Why Evolution is True is a blog written by Jerry Coyne, centered on evolution and biology but also dealing with diverse topics like politics, culture, and cats.
Today’s post comes from Joseph Shen, a pharmacology student in Chicago. He has guest-posted here once before (see link below), and this week sent a contribution on what he’s learned about puberty blockers. I am not a pharmacologist and haven’t checked all the claims in this post, so please do so yourself if you have concerns. Also I am not giving any medical advice here and am not responsible for whether people decide to take or not take these drugs.
Shen is worried about the overuse of puberty blockers in “affirmative care” by doctors and therapists who don’t know about possible side effects of these blockers or the fact that they haven’t been tested properly for their effects on blocking puberty.
Finally, there’s a felid lagniappe to this post that I’ve put below the fold.
Without further ado (and see the “Update” at bottom.
What a Student Pharmacist Thinks about Puberty Blockers
Joseph Shen
Hello readers, I have been on this website once before when Prof. Ceiling Cat (Emeritus) kindly shared my post about UIC’s mishandling of the Jason Kilborn controversy. What I didn’t mention at the time was that I am a pharmacy student. The ultimate role of the pharmacist is to optimize drug therapy, which means following best-practice guidelines, understanding side effects, and avoiding unnecessary therapies. You can see how this will connect to the transgender debate around puberty blockers.
I’m sure most readers here are familiar with articles giving critiques of puberty blockers like the one in the New York Times and the ones by Jesse Singal on his Substack site. While their content is good, I wanted to share with you how I viewed this topic through the lens of a pharmacist, focusing more on the drugs: what they are and how they are (mis)used. My goal is to inform you so that the next time you tell an affirmative care supporter that puberty blockers are not safe, they retort “what do you know about them?” or “why do you care that they need to be safe?”, you will have an answer.
Background Knowledge.
To understand drugs like a pharmacist, you must do a basic review of anatomy and physiology, specifically the hypothalamic-pituitary-gonadal (HPG) axis pictured here.
From Wikipedia
For anyone unfamiliar with this, the simplified version is that the hypothalamus releases gonadotropin-releasing hormone (GnRH) into the pituitary gland in front of it. The pituitary gland secretes two more hormones, follicle-stimulating hormone (FSH) and luteinizing hormone (LH). FSH stimulates cells around immature ova and spermatozoa to help them mature. More importantly, LH triggers other cells nearby to synthesize progesterone, testosterone, and estrogens. This process triggers all the changes in puberty.
What, Exactly, are Puberty Blockers?
To block puberty, you have to interrupt the effects of the HPG axis. The most popular way is to inhibit the function of LH so that no hormones are synthesized. GnRH agonists are synthetic peptide molecules that mimic GnRH. They bind the same receptor and trigger the release of LH. At first, there is a release of LH and temporary increase in sex hormones. But after around 10 days, the stores of LH are depleted and desensitization reduces the number of receptors for GnRH, so releasing LH becomes harder. There are also GnRH antagonists: other synthetic peptides which bind the same receptors but don’t trigger any reaction, stopping the cycle immediately. While they work faster, these drugs are more costly and have more side effects, making them far less popular. When a person stops taking either class of drug, the HPG-axis resumes its cycles. This is what leads activists to claim that their effects are reversible. The cycles may resume on the molecular level, but that does not mean puberty will resume as normal on the bodily level.
Among GnRH agonists, just a few are used in most cases. Leuprolide is the most common drug in the class. It can be injected as a suspension into the muscle/fat every month, or it can be a biodegradable implant. Two other very similar drugs are goserelin and triptorelin, though they are available only as an implant and injection, respectively.
While known to the public as “puberty blockers” thanks to the controversy, GnRH agonists have several uses. They are first-line treatments for all stages of prostate cancer, depriving the tumor of growth-stimulating testosterone. They can also be used to treat endometriosis, in which uterine-like tissue grows somewhere else in the body, causing severe pain. Since that tissue is stimulated by sex hormones, GnRH agonists make it inactive. And during in vitro fertilization, a woman takes a dose to make sure she doesn’t ovulate early.
Notice anything about these uses? They are all either short-term or used to correct a hormonal abnormality. What GnRH agonists are not well-supported for using is stopping normal onset of puberty, leaving the body in a developmental limbo. Leuprolide, in fact, has a shady history. Its initial approval by the FDA was based on very limited data, with some small sample sizes and short durations. Some post-market studies carried out after approval also had issues, with serious side effects such as bone disease omitted from a 2010 study. The poor literature means we can’t definitively predict what will happen when you start and stop using the blockers. Human bodies going through puberty are not tardigrades that will hibernate when the environment is hostile and later restart as if nothing happened. Pausing puberty is more like pulling on a Slinky: leave it stretched too long—and it may never slink again. With no big longitudinal studies, we just don’t know.
The thing most people want to hear about GnRH agonists are their side effects, and there’s a lot to discuss. Mainstream articles frequently mention poorer bone health. Sex hormones trigger the cartilage known as the growth plate in the femurs to grow and then turn to bone. They also maintain a balance between bone growth and breakdown. For someone on puberty blockers, the growth plate may not mature, and the balance shifts towards bone breakdown, both of which make fractures more likely. Sexual issues are another real possibility. The lack of sex hormones can reduce or eliminate development of libido in both trans boys and girls. What I haven’t seen discussed is what happened to many girls who were given leuprolide for years to delay puberty so that they grew taller. Decades later, these girls who had normal puberties and who have never been on other treatments developed osteoporosis, weak joints, and fibromyalgia. What reason is there to believe similar cases won’t happen with trans kids without normal puberties? Beyond that, leuprolide and the others currently carry warnings for increased risk of heart attacks, dizziness and fainting, and a host of other conditions, all based on thousands of cases of reported adverse effects—how can these drugs possibly be perfectly safe?
A Pharmacist’s Concerns
It confuses me why all the debate over these drugs rarely involves pharmacists, who are the drug experts. Doctors may know treatments, but it’s pharmacists who are more keenly aware when a drug therapy is lacking evidence.
