Beyond Rivalry

"It occurs to me now, for the first time, that film critics are the only people in the world who go to the cinema when they're not feeling well. Normal people slump in front of the telly and watch wall-to-wall Poirots until their eyes start to bleed. But the deadline of deadlines was looming. Captain Hastings was beginning to get on my nerves and the first blockbuster of the summer was in town. There was nothing else for it."

-- Marcus Berkmann, film critic, in The Oldie, July 2008.

Reading lots, between my inter-library loaned crime novels -- finished Tana French's The Likeness last week, am reading PD James' new Dalgleish novel, The Private Patient, now, and have Reginald Hill's The Price of Butcher's Meat to read afterwards -- and the arrival of the Wall Street Journal through the door slot almost every day, a little 6-month perk for having completed about 200 online surveys in the last few years ... I love the WSJ, its editorial board notwithstanding.

Here are a couple of recent gems from its pages:

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Destructive Delusions: How therapists and 'victims' seized on the idea of repressed memory, leveling false charges and ruining lives, by Theodore Dalrymple, a book review of Dr. Paul McHugh's Try to Remember: Psychiatry's Clash Over Meaning, Memory, and Mind. Best lines:

"One of the most extraordinary outbreaks of popular delusion in recent years was that which attached to the possibility of 'recovered memory' of sexual and satanic childhood abuse, and to an illness it supposedly caused, Multiple Personality Disorder. No medieval peasant praying to a household god for the recovery of his pig could have been more credulous than scores of psychiatrists, hosts of therapists and thousands of willing victims."

"In Try to Remember, Dr. McHugh hints at the cultural context in which preposterous and vicious accusations against parents and others could be so easily believed by seemingly intelligent people, including courtroom judges. ... Freudianism alone could not have produced the necessary atmosphere; there must have been other forces at work as well. The sanctification of victims and victimhood comes to mind."

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Japan's Latest Fashion Has Women Playing Princess for a Day

Japanese women in their 20s and 30s are dressing up as doe-eyed princesses, aiming "to look like sugarcoated, 21st-century versions of old-style European royalty. They idolize Marie Antoinette and Paris Hilton, for her baby-doll looks and princess lifestyle." They buy $1000-outfits (frilly dress, parasol, handbag, shoes) and work their straight hair so that it's curly with 'super-volume" to assuage a "longing for a happy-ending fairy tale," if you accept that bit of sociological analysis.

The women (aka 'girls') particularly idolise 24-yr-old Keiko Mizoe, sales clerk at one of the stores that sells the gowns, who calls those who sport the look "perfect, gorgeous and feminine."

A 16-yr-old who's buying the clothes online because the store seems too intimidating says:

"Their cuteness is beyond human. I'd like to be like them."

A 36-yr-old housewife felt "shy about her plump figure" so she lost 33 pounds and can now wear the tight-waisted dresses, on which she spends $2,000 or $3,000 a month. Her parents "send the couple food so they have more money for Ms. Yamamoto's shopping sprees.

'I figure it's OK as long as what I'm buying is pretty,' she says."

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How a Drug Maker Tries to Outwit Generics describes how pharmaceutical company Cephalon, Inc. maximises profits on its drugs, in particular, its narcolepsy drugs Provigil and Nuvigil, and entices customers away from cheaper generics. The company, using an apparently common tactic of pharmaceutical companies, has been recently increasing the price of Provigil -- now $8.71 per tablet, 24% more than 8 months ago and 74% more than 4 years ago -- so that patients will have an economic incentive to switch over to Cephalon's new and longer-lasting narcolepsy drug, Nuvigil, which will be available next year at a lower cost -- and, critically, which won't be off patent until 11 years after Provigil will be:

"It works like this: Knowing that Provigil will face generic competition in 2012 as its patent nears expiration, Cephalon is planning to launch a longer-acting version of the drug called Nuvigil next year. To convert patients from Provigil or Nuvigil, Cephalon has suggested in investor presentations that it will price Nuvigil lower than the sharply increased price of Provigil. By the time the copycat versions of Provigil hit the market the company is banking that most Provigil users will have switched to the less-expensive Nuvigil, which is patent-protected until 2023."

