Scientists Report 30% of U.S. Adults are Disabled; Other 70% Exhausted

This is a perfect example of the reason I view "Evidence-based medicine" with a suspicious eye. The first reaction is one of interested surprise - "What? 3 out of 10? Amazing! I never would have thought..."

For me at least, there is a second thought process that begins to form when I hear these seemingly unbelievable reports: I begin to assess whether that information is consistent with common sense. Those who preach the religion of Evidence would call that inappropriate, unscientific, or even "allegorical" (that is the new term for idolatry in the Church of Evidence).

Think about it. How many people do you know? How many people are you in contact with? Would you say that 30% of them are "disabled" in some way? I know literally hundreds of people as a result of my work as a doctor. There is no way that 3 out of 10 of them are disabled.

So, then, what does this mean? Am I horribly mistaken? Is there a vast unknown number of Americans with disabilities out there? Have I simply missed them somehow? Or has some sort of error been made in this study?

Errors occur from time to time, and are dealt with by the scientific method itself. Unless of course, the study does not lend itself to scientific methodology. Errors can be of basically two types - (a) errors in data collection and (b) errors in conclusions regarding the data. At the very least, I believe the author of this study is guilty of scientific error. Fortunately for her, her study can not be subjected to scientific scrutiny. Her interpretations of the data indicate that there is something missing - some piece of the puzzle undefined. So much so that a dedicated physician, diligently attempting to find how this study might impact his practice feels left out of the inside joke. So I continue digging...

The author is Barbara M. Altman, Ph.D. A former employee of the CDC's National Center for Health Statistics, Dr. Altman, a psychologist by training, has a long history of research dealing with the disabled. She seems especially interested in the relationship between disability and occupations. In fact, she seems to be a bit of a revolutionary in this field. She supports a new and controversial definition for disability that, as the review of her textbook puts it, "focuses attention on the dual themes of theory and methodology that must form a basis for studies of impairment and disability". It goes on to describe the general aim of the book:

"Issues discussed include: critiques of current concepts of disability; the fit between sociological role theory and the concept of disability; the operationalization of different definitions of disability; conducting surveys with people with impairments; the reliability and utility of several qualitative research methodologies as applied to impairment and disability. Overall, the papers in this volume represent the beginning of a resurgence of interest in social science theories and methodologies within the study of impairment and disability".

Allow me, if you will, to define this for those of you as-yet untrained in the language of Psychotripe. Dr. Altman and her co-editor wish to redefine disability. No longer is it merely the (they would say seriously inadequate) definition which deals with concrete, objective, verifiable facts of inability to perform a certain task. Now this highly-charged social phenomenon of disability is placed into the nebulous universe of the psychologist, where definitions are impossible because nothing has actual meaning. If you read the methodology for the study, you find that Dr. Altman unilaterally uses the broadest possible sense of the term "disability". In her world, disability includes "feelings that interfere with productive work". Under this ridiculous definition, I and the ever-diminishing number of us who actually get up every morning and go to work and make a living are clearly, perhaps permanently, disabled.

Here is the problem. It is fine if Dr. Altman wishes to destroy any useful meaning for the term "disability". In fact, I support her right to live in a self-made universe without meaningful definitions. That will not be enough for Dr. Altman, however. As evidenced by her much-publicized recent study, this will grease the skids for vast increases in tax monies spent to care for this new onslaught of the "disabled". Those of us who are too busy paying for all those leeching off the system already will once again be harnessed with a new yoke.

If we are going to use "Evidence-Based Medicine" as the new standard for practice, I demand that we at least exercise some controls on what constitutes evidence. I barely scratched the surface of this article and found what appears to be a deep, dark, festering core of liberal social engineering, propaganda, and dishonesty. How many other "studies" could be similarly debunked?

More dangerous: Guns or Doctors? The debate rages on.

I must be on the right track with this blog. MedPageToday had a survey about whether gun control is a public health issue. Shockingly, the response was overwhelmingly "No". God bless us crazy doctors. We may save the world yet. Other than that bit of good news, the article and survey were so last week.

http://www.medpagetoday.com/Surveys/#ayk

I had a really interesting talk with a fellow physician last night at dinner. We were discussing the possibility of starting some weekend work at his clinic. I realized well into the conversation, which got really deep and intense about a lot of the things this blog is about, just how nice it is sometimes to have professional colleagues. It sort of made me feel a little better - not so isolated and alone.

