User talk:MastCell

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Don't try to worm your way out of this

Are you really a real doctor? Note for the humor-impaired: this is not a serious question. - 2/0 (cont.) 19:49, 21 May 2010 (UTC)

Hello central?. . . dave souza, talk 20:47, 21 May 2010 (UTC)

The definitive word on my qualifications can be found at Wikipedia:WikiProject Medicine/Participants, under my username. MastCell ^Talk 03:27, 22 May 2010 (UTC)

Looked at it. Putting two and two together in the accepted Wikipedia fashion, I have deduced that your real name is Robert Sean Leonard. Short Brigade Harvester Boris (talk) 03:32, 22 May 2010 (UTC)

Yeah. Looking at my picture from my Wikipedia biography, I can't help noticing that I've let myself go a bit since Dead Poets' Society. But then, you should see Robin. MastCell ^Talk 03:41, 22 May 2010 (UTC)

Speaking of, do you think House has jumped the shark? We used to watch it religiously but this year we found we weren't bothering to keep up. Short Brigade Harvester Boris (talk) 03:49, 22 May 2010 (UTC)

To be honest, I think it jumped the shark in the first season, but it's saved by the fact that it generally doesn't take itself too seriously, and because the character and acting are great. I have to admit I haven't seen much of this season. Community won me over, and this season of 30 Rock has been pretty great. So I've been watching those - I feel like I don't have time for an hour-long drama anymore. Life is too busy. And basically, every day of my life is exactly like an episode of House - they really nailed the realism... (just kidding). MastCell ^Talk 18:41, 22 May 2010 (UTC)

Hi MastCell, Speaking of one’s wikipedia-relevant life experience…have you ever done any basic research, of the kind geared toward ascertaining a physical fact about nature? I’m asking because my training is in that kind of science, and I’m finding there’s a bit of a culture gap between the top priorities of that kind of science and the kind of science that is most immediately useful in the daily practice of medicine.

I dearly hope this question isn’t offensive. I have great respect for medicine and don’t mean to suggest there’s anything “wrong” with that kind of science; merely that there are, necessarily, proximal social considerations in medicine that are more distal in the science of isolated cells and molecules. Best wishes, Postpostmod (talk) 13:18, 26 May 2010 (UTC)

I'm going to decline to go into detail about my personal history, because I value what's left of my pseudonymity here. I do agree with your observation; I think that clinical research is a very different endeavor from basic science. The two areas attract different kinds of people and have different approaches and criteria for measuring success. If I were to greviously oversimplify, I'd say that in basic science questions are pursued primarily because they're interesting, while practical applications are often a secondary consideration. In clinical research, practicality is a prime consideration; often the most interesting and important questions can't be feasibly answered because it would be insurmountably impractical to do so. The best-designed clinical trial on Earth is no use to anyone if it fails to accrue patients and can't achieve any statistical power.

More to the point, the kind of questions faced in the daily practice of medicine are difficult precisely because they often haven't been the subject of rigorous clinical research. It would be impossible to practice truly "evidence-based" medicine, because it would be impossible to acquire a suitable evidence base to face every conceivable (or even every common) clinical scenario. For conditions that are uncommon or clinically heterogeneous, it is impossible to conduct a suitably powered randomized controlled trial, or sometimes even a decent prospective observational cohort. If you focus too narrowly on specific clinical conditions and scenarios, then you'll never accrue enough patients to conduct a meaningful study - and even if you did, the results wouldn't necessarily be generalizable if your population was narrowly defined. On the other hand, if you cast a broader net, then your patient population becomes heterogeneous, limiting your ability to draw specific conclusions.

That's why I get annoyed when people compare medicine to aviation (usually in terms of the markedly superior safety record of commercial aviation). Sure, practicing medicine would be like flying a plane - if every time you took off you had no idea exactly where you were going, and you'd never flown that exact model of plane before, and an M.B.A. at air traffic control might decide to override your judgment about the best flight plan, and if the passengers were actually at the controls and were free to decide to ignore your recommendations about flying the plane because of something Dr. Oz said on Oprah, and if your navigational maps were accurate only to a p-value of 0.05 at best...

In terms of social considerations, I do feel for scientists who lose control of their work when it's in the public domain, and have it re- (mis-)interpreted by various political forces. In general, I don't think scientists are very well-equipped for the political arena, and to the extent that ignorance routinely triumphs over enlightenment, I think that disconnect is partially to blame (of course, the pathetically poor state of scientific literacy and education in the US is also part of the problem, as is the media's approach to scientific controversies).

Anyhow, I'm digressing again. Did you have a specific issue in mind, or was that a general question? MastCell ^Talk 16:39, 26 May 2010 (UTC)

Hello, thanks. Your second paragraph describes beautifully the issue I'm exploring. I offer you kudos for your writing skill.

It will take me a little while to craft an explanation of how this relates to our conversation about the diagnosis of Lyme disease. Frankly, I'm concerned about unintentionally offending. Obviously, it‘s both a complex, and a touchy, subject. I feel that extracting a “best guess” at the biological facts from the perhaps overly voluminous literature is quite challenging enough, without bringing emotional issues into the mix.

By the way, I love your aposematic moniker - thanks for the warning. I’ll create what I hope will be an adequately non-inflammatory explanation of my concerns and send it along here when it’s ready.Again, many thanks, and my compliments, for your elegantly phrased, substantive reply to my question. Best wishes, Postpostmod (talk) 15:16, 27 May 2010 (UTC)

I wouldn't worry too much about offending me. I (try to) have a pretty thick skin, at least as far as online discussion is concerned (arguably less so in real life, depending on whom you ask). I actually value a thought-provoking discussion over an excessive concern for politeness, although that preference doesn't translate well onto Wikipedia. By the way, I don't mean to minimize the human aspect of the issue. I think anyone who knows people debilitated by symptoms that cannot be readily explained has a sense for both the suffering and the vulnerability that result. Anyhow, thanks for the thought-provoking discussion, and take your time. MastCell ^Talk 17:44, 27 May 2010 (UTC)

Hello, I’m back, after having a houseguest for several days and then enjoying the incredible holiday weekend weather. Warblers have almost all passed through, but the locally breeding birds have lots of ugly-cute babies. It's endlessly amusing to watch their family life.

