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| Tue Apr. 7, 2015 2:22 PM EDT

I continue to be a star patient. Final results from yesterday clocked in at 5.2 million stem cells. Apparently I only need two million for the transplant, but they like to get a double sample in case I need another transplant a few years down the road. So four million is the goal.

So why am I still here? Good question. I don't really have a good answer, though. Just in case? More is always better? This is actually a SPECTRE front and they use excess stem cells to breed an undefeatable clone army that will take over the world?

Not sure. In any case, stem cell collection has gone swimmingly and I'll soon be out of here. Now there's only one step left: the actual second round chemo itself followed by transplanting my stem cells back into my body. That begins on April 20.

BY THE WAY: The folks here, who have much more experience with cancer meds than your standard ER facility, are quite certain that my excruciating back pain on Friday was a side effect of the Neupogen. So that's that. Today was my last shot of Neupogen, which means I can get off the pain meds in the next day or two.

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Rand Paul Just Announced That He's Running for President. Here's His Speech.

| Tue Apr. 7, 2015 1:28 PM EDT

Rand Paul just announced that he is running for president. He said some weird things, and some stupid things, and some okay things, and some smart things, and a lot of meaningless things.

Politics!

Here's the transcript, courtesy of TIME.

I have a message, a message that is loud and clear and does not mince words. We have come to take our country back.

We have come to take our country back from the special interests that use Washington as their personal piggy bank, the special interests that are more concerned with their personal welfare than the general welfare.

The Washington machine that gobbles up our freedoms and invades every nook and cranny of our lives must be stopped.

Less than five years ago I stood just down the road in home town in Bowling Green and said those same words. I wasn't supposed to win, no one thought I would.

Some people asked me, then why are you running? The answer is the same now as it was then. I have a vision for America. I want to be part of a return to prosperity, a true economic boom that lists all Americans, a return to a government restrained by the Constitution.

A return to privacy, opportunity, liberty. Too often when Republicans have won we have squandered our victory by becoming part of the Washington machine. That's not who I am.

That's not why I ran for office the first time just a few years ago. The truth is, I love my life as a small-town doctor. Every day I woke up, I felt lucky to be able to do the things I loved. More importantly, I was blessed to be able to do things that made a difference in people's lives.

I never could have done any of this, though, without the help of my parents who are here today. I'd like you to join me and thank my mother and dad.

With my parents' help, I was able to make it through long years of medical training to become an eye surgeon. For me there is nothing that compares with helping someone see better. Last August I was privileged to travel to Guatemala on a medical mission trip together with a team of surgeons from across the U.S.

We operated on more than 200 people who were blind or nearly blind from cataracts. I was grateful to be able to put my scrubs back on, peer into the oculars of the microscope, and focus on the task at hand, to take a surgical approach to fix a problem.

One day in Guatemala, a man arrived and told me that I'd operated on his wife the day before. His wife could see clearly for the first time in years, and she had begged him to get on the bus, travel the winding roads and come back to our surgery center. He too was nearly blind from hardened cataracts.

After his surgery, the next day, his wife sat next to me. As I unveiled the patch from his eyes, it was a powerful emotional moment for me to see them looking at each other clearly for the first time years to see the face they loved again.

As I saw the joy in their eyes, I thought, "This is why I became a doctor."

In that moment, I also remembered my grandmother, who inspired me to become an eye surgeon. She spent hours with me as a kid. We would sort through her old coin collection, looking for wheat pennies and Indian heads. But as her vision began to fail, I became her eyes to inspect the faintness of the mint marks on the old weather-worn coins.

I went with my grandmother to the ophthalmologist as she had her corneas replaced. I was also with her when she received the sad news that macular generation had done irreparable harm to her eyes.

My hope… my hope that my grandmother would see again made me want to become an eye surgeon, to make a difference in people's lives.

I've been fortunate. I've been able to enjoy the American Dream.

I worry, though, that the opportunity and hope are slipping away for our sons and daughters. As I watch our once-great economy collapse under mounting spending and debt, I think, "What kind of America will our grandchildren see"?

It seems to me that both parties and the entire political system are to blame.

Big government and debt doubled under a Republican administration.

And it's now tripling under Barack Obama's watch. President Obama is on course to add more debt than all of the previous presidents combined.

