Surgery and The Doctors

While I was in the waiting room at San Francisco General Hospital for my surgical consult, I caught wind of a very terrible daytime television show called The Doctors.

This particular episode was about sex in America and the current state of how people approach sex. I had multiple problems with this episode, not least of which was the fact that the rather excrable Ann Coulter was on. I shall break it down for you point by point.

When arguing about the rise of teen pregnancies, not ONCE did anyone mention  the incredible damage that abstinence only education has done to this country's youth. Education on sex, how to prevent disease and pregnancy, and how to handle sexual situations is critical to decreasing these numbers, and yet all they could talk about was how people need to take better control of their kids and the teenagers need to take some responsibility for their actions. This is total bullshit, as the numbers bear out.

Ann Coulter started spewing random 'facts' about how 90% of people in jail were the product of single parent homes and how single parents are contributing to the breakdown of morals in this country. I was deeply proud of the doctor who pointed out that she was the product of a single parent household, and now she's an MD. If I'd been on that panel I would have said something like "This is hardly the fault of the person who sticks around and makes sure that the child is well taken care of. Those millions of couples who want to adopt don't exist. Ann, you have a long and sordid history of playing fast and loose with the facts, and I frankly cannot take any numbers you come up with out of your head seriously."

After Ann finally went away (thankfully) it became a show about slut-shaming. There was a pregnant 15 year old girl (was she really?) on who said that the condom broke. It's not nearly as common as people make it out to be. The whole point of the program from then on was "See? If you don't have sex you never have to deal with this."

It was all about scaring the crap out of kids in order to get them to never have sex. If they wanted to really help (I'm thinking about the gynecologist on the show who said some incredibly ignorant stuff) they would educate the kids: this is how birth control works, this is how condoms work, this is what the real risks are but lets talk in terms of statistics and how likely it is that you get diseases. Did they talk at all about the benefits of Gardisil and whether or not they should have it? Did they talk at all about Pap smears and pelvic exams and why they were a good idea? Nope. It was abstinence education all over again.

On a completely different note, I have a surgical date which thankfully does NOT involve me missing school. I am very very grateful for that.

I hope to finish my discussion of action potentials and hopefully look at the Dr. Oz show for juicy tidbits to debunk. Once I'm done with action potentials, I think I would like to talk a bit about imaging techniques and brain cancer/central nervous system tumors.

Yes, I'm back.

Surgery On A Scientist Part Two

I went in for blood work today, just to make sure that my liver and kidneys can handle the extra stress of the anesthetics and painkillers that will be part of the surgery. Blood tests can test for different enzymes made by the liver, and it is important to make sure that they are at the appropriate levels before surgery. If they are too low, recovery can be difficult. The liver clears the drugs from the system, so you want to be sure that the organ is performing adequately.

Butterfly catheters are really quite interesting. There was a little prick of pain and then this exceptionally sharp piece of metal went into my arm. I watched it disappear. And then rich red blood came out.

I enjoy understanding and watching things like this. What can I say. The dissection and understanding of any phenomena around me is my way of interacting with the world.

So once I get the test results back I should have all my ducks in a row for the surgery. According to the online forums, a tonsillectomy is a great way to lose weight.

More on The Oslo Massacre

So apparently there was a couple that were instrumental in helping some of the young people escape from the massacre near Oslo. And yet, we in the States have heard nothing about it because the rescuers were A) female and B) lesbians.

I just don't understand why this has yet to hit the American media. Well, I kind of do, and this article explains the narrative that the American media likes to portray, but honestly, I thought we were past this kind of blatant misogyny and hatred of homosexuals.

Considering that I'd never heard of Alan Turing until I was in my 20's, perhaps I shouldn't be that shocked. My home state, California, just recently passed legislation mandating the teaching of the accomplishments of gays and lesbians in history. It's a step in the right direction, but really? We had to wait until 2011 to do it?

New Mr. Deity!

I LOVE Mr. Deity. And it has an excellent guest star this time around. Enjoy.

Surgery On A Scientist

So a big reason why I've not launched wholeheartedly into this blog just yet is because I've not been feeling too great. I went to the Ear, Nose, and Throat specialist yesterday, and was diagnosed with chronic tonsillitis. Between feeling like I have a low-grade flu pretty much constantly, not being able to breathe or swallow properly, and having quite sharp pains in my throat, I've not been having the best couple of weeks.

After a lot of consideration, I've decided to go ahead and schedule the tonsillectomy. The ENT says it is elective, but frankly, I can't disagree with him more.

And because I am who I am, I became fascinated with how they excise the tonsils and how the anaesthesia works. Here is an amazing video of excising the tonsil from the ligament. Notice as the surgeon pulls the tissue away how clean and smooth the surgical site is. That is where the scab forms. This is not for the squeamish, but it certainly isn't the worst surgery I've ever watched. ;)

I began this process nervously; I haven't had surgery in years, and certainly nothing was removed. But I find comfort in an understanding of the procedure and the recovery period. I also have found some good tips on keeping myself as pain-free and healthy as possible while I recover. From what I understand the recovery period is not fun. But then, surgery isn't all that fun either.



A side note: when obtaining medical information, I like the NIH website for information I can trust and verify, as well as clarity and organization. This is a pretty good article for general anesthesia. I studied anesthetics during my pharmacology class last semester, and while the drugs may be different depending on what the doctor likes to use and the patient's history, generally an injected anesthetic is used to sedate the patient and then inhalant anesthetic is used to maintain unconsciousness. The patient may also take an oral sedative or antipsychotic to calm themselves if they are experiencing anxiety before the operation.

By all accounts the average tonsillectomy is about 25 minutes. That's not too bad at all. Because we are such big animals, surgery can be a long and complicated process. But tonsillectomies are considered external surgeries, and so sutures aren't used and there is no need for 'closing up'.

Hopefully things will be a bit better soon. I am allotting 2 weeks for recovery time, because I am a wimp. We'll see how soon I can get in and hopefully I will be 100% before school starts.

A Word On The Oslo Bombings

It was horrible. Most of the people that died were children and teenagers. And people are using this sad, sick day to further their religious and political agendas. Not cool, Faux News. Not cool.

