Grant writing open thread

Words that contain woo:

wool, swoosh, wood, swoon, woof, swoop, woozy

Did you bring me a monkey?

[/Multiplicity]

How does one go about finding a doctor (internist most probably). I'm 58 and haven't had a personal physician (or whatever the term is).

I see I'm due (and overdue) for vaccines and tests, and have some conditions that are going to need tending. I have good insurance (entitled to a free yearly physical).

I don't know where to start. Can I 'interview' a potential doctor? How can I reliably determine said doctor is not into woo? How are the hospitals' 'find a physician' services?

While you're waiting for more pearls of insolence from the fevered mind of Orac, you might want to give her some tactical air support.

I'm so far from being qualified to comment on Tara's field that she might be writing in some undeciphered script. But I totally admire her persistence. I've never come across a blogger who attracted so many batshit insane trolls so much of the time. More power to her.

Khan: I suppose one place to start would be to do a search on your health insurance companies' website for doctor's in their plan that are in your area. Beyond that, I don't really know how you'd find out about a particular doctor's reputation, except for word of mouth. Many states have databases where you can search for malpractice lawsuits - though that's not perfect, since even good doctors can get sued. If there's a pattern, though, I'd stay clear.

I found my first doctor through a friend who was a pharma rep - they pretty much meet all the docs, and can tell you with perhaps some accuracy who has a good reputation, etc. So if you have friends who work in the medical field, they might well be able to point you in the right direction.

So far my wife and I have gotten consistently good primary care doctors, and the specialists have also been generally good. The only problem doctor was a hematologist, who seemed like a nice guy who cared, but was giving some really strange advice that was pretty much the opposite of the standard of care [FWIW, my wife had hereditary hemochromatosis (iron overload) - standard of care is to remove blood periodically via phlebotomy - weird doc wanted to put her on oral chelation, which is very expensive, less effective, and not recommended at all by CDC or anybody else unless you absolutely *can't* do phlebotomy]

Khan, I know what you're facing. I've faced this question of which doc to go to several times, as they have this nasty habit of retiring, staying home to care for new babies, joining "Doctors Without Borders", etc.

Ask relatives and friends who they see and how they like their doc. See if your insurance plan has the doc on their list of providers.

When I worked at a hospital, I had the benefit of being able to talk to staff and observe doctors' bedside manner. While I wouldn't completely judge a doctor on her bedside manner, it helped if the behavior was so harsh I knew I couldn't put up with it.

If you have any friends or relatives in the medical field, ask them who they like or respect.

Good luck.

"If you thought this was going to be easy, then you don't know Jack!" Seems kind of appropriate when writing a grant! Go kick some a#@!

Apologies to 24.

Hope the grant writing goes smoothly.
Dropped by Aetiology to leave a brief note.

I'm up late grinding on my own grant. It may be a long weekend...

Ask for twice as much as you want. My first grant was cut in half, so was my second. After that I just asked for twice as much and, if given the money, it was never what I asked for but usually enough to squeeze me through the project as other money also came from other team members. Fortunately for me I managed to team up with some very experienced grant writers halfway through my career and learned a great deal from them.

I haven't need to write a grant since 2005 but for those of you who are still writing...I really and sincerely feel your pain.

Left a comment on Aetiology too. Didn't take too long for my wingnut detector to go off.

Since this is an open thread, I've got kind of an open-ended question that I've been wondering about for a while, and think people here might be able to help educate me.

A while back, one of my friends linked to an article written by a woman recounting her experience giving birth to her child in a hospital. This woman was rather upset about the whole thing, likening the delivery to sexual assault, and generally upset about the prevalence of medical intervention in childbirth. She was especially upset that they took away her newborn to check its health and give it some injections. Well, the entire article is here.

I bring this up because in the article, and the subsequent discussion with my friend, there were numerous ideas that raised red flags to me, and made this whole "natural childbirth" craze seem very woo-like: the idea that medical intervention (C-sections, drugs, etc.) are "bad" and birthing children the "natural" way is "good"; that doctors and medical professionals shouldn't be trusted; that doctors are just in it for the money and therefore do unnecessary things to increase their profits; that mothers know best what to do with their children (and, I suppose, how to give birth to them); etc. It really rubbed me the wrong way.

