Sunday, May 31, 2009

2 months down...

... and 4 to go in baseball this year. The end of May finds the Sox half a game behind the Yankees in the now-the-universe-is-back-in-order AL east (know your place, Toronto). The Sox are on pace for ~92 wins so on balance there's no need for any one way trips off the Tobin Bridge.

The Good
The Red Sox bullpen has been as good as advertised, with an AL-best 2.96 ERA. Ramon Ramirez, the counterpart in the Coco Crisp trade, has been nearly unhittable, and Manny Delcarmen has become reliable, although Tito has mostly avoided using him in pressure situations. Okajima continues to be effective with his smoke and mirrors, and his countryman Saito has, after a rocky start, settled in nicely to the backup closer role (distinct from the set-up role, which is mostly Okajima and Ramirez). Papelbon has gotten the job done at closer with only a single blown save and an ERA of 2.45, although his peripheral stats haven't been as good as in the past: fewer strikeouts, more guys on base, more pitches per AB. So that's five guys in the pen with ERAs below 3.00, plus a sixth if you count the new guy, Daniel Bard, who really brings the heat. Masterson does a fine job as the swing guy, capable of starting if need be, or pitching multiple innings out of the pen. To call him the long man/mop up guy would really do him a disservice, it is much more a credit to his rubber arm, and he is more than capable of pitching the 8th inning in a one-run game.

The Okay
The Red Sox lineup has its share of hits and misses so far this year. They are third in the AL in OPS and fifth in runs scored, so it isn't like they are anemic, but there is the walking corpse that is David Ortiz, he of the lone home run and 0.185 batting average. There have been no reports of any health issues, so who knows what's wrong with him. The guy most-expected to be a corpse this year, Jason Varitek, has been nicely non-rotting, with 10 HRs and an OPS of 0.849 (last year was 0.672). The meat of the order has been mostly as advertised, with Youkilis continuing to put up MVP-type numbers, his 1.150 OPS behind only Joe Mauer in the AL; Jason Bay with 15 HRs, good for third; Mike Lowell coming back nicely from hip surgery. Pedroia's power numbers are down from last year, but he's still hitting for average and a lot of doubles. Drew has been good, with an 'eh' attached to it, because that's what he does -- he has yet to have a really hot streak. Ellsbury was, appropriately, moved out of leadoff spot for today's game. He's a good ballplayer but he doesn't get on base enough to justify hitting at the top (yeah, he's hitting 0.300, but an OBP of 0.330 is below-average for a leadoff hitter). The SS hole is exactly that, a hole -- Green and Lugo have put up OPS of 0.783 and 0.714, respectively, which I guess classifies as "not horrible" but no better than that.

The Ugly
It'd be a bit simplistic to say the starting pitching has sucked for the Red Sox, only because the defense has largely sucked too, and the two are non-separable. Beckett's top line numbers aren't great, but he had a spectacular May, so the arrow is pointing in the right direction. Lester finally had a good outing today, let's hope it keeps up -- otherwise, he has more or less sucked. Wakefield has been, as always, steady, and he pitched some real gems when the Sox needed it most, coming on nights after the pen was severely taxed. DiceK continues to make me want to blow my brains out, taking forever when he pitches, nibbling, putting a ton of guys on base, same old same old. Of course, last year he was very lucky (low BABIP) and this year he has been very unlucky (high BABIP) and the results show it. Brad Penny has been exactly what you'd expect out of a fifth starter -- with him, the question is do the Sox keep him when Smoltz and/or Buchholz are ready? The former has looked good in several rehab assignments, while the latter has been lights-out in AAA all year.

In sum
The Sox are chugging along with no major needs that can be addressed. That's a good position to be in come June. If Ortiz turns it around then so much the better, although it is not clear to me, or to anyone really, what they do with him if he doesn't. Green and Lugo are a real problem at SS, mostly because of their atrocious defense, but I don't know if Jed Lowrie is the solution (at least he can field okay). I still think they are the favorite to win the AL East.

Thursday, May 28, 2009

100% accurate

Coach Dale passes this along:

Wednesday, May 27, 2009

Good advice?

In the course of emailing a student worrying about her grade for the semester, I wrote something that I think is actually pretty good:
That said, to paraphrase Lyndon Johnson when describing the value of the vice-presidency, GPA is worth a warm bucket of [spit]. I know it is something one worries about when in college, because it is the only barometer one has at the time, but really, it is a very poor predictor of future success. In whatever career you decide to pursue, people will judge you based on the interactions you have with them -- within 5 minutes of meeting you, people of importance will know if you are an idiot or not -- and that judgment is really all that matters.

