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Studying Naked

Sophie Germain (1776-1831), a great French mathematician.

No, not me. Sophie Germain. I took a study break last night and was reading about her.

Unfortunately, I got absorbed in my reading and the next thing I knew, it was 2:30am. I’ve been sleepy all day. I know that I’m too young to be “too old for this,” but today I sure felt like it.

Sophie Germain (1776-1831) was a French mathematician who overcame sexual discrimination to achieve great things. She first got interested in mathematics by reading the books in her father’s library. But her parents disapproved of her interest because it wasn’t considered suitable for a young woman. So she started sneaking the books up to her bedroom at night and reading by candlelight.

When her parents found out — well, I guess it was a different era. And maybe her parents were a little crazy. They took away her clothes and kept her bedroom ice cold, but even being naked and freezing couldn’t stop her from studying mathematics. So they gave up trying to stop her.

French society hadn’t given up, of course. The university wouldn’t admit her as a student because she was a woman. To get her education, she eavesdropped at the doors of lecture halls and borrowed lecture notes from male students.

She started writing mathematical articles, using the pen name of Antoine LeBlanc to hide the fact that she was a woman. Eventually, she wrote to the greatest mathematician of the age, Carl Friedrich Gauss. When Gauss discovered her true identity, he became her dedicated supporter. He wrote that she had “the most noble courage, extraordinary talent, and superior genius.”

Urged by Gauss, in 1831 the University of Gottingen decided to award Germain a doctorate for her work in mathematics. That was an almost unheard-of honor for a woman in a sexist society. Sadly, Germain died before she could receive the award. But her example of courage and determination can still inspire us today. Even when we’re so tired that we feel like we’re “too old for this.” 🙂

(Blog post #195!)


Copyright 2011 by Rinth de Shadley.

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Putting My Diagnosis Where My Mouth Is

That isn’t me treating the patient, but in a few years? Photo: “House, M.D.” / Fox.

Okay, so the title doesn’t make much sense.

I wanted to say something like “putting my money where my mouth is,” but that doesn’t connect with the topic of this post. Anyway, money is crawling with microbes and all kinds of awful stuff. You don’t want it anywhere near your mouth.

The Well blog on The New York Times today had a diagnosis contest under the title “Think Like a Doctor.” Since I’m going to be a doctor in a few years, I gave it a try.

The blog article was written by Lisa Sanders, M.D., who is a clinical professor of medicine at Yale University. She’s also technical advisor to the TV series “House, M.D.” and author of the book Every Patient Tells a Story.

Dr. Sanders described a patient’s history and symptoms, then challenged her readers to make the correct diagnosis. Hundreds of readers replied, including practicing physicians, nurses, and medical students. And me.

Since I’m not even in medical school yet, I don’t expect my diagnosis to be right. But it makes sense to me, and a lot of the other diagnoses that people wrote about don’t make sense to me.

The Patient’s History and Symptoms

Here’s the short version of the patient’s situation, obviously focusing on what I think is important. I encourage you to read the whole article on The New York Times site.

The patient was a 76-year-old woman previously in good health except for a few minor complaints (high blood pressure and low thyroid) that were well controlled with medication. Her mother, 99, had died a few weeks earlier.

The patient initially had intestinal bleeding for which she was hospitalized. A colonoscopy found that she had blood vessel abnormalities. She was treated without surgery and recovered, but she still complained about feeling very tired.

More tests revealed a heart valve abnormality that the patient had probably had for a long time. She had an elevated white blood cell count. Although white blood cells are involved in fighting infections, an elevated white blood cell count shows only that the patient’s immune system is “on red alert,” possibly due to an infection. There can be other causes.

The patient started having mood swings and behaving bizarrely. She was alternately manic and depressed. She still complained of extreme fatigue. An MRI of the patient’s central nervous system (including the brain) was normal. She developed dark spots and infected-looking lesions on the skin of her hands and arms. She gained weight.

