Things to Read Elsewhere

I’ve been catching up on my magazine reading the past few days. Several science articles have caught my attention:

What Happened to the Girls in LeRoy? 
by Susan Dominus, in the March 7, 2012 New York Times Magazine

I came across this very interesting discussion of the LeRoy “medical mystery” on Longreads. Most non-physicians I know are very skeptical of the idea of conversion disorder or mass psychogenic illness. I get that, it seems dismissive of the girls or that the doctors are trying to excuse their own failure to diagnose by calling the girls crazy or their symptoms supratentorial.I admit to being a bit skeptical myself.

However, when I was in residency I was working in the emergency room one night and had a teenager arrive in status epilepticus. She had been seizing for 30 minutes with no response to multiple medications. Our primary concern was that she would “lose her airway” (medical slang for choking) so we paralyzed her, sedated her and intubated her in order to have control of her airway while we tried to stop the seizures. A few minutes later the medical student who had been sent to medical records for her old records came back with a thick file. On opening it we were shocked to find case after case after case of her arriving in the ER with pseudoseizures. Meaning that her seizures were not “real” but were psychogenic. I would have felt stupid for not seeing it and for intubating her if not for the fact that she had fooled the ER attending, all the paramedics, the experienced ER nurses and had been intubated at least one other time in that same ER. Were her seizures “real”? No, not in the sense that she had abnormal electrical signals in her brain. However, her illness wasn’t any less dangerous. And if you’ve ever seen someone having a tonic-clonic seizure (think of the classic seizure where all four limbs are convulsing) you can imagine that it would be oversimplfying to say she was “faking” it for 30 minutes. It was a case I’ll never forget and one that taught me not to underestimate the power of the mind. A cliche, perhaps. But true.

Kin and Kind: A Fight about the Genetics of Altriusm
by Jonah Lehrer from the March 5, 2012 New Yorker 

This was particularly interesting after reading an essay on Darwinism in Marilynne Robinson’s The Death of Adam that explored the dangers and failings inherent in looking to natural selection to explain behaviors such as altruism.

The Deadliest Virus
by Michael Specter from the March 12, 2012 New Yorker 

About the recent creation of a new strain of H5N1 Influenza, one of the most lethal influenza strains known. The article looks at the ongoing discussion about whether or not the scientists who created it should be allowed to publish the results (leading to further research on the virus) because of concerns about bioterrorism.

From Ab Osterhaus, one of the scientists interviewed:

You have to compare the risk posed by nature with the theoretical risk that a human might use this virus for harm. I take the bioterror threat very seriously. But we have to address the problem logically. And nature is much more sophisticated than anyone in any lab. Nature is going to manufacture this virus or something like it. We know that. Bioterrorists might, but nature will. Look at the past century: the 1918 flu, H.I.V., Ebola and H1N1. The Spanish flu took months. SARS maybe a couple of weeks. This is happening all the time, and we have ways to fight it. So where is the greatest risk? Is it in someone’s garage or in nature? Because you cannot prevent scientists from getting the information they need to address that risk. I understand politics and publicity. But I also understand that viruses do not care about any of that.

 

One thought on “Things to Read Elsewhere

  1. The Le Roy case is certainly interesting. One of the adages of flight testing is that sometimes you don’t know what you don’t know. I doubt if anyone has a real clue as to what’s happening with the girls in LeRoy. Sometimes chains or confluences of events produce unexpected outcomes that leave a barely discernable trail to discover. But then, correlation doesn’t equal causality. Dr. Richard Feynman once said in a university lecture:

    “It’s a great game to look at the past, at an unscientific era, look at something there, and say have we got the same thing now, and where is it? So I would like to amuse myself with this game. First, we take witch doctors. The witch doctor says he knows how to cure. There are spirits inside which are trying to get out. … Put a snakeskin on and take quinine from the bark of a tree. The quinine works. He doesn’t know he’s got the wrong theory of what happens. If I’m in the tribe and I’m sick, I go to the witch doctor. He knows more about it than anyone else. But I keep trying to tell him he doesn’t know what he’s doing and that someday when people investigate the thing freely and get free of all his complicated ideas they’ll learn much better ways of doing it. Who are the witch doctors? Psychoanalysts and psychiatrists, of course.”

    Science, as Feynman once observed, is the belief in the ignorance of experts.

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