Morning in America: Butthurt Achieved

[CBStew]

Have you any close relatives who have had prostate cancer? Have you ever had a PSA test? If not, will you ever have one?

1. No, not to my knowledge. My mother has HER2+ metastatic breast cancer (which, as these things go, could be worse), and I lost my best friend far too early, and before he was able even to see his second child, to metastatic colon cancer. I'm not trying to minimize things.

2. No, but I don't think I've reached the age bracket.

3. On the off chance that I manage to secure insurance rather than simply jumping off a bridge, if my physician suggests that it's warranted, sure.

Stew, the question is what is generalizable. In this case, the evidence for universal screening simply isn't good.

[Edit.--Oh, and there's a good, non-self-diagnosed, chance that I have Gardner syndrome, but a colonoscopy is out of the question at the moment. So goes anecdote, as immediate or distant as it may be.]

I hate cancer. Medical science has lengthened our lives to the point where it is one of the last things that can kill us. From what I have seen it is a really shitty way to go. I met a doctor years ago who drank like a fish, smoked like a chimney and ate all of the things that common sense tells us to avoid. When I thought that I knew him well enough I asked him why, since he was a doctor, he chose a life style that was so unhealthy? He said because he was a doctor. He had seen enough suffering and when it was his turn he wanted to go out with a bang. No lingering. No suffering. Just the big one and out. And he was going to enjoy life on the way there. But I am not that brave.  

Stew, this is either simply contradictory or an argument for assisted suicide. We're talking about the risk-benefit balance in PSA testing, right? This doesn't cause prostate cancer to happen or not to happen. It is certainly true that cancers, as derangements of cellular reproduction, cone hand-in-hand with longevity. But if you're going to invoke QALYs, quality-adjusted life-years, it's back to square one. One can't glibly bank on (or, really, target) "the big one," because Moby Dick might turn out to be a debilitating but nowhere near fatal stroke.

You are absolutely right.  With that life style he was just as likely to end up a diabetic with emphysema as to suffer a massive coronary. 

[CBStew]

Cancer is the classic disease of longevity, right? I mean, each cell division is a little roll of the the dice. The longer you live, the more likely you are to eventually come up snake eyes with a nasty malignant mutation.

It's complicated. It is horribly complicated. It is not one disease. I was once young and naive and proud enough to think that the biological sciences paled in comparison to the physical sciences and, oho!, look at this Riemannian manifold! I was dead fucking wrong. Cellular mutations accumulate; there's no snake eyes. There is a mitochondrial clock, and a roundabout of checkpoints. What might be a survival benefit in normal metabolism may be a turnkey to destruction later on. Malignancies adapt to evade cytotoxic chemotherapy. The search for therapies is a painstaking hunt for ways to sabotage saboteurs. And once childhood leukemia was death sentence, and now it is not, and HER2+ breast cancer was once a bad actor, and now it is subject to significant immunological attack.

I suppose I'm just rambling. But given the massed assault of human endeavor in this regard, I'm not willing to dismiss the considered opinion on screening, and not just prostate, in favor of some sort of "informed consumer" routine any more than I would engage in the drastically simpler activity of pro se representation.

Once again I agree.  When we use the word "cancer" to describe all of these diseases we are echoing centuries old science.  The diseases have similarities, but they are obviously different. 
But on the subject of screening, I don't believe that ignorance is bliss.  There are those who don't care to know what is going on in their bodies, and there are those who insist on knowing.  I am in the latter group.  Each time I get the results of my annual physical I think "Yeah, that only means that I was healthy two weeks ago when I took those lab tests."  I need a shrink more than I need a GP.

[Wheezer]

Once again I agree.  When we use the word "cancer" to describe all of these diseases we are echoing centuries old science.

Well, decades-old. People may complain about Nixon's other war, but most of the real advances in understanding have occurred since then. (Ergo hoc sold separately.)

[CBStew]

Once again I agree.  When we use the word "cancer" to describe all of these diseases we are echoing centuries old science.