Thanks for your kind understanding of my issue around offending on a touchy subject. I think it takes a pretty thick skin to edit Wikipedia, and in fact to do anything that puts one out in public (including cyberpublic) on potentially contentious issues. I'm not blessed with that; I'm just wistfully hoping for WP:NAM, and hoping that if I treat peoople with respect, they'll treat me with respect. This strategy, of course, is famously useless in dealing with bullies of various sorts; I think it's best for delicate souls to ignore or avoid them whenever possible. They've got their reasons, and they've got their natural enemies who have the chops to deal with them.

The more general issue about offending is that it tends to drive a discussion away from facts and logic, and toward irrelevant emotional defenses. Nothing wrong with emotion, we all have it and need it. It's just that it muddies the waters of an investigation of the facts. So I'm hoping to avoid stirring up that unhelpful murk.

Having said that, I, as Murphy's law would dictate, now need to ask an indelicate question. May I ask if you're naturally inclined to notice breaks in logic? I think this is a separate skill from general intelligence, somewhat like a sensitivity to spelling and usage - some highly intelligent people are not naturally good spellers, and their skin doesn't crawl when someone mixes up there, their, and they're, or affect and effect. I happen to be a good speller, but I recognize that, useful and aesthetic as it is, it could fairly be regarded as a sort of idiot-savant skill, like being good at fast mental math. I'm asking, not because I personally doubt your personal skill at logic, but because I think, not to put too fine a point on it, that there are some whoppers (or, to put a fine point on it, some commonly stated assumptions of unsubtly dubious merit) in the medical literature, that somehow don't get detected by either the experts or the rank and file. And when they're pointed out, the whole profession's eyes seem to glaze over (or the hapless messenger is indignantly censured for unseemly behavior). This must mean, unless you see an alternative explanation which I'd be grateful to consider, that in the culture of medicine there is no social pressure to recognize such gaps, and could even mean that there is social pressure against recognizing them.

So I guess I've raised two (potentially thorny, sorry about that) issues - are you sensitive, in general, to breaks in the chain of a logical argument? If not, then I won't bother discussing them, but will focus on other ways of understanding reality, of which there are many. And, if you are, and have consequently noticed some of the more obvious ones in the medical literature, what do you think culturally accounts for their going unremarked? I'll end here, as it seems that considering too many issues at once is counterproductive to a straightforward discussion, and if emotional issues arise, we'll be able to know what triggered them and how to backtrack to the place where rationality was last in effect.I hope, if I say something unnecessarily tactless, you will dispassionately explain where I've gone astray and help me improve my skills in respectful debate.

I congratulate you again on your writing skill. And I appreciate your mention of the suffering caused by debility that cannot be readily explained by current medical concepts. Perhaps we would both agree, in principle, that such suffering and debility should be related as carefully as possible to any physical evidence that sheds light on the case, in order to have the best chance of alleviating it. And finally, thanks for your appreciation of the inherent limits of clinical research, when compared to more easily manipulated fields of enquiry (or is it inquiry? ;-). I think that's a rare insight, and extremely valuable.

I hope you're getting good spring weather wherever you are. You'd be astounded at how many people I saw last weekend lounging directly on the grass in shorts and flip-flops, in this LD-endemic area. Good for the local tourist economy, bad for the public health. Best wishes, Postpostmod (talk) 15:12, 3 June 2010 (UTC),

Apology/Revision

Oops, I blew it. I just resumed listening to Jon Stewart's America on CD, and my chuckles died away as I realized I had let his sarcasm infect my tone in my very recent post to you, above. I gather it's not proper WP policy to edit it out, and I don't know how to use the strikeout method yet, so please, help me out and make the following changes in it, mentally if it can't be done physically:

Replace the portion between "whoppers" and "dubious merit" with "discrepancies". Ignore the entire following sentence.

Replace my references to "you" with references to a purely abstract, hypothetical member of WP:MED, with regard to following a train of logic. Maybe be could call him/her THD for The Hypothetical Doctor.

I'm very sorry, this caught me by surprise. It's amazing how contagious an impartial tone can be, especially if it includes the pleasure of humor. Anyway I just learned a valuable lesson, and I'll be careful never to read or listen to Jon Stewart or his ilk before talking to anyone who disagrees with me! Best wishes, a much subdued Postpostmod (talk) 17:43, 3 June 2010 (UTC)

Sorry for the delay. Don't worry so much about offending me; I didn't see anything in your initial post that was anything less than civil, although I appreciate your attention to tone.

Of course I think I'm capable of recognizing breaks in logic, but then people are notoriously bad at assessing their own capacity for introspection and critical thought. One has to be wary of the Dunning–Kruger effect - my lack of ability to think critically may actually impair my ability to recognize that lack. Sorry for being, er, post-modern about it. :P

In terms of specific logical gaps underlying common medical assumptions, that's a complex question. I think there is a tendency toward groupthink, or at least accepting something because X authority said so, inherent in any complicated and highly specialized field of knowledge. In some ways it's a useful heuristic - for example, I don't consider myself qualified to analyze the relative impact of various antiplatelet agents after myocardial infarction, so it's quite useful for me to accept the American College of Cardiology's take on the subject. The danger, of course, is that if their (undoubtedly human and fallible) expert panel missed something major, then I've also missed it by accepting their synthesis. Critical thinking is essential, but it's also impossible to apply universally - there just isn't enough time, especially for a working physician or researcher, to independently assess every assumption underlying standard medical practice.

On the other hand, I'm also deeply dubious of assertions that all of the expert bodies in a field have made some major, basic error of logic. At the extreme, it's like the AIDS denialists, who claim that every scientist who's done successful work with HIV has been duped into thinking it causes AIDS. At some point, it's just entirely implausible that such a basic error could have been carried forward so far. To a lesser extent, the climate-change "skeptics" are in the same boat, as if there were some magical set of assumptions that the National Academies of every large nation on Earth have overlooked. That's not to say it's impossible, and we shouldn't set up sacred cows that are beyond reasonable questioning or debate. The trick is to know when you've passed the "reasonable" threshold.

