Dear Dad, With Love (repost)

This is a repost of my reflections on my father who passed away 13 years today. It took me 12 years to write the following eulogy and remembrance. While quite personal, I posted it here last year because I felt that my experiences were quite universal, shared by the families of the ten or twenty million alcoholics in the US and the hundreds of millions worldwide. Moreover, I wanted to provide a face for my colleagues who work in the area of substance abuse and a reminder for my clinical colleagues of the people behind those they may dismiss as drunks and junkies.

In becoming one my most most highly-read and highly-commented posts, I thought I would share it again this year, especially for the new readers who’ve come on board in the last twelve months.

This post originally appeared at Terra Sigillata on 12 March 2009.

Today marks 12 years since you died.

Well, it might have been today, possibly yesterday, I hope not too many days ago.

You see, you died alone in your apartment you rented from your sister downstairs. Yet no one checked on you as your mail accumulated Monday and Tuesday. One of your drinking buddies from the Disabled American Veterans post told me proudly at your funeral that he probably had with you your last beer that Saturday night. So, maybe it was the 8th or 9th?

When I think back, though, I believe you died some eight years earlier, just after your 50th birthday party. For your wife, my Mom, it was even long before that – she is a saint for staying with you as long as she did – no offense, Dad – and I know she still loves you no matter what.

Our family runs rich with depression and alcoholism but you died exceptionally early; my Dad – the young, fit, handsome fella you were in those pictures with little me at the Jersey shore, at home, or with me in that horrible Easter outfit – had died back then and was replaced for the last eight, ten, fourteen years by someone else.
dad and me 1966 515px.jpg
dad 04 Easter 1966 515px.jpg

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On the Origin of Witches, Broomsticks, and Flying

This post appeared here originally on 31 October 2007

Have you ever wondered, perhaps on 31 October, why witches are depicted as riding brooms?
The answer is alluded to by Karmen Franklin at Chaotic Utopia in her post as to why witches need to know their plant biology.
The excerpts I’m about to give you come from a superb and accessible pharmacology text entitled, “Murder, Magic, and Medicine,” by John Mann, host of the BBC Radio 4 series by the same name.

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Pandora Radio and the Music Genome Project (repost)

Science journalist, Steve Silberman, just brought to my attention that Rob Walker at The New York Times wrote an article that last week on the method behind Pandora online radio. The article, The Sound Decoders at Pandora, made me go back through my archives to my own visit three years ago with Pandora founder, Tim Westergren.
Tim, together with musicologist Dr Norman Gasser, has applied science to music by cataloging songs based purely on musical attributes (over three dozen criteria) and providing the listener with a program of music similar to one’s liking of a band or even a particular song. You can then tweak the system by assigning selections a “thumbs up” or “thumbs down” to further refine your “station.” The scientific part of this approach, termed the Music Genome Project, takes out of the equation all sorts of hipster hype and emotional aspects of music preference.
From Walker’s NYT article:
[Westergren] likes to tell a story about a Pandora user who wrote in to complain that he started a station based on the music of Sarah McLachlan, and the service served up a Celine Dion song. “I wrote back and said, ‘Was the music just wrong?’ Because we sometimes have data errors,” he recounts. “He said, ‘Well, no, it was the right sort of thing — but it was Celine Dion.’ I said, ‘Well, was it the set, did it not flow in the set?’ He said, ‘No, it kind of worked — but it’s Celine Dion.’ We had a couple more back-and-forths, and finally his last e-mail to me was: ‘Oh, my God, I like Celine Dion.'”
I was quite happy to read that Pandora is finally almost turning a profit. It couldn’t happen to a nicer guy or a greater group of people who are dedicated to the enriching role that music plays in our lives.
I wanted to run this repost because there are some aspects of Pandora that were not hit in Walker’s article. Most notable is the end of my post where I took Tim to Schoolkids’ Records in Chapel Hill, an independent record store that closed its doors in March 2008. I worry about how this trend of indy record store closures affects local music scenes in college towns and cities around the world. I hope that internet music sharing, iTunes,, and YouTube are still equalizing the field for the multitude of amazing local bands who never get a major recording contract.
Congratulations to Tim and all the lovely folks at Pandora for the new high-profile press as well as the great memories.