Well, decades-old. People may complain about Nixon's other war, but most of the real advances in understanding have occurred since then. (Ergo hoc sold separately.)

Did I say centuries?  Make that millenia.
"Hippocrates (ca. 460 BC – ca. 370 BC) described several kinds of cancer, referring to them with the Greek word carcinos (crab or crayfish), among others.[1] This name comes from the appearance of the cut surface of a solid malignant tumour, with "the veins stretched on all sides as the animal the crab has its feet, whence it derives its name".[2] Since it was against Greek tradition to open the body, Hippocrates only described and made drawings of outwardly visible tumors on the skin, nose, and breasts. Treatment was based on the humor theory of four bodily fluids (black and yellow bile, blood, and phlegm). According to the patient's humor, treatment consisted of diet, blood-letting, and/or laxatives. Through the centuries it was discovered that cancer could occur anywhere in the body, but humor-theory based treatment remained popular until the 19th century with the discovery of cells"   Source is Wikipedia, but that is good enough.

[Wheezer]

Leave Dubbs out of this.

[morpheus]

Leave Dubbs out of this.

I admit it, I LOLed.

[Gilgamesh]

Why even bother reforming your political ideology or outreach to minority/women voters when you can just rig the system and win the White House faster?

http://www.nationaljournal.com/columns/on-the-trail/the-gop-s-electoral-college-scheme-20121217

Republicans alarmed at the apparent challenges they face in winning the White House are preparing an all-out assault on the Electoral College system in critical states, an initiative that would significantly ease the party's path to the Oval Office.

Senior Republicans say they will try to leverage their party's majorities in Democratic-leaning states in an effort to end the winner-take-all system of awarding electoral votes. Instead, bills that will be introduced in several Democratic states would award electoral votes on a proportional basis.

They tried this earlier in the year in Pennsylvania before the proposal was quietly shelved.

[morpheus]

All I know is that I'm excited that this is about to be relevant again.

[Brownie]

Why even bother reforming your political ideology or outreach to minority/women voters when you can just rig the system and win the White House faster?

http://www.nationaljournal.com/columns/on-the-trail/the-gop-s-electoral-college-scheme-20121217

Republicans alarmed at the apparent challenges they face in winning the White House are preparing an all-out assault on the Electoral College system in critical states, an initiative that would significantly ease the party's path to the Oval Office.

Senior Republicans say they will try to leverage their party's majorities in Democratic-leaning states in an effort to end the winner-take-all system of awarding electoral votes. Instead, bills that will be introduced in several Democratic states would award electoral votes on a proportional basis.

They tried this earlier in the year in Pennsylvania before the proposal was quietly shelved.

I'm shocked that a political party would use its power to tilt elections!

[Gilgamesh]

Why even bother reforming your political ideology or outreach to minority/women voters when you can just rig the system and win the White House faster?

http://www.nationaljournal.com/columns/on-the-trail/the-gop-s-electoral-college-scheme-20121217

Republicans alarmed at the apparent challenges they face in winning the White House are preparing an all-out assault on the Electoral College system in critical states, an initiative that would significantly ease the party's path to the Oval Office.

Senior Republicans say they will try to leverage their party's majorities in Democratic-leaning states in an effort to end the winner-take-all system of awarding electoral votes. Instead, bills that will be introduced in several Democratic states would award electoral votes on a proportional basis.

They tried this earlier in the year in Pennsylvania before the proposal was quietly shelved.

I'm shocked that a political party would use its power to tilt elections!

I think you're missing the point; this is gerrymandering writ large.  Making the Electoral College dependent on the winner of the Congressional district re-focuses the power on those already gerrymandered districts.

This is one instance when the pox on both your houses is just another false equivalence.

[J. Walter Weatherman]

South Carolina gives us some of that ole time religion...

http://www.usnews.com/news/articles/2012/12/17/south-carolina-lawmakers-propose-5-year-jail-sentence-for-obamacare-implementation

Nullification is yet again picking up steam in Dixie.