Without knowing which specific apparent breaks in logical thought you're referring to, it's hard for me to comment intelligently on your second question. I'm guessing that it has to do with the Lyme ELISA, but it would probably be easier to discuss if I had a more concrete sense of what you're referring to. Sorry for the non-answer... MastCell ^Talk 18:29, 7 June 2010 (UTC)

Hi MastCell. Thanks for your patience with my spilkes. I like your Sontag quote. I didn’t figure that out until I was in my mid-forties. ;-)

Lots of great early summer action in the wetlands. My area is blessed with numerous parks with wide paths along water. Some of the newbie bird (and newbie bird-parent) antics are hilarious. We saw a kingbird trying to feed a mulberry to the babies. S/he tried each of the three in turn, and each tried but failed to engulf it. Good idea that didn't work out. The moms and dads are overworked trying to feed everybody, but it doesn’t last long, and I’m sure it’s well-compensated by the sense of purpose and dignity they enjoy. At least that’s how I felt at the height of my scientific career. I don’t have kids - not enough faith in the benevolence of the universe, I guess.

Now, about the logical problems with using the ELISA for LD diagnosis. Here is one notable inconsistency in the officially stated policy, which raise questions about the reliability of the IDSA guidelines. I’m using your quotes on the subject, since I can be sure that you are both aware of, and willing to acknowledge, the presence of these statements in legitimate medical discourse. Of course, there is abundant verifiable evidence to back up these statements, which we could both cite if necessary.

“ELISA is an inadequate diagnostic tool when used in isolation. That's why no one in their right minds recommends using it in isolation; for instance, as you note, the CDC recommends that diagnoses be made clinically and laboratory testing used in an ancillary role.” MastCell[[1]]

“I think Lyme disease is almost certainly grossly underdiagnosed and underreported. A more useful screening test would be hugely important.” MastCell [[2]]

I agree with you, and more importantly, I think the preponderance of data agrees with both of us. But, the IDSA guidelines say:

"Clinical findings are sufficient for the diagnosis of erythema migrans, but clinical findings alone are not sufficient for diagnosis of extracutaneous manifestations of Lyme disease or for diagnosis of HGA or babesiosis. Diagnostic testing performed in laboratories with excellent quality-control procedures is required for confirmation of extracutaneous Lyme disease, HGA, and babesiosis.’ [emphasis in original]"[[3]]

See the problem in the guidelines, and how it contributes to the gross underdiagnosis (and consequent undertreatment, delayed treatment, etc.) of LD? And see how it's therefore not a good idea, from a humanitarian standpoint, to defend the guidelines beyond what is reasonably required by WP:MEDRS?

Hope you're enjoying the summer, best wishes, Postpostmod (talk) 15:04, 17 June 2010 (UTC)

Hi, just a note to let you know I'm still interested. Hope all's well, Postpostmod (talk) 21:04, 30 June 2010 (UTC)

Sorry - I had gotten a bit preoccupied and missed your response until just recently. But continuing our discussion is now officially on my to-do list. :) MastCell ^Talk 21:06, 30 June 2010 (UTC)

Hello, just checking in. We've been having quite the heat wave, but it just thunderstormed and Yay! it's down to 70 (deg F). Hope you and yours are well, Postpostmod (talk) 20:35, 10 July 2010 (UTC)

Hi there, checking in again, so thread doesn't get accidentally archived. (If it does, I guess we can dig it out again if need be.) I see I'm still on your to-do list. Looking forward to hearing from you. New heat wave coming here, after a few days' relief, which gave the house a chance to cool down. Hope all's well, Postpostmod (talk) 14:49, 16 July 2010 (UTC)

Sorry, I've been spending most of my on-Wikipedia time elsewhere, as you can probably see... I don't like to get caught up, but those kinds of processes are usually time-sensitive. If you ignore them and then wish you'd said what you had to say, you can't go back. Anyhow, I just haven't had the time/mental energy to continue our conversation in the past week or two, although I do intend to. I don't have an automated archive system (I do it by hand), so this thread won't go anywhere. Thanks for your patience. MastCell ^Talk 16:40, 16 July 2010 (UTC)

Just caught your reply - it didn't show up on my watchlist for some reason - oh well. Thanks for communicating, looking forward to it. Best wishes, Postpostmod (talk) 00:00, 22 July 2010 (UTC)

Laetrile again

In regard to that old discussion over here, you might find this article interesting (plus this). II | (t - c) 01:41, 6 June 2010 (UTC)

Frankly, the first source isn't very impressive. I get really tired of hearing that studies of various alternative medical approaches failed to show benefit because the researchers didn't give the drug the "right" way. No matter how the Mayo folks had given laetrile, someone would have criticized it (because no one has ever bothered to funnel some of the proceeds from marketing the drug into doing Phase I dose escalation, pharmacokinetics, or any of the basic things that a drug company has to do before they can even dream of marketing a drug to patients). It's kind of the mantra of the megavitamin people - no matter how many trials show that megadose vitamin E, or beta carotene, or folate are useless or even harmful, they'll just wave their hands about the wrong isomer of tocopherol or something.

When you do a clinical trial, you have to pick some specific dosing regimen. Inevitably, it's possible that you didn't pick the right dose, or administration route, or whatever. That's a possible explanation for any negative trial of an agent. It doesn't invalidate the result of a clinical trial, though. It merely makes it incumbent upon people who believe that the trial was conducted incorrectly to design and carry out their own clinical trial, where they can use whatever intervention they believe in. Designing a clinical trial and seeing it through to some kind of meaningful result is a lot harder than it looks.

