They Will Rise Again from the Tundra - Latest Comments

Re: Taking the Driver out of Driving

horseman_1st — Thu, 23 Feb 2012 13:50:48 -0000

This would all be moot if they'd just hurry up and invent the transporter already.

Re: Christ v. Christ

Evil Mammoth — Wed, 22 Feb 2012 18:07:20 -0000

Looks like I've muddled up my insinuations again. All war is about land (or capital of some kind, but mostly land); I didn't mean to suggest otherwise, nor did I mean to suggest that religion was the cause of these takeovers.

I did a little cursory search and wasn't able to dig up much on Turold. Thurstin, however, I learned, was dismissed for the murders of these monks in 1077. (On this note, it appears the book cites a different date taken from the Peterborough Chronicle; Glastonbury Abbey's own website also uses 1077, though.)

As for the situation you propose, it's totally speculative, though a reasonable enough estimation of the choice many non-heirs might have had to make. I don't know that we can apply it directly to this situation.

Regardless, I called this anecdote "candy" for a reason: there are no real conclusions to draw from it except that politics/money can trump religion, even for religious leaders and allies, who aren't necessarily sincere in this capacity, of course. So, yes, these were political and material acts, not religious ones. They were a part of a systematic replacement driven by the Normans.

This one's from the top... the boss has a little job he wants you to do.

Re: Christ v. Christ

veti — Wed, 22 Feb 2012 15:12:42 -0000

Imagine it's the 11th century. You're the younger son of a minor Norman noble. You know nothing about craft or agriculture, all you know how to do is fight, and you're not particularly keen on that - maybe you're over 30, maybe you've seen enough, maybe you're just a coward...

Where are you going to live out your life, in the reasonable comfort and ease you've been accustomed to?

Not on your father's estates, that's for sure - your older brother is grabbing all that, and you can't stand him. But to get you off his hands, he's had a word with his lord, who is willing to let you take up a nice secure position in an abbey on his newly conquered land. All you have to do is deal with the present incumbents.

It's nothing to do with religion. It's important to remember that every war ever fought, without any exceptions whatsoever in the entire history of the human race, was about land. Who lives where?

Re: A Question of Consumption: Should We Really Buy Nothing?

Evil Mammoth — Mon, 28 Nov 2011 14:18:09 -0000

In so far as the collateral damage argument does apply, surely it applies to everything the Occupiers do?

Yes, you're probably right. I had been roused by this Buy Nothing thing specifically, and I wasn't thinking along those lines. I think Occupy has some idea that they can convince the executives to give up some cash and push it down the slide, hence circumventing the unemployment problem. Unlikely.

Regarding your second point, the problem is, however, that this incoherence in their "platform" is a seeming point of pride for them. I'm not wholly unsympathetic, but if you're pushing for some kind of change, you should have some concrete demands. How is your foe supposed to respond without them? The most consistent echo from Occupy is to get the money out of politics; but that's a vague demand in and of itself, and it's not clear to me they've expressed the preferred channels by which to achieve such a goal.

I don't agree with you about the alliance with the Tea Party, though, mostly because I think the Tea Party would fervently oppose trust-busting, which your Item B would necessitate. The Tea Party wanted to allow the banks to fail, so long as that's what The Market had in store for them; they opposed government backing, not the very existence of a massive corporation.

Personally, I was for a little trust-busting, but I'm not sure Occupy and the Tea Party share much common ground. As much as the former has attempted to deny its being a leftist movement, I think this alignment has become increasingly apparent. (Again, the political waters have become so murky, and the din from over-confident commentators so loud, that I'm reluctant to express staunch support either way. A little more ambivalence is in order, though I will say Occupy managed to spur some truly shameful police behavior—but that's beside the point.)

Re: A Question of Consumption: Should We Really Buy Nothing?

Evil Mammoth — Mon, 28 Nov 2011 14:00:47 -0000

I'm not as up on Caplan, though he is worth reading, but this was an article that peaked my interest, having been staunchly in the pro-anti-fertility camp (if that makes sense). As of now, I still don't plan to do a fetus the disservice of contributing my own genes to it.

Re: A Question of Consumption: Should We Really Buy Nothing?

veti — Mon, 28 Nov 2011 06:33:28 -0000

In so far as the collateral damage argument does apply, surely it applies to everything the Occupiers do? For instance, Bank of America employs over 280,000 people - if their profits take a hit, some of those people will be fired. Same goes for every one of the corporations whose greed they're railing against.

