regions of the brain larger; for example, concert pianists tend to have particularly large portions of the motor region devoted to the fingers. I want to scan some used-car salesmen and politicians as well as certain “science” “journalists” and see if we can’t locate the areas involved in truth-stretching.)

Via @sbma44, this article has what might be the worst headline I’ve ever read.

The article itself, minus the headline and lede, is really interesting and, I think, accurately represents the research.

When a neurosurgeon electrically jolted this region in patients undergoing surgery, they felt a desire to, say, wiggle their finger, roll their tongue or move a limb. Stronger electrical pulses convinced patients they had actually performed these movements, although their bodies remained motionless.

That’s cool! As a quoted scientist points out, volition is presumably a sensation like anything else, and it’s interesting to find the brain region where that occurs.

What I want to know is whether the headline’s author seriously thought that free will might actually be something that scientists could invoke with electricity or just thought that would make the article sound more interesting. I mean, surely, whatever disagreements philosophers and theologians might have about the nature of free will, even the lowliest layperson can agree that it’s by definition something that somebody with a scalpel and a probe can’t do to you.

April 24th, 2009

Tyler Cowen and Megan McArdle both recently posted about streetcars, asking why people like them so much. I’ve been pondering this question myself since I spent a month in Philadelphia last fall, living in a sublet less than a block from a streetcar stop. It was great. And I still can’t figure out why I like streetcars so much more than buses!

I definitely do not think it’s because of charm or nostalgia; the Philly streetcar wasn’t particularly charming (and, having lived right next to the route, I can tell you it was way louder than the bus). I also don’t think I was getting away from poor people; the people on my streetcar were pretty much a cross section of people who lived in West Philadelphia/University City, who would presumably be the same people who’d ride buses, though I never got on a city bus so I don’t know.

I think it’s not so much that I love streetcars; I don’t like them any more than subways. (The convenience of not having to take an escalator or stairs to get to the platform is balanced out by the fact that you have to wait in the cold, rain, or heat.) Instead, I think I just really hate buses.

First, while I have certainly gotten queasy on subways or streetcars and even have trouble reading on Amtrak, buses are far worse for motion sickness. Second, buses get stuck in traffic. (I know streetcars in some cities do, too; this wasn’t a problem with my streetcar line in Philly.) Third, I have never been on any kind of light rail with shock absorption as poor as on the buses I used to occasionally ride in Cleveland when I was in college. I literally felt like my teeth were rattling in my mouth.

I think, though, that my main problem with buses is that they’re unpredictable. They can get rerouted, turn unexpectedly, fail to stop as scheduled, get stuck in traffic, etc. Furthermore, this is embarrassing to admit, but as someone raised in the suburban Midwest where we never used public transportation, I am intimidated by figuring out buses. Anything on a track is easy – there’s a straightforward map of which lines go where. Stops are clearly marked, and there is almost always a map at each stop, or at least a list of stops on that line.

I don’t actually know how people usually figure out which bus line to take, because there are hardly ever any maps posted. On the rare occasions when I need to take a bus, I use the local transit authority’s web site to plan my route and it tells me which line to get on. I can’t remember how I figured out my route when I’d take the bus home in college, because I’m pretty sure that was before those services existed, but I do remember transferring buses in Public Square and being very concerned that I wasn’t standing at the right stop, or that I’d get on the 57B instead of the 57A (or whatever) and it would turn out that it took a different route to its final destination and I’d have to call my parents to come get me from the next suburb over.

In St. Louis, the MetroBus map and schedule page consists of a list of numbered and named routes, with links to schedules and maps. Same story for Philadelphia, where I’m moving next week. I’ve seen lists like this around transit stations, but I guess you are supposed to already know which route you are interested in. There are maps online that show routes; I assume these must be available in printed form somewhere but they’re not posted at bus stops (at least in St. Louis, Cleveland, and NYC, which are the cities where I can remember looking closely at bus stops).

This is how I like to navigate: I was in San Francisco last weekend and took BART from SFO to my destination in the East Bay. I decided to stop in the city to visit a yarn store and get dinner. I wanted to go to ImagiKnit, at 18th and Sanchez, so I got off BART at the 16th St Mission stop, walked down to 18th, looked at the house numbers, and set off in the right direction to my destination some half dozen blocks away. I am sure that I could have taken a bus and it would have been faster, not to mention easier considering I had a heavy handbag and a suitcase.

But my navigational style is to know where I am and where my destination is on the grid, and move appropriately. I can remember where subway or trolley lines are, even in a transit-dense place like Manhattan. If I decide I’d like to ride instead of walking, I can go to a subway stop, consult the map, and decide which line to take. I find that much more challenging with buses because of the unpredictability and the fact that there aren’t maps posted all over the place (presumably, of course, the latter follows from the former).

And that is why I don’t like buses: I would rather walk eight extra blocks than get on public transit when I’m not completely sure where it’s taking me. That bus could go ANYWHERE!

