Dept of Lazy Reportage

Surprise, surprise. It's from Slate.

Honestly, Slate is second only to HuffPo in its rate of eye-roll-inducing, "why do I bother" stories? (And yet, I still go back, largely for Dahlia Lithwick.) Its obvious pride in its ersatz edginess and counter-intuitive take on [insert topic] annoy me on a regular basis.

Today's arglebargle is about acid-reducing medications for infants. Writes Darshak Sanghavi:

And now the war on stomach acid has a new front: babies with colic. Normal infants reflux all the time (the average preemie, for example, has 71 minor spit-ups daily), but fewer than one in 300 has any evidence of damage to the esophagus. Randomized studies regularly show that acid blockers do nothing to help baby reflux. Worse, drugs like Nexium or Zantac (which blocks acid in a slightly different manner) may increase brain bleeds and gut damage in preterm infants as well as the risk of food allergies in older infants.

[snip]

The overuse of drugs like Nexium isn't a new problem. For years, doctors prescribed COX-2 inhibitors like Vioxx and Celebrex, though they worked no better than Tylenol and ibuprofen. Pediatricians use antibiotics to treat almost half of all kids with colds, though the powerful drugs do no good and drive up the number of resistant microbes. Can we really blame the drug companies for these messes? Malcolm Gladwell, writing on the prescription drug crisis, notes, "For sellers to behave responsibly, buyers must first behave intelligently." For many adults with heartburn and for many babies with colic, doctors regularly write useless prescriptions and insurers happily pay to fill them.

[snip]

In the meantime, the next time your pediatrician suggests Nexium, Prilosec, or Zantac for your baby's mild spit-ups, ask her to explain their necessity better. Tell her you don't need any fancy pills. You would prefer a far more powerful therapy—words of explanation.

Dear God, the douchebaggeryon display here is breathtaking.

I'll start by conceding a point. Nexium is ridiculously over-prescribed. It is no more effective than the (now-generic) Prilosec, and its persistent use by lazy prescribers irks the living daylights out of me. Sanghavi's point about that is a fair one.

But egads, one would really expect a pediatric cardiologist to write a better, more intelligent article about medical science. I'll start with the last paragraph first. I do not prescribe anything for "mild spit-ups, "fancy pills" or otherwise. (Typically newborns have trouble with pills, no matter the degree of fanciness.) For "mild spit-ups" I typically use "words of explanation" about the mechanics of newborn stomachs, and how common it is for babies to spit up. I do sometimes prescribe Zantac (or rather, its generic equivalent) for babies that seem very fussy after feeds. This is because reflux can be very painful, and babies can't tell us what they're feeling. If the medication makes no difference, I stop it.

Are Zantac et al overprescribed? Probably. But let's dial down the rhetoric about pediatricians as pill-happy under-explainers.

The first paragraph quoted above is so intellectually dishonest and so rife with fear-mongering, it disgusts me. Not one of the embedded links supports the contention Sanghavi associates with it. "Brain bleeds" links to an abstract for a study about whether acid-blocking medication protects the lung, and which mentions the brain not at all. "Gut damage" links to one study about acid-blockers possibly being related to a very common complication for very low-birth-weight preterm infants, and it is flagrantly inappropriate to either make a broad conclusion from one study or to extrapolate about healthy infants from a much different, far sicker population. "Food allergies" links to (again) one study in mice and humans, which was entirely lab-based with nothing to do with actual patients experiencing actual allergies. Sanghavi grossly misrepresents what the science is saying.

Finally, the thing that sent me over the edge -- "[p]ediatricians use antibiotics to treat almost half of all kids with colds." Really? That link yields yet another abstract. The setting for the study was merely "physician offices," not specifically pediatricians. Thus, there is no way of knowing how many providers were family practitioners vs. pediatricians. Beyond that, the article is 12 years old!! So, what we have here is one snapshot of medical providers from a dozen years ago used to denigrate what pediatricians "do."

This makes my blood boil. This kind of sloppy laziness would be bad enough from a lay writer, but there is no excuse for it coming from a pediatrician. Slate should be ashamed of publishing such a poor excuse for writing.

