Archive for December, 2008

The 1918 flu pandemic

Wednesday, December 31st, 2008

Genetic engineering may have explained the mortality of the 1918 flu. Apparently, three genes are responsible for the viruses ability to infection lung and not just bronchus.

“We wanted to know why the 1918 flu caused severe pneumonia,” Kawaoka said in a statement.
They painstakingly substituted single genes from the 1918 virus into modern flu viruses and, one after another, they acted like garden-variety flu, infecting only the upper respiratory tract.
But a complex of three genes helped to make the virus live and reproduce deep in the lungs.
The three genes — called PA, PB1, and PB2 — along with a 1918 version of the nucleoprotein or NP gene, made modern seasonal flu kill ferrets in much the same way as the original 1918 flu, Kawaoka’s team found.

There was a second reason for the high mortality in 1918-1920. The principles of thoracic surgery, including the physiology of respiration were not understood at the time. Thousands of flu cases, those with pneumonia, developed a secondary bacterial pneumonia and then developed empyema. Empyema is a collection of infected fluid in the space between the lung and the chest wall. We now know how to treat this condition. The principles of treatment are here. Note the observation that Hippocrates understood the principle of empyema; namely that thin fluid in the collection could be drained by an opening in the chest wall but the patient would die. Hippocrates didn’t understand why. The knowledge of lung physiology would not come until the 19th century. However, Hippocrates did observe that draining thick pus through an opening in the chest did not result in the death of the patient in all cases, as it did in those where the fluid was thin and watery. What was the reason ?

We now know that a relative vacuum exists between chest wall and lung. The chest wall is rigid and, during respiration, it changes its volume by using the “bucket handle effect” of the ribs.

The space between lungs and chest wall is shown along with the general anatomy. That space is what fills with fluid in cases of pneumonia that develop empyema.

The ribs are curved and, when the muscles of the chest wall pull up on them, as shown by the arrows, the cross section of the chest cavity increases because of the “bucket handle” effect. With expiration, the ribs move back down and the volume of the chest cavity decreases. This volume shift, aided by the piston effect of the diaphragm, moves air in and out of the chest. The lungs are not attached to the chest wall, allowing them to slide up and down and accommodate their shape to the shape of the chest wall. If there is a hole in the chest wall, the air can move into the space between the lung and chest wall, collapsing the lung. This is called a “sucking chest wound” in trauma care. If the hole in the chest wall is larger than the trachea, air will move more easily in and out of the chest and respiration through the trachea will stop. This was the great barrier to chest surgery that was not overcome until the 1920s. The flu epidemic, and the research into the cause of death in so many cases, led to the understanding of how the chest works.

I recently reviewed a book about the history of the 1918 flu epidemic and, because it ignored the issue of empyema, I could not finish it. They had only half the story. The story of empyema, and the cause and cure, resulted from work of the Empyema Commission, chaired by Evarts Graham, professor of surgery at Washington University of St Louis medical school. Here is one of many scholarly works describing his great accomplishment. Unfortunately, little of this has penetrated the general history of the epidemic in spite of 90 years. In a recent article about the military cases during the First World War, it states: During World War I, the overall empyema mortality rate among US military forces was 61%. The same, or greater, mortality was seen in the flu cases that occurred in the same period. Untreated empyema was virtually 100% fatal.

During World War I, empyema treated by thoracotomy was associated with a mortality of > 30%. This prompted the establishment of the Empyema Commission, which recommended chest tube drainage for treatment.

The surgeons who were treating the flu cases, just as those treating empyema due to war wounds, used the old Hippocratic treatment of draining the pus from the empyema. Note that in the war wound cases, 70% of these patients survived. The flu cases were different and almost all died in a few hours after the fluid was drained. The difference was that the empyema in flu cases was due to streptococcus infection, which produces a thin fluid and does not cause the lung to stick to the chest wall. When the chest was opened, the lung collapsed and these already sick patients succumbed. Hippocrates had predicted this. The war wound cases did better because the staph infections of the pre-antibiotic days (“Laudable pus”) caused the lung to stick to the chest wall and it would not collapse.