This post originally appeared here at Terra Sigillata on 21 September 2006.
This post should actually be called, “Driving Mister Tim,” in recognition of the delightful day I just spent here with Pandora Internet Radio founder and chief strategic officer, Tim Westergren.
Tim was in the area for a couple of town hall meetings and chats with groups in the Raleigh-Durham community, Duke University, and the University of North Carolina at Chapel Hill.
What is Pandora Internet Radio?
Before I talk more about Tim, let me tell you about Pandora if you have not yet experienced it. Their thumbnail give you a good idea but here is my view as a user: Pandora is a streaming music service that allows one to create up to 100 personalized “stations” based on your input of either a specific band or song. Then, while the player streams your song, it asks you for a “thumbs up” or “thumbs down” evaluation to indicate whether the song selected meets your needs.
Subsequent song selections come from what Tim calls the Music Genome Project, a mathematically-constructed taxonomy of a growing library of currently 500,000 songs. Your own “thumbs” to play more songs like this, or not, serve to train the data set for subsequent fine tuning of your station. Tim notes that Pandora has accumulated over 200 million thumbs in their evaluative data set, not only to fine-tune individual stations, but also to assess the accuracy of how their human musicology analysts classify songs.

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Personal reflections on a September 11th 9/11 hero

[Here is why I will always remember. This was posted here originally on 11 September 2006.]
Let me tell you about John Michael Griffin, Jr.
Griff, as he was known in high school, was a friend of mine.
Late in the first half of our lives, he stood up for me physically and philosophically, for being a science geek. John’s endorsement was the first time I was ever deemed cool for wanting to be a scientist.
Griff died an engineer and hero in the collapse of one of the World Trade Center towers five [eight] years ago today.
We lost touch almost twenty years before, but his kindness and friendship formed not only one of the cornerstones of the scientific life I have today, but in the person and father I have become as well.

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Pediatric cancer patient checks in at age 55; beneficiary of Dr Charlotte Tan’s actinomycin D work

gary grenell.jpgI love it when new readers stumble upon old posts.
Such was the case when I received the following delightful comment from Seattle-based psychologist, Dr Gary Grenell, on my April 2008 post about the passing of Dr Charlotte Tan, a pediatric cancer chemotherapy pioneer:

I was probably in one of her earliest actionmycin-D trial groups for Wilms tumor in 1957. Now at age 55, 52 years later, still going strong!

Most of you scientific youngsters today probably only know of actinomycin D as a laboratory tool for inhibiting RNA synthesis. But here in the following repost, learn about the bacteria-to-bench-to-bedside application of actinomycin D:

This post appeared originally on 4 April 2008.
Childhood cancer chemotherapy pioneer, Dr Charlotte Tan, dies at 84
Charlotte%20Tan.jpgActinomycin D was the first antitumor antibiotic isolated from Streptomyces parvallus cultures by the lab of 1952 Nobel laureate, Dr Selman Waksman, at Rutgers University. However, it took a young Chinese physician and the confidence in her by a future US Surgeon General for this natural product drug to positively impact the lives of children with cancer.

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Rave drug testing – public benefit?

A recent discussion with some of my neuropharmacology colleagues led me to go back through the cobwebs and revisit the Terra Sig archives for posts on drugs of abuse. The following was my third post ever and the first on actual scientific substance (the first two were introductions: a hello post and an explanation of what the heck Terra Sigillata actually is).

The following post appeared at the Blogspot home of Terra Sigillata on 26 December 2005.
Let me start by saying that the draconian US laws in the ‘war against drugs’ would ever prevent the following from happening here:
Sounds like a good thing to me: your kid is at a rave party and wants to experiment with some substance that you took blindly 30 years ago without thinking about twice. Fortunately, the party has a booth staffed by a staff of profs and grad students who are willing to anonymously run a sample of your stash through a Bio-Rad HPLC that has a library of comparative chromatograms for over 1000 psychoactive compounds.
Lucky for you, your kid’s dope is proper MDMA (methylenedioxymethamphetamine) but his buddy’s has paramethoxymethamphetamine (PMA), a compound that induces vomiting and potentially life-threatening hyperthermia. The lab gang notifies the DJ that some bad stuff is circulating, they drop the music a tad, and DJ Funkmaster Phenylethylamine tells folks the appearance of the dosage form (color, size, markings) to look out for.

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Celebrating Steve Blackwell at SteveFest ’09 and Florida Frontier Days