April 22nd, 2009

Apparently yesterday the Supreme Court discussed underwear. The article is especially bizarre for that reason, but the case is about whether middle school officials can strip search students.

The student in question was suspected of having prescription-strength ibuprofen. Ibuprofen! I’m aware that many schools have (ill-advised and unnecessary IMO) rules against students carrying medication, but I can’t believe the administration in this case didn’t think it might be just a little over the top to strip-search kids for something this innocuous. I can only imagine that next year we’ll be hearing about body-cavity searches for Claritin.

April 14th, 2009

Our new apartment in Philadelphia has a rooftop deck. I’m excited about starting a new herb garden (it’ll still be in pots, but I won’t be limited to the number I can reach on the windowsill). One of the first things I’ll plant is rosemary. I like pretty much everything I’ve ever used rosemary for (two favorite recipes starring this flavor are a tomato and pork ragu, and a lamb and lentil stew), and last year I visited the (highly recommended) Piedmont Restaurant in Durham, NC, where I tried a cocktail that combined rosemary with two of my other favorite flavors, grapefruit and gin. It was called a Rose Marie and it was awesome.

So last summer, I infused some gin with rosemary, and the one cocktail I made with that was very good. Then I dropped the container on the floor and it shattered (messy, but smelled good!) so to speed up the time it would take to get the rosemary flavor in, I had the idea of doing it as a granita instead. Here’s what I did:

1/2 cup water
1/2 cup sugar
2 sprigs rosemary
1/2 cup gin*
3 cups pink grapefruit juice

Simmer the water, sugar, and rosemary together until the syrup is slightly reduced and the rosemary is wilted. Remove the rosemary. Stir in the gin and grapefruit juice. Pour into an 8×8 baking dish and put in the freezer. Stir every 30 minutes for about 4 hours; you’ll end up with a granita that is on the soft side and can easily be scooped into wine glasses. It keeps forever in the freezer; just stir it up again before scooping.

*I think this would work fine without gin if you are a gin-hater or want to feed it to precociously-foodie children; adding additional sugar should keep it from freezing too firmly. By my calculation it has about 1/2 oz gin per half-cup serving.

I’m looking forward to making another batch once I have some rosemary! I have also recently been told that three more of my favorite tastes, lime, ginger, and maple syrup, taste great together. That was in the context of a main-dish recipe, but now I’m thinking granita…

April 13th, 2009

Exciting news in women’s health: a relatively cheap DNA test for HPV (the virus that causes cervical cancer) looks like it works better than Pap smears in preventing cervical cancer through early detection. (New York Times, New England Journal of Medicine).

This is huge for developing countries. The widespread use of Pap smears in the US and other developed countries has made cervical cancer largely a preventable disease. But in much of the world, repeated office visits for cytology that must be read by a pathologist are just not doable. In this study, a single HPV test made a significant impact.

The article has started an interesting debate about the role this will play in the US – it sounds likely that HPV testing will continue to prove better than Pap smears. That alone won’t change women’s experiences much (the DNA sample is still obtained from the cervix, so it requires a pelvic exam), but we may be able to stretch out the interval between screenings.

As both the NY Times article and the editorial accompanying the NEJM article point out, research has already shown that the interval between Pap smears can be extended after enough negative tests, and that screening very young women for cervical cancer leads primarily to excessive procedures. Neither of those has been fully accepted yet by either gynecologists or patients. Presumably any proposals to use relatively-infrequent HPV testing as the primary screening modality will be met with similar caution, so I expect we’ll be doing annual exams for the foreseeable future.

It’s interesting to think about how this will affect my practice, though – it is weird to imagine a clinic schedule where annual exams don’t predominate!

(I have to say, also, that the New York Times article gets a gold star for health reporting. Not only does it accurately report the results of the study, but the background information it provides is all correct. I’m particularly impressed that the article points out that the current recommendations for Pap smears are not for every year in most women, and that most women do contract HPV but the vast majority of these infections are benign and cleared up quickly by the body’s defenses.)

April 11th, 2009

This is so true. I didn’t realize how important pens were going to be when I entered the medical field, and now I am sort of fixated on them.

Today, in fact, I was teaching a CPR class and needed to provide a pen for people to sign the attendance sheet. The only one I had in my purse was a high-quality one. I lent it out, but only after announcing to the whole class that it was mine and nobody better steal it.

Usually I do employ the Sacrificial Pen strategy Michelle describes – pharma pens are great for this but I actually bought a pack of Bic pens to “lend” as well. Hey, my pens cost a dollar apiece! (As I tell people whenever I’m forced to lend out a good one.)

My current favorite pen:

The only drawback is that I currently only have the 0.7mm size and I really like 0.5mm better.

My previous favorite was a very popular one, the Pilot G2:

On one rotation, it turned out my attending had the same preference – he saw my pen in my pocket and accused me of stealing his! Luckily mine were 0.5mm and his were 0.7mm so we could keep them straight.