Eventually, Graham learned that using a tube instead of an open hole to drain the pus, and placing the chest tube under water at its lower end, would seal the air leak but allow drainage of the pus. His work opened the door to thoracic surgery and, today, would save most of the cases in a new flu epidemic. Graham was also the first to warn of the association between smoking and lung cancer, a disease he was to die of 1957. He performed the first successful removal of a lung for cancer and his patient attended his funeral 24 years later.

Genetics is a powerful tool in the treatment of disease but physiology is still as important. Scientists understand the first but may not be aware of the other factors. There is no substitute for the experience of treating patients.

The coming California bankruptcy

Thursday, December 25th, 2008

Governor Schartzennegger has announced a huge budget deficit this year. He tried to cut spending a year ago, and got nowhere.

Schwarzenegger’s $141 billion budget for the 2008-09 fiscal year proposes cutting 10 percent from every state agency, even as California struggles to provide for millions of [illegal] new residents, fix failing schools and address myriad problems in its overcrowded prisons.

The across-the-board spending cut is the kind of draconian tactic his Republican Party colleagues have long sought to realign state spending and revenue.

But it touched off a firestorm of criticism among the state’s ruling Democratic majority in the Legislature and promised to put his pledge to move California beyond partisan politics to the ultimate test.

If ultimately passed, Schwarzenegger’s budget would cut hundreds of dollars in classroom spending for every California student and release 22,000 inmates back to the streets. It also would close nearly one in five state parks and eliminate dental coverage and other benefits for millions who rely on the state for health care and welfare.

The governor painted his spending plan as tough love and the only option left for the state after a housing market meltdown and years of deficit spending by California lawmakers. It was a pattern he helped perpetuate by borrowing to cover past deficits and increasing spending for popular programs on the eve of his 2006 re-election bid.

Now the deficit is three times as large. He has said that, by March, the state will no longer be able to pay its bills. One option, used in past budget crises, is to pay with IOUs or scrip, redeemable after the crisis is over. The public employee unions have already announced that this is illegal and they plan to fight any attempt to cut salaries, such as with unpaid days off. It must be reassuring to have the power to demand to be paid, no matter what is happening to the employer. The alternative for the state, becoming more likely as the unions dig in, is bankruptcy. The more one looks at this option, the more it seems the only one available.

The city of Vallejo—population 120,000—declared bankruptcy earlier this year because it was locked into spending 74 percent of its $80 million general fund budget on public-safety salaries. Police captains were entitled to receive $306,000 annually in pay and benefits, while 21 firefighters earned more than $200,000 a year, including overtime. After five years on the job, all were entitled to lifetime health benefits. Now two smaller towns north of San Francisco, Isleton and Rio Vista, also appear on the brink of bankruptcy.

My own small city of Mission Viejo has similar problems with pensions and excessive employees. I have been a member of a local activist group trying to get control of the city council but the group has found that, even if we succeed in electing our own candidate, the new council members quickly adopt all the bad practices of the old guard. The city has seen its reserves fall steeply over the past eight years and it has become dependent on sales tax revenue, dangerously dependent on retail sales, especially auto sales.

What will happen ?

In a preview of political fights to come, both New York State and California budgets are being crippled by outsized public sector union pension obligations that are now coming due in a perfect storm—a combination of an aging population, a declining tax base, and a fiscal crisis.
The Democrats who narrowly control both state legislatures have a notoriously cozy relationship with unions and they will be unlikely in the extreme to bite the hands that feed. But the unsupportable absurdities of the current arrangement are becoming evident.

The average state and local government employee now makes 46 percent more in combined salary and benefits than their private sector counter-parts, according to the Employee Benefit Research Institute—including 128 percent more on health care and 162 percent more on retirement benefits. New York City, for example, not only spends 10 times more on pensions than it did ten years ago, it now spends more on pensions and benefits for firefighters than it does on firefighters’ salaries.
These tax-payer sponsored paychecks cannot be renegotiated in tough times to balance a budget. They can only go up, never down.

