Never Learn to Stop Worrying and Love the Bomb

I don't know much about nuclear weapons, but having listened to a recent talk by former Secretary of Defense William Perry about the ongoing risk of nuclear conflict, I am primed, at the moment, for related subject matter to catch my eye. Of course, the United States is the only nation so far to have detonated a nuclear weapon in combat—over Hiroshima and Nagasaki in Japan during the closing stages of World War II. You can actually view color photos of the aftermath, which indicate both the reach and severity of the destruction.

Alex Wellerstein, a nuclear historian at the Stevens Institute of Technology, reminds us that the novelty of the atomic bomb was as much one of scale as it was of kind:

The atomic bombs used during World War II killed most of its victims by burning and crushing them — the classic medieval tortures, made wholesale by technology but not much more modern. (Only about 15-20% of the people at the cities died truly “modern” deaths, from the radiation effects.)

According to Perry, though, we lost sight of the threat posed by nuclear weapons after the Cold War ended, despite the fact that more countries than ever have access to the Bomb. He believes, contrary to the relative invisibility of the issue, that the risk has in fact never been higher, citing the potential for terrorist groups or other non-state actors to gain access via improvised devices or poorly monitored nuclear stockpiles.

The picture he paints in his talk is unnerving. Considering the existential threat that nuclear war poses, the mere hint of its possibility conjures goosebumps, not to mention the fact that, in 1983, the world really and truly found itself on the brink of nuclear war. For one, relations between the US and USSR were extremely contentious. Furthermore, many of us likely owe our lives to a Russian officer named Stanislov Petrov, who, in that same year, correctly identified not one but two false alarms thrown by the USSR's early warning system, which seemingly indicated incoming nuclear missiles.

Had he responded as if to a live attack…

So with this rattling around in my head, I was drawn to two datasets Jeremy Singer-Vine shared via his (I have just found out) excellent newsletter Data Is Plural. The graphic below uses data from the Stockholm International Peace Research Institute (SIPRI) on nuclear detonations between 1945 and 1998. This dataset was much cleaner than the Okalahoma Geological Survey's, the other set that Singer-Vine shared, which is why I chose to work with it.

According to SIPRI, atmospheric testing was banned via treaty in 1963, marking the end of such testing by the US, USSR, and the UK. (This ban extended to underwater and outer-space testing as well.) China and France ceased atmospheric tests a decade or so later. Therefore, much of what this map shows are underground tests. I highly recommend reading the SIPRI report, which has a plot of its own on page 9 summarizing the depths/heights of these explosions.

A few notes on the information contained in the graphic below:

  1. The SIPRI report indicates that 2052 detonations have occurred, while the dataset contained 2051 observations.
  2. Not all of these detonations were tied to military testing. Some were so-called "peaceful nuclear explosions" conducted for civil purposes (e.g., excavation, other research, etc.).
  3. The gap in the bar plot corresponds to a voluntary moratorium on nuclear testing observed by the US, USSR, and the UK between November 1958 and September 1961.
  4. I've corrected some errors in the dataset as well, in order to get the correct regional weights you see on the map. These refer to the number of detonations in a given region. Where latitude and longitude were missing (6 observations), I looked the region up on Google Maps and took coordinates from near the center of the marked area. The center of each circle is aligned with the average detonation latitude and longitude within the given region. (Had I left the latitude/longitudes at 0/0 for these 6 observations, they would have distorted the average coordinates in their respective regions, pulling the circles off-target. For the purposes of the map, the exact detonation locations are not crucial.)
  5. The colors shown apply to both the bar plot and the map.

nukes_weight_2016-04-17

The image above is in SVG format, and I can't get the bottom legend to render quite right in this format, for whatever reason, but here is a PNG in case you want to share it. I just ask that you link back to this post.

For a truly breathtaking visualization of our nuclear history, check out this animation by Isao Hashimoto, which charts very similar information to that shown above but accounts for the time between detonations.

Since 1992, the US has voluntarily imposed a moratorium on its own nuclear weapons testing, and in 1996 the UN General Assembly adopted the Comprehensive Test Ban Treaty (CTBT). The SIPRI report had this to say in 1998 regarding the treaty (emphasis mine):

The treaty bans only actual physical explosions, not subcritical tests or computer-simulated tests. This means that even after entry into force of the complete ban, the nuclear powers will be permitted to verify the safety and reliability of their nuclear weapon arsenals. Moreover, in the opinion of experts, the CTBT cannot prevent any state aspiring for nuclear status from constructing, without explosive testing, a small arsenal of fission weapons, and doing so with some degree of certainty that the weapons will perform as envisaged. It is, however, considerably more difficult to develop thermonuclear weapons without test explosions.

As of 2015, according to the Wikipedia entry, eight more states must sign and ratify the CTBT before it can take effect, including the United States, who has signed but not yet ratified.

Stephen Curry's Historic Season: Updated

Earlier in the 2015-16 NBA season, I took a look at how Curry's year was stacking up against some of the best in NBA history, a list which, naturally, included luminaries like Michael Jordan and LeBron James. (Kobe Bryant, however, did not make the cut, and you can read why I left out Wilt Chamberlain and Kareem Abdul Jabaar, both of whom certainly belong in the conversation.) See the original post for what went into the plots. Curry's astronomical numbers tapered off a bit throughout the course of the Golden State Warriors' record-breaking run of 73 wins and 9 losses, beating my beloved Chicago Bulls' 1995-96 mark of 72-10, but I think it's fair to say he had a year unlike any other—a truly unique and heretofore unfathomable player.

To say the least, the Warriors season has been remarkable and, if they romp through the playoffs like I suspect they might, they will have earned their stripes as the greatest team of all time. Likewise, Curry solidly has put his mark on the league and on the record books. He hit over 400—4 fucking hundred—three-pointers this year, which puts him so far above the previous record (his own) that calling it "rare air" would seem like a gross understatement.