Improper prescribing is a huge, pharmacist-specific concern. Contrary to popular belief, pharmacists don’t just fill prescriptions made by physicians without question. Pharmacists are required by law to exercise “corresponding responsibility” and dispense drugs only when they’re safe and appropriate. I see the transgender controversy as having some of the biggest potential for improper prescribing. Without solid guidelines and with influence from various organizations like WPATH, pharmacists are put into a bind. We can either sign off on unwarranted med orders or refuse to fill them and be condemned by societal and professional peer pressure. We will have to stand up for our profession by saying NO when decisions are not based on good science. It is our duty to stop potential harm to patients, sometimes even if it’s what they want.
Another pharmacist-specific concern erodes trust in modern medicine. Physicians live by the Hippocratic Oath, often condensed into the phrase “first, do no harm.” At times, doctors withhold information from patients to spare them emotional and psychological harm (e.g., giving “affirmative” advice without telling parents so that they can’t be obstacles). This causes doctors to butt heads with pharmacists who, in contrast, live by the Oath of a Pharmacist [side note: the 2021-2022 updated oath includes the line “I will promote inclusion, embrace diversity, and advocate for justice to advance health equity.”] We tend to emphasize patient autonomy, being truthful, and giving enough information for them to make rational choices. It is unethical to deceive patients about a drug’s safety to increase the likelihood of using that drug. This kind of behavior makes practicing medicine seem like it’s based on reckless opinion rather than on evidence from clinical trials. When patients think their doctor’s suggestions are just opinions, then all they need to refuse a suggestion is their own opinion—the same kind of opinion that could make them refuse vaccinations or turn to alternative medicine.
Conclusion
This controversy would not exist if there was simply enough evidence. But we can’t do large-scale, longitudinal studies because they’re ethically and practically impossible. Subjects would have to be prepubescent and started on these drugs for years with consent from their parents. No thinking parent would allow this. Studying only children who claim to have gender dysphoria seems like the clear next option. But sample sizes would be much smaller, and the zealous proponents of affirmative care don’t want to wait years and delay transition. Observational studies are the best we can do, and we know their results so far are not promising.
I genuinely sympathize with the young, dysphoric people who are in a catch-22. If they use blockers but then lose their dysphoria, they may incur irreparable damage to their bodies for nothing. If they wait until they’re sure they want to transition, but their bodies develop, they may never be satisfied with themselves. But when I choose patient safety over satisfaction, I’m doing it not out of malice but because I care enough to value their wellbeing.
I apologize if this sounds like a polemic. While I speak from the principles taught to me as a pharmacist, I speak only for myself. I hope this piece was at least somewhat engaging and not as dull as the actual lectures we all had to sit through to learn this. I’ll end on a high note. As is customary for a cat’s staff member, I must share pictures of my boss. They tell a comedy in 3 acts.
UPDATE:
One commentor (#9 below) correctly pointed out that I implied without evidence that physicians are frequently not discussing the risks of GnRH agonists with patients. This was wrong of me. What I should have written was that the medical field (at least in the U.S.) is largely supporting GnRH agonists regularly despite the lack of evidence for their safety, and not admitting to that. It is this air of support, not individual people, that concerns me. If and when individual physicians downplay the risks, then that is even more unethical; I’m certain that’s not the vast majority of doctors treating gender-dysphoric kids.
Here is the evidence for that support. The Endocrine Society (ES)’s 2017 guideline claims “pubertal suppression is fully reversible,” implying that long-term side effects are negligible. They “recommend,” (a strong statement) not “suggest,” (a weaker statement) that puberty suppression be used when indicated. They give a lukewarm review of the effects on bone and say next-to-nothing about brain development. Wikipedia conveniently lists the American organizations. that give position statements supporting GnRH agonists and/or the ES’s position. Position statements are not scientific evidence but carry scientific credibility in people’s minds.
This is exacerbated by mainstream media, in which articles from progressive-leaning venues (see here, here, and here) cite individual professionals who claim that puberty blockers are “well-studied, well-documented, and well-tolerated”, are “a benign medication”, and that the side effects are “not enough of a reason to allow a child … to continue going through puberty.” This small number of professional opinions (one of the lowest forms of scientific evidence) can shape what the public perceives to be the state of medicine. And again, it’s aways about what the doctors think in these articles, not the drug experts. Doctors are not always perfectly scientific and rational, needing pharmacists to help guide them with drug therapy. It’s just that no one in the media bothers speaking to a clinical pharmacist.
Guidelines are the starting-point resources for doctors before they make their own professional decisions. It is not a good thing when they hold poorly supported statements and when people are hesitant to challenge them because of social pressure. It is misleading at best and needs to be addressed with evidence and compassion, not instinctively calling critics transphobic.
[JAC: Read the story below the fold (click “read more”)]
Today we have insect photos by regular Mark Sturtevant. Mark’s captions are indented, and you can enlarge his photos by clicking on them.
Here are more pictures from the previous summer. All were photographed near where I live in eastern Michigan, and most come from a single park about a two-0hour drive to the south of me.
In the woods of this park, there were many of these interesting caterpillars on the ground vegetation. I believe they are the larvae of the Red Admiral Butterfly (Vanessa atalanta), which has been a challenging species to photograph. On a return visit, I would like to bring some back to raise since I’ve never been completely satisfied with my pictures of the adults:
The woodland trail followed a lovely river, and periodically the woods would open up into a meadow. At one such riverside meadow was a stand of interesting flowers (maybe wild mint?) being worked over by the large black butterfly shown in the next 2 pictures. This was for me one of the most exciting finds of the whole summer! This, people, is the melanistic form of the Eastern Tiger Swallowtail Butterfly (Papillio glaucus). I swear this is the same species as the familiar black and yellow swallowtail! This dark form is always female, identified by the splash of blue on the hind wings. The melanistic Tiger Swallowtail is not recorded where I live, but it becomes more common to the south, via natural selection, because there it starts to overlap with the toxic Pipevine Swallowtail which it resembles. But only females can pull off the mimicry trick for some reason. Anyway, I was pretty much hyperventilating while taking these pictures. From the ventral view you can still see the faint Tiger Swallowtail stripes:
JAC: Species in which females mimic another toxic form but males keep the ancestral pattern are far more common than the reverse. Can you guess why males don’t evolve to change their pattern? I’ll put the answer in the comments later.