We borrow a million dollars a minute. This vast accumulation of debt threatens not just our economy, but our security.

We can wake up now and do the right thing. Quit spending money we don't have.

This message of liberty is for all Americans, Americans from all walks of life. The message of liberty, opportunity and justice is for all Americans, whether you wear a suit, a uniform or overalls, whether you're white or black, rich or poor.

In order to restore America, one thing is for certain, though: We cannot, we must not dilute our message or give up on our principles.

If we nominate a candidate who is simply Democrat Light, what's the point?

Why bother?

We need to boldly proclaim our vision for America. We need to go boldly forth under the banner of liberty that clutches the Constitution in one hand and the Bill of Rights in the other.

Washington is horribly broken. I fear it can't be fixed from within. We the people must rise up and demand action.

Congress will never balance the budget unless you force them to do so. Congress has an abysmal record with balancing anything. Our only recourse is to force Congress to balance the budget with a constitutional amendment.

I have been to Washington, and let me tell you, there is no monopoly on knowledge there.

I ran for office because we have too many career politicians. I believe it now more than ever.

We limit the President to two terms. It's about time we limit the terms of Congress!

I want to reform Washington. I want common sense rules that will break the log-jam in Congress.

That's why I introduced a Read the Bills Act.

The bills are thousands of pages long. And no one reads them. They are often plopped on our desks only a few hours before a vote.

I've proposed something truly extraordinary — Let's read the bills, every page!

———
Many Americans, though, are being left behind. The reward of work seems beyond their grasp. Under the watch of both parties – the poor seem to get poorer and the rich get richer.

Trillion dollar government stimulus packages have only widened the income gap.

Politically connected cronies get taxpayer dollars by the hundreds of millions, and poor families across America continue to suffer.

I have a different vision, an ambitious vision, a vision that will offer opportunity to all Americans, especially those who have been left behind.

———
Liberal policies have failed our inner cities. Let's just get the facts straight. They have failed our inner cities. Our schools are not equal and the poverty gap continues to widen.

Martin Luther King spoke of two Americas. He described them as "two starkly different American experiences that exist side by side."

In one America, people experience the opportunity of life, liberty and the pursuit of happiness. In the other America, people experience a daily ugliness. …

My trips to Detroit, Appalachia, and Chicago have revealed what I call an ‘undercurrent of unease.'

I want all our children to have the same opportunities that I had. We need to stop limiting kids in poor neighborhoods to failing public schools and offer school choice, not just for the privileged, but for everyone!

It won't happen, though, unless we realize that we can't borrow our way to prosperity.

———

In my vision for America, freedom and prosperity at home can only be achieved if we defend against enemies who are dead-set on attacking America.

The enemy is radical Islam and not only will I name the enemy, I will do what ever it takes to defend America from these haters of mankind!

We need a national defense robust enough to defend against all attack, modern enough to deter all enemies, and nimble enough to defend our vital interests.

But we also need a foreign policy that protects American interests and encourages stability, not chaos!

I envision an America with a national defense unparalleled, undefeatable, and unencumbered by overseas nation building!

I envision a national defense that promotes, as Reagan put it, "Peace through Strength."

I believe in applying Ronald Reagan's approach to foreign policy to the Iran issue.

Successful negotiations with untrustworthy adversaries are only achieved from a position of strength.

We brought Iran to the table from strength, through sanctions I voted for.

Now we must stay strong. That's why I co-sponsored legislation that insures that any deal between the U.S. and Iran must be approved by Congress.

Not only is that good policy, it is the law.

I will oppose any deal that does not end Iran's nuclear ambitions and have strong verification measures. I will insist that any final version be brought before Congress.

The difference between President Obama and myself-he seems to think you can negotiate from a position of weakness.

———
We must realize, though, that we do not project strength by borrowing money from China to send it to Pakistan.

Let's quit building bridges in foreign countries and use that money to build some bridges here at home!

It angers me to see mobs burning our flag and chanting death to America in countries that receive millions of dollars of our foreign aid.

I say it must end. I say not one penny more to these haters of America!

———

Today begins the journey to take back America, to rescue a great country, now adrift.

If you love liberty, stand with me!

If you want to defeat the Washington machine, stand with me!

God bless you. God bless America.

 

Area Doctor Seeks SEO Boost

| Tue Apr. 7, 2015 11:14 AM EDT

Here's one way to drum up some business.

