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I've Never Gotten an Annual Physical. How About You?

| Fri Jan. 9, 2015 11:17 AM EST

Ezekiel Emanuel passes along the results of research about the value of getting an annual physical exam:

The unequivocal conclusion: the appointments are unlikely to be beneficial. Regardless of which screenings and tests were administered, studies of annual health exams dating from 1963 to 1999 show that the annual physicals did not reduce mortality overall or for specific causes of death from cancer or heart disease. And the checkups consume billions, although no one is sure exactly how many billions because of the challenge of measuring the additional screenings and follow-up tests.

How can this be? There have been stories and studies in the past few years questioning the value of the physical, but neither patients nor doctors seem to want to hear the message. Part of the reason is psychological; the exam provides an opportunity to talk and reaffirm the physician-patient relationship even if there is no specific complaint. There is also habit. It’s hard to change something that’s been recommended by physicians and medical organizations for more than 100 years. And then there is skepticism about the research. Almost everyone thinks they know someone whose annual exam detected a minor symptom that led to the early diagnosis and treatment of cancer, or some similar lifesaving story.

This is a funny thing. I've never had an annual physical. This isn't for any specific reason. It just never occurred to me, and none of my doctors has ever recommended it. I've probably had half a dozen different primary care physicians over my adult life, and not one of them has ever suggested I should be getting an annual physical.

I'm not sure what this means. Is the annual physical something that doctors only do if their patients ask? Or have I just had an unusual bunch of doctors over the years? What's your experience with this?

And as long as I'm noodling about stuff like this, here's a thought that passed through my brain the other day. I was thinking about the fact that one of the indicators of the multiple myeloma that I was diagnosed with comes from blood tests. So why not test routinely for the markers of multiple myeloma? The answer is obvious: you'd be performing millions of blood tests every year with a vanishingly small chance of finding anything. What's more, there are lots of different cancers. Are you going to draw a few pints of blood every year and test for all of them at a cost of tens of thousands of dollars? That makes no sense in otherwise healthy people.

But this got me thinking about that new blood testing technique I wrote about a few months ago. In a nutshell, it requires only a tiny amount of blood, and the tests themselves are super cheap. If this works as advertised—and presumably gets even cheaper with time—does it open up new possibilities for an annual physical that actually makes sense? Would it be possible to draw no more than a standard vial of blood once a year, and then perform a huge variety of tests at a cost of a few hundred dollars? The odds of finding anything would still be small, but it might nonetheless be worth it if the cost both in time and money was also small.

Of course, there are still problems with false positives and so forth, even if the cost of this regimen was small. So maybe it would be a lousy idea regardless of its feasibility. I really have no idea. But it's an intriguing possibility.

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Chart of the Day: Net New Jobs in December

| Fri Jan. 9, 2015 10:12 AM EST

The American economy added 252,000 new jobs last month, 90,000 of which were needed to keep up with population growth. This means that net job growth clocked in at 162,000 jobs, which is not quite as good as last month but still not bad. Virtually all of this growth was in the private sector, yet another sign that the recovery is finally motoring along at a steady if unspectacular rate.

But the news was not all good. The headline unemployment rate fell from 5.8 percent to 5.6 percent, but this was mostly because of people dropping out of the labor force. Wage growth was also disappointing. Last month's wage increases, which I was skeptical about, were entirely washed away. Earnings for nonsupervisory workers actually dropped to slightly below their October levels.

Overall, this jobs report is decent news, but hardly great. Until we start to see steady employment growth and steady wage growth, the labor market still has a lot of slack no matter what the headline unemployment rate is. Given this, in addition to possible headwinds in the rest of the world, the Fed needs to continue to keep interest rates low for quite a while longer. It's not yet time to tighten.

Gunmen Suspected in Charlie Hebdo Attack Killed; Four Dead in Second Hostage Situation

| Fri Jan. 9, 2015 8:49 AM EST

This is a developing story and is being updated below.

Police have closed in on two men they believe are the brothers suspected in Wednesday's terrorist attack at the Charlie Hebdo newspaper. The Times reports hundreds of security forces have descended upon a printing shop northeast of Paris, where at least one hostage has been taken.

A second hostage situation is developing elsewhere in Paris, near Porte de Vincennes, with multiple hostages being held inside a kosher supermarket.

The AP reports the hostage-taker inside the supermarket is believed to have fatally shot a French policewoman in a southern suburb of Paris on Thursday. He appears to be connected to the gunmen behind the Charlie Hebdo massacre. 

For live video of both situations, watch below: 

Update: Friday, January 9, 11:10 a.m. EST: Gunshots and explosions have been heard  at both the printing shop where the two suspected gunmen, brothers Chérif and Saïd Kouachi, are holed up and the kosher supermarket.