Pursuing an archaic legal theory that punctuated pre-Civil War disputes between the federal government and states, South Carolina state Rep. Bill Chumley last week pre-filed a bill for the upcoming legislative session that would criminalize implementation of President Barack Obama's 2010 healthcare reform law.

If his bill becomes law, any state official caught enforcing the healthcare law would be guilty of a misdemeanor and "must be fined not more than one thousand dollars or imprisoned not more than two years, or both."

Federal officials caught enforcing the law, however, would be given stiffer punishment under the proposal.

Any federal employee or contractor enforcing the law "is guilty of a felony and, upon conviction, must be fined not more than five thousand dollars, or imprisoned not more than five years, or both," the bill proposes.

"I think we're within our rights to do this," Chumley explained to U.S. News. "It's an obligation, I swore an oath to uphold the Constitution and protect the people."

...

"If we don't do something now, when do we?" says Chumley. "It's a sad situation that the government put us in... an unpleasant task you have to do from time to time."

A bit of 'unpleasantness' can be quaht necessary from tahm to tahm.

[J. Walter Weatherman]

DPD... There are hours' worth of entertainment for Gil in the comments to that...

Obama should be deported.

There is a reason there is a 2nd amendment. Bama has plenty of guns to defend her against the likes of mexico or liberal idiots and tyrannical governments.

And Tenthers aplenty!

Hey UCLA law professor Eugene Volokh! The supremacy clause establishes the supremacy of the Constitution, not Obama, or any other federal. If your interpretation of the supremacy clause were accurate, there would be no 10th Amendment. Unfortunately for you, there is a 10th Amendment and we intend to put it to good use.

UCLA law professor Eugene Volokh, however, told U.S. News the proposed law "would be clearly un-enforceable, because the federal law – upheld by the Supreme Court – trumps state law."

They give any ignorant tool of the statists a law degree these days, don't they? The County Sheriff trumps any Federal agent. Period. It's EXTREMELY enforceable. That "law professor" needs a lesson in the law.

"UCLA law professor Eugene Volokh, however, told U.S. News the proposed law "would be clearly un-enforceable, because the federal law – upheld by the Supreme Court – trumps state law."

Another liberal professor. Sorry but the Constitution says STATE law TRUMPS the feds.

Eugene Volokh: just another liberal statist libertarian.

[Gilgamesh]

DPD... There are hours' worth of entertainment for Gil in the comments to that...

Obama should be deported.

There is a reason there is a 2nd amendment. Bama has plenty of guns to defend her against the likes of mexico or liberal idiots and tyrannical governments.

And Tenthers aplenty!

Hey UCLA law professor Eugene Volokh! The supremacy clause establishes the supremacy of the Constitution, not Obama, or any other federal. If your interpretation of the supremacy clause were accurate, there would be no 10th Amendment. Unfortunately for you, there is a 10th Amendment and we intend to put it to good use.

UCLA law professor Eugene Volokh, however, told U.S. News the proposed law "would be clearly un-enforceable, because the federal law – upheld by the Supreme Court – trumps state law."

They give any ignorant tool of the statists a law degree these days, don't they? The County Sheriff trumps any Federal agent. Period. It's EXTREMELY enforceable. That "law professor" needs a lesson in the law.

"UCLA law professor Eugene Volokh, however, told U.S. News the proposed law "would be clearly un-enforceable, because the federal law – upheld by the Supreme Court – trumps state law."

Another liberal professor. Sorry but the Constitution says STATE law TRUMPS the feds.

Eugene Volokh: just another liberal statist libertarian.

I'm trying very hard to stop reading internet comments, but I guess I picked the wrong day to quit sniffing glue.

[Wheezer]

"If we don't do something now, when do we?" says Chumley.

[flannj]

I can't imagine how hard it must be to parent in a situation like this.
"Liza Long, a writer based in Boise, says it's easy to talk about guns. But it's time to talk about mental illness."

I am Adam Lanza's Mother.