Blessed by the Potato

Though I don’t write with a mind to what people might want to read and just write/rant about whatever happens to interest me at the time, I always kind of fancied having people read what I say. I know that I really only have about 3.5 readers (the half is the guy who keeps checking in every few weeks just to say “TLDR”), and suddenly I think that might be a good thing.

Right now I’m struggling, really struggling, to finish writing a paper. I like science, I like what I do (err… mostly), and I love the fact that I’m advancing knowledge, possibly standing on the forefront of a major revolution in medical care. Of course, all my work is really for naught if I can’t share it with the world, which is where the publishing process comes into play. Publishing my work and contributing to the body of knowledge of the human race is perhaps the coolest thing I will ever do, but I also find the whole idea patently terrifying. This is not a small or friendly audience I’m trying to address, and once the paper is out of my hands there’s very little I can do to affect changes if a mistake slips through. Just thinking about what potential reviewers might find to criticize locks my brain up in a kind of writer’s paralysis; stage fright of the written word. When I don’t really care what people think when they read my writing, when everything is at least psydoanonymous, and particularly when I can play it fast and loose with the references (how I hate referencing), I can hammer out prodigious word counts. Most of my blog posts go up almost as fast as I can type them out, often without any proof reading even — a few thousand words a night is not uncommon (this post was hammered out in like 20 minutes and has 373 words). When it’s for a serious publication, suddenly I lock up and my output drops to something like 50 words/day average. I just churn the keyboard, writing and re-writing and deleting and staring and thinking and worrying.

This blog is not popular. I think that might be a good thing, or else it might not exist at all.

Not too long ago, there was a considerable political stink raised when the NRU in Chalk River went down for maintenance and was found to not have the proper emergency power supplies, etc., in place. The outage caused a significant ripple in the medical community, as the NRU provides about half of the Tc-99m used in the world, the most commonly used isotope in nuclear medicine. Indeed, it was pressure from patients and the health care community that made the government take the incredible step of over-ruling the nuclear safety watchdog.

The restart and upgrades to the NRU are really just stop-gap measures though: that reactor is a bit of a dinosaur, and due for replacement. Long in the works, the twin MAPLE reactors were supposed to be that replacement, but recently it was announced that their continued development was going to be cancelled. They had been almost completed, when it was found that their reaction characteristics were not as expected, and years of tinkering and experimenting were not able to find or fix the design flaw. For now, things will muddle on: the NRU has a license to operate until 2011 and can probably continue operating for a few years beyond that.

But the simple fact remains that Canada has no long-term plan for the supply of isotopes for nuclear medicine. And that means, essentially, that half the world doesn’t have a long-term plan for medical isotopes. One thing we can say for certain is that nuclear medicine is about to become a whole lot more expensive. All along, the costs of the NRU have not, AFAIK, been passed on to customers. Money was not being collected to fund the construction of MAPLE reactors. The Canadian government was essentially subsidizing the cost of nuclear medicine the world over. I’m all for subsidizing it in Canada, don’t get me wrong, but my understanding is that our exports of nuclear material did not fully recover the true costs (granted, including money sunk into research in the 50’s/60’s).

An alternative option for many (but not all) present nuclear medicine scans is the use of PET. PET is not currently paid for by OHIP, largely because it is seen as too expensive, even though it offers advantages for some types of imaging (e.g.: cancer). However, that cost disadvantage is partly artificial: a PET scanner requires a ~$10 Million cyclotron facility within about 2 hours of driving distance, which adds up to a fair number of cyclotrons needed across the province. However, traditional nuclear medicine requires a billion dollar+ reactor, which just happens to be subsidized by the Canadian government.

It’s hard to say at this point what the future will hold for nuclear medicine. Maybe it will get more expensive, as a private group (or another country, like the US) builds a reactor to replace the NRU, and tries to run it at a profit. Maybe it will change quite rapidly over to PET imaging if the end of the NRU is seen with no replacement in sight. Or perhaps nuclear medicine will go away, except for a small number of truly needy cases who might warrant bringing isotopes across the Atlantic.