Turning up tree leaves hanging over a forest trail will commonly reveal something of interest. One leaf along this riverside trail had this weird Derbid Planthopper (Anotia uhleri). I am sometimes asked about the yellow thingies below the eyes of this insect. Those are the antennae, which tend to be oddly distinct in this group of planthoppers:
Another thing that one can find under leaves are insect eggs or recently hatched insects. Here is a group of Leaf-footed Bug hatchlings (Acanthocephala sp.), staying close together to amplify their colorful advertisement that they are chemically protected. Whenever I find these groups, I have to take a deep breath and just do my best. Step to one side, prepare the camera for an extreme close-up, and do some test shots on a random leaf to figure out the correct exposure. Then lift up the leaf again and frantically fire away as the nymphs scamper off:
Along the river bank of the park were some sandy areas, and on the sand were quite a few of these well camouflaged insects. This is a young Big-eyed Toad Bug (Gelastocoris oculatus), which are aptly named predatory Hemipterans that are entirely invisible until they hop:
Here are a couple more finds. This tiny beetle, about the size of a sesame seed, is the Basswood Leaf Miner, Baliosus nervosus:
And the unsavory face in the next picture actually belongs to a rather cute and mild-mannered Two-spotted Tree Cricket, Neoxabea bipunctata:
I’m not always sure which critter in this set was from that distant park that I mentioned. But this one sure was! There, I was delighted to find this large katydid known as the Common True Katydid (Pterophylla camellifolia), which is another insect that does not occur in my area. Despite their large wings, True Katydids are flightless. At dusk, this male will begin its song; with some imagination, it is described as sounding like: “Katy did! Katy did !! She didn’t! She did !!!” Readers who live in its range will know it well, as they can be fairly deafening. Here is one singing. If it doesn’t hurt your ears a little, you aren’t playing it loud enough:
And finally, for the heck of it, here is what I believe is a Northern Leopard Frog (Lithobates pipiens) although there is also the similar species called the Pickerel Frog. The two differ in the form of their spots plus some other details. We see some colorful frogs from far-off places on this website, but this domestic one is still quite lovely, I think:
Welcome to the Cruelest Day: Tuesday, August 29, 2023, and oy, it’s National Chop Suey Day. This vile dish, often made with canned crispy noodles, stir-fried celery, and a cornstarch-infused goo poured over the whole odious mess, may be the worst example of cultural foor appropriation I know. It’s okay if you’re hungry (everything is), but is bland and flavorless.
The federal judge overseeing former President Donald J. Trump’s prosecution on charges of conspiring to overturn the 2020 election set a trial date on Monday for early March, rebuffing Mr. Trump’s proposal to push it off until 2026.
The decision by Judge Tanya S. Chutkan to start the trial on March 4 amounted to an early victory for prosecutors, who had asked for Jan. 2. But it potentially brought the proceeding into conflict with the three other trials that Mr. Trump is facing, underscoring the extraordinary complexities of his legal situation and the intersection of the prosecutions with his campaign to return to the White House.
The district attorney in Fulton County, Ga., has proposed taking Mr. Trump to trial on charges of tampering with the election in that state on March 4 as well. Another case, in Manhattan, in which Mr. Trump has been accused of more than 30 felonies connected to hush-money payments to a porn actress in the run-up the 2016 election, has been scheduled to go to trial on March 25.
And if the trial in Washington lasts more than 11 weeks, it could bump up against Mr. Trump’s other federal trial, on charges of illegally retaining classified documents after he left office and obstructing the government’s efforts to retrieve them. That trial is scheduled to begin in Florida in late May.
The March 4 date set by Judge Chutkan for the federal election case at a hearing in Federal District Court in Washington is the day before Super Tuesday, when 15 states are scheduled to hold Republican primaries or caucuses.
Judge Chutkan said that while she understood Mr. Trump had both other trial dates scheduled next year and, at the same time, was running for the country’s highest office, she was not going to let the intersection of his legal troubles and his political campaign get in the way of setting a date.
“Mr. Trump, like any defendant, will have to make the trial date work regardless of his schedule,” Judge Chutkan said, adding that “there is a societal interest to a speedy trial.”
The article notes that Trump is plotting to delay the outcome of the federal trials until after the election, for if he wins he can pardon himself. But he cannot pardon himself if convicted for state crimes. And, of course, there are legal issues with a President pardoning himself.
In recent years, research reviews have begun to conclude there’s enough evidence to say which public health interventions prevent shootings, which do not, and which need more study. Knoxville is one of a growing number of cities teaming with researchers to develop an evidence-based plan to stop the bleeding.
Though some big questions remain, there is a growing consensus about what programs and policies make a difference — and which don’t.
According to an assessment by the Rand Corp., measures that work include laws that permit charging adults who let children have unsupervised access to guns, well-enforced background checks and policies that ban guns from people subject to domestic violence restraining orders.
Measures that don’t: stand-your-ground and concealed carry laws, which studies consistently show increase gun homicides, and gun buyback programs, which have been shown to have little, if any, effect on crime.
I don’t get the concealed-carry stuff; if those laws increase gun homicides, then repealing them should be a recipe for reducing deaths.
. . .As shootings accelerated, Kincannon turned to Thomas Abt, whose book, “Bleeding Out,” offers a plan for cities that includes having police and community organizations work together.
Crucially, Abt’s program doesn’t count on policymakers to take action to restrict gun access. That was appealing, because Tennessee’s state government has been moving in the opposite direction.
Kincannon supports expanded background checks and other gun control measures, but said Knoxville’s efforts are designed to make a difference “no matter what happens legislatively.”
But the stuff above all involves the legislature, and the solutions suggested for the test city of Knoxville seem like weak beer. Here’s one:
The research also supported police data showing most gun violence happened in a few “hot spots,” mostly in East Knoxville, leading to a plan initially focusing police and community outreach to a nine-block area there.