I'm not going to say much, because I think these plots tell enough of the story, as muddled as they are. All data is from Basketball-Reference.com.

per_game_full_season

Curry's main competitors here are a shooting guard and a small forward, so it's no surprise to see his blocks and rebounds per game a bit lower. He did finish the season averaging 30.1 points per game and played fewer minutes per game than anyone on this list, which is worth considering.

standard_per_full_season

Remember that Jordan's 1995-96 three-point percentage can be solely attributed to the line having been moved in for those two years. With that in mind, Curry, obviously, is in a league of his own when it comes to shooting, which is also born out by his effective field goal percentage. I think we can agree, though, that LeBron had a pretty good year in 2012-13.

Rplot

This group of measures looks a little less'favorable for Curry. He is clearly the best offensive player of the bunch (yes, including Jordan), but, while he logged more than 2 steals per game, his defensive box plus-minus remains pretty abysmal compared to the others, with the exception of Durant. All this equates to a wash in the overall measure when comparing him to Jordan and LeBron.

advanced_full_season

The advanced stats make a pretty good case, if we needed one, for this one being among the top seasons. Curry's PER and WS/48 are right up there with the best of them. You might nick him for his VORP, even though he led the league this year. I suspect the fact that he played fewer minutes per game depressed his score a bit, but with the Warriors so stacked, I'm not sure how relevant the VORP is when comparing seasons like this. (Special pleading?)

Anyway, this year was something else.

What in God's Holy Name Are You [Economists] Blathering About?

My Saturday afternoons are productive. If I'm not dicking around on Facebook, I'm dicking around on Twitter. And, like any truly productive person, I bemoan constantly that I have but a few precious few seconds available to get any work done…

So it was this afternoon, when I came across a lovely little tweetstorm from Noah Smith illustrating why it is sometimes so hard for people to talk about economics or to understand what economists themselves are talking about. If you're like me, you have a passing interest in econ, and you may have even learned enough vocabulary to trick yourself into thinking you know a thing or two. Likewise, despite this familiarity, you may also secretly wrestle with the suspicion that, no, you do not understand in any substantive, non-abstract way what is being argued.

For my part, I remain relatively agnostic about most of the hot-button issues (e.g., minimum wage, free trade, etc.), as I feel unable to evaluate competing claims. Often, I feel quite lost.

Like this:

blathering

At any rate, maybe I'm an econ nincompoop, but I get the sense that, if that's the case, so are most of the other layfolk yelling about this or that system, this or that intervention… you know how it goes: Bernie Sanders tweets out some labor statistics and now you've got a PhD.

Ultimately, it takes a significant investment—of time, of work, and of thought—to really understand the forces in play, and sometimes the bramble of jargon represents an impediment to entering the weeds, which is not necessarily unique to economics as a discipline.

Without further adieu, though, the tweetstorm:

Just thought I'd share since this gave me a chuckle.

Okay, back to "work".

Yes, I Am a Snob

I was born for this
I was born to hustle roses down the avenues of the dead.
Charles Bukowski, "Consummation of Grief"

A friend of mine sent an article to me today [months ago now], requesting my feedback. He will be getting a link to this blogpost in reciprocation, and I should mention—for his benefit, primarily—that I take his solicitation of my opinion as a sort of backward compliment. It's not my input he wanted, you see. Not in the least. Rather, I suspect I stand accused of cultural snobbishness. I am supposed to see something of myself in Jonathan Jones, the maligned Guardian writer this piece from the Paris Review takes to task for delighting in the ebullient flexing of his own literary sphincter, employed in an attempt to filter out the noise of "middlebrow" culture misconstrued as genius.

I have not read the offending Jones piece, nor do I care to (this should strike you as "ironic" in a short while and, hopefully, in the spirit of the current fracas). My comments will focus only on the meta-commentary that my friend lobbed like a grenade into my inbox today. In it, Dan Piepenbring mourns Jones's hit piece on Terry Pratchett, in which the latter op-ed scribe bemoans the exaltation of Pratchett as a "literary genius". I've never read Discworld myself, Pratchett's famous and popular science fiction series; neither has Jones, which, Piepenbring says, makes Jones's a purely rhetorical, rather than reasoned, screed. Piepenbring illustrates the phenomenon with this incisive diagnosis of the exhibited cultural malady:

Granted, there’s nothing quiet about Jones’s not-reading. Not all of us, thankfully, have the gall to write a piece blasting our favorite not-reads, but all of us harbor, somewhere, a list of those toward which we feel an inexplicable animus. At the top of my list, ironically enough, is Charles Bukowski, who Jones singles out as “a voice from hell with the talent of an angel.” I have for many years now actively enjoyed not reading Charles Bukowski. I want to say with conviction that Bukowski is not so much a voice from hell as a voice from Hell-Lite™, a kind of flimsy, adolescent imitation of true misanthropy—but I have no evidence to furnish in my case against him. How could I? I’ve never read him. All I know is that I’ve listened to a tepid Modest Mouse song about him; I have spoken to a stranger at a bar who told me she’d “snort his words off the page,” if she could; and I’ve sneered at the cover of Ham on Rye in a Park Slope Barnes and Noble. If you asked me to mount a cogent defense of my antipathy, I’d have to say something pretentious like “I find his role in the culture banal.”

Leaving aside the fact that Piepenbring is undoubtedly right, and wrong, about Charles Bukowski, his comments are spot on, and hardly limited to literature. In the spirit of openness, therefore, here is a short list of selected popular media I will (probably) not consume, for my own irrational and elitist reasons.