Our New England Schoolmarms Strike Again

In one of the few rulings by the Supreme Court that has made sense in recent memory, the self-proclaimed Third Branch of American Government ruled last week that a local ban on the keeping and bearing of firearms by the law-abiding, tax-paying residents of the District of Columbia was, in fact, unconstitutional. Duh. Not surprisingly, the academic medical community, much too busy to work to save American Healthcare from destruction by the insurance industry, and complicit in its destruction by the forces of socialism, came out against the ruling in an editorial in the most recent New England Journal of Medicine.

http://content.nejm.org/cgi/content/full/NEJMe0805629

If the sentiments expressed in the article were not so deeply-felt and so dangerous to our way of life, they would be almost laughable. It betrays the Technocratic mindset of so many in power in today's academic institutions - that somehow it is up to them to save us from ourselves. Epidemiological experiment? Hilarious. Liberty must be so incredibly irritating to these braniacs. It is so...untidy. Their silence was deafening as we the people (apparently their helpless, hapless wards) were subjected to other "epidemiological experiments" at the hands of the Highest Court - "Law enforcement officials can not be held responsible for defending people in their homes"; "Your personal property can be seized through imminent domain not only for the good of a community but also for the good of a more profitable tenant".

Where is the outrage at the New England Journal when people are attacked and out-gunned by criminals in their own homes? Where is their scientific input on the true causes of inner city violence, crime, and illiteracy - namely, the irresponsibility and even participation of those communities in those problems? Where is their backing of Bill Cosby when he addresses matters such as these? There is absolutely no doubt that those problems are at the root of the issue, but still the New England Journal remains silent. Well, silent at least until something occurs that offends them personally. Their fear of law-abiding citizens owning the firearms to protect themselves is legendary. They've always sided with the criminals in that regard. In their world, the law-abiding, ignorant sheep are supposed to look to the increasingly impotent government for everything, and remain victims of circumstance. This ruling was a slap in the face.

Their statement shows how utterly despicable and irresponsible they have become. They care nothing for the residents of Washington D.C., or any other city, town, or rural area in the country. If they did, they would use their power as the leadership of a (previously) highly-respected medical publication to educate our most vulnerable citizens about how to work and fight their way out of illness. They instead use their power to push their ultra-liberal agenda using the mantle of medical expertise to hide their true intentions. Their ridiculous opinion is thus given artificial credibility. What cowards. They know that their beliefs are losing traction, so they must package them as the "advice of the experts".

The New England Journal of Medicine thus continues to lose much of its credibility, hijacked, like so many of the great institutions of our nation by the socialist parentalism of the academic community. They are not welcome to speak for me. They should be ashamed.

The Hyper-sensitive Beefcake - and Other Children's Moral Tales

I've never really liked Governor Jesse Ventura. Which is odd, because there are several things about him - at least the Cliff's notes version of him - that I should have liked. We are both veterans - he is a former Navy SEAL and I am a former Marine. We are both small-government guys. We both like underdog political candidates because we think they are, in theory, good for the system. Then I heard him on Fox News this morning on the way to work, and it all became a little more clear for me.

"Fox and Friends" is sort of a goofy show. I know that. And the blogosphere is all lit up with complaints about them. But that is just their shtick - they are silly. I can appreciate that. If Iran shot all their nukes at us, I probably wouldn't turn to Steve, Gretchen, and Brian for their reportage. But if I'm looking for something kind of light in the morning on the way to work, and still want to know the headlines, they are a good choice for me. So it is in that context that I heard the wrestler this morning.

I had always assumed that Minnesotans voted for Jesse out of a sense of their own masculine inadequacy - sort of a Stockholm syndrome thing. But it turns out from listening to him this morning that he was actually a good choice, because he may be the biggest liberal, conspiracy-theorist clown in the whole state. I was stunned to hear him suggesting 9-11-01 as an "inside job" wouldn't surprise him, and using his past as an Underwater Demolition Team (UDT) member as some sort of credential for this conclusion. His statement was that his government had lied to him so many times in the past that they'd lost all credibility.

The thing that really gave me a clue into his personality, however, was what he did next. I preface this with a little story. In the Marines, we were all brothers of a sort. And although we were supposed to refer to each other as Rank and Name (example: PFC Smith), in privacy, we would "break the rules" and call each other by our nick names. There were those, however, like a certain Sergeant I remember, who were so empty inside and so dependent on their rank for their self-worth that they required everybody to call them by their rank and name.

He (Jesse) stopped the interview to ask them, in his characteristic "'-roid voice",

"Do you call all former Governors by their first name, or is it just me?"

Are you kidding me??? Ummmm. Aren't you that jack-ass that used to dress up in a fur stole and tights and prance around before your wrestling matches? I'm sure that he would play it off as a joke, but I heard something a little too familiar in that. You might be able to fool a lot of people, JESSE, but you can't fool a fellow Vet. At least not all of us. I know where you were coming from. You are just a scared little boy in that beefy, steroid-laced body. Take away your little titles and you fall apart, don't you?

The morals of this story are (1) that you can't trust your government, no matter what, (2) that former SEALs are experts on how 100-story skyscrapers are supposed to fall, on architecture, on physics, on aerodynamics, on meteorology, and on rules of etiquette, (3) don't ever criticize a main-streamer. Not so much a free-thinker as much as just one more authoritarian schoolmarm who knows what others are supposed to do because he is a know-it-all.