Thursday, January 24, 2013

Letter to Momma, re David Brooks

Dear Mom,

Thanks for the link on David Brooks!

I cannot be precisely sure what you mean by your quick attached note: “I’m just sayin’.” I mean, I get the phrase in general—like “I’m just sayin’ that someone else out there agrees with me”—as a simple for instance. But both Jonathan Bernstein and Jonathan Chait operate from the assumption that pretty much everything that David Brooks writes is either stupid or crazy or disingenuous or all three; they only quibble over whether such nonsense defines his character (Chait’s point of view) or his job (Bernstein’s point of view). I happen to think that Chait is more correct on this point than Bernstein, although it is very nearly a distinction without a difference.

The problem, in a nutshell, with David Brooks and his ilk is that he puts on the appearance of reasonableness, but this is a very thin patina covering over the madness that is today’s Republican Party. Whether he knows that his chiding of Obama for not “coming to the center” (when in fact Obama is a deeply centrist—or even center-right!—President) is pure bullshit, or is just a clever ruse as part of the role of “House Conservative” at the Gray Lady, is immaterial. Pure and simple, he serves as a polite apologist for the ugliest elements of power, and neither the article you link nor the one on which it is based would disagree with that sentiment.

Now, I know that I’m decidedly un-DavidBrooksian, and I’m not simply referring to my political views. I know that I crew cut half my head when I was sixteen while leaving the other mop-top long, much to your general consternation (a view I would probably share if one of my eleven year-old children tried today; I have gotten a touch more conservative, at least in certain ways, as I've grown older). I know that I pepper my conversation with far too much foul language, writing such impolite disquisitions during college to garner the somehow less than subtle nickname “Billy ‘Pigfucker’ Rubin” in a nod to a moniker I once applied to a philosophical foil. I know that my rhetoric tends toward what one might call “destructive”—or what dad used to describe with glee as my “vitriolic prose”—although in my defense, I note that have worked and worked and worked toward keeping my verbal TNT reserved for only the most outrageous and cynical actions/statements/personalities and whatnot. Whether I have succeeded at that I leave you and others to judge, though I keep in mind Paul Fussell’s immortal words of advice, “contempt for the contemptible”. Words by which to live! (Plus, there's just so much crap out there for which utter contempt is the only reasonable response.
And note: in my blog incarnation, I’m incredibly well behaved.)

All of which is to say that, though I know David is the son you may have wished for, you are, now and forever more, stuck with your sometimes rude and nearly constantly foul-tongued son.

But know this as well: I care about those people whom power ignores—or worse (to hear the squawks of outrage from the Neanderthals who found Obama’s Second Inaugural references to Selma and Stonewall objectionable), actively vilifies. I will always be on their side. (Well, almost always. That’s a longer discussion.) David? Not so much. Never forget that key difference between the Nice Jewish Boy and the Boy Who’s Jewish And Nice Underneath It All.

Your loving son, (and seriously, I rilly do love you!),
With a wink,


Saturday, January 19, 2013

Flu: Yes, the Vaccine Works

If you have been stranded on a desert island the past month, you may not be aware that this year's flu season has been, to use not fully professional terms, a bitch. "Thirty states and New York City are reporting high ILI activity, an increase from 24 states last week," the CDC says in its typically restrained fashion ("ILI" stands for "influenza-like illness"--since a good percentage of these illnesses turn out on closer inspection to be due to other viruses such as metapneumovirus or parainfluenza). The city of Boston declared a state of emergency last week, and plenty of other places are buckling under the strain that the epidemic has placed on hospitals, nursing homes, doctors' offices, and pretty much everywhere else too.

I've been hearing various comments, sometimes from health professional colleagues, that the magnitude of the outbreak is the fault of a lousy vaccine--as many patients these docs and nurses have encountered with lab-confirmed flu did receive the vaccine. (I've seen about three such patients myself.) Hard not to conclude that we just had a dud of a vaccine, and if it weren't for that, we'd be in for smoother sailing this winter.

But it's worth noting that the influenza vaccine does, in fact, actually work. The data this year, while preliminary, indicate that the vaccine is about 60 percent effective--which means (roughly) that for every 10 people who would become sick from influenza infection as a matter of course, only four would become sick if those 10 people were vaccinated. That may not sound hugely effective but that's well within the range of a typical influenza vaccine, as this report demonstrates. And from a public health standpoint, a 60 percent effective vaccine translates to a tremendous preservation of resources.

That is, assuming people actually take the vaccine. Currently the vaccination rate appears to be hovering around 30 percent. Wouldn't it be fiendish if we charged higher copays for unvaccinated people who get hospitalized for influenza? Or made them pay full cost for oseltamivir (aka Tamiflu) once they develop symptoms? Now that might serve as a motivator to get people to offer their arms for the vaccine needle!

Also worth noting, since vaccines are so wildly misunderstood, that while the flu vaccine is only 60 percent effective, most other vaccines--especially the ones we offer children like the MMR--have effectiveness rates in excess of 95 percent. And there is no proof--none--that vaccines cause autism. For further reading, see here.