Donald Trump

…and the revolt of the unseen:

one day, the Deplorables, standing athwart history, yelled “Stop!” They saw their taxes given to crony capitalists, welfare recipients, and government employees; they saw their plants close and their jobs go overseas due to government regulations and taxes; they saw veterans used and abused by a dysfunctional Veteran’s Administration; they saw their cities erupt in protests and violence based on “Hands up, don’t shoot” lies; they saw their police officers assaulted and murdered by ideological thugs; they saw Islamic jihadists commit mass murder; and they saw the government schools force their kids to read Heather Has Two Mommies but otherwise leaving them uneducated.

The Deplorables had been neglected, forgotten, and abused for so long that the Ruling Elite just assumed they would fall in line as they always do. The Ruling Elite didn’t notice that the Deplorables had been pushed to the brink of despair. They were humiliated by unemployment and the foreclosure of their homes; they were sick and tired of twentysomethings defining marriage and bathroom policy for them; they felt threatened that their guns would be taken from them; they cried at the sight of their neighbors’ sons coming home in body bags; they were fed up with being called racists, sexists, homophobes, transphobes, xenophobes, and Islamaphobes.

What can’t go on forever, won’t. One day, about two years ago, the Forgotten Man, the faceless American, finally awoke from his slumbers. He looked around and saw the devastation, and he knew the promise of American life was no longer open to him. And so he screamed, “I’m mad as hell, and I’m not going to take it anymore.” The cry went unheard by the Ruling Elite. One man did hear it, however. That man was, of course, Donald J. Trump.

For better or worse, Trump did get people to the polls who don’t normally vote.

When Evidence Says “No”

…but doctors say “yes”:

WHAT THE PATIENTS IN BOTH STORIES had in common was that neither needed a stent. By dint of an inquiring mind and a smartphone, one escaped with his life intact. The greater concern is: How can a procedure so contraindicated by research be so common?

When you visit a doctor, you probably assume the treatment you receive is backed by evidence from medical research. Surely, the drug you’re prescribed or the surgery you’ll undergo wouldn’t be so common if it didn’t work, right?

For all the truly wondrous developments of modern medicine — imaging technologies that enable precision surgery, routine organ transplants, care that transforms premature infants into perfectly healthy kids, and remarkable chemotherapy treatments, to name a few — it is distressingly ordinary for patients to get treatments that research has shown are ineffective or even dangerous. Sometimes doctors simply haven’t kept up with the science. Other times doctors know the state of play perfectly well but continue to deliver these treatments because it’s profitable — or even because they’re popular and patients demand them. Some procedures are implemented based on studies that did not prove whether they really worked in the first place. Others were initially supported by evidence but then were contradicted by better evidence, and yet these procedures have remained the standards of care for years, or decades.

Even if a drug you take was studied in thousands of people and shown truly to save lives, chances are it won’t do that for you. The good news is, it probably won’t harm you, either. Some of the most widely prescribed medications do little of anything meaningful, good or bad, for most people who take them.

My faith in the medical profession has never been high, and stories like this do nothing to raise it. If you want to be healthy (and in some cases just stay alive), you have to be pro-active.

[Update a while later]

I hadn’t read the whole thing when I posted this (I still haven’t; it’s long), but I found this interesting:

In the late 1980s, with evidence already mounting that forcing open blood vessels was less effective and more dangerous than noninvasive treatments, cardiologist Eric Topol coined the term, “oculostenotic reflex.” Oculo, from the Latin for “eye,” and stenotic, from the Greek for “narrow,” as in a narrowed artery. The meaning: If you see a blockage, you’ll reflexively fix a blockage. Topol described “what appears to be an irresistible temptation among some invasive cardiologists” to place a stent any time they see a narrowed artery, evidence from thousands of patients in randomized trials be damned. Stenting is what scientists call “bio-plausible” — intuition suggests it should work. It’s just that the human body is a little more Book of Job and a little less household plumbing: Humans didn’t invent it, it’s really complicated, and people often have remarkably little insight into cause and effect.

“Bioplausible” also applies to terrible dietary advice: If you don’t understand biochemistry (and unfortunately, most nutritionists and even many MDs don’t) it makes sense that eating cholesterol gives you high cholesterol and eating fat makes you fat. You are, after all, what you eat, right?

Note also the story about the blood-pressure meds that have no measurable effect on reducing rates of heart attacks. I suspect that, like cholesterol lowering, such drugs are treating a symptom. It’s why despite my life-long high BP (really, my only health risk other than bad choice of parents), I resist using drugs to lower it, because I really have never had any evidence of other issues, and keep a close eye on things like peripheral arteries, carotid blockage, liver function, eye health, etc.

The Diet That Cannot Be Named

This mouse study seems very promising, but there is a word missing here:

In consideration of the challenges and side effects associated with prolonged fasting in humans, we developed a low-calorie, low-protein and low-carbohydrate but high-fat 4-day fasting mimicking diet (FMD) that causes changes in the levels of specific growth factors, glucose, and ketone bodies similar to those caused by water-only fasting (Brandhorst et al., 2015) (see also Figure S1 for metabolic cage studies). Here, we examine whether cycles of the FMD are able to promote the generation of insulin-producing β cells and investigate the mechanisms responsible for these effects.

It’s called “ketogenic,” people. Kee Toe Jen Ick. Low carb, high fat.


wonders why NASA is considering crewing the first flight of SLS/Orion:

In a statement at the beginning of the Feb. 23 meeting of the Aerospace Safety Advisory Panel (ASAP), chairwoman Patricia Sanders said that if NASA decides to put a crew on the first SLS/Orion launch, Exploration Mission 1 (EM-1), it must demonstrate that there is a good reason to accept the higher risks associated with doing so.

“We strongly advise that NASA carefully and cautiously weigh the value proposition for flying crew on EM-1,” she said. “NASA should provide a compelling rationale in terms of benefits gained for accepting additional risk, and fully and transparently acknowledge the tradeoffs being made before deviating from the approach for certifying the Orion/SLS vehicle for manned spaceflight.”

“If the benefits warrant the assumption of additional risk,” she added, “we expect NASA to clearly and openly articulate their decision-making process and rationale.”

The point of my book was not that NASA should simply be more accepting of risk, or be reckless, but balance the risk against the reward. In my opinion, accelerating commercial crew would be worth the risk, to end our dependence on Russia, and increase the productivity of the ISS. Redoing Apollo 8 half a century after the original as a political stunt would not.

[Update a little before 1 PM EST]

NASA is about to have a news conference, probably in response.

[Update post conference]

It was the Bills Gerstenmaier and Hill. Gerst is always deadpan, but one had the impression that he’s not enthusiastic. They’re doing a feasibility study because the White House asked, and won’t be making any recommendations, just describing would it would take in terms of changes in schedule and budget. They just want to see “if they can fly crew sooner.” They expect to have some answers in a month or so (presumably as part of the input for FY2018 budget request). I wish the White House would ask them if they could fly crew sooner on Dragon and Starliner. That would be worth doing.

I can’t believe I just typed the words “FY 2018 budget request.” Makes me feel old.

[Update a few minutes later]

[Update a few minutes later]

Here‘s Keith Cowing’s story.

[Early afternoon update]

And here‘s Eric Berger’s take.

[Update a while later]

And Joel Achenbach’s.

I’d note that the reason they would only have two crew is probably a) to reduce the number of losses if it doesn’t go well and b) more margin in the (primitive?) life support.

[Saturday-afternoon update]

Amy Shira Teitel (like me) thinks that this makes no sense.

Biting Commentary about Infinity…and Beyond!