"Norway’s Prime Minister is a liberal atheist, they have one of the best economies in the world, they have universal health care, and subsidized education, it has had the highest Human Development Index 7 years in a row, and it’s never started a pointless war, given tax breaks to the richest, and created Jersey Shore — yet it’sAmerica that knows best."

— Matthew Trevithick, responding to this story, “Former Bush Official Places Blame For Oslo Attack On Norwegians For Not Being ‘Serious’ About Terrorism,” with a comment that wins the universe. (via cognitivedissonance)

Once again, from the wonderful blog of abaldwin. 

Plans? We Don't Need No Steenkin' Plans!

I totally stole this from Activate the Mechanism. By the way, go read his blog. He is awesome and sexy and hilarious. Enjoy.

Thanks, Tyler. This was too perfect not to share!

Summertime In The City

I very much want to dust off my blog and get back into the swing of things. The last several months have been both extremely busy and rather hard, and now that the dust and cat hair has settled I'd like to pick up where I left off. I know I owe you two further discussions on action potentials, and I'd like to do a regular reaction/debunking of the Dr. Oz show.

But let's catch up a bit, shall we? Have some wine and some cheese, get comfy. This is going to be a sweet, smooth return to being friends.

We'll only go as far as you're comfortable, baby. ;)

I finished my last semester at State in May. In a way, I'm a little maudlin. State gave me so much: new goals, new aspirations, departmental and faculty contacts, opportunities that I certainly lacked previously. I am deeply grateful to my friends and professors. I am so happy and excited about where my life is going next.

And boy is it going! I got into a graduate program at CSU East Bay, in the Biology Department. I have a whole field of research to look forward to, a TA position, possible papers that I can publish. It is a whirlwind and so thrilling. I get to do 2 years of bench research, and that is just precisely where I want my life to be.

And it opens up options. In a year I can decide whether or not to push on through to med school or find a program to obtain my PhD. If I get my PhD I will probably go get my PA license so that I can do clinical neurology research and I can still get my hands on patients. If I get my MD I won't need a PhD to do clinical research, just permission from the ethics and humanities board at my hospital. That is the norm for all clinical research.

And I am still looking at what the military can offer me in terms of benefits. The Air Force or Navy look very appealing, and not only are the medical and housing benefits nice, so is retirement. In addition, I can get my hands on the types of patients that I want to: patients suffering from percussion neuropathy or patients with phantom limb or other types of odd pain. I still want to look at the modulation of the nervous system by the endocrine systems, and I would still love to be a surgeon.

And what is most exciting about my acceptance by this program is that all of these options are laid out for me on the table. I just have to grab for them.

My completing GPA at State was 3.3. That is not half bad for all upper division pre-medical science courses.

I know I haven't been around much lately. But I'm hoping to change that.

Keep watching. There will be more new stuff coming up. Also, as I get into research and teaching, there will be more for me to talk about.

Stay reasonable,
-Reading Frame

The Freethinker's Pantheon

My husband and I were BSing in the car when I mentioned in passing that I'd be praying if I was on the back of a sports motorcycle that was going about 60mph, like the girl we'd just passed. My husband, also an atheist, grinned and asked who I'd be praying to.

Without missing a beat, I said "I'd be praying to our great Lord and Savior, Sagan. All hail his name."

Within seconds we'd put together an atheist pantheon, and I was so amused by the idea that I thought I'd share.

All hail the great and mighty Sagan.

All hail and worship the Son of Sagan, Neil Degrasse Tyson.

The saints of this pantheon would be Saint Dawkins, Saint Dennet, Saint Myers and Saint Harris for the multiple miracles performed in the name of skepticism and science. 

The two apologists for this particular religion (if you can call it such!) would be Hitch and Ophelia Benson.

We giggled all the way home on this. Pure gold.

Brain Diabetes: Why The Dr. Oz Show Makes Me Wish I Had Alzheimer's

Thanks to some truly excellent work by Orac, I am now highly skeptical of just about anything that comes out of the Dr. Oz show. I made the mistake of expressing my distaste to my parents, who are Dr. Oz devotees. Now, every new show is a chance for them to challenge my knowledge of physiology.

A true scientist, when faced with something that is beyond their knowledge and experience, will humbly state that fact. This is respectable, and opens the lines of scientific inquiry. Curiosity is a lovely thing, and a good scientist will combine it with an interest in investigation. 

If one does not know the answer, however, one should not make shit up. And frankly, that was the take home message from Dr. Oz's latest guest, Dr. Suzanne DeLaMonte. I was alarmed to discover that this woman is a neuropathologist. And she is making some rather insipid and outrageous claims about the way insulin interacts with the brain.

I was informed of this episode by my mother. I grew increasingly suspicious the more she explained about the show, and I resolved to do some research. First, let's take a look at what Dr. DeLaMonte claims is happening in Altzheimer's patients, and then let's take a trip through neurophysiology. Neurophysiology is my passion; I was frankly excited to be able to use my knowledge to see what this woman was talking about.

"Although we’ve always known that Alzheimer’s disease is typically associated with numerous tangles and plaque in the brain, the exact cause of these abnormalities has been hard to pin down. Now, we may be closer to an answer.

In many respects, Alzheimer’s is a brain form of diabetes. Even in the earliest stages of disease, the brain’s ability to metabolize sugar is reduced. Normally, insulin plays a big role in helping the brain take up sugar from the blood. But, in Alzheimer’s, insulin is not very effective in the brain. Consequently, the brain cells practically starve to death."

Alarm bells immediately rang in my mind. I'm not an MD (yet) but I do know neurophysiology, and my degrees cover two different types of physiology. This just made no sense to me whatsoever. 

Insulin is a protein hormone synthesized in the beta cells of the pancreas, in a structure called the Islet of Langerhans. Like most proteins, it is a polar molecule and has an overall charge.  Most importantly, it is not lipid soluble because of this polarity. 

When a meal is consumed, the food is broken down into much smaller molecules that circulate in the blood; mainly glucose but some fructose as well. When the concentration of glucose reaches a certain threshold, insulin that is already circulating in the blood both signals insulin receptors in cells to upregulate glucose transporters to get the glucose into the cell, and signal pancreatic beta cells to make and release more hormone. 

Thus you have glucose circulating through the blood until they find more transporters and insulin circulating until the molecules find receptors or transporters to bind with and activate. All of this cellular activity occurs on the surface of cellular membranes, which are rather like a slippery film of oil that prevents substances that are not similar to it (also oily or fatty) to pass through unless it has its own special 'door', called channels or transporters.

