Wednesday, December 20, 2017

Happy 9th Birthday

Well this Blog is now 9 years old. There have been almost 300,000 visitors over that period from hundreds of countries. Hopefully those who came received something of interest.

A while back I read that people found this a very idiosyncratic site. It made me pause and think just what that meant. It was a word I knew from my SAT tests but had never incorporated into my expression. Now I think I understand it if I have become one.

What makes this idiosyncratic:

1. A diversity of topics. We had examined economics, healthcare, international politics, nuclear weapons, taxes, philosophy, religion and the like. Generally the approach was to focus on some recent news article and then make an assessment.

2. We have been fortunate to have seen certain advances before others. Take CRISPRs. I actually taught my grandchildren's 6th grade class about then some five years ago. Instead of "plastics" I told them about CRISPRs. Not that any will ever remember. My second focus was on CAR-T cells. That exploded even faster than CRISPRs. I now wonder about Gene Drives.

3. Politically I am an Ockhamist, which is an individualist somewhat reminiscent of de Tocqueville's observation. There is a great deal which flows from that view. History is critical to understanding the human beast. Great ideas are not all recent, they come from a long process of give and take and one must examine their progression. Individualism came from an understanding that each individual was responsible for their own actions and that each individual had the same rights. For Ockham that meant Natural Rights, and what flowed from that.

4. Cancer had become a focal point. Not that I am a hypochondriac, I guess I leave that to Woody Allen et al, but because I saw that understanding it and controlling it had become a "systems" problem. I was fortunate to live long enough to see the beginning of treatments of this set of diseases. Namely they must be understood as a system not as a cell only problem. I expect that even more advances will occur in the next none years.

5. I have really become annoyed with the plethora of opinionated folks who are telling us how to deal with our health. Take the collection of women writers telling men not to treat their prostate cancers. In the NY Times, the  most trusted source of truth II am really kidding), we have some woman telling men that they should just forget about their prostate cancers. The author writes:

With prostate cancer, doctors today try to reduce the harm by offering men with early-stage disease “active surveillance” instead of immediate treatment. A study published last year in the New England Journal of Medicine found that men are just as likely to survive 10 years whether they choose to be treated or monitored. ....... was found to have a low-risk prostate cancer last year. Since then, his doctor has monitored him with additional tests. He’ll be treated only if tests suggest his cancer has become more aggressive, an approach that aims to spare him from long-term side effects. Among men who have had prostate cancer surgery, 14 percent lose control of their bladders and 14 percent develop erectile dysfunction.

 Words mean something. You must note they changed "Watchful waiting" to "active surveillance" which tells you something. Every time they "power that be" change the in word they are losing the battle. The NEJM analysis mentioned above is flawed since as we have discussed herein we have about 5-8% of PCa patients with an aggressive form, which we unfortunately cannot identify. Thus the result is dominate by the massive amount of benign types. The statistical analysis was flawed due to a small sample size. Welcome to statistics 101 folks.

6. Politics. Here we have a plague on all houses. It seems that every time Congress does something it gets messed up. Take the ACA. Is healthcare any better? Not really. The costs have exploded due to the increased administrative overhead, massive. Now to taxes. This recent bill was almost a disaster. Fortunately we save the medical expense deduction as well as the Graduate Student exemption for tuition assistance. These two we discussed in this Blog. So we are 2 for 2. The SALT taxes frankly may be good. If you do not like New Jersey taxes then move! Go to Florida, Texas, or New Hampshire. Definitely not California!

Well some thoughts on being 9!