and I quote

august 2009

click here for permalink August 31, 2009

A fascinating article was posted by Wired Magazine last week entitled Placebos Are Getting More Effective. Drugmakers Are Desperate to Know Why. Here's the premise:

placebos"Two comprehensive analyses of antidepressant trials have uncovered a dramatic increase in placebo response since the 1980s. One estimated that the so-called effect size (a measure of statistical significance) in placebo groups had nearly doubled over that time... Half of all drugs that fail in late-stage trials drop out of the pipeline due to their inability to beat sugar pills... Despite historic levels of industry investment in R&D, the US Food and Drug Administration approved only 19 first-of-their-kind remedies in 2007 — the fewest since 1983 — and just 24 in 2008."

Implying a causal relationship between those two sets of statistics is a bit misleading, though, as it overlooks the fact that, since the 1980s, the pharmaceutical companies have drastically reduced the number of new drugs they research at all, preferring to take the safer and exponentially more profitable route of reformulating or simply re-branding theirbestsellers. Why risk testing new cancer drugs when you can rake in billions of dollars marketing antidepressants and erectile fortifiers directly to consumers through advertising and by dispatching a mercenary army of seductive drug reps laden with free samples to doctors' offices everywhere?

Also, if one didn't know that the exact opposite was true, one might read into that the implication that the FDA was somehow preventing new drugs from being approved in a timely fashion. If purposeful, this would be a highly disingenuous suggestion, since we know that the FDA, like the EPA and other federal agencies, experienced such reversals of their fundamental charters under the Bush administration as to render them incapable of acting in the capacity of regulators or even speed bumps to the industries from which they are supposed to keep us safe. Furthermore, in recent years the FDA has drastically reduced the time it takes a drug to go from research stage to retail.

Nevertheless, the article brings forth some very interesting findings and comes to some intriguing conclusions.

"The blockbuster success of mood drugs in the '80s and '90s emboldened Big Pharma to promote remedies for a growing panoply of disorders that are intimately related to higher brain function. By attempting to dominate the central nervous system,* Big Pharma gambled its future on treating ailments that have turned out to be particularly susceptible to the placebo effect..."

*(Earlier in the article, a Merck research director named Edward Scolnick is quoted from an interview with Forbes magazine: "To remain dominant in the future, we need to dominate the central nervous system.")

"Existing tests also may not be appropriate for diagnosing disorders like social anxiety and premenstrual dysphoria — the very types of chronic, fuzzily defined conditions that the drug industry started targeting in the '90s, when the placebo problem began escalating. The neurological foundation of these illnesses is still being debated, making it even harder for drug companies to come up with effective treatments." (

This is where what had seemed like mere irony takes an almost poetic turn. The drugs that are now failing most catastrophically against placebos are the very drugs that have been such a goldmine (or is it more like an oil field?) for pharmaceutical companies, the drugs that are designed to treat the "chronic, fuzzily-defined conditions that the drug industry started targeting in the '90s." Another way to describe those conditions might be incurable yet eternally treatable, with definitions so purposely vague as to be all-inclusive at a population level. Those conditions that only a few innocent/ignorant decades ago were thought of merely as moods, stages of life, natural reactions to human events or even simply personality traits. Those are the conditions that are showing such a maddeningly positive response to treatment with placebos in clinical trials (one might guess they would even respond to the mere suggestion of treatment), often with better results than the "real" treatments.

brainThe drug companies spent the last 20 years convincing a nation of undereducated, overworked, socially isolated, emotionally immature consumers that they were suffering from an ever-expanding multitude of "disorders" whose symptoms include every unpleasant sensation and emotion ever imagined. Thousands of new diagnoses sprang into existence based on the consumers' subjective feelings of sadness, loneliness, emptiness, lethargy, shyness, sexual insecurity, social awkwardness, lack of self-esteem, charm or motivation. They were sold and eventually accepted as disorders — treatable but not curable — because once you're "sick," the surest sign of relapse is "believing you're cured."