Only very small or lipid soluble molecules pass through the blood brain barrier, a series of tight junctions that prevents unwanted substances from passing through. Insulin, as is, cannot pass. Oxygen and carbon dioxide can, because they are small gasses. Glucose, surprisingly, cannot either, without help. This is important: the only water soluble molecules that can cross the blood brain barrier MUST have transporters in order to do so. For a great refresher on the blood brain barrier (hereafter abbreviated BBB) see here. 

It is true that glucose metabolism is impaired in Alzheimer’s patients, which can lead to a sad downward spiral of dementia, but not for the reasons that the good doctor says. Insulin is not necessary, and indeed is not used, for glucose uptake and cellular metabolism in the brain. Thus, insulin’s decreased efficacy is irrelevant in the brain. Once one understands this, the entire argument falls apart. 

The good doctor continues. 

"These days, most people with diabetes have Type 2 diabetes mellitus. Basically, cells throughout the body become resistant to insulin signals. In an effort to encourage cells to take up more sugar from the blood, the pancreas increases the output of insulin. Imagine having to knock louder on a door to make the person inside open up and answer. The high levels of insulin could damage small blood vessels in the brain, and eventually lead to poor brain circulation. This problem could partly explain why Type 2 diabetes harms the brain. In Alzheimer’s, the brain, especially parts that deal with memory and personality, become resistant to insulin."

Since insulin doesn’t circulate through the brain, and is kept in very tight quantities in a very small portion of the brain, the idea that insulin could damage small blood vessels in the brain is questionable at best.

However, since the brain literally consumes a massive portion of the glucose that we eat, up to 70%, any disruption in the body’s ability to control and monitor glucose intake can have a devastating effect on the brain. A disruption in overall body metabolism can definitely affect the brain because the brain uses so much of the body’s energy. There is evidence that brain function is impaired in diabetes and other metabolic disorders. But Alzheimer's? There just isn't any evidence for this.

 "Why does the brain need insulin?

As in most organs, insulin stimulates brain cells to take up glucose or sugar, and metabolize it to make energy. Insulin also is very important for making chemicals known as neurotransmitters, which are needed for neurons to communicate with each other. Insulin also stimulates many functions that are needed to form new memories and conquer tasks that require learning and memory.

 The alarms became sirens, drowning out everything around me. I was reminded of the line from Tim Minchin's amazing poem 'Storm': "I'm like a rabbit suddenly trapped in the blinding headlights of vacuous crap."

Insulin, again, is not required for brain cells up uptake glucose. There are specialized transporters in the blood brain barrier that undergo facilitated diffusion with a chemical gradient that allows glucose to pass on through. Once there, cells with their own transporters bring glucose inside for metabolism. No insulin necessary; the transporters do not need signaling or upregulation. 

I hunted through the literature looking for a link between insulin and neurotransmitters, to no avail. I have to conclude that insulin, seeing as how it doesn’t circulate and doesn’t cross the BBB freely, is not involved in neurotransmitter synthesis whatsoever. 

Again, no circulating insulin = not necessary for any of the stuff that the doctor says it is essential for. 

Where does the insulin come from in the brain?

Very sensitive tests showed that insulin is made in the brain. It’s made in neurons, and the hormone made in the brain is the same as that produced in the pancreas. This point may seem surprising, but if you consider the fact that every other gut hormone is also made in the brain, it only makes sense that insulin would be among them. Insulin that’s made by the pancreas and present in blood does gets into the brain as well."

 Claxons were going off in my head if I didn't stop this nonsense.  I stopped right about here, because frankly, I felt like my brain cells were going to undergo apoptosis just to spare themselves the misery of having to read on. 

Insulin is not made in the brain. It isn’t necessary, so why would it be synthesized? 

The only function I found for insulin in the brain was as a signal to the hypothalamus for satiety and the feelings of fullness from the gut. It’s sort of as if the hypothalamus ‘sips’ the insulin, tests it and measures it, and tells the body how full the gut is. But insulin gets to the hypothalamus via a transporter, much like the one at the BBB. So again, it isn’t free circulating. 

In fact, the more I dug, the more I found that insulin really doesn’t do anything in humans. The role of insulin in the hypothalamus in humans remains unclear. Glucokinase, a protein on pancreatic beta cells that sense the presence of glucose, is on the hypothalamic membrane, and so can tell when there is sufficient glucose in the brain or not. 

Every other gut hormone is made in the brain? Really? Incretin, ghrelin, fibroblast growth factor19, cholecystokinin, secretin, gastrin, leptin, and others are all made in the brain? My, I never knew that the brain was a digestive organ as well as a control and computational organ. Did you? 

And now we return to the point of her insipid little diatribe: the effect of insulin resistance on Alzheimer’s patients. We now know that insulin really has nothing to do with it. So what does?

Well, it’s tough. There is an awful lot we don’t know about Alzheimer’s. Each group researching the disease has their own pet theory and project that they hope will explain everything. Many of them have found just enough correlation that makes them think they are on the right track. One group that my neurobiology professor is acquainted with is studying possible viral causes of the disease. The big idea when I was an undergrad was that pesticides might be a cause since there seemed to be a larger than average rural population with the disease. 

This is a very excellent review article on Alzheimer’s disease, which sums up much of the current thinking on how it works. 

Basically, similar to prion diseases, normal proteins in our brain mutate at a certain point and contribute to the breakdown of our cognitive function. There are a couple of competing hypotheses, two of the strongest  involve the buildup of amyloid beta plaques or tangles in the axons of neurons made of a protein called tau. There is some evidence to suggest that it may even be a combination of the two. 

In any case, the degeneration of the brain is quite clear, with advanced cases involving dementia, severe memory loss, and the inability to form new memories. This is an excellent illustration of the types of differences that are apparent in Alzheimer's patients compared to a normal brain.

We do know that genes seem to have a big role to play. But we are not sure how big of a role, and what other factors may be at work. Heritable cases tend to have an earlier onset and be mostly genetic in nature, while 'sporadic' or those that don't have a clear heritable lineage are perhaps 25% genetic. And the number one risk factor seems to be age.