I can think of only one example where a clearly negative result later turned out to be due to sub-optimal dosing (cf. flavopiridol). There may be others that aren't coming to mind. But in general, when a drug is clearly ineffective in a well-designed clinical trial, the chance of it becoming a miracle cure (or even modestly effective) with a change in dosing regimen is extremely small, in my experience. MastCell ^Talk 05:08, 6 June 2010 (UTC)

Well, at least you didn't say that Stephen Krashen should not have written the paper or should be ignored because he's a linguist. I'm also glad to see that you and him might sort of agree, since he concludes that "the Moertel et. al. study teaches us a great deal: It shows that using a mixture of pure and synthetic Laetrile on a rigid schedule with terminal patients does not work". He had four criticisms, summarized as: "The kind of Laetrile used. The way the Laetrile was administered. The use of terminal patients. The interpretation of the results". You're only commenting on the second one, and I'm pretty disappointed in your nihilistic attitude, although I guess I shouldn't be surprised given the cynical persona. :) It reminds me of neoconservatives who say regulation is unnecessary - because no matter what the regulation, there will be some negative unintended consequence or loophole. The implicit argument is that flaws and permutations are infinite and cannot be quantified and addressed as they are discovered.

On the dosage itself, Krashen said that the dosing would have been optimal ("dose of injected Laetrile appears to be more than sufficient and is consistent with previous practice") had the substance used been the one actually promoted, and had it been used for more than 3 weeks. Arguing that, had this been done as Krashen suggests, another argument would have magically sprouted up seems dubious, and further it could be interpreted to mean that critics are not acting in good-faith or are intellectually dishonest. It's also notable that laetrile did get a lot of early research (see Laetrile#Initial_studies_at_Sloan-Kettering). And it's not really the proponents who decided to jump to an uncontrolled, larger sized trial (Moertel 1982) rather than a couple smaller studies testing different administrations and doses, although I imagine it's possible that the tools and knowledge weren't readily available to do detailed pharmacokinetics at the time, or even today. The sad result of all this is that, as we discussed in our earlier thread, the Cochrane review cannot say with conviction that the case has been settled and recommends future research, including clinical trials. The key point is not to convince the diehard proponents so much as it is to convince rational objective third parties. You're jumping to the conclusion that Krashen is on the same level as promoters of megavitamin E supplementation, but that's not really fair. Krashen's conclusions are broadly the same as the 3 Cochrane reviewers.

The overall issue of not engaging or replicating the AltMed claims applies broadly, and in my mind explains a lot the current tension. You seem to have an attitude that engagement and rational discussion are hopeless with these people, but my impression is that lack of proper engagement is much more damaging. The lack of engagement is not just an old 70s and 80s thing, either; similarly disappointing work was done more recently with glucosamine, when despite all earlier trials pointing to chloride not working and sulfate working, the trial went ahead with chloride [4]. If sulfate had been used and the results had been the same, a significant point of the controversy would been closer to being settled.

Incidentally, I did research the whole synthetic racemic alpha-tocopherol versus natural alpha-tocopherol a couple years ago. The main engagement I came upon was this (see first letter then response on 9-10) in 2005. It looks fairly convincing, but considering that the orthomolecular folks have been making this argument for probably 30-40 years, it's a bit late. II | (t - c) 02:10, 7 June 2010 (UTC)

Well, I actually was going say something about Krashen's field of expertise, but I thought it would be uncharitable and I wanted to focus on the substance instead. But since you mention it - I'm always amazed at the lack of respect for complexity and expertise and the amateur I-could-do-that-better attitude that medicine brings out. I would never lecture Krashin on language acquisition, but he clearly feels very comfortable criticizing the design of clinical trials.

Think about it. Practicing medicine, or conducting medical research, is actually far more complex and requires far more training and expertise than, say, piloting an aircraft. But people are way more eager to second-guess a physician than a pilot. You'd never knock on the cockpit door and tell the pilot how to configure the aircraft for landing, no matter how much reading you'd done on Google or in the library. But the same people feel no compunction second-guessing much more complex undertakings in medicine. I think it's probably because flying an aircraft looks complicated, so people are willing to defer to established expertise. On the other hand, designing a clinical trial looks deceptively easy. That's not aimed at you or Krashin; it's just a general gripe of mine.

And since you brought up regulation, let's talk about that. The dietary-supplement industry wrote DSHEA and spent millions on lobbying to ensure its passage. As a result, the industry is essentially unreglated. Based on your comments about neocons, I'm sure you agree with me that this state of affairs is a disaster for everyone except dietary-supplement manufacturers. It's certainly a disaster for anyone who wants to do meaningful research on dietary supplements. Since there are huge variations in the quality, potency, and chemical makeup of various brands of a given supplement, it's basically impossible to generalize any result seen in a clinical trial. Of course, the double bind is that any negative result can be written off as "well, you just didn't use the right brand."

It would help, of course, if someone did basic work to understand why it might make a difference whether glucosamine is sulfated or HCl-conjugated, or whether there is any biological difference. For a pharmaceutical company, that would be step 1A, but there's no mechanism or incentive for such studies in the deregulated world of supplements. By the way, glucosamine and chondroitin bring in upwards of $730 million annually. That compares admirably with the best-selling pharmaceuticals - except that the supplement makers didn't have to spend a dime proving that their products actually work, whereas regulatory approval is a multimillion dollar expense for a drug company.

So I have zero sympathy for people who lean on "more research is needed" and criticize the medical establishment for not doing these studies. The supplement makers have millions in unregulated income every year. They can spend that funding studies to show that their products actually work - but that would be stupid, because a) they'd rather keep that money for themselves as profit, and b) the studies would likely be negative in which case they'd have killed the goose that lays the golden eggs. That's human nature, but I think if you want to understand why the state of scientific research on alternative-medical compounds is so shitty, then DSHEA is exhibit A. And it didn't come from greedy doctors or drug companies - it was written by the supplement industry, the ones who constantly demonize those other forces.

Sorry, I got distracted, and I don't think I actually addressed your comments about laetrile. But now that I got that out of my system, let me come back to it in a little bit. :P MastCell ^Talk 18:04, 7 June 2010 (UTC)

Is everything ok?