They created a generation of parents incapable of recognizing that not being able to sit still, getting bored easily, asking inappropriate questions, talking back to adults, storming up to their room and slamming the door are simply the classic symptoms of childhood. These evil geniuses are now discovering a fatal side effect of their greatest triumph; the gullible population of perpetual patients they spawned with their poisonous and greedy manipulations is just as susceptible to believing that a sugar pill is as effective as the real thing for treating all those fake mental illnesses they've been tricked into believing they have.

The Neuroskeptic reports that the number of Americans using antidepressants nearly doubled from 5.8% in 1996 to 10.1% in 2005 or an increase of around 15 million people (survey data: National Patterns in Antidepressant Medication Treatment). According to a 2007 report by the National Institutes of Mental Health, "It is estimated that between 3 and 5 percent of children have ADHD, or approximately 2 million children in the United States." They say that's at least one in every class of 20 or 30.

A related article from Mind Hacks (Placebo has strength in numbers) attempts to explain some of the observed increase in the placebo effect away by clarifying what is meant by the phrase in a clinical setting.

"The term 'placebo effect' is used to refer to two things in the medical literature. The first is a statistical concept and it refers to the improvement in patients given an inactive treatment in a drug trial in comparison to those given the actual drug. The second is a psychological concept and it refers to improvement due to expectancy and belief."Mind Hacks

One significant factor that could account for the increase is the vast improvement in clinical trial methodology over the last 50 years. "The more rigorous the study the less strong the drug effect is, or, in other words, the stronger the placebo effect." Better testing practices aside, however, the article concludes that if there has actually been an observed increase in the psychological placebo effect, the most likely explanation is "marketing."

"[Drug companies] would like to influence your beliefs so the drug works better for you, because once it's on the market, it's the customers' experience that brings them back for more. In an industry where genuinely new drugs are rare and most are just no-better copies of rival medications, your beliefs could make all the difference." (Mind Hacks)


On a totally unrelated note, I've been thinking about all these superstitious, unpolitically correct rituals of modern life, barbaric practices that we prefer to believe we left behind in the ancient and uncivilized past. Human sacrifice, for example; if we no longer practice human sacrifice in our society, then what did we do to Saddam? To Timothy McVeigh? To Nicolae Ceausescu (and his wife)? Closely related and even more revealing of our pathological projection dynamic is the modern practice of scapegoating. For those who missed it in 9th grade Humanities (the single most relevant class of my educational years), the Cultural Dictionary defines a "scapegoat" as:

"A person or group made to bear blame for others. According to the Old Testament, on the Day of Atonement, a priest would confess all the sins of the Israelites over the head of a goat and then drive it into the wilderness, symbolically bearing their sins away."

Marion Barry videoIf we doubt that this practice is in full effect today, we need only consider the political arena, to contemplate the proportional relationship of punishment-to-crime in the transgressions of an Eliot Spitzer or a John Edwards. Of course, politics is full of such tales, as it is of their flip-side, the "redeemed sinner," amongst whom former Washington DC Mayor Marion Barry is the poster-boy. High profile "whistle blowers" also frequently ascend to this special category, former cigarette company employees and "economic hitmen" chief among them.

My favorite detail in the heroic journey of Marion Barry from crack-smoking-on-camera scandal to conviction to his re-election (unbelievably) shortly thereafter is that, less than one year after his release from prison, Barry won a seat on D.C.'s city council, running under the slogan: "He May Not Be Perfect, But He's Perfect for D.C." You've got to respect a politician who knows his constituents that well and has the confidence to act on that knowledge; to hell with what it looks like to the rest of the world.

Finally, as we're subjected to the seemingly endless media post-mortem that follows every high-profile, low-dignity celebrity death — your Michael Jacksons, your Anna Nicole Smiths — with TV cameras jostling forthe best angle on the hearse and magazines printing lurid prescription histories and embarrassing fridge contents, one can't help feeling that we're all engaging in a passive form of cannibalism. (I suppose for Catholics, this is nothing new.) We have the somber anchorman walk-through ofNeverland, suddenly vacated and scrubbed to the floorboards, like they decided to hold an open house during the prime time news hour. (Watch your step, Matt; that's a crime scene now.)