True, by definition

As I've made my very sporadic return to blogging, it's good to see that some things have stayed consistent. Lindsay Lohan still can't grasp the concept of pants. Huffington Post still publishes the most ridiculous piffle. And Michele Bachmann still brings the crazy:

Rep. Michele Bachmann (R-MN) is emerging as a fierce critic of the Obama administration's proposed escrow fund to handle damage claims against BP.

The Minnesota Independent reports that Bachmann spoke Tuesday to the Heritage Foundation, and badmouthed the idea. "The president just called for creating a fund that would be administered by outsiders, which would be more of a redistribution-of-wealth fund," said Bachmann. "And now it appears like we'll be looking at one more gateway for more government control, more money to government."

On the one hand, it's kind of hard to argue against the "redistribution-of-wealth" line. After all, this is technically true. By that same token, whenever I buy a ham sandwich, that is also a redistribution of wealth. Ditto putting quarters in parking meters, paying my electrical bill, and collecting my salary. Since the only alternative to redistributing one's wealth is to hoard it, Bachmann has a point, even if it's hilariously daft.

Now, while I'm not expert, it seems to be that BP is probably criminally negligent and certainly civilly liable for the Gulf oil spill. That they are a monstrously rich international mega-corporation does not somehow change their obligations when they screw up. And, just like the rest of us when we screw up and cause damages to others, they should have to pay for it. "Paying for it" will mean redistributing some of their wealth, just like when anyone else has to pay damages or fines. The inflammatory rhetoric doesn't change the justice.

Along those lines, I'm not entirely sure what Bachmann is getting at with "administered by outsiders." When I get a speeding ticket [confidential to readers who may or may not be my parents -- this is fleetingly rare], I do not get to determine how my fine is spent. If Bachmann is arguing that BP executives are the best people to evaluate the claims against BP, I would counter that there may be some conflicts of interest and questionable objectivity at play in that scenario.

At the end of the day, however, the underlying lunacy of the arguments is dwarfed by the fact that, God help her, Michele Bachmann appears to be going to bat for BP.

My eyes!! The burning!!

This weekend, the Better Half and I decided to head into Boston for the annual Gay Pride Parade. We've both marched in both the Boston and New York parades, always with the contingent from the Episcopal church. It doesn't rise to the level of "tradition," but we have something of a history with it, and we thought we'd schlep the Critter along for his first parade (of any sort), trip on the subway, etc.

First of all, while I understand the semantics of calling the whole gay empowerment movement "pride," I don't actually like that word for it. "Pride" is not the same thing as "self-respect" or "dignity." Further, if (as our side so often argues) being homosexual is innate, then it is no more a cause for pride than one's height or hair color. We hold forth (correctly) that it is not a choice, and by that some token neither is it an accomplishment. I understand "Gay Self-respect" just doesn't scan, and am not about to start attacking event posters with a red pen, but I find the word problematic.

One could argue that what we're proud of is the community we've built, and I could be on board with that in theory. It's the practice where that description breaks down. Andrew Sullivan quotes a reader who likens the "new atheists" to gay pride marchers:

Like a gay pride parade the New Atheists overreach.

I cringe when I hear them make blanket dismissals of people with any religious convictions as ignorant, bigoted, or just plain stupid-- just as many of my gay friends cringe when they see... lets say 'breaks of decorum' at gay pride parades that many of us find unacceptable in anyone, gay or straight.

Oh, yes. "Breaks of decorum" is a nice way of putting it. And cringe I do, indeed.

At their inception, gay pride parades served a purpose (as Sullivan's writer says) by confronting mainstream society with our presence and our refusal to be kept quiet and second-class. Over time, they've evolved into more of a celebration than a protest, though there are still plenty of political agendas on display (particularly in areas that lack marriage equality). There are elements that are of a more "supportive" nature (eg. the various religious groups that show up) and others that are more "expressive."

Into the latter category falls a lot that is outlandish. The more mainstream the viewer, the more outlandish the display will seem. From my perspective, the majority is benign, even if it's not to the taste of many. For example, drag queens have been part of gay culture for time out of mind, and it wouldn't be a gay pride parade if they weren't marching along in platform heels of improbable height. Same goes for Dykes on Bikes, etc.

The various go-go boys draped on the floats push the boundaries a bit, and contribute toward the (not entirely undeserved) over-sexed reputation of the gay community. But they're here to stay, I suspect. I wouldn't mind if maybe they reigned in the licentiousness just a titch, but that ship has pretty much sailed.