stevefest 09.jpgThis is for all of my peeps in SW Florida and all who love folk music. I received a lovely e-mail last week from Robin Leach, wife of mandolin player Dan Leach (and mother of bassist Andy Leach), who came upon my posts about a very special musician. Dan played with a gentleman named Steve Blackwell, a Midwestern transplant who came to the Sunshine State as a high school English teacher and became a fixture in the Florida folk music scene. My path crossed with Mr Blackwell in the months before his untimely departure from melanoma at age 58.
Yesterday, my friends celebrated Steve’s life and music in Charlotte Harbor at the second annual SteveFest. I love these people: “Coolers Are Allowed.” People joke with me when I say “Florida folk music scene” but it is indeed strong and a big, welcoming community. I’ve been traveling a lot lately and couldn’t get down this year but I’m really hoping to do so in 2010.
I detailed my connection with Mr Blackwell in this repost of my thoughts from the day of his memorial service. Mr Blackwell’s daughter and other former bandmates continue performing as Still Friends and were there yesterday. I hope that y’all had a great day!
[REPOST: The following post appeared originally on 9 September 2006]
Another reason I reposted yesterday on my Stetson Kennedy visit in January was to also note some bad news that came my way this week. Steve Blackwell, Florida folk guitarist and magnificent songwriter, lost his battle with malignant melanoma last Sunday. He was only 58. His memorial service will be this afternoon in Punta Gorda, Florida.
As I wrote in May of the first time I heard Mr Blackwell at the Stetson Kennedy Foundation inaugural event hosted by former NPR Morning Edition Host, Bob Edwards, with performances by Arlo Guthrie:

My admiration for Arlo Guthrie notwithstanding, the musical highlight of the night was the Steve Blackwell/Dan Leach duet of “Beluthahatchee on my Mind,” a song Steve wrote but has yet to record. Steve and Dan are stalwarts in the Florida folk music community and students of Florida folk legend, Frank Thomas, who also performed. Steve and Dan offered to meet with me on a subsequent trip to Florida to learn the song, but my schedule didn’t permit. Such is the kindness and openness of folk musicians.

Steve and Dan essentially drove five hours each way to be at Stet’s celebration to play one song. But Steve told me then that he wouldn’t have missed it for the world.
After serving on a grant review panel a few weeks later, the family Pharmboy went to southwest Florida for four days for me to reconnect with them. I had been corresponding with Steve and he and awesome mandolinist and singer, Dan Leach, offered to meet me at the weekly folk gathering Steve established in Punta Gorda to teach me “Beluthahatchee On My Mind.”
But, after spending the first day of family vacation in another grant review teleconference, it was felt that I should best spend the evening with my wife and daughter, who I had ignored in the weeks of frenzy leading up to my study section meeting.
As I get to Florida quite often, I figured that I’d always have another chance to catch up with Steve and play with him and Dan. In fact, we were already planning to come to Jacksonville/Fruit Cove in October for Stetson’s 90th birthday and I was certain that Steve would still be well enough to attend and for us to finally jam (note added: I ended up not making it due to a US Airways snafu but I at least had a chance to speak with Billy Bragg as a result).
Steve’s last post on his Steve Blackwell & Friends band site back in December documented his melanoma setback, interferon therapy, and even Dan’s own battle with colon cancer, of which I had been unaware at the time. Steve was always an incredibly upbeat guy, despite losing his house in one hurricane and having extensive damage in another.
This challenge, though, was too much to overcome.
Having lost PharmDad when he was also 58, I know some of the sadness and loss being felt today by the Blackwell family, especially his wife, Margie, and daughter and bandmate, Carrie Hussey. I also think of the grandkids, who may be too young to understand completely, and, of course, the larger musical family, students, and friends who knew and loved Steve.
Steve’s place in the Florida and national folk music community cannot be replaced, but his devotion to Florida natural history will survive in his recordings. His spirit of friendship, openness, and unassuming encouragement will also live on in those who had the honor and pleasure to play with him.
I’m so sorry to not have known him better but my life is much richer for having had this one snapshot of a memory of this musician and gentleman.

Diluting a Disease?. . .Or Deluding Yourself?

My clinical counterpart, surgical oncologist Dr David Gorski, has an excellent post up today at Science-Based Medicine on the irresponsible and misleading information being provided at The Huffington Post during the current H5N1/2009 influenza (“swine flu”) outbreak. The Huffington Post’s War on Medical Science: A Brief History” provides a cautionary tale for us in embracing web-based news sources as our excellent print newspapers are going by the wayside.
Within the post, Dr Gorski shows that he is even more familiar with my writing than myself by citing a post at the old Terra Sig on the last time the press proposed the use of homeopathy to combat the then-avian flu outbreak.
I am extremely concerned that a similarly misleading stories put forth by HuffPo’s “health and wellness” experts who lack any credentials in science-based medicine and are either authors of books on enemas or practitioners of the repeatedly-disproven practice of homeopathy. Among these stories and blog posts propose treating H1N1/2009 influenza with massage therapy, colon cleansing, liver cleansing, and detoxification.
Dr Gorski deals with these cases in a systematic manner but I specifically take issue with any “detoxification” protocol. I have yet to have an alternative practitioner tell me when challenged what exactly are the toxins for which we are being detoxified? Chemical structures? IUPAC names?
In my original field of drug metabolism and toxicology, detoxification referred to the oxidation, reduction, or conjugation of hydrophobic or chemically-reactive metabolites by enzymes in the liver, kidney, and elsewhere. I have never been given a satisfactory explanation of what “detoxification protocols” do for our bodies than what our intrinsic physiology of the liver and kidney already do for us.
Off soap box.
In any case, I thought I would unearth the post of mine to which Dr Gorski describes, when an article in Ode Magazine suggested that homeopathy might be used to treat avian flu. It’s fun to read the old stuff but I am also reminded that we keep revisiting the dangerous side of pseudoscience with this irresponsible journalism.

