Blessed by the Potato

I’m sure you’ve all been checking the site hourly, awaiting my return from Turkey. I’m proud to say I’m back, after spending what is one of the best weeks in Canada (see below for why) away in some other land. It was of course Canadian Thanksgiving as well, so we* had turkey in Turkey.

* – The rest of the group that is. I had pasta.

The conference itself was fairly mediocre (the rooms were so hot!), the resort was nice, but the travel itself to get there and back was ridiculous. Over 24 hours door-to-door, including 3 flights and an hour-and-a-half long bus ride through these tortuous roads.

Once there though we made the best of it, playing tennis, swimming, hitting the gym, and even taking in some scientific presentations. The pool was hardly chlorinated at all, which is either fantastic, or a little worrisome, depending on how much you think about it. I suspect it may be that the water stays pure because they kept it refrigerated, as it was a very chilly pool (really only ever saw Canadians and Scots in there). The food was decent, and my willpower strong, so combined with all the activity I managed to lose 5 pounds last week, which is fantastic! How strong was my willpower? Well, I brought 3 bags of candy with me, and 2 of them came back home. The hotel was all-inclusive, which included all-you-can-eat ice cream in the afternoons (or ice cream plus waffles on some days). Every day I went down to the ice cream bar, had a good, long look, inhaled the delicious smell, and then walked away from the free ice cream.

There were no speaker awards at this conference to win, so naturally I came home empty-handed on that front. The hotel, however, had little mini-competitions amongst the guests, and one such competition involved a video shooting/marksmanship game with a laser rifle. I did win that, and came home with a small kitschy medal :)

Now I’m safely back home… and sick. Right now it’s just the sniffles and a small fever, so I’m trying to work through it since I’m already pretty far behind on my timeline. I really hope it doesn’t get any worse, as I can’t afford to get sick now.

Sad news while I was gone: Benoit Mandelbrot died.

Anyway, it’s good to be back in Canada, especially since this is the best time of year:

So I was out at a conference in Victoria, and while I’ve been to a lot of conferences before, it was the first physician-oriented scientific conference I’ve been to. I must say that the quality of the presentations is vastly different than that seen at a typical conference for scientists. The clinicians were much more confident, articulate speakers, like smooth salesmen, which stands in stark contrast to the introverted scientist reading his slides. Unfortunately, they also tended to present fairly shaky data as facts and guidance for future treatments.

For example, there were some presentations on the use of botox and acupuncture to treat chronic pain. The presentations were basically “this worked for these patients, everyone should try it.” Now, here’s the thing about research in medicine: you really need double-blind placebo-controlled studies before you can really say anything with a great deal of confidence, before you really have proof of a treatment working. When this was pointed out to one of the presenters, he countered by saying “Well, the proof is that these people keep coming back and paying for more treatments; these aren’t covered by provincial medicare. If it wasn’t working, they wouldn’t keep coming back.” A bit later in response to another question, another of these practitioners said that about 30% of the people he tried his alternative treatments on returned for more.

The thing is, there’s what’s known as the placebo effect: even if you give someone something that shouldn’t do anything to or for them, some portion of people will find some measure of effect from that treatment. The size of the placebo effect varies greatly depending on how the placebo is presented and what the placebo is acting on. The placebo effect is hard to understand, but we believe that it’s largely “mind over matter” and as such, it seems to work best on ailments that are largely in your head to begin with. If you’re sad, and a respectable looking fellow in a white lab coat hands you a pill and promises that it will make you feel less sad, you’re likely to feel less sad even if that pill is just gelatin-encased starch. Likewise with pain: from a number of studies, it seems that about 30% of people find that their pain gets about 30% better when damned near anything is tried. Pain is a complex phenomenon, but it is at least partly sensation and partly emotional, so it’s something that is easy prey for the placebo effect. Contrarily, something much more objective like a broken bone or open wound is less susceptible to the placebo effect.

So I found it rather disingenuous that when a self-selected sample of people (those who come in to a doctor’s office ready to pay for acupuncture must already believe it may work) has some measure of pain relief, that a doctor can extrapolate from that to suggest that acupuncture is a generally effective therapy for pain.

The double-blind part means that the subjects in a study must not know whether they have the real or placebo treatment: if they knew, it would really eliminate the point of the placebo. That’s blinding. Double-blinding is when the experimenter also does not know, since unconscious clues might be passed to the subjects. All important stuff in research, but let me get back to the placebo effect.