Update: Friday, January 9, 11:30 a.m. EST: There are multiple reports citing the gunmen in the Charlie Hebdo attack have been killed. 

Update: Friday, January 9, 12:05 p.m. EST: Multiple reports are indicating that the hostage-taker at the kosher supermarket is dead, along with at least four hostages. Police officers are reportedly injured.

Update: Friday, January 9, 2:10 p.m. EST: President Hollande confirms at least four people were killed in the kosher market siege. 

Net Neutrality Might Be a Step Closer to Reality

| Thu Jan. 8, 2015 9:20 PM EST

Net neutrality got some new momentum yesterday from FCC Chairman Tom Wheeler:

Speaking here at the 2015 International CES tech trade show, Wheeler repeatedly hinted he favors reclassification of broadband as a public utility, which would subject Internet providers to some of the same rules that govern old phone companies. The approach is already drawing heavy fire from Republicans and telecom giants who warn it will lead to burdensome regulation.

....Back in Washington, Sen. Dean Heller (R-Nev.) quickly slammed Wheeler’s comments, urging him to defer to Congress. And Senate Commerce Committee Chairman John Thune (R-S.D.) separately on Wednesday said he’s pushed the FCC to delay its new rules until lawmakers have a chance to come up with their own solution. He expressed early interest in legislation that would specify new consumer protections without going as far as reclassifying broadband

We think a legislative route is a better way to go, and we’ve developed some language that we think addresses a lot of the concerns that Democrats have raised — but does it without that heavy regulatory approach,” the senator said.

The best solution to the problem of net neutrality would be the introduction of genuine competition among ISPs. Your local cable company might still want to discriminate against rivals in the video business—or maybe team up with one of them and degrade the others—but they'd have a hard time doing that if Google was providing great quality for every web-based video service and customers could easily switch if they got tired of poor Netflix streaming. More generally, competition would put a ceiling on all sorts of bad behavior. If your prices are high, or your service is poor, or you have a habit of playing favorites with certain sites, then you're going to lose customers unless you get your act together. True competition would make heavy regulation of broadband mostly unnecessary.

But we don't have true competition and we're not likely to get it anytime soon. So we do what we always need to do when corporations enjoy monopoly positions: we regulate them. And given the noises that ISPs and other broadband suppliers have occasionally made in candid moments, strict regulation requiring equal treatment for everyone is probably in order.

This means that Wheeler's announcement is good news. In theory, so is John Thune's. That's because I agree with him: the best net neutrality solution would be a legislative one. It would allow more flexibility than the FCC has under its existing Title II telephone regulations, and it would almost certainly be less vulnerable to court challenges.

But is Thune really serious about addressing "a lot of the concerns that Democrats have raised"? I guess I'm skeptical. Part of the reason is that I've never really understood exactly why Republicans are so dead set against net neutrality regulations. This isn't something that would stifle competition, after all, nor is it a simple matter of siding with corporate interests that Republicans are traditionally sympathetic to. Rather, net neutrality is basically a battle between corporate behemoths: in general, content providers are for it and ISPs are against it. I've never quite figured out why the GOP has so steadfastly taken the side of the broadband providers in this battle.

This makes me wonder what forces are driving Thune, and whether he's really able and willing to make substantive compromises on net neutrality. Without something to prod him, my guess is that he'd prefer doing nothing, so if Wheeler's actions provide that prod, then three cheers for Title II regulation. It might not be ideal, but it might be just the incentive Republicans need to get serious about introducing legislation good enough to get support from both President Obama and enough Democrats to pass the Senate. We'll see.

This Is One of the Worst Retractions a Newspaper Has Ever Had to Publish

| Thu Jan. 8, 2015 8:04 PM EST

The News-Enterprise in Elizabethtown, Kentucky, had a story on its front page today that paraphrased a local police official as saying that most cops typically go into law enforcement "because they have a desire to shoot minorities." Spicy stuff! Only problem: It never happened.

The paper quickly issued a retraction on its home page and updated the online version of the story—ironically headlined "Law enforcement to be honored for service"—to include a formal apology from editor Ben Sheroan. The corrected story now reads: "Hardin County Sheriff John Ward said those who go into the law enforcement profession typically do it because they have a desire to serve the community."

So what happened? The paper initially called it a "typographical mistake" but that obviously didn't make any sense. Jim Romenesko reports that it was actually a joke mistake. "One [copy desk staffer] wrote the 'shoot minorities' line on the page proof as a joke and the second—in charge of the front page—put it in the story."

Never joke on the page proofs.

