Tamoxifen decisions

The New Neo Posted on by

Is it at all surprising that, given these odds, many women who are judged to have a higher risk of getting breast cancer are refusing to take tamoxifen as a preventative? The only surprising thing is that anyone would find it surprising.

Here are the stats:

..[A]mong 1,000 similar women [judged to be at slightly higher risk than average of developing breast cancer], 19 would be expected to develop breast cancer over the next five years.

If those women all took tamoxifen, however, 9 of those women would avoid breast cancer ”” and, as a bonus, 13 would avoid broken bones from osteoporosis.

It is true that tamoxifen can have side effects, some of them serious. Among 1,000 similar 52-year-old women, the drug would be expected to cause 21 additional cases of endometrial cancer, a cancer of the uterine lining that is typically treatable when caught early. An additional 21 would develop blood clots, 31 would develop cataracts and 12 would develop sexual problems. And while more than half of the 1,000 women would naturally develop hormonal symptoms like hot flashes, changes in vaginal discharge or irregular periods, tamoxifen would cause those symptoms in about an additional 120 women.

So, there would be a significantly higher risk of developing another cancer (albeit one easier to successfully treat) and potentially fatal blood clots, as well as a much higher risk of developing a host of other symptoms that would impact negatively on quality of life. All to reduce a breast cancer risk from 19 per thousand to 10 per thousand. And the study doesn’t even say how many of these breast cancer cases would likely be treatable and survivable. Nor does it compare death rates in the groups; I wonder why, since that fact seems extremely relevant.

I’m not knocking the recommendation. I just think the correct decision is hardly a slam-dunk. Both prospects sound pretty dreadful, especially for women who are relatively young.

The Obama administration: who’s weeping now?

The New Neo Posted on by

Simon Heffer remarks on the apparent fracture of the Obama in-crowd, and sees it as a sign that things are going very badly indeed for the administration:

The descent of Barack Obama’s regime, characterised now by factionalism in the Democratic Party and talk of his being set to emulate Jimmy Carter as a one-term president, has been swift and precipitate. It was just 16 months ago that weeping men and women celebrated his victory over John McCain in the American presidential election. If they weep now, a year and six weeks into his rule, it is for different reasons.

I have noticed that the post-2008-election British press has seemed quicker to notice Obama’s flaws and to call him on them. Perhaps distance yields perspective. I have also noticed that the British press—even the leftist Guardian—has been relatively fair in covering Climategate, perhaps because Britain was the epicenter.

Our press, on the other hand, has been asleep at the switch on a huge scientific debacle, so much so that the vast majority of Americans have probably never even heard of it. Most of my friends certainly have not; I drew unanimous blank stares when I mentioned it the other day to a group of them.

This, again, is by design of the MSM. If a climate science falls in the forest and no one is there to hear it, does it make a sound?

All Oscared out

The New Neo Posted on by

In brief (although little about the Oscars is ever brief): it was a long-winded self-congratulatory bore. But that’s what I’ve come to expect. I watch the Oscars for the fashions. That’s just how shallow a person I am.

Oscar observations:

Pale pinkish-ivory dresses on pale white women make the wearers resemble wraiths. (Say that five times fast and I’ll give you a gold star.)

Necklaces are out, although strapless gowns are in. That leaves a very large, undecorated, and lonely-looking expanse of flesh between head and gown.

Whatever happened to long gloves? They were nice.

Middle-aged women with long black hair should not wear floor-length black dresses. Makes them look like witches. Although, if that’s the look you’re aiming for—

Miley Cyrus has terrible posture.

Barbara Walters (glimpsed briefly by me at the end of the pre-game show) has finally crossed a line into much too much cosmetic surgery. Something extraordinarily weird has happened to her eyes as a result.

I heart Jeff Bridges.

“Avatar” got dissed—perhaps because it turns out that director James Cameron might just be the most hated man in Hollywood.

There was a blessed absence of political remarks. It seems even the Hollywood crowd is tired of hope and change and blaming Bush for everything.

Notes from the circular firing squad

The New Neo Posted on by

Representative Eric Massa (D-NY) accuses the Democratic leadership of forcing him out to save health care reform. He says the target has actually been on his back since he voted against cap and trade:

“When I voted against the cap and trade bill, the phone rang and it was the chief of staff to the president of the United States of America, Rahm Emanuel, and he started swearing at me in terms and words that I hadn’t heard since that crossing the line ceremony on the USS New Jersey in 1983,” Massa said. “And I gave it right back to him, in terms and words that I know are physically impossible.”…

Massa slammed House Maj. Leader Steny Hoyer for discussing a House ethics committee inquiry, accusing Hoyer of lying in an effort to eliminate an opponent of health care. Hoyer said last week he heard in early Feb. about allegations against Massa, and that he told Massa’s office to report the allegations to the ethics committee.

“Steny Hoyer has never said a single word to me at all, never, not once,” Massa said. “Never before in the history of the House of Representatives has a sitting leader of the Democratic Party discussed allegations of House investigations publicly, before findings of fact. Ever.”