What’s interesting is that placebos are almost as effective as some FDA-approved treatments, and often with less severe side effects (though perhaps somewhat unsurprisingly, placebos also have side-effects; mind over matter cuts both ways). However, it’s generally considered unethical for a doctor to prescribe a placebo because it involves deceiving the patient.

Along with the placebo effect is the tendency for patients to lie and pretend they’re all better when a treatment is noxious. Take, for example, trepanation. Whether or not your chronic pain was cured by the medicine man drilling a hole in your head, you sure as hell were going to shut up about it or else he’d go and drill another one. I haven’t seen it reported, but I also have to wonder if there might be an under-reporting of effectiveness for some addictive treatments: could patients over-report their pain if they’re hooked on morphine, saying it isn’t working when it is in order to get an extra dose?

There was a good article about the placebo effect in Wired recently, even touching on the subtle aspects of pill design that can enhance the placebo effect.

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Well, I’m back from the trip out east. I didn’t take a single photo while out there, not even of the rental car I’m about to talk about. I fail at vacation.

While there I rented a Ford Fusion (a free upsize from the “cobalt or similar” I had reserved since it was the only car they had left). It cost me $350 for the week, which was pretty good — I had to wait a month for the price to come down to that level, the first few quotes I was getting were over $800! Oh, and if you are going to fly into Charlottetown in the peak of tourist season and will need a rental car, be sure to reserve one in advance. There was more than one person hoping to just pick a car up, and between the four rental counters there were only two cars available (I heard them all yelling about it :).

The Fusion was a nice ride, I must say the things I’ve heard about Ford improving (especially with the new Fusion) seem to be true: the car was fun to drive, quite responsive, and everything seemed to fit together well, no rattles or even much engine noise. The seats seemed to hug and support us quite well. I’m sure it’s a standard feature on most cars now, but there was a USB port inside the centre armrest to plug in an iPod so we didn’t have to listen to the radio.

However, the visibility was ass. The rear end seemed to be sprung up in the air a bit, which combined with the spoiler and large C-pillars made backing up really hazardous. The rear-view mirror was also oddly low on the windshield, so even with my seat lowered as far as it would go, I just couldn’t seem to see under it to look out to anything right of centre. In fact, the car was oddly proportioned: I’m only 5’8″ tall, and when I first got in, my head hit the ceiling. Even after lowering the seat I only had about 3″ of headroom, and felt like I was too high up relative to the rear-view mirror… I don’t know how anyone over 6′ would ever be able to get in it. Despite that, the dash and “beltline” (bottom of the windows) were very high, making the car seem somewhat claustrophobic (and it also made the steering wheel feel too high, like I had to reach up for it rather than straight out; my arms couldn’t quite get into a natural position to hold it). Wayfare also complained that the passenger seat wouldn’t recline very far, making it hard for her to nap. The experience was valuable though, since it helped give me an idea of the sorts of things that can start to drive me crazy after a week of living with them, so I’ll have a more watchful eye when it comes time to start test-driving replacements for the Accord (the number one choice needing no mention here, of course).

Some of those issues are just subjective things, but it was the numbers I was perhaps most disappointed in: the fuel consumption. Pretty much the only driving we did was between the cottage and Charlottetown, a ~20 km drive on rural highways with speed limits of 80 or 90 km/h. There are only 3-5 stops along the way (depending on your luck with red lights). This is about as close as you can get to mimicking the government test cycle, so the car should have achieved (or even beat, with luck, since driving conditions don’t get better than PEI!) its highway rating:

Flex fuel SEL AWD flex-fuel: 7.8L/ 100 km HWY. (The I4 FWD is rated at 6.4L/ 100 km HWY.)

