Scientists Reverse Brain Damage in Drowned Toddler?
newsweek.com
newsweek.com
The enthusiastic replies on this thread are understandable, but disappointing to see: we all need to be less credulous regarding the lay science press, and especially the lay medical press.
I would love nothing more than to have this kind of therapy be a reality for my patients. However, I am deeply skeptical of this report.
Why? Because
- hyperbaric oxygen therapy has a big industry of quackery behind it[1][2]
- oxygen is a standard part of medical care and can just as easily be harmful as helpful
- because there is just no way in hell that oxygen is going to reverse cell death.
- this is in newsweek, and not a peer-reviewed journal.
And if there was no cell death, then the recovery is almost inevitable.
Some posters are skeptical because 15 minutes is impossible.
On the contrary: the key point is the temperature. The article says the water was 4 degrees C. That is cold enough that you can recover fully. In fact, the most amazing recovery is also one of the best-documented: with a 66-minute submersion in Utah that was followed by complete recovery[3] (this is a far more interesting article than the original post - it was in 1988, and utilized extracorporeal rewarming). This observation was used to pursue hypothermia in other causes of anoxic injury, which is clinically used today. I'm sure the 66-minute case also got oxygen during the recovery, but to say that it was due to oxygen (which is standard of care) rather than the temperature is silly.
Sorry to be a wet blanket, but this article is just clickbait junk.
1. https://www.fda.gov/ForConsumers/ConsumerUpdates/ucm364687.h...
2. https://www.quackwatch.org/01QuackeryRelatedTopics/HBOT/hm01...
3. http://www.nytimes.com/1988/07/26/science/the-doctor-s-world...
Clue in on what exactly? That the current top commenter, and others - including myself - got baited? Hard to blame them, IMO. That's the effect when popular press is literally lying to people. :/.
(Also that's why I usually read HN comments even before the original article - in case there's an expert who debunks the story, which happens pretty often.)
On the fact that it does sound too good to be true.
Remember: the "theory" behind any medical idea is almost irrelevant if you have data regarding the outcome. If you have outcome data, it supercedes the theory, and is all-important. The theory simply helps us prioritize which treatments to assess first - the better the fundamentals, the more worthy it is of scarce research resources.
That's one of my biggest criticisms of the lay press: they emphasize the scientific narrative and don't focus enough on the outcomes. The most meaningful outcomes in scientific terms always mean the same thing: a meaningful improvement by blinded observer in something we care about.
"meaningful improvement" - this means that improving survival by a tenth of one percent might not be worth the trouble of implementation
"blinded observer" - because it cancels out the placebo effect and expectations
"something we care about" - such as returning to school. But if you do a SPECT scan and the SPECT scan "looks better" to the doctor? That's not important. We sometimes use things that are well-documented to reflect important things even though they are not important in their own right... we call these biomarkers.
Dr. Harch is published and well respected. He also has many documented cases of saving divers lives - including working with the US Navy. Could this be just a case of the medical community not accepting a new technique? In March 2000, the American Board of Medical Specialties approved undersea and hyperbaric medicine [1]. He has a legit cv: http://www.hbot.com/about. Some of this publications:
1. Harch PG, et al. SPECT brain imaging in the diagnosis and treatment of type II decompression sickness. Undersea and Hyperbaric Medicine, 1992;19(Suppl):42.
2. Harch PG, et al. The effect of HBOT tailing treatment on neurological residual and SPECT brain images in type II (cerebral) DCI/CAGE. Undersea and Hyperbaric Medicine, 1994;21(Suppl):22-23.
3. Harch PG, et al. HMPAO SPECT brain imaging and low pressure HBOT in the diagnosis and treatment of chronic traumatic, ischemic, hypoxic and anoxic encephalopathies. Undersea and Hyperbaric Medicine, 1994;21(Suppl):30.
From the article [1] you mentioned: "In March 2000, the American Board of Medical Specialties approved undersea and hyperbaric medicine as a subspecialty of both emergency medicine and preventive medicine."
That seems like the most persuasive argument to address, and I'm not sure those references do.
https://www.ncbi.nlm.nih.gov/pubmed/?term=harch+pg%5Bau%5D
As far as I can tell, he only really has editorials and reviews for the most part (which you can pump out to low quality journals any day). He was involved in a small scale rat experiment, a few case reports, and 40-patient non-controlled case series. Basically, at the level of a junior medical resident or fellow.
Furthermore, any references to his publications on his site are buried. The best I can find is here:
http://www.hbot.com/blog/edward-lucarini/hbot-tbi-references
Which are mostly book chapters (grunt work often farmed out to suffering medical students) and case reports (considered "interesting" but scientifically worthless). When judged by academic accomplishments, i.e. peer reviewed papers in high-impact journals, he is essentially not on the map.
That the medical community wants evidence to substantiate an extreme claim is not a valid criticism of the medical community: it's literally the scientific process.
There are just too many extreme claims based on "unconventional" medical ideas to possibly draw conclusions that any one of them deserves closer attention.
It's great that some doctors at LSU think these ones are deserving - I really want them to succeed, because it means my patients benefit. But the mechanistic reasoning behind /why/ we think it /should/ help is so dubious that there are a thousand better places for me to spend my own time.
Bottom line: 99% of doctors want to see new, revolutionary ideas succeed. If they don't think things are work, it's because they haven't personally seen it being revolutionary. And the harder it is to see a revolutionary effect... the less revolutionary it is, by definition
• Stroke
• Autism and other learning disabilities
• Cerebral palsy and other birth injuries
• Alzheimer's, Parkinson's, multiple sclerosis, and other degenerative neurological diseases
https://www.amazon.com/Oxygen-Revolution-Hyperbaric-Groundbr...
Wikipedia is saying there is zero scientific evidence to back up any of this. I'd say Dr Harch crossed the line into quackery by making these grand claims, despite his otherwise reputable background.
Which is sad because his books all have plenty of 5/5 star ratings by people who are desperate for answers and are being oversold an unproven science.
I highly doubt there has been a conspiracy in the "medical community" to not take oxygen therapy seriously. It's not exactly a new treatment, as the OP's comment points out, it's been tested since at least 2000 (17 years ago) by mainstream medical groups.
You honestly think neurologists enjoy going to parents of toddlers and telling them their child may never lead a normal life again? If this were a legitimate treatment most neurologists would jump on it.
The fact is there is -zero- chance that oxygen therapy months after the accident had any effect. Oxygen doesn't magically make neurons regenerate. Neurons are energy hungry and die within hours under the absolute best of circumstances.
This story is nothing new. The pool was very cold, that's why the kid made a "miraculous" recovery. Cooling the brain massively reduces neuron losses. This has been known for decades now and contrary to your supposition the medical community has adopted it where the evidence proves it is helpful - in some cases of suspected brain damage due to oxygen deprivation they will force the person's body temperature down and slowly re-warm while introducing oxygen. This has to be done carefully because re-introducing oxygen too quickly after a certain amount of time can induce apoptosis and make the damage worse.
First, after looking at the MRI, I see more evidence of cerebral edema than of infarction. The MRI sequence that would show the actual infarction, DWI is presented, but as a 3d volume(which I have never seen done before with DWI) and does not show the thalami where most of the FLAIR hyperintensity is.