A wedding is supposed to be many things. A family reunion, a chance for your parents to show you off, and of course indulging a certain someone’s princess complex fantasy. But it’s also supposed to be a grand old party where the special couple gets to call the shots, and get all their dear old friends and family out in their finery to rock the night away. So it was really sad to see everyone, on a saturday night, play the “old” card and quit the wedding early the night before last. Sure, the new parents have a decent excuse, since it’s tough being away from (or keeping) a youngster to that late at night, and I’m sure even the ones who were getting sloppy drunk on the open bar came up with some kind of excuse for cutting out early — some before midnight even! Even some of the people in the wedding party were heading off for bed before the end of the night, which was scheduled for 1 am. I don’t know what is up with that. It was not so very long ago that we started a night out (or in) at 1 am. Shit happens, and it’s usually ok if one or two people have to leave early for whatever reason. However, somehow everyone left early, and that starts to look bad.

Not only did this put a bit of a damper on the giant celebratory party thing but it also meant that there was a constant trickle of people leaving all through the night, all of whom had to stop and say their individual congratulations and goodbyes to the happy couple. This resulted in them spending almost the entire night saying goodbye, rather than partying hard at their own fete and then getting kicked out as the lights came up and saying a big goodbye as they got into the limo. Instead of a big crowd sending them off and cheering after the car, they were virtually the last ones to leave.

I’m an understanding guy. I understand that you have external demands on your time. I understand that it can be difficult to arrange a day off when you only have a year’s notice, or that you don’t want to eat into your limited vacation time for a wedding. I understand that you need your beauty sleep to function properly the next day. But understand this: the bride spent the last year of her life (in Teresa’s case, the last two years) planning the perfect party to celebrate her once-in-a-lifetime event. When you leave early, it says either that she didn’t do a good job in the planning, and you’re just not having a good time; or that you have better places to be, that there’s something more important out there than her special day.

Just fair warning: this will not happen at Wayfare’s wedding. Yes, it’s selfish of us, but you’ve been warned. Play it safe: tell the sitter you won’t be back until 3, or pump some breast milk and tell granny you won’t be back at all. Book the next day off work if you are stuck working on Sunday, or learn to cope with 5 hours of sleep for one day. Decide not to cut back on caffeine that day. I don’t care if I have to break the fire code and bar the doors, but no one under the age of 60 will be leaving before we do. At the end of the night, we will rush out to the car, and you will follow and cheer and wish us well, and you will smile. The only acceptable alternative is a weepy farewell, and then only for Ryan and the aunts. Now, Wayfare has a hell of a time staying up until 1 am, so we understand some of the difficulties involved, and we’re going to try to work with you as much as possible. But remember: if she can do it, you can do it. We’ve scheduled the whole thing so that the ceremony starts late in the day and goes straight into the reception, without you having to figure out what to do with yourself while we’re off getting photos taken. It won’t take up the whole day on you, and you won’t have to wake up early. You’ll have lots of time to relax and nap through the day, or even get a full day of work in if you skip the ceremony and jump straight to the reception. The reception is centrally located in North York, close to the 404 so the Torontonians and Markhamites can get home quickly without having to factor in much in the way of travel time; we’ll try to arrange decent rates at a nearby hotel for those from out of town. We’ll work with you to make sure that you can make it through that grueling marathon of merriment, good food, and dancing. Let us know why you had to leave so early the night before last. Was it a car issue? We can arrange cabs for everyone. Was it too hard to go up to the open bar? We can send out more waitresses with more free booze. Too much hootch, and you were ready to pass out by 10? We can hold the alcohol until after dinner, or indefinitely. We can get rid of the dessert table if that temptation was overcoming your willpower and you just had to leave to avoid scarfing down a whole cake. I know a lot of doctors, if you need a note to take a sick day at work. If the narcolepsy’s got you down, I’ll see if my dad can bring the camper van so you can catch a few zzz’s in the parking lot and still pop back in for the last dance.