The effort involves church leaders and a range of community organizations. There were also changes at the police department, including a new police chief, a detective unit focused only on homicides and shootings, and officers dedicated to patrolling in areas with many shootings.
A goal is to increase public trust in law enforcement, which had been low and sometimes abysmal. A particular low point occurred in 2021, when a police officer killed a student in a high school bathroom in East Knoxville.
There are other things one can do (programs for kids, more outreach), but the article says that so far there’s been no palpable effect on homicides in Knoxville. I really don’t think you can make inroads on the American issue of gun violence without restricting access to guns—and that will take legislatures and, more than that, a change in morality equivalent to that which lead to the civil rights laws of the Sixties.
*Here’s a clickbait WaPo headline for me, “This is the most glamorous book you’ll read this year. Or any year.” What’s a “glamorous” book? And what is reviewer Jacob Brogan recommending? It turns out to be the memoir Better than Sane: Tales from a Dangling Girl by “model, actress, and New Yorker writer [now writing for Vogue] Alison Rose.” The book review is glowing, though other reviews haven’t been. I’ve requested the book from our library, though. A few words:
On one of those early June afternoons when the weather in Washington is like a kettle recently off the stove, I found myself on the covered terrace of a cafe, almost involuntarily proselytizing to a friend about the book I was reading. “It is the only memoir that really needed to be written,” I told her. I was speaking about “Better Than Sane: Tales From a Dangling Girl,” by the model-turned-actress-turned-New Yorker-writer Alison Rose, which was published to little notice in 2004, soon fell out of print and is now, thankfully, being reissued by Godine.
“She is incredible,” I said, volume rising, words speeding up. “When she’s a child, she has a crush on Gardner McKay, the handsomest actor who ever lived. Then she meets him when she’s grown up. They become best friends! He casts her in a play that he wrote where she plays a mentally disabled boy. They screened it on PBS! Things like that just keep happening to her. She’s the hottest person you’ve never heard of.”
. . . “Better Than Sane” is the most glamorous book you will read this year. If you read it next year, that will still be true. If you were one of the few who read it in 2004, read it again. Rose’s natural glamour is of the slightly sorrowful kind Lana Del Rey aspires, sometimes successfully, to convey. But in her memoir, Rose also exudes aglamour of the kind some fairies in folklore possess: a beguiling but slightly illusory beauty that perhaps disguises a still more compelling ugliness, after which we can only ever wonder.
There are, of course, many affairs and a lot of sex, but I’ll skip that part and go to the reviewer’s conclusion:
. . . It is, however, a perfect book; not in the way that gemstones are, but in the way that a Saturday can be. This is the rare sort of memoir that invites you into a world beneath our own, a secret commonwealth made possible by Rose’s spiky genius and irresistible magnetism. It deserves to be reveled in, returned to and, if you are anything like me, enthusiastically and loudly shared. There are treasures here on every page, sometimes an unforgettable quip and sometimes just a joyful little encounter with a pet. Above it all there is Rose herself, as adventurous and unhinged as Titania, friend to movie stars and poets, glamorous precisely because she is possibly unreal.
Them’s very positive words! Well, this is a challenge for me. Will I find this a “perfect Saturday-like book”? Stay tuned.
*The conservative WSJ op-ed section has a piece on Nikki Haley, my second favorite Republican candidate after Chris Christie (I won’t, of course, vote for a Republican in the next Presidential election, but I’m not happy about voting for Biden, potentially turning Kamala “Do Nothing” Harris into President. The article, “Nikki Haley’s debate truths“, says this:
If Nikki Haley gets a bump in the polls from Wednesday’s presidential debate, one reason will be that she respected viewers by telling them the truth. Ms. Haley said, accurately, that passing a national abortion ban at 15 weeks is politically off the table, since it would require 60 votes in the Senate. She has argued this before, but many Republicans might be hearing it for the first time.
The former South Carolina Governor instead suggested—brace yourself—consensus policy-making. “Can’t we all agree that we should ban late-term abortions?” she asked. “Can’t we all agree that contraception should be available?” At the same time, Ms. Haley called herself “unapologetically pro-life.”
The contrast to Ms. Haley came from her fellow South Carolinian, Sen. Tim Scott, and especially former Vice President Mike Pence, who have endorsed a national abortion ban at 15 weeks. “A 15-week ban is an idea whose time has come,” Mr. Pence said. “It’s supported by 70% of the American people. But it’s going to take unapologetic leadership.”
Mr. Pence is principled, and he’s right that the Democratic Party’s abortion absolutists are far from the center of public opinion. In a recent Gallup survey, 55% of Americans (including 52% of women) said abortion should be generally illegal in the second three months of pregnancy, versus 37% who said legal.
Yet Ms. Haley is right that Mr. Pence’s idea would get zero support from Democrats in the Senate. Breaking a filibuster would take a supermajority that Republicans haven’t enjoyed in living memory, and if Mr. Pence has a plan to flip another 11 seats, he isn’t sharing it.
. . .Ms. Haley’s honesty didn’t stop there. “Donald Trump added $8 trillion to our debt,” she said. “You look at the 2024 budget: Republicans asked for $7.4 billion in earmarks. Democrats asked for $2.8 billion. So you tell me who are the big spenders.” Those figures are backed by a Roll Call story last month: “House Republicans have so thoroughly stacked the earmarking deck in their favor in appropriations bills for the upcoming fiscal year that the top Democratic recipient doesn’t even appear in the top 60.”
Then there was the elephant not in the room, as Fox News host Bret Baier put it, meaning former President Trump. “Three-quarters of Americans don’t want a rematch between Trump and Biden,” Ms. Haley said. “And we have to face the fact that Trump is the most disliked politician in America. We can’t win a general election that way.”
Haley’s foreign policy, made evident when she was ambassador to the UN, isn’t bad, either. As I said, I wouldn’t vote for her, but she and Christie are way, way better than Trump as Republican candidates.