So, I'm basically wondering what the commenters here think about natural childbirth / using midwives? Am I overreacting to this article? Do these people have valid concerns about the rise of medical intervention, or are they overreacting because they don't have any clue why doctors do what they do (or any other possibilities that come to mind, I don't mean to restrict to just these two)?

-While you're waiting for more pearls of insolence from the fevered mind of Orac, you might want to give her some tactical air support.-

Ugh, AIDS denial is on par with the flat earthers. I read the comments and they and their sock puppets are as vacuous as ever

This just came through on my listserv:

"Hyperbaric Rentals Posted By: 4muskateers
Posted On: 04/02/2009
Hyperbaric Rentals

Our single bag chambers can be rented for
$2,000 a month and our double bag chambers for $2,675.00 a month. We require first last and a security deposit so the initial charge is $6,000.00 and $8,025.00 repectively. The renter will be responsible for paying shipping both ways. The minimum rental period is for one month and is done in monthly increments. For more information visit
www.performance-hyperbarics."

That is more than I thought they charged. This is in Maine. Talk about fleecing the public! If these parents only put that money into a good Social Thinking course, which costs nothing near this about, or some extra OT or PT, it would be better spent and more beneficial. This just burns me!

@Skemono

Anytime they start throwing around the "natural childbirth" phrase, you need to be skeptical. I have to get my kids ready for school and get to a conference. I'll try to get back here to comment specifically. All I can say is, I've had to clean up some pretty big messes after this philosophy!

@Skemono:

Since Storkdok is getting the kids ready for school, I'll comment (and give you one certified nurse-midwife's view):

Childbirth is natural. However, that doesn't mean that it is safe. A normal, healthy woman can concievably give birth anywhere, alone, and have no problems. However, in obstetrics, problems can occur at the very last minute and lead to the death of mother and/or baby. Most problems give plenty of warning that an ethical caregiver would react to and perform the type of delivery needed to give the best outcome to mother and baby.

Do I think there are too many interventions in OB? Depends on the doctor and the patient. Monitoring of the baby's status is very important. If someone can remain with the mother and check manually on a regular basis then no, electronic fetal monitoring constantly probably isn't needed. On a busy hospital floor, nurses usually can't be with the mother constantly so for best outcomes (and avoidence of malpractice suits, let's be honest here), continuous electronic fetal monitoring is the best thing.

Does every woman need an IV, epidural, being stuck in bed with nothing to eat/drink, a C-section? No. Some do. Some don't. If they are needed for the best outcome, then they are necessary. If they are done only for the convenience of the mother, the hospital staff or the doctors, then no, they probably aren't necessary.

However, I have also seen unnecessary intervention: a woman who came in very close to delivery and her OB, when informed of the status, ordered an epidural anesthetic "to give him time to arrive and do the delivery). The patient didn't want or need the epidural (and actually delivered prior to getting it) and EVERY nurse got chewed out by the OB because his orders weren't followed.

I have attended home births that went fine, home births that required transport to the hospital, birthcenter births that went fine, some that required transport, and hospital births that went fine and others (one that lead to the death of both mother and child) that went disasterously wrong very quickly. There are no guarantees in OB. And no simple answers, either.

@Skemono

Personally, I do think that in some cases there are valid concerns about too much medical intervention, but I also think that many women, especially first time mothers, are sucked into the whole woo side of natural childbirth. I say this as a woman who has done the necessary emergency c-section thing (we discovered my son was feet first when I was in labour) and a natural VBAC. I chose to go natural the second time around because, well, I didn't need any interventions and could manage the pain.

I have heard natural childbirth described as "orgasmic" if it's done right. The whole birth process is romanticised and women can be made to feel that if they need any intervention it is something wrong with them or they just weren't trying hard enough. They then do feel angry after a birth involving interventions because they were weak, either physically or mentally.

Lack of knowledge is a part of this whole thing I'm sure, but I don't think it always plays a large role. I know in my own case I knew that the c-section was the best choice and I didn't fight it at all but I still felt a sense of loss of the idealised childbirth I'd been planning on.

I do think that in many cases the biggest issue is the peer pressure one, particularly in certain circles.

Childbirth hurts-I'm one of those that asked for minimal pain meds for my labor. If no pain meds were available, I would have pulled through, but knowing pain relief was just down the hall?
My last child was a C-section at 37 weeks-my OB noted a problem in my routine check-up and arranged surgery that day. Surgery was harder to come back from than regular birth, but a healthy child was worth it. I had planned a certified midwife delivery with medical back-up, but we never got to try that. Most hospitals ofer birth rooms with minimal intervention, but with the safety of medical intervention if it is needed.