Satellite Imagery Shows the Extent of Boko Haram Devastation in Nigeria

| Thu Jan. 8, 2015 5:53 PM EST
Residents stand outside burnt homes in Gambaru, Nigeria after a Boko Haram attack in May 2014.

Update, Thursday, January 15, 2015: New satellite imagery released by Amnesty International shows the extent of the devastation Boko Haram has visited upon northern Nigeria over the past week. Below are before and after images of the town of Doron Baga. Healthy vegetation is colored red.

The Islamist militant group may now control up to 20 percent of the country, according to NPR. Journalists are unable to report on the killing in the north, because approaching the area would be a "death wish," The New Yorker's Alexis Okeowo told host Melissa Block Tuesday.

Update, Friday, January 9, 2015: On Friday morning, Amnesty International said the latest Boko Haram attack could be the "deadliest massacre" in the group's history, if the early reports that as many as 2,000 people were killed turn out to be true.

This week, Boko Haram, the Islamist terror group based in northern Nigeria, launched a massive attack on the town of Baga, killing dozens, according to Reuters. Other initial reports put the number of dead in the hundreds or thousands. The attack is the latest in the group's increasingly bloody campaign to establish an Islamic state in the West African country. The group attained international infamy last April after it abducted some 300 girls. More than 200 of them are still missing.

Over the course of this Tuesday and Wednesday, the militants set fire to buildings in Baga and shot indiscriminately at civilians. Nearly the entire town was torched, according to the BBC. Baga, which had roughly 10,000 residents, is now "virtually non-existent," Musa Alhaji Bukar, a senior government official, told the British news agency.

Here's more from the BBC:

Those who fled reported that they had been unable to bury the dead, and corpses littered the town's streets, he said.

Boko Haram was now in control of Baga and 16 neighbouring towns after the military retreated, Mr Bukar said.

While he raised fears that some 2,000 had been killed in the raids, other reports put the number in the hundreds.

The attack follows an assault by Boko Haram on a military base in Baga on Saturday.

The AFP reported late Thursday that the terror group also decimated over a dozen towns and villages surrounding Baga:

Boko Haram launched renewed attacks around a captured town in restive northeast Nigeria this week, razing at least 16 towns and villages, a local government and a union official told AFP.

'They burnt to the ground all the 16 towns and villages including Baga, Dorn-Baga, Mile 4, Mile 3, Kauyen Kuros and Bunduram,' said Musa Bukar, head of the Kukawa local government in Borno state.

Boko Haram has been terrorizing Nigeria for more than five years. Over the past year, the group has killed more than 10,000 people, according to the Council on Foreign Relations.

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Mickey Mouse Still Stricken With Measles, Thanks to the Anti-Vaxxers

| Thu Jan. 8, 2015 5:47 PM EST

Update (1/23/2015): At least 59 Measles cases have been confirmed in California this year, 42 of them linked to the Disneyland outbreak, according to the state health department. Public health officials around the state, but particularly in Southern California, where the outbreak is the worst, are practically begging parents to have their children immunized. The disease is highly transmissible by air—droplets from an infected person's cough can remain suspended for up to two hours, the CDC notes, and the virus can live for just as long on surfaces. The current outbreak is "100 percent connected" to the anti-immunization movement, Dr. James Cherry, a specialist in pediatric infectious diseases at the University of California-Los Angeles told the New York Times: "It wouldn't have happened otherwise—it wouldn't have gone anywhere," Cherry said. "There are some pretty dumb people out there."

Update (1/13/2015): The number of reported Measles cases linked to Disneyland has grown to 22, reports the Los Angeles Times. At least 12 of the infected people were unvaccinated, while four had had a Measles shot at some point. The vaccination status of the other six was unknown.

****

Yesterday, instead of cherishing freshly made memories of mouse ears or trying to get the song "A Pirate's Life for Me" to stop looping in their heads, nine Disneyland visitors were left battling a potentially deadly disease. As The LA Times reports, the California Department of Public Health has confirmed nine cases and is investigating three others in California and Utah, all people who visited the Anaheim theme park last month.

The highly infectious disease, which is transmitted through the air, can lead to pneumonia, encephalitis, and sometimes death in children. In 2000, the US Centers for Disease Control declared it eliminated in the United States, thanks in large part to an effective vaccine. But because of anti-vaccination hysteria, fueled by discredited claims about links between vaccines and autism, many parents have opted out of vaccinating their kids, leaving them—and others, including children too young to be vaccinated—vulnerable. And while some children do react badly to vaccines, it's important to remember that the diseases we vaccinate against are killers; the shots save countless lives.

Of the seven California cases, six hadn't been vaccinated—two because they were underage. (Doctors administer the vaccine twice after the child is 12 months old.)