I saw this and wondered if you need some support. Sorry for the intrusion. --John (talk) 06:16, 12 June 2010 (UTC)

Thanks for the note - that's kind of you. Just one of those times when this place gets discouraging. I sometimes feel that relentless persistence carries much more weight in resolving disputes than minor issues like basic understanding of this site's policies, or the desire to create a serious, scholarly reference work. If you have 2 editors who don't understanding basic Wikipedia policy and 2 who do, then meeting halfway is not a "compromise". It's a failure. I'm talking purely abstractly, of course, and any similarities to any actual ongoing disputes are entirely coincidental. Anyhow, thanks for the kind note. :) MastCell ^Talk 17:14, 14 June 2010 (UTC)

Lightening strikes!

"for comparison, there are about 400-600 lightning strikes per year in the US" That many?? Really?? That must include Alaska and Hawaii? :) Sorry, it made me laugh. Verbal chat 18:55, 13 June 2010 (UTC)

Abortion

You were former involved in a discussion in Talk:Abortion#More reliable references so, if you're still interested about the outcome of that discussion, I ask you to express your opinion in Talk:Abortion#Assessing the current agreement status--Nutriveg (talk) 04:37, 14 June 2010 (UTC)

Against my better judgment, I have commented. MastCell ^Talk 17:11, 14 June 2010 (UTC)

Sub-issues question

As you predicted on the Workshop page, I removed your suggested sub-issues. As requested, they need to be a single-sentence, neutrally worded question. You can reformat your previous content and readd the other questions (I left what I felt were the two most important ones). ~ Amory (u • t • c) 20:18, 16 June 2010 (UTC)

No problem. Thanks for the heads-up. I don't think I feel strongly enough to re-word them right now, so I'm fine with whatever. If I feel fired up about it, maybe I'll raise it for discussion later in the case in a more appropriate venue for free-form discussion. MastCell ^Talk 20:50, 16 June 2010 (UTC)

Barnrock of general admiration

		You ROCK!!!!
		Contrary to the caption, I think you might actually be as awesome as this. Now go wail on a guitar! WLU (t) (c) Wikipedia's rules:simple/complex 20:39, 16 June 2010 (UTC)

Cansema

Would you look into the cansema page. I am involved in a bit of a battle with an IP user who is deleting and altering the article away from its encyclopedic form. Jettparmer (talk) 15:47, 22 June 2010 (UTC)

Yes, it looks like your reversions were correct on grounds of sourcing and so forth. It looks to have quieted down a bit, but I will watchlist the article. Happy editing. :) MastCell ^Talk 16:26, 22 June 2010 (UTC)

Thanks - appreciate the objective view. Jettparmer (talk) 01:24, 23 June 2010 (UTC)

Maybe

I don't know how busy you are, but if you've got time to step through the recent changes at Hairy cell leukemia, I'd appreciate it. A well-informed anon seems determined to push current clinical trials and some, shall we say, "pre-publication" claims, and I'm trying to avoid edit warring. The new information is generally not wrong, but IMO it's undue emphasis on treatment of a tiny minority of patients (young treatment-resistant patients in a disease that mostly strikes older men and has a 90% success rate for standard treatment).

If, on the other hand, you think it's okay, then I'll leave it alone. WhatamIdoing (talk) 05:26, 25 June 2010 (UTC)

Hmmm. Let me take a look. At academic medical centers, one sees an overrepresentation of young patients with aggressive hairy-cell leukemia (probably because of referral patterns), so I can understand the anon's focus. The folks who will do well with a little cladribine never get referred, so it's easy to get a skewed perspective. That said, it might not be the best way to go for a Wikipedia article. I'll take a peek. MastCell ^Talk 05:51, 25 June 2010 (UTC)

Just wanted to remind you about this. The focus appears to be on promoting the 'need for further research'. (Actually, it's probably one of the best-understood and certainly best-treated diseases in its class, especially relative to the number of people affected and the years of potential life lost.) WhatamIdoing (talk) 01:46, 22 July 2010 (UTC)

Would you mind taking a look?

Hi, I know you hate going to this article. That being said, would take a look at this editor? Petergkeyes is becoming tenacious with his POV about things. He hasn't breached 3 rr since he waits before he redoes his edits. He keeps making the same edits over and over no matter what other editors tell him. Oh, he is on the talk page too finally. Thanks in advance, --CrohnieGal^Talk 13:37, 27 June 2010 (UTC)

That editor's talk page is one long series of warnings. SandyGeorgia (Talk) 13:48, 27 June 2010 (UTC)

Please add Water fluoridation to your watchlist, which is being targeted by the same editor. Now that Eubulides has gone, I fear the POV pushers will take over. I don't have good access to sources so there's a limit to how well I can defend the article. Colin°^Talk 14:37, 27 June 2010 (UTC)

Filed 3RR. SandyGeorgia (Talk) 07:39, 28 June 2010 (UTC)

Sorry I've been a bit slow with this. It looks like your 3RR report was handled appropriately. I've added water fluoridation to my watchlist and will try to help maintain its quality. Quackwatch is an article that I'm much happier having de-watchlisted years ago, but I suppose I can keep an eye out at least for egregious abuses. Has anyone had any sort of contact with Eubulides since he disappeared? I'm willing to beg him to return. The amount and quality of work he did was phenomenal, and we really miss his presence. MastCell ^Talk 16:03, 28 June 2010 (UTC)

As far as I know, no one ever had e-mail contact with Eubulides. Most unfortunate. SandyGeorgia (Talk) 17:12, 28 June 2010 (UTC)

And now I see WLU is encountering similar at Talk:Bioidentical hormone replacement therapy (again-- another long time issue). Keeping articles clean, reliable, well-sourced and quackery free without Colin and Eubulides is going to be a chore. SandyGeorgia (Talk) 23:19, 30 June 2010 (UTC)

Wait, what happened to Colin?!?! MastCell ^Talk 00:00, 1 July 2010 (UTC)

Wikipedia talk:Alternative text for images#Something is amiss here. SandyGeorgia (Talk) 00:03, 1 July 2010 (UTC)

Well I just got here again to see all of this and it's really sad to see we are losing valuable editors again. Not going to say anything more about this because I won't be able to say it 'nicely'. --CrohnieGal^Talk 12:10, 1 July 2010 (UTC)

That is most unfortunate. Colin and Eubulides are both essentially irreplaceable. People with their level of knowledge, skill with sources, writing ability, and dedication to this project don't grow on trees, even though the official party line around here is that such people are an infinitely renewable resource.