As I see it, the Occupiers have a choice. Their present programme is incoherent. They can (a) embrace full-blown socialism for a post-scarcity society - press for a solution that partially decouples work from income, so that unemployment is seen as a normal part of life and a perfectly valid way to spend at least a few weeks out of every year; or (b) concentrate on tearing down the barriers that big companies set up to prevent anyone competing with them, which would result in most big companies breaking up. (That would mean, basically, allying with the Tea Party...)

Re: A Question of Consumption: Should We Really Buy Nothing?

Vinnie — Sun, 27 Nov 2011 15:27:39 -0000

I agree. Depending on how you choose to interpret the Occupy movement, it could go hand-in-hand with the buy-nothing message, or it could contradict it. The version I'd like to believe is that Occupy is a yearning for a better society in which consumerism is no longer a tool the elite use to anesthetize the masses. But I realize the reality that many of the Occupiers are just people who'd like to have more of what the rich people have and for the rich people to have less of it.

I usually think Bryan Caplan is great, and I would adopt his cheery, pro-fertility outlook if I could buy it, but I can't.

Re: A Question of Consumption: Should We Really Buy Nothing?

Evil Mammoth — Sat, 26 Nov 2011 22:44:05 -0000

Don't get me wrong, that concerns me, too, though more meaningful improvements will require a change in how we create our energy. No ifs, ands, or buts. Based on our previous conversations I think you'd probably agree.

For my part, I just thought it a bit odd that Occupy may be playing against themselves on this one.

(On the anti-fertility front, Bryan Caplan actually argued in what I think was an EconLog post that we should hope for more people because it would increase the numbers of able contributors--thinkers, visionaries, etc.). I don't know if I agree, but it struck me as an interesting thought. I'm not sure we'll really consume ourselves to extinction, anyway; we may not even have a chance. More likely, we'll just thin ourselves out, substantially.)

Re: A Question of Consumption: Should We Really Buy Nothing?

Vinnie — Sat, 26 Nov 2011 22:18:15 -0000

Personally, I'm less concerned with the near-term economic effects than with the prospect of consuming our way into extinction. Though I'm starting to think I'm better off boarding the anti-fertility bandwagon.

Re: Writers Writing: Whence Our Manufactured Epiphanies?

Evil Mammoth — Fri, 14 Oct 2011 18:28:03 -0000

As far as my own limitations, I'm not worried about the creativity so much as I am the drive and resolve, which are just as (probably more) important than possessing simple powers of concoction. I can come up with the scenarios, but I grow lazy and passionless when I elbow deep in a piece.

Re: English degrees—hence my encouragement against them...well, not against them, necessarily, but certainly a caveat against thinking there is some de facto creative endgame in the pursuit of one. Bellow's degree in anthropology comes through marvelously, I think, in Henderson the Rain King, and I don't believe he'd be the writer he was without it. Ditto for the personal experiences of the others on that list.

My impugning ad copy was, admittedly, a shotgun burst. Whoring is an honest trade, but I don't really consider copywriting whoring, per se. I can't write if I don't exaggerate, libel, and fabricate all the way to the top...er...bottom...whatever.

Re: Writers Writing: Whence Our Manufactured Epiphanies?

veti — Wed, 12 Oct 2011 19:17:53 -0000

Mammoth, your lament strikes many chords in me. I too was cursed with a care for writing and a deathly lack of creativity. I've spent most of my working life editing the writings of people whose gifts are the inverse of mine - which of course means they get the credit, and I just get a modest page rate. But it's a living.

The key to writing is not to have an English degree, but to have something to say. How many English degrees would you find between Bellow, Parker, Thompson, Eliot and Nabokov? (Hint: it's a number that starts with 'n'.)

Now I take money to write what I'm told to write, because it's so much easier than thinking of something for myself. Some people might call me a corporate whore, and I wouldn't flinch from that description: whoring is an honest job.

Re: Writers Writing: Whence Our Manufactured Epiphanies?