The following appeared originally on 18 Feb 2006 at the old Blogspot home of Terra Sigillata:

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Enjoy the Oscars

You can see all the stars as you walk down Hollywood Boulevard,
Some that you recognise, some that you’ve hardly even heard of,
People who worked and suffered and struggled for fame,
Some who succeeded and some who suffered in vain.
Celluloid Heroes, The Kinks, 1972

Star-generator hat tip: Pharmagossip
With gratitude to Johnny G. for taking me and T.P. to our first big concert, The Kinks at Nassau Coliseum, 1979-ish.

Lesson 1: Homeopathy is NOT herbal medicine (repost)

This article yesterday in the Wall Street Journal has led me to revisit and repost an old essay I had at the old place on 6 January 2006. The article addresses Oscillococcinum, an extract of the liver and heart of the Muscovy duck that is diluted so many times that, thankfully, it contains no duck organs but only water, and is then packaged into degradable beads. This product is sold by the French company, Boiron, to prevent colds and flu and you can find this stuff sold at Whole Foods and other “health” stores. There is even a children’s product by the same name but I have no idea how one makes a different “strength” of nonexistent molecules.
As you’ll read the repost below, homeopathy requires that you suspend belief in all concepts and principles of physics, pharmacology, and medicine. While the occasional paper will report a positive effect of homeopathy, all systematic reviews of the homeopathy literature suggest that these “remedies” are no more than expensive placebos. In the Laura Johannes article, we learn that even high-ranking physicians can fall prey to credulous thinking:

“If you take it when you begin to feel ill it really makes a difference,” says Robert Schiller, chairman of family medicine at Beth Israel Medical Center in New York. He recommends the homeopathic remedy to many of his patients, but still prescribes antivirals, particularly to patients at high risk for complications from the flu.

This gives me agita.
Here’s my repost:

I love Ode Magazine – much, much more often than not.
Today, I have a bone to pick.
In the aftermath of the 2004 US presidential election, I had to cancel my subscription to The Nation just because I got so depressed about negative news coming into every conduit of my house.
Ode is a Dutch-based mag that offers original and reprinted stories describing where people and ideas are working around the world to create positive change. From their mission statement: “We publish stories that bridge the gap between thinking and doing, between rage and hope, and the painful gap between the rich and the poor. By doing so we build peace and sustainability.”
Cool. A breath of fresh air when everyone is screaming at one another. And, largely, Ode succeeds. Until this issue, when I ran screaming from my mailbox like Steve Martin in The Jerk.
In the January 2006 issue, Kim Ridley offers an overview of homeopathy as “a healing idea whose time has come – again?” The article does wisely posit, “Is homeopathy a 200-year-old hoax, or a powerful paradigm for healing?” But the cover statement (above) that homeopathic remedies produced much higher survival rates than conventional medicine during the 1918 influenza pandemic is poorly substantiated in a related article. More disturbingly, an Indian homeopath who uses these remedies to treat cancer is quoted as saying, “The only things I don’t approve of are chemo and radiation.”
Together with surgery, I know of no two other modalities that HAVE been shown conclusively to produce long-term cancer remissions (I hate to use the word ‘cure’). Yet the article irresponsibly provides further details on how to seek this ‘healer’ who claims to have cured 80 percent of cancers over the last 10 years.
Homeopathy is a late 1700s/early 1800s practice of using extremely dilute preparations, largely of plant extracts and toxic metals, to treat diseases based upon the so-called ‘law of similars’. The philosophy that ‘like cures like’ was first espoused by a German physician named Samuel Hahnemann who took high, conventional doses of plant medicines, observed the symptoms produced, and then used extremely dilute versions of the same plant to treat diseases that produced similar symptoms. For example, the vomit-inducing syrup of ipecac is offered in an extremely dilute form as a homeopathic treatment for any disorder where the patient is experiencing vomiting.
Where homeopathy is most controversial is in the claim that a remedy becomes more potent as it is diluted. Even experts quoted cannot account for how this is scientifically possible, although some invoke a sort of “quantum physics” change in the structure of water. Hmmm.

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