In 20 years or so, when people are writing sociology Ph.D. theses on the rise and fall of Wikipedia, I suspect they'll point to things like this as a tipping point. When a discussion about something as meaningless (in the grand scheme of things) as alt-text becomes poisonous enough that excellent, sane, well-adjusted people are driven off, then we've basically planted the seeds that will eventually destroy this project. MastCell ^Talk 18:09, 1 July 2010 (UTC)

I wondered why things were going to pot again. I don't recognise Colin's name, but sad to loose anyone you guys respect. Verbal chat 18:44, 1 July 2010 (UTC)

Agree, MC, this is very bad news, and may be a tipping point. We need all hands on deck just to deal with quackery now. I won't have any free time until August. :-(( SandyGeorgia (Talk) 11:36, 2 July 2010 (UTC)

I'll help where I can, can you give me some articles to put on my watchlist? --CrohnieGal^Talk 19:59, 2 July 2010 (UTC)

User:RoyBoy/Sandbox#In_art.2C_literature.2C_and_film

If you are able can you please review my draft of a new abortion section; please add your notes in the section below. Thanks! - RoyBoy 02:58, 28 June 2010 (UTC)

It's kind of you to ask my input, especially given the differences we've had in the past. I will try to take a look; if I don't get around to it, I wish you the best of luck in getting it squared away for mainspace. MastCell ^Talk 16:04, 28 June 2010 (UTC)

Global Warming Evidence

Just wanted to leave a note. I thought the evidence you posted on the ARBCOM evidence page was spot on. I full agree with it. --Snowman frosty (talk) 01:36, 30 June 2010 (UTC)

I second that. I wish wikipedia had more sane admins like you (or Boris) SPLETTE :] ^{How's my driving?} 00:08, 1 July 2010 (UTC)

Another User:DPeterson sock

YorkieDoctor (talk · contribs) is the latest! --Ronz (talk) 00:17, 1 July 2010 (UTC)

I removed all his edits and wrote Wikipedia:Sockpuppet_investigations/DPeterson. --Ronz (talk) 01:21, 1 July 2010 (UTC)

A good point

[5] A good point, but that's mostly because of the contentious nature of CC articles. You know as well as I do that editors are fighting tooth and nail over every little sentence of every little article. A Quest For Knowledge (talk) 22:38, 6 July 2010 (UTC)

Yes, but I see the root cause of the problem as a loss of perspective. I think these are predominantly people with the potential to be good encyclopedic editors, but they've been sucked into this bubble where arguing about blog comments assumes paramount importance. We either need to break that bubble so they see how ridiculous these sorts of arguments are, or (less appealingly) ask people who don't get it to leave. Apologizing to people who have been hurt by this obsession is reasonable and proper, but it doesn't fix the underlying problem. If we don't restore some sense of what's important, and what an encyclopedia is supposed to be, then we're going to be sending out a lot more apologies. MastCell ^Talk 22:43, 6 July 2010 (UTC)

Hi back

Thanks for the note on my talk page. Nice to see a familiar name over there :) Lyrl^Talk _C 23:38, 6 July 2010 (UTC)

the editing environment is contentious and has given rise to a range of intractable disputes?

I think your characterisation of this as "chicken and egg is wrong". But arguing on the workshop page will end up being drowned in noise, so: you you think yuo, or anyone else, has provided any evidence for your assertion that the editing environment is contentious and has given rise to a range of intractable disputes? William M. Connolley (talk) 08:17, 8 July 2010 (UTC)

I don't know that there's anything in evidence; I guess I didn't anticipate it being particularly contentious, and we are limited in the amount of evidence we can present (at least in theory). I do think that so much has transpired that things tend to escalate very quickly. I guess as an example I'd point to "retired"-gate. If the issue of whether to describe a retired professor as "retired" can escalate across multiple noticeboards into widespread acrimony (and the issue is still not dead), then I think the contentiousness of the editing environment is giving rise to intractable disputes, and creating them out of things that should be minor at most. MastCell ^Talk 04:10, 9 July 2010 (UTC)

Well, it is contentious. Oh well, I'll just have to put up my own proposal with yours reversed. I find it difficult to understand why you don't appreciate the importance of this getting-it-the-wrong-way-round. You seem to think it barely matters. As for retired-gate: I think this is a bad example, because it the great scheme of things it is so minor. The dispute should not have been escalated, I agree. The obvious solution to that puzzle is to look at who escalated it, and their motives for so doing William M. Connolley (talk) 12:55, 9 July 2010 (UTC)

Wikipedia:Arbitration/Requests/Case/Climate_change/Workshop#Locus_of_dispute William M. Connolley (talk) 12:59, 9 July 2010 (UTC)

OK. To be honest, your proposed finding looks reasonable as well. I think you're talking about people importing off-wiki disputes and agendas, leading to a deterioration of the editing environment on-wiki. Undoubtedly, that has happened (and is happening). I also think that things have been so contentious for so long that disputes rapidly become intractable. I'm not sure they're mutually exclusive. MastCell ^Talk 17:00, 9 July 2010 (UTC)

Just remebered another factoid in this: prior to the CRU stuff hadn't we had a period of peace and quiet for about a year? Or possibly just prior to the Abd stuff? I must try and dig around: it is, I think, evidence that things are OK here until poisoned from the outside William M. Connolley (talk) 17:39, 9 July 2010 (UTC)

Yes, I think the coverage of CRU clearly led to a large increase in the volume of new editors, of partisanship, and of contentiousness. MastCell ^Talk 17:44, 9 July 2010 (UTC)

Hey, hope that's not me you're talking about! :-/ Yes, it did raise the profile of a topic I'd been avoiding because of the bunfights, to the point where I thought I'd help a little once the Darwinversary had passed. And I'm still in the swamp! (if only just) . . dave souza, talk 18:27, 9 July 2010 (UTC)

Climate case

If you have additional recent diffs about thegoodlocust, post them on evidence page and notify me on my talk. Tks. — Rlevse • Talk • 02:03, 14 July 2010 (UTC)

regarding me and 2/0

MastCell, regarding this comment, you wrote:

"If an admin declared that they thought the scientific consensus was underrepresented in climate-change articles, and then proceeded to opine on enforcement requests in a manner reinforcing that viewpoint, you (ATren) would have a problem with it. I know you would, because you leveled exactly these sorts of allegations about 2/0."