One woman who takes Provigil off-label for Parkinson's stopped taking the drug when her cost went to $565 per month. Her insurer, like most, won't cover payment of an off-label use (a use not approved by the FDA).

The article later notes that "fully preventing tactics like Cephalon's would be difficult short of outright regulation of drug prices. Most other countries in the world control drug prices, but most U.S. regulators and legislators have opposed such moves."

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In further drug-related news: Power of Suggestion: When Drug Labels Make You Sick by Melinda Beck looks at the effect of nocebos, which are the opposite of placebos: the power of suggestion that brings on illness:

"Research deliberately causing nocebos has been limited (after all, it's kind of cruel). But in one 1960s test, when hospital patients were given sugar water and told it would make them vomit, 80% of them did.  Studies have also shown that patients forewarned about possible side effects are more likely to encounter them."

Interestingly,

"the rare, serious side effects listed on drug package inserts -- say, toxic epidermal necrolysis, in which one's skin falls off in large sheets -- are less subject to nocebo effects."

It's harder to "suggest" one's skin to slough off than to evoke headache and fatigue by suggestion, and anyway, as is noted in the article, large percentages of the general population experience these vague symptoms regularly; in a 1968 study of healthy subjects not on medications, only 19% said they had no symptoms (such as headache, fatigue, dizziness) in the past 3 days. Also noted, that anxiety about illness can bring about common side-effect symptoms like nausea, diarrhea, dry mouth and rapid heart beat.

** Hours after I read this, I learned that the dear friend of a friend of mine is suffering from exactly this "rare, serious side effect" of toxic epidermal necrolysis, likely from anti-inflammatories she had been taking for a while.

I've watched most of season 5 via Hulu on my laptop. "Lucky Thirteen" (5x05) -- genius show. "Joy" -- again the realisation that House says what most people are really thinking but automatically censor because it's cruel and would cause conflict to say aloud (particularly, in this episode, about Cuddy becoming a mom; what he says is truly cringe-worthy -- and yet it's part of what was in my thoughts, too).

A few bits:

Wilson to House: "I'm leaving."
House: "What? Are you going to take another two months. Boy, you're really milking this bereavement thing, aren't you? [Pause] I mean good for you. Take all the time you need."

(Dying Changes Everything, 5x01)

House to Cuddy: "You have to stop Wilson from committing career malpractice."
Cuddy: "Talk to him."
House: "I already talked to him. Twice."
Cuddy: "Mocking him and insulting him --- let's see --- yes, technically those are categories of conversation.... Talk to him. Deal with his grief. Talk to him about what he's going through."
House: "That's a brilliant idea. I'll take him out for a beer. That'll make up for the fact that Amber's in a pine box and that there's randomness and chaos in the universe."

(Dying Changes Everything, 5x01)

Cuddy: Why do you think Wilson's leaving?
House: How many times do I have to use the word "idiot"?

(Dying Changes Everything, 5x01)

Cameron to Wilson: "You think you're making a rational choice. You think the worst is over. And then six months later you look back and you realize you didn't know what you were doing."
Wilson: "Are you saying the pain doesn't go away?"
Cameron: "It gets easier. Not in two months. Not in two years. But no. It never really goes away."
Wilson: Being here -- this building -- I was just in the lounge. I kept staring at Amber's locker."
Cameron: "I saw a guy wearing a scarf this morning. The color reminded me of his eyes. We lived 500 miles from here."
Wilson: "I have to do something."
Cameron: "Then do it. But don't think it's the right choice. Because there isn't one."

(Dying Changes Everything, 5x01)

Lucas (House's' PI, speaking about Wilson): "You want to find out he's pining. You want to find out if there is something about him that will tell you he's going to come back. Or something you can use to make him come back."
House: "Is there?"
Lucas: "No. No, there's nothing. Sorry."