This will head to a showdown in March and bankruptcy seems inevitable. California is the 8th largest economy in the world but Democrats can spend faster than an economy can generate tax revenues. One major factor is the erosion of the tax payers class in California. Millions of illegals exist in an underground economy like that of a south American banana republic. Middle and upper class taxpayers are leaving. The tax base is dangerously narrow with 380,000 Californians paying 40% of all income tax revenue. That is down from ten years ago. People are leaving and the state can’t afford the loss.

With large employers leaving the state, fed up with the tax burden and offered better business environments elsewhere, we have to protect the jobs we have. We just lost 1,000 jobs when the largest manufacturer of hybrid cars chose business-friendly Mississippi. The increased business tax rate proposed as a Democratic budget “fix” didn’t appeal to Toyota any more than it did to a major California employer, AAA auto club. The company is taking its business — and 900 jobs — elsewhere.

But the taxes do not stop there. The tax rate on the citizens who together already pay $9 billion of our state’s revenue will become twice the national average. It is clear why wealthier Californians choose to leave for economically sunnier pastures, leaving even more of the burden on middle income workers.

When the rich leave the state, those in control of the legislature simply change the definition of rich. Democrats have proposed to stop accounting for inflation when defining “middle income” Californians. Conveniently, this allows higher tax brackets to apply to more and more people every year, including those earning more than $100,000 — despite the fact that they already foot almost 85 percent of the state’s tax bill.

Soon the absence of taxpayers will be irreversible. My chief concern is to sell my house while there are still buyers. Then I’ll be gone.

The Nixon Coup

Monday, December 22nd, 2008

UPDATE: The NY Times now claims it had the Watergate story from L. Patrick Gray and flubbed it. Except for the discussion of Gray’s honorable conduct, the story is meaningless, even if true.

UPDATE #2 Today (6/12/12) there is an interesting article in The Daily Beast about Watergate and the movie, “All the President’s Men.” It casts more doubt on the Woodward and Bernstein series about the break-in. has a very important discussion of the Watergate story today. We now know that Mark Felt, who died last week, was the “Deep Throat” source for Bob Woodward and Carl Bernstein in their coverage of the Watergate scandal. Felt was the number #3 man in the FBI hierarchy at the time J. Edgar Hoover died. He expected to be named as Hoover’s successor but Nixon appointed an outsider, L Patrick Gray. Gray had had an outstanding career but was vilified in the Watergate story. He never spoke of it again until he commented on Felt’s admission of his role three years ago.

The Stratfor analysis has some interesting comments on the origins of the story.

Felt saw Gray’s selection as an unwelcome politicization of the FBI (by placing it under direct presidential control), an assault on the traditions created by Hoover and an insult to his memory, and a massive personal disappointment. Felt was thus a disgruntled employee at the highest level. He was also a senior official in an organization that traditionally had protected its interests in predictable ways. (By then formally the No. 2 figure in FBI, Felt effectively controlled the agency given Gray’s inexperience and outsider status.) The FBI identified its enemies, then used its vast knowledge of its enemies’ wrongdoings in press leaks designed to be as devastating as possible. While carefully hiding the source of the information, it then watched the victim — who was usually guilty as sin — crumble. Felt, who himself was later convicted and pardoned for illegal wiretaps and break-ins, was not nearly as appalled by Nixon’s crimes as by Nixon’s decision to pass him over as head of the FBI. He merely set Hoover’s playbook in motion.

Woodward and Bernstein were on the city desk of The Washington Post at the time. They were young (29 and 28), inexperienced and hungry. We do not know why Felt decided to use them as his conduit for leaks, but we would guess he sought these three characteristics — as well as a newspaper with sufficient gravitas to gain notice. Felt obviously knew the two had been assigned to a local burglary, and he decided to leak what he knew to lead them where he wanted them to go. He used his knowledge to guide, and therefore control, their investigation.

The story was not an example of outstanding journalism. It was Washington power politics but it was worse than that.