I'd like to make a subtle distinction: there is a vast difference between opine and act. My problems with 2/0 were based on actions, not opinions, in particular, several quick, unilateral actions he took early on in the probation against "skeptics" coupled with his later defense of WMC for behavior that was as bad or worse. I had a major problem with his indef block of GoRight, where he not only executed the block but actually did the work of collecting and presenting evidence, which is far more than Lar ever did. In fact, until his 1-hour block on WMC (which was clear baiting on WMC's part) I don't think Lar had enforced a single request, while 2/0 had handed out several lengthy topic bans and one indef block -- all to "skeptic" editors. Since then, Lar has, at times, been harshly critical of "skeptic" editors like Marknutley, TGL, and me, whereas 2/0 has actually defended WMC (do you recall 2/0's long, diff-by-diff defense of WMC back in Feb or March?).

Despite all this, I've chimed in several times recently in support of 2/0's participation on the request page, as long as he didn't take hasty, unilateral action -- i.e. as long as he contributed opinions toward consensus but didn't act unilaterally. I don't have diffs handy, but I know I've said that. I'd appreciate if you'd correct your statement (which I believe to be wrong but said in good faith) on the case page.

^{Note: in the above, "skeptic" is in quotes, indicating that we're not necessarily true skeptics, but we edit from that "side"}

ATren (talk) 19:57, 14 July 2010 (UTC)

I do think that's a subtle distinction. I don't think it's fair to criticize 2/0 for presenting a long list of diffs supporting GoRight's block. We both know that GoRight was intensely legalistic, and previous actions had been criticized because the admin failed to present a lengthy diff-by-diff justification for their actions. I think 2/0 was responding to the conditions that had been established, and probably trying to head off the inevitable wikilawyering by GoRight. If he had not presented all of those diffs, then the first response would have focused on the lack of specific diffs supporting his action. So I see that as sort of a double bind.

I think it is worth asking whether any of 2/0's actions lacked support or consensus. I think the ban of GoRight was extensively debated and ultimately supported at all levels, including up to the Ban Appeals Subcommittee. Similarly, I think it would be very difficult to convince me (or the community) that topic bans of editors like Thegoodlocust were undeserved.

On some level, it's a moot point, as my understanding is that 2/0 is voluntarily stepping back from climate-change enforcement (correct me if I'm wrong). I think that's a laudable response, and one that speaks of confidence in one's fellow admins, although I can understand why it might also feel like giving in to bullying.

I'm actually in favor of what you describe as "unilateral action", within reason - I think the probation board ended up bogging down in interminable attempts to thin-slice each enforcement request and proactively generate consensus. In some cases, it makes more sense for an admin to simply take action and then submit that action for review - in fact, many non-climate-change enforcement requests are handled this way. If an admin is taking unilateral actions that subsequently lack consensus or are deemed ill-advised, then it becomes clear that they need to stop taking unilateral actions. That's sort of how these things are supposed to work, in my opinion anyway. MastCell ^Talk 20:51, 14 July 2010 (UTC)

MastCell, 2/0's actions early on were, IMO, very harsh towards several "skeptical" editors, not just GoRight. JPatterson was an example: he was topic banned for almost nothing by 2/0 (who later reversed his action, but only begrudgingly). There were others. And in a topic like this with such a long history of partisan conflict, I don't agree with the "shoot first, ask questions later" approach you seem to advocate, because it inflames an already hot situation. Consensus of multiple admins is necessary in these cases. IMO. ATren (talk) 20:57, 14 July 2010 (UTC)

That's a philosophical difference, I guess. Although I wouldn't frame it as "shoot first, ask questions later". When a topic area is placed under probation, it's usually because the community has deemed that it's problematic enough that admins should be given more leeway to police it. I don't remember JPatterson's case so I can't really comment on it offhand, nor do I agree with every administrative action undertaken by 2/0 (in particular, under no circumstances would I have reversed Lar's 1-hour block of WMC, although under no circumstances would I block someone for 1 hour either). I do think that 2/0 is overall an excellent admin (perhaps you might expect me to say that, as the person who nominated him for adminship). MastCell ^Talk 21:03, 14 July 2010 (UTC)

I agree he is overall a good admin, and I think he's acted in good faith on the CC probation. But I think he has a POV blind spot in this topic area, and I think his actions demonstrate that. FWIW, I think every admin who has participated in that probation has some POV, 2/0 is not unique in that sense, and that's why I think discussion before decision is necessary, because it helps to negate these varying POVs. I also think there's a secondary benefit to the consensus-building approach: disgreeing admins forming consensus on decisions can be a model for editors to follow -- lead by example. ATren (talk) 21:17, 14 July 2010 (UTC)

Yes, I think the last point is a good one. When it works, there are definite advantages to the consensus model, as you've outlined. The trade-off is that takes a long time to reach consensus, during which even minor events fester and molehills accrete into mountains. The dispute between Mark Nutley and Ratel about name abbreviations, for instance, should have just been clarified as a misunderstanding in one line. Instead, it went back and forth and escalated far more than it should have, because the process is inherently unwieldy. Maybe the answer is to use a consensus model for complicated disputes, but a more rapidly responsive one for matters that should be handled expeditiously. I don't know - if I had any great suggestions about how to improve oversight of the area, I would have made them long ago at the ArbCom workshop. MastCell ^Talk 21:25, 14 July 2010 (UTC)

