What is a disease?

Gilbert’s Syndrome is a genetic condition, marked by raised blood levels of unconjugated bilirubin, caused by less active forms of the gene for conjugating bilirubin.

There are disagreements about whether this should be called a disease. Most experts say it is not a disease, because it has no significant adverse consequences. The elevated bilirubin can lead to mild jaundice, and some people with GS may have difficulty breaking down acetaminophen and some other drugs, and so be at greater risk of drug toxicity. They also have elevated risk for gallstones. GS may be linked to fatigue, difficulty in concentration, and abdominal pain. On the other hand, a large longitudinal study found that the 11% of the population possessing one of these Gilbert’s variants had its risk of cardiovascular disease reduced by 2/3.

WHAT? 2/3 lower risk of the greatest cause of mortality in western societies? That’s the “syndrome”?

Maybe we should rewrite that: anti-Gilbert Syndrome is a genetic ailment, marked by lowered blood levels of unconjugated bilirubin, caused by overly active forms of the gene for conjugating bilirubin. This leads to a tripled risk of cardiovascular disease. On the other hand, the 89% of the population suffering from AGS has lower risk of gallstones, and tends to have lowered risk of acetaminophen poisoning. They may have lowered incidence of fatigue and abdominal pain.

The gambler’s cross

2013-08-28 15.55.13The 13th century University Church of St. Mary is an important Oxford landmark. It was the first building of the university, and stands as an imposing symbol of traditional Anglicanism on the High Street. And now, apparently, it is funded by the proceeds of gambling.

I’ve long been fascinated by the gradual moral detoxification of gambling, something that I discussed at some length in my review of The Quants. Christians have vacillated between viewing gambling as a heinous sin and as a good way to fund their churches. Not unlike their earlier views of loans at interest and capitalism more generally.

It’s particularly striking to see a church displaying the symbol of the cross in the sacrilegious form of the gambler’s crossed fingers. I wonder how Christians react to the symbol. It seems like a gestural swear word, as though a priest began his sermon with “God almighty, it sure is hot this week. What are we doing in church, for Christ’s sake?”

The cost of anti-terror

By way of Brendan James at The Dish comes this report by Ben Richmond on the disruption of vaccination efforts in rural Pakistan caused by the CIA smuggling a spy into Osama bin Laden’s refuge disguised as a health worker distributing hepatitis B vaccines. I won’t question the justice of killing bin Laden, nor will I call it useless because bin Laden may have been, by that point, barely even a figurehead of al Qaeda. I appreciate the value of propaganda by force in the important struggle against violent Islamists.

But when we reckon the costs against the benefits of killing terrorists, let us consider the 22 vaccination workers killed and 14 injured in retaliation attacks, or the many thousands who will be killed or maimed by polio, now that the realistic hope of soon eradicating that horrible disease has been set back, perhaps for a very long time. One wonders iƒ the cost to public health had any place in President Obama’s decision-making in approving this particular CIA operation. Is there anyone who speaks up for non-American interests? Is there any number of  lives of the poor bystanders for whose sake a US president would judge it worth giving up a symbolic victory in the struggle to save American (and wealthy western more generally) lives? Other than because of threats of diplomatic or military retaliation against Americans.

I’d be genuinely interested if any political theorist has thought through how this calculus works.

Jane and Edith and Hunter and Bill

Jane Austen and Edith Wharton and Hunter Thompson and William Burroughs. I presume I am the first person to put those four names on the same page, but it is not in the interest of priority that I mention them.

Rather, I happen to have just read The Age of Innocence right after Pride and Prejudice, and was reminded obliquely of my experience, many years ago, reading Naked Lunch right after Fear and Loathing in Las Vegas. My thought then was, Hunter Thompson, for all his skill as an entertainer, is just a little boy playing at decadence. Burroughs, for good or ill — and he seems pretty ill — is serious. And it caused me to feel retrospectively revolted at Thompson for playing with horrors, instead of feeling revolted at Burroughs, who describes the perversity of the flesh in a  style that feels more real — hence more disturbing — than any realist chronicle could be. Surreal in the original sense: higher than reality, more intense.

And it is the same with Austen and Wharton. I am not insensible to the charms of Austen’s prose, and I finished P & P with great satisfaction, but next to Wharton, her fellow in the comedy-of-manners genre, she seems terribly unserious. Her characters have motives and passions, but they all seem so superficial. Obviously we can’t blame Austen for not anticipating the psychological revolution in fiction that Wharton was heir to, and her elegantly polished prose has many pleasures that Wharton’s prickly — and sometimes overly analytical — sentences can’t match. But her characters are all such simpletons — particularly the men. There is an occasional mention of the virtue of someone being generous to his servants, but no one has any real project beyond redesigning her garden, and ambition is scoffed at. It all feels so confined and dreary.

Maybe a mathematician has trouble appreciating Pride and Prejudice because it’s too much like our work. It’s like a chess game, or someone working through all the combinatorics of possible relationships with a certain set of people, given some arbitrary but fixed social rules. A friend of mine  likes to compare Jane Austen’s novels to the publications of the RAND corporation.