“I was set up for this from the very, very beginning,” he added. “The leadership of the Democratic Party have become exactly what they said they were running against.”

Apparently, however, Massa is no blue dog: he didn’t vote for health care reform because it wasn’t liberal enough (the link has more on Massa, and on the incident that got him into hot water).

As they say, politics ain’t beanbag. Although I’ve heard that some beanbag games can be mighty rough.

[NOTE: And here Massa actually calls Rahm Enanuel “the devil’s spawn.”]

Liberals and “it’s not fair!”

The New Neo Posted on by

Yesterday in the thead about the deficit there appeared this thought-provoking comment by Geoffrey Britain, in which he described the prevailing liberal/left mindset. Here’s an excerpt

We’re not really dealing with Machiavellian malevolence, we’re dealing with immature, arrested emotional development and with narcissism.

ALL points of view which spring from the left are, at base, centered in issues of ”˜fairness’.

Dig deeply enough and all leftist ”˜ism’s’ boil down to the child’s eternal cry of “it’s not fair!” and just as logic and reason are totally ineffective when dealing with a toddler’s temper tantrum, just so with trying to reason with liberals using facts and logic.

There’s some truth there. Yes, much liberalism is based on a sort of childish although natural human desire on the part of many poorer liberal Democrats to be given more stuff. But many liberals are the ones with more stuff. In fact, liberals (and Obama voters) tend to be the ones on the very bottom and the very top of the income ladder; it’s a somewhat U-shaped curve:

In 2008, the Democratic Party blossomed into a successful alliance of the upscale and the downscale—wealthy and needy marching hand in hand…The extent to which Democrats are relying on the far extremes of the income spectrum is striking. Democrats have generally performed well among low-income voters in the past, but now, the phenomenon has become more pronounced…Democratic gains among the rich have been even more dramatic and, given the party’s history, surprising…Obama…carried those making $200,000 or more by 6 points. True, these very affluent voters make up only 6 percent of the electorate, but Obama fared well in other upper-income categories too. Among non-Southern white voters–that is, voters living in states a Democrat must carry or have a shot at carrying to win an election–Obama claimed a majority of those making $80,000 or more…

Obama needed this strong showing at opposite ends of the income spectrum because he was far weaker in the middle.

So it’s not just narcissistic have-nots wanting their share of the pie, and willing to take it—if necessary by government force—from others who have more. It’s also many of the haves themselves shouting, “take mine, please; I’ve got too much!” This latter phenomenon may be a lot of things, but it’s not a “toddler’s temper tantrum.”

One of the things involved for many in this upper portion of the liberal socioeconomic curve is the opposite of wanting a bigger piece of the pie. It’s guilt—for having too much stuff when others lack it. But instead of doing the individual and voluntary thing—giving away their goods and becoming poor (that’s the path of the saint who takes a vow of poverty—or the follower of a leftist cult leader such as Jim Jones who required that members donate their personal property to the church), most well-off liberals who happen to feel the pangs of this sort of guilt take the less extreme route of supporting government taking a certain amount of their money (not enough to be too painful for them) and redistributing it to the poor.

This offers the multiple benefits of relieving them of their guilt and establishing them as good and generous people, all without having to take the initiative themselves as individuals, and without going so far as to make them markedly financially uncomfortable. And just to make sure there’s strength in numbers, the liberal/leftist wants to spread the responsibility around and take away the element of choice (and the individual soul-searching involved) by making such giving compulsory and universal above a certain income level.

In summary, liberalism and/or leftism promise to relieve the liberal have-nots of the twin burdens of envy and initiative, and the liberal haves of the twin burdens of guilt and choice. This latter phenomenon has long been one of the major attractions liberalism and leftism have had for the intelligentsia and/or the wealthy. Anguish over the unfairness of life can deeply affect those on both ends of the spectrum, and the simplistic solutions offered by leftism and/or socialism can appeal greatly to people who have not noticed or cared about the repeated failures of the leftist/socialist methods, their tendency to lower all boats and sink entire economies, and the heavy sacrifices of liberty that they inevitably require.

David Axelrod: again with the message

The New Neo Posted on by

It’s not the message, stupid!

But the New York Times, a goodly portion of Obama’s remaining supporters, and the Obama administration itself seem to continue to think (or to pretend?) that it is.

This Times piece focuses on how David Axelrod has somehow failed to help the great communicator Obama get his message across. It also draws a portrait of the Obama aide as a beleaguered and long-suffering idealist who’s too soft for the rough and tumble world of Washington.

This is rather humorous, actually, to anyone who knows much about the tough-minded Chicago-based Mr. Axelrod. But it’s not the only unintentionally funny thing in the article. Here are a few choice items:

In a lengthy interview in his office on Wednesday, Mr. Axelrod was often defiant, saying he did not give a “flying” expletive “about what the peanut gallery thinks” and did not live for the approval “of the political community.”…

“Have I succeeded in reversing a 30-year trend of skepticism and cynicism about government? I confess that I have not. Maybe next year.”