MarilynUntil we've seen an actual coffin lowered into the ground, we're treated to this morbid 24-hour "body watch" that rivals Lenin's burial procession in sheer numbers. Live helicopter shots of tasteful funeral parlors in the suburbs of LA or Miami are breathlessly narrated by inane newscasters nattering away at each other after they've run out of distant relatives and ex-employees to interview. Did I say "until?" That was misleading; it never ends. Shortly after Marilyn Monroe was buried 47 years ago, post-autopsy photos of her were published and her satin bed sheets were cut into one-inch squares to be sold in memorabilia shops. In 2008, trunks filled with her dry cleaning receipts and personal letters were discovered and photographed for Vanity Fair magazine.

cryptThis month Marilyn is making headlines again, thanks to Elsie Poncher, the owner of the crypt above hers. It is currently occupied by Poncher's ex-husband, whose last wish was to be buried "facing Marilyn," but this prime piece of real estate is now being re-sold on eBay and Poncher plans to move her ex into the next crypt over (maybe she'll have him propped up at a 45 degree angle, in partial keeping with his final wishes).

As the New York Daily News leeringly commented, "Even in death, Marilyn Monroe is still snagging millionaires." The highest bid so far came from an unnamed Japanese man but he had to withdraw his offer of $4.6 million last week, citing "the paying problem." (Which is pretty much my reason for not bidding in the first place.)

click here for permalink August 16, 2009

meteorsI was doing something totally unrelated yesterday when I started thinking about how the phrase "a meteoric rise to fame" actually means the exact opposite of what we mean when we say it. A meteor is a piece of debris floating in space that intersects the earth's orbit, entering our gravitational field and igniting when it hits our atmosphere, then plummeting to the surface and quite often breaking up completely before it hits the ground.

If any part of the meteor makes it all the way to the ground, then it's called a meteorite, a tiny remnant of whatever it was before breaking up and mostly disintegrating, leaving only a few scattered rock fragments many miles apart. Yet, when we hear the phrase "a meteoric rise to fame," it's usually in reference to someone whose ascent is sudden, dramatic and sometimes — though less frequently — fleeting.

As The Free Dictionary defines it: "like a meteor in speed or brilliance or transience," which captures the characteristics of a "meteoric rise" at its perceived apex, but only if you catch it the split second it appears to streak across the sky with no obvious downward trajectory. This illusion, of course, is shattered within a literal blink of an eye, as the rocky formation is buffeted by dense layers of atmosphere and burned away in a fiery, thousand-mile-an-hour descent. It vanishes from view within a few seconds at most and more often than not it disappears without a trace of it ever reaching the earth.

perseids 2007I had to look it up and see if anyone had published an etymological debunking on the subject. It turns out that Bad Astronomy agrees with me but then his job is to debunk astronomical misconceptions, not misused phrases based on astronomical phenomena (there's a phrase that defies articulation). He does have this to say about the misuse of "meteoric rise" in reference to a politician:

"[W]ere we to be literal, the official would have made a sudden eye-catching appearance in the political arena and then quickly burned himself out. He may have left a trail behind him, and even made quite an impact in the end!"Bad Astronomy

I remember when I was little people used to call them — meteors that is — shooting stars. You were supposed to wish on them when you saw them, which is kind of tricky because they go so fast (it helped to have a really quick wish prepared ahead of time just in case you saw one). Naturally, I thought they were actually falling stars. How could one think anything different, what with all the song lyrics and popular children's book art that seemed to reinforce the idea? So, on the one hand I believed that and, at the same time I knew that the light of a star takes billions of years to reach the earth.

meteorsNaturally I extrapolated from these equally solid-seeming bits of information that when you see a "shooting star," that star must have died — burned through all its nuclear fuel, gone supernova or whatever — billions of years ago and the news is only just now reaching us on earth. Furthermore, when you're looking at any particular star in the sky, that star could have died thousands or even millions of years ago and we would still be seeing the light it emitted in the prime of its life, never knowing that it actually died long ago, maybe before the human race even existed. This also threw the whole wishing-on-a-star thing into question — what if it wasn't even really there when you wished on it?