On a peripheral note, I discovered recently that there is a whole world of Jane Austen reënactors, who meet at the Jane Austen Society of North America to dress up in regency gowns and do… stuff. (Deborah Yaffe has written a whole book on the cult.) It seems pretty bizarre to me. There are authors whose fictional worlds I would less like to inhabit — the aforementioned William Burroughs is one; George Orwell comes to mind — but not many. I’ll have to read Yaffe’s book for insights. I suppose there are all those Civil War reënactors who play at having their legs sawn off in a field hospital, so who can say what motivates people? Continue reading “Jane and Edith and Hunter and Bill”

LOVEINT

John Quiggin points us to this Washington Post report: By analogy with the classic military terms SIGINT (signals intelligence) and HUMINT (human intelligence), there is now the NSA-internal abbreviation LOVEINT:

The LOVEINT violations involved overseas communications, officials said, such as spying on a partner or spouse. In each instance, the employee was punished either with an administrative action or termination.

NSA released a statement saying that  “NSA has zero tolerance for willful violations of the agency’s authorities” and responds “as appropriate.” I contend that if you respond “as appropriate”, you don’t understand the concept of “zero tolerance”. “Administrative action or termination” doesn’t sound like Edward Snowden’s experience of NSA’s zero tolerance — depending on what they mean by “termination”.

But it gets better.

NSA Chief Compliance Officer John DeLong emphasized in a conference call with reporters last week that those errors were unintentional. He did say that there have been “a couple” of willful violations in the past decade. He said he didn’t have the exact figures at the moment.

So, he’s the Chief Compliance Officer of our super math spies, but he can’t keep track of numbers bigger than two.

But it gets better. “Most of the incidents, officials said, were self-reported.” Is this supposed to reassure us about the fundamental honesty of NSA employees? Here we have a secret government agency, accused of abusing its power. We are told that there have been only “a couple” of abuses, all of which were revealed by the perpetrators themselves. Might a more robust investigation — you know, maybe not third-party investigation, but at least second-party?

At least we know Snowden wasn’t the only one being granted too much trust.

Police break the law: The law must be stopped!

Former Metropolitan Police Commissioner Ian Blair — now titled Lord Blair as reward for his 2010 resignation and his tireless efforts to expand the scope of police anti-terror activity — has given an interview in which he advocates criminalising any release of information that the state wishes to keep secret. He bemoans the fact that

Most of the legislation about state secrets is in the Official Secrets Act and it only concerns an official.

Now, before you wonder how far he might go in criminalising the discussion of public policy, rest assured, Blair is only interested in promoting discussion:

I think there is going to have to be a look at what happens when somebody possesses material which is secret without having authority.

That doesn’t sound so bad. They’re just going to “have a look”, and see “what happens”.

You might think, as soon as someone without “authority” possesses the material, that it is no longer a secret, but that would be only if you don’t have Lord Blair’s experience of making words mean what you intend them to mean.

If only we’d had these laws back in 2005, poor Charles de Menezes might still be a terrorist today!

Spying on the UN: The majestic equality of the law

One of the superficial arguments made against Edward Snowden is, He signed a contract, for crying out loud! He agreed not to reveal this information. And he broke the law. So, of course, he belongs in prison.

Let’s talk about some of the other people who violated the contracts they signed and broke the law. People like Barack Obama. Just to pick an example at random, we have today in Der Spiegel (odd that it hasn’t appeared yet in the English-language press, so far as I have seen):

The US clandestine service NSA has been spying not just on the European Union, but also on the United Nations Headquarters. That has been revealed by secret NSA documents that Spiegel has examined.

According to these, the NSA succeeded in the summer of 2012 in penetrating the videoconference system of the community of nations, and to break the encryption. This “dramatically improved the data received from video-teleconferences and the capacity to decrypt these data,” according to one secret NSA document. “These data transmissions deliver to us the internal video-teleconferences of the United Nations (yay!)”. Within three weeks the number of decrypted communications rose from 12 to 458.

The US is committed by treaty not to conduct clandestine operations against the UN or the national representations there. “yay!” indeed. It’s good to see that violations of international treaties are considered with an appropriate level of seriousness within the agency.

So Barack Obama — and his security agents — have violated solemn treaties, ratified by Congress, hence part of the “supreme law of the land”. So do those who break the law definitely belong in prison? What about those who have revealed information that they have pledged to keep secret? Or is there some wiggle room to consider justifications and rationales for breaking the law?

The peer-review fetish: Let’s abolish the gold standard!

I’ve just been reading two books on the climate-change debate, both focusing on the so-called “hockey stick graph”: Michael Mann’s The Hockey Stick and the Climate Wars: Dispatches from the Front Lines, and A. W. Montford’s The Hockey Stick Illusion: Climategate and the Corruption of Science. I’ll comment on these in a later post, but right now I want to comment on the totemic role that the strange ritual of anonymous peer review plays for the gatekeepers of science.

