Monthly Archives: December 2017

Google Ngram story

Every so often I’ve used the predictive power of the Google Ngram Viewer to create a story from a seed phrase. I fed Ngram the italicized words in the story and the website predicts the next word based on the last three or four words. It gives the ten most frequent following words (if there are that many). Occasionally I had to use the second or third word instead of the first to avoid lengthy run-on sentences or loops, but other than the seed phrases, the story is google’s.

Who would have believed that the world was created by God. No one ever said that to me before I left for the United States. Nevertheless I couldn’t help but notice that the second and third centuries are the most common cause of death. Then, surprisingly, he was not a man to be a man of the world. On New Year’s Day in Pasadena and the San Gabriel Valley in the early days of their marriage he had been a member of the family. That region was not a part of the body of the text is not a substitute for the advice of an attorney.

Prostate Cancer – What Doctors Do Wrong – part 11

It is now a month after I had brachytherapy for my prostate cancer. I still have some unpleasant side effects, but they are much less intrusive than before. I also still have some unpleasant interaction with doctors. Read on.

A couple of weeks after the procedure I received a letter from my health insurance company that if I needed a long-term (90 day) prescription for Tamsulosin (generic Flomax) I needed to switch from the drug store I used for the first prescription to their mail order service or another local pharmacy that participates in their discount service. I could tell I would need a refill, so even though it was cheap at the pharmacy I used first (about $5.00 for a 1-month supply) I wanted to make it cheaper for the health plan as they had requested. I messaged Dr. A that I wanted to switch from the pharmacy he had sent the first Rx to and to send a 90-day one to Pharmacy #2. He replied quickly that he would. Three days later he still had not and I was down to my last five days worth. So I called my health plan’s drug service and explained and they said they would contact the doctor and get it renewed through them and they would send my refill by mail. Two days later I got an email from them saying the doctor had not responded. I was down to my last two pills and had decided I would have to get a refill at the original pharmacy. However, before I got around to that, that pharmacy called me and told me my prescription was ready. Dr. A had sent a 90-day refill there instead of to the one that participated in the discount program. Even though he had read my message, he apparently had not understood anything other than I wanted a refill. He totally disregarded which pharmacy I wanted it sent to, even though I included the name, address and phone number of that pharmacy in my written message. He also disregarded the request from the mail order people. Ironically, the new Rx cost the same amount ($5 a month) as before, and less than the mail order service provided, and it was for twice as much because the doctor had doubled the dosage. I didn’t need the double dosage, so now I have a six-month supply at what is effectively $2.50/mo but will probably only need another two or three weeks worth, based on my progress. What a waste; only drug companies benefit while your premiums and mine go higher. All because the doctor didn’t read my message carefully and didn’t do what he said he would. Doctors are clueless about insurance.

So a few days ago I was sitting at home and got a call from the office of Dr. K. The woman there asked if I could come in for my 1-month follow-up. She wanted to know if I could come right away. What the heck!? If I was supposed to have a 1-month follow-up, why didn’t they schedule that much earlier, at the same time they scheduled the procedure, for example? The patient is supposed to drop everything during the holidays and run right over if the doctor calls? She told me it would only take 15 minutes and if I couldn’t do it, I wouldn’t be able to get an appointment until mid-January (three weeks away). I had another doctor’s appointment (annual vision check) right after lunch, but fortunately I was free for the morning so I decided to get it over with. I took my book (foresight!) and went. I was quickly given a CT scan, which is standard procedure to verify the seed placement after the swelling has gone down, The attendant tried to put me in an examining room, but they were all full (which flummoxed her), so I sat in the waiting room reading waiting for the doctor. They obviously weren’t really prepared for me, which makes we wonder why they called me in. Half an hour later I was getting visibly peeved and the receptionist noticed it. She apologized for the delay. I told her I had another appointment and wasn’t going to skip lunch to make it, so if the doctor didn’t see me in the next five minutes I was going to have to leave. Two minutes later Dr. K emerged and asked “who’s next?” The receptionist pointed to me. I sat down with him in an exam room and he asked about my post-operative side effects, etc. It was pretty standard stuff, no surprises for me and apparently not for him. But when I asked him the results of the CT scan he told me “they’ll be fine – they always are.” He obviously hadn’t looked at them yet. I then asked him to confirm what I’d remembered about the number of seeds and needles used in the procedure. He didn’t remember and left the room to get my file, which he obviously hadn’t even reviewed before seeing me. He came back and confirmed that my recollection was correct as to those numbers. I asked him what my prostate size was, something that is sometimes important in rates of recurrence or future treatment options if the PSA goes up again. He didn’t remember that either and flipped through some pages, but couldn’t find it. That was what I had come in for the first time I saw him, to measure my prostate, but now he can’t find it. He obviously had no recollection of me as a patient and was making almost no attempt to answer my questions.