Slip — Tue, 11 Oct 2011 22:09:51 -0000

"PLAY FROM YOUR FUCKING HEART!!!" - Bill Hicks

Re: Mammoth Reads: The Death Penalty

Evil Mammoth — Tue, 27 Sep 2011 01:00:26 -0000

I agree in part with what you're saying. I think Wilkinson, more so than the others, has the tendency to make assumptions on the nature of what is moral, but I do think his skepticism of the revenge impulse is well placed.

As for Brennan's post, I don't think he's begging the question the way you insist he is. Granting a hypothetical set of moral values to a cross-section of people who pretty clearly believe that some people "deserve to die" and that the state has the "authority" to dole out fatal punishment, and then finding fault with the practice even in the presence of those assumptions, is not the same as actually taking them as a given, which would be begging the question. I think his point, in fact, actually reflects your objections to the statement: that many people assume these rights/authorities as innate, and do not attempt to define them with sufficient rigor. I think he is skeptical of all these terms.

Perhaps I'm misunderstanding what you're trying to say, or perhaps I read Brennan's post a bit differently.

I'm not sure the primary objection to capital punishment—at least mine—has anything to do with God's expiration date; your argument to that effect is one that I'm not sure I buy, or understand. Personally, I'm more concerned about wrongful death than I am about messing with a natural lifespan; we do that all the time, after all, both adding years and subtracting them. Preempting the determination isn't usurping any power; it's infringing upon another person's ability to exist, whether you believe that person's right to or not. I don't think it's fallacious to insist we proceed with caution when making the call.

But I'm curious as to how you would frame the argument, especially in a revision of Brennan's comment.

Re: Mammoth Reads: The Death Penalty

veti — Mon, 26 Sep 2011 23:36:41 -0000

I think many of the people you link to are being - not exactly dishonest, but unclear in their thought processes.

Let's look at the one you quote in full. "Even if we grant for the sake of argument that some people deserve to die..."

What does the phrase "deserve to die" mean? What is this "desert", who judges it and by what standard? What about "authorized to kill"? What is this "authority", why is it needed and where does it come from? "For a state to have the right" - what is this "right", is it distinct from the previously mentioned "authority"?

I could go on, but I think I've made my point. There's one hell of a lot of question-begging going on, a great many appeals to authority that are every bit as imaginary as the "pervasive ethereal moral substance" that requires just retribution. I think nearly all of these arguments are, unwittingly, rooted in religion rather than rationality: the gut feeling that it's "God" (in one of His infinite forms) who has the "right" to determine the date of someone's death, and to pre-empt that determination is "usurping" that right.

Re: Wallowing in the Arts: What Are Our Fictions Worth?

Evil Mammoth — Sun, 11 Sep 2011 23:18:08 -0000

The time for challenging books being routinely embraced by large masses is likely past, with a blip or two on the radar screen every now and then; you're definitely right on that count. Information consumption has changed too much.

I haven't read The Golden Compass (yes, that's how it's billed over here). I've heard some good things, especially its handling of the concept of diety for the YA crowd.

Re: Wallowing in the Arts: What Are Our Fictions Worth?

veti — Tue, 06 Sep 2011 19:04:06 -0000

For the past 15 years or so, my father has been using me to test books. Each birthday he gives me something he's been hearing about but can't quite steel himself to read for himself, and awaits my report on it before he decides whether to bother. That's how I came to read The Da Vinci Code, and yes it was execrable. But he also introduced me to Northern Lights (possibly known to you as The Golden Compass) and its sequels, which I think have been at least as influential.

Books have a niche impact, because only a small minority will ever read them (unless they're about a schoolboy wizard), but those people tend to be better than average at spreading their thoughts about.

Re: Mammoth Reads: Homeopathy, Philosophy, Monopoly

Evil Mammoth — Fri, 17 Jun 2011 13:41:24 -0000

The patient has the right to refuse medical service: This is codified and probably a good thing in order to prevent unwarranted/unwanted treatment. That being said, I usually take a doctor's advice or get a second opinion if I'm not satisfied. However, I've had to refuse antibiotics in the past because a doctor prescribed them for an illness that was likely viral, despite knowing that I am allergic to most antibiotics.

That was improper care, and without the luxury of patient consent, I would have unknowingly taken a drug that may have been dangerous for me.

There are no absolutes in the doctor-patient relationship; a well-educated patient probably makes a better one, though.

At any rate, I'm with you: There is more reading we both could be doing at this point.