One commonly hears that anonymous peer review (henceforth APR) is the “gold standard” for scientific papers. Now, this is a reasonable description, in that the gold standard was a system that long outlived its usefulness, constraining growth and innovation by attempting to measure something that is inherently fluid and abstract by an arbitrary concrete criterion, and persisting through the vested interests of a few and deficient imagination of the many.

That’s not usually what people mean, though.

An article is submitted to a journal. An editor has read it and decided to include it. It appears in print. What does APR add to this? It means that the editor also solicited the opinion of at least one other person (the “referee(s)”). That’s it. The opinion may have been expressed in three lines or less. She may have ignored the opinion.

Furthermore, to drain away any incentive for the referee(s) to be conscientious about their work,

  • They are unpaid.
  • They are anonymous. We know how well that works for raising the tone of blog comments.
  • Anonymity implies: Their contributions will never be acknowledged. If they contribute important insights to the paper, they may be recognised in the acknowledgement section: “We are grateful for the helpful suggestions of an anonymous referee.” Very occasionally an author will suggest, through the editor, that a referee who has made important contributions be invited to join the paper as a co-author. More commonly, a paper will be sent from journal to journal, collecting useful suggestions until it has actually become worth publishing.*
  • No one will ever take issue with any positive remarks the referee makes, as no one but the authors (and the editor) will ever see them. Negative comments, on the other hand, may get pushback from the author, and thus need to be justified, requiring far more work.
  • Normally, the author will be forced to demonstrate that she has taken the referee’s criticism to heart, no matter how petty or subjective. This encourages the referee to adopt an Olympian stance, passing judgement on what by rights ought to be the author’s prerogative.

Of course, I don’t mean to say that most referees most of the time don’t do a very conscientious job. I take refereeing seriously, and make a good-faith effort to be fair, judicious, and helpful. But I’m sure that I’m not the only one who feels that the incentives are pushing in other directions, and to the extent that I do a careful job, it is mainly out of some abstract sense of duty. I am particularly irritated when I find myself forced to put original insights into my report, to explain why the paper is deficient. I would much rather the paper be published as is, and then I could make my criticism publicly, and then, if I’m right, be recognised for my contribution. Continue reading “The peer-review fetish: Let’s abolish the gold standard!”

Why should David Miranda keep David Cameron’s secrets?

One more thought on l’affaire Miranda that hasn’t, I think, been sufficiently represented in the public discussion: What is stolen information? If David Miranda had picked up the British crown jewels in Berlin, and was flying them to Brazil, and was foolish enough to change planes in Heathrow, of course the police would have every right to stop him there and confiscate the jewels.

In fact, though, Miranda was carrying information. If his memory was good enough — if he had a photographic memory — he could have carried it in his head. He is a Brazilian citizen who has, so far as I know, no connection to the UK. What possible justification could there be for expecting him to keep British secrets? If we consider the implications of countries stopping travellers in transit, to examine and confiscate the information they are carrying, it is chilling. And again, what if the traveller is carrying the forbidden information in his head rather than on a hard drive? I’m sure I know many things which whose distribution could benefit enemies of, say, the Iranian state, or the Chinese.

“Could be of benefit to terrorists”: Theresa May channels Al Franken

One of the more ingenious bits of political satire that I have seen in recent years was a Saturday Night Live sketch (apparently conceived by Al Franken) that parodied the use of out-of-context quotes or intentional misunderstanding of words in political advertisements. This was during the 2008 US presidential election, and was directed at John McCain, but there was no shortage of alternative targets; and Mitt Romney’s 2012 presidential election campaign exceeded even the satire.

The sketch showed McCain in a sound studio, recording the “I approved this message” message, purely as a frame for showing a succession of increasingly ridiculous ads. In one, an ominous voice says,

Barack Obama says he wants universal health care. Really? Health Care for the whole universe? [pictures of spiral galaxies] Even for Osama bin Laden? [pictures of Obama and bin Laden next to each other]

It proceeds to my favourite, the same ominous voice intoning that “Barack Obama says he wants to provide tax breaks to child molesters”. At that the McCain character asks, is that true? The advertising executive explains that Obama has proposed giving tax breaks to all Americans, and that would certainly include child molesters.

I thought of this when I heard about this recent BBC interview with Home Secretary Theresa May, explaining why the police were justified in using anti-terrorism laws to interrogate David Miranda, who was suspected of nothing other than ferrying documents that the UK wanted to keep secret between two journalists. Despite the fact that the law seems to allow detention only for the purpose of ascertaining whether the person detained is a terrorist, May argues that the information he was carrying “could be of benefit to terrorists”. Of course, as William Saletan has pointed out, this is a climb-down from the Home Office’s earlier language that Miranda carried “information that would help terrorism”, and that many people believe — and certainly the journalists and their publishers seem to believe — that publishing this information would help everyone. If it helps terrorists, then only incidentally.

Or, as Theresa May would have rewritten the SNL sketch,

Glenn Greenwald and Eric Snowden say they want to provide secret information about US and UK espionage activities to al Qaeda.