*Gross news: reader Pyers informs me that an Australian woman who was having bouts of “abdominal pain and diarrhoea, followed by a constant dry cough, fever and night sweats,” graduating to “forgetfulness and depression”, was diagnosed with harboring a live roundworm in her brain!
It was a fairly regular day on the ward for Canberra hospital infectious diseases physician Dr Sanjaya Senanayake, until a neurosurgeon colleague called him and said: “Oh my God, you wouldn’t believe what I just found in this lady’s brain – and it’s alive and wriggling.”
The neurosurgeon, Dr Hari Priya Bandi, had pulled an 8cm-long parasitic roundworm from her patient, prompting her to call on Senanayake and other hospital colleagues for advice about what to do next.
The patient, a 64-year-old woman from south-eastern New South Wales, was first admitted to her local hospital in late January 2021 after suffering three weeks of abdominal pain and diarrhoea, followed by a constant dry cough, fever and night sweats.
By 2022, her symptoms also included forgetfulness and depression, prompting a referral to Canberra hospital. An MRI scan of her brain revealed abnormalities requiring surgery.
“But the neurosurgeon certainly didn’t go in there thinking they would find a wriggling worm,” Senanayake said. “Neurosurgeons regularly deal with infections in the brain, but this was a once-in-a-career finding. No one was expecting to find that.”
The surprising discovery prompted a team at the hospital to quickly come together to uncover what kind of roundworm it was and, most importantly, decide on any further treatment the patient might require.
. . .“Canberra is a small place, so we sent the worm, which was still alive, straight to the laboratory of a CSIRO scientist who is very experienced with parasites,” Senanayake said. “He just looked at it and said, ‘Oh my goodness, this is Ophidascaris robertsi’.”
Ophidascaris robertsi is a roundworm usually found in pythons. The Canberra hospital patient marks the world-first case of the parasite being found in humans.
She’s okay after the worm was removed, though she’s being tested for any sign of being immunocompromised, She may have gotten infected by coming into contact with python feces, as snakes live in her area. Here are two pictures from the article:
Caption from the Guardian article:
The roundworm specimen after being pulled out of the woman’s brain. Photograph: Canberra Health
Meanwhile in Dobrzyn, Andrzej gives Hili some bird-catching lessons:
Hili: What is the probability that this bird will not fly away when I come close to it?
A: Close to zero.
Hili: That’s just a theory.
In Polish:
Hili: Jakie jest prawdopodobieństwo, że ten ptak nie odfrunie, kiedy do niego podejdę?
From Barry, a figure he found on reddit about the decline of religion in America (I can’t vouch for the data):
From Facebook, but I can’t find the artist:
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From Masih. This really is a chilling video, showing several guys removing a woman not wearing a hijab from a taxi and beating her up. (Sound on.) Taxi drivers don’t have to accept women without hijabs, but beating them up for going unveiled is beyond the pale. Such is life for women in the Iranian theocracy.
Chilling video shows Iranian woman being beaten after removing hijab in Snapp car. The girl who sent this video to me says: this woman got attacked savagely. Taxi driver didn’t accept her for not wearing hijab. Iran’s authorities allowed taxi drivers to not accept unveiled women. pic.twitter.com/t3XFnAjGj5
From the Auschwitz Memorial, two sisters gassed upon arrival:
28 August 1942 | The 24th transport of Jews deported from Drancy in German-occupied #France arrived at #Auschwitz.
There were 1,000 people in the transort (including 320 children aged 2-12). Some 200 Jewish able-bodied men were selected during a stop on a train station in… pic.twitter.com/t8gXc1Wj1u
I am elated to report that all ten “ducklings” on the dorm plaza have taken wing and flown away. As we predicted from the condition of their feathers, they would be ready to leave last week—and, indeed, they made their egress over that week.
Last Monday: Nine ducklings (one had left over the preceding weekend)
Last Wednesday: Seven ducklings (two more left)
Last Friday: Four ducklings (three more left)
This morning: Zero ducklings and no mom (last four left)
Here is the very first shot (iPhone camera) I took of Marie and her brood; it was June 23, and they were only a couple of days old. All ten are crowded into their tiny pool (we immediately got larger ones). Food is on the right.
And from last Monday, August 21. It was eight weeks from hatching to flight. Marie is on the extreme right, still watching over her seven remaining babies. Hen mallards make terrific moms!
All we can hope for now is that every offspring has found a pond or other body of water with food. I can only imagine how they felt when they were first able to swim at great length, duck and dabble under water, do zoomies, hunt for food, and take to the air on their mighty wings. They’re doing what natural selection and their genes built them to do. If that means “happiness” for ducks, then they’re happy.
We are also a bit sad that they’re gone, but that’s far outweighed by the satisfaction of Team Duck in knowing that we saved every one, and that we did our job well.
Thanks to the other members of the team, Marie and Gracemary, for sharing the hard work of tending these fowl. And thanks to the woman in charge of the dorm who, after asking us for help, cooperated with us to get food and water to the brood three times a week.
I’ve always said that in person I’ll call anyone by the pronoun they wish to be called, and I intend to abide by this as a simple matter of civility. But I’m not sure I’d do that when talking about someone who uses a “neopronoun” when they’re not present, because some of those pronouns seem pretty bizarre and would stick in my craw (see below for examples).
Pronouns like “they” for bi-gender people are okay by me, as are “he/him” for trans males or “she/her for transfemales. But when you go on, and look at lists of other ones, it seems like going down the rabbit hole. The article below mentions over 200 different neopronouns!
The most common third-person pronouns include “she,” “he” and “they.” While “she” and “he” are typically used as gendered pronouns to refer to a woman and a man respectively, “they” can be used as a gender-neutral descriptor for an individual person or a group of people. Celebrities like Janelle Monáe, Emma Corrin and Jonathan Van Ness have each said “they” is a pronoun that works for them. [JAC: I use “they” when referring to a generic person.]
Neopronouns, meanwhile, are less commonly used than those three familiar pronouns. They’re often used by nonbinary, transgender and gender nonconforming people because they offer more freedom of identity. In his book “What’s Your Pronoun?” Baron wrote that neopronouns “expand the ways that people are able to indicate their gender identity to encompass anyone who is trans or nonbinary, as well as those who choose an altogether different term to characterize their gender.”