Thanks to you as well—for reading and for the discussion.

Re: Mammoth Reads: Homeopathy, Philosophy, Monopoly

Mike Kew — Fri, 17 Jun 2011 01:01:41 -0000

Interesting philosophical question here.

You say "Agreeing on a treatment regimen in consultation with their doctor is a patient's right, is it not?" - so basically, yes, this is an ideological position, not a scientific one.

Assuming for the sake of argument that I agree to that (which I'm not at all sure I do), how does it reconcile with the doctor's duty - which you've previously described as "to treat someone and to provide effective treatment"?

I suspect your first reaction will be that the duty of honesty should trump the duty to provide effective treatment - i.e. if the doctor could provide better treatment by lying to their patient, they still shouldn't. But how does that order of priorities affect the doctor?

Speaking for myself, I want my doctors to be the sort of people who care about their patients and get fulfilment out of healing them. What I fear - although obviously there's no research to back this up either - is that requiring them to get patient buy-in all the time is going to drive those kinds of people out of the profession, to be replaced with cooler, more detached types who are happy so long as they get paid at the end of the day.

Anyway, I've spent quite enough time on this now - it's time I did some work. Thank you for a very stimulating discussion. I'll try to check out the posts you mentioned.

Re: Mammoth Reads: Homeopathy, Philosophy, Monopoly

Evil Mammoth — Thu, 16 Jun 2011 18:40:16 -0000

By the way, I will read deeper into this to try and cover my blind spots. I'm sure they're there.

I think you should read the series of posts called something like "EBM vs. SBM Redux" over at Science-Based Medicine. It might be interesting and tangentially related to the differences in our opinions.

Re: Mammoth Reads: Homeopathy, Philosophy, Monopoly

Evil Mammoth — Thu, 16 Jun 2011 18:18:00 -0000

To be clear, I'm not saying it can't; I'm saying it's highly unlikely that placebo does have any specific indication. If it does, that indication has not yet been identified.

As for the ulcer meta-analysis: I checked the Wikipedia entry and began reading a couple of the references there. At least one study that I started on—plus, I'm fairly certain I heard mention of others like it—was non-randomized. Now, not being a doctor or statistician, I'm not sure if this puts the results in definite doubt, but I do know it's a red flag. In addition, the positive effects of placebo seemed to be all over the map in many respects, and the seemingly improved rate of relapse for placebo could have been explained by unknown negative effects of the active drugs somehow promoting relapse. I simply don't know enough to say, however.

The point is not that the placebo effect shouldn't be studied. You mentioned scientific rigor in your reply; I am by no means the poster boy for that, but I try to base my opinions on expert interpretation of the evidence as well as my own accumulated knowledge, the latter of which serves primarily to identify obvious red flags: I leave the complicated analysis up to those who know what they're talking about. After all, doubt is the primary driver of science.

It's possible I'm being a bit axiomatic, but my point is mainly that the placebo effect has not been subjected—as a specific treatment—to sufficiently rigorous tests which would justify its use by a doctor. Most meta-analyses (such as those from Cochrane, which do have their problems sometimes) show no overall indication for placebo use in the treatment of disease with objective outcome parameters. (Again, those with subjective outcomes are a bit trickier.)

Saying that something works but that we don't know how means that the intervention is not likely ready for the big time. I hate to bring complimentary and alternative medicine (CAM) into this, but that's the argument we hear too often from homeopaths and acupuncturists. "Well...something is happening, so it must be a justifiable treatment."

"then there is pretty good evidence that a placebo is still better than nothing" : I'm not sure this is true. Again, it depends highly on what disease you're talking about. I could not imagine someone with Guillain-Barré Syndrome experiencing much relief due to a placebo.

That being said, I like what Harriet Hall says in this comment about "comfort measures." I'm all for comfort measures, but a doctor pretending to give a patient something for their disease—even a placebo described as "something that may make you feel better"—is a violation of the doctor-patient relationship.

"I know the fashion nowadays is for patients to be consulted and informed about all aspects of their treatment. But I'm not aware of any trials showing that this leads to better health outcomes. As far as I can tell, it's a question of ideology, rather than medical evidence."