 

The Times' Letters Editor should talk to the Times' sponsored content department. This could be a bold new revenue stream.

This Iconic California Drought Photo Is Pretty Personal for Me

| Tue Apr. 7, 2015 7:00 AM EDT

If you've seen any photos of the current California drought, you've probably seen some variation on these striking before-and-after images of this bridge near Lake Oroville:

California Department of Water Resources

Seeing those images popping up everywhere has been a little weird for me since that bridge used to be named after my grandfather. 

My grandfather, B. Abbott Goldberg, was the deputy director of California's Department of Water Resources from 1961 to 1966. He was one of the legal architects of Gov. Pat Brown's California Water Project, the massive, contentious undertaking that built the infrastructure that currently supplies 25 million people and 1 million acres of farmland. He argued and won two Supreme Court cases, the details of which are mind-numbingly arcane. But they were essential to realizing Brown's vision for mastering the natural resource that he saw as essential to the state's survival.

Winning the West's water, my grandfather explained in a University of California oral history project, was almost a religious mission. His colleagues, he said, "had come up and they had transmitted to me, certainly, the tradition of the Old West, that water is the limiting resource and that by bringing water to the thirsty land, you were in effect doing the Lord's work and that there was nothing more important for the people of California than providing an adequate water supply."

He was proud of his work, whose effectiveness was evident in Californians' unquestioning expectation of plentiful, cheap water. When the state went through the big drought of 1976-77, he noted, "There wasn't a murmur about a shortage of domestic water in Southern California…I didn't find anybody beating the doors down to thank us for what had been done. The fact that it took some forty years to achieve it was just forgotten." Later in his life, he read Cadillac Desert, Marc Reisner's critique of the growth-at-all-costs mentality embodied in the Water Project. He wasn't a fan.

Not that he couldn't see the other side. In his oral history interview, conducted in 1979, my grandfather admitted to some conflicted views about California's relationship with water. Sounding like a good Northern Californian, he mused, "Someplace along the line, the idea began to dawn on me that really Southern California was an environment essentially hostile to human occupation…[B]ut what are you going to do about the millions of people already down there?" And: "I do remember saying to someone that really, the only solution to the water problem was birth control."

He even indulged the what-if question that every thinking Californian asks once they've been here long enough: "I sometimes wonder, maybe it would have been better to let California dry up and blow away, and keep it the way we used to know it."

Which brings us back to the bridge, another symbol of Californians' ambition and ambivalence. After the state named it after my grandfather in the late '60s, local lawmakers objected, insisting it be renamed the Enterprise Bridge, after a town of the same name that had been inundated by Oroville Dam—one of the signature features of the California Water Project.

The Link Between Fracking and Oklahoma's Quakes Keeps Getting Stronger

| Mon Apr. 6, 2015 3:30 PM EDT
A man in Sparks, Oklahoma, picks through rubble from his home following an earthquake in 2011.

Over the last few years, Oklahoma has experienced an insane uptick in earthquakes. As we reported in 2013, the count exploded from just a couple per year back in the mid-2000s to over a thousand in 2010, growing alongside a boom in the state's natural gas drilling industry.

There is now a heap of peer-reviewed research finding that Oklahoma's earthquake "swarm" is directly linked to fracking—not the gas drilling itself, but a follow-up step where brackish wastewater is re-injected into disposal wells deep underground. It's a troubling trend in an industry that thrives under notoriously lax regulations, especially when the risk to property and public safety is so obvious.

If those numbers weren't dramatic enough, here's another: This year, Oklahoma has experienced an average of two quakes per day of magnitude 3.0—enough to be felt and inflict damage to structures—or greater. That's according to a deep, comprehensive report on the subject out in this week's New Yorker.

But even freakier than the earthquakes themselves, according to the story, is the pervasive denial of science coming from state agencies like the Oklahoma Geological Survey, whose job it is to oversee the oil and gas industry:

The official position of the O.G.S. is that the Prague [Oklahoma] earthquakes were likely a natural event and that there is insufficient evidence to say that most earthquakes in Oklahoma are the result of disposal wells. That position, however, has no published research to support it, and there are at least twenty-three peer-reviewed, published papers that conclude otherwise.