I'm not saying don't try hard to get good grades, but I am saying that it is far more important that you understand the material and, in a broader, why-am-I-in-college-sense, figure out what really gets you intellectually excited. People who don't like their jobs don't feel that way because their job is mentally hard, but rather because it doesn't engage their brain. Likewise, people who do like their jobs don't feel that way because it is as easy as high school, but rather because they're not staring at the clock every day waiting for it to hit quitting time.
Judge Smails continues on medical ethics:
I think I agree with most of what you said about the medical ethics issue. For me, some things your post made me think about:
(1) Are we dealing with a born child or a fetus? From the current legal standpoint, a fetus shouldn't really qualify for any protection from society against idiotic parents. So I think that means i agree with you: once we accept that people can abort babies for any reason (including "I don't feel like being pregnant anymore"), then I don't think there's a legal line to be drawn about aborting babies because you don't like their eye color. Similarly, if people want to have "natural" babies, even one's with down's syndrome, it's hard to say no, given that we think they should be able to abort. Of course, this means we have to accept as legit people who want to give their child pre-natal care via prayer only. I think.

I think it's much harder with already-born babies, especially when you get to cases in which treatments have possible fatal side effects and "not doing anything" involves no chance of death. So you're taking risks to increase quality of life. I don't know how to think about this. Even worse is when you're dealing with an almost certain possibility of death whether you treat or not, but treating involves horrific pain. Would I get my daughter a bone marrow transplant if it gave her a 5% chance to live and otherwise she dies? I probably would. Could I stomach the government requiring that people do that? No.

(2) If we forget the law, and just ask "Given the pro-choice world, what would I counsel my sister to do?" I think the decision largely rests on a cold calculation based on invasivness, probability of disease, and quality of life. I concur with you that in the case of horrific childhood diseases that always result in severe handicap and early death, when the parents know they are carriers, it makes sense to test --- and possibly abort. But that's the easy case. The hard case is when you're just fishing for non-fatal handicaps that don't always severely diminish quality of life, like DS. I don't think you can dismiss the miscarriage rate until you're actually sitting there talking about your own future child. Especially when the miscarriage rate is higher than the probability of having the disease. You're right that technology may wash away this problem soon, but then again, many readers of your blog might be making these decisions later this year.

For me, I would personally find it almost impossible to counsel someone to abort a baby simply because it had down's syndrome. In fact, I think I can safely say that I look down upon people who do so. I wouldn't look down on someone who aborted a baby with Angelman's syndrome or something horrific like that, but I'd have a hard time telling them to do it. But that largely has to do with one's opinions of abortion, pro-choice or not.

And, of course, I think some cases are just beyond the pale, even though they are highly realistic: If someone told me they were aborting a baby because they wanted the other gender, I'd probably have to stop being friends with the person.

(3) What about government action to "force" treatment? To me, this is the most interesting question. We can think of all sorts of things that, if we eliminated them from society, it would just be more efficient. Even dumb things: closest to my heart is left-handedness. If we could just get rid of all the lefties, there'd be a significant economic gain via the synchronization of education and the reduction of highway fatalities. We'll probably be able to eradicate "gay" as well. And from an economic standpoint, there's little reason not to.

Still, it's very scary to me to think about the government makign these decisions. It seems inconsistent to say "you can kill the fetus, but if you choose not to kill the fetus, you have to get it this treatment." On the other hand, we require vaccinations to go to the public schools, so why not.

First, a minor point: I ignored the 1% miscarriage risk of amnio only in the context of a 25% chance of a Batten Disease child. Unless you're specifically worried about something, like Batten Disease, Tay Sachs, or you're high risk for something like Downs, the benefits probably don't outweigh the costs. Now, in the context of Down Syndrome, which I believe is one of the more common positive results from an amnio, I do think one's socioeconomic status legitimately plays a role in one's decision to abort. Certainly it helps to be well-off with a strong network of family to help out, and I can't say I'd look down on someone who was worse off if she chose to abort a DS baby.

As for the vaccinations, a very interesting point, but I think there is a difference. From an epidemiology standpoint, there's very little difference to having only some people vaccinated and having no one vaccinated. In other words, one person's refusal to be vaccinated can have a direct negative consequence on the next guy (especially if the next guy is very young or very old) -- it is a bad idea to have anyone in the population carrying the disease, even if for them it isn't lethal, it might be for someone else.