Can Alzheimer's be prevented? Well, seeing as how metabolic diseases can affect onset and severity of Alzheimer's, balancing your diet, exercise, and controlling your diabetes is definitely a good idea. The phrase 'use it or lose it' definitely seems to apply here, as keeping an active mind during your later years seems to reduce the severity or even the occurrence of the disease. 

However, the good doctor goes a bit further than I would. 

Could diabetes and Alzheimer’s be caused by some types of exposures?

We have reasonable evidence that human exposure to nitrosamines is at the root cause of not only Alzheimer’s, but several other insulin-resistance diseases, including Type 2 diabetes, fatty liver disease, also known as NASH, and visceral obesity. 

Again, since Alzheimer's is unrelated to insulin, this is quite a claim. She is basically saying that the nitrates in our food, used as preservatives, are causative factors in the disease. After a search in PubMed for 'nitrosamines+Alzheimer's' came up with only her own work, I am suspicious of this link, to say the least.

She goes on to discuss diet and exercise as preventative measures, something which is definitely supported as being useful to making sure the brain gets the nutrition it needs to keep going in a healthy fashion. However, she goes off the cliff of woo when she talks about antioxidants, Omega-3s, and other substances that are purported to keep Alzheimer's at bay. No one is arguing that fresh fruits and vegetables are an essential part of a healthy diet. The role of Omega-3s and other fats are less well indicated.  But if you think that supplementation with these is either going to prevent Alzheimer's or extend your life, you are sadly mistaken.

It seems as if this doctor had settled on her own pet idea, but I am frankly alarmed at the gross misunderstanding of neurobiology that has led her to these conclusions. 

This all cycles back to the idea that if you are a scientist and do not know the answer to a question you should A) do some research and B) if there is no information out there you test it using, you know, science. It honestly seems as if this lady made some shit up based on some pet theory. 

Alzheimer's is an important and debilitating disease. I have seen first hand the devastation it can cause in families that lose someone a piece at a time. But we are not going to get anywhere in terms of a diagnosis and a cure if we continue to entertain these fashionable theories based on sheer nonsense. 

Debating A Fundamentalist and A Creationist Part II

When we last left off the Fundie had posted some incredibly smug and patronizing drivel about how our hearts aren't able to accept his god yet. I frankly don't feel any gaps in my life, thank you very much. And now the Creationist rolls in on her steamroller of evidence denialism and patronizing faith. Enjoy.

Creationist: Well, as a geologist/geophysicist who is also a Christian, I can assure you that there is a plethora of evidence and documentation which clearly supports the idea of "Intelligent Design" and "Creationism". There are so many holes in the Theory of Evolution that it takes more "faith" to believe in it than not!

Me: I'm still curious to see your evidence about these 'holes' in the Theory of Evolution, as well as 'evidence' for Creationism and Intelligent Design. Since you are a geologist, I'm sure I don't have to explain what Theory means in a scientific context, right? Also, appealing to the bible as being infallible because it says it is isn't really evidence, is very circular reasoning, and I'm not really going to take as evidence a book that was written thousands of years ago by pre-scientific societies. Appeals to 'irreducible complexity', I'm afraid, will garner you no sympathy since every time a creationist has tried that one they refuse to accept the real scientific evidence that we have regarding how those complex structures have evolved. If there was an intelligent designer, I'm sure they wouldn't have 'designed' the recurrent laryngeal nerve or the prostate or the sperm whale. Or anything vestigial, for that matter. And appeals to the god of the gaps will truly get you nowhere, since there is a difference between saying 'we don't know, but want to find out' and 'oh look, there's god in that tiny hole in our knowledge that someone some day will figure out.' It's lazy science at very best. If your 'evidence' for intelligent design covers none of those things, or your 'hole' in the Theory of Evolution is something other than what I've listed above, by all means, fire away. But frankly, these canards are classic intelligent design/creationist tropes, have been refuted multiple times and by people much smarter than I, and the only conclusion that I can draw is that people who cling to such are being willfully ignorant. Go look at my reply above to Fundie's question about the age of the Earth, what we know about evolution, and a couple of scholars that have questioned the validity of the bible.

Tell you what, let's agree to the terms of debate outlined here.  

Creationist: Gosh, so much to say and so little space! Here are two reputable sites for scientific study and debate in support of Creation and/or the existence of God in Science. THe first is the Institute For Creation Research.  Have a peek at some of the findings under the "resources for scientists" section. The other is 4th Day Alliance. Again,check out some of the articles...not to mention the beautiful images. Reading Frame....where do I begin? Clearly, you have a way with words in that you have great command of the English language, however, I find your reasoning lacks substance. For starters you mentioned in an earlier post that the Bible was written in a "pre-science" time. Simply google the history of mathematics or science and you would find that great thinkers in both fields made huge discoveries as far back as 1900 B.C. Math as a study began in the 6th century BC...don't see anyone doubting that. The Greek philosphers Plato, Soccrates, Aristotle all made significant contributions to their fields years before Christ was born and the New Testament penned. Archimedes, Eratoshtenes, Hippocrates, Galen, Euclid all brilliant scientists and all lived B.C!!! Do you question their validity? Pliny the Elder produced and encyclopedia of the Natural World in 77 AD (around the same time that many of the New Testament books were penned). I never hear of anyone second guessing the intellect of Pliny. The idea that the authors of the Bible were nothing but "goatherders" is weak at best. As far as the holes in the Theory of Evolution goes...I need more space! Would you like me to e-mail you privately??

(Side note: Feel free to google the Institute For Creation Research and the 4th Day Alliance. All they are are faith based propaganda pieces that add nothing to the scientific  discussion except badly worded and completely false refutations of evolution. The content on those sites consists of nothing but "Evolution didn't happened the way scientists think it did, therefore Jeebus!" Pathetic really. Game on)

Me: Philosophy is not a hard science. All of the scientists you mentioned maintain various things about human physiology that were plain wrong. We didn't know we had a circulatory system until the Renaissance. Calculus, which is what we use to ...study motion, physics, and so forth, was not developed until the 18th century. They did not know that the Earth went around the sun, a very basic tenet of science. They knew nothing of geology, antibiotics, vaccines, etc. While there were questioning minds among the lot, they got and maintained much that was inaccurate. I'm not second guessing their intellect, only their data. It is quite obvious reading the writings of Galen, for example, that he was clearly winging it. A questioning mind does not a scientist make. Hard data and understanding of the world around us did not come until long after the bible was written. As for your links..... I'm terribly sorry if I was at all unclear. I did ask for credible sources. Christian creationist websites are hardly unbiased sites, nor are they credible scientifically. Again, I urge you to go look at the Talkorigins website on creationist and intelligent design refutations.