Coincidentally, my little morning research project reminded me that the perseids meteor shower has been visible in the northern hemisphere for about a month now. As a result, there are tons of great meteor photos out there.

lightningOh, and speaking of photos, I just posted a bunch of still frames from the video Mr. Pink took last month the night of the flaming orange sky, lightning storm and fireworks hat trick. It's up on the images page. It was so funny when I uploaded it last night, my ftp program comes up with a "do you want to overwrite the existing file" message, with the timestamp on both the local and the live versions side by side. They both had the same date, August 16, the time on the live one was 12:00 am while the local version said 12:36 am. I looked at the dates for a second, puzzled, and then realized the live one was updated August 16, 2008 at 12 am and here I was updating the same page exactly one year and 36 minutes later. I found that an incredibly odd coincidence but for some reason it made me kind of happy.


click here for permalink August 8, 2009

Virgin Mother[Damien Hirst's 35-foot-tall bronze sculpture, the pregnant "Virgin Mother."]

A couple of summers ago I was leaving work when I suddenly had this Matrix moment where time slowed down and I felt as if I was taking in the entire scene from all directions at once in heightened detail. Oh my god, I thought as the realization struck me; Is everybody fucking pregnant?? Perhaps coincidentally, I also noticed that nearly everyone was wearing some sort of floral print. That secondary observation may have been illusory but the baby boom I had glimpsed at its onset turned out to be an undeniable statistical reality.

I know I'm not going to win any friends — or land any jobs — publishing rants about people who have babies; on the other hand, it seems a tad narcissistic and more than a little paranoid to be so worried about my hypothetical audience that I end up not ranting at all. Besides, haven't I always said this site was little more than a labor-intensive way to communicate with my mother, grandmother and a small cadre of supportive friends? Anyone who knows me at all knows how I feel about this outdated, unquestioned and, to me, rather selfish and irresponsible insistence on continuing to overpopulate the planet.

I know that my grandmother, for one, would be anything but offended. During the administration of Bush I, she proudly owned a button that said "If you are a Pro-Lifer, you should adopt an interracial crack baby or shut the fuck up." Possibly due to the political climate in central Virginia where we lived at the time, or to the rash of abortion clinic attacks occurring at the time — or maybe on account of her grace as a Southern woman — she never actually wore this button outdoors but it was displayed prominently at eye level; stuck into the wall beside the front door where visitors couldn't miss it on their way out.

When I was little, my mother was in medical school and one day she brought home The Visible Woman, an anatomically-correct scale model with transparent skin and removable organs. She came with two sets of "torsos" — one pregnant and one not — and all the organs that went with the "pregnant" torso were squished and flattened to fit around the baby in what little space was leftover.

I don't know if that had anything to do with it but I knew from a very early age that I didn't want children — and by age eleven I was announcing as much to everyone around me — although I don't think anybody took me seriously until I was in my thirties. I used to say it was because I "hated" kids — which sounds kind of cute when you're eleven but a little less so every year after that. The real reasons are too numerous and various to list here but the bottom line is that I just don't feel compelled to have them and I think that's a feeling too many people ignore. Anyone who brings a child into the world — especially now, especially this world — should really want to be a parent, almost more than anything else.

Since 2007, more than 10% of the women at the company where I work have gone on maternity leave and almost as many men have taken the non-gestating partner's equivalent — or at least a long weekend and a pink or blue corporate gift basket. A handful of women have even resigned with the stated intention of starting or expanding their family.

While the "biological clocks" of first world females have been somewhat delayed by technological advances, they are apparently still ticking powerfully away, even if more women are hitting the snooze button until their mid to late-thirties. Of course, when that alarm does go off, it's not always as easy to silence it with a speedy conception as it might have been a decade earlier. Aging eggs and environmentally degraded sperm are fighting an uphill battle already; now those stresses are compounded by performance anxiety brought on by the modern business of childbirth. Once a natural, even serendipitous phenomenon, parenthood is now a planned, calculated and highly scheduled affair; a long-awaited process involving much preparation, study and sacrifice and increasingly it is rare that pregnancy occurs without medical or chemical intervention. Still, for some, the evolutionary imperative— and pressure from would-be grandparents — is overwhelming.