  • Neil Gaiman
  • David Foster Wallace
    • Disclosure: I think I may have read "Consider the Lobster", and liked it.
  • The Harry Potter series of books
  • Ernest Hemingway (DGAF)
    • Disclosure: I read "Hills Like White Elephants" and enjoyed it also.
  • Mad Men
  • Jacques Lacan (I'm pretty sure about this one)
  • Jonathan Franzen
  • Marvel Universe
  • Selected Joss Whedon (minus Firefly)
  • Jack Kerouac
    • Disclosure: I've read 60 pages of On the Road and 60 pages of Dharma Bums. Not impressed.
  • Parks and Recreation
  • Bruno Latour

This is not an exhaustive list, and I reserve the right to go back on my word at any time. Notably, I've also kept off those atrocities I have imbibed yet which, despite their being atrocities — or simply not nearly as good as everyone says, e.g., Inception—people seem to regard as watershed achievements of human culture. I'm a little surprised I can't do better than this, to be honest, considering all the shit I get for being a dismissive naysayer.

Life, alas, is too short not to filter mercilessly and pre-emptively. At least, that's one way to rationalize one's own insularity.

Is Stephen Curry Having the Greatest NBA Season of All Time?

Anyone with an inkling of interest in NBA basketball will have learned by now that the Golden State Warriors are having a historic season. At the time of this writing, they are 24-1 and will very likely threaten the 1995–96 Chicago Bulls' record of 72-10. That team was helmed by Michael Jordan and basically ruined me as a basketball fan in childhood. Anyone who remembers being a Bulls fan as a kid likely recalls the air of inevitability that hung around each of those championship teams, especially the 1996 squad.

Yet the Warriors may have a shot at being the best team of all time, and in the midst of this out-and-out steamroll, their point guard, Stephen Curry, may be having the best single player season in NBA history. FiveThirtyEight has a great piece on how novel Curry's own brand of greatness is, and I highly recommend you go read that prior to continuing this post.

Personally, I was curious to see how Curry's stacks up against the greatest seasons of all time. Watching him it seems obvious—and I don't usually fall back on intuition in basketball—that we have never seen anyone shoot the way he does. I will not be surprised in the least, provided his continued good health, if he goes down as the greatest shooter ever. It won't even be close. But is he Jordan or LeBron good?

I deliberated a bit about what to use as the primary criterion for selecting the best seasons and eventually settled on Win Shares per 48 Minutes (WS/48). For one, I suspect PER overvalues shooters, whether or not they are efficient, and two, while Win Shares are commonly touted as one of the better metrics, I needed to use a rate statistic for comparison, because Curry has not yet played a full season and hence will not have had the opportunity to accrue enough Win Shares to put him in the top 10.

To get my final dataset, I pulled the top 9 WS/48 for point guards (PG), shooting guards (SG), and small forwards (SF) from Basketball-Reference.com (NBA/ABA combined), reasoning that power forwards and centers do not make for informative comparisons with a point guard, and then I added Curry's 2015–16 season to the list. The top 4 WS/48 spots, for the record, are split between Kareem Abdul-Jabbar (ranked 1, 2, and 4) and Wilt Chamberlain (3), who were both centers. LeBron James is the first PG/SG/SF to appear on the list, taking the 5th spot. In all, four players were included in my dataset: Stephen Curry, Michael Jordan, LeBron James, and Kevin Durant.

The plots below compare standard per game statistics for each player, standard percentages, and two sets of advanced/semi-advanced statistics. For the purposes of comparison, I would concentrate less on per game statistics and more on percentages and advanced stats, which will provide a much better idea about how Curry stacks up relative to the other players. I color coded the bars by each player's team to assist a bit in looking at individual seasons across statistics, and all of Curry's stats are through the first 22 games of the 2015–16 season.

pergame

Click for full-size image

Like I said, per game statistics can be misleading, but note here that Curry is playing fewer minutes than everyone else on the list, which depresses some of his per game averages relative to the other players. We also would not expect him to block many shots as a point guard. Even if we did, it should be mentioned that Jordan was the best shot-blocking guard of all time.

Click for full-size image

Click for full-size image

The second plot speaks for itself. Curry is easily having the best shooting season of the bunch, as his effective field goal percentage dwarfs those of his rivals. In fact, Jordan looks a little better on this chart than he should. Never a good three-point shooter, he logged his approximately 43% mark in 1995-96 because the NBA moved the three-point line in by over a foot, a change that persisted from 1994 through 1997 before the league switched back to the previous distance.

Offensively, Curry again outshines the others—no one appears to be in his league. Likewise, though, his overall box plus-minus remains comparable to the others' due to his apparent defensive deficit.

Click for full-size image

Click for full-size image

And finally, we get to what brought us here in the first place. Curry again dwarfs the rest as measured by WS/48, for which the league average is typically around .100. Furthermore, despite what I said about PER, it is still considered one of the better overall measures of a player's performance, and Curry's 2015-16 sits atop the greats here as well.

"Wait," you might say. "What about Value Over Replacement Player?"

Well, not so fast. Here is the equation for VORP, where BPM stands for box plus-minus:

(BPM - (-2.0)) \times (\% \text{ of minutes played}) \times \frac{\text{team games}}{82}

As you can see, that last term in the equation makes the VORPs incomparable until this season is in the books. For the record, at the time of this writing, Curry leads the league this with a VORP of 3.1. Russell Westrbook is second at 2.8.

In the end, the conclusion isn't very surprising: Curry is having a truly special season. If he continues at pace, he will have dominated the league in a fashion no one has ever done, and if you're not convinced that he could ever eclipse Jordan or LeBron, even for a single season, you will have to at least put him in the same conversation.

