The Last Psychiatrist

Comment on "Heidi's Real Problem On The Hills: She's In The Wrong Movie"

2009-01-05T19:15:29Z

Thanks for pointing out that if I think I might be a narcissist then I ain't one. I have been worrying about that ever since I started reading your fabulous blog because I'm told by mental health professionals that my father is one. Living alone and having only myself to look after, I thought I might have learned it from him. I'm relieved. Thanks so much.

Comment on "Should Kids Go To College Early?"

2009-01-05T15:51:50Z

@Susie: You can certainly get a secretarial job with a high school diploma. In some offices, there may be the opportunity to rise to other levels; in law offices, at least the chance to accrue seniority (generally worthless, in my experience, but at least with the prospect of yearly raises). I know quite a few secretaries, ranging from adequate to quite good, who have had only a high school education. I knew one tough cookie who had her GED, and was quite a good secretary.

Comment on "Can A Patient Postpone Their Own Death?"

2009-01-05T15:45:11Z

Ditto on the "Can a Patient Postpone His/Her Own Death Due to Cancer?" - and the empirical answer, in my case, is yes; my own father, who had cancer, managed to hang on in order to say goodbye to all his children - one of whom had to sail back from Italy on compassionate leave from the Navy. But he managed.

Comment on "What Happens To An Action Hero When We Grow Up?"

2009-01-04T23:23:57Z

I desperately want to see JCVD. I have no interest in Gran Torino, so I'll take your word on that. One point of view on the cigarette kicking scene, that I can see it from without a viewing anyway, is that in the middle of a heist with several dudes robbing the place, kicking one of them into a pulp is probably not going to help in even the intermediate run, since there's still other dudes with guns and bystanders. Once I've convinced someone else to see a Jean-Claude movie I may rethink that.

One thing I have to say about Bloodsport, as someone who grew up with these sort of movies, is that he didn't magically get the power to win, but rather it was the product of a lifetime of training. That said, I realize the guy who's story it was based on is likely little more than an advanced Mall Ninja (google that for some laughs), but at least the tale involved effort.

Comment on "Should Kids Go To College Early?"

2009-01-04T07:56:15Z

I disagree that rich kids wouldn't be allowed and poor kids would be all over it. If it's anything like the French "Bacc" it will be tough, and require kids to actually gain the knowledge that other kids may take 4 years to work through. I'm 19, so high school is not a distant memory for me. I went to two different above average public schools in Pennsylvania and California, and graduated with a 4.0 without undue effort. I'm reminded of the words of Steve Pavlina, the successful blogger who graduated college in 3 semesters: "Just because everybody else goes at a snail's pace, doesn't mean you have to." I predict rich kids will do this more than poor kids because their ambitious parents will push them, and their rich-kid genes may be more academically inclined than those of poor kids. As for poor kids who'd do this just to graduate early, I suspect that the kind of student who wishes to drop out wouldn't have the ambition to do what it takes to graduate early.

Comment on "Can A Patient Postpone Their Own Death?"

2009-01-04T02:41:53Z

Yes, I did notice that, pretty depressing. Depressing that no one else felt as I did (or, that the editors refused to print their letters), and even more depressed that anyone (e.g. insurers) could even attempt to use this pseudoscience as a way of setting rates. As for whether people even read the article at all, overall you're probably right, but this has a catchy title and is interesting enough that it could make the rounds. If anyone is so motivated, they can check the stats and see how many times that article was cited by other articles.

Comment on "Can A Patient Postpone Their Own Death?"

2009-01-04T02:23:41Z

No, I was right about that much-- epistemology-- as in the study of knowledge itself, what can we know and what is not possible to know? And this applies to Neuroskeptic's and dES's comments, the idea is not simply that the methodology is flawed, but that the question they are studying cannot be studied this way at all, because, essentially, you are looking to prove something doesn't exist by observing its absence in a couple of places.