Per the LGBTQ advocacy group the Human Rights Campaign, neopronouns are a “step towards a society where people can more fully express all parts of themselves.”
And here’s a handy list from the article. As I said, I’d use them to a person when encountering them directly, but I’m not so sure if, when talking about such a person to another, I’d use them. In fact, while I’d use them as well in writing about a person, I would probably refer to a neopronoun user by name rather than use these words, which seem awkward. Actually, for most of the examples below, you can use a person’s name instead of their pronoun (i.e. “I asked Sammi to come to the movies. Sammi said yes!”, and so on).
Ae is my best friend — most of aer’s weekday evenings are spent at my house.
I’m not sure exactly how these pronouns express a person’s identity, beyond reject the familiar “binary” pronouns, but that’s their business, not mine.
The article notes that some neopronouns were introduced in the 1700s, but an expert weighs in on their history. (The expert is “Dennis Baron, one of the foremost experts on neopronouns and their histories and an emeritus professor of English and Linguisticsat the University of Illinois at Urbana-Champaign”.) Baron notes that
Even though there were dozens of neopronouns that made it into print in the 19th and 20th centuries, most of them didn’t make a huge impact upon their introduction or were lost to time, Baron said. During that time, the public was resistant to language change, and men in positions of power often didn’t take issue with a lack of gender-neutral pronouns, Baron wrote. [I suspect you can’t pin this solely on “men in power”, as these neologisms would seem strange to many people.]
And I don’t think I’ve ever see any used in literature, whether fiction or nonfiction. But times have changed:
Some neopronouns were created by writers as far back as the 18th century, many of whom did not publicly identify as nonbinary, because they wanted a genderless word to describe a person or group of people —only recently have pronouns been used as a political tool for the way they’re used by nonbinary and trans people, Baron wrote.
The “political use”, says Baron, is that ” Understanding and using someone’s pronouns is one way to show solidarity and respect toward trans people.” And that’s why I’ll use these terms to people’s faces, but there’s an element of compulsion about using them otherwise that smacks of virtue signaling and attempts to appropriate power through language change. I’d rather use someone’s name. And really, are you being a good ally when you use the ones below?
Leaf, sun, star — nounself pronouns are neopronouns that use nature and other inspirations as nonbinary or genderless descriptors. Linguist Jason D’Angelo told The New York Times that nounself pronouns were popularized on the social platform Tumblr around 2012 and 2013 and remain in use among members of fandoms who may take their nounself pronouns from the properties they enjoy.
For someone who uses the nounself pronoun “leaf,” that may look like: “I hope leaf knows how proud we are that leaf is getting to know leafself better!” or “Leaf arrived at the coffee shop before me; I was mortified to have been late to meet leaf.”
I don’t think I could force myself to say such things. And I get that someone might have a non-standard identity and want a novel identifier, but who identifies as part of a tree, or as an astronomical body? Really, would you refer to someone as “leafself”?
Today’s photos come from ecologist Susan Harrison at UC Davis. Her captions are indented, and you can enlarge the pictures by clicking on them.
Southeastern Arizona (part 1)
Sooner or later, a U.S. birdwatcher must go to Southeastern Arizona. That’s because dozens of Mexican and Central American bird species make it just across the international border into the tree-lined canyons of Arizona’s Chiricahua Mts., Huachuca Mts., and other small north-south oriented mountain ranges. Many of these birds are as dazzlingly colorful as you’d expect from their mainly tropical and subtropical distributions.
In August 2023 I made my pilgrimage to see these species. Today I’ll show the most localized species, and next time I’ll show some of the ones that also range east into south Texas, west to the California deserts, and/or north to the Great Basin deserts.
First, a habitat shot of a canyon in the Chiricahua Mts.:
Next, the region’s most fabled bird, the Elegant Trogon (Trogon elegans):
Hummingbird diversity is perhaps the region’s greatest claim to fame besides Trogons. Over a dozen species can be regularly found here! The technique for seeing them is to visit small eco-lodges and visitor centers where feeders have been set up. Here are four species:
Some Southeastern Arizonan birds are close southern relatives of birds that are familiar elsewhere in the U.S. Here are four examples:
Mexican Jay (Aphelocoma wollweberi), almost identical to California Scrub Jay (Aphelocoma californica) but more social in its behavior; we always saw them in flocks:
Mexican Duck (Anas diazi) in front of a Mallard (Anas platyrhynchos); these two species often hybridize in urban settings like this Tucson pond:
Whiskered Screech-Owls (Megascops trichopsis), related to Western Screech-Owls (Megascops kennicottii) and living beside them in this area, but in slightly drier habitats:
Mexican Spotted Owls (Strix occidentalis lucida), found in pine and fir forests at higher elevations, closely related to and just as threatened as the Northern Spotted Owl (Strix occidentalis caurina). This roosting pair is grooming each other’s facial feathers. My title for this photo is “Get a room, owls!”:
Greeting at the beginning of the “work” week: Monday, August 28 2023. In one week I’ll be in Israel! (Posting will be light for three weeks after Friday, but I do my best.) It’s National Cherry Turnover Day, second only to the strawberry turnover as a tasty species in this genus of pastries.
It’s also National Bow Tie Day, International Read Comics in Public Day, National Thoughtful Day, Red Wine Day (I have mine for tonight), and the Christian feast day of Augustine the Hippo. (Yes, I know the right name.) I had to read tons of Augustine when I was writing Faith Versus Fact, and I have to laugh when he’s signled out as a great Church Father who did not take the Bible literally. “A great thinker” about theology is like a great thinker about the Loch Ness Monster. And yes, Augustine did take the Bible literally, allowing a metaphorical dimension, too. But he was bonkers as well, writing at great length about the types of angels that existed and their nature. He was obsessed with angels!
Here’s Augustine the Hippo:
Readers are welcome to mark notable events, births, or deaths on this by consulting the August 28 Wikipedia page.
