Ne, niko sa Stanforda nije pronašao lek protiv raka, i zašto uopšte čitate dnevne novine?

Znam da je u Srbiji nešto postala vest kada mi u par dana na WhatsApp dođe isto pitanje od tri različite osobe koje međusobno ne komuniciraju. Obično se ispostavi da je neko sa polu-znanjem engleskom i potpunim neznanjem medicine probao da prevede nešto što je neko sa za nijansu većim znanjem oba napisao na osnovu nečijeg saopštenju za štampu.

Zato, malo uputstvo za tumačenje vesti o medicinskim istraživanjima:

  • Ako istraživanje nije na ljudima već na životinjama ili ćelijskim linijama, prestanite da čitate;
  • Ako je istraživanje na ljudima ali se spominju reči kao “retrospektivno”, “intervju”, ili “ishrana”, prestanite da čitate;
  • Ako vest o istraživanju dolazi sa konferencije za novinare a ne iz objavljenog rada, prestanite da čitate;
  • Ako osoba koja piše vest nije potpisana imenom i prezimenom i nema iskustva u pisanju o medicini i nauci, prestanite da čitate;
  • Ako u vesti nema komentara od lekara ili naučnika iz Srbije koji stavlja nova saznanja u kontekst srpske medicine, prestanite da čitate.

(svaka od ovih stavki zavređuje zaseban tekst, prve dve i nekoliko, ali život je kratak)

Bez konkretnih cifara, imam osećaj da je broj tekstova koje vredi čitati u dnevnim novinama i nedeljnicima o lepoti i zdravlju nula, a u malo ozbiljnijim nedeljnim i mesečnim listovima 1-2 godišnje. Što je samo za nijansu manje od broja objavljenih radova koji uopšte zavređuju pažnju laika.

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The Last Jedi 👊

Extraordinary set pieces strung together by the thinnest of plots, based on an absurd, sitcom-worthy failure to communicate. A particular subplot should have been spun off as a buddy cop movie.

The Ray-Luke-Kylo triangle should have been a bigger part of the movie, but then many of the new characters, the ones that aren’t white and/or men, would have nothing to do. Such are the problems of building on an old and popular franchise: you can’t both stay true to the roots and change with the times.

It has cute animals and looks good in 3D though, so Dora (5.4) approves.

Directed by Rian Johnson, 2017

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Kako je NATO bombardovanje postalo zgodan izgovor za sve zdravstvene probleme u Srba

Verujem da incidenca karcinoma u Srbiji raste, ali raste i svuda u svetu. Za to vreme:

  • Više od polovine odraslih građana puši, ostali udišu;
  • Vicevi o parceli za pijacu i parceli za ličnu upotrebu u srpskih seljaka pričaju su decenijama; siguran sam da je situacija sada bolja, pošto iza kvaliteta i čistoće hrane stoji jaka država (ha, ha);
  • Država kontroliše i ispravnost vozila na putu (uključujući emisije gasova), protok otpadnih voda, kvalitet zemljišta oko deponija; jeste li bili skoro u Pančevu?
  • Zemljom tutnje putujući mamogrami, svaki muškarac stariji od 50 zna svoj PSA, dok se kolonoskopije, Papa Nikolau testovi i CT pluća kod pušača — jedine tri skrining metode za koje je pokazano da smanjuju smrtnost — ne rade uopšte, ili sporadično;
  • Postoje vakcine koje smanjuju incidencu nekih karcinoma (hepatitis B, HPV) ali će vakcine izgleda biti sramna reč sve dok se dečija paraliza i male boginje ne vrate na velika vrata;
  • Fizička kultura je na nivou duhovne;
  • Kultura ishrane je još gora;
  • Kultura iskrenog razgovora o bolestima ne postoji, tako da ljudi još uvek imaju “najtežu bolest” i “ono najgore”, a umiru od “duge i teške bolesti”.

To samo za rak. A gde su srčane bolesti, šlogovi, dijabetes, i da li je i za njih kriv osiromašeni uranijum?

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What I believe that most people probably don’t (no data behind this, just the armchair)

The world in general, and the US in particular, is spending too much on goal-directed, targeted biomedical research while undervaluing both applied and theoretical physics. Picture Leonardo da Vinci drawing helicopters: that’s the modern-day cancer researcher. The universal cure for cancer — and there should be one, if humanity survives long enough to create it — will not come from an NIH grant. If grants are involved at all, it will be something initially funded by the National Science Foundation. The current system of funding (government, non-profit, biotech, you name it) is broken, and if you account for the opportunity cost it is a complete disaster. Each of these statements deserves at least a paragraph, but I am saving my carpal tunnels for a manuscript, an LOI, and a couple of protocols (oh, the irony).