Second, Unlike what the article would have you think, there is not massive cortical infarction. In fact the cortex looks not too bad. The main lesions appear to be bilateral thalamic edema. Note that thalamic dysfunction can present with severe neurological deficits often mimicking massive cortical dysfunction.
Third, measuring volumes in an MRI that is not taken at 1mm slices can be problematic. Thus where the authors talk about volume differences may just be slice variations between scans.
Fourth, I would have expected something this groundbreaking to be in NEJM, JAMA, BMJ, Lancet, Stroke, or Neurology. Medical Gas Research is a very obscure journal.
Fifth, Paul Harch is way outside the medical mainstream. During the Terry Schiavo case in Florida he was one of the people arguing that she was not in a permanent persistent vegetative state. It seems like he pushes hyperbaric oxygen to treat a host of brain disorders such as cerebral palsy, autism, stroke, traumatic brain injury. There is very little actual scientific studies backing up these assertions.
So overall, I am very skeptical about this article. In addition, usually when groundbreaking science is presented by the press, you often have an expert in the field who was not involved with the study, talk about methodology, background, and implications. This article did not do so, making it all the more suspect. I think, ultimately this is another Newsweek poorly researched click bait article.
One question: some of your responses attack only the credibility of the speaker (OP's 1st, 4th and your 4th, 5th points). Is this typical in scientific discourse? They seem to detract from your analysis to me.
Really what you're observing is that the argument in Newsweek sidesteps logic and appeals implicitly to the authority of that doctor. Presented with the argument that the subject of the article is credible enough to be believed on their own terms, we're left with a debate about that subject's credibility.
The weird idea embedded in this meta-debate is that alone among all the innumerable topics we can address with logical argument, from rankings of Led Zeppelin songs to the proper distribution of ownership of the means of production between capital and labor, the credibility of a human being on any particular subject is exempt from scrutiny, lest we fall into the trap of "ad hominem".
https://news.ycombinator.com/threads?id=throwaway7890
Credibility is not "exempt" from scrutiny, it simply doesn't change the truth value of any factual statements about whether the treatment works. If it somehow could change the truth of whether this approach worked or not, then if this guy presented the opposite conclusion, somehow this treatment could either start or stop working based only on the person's opinion and reputation.
There's obviously no causal mechanism for that to happen and believing it would require magical thinking. So arguing over it is irrelevant and inserting it into the argument is pointless. We instead can properly say that he hasn't answered a lot of good questions about his approach or presented sufficient evidence to believe in it, which is the rational approach.
This is a valid inductive argument. It is valid when A is an actual authority, when they are speaking truthfully, etc. It doesn't guarantee the truth of the conclusion but it is a fine argument. How do you know Booth shot Lincoln? You read it in a textbook, the textbook is written by someone who is an authority on history or that part f history, etc. It isn't deductive (like a proof in geometry or logic) but it is a good argument. Many logic books call argument from authority invalid and what they mean is that it isn't deductively valid but it is an inductively valid argument form (If it were always invalid, we would be quite mired in ignorance).
Another way to think about it is as witness testimony.
When you do a logical, mathematical proof, you are building on a well-defined and well-known set of axioms, using well-defined steps of logical inference. With a few well-known exceptions, we don't argue over mathematical proofs. Either the logic flows from the axioms or it doesn't.
Once you step away from pure mathematics, you no longer have a small number of well-defined axioms or clear inference. Instead you have a lot of what amounts to witness testimony. Sometimes, you recount an observation. "X drowned and was dead for 15 minutes." "X had brain damage." "X fully recovered." It is reasonable to dispute these statements based on the credibility of the person making them.
Some of these statements may be the product of inference, which is also less clear than logical inference. For instance, "X has brain damage." might have been inferred from "An MRI of X looked like Y." and "Y indicates severe brain damage." Now you have a host of ways where the statement could be wrong, based on the reliability of the person making the observation and the inference. Did the person actually take an MRI, or were they lying about it, or did they misread it, or did they actually rely on a third-party who did one or the other? Is the inference method "Y indicates severe brain damage" valid? Did the person in question correctly apply it?
People don't like to attack the credibility of others; it seems mean and it can easily slip into elitism. But examining the credibility of someone presenting evidence is absolutely critical to truth-finding. Personal integrity is an absolute necessity, in science, medicine, and law.
It's always useful to think of these situation in circumstances where you don't have any emotional involvement because otherwise you mind can play tricks on you.
For example imagine you are a European Scientist who really wants to fit every animal onto tree structure with mammals over here and squid here and all the animals fall into some easy to understand structure that makes total sense to you.
And some weird guy comes back from Australia with natures most awesome animal the platypus. A furry creature that lays eggs with poison feet. Your simple identification chart is totally jacked. It way easier to say he is a quack that evaluate the evidence you don't like. Heck it's totally inconvenient that your life's work is wrong, it's going to cost you money and esteem.
tldr; pointing out a quack is a great excuse for avoiding evaluating their arguments but refutes none of them. Everyone's time is valueable and figuring out what adventures to spend it on is important. Confusing that reasonable justification of where to spend your time with their argument being false is a dangerous habit to get into. You end up always thinking you are right and avoiding things that challenge your beliefs.
I could propose in this comment a cure for cancer based on a perfectly sound a logical argument and my (lack of medical) credibility would have zero affect on the cogency of what I was saying.
But it does mean, you should probably not be convinced, or at least not send me all of your money to invest in my cancer research startup.
Also for some reason it's very easy to judge something as reasonable when we actually don't have any domain expertise. Not sure why, it seems built into most of us to feel natural.
The "ad hominem fallacy" is misused on the Internet probably more than it is applied correctly.
The reason is imperfect information. If I described here an actual, real, cure for all cancer, people shouldn't believe it because credibility is shit, it hasn't been clinically proven, and it might take 10 years to do so.
If I write in a solid proof for a millennium prize problem, you're probably going to be safe not worrying about my credibility at all because the truth will be known in pretty short order.
Usually the more uncertainty the more credibility has to be weighted.
The arguer's credibility does not affect the truth value of any statements, so it's always more useful to argue over why someone is wrong. You cannot guarantee that any segment of the population agrees with your credibility assessments. And these assessments should be established via appeals to factual evidence to begin with, anyhow, if we're to believe they should carry any weight at all. Otherwise, we're arguing over feelings instead of facts.
For people with wild, unsupported claims, it's better to simply take the tact that we have not yet seen evidence that establishes those claims and that what's on offer presently does not meet the necessary burden. In that argument, it really doesn't matter who is making the claim, only that the claim itself is not supported.
It is evidence which you should weigh in deciding how much credence to give their statements.
> so it's always more useful to argue over why someone is wrong.
It's a tradeoff, so there's no obvious bright line with which everyone will agree. But certainly there are some people for which some arguments or claims can be reasonably dismissed out of hand, relative to the preferences of the person making this decision.
You essentially point out that it's an easy shortcut. And it is, but there's no good reason to take it. One's feelings of credibility do not change the truth value of any statements and so arguments over it are not useful. You will end up arguing over whose feelings are superior and not over observable facts.
(Though an appeal to authority is a perfect setup for a motte-and-bailey, so it's important to be wary. Also, it is not, nor ever can be, proof, since that should hold irrespective of authority.)
Moreover, when it's an argument, you want others to agree with you. If you have to take shortcuts and infer the truth of something by proxy because you are either too lazy or not capable of evaluating the matter directly, you probably have no business arguing over it in the first place when you could instead apply your expertise to show how wrong it is.