Da Nooz:
*Shooting of the day: It’s in Chicago again: three people were found wounded in a car yesterday morning in the Little Village area of Chicago’s West Side. All the victims will survive, but the shooter hasn’t yet been found. It’s the Second Amendment, folks: the shooter was part of a well regulated militia!
The Russian authorities have officially confirmed the death of the Wagner mercenary chief Yevgeny V. Prigozhin, with investigators saying on Sunday that genetic testing showed that the victims of a plane crash last week matched all the names on the jet’s manifest.
The announcement put an end to several days of speculation over the fate of the mercenary chief, who was presumed to have died in the plane crash on Wednesday, just two months after he launched a failed mutiny against Russia’s military leadership. U.S. and Western officials believe the crash was the result of an explosion on board and several have said they think that President Vladimir V. Putin of Russia may have had Mr. Prigozhin killed in retaliation for his mutiny — suggestions the Kremlin on Friday dismissed as an “absolute lie.”
Svetlana Petrenko, a spokeswoman for Russia’s investigative committee, said in a statement on Sunday that “the identities of all 10 victims have been established” and that “they correspond to the list stated in the flight manifest.”
. . .Tearful mourners gathered in Moscow over the weekend to pay muted respect to the founder of the Wagner mercenary group, Yevgeny V. Prigozhin, and nine other people whom the Russian authorities said were killed in a plane crash last week.
Hundreds of people have placed flowers, photographs, candles and flags — including some bearing the private military group’s skull design — at a small sidewalk memorial near Red Square in Moscow.
Many wept openly, expressing shock over the death of a man they said they respected, and sadness at the loss of life. Almost all expressed their support for the invasion of Ukraine.
Pity they can’t be mourning Prigozhin for standing up to Putin and starting to instigate a mutiny. But of course they wouldn’t publicly criticize the invasion of Ukraine to a Western reporter.
It’s part of a multiyear effort to undermine public confidence in the American electoral process as he seeks to chart a return to the White House in 2024. There is evidence that his lies are resonating: New polling from The Associated Press-NORC Center for Public Affairs Research shows that 57% of Republicans believe Democrat Joe Biden was not legitimately elected as president.
The FACTS:
Biden’s victory over Trump in 2020 was not particularly close. He won the Electoral College with 306 votes to Trump’s 232, and the popular vote by more than 7 million ballots.
Because the Electoral College ultimately determines the presidency, the race was decided by a few battleground states. Many of those states conducted recounts or thorough reviews of the results, all of which confirmed Biden’s victory.
. . . Trump was repeatedly advised by members of his own administration that there was no evidence of widespread fraud.
Nine days after the 2020 election, the federal Cybersecurity and Infrastructure Security Agency issued a statement saying, “The November 3rd election was the most secure in American history.” The statement was co-written by the groups representing the top elections officials in every state.
The review of ballots and records from more than 300 local elections offices found that almost every instance of voter fraud was committed by individuals acting alone and not the result of a massive, coordinated conspiracy to rig the election. The cases involved both registered Democrats and Republicans, and the culprits were almost always caught before the fraudulent ballot was counted.
. . . Many of the claims Trump and his team advanced about a stolen election dealt with the equipment voters used to cast their ballots.
At various times, Trump and his legal team falsely alleged that voting machines were built in Venezuela at the direction of President Hugo Chavez, who died in 2013; that machines were designed to delete or flip votes cast for Trump; and that the U.S. Army had seized a computer server in Germany that held secrets to U.S. voting irregularities.
It goes on, but you’re familiar with the lies. As I’m not a psychiatrist or therapist, I violate no professional dictum when I say that the man is an arrant sociopath.
*Speaking of the Trumpster, Mark Meadows’ request to move his Georgia racketeering trial from Georgia state court to federal court (there are 18 defendants in total, including The Donald, and many of these may file similar motions), could provide an instructive preview of the prosecutors’ evidence against Trump. From CNN:
Why is Meadows doing this?
US law allows defendants in state civil suits or criminal cases to seek to move those proceedings to federal court if those defendants face charges based on conduct they carried out “under color” of the federal government.
While such proceedings are not uncommon in civil lawsuits against current and former federal officials, they are extremely rare in criminal cases, legal experts told CNN, meaning Jones will be navigating in uncertain legal territory.
“This is just that rare case where there is just not a lot of law,” Vladeck said.
Meadows is arguing that under the Constitution’s Supremacy Clause, the federal court should dismiss the charges against him, because the conduct underlying the charges was conducted as part of his duties as a close White House adviser to Trump.
Back to the juicy details:
Fulton County District Attorney Fani Willis will lay out the first details of her sprawling anti-racketeering case against former President Donald Trump, his White House chief of staff Mark Meadows and 17 other co-defendants at a federal court hearing on Monday morning.
This will be the first time that substantive arguments will be made in court about the four criminal cases brought against Trump this year.
The subject of the hearing, set to begin at 10 a.m., is Meadows’ motion to move his case to federal court and possibly have it thrown out, but it’s much more than that – it could end up acting as a mini-trial that determines the future of Fulton County’s case against the former president.
Willis is expected to preview the case that she is planning to bring against the 19 co-defendants, getting on the public record some of her evidence and legal arguments for why Trump and his allies broke the law when pressuring Georgia election officials to meddle with the 2020 results.
. . .Beyond Meadows’ participation on the Raffensperger call, Willis has also highlighted as alleged acts in the racketeering conspiracy his surprise visit to an Atlanta election audit and a request Meadows and Trump are said to have made to a White House official to compile a memo on how to disrupt the January 6, 2021, election certification vote in Congress.
“In order to prevail, Meadows has to convince the court that when he was banging on the audit door he wasn’t representing the private interests of Donald Trump,” said Lee Kovarsky, a University of Texas law professor and expert in the removal statute.
Willis, in her response to Meadows’ filings, is leaning on a federal law known as the Hatch Act, which prohibits government officials from using their federal office to engage in political activity, including campaign-oriented conduct. She argues Meadows’ involvement in the pressure campaign on Georgia election officials is clearly conduct he was not allowed to engage in as a federal officer, and therefore he is not entitled to the federal immunity defense.
