Morris E. Chafetz M.D.

Second hand smoke causes death

The Answers Are Different for Each of Us

As I recently celebrated my 82nd birthday, the ancient idiom "If
you don't die with a question on your lips, what reason could
you have for going on with life?" has grown stronger in my
mind and emotions.

Some strong examples exist to be applied to the idiom. For
example, we keep hearing and reading about how the HIV
virus is spreading the wildfire of AIDS throughout many
nations although Nicholas D. Kristof in the New York Times
(May 30, 2006) says "(It's not certain that all died of AIDS,
because so few people are tested that the cause of death is not
always known)" Although HIV is a transmittable virus, what
disease does it cause? For example, no one, can develop the
infection of smallpox without having the smallpox virus nor can
anyone develop tuberculosis without the active presence of the
tubercle bacillus. These are both infectious diseases. AIDS, on
the other hand, is a syndrome ­not a disease, and I do not
know of a single illness that can exist only if you show a
positive HIV presence.

We keep reading how the risk of certain medication is great
because of a controlled study: i.e. the use of a placebo (an inert
substance). What is used as a controlled study, for example,
is if thousands of patients take a trial substance, and 40 people
on the substance suffer heart disease or a stroke, while only 20
people on placebo suffer heart disease or a stroke, that is
scientific proof of how dangerous the substance is. But
the "numbers game" and the "religion" of correlation-as-cause
grows. It grows because there cannot be anything that can
fulfill the two basic rules of scientific studies: 1) you have to
compare the same thing and no two people are alike (not
even identical twins), and 2) you have to control all the
variables that can affect outcome which is humanly impossible.
No one can know all the subconcious, unconcious and chance
incidents that occur all the time that can affect mood, physical
well-being, and a host of responses that can affect all of us.
We have to remind ourselves that there has never been
anyone like us, and there can never be (even though we'll push
genetic explanations). But our uniqueness and specialness are
not so special, since they apply to each and everyone of us

We keep hearing about global warming. Of course, there is
global warming (and global cooling). But the global warming
we are experiencing today and the carbon dioxide ratios to
oxygen levels are no different than existed millions of years
ago, before there were humans or animals on the planet. But
can there be anything more noble than saving the planet?

We hear about addicting substances. In over a half ­a-century
of work in this medical area, I have never met an addicting
substance. By definition, an addicting substance would be a
substance that if anyone used it, they would absolutely
become addicted to it. I know of no such substance. On the
other hand, I know of nothing to which a person, for whatever
reason, cannot become addicted (gambling, sex, marriage,
work, etc.).

There is a basic question each of us should ask ourselves in the
privacy of our own thoughts: Would I feel the way I do, would I
see the world as I do, would I value what I value, if I were
born to different parents, at a different time in a different
society? We are all products of and prisoners of our past. We
all need to remember: Thinking and reading are for the brain
and mind what exercise is for the body.

Alligator Epidemic

If you've paid any attention to the news the last week or so, you know that alligator attack is suspected as the cause of the deaths of three young women in Florida this month.

Typically, alligators are blamed for approximately one death every three years in the Sunshine State. So the recent reports suggest a tenfold increase in alligator fatalities in Florida this year -- and the year isn't even half over. Even if there are no more fatal attacks by alligators this year, were the trend to continue there would be 30 deaths by alligator next year, 300 in 2008, 3,000 in 2009, 30,000 in 2010, 300,000 in 2011, 3,000,000 in 2012, 30,000,000 in 2013, and in 2014 alligators would devour the entire population of the United States! What are we to do?

Nothing, of course. The trend will not continue. Anything that happens to three people out of a group the size of Florida's population is statistically insignificant -- statistically the same as zero. Mind you, this is small comfort to the families of the women who were killed.

What makes alligator attacks newsworthy is precisely the fact that they are so rare. How many people do you suppose died of, say, injuries received in automobile accidents in the period of time spanned by the alligator attacks? Yet no special fuss was made over those unfortunate persons, even though their violent deaths were probably every bit as dramatic as death by crocodilian.

One of the most important points I seek to make in Big Fat Liars is that it is extremely dangerous and generally impossible to accurately generalize. Yet the attempt is always made and the results are often misleading. Is being a woman a risk factor in alligator attack? Is being a woman in 2006 a risk factor?

The chances are good that the victims knew the slight risk of alligator attack when they went outdoors on what turned out to be their last days. As did the millions of Floridians who knew that risk on those days and went out without anything bad happening to them (or to then succumb to a car wreck or a sudden heart attack or a pistol's slug). The one indisputable cause of death is birth. The death rate is 100 percent. The only issue is timing, with most of us seeking to put as much time as is reasonably possible between birth and death.