The story goes on to detail super-cozy relationships between top regulators and drilling company executives; the state's ongoing and systemic habit of dismissing or ignoring the rapidly accumulating pile of evidence about the quakes; and a failure by regulators and the state legislature to take any meaningful steps to address the crisis. It's really quite damning.

As a reporter covering the fracking industry, I've found that a lot of the problems associated with the technique aren't necessarily inherent to it, and could be resolved with more pressure on companies to behave responsibly, or laws requiring them to. Better zoning regulations could keep wells out of neighborhoods. Stricter well construction standards could cut down on the leakage of methane, a potent greenhouse gas, and help ensure that gas or chemicals don't contaminate groundwater. In other words, while industry may resist them, there are ready solutions at hand to many of the most cited drawbacks. And the same could be true in the case of earthquakes: while many geologists have now found that drilling wells into deep "basement" rock can set off temblors, there still isn't a law in Oklahoma that simply requires locating disposal wells elsewhere.

Their state's lack of basic engagement on the fracking-and-earthquakes issue is, understandably, a source of great frustration to Oklahomans, including those who are otherwise totally supportive the drilling industry. They're worried not only about above-ground damage, but about how quakes might effect the state's vast network of oil pipelines and underground aquifers. It's hard to imagine the nightmare that would result if a serious earthquake ruptured these pipelines and caused a major spill. That sentiment was nicely captured in the New Yorker by a quote from the town manager of Medford, a hamlet outside the oil center of Cushing:

"We want to be a good partner for the oil companies—it's exciting for us that they're here. But if they can move the disposal well even just three miles, what a difference that would make."

Fabulous Health News

| Mon Apr. 6, 2015 3:20 PM EDT

I am blogging direct from the Apheresis Center at the City of Hope in Duarte, California. There's a large machine to my left that makes ticking noises and—hopefully—is drawing blood from one of the catheters in my Hickman Port. The stem cells are then removed and the remaining blood is returned through the other catheter in the Hickman Port.

There was some question about whether this would happen today. You see, my daily Neupogen injections are supposed to stimulate my white blood cell production and therefore my plasma stem cell production. The goal is for my stem cell production to be above 10, and if it's lower than that, there's no point in doing the collection.

So earlier this morning they drew some blood to test my CD34 level. It was....

102.00.

This is superheroic performance, though the nurse declined to tell me if I had set a new world record. In any case, this is great news for two reasons. First, it means no more Neupogen shots. Second, it means that I'm likely to be finished here in two or three days. Yippee!

And this surely demands a treat for everyone. So here's some bonus catblogging. As you can see, Hilbert has cleverly used staircase access to perch himself on the top of Karen's bookcase, where he is lord of all he surveys. As usual.

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Science Is Ignoring its "Publication Pollution" Problem

| Mon Apr. 6, 2015 11:05 AM EDT

In a damning op-ed published Friday, Arthur Caplan, a medical ethicist at NYU's Langone Medical Center, called out scientists who are turning a blind eye to the scientific publishing industry's "publication pollution problem." At the root of the matter: pay-to-publish journals with weak or nonexistent pre-publication review standards that are "corroding the reliability of research." As he wrote in the Mayo Clinic Proceedings, "neither the leadership nor those who rely on the truth of science and medicine are sounding the alarm loudly or moving to fix the problem with appropriate energy." 

Consider this recent experiment, as described in the commentary:

Harvard researcher Mark Shrime recently wrote an article entitled "Cuckoo for Cocoa Puffs?: The Surgical and Neoplastic Role of Cacao Extract in Breakfast Cereals." The fake authors he chose for the piece were Pinkerton A. LeBrain and Orson Welles. Shrime submitted this fake article to 37 journals. At last count, 17 had accepted the obviously phony, nonsensical paper. John Bohannon did the same thing with a completely phony paper, with even more depressing results in terms of peer reviewed acceptance to journals. The journals that took these gibberish-laden, concocted articles were scam, author-must-pay, profit driven entities that nevertheless have every appearance of being legitimate journals.

"Predatory publishers" create a seeming win-win situation: the publisher makes money and the author gets a journal article published—currency in the world of science and academia. The result?

Predatory, pay-to-publish, non-peer-reviewed journals flood disciplines with bad or fake science, making it hard, much as light pollution does, to see the real stars. Worse, publication pollution lessons the impact of legitimate science in the formation of public policy, undermining public health, weakening the overall value of legitimate publications in influencing policy, and creating opportunities for the continued power of crackpot views that corrode many areas of public life, such as vaccination, fluoridation, and the prevention and treatment of diseases, such as autism, AIDS, and cancer.