In the meantime, a few things physician-scientists should do for the overall good:

  • find causes and create better prevention strategies, because a look at the SEER database will tell you that it’s not just bad luck;
  • eliminate barriers for administration of known curative therapies world-wide (do we really want to leave this to politicians and economists?);
  • ensure rapid and honest evaluation of the many new treatments, procedures, and diagnostic/prognostic methods coming out of the biomedical behemoth.

How beneficial any of this would be for one’s career is a different question altogether, but let’s not get into incentives because RSI. I am also very open to opposing opinions, since my being wrong would make my life easier.

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Brush up on your Serbian

Serbia’s public broadcaster, RTS (that’s PTC in cyrillic) has a good chunk of its archive spread across multiple YouTube channels, and it is magnificent (this one in particular).

Observe the 1960s-1990s televised plays and TV dramas. I still have vivid memories of watching one particular product the first time it aired, about a Serbian family keeping in touch with their ex-pat relatives in Germany via VHS tapes. Replace camcorders with smart phones and speed up the timeline to account for the internet, and it could have been shot today. Technology changes, people don’t.

My favorite childhood TV show hasn’t aged well at all; then again has anything from the ‘90s? If you consider most of it was made during a civil war and in a time of hyperinflation it is actually quite good. What was 90210’s excuse? Better kids’ shows have been made in Serbia both before and after.

Best for last: the celebration of hard core nerddom that is Serbia’s longest-running quiz show, important enough to have its own channel. It starts with anagrams and math problems, makes a detour to Mastermind, then finishes off with three different ways to test for trivia. Jokes about the autism spectrum would be writing themselves if this were an American show, but it’s not, and (before I left, at least) Serbian viewers still had some admiration for the participants. It is all very serious and competitive, and has been on the air every weekday for the last 24 years. (A political side-note: this does not mean Serbia is free from anti-intellectualism, quite the opposite in fact. Some combination of militant anti-intellectuals, gas-lighters, and proponents of economic/financial scientism has been in positions of power since the early 90s. There are no lessons here, just observations).

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A few unpopular (in certain circles) opinions from a person who has no rights having them

For better or worse, the American system of government is strong. Those who say otherwise have a financial interest in people thinking the opposite.

Culturally, US has more similarities with Iran than with Saudi Arabia, even if you count religion and religiosity as part of culture. The Christian right is working hard to make them even more similar.

Though still quite hard, it’s easier for a high-skilled immigrant to come to America than to any other country in the world. Comparison is even more favorable for low-skilled and unskilled immigrants. For all of them, quality of life, acceptance, and protection they get are better than anywhere else.

The randomness of the Green Card lottery process is a feature not a bug.

Reading the non-fiction sections of The New Yorker, The Atlantic, and whatever their conservative equivalents are, is good for generating fake insight but ultimately pointless. The Economist is useful for a tiny segment of the population but lets be real: if you’re reading this you are not it.

The only useful section in the daily newspapers is Local. Maybe Sports, if you are into that sort of thing, but professional and college sports are a scam so stick with the amateur leagues.

TSA agents and airline personnel are nice people but some passengers check out their brains at the curb and make everyone’s lives less pleasant.

Apple hardware products are underpriced for what you get but do you actually need what they offer? This doesn’t include the AirPods, which are the best thing Apple has made in the last 20 years and still underpriced; though they unfortunately resemble in both name and appearance a mind control method from Doctor Who S2 and paired with a smart phone are not far from it.

The world doesn’t need another IPA. America needs more tripels.

This is all coming from a non-immigrant resident alien with no expertise in politics, international law, transportation, or technology. I do know beer though.