On the other hand, however, there are some people who show up clearly determined to let their freakiest flags fly. And let's just be clear that, no matter how non-mainstream homosexuality may be, some of these people are waaaaaaay out of our mainstream. To those people of a more... let's say "Mapplethorpian" persuasion, I say this -- I don't judge what you do in private, but none of us need to see you acting that way on the street. You're making the rest of us look bad, and I'd rather you put on more appropriate clothing.

I don't know who's in charge of deciding who's in and who's out (if you will) as far as Pride is concerned. As a community, we're chary of casting judgment, having faced plenty of judgment ourselves. This leads to the occasional epically bad decision, like allowing groups that champion pederasty to march. (For the record, the day NAMBLA shows up in Boston Pride is the day the local gay rights movement loses its moral authority [such as it is], and the day I stop showing up, much less marching along.) Nothing brings out my etiolated inner social conservative quite like some of the characters who gallivant around at these events, and if it freaks me out, then God only knows how it will play in Peoria.

I am all for telling the world that it can stuff its condemnation, and that people who don't like us can go hang. I've been there myself. But neither do we need to be providing the Family Research Council with raw footage for their campaign materials. Is it too much to expect that the parade organizing committee showed a little common sense?

[insert magic sounding title here]

I was trying to come up with an "expelliarmus"-like spell to denote the magical venting of spleen, but I couldn't come up with one. Readers (those that remain) are welcome to submit suggestions in the comments.

Anyhoodle, I happened across this article in the Times about a new Harry Potter-themed ride at the Universal theme park in Florida, and it's reminded me of one of the more irritating experiences of the past few days.

The other night, the Better Half wanted to watch the latest Harry Potter movie (Harry Potter and the Extended Franchise, for those of you unfamiliar with the series), so we rented the DVD from a local store. I noted, with suspicion, that the DVD was emblazoned with the word "rental" before putting it in the player.

Want to know what "rental" means when it's emblazoned on your DVD? It means you get to sit through over 20 minutes of distinctly un-magical commercials. In this case, there were commercials for not one but two different Potter-themed video games, the aforementioned ride, and various other chazerai. None of the ads could be fast-forwarded.

I know that we live in this wonderful world where we can fast-forward through ads on TV, and apparently American industry is going the crumble into dust if they don't find a way to make up for it. But the only result of being forced to sit through 20+ minutes of Potter-related commercials was a deep antipathy toward the character before the bloody movie had even started.

Confidential to Lady Gaga

Thanks, but no thanks.

Makes me proud to be from Missouri

I see that Ike Skelton is doing his level best to remind me that a "D" after one's name is no guarantee of sanity.

Over to you, Ike (via Political Animal):

House Armed Services Committee chairman Ike Skelton said Tuesday that his constituents aren't interested one way or the other in the congressional drive to repeal the military's "Don't Ask, Don't Tell" policy, but he's going to keep opposing it anyway.

During the congressional recess, Skelton toured his home state of Missouri, made numerous speaking appearances, met with several veterans groups, and only one person even mentioned it ... in passing.

"I was everywhere in my district, everywhere. It just wasn't raised," Skelton said. "There are other things on people's minds, like jobs and the economy."

[snip]

So why is Skelton so determined to keep the law in place, above the objections of the White House, Defense Secretary Robert Gates, Joint Chiefs Chairman Mike Mullen, the House of Representatives, and the Senate Armed Services Committee? It's about the kids, apparently.

"What do mommas and daddies say to a seven-year-old child about this issue? I don't know," Skelton said. "I think it would be a family issue that would concern me the most ... What they might see in their discussions among the kids."

Got that, mommas and daddies? Ol' Ike's got your back, so there's one fewer tough conversation you'll have to have with your second-grader about military personnel policy.

Buried in Skelton's thinking, somewhere hidden in the piles of steaming manure, is the implication that voters in Missouri's 4th district don't give a good goddamn about Don't Ask, Don't Tell, but by God their children do! And that keeping those poor, innocent brows un-furrowed is more important than letting decorated veterans keep their jobs.

Let's all just pause and reflect that this giant of political thought chairs the House Armed Services Committee.