Jeffrey Beall, a University of Colorado librarian who wrote a similar op-ed in Nature in 2012, estimates these publishers make up a whopping 25 percent of all open-source journals. Beall maintains an ongoing list of "potential, possible, and probable" predatory publishers on his website, Scholarly Open Access. He's identified over 1,300 such publishers and journals to date.

Watch John Oliver Travel to Moscow to Ask Edward Snowden About Your Dick Pics and the NSA

| Mon Apr. 6, 2015 9:25 AM EDT

In the latest Last Week Tonight, John Oliver traveled to Moscow for an in-depth interview with Edward Snowden, or as Oliver introduced on his show as "the most famous hero and/or traitor in recent American history."

The segment, which started out measuring how much the NSA whistleblower missed Hot Pockets, quickly delved into surprisingly tough questions aimed at Snowden and the arguable value over his massive surveillance leak. At one point, Oliver even challenged Snowden by asking how many of the leaked NSA documents he actually took the time to read.

"I do understand what I turned over," Snowden responded.

"There's a difference between understanding what's in the documents and reading what's in the documents, because when you're handing over thousands of NSA documents the last thing you want to do is read them," Oliver shot back.

Throughout the rest of the episode, which was pegged to the upcoming June 1st deadline for Congress to reauthorize or end the controversial Patriot Act, Oliver repeatedly reminds Snowden that Americans don't seem to care very much about government surveillance. But when it comes to more intimate matters, that's a different story.

"This is the most visible line in the sand for people: Can they see my dick?" Oliver said.

"Well, the good news is there's no program named the 'Dick Pic' program," Snowden explained. "The bad news is that they are still collecting everybody's information—including your dick pics."

Watch the full exchange below:

Do Your State's Hospitals Serve Big Macs?

| Mon Apr. 6, 2015 6:00 AM EDT

Would you like fries with your hospital stay? If so, you're in luck: Many hospitals house fast-food restaurants. Some even offer delivery to patient rooms. The Physicians Committee for Responsible Medicine (PCRM) isn't wild about this phenomenon and made this map, which shows the US hospitals with fast-food chains inside them:

Image by Physicians Committee for Responsible Medicine

Of the 208 hospitals—most of them public—that PCRM investigated in its report, 43 had fast-food chains inside, mostly McDonald's, Wendy's, and Chick-Fil-A. PCRM staff dietitian Cameron Wells told me that some of the fast-food joints have contracts that require them to give a certain percentage of their profits to their hospitals, "meaning the more unhealthful food the restaurant sells to patients and their families, the richer the hospital gets," she said. 

Six of the fast-food-serving facilities in the report were children's hospitals. One of those, Children's Hospital of Georgia, offers delivery service from McDonald's straight to patients' beds. "Seeing this in a children's hospital—that's the most vulnerable population," Wells says. "Fast food is not going to help children get better."

This New Country Blues Compilation Is the Best Kind of History Lesson

| Mon Apr. 6, 2015 6:00 AM EDT

Various Artists
The Rough Guide to Unsung Heroes of Country Blues
Rough Guide

There are any number of ways to approach this fine 24-track compilation of performances from the '20s and '30s. First, it's an intriguing history lesson, showing how ragtime, jazz, folk, and other styles were blended to create the music that would ultimately become the blues. If that seems too much like eating your vegetables, instead consider it an exploration of the roots of more celebrated artists. The Lovin' Spoonful covered Henry Thomas' "Fishing Blues," while Cream updated Blind Willie (Joe) Reynolds' "Married Man Blues" and Muddy Waters turned Hambone Willie Newbern's "Roll and Tumble Blues" into a landmark of the genre.

It's easy to imagine the Stones cribbing from any of these songs. But the best way to appreciate The Rough Guide to Unsung Heroes of Country Blues is on a strictly musical level. There's infinite variety and subtlety to be found in the artful singing and inventive acoustic guitar playing of the men—and a handful of women, including the elusive Geeshie Wiley—represented on this excellent set. Start with Lane Hardin's spooky "California Desert Blues," or practically any other song, and prepare to be hooked.