If that weren't enough, I'm afraid the influence of assholes like this guy should not be underestimated. Writes Leonard Stern of the Times Colonist newspaper:

"The headlines are swine flu, terrorism and climate change, but economists know that the real threat to our way of life is the reluctance of women to produce lots of babies. Well, not just any women. This is about women in the industrialized West. In poor parts of the world, women have plenty of children. Unfortunately, they can't afford them. Here in the wealthy West we can afford to have more children but we don't... Canada's fertility rate is about 1.54 children per woman. The rate needs to be 2.1 simply to replace ourselves, never mind growing the population."Leonard Stern (July 17, 2009)

twin strollerYou got that, white — er, Western — women? Get back in the goddamned bedroom! And don't come out until we've attained viral levels of population growth (look at your grandparents — they did pretty well after WWII — and without all this whining about posttraumatic stress, I might add). You don't want the wealthy, industrialized West falling behind a bunch of third worlders in the race to use up the planet's resources, do you? Breed faster, damn it! The dark continent is gaining on us! (Gee, it's too bad the pope is dead set against those heathens using condoms, huh? It's a real catch-22.)

Not to harp on this one article but, if this Stern guy's views represent even a small percentage of Canadian citizens, it means we have something almost as scary as the Doctor-killing End Times crusaders that proliferate (ooh, no pun intended) south of the border. Is it possible that our radical religious right-wing nuts don't even realize that's what they are? Further into the same article, Leonard Stern says:

"The only surefire way to ensure women have lots of children is to deny them sexual equality. (Needless to say, this is an approach I'd oppose.)"

Heh, yes... it's "needless to say" because it isn't true (but notice how he says it anyway). He continues:

"In the West there are communities where women routinely have five, six, seven children, but these are almost always religious communities... Muslims, Orthodox Jews, Catholics [etc.]... not just because women derive status only through the role of matriarch; [but] because men and women feel they are custodians of sacred traditions..."

Yes, "sacred traditions" like the belief that birth control is evil, that it's a sin for a woman to defy her husband and that divorce is a capitol offense punishable by stoning and/or/followed by eternal damnation. In his closing paragraph, Stern reminds his readers that "individual autonomy is among the great benefits of the secular West" and therefore so is freedom of choice, which seems an ironic choice of words in this context. He concludes, "Too bad there's no way, at least none that I can think of, to get young liberal westerners to choose parenthood."

Stern clearly lacks the imagination of some of his colleagues who have suggested that the economic downturn is providing the "perfect opportunity" for women of childbearing age. Whether as a result of downsizing or as a pre-emptive measure against it (planned maternity leaves can secure a job for at least one year), many Canadian women are reacting to the financial crisis by "taking a break" from the career path to start a family. At least according to Canwest's Misty Harris, who suggests that the worst economic conditions since the 1930s have in fact provided young, liberal westerners with some perspective. Damn, there go my chances of making a killing in investment banking — I guess I'll choose parenthood instead. That's one way to justify a baby boom — and, given Canada's ranking among the world's military powers, it's probably more feasible than invading Germany.

But it's not just that we're in the middle of a boom — fertility rates are at a 10-year high in Canada — we've also seen a dramatic increase in the number of women having not just babies but litters. Here are some numbers to explain what I mean by "dramatic." In Canada, since 1974:

  • Births involving twins increased over 35%.
  • Births of triplets increased almost 300%.
  • Quadruplet births increased over 400%.

The National Centers for Health Statistics reported that the rate of twins born in the United States "climbed 42 percent since 1990 and 70 percent since 1980," hitting a record high in 2004. According to the UK-based, "The number of multiple pregnancies [is] largely the result of more couples having babies at an older age. Between 1996 and 2006, there was a 182 per cent increase in multiple pregnancies in women 35 or over." This is not only due to the fact that older women are naturally more likely to produce multiples but also because the older the couple, the more likely they are to have trouble conceiving and turn to fertility drugs and treatments like in vitro fertilization — a method that, until recently, was practically guaranteed to produce litters.

strollerStatistics don't lie. It's impossible to walk or take a bus anywhere in Vancouver without seeing these women pushing matched sets of babies around in strollers that look like minivans, laden down with shopping bags and fitted with travel mug holders. It probably goes without saying that they're talking on the phone — paying attention to anything but their child. Sometimes you see them traveling two or more abreast in a multiple-mommy phalanx, an inexorable force behind a wall of gore-tex, lightweight aluminum and moisture-repellant mosquito netting.