Side Note: I've been giving Kobe Bryant a hard time recently. He's a great player, but he is not in the same league as Michael Jordan, as folks have been fond of claiming. In fact, in case you were wondering why he was absent from this post, Bryant doesn't show up until #217 on the NBA/ABA list for WS/48. I may do a similar comparison between him, Jordan, and LeBron, and I am confident that we'll all see James is the real threat to Jordan's legacy as the GOAT. If you look at their stats here, Jordan and LeBron appear to be pretty close in skill and value.

2016 Presidential Candidates' Facebook and Twitter Followings

Yeah, so, I'm not really certain why I took the time to do this. If there is one thing I patently don't give a fuck about right now, it's presidential politics. Still, I need excuses to mess around with ggplot2 theming, relative neophyte that I am.

A couple of notes about the chart. First, I tried to use campaign feeds where possible, but stuck with verified feeds in all cases save one: while gathering the data, I wasn't able to find Lawrence Lessig's official campaign Facebook feed. His numbers come from the automatically generated page based on his Wikipedia entry. (If anyone finds an official page that isn't for his foundation, let me know.) I should also note that both Rand Paul and Bernie Sanders have sizable (or larger) followings on their personal/professional accounts.

Second, Twitter counts were rounded (e.g., 56.8 for 56,800; 1.5 for 1,500,000), while Facebook counts were continuous. I just snagged the numbers right off the respective sites. This shouldn't make much difference with regard to the graph.

I admit, considering the reputation he has for social networking savvy—not to mention the frequency with which his Twitter feed appears to be cited in the press—I was a little surprised to see such modest numbers for Bernie Sanders. Joe Biden's numbers also seem a little light to me. Continue reading

Quick-and-Dirty Antibiotic Resistance Cheat Sheet

Spurred by a post over at BioMed Central blogs, which outlined challenges in effectively communicating to non-experts the risk of antimicrobial resistance, I decided to put together a little resistance cheat sheet for my mother, the legions of fans who read this blog, or at least the handful of folks who might see this on Facebook. This is by no means an in-depth list, nor does it cover every area of interest (e.g., farm use of antibiotics in livestock). It's meant to provide a quick-and-dirty back-of-the-hand reference of the broad strokes.

What is antibiotic resistance?

When a given drug, in this case an antibiotic, is effective at killing a certain strain of bacteria, that bacteria is considered susceptible to the drugWhen the bacteria evolves such that the drug is no longer effective against it, or becomes less effective, that bacteria is considered resistant. 

Synonyms for antibiotic resistance:

  • Antimicrobial resistance (AMR)
    • This is a broader term that refers to resistance against drugs used to treat other microbes, like viruses
  • Drug resistance
  • Superbug (refers to highly resistant bacteria)

What do antibiotics treat?

Bacteria! That's it.

What do patients do in order to make the problem worse?

(Or, worded more positively: Things you can avoid doing in order to help!)

  1. Don't take the full course
  2. Take the drugs inconsistently
  3. Share antibiotics
  4. Pressure doctors to prescribe antibiotics, even for viral infections

You can actually create an antibiotic-resistant strain by failing to take a full course of drugs. In essence, say you come down with an infection that is susceptible to drugs, but you only take half the course. By doing that, you may have allowed some of the hardier bacteria to survive. This subset of organisms will then continue to reproduce, eventually creating a population of bacteria that is less susceptible to the drug you're on.

Why is resistance bad or worrisome?

  1. Bacteria that are resistant to antibiotics are more difficult to treat.
  2. Your risk of serious, or even catastrophic, infection increases.
  3. Bacteria can share their resistance genes with other bacteria, even across species.
  4. Antibiotics are required for all sorts of procedures, such as surgery. The more resistance that emerges, the greater the chances are that in the coming years it will be took risky to do even simple operations.
MRSA (yellow) being ingested by neutrophil (purple). Photo Source: National Institute of Allergy and Infectious Diseases (NIAID).

MRSA (yellow) being ingested by neutrophil (purple). Photo Source: National Institute of Allergy and Infectious Diseases (NIAID).

What are some of the most worrying antibiotic-resistant bacteria?

CRE (Carbapenem-resistant enterobacteriaceae)

A strain of this bacteria caused a deadly outbreak in an Illinois hospital last year. Most of these infections are hospital-acquired, often through endoscopic procedures when the scope has not been cleaned properly.

MRSA (Methicillicin-resistant Staphylococcus aureus)

You may have heard of MRSA before. That's partly because staph is incredibly common: about 33% of people are non-symptomatic carriers, and something like 2–3% are carrying MRSA at any given time. However, MRSA has been making news over the past several years because what was once a primarily hospital-based infection has increasingly caused what are called "community-acquired" MRSA infections — infections picked up outside the hospital.

Tuberculosis

That's right. While you may know it because you read Angela's Ashes in high school, TB is still with us and gaining resistance to the antibiotics used to treat it. It is a much larger problem in certain populations, such as the homeless, and in developing countries. Resistant TB strains can be classified as "multidrug-resistant" (MDR) or "extensively drug-resistant" (XDR) when certain classes of drugs are no longer effective against a given strain.

Gonorrhea

The bacteria that causes gonorrhea (Neisseria gonorrhoeae) garners resistance quickly, and we may be approaching an era of untreatable gonococcal infections. Currently, the Centers for Disease Control and Prevention (CDC) run a program called the Gonococcal Isolate Surveillance Project (GISP, for short), which monitors the emergence of resistant gonorrhea strains around the United States. Physicians and public health experts have had to continually revise treatment protocols over the past 30 years in order to maintain the effectiveness of antibiotics currently in use.

Tip of the iceberg

There are other issues not directly related to patient behavior, but there are a few things you (and I) can do to help. If you want to know a little more about antimicrobial resistance in general, refer to entities like the World Health Organization or the CDC.

