edself's Comments

We westerners are used to an economic system where materials are cheap and labor is expensive; it's always a surprise to travel to a place where labor is cheap and materials are expensive....
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Sorry you got measles*, but when the MMR was first introduced in the United States, kids only got one dose, and it seemed to work pretty well - because most kids subsequently got exposed to wild measles, giving them a nice booster effect. Once the rate of measles really dropped, it became clear that one dose of the vaccine, minus exposure to the disease, did not give good protection - which is why we now give two doses.

Why dredge up this old history? Because exactly the same thing happened very recently when the chickenpox vaccine was introduced in the US. It had been used for twenty years in Japan, where only high-risk individuals got the vaccine - one dose worked great, because there was still a lot of chickenpox circulating, so everybody got the booster effect. The Varivax vaccine started in the US as a single dose, just like the MMR. Once the level of wild chickenpox dropped, it became apparent that two doses were needed to give good protection.

Around the world, measles still kills several hundred thousand children a year. I made sure to take my daughters to an old settler cemetery to show them why vaccines are important. Nothing like seeing the tombstones of multiple children in a family, all dying in the same month, to bring home how lucky we are to live in a time when vaccination prevents so many childhood deaths.

* By the way, parents often misdiagnose the various rash-causing infections, which explains most of the cases where people claim to have had chickenpox twice. So maybe it was measles, maybe not.
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My father always said you were truly cultured if you could listen to the William Tell Overture without thinking of the Lone Ranger. Maybe now I can pass the test!
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I think a lot of us grew up reading a wider vocabulary than we heard spoken. I was an adult before I learned that gauge does not rhyme with dodge, and awry does not rhyme with sorry.
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This reminds me of a story I read about Americans living somewhere in Africa - if a pickpocket stole your wallet, you could expect it to be tossed into your compound a few days later (empty of cash, but with all your hard-to-replace identification). The pickpocket viewed the victim not like a hunter views a deer, but like a farmer views a dairy cow.
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The "two trunk" design was featured in the Volkswagen Type 3 ("Squareback" in North America, "Variant" elsewhere). I think the appeal of having front and back storage couldn't compete with the hassle of having to access the engine through a little trap door.

Readers who lived and loved the John Muir "How to Keep Your Volkswagen Alive, A Guide for the Compleat Idiot" book will remember the parallel sets of instructions for bugs, vans and squarebacks - I always felt sorry for anyone trying to work on a squareback.
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I have a very fond and specific memory of the demise of ring-pulls in the U.S. I was a foreign exchange student in 1979-80, so missed all the media about the change. When I got home (in the hottest part of summer), I was completely stumped the first time I tried to open a soda!
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(Oops - sorry, the above comment was for the preceding "doctor asked about guns" story.)

The American Academy of Pediatics chapter in California had quite a struggle in the state legislature a few years ago. The opposing lobbyists were not employed by alcohol or tobacco manufacturers, but by contractors. The AAP chapter was lobbying to require four-sided fencing around backyard pools, and the contractors were afraid it would cut into their pool construction.
As the Freakonomics authors have pointed out, having a pool at your house is much more likely to kill your kid than having a firearm at your house. So I'm glad your doctor asked....
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Here's my two cents as a pediatrician:
In this age of vaccination and antibiotics, most of the significant decrease in mortality is going to come from accident prevention and preventing chronic diseases of adulthood. (For pediatricians, the latter mostly involves preventing smoking and obesity.) Pediatricians save a lot more lives through "anticipatory guidance" and prevention than with any sort of wizardry with diagnosis and treatment. Since it seems so commonplace, patients often don't especially see this part of a visit as important.
I rarely ever fire patients, since I think kids with jerks for parents probably need a good doctor as much or more than than kids with good parents. However, many doctors take the approach that a parent who has a basic disagreement with the doctor's approach would be better served with another doctor (or is just a pain in the ass, and not worth having as a customer.)
Over the years, the leading cause of parents dropping me as their child's doctor has been my telling them to quit smoking. It's always a balancing act to be forceful enough to motivate parents without alienating them, and I don't always get it right.
I do ask about firearms in the home. If they're present, I talk about safe storage (for little kids) and about keeping firearms out of the home completely ("store your deer rifle at grandpa's house") during the years when kids are prone to suicide. ("When your 16 year old son comes back from the party where he sees his ex-girlfriend with her new boyfriend, I'd rather he came home to a house without a gun.")
There are certainly doctors who don't bother to address uncomfortable subjects like parental smoking, guns in the house, excess television watching or refusing vaccinations. The doctors probably spare themselves a lot of hassle and get home for dinner more often than I do, but I don't think they're doing a service to the children they care for.
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This makes total evolutionary sense: Traditionally-built turtles (thank you, Ladies' Detective Agency) don't need to invest resources in speed, soft-shell turtles do.
Soft-shell turtles also can't withdraw their limbs and head into the shell.
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Profile for edself

  • Member Since 2012/08/07



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