• 2/0 is voluntarily stepping back from climate-change enforcement (correct me if I'm wrong) - oh sweet Athe, yes; there has been a little backsliding related to keeping up with the ArbCom case, but on the whole I think I am much happier when people are only yelling at me for removing their copyright violations or protecting the version with(out) the term British Isles. On an unrelated note to you or any TPWs - WP:AN3 has one case just sitting there, but I cannot close it due to being somewhere in the vicinity of WP:INVOLVED.
• WMC unblock - you are probably right about that. The lack of time for any reviewing admin to think, ponder, consult, and think again is one of the reasons why personally I disfavor very short blocks. On balance and with 20/15 hindsight (because it would be a shame if my metaphorical vision were inferior to my physical), I would not say that that unblock was in anyone's best interests, or those of the project. Ah well, time to read last month's FDA update to the blood donation exclusion criteria - the encyclopedia awaits.
• I do think that 2/0 is overall an excellent admin :) - 2/0 (cont.) 02:58, 16 July 2010 (UTC)

Diff

Per your conversation on Rlev's talk page, you might want [6]. Hipocrite (talk) 16:54, 15 July 2010 (UTC)

[7], with extra BLP vio. Hipocrite (talk) 18:16, 15 July 2010 (UTC)

Rand Paul

Hi I was just over at Rand Paul and noticed that the "Board certification" section is listed twice. It may well be a WP:BLP vio listing this in the "personal life". I suggested that the info me merged into the "2010 Senatorial campaign". But was reverted immediately before I could add the info into the lower section. The editor who reverted listed talk page, where I saw you were active. I do not want to get into an edit war maybe you can take a look at the page and fix it if possible.--Duchamps_comb MFA 18:32, 16 July 2010 (UTC)

I'll comment there. Actually, I already did, a few days ago, with this very proposal, but no one responded. Basically, I agree that it should be mentioned only once, not twice. I think it's better in the "Medical career" section, rather than the "Campaign" section. I also think that the text from the "Medical career" section is better than the "Campaign" section text (although I wrote the former, so perhaps that's not surprising). Anyhow, I'll comment on the talk page. MastCell ^Talk 18:34, 16 July 2010 (UTC)

MC, I hate to bother you again, but if you could take a look at the Rand Paul talk page. I believe there is a user adding WP:OR, WP:SYNTH but he will not listen to me, maybe you can help clear this dispute. Tanks, --Duchamps_comb MFA 00:25, 19 July 2010 (UTC)

I really don't want to get involved in any disputes about Rand Paul. I edited the page only because our coverage of his medical board certification was so poor and erroneous as to constitute a glaring WP:BLP violation. I prefer to strictly limit my editing to the pages of active politicians, both for my own sanity and as a matter of trying to ensure that my editing doesn't become guided by my own political views. Choosing not to edit or watchlist Sarah Palin in the run-up to the 2008 presidential election was one of the best decisions I've made on Wikipedia. That said, I will take a look, but outside of correcting clearly erroneous or inappropriate statements about his medical board certification I don't think I'll have much more to contribute. MastCell ^Talk 18:39, 19 July 2010 (UTC)

Was there some kind of drama at our Sarah Palin article? I find that hard to believe. :) A Quest For Knowledge (talk) 17:29, 22 July 2010 (UTC)

Nothing major - just a wheel war or two, an Arbitration case, a bunch of angry op-eds about Wikipedia's editorial biases, a community-imposed probation, a bunch of admins accused of bias... fortunately, nothing similar has happened since. :P MastCell ^Talk 17:40, 22 July 2010 (UTC)

Your input is requested

FYI - WP:GS/CC/RE#Request concerning ChrisO, submitted by myself. In view of your comment about my editing here your input would be appreciated. -- ChrisO (talk) 08:19, 22 July 2010 (UTC)

Looks to have been closed, so I think it can rest there. MastCell ^Talk 16:45, 22 July 2010 (UTC)

Hi

I see that you have deleted a page about Sujit Saraf. Why ?  Jon Ascton  (talk) 11:22, 24 July 2010 (UTC)

It looks like I did that about 3 years ago. Based on the deletion summary, it looks like the article was nominated for deletion via the proposed deletion pathway. When no one contested the deletion after 5 days, I deleted the article as a housekeeping matter. The deletion isn't permanent by any means, so if you'd like to create an article on Sujit Saraf, please feel free. The original (deleted) article contained essentially no content or references, so I don't think there's much useful there, but you can always start a new article about the subject. MastCell ^Talk 17:50, 24 July 2010 (UTC)

Linksearch extension

Since your search extension seems to be a lot more useful than what I have available through LinkSearch (you apparently can search by namespace), could you give me the mainspace totals for the other groups:

• www.fair.org
• www.aim.org
• www.mrc.org
• www.newsbusters.org

And one more (unrelated to the discussion) www.sourcewatch.org--which has a mindboggling number of links to an OPEN WIKI. I think that will need a bit of cleanup too.

Thanks. Horologium (talk) 20:56, 26 July 2010 (UTC)

If you want to use the search extension, it's easy. Just go to your vector.js page (User:Horologium/vector.js) and add the following:

importScript('User:MastCell/el-namespace.js');

That will import the JavaScript extension that I wrote, so that when you go to Special:Linksearch, you should see a drop-down box where you can select the namespace you'd like (or go with all namespaces). The actual code is at User:MastCell/el-namespace.js, as you probably deduced from the importScript line. It's not bug-free - for example, I still need to fix the links that show up. I've only tested it on recent versions of Firefox and IE on a Mac, Linux, and Windows, so I can't guarantee it will work for you - but if it doesn't, just remove the line from your vector.js page and things will go back to normal.

That said, I get 286 links to *.fair.org, 89 links to *.aim.org, 37 to *.mrc.org, and 92 to *.newsbusters.org. Those are link totals for article space alone and do not include links in other namespaces. I get 1,000 links to *.sourcewatch.org, which probably means that there are >1,000 but the linksearch tool just tops out there. Hope that's helpful. MastCell ^Talk 22:04, 26 July 2010 (UTC)

BLP warning

It is not acceptable that you have allowed distortions and misrepresntations of the sources to remain in the Philip E. Johnson article, as well as stood by while the dispute tag was removed. Your conduct is particularly unbecoming of an administrator. Whatever our personal views, we must abide by editing policies and refrain from defaming biographical subjects and misrespresenting their views. Please fix this mess you've helped foster. Thanks. Freakshownerd (talk) 19:45, 27 July 2010 (UTC)