April 11th, 2009

A friend mentioned that her kid is building a model of the Great Wall for school, and her husband is trying to keep from taking over. That reminded me of one of my favorite childhood memories.

When I was in maybe third grade, I had one of those projects and I decided to make a log cabin. My dad, who’s a model train buff, helped a lot – I think all the major ideas were his. We used a cardboard box to build the walls against. My uncle had just cut down a pine tree in his yard, and my dad took all the small branches and cut them into little logs, notched at the ends to fit together. I assembled them. He helped me figure out how to make a chimney structure out of more cardboard, then I glued on stones, and he provided sawdust that I colored with food coloring and used for grass and a dirt path. He designed and built the roof, which was removable, and I shingled it with construction-paper rectangles I cut out. Oh, I did contribute one idea which was having a window glazed with waxed paper. (I think it might have bugged him that the window frame wasn’t structurally sound, as it was added later and not built in.)

Mine was one of those projects that obviously was not done by the kid on her own (although I think there were one or two that were fancier than mine). But my parents still have it – who could bear to throw that away! – and I love looking at it and remembering all the evenings spent working with my dad on something we both enjoyed, and producing something pretty cool.

April 10th, 2009

I heard an ad on the radio this morning for a company that will finance a brand new computer as long as you have a bank account and can afford weekly payments of $29.99 — for 12 months. They’re selling this as a way to (1) get a computer when you have no credit or bad credit, and (2) build up good credit.

I guess when kids who trick littler kids out of their lunch money grow up, this is the kind of thing they do for a living.

April 10th, 2009

Via Jacob Grier, a very convincing post against URL shorteners.

The worst problem is that shortening services add another layer of indirection to an already creaky system. [...] The extra layer of indirection slows down browsing with additional DNS lookups and server hits. A new and potentially unreliable middleman now sits between the link and its destination. [...] The clicker can’t even tell by hovering where a link will take them, which is bad form.

I completely agree. (Actually, it turns out that I complained about TinyURL back in 2004 [in a post that now has a mildly broken permalink, amusingly enough].)

I think these services were useful for their original purpose (reducing the likelihood that copy-pasted links would break in emails/Usenet posts). I never understood why people started using them instead of direct links on the web, but I hoped that they would die out, one silver lining to the HTML email cloud.

Then came Twitter! I enjoy working with the 140-character limit, and it does make sense to use shortened URLs in this case. If people would restrict their use of shortened URLs to Twitter, the downsides wouldn’t bug me much – Twitter is kind of supposed to be ephemeral, so the effects of link rot are not terrible, and if a service did get hacked, the news would spread quickly enough! But this has caused a general resurgence of the fad (again, I don’t understand it), and it’s driving me nuts again.

I’m tempted to say that Twitter caused this problem and ought to fix it. I see two possible ways to do that: Twitter could roll their own URL shortener, ensuring that as long as Twitter is around, links in tweets will work. (This might require blocking use of other URL shorteners, which sounds attractive to me although of course it’s not that simple.) Or Twitter could create some sort of “relevant link” field so URLs wouldn’t need to go in tweets at all. (I think this would be great; people doing Twitter by SMS can’t click links anyway.)

It might be too late, though – now that everybody and their local newspaper is on Twitter, the strange attraction of the short obfuscated URL might have spread too far to be stopped.

P.S. Naturally, the first thing I wanted to do when I read the above-linked post was Twitter it. I thought it would have been kind of funny to use a link shortener, but it turned out that I fit the link in without a problem. Then Twitter automatically turned it into a TinyURL link. Thank you, Twitter.

April 5th, 2009

Somebody recently invited me to a Facebook group called “We Will Not Pay To Use Facebook. We Are Gone If This Happens” (currently with 3,815,847 members).

Apparently in light of Google’s interest in Twitter, I’ve been seeing people talking about how they’re not going to pay to use Twitter.*

What I want to know is, what makes these people think Facebook and Twitter have any intention of ever charging users for their services? It has become abundantly clear that social sites are valuable because of the content they create and the users they attract – that value is much more than what individual users would be willing to pay for the utility they derive from the sites. Site owners can hardly have failed to notice this.

So not only is there no reason to think Facebook, Twitter, or others would think it wise to start charging for services, there’s no precedent. What social sites/services have started out free and gone pay? Blogger? Gmail? WordPress? Flickr? MySpace? Friendster? Orkut? Some have prospered, some have failed, but none have gone pay-only. (Some certainly charge for added services, but I don’t think many people have a problem with Flickr, for example, letting you pay for even more storage space.)

I can only think of one site that’s gone pay, and that’s Salon’s Table Talk. Haven’t heard much about Salon lately? Yeah, me neither. I don’t think other entrepreneurs are going to be taking their business decisions as a model anytime soon.

*funny that I now think “seeing people talking” is a valid construction.