The Hatch Act framing is a “nice way of illustrating that he was acting outside the scope of his official duties,” Kovarsky said, adding that Willis will not have to prove that Meadows violated the federal statute to be successful in the argument.
Willis’ filings in the dispute also appear to be a shot across the bow at Trump and any attempt he could make with similar claims.
Several key witnesses may take the stand at Meadows’ hearing, and these could tell us some of the evidence that could be used against Tr*mp.
*Obsessed with mortality as I am, I’m a sucker for stories like this one in the WaPo: “I am dying at age 49. Here’s why I have no regrets.” Actually, she does have regrets, but also gratitude for the good things that happened to her (“She” is Amy Ettinger, who has stage 4 4 uterine leiomyosarcoma, an aggressive cancer that, doctors says, gives her just a few months to live.)
The good stuff she mentions is this:
I learned that lasting love is about finding someone who will show up for you [she wed a good man and they’ve never been apart for a day, even after 25 years of marriage]
I pursued my dream career with passion [she was a writer and published a guide to America’s best ice cream, a worthy endeavor]
I have never had a bucket list; instead I said ‘yes’ to life [she took a lot of trips on the spur of the moment]
I found people in my life who can accept me as I am [although she’s an introvert, she has some very close friends]
I live where I want even though the numbers never add up [she lives in hyper-expensive but beautiful Santa Cruz, California.
Her ending:
I am dying around people who love me and are bringing me meals when I need them. These are people who are willing to show up for me no matter what. And I know they will show up for my husband and daughter, even after I am gone.
The end of my life is coming much too soon, and my diagnosis can at times feel too difficult to bear. But I’ve learned that life is all about a series of moments, and I plan to spend as much remaining time as I can savoring each one, surrounded by the beauty of nature and my family and friends. Thankfully, this is the way I’ve always tried to live my life.
By Michael Arceneaux, author, speaker and someone who
usually eats according to his morals.
Chick-fil-A has historically been a very anti-gay company. It has donated to charities with anti-L.G.B.T.Q. stances, and its chairman, Dan Cathy, was once quoted saying he believes in the “biblical definition of the family unit.” Yet, traitorous and masochistic though it may be, I, a gay man, regularly consume its homophobic chicken.
What can I say? I know it’s wrong, but McDonald’s simply can’t compete, Burger King and Jack in the Box don’t compare, and while Popeyes and Wendy’s might come close, they’re not the same. And none of them offer what I find most appealing about Chick-fil-A anyway: the Southern charm of its employees.
It reminds me of home. And while that doesn’t make me any less guilty for pulling up to the drive-thru, I won’t apologize for the pleasure I feel driving away, crispy sandwich in hand.
I don’t think the company is still anti-gay, and I have to say that I partake of one of their delicious sandwiches once in a while.
This guy STEALS!
By Thomas Morton, writer, TV host and frequent flier.
Whenever I’m at the airport, I like to do a little shopping at the Free Store. The Free Store is any establishment that leaves its permanently price-gouged wares unsecured on shelves unattended by underpaid and overharried employees. I stroll in, select my items, then suddenly “receive a phone call” that “my flight is almost done boarding.” I’ve known people who get a rush from the act of stealing. Not me. What I love is having and using things I didn’t pay for.
By Megan Nolan, novelist, journalist and friend.
I sleep with my friends, and I befriend the people I sleep with. As a result, my social life mostly consists of a sort of merry traveling band of fellows with whom I have happily porous and shifting relationships. This is what we all used to do when we were young and then grew out of when we moved into the serious part of life. Except I just didn’t.
I know this sounds like hell to most people — the lack of boundaries and the mess and the logistics — and it certainly can be. I’ve been hurt and I have hurt people. It’s icky and embarrassing and kind of a pain in the ass.
When it works, though, it feels like a vindication that the worth men and women can hold for one another is beyond sexual and romantic and also that it can continuously change, like everything else. When it doesn’t, it’s still pretty hot.
Oh, and I have to add Paul Bloom:
By Paul Bloom, Yale psychology professor, author and
generally a balanced, open-minded guy.
Saint Augustine, in his “Confessions,” describes going into an orchard with his friends to steal some pears and writes: “I had no motive for wickedness except wickedness itself. It was foul, and I loved it.”
As a psychologist who has spent my career studying transgression, I’m particularly attuned to my own Augustinian impulses. My most regular one is hate-reading. I can spend hours on end consuming the words of people whose views I find repugnant and unhinged, becoming inflamed in both anger and self-righteousness.
You can, of course, learn things from awful people. But there is also a simple evil pleasure in indulging in their wrongness.
Indeed, and there are certain websites that I can’t resist hate-reading.
Meanwhile in Dobrzyn, Hili is getting older and a bit chunky:
A: It’s been a long time since you jumped up on this shelf.
Hili: Unfortunately, it has begun to be difficult.
In Polish:
Ja: Dawno nie wskakiwałaś na tę półkę.
Hili: Niestety, to zaczyna być trudne.
And a picture of the loving Szaron:
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From Barry. I think I’ve posted this one before, but I love the bit about theology:
From Masih, more Iranian women defying the hijab dictates of the theocracy big time. They could get into serious trouble for this.
Iranian National Muay-Thai team’s women defied mandatory hijab at Asian Championship 2023. Authorities immediately threatened suspension, but this is a clear message from Iranian women to the Islamic regime’s clerics: we won’t back down. #WomanLifeFreedompic.twitter.com/FskTjLyvt4
Tweets from Dr. Cobb, who’s beavering away on his biography of Crick:
Also: Oppenheimer, a postcard of a chipmunk, the second man in space, Captain Kane ‘late of the Indian Army’ and a specially chartered train from Paris.
Matthew says, “This is worth 10 mins of your time, with a cracking reveal that made me laugh out loud.” It’s a (free) New Yorker piece:
When a TikToker made the filmmaker @hugh_clegg’s video go viral without crediting him, Clegg started searching for the person behind the anonymous account. Watch his pursuit here. https://t.co/Eis4DB1M9K