I’m not big in the way of arbitrary traditions for “showing respect”. I don’t care if you wear a suit, or bring a gift, or bow to the altar, or wear uncomfortable shoes, or can’t wait your turn and just start incoherently yelling out a speech you’ve prepared in the middle of the ceremony. Show up in shorts and a T-shirt with some flip-flops. Don’t even take your hat off in church, it’s a nice look on you. If you don’t like the food, go ahead and order in a pizza, I’ll even chip in for a slice of plain cheese. I don’t care if you throw a tissy fit like my dad did about the guest list or the seating arrangements. I don’t care if you follow the seating arrangements. They’re a suggestion, sit where you want, just sort it out with the person whose seat you’re taking. I want you to be comfortable, have a good time, and moreover I want you to be there to share our big day with us. But if you can’t block out 8 hours of your time a year in advance for Wayfare, then that will be disrespecting my wife.

I just got in after a long and treacherous drive on the 401. I couldn’t quite figure out why it was so busy in the middle of the day on a Friday, why there were so many dickwads. Then it hit me as I was looking at the plates: Michigan, Wisconsin, Michigan, Michigan, Illinois, New York, Michigan… today is July 4.

Dear Comrade Americanzi’s:

Welcome to Canada. Please to buy lots of Alberta tar for your tiny-penis trucks. They go very fast on our roads, drink fuel like cheap beer, is nice. Unless they pull boat, then they go very fast until hill and stop in traffic. That is not good. But comrades, you must realize Canada is poor communist country. We have one road, must be shared by many drivers. You can not buy a lane with your worthless green paper like capitalist pigs you are: share, everybody shares here. Fast cars go on left, slow cars on right. Is not other way around.

Thank you for visiting, is all I have to say for now.

I don’t really get it — there is a lot of fear and doubt out there about hybrid cars, a lot of people saying things to detract from the new technology. Some of it is pure bullshit, like the CNW study or the crap about the Sudbury moonscape. Some of it is selective accounting looking at the purely financial side of things, such as comparing a nicely equipped mid-sized car like a Prius to a bare-bones compact, or assuming that the price of gas won’t go up over the next 15 years, or that you’ll only own your car for 7 years at which point it will be worthless.

I can understand why some companies (cough, GM, cough) who are losing out on sales to hybrids might have an interest in sowing FUD, but I’m surprised that so many people out there seem to take it up without a second thought (how many times have I heard “oh, but the batteries will have to be replaced every 5 years”?!). Hybrids are a very promising technology and a vital step on our path to electric cars, and while rare until very recently on the ordinary streets of Canada, aren’t really all that new.

One of the latest rounds of fear-mongering focuses on the electromagnetic fields (EMFs) produced by hybrid cars, getting international attention in a recent New York Times article “Fear but few Facts on Hybrid Risk” which was linked to by the Consumerist. To quote from the article:

Kent Shadwick, controller of purchasing services for the York Catholic District School Board in York, Ontario, evaluated the Toyota Prius for fleet use. Mr. Shadwick said it was tested at various speeds, and under hard braking and rapid acceleration, using a professional-quality gauss meter.

“The results that we saw were quite concerning,” he said. “We saw high levels in the vehicle for both the driver and left rear passenger, which has prompted us to explore shielding options and to consider advocating testing of different makes and models of hybrid vehicles.”

I sent a message to Kent Shadwick, asking if he’d share his data so I could see what he considered “high” and whether that was a static (DC) field or a time-varying field measured. He did respond, and promptly, but only to say that he hasn’t shared the results anywhere, and that they hired an outside company to take the measurements using a rigourous procedure. He also said that he was looking into shielding solutions.