(Not Cancer, 5x02)

Lucas (PI) to Cuddy as she walks away: "Hey, I like the shoes by the way."
Cuddy (tentatively): "Thank you."
House to Lucas, "You don't like her shoes, you like her legs."
Lucas: "It sounds less creepy if you say shoes."
House: "Less creepy, more gay."
Lucas: "That's my firm's motto."

(Adverse Events, 5x03)

Wilson: That's how we met: I was in jail.
Sheriff Costello: This guy was a total stranger to you and you bailed him out?
House: It was a boring convention. I had to have somebody to drink with.

[after Wilson breaks a stained glass window by throwing a bottle]
House: Still not boring.

(Birthmarks, 5x04)

House to Wilson [after pressing down the accelerator while Wilson's driving and being pulled over by a cop]: You "lost track of your speed"? I think that was Hitler's excuse. Lost track of the Jews. No one held him responsible.

(Birthmarks, 5x04)

House: [giving his father's eulogy] There's a lot of people here today. Including some from the Corps. And I noticed that every one of them, is either my father's rank, or higher. And that doesn't surprise me. Because if the test of a man is how he treats those he has power over... it was a test my father failed. This man you're eager to pay homage to, he was incapable of admitting any point of view but his own. He punished failure, he did not accept anything less than... He loved doing what he did, he saw his work as some kind of sacred calling, more important than any personal relationship. Maybe if he'd been a better father, I'd be a better son. But I am what I am because of him, for better or for worse.

(Birthmarks, 5x04)

Foreman to House: "There are ways of getting to know people without committing felonies."
House: "People interest me, conversations don't."
Foreman: "'Cause conversations go both ways."

(Lucky Thirteen, 5x05)

Wilson: House, you are a drug addict. You go to prostitutes. You can't be judgmental.
House: And yet...

(Lucky Thirteen, 5x05)

Cuddy: Why do you have to negate everything?
House: I don't know.

(Joy, 5x06)

House to Cuddy: There's a reason that we've evolved the feeling of awkwardness -- it tells us not to talk about things.

(The Itch, 5x07)

Cuddy: House, you OK? ... Your hand --

House: That's weird. I usually don't get the stigmata until Easter.

(The Itch, 5x07)

House: You want to change your life -- do something. Don't believe your own rationalisations.

(The Itch, 5x07)

(Image credit: Triny's World)

THIS IS WHAT I WANT. OMG. Imagine.

"Even as she was dying, she would take walks in Central Park in the daytime, and in the evening sit in a back booth in Bemelmans Bar, looking at the whimsical illustrations of New York City on the wall by the artist Ludwig Bemelmans, best known for the Madeline children's books, and listening to Mr. Harris play. She loved Cole Porter, and she would pass requests to the waiter."

On Oprah today, regular guest and cardiologist Dr. Mehmet Oz and neuroanatomist Dr. Jill Bolte Taylor will be talking about what a stroke feels like and what's happening in your brain when you have a stroke. Taylor's book about her stroke is My Stroke of Insight: A Brain Scientist's Personal Journey (2008). You can watch her TED talk about her stroke online.

Dr. Taylor offers a few exercises to help us make the choice to be peaceful and joyful. Here are two:

>> Pay attention to the energy that other people bring to you. Realize that you can observe other people and interact with them without engaging with their energy. Write about a time when someone else's energy affected you in a negative way. Consider how different the situation might have turned out if you had chosen to observe rather than be engaged and swept away by their energy. How might you approach the exact same situation in the future?

>> Brain circuits are very predictable and consistent entities. The more time you spend thinking a thought, then the stronger that circuit becomes and the less outside energy it takes for that circuit to run. As a result, for many of us, our brains run constantly with brain chatter,  and loops of thoughts go around and around in our minds. Pay attention to what is going on inside your brain. Journal about the thoughts that seem to go around and around that make you unhappy, angry or uncomfortable. Recognize that you have the power to choose not to think these thoughts by choosing to think about other things.