Morning TV

Since I'm driving into work these days, and since I really hate sitting in traffic (how do people do this every day of their lives?), I'm attempting to hang out at home in the mornings until the traffic dies down and then leave for work at about 9am. Likewise I work a little later into the evening, for the same reason. Because of this, and because I know a guy who will be on later in the show, I currently have the Today Show on the teevee. How do people watch this? Today's big story is some girl & mother that were apparently kidnapped in Pennsylvania. So what does the Today Show think will be a good thing to do? Put on the father and ex-husband of the two! And then ask him how he is feeling!

On a side note, I haven't cut my hair in quite some time, to the point where its length would just be described in centimeters instead of millimeters. The wife (Mrs. Disconfirmed?) is a fan of this development, but now that I've seen Matt Lauer and his apparent buzz cut...

But I will say this... the Today Show might be more watchable than Sportscenter, which used to be half an hour long and, you know, gave highlights of sporting events, in much the same way that MTV used to play music videos. Two years ago I turned on Sportscenter while on vacation and they were earnestly debating which of two atheletes was more now.

Friday, May 22, 2009

The answer is D

Coach Dale sends along this link to a poll, asking how many millions are in a trillion.  Go read the comments.  Really.  You will laugh, a lot, at the numberical idiocy.

Funny Balls

I like this picture, which ran alongside a "News & Views" in Nature Reviews Cancer this month.  If (and I emphasize the if) this picture has any relation to the story that it is next to, then the light blue ball with a "black" (green) eye is "mutant FGFR3" while the smirking purple ball is "phage-displayed inhibitory antibody."  Presumably the light ball is angry because he is no longer causing cancer in mouse xenograft models.
Judge Smails writes in:
I agree with you that anyone who withholds medical care from a child is doing something seriously wrong. And while I generally think that any radical ideology --- not just religious ones --- can produce these kinds of mentalities, i think there's a much more interesting question in all this.

Namely, how much discretion should parents have in the medical treatment/non-treatment of their children?

I experienced this first hand when [my wife] was pregnant with [my child]. We were at one of the first checkups and the doctors asked us if we wanted to have the test done for down's syndrome. I asked if it was invasive and they said yes (it's an amnio test that has something like a 1% of complications or miscarriage). So I then asked what good could come from finding out if the baby had down's syndrome. They hemmed and hawed until I determined that what we were really talking about was abortion. I told them that I thought aborting a DS child was disgusting, and that we would pass. They then threw in the (more reasonable) possibility that we might just like to know ahead of time, such that we could prepare ourselves mentally for a DS child. But to me it was a no-brainer, I'm not taking a 1% chance of miscarriage just so I can be better prepared for some unlikely outcome like that. We politely declined.

But here's the thing: what if something could be done? What if, 10 years from now, they can "fix" down's syndrome pre-natally? That might change things for me. On the other hand, I'd still be queasy about doing a test with a 1% miscarriage rate, just on the miniscule chance that the baby has DS. I'd feel even more queasy about looking down on parents who chose not to have the test and ended up with DS child, and even more queasy about a government regulation that required you to get the test.

This is a topic I've been thinking about quite a bit lately, both as part of the on-going health care debate and as part of the genetics class I taught this past semester, in which each student had to research a genetic disease. Does the severity of the disease, at some point, compel the government to step in? Does a government that is paying for the health care have a right to step in? I think we'd all agree that, in terms of children, the rights of parents are not infinite, and the rights -- or perhaps, obligations -- of government are not zero. In the near future, it will be feasible for people of even modest means to get a genetic profile -- maybe not an entire profile, but certainly sequenced for known disease-causing alleles that could be passed on to an offspring.

Let's say that both parents learn that they are carriers for the recessive gene for Batten Disease, a truly horrific juvenille-onset neurodegenerative disorder. The affected are blind by age 10, start showing mental decline by age 15, and are dead by age 25. So what options to these parents have? First is to do pre-implantation testing -- take eggs from mom (hardly a simple or cheap proceedure) and sperm from dad (dads always have it easier), fertilize in vitro, screen out embryos that received a disease gene from both parents (1/4 of them) and then implant some of the good embryos into mom. This would be quite an expensive and laborious proceedure, and I don't really see the cost coming down any time soon.