And now we come to the major point. For Felt to have been able to guide and control the young reporters’ investigation, he needed to know a great deal of what the White House had done, going back quite far. He could not possibly have known all this simply through his personal investigations. His knowledge covered too many people, too many operations, and too much money in too many places simply to have been the product of one of his side hobbies. The only way Felt could have the knowledge he did was if the FBI had been systematically spying on the White House, on the Committee to Re-elect the President and on all of the other elements involved in Watergate. Felt was not simply feeding information to Woodward and Bernstein; he was using the intelligence product emanating from a section of the FBI to shape The Washington Post’s coverage.

Instead of passing what he knew to professional prosecutors at the Justice Department — or if he did not trust them, to the House Judiciary Committee charged with investigating presidential wrongdoing — Felt chose to leak the information to The Washington Post. He bet, or knew, that Post editor Ben Bradlee would allow Woodward and Bernstein to play the role Felt had selected for them. Woodward, Bernstein and Bradlee all knew who Deep Throat was. They worked with the operational head of the FBI to destroy Nixon, and then protected Felt and the FBI until Felt came forward.

In our view, Nixon was as guilty as sin of more things than were ever proven. Nevertheless, there is another side to this story. The FBI was carrying out espionage against the president of the United States, not for any later prosecution of Nixon for a specific crime (the spying had to have been going on well before the break-in), but to increase the FBI’s control over Nixon. Woodward, Bernstein and above all, Bradlee, knew what was going on. Woodward and Bernstein might have been young and naive, but Bradlee was an old Washington hand who knew exactly who Felt was, knew the FBI playbook and understood that Felt could not have played the role he did without a focused FBI operation against the president. Bradlee knew perfectly well that Woodward and Bernstein were not breaking the story, but were having it spoon-fed to them by a master. He knew that the president of the United States, guilty or not, was being destroyed by Hoover’s jilted heir.

There have been conspiracy theories about Watergate for years. I have read one book, Silent Coup, that postulates a conspiracy to overthrow Nixon by his political enemies. What the authors did not realize was that the coup was not by politicians but by the FBI.

The story of Deep Throat was well-known, but what lurked behind the identity of Deep Throat was not. This was not a lone whistle-blower being protected by a courageous news organization; rather, it was a news organization being used by the FBI against the president, and a news organization that knew perfectly well that it was being used against the president. Protecting Deep Throat concealed not only an individual, but also the story of the FBI’s role in destroying Nixon.

This story has been ignored since Felt’s admission. Why ?

Until Felt came forward in 2005, not only were these things unknown, but The Washington Post was protecting them. Admittedly, the Post was in a difficult position. Without Felt’s help, it would not have gotten the story. But the terms Felt set required that a huge piece of the story not be told. The Washington Post created a morality play about an out-of-control government brought to heel by two young, enterprising journalists and a courageous newspaper. That simply wasn’t what happened. Instead, it was about the FBI using The Washington Post to leak information to destroy the president, and The Washington Post willingly serving as the conduit for that information while withholding an essential dimension of the story by concealing Deep Throat’s identity.

Journalists have celebrated the Post’s role in bringing down the president for a generation. Even after the revelation of Deep Throat’s identity in 2005, there was no serious soul-searching on the omission from the historical record. Without understanding the role played by Felt and the FBI in bringing Nixon down, Watergate cannot be understood completely. Woodward, Bernstein and Bradlee were willingly used by Felt to destroy Nixon. The three acknowledged a secret source, but they did not reveal that the secret source was in operational control of the FBI. They did not reveal that the FBI was passing on the fruits of surveillance of the White House. They did not reveal the genesis of the fall of Nixon. They accepted the accolades while withholding an extraordinarily important fact, elevating their own role in the episode while distorting the actual dynamic of Nixon’s fall.

I wonder if the history books will add this to the Nixon story. Conrad Black’s excellent Biography of Nixon does not consider this aspect of the story. Nixon did commit illegal acts in trying to cover up the break-in, which he may not have known of. Theodore White, who wrote Making of the President 1960, later wrote that he believed Nixon felt the country owed him some forbearance since he could have challenged the 1960 election results with a fair possibility of success. There was clearly vote fraud in Chicago and Texas, both states won very narrowly by Kennedy. The Eisenhower Attorney General, William P Rogers, told Nixon that he had enough evidence of fraud to probably overturn the result. Nixon declined to challenge the election result for the good of the country. According to White, he expected the same consideration during a war but did not receive it. He was naive. Something never said about Nixon.