This outbreak is part of an ongoing trend. Measles rates have risen dramatically over the past few years. As my colleague Julia Lurie pointed out last May, the CDC reported record numbers in 2014, due in large part to gaps in vaccinations. According to a CDC press release, "90 percent of all measles cases in the United States were in people who were not vaccinated or whose vaccination status was unknown. Among the US residents who were not vaccinated, 85 percent were religious, philosophical, or personal reasons."

In the video below, my colleague Kiera Butler interviewed a Marin County pediatrician who caters to anti-vaxxer parents:

Jessica Chastain Hits Back at Russell Crowe's Denial of Hollywood's Ageism Problem

| Thu Jan. 8, 2015 3:27 PM EST

Jessica Chastain is firing back at comments made by actor Russell Crowe, after he attempted to explain why there aren't enough roles for women over the age of 40 by blaming unrealistic, female desires to only play the hot young thing.

Crowe's controversial comments came during a recent interview with Australian Women's Weekly:

The best thing about the industry I'm in – movies – is that there are roles for people in all different stages of life. To be honest, I think you'll find that the woman who is saying that (the roles have dried up) is the woman who at 40, 45, 48, still wants to play the ingénue and can’t understand why she's not being cast as the 21 year old.

In response to Crowe's victim-blaming away Hollywood's well-documented ageism problem, Chastain told reporters, "Russell keeps getting his foot stuck in his mouth!"

"There are some incredible actresses in their 50s and 60s that are not getting opportunities in film, and for someone to say there are plenty of roles for women that age, [that] is not someone who's going to the movie theater," she added. 

Riding to Crowe's defense, however, is 18-time Academy Award nominee Meryl Streep:

I read what he said -- all of what he said. It's been misappropriated, what he was talking about. He was talking about himself. The journalist asked him, 'Why don’t you do another 'Gladiator,' you know, everybody loved that.' He said, 'I'm too old. I can't be the gladiator anymore. I'm playing parts that are appropriate to my age. Then the conversation went on to actresses. So that was proving a point, that he was talking about himself, as most actors do. That aside, I agree with him. It's good to live in the place where you are. You can put old age on; it's a lot harder to take it off.

But as Jezebel points out, Streep is not dismissing the charge that Hollywood lacks roles for older women—she has spoken out against both sexism and ageism in the film industry on numerous occasions. Streep is suggesting actors in general play their own age. Chastain is saying that many great actresses aren't given that opportunity. 

Neil deGrasse Tyson Is Bringing Science to Late Night Television

| Thu Jan. 8, 2015 2:39 PM EST

"April is the cruelest month, breeding/ lilacs out of the dead land, mixing," wrote T.S. Eliot. I don't know what the hell he was on about because this April is going to be awesome.

Famous science man Neil deGrasse Tyson's new late-night talk show Star Talk, based on his acclaimed podcast, is coming to the National Geographic Channel in that very merry fourth month of 2015. With it brings the promise of dozens of easily embeddable, highly shareable video clips of Tyson debunking anti-science nonsense to creationists, and explaining actual science goodness to America's sweethearts (movie stars) and black sheep (comedians). The Hollywood Reporter, err, reports:

Star Talk will indeed follow a similar format to Tyson's podcast, which marries science and popular culture and feature interviews with celebrities, comedians and scientists. He's still sorting through all of the elements that he'll add to the television iteration, but he does intend to give Bill Nye a platform for a minute-long rant in each show, much as Andy Rooney had for many years on CBS' 60 Minutes.

Look out, John Oliver: America fucking loves science.

(via NYMag)

Don Lemon to Prominent Muslim Human Rights Lawyer: "Do You Support ISIS?"

| Thu Jan. 8, 2015 2:26 PM EST

After Arsalan Iftikhar, a prominent human rights lawyer and editor, explained at length to CNN's perpetually clueless Don Lemon why it's dangerous "to conflate the actions of a very few to a population of 1.7 billion people" when discussing the attack on Charlie Hebdo, Lemon followed up with a stat claiming 16 percent of French citizens support ISIS.

"They obviously have sympathies for that ideology,” Iftikhar said. "I don’t think that would mean they would justify the killing of innocent civilians or murdering people on the streets."

Unsatisfied with Iftikhar's response, Lemon says, "I just want to get more specific. Do you support ISIS?"

"...Did you just ask me if I support ISIS?" Iftikhar asked in apparent disbelief. 

"Mmm hmm," Lemon nodded in confirmation, yet again blinded by the sheer offensiveness of his question.

"I just answered your question. I said that obviously these 16% of people support the ideology, but I don’t think that would necessarily extrapolate to supporting of killing of innocent people. You can have sympathy for an ideology and not support the mass murdering of people."

Watch below:

(h/t Mediaite)