GameScore and the 2014–15 NBA MVP Candidates

If you're a basketball fan — particularly an NBA fan — you've undoubtedly heard by now that the Golden State Warriors point guard Stephen Curry won this year's MVP award. The only other real contender was James Harden of the Houston Rockets, but also in the mix were LeBron James (as usual), Anthony Davis, and Russell Westbrook. Personally, I think Curry was the right pick, but no one could have argued all that bitterly had Harden won.

Needing to learn a little R, though, and inspired by a series of density charts looking at the game-by-game distribution of QB ratings for NFL quarterbacks, I decided to look at the distribution of GameScores (GmSc) among the top 5 MVP candidates for this year's NBA season. GmSc is based on John Hollinger's Player Efficiency Rating statistic, and while it has its problems, namely overvaluing scoring, it's good enough for my own modest purposes. The equation for GmSc is as follows:

GmSc = PTS + 0.4 \times FG - 0.7 \times FGA - 0.4 \times (FTA - FT) + 0.7 \times ORB + 0.3 \times DRB + STL + 0.7 \times AST + 0.7 \times BLK - 0.4 \times PF - TOV

The statistic is standardized so that a GmSc of 10 represents an average game.

The plots below were created using the ggplot2 package, which, as a n00b, I'm a fan of for its simplicity and the beauty of its graphical outputs. Continue reading

No Big Deal, Vaccines Have Just Almost Eliminated Polio

Vaccines are the best. Seriously, the first thing you would ever ask for — if charged with eradicating or decreasing the incidence of a given disease — is an effective vaccine against it, which makes anti-vaccination movements all the more perplexing, and vexing. Plenty have written about what fuels some of this animus: distrust of the medical establishment, ignorance about risk-benefit calculations, and general suspicion of the pharmaceutical industry. Yet, what makes some of these narratives occasionally difficult to refute convincingly are the nuggets of truth they sometimes contain.

For instance, vaccines can and do cause serious adverse effects, in very rare cases for the most part. Remaining vigilant about those risks is important, but so is the utilitarian concern that weighs the benefits (in lives saved or illnesses prevented) against the risks (in deaths, neurologic problems, and other adverse effects). In the vast majority of cases, that comparison works out overwhelmingly in favor of immunization as a category, even as the efficacy and risk profile varies depending on the vaccine.

This physical therapist is assisting two polio-stricken children holding on to a rail while they exercise their lower limbs.

This physical therapist is assisting two polio-stricken children holding on to a rail while they exercise their lower limbs. In the early 1950s there were more than 20,000 cases of polio each year. After the polio vaccination was introduced in 1955 that figure dropped to about 3,000 per year by 1960.
Image and Caption: CDC/Charles Farmer, ID# 2612

Today, for World Polio Day, the World Health Organization (WHO) posted a short informational page on poliomyelitis, a highly infectious disease that results in lower limb paralysis in a number of those who contract it (about 1 in 200). Once a common infection, vaccines have drastically reduced the burden of polio in both the developed and developing worlds.

The WHO:

Polio cases have decreased by over 99% since 1988, from an estimated 350,000 cases in more than 125 endemic countries then, to 416 reported cases in 2013. These included only 160 cases in endemic countries; international spread from endemic areas into polio-free areas accounted for the remainder.

In 2014, only parts of 3 countries in the world remain endemic for the disease–the smallest geographic area in history. Of the 3 strains of wild poliovirus (type 1, type 2, and type 3), wild poliovirus type 2 was eradicated in 1999 and case numbers of wild poliovirus type 3 are down to the lowest-ever levels with the no cases reported since November 2012 from Nigeria.

However, the oral polio vaccine contains a weakened strain of the virus itself, which can in rare instances lead to the establishment of a new circulating strain. As I learned today, this is referred to as vaccine-derived polio. Interested in the burden of such cases, I looked it up and came across a beautiful illustration of the risk-benefit issue. Again we turn to the WHO, this time to their Question & Answer on vaccine-derived polio:

When a child is immunized with OPV [oral polio vaccine], the weakened vaccine-virus replicates in the intestine for a limited period, thereby developing immunity by building up antibodies. During this time, the vaccine-virus is also excreted. In areas of inadequate sanitation, this excreted vaccine-virus can spread in the immediate community (and this can offer protection to other children through ‘passive’ immunization), before eventually dying out.

On rare occasions, if a population is seriously under-immunized, an excreted vaccine-virus can continue to circulate for an extended period of time. The longer it is allowed to survive, the more genetic changes it undergoes. In very rare instances, the vaccine-virus can genetically change into a form that can paralyse – this is what is known as a circulating vaccine-derived poliovirus (cVDPV).

How often does this happen? According to their Q&A:

Since 2000, more than 10 billion doses of OPV have been administered to nearly 3 billion children worldwide. As a result, more than 10 million cases of polio have been prevented, and the disease has been reduced by more than 99%. During that time, 20 cVDPV outbreaks occurred in 20 countries, resulting in 758 VDPV [vaccine-derived polio virus] cases.

Do that math.

 

Update (10/24): I should have been a little more precise in my wording. Polio infections have been eliminated in many areas, while eradication may remain a ways off. For a brief discussion of the obstacles still standing in the way of full eradication, I point you to this editorial in the Lancet. I have updated the title of this post to reflect what I think is a better approximation of the situation, but this page on disease elimination and eradication from the Centers for Disease Control and Prevention (CDC) discusses some of the ambiguities between the terms.

End Times Jabberwocky Blues

Making fun of religion somewhat bores me these days. The beliefs are silly on their faces, yes, but so too are some of the histrionics of over-caffeinated atheists, in which I see plenty of past reflections of myself.

Every now and then, though, I hear something that fills me with terror. Of course I realize people are saying crazy shit constantly, but when you hear it, sometimes, the delusion required to spout this nonsense without a hint of irony comes into stark relief.

