RWP was born in Manchester, in the north of England, in the late 1950s, so he is very old. He really liked the north of England, which by 1965 was hip and had three TV channels, and where he went to a coed school. His parents, for reasons best known to themselves, then yanked him away, to Belfast and then Dublin, which had one TV channel that started up at 6 pm with the Angelus (Catholic call to prayer). He also had to go to an all boys school, where he realized he really missed girls. This probably let him focus on schoolwork, though, and at age 19, after he had finished college, he set off for America, where he still resides. He has a bachelors degree in biochemistry and a Ph.D. from Harvard in biophysics, and has lived also in Mainz, Germany, Setauket NY, and Richland WA. He currently divides his time between Nebraska, Rosslyn VA, and Florida.

Monday, May 6, 2013

Ezekiel Emanuel, ice water, and colonoscopies

Ezekiel Emanuel, brother of Rahm, and guru of much of the left when it comes to health care reform, today penned a shocking column in the New York Times. Shocking not because of its content, which was pretty vapid (comparing home renovation to colonoscopy) but in what it revealed about the writer's ignorance of science and modern medicine. And I quote:
In the early ’90s, the psychologist Daniel Kahneman and his colleagues did a series of experiments that revealed how people remembered the pain of a situation. In one experiment, participants held a hand in an ice-water bath (of 14 degrees Celsius) for 60 seconds — a pretty painful experience. To be precise: an 8.3 on a 10-point pain scale. In a second experiment they held their hand in the same ice-water bath for 60 seconds and then for another 30 seconds, during which the water was warmed just 1 degree.
Problem is, 14 Celsius isn't the temperature of icewater, and it isn't painful. It's 57°F. I've looked at the original paper, and they used icewater to cool the water to which the subjects were exposed, but the latter water was at 57°F; it wasn't ice water. I find the entire study very fishy; even though the pain was rated as 8.3 on a 14 point (not 10 point) scale, it's hard for me to believe 60 seconds in 57°F water caused any significant pain at all. I checked the cold water in our building; after running for 30 seconds, it reached a temperature of 13°C. I filled a bucket with it, checking the temperature was staying approximately constant, and immersed my left hand in it for several minutes, moving it around to make sure it was exposed to the cold. I felt very little discomfort; certainly not pain of 8 on a scale of 0-14.

But it gets worse

This was confirmed in 2003 by another experiment by Dr. Kahneman, who won the Nobel Prize in 2002, and his fellow researchers, concerning the pain associated with colonoscopy. The patients in the study underwent the usual procedure, but one group experienced a slight change at the end. How to put it delicately? After everything was finished, the tip of the colonoscope was left resting in the rectum for up to three minutes before being removed. Afterward, when all the medications wore off, patients evaluated the pain of the procedure. Surprisingly, those who had the colonoscope in longer on average remembered less total pain. And this just wasn’t a matter of self-reporting: over the next five years, they were also 18 percent more likely to return for a repeat colonoscopy — increasing the opportunity to reduce deaths from colon cancer.
But, in fact, anyone who's had a recent colonoscopy (and I just had my second in the last year) will tell you the procedure isn't at all painful. You're so doped up on fentanyl you don't feel or remember a thing. Emanuel's column is distinctly noxious; it will probably discourage some people from having a procedure that might save their life.

This is the guy guiding much leftist thought on health care delivery. Yikes.

1 comment:

  1. Dr. H,

    Saw you over at Ace of Spades. Thought I was the only hostage in Lincoln.

    Take care,