So we should have been getting roughly 8 L/100 km on the trip, but instead averaged over 10 L/100 km. I know my Accord would have got at least (most?) 7 L/100 km in that kind of driving, and I can’t figure out why the Fusion did so poorly. Yes, it’s got AWD and a flex fuel engine which is going to hamper it relative to the Accord, but that’s factored into the rating above: why the 25% miss? It’s possible that Ford gets a “credit” towards its fuel consumption rating for having the ability to burn ethanol/E85, but I doubt it — that sort of stuff can get figured in for things like overall fleet consumption goalposts, but I don’t think it actually affects the sticker rating above. Beyond that though I’m at a bit of a loss: perhaps the rental agency filled the tank with ethanol… but I can’t find any mention of stations in the Charlottetown area that sell E85. Maybe the rental wasn’t in very good condition, despite only having 6000 km on the odometer? Maybe the tires were soft, or the engine hadn’t finished breaking in… Whatever the reason, I was not pleased by the mileage. Perhaps Ford should sell their “ecoboost” engines to the rental agencies over the flex fuel options…

Whatever it was I just wasn’t satisfied with the car in the end, and was actually happy to leave behind the brand new, sparkling clean car to get back into my 13-year-old Accord.

(Though I do miss the instantly-cold air conditioning).

Paris is a big city. It doesn’t really seem to have an identifiable “downtown core” like most Canadian cities do, no single major street or intersection that defines the centre. There’s the La Defense district, which we haven’t been to see yet, but seemingly the whole of the city is crowded with one-way alleys and 5-storey apartments with retail on the ground floor. It makes the whole city seem like a teeming downtown core, and I just can’t quite wrap my head around it all.

The stonework is impressive though, and Wayfare and I were wondering how it was that they managed to put so much effort into seemingly every building over such a wide area. Of course, the downside is that there’s very little greenspace to be found, and any little patch of lawn seems to instantly spring sprawling sunbathers in this summer heat.

Oh, the terrible heat. I don’t know how it’s so hot underground, but that has to be the biggest downfall of the metro system here. None of the trains are air-conditioned, which is especially bad when bathing seems to be as optional as it is here. They open the windows so there’s a bit of a rush of air when the small trains are moving, but the system is quite a bit different from the subway of Toronto. There are an enormous number of stations and lines, all criss-crossing across the city. It’s kind of nice knowing that up on the surface a metro stop is never much more than 300 m away, unlike the 20+ minute walk you could face in North York or London just to get from your house to the nearest bus stop, let alone subway station. However underground it means that the trains spend way too much time stopped at the stations, baking with no air movement, rather than making progress through the tunnels. There’s also no guard car like the TTC has — no one checking to make sure that everyone is off the train, that those boarding aren’t getting caught by the doors. The buzzer sounds (and it’s an unpleasant noise that does not help the claustrophobic nature of the situation), the doors slam closed and the train moves. The doors don’t even open on their own, you have to hit the release yourself. Of course, none of these issues stop it from being a very well-used service: even at night just before the system shuts down the trains are fairly busy; at one stop the people hadn’t even finished getting off, let alone given a turn to the hundreds of people on the platform to get on, when the buzzer buzzed and the doors tried to close.

Today we spent a lot of time walking and looking at buildings, including the impressive Notre Dame cathedral. However we were pretty baked by the heat and the sun and a slight bit of dehydration given that a bottle of water or can of pop runs us north of $3, so we haven’t been taking as many pictures as we should have been. We walked by the Louvre, where bizzarely enough a gang of people were giving out free hugs (with the signs to advertise it). Wayfare was quite excited by the free hugs, and got 7 or 8 on the way through the crowd.

“Yay, free hugs!”

We grabbed some crepes for lunch at a small restaurant in the shadow of Notre Dame, where there happened to be a small white kitten sleeping on the bench (until some American girls came in and decided to pick him up and tell him how cute he was). We now have more pictures of the little white cat than we do of the Louvre and Notre Dame cathedral combined.

Imagine you step off the train coming in from Davos into the busy Zurich main station, and find yourself confronted by a full orchestra warming up. A dancefloor is in place within the airy main hall, gauzy chandeliers have been set up, and linen-topped picnic tables separate the hustle-and-bustle of the train-riding public from the other-world-ness of the dance floor. You think to yourself this must be some cool, swanky black-tie, invitation-only event.

Only when you see excited passengers in jeans and t-shirts run out to the dancefloor to join with those who dressed in tuxes and ballgowns do you realize that it’s free and open to any who care to dance on the shortest night of the year. Sounds too fantastic to be true, doesn’t it? Like something from a dream?

But that’s what we saw last night at Zurich HB for the mid summer’s night ball, it was quite the sight. Unfortunately, we were too tired after the conference and all the travelling to come out to dance (that, and at one point while watching it looked like someone was calling a particular dance in German, and there’s no way we’d be able to follow directions, or waltz as well as most of the dancers out there).

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