The other, much cheaper option for these parents would be to get pregnant the usual way and then test the fetus -- and just for the purpose of clarity, I'm going to ignore the slight increase in miscarriage, because I'm more interested in the ehtical debate rather than limitations of current medical technology. There's a 1/4 chance the fetus would test positive for Batten Disease. If there's a positive, have the baby, or have an abortion? I'd opt for an abortion. Perhaps this is another way of saying that I don't see much of a difference between a newly-fertilized egg in a tube and a 3 month-old fetus.

But the waters get murkier when we're talking about less "in-your-face" diseases. Hemophilia? Increased risk of skin cancer at age 60? Attached ear lobe? At some point even the most science-minded, cold-hearted of us will say no, you probably should not have an abortion to avoid a child who cannot roll his tongue. Of course, when I say that, it is not because I've suddenly become squeemish about abortion -- being pro-choice and all -- but rather that the cost of an abortion (risk to the mother, financial cost, etc.) are not outweighed by selecting one genetic variant over another.

I do not think the government should play the role of arbiter and prevent this woman from having an abortion, just as I do not think the government should enforce the abortion of a Batten Disease child -- actually, my logic runs in the reverse: because I think the government should not enforce the Batten abortion, it then follows that the government should not prevent the tongue-roll abortion, no matter how silly I regard the latter.

I suppose this is the cost of a free society, namely that others around you are going to draw lines at wildly different places than you do. One approach would be to say that's fine, you make your decisions and I'll make mine. The second approach would be to villify those who draw their line far away from your line and attempt to use the power of government to make your line the legal standard. I obviously put "reproductive issues" in the first basket, but I also put a heckuva lot of things in the second basket: through the last century -- voting rights for women, civil rights for blacks, environmental regulations for industry, marriage rights for gays. I'll ponder my apparent ideological inconsistency and let you know if I come up with anything.

Wednesday, May 20, 2009

Perhaps when it is all said and done I'll provide some of my thoughts on the American health care system, as least as I've experienced it over the past 10 days, but in the meantime one story I've been following (and things like this crop up every now and again) centers on some religious nut who killed her child by refusing medical care. Pharyngula has the whole story, and concludes with this jeremiad:
These are cases of religion gone pathological, of belief so absurd and so deep that it denies truth and has overt negative consequences. Moderate Christian believers will read about this and dismiss it as irrelevant to their faith; sure, they'd pray, but they'd also get their children in to legitimate doctors who would give them effective treatment.

I have to say something that is heartfelt, and is also meant to offend. I do not absolve you mealy-mouthed moderates, I do not regard your beliefs as harmless. If Colleen Hauser or Leilani Neumann were in your church, you'd tell them to get medical care, but you'd also validate their belief in prayers. You would provide the soothing background muzak that says prayer is good, prayer is virtuous, prayer will connect you to the great lord who can do anything, prayer will give you solace in your time of worry. You would not raise your voice to say that prayer is useless, prayer is self-defeating, that while prayer might make you feel better while your child is suffering, that is no virtue. You pray yourselves. You think it is a noble and generous act for your representatives to prowl the corridors of hospitals, preying on the desperation of the sick. You abase yourselves before false hopes, and sacrifice human dignity on an altar built from the bones of the dead. You would spread the poison, piously excusing yourselves because you only want to administer sub-lethal doses.

Saturday, May 16, 2009

Mighty chondria

Rachael Alexander won the Preakness today, not quite the impressive win that she had in the Kentucky Oaks, but she was running against better horses this time around, and she led wire to wire. As a reminder, a female horse is a 'filly' when she's 4 years old or younger and a 'mare' from then on, while a male 4 years old or younger is a 'colt' and then becomes a 'stallion' assuming his balls are still intact (and known as a gelding if they're not). When horses breed, 'sire' is the father and 'dam' is the mother.

The reason I was thinking about this is that it is rare for fillies to race, and even more rare for them to win big races going up against colts, because in general, colts are bigger, faster, and stronger. But from a horse breeding perspective, which is where a lot of the money comes from, I'd think that there should be huge demand for a fast filly: all mitochondria are maternally inherited, and mitochondria play a major role in energy production.

Certainly, there are benefits to having your breeding driven largely by males -- there's a much higher throughput if your impregnating rather than being impregnated. But having a proven dam passing on her mitochondria could give a substantial boost.

Friday, May 8, 2009

Hey, I know that place

I'm pretty sure today's View From Your Window on Sullivan's blog is my first home in Boston, Edgerton at MIT

Thursday, May 7, 2009

Manny being... on drugs

I don't have anything Manny-specific to say about today's story, but rather a general lament about athletes-caught-on-drugs. Why do they have to lie in their 'apologies'? Here's part of Manny's statement:
Recently I saw a physician for a personal health issue. He gave me a medication, not a steroid, which he thought was OK to give me.