That’s the essence of it. And people came up with a lot of diagnoses.

Proposed Diagnoses

Many of the people who replied came up with diagnoses that I considered and then rejected.

Lyme disease was one: it’s a bacterial infection spread mostly by tick bites. It causes seemingly unrelated symptoms like the woman had. The microbe is similar to that for syphillis, a sexually-transmitted disease that several people also suggested as the cause. People who have had those infections for years can develop dementia. However, there was no indication that the woman was at risk for Lyme disease or had syphillis, so I rejected those possibilities.

Other suggestions were Cushing’s disease (caused by too much stress hormone) and Lupus Erythematosus, an “autoimmune” disease in which the patient’s immune system attacks the patient’s own body. But neither of those would have developed over a period of a few weeks. The patient had a family doctor who had treated her for years, and who would have known if she had either of those conditions. I rejected those possibilities.

Some people suggested Creutzfeldt–Jakob disease, better known as “mad cow disease” that people can contract by eating infected beef. It’s a horrible disease, but it wouldn’t have developed over a period of a few weeks. Rejected.

Some people suggested that her medications had made her sick. That’s certainly possible, since “iatrogenic illness” (illness caused by medical treatment) is the third leading cause of death in the United States, right after heart disease and cancer. But I think that her first symptom was intestinal bleeding, and that occurred before she started treatment with all the new drugs. So although iatrogenic illness is a good guess, I rejected it.

A lot of people suggested vasculitis, which is kind of a non-specific disease of blood vessel inflammation. However, from the doctors in my family, I know that vasculitis is a “diagnosis of exclusion.” That means you diagnose someone with vasculitis when there’s obviously something wrong with them, but you’ve eliminated all the other possibilities and you can’t figure out what the problem actually is. Dr. Sanders wouldn’t have used that as a diagnostic challenge. Rejected.

My Diagnosis

I won’t find out if my diagnosis is correct until The Well blog is updated on Thursday, when Dr. Sanders has promised to reveal the answer. As I said, I don’t expect to get it right but will be thrilled if I do.

Here’s what I think. You can throw out most of the patient’s previous medical history because the onset was relatively sudden. Also, the intestinal bleeding strikes me as a symptom rather than a cause. The patient probably had the blood vessel malformations in her intestines for years. Something caused them to start bleeding.

Two facts are key:

  • The symptoms appeared within a few weeks after she had been caring for her mother, who died. We can assume that she cleaned out her mother’s house, and that the house contained items that had been there for many years undisturbed.
  • We want a diagnosis that explains fatigue, intestinal bleeding, dementia, elevated white count, and skin lesions.

My diagnosis: While cleaning out her mother’s house, the patient was exposed to black mold (Stachybotrys chartarum) and infected. Most of her symptoms resulted from the infection and from attendant mycotoxicosis from Tricothecene.

We’ll see on Thursday, April 21 if I was right.

And the Results Are In

Looks like I still have to go to medical school! 🙂

The correct diagnosis was Cushing’s syndrome, which I rejected because I thought that the patient’s symptoms developed too quickly and it wouldn’t explain the intestinal bleeding.

Apparently, however, the bleeding was unconnected. The Cushing’s syndrome was confirmed by a test that in a normal person should suppress blood levels of cortisol, a stress hormone. However, the test did not suppress the patient’s cortisol levels, which remained very high.

But the really exciting thing is …

Even though my diagnosis was wrong, Dr. Sanders commented on it in her blog. She said that my diagnosis was “very House-ian.” To me, that seems like a huge compliment, since she’s the medical advisor for “House, M.D.” and House is supposed to be a genius. I was excited about it, anyway. 🙂


Copyright 2011 by Rinth de Shadley.

Praying to be Straight? Why?

Dr. Drew discusses a religious program to "cure" gays with the program director and a gay couple.

I was walking past a TV this afternoon when a talk show topic caught my attention: “Gay to Straight with Prayer?”