There’s another mildly comic but strange bit in the middle of the piece that includes what appears to be a gaffe by President Obama, unremarked upon by either Axelrod or the article’s author, Mark Leibovich. First, here’s Axelrod, making an intentional funny:

Sitting at his desk next door to the Oval Office last week, he was tearing into a five-inch corned beef sandwich on rye with a Flintstone-size turkey drumstick waiting on deck. “I am the poster child for the president’s obesity program,” he said.

Then Obama enters and tries another witticism:

Mr. Obama surveyed the spread on Mr. Axelrod’s desk with a slight smirk.

“What is this, King Arthur’s court?” he asked, then pulled Mr. Axelrod aside to talk about a health care speech he was about to deliver.

King Arthur’s court? I believe Obama must have meant to refer to King Henry VIII, who was often pictured as a glutton holding a drumstick:

henryviii2.jpg

This is a small matter, but it’s another example of the peculiar lacunae in Obama’s experience. The reference—Henry VIII chomping on a drumstick—is a fairly common one, not an arcane association. King Arthur’s court (correct me if I’m wrong) doesn’t conjure up any epicurean associations of the culinary sort; it’s about idealism and chivalry and courtly love, as well as a bit of sexual fooling-around.

The fact that Obama got it wrong is more evidence of his disconnect. And speaking of disconnect, take the end of that same sentence—Obama and overeating gourmand (not that there’s anything wrong with that) Axelrod are about to consult on the president’s health care speech, in promotion of a policy that, among other things, is supposed to stress preventative medicine and good health habits.

Has Obama done any irreversible damage so far?

The New Neo Posted on by

I saw the above question in the comments section of a post at Althouse, and I believe the answer is “yes.”

But the reason I say this may surprise you. It’s not any one action or decision, or even several. It’s not even whether health care reform, if passed, can be reversed. It’s not the terrible precedent set by using reconciliation for a bill that is unpopular, not a budget or deficit measure, and has no bipartisan support. It’s not even Obama’s foreign policy, that insults our allies and emboldens dictators and fails to scare Iran in the least, although all of the above matter very much and they are all very bad.

I think the worst damage Obama has done is that, until now, America has always been a solid and somewhat predictable commodity, both domestically and internationally. There have been many fluctuations, of course. Presidents came and presidents went. Some were Republicans and some Democrats, some conservative and some liberal. But there remained a certain commonality and dependability that Americans and the rest of the world—our allies and our enemies—could depend on.

Allies would remain allies, and when the chips were down we would defend them. Enemies would remain enemies, even if we sometimes got closer to them and sometimes backed away from contact. We would get into debt, but not too much. Our economy was solid. And so on and so forth. But Obama has become a loose cannon, and American is suddenly not the rock it used to be. And I wonder if we ever again will be regarded in the same way.

Companion pieces about reconciliation for HCR

The New Neo Posted on by

If you’re finding it difficult to understand exactly how reconciliation would work in terms of the current bills regarding health care reform, you’re not alone.

To clarify—or perhaps to add to your confusion—here are two somewhat opposing articles on the subject. The first is by Senator Kent Conrad, Democrat and chairman of the Senate Budget Committee, presenting the Democrats’ argument—reconciliation is just a little fix on some piddling budgetary matters. The second is by Daniel Foster and Stephen Spruiell for National Review, critiquing the Democrat argument and exposing its myths.

One thing that seems abundantly clear is that the entire edifice rests on the Democrat members of the House passing a bill they don’t like and trusting the Democrat members of the Senate to fix it ex-post-facto. This is by no means a sure thing. But you can bet that the pressure being brought to bear on Democrats in the House is extraordinary and viselike.

[ADDENDUM: Mark Steyn explains in his own inimitable way just why Democrats are determined to pass this even if they lose seats and control of Congress as a result. For them, it would still be a win in the long run.]

Thomas Sowell. Again.

The New Neo Posted on by

An excellent interview with Thomas Sowell.

The point he makes reminds me of the following, one of my favorite quotes from the work of Czech novelist Milan Kundera:

For example, communists used to believe that in the course of capitalist development the proletariat would gradually grow poorer and poorer, but when it finally became clear that all over Europe workers were driving to work in their own cars, [the communists] felt like shouting that reality was deceiving them. Reality was stronger than ideology. And it is in this sense that imagology surpassed it: imagology is stranger than reality, which has anyway long ceased to be what it was for my grandmother, who lived in a Moravian village and still knew everything through her own experience: how bread is baked, how a house is built, how a pig is slaughtered and the meat smoked, what quilts are made of, what the priest and the schoolteacher think about the world; she met the whole village every day and knew how many murders were committed in the country over the last ten years; she had, so to speak, personal control over reality, and nobody could fool her by maintaining that Moravian agriculture was thriving when people at home had nothing to eat.