DeMint's gonna clean his clock anyway

Which is why this story is hilllllllllllllarious.

Warning! Contains vicarious swearing!

Jonathan Chait wrote a post the other day about politics and bullshit. It is, in itself, worth reading. However, the post contains a link to a longer essay on the topic of bullshit by Harry Frankfurt. It contains what may be my favorite paragraph of academic writing ever:

The notion of carefully wrought bullshit involves, then, a certain
inner strain. Thoughtful attention to detail requires discipline and
objectivity. It entails accepting standards and limitations that
forbid the indulgence of impulse or whim. It is this selflessness
that, in connection with bullshit, strikes us as inapposite. But in
fact it is not out of the question at all. The realms of advertising
and of public relations, and the nowadays closely related realm of
politics, are replete with instances of bullshit so unmitigated that
they can serve among the most indisputable and classic paradigms of
the concept. And in these realms there are exquisitely sophisticated
craftsmen who -- with the help of advanced and demanding techniques of
market research, of public opinion polling, of psychological testing,
and so forth -- dedicate themselves tirelessly to getting every word
and image they produce exactly right.

I've never met Harry Frankfurt, and up until this morning had never even heard of him. But I can't help but admire the wry humor that went into crafting this perfect paragraph, and I just had to pass it on.

Funny, I thought I was an Episcopalian

Let's start things out on a good note, shall we?

I've been critical of the President in the past for what seemed like slow progress on gay rights fronts. To that end, I had stopped giving money to the national Democratic party as a sign of my frustration. While it's hard to know whether or not a similar withdrawal of support on the part of gay and lesbian supporters made any impact, it does seem like the desired progress is being made.

First of all, it seems that the idiotic Don't Ask Don't Tell policy is on its way to repeal. Having passed in the House, repeal is on its way to the Senate, and it seems key votes are lining up the right way. (Sadly, the flagrantly unhinged 2008 GOP presidential nominee is not one of them.) I think there's plenty of reason to be optimistic.

On a similar note, this is very encouraging (via Political Animal):

President Obama on Wednesday extended a modest package of benefits to the same-sex partners of federal employees, a move that will make them eligible for day care, travel and relocation allowances, employee assistance programs and, in some cases, enable them to inherit retirement benefits.

But Mr. Obama lamented that federal law – the Defense of Marriage Act – prevents him from extending the full range of health and retirement benefits to federal employees. He called on Congress to pass legislation that would allow him to do so.

I'm far less optimistic about repeal of DOMA, but am pleased to see that the President is doing his best within the constraints of the law.

So, all in all, plenty of reason to be pleased with the Democrats. I may even give them money again.

Meanwhile, across the aisle...

Sen. Orrin Hatch (R-Utah) spoke to about 300 constituents earlier this week at Dixie State University. His remarks included some advice for conservatives. (thanks to reader J.S.)

He said the Republicans need to organize and pull together just as unions, environmentalists, personal injury lawyers and gay rights activists do for Democrat candidates.

"Gays and lesbians don't pay tithing, their religion is politics," said Hatch.

Nice syntax there, Orrin. How are we on paying taxing?

There's ever so very much wrong with that fun little sentence. To begin with, one wonders why ol' Orrin would conflate our religious views with our politics. I don't actually know if gays and lesbians are more likely to be politically active than straight people. but it wouldn't surprise me. This probably has more to do with not wanting to be second-class citizens anymore, and less to do with some kind of religious transference.

Also, plenty of us gay types are very religious. Like, you know... this guy.

I have very close ties to the church. (People who know me personally know just how close, but I'll leave it at that for the purposes of a public forum like this one.) As much money as I've given to the various political causes I support over the past few years, the amount I gave to my church was much, much more. (How much more is, of course, none of your damn business.) And my last church had many, many gay and lesbian members, many of whom were among the most active.

Finally, it's probably true that a lot of gays and lesbians are no longer religious. Again, this probably has less to do with our being a bunch of God-hating hedonists and more to do with being unmistakeably unwelcome in a whole bunch of churches. (A certain Utah-based church springs to mind, though it's certainly not alone.) Perhaps if religion were not so flagrantly, consistently hostile to homosexuals, more of us would be active, tithing members with less cash to throw around at political rallies.