Take the other day, for example. While driving, I accidentally flipped to the second tier of FM stations on my radio, which I have neglected to program. By some fortuitous fluke, Moody Bible Radio makes its home there, and I left it on because someone was reading from the Book of Revelation, which, whether you're religious or not, is a fantastic piece of mythology.

The Great Red Dragon and the Woman Clothed with the Sun (1805–1810), William Blake

The Great Red Dragon and the Woman Clothed with the Sun (1805–1810), William Blake
Licensing information: Wikipedia

When the reading finished, the host came on, the rapture in her voice unmistakable, feigned or not. (You never can tell with radio or TV Christians.) Proceeding, she spoke these words: "That's going to be amazing. And it's all really going to happen. Every promise He made, He's going to keep."

Thankfully, I was stopped at a light, so I did what I try never to do anymore: I got out my phone and recorded a voice note so that I'd remember. In fact, I'd forgotten, and just came across it again in Google Keep, so despite that quote being slightly paraphrased, I am sure it's very close to her exact words.

All the jabberwocky that followed — an interview with a pastor, whom the host was very careful to refer to as "Doctor," constantly, about whether the end times will truly result in mass slaughter at the hands of God — was just as batshit, sure, but my heart had already sunk. Religious people shouldn't be defined by the extreme contingents of their cultural groups, yet both Christianity and Islam seem to produce a non-negligible number of agitators (and worse) who sincerely attempt to promote and proliferate radical agendas fueled by religious conviction. Saying so should be uncontroversial by now. We see it here. We see it around the world.

If anything, this is just a little sidenote to the recent dust-up involving Bill Maher, Ben Affleck, and Sam Harris, all of whom are rather boorish in their own right when it comes to hawking politics. While I didn't watch their argument — because who needs that? — I waded into the churning waters that developed and, luckily, found a modicum of sanity somewhere within the bitter and predictable divide.

Treat an anecdote as an anecdote. Every once in awhile, though, I think it's okay to let your jaw go slack with astonishment, even if you didn't learn anything you didn't know already.

The ALS Ice Bucket Challenge: Money, Water, and the Social Game

Full disclosure: I did donate to the ALS (Amyotrophic Lateral Sclerosis) Association. It wasn't much, but it was a good cause, even if my reasons for doing so were partially irrational. On one hand, I thought, I'll enhance a small donation a bit because an offer to match was available [rational], but I am not doing so with due diligence, based on information about the disease or the charity [irrational], though I did head to Charity Navigator afterward to check them out, and I did already know about ALS. Furthermore, I fully anticipated being nominated for the Ice Bucket Challenge eventually, so somewhere deep down in my icky stuff I probably thought, hey, this insulates me from the inevitable inner conflict when I am finally implicated. Someone would get around to it, surely, and lo and behold, someone did—a close friend of mine, who also happened to make a pretty hilarious video out of his own Challenge. (He actually anticipated my discomfort, and cited it in his video as the reason for my nomination. I have some respect for this sort of trolling.)

But there is something that doesn't smell right. If it were simply the contrarian impulses that sit in my bowels, I'd be inclined to let the matter go without much more thought. On one hand, I do resent that a person can so easily be made to look like a heartless bastard, simply by not participating in a popular trend or meme, for charity or otherwise. In addition, I don't think we can ignore the oddity of wasting so much water—a back-of-the-envelope calculation by a Washington Post blogger estimates that 5 million gallons have been dumped—or the fact that by pouring ice water over your head you purportedly signal that you'd actually rather give less than the $100 "penalty" assessed in the event of refusal. Granted, many or most people just do both.

Besides the social pressure, though, one might also suggest those partaking in the Challenge are doing so out of sound self-interested decision-making: a person can mitigate both their financial and social losses.

More on that later.

You can, of course, donate whatever the hell you want, whether you decide to freeze your ass off or not. Explicitly calling on others by name to do so, however, puts undue pressure on that person for a number of reasons, not the least of which is that you have no clue what their financial situation might be.

Addressing practical considerations, Vox has an excellent piece about why donating to charity based on viral memes isn't a great idea—namely, because that sort of donation leads to inefficient allocation of resources—and I highly recommend you read this one to get an idea of the health burdens created by various diseases in comparison to ALS. The ALS Association is now going to have to figure out now how to use the unprecedented influx of cash, more than $20 million as of this writing, and I sincerely hope it is allocated well in order to support new and exciting research efforts. I really do. The fact that ALS affects such a small number of people, it should be stressed, does not make studying it worthless, nor should we fail to recognize those who have it. They deserve the hope and awareness that this Challenge, in its best iterations, provides. Neither is it heartless, though, to take utilitarian concerns into consideration, as I've seen suggested among acquaintances. Millions of people die every year from malaria, heart disease, lack of access to sanitary water, and a host of other causes. Something tells me Ice Bucketers won't be infusing charities that address those problems with loads of cash, despite the fact that the life-per-dollar ratio is undoubtedly much higher. This, from the Vox article's quoting of William MacAskill, illustrates the reasoning [emphasis mine]:

If you're concerned about the latter [maximizing impact], he suggested giving to diseases that impact the developing world. As a rule, he explained, "donating money to the best developing world health charities will reach at least 100 times as many people than if you donate to developed world health causes." For example, consider the potential public-health impact of your dollars spent, using a measure of disease burden like the quality-adjusted life year. With ALS, he said that $56,000 would provide one quality-adjusted life to a sufferer. On the other hand, he said, "the same amount of money could provide 500 quality-adjusted life years if you give money to bed nets for malaria."

"People can get upset when you say some causes are more effective than others. That's not true, because it's as tragic for someone to die of ALS as it is for someone to die of malaria. But wanting to respect and honor a particular tragedy is different from trying to help as many people as you can."