Worse, your own correlations work against you, as you can now correlate that someone who cannot or will not do that work in making an argument, dragging irrelevant (if sometimes correlated) things into the argument becomes a signal for someone using non-factual means to persuade, which necessarily correlates quite strongly with making false claims.
In short, yes, it can be simpler and it can lead you to being right, if for the wrong reasons. But nobody else has good cause to trust it, it's vulnerable to manipulation, and it's simply better in all cases to be less lazy and fully explain why something is wrong using facts instead of opinions of someone's credibility.
I understand evaluating someone's credibility as a proxy when I have no means of investigating something. I do not understand it when we are talking about scientific assertions, which must be falsifiable in order to be scientific in the first place.
That's of course a bit black/white to say, most arguments don't hold if you push them to their extremes like that. I said it because I believe (your) arguments like "saying that a person's credibility decides the truth value of the statement requires a causal relationship" are similarly black/white.
So yes, in a way the disagreement hinges on a very strict interpretation of the word "fact" versus a less strict interpretation.
It's also to save time in evaluating claims like these. If you've spent any amount of time arguing about pseudoscientific topics (or considered pseudoscience by some), you must have found that yes you can in theory evaluate all[0] (dubious or not) claims in logical, scientific, falsifiable manner. But at some point, especially in pseudoscientific-ish topics, there will be such a great number of claims[1] that you'll find yourself spending most of the time refuting spurious claims rather than actually getting any further.
At that point, you'll never get to the strict definition of the word "fact" (at least, about the particular claim that is the topic of interest), because the claims just keep piling on faster than you can evaluate them. Allowing for a bit less strict definition, allows you to prune the evaluations greatly, and at least allows you to get somewhere.
Now, that struggle doesn't seem to take place in this thread on HN, but according to user "dumbneurologist" it has taken place before elsewhere. And you're still taking that person's word on a matter of (merely claimed) reputation as well.
So yes, there is something to say for taking someone's reputation into account. But it's a pragmatic reason. If you had all the time in the world to dig into everything as deep as you want, you wouldn't strictly need to. But since we do not live in this perfect world, we can and probably should shortcut to the more interesting points of debate by including reputation.
That's the best I can argue this, I think :) It's still a choice, however. You can still choose to only accept strict facts (including "I don't know" when more specific strict facts are unavailable).
[0] ok, not all of them
[1] part of the definition of pseudoscience, where you keep adjusting or special-casing gaps in your hypothesis when it doesn't fit the data, almost necessitates this
We're not discussing the study but logic, so that's really not germane.
> It's also to save time in evaluating claims like these.
You can save far more time by ignoring them.
Poor researchers are very common. Conspiracies to smear people are very rare. If an academic has a bad reputation, the odds are good that their reputation is deserved.
None of this is conclusive - mavericks do occasionally produce brilliant-but-unconventional research - but it's hugely relevant. There aren't enough hours in the day to give every paper the benefit of the doubt. We have to use Bayesian shortcuts and crude heuristics to filter things for credibility, otherwise we'd be drowning in a sea of junk. The occasional false-positive is a price worth paying.
I'm grateful I have something to contribute to a site that I've gotten an incredible amount out of. And it's a powerful reminder that very very smart people can have a hard time critically appraising medical claims. As powerful as the internet is, medicine is really complicated, and it's easy for doctors to forget that.
I'll let the surgeon speak for him/herself, but for my part: I am raising the issue of industry size and quackery to give other readers context. It doesn't make the article wrong necessarily, but I would want to have that context as a non-expert reader trying to understand how it fits into the larger body of scientific understanding. And I would say yes, that does happen (and is appropriate to have happen) in scientific discourse.
On a related note: one amazing site that isn't well known is the OpenPayments[1], maintained by the US government. If you live in the US and have doctor, you can see how much compensation they received from industrial sources. Some of the numbers are shocking. Put your own doctor in, and see where they are. There is no need to resort to conspiracy claims when you can audit them, to some degree, yourself.
The physician mentioned in the article, Dr. Paul Harch, has received $74.48. So way to go Dr. Harch! we can worry much less about getting a skewed opinion based on a industry payments.
But weighing against that is his CV, which lists publications with "D Amen", who I suspect is Daniel Amen - an overly-credulous hyperbaric oxygen physician who has his own page on quackwatch[2], and subscribes to medical theories that are even less credible than the ones in newsweek. When Mehmet Oz[3] is an endorsement on your web site (Amen; not Harch), the public is justified in putting you in the same category. Farther down the CV is "Department of Defense trials for hyperbaric oxygen and TBI: issues of study design and questionable conclusions", wherein I'm predicting he single-handedly dismantles a large federal study of whether HBO is useful for traumatic brain injury. Feel free to find the original article and independently appraise it, if you think it's worth your time... I can barely find 10 minutes to pay back a favor to a good-natured community that has taught me a lot about computers and programming.
Finally: let's not lose sight of the incredibly good thing that happened for this child. Regardless of how or what or why, this is an exceptional outcome, and it's fantastic for this child. I only wish it wouldn't create false-hope for families who are less fortunate, but have thousands (or tens of thousands) of dollars to blow on questionable treatments and false reason for hope.
1. https://openpaymentsdata.cms.gov/
As a medical student I appreciate you all commenting here, it also helps those of us with a general understanding put things into perspective.
[1]: https://www.propublica.org/article/about-the-dollars-for-doc...
Infarction - Tissue death due to inadequate blood supply
Edema - Abnormal build up up fluid within the body
Cortex - Wrinkly, outermost layer of the brain.
Thalamus - Part of the brain relating to sensory and motor signals.
DWI - Form of MRI. Measures Brownian motion of water molecules. Does not necessarily involve driving while intoxicated
"She was immobile and constantly squirmed and shook her head."
Uhhh... That's a pretty fast and loose use of "immobile".
Everyone has their faults and I'm not saying that HN never gets caught up in hype sometimes, but this is the best place to be for a level-headed thoughtful takes on things, and you usually do it while retaining a general optimistic attitude.
So thank you.
- this is hacker news I hope people are in it for some sort of rigor, not just for wow effect
I forgot the 66min case, but that brings me to something I heard recently. Some paramedics said they managed to sustain some kid under cardiac arrest for 18 minutes (he had a nice if not full recovery). The average rule is that if heart has not restarted after 6 minutes, brain damage is irreversible. So where does that leave us ? Should we try (say we have many people capable of doing CPM) to pump as long as possible ?
- should we try to lower body temperature as much as possible to slow metabolyc processes ?
My only point regarding
> The average rule is that if heart has not restarted after 6 minutes, brain damage is irreversible
is that it doesn't mean it's worthless to continue CPR. Different people have different preferences about how grievous an injury they would want to survive. Whether to continue comes down to that preference. Have an advanced directive, and make sure your loved ones know what you want to have happen if you are every in an emergency!
My friend was in a coma for 6 weeks and had brain damage because of the lack of oxygen.
On one hand, this was distressing because she lost mathematical ability. This prevented her working in her previous field as a chemistry researcher.
On the other hand, she switched to psychology via a one year Masters degree and is now working on a fascinating project on hacking the mind's compassion responses to activate the parasympathetic nervous system and damp down anxiety (sympathetic nervous system) triggered by cardiac damage.
Just saying that although brain damage sounds terrifying, people can and do cope with it.