Do these people have valid concerns about the rise of medical intervention, or are they overreacting because they don't have any clue why doctors do what they do (or any other possibilities that come to mind, I don't mean to restrict to just these two)?

Yes? There may be legitimate concerns surrounding overuse of interventions in childbirth but they're also overreacting in a big way. Patient demand has driven the development of in hospital birthing rooms, the increase in CNM availability, and the use of non-pharmacologic means of pain control. All of which are generally positive things if not taken to extremes.

On the other hand, I think that at least part of the "natural childbirth movement" (as opposed to women who simply have easy deliveries and don't want much intervention) is rather wooish. For one thing, if you point out to some of the more extreme advocates that some women simply can't delivery naturally, they'll start talking about how women who have c-sections are "weakening the species" and "making people dependent on technology"--a grave misunderstanding of evolution and the ways that people are already dependent on technology (the carrying capacity of the earth for human hunter-gatherers is something like 100K) as well as being a bit genocidal. Or maybe I'm just annoyed at being told that I should have been left to die in pain when my labor went wrong.

As they were getting their asses properly kicked by "PROVE IT", It seems that the infantry battalion of the hiv faithful relayed to the Generalisimo of the Faith, Orac, a call for more troops, as Orac posted this brief on his site yesterday:

"Oh, and by the way, I see that HIV/AIDS denialists have infested Tara's brief post about Christine Maggiore. While you're waiting for more pearls of insolence from the fevered mind of Orac, you might want to give her some tactical air support."

Certainly explains the sudden infusion of fresh dimwits harping in while presenting no evidences of anything!

No, actually I did it partially for that reason, but also to annoy the HIV/AIDS denialists infesting Tara's blog. That's why I later followed up in her comments by posting a couple of links that might have drawn the ravening horde away for a while:

http://scienceblogs.com/insolence/2008/12/hivaids_denialist_christine_m…
http://scienceblogs.com/insolence/2008/12/hivaids_denialist_celia_farbe…

Here's your big chance to shut down the denialists with any of all of your choice of studies from the "mountain of evidence" on HIV.

Please show the world that the mountain has anything in it but FOOLS GOLD!

Would Generalisimo Orac, or any of the hiv faithful,

PLEASE present us with any study that evidences

1) hiv as being properly isolated directly from the blood of any of the presumed "infected",

2) hiv as proven to be causing harm or death to any CD4 T-cells

2) hiv as proven to be causing immune suppression

3) hiv as being proven to be sexually transmitted

Note to Chris y:

You said: "'m so far from being qualified to comment on Tara's field that she might be writing in some undeciphered script."

Don't worry Chris, Orac himself is so far from being qualified to comment on the subject of hiv and aids, that he regularly writes on it in undeciphered scripts.

To Daniel Andrews, who said: "Didn't take too long for my wingnut detector to go off."

Your wingnut detector must be rattling away full time, considering the wingnut it is attached to.

@ Richard Eis, who said: "I read the comments (at aetiology) and they and their sock puppets are as vacuous as ever."

Speaking of vacuous, Please present any evidence that you yourself are not completely vacuous on the subject of hiv or the theory of aids.

Show us any studies from the "mountain of evidence" that show HIV as the cause of aids, as the cause of T-cell loss, as sexually transmitted, as isolated from blood sera, so we can tear it apart before your very eyes and show the world just how vacuous you are on the subject.

"evidences" LOL.

Here are a couple links to standard lab tests for 1) and 2a):

1) http://www.labtestsonline.org/understanding/analytes/viral_load/test.ht…
2) http://www.labtestsonline.org/understanding/analytes/cd4/test.html

2b follows from 2a and I'm too lazy to find a link for 3) right now.

Kate, just noticed your post at aetiology.

You yourself are "Sickening. So very sickening."

"Hate to break it to you, Kate, you woo-addled twat-waffle:" AIDS has NOT been proven to exist, kill t cells, or be sex xmitted. The HIV virus IS A MEME. Lots of things, and factors cause immune suppression and kill people. If it can be treated to drastically increase life expectancy and lower the chances of transmission to loved ones during normal daily contact, then PROVE IT WITH SCIENTIFIC STUDIES.