I'm not aware that any trials of this kind are necessary. Agreeing on a treatment regimen in consultation with their doctor is a patient's right, is it not? How can consent be mutual if the patient must be deceived—though this concept might differ based on our seemingly different definitions of deception. (The Patient's Bill of Rights also gives the patient a right to have a say in their treatment decisions, so there is some legal framework for this as well.)

There just isn't enough evidence that placebo is an effective treatment option, and sanctioning its use for clinicians might open a door for widespread use of other dubious treatments. We're already seeing some CAM creep into respected hospitals.

Re: Mammoth Reads: Homeopathy, Philosophy, Monopoly

Mike Kew — Wed, 15 Jun 2011 19:45:33 -0000

Of course regression to the mean (etc.) can cause a false impression of placebos working. But that doesn't mean they don't work.

You can read about the gastric ulcer effect on the Wikipedia page on placebos. Ulcers are a very popular effect to study, because they don't rely on patient self-reporting - either you have an ulcer or you don't, and there's a very unambiguous clinical test to tell the difference. (Another twist which I didn't know: of 31 trials included in the meta-study, two included followups to check on levels of relapse, and it turned out that patients treated - and healed - with placebo were much less likely to relapse than those treated with actual drugs.)

So I think, if a doctor says to a patient "sugar pills never cured anything", he is making a statement of faith that's simply not supported by clinical evidence. It is both more encouraging and more truthful to say "we don't understand why, but some patients respond well to this treatment."

I suspect (although I don't have any direct knowledge) that clinical researchers are trained, from an early stage, to think of "placebo" and "ineffective treatment" as synonymous. A placebo group is a control group, it's the group where you don't expect to measure any improvement. And so when members of that group do improve, it's attributed to normal regression. Similarly, you seem to take it as axiomatic that a placebo, by definition, can't be an effective treatment. I think that's a mistake, and one that undermines your scientific rigour.

I think a doctor's role is to provide a patient with the best available treatment for their condition. If there's an appropriate drug to prescribe, then fine. If not (and there may be very valid reasons why not - if the diagnosis is uncertain, or the available drugs may be contraindicated for any number of reasons), then there is pretty good evidence that a placebo is still better than nothing. And sure, there may be other ways to induce the psychological benefit (if that's what it is) of the placebo effect - but it's not clear to me why that's a reason not to use placebos. To make it so, you'd have to show that these hypothetical alternatives are actually more effective (taking into account the time they require, cost, likelihood of the patient actually completing the treatment, etc.).

The point about my own experience is not whether the suspected-placebo was effective or not. (Because as you rightly point out, it would be ridiculous for me to come to that conclusion based on the total lack of evidence I have.) The point is that I, as a patient, believe my doctor lied to me - and I don't mind.

I know the fashion nowadays is for patients to be consulted and informed about all aspects of their treatment. But I'm not aware of any trials showing that this leads to better health outcomes. As far as I can tell, it's a question of ideology, rather than medical evidence.

Re: Mammoth Reads: Homeopathy, Philosophy, Monopoly

Evil Mammoth — Wed, 15 Jun 2011 18:06:14 -0000

I'm not a doctor either, but I have some basic issues with a couple of these points:

1. "...If you use a careful form of words, similar to what I've described above, to describe the pills - honestly, but without using words like 'ineffective' or 'placebo' - they can still work." Placebos probably can't still work if you tell someone who earnestly believes in them that sugar pills are rubbish and will never cure anything. The effectiveness is contingent upon the willingness of the patient to believe in the effect. Basically, you're saying that a type of deception is still necessary to achieve the effect: the doctor has to pussyfoot around the real answer and say that other patients may have experienced benefit. Generally, there are a number of things (regression to the mean, self-limited illness, etc.) that can give the false impression of placebo being effective.

2. "...placebos can have real, measurable physiological effects." That ulcer study, as far as I know, doesn't actually prove any measurable physiological effects. It studied placebo for a condition known to be affected by stress levels; a placebo's ability to put a patient at ease (a psychological effect), thus decreasing said stress, could easily have contributed to the quicker resolution of the ulcers.

If we agree that a doctor's job is to treat someone and to provide effective treatment, then placebo has no place in clinical practice. Helping a patient deal with a condition psychologically can be achieved through other means, and any prescription a doctor makes should have a reasonable chance of affecting disease course. Placebo most likely does not; it only alters patient perception.