I had a teacher in grade school and one day she didn't come back to class, she had had a gigantic stroke. 6 months later she rolled into class in a wheelchair, a changed person, she could not speak or do basic tasks for herself.
Over the next two years she relearned most of her abilities, walking, talking, thinking, speaking, teaching and was back to "normal" again. Then she had another stroke.
She did not give up, and did it all over again.
She was always a cruel teacher in my eyes (I was very young) but seeing her persist throughout what I would assume would permanently put you out to pasture was an amazing experience and I always had enormous respect for her.
She continued teaching and retired ~20 years later.
But future generations will probably laugh at us. Our rule of thumb about deprivation of oxygen and brain damage is based on the idea that brain damage occurs on the "down" side when the brain is deprived. Actually, the damage occurs on the "up" side when a patient is revived under non-ideal circumstances for brain operation. It turns out the brain if you wake it "up" properly can stay "down" as long as other organs. Think kidneys frozen for 24 hours before being successly transplanted. And a proper wake up involves slow extracorporeal rewarming as mentioned in one of the top comments.
If we can accept this down/up inversion as true, then it means that rushing to revive a patient is what does the damage. It means applying CPR in the field as soon as possible does the damage.
If true, it means 20 minutes, or even 2 hours, of not breathing is nothing as long as the cold body is rewarmed slowly.
If true, it means it is better to keep the brain "down", body "frozen", everything cold as possible (but above the temp of ice crystals riping apart blood cells causing permanent limb loss) until --and this is the key part-- a proper wake "up" can be performed.
If true it means the current limits observed with oxygen deprivation exist only because we are still concerned with reviving as soon as possible. Leave that child passed out! (But keep 'em cold.)
If all this is true, it means that saving a loved one is best done buy applying ice over applying CPR.
Future generations will shake their heads in disbelief, at how many people we have needlessly injured and killed with the barbaric practice of rushing to revive. I look forward to the improvement in how we save/restore lives. I look forward to the improvement from the slow but steady diffusion through our collective awareness of of the idea:
Down-and-cold-is-okay/ Prematurely-revived-is-bad.
What book was this ?
With pretty astounding results, honestly. My son was born having been without oxygen for at least 6-9 minutes. He was immediately put on a "cold blanket" with his temperature maintained at 92 (F) for 72 hours to prevent brain damage... He has since made a complete recovery with no physical neurological issues present.
This article might be complete bunk, but the hypothermia treatment protocols definitely are NOT.
Thanks for a second opinion and the links.
Does oxygen have the ability to promote neurogenesis?
So fucking what? I suffered a moderate (GCS 8) TBI 6 years ago and it has been the most impactful thing to ever happen in my life, more so than even the births of my children. This article is a small glimmer of hope in an otherwise depressing and difficult subject.
I am beyond glad people such as yourself exist in this world, are skeptical, and do the hard work of helping people and making lives better. But please remember that us lay people need these bits of hope and glimmers of light. I don't particularly care about the science, as a parent and TBI patient I'm simply glad she's ok. This article made me tear up.
"Hope" is a real, tangible thing, crucial in our lives, and provably effective.
The question is do we need to accept quackery to have it? Is that sometimes the only way? I suspect the answer is, rarely.
There is so much legit and exciting work being done w.r.t. TBIs that it seems we should not have to rely on it in this area. But that's a guess. Until you've walked in someone's shoes...
Sorry to hear of your suffering.
I am an atheist, scientist (physics) and I used to actively discourage people from religion (which is pure quackery).
This until I realized that religion helps people who do not want to otherwise think about the world around them. One of the people I managed to move away from religion and change his beliefs ended up deeply depressive. Another one was deeply unhappy with the change. I lost these two friends.
So, while I profoundly belive that people who do science must be atheists (otherwise they have some mental disorders, trying to combine fire and ice), I do not think anymore that everyone is a good candidate for enlightenment. The hope you get from religion vs. the hope you do not have in science (in the religious sense) must be carefully weighted.
Some time ago religion was the only way to go, now science has taken over. Science also gave people the right to say "I do not know".
I profoundly belive that people who do science must be atheists
What was "god" yesterday is science today.
Science and religion have exactly zero common points, they function in fundamentally different ways. One way is to invent our of the blue some kind of superior entity (because why not), the other is to take the risk to say "this is how it works, and this is how you can prove it does not".
I have a PhD in physics and attended a fair share of "discussions between physicists and priests" - complete loss of time. Our world works on science, if someone does not agree I purpose to move back to middle age comfort, propelled by religion and not science. This until winter comes, when suddenly electricity is no longer the effect of the wrath of Zeus but something explained by science.
And this is not a matter of belief : if someone states that he is a scientist, it is not possible to be religious. Simply because these two postures are not compatible. You can be one of the other but not both.
You deserve to have hope, but for me personally, hope comes from the fact that science works. This article is not real progress (even though the child had a good outcome, and that's awesome), but there are a dozen places where real progress is occurring, even if it's less visible.
Newsweek... that rings a bell. Didn't they also do the Satoshi Nakamoto fake?
Edit: somewhat unrelated since this girl fell into an unattended pool, but it's important to know the signs of drowning, which are not what you see in movies: http://www.cbsnews.com/news/how-to-spot-signs-of-a-child-dro...
Edit 2: I get that people have a right to downvote whatever they want, but seriously, did I say something wrong here?
It was done for the first time, we have no idea what really did the magic here, we can just assume. In any future medicine scenario I'd expect us to exactly know what we are doing and how it works. Yes medicine is improving but we really are in the dark ages still.
No, we'd be in the dark ages if we were in still the dark ages. Our current level of progress would seem like science fiction or even magic as little as a century ago.
I think I understand your point, that we have so much more to learn we're not even able to quantify what we don't know.
But this is not some kind of endless quest. We're dealing with a machine in the end with finite complexity and eventually it will be understood fundamentally.
I don't think I would be surprised if the most common diseases were eliminated in the next 100 to 200 years.
I'm guessing you don't work in the medical field (I have). First their's the emergent complexity of scale (after all the universe consists of a finite number of a small number of fundamental particles). Second, the human body (and all the pathogens etc) are object code highly optimized over billions of years. We understand almost nothing about how it all works. We can transcribe most of a human's genome but barely understand how even a tiny part of it works.
> I don't think I would be surprised if the most common diseases were eliminated in the next 100 to 200 years.
The most common causes of death have been pretty much eliminated in the wealthy world over the last 50 years. People still die, just of a wider variety of less common reasons. In the limiting case, each person will die of a unique cause.
> People still die, just of a wider variety of less common reasons. In the limiting case, each person will die of a unique cause.
Right now, human lives are still capped at ~120 years, and usually much less than 100. In the (mathematical) limit, each person will die of a unique cause at age infinite. While we won't ever reach that limit, it's worth to continue getting closer to it.
Maybe the fact I don't actually makes it easier to understand biological complexity.
You guys have to figure out how to fix a brain when it breaks.
In CS, a holy grail is to match or exceed human cognition with general AI. It's not fixing something broken, its reverse engineering or alternatively engineering from scratch the greatest known computational device in the universe which has evolved over a billion years.
It's often not appreciated that this hasn't happened yet not due to lack of computing power. It hasn't happened yet because we're still not even remotely close to knowing what code to write if we did have 10,000 times more compute. We don't know how to do it, and instead are forced to plod along in awe as every year we learn a little more about what we don't know.