Creationist: Reading Frame, before I decided to enter into this conversation I knew that I would be lead into a "p---ing contest" (pardon the expression) with someone who is under the impression that their opinion is superior, or their brand of science is superior. Your link "talk origins" has no more credibility and is "equally biased" as than the ones that I supplied. Your assessment (ie. opinion) of the history of math and science are, again, weak! For you to say that their discoveries were inconsequential is clearly ignorant. Of course science is more sophisticated today, but I'll tell you this, we wouldn't be were we are today if it weren't for their earlier findings. The development of Calculus required a knowledge of Algebra and Geometry, which were discovered much earlier.Anyways, the point I want to make is this: I am not interested in trying to convince anyone of anything.You are entitled to believe what you want and I am entitled to my beliefs as well. I am very interested in truth and good science and let me tell you as someone who has worked in the Earth Science field and academia for many years....there is a whole lot of bad science mixed with politics out there. I don't accept any of it. So Reading Frame, you are welcome to your very strong opinions, but they are just that, opinions. If you would like to supply me with hard evidence (Scientific fact) as to when or how the Bible has ever been refuted or substantiate why Christian scientists are less credible than atheist scientists then I will surely hear you out. Otherwise I'm just not into meaningless cerebral bantering.

Me: This conversation is not based on opinion. I could in theory go through the entire website that you gave me and deconstruct each of the statements that the website gave me. But I thought I would provide you with a website that actually did ...so instead of taking all of that time myself. That website is based on scientific fact. As a scientist yourself, you should appreciate that biases and opinions do not last long in science, and whatever is left are facts. There is a formidable amount of information that explains evolution. As for the history of science and math, I never said their discoveries were inconsequential. They clearly got some things wrong and clearly made stuff up. The point I was trying to make is that the knowledge we have today, or even in the last 400 years, far outstrips that available to people in the bronze age. This particular argument is irrelevant to the topic at hand in any case.

If you want to see some of the evidence I gave Fundie above on how the validity of the bible has been questioned, I invite you to look at everything, watch all of the videos in detail, and then come back. As I told him, I present facts so that you can see them all in context. I will not paraphrase anything. I will answer questions, but I urge you to look at all of the evidence. I never said that christian scientists are less credible than atheist scientists. I do think that creationist scientists are questionable scientists depending on their field of expertise. I still don't know what these 'holes' in evolution are that you claim are enormous; we've spent far too long bandying over an irrelevant phrase in a previous post. But I will say that all those sites you sent me say, over and over and over again, that science is questionable and biased at best, goddidit, and that's that. There is no new data, no theories to look at, no hard science to evaluate. There are bold assertions, misrepresentations of the actual evidence, and serious problems with their conclusions. There aren't even any authors or papers to read or evaluate. If there were true refutations of evolution, then scientists would be all over it, sifting through the evidence and judging it based on its merits. That's how science works. As a scientist, you should know that. But all there is on these sites are blanket statements that just say "That's not how it works!"  

Creationist: sigh....well, after having a night to sleep on this I have come to the realization that we will probably never agree....and that is ok. Everything that you feel is lacking in my scientific assertions, I feel is lacking in yours. We need not... belabor that any longer. If I provided you with a dissertation of what I (yes, as a competent scientist) believe to be holes in the Theory of Evolution, you would merely refute it. Therefore any effort on my part would be shear vanity. I do want you to know just a couple of things about me, as a person who prayed about this conversation. I am a Christian woman first and a Geophysicist second. 18 years ago I was a diehard evolutionist and human secularist teaching my stuff in a well known university in Mass. At a particular point in my life God made himself known to me and changed my heart of stone into one of flesh (spiritually speaking of course). That is a supernatural transaction which requires faith in order to receive it or understand it. I also came to realize that secular humanism is a philosophy (a religion) of sorts that also requires some semblance of faith in order to receive it and accept it. Regardless, I do know this: The God of the Universe created you in His image and you are priceless in His sight! You have great value! Therefore you do in my sight as well. Conflict does not sit well with my nature and it bothered me all night. I have not changed my views of science, however, I have adjusted my views of you....Be Blessed and may God touch your heart someday, just as He did mine. 

Me: Why is it when I present you with facts and evidence,you come back with how I'm a child of your god and your fervent wishes that I convert some day? How, precisely, is this meant to make your case or accomplish anything besides your sounding patronizing? It is obvious that we disagree on the whole religion thing, and frankly you wouldn't have taken kindly to me proselytizing to you. Why then do you think it is appropriate to do the same to me? My world view requires no faith,(defined as belief without evidence) only evidence. I'm sorry that our conversation bothered you, and I'm afraid that I still don't understand how someone with your scientific credentials could be a creationist. I hope you have a very nice day, and take care.

And that's it. Instead of providing concrete examples, she bases her entire argument on faith and nonsense, and drives off the deep end with non-sequiturs. And then she concludes the debate with a smug and patronizing wish that I become as religiously blind to reality as she is. 

I do not think it is possible for a scientist and rational thinker to completely subsume their intellect into the kind of faith that this woman has. I think that she was already religious and then dove into it head first. If she is a geophysicist as she claims (I actually have doubts) then she has got some powerful cognitive disconnect going on there.  

If I had put something on there about how I hope she finds the light of reason and realizes that we are alone without a magic sky daddy to watch our every move, she'd have become religiously offended. But since she was proselytizing to me, it is perfectly acceptable. 

Let me tell you something about how to evaluate facts. If the website you are looking at is faith based and has an agenda to perpetuate that faith, and has no references whatsoever, it probably isn't worth accepting those facts. If the website you are looking at has scientific credentials, with lists of papers to read and lists of scientists that have contributed, it probably more reliable. Forgive the argumentum ad popularum here, but if the National Academy of Sciences says that evolution is a fact, then it probably is. And I would trust their facts much more than some random religious dude that wants to block scientific fact in order to maintain control over his flock. 

