Yesterday afternoon, a small black bear loped across Skyline Drive in front of Les UDs, who put on their brakes and watched him.

The bear watched Les UDs. Then the bear loped away.

We proceeded to park at Big Meadows Lodge and hike a bit and call La Kid back in DC to report the bear.

Mr UD insisted they eat at the dining room in the Lodge. Totally not UD‘s aesthetic (the open woody look is fine, but note the stiff-backed regimented chairs… and the curtains.. ), and she knew the food would be bland, but marriage is about compromise.

UD has fallen behind on a number of university stories, but she will now pull herself together and do a little blogging.

… and more recent memories of the shooter in Norway, people are finding events at Virginia Tech – a gunman was spotted on campus this morning – particularly unnerving.

Christa, our innkeeper, has hung mucho hummingbird feeders along our deck. As I stood out there a moment ago, one of the birds – weird, thrumming, gold-green – buzzed my head, wondering if it contained sugar water. I shooed it away before it could put a beak in my ear.

Below the deck Christa has planted blowsy stands of pink hibiscus… I’m seeing hydrangea in there too… Down the hill a butterfly garden with plenty of purple buddleja vibrates.

The sun is hot, but there’s a breeze outside. And inside. In our room, where we’re resting up after breakfast, a quiet ceiling fan rotates.

Very peaceful, in other words. Even the black bears, according to Christa, keep to themselves.

The view? Wave after wave of bluegreen mountains.

Adam, a 22-year-old junior with a double major in psychology and sociology at George Washington University, said he’s not sorry he left school in March to join the [Libyan anti-Gaddafi fighters]. He told his Libyan parents, who also live in Washington, about his plans only after he’d bought the plane ticket.

“You value things more and get a better perspective on life,” said Adam, sporting thick black-rimmed glasses, military fatigues and a bandana in camouflage colors. If he survives the war, he plans to go back to school to finish his degree and then settle in a free Libya.

… has died. Both immunologists, they worked together at the National Institutes of Health in the 1960s (UD‘s father spent his whole career at NIH).

I can’t find papers they co-authored, but they cited each other a lot. Benacerraf’s name, for instance, shows up as the last reference in this paper (UD‘s father is Herbert J. Rapp), “Heterogeneity of Rabbit IgM Antibody as Detected by C′1a Fixation.”

UD‘s been having rather trying summers lately.

True, she doesn’t teach during the summer, which means that her reading and writing time is her own. This fact alone makes her summers enviable from the point of view of most people, who have to go to workplaces.

On the other hand, last summer, as she prepared to go to her houselet in the hills of upstate NY, Righthaven came calling. No traditional birthday dinner for UD at Woodstock’s Bear Cafe. She had to stay home and deal with that.

This summer, which was going to involve a variation on the Bear Cafe birthday — an event at Peter Galbraith’s house in Vermont was planned — is also messed up, because she’s having surgery mid-August. Nothing scary, but she’ll need a few weeks recovery, etc.

Mr UD came up with the idea of their taking a little trip the week before the surgery, so today they drive to a bed and breakfast in Luray Virginia, where they will explore caves (this will impress you). UD will of course blog throughout the week.

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Longtime readers know that Les UDs – for reasons of Soltan family history – own a fifty-acre snail farm in Latgale, Latvia, not far from the town of Rezekne. (“It’s not a snail farm,” Mr UD just said, and indeed no snail farming goes on there; but someone imported snails to the property a long time ago, and they’re crawling all over the place, and someday maybe we’ll farm them, so I call it our Latvian snail farm.)

Time and priorities being what they are, UD has never spent a summer, or any other season, on the snail farm, but there’s a story in today’s news that reminds her she should visit the region.

Vilnius, Lithuania is a couple of hours away from the snails, and its mayor the other day took an armored vehicle and crushed a car illegally parked in a bicycles only lane.

… where the state Medical Practice Board is holding hearings into whether the director of the student health clinic “failed to supervise a physician’s assistant who was improperly prescribing prescription opiate medications to students.”

And dat ain’t all. Try to figure this one out. They’ve had to delay the hearing because a panel member has a conflict of interest. The conflict? This person “had participated in a related hearing involving a UVM health clinic employee that the board also was investigating.”

Since when is participating in a hearing related to the hearing you’re hearing a conflict of interest? And – okay – a second UVM health clinic person is also under investigation… But wait. Actually, the board’s executive director isn’t sure whether the COI “involved the [first employee’s] case or that of a third clinic worker, whose case did not result in the filing of formal charges.”

Got that? If I’m getting the math right, we’re talking about four student health employees who have been or are being investigated: The possibly negligent doctor, a physician’s assistant, and… two others?

Developing…

UD