Also, while most Challenge videos do cite the reason for the stunt, some do not. In case your feeds have been replete with less-than-explicit explanations for why this challenge is going on (ignoring its real roots), please at least read the following passage entitled "What is ALS?" from the ALS Association's website:

Amyotrophic lateral sclerosis (ALS), often referred to as "Lou Gehrig's Disease," is a progressive neurodegenerative disease that affects nerve cells in the brain and the spinal cord. Motor neurons reach from the brain to the spinal cord and from the spinal cord to the muscles throughout the body. The progressive degeneration of the motor neurons in ALS eventually leads to their death. When the motor neurons die, the ability of the brain to initiate and control muscle movement is lost. With voluntary muscle action progressively affected, patients in the later stages of the disease may become totally paralyzed.

A-myo-trophic comes from the Greek language. "A" means no or negative. "Myo" refers to muscle, and "Trophic" means nourishment–"No muscle nourishment." When a muscle has no nourishment, it "atrophies" or wastes away. "Lateral" identifies the areas in a person's spinal cord where portions of the nerve cells that signal and control the muscles are located. As this area degenerates it leads to scarring or hardening ("sclerosis") in the region.

As motor neurons degenerate, they can no longer send impulses to the muscle fibers that normally result in muscle movement. Early symptoms of ALS often include increasing muscle weakness, especially involving the arms and legs, speech, swallowing or breathing. When muscles no longer receive the messages from the motor neurons that they require to function, the muscles begin to atrophy (become smaller). Limbs begin to look "thinner" as muscle tissue atrophies.

If you want a really thoughtful post about the social game involved, look no further than the Google+ post below. Before you read it, though, let me stress once again that donating to support ALS research or work on other rare diseases is important. I am certainly not trying to discourage people from giving generously to causes they feel strongly about. More people should give to charity more often, myself included.


ALS is a horrible illness that I cannot myself fathom going through. I feel for those who have it, and I do sincerely hope that these dollars, however wrought, will succeed in pushing ALS research forward. In the meantime, I will also suggest that you donate to a charity I support because of the fantastic work they do across the world in bringing basic medical services to dangerous and poverty-stricken parts of the world: Medecins Sans Frontieres / Doctors Without Borders.


Support Doctors Without Borders

All of the inevitable points and counterpoints have been bandied about, I know. Such are the social media cycles that revolve around hot topics, so if you made it to the end of this one, I thank you.

It's... Monty Python's Final Circus

Sex. Sex, sex, sex... er, Python. That's it. That's what's been gnawing at me since Sunday, since I watched the living members of Monty Python bid us all adieu once and for all. Bleedin' demised, they've gone to meet the Choir Invisible, and in the end, fittingly, they sang. As Eric Idle strummed his guitar, leading the Pythons and the rest of the audience in one final rendition of "Always Look on the Bright Side of Life," I sang with them. I don't usually join in, but there was something beautiful about it this time—the last time the group would perform together, beamed out across the world, everyone singing. Why not?

The final performance of their 10-show run at the O2 Arena in London was uneven in terms of the comedy, even lazy at times. It felt part of the charm, though. John Cleese impugned Terry Jones onstage, the latter having forgotten his lines in the Crunchy Frog sketch despite reading them right off the back of a card made up to look like a Whizzo Chocolate Company product guide. Lines, remember, that tens of thousands of adoring fans have known by heart now for decades. Perhaps it would be more accurate to say he lost his place.

Michael Palin, long my favorite of the bunch, lacked the naive buzz he emanated as the accountant cum lion tamer during the original Flying Circus broadcast of the Lion Tamer sketch, but made up for it with decent reenactments of Argument Clinic and the Dead Parrot. Terry Gilliam filled in around the edges with his insanely wide smile, making cartoon faces all the while and playing the only Gumby of the evening. Carol Cleveland danced and played the supporting roles she was known for on the television show, but I would have loved to have seen her do a Zoot bit, which, in retrospect, I'm surprised was never referenced. Standouts like Architect Sketch and Dirty Fork, two of Cleese's finest meltdowns—seriously, there is nothing funnier than listening to him scream at someone—and the hilariously absurd Silly Job Interview were notably absent, but what are you going to do? Let the fans select from a menu?

Monty Python Live (Mostly)

In all, Python sent us a farewell card, packed with greatest hits and a few musical numbers arranged by Eric Idle. Cleese will get to pay off his alimony, and the fans were left with a retrospective and the somewhat surreal experience of watching the finest television comedy troupe of all time wink at them over forty years after their groundbreaking show first aired on the BBC. It was fun. It was comfortable. If you'd been expecting new material, if you'd been hoping they would pull off one more absurdist feat of brilliance by throwing us a bunch of new material and then saying "Fuck off!", proving they still had It, would die having It, you'd have been disappointed. Cleese, in fact, broke character in the Dead Parrot sketch to give it to a Daily Mail writer who'd panned the show. Palin gamely played along with the ad-lib, clearly not having expected it.

Monty Python didn't always hit their marks in the old days. They will admit as much. Palin himself has called much of what they did "crap," and I'm pretty sure that Gilliam, who, let's say, has rather self-righteous views about culture and art, probably agrees with him. I understand what they mean. There were plenty of flubs throughout the course of Flying Circus. You can't be great all the time. But when Python was brilliant—and they often were—they were the best, wrinkles and all. Sometimes they were the best because of the wrinkles.

mp-meaningIn their whole canon, though, I think The Meaning of Life is my favorite. Life of Brian is a better movie; Holy Grail is funnier; and Flying Circus is full of sketches that, for me, are personal cultural milestones, bits of writing that I've simply incorporated into my everyday speech. The Meaning of Life has something at its core, however, that appeals to me very personally, an undercurrent that is found in much of the rest of their work but not so acutely: existential despair. It's written right into the title, for God's sake.