As Tim Minchin said, "Science adjusts its views based on what's observed; faith is denial of observation so that belief can be preserved." 

So what do you think? What did I do well? What could I have done better? 

Coming up soon: parts 2 and 3 of action potentials, as well as some articles I found about religion and medical students. 

Debating a Fundamentalist and a Creationist: Part 1

So, a friend of mine posted on his Facebook an article on some plates being found in Jordan that may have some information on the validity of the bible. He wondered if this would have any affect on the gung-ho fundamentalist crowd. I said it wouldn't, because evidence of any sort has little effect on the entrenched views of fundamentalists. We've seen this over and over with evolution.

Enter the fundamentalist. Enjoy the show.

Me: I don't feel that ANYTHING at this point will make people who consider the bible the literal word of their god reconsider. The bible has been debunked a number of times, copied and recopied with an incredible number of errors, with huge swaths that were considered too difficult left out or buried. A new discovery at this point will hardly change anything.

Fundamentalist: The Bible has never been debunked credibly by anyone at anytime. Those who believe it is full of contradictions do not understand it and cannot interpret it. It is a mystery to be discovered by those who have an open to heart to receive it. I challenge anyone to come up with a valid "debunking" of it. It doesn't exist.

Friend: To Fundie:  How old would you say planet Earth is? :^)  

Fundie: I don't believe it can be determined to any reasonable degree of accuracy. The science used to make estimates is dubious at best. To me, the answer seems irrelevant to the human condition.

Friend:  I dunno, Fundie. 10,000 years or 4,500,000,000 seems to be enough of a disagreement to warrant a seat at the accuracy table, don't you think? :^)  

Me: *rolls up sleeves* How about this.  Or this.. Or this. Bart Ehrman is a scholar of biblical literature, has read the bible in all of the languages it was written in, and has debunked the legitimacy and the validity of it The bible is kind of the oldest game of telephone. Here's a good summary video. Or this is a good one: This gentleman has some really good things to say about debunking the validity of the bible:  This is an excellent source of information on how to evaluate these sources of information:  By the way. That science that you say is 'dubious at best'? It is the exact same science that you are using to type on your computers, that develops your medicines, that evaluates your clean water and food, that makes your car run, that keeps your air clean, that allows us to live and survive to the age we are now. Things we take for granted in the modern world are developed by using scientific methods, and so are the conclusions we have drawn about the age of the Earth and the universe. And the age of our own species. Please, read all of these sources, watch all of the videos, and look at everything I've given you carefully. I'm not paraphrasing or changing anything so that you can get a direct line on the information yourself. I'm happy to answer any questions you may have, but please, do the research. There is literally a ton of information out there on evolution and the age of this planet, and a little less but no less credible information out there on the evaluation of the bible.

I found this, as well. I think it's really well done. . Also, this is an interesting video on the weaknesses of radiocarbon dating.


Fundie: Spirituality (the existence of God) cannot be examined or evaluated by man's limited intellect. Those who try are missing it entirely.

Friend: Common, Fundie. That's the same argument used by the Emperor's tailors. You said earlier that "all credible arguments are welcome". Would you care for a rebuttal more substantial than "If you don't know, you're just stupid"? Please??

Fundie: Friend, It's Ok. You just don't have the heart to receive the things of God... yet. I'm certain that an opportunity will be presented to you at some point. No argument is required. When God wants to get in touch with you, He knows where to find you. Then, you will know. No rebuttal is needed. Just wait and see.

Friend: In the same vein, Fundie, one might opine that you might be in store for a brief moment of disappointment when your final breath passes your lips, and then,... nothing?

You're the one who volunteered in this thread to "challenge anyone here t...o come up with a valid debunking of " The Bible, and Reading Frame offered some meaty counters to your challenge. How's about some follow through, please?

 

As you probably guessed, this is the point where he shut up and the creationist stepped in.  Stay tuned for the next installment. It's gonna be a doozy.

 

 

 

A Rule on Discussions

If they follow the No, framework, you're probably debating a creationist.

Warm Up Before the Fireworks

*waves* Miss me?

I'm sorry, everyone. I've been bogged down in getting sick and school and loads of other stuff. I'll be back with lots of content on action potentials and neurotransmitters very soon. But first, I found this yesterday and I found it very interesting. It seems to follow the exact same tactics of certain religions, wouldn't you say?

Stay tuned for my debate with a creationist! (yes really! I thought they went extinct with the advent of Google!)

Happy St. Patrick's Day!

UFOs?

This video is interesting because you can replace UFO with 'religious experience' and it will still work.

Plus I just love Neil Degrasse Tyson. He is becoming the Carl Sagan of this generation. He has boundless energy and he just loves teaching people about science. Enjoy.

Unintelligent Design

I really enjoyed this video of Richard Dawkins attending a dissection of one of the major nerves in a giraffe's neck. Not only do you see some pretty compelling evidence for unintelligent design, a giraffe is a fantastic model for understanding and seeing the major nerves and blood vessels in a mammalian neck.

Also I love how he makes a joke about not screwing up and the lady basically tells him to shut the fuck up; that she knows what she's doing. Not many people have the temerity to tell Richard Dawkins to fuck off when it comes to biology. I laughed when I heard her say that.


Richard Dawkins Demonstrates Laryngeal Nerve of the Giraffe
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Neil Degrasse Tyson

I don't want students who could make the next major breakthrough in renewable energy sources or space travel to have been taught that anything they don't understand, and that nobody yet understands, is divinely constructed and therefore beyond their intellectual capacity. The day that happens, Americans will just sit in awe of what we don't understand, while we watch the rest of the world boldly go where no mortal has gone before. - Neil DeGrasse Tyson

I got this quote from The Hateful Atheist. I think it is brilliant and sums up a lot of my feelings about science education.

The New Tithe

$40,000,000,000 in RELIGIOUS GRANTS? I thought this was a secular country! Let these people fend for themselves since they aren't paying taxes and use that money to pay for the NIH, education, and Planned Parenthood!!

I am SO disgusted.

The New Tithe from Justin Wilson on Vimeo.

NIH Is Under Attack

Spread the word. Funding for things like new medicine, treatments, and technology for medical use is about to be slashed to the tune of billions. 

So is higher education, which pisses me off just as much.

Michael Shermer

Enjoy.