I have to say that this is really disappointing, and I think it shows the real lack of a decent science education in the general public that the New York Times ran this piece without even being able to say what the fields are or how that compares to the geomagnetic field, let alone whether there’s any risk from that. The field, if you will forgive the pun, of bioelectromagnetics is so controversial and so lacking in standards that it means virtually nothing to have one person say that something is “concerning” without knowing what their threshold for concern is. Some people are concerned by static fields that are weaker than the Earth’s magnetic field; some aren’t concerned about static fields at all until we get beyond the MRI level. Likewise with time varying fields: some people think that virtually any exposure should be eliminated, others think nothing of using microwaves up to the point where they cause protein denaturation or other fields up to the point where they start to heat the tissue. I have no idea what Kent Shadwick might find concerning, so even if he does have a respectable position with the school board (not some random nut falling asleep at the wheel) and even if he did hire qualified people to take good measurements with the proper equipment… his “concern” is not really newsworthy to me unless I know how his threshold of concern compares to mine.

Plus all this concern about magnetic fields in hybrids is really only part of the issue.

The question asked is always about the risks — we know, for instance, that ionizing radiation is something that can cause cancer and other health issues. However, if you have a broken arm or get a nasty bump on the head, you can be sure you’re popping in for an x-ray/CT no questions asked because there is a big benefit to those diagnostic tests that far outweighs the small inherent exposure. It’s really all about risk-benefit ratios.

So for the hybrid car issue, we have the question “what are the fields?” and we don’t even have a good answer to that, from which point some people fall into hysterics (up to selling their car). The real issue is then several steps removed: the Prius may have higher magnetic field exposures than other cars, and those fields have an unknown but probably small effect on human health, and that might outweigh the positive aspects of the technology.

One example used to show that pulsed magnetic fields can effect biology is the FDA-approved bone growth stimulator. I had the pleasure last week of listening to Arthur Pilla’s (one of the inventors of the electromagnetic bone stimulator) plenary talk in San Diego. He talked about the first use of the bone stimulator on a woman who had a fractured tibia just below the knee that hadn’t healed for 9 years, despite multiple bone grafts, etc. They had this theory that an electromagnetic stimulator might be able to stimulate bone growth, but they also knew that the fields would not be restricted to just the break, and that the knee itself would also be exposed. There was a real concern that the bone might grow wildly out of control and completely fuse the knee, but since this woman’s only other option was amputation, they gave it a try. The stimulator only caused bone growth where there was a break. My point is that it’s not quite so simple to say that induced currents will have an effect on tissue; they may have an effect on some tissue some of the time.

So ok, there might be some small risk with hybrids (though probably not). On top of that the benefits have to considered (fuel efficiency, emissions, safety…) One colleague off-handedly said that even if magnetic fields cause cancer, you’d probably be better off with a Prius because you’d be exposed to less gasoline from the gas stations and escaped vapours in your garage… another possible carcinogen. To save less fuel than switching to a hybrid would net, some people will tailgate (draft) semi trucks in their blind spot. That’s a behaviour with a definite and immediate risk — not of possibly getting cancer 20 years down the road, but of getting instantly killed by a tire blowout or sudden stop with zero space for reaction time. Of course, the risk of being turned into a red smear on the pavement is not a new type of risk to drivers.

The benefits of a Prius vs. a comparable conventional car are real and material. The risks are unknown, but probably negligible. Unfortunately people have such a fear of the unknown that they can blow it out of proportion in their decision making, and focus on their fears rather than the overall picture. Back to the York Catholic District School Board: as a scientist, I was a little disappointed that he wouldn’t share his results so that I could come to my own conclusions; however, I understand why he went to the effort of measuring the fields and looking into solutions — for an individual driver, the risk-benefit ratio is pretty clear: just buy the hybrid. For a school board fleet however, there are unions to consider, and a union will fuck up a school board over a perceived threat to its drivers, whether or not that’s a real concern or a valid trade-off (after all, it’s not the union members who are saving on gas in a fleet purchase situation, so in their minds the risk-benefit works a little differently).

The title of the article was spot-on: Fear, But Few Facts.

I don’t know why there is so much misinformation and so much fear being spread about hybrids out there. I wrote Hybrid Cars: The Benefit of My Research (the 2nd link down in the static pages on the bar to the right) to try to distill some of my research over a year ago. Some of that information is starting to get out of date, but I don’t think that anyone has ever read it anyway, so I’m not sure if I should bother updating it with things like this.