Finding the truth of events containing secrets is always difficult, as we know all too well. There is no simple solution to this quandary. In intelligence, we dream of the well-placed source who will reveal important things to us. But we also are aware that the information provided is only the beginning of the story. The rest of the story involves the source’s motivation, and frequently that motivation is more important than the information provided. Understanding a source’s motivation is essential both to good intelligence and to journalism. In this case, keeping secret the source kept an entire — and critical — dimension of Watergate hidden for a generation. Whatever crimes Nixon committed, the FBI had spied on the president and leaked what it knew to The Washington Post in order to destroy him. The editor of The Washington Post knew that, as did Woodward and Bernstein. We do not begrudge them their prizes and accolades, but it would have been useful to know who handed them the story. In many ways, that story is as interesting as the one about all the president’s men.

The Illinois Way

Sunday, December 21st, 2008

Thus far, we have been treated to the “Chicago Way” of Obama and Daley and the other Daley machine cronies. Now, with the nomination of Republican Congressman, Ray LaHood as Secretary of Transportation, we will be introduced to the Illinois Way, the bipartisan corruption that has killed off the Republican Party in Illinois. Dennis Hastert was the Speaker of the House when the Republican majority frittered away its chances for a long run by passing pork-laden spending bills and convincing Bush not to veto them. Hastert retired before the 2006 election and his seat was taken by a Democrat in that election. What about LaHood and Obama’s “infrastructure projects?”

Via David Frum, John Kass of the Chicago Tribune has the explanation of LaHood’s appointment.

What Obama forgot to mention is that with LaHood in charge of the roads, they’ll lead to one place:

Bill Cellini.

Cellini, the Republican boss of Springfield who has been indicted in the Blagojevich scandal for allegedly shaking down the producer of the movie “Million Dollar Baby,” is a strong LaHood ally. Cellini runs Sangamon County, and LaHood has enjoyed Cellini’s political support.

They also joined to help oust the last true reformer in Illinois politics, former Sen. Peter Fitzgerald, the Republican who was denied an endorsement from his own state party after he brought federal prosecutors to Illinois with no connection to the bipartisan Combine that runs things here.

Republican money man Cellini is not only the Chicago political connection to machine Democrats and Mayor Richard Daley’s City Hall—and a Blagojevich fundraiser—he’s also the boss of the Illinois Asphalt Pavement Association.

I wonder if former Senator Fitzgerald might be convinced to come back and try to clean up Illinois. He’s probably too smart of try an Augean stables project like that.

Turkey and corruption

Saturday, December 20th, 2008

I have previously posted some of my concerns about the future of Turkey and the role of the Islamist party, AKP. Claire Berlinsky has a new piece about corruption and the AKP. She believes that the Islamist threat is exaggerated but the real enemy of Turkish success is corruption.

The AKP came to power promising reform. It has stayed in power because it is perceived, in Turkey, to be delivering reform, and it has received tremendous support from Europe, the United States, the International Monetary Fund, the World Bank, foreign investors, and the foreign press for the same reason. If the AKP is not, in reality, getting very far—if the reports of substantial reform are wrong, predicated on faulty data, and derived from faulty analysis—then it is only a matter of time before Turkey experiences its next major financial meltdown, much like the one that brought the AKP to power in the first place. When this happens, the AKP will be voted out of power, if it has not already been ousted by the courts or the military.

I criticized Condaleeza Rice in my other post for her support of AKP, whether they are honoring the secularist traditions established by Ataturk or not. Berlinsky believes that their success is a house of cards.