The Nocebo Effect

I know that you are absolutely dying to have me finish my discussion of action potentials, and don't worry, it will be up soon. However, this video on the nocebo effect is highlighting one of the most interesting thigns about neurobiology: the ability of the brain to make you feel like absolute crap.

Enjoy.

Happy Valentine's Day!

I'm totally stealing these from Pharyngula since I'm behind on my homework and I only have a few hours to catch up before my husband gets home and we have our romantic evening. But they are also so cute and surprisingly tender that I thought they would make perfect V-Day fodder.

Tell your sweetie that you love them.

New Favorite Science Blog!

I love this blog. This guy comes up with the COOLEST pictures, and I LOVE learning more about space and astronomy.

Give a big welcome to Starts With A Bang!

And this entry from his blog is like something out of Star Trek. Go read about the solar sails we launched and are now orbiting the Earth.

And then consider this quote, and realize that we are so lucky to be alive now.

"Twenty years from now you will be more disappointed by the things that you didn't do than by the ones you did do. So throw off the bowlines. Sail away from the safe harbor. Catch the trade winds in your sails. Explore. Dream. Discover." -Mark Twain

Sits

*Sigh* My cat does this all the flipping time.

Happy Darwin Day!

Borrowed from I H8 Religion, this picture is fantastic! Go zoom in and look at all of the details; it's extraordinary.

Jenny McCarthy Body Count

Those numbers are exceptionally depressing. I doubt they even take into account all that has been going on in Britain.

This is taken from an excellent web site called Jenny McCarthy Body Count. Check it out.

Alternatives To Health Reform

So the good news is that a move by Senate Republicans to repeal Health Reform failed. They will try again, though.

And in the meantime, the House Republicans have been drafting alternatives. Here is some info on the result.

I am deeply torn about putting caps on damages. Physicians that do damage should pay. But exorbitant damage fees are part of why malpractice is so fucking expensive in the first place.

Here are some intriguing new approaches to medical care. 

I'm keeping a close eye.

And somewhat off topic: anyone who calls me a Pharma shill will get a punch up the bracket.

Primary Care Shortages, Malpractice, and Obamacare

I'm going to put my three part discussion of action potentials on hold while we talk about primary care physicians, Obamacare, and health insurance.

Primary care physicians in this country make some of the lowest salaries in the business, and are expected to see ever more patients in an aging population. The average medical school debt is  $157,944 according to the AMA. The average primary care visit is approximately 10 minutes.

Primary care physicians (PCPs)have a lot stacked against them. They spend about the same amount of time in a residency as other specialties (I found this fantastic site that breaks down the time required per residency and where people choose to go) They also pay a fair bit in malpractice insurance compared to their salaries (it is stupidly difficult to find any numbers that are helpful here. This is the best and most recent I could find)  I've seen that PCPs can pay anywhere from $6,000 a year to nearly $60,000 a year. Balance that with the huge amounts of debt and the low pay, and you can see very quickly that the financial appeal is very low. Yes malpractice is higher for other specialties (With Ob/Gyn at the very top, proportionally, with anywhere from $55,000 to $200,000 depending on the state) but these specialties also make MUCH more. One of the highest paid specialties is coincidentally the one I'm interested in: neurosurgery, with estimates around the $530,000 mark and malpractice averaging $100,000 and capping at around $300,000 in some states. (Though believe me, this is NOT the reason I want to do it.)

Medical school debt? Not taxable, because it will all be paid back with interest. Residency salary? Taxable under the current IRS laws. Lawsuits are moving forward with that, but I'm not sure if that will change any time soon. Also, there was a brief kerfuffle over whether or not medical residents are in or out of school, and thus responsible for repayment of loans. I know that they can apply for deferments, but due to the economy those are drying up.

Plus the Baby Boomers are beginning to retire, and will continue to do so for probably another decade. This means that not only will the vast majority of people that are of retirable age do so, so will the primary care doctors that are of the same generation. The United States has an aging population and we need people in primary care and geriatrics to help us manage it.

There are some wild estimates to our primary care shortage, anywhere from 16,000 to 46,000 doctors that will be needed as this phenomena occurs. But there is no money in primary care, and the hours are punishing. In addition, rural areas that are already poorly served by the medical communities will also face critical doctor shortages. It seems as if we will be facing critical doctor shortages period, since this is hardly something that is limited to Northern California.

And as a result of the poor economy and enormous deficits, some medical schools have begun to slash enrollment. This is counterintuitive if they are going to be able to produce enough physicians to manage the aging and retiring population and replace all of the retiring physicians.

Ahh, medical malpractice, the bane of many physician's lives. Malpractice costs have skyrocketed in our litigation-happy culture, with the highest proportional costs in Ob/Gyn and the lowest in primary care. Basically lawyers have found a great way to get rich quick, and do so by tapping the veins of doctors that make more money. Frankly I'm glad that doctors make more money: they have more debt, more responsibility, and take more time out of their lives to become licensed to practice. It is truly a shame that primary care doctors have to practice defensive medicine in order to not have to deal with excess litigation. It costs this country billions of dollars but it seems a natural way to avoid lawsuits.

The problem of course comes with situations where people that don't understand medicine are the ones making laws that govern doctors. A doctor can do everything right and still end up with a dead patient, and somehow that is cause for a lawsuit. The science behind medicine often comes down to statistics: the chances that a given treatment or medication will help in the patient's case. This is often the situation for oncology, for example, where depending on the location, type, and stage of cancer, the decision to treat comes down to statistic probability of the treatment prolonging life and quality of life. It is impossible to predict how a patient's idiosyncratic genetic makeup will react to every medication and every treatment, and so medical probabilities are often the best way to make such decisions. When this goes wrong (and it happens very rarely) everyone in the medical community suffers because a politician or an insurance company sees the damage and decides to make it a sticking point. And so a doctor writes an order for a CT scan for that 1 in a billion chance that this person this time has an aneurism when they come in complaining of a headache, because they don't want to get sued.

I'm not suggesting that bad doctors or doctors who make stupid mistakes shouldn't pay for them. They should absolutely help pay for any damage they've done. But they shouldn't have to pay for other people's mistakes, which is where the system is at the moment. We have a vaccine injury court where people who had that 1 in a million chance of having a reaction to a vaccine (which is an incredibly safe procedure) can get some damages even though the physician did nothing wrong.