Identify something that your mind obsesses about that you would rather not spend so much time thinking about and document three different things that you can purposefully choose to replace in your mind when those thoughts come up. Create this list for yourself so you can arm yourself with alternative circuits to run in your mind when the time arises. Learn to 'tend the garden' of your mind in this way.

As I've mentioned, I've read the NPR blog of journalist and Nightline producer Leroy Sievers' battle with cancer for a couple of years now. (I wouldn't call it a battle but he did.)  I was away all week and when I returned home on Sunday afternoon, I found that Leroy had died rather suddenly on Friday night at his Maryland home, at age 53, just three days after he and his wife decided to contact hospice. It was a shock. I knew he was dying but I hadn't expected it this soon. His last post, the day before, was about a stuffed Bernese Mountain dog, sitting on the bed with him.

More at ABC News. And NPR. And NYT. There's a memorial fund set up.

(Photo of Leroy with his wife Laurie Singer.)

Years of experience in your given field does not make you an expert performer. It can help -- if you have 10 years experience or more, that is -- and it can also hurt -- acting unconsciously and missing key information, being overconfident -- but what really helps is to spend most of your time practicing the hardest aspects of your job, profession, skill, talent, or field: "In other words, we like to practice what we know, stretching out in the warm bath of familiarity rather than stretching our skills. Those who overcome that tendency are the real high performers."  Another factor that helps make experts expert is "regularly obtaining accurate feedback." This is true for a variety of fields, including nurses, doctors, athletes,  crossword puzzle solvers, chess players, drivers, and, perhaps, politicans.

More at "The Science of Experience" in Time.

Stuart Buck at Overcoming Bias looks at the overarching theme of bias in Gary Taubes' book Good Calories, Bad Calories [published as The Diet Delusion in the UK], "a book of some 600 pages (nearly 70 of which are the bibliography). ...

"Why is Taubes so interested in bias?  For several decades, it has been the conventional wisdom that dietary fat (and especially saturated fat) contributes to obesity, heart disease, and cancer.  Judging from Taubes' exhaustive research -- indeed, I'd be surprised if any other book examined bias within a particular scientific field in such detail -- the conventional wisdom was based on unreliable and slender evidence that, once established and institutionalized in government funding, set a pattern of confirmation bias by which further research was judged (or ignored)."

Examples follow, including that dietary researchers ignored or suppressed "studies showing that diet, cholesterol, and heart disease were not even correlated ... or even that low cholesterol raises other risks of death."

Taubes' contention, by the way, is that heart disease and other "diseases of civilization" are more likely caused by high triglyceride levels, which are elevated by eating refined carbohydrates.

In a January 2008 interview with the Telegraph, he admits "that he himself might be biased: 'What are the chances of writing an article that says the entire medical establishment is wrong, and them going, "Good point, thank you, Gary. Can we give you an award?" When people challenge the establishment, 99.9 per cent of the time they are wrong. If I was writing about me, I'd begin from the assumption that I am both wrong and a quack.' ... 'I have a friend who says that, if I'm wrong, I will have to live in Argentina with all the other mass murderers."

(Is that a real cat in the photo??)

"When it became clear he wasn't going to move out of the way, I closed my eyes, covered my face and held my breath.

 

"By the time we were stationary, four of my eight cars were in the platform and I was on autopilot. I told the passengers there would be a delay in opening the doors due to an 'incident', and was calling the line controller for assistance when I heard a tap on my cab door. A smart man inquired, 'Do you know there's a person under your train?' I looked at the blood on the windscreen momentarily before assuring him that, yes, I was aware.

 

"He paused for a heartbeat, looked at his watch and said, 'So, how long before we get on the move again?'"

(from "Last Year I Killed a Man," by Vaughan Thomas, in the Guardian, 19 July 2008, via Scott)

In the Boston Globe, a 5-page piece by Vicki Constantine Croke about making tough veterinary care decisions features a lovely story about Mark Podlaseck and his goose with cancer, Boswell, who seems to like The Iliad.