I see this as agreeing with the person you're replying to. We can make certain limited interventions which are amazing, but the kind of complete understanding that you're referring to is a long, long way away. Even when we do have a treatment, we often do not fully understand how they work.
Nice side effect of solving coordination problems include: solving poverty, solving peace on Earth. :).
...which is true of most of medicine. Most indications (e.g. diseases) are named after their symptoms rather than causes, and a lot of treatment is just creating / improving the environment in which the body can do its job.
None of which should be taken as denigration of amazing achievements in the medical field!
http://www.parents.com/kids/safety/outdoor/dry-drowning/
"Any child pulled from the pool needs medical attention," says Dr. Berchelmann. "At the very least, call the pediatrician."
Our daughter was coughing after swimming in a river a few weeks ago, and my mother in law found the dry drowning stuff on the internet. I was like "dry drowning doesn't exist," but we called a nursing hotline which told us to go to the ER. The doctor checked out the kid, then asked us for the number of the nursing hotline so she could yell at them for sending parents to the ER over a condition that doesn't exist.
No shit swallowing water is not the same as aspirating [breathing] it and nobody said it was!
"And I’m pretty sure everyone understands that a child who is down in the water, gets pulled out, and requires resuscitation needs immediate medical attention, even if they seem to recover." - No, they might not!!! And that's the point!!!
The takeaway is:
If someone has a serious near-drowning episode they should seek medical attention even if they appear fine.
If someone exhibits symptoms listed after aspirating water, they should seek medical attention.
His doctor contradicted you, and the advice you gave at the end of your comment. Are you also a doctor?
http://www.nhs.uk/conditions/Sudden-infant-death-syndrome/Pa...
I'm speaking a little in hyperbole here, but you get the point I'm sure.
My mom was a great parent and wonderful overall, but that was a particularly excellent decision of hers. She was still careful with my little brother and me around water - we were enrolled in Red Cross swim classes during the summers in elementary school, and always had lifejackets on at the lake. Despite being terrible at pretty much all sports (unlike my athletically-gifted brother), I was always a decent swimmer.
When my wife and I were on our honeymoon we watched a couple throw their 6 month old (10 month maybe? wasn't walking, only crawling) in the pool over and over again. Most of the pool looked on in horror, but they had taught her the "leg kick to turn over onto her back and float" skill. Definitely gave us perspective.
We just got done doing a swimming class for our 2 year old and this was addressed in the class. I highly recommend you take a class with your children. Classes for younger than 3 years old are done with parents in the water. It'll make both your children and you much more comfortable and safe.
I know this doesn't really matter much, but if we're going to throw in hyperbole, it should at least be somewhat accurate. I think people are boo'ing anyone who brings up this point because it's such an incredible achievement. That's true, it is, and it's amazing that brain damage was reversed. But Star Trek is a useful, iconic yardstick for measuring our progress. Saying we're close to it discounts how much work we have left to do.
To that end, I'm curious how Star Trek is a useful iconic yardstick? My assertion would be that it is not. It is a common one. But there is nothing useful in it. Precisely because you have to cherry pick what parts you use and how you interpret them. For example, you interpreted it to refer to the method of curing. The comment was taking it for the level of the sickness that was cured. Both are valid places to look.
I suppose it's sentimentality. If you watch TNG (which is difficult nowadays -- it's so far out of time), the writers made some interesting observations.
We now have the capability to ask the computer for information (Google), the ability to send each other messages (email), and we can verbally ask the computer questions (Siri). Touch interface (iPhone). These are landmark achievements, and they were all predicted by a show which ended in 1994, before the advent of the internet. The technology predictions have generally been on-point, and it seems like a useful metric for how far humanity can progress.
Simultaneously it postulated that the humans of the future would not be cyborgs, which appears unlikely. Furthermore, few tasks were automated in a manner we might see in our lifetime, let alone the time of the show.
Umm. I was reading about TNG on the web in 1994. The internet had been around for a long time before the web was useful to ordinary people. Email has been around since the 70s. Search engines were certainly limited, but were already available in the early 90s.
All these predictions succeeded because they were "predicting" incremental improvement on something already known to exist.
I'd wager most of the things that you are quoting were less pioneered by Star Trek, and moreso popularized to an audience. In particular, using a computer to find information, talking to a computer, and sending messages electronically have long been staples in science fiction. Before science fiction, the only thing that was different was the "electronically" part. And really, I don't know as even Star Trek was treating "electronically" any different than earlier stories used "magically."
(To those who haven't watched TNG, the whole series is on Netflix, mostly (entirely?) in the remastered edition, so no TV-like quality. A piece of caution: this is not your typical sci-fi; it's much more positive about the future, science and technology than what we get served on TV these days.)
RE the yardstick thing - there's still lots of things that in Star Trek are shown as easy, and that they feel like they should be easy with sufficiently advanced tech, and that are still hard for us today. So it's maybe less of an yardstick and more of a goal / reminder that there's lots to be done yet.
The internet was around well before 1994.
Exaggeration is an essential part of the definition of hyperbole. Merriam-Webster literally gives the definition of the word simply as "extravagant exaggeration."[1]
https://en.wikipedia.org/wiki/Photorefractive_keratectomy
> They can erase and alter people's memory
https://www.ncbi.nlm.nih.gov/pubmed/14572521, plus lots of pharmacological stuff in spook-land which is well-attested but rarely peer-reviewed.
> They can scan for problems using a handheld device.
http://edition.cnn.com/2017/01/26/health/ai-system-detects-s...
> We are nowhere near any of that.
In the case of your specific examples, we are. It's early days and unevenly distributed, but actually we are getting there.
https://www.sciencedaily.com/releases/2013/10/131022102227.h...
https://www.sciencedaily.com/releases/2013/09/130910142334.h...
http://www.dailytech.com/New+Miracle+Diagnosis+Handheld+Medi...
https://www.cnet.com/news/esight-video-glasses-restores-sigh...
https://www.theguardian.com/science/2010/nov/03/vision-chip-...
Maybe the oxygen had a substantial positive effect, or maybe the child would've recovered on her own. We really don't know, since there are other reports of children who have good neurological outcome despite terrible prognosis [1] [2].
I'm suspicious because of the unusual and/or stereotyped responses in the Medical Gas article and the linked YouTube videos: "doctors said she had 48 hours to live" (doctors don't say things like that) and "this demonstrates that we're inducing 8101 genes!" (ummm, OK...), etc.
Also, be suspicious when something like this hits all the pseudo-news sites simultaneously. It reminds me of the articles that go something like "16 year-old cures cancer...DOCTORS HATE HIM!".
Finally, I'm very happy this little girl has been given a second chance and hope for her continued recovery. However, don't forget that a toddler was left unsupervised and submerged in a pool for 15 minutes. Some people call that an accident; some people call it neglect.
Whoa there, slow down.
Kids are quick. One moment, your three kids are happily watching Finding Dory on the tv, while you're making dinner. The next, only two are: the third has quietly wandered off.
Unless you know the particulars, be very careful about tossing around words like 'neglect'.
However, I have a 2 and a 3 year-old. And I would consider it my fault if they wandered into a freezing pool.
> And I would consider it my fault if they wandered into a freezing pool.