For what it’s worth, my eye exam was done quickly and professionally and everything was fine there. I have a great ophthalmologist. She and the optometrist in her office are female and had to stand near me, but I’m safe for a pregnant woman or anyone else to be near now. I’m able to run again, although I need to stay near a bathroom. My Achilles tendon is manageable, although there’s still some tendinitis. I’m way out of shape from the long layoff from running, but I feel like my life is returning to normal now.

Proof! Women are better drivers than men

Here’s one to start some arguments around the dinner table. I have statistical proof that women are better drivers than men. I downloaded from the National Highway Traffic Safety Administration (NHTSA)  Fatality Analysis Reporting System (FARS) all cases nationwide in 2016 in which there were multiple cars and multiple drivers and at least one male and one female driver and where one driver had a factor listed of “careless driving” and the other did not. Of the tens of thousands of fatal accidents recorded there were exactly 432 that met these criteria. Of these the male was listed as careless 241 times, the female 191 times. When I select for factor “reckless” it’s even worse for men, 222 to 79 and for “aggressive driving/road rage” it’s male 69, female 13. I rest my case.

Bear in mind this only shows what a law enforcement officer reported to NHTSA in fatality cases. It doesn’t include fender benders or single car fatality cases or cases where both drivers were found to be careless. Nor does it include skills like parallel parking or navigating or traffic violations. These numbers compare only cases where careless driving, reckless driving, or aggressive driving was a factor (coded by the officer) but not other listed factors. I ran the data again where I included all cases where there was any driver factor that could be considered bad driving. There, the difference is much less,  5025 for men to 4916 for women. These raw numbers, however, aren’t very significant because they include such minor factors as “overloading” or “inexperience” along with some serious ones like alcohol-related and speeding. If one driver is reckless and the other inexperienced (apples to oranges) they would score the same for this test. That’s why I tested apples to apples limiting it to the three clearest fault indicators.

In California there is a meme (racist?) that Asian drivers are the worst drivers. There is even a fictitious offense of DWA (driving while Asian) bandied about frequently. So I did the same thing for the race of the driver comparing only listings of white vs. Asian. The data produced only three cases. In all three the Asian driver was listed as careless, not the white driver. None were in California. This is too small a data set to be convincing. I suspect that many accident reports do not list the race of the drivers, especially if one is non-white. I would not be surprised if politically correct California has a policy of not putting race on their form, at least in many departments. The vast majority of California reports had no listing or unknown in the race field. The NHTSA coding form specifies several specific Asian “races” (e.g. Chinese, Japanese, Filipino, which are really nationalities) but also a general category of “Other Asian.” I suspect that of those departments that do report the race, they choose that rather than ask or guess at a driver’s Asian “race.” It was the single most frequent Asian race category that was reported in California. I can tell you that I spent a year as a volunteer judge pro tem doing traffic court in Palo Alto, California and there were probably as many ticketed Asian drivers as white drivers in that courtroom. I don’t think native born Americans of Asian descent are any worse than other Americans but so many of the recent immigrants, especially adult women, have had so little experience driving in their native country that I think there is truth to the meme.

Car ownership (Domestic vs. Foreign)

Consider the following chart showing the relative ownership of domestic makes of cars to foreign makes by state.

The data is taken from the NHTSA fatal accident data base for 2016. It is not surprising that Michigan and other states with or near U.S. make factories have higher ratios of domestic makes than the coasts. I was surprised the difference was as great as it is, however. North Dakota (the highest ratio) had more than five times as many domestic cars as foreign cars. Hawaii (the lowest) had only about 44% as many domestic makes as foreign. The medium blue of Washington and Oregon indicates about equal numbers of domestic and foreign makes; anything to the right on the color line indicates more U.S. makes.

I used fatal crash data mainly because it was readily available, but I also think it is a reliable indicator of ownership in general. The chart does not represent new car sales but what is on the road now. Since newer cars are safer in general than older cars, the data is probably skewed somewhat toward older cars. I don’t think there is a significant difference in safety between the two groups as a whole, certainly not enough to make the map look much different. The data is based on the state where the accident took place, not the state of registration.

The Late Show by Michael Connelly

The Late Show (Renée Ballard, #1)The Late Show by Michael Connelly
My rating: 5 of 5 stars

This is as good as it gets. Connelly has produced another masterful police procedural, his best in a long time, although they’re all good. His phenomenal accuracy in describing every detail of how a good LAPD detective thinks and acts still amazes me. Not that I was in the LAPD, but I was in law enforcement. This is a mystery that you can put together yourself if you pick up on all the clues and are as smart as Renee Ballard, Connelly’s new detective.

Ballard is a surfer from Hawaii and one tough cookie, attractive enough to get hit on or harassed, but hard-nosed enough to give as good as she gets. As usual the author has more than one investigation going and Ballard is working them all – a transsexual who got beaten with brass knuckles, a multiple homicide that took place in a bar, and later, the murder of a cop, her former partner. Of course, like Bosch, she has the reputation of being a pain in the ass to the brass. To avoid spoilers, I’ll leave it at that plot-wise.