As for your experience in 1996, there a few limitations to the interpretation of placebo's role in your recovery: 1) you're not sure they were placebos; 2) there is no objective confirmation of a viral infection, only the doctor's impression (from what it sounds like); 3) even if you did have a viral infection, these types of infections are normally self-limited and will resolve in a reasonable period of time without intervention. There is no way of knowing that the placebo had anything to do with your recovery or how long you would have been sick if you hadn't taken them at all. It's good that you felt better during the illness, but it's also possible you may have been prescribed antivirals of some kind, which may have had a noticeable impact on the duration of your infection.

(I don't mean to diminish your experience. I've had acute bouts of pain as well, and I know they can be frightening and extremely frustrating, especially when the cause remains unknown.)

If the element of comfort is to be part of the rubric, then we have to pull back or temper our criticism of acupuncture, chiropractic, and other such modalities that rely specifically on the vagueness of the placebo effect in order to thrive. (Chiropractic has some evidence for its utility in alleviating low back pain, but, otherwise, I think this statement holds true.)

Re: Mammoth Reads: Homeopathy, Philosophy, Monopoly

Mike Kew — Wed, 15 Jun 2011 01:29:30 -0000

I'm not a doctor, I'm going mostly by Goldacre's writings on the subject, but I did pick up a couple of things that surprised me.

One: it's not true that telling the patient sacrifices the efficacy of the placebo. If you use a careful form of words, similar to what I've described above, to describe the pills - honestly, but without using words like "ineffective" or "placebo" - they can still work.

Two: placebos can have real, measurable physiological effects. In Goldacre's book he describes a study with stomach ulcer patients. I'll try to find the full reference to the study, but the gist as I remember it is that patients "treated" with a placebo had a significantly improved chance of the ulcer diminishing and vanishing over the course of treatment.

And even if it is just a trick to make the patient think they feel better - isn't that a worthwhile goal in itself?

Speaking for myself: around 1996, I went to a doctor with acute stomach pain. She diagnosed a viral infection, and prescribed pills that, in retrospect I'm reasonably sure, were placebos. They didn't noticeably ease the pain, but there was still an element of comfort in feeling that I was taking a treatment. And I really don't see why doctors should be judged or condemned for giving that kind of treatment.

Re: Mammoth Reads: Homeopathy, Philosophy, Monopoly

Evil Mammoth — Wed, 15 Jun 2011 01:04:14 -0000

I swing by Bad Science every now and then; Goldacre's done some interesting work, but I'm not sure I agree that placebo has a place in clinical practice. It should be studied, certainly, but should it really have a place in clinical practice? If so, to what end? Most of the placebo effect can probably be explained by observer bias and selective (subjective) pain reporting on the part of a patient. There is nothing that supports the use of placebo for any specific indication.

So what's the point? What would the point of telling the patient be? One sacrifices most of the "efficacy" of the placebo effect when this happens, and when would it be appropriate to prescribe placebo?

The only scenario in which I can see it being legitimately considered is during palliative care, which is normally carried out with heavy sedatives anyway.

I think the perception of the placebo effect suffers from the same mystic shroud people have thrown around quantum mechanics. Placebo, when there is a physical effect, amounts to the brain fooling itself.

(Also, practicing physicians often rely on anecdotal experience a bit too much. Sometimes that's all they have to go on, but it's not clear to me—not necessarily, anyway—that the distinction between a clinician and a researcher should affect our view of placebo as a treatment modality.)

Re: Mammoth Reads: Homeopathy, Philosophy, Monopoly

Mike Kew — Tue, 14 Jun 2011 19:46:15 -0000

If you're interested in homeopathy, I recommend Ben Goldacre's blog at badscience.net.

I don't think physicians should ever dismiss the placebo effect (and I suspect practising physicians have a great deal more respect for it than researchers). If you're worried about the ethics of it, then by all means tell the patient that it's a placebo, but give it anyway. The form of words is something like:

"At the moment, I don't think I can prescribe anything for your specific condition. However, many patients who have had similar symptoms have said that these pills, called 'sugar pills', have been a great help to them. I suggest you try these pills - take one three times a day, after meals, for a week, and I think your symptoms will improve by the end of that time."

No lies necessary. Also, the pills don't have to be made with all that seriously expensive homeopathic voodoo crap - they can be plain ol' sugar, as cheap as you like.