Here are some commonly reported statistics: when the AKP took power, foreign direct investment (FDI) in Turkey was $1 billion; in 2007, FDI stood at $19.8 billion, an amount equal to the past 20 years combined. Under the AKP, Turkey’s average economic growth rate has been over 7 percent, compared with an average of 2.6 percent during the previous decade. Per capita income rose in their first term (2002-2007) from $2,598 to $5,477. In the 1990s, inflation reached highs of 100 percent; under the AKP it has been reduced to an average of 10 percent. Foreign debt has declined from nearly 80 percent of GDP in 2001 to less than half of GDP today. The budget deficit has dropped from 16 percent of GNP to 1 percent. Public sector debt has been reduced from 91 percent of GNP to 51 percent.

Looks good, doesn’t it? I thought so, too. Previously, I have accepted these statistics at face value and applauded the AKP’s economic record. But having looked more closely at the question, I am now recanting. These statistics might be right, but they might also be nonsense. The truth is, nobody knows.

Turkey has an enormous underground economy, much of it may be illegal. Nobody knows where the money comes from. There are rumors that a small group of secretive figures really runs the country.

I say this because Turkey has one of the largest underground economies in the world. By definition, data about the size of the underground economy do not exist. But economists in Turkey estimate it to be worth somewhere between one-third and two-thirds of Turkish GDP. Every major economic sector in Turkey—agriculture, construction, markets, textiles, tourism, shipping—is largely underground, off-the-record, and undeclared. No one knows how big these sectors really are. No one knows if they are growing or shrinking. No one knows how they are being financed. No one knows where the profits are going. Of the 23 million people working in Turkey, only 10 million are working on the record. The economic growth rates commonly cited in the press cannot be meaningful. They cannot even be approximate. They probably pertain to less than half of the Turkish economy.

Osman Altug, an economist at Marmara University who specializes in the study of Turkey’s underground economy, told me that he can think of only one country in modern history with an underground economy so large by comparison with the official one: Argentina under Carlos Mendez. “Not even Africa is this bad,” Altug said. Other economists may not go so far, but most agree that as underground economies go, Turkey is top-tier.

Read the rest. It is not reasuring.

Here it comes

Friday, December 19th, 2008

So far, conservatives have been pleasantly surprised by Obama’s foreign policy and national security nominations. He kept Gates at Defense and named General Jones as National Security Advisor. Hillary Clinton as Secretary of State is not exactly a conservative choice but it could have been worse. Some of his campaign advisors were pretty odd. Now we are starting to see his domestic policy nominations and his leftist roots are showing. His choice for science advisor is an old fashioned eco-nut.

The Anthropogenic Global Warming movement has elements of a New Age religion. Even though the bona fides of the advocates have been debunked, the main stream media is oblivious to skeptics. This is not a good sign.

Here is more on him. Ugh !

Dr. Holdren, now a physicist at Harvard, was one of the experts in natural resources whom Paul Ehrlich enlisted in his famous bet against the economist Julian Simon during the “energy crisis” of the 1980s. Dr. Simon, who disagreed with environmentalists’ predictions of a new “age of scarcity” of natural resources, offered to bet that any natural resource would be cheaper at any date in the future. Dr. Ehrlich accepted the challenge and asked Dr. Holdren, then the co-director of the graduate program in energy and
resources at the University of California, Berkeley, and another Berkeley professor, John Harte, for help in choosing which resources would become scarce.

In 1980 Dr. Holdren helped select five metals — chrome, copper, nickel, tin and tungsten — and joined Dr. Ehrlich and Dr. Harte in betting $1,000 that those metals would be more expensive ten years later. They turned out to be wrong on all five metals, and had to pay up when the bet came due in 1990.

I’ve worried about this before.

The next step to unmanned aircraft

Friday, December 19th, 2008

Northrup-Grumman shows off its big Navy UAV. It can do in-air refueling and carrier landings and takeoffs. It has a 62 foot wing span and weighs over 20 tons at takeoff. It will be flying next year and the carrier exercises begin in 2011.

I have previously posted about this topic here and here and this is interesting. Unfortunately, Falcon-Blackswift seems to have been cancelled. I don’t know if this means the Democrats are going to gut new technology or it had reached a dead end in the program.