Manny tested positive for a frickin' fertility drug... a drug given to women... to help them get pregnant. Now, maybe Manny is being nuanced to a Clintonian level, in that he perhaps did see a physician, and the medication he was given was not in fact a steroid, and the doctor did think it was okay to give him, in that it wouldn't violate his Hippopatamus Oath to do no harm. So that could all be true if you really parse it. He continues:
Unfortunately, the medication was banned under our drug policy. Under the policy that mistake is now my responsibility.

'Unfortunately' is when you have to sentence an innocent man to death because evidence exonerating him is inadmissable. 'Unfortunately' is not when you did steroids and were caught using a feminine hormone as a masking agent. Further, taking that drug is not 'now my responsibility' because of the policy, it is your responsibility because you f'ing put it in your mouth.

Now, I'm not under any illustion that Manny wrote that statement, and he probably hadn't even seen it before he said it (in fact, did he even speak the words, or was it just released as 'from Manny'?) Regardless of who wrote it, are we supposed to take this apology seriously? All it does is inspire even more cynicism. Just for the novelty of it I'd love to see a player come out and say, yes, I did it, and stop there.

Wednesday, May 6, 2009

WaPo & Specter

Washington Post runs an article today titled "Party Switch Costs Specter his Seniority on Senate Committees" by noting that Specter had been promised by Reid that he'd keep his seniority, but when it came down to a vote, he was actually given junior standing on several committees. From reading this article, you'd have no idea why the Democrats might possibly have stripped Specter of seniority, indeed, you'd probably think that they'd lied in in order to get Specter to switch. But we do get this "analysis":
Meanwhile, Specter backtracked yesterday from comments he made to the New York Times Magazine in an interview to be published Sunday. He had joked about how Norm Coleman of Minnesota could possibly win his legal contest and reclaim his Senate seat, ensuring that there would still be at least one Jewish Republican in the chamber.

Hmmm, joked? His quote implied that a Franken victory would be an injustice. Not really sure where the humor is in that. Now, I doubt that Specter's quote about wanting Coleman to win was the sole or even primary reason for stripping Specter of his seniority -- rather, I imagine that a lot of Senate Democrats did not want to stand in line behind someone who is only nominally committed to progressive legislation. But bad reporting by the Washington Post.

Tuesday, May 5, 2009

Shove a magic bullet up your arse

One of my least favorite people right now is Arlen Specter.  He's always been a pain in the ass with his 'centrism' (meaning, pissing off the entire population rather than just half with his incoherent positions from issue to issue).  For example, there's this:
In an interview with the New York Times Magazine, Sen. Arlen Specter (D-PA) said he hopes Norm Coleman (R) prevails in his Senate recount court fight against Al Franken (D) in Minnesota.

Said Specter: "There's still time for the Minnesota courts to do justice and declare Norm Coleman the winner."

Now, never mind the fact that Specter is now a Democrat, but what in the hell could he possibly mean by this? By what possible criteria would the Minnesota courts be unjust by declaring Franken the winner? Things were very close on election night, they did a recount, and Franken got more votes. And that's even ignoring the fact that Coleman's lawyering was far more active during the recount process, challenging far more ballots and generally asking the courts to deeply intervene in the process.

Arlen Specter is an ass.

Monday, May 4, 2009


I've got a secret: Ortiz is raking now. He's been swinging a good bat for the past week, and finally the ball is not headed directly for fielders. The ball will (eventually) leave the park, but he's absolutely smashing the ball right now.

Sunday, May 3, 2009

Hopefully wrong

I won't use the word 'beloved' to describe the color commentator for the Red Sox TV broadcast, Jerry Remy, but he's really good at what he does, and every time I have to hear Joe Buck or Tim McCarver or Joe Morgan or any of those other really crappy national guys do a Sox game, I long for the RemDawg.

Which is why I really hope my oncologist colleague is wrong. So Remy missed some time in February with pneumonia, and now he's back on the DL with another flare up. My doctor friend says this is likely to be caused by lung cancer, as back-to-back pneumonia would be extraordinarily rare. Essentially, he thinks there is a tumor blocking some of the small blood vessels, so there's this area where's nothing moving and thus it is easily infected. Remy was (is?) a smoker...

Again, I hope he's wrong.