The film is almost unfailingly grim, shot through with angst, and thoroughly eerie in a way only a movie filmed in the 1980s—just before the stratospheric rise of the personal computer, flash trading, and corporate fuckery became cultural staples in the way we think of them today—can be. Moving from the stark, gray streets of Yorkshire to a religious boarding school to a dance among planets and stars, the film prods at all the wonderful and horrible aspects of being human. The opening credits feature assembly line molds of families, naked, sad-looking, all adorned in Mickey Mouse ears. Doomed tourists in an indecipherable universe being stamped into existence and, one day, stamped out again, for whatever reason. And when the absurdity emerges, it's absolutely devastating. Humans exalted as heroes for tearing apart other humans. Aristocrat officers carrying on with the cool, calm leadership of the upper classes as battle rages just outside the tent, the ground a mess of severed limbs and unspeakable gore.

A mother gives birth standing up at a sink, her baby falling headfirst onto the floor. Sighing, she continues to scrub away. "Get that for me, would you, Dierdre?"

A boarding school chancellor tells a child nonchalantly, in front of all his choir mates, in the middle of a chapel service, that the boy's mother died that morning. Later, disinterested pubescent boys encounter sex education awkwardly, with mystified looks on their faces, though only after the instructor lists off an arcane hodgepodge of rules about clothes on pegs, letters home, haircuts, and little brothers. What sort of sadist comes up with this shit? Incidentally, one of the boys is condemned for a minor infraction to play the masters in rugby that afternoon, a sentence that results in his being smashed into the mud repeatedly, his classmates punched brutally in the head by massive grown men on a rampage. The chancellor himself even trips one of younger kids, who's escaped unnoticed from a scrum with the ball in his hands. The pettiness. The good-old-boy audacity of the man. Is every game rigged? Is there any way out?

Two people sit down at a table. A theme restaurant with the trappings of a dungeon but featuring hula dancers swaying to the soft strum of a ukulele. Given the opportunity to have a deep, philosophical conversation, the visiting Americans are patently unable to say a single word of significance, and instead prattle away vapidly about Burt Bacharach.

I mean, what the fuck is going here? Is it all really this irrepressibly drab and awful? I feel like one of those goddamned fish. We may as well just watch each other be devoured calmly at the hands of some handsomely dressed couple filled to gills with sedatives and forty-dollar martinis.

In the end, Death comes for everyone. The salmon mousse, he tells them, and takes them up into Heaven, where it's Christmas every day. Could you imagine anything worse?

And what do we get for confronting these absurdities of everyday life? What do we learn from the horror, the violence, and the feeling of being hopelessly lost? What is the meaning of this?!

The presenter sits down, addresses the audience, and, producing an envelope, opens it to read from the letter inside:

Well, it's nothing very special. Uh, try and be nice to people, avoid eating fat, read a good book every now and then, get some walking in, and try and live together in peace and harmony with people of all creeds and nations. [Looks up from note.] And, finally, here are some completely gratuitous pictures of penises to annoy the censors and to hopefully spark some sort of controversy, which, it seems, is the only way, these days, to get the jaded, video-sated public off their fucking arses and back in the sodding cinema. Family entertainment? Bollocks. What they want is filth: people doing things to each other with chainsaws during tupperware parties, babysitters being stabbed with knitting needles by gay presidential candidates, vigilante groups strangling chickens, armed bands of theatre critics exterminating mutant goats. Where's the fun in pictures? Oh, well, there we are. Here's the theme music. Goodnight.

It's never changed. Probably, it never will.

And if I mean to convey anything by this digression about a film that creeps up on me at unexpected times, it's that Monty Python meant something to me, in all the ways I typically scoff at when I see fanatic cultural affinity in others. Perhaps saying so is uncharitable, both to myself and to everyone else.  Finding a film or a book or, in this case, a comedy troupe that grabs your guts can be a special experience. Sure, excess remains a possibility always. Thumb through any Facebook newsfeed in the world, and you'll see the hideous product of a largely undiscerning populous obsessed with its culture carriers. It feels something like drowning.

mp-idleStill, how strange is it? I was born ten years after Flying Circus ended, and one year after The Meaning of Life was released, their last major work together. I wasn't even alive for any of it. But there I was on Sunday, watching them sing us all off for the last time. When you're chewin' on life's gristle, don't grumble, give a whistle...

Really and truly, I felt sad. It's a sadness that lingers still, a little bit, and not just because Python is done. Yes, there is the nostalgia, if you can call it that, but something darker and more desperate lurks at the bottom, that unsettling existential angst again, a feeling of floating, of aimlessness.

Everything ends. We all watch our youths skip swiftly off into the past and then witness the slow decay of our bodies over time. I will never get over it. And often the best I can do, when pondering the "meaning" of life, is come to the same conclusion Gaston does after he leads the camera, weaving and serpent-like through the thick London crowds, off into the countryside to a quaint, little cottage sitting by itself in a meadow, smoke wafting lazily up out of the chimney. This is where he was born, he explains, where his mother sat him on her knee and told him to try to bring peace and to make people happy everywhere he went.

Whatever else they did, Monty Python at least did that much.

It's not much of a philosophy, I know, but, well, fuck you! I can live my own life in my own way if I want to. Fuck off! Don't come following me...

 

Update 7/25: Seems my memory was a little fuzzy. I originally claimed the poor lad who was sentenced to a rugby match would be condemned to play against older boys, but it was, in fact, the masters at whose hands he would suffer. Adults, in other words. Tweaks have been made to reflect these details. Rewatching the sex education scene, it has lost none of its punch.

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