Right now, private medical insurance and public programs like Medicare and Medicaid pay for medical care for the average person. Emergency rooms MUST provide care regardless of insurance status, and private hospitals may transfer a patient to an ER if they lack insurance, but only after stabilizing. Also, COBRA stipulates that a hospital that gets public money must see patients without insurance. I can't imagine any self-respecting doctor refusing to care for a patient if they don't have the insurance or the means to pay, however. From what I understand, primary care doctors not only get less in terms of reimbursement from insurance, Medicare and Medicaid than other specialties, but they also take a financial hit in this fashion as well.

Under Obamacare, (I know it is meant to be derisive, but I like that he was so instrumental in getting it passed) the plight of the average PCP seems uncertain. Medicare and Medicaid payments remain uncertain, but more people will have insurance (mandated or face penalties, with government subsidies) which means that doctors will actually be able to get their fair share. On the other hand, the overseers of the program will make recommendations of budget cuts if the program goes over budget, and PCPs will probably feel the brunt of that first.  Here is a wonderful breakdown of how exactly the plan will affect primary care doctors and insurance.

Also, many physicians that responded to that survey said that they simply did not have the time to see more patients, since an influx of 39 million insured patients will definitely increase case loads.

Medical schools have to increase their enrollment to prepare to care for an aging population, otherwise shortages can get even more desperate. There is a 3 week waiting list to get to a primary care physician, and it may take longer before the newest crop of doctors graduates  from medical school.

After all of this reading and research, one thing is certain: physicians are GROANING under a bloated bureaucracy and resent having to spend their time with paperwork and billing in order to provide quality care. Too much time is spent with non-clinical or health related tasks, and too much is spent hassling with insurance companies to get reimbursed.

I resented the Republican's efforts to repeal Obamacare: it just seemed like yet another of their tactics to use misdirection and falsehoods to undermine Obama's goals for this country. But I must say that after reading all of this, I am deeply torn as to whether or not it should be repealed. There is a lot in these surveys that shows that doctors (overwhelmingly represented here by PCPs) are not happy with all of this. If one thing is certain, it's that most of the respondents that wrote comments think that malpractice is the primary problem with medicine, and I'd have to agree. Some of these comments are made out of sheer ignorance (where has public free health care failed? I can't think of anywhere) but it seems like a single payer system plus tort reform is really what we need here. I also wholeheartedly agree that doing this without getting an actual board of doctors to weigh in is incredibly stupid and shortsighted.Who better to tell the politicians what is really needed to improve the system?

And so we come full circle. Given the options available and the kinds of financial and bureaucratic issues that primary care doctors have to deal with, who wants to go into primary care? This is a snowballing effect, until the insurance companies are thrown out (will never happen in this country. Their lobbies are too powerful) and doctors can practice without constant fear of litigation.

Thanks for reading all of this. I know it was pretty heavy, but these are the issues that we face. These are the kinds of choices that medical students have to make going into internships and residencies. This is the kind of situation that will affect decisions to practice medicine in the first place.

I know a lot of doctors don't do it for the money, but frankly once you've been a med student and a resident and a freshman doctor, a little compensation for your time, effort, and money would really be nice. In the specialty I want to go into, it will take me 10 years, including med school, internship and residency, to become an independent doctor. It is heady to consider.

Action Potentials!

Hooray for a post with actual substance!

So here is a great picture of a typical neuron cell. This is taken from psychology.wikia.com, a fantastic website with very clear diagrams.

So let's talk a bit about the morphology of this cell a bit. What we have is a normal cell that has a bit of an unusual shape and some specific changes that allow it to have a bit of a different function.

The cell body in this picture is the main portion of the cell, with the nucleus and all of the typical cellular machinery: mitochondria, rough endoplasmic reticulum, ribosomes, smooth endoplasmic reticulum, golgi apparati, and so forth according to the function of the cell.

It also has little processes that come off of the cell body called dendrites. These processes allow for signals that come in from other cells. Dendrites are how a cell receives information. Depending on the type of cell, these processes can either be concurrent with other cells, i.e. their cytoplasm is continuous from cell to cell, or there is a gap between cells called a synapse. Both are means by which signals are sent from cell to cell. We will come back to this concept.

See that long big process coming off of the cell body? That's an axon. Signals that are received from the dendrites travel down these axons and hit the axon terminals, which connect to dendrites or cell bodies of other cells depending on whether they are an electrical synapse (or continuous) or a chemical synapse (gap between cells).

Imagine you have a balloon filled with and submerged in water. The water inside the balloon has a different mix of stuff than the water outside the balloon. The stuff that we are talking about here are ions, or atoms with charge. If you aren't sure what an ion is, here is a clear article on the topic by Wikipedia.

Since the mixture of ions is different inside than outside, it is called a gradient. There are two different types of gradients: electrical, based on the overall charge of the mixture, and chemical, based on the overall concentration of the mixture.

Imagine that the balloon has little holes that allow the ions to move. The little holes can just stay open to let the ions move freely, or they can be regulated to only allow the ions to move at certain times. These holes are called channels. The ones that stay open all the time are called leak channels. They allow for small amounts of movement in and out of the cell. There are many types of channels that are regulated, but the ones we will concern ourselves with are channels that mainly allow only one type of ion through at different times, and pumps. Pumps allow for exchange of ions between the inside and the outside and depend on actual energy to operate. The best known is the sodium/potassium/ATPase pump, which burns the currency of metabolic energy, ATP, in order to exchange sodium (hereafter referred to by its atomic ion symbol, Na+) and potassium (K+) between the inside and the outside.

Our balloon analogy can only go so far here, so let's replace in our minds the balloon with a cell. The walls of the balloon are the walls of the cell, called a membrane. The channels are proteins that are embedded in the membrane and allow for passage of ions. The pump is a channel but it has a very specific purpose. The fluid inside of the cell is called the intracellular fluid (ICF) and the fluid outside is the extracellular fluid (ECF). This will become important later.

So bear in mind that leak channels allow ions through freely, but that there are many of these pumps that maintain concentration gradients. The question, of course, is what effect these pumps have on maintaining the electrical gradient.


Stay tuned for the next installment, where I will talk about setting up electrical gradients and how the membrane has a resting potential. I anticipate there being a part three that discusses what an action potential is and why they are important.

-RF