I listened to it on disc and the reader, Katherine Moennig, was both good and bad. She had the right tough cookie voice and was a good actress but her frequent mispronunciations detracted from her reading: joolery-jewelry, supposably-supposedly, My-Ako – Miyako. She just didn’t sound smart enough to be Ballard.

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Not me

Interesting article here. For the record, I am not on Mueller’s investigation team and I did not contribute to the Clinton campaign or the Trump campaign. I do not know, nor have I ever previously heard of, the Russ Atkinson in the story.

“Deputy AG Rod Rosenstein is answering questions in Congress this morning. In the light of the clearly partisan views of Peter Strzok, which Ed wrote about this morning, Republicans are looking to question the partisanship of the team assembled by Special Counsel Mueller to investigate Russian interference in the election. … Next, again in alphabetical order, Russ Atkinson. He donated to the Clinton campaign last year. Again, zero to the Trump campaign.”

Full article here: Hot Air

Designer Babies – the CRISPR tool

A Crack in Creation: Gene Editing and the Unthinkable Power to Control EvolutionA Crack in Creation: Gene Editing and the Unthinkable Power to Control Evolution by Jennifer A. Doudna
My rating: 5 of 5 stars

The author is one of the scientists who helped invent the CRISPR tool that makes possible easy gene editing. The first half of the book gives the history of how the tool was discovered and improved. That part is quite technical. I found it interesting, but many will find it too difficult. It is also quite repetitive. How many times do we need to be told that scientists have used gene editing to create micropigs or that the tool can be used to find treatments for muscular dystrophy? For those not into the hard science, though, you can skip directly to Part II where the complex ethical and moral issues are discussed. The tool can be used to cure disease and to feed starving populations. Crops are already being made more resistant to pests or diseases, thus allowing for crops that have more nutritional value and which do not require pesticides, fungicides or other harmful chemicals, or at least not in the same volume as before. The author makes a compelling case for the value of gene editing and indeed for GMO foods, which are actually healthier both for the consumer and the environment than traditionally farmed foods, not to mention cheaper, yet 60% of Americans think they are somehow harmful or at least less desirable than traditional farming methods.

However, the CRISPR tool can also be used to modify the human genome. For now that is only being done therapeutically in somatic cells, i.e. ones that are not involved in reproduction. The genetic changes are only for an affected individual who is suffering from a genetic disease. But the technology can be used to modify egg and sperm cells’ DNA, either for good, such as repairing a defective gene that would have led to a horrible heritable disease in the child, or, in theory at least, to “designer babies” or some Nazi-inspired eugenics movement. Human embryos have been modified in the lab, although only non-viable triploid embryos were used. The author does an outstanding job of showing the different viewpoints and the goods and bads of gene editing. Personally I side squarely with those who are plunging forward with the research. I don’t fear an onslaught of designer babies. I doubt the technology will ever be used for cosmetic reasons except perhaps in a few dozen cases a year, if that, and that’s not likely to be harmful. Much more likely, it will be able to eliminate defective genes that nature provided by its random mutations, diseases like Duchennes muscular dystrophy, sickle cell disease, and early onset Alzheimer’s. Why some people consider that a bad thing is beyond me. Even the so-called “designer babies,” i.e. modifications not done to cure a disease, aren’t likely to be Aryan master race experiments or super athletes, but severely myopic parents who “design” a child with 20-20 vision, or musician parents who “design” a child with perfect pitch. I see these as helpful for everyone and not harmful. I am more concerned with the use of the technology in a way the author does NOT discuss – as a weapon. I can foresee some dictator (e.g. Assad) dropping genetically-modified unkillable bacteria or viruses on their enemies and a worldwide pandemic beginning. We must continue responsible genetic engineering to be able to prevent or protect against those who do not have the ethical or moral compass we do.

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When Breath Becomes Air by Paul Kalanithi

When Breath Becomes AirWhen Breath Becomes Air by Paul Kalanithi
My rating: 3 of 5 stars

This unfinished memoir by a neurosurgeon who died of cancer documents his decline and suffering along with his aspirations and accomplishments during the period of his diagnosis and treatment. It contains a plethora of medical information that will be fascinating to those into brain science. Despite this, I cannot give it a high rating for two reasons: it is unnecessarily depressing and pretentious. The author almost wallows in self-pity at the unfairness and the suffering of his disease, and indeed it is a great loss not only to him, his friends, family, and colleagues but also to future patients who are denied his skill. He was no doubt a highly skilled and dedicated doctor, a fact I know only because he repeatedly tells us so. He tells us so in flowery, overwritten prose stuffed full of literary quotes, esoteric vocabulary, and accounts of his sacrifice and the admiration of colleagues. In addition he takes it upon himself to tell the reader what is important in life and how to live it as though he were an oracle or philosopher. Reading this I am reminded of the Smothers Brothers skit where the psychiatrist wears a badge that says M.D. and points to it while identifying himself as “me, deity.” The long epilogue by his wife places him on an even higher pedestal than he has placed himself.

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