Putin’s dilemma

Friday, December 19th, 2008

Russia has been run by a KGB hierarchy for the past ten years. I have previously posted on the story. I think the methods of Putin resemble Fascism and he has shown signs of a return to aggression as state policy. Much of the Russian adventurism was fueled by high oil prices as Russia is a major oil producer and has not used the income to diversify their economy. Now, with the steep decline in oil prices, there is unrest in Russia. The ruble has fallen sharply even as the Russian central bank has spent 160 billion dollars in gold supporting it. The KGB Russia is in trouble.

The Long Range Desert Groups

Thursday, December 18th, 2008

I finished an excellent war novel by Steven Pressfield titled Killing Rommel. The title comes from a mission that the group is assigned, somewhat similar to the shoot down of Admiral Yamamoto in the Pacific. Here is a Japanese language video of the death of Yamamoto. It was a devastating blow. One of the pilots, Tex Lanphier was a long time friend of my father-in-law.

The novel, which is very well written, got me interested in the LRDG services of the British Army. They were the forerunner of the SAS and there is increasing interest in their exploits.

They set out on missions of hundreds of miles in trucks and jeeps carrying repair facilities with them. They ranged across the desert behind the lines and scouted Rommel’s Afrika Corps. They also carried SAS teams and attacked German airfields, destroying hundreds of planes. There are even American societies devoted to the LRDGs.

Some of the characters in the novel are real people, like Paddy Mayne an incredible special forces soldier. He was awarded four Distinguished Service Orders, the last having been downgraded from a Victoria Cross by a jealous REMF officer.

The commander and founder of the SAS was David Stirling, a Scottish Laird who was training to climb Mount Everest when the war began. He organized the SAS and led it until captured by the Germans. Thereafter, it was led by his brother and by Paddy Mayne. Many of the SAS men captured were spared by Rommel and Kesselring, his superior in the Mediterranean theater, but other German officers executed SAS prisoners. After the war, the surviving SAS men hunted down those Germans. The web site says the captured Gestapo and Nazis were turned over to the War Crimes Commission and I suppose the surviving ones were turned over. I wouldn’t give much for the chances of the rest of them, however. On one raid, the SAS men discovered that the German planes each had an armed guard. Mayne methodically went to each plane, killed the guard with a knife and destroyed the plane. On some raids, they destroyed as many as 60 planes.

The organization continues as Britain’s Special Forces.

Neuroscience, the next medical frontier

Monday, December 15th, 2008

When I was a freshman medical student, I spent a summer working in the VA psychiatric hospital in west Los Angeles. While there, I spent many hours talking to chronic schizophrenic patients, some from World War II and one even from World War I. I watched electro-shock therapy for psychosis and spent hours listening to the professor there, George Harrington. He was one of the two or three most impressive men I met in medicine. He was convinced that psychosis was an organic disease and had no confidence in psychoanalysis to explain anything to do with psychosis. I was very interested in psychiatry for a while but my exposure to other psychiatrists in medical school soon ended my enthusiasm.

Now, neuroscience is one of the most promising areas in medicine. We have increasing evidence of the anatomy of mental illness. Obsessive-compulsive disorder can now be cured with a surgical interruption of a feedback loop in the brain. Functional MRI can show differences in the response to stimuli between schizophrenic and non-schizophrenic twins.

Now, we are getting to the analysis of normal function. The visual cortex seems to have a map of the retina contained in it. By analyzing the fMRI of the visual cortex in a subject looking at a picture, it has now been possible to reconstruct the image from the fMRI. We can look at the brain in a functional way and read what it is seeing.

The next step, and it is coming fast. is to create a biological-electronic interface. We already have one called the cochlear implant. It is able to restore hearing by stimulating hair cells in the ear. A visual implant would stimulate the optic nerve when the rods and cone cells are lost.

If I were a medical student today, I would be looking very hard at this field. When I was a medical student 46 years ago, I decided that the science of the brain and the immune system were too primitive at the time to have any implication for clinical work. I decided that, if I wanted to go into research, I would be better off as a physical chemist. That was true then but is no longer true.