These strollers are not cheap either, so I guess it makes sense that parents would try to get as much use out of them as possible, multitasking them into combination shopping carts, laundry hampers and portable playgrounds as their kids get older. I saw a woman just last week pushing a stroller with one kid inside and two kids standing up on the footrests on either side of her, with a bag of take-out and a change of clothes for everybody balanced on top. Later that same day, I saw this rogue kid pushing twins down the street in a stroller that was taller than his head — no mom in the vicinity. I guess he got bored waiting outside the fitting room at La Senza (the Canadian Victoria's Secret).

3 wheel strollerThen there are the urban uber-Dads whose masculine vanity demands a stroller that oozes testosterone, a black-and-steel convertible contraption with tires like a Jeep Wrangler. Not that he knows how to "convert" it when the need arises. I witnessed one such Dad wrestle his way onto the bus with one of these Baby Batmobiles; his arms straining to lift its elongated frame, he rammed the driver's seat with the front monster truck tire as he attempted to maneuver around the fare box. He inadvertently cleared out the front section before he could even see what was happening, as all the little old ladies and old men with canes leapt to their feet and moved to the back to avoid injury. (Sadly, there were no wheelchairs on board; I think I would have enjoyed watching how that little confrontation played out.) The dad and his stroller were eventually helped into place with the help of two passengers and the bus driver, who were all well aware that we weren't going anywhere until the ATV was secured.

quad strollerOnce in a while you'll see a multiple mom without a cell phone or a sidekick and you can see it is taking 100% of her attention just to maintain the momentum of her towering double-wide stroller; an Eddie Bauer Jr. special outfitted with collapsible awning, side rain-guards and mud flaps. These things take up the entire sidewalk with their wide wheel-bases and double sets of all-terrain tires and the parents who operate them are oblivious to pedestrians or anything else that gets in their way.

They're like those tanks you see in Baghdad driving through neighborhoods and running up on the sidewalk, flattening garbage cans and dragging mangled branches and bits of fence behind them. Unlike the 19-year old soldier hopped up on ADD medication, however, this mom is probably comfortably numb thanks to a postpartum prescription of Effexor, Lexapro, Cymbalta or some combination thereof. (Good luck getting that quad stroller on the bus, by the way.)

Here's another interesting tidbit from the NCHS; it was reported in December 2007 that "the teen birth rate (that's women aged 15-19) for the [United States] as a whole increased for the first time in 15 years." I just have to say: Way to go, Bush administration. Talk about "no child left behind!" Faith-based, abstinence-only sex education has clearly been every bit as successful as Nancy Reagan's Just Say No campaign was at winning the War on Drugs. To coin a phrase, mission accomplished. I think the Republicans have earned themselves a long break, don't you?


Toxic BeautyI picked up this book at the library called Toxic Beauty; besides the obvious charms of the cover art, the title combines two of the most intriguing words in the english language. It's about the horrifically negligent regulatory vacuum that exists around the "personal care" product industry and all the carcinogenic, hormone-disrupting, allergenic ingredients that are in nearly everything we put on our bodies, hair and faces every day. Most of these products are never tested and many of the ingredients are tested separately and deemed safe but, thanks to the wonders of chemistry, turn unexpectedly deadly when combined.

The second half of the book's subtitle "And What You Can Do About It" offers the reader hope but if the pages within offer any, I haven't read far enough to report on it yet. So far, all I know is that every product in my house is trying to kill me slowly and a special few are trying to get the job done as quickly as possible (Sebastian Shaper Mega Hold hairspray, I'm looking at you). I'm afraid that after reading this book, I'm going to be so paranoid about all the poisons and contaminants I'm willingly exposing myself to that I'll give myself an ulcer from worrying about it. It doesn't get much more Virgo than that.