To deny the evidence in order to promote your favorite brand of snake-oil, or in some misguided or evil attempt to sweep it under the rug is to cause many others to die.

Your friend, John Higgins, died not of AIDS, but of high dosage AZT and stressing himself to sickness in 1991.

Deny it all you want, but HIV and AIDS are not founded in BS, they are unproven to be related and no amount of whining or wishful thinking on your part is going to change that fact.

Every person that dies a day sooner than they should have due to liver failure, suicide, or toxic drug effects from listening to you reality denialists and your bullcrap is a death for which you are responsible. Those deaths are on you. "THOSE DEATHS ARE YOUR FAULT AND YOU ARE NO BETTER THAN MURDERERS".

If you want to claim the dissidents are responsible, then whip out the studies and PROVE IT!

You're chomping at the bit, Mikey. Overly excitable, as usual.

Ever think of finding a job or something? You might even get hired to be cooler's boss at Burger King.

Just present the missing evidence, there Joey, or perhaps you are the one that would do the world a favor by flipping burgers.

Mike,

You're not interested in evidence. You're just interested in low-end trolling. You're not even that good at that even though you've had a ton of practice.

Still waiting for Christine's autopsy results. Or was one not done because there is something to hide?

Joey, and what would her autopsy show you other than that she became severely ill and died after 19 years of perfect health?

What would it show other than another anecdotal case of someone who was diagnosed 19 years ago with hiv one day got sick and died at age 52?

By the way, a bit over a year ago, an hiv poz aids drug user and promoter named Dan Dunable also died at the exact same age as Christine of age 52.

http://www.thebody.com/content/art45171.html

Do you have some evidence that the aids drugs did not contribute to weakening his heart and causing a heart attack? There is already much evidence in studies showing heart attacks to be alarmingly high in those taking the drugs.

No, you do not have any such evidence.

Do you have evidence that he would have sickened and died at an earlier age without the drugs?

No, again you do not have evidence.

If I hold up Dan as proof that aids drugs cause early death, would that be sufficient proof for you or any other aids drug promoters?

No, it would not. Not any more than Christine's death proves or nullifies anything.

So, what exactly is your point about Christine's death from disseminated herpes and pneumonia that followed extremely high and ongoing stress in her life, as well as her general and quite reasonable distrust of most doctors and western medicine that may also have contributed to her earlier than normal demise?

What exactly would Christine's autopsy prove? And why would it be any such proof?

Michael,

You're pitiable. You attempt to troll, but only wind up getting yourself worked up into a histrionic tizzy. You attempt to use sock puppets, but your incoherent, half-literate posts give you away every time. You fail to maintain any sort of logical consistency. For example, it's not good to complain about anecdotal evidence in a post that also uses an anecdote.

Well, Joey, I am glad to see that you understand both examples are anecdotal.

And to stretch the point above even a bit further,

Do you really believe, that an autopsy done by the very same individuals, the Los Angeles coroner who she and her husband were concurrently criminally charging with fraud, and that she was about to take to court could possibly be considered to be absolutely believable and honest and trustworthy?

Considering this lawsuit that Christine and her husband had against them, just how difficult would it have been for anyone in the coroners office to creatively pursue whatever autopsy reports for Christine's body that they desired?

Surely you are not naive enough to think that any findings by the LA coroners office regarding Christine would have been fully acceptable as the last word.

Or are you that naive?

@ storkdok:

What are Social Thinking classes, and how does one find a good one? Is it only for children, or would an adult benefit?

Michael,

Why should anyone believe a word you say when you repeatedly post such blatantly wrong information?

There were no criminal charges brought against the LA County Coroner. The law suit had nothing to do with fraud. It was about violation of privacy.

Furthermore, individuals such as Christine and Robin *do not* have the power to press criminal charges. Criminal charges are brought forth by prosecutors.

It seems that the LA County Coroner's "crime" in the eyes of the HIV cranks was to report that EJ died of AIDS-related causes. Well, duh!

Joey,

spin it any way you like. She and her husband had an ongoing case against them which could certainly have directly and quite easily tainted any such autopsy results presented by them.

Are you in denial of this quite obvious fact as well?

Micheal,

It's not a matter of "spin". It's a matter of fact. It wasn't a criminal case. You said it was, but it most certainly was not. Do you even know the difference?