The show was “Dr. Drew” on the HLN news channel. I’ve never watched the show beyond the few seconds I saw today, but I know who Dr. Drew is. He’s a psychiatrist who graduated from medical school at the University of Southern California. Before that, he graduated from Amherst College, so he’s local to Shadley and he’s smart enough to get into Amherst. In other words, he’s no random homophobic nut.

From what I could tell, his guests included a fundamentalist Christian minister who wants to “cure” gays, a gay man who he supposedly cured, and a gay minister. I didn’t watch long enough to follow the discussion, but the viewpoints are easy to predict.

The fundamentalist minister probably cited the Bible’s Book of Leviticus to say that gays will burn in Hell. The ex-gay(?) man probably told about how he’s now married to a wonderful woman. And the gay minister pointed out that Leviticus prohibited many other things besides homosexuality, such as shaving and wearing clothes made from two kinds of cloth.

I Wasn’t Quite Right

I just watched some of the show on the Web so that I could grab the picture for this blog. My earlier guess about the fundamentalist minister wasn’t quite fair. He seemed much nicer than I expected, though he’s obviously still wrong about gays needing to be “cured.” The two men on the right side of the picture are a gay couple who met at the minister’s cure-the-gays program. They’re both still gay and are very happy.

People Should Be Happy

Now, I’m probably going to get in trouble with friends for saying this, but I think people can sometimes change their sexual orientation. Not always, but sometimes. Gays can become straight. Straights can also become gay, though I’ve never heard anyone bring up that option.

What makes it so radioactive to discuss changing sexual orientation is that it gets mixed up with a lot of other issues that really have nothing to do with it. It amounts to guilt by association.

Most people who talk about gays changing their sexual orientation are either nutty homophobes or self-hating gays. They believe that gay relationships are wrong, disgusting, an abomination, and all that hateful bigotry. So people think that it’s the only context in which gays might ever want to be straight or vice-versa.

As a future physician, I have what I consider a common-sense attitude: People should be happy. Helping them be happy and healthy will be my goal.

Two Options

If a patient of mine was gay and unhappy about it, we would have two options.

The first option is better. We would try to correct any mistaken beliefs or emotional biases that cause the unhappiness. Since being gay is a perfectly healthy form of human sexual expression, it’s better not to try to change that unless absolutely necessary. I would very strongly advocate the first option.

The second option is more difficult and risks reinforcing negative beliefs. If we’ve tried the first option but the patient just can’t be happy and gay, we could try to change that. Sexual orientation (gay or straight) has multiple causes, both biological and psychological. Some people’s sexual orientation is pretty much set in stone, and the second option won’t work for them. Other people’s orientation is more flexible. If they really want to change, and are absolutely determined to do it, then they can. I’m not saying it’s right or that I’d recommend it, but it’s an option. It shouldn’t be dismissed just because some of the people who push it are hateful homophobes.

Happiness is More Important Than Stereotypes

I reiterate: People should be happy — preferably by accepting and loving themselves as they are.

But if for some reason they can’t do it, we shouldn’t let ideology or stereotypes stand in the way of helping them be the people they want to be and having the lives they want to have.


Copyright 2011 by Rinth de Shadley.

Sneaky Scientists Undermine Patriotic Ignorance

According to the Boston Herald, a majority of Massachusetts residents think that global warming is real:

More than half of Massachusetts residents believe global warming is real and at least partially caused by human activity …

Now that might be only because Massachusetts is dominated by them godless libruls, Democrats, and Kenyans who want to take away everyone’s guns and require gay marriage for first-graders. As Stephen Colbert said, reality has a well-known liberal bias.

But global warming isn’t the only subject on which progressives, scientists, and other subversives have worked their insidious deceptions. Other polls reveal that:

  • Only 40 percent of Americans deny the theory of evolution.
  • Only 44 percent of Americans still believe that God created the world in six days.
  • Only 43 percent of Americans believe that gay relationships are wrong.
  • A full 59 percent of Americans believe it’s okay for unmarried people to have sex. That’s fornication! OMG, we are all doomed.