What about a warm pool? Are you telling me that you consider all environmental factors at all times and act accordingly to reduce the risk as far as possible? If so, you're pulling off a superhuman feat, IMHO.
Analogously, maintaining a nuclear power plant is a very involved procedure, and if key individuals neglect to pay attention to certain monitors for what what in other contexts is a short period of time, failure occurs.
Yes, it requires constant attention. Not giving the task the attention it needs is to fail to care for it properly.
I always believed that brain damage cannot be reversed. If version 1 means reversing it in toddlers, maybe version 10 will do miracles for many other people. Truly amazing and congratulations to the medical team!
Even if adults could regenerate large numbers of neurons like we do skin cells, those new neurons would have no idea how the old ones were connected.
The surgery was performed by Dr. Ben Carson. I'll admit, not the best in politics, but one hell of a doctor.
as my professor used to say: If you're going to drown, drown in almost-freezing freshwater.
I imagine it could actually be worse, as liquid saltwater below 0 would damage tissues very fast by freezing them. While fresh water is guaranteed to be above zero and therefore cannot damage tissues through freezing.
There's a tiny bit of jealousy that I didn't have a similar treatment as a kid, but I also have to count my blessings that I was born in a time where a UCLA professor could consult from a thousand miles away and that a concoction of steroids were enough to make the brain swelling dissipate, leaving me with damage small enough that neuroplasticity could do its wonderful magic.
On the other hand, if your health insurance is through one system and your disability insurance through another, you have everyone optimizing for their personal local minimums rather than the global minimum.
Like most "alternative" medicines this one gets pushed hard as a solution for everything, regardless of evidence.
we wish it were otherwise, but: if your son had a brain injury where cells died, no amount of oxygen is going to bring them back (or even help his recovery).
i'm sorry for your son's circumstances (and yours...). But you are a victim twice when you invest time, energy, money, and hope in these quack therapies (I'm sorry to call them that, because it seems so pejorative, but that's what they are).
i don't know what it is about quack treatments that make us so susceptible to them... I think it's a missing piece of the Kubler Ross model of grief. Just like our parents who fall victims to ridiculous "nigerian prince" or "check cashing" scams when you can't understand how... it's not because they are dumb, or stupid, but because there is some aspect of human psychology (hope? denial? grief? whatever...) that puts us all at risk of fooling ourselves... we become unable to see the truth, because of how powerfully we want to see something else.
i hope this possibility makes sense to you, because your son will benefit a thousand times more from your attention than if you take the same attention and spend it fighting against "the system" (in whatever form it takes). and take comfort in the fact that even though "the system" really sucks in terms of its limitations, that it does, in general, stumble toward progress, and the future will be better than the present.
Until then... cherish your son and enjoy your time with him to the best of your mutual abilities.
> Neuro-rehabilitation
> As of 2012 there is insufficient evidence to support using hyperbaric oxygen therapy to treat people who have traumatic brain injuries.[51] In stroke, HBOT does not show benefit.[52][45] HBOT in multiple sclerosis has not shown benefit and routine use is not recommended.[44][53]
> A 2007 review of HBOT in cerebral palsy found no difference compared to the control group.[54][55] Neuropsychological tests also showed no difference between HBOT and room air and based on caregiver report, those who received room air had significantly better mobility and social functioning.[54][55] Children receiving HBOT were reported to experience seizures and the need for tympanostomy tubes to equalize ear pressure, though the incidence was not clear.[54]
In fact drowning does not require filling the lungs completely. Even a volume of a few milliliters/Kilogram of body weight is enough to cause drowning. Additionally, drowning can cause serious damage to the lungs themselves even if the patient survives initial attempts at resuscitation. The alveoli (functional unit of the lungs) are lined with a surfactant that is critical to the exchange of air to the blood stream. Water can severely disrupt the surfactant and impair function not just while the water is present but until the body is able to restore the surfactant layer. Damage to the patient's lungs in this case seems to have been mild enough that the oxygen therapy could do it's job.
Also notable is the 5 degree celsius water temperature (41 degrees Fahrenheit). This water temperature compared with the temperature of an olympic practice pool (~76 degrees Farenheit) is cool enough (though not as cold as many other reports) to trigger the so called "diving reflex" where stimulation of thermo-receptors in the skin triggers a vagal response that shunts blood away from the periphery and to vital organs.
Minimal surfactant damage and the diving reflex (as well as the patient's age) seem likely to some degree to have facilitated successful treatment of the patient.
References: https://www.ncbi.nlm.nih.gov/pubmed/22972044 https://www.ncbi.nlm.nih.gov/pubmed/10338105 https://www.ncbi.nlm.nih.gov/pubmed/9412612 https://www.ncbi.nlm.nih.gov/pubmed/9316679
So most likely the parents approached a university research group, or a research group was referred to them, and they did the study with the child at a later date following the initial treatment of the injury.
> An MRI scan a month after the 40th HBOT session showed almost complete reversal of the brain damage initially recorded. Researchers believe the oxygen therapy, coupled with Eden having the developing brain of a child, had activated genes that promote cell survival and reduce inflammation—allowing the brain to recover.
We can reverse brain damage. Wow.
I'm going to tell you that I have never been more glad to read Hacker News first thing in the morning.
I am sleeping in my mother's ICU room @ UIUC after she's suffered a subarachnoid hemorrhage causing substantial brain damage. This is coming with me to the ICU team huddle this morning.
Side note: if you're in neurological field or specialize in neurogenesis, please get in touch with me
I'm prepared for her to pass; she's in a coma and she's suffered brain damage, but I'm doing my best to advocate for her.
The time when I didn't know the extent of the damage (would my friend ever wake up) was terrifying. The thought of a decision I might have to make as "next of kin" was worse.
I feel for your situation. I'm sure you will do the best thing you can do. Happy to chat - email is in my profile.
From Wikipedia:
"A few small clinical studies have shown possible links between prescription of phenylpiracetam and improvement in a number of encephalopathic conditions, including lesions of cerebral blood pathways, traumatic brain injury and certain types of glioma."
Study in rats:
"In Wistar rats with gravitational cerebral ischemia, Phenylpiracetam reduced the extent of neuralgic deficiency manifestations, retained the locomotor, research, and memory functions, increased the survival rate, and lead to the favoring of local cerebral flow restoration upon the occlusion of carotid arteries to a greater extent than did piracetam."
I'm advocating for a continuous drip of heparin to protect against secondary brain damage from ischemic strokes post-SAH; whether this is safer then putting her into hypertension, I don't know yet.
I'm off to do more research.
don't forget the '...having developing brain of a child...' part, which might also be significant factor in the recovery process.
Cold water lengthens the survival time by two mechanisms. It triggers the mammalian diving reflex, which halts breathing and conserves oxygen by slowing the heart rate and moving blood to vital parts of the body. This response is stronger in children than adults.(14) An opposing “cold shock response” may predominate, which leads to a faster heart rate with potential fatal rhythm disturbances(15). This response also causes immediate aspiration and swallowing of water, which quickly cools the heart and carotid arteries leading to “selective brain cooling”.(4) A reduction of brain temperature by 10° C decreases energy consumption by 50% and doubles the duration of time the brain can survive without oxygen.(16) This “therapeutic” hypothermia is accelerated by surface cooling in children and small adults with higher surface-area to body mass ratios and less subcutaneous fat. Panic by the victim (breath holding and vigorous attempts at escape) and protective gear worn in cold water work against these principles and may prevent therapeutic hypothermia.
http://www.sitezed.com/an-analytical-look-at-survivable-subm...