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Voices in my head, 2018 edition

(voices as in podcasts, not a psychotic episodes)

  • Conversations with Tyler: I much prefer this over his mostly spartan, often cryptic, and always clueless about things medical blog Marginal revolution. Cowen‘s interview style brings out the best from people; it is also a good and rare example of clear thinking. Compare and contrast his chat with Malcolm Gladwell and Patrick Collison’s chat with Cowen: when answering, Gladwell uhms and ahhs and changes direction mid-sentence; Cowen pauses for a half-second, then produces paragraphs of prose that could have been lifted right out of an encyclopedia. Not to belittle Gladwell — for one, I’d be even worse (as anyone who had to finish my sentences for me can confirm); and two, he is responsible for
  • Revisionist history: He had me at Food Fight. Gladwell embraces and owns his Well, actually kind of story-telling — even the show’s name is a big Well, actually to the Gladwell-haters. And good for him, because the stories are marvelous in both topic and style, and make me want to read his books again.
  • Sources and methods: Two ex-spies talk about learning and cognition. They are still in intelligence-gathering mode, interviewing guests you‘re unlikely to hear anywhere else. It’s how I learned about Tinderbox (and you can too).
  • America the bilingual: One part pep-talk to encourage the pre-1990s waves of immigrants to America to take up a second language, one part advice to parents raising multilingual children. The latter validated my plan to ~~save money~~ strengthen the offspring’s Serbian by shipping them across the Atlantic to spend some quality time with the grandparents.
  • Novel targets: Finishing of the list of men talking to each other is the best oncology podcast I’ve come across. It may be heavily slanted towards immunotherapy, and not zealous enough in dampening the hype, but it tries.
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The hero with a thousand faces

What you do is you take as many fairy-tales and myths and other stories as you can — Campbell is extraordinarily good at collecting them — then squint and trace out the patterns. Us humans are very good at finding patterns where none exist (just ask Percival Lowell), so it is no wonder that we end up with an overarching story, albeit disjointed, which is — of course it is — steeped in New Age monism.

Plot twist: unlike similar attempts in other arts, this one becomes wildly successful, serving as a template for other stories that end up following it more closely than any of the tales of old ever did (see Kevin Garvey’s literal and metaphorical travails for the most recent example). I like The Leftovers, so I would say The Hero… is a net benefit for the civilization. It just wasn’t for me.

Full disclosure: I stopped reading the book near the end of the first (of two) sections, the one about The Hero’s Journey. I therefore never got to the Cosmogonic cycle, and cannot comment. Do let me know if there was a surprise ending.

Written by Joseph Campbell, 2008

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50/50 👍

An oncologist(?), a psychologist, and a surgeon give master classes on unprofessional behavior while treating JGL and his unfortunately named tumor. Even though only one of the three was meant to look bad in the movie, they each break a fundamental rule of the doctor-patient relationship: don’t be a douchebag, don’t sleep with the patient, don’t tell them everything will be fine when you have no clue. Cut out the profanities, and you’d have a semester’s worth of medical ethics discussions.

Cut out the profanities, though, and you’ll miss half the movie. Seth Rogen — a dirty old man trapped inside Fozzy the Bear — does what he’s been doing ever since Judd Apatow found him, heart of gold included. Fortunately, 50/50 has better timing than anything to come out from the Apatow cringe factory, and even has a point.

Medical miscellanea: was the diagnosing physician a medical oncologist, neurologist, neurosurgeon, or an orthopedic surgeon? Likely not the first, else he wouldn’t give neoadjuvant cytarabine for a sarcoma, and probably not the latter two since another, overoptimistic MD does the actual surgery. Can a psychologist perform interviews for what she admits will be her PhD thesis without getting informed consent? How can a surgeon say with any certainty that “everything will be fine” minutes after performing what she admitted to be a difficult operation for a tumor with a relapse rate north of 50%. You know, the 50% that gave the movie its name.

Still, thumbs up.

Directed by Jonathan Levine, 2011

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Doctor Strange 👎

Inception for the Disney Franchise Age of American cinema. Trying to be deliberately inoffensive to a particular class of consumer, it dodges Mickeydom’s most glorious moments of cultural sensitivity only to fall on the sword of blandness. But credit where it is due — it takes talent to make a trippy 60s comic book that’s oddly relevant in today’s world of magic mystery turmoil into a boring, predictable, dull, uninspired, yawn-inducing, delta wave-producing, paint-by-numbers origin story.

And if you thought only the Strange-ness was fumbled you must not be a doctor, because his day job features the most laughable medicine this side of the Human Centipede. Though I shouldn’t complain too much — I imagine aerospace engineers cringe an order of magnitude more when watching any other Marvel miracle.

Thumbs down.

Directed by Scott Derrickson, 2016

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