There’s only one reassuring statistic:

  • About 60 percent of Americans are unsure why Justin Bieber exists. The other 40 percent have never heard of him. 🙂

Copyright 2011 by Rinth de Shadley.

Protect Your Privacy on Wi-Fi Networks

Be careful when you use wireless networks. Photo: BBC.

A big problem with our stupid airport security is that it makes people think all security is stupid.

But it’s not. Especially when you’re using your computer over a wireless (wi-fi) network.

If you check your email, log into Facebook, or buy something, you’re sending your private information over a wireless network. Some of the information will be “encrypted” so that it’s unreadable. But a lot of it won’t. Eavesdroppers can intercept and read any information that isn’t encrypted.

That even applies to Web sites that encrypt your login information, like your user name and password. Those Web sites forgot to encrypt the little text files, called “cookies,” that they send in response to your login. Someone can intercept those cookies and get your login information. There’s a Web browser add-in called Firesheep that does it.

Even if they don’t get your login information or your cookies (I’m very careful about who I let touch my cookies), they can still intercept and see everything you do online. That includes what you write in emails, what Facebook pages you view, and what Web sites you visit.

I have both a Macbook and an iPod Touch, so I use wireless networks a lot. LITS provides wireless coverage on campus, and a lot of other places have it. It is of course pretty safe on campus. But I don’t want to risk anyone snooping on my personal information.

Fortunately, there are ways to protect yourself. With a PC or a Mac, you can use the GoTrusted Secure Tunnel service. For $5.99 a month, it encrypts all of the information you send over the wireless network. A free, advertising-supported product that does the same thing (for PCs only) is HotSpot Shield.

On your iPhone, iPod Touch, and iPad, you can go to the App Store and download VPN Express. The software itself is free but you pay for the amount of information you send over wireless networks.

Using the encryption services isn’t as simple as just connecting to the network. But it makes your personal information and your privacy a little safer.


Copyright 2010 by Rinth de Shadley.

A Fit Present for Grandparents

Wii Fit trainer. Photo: Los Angeles Times.

We’ve all got parents and grandparents, right?

Regardless of which holidays you celebrate this season, there’s a great present you can get for them. But it will surprise you: It’s a game console, platform, and software.

It turns out that the Nintendo Wii Fit is especially beneficial for older people.

The Wii Fit is a gaming platform about two inches high that you stand on to play Wii Fit games on the Wii console.

As people get older, their balance gets worse. That’s why we’re always hearing about older people who “have fallen and can’t get up.”

According to The New York Times, regular gameplay with a Wii Fit greatly improves older people’s balance:

After only a few sessions with the Wii Fit, though, the older volunteers improved their balance scores significantly, lowering their supposed “Wii age” (a score assigned by the game system, based primarily on balance tests) by about eight years. The young people improved by only about one year.

Older people probably get more benefit because their balance is worse. They have more room for improvement.

Wii Fit isn’t cheap: it’s about $200 for the console and $100 for the platform. But it’s a better present than those restaurant gift cards you gave them last year.

And anyway, if they don’t use the Wii, then you can. 🙂


Copyright 2010 by Rinth de Shadley.

Can We Be Unselfish?

A column in The New York Times asks, “Is Pure Altruism Possible?”

Of course, a lot depends on how you define “pure” and “altruism.”

Altruism means acting unselfishly, for the benefit of others or for the good of society. But does that mean it can’t benefit you? Or does it just mean that your motivation must be unselfish?

And our motives are usually complicated. Does “pure” mean that no part of our motivation can be selfish? That almost never happens. I might do volunteer work and get a good feeling about helping others. But my main motivation was still just to help.

Actually, I like something my grandmother said:

A good deed only counts if nobody knows you did it.

If you do a good deed and keep it a secret, then you can be pretty sure you did it for the right reasons.


Copyright 2010 by Rinth de Shadley.