Apparently if a child is very young, the water is extremely cold, and everyone involved is extremely lucky then crazy stuff can happen. (Un?)Fortunately this isn't something that happens often enough that we can get a lot of data on how the body can recover from stuff like this.
Impressive. I wonder if there are ways to force this level of regenesis in adult brains with less generative power and neuroplasticity.
I don't think there's anything sweeter to a human being than "here's your child back".
> she spent 15 minutes submerged in a swimming pool
This seems highly implausible, given she survived. Also, how would they know the moment she dropped in?
Further down:
> up to 15 minutes
Ah ok. From what I know, brain damage starts occurring even after 2-3 minutes without air (for adults), so I suppose it was rather on the lower end. Does anybody know a bit more about this?
It seems like a word flow thing.
EDIT: I'm referring to the fact that the title says the girl drowned, not that she was at some point "drowning".
It's no big deal, but I've also thought that if someone drowned it implies they died.
It usually leads to death but not always. You can end up with significant brain damage, due to oxygen deprivation, and still survive though.
"Clinical death is the medical term for cessation of blood circulation and breathing[...] It occurs when the heart stops beating in a regular rhythm, a condition called cardiac arrest. The term is also sometimes used in resuscitation research.
Stopped blood circulation has historically proven irreversible in most cases. Prior to the invention of cardiopulmonary resuscitation (CPR), defibrillation, epinephrine injection, and other treatments in the 20th century, the absence of blood circulation (and vital functions related to blood circulation) was historically considered the official definition of death. With the advent of these strategies, cardiac arrest came to be called clinical death rather than simply death, to reflect the possibility of post-arrest resuscitation."
That quote is meant to be funny, but with modern medicine it's also true. The girl's heart wasn't beating for 2 hours, which meets most people's definition of dead. She was given CPR and proper treatment, so the fact that she survived is not too surprising in this day and age. What's absolutely amazing that she recovered from brain damage due to oxygen deprivation. Hopefully this isn't just a fluke.
The evaluation of P -> Q happens independently of the speaker. If you're trying to refute P -> Q by mentioning an attribute of the speaker, you're necessarily answering some other question entirely, while making an excuse to ignore the original question.
You can say that someone making such an argument is more likely to be incorrect based on their beliefs, but that's still an untested hypothesis (more bluntly, a rationalization) until you actually sit down, stop making excuses, and verify it yourself.
Excuses aren't logic. You can say you don't have time, and that's valid, you can say you don't want to, and that's valid, but don't say you're doing logic. You're coming up with reasons to avoid doing logic.
Yes, of course untrustworthy people can make truthful claims! But you would still be wise to discount their claims (sometimes, under some conditions).
Evaluating arguments is, like everything else, subject to opportunity costs, so discussing the credibility of people making 'extreme' claims is certainly valuable.
But when you're on an internet board spending more time shouting down an argument for its source when it would take equal or less time to just figure it out - that is an excuse. It's also terribly non-conducive to a discussion.
"This guy says P -> Q, but he's not an expert on the matter of P, so I'll ignore anything he has to say on the matter" is not a logical argument. Correctness or incorrectness of the statement is being willfully ignored in this case.
You're right but the condition you mention doesn't apply here. This discussion is relevant to claims about therapies for reversing brain damage in people that (nearly) drowned. 'Just figuring it out' seems pretty difficult.
It's perfectly reasonable to discuss the credibility of people and there's no reason why that can't be conducive to discussion.
> ... is not a logical argument. Correctness or incorrectness of the statement is being willfully ignored in this case.
This is a little confusing and doesn't seem to match very closely to this specific subject. But whether or not dismissing someone's claim is a logical argument is just begging the question – why are you assuming that it's right or fair or proper for every claim or argument to be refuted logically? Are you literally demanding that everyone either (a) refute an argument logically; or (b) refrain from commenting at all?
Bad papers often have facially bad bookkeeping. Things like tiny sample sizes, no blinding, insignificant p-values held up as definitive, unlabeled graphs, conclusions that merely repeat the abstract... red flags that can be caught in a minute or two by anyone who knows how to interpret an academic paper, not necessarily a domain expert in the field.
Rather, people go to great pains to explain and rationalize away their lack of interest, rather than investing that same or less amount of time in actually looking at the paper (and probably learning something as a result - even if that "something" is better bullshit-detection skills)
It's reasonable to "discuss", sure, so long as all parties involved understand that the discussion is something unrelated to the thing being put forward. But that is usually not the case. Instead, those meta arguments are used to dance around pointing at any kind of concrete issues.
>Are you literally demanding that everyone either (a) refute an argument logically; or (b) refrain from commenting at all?
In a perfect world? Yes. "Authority" arguments are only one step removed from the bottom of the hierarchy [1] because they don't even attempt to touch on the central point. A serious, healthy discussion should never go any lower than the top three tiers, and discussion as a whole would be better for it if people strived to do that rather than reaching for the easy dismissal.
"This is crap because the author's conclusion has a sample size of one" is completely reasonable and logical. "This is crap because of the author's credentials" may or may not be true (unsubstantiated conclusion! red flags going off!), but at that point, you've ceased talking about "this" and started talking about the author. Hence, fallacious ad hominem. Diversion. Excuses. Whatever word you'd use to describe willful avoidance of the central point.
[1]:https://en.wikipedia.org/wiki/File:Graham%27s_Hierarchy_of_D...
In non-deductive arguments, like we have here, any claim (be it conditional or otherwise) certainly does not happen independently of the speaker or of what logicians call the knowledge base (KB).
Please don't make personal comments even when someone else has been uncivil. Your reply would be just fine without this.
Feel free to tell me I'm confused. Because I am.
This crosses into incivility. Please don't do that here.
We detached this subthread from https://news.ycombinator.com/item?id=14814687 and marked it off-topic.
If you are making arguments to authority, you are not doing a logical argument, period. You are making excuses to avoid doing logic. Is also not a personal attack, it is a statement of objective truth when you ignore correctness in favor of anything else.
That was a general statement and was not directed at tpatacek, and now this thread makes no sense.
> {informed comments}
A little off-topic but I see this so often I feel like I should mention this at some point:
I think you mean "disclosure" and not "disclaimer" (and most likely it's best if both are omitted and you just mention you're a neurologist).
"Disclaimer" means refusing to accept responsibility, which doesn't make sense when it's a preface to what looks like a comment based on expertise. If, on the other hand, you're really trying to say that you're refusing any responsibility for what you say, then the disclaimer should probably be something more along the lines of "I'm NOT {a qualified lawyer/neurosurgeon/whatever}", and not "I AM {a qualified whatever}".
It is kind of a polite apology that indicates "I know people here are excited, but as someone in the know, I don't think it is exciting. And I don't really mean to be a party pooper, but y'all need to calm down, because this is not that exciting. Seriously."
Lots of talented people get used to being hated on for being more knowledgeable than other people. It often fosters verbal ticks to cope with the social and emotional BS.
Edit: I couldn't even post this because I've been supposedly "posting too fast" when I've only had ~5 comments in the last day. Are you causing/influencing/related to this in some way? I had never seen this happen before but ever since our last conversation I have seen it happen twice, both when you have been around the thread.