Some people, surely, are devoted solely to prolonging their own lives, at the expense of the quality of those lives (unless merely being alive is all that pleases them). The rest of us weigh risks against the rewards we hope to receive as a result of engaging in "risky" activities. It's our choice to make, and it ought to be.

A statistic that proposes to tell you you're 10 times more likely to get eaten by a giant reptile in Florida this year than you were last year ought to be goven consideration equal to its statistical significance -- zero -- as you decide where to vacation.

Doom for Dollars

A few weeks ago, on a night when a large number of thunderstorms and their associated tornadoes were ravaging central Illinois, a person seeking information on these storms and therefore turning to the Weather Channel would have found instead a program called "It Could Happen Tomorrow." That show describes some terrible event that might happen someday. Viewers might be excused for having tuned in hoping to see "It's Happening Right Now," a program that was somewhat more urgently needed

Likewise, people heading off to bed and thinking to get a sense of the next day's forecast first might turn to that channel, only to find "Storm Stories," a program about weather in other times. Describing what the weather was is oh-so-much easier than predicting what it will be. And there are better pictures, television in the minds of programmers being all about pictures.

There is a swarm of television channels -- Discovery, History, History International, National Geographic, Times, Science, Learning, and one or two others -- that seem to be run out of the same closet somewhere, sharing about 50 programs that pop up on each in turn. Added to their mix this year are some highly speculative disaster programs similar to the one the Weather Channel ran that night instead of reporting on the destruction of Illinois's capital.

There seems to be money in predicting doom. And it is safe to say that something terrible will happen someplace sometime. When one can predict a horrific event with any more precision than that, it can be a real cash cow.

One has to wonder, then, how much of the panicked reporting of "avian flu" has been real and how much is hype. For well over a year we have been warned that any day now this apparently virulent strain will mutate such that it can be easily spread and by the time the contagion has cleared as much as a quarter of the world's population will be dead before its time.

And one has to be a little bit amused at a story in today's New York Times under the headline "Avian Flu Wanes in Asian Nations It First Hit Hard." It turns out that in the nations where a quick and factual (as opposed to feelings-based) policy is imposed, the contagion can be knocked down before it has much of a chance to mutate. The amusement comes in seeing, also today, this from the Stamford Advocate: "City braces for possibility of bird flu." The headline alone conjures images of residents of that affluent Connecticut city cowering in their homes, perhaps peeking through the curtains from time to time to see whether the menace has made it any farther up the street.

The problem is, a story which carries the headline "City makes provision for epidemic when and if it ever comes to pass" would not draw as many readers as the one that has people "bracing" for something -- which the New York Times reports may well be controllable.

It is all fear mongering. I'd be the last to say that there is nothing in the world to fear. I'd also be the first to say (and I was, in the two books you may purchase through the links on the right) that nothing but prurient interest is served by speculative articles and programs which tell us the world will come to an end.

Basic Principles

There are several ideas which run through this blog and through Big Fat Liars and The Tyranny of Experts. It makes sense to list them here:

1. There is no such thing as human science. Humans vary too much to allow useful generalization about any but the most obvious human attributes. In our attempt to go farther, we substitute the numbers game and correlation-as-cause. These do not give us nything of much use. (A perfect example is the recent Vioxx nonsense: A huge number of people were well served by that product. A few were not. The product was withdrawn.)

2. HIV does not cause any disease. AIDS is a syndrome, not a disease.

3. Global warming is scarcely worth becoming upset about, because it is and always has been out of our control. Of course there is global warming. There is also global cooling. That is the nature of things, not the result of some human behavior. The global warming of today is no different in any way than the global warming that occurred before human beings or animals were on the planet. What's more, scientists can scarcely agree as to anything having to do with temperature change or its effects. Where once it was thought that cavemen had wiped out the large prehistoric mammals of North America, it is now thought that a change in temperature brought about those extinctions. What caused the temperature change? Surely not the cavemen in their pre-industrial society.

4. Reading and thinking are for the brain and mind what exercise is for the body. Go without exercise, if you like, but know there's a good chance you'll become flabby and unenergetic as a result. Go without reading and thinking, and your mind may well go dull.

5. There is no such thing as an addicting substance such that anyone using the substance becomes addicted. On the other hand, there is nothing in human behavior or thinking to which one cannot become addicted. The substances don't addict us, we addict us.

6. You can take back control of your own life by freeing yourself of the fears imposed on you by so-called experts.

7. We are all so some extent the sum of our experiences and circumstances. Big Fat Liars asks a question we all might well ask ourselves if we want to be free: Would you feel the way the way you do, would you see the world as you do, would you value what you do, if you were born to different parents, at a different time, in another society?

Think about it.