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I vividly recall a meeting when I was a young assistant professor and all the other male faculty, all MDs, were wearing white coats. The topic of “evidence-based medicine” came up. It was the first time I’d heard the phrase, so I asked the white-coat next to me (sotto voce, of course): “As opposed to what, magic-based medicine?” He replied, with more courtesy than I deserved: “As opposed to tradition-based medicine.” It hadn’t occurred to me before that there would exist any standard for medical practice other than evidence. Now I know better. The MAHA brand has become a mockery under RFK Jr and his minions. On the one hand, they’ve discovered that eating a healthy diet is a good idea, which is like discovering water at the bottom of the ocean. On the other hand, they’re promoting policies that are already making America sicker. Chief among them is the anti-vax agenda, which has led to an explosion in cases of measles and whooping cough, both deadly and preventable childhood diseases. ...

The definition of insanity is making the same mistake over and expecting a different outcome. By that definition, the Trump coup in Venezuela is insane.   Maduro was a corrupt and illegitimate ruler. And the same was true of Saddam Hussein in Iraq. Bush deposed Saddam, freeing Iraq from one nightmare but plunging it into another. The excuse in Iraq was phony charges of WMDs. The real reason was access to oil. Trump has deposed Maduro based on phony charges of drug manufacture and gang support. The real reason is access to oil.   Historian Juan Cole summarizes the five mistakes that Bush made in Iraq and that Trump is making in Venezuela:   “1. Violation of the UN Charter and the International laws of war   “The Bush administration attacked Iraq in 2003 without any foundation in international law. Iraq had not attacked the United States in the decade leading up to the American intervention. The UN Security Council, led by France, Russia and China, specifically decline...

I started college at the dawning of the age of cloning. Recombinant DNA technology represented the transition from descriptive molecular biology to genetic engineering. By the time I started teaching medical students, the genes mutated in terrible diseases like cystic fibrosis, Tay-Sachs, hemophilia and Fragile X were cloned. There was always an obligatory paragraph at the end of the paper to the effect that now the door was open to gene therapy. For decades, the cloning of such genes made the diagnosis in affected individuals much simpler, freed from pedigree analysis. The bottleneck to gene therapy was not cloning the affected gene, it was delivering a therapeutic gene in useful amounts to the appropriate organ or tissue.  Since the turn of the century, genuine progress has been made in gene therapies. Unfortunately, this has presented a new barrier to these technology—cost. Pharma companies have priced gene therapies so high that they are out of the reach of middle class and poo...

“Documents obtained by   the New York Times   found that the third-highest-ranking official in the Interior Department failed to disclose her family’s financial interest in a controversial government-approved lithium mine.   “ Frank Falen, who owns Home Ranch in northern Nevada, sold water to Lithium Nevada Corporation, a subsidiary of Lithium Americas, for $3.5 million in 2018. The mining company was planning a new lithium mine near the ranch called Thacker Pass. Falen is the husband of Karen Budd-Falen, who currently serves as Associate Deputy Secretary of the Interior.   “ At the time of the sale, Budd-Falen was deputy solicitor of the agency, which manages the country’s natural resources and land. Falen’s water contract was dependent on Thacker Pass securing a permit from the Interior Department, according to the New York Times. ” Government official busted for apparently using their post in the Trump administration for personal gain.  In other news, dog bit...

My junior high instrumental music teacher and band director was a spinster who never owned a car. She took taxis to get around our small town. At the time, it seemed odd. Now that I’m 70 years old, it looks like my future.   The promises of robotaxis (I’m looking at you, Elon) have so far outdistanced reality. I’m silently cheering for them, though. I know the day will come when my wife or daughter will demand the car keys, saying I’m no longer fit to drive.  There are several alternatives, of course. An e-bike. Lyft/Uber. Regular taxis. But Elon isn’t the only one making promises about robotaxis:   “Tesla, again on the downswing for its vehicle deliveries, is on the upswing, aiming to overhaul ride-hailing like it did the auto industry. “Uber is wheeling and dealing, touting more than a dozen partnerships, with plans to operate robotaxi services in 10 markets by the end of 2026. “Alphabet's (GOOG, GOOGL) Waymo is seeking new funding at a valuation of at least $100 billio...

I live in Rhode Island. Ca. 90% of electricity in Rhode Island is generated by natural gas. So if you re-charge your EV in Rhode Island, you’re fueling your car with natural gas. Some folks have pointed out that EVs are about twice as efficient as ICE vehicles. That is, they waste about half the energy converting battery electricity to motive force as ICE vehicles do converting gasoline in the tank to motive force.  That’s correct. But what this calculation overlooks is that even in the more advanced combined cycle power plants, only about 60% of the energy stored in natural gas is converted to electricity. So here in Rhode Island, there isn’t much difference between EVs and ICE vehicles for carbon consumption. Now there are plenty of states that generate more electricity from renewables than RI. And for our electrical needs, we’ve contracted with a solar farm, so if we recharged an EV at our house, it would be running on green fuel.  I’m not constitutionally opposed to EVs, b...