Rate limiting is a crude tool, but it's one of the few mechanisms we have to try to prevent discussion quality from degrading. If you limit yourself for a while to comments that are substantive, not flamewars, and not generically off-topic, email us at hn@ycombinator.com and we'll be happy to remove the rate limit.
I suppose in addition you'd naturally hope for me to assume this was a totally unbiased decision not at all associated with the fact that I had recently criticized your treatment of another user immediately beforehand publicly, right? I was so happy I'd found a moderator who really seemed to want to treat people well and equally, and instead what I'm seeing now is a moderator who instead turns around and actively follows his critics to stab them in the back silently. Never mind the normal process of giving them a warning or some other signal that you think there might be anything wrong with their behavior at all.
And I'm sure you're going to claim this was a totally independent decision and not anything revenge-like on your part, which I'm supposed to again believe despite so much direct evidence to the contrary, and I'm sure you cannot comprehend how someone with good intentions could possibly think otherwise. Like you've said yourself before -- it's not like the dynamics aren't well-known. Shame on me and my naiveté for thinking HN mods would be able to take some criticism and treat a critic like a normal user instead of looking for a way to stealthily get e-revenge at the guy who gave it.
Edit:
Regarding "this subthread" also being off topic, which I just noticed -- I didn't recall that rule, so my bad on that. Now that I've already written this, though: like I said before regarding your moderation of the previous user: I would've expected a warning or some other kind of moderation that's like a normal treatment. Not a silent stab like this, especially given the surrounding context. It's extremely hard to view things generously when you moderate things you disagree with so harshly and unusually.
A colleague from Senegal (who didn't know how to swim himself) told me there were biological reasons as well (bone structure or something) but I'm highly dubious of that. I can believe that genetics can play a role in swimming proficiency but I doubt that it would prevent anybody from reaching very basic swimming skill levels.
It's like saying that black people run faster than whites, looking at the olympics it appears to be true but that doesn't mean that white people fall over when we attempt a brisk stroll.
> Disparities were greatest in swimming pools, with swimming pool drowning rates among blacks aged 5–19 years 5.5 times higher than those among whites in the same age group.
The reason it matters is because it is a fact. If you are a lifeguard at a swimming pool, research shows that you should spend MORE time watching after the black kids than the white kids. It's not about being PC, it is about keeping kids alive. If one group is more likely to drown, then you should know about it and spend more effort on it. Not pretend to be colorblind and increase the risk of causing deaths.
Theorises that segregation meant many POC never learnt to swim and then their fear of drowning (along with socioeconomic factors, of course) has lead them to keeping their children away from swimming lessons.
>A month ago, six African-American teenagers drowned in a single incident in Louisiana, prompting soul-searching about why so many young black Americans can't swim.
>When 15-year-old DeKendrix Warner accidentally stepped into deeper water while wading in the Red River in Shreveport, he panicked.
>JaTavious Warner, 17, Takeitha Warner, 13, JaMarcus Warner, 14, Litrelle Stewart, 18, Latevin Stewart, 15, and LaDarius Stewart, 17, rushed to help him and each other.
>None of them could swim. All six drowned. DeKendrix was rescued by a passer-by.
>Maude Warner, mother of three of the victims, and the other adults present also couldn't swim.
Then amazingly
>"Fear of drowning or fear of injury was really the major variable," says Prof Carol Irwin, a sociologist from the University of Memphis, who led the study for USA Swimming.
>In focus groups for the study, Prof Irwin said many black parents who could not swim evinced sentiments like: "My children are never going to learn to swim because I'm scared they would drown."
> Adjusted bone density at various skeletal sites was 4.5-16.1% higher for black than for white men and was 1.2-7.3% higher for black than for white women
Initially I thought that a bone-density increase of 16% would not significantly affect buoyancy, but the human body has relative-density of 0.98 compared to water... with a margin that narrow I can imagine that a 16% increase in bone density would tip someone to have a >1.0 relative-density compared to water - which then makes swimming difficult.
For almost any statistic you care to break down by gender or ethnicity there is greater variation within the group than between groups. By way of example, there is a greater variation of intelligence within men as a group than between men and women. That makes any statements about the intelligence of men vs women almost completely useless garbage. It certainly says nothing about individuals.
Perhaps someone may, at some point, attempt to use such a fact to justify their own subjective value judgment about something, and then you can address any potential racism associated with that.
People should not be discouraged from exploring, sharing, or understanding anatomical realities just because someone somewhere may use those realities to draw unfair conclusions. Address the unfair conclusion instead of trying to stop people from understanding themselves and their world.
Maybe nature will prevent a black person from reaching Michael Phelps-levels of swimming proficiency but I don't think it would prevent anybody from learning natation 101.
I don't think I'll ever win the 100m sprint at the olympics but I can definitely run 100m and probably faster than the average black person too.
I think you may be confusing fast twitch muscle density, as in the ratio of fast twitch to slow twitch muscles, with density as a physical property. As far as I know fast twitch muscles aren't any more dense than slow twitch muscles.
If the discussion were about a physiological distinction [+] sure. But this discussion was about social/cultural issues that specifically distinguish swimming ability rates among African Americans in the USA versus whites in the USA.
Which is interesting, because you can also see these distinctions, without racial differentiation, in groups world wide who do / do not live near large/deep bodies of water. But in the US case race is a larger determiner regardless of the physical environment. That distinction is interesting.
[+] A black friend of mine once said, "I can't swim -- I sink", a reference to the belief that people of African origin have less subcutaneous fat and therefore higher density, so swimming is harder. I have no idea if this physiological property is true or not but the belief is widespread. I have one white parent and swim like a fish. Everyone on that side of my family loves to swim. Hmm...
It's vestiges of jim crow era laws and mentality.
Edit to add: statistics apparently show that black children are more at risk to water fatalities.
The none-more dark ages?
First they install a permanent port into your bloodstream. Your kidneys aren't working, so after 2-4 days you're feeling bloated and your blood is full of various toxic metabolic by-products. You bum a ride to the dialysis clinic where they cycle your blood out of your body, run it through a filter, and push it back in, for hours. They try to be careful of your red blood cells, but some of them get smashed up in the machinery. They try to regulate the temperature of your blood as it gets returned to your body, but it's often too cold or too hot. You get very dried out during this process because you want it to last another 2-4 days, so you overdo it a little. You and the dialysis clinic want to get this over with as quickly as possible (they have other customers to schedule) so you have 2-4 days' worth of filtering to do in a few hours, which puts a lot of stress on your internal organs.
The #1 cause of death of people on dialysis is people deciding to quit because they'd rather die in the next few weeks than continue the treatment.
I happen to be a dialysis patient (just recently) due to a uncommon autoimmune disease harming my kidneys. Maybe 1 in 1500 chance of you having it but that is uncommon enough that doctors don't have a fully understanding of what exactly happens. There is no blood test or meaningful treatment. Through all my experience in the medical system we are truly living in the dark ages. Other than a few common classes of illnesses, they have no clue how to treat you.
Kidney disease doesn't seem to have much advancement in treatment because there is already some crude way to keep people alive. There are some efforts going on with artificial kidneys that fit in your body. One in particular https://www.ucsf.edu/news/2015/11/165666/artificial-kidney-r.... But I see it struggle to get funding over the years. I see every day shitty tech startups funded for 10x the amount in that project and produce nothing meaningful.
This is why you shouldn't even mention downvotes, however.