If they got a hundred people with cancer and asked them to try to postpone their own death until a randomly chosen date, that would at least be sound study; but even that, if negative, wouldn't necessarily negate the ability of others from doing it. "We asked three hundred people to try to bench press 275lbs, and none could do it." So? But again, that study would be a better one than this.

And it comes back, for me, to the purpose of studies in medicine-- either they are for science-- whatever it finds, even if we don't want to hear it-- or for "humanity" e.g. anything that makes suffering less. This does neither. It is for the authors' benefit ONLY. So much for the categorical imperative. (The what? Exactly.)

As for the title, yes, it is not really that good. Fixed. (I hope.)

Comment on "Can A Patient Postpone Their Own Death?"

2009-01-03T20:10:26Z

It should be "Can a patient postpone his death due to cancer?" Or "her," if you're a feminist. Patient is singular and their is plural...there needs to be parallelism. But honestly, who gives a shit.

Comment on "Can A Patient Postpone Their Own Death?"

2009-01-03T17:55:46Z

The article title needs correcting. Reads awkwardly as "I can postpone my death because of cancer".

Comment on "Can A Patient Postpone Their Own Death?"

2009-01-03T15:04:53Z

I think you mean "epidemiology," not "epistemiology." And as a former epidemiologist, I've got a huge beef with the crap PhD epis put forth in order to pad their CV. They know better.

Comment on "Psychopaths Are Charming?"

2009-01-03T08:38:32Z

We had the opportunity to watch a psychopath in action when we got a new regional CEO this summer. It was interesting to see how our staff regarded this guy- we'd all leave meetings with wholly different evaluations of what was said. Eventually, I figured observed that it was the soothing tone that made the difference. People were reacting to how the charm and charisma made them feel rather than the words that were said. Try transcribing meetings? Like reading stereo instructions. Our company is now involved in a lawsuit and expecting to close our doors any day now.

For some reason, from the first meeting, I felt uncomfortable with the guy and found him instinctively revolting.

Comment on "Can A Patient Postpone Their Own Death?"

2009-01-03T06:05:24Z

Cited in the Annals of Internal Medicine 2008 - did you check that link?

Tax incentives can provide a large financial impetus to change behavior. Current U.S. law establishes a substantial discontinuity in the amount of estate tax that many patients will have to pay in 2010: During this year only, the tax rate drops to zero. This article discusses concerns regarding the sharp change in tax rate and the incentives it creates for persons who are nearing the end of life and provides estimates of the number of people affected by this issue.

Planning on dying? Try to hang on until 1-1-2010. Your heirs will be appreciative.
/snark

Maybe no one is reading JAMA these days (or the Annals). That might explain the drop in editorial standards. No readers = no fear of public humiliation.

Comment on "Can A Patient Postpone Their Own Death?"

2009-01-03T01:24:29Z

Actually I wasn't defending this study, which is clearly not perfect, although not meaningless either. But I think it's obvious that TLP wasn't primarily attacking the methdology of the study. This isn't about whether it's right to assume that Jews celebrate Christmas. Let's pretend the study was methdologically flawless - most of what he said would still stand. And I'd still stand by what I said even if I thought this particular study was rubbish.

Comment on "Can A Patient Postpone Their Own Death?"

2009-01-02T23:25:51Z

SURE it's a virtue, but TLP did not disagree, and "knowing for the sake of knowing" was not by any stretch of the imagination what the study was about. If you had gone and asked, patient by patient "is there something you're hanging on for," and then recorded whether or not they made it, THAT would be a study. Flawed, certainly, but better than this. The 19th century doctor who tried to weigh souls did a better study than this! This "study" was an absence of study, and by defending it and pseudo-studies like it, you ultimately attack the advancement of human knowledge itself.

Comment on "Can A Patient Postpone Their Own Death?"

2009-01-02T23:10:59Z

I guess it would old-fashioned and sentimental of me to say that one of the virtues of humanity is the urge to know for the sake of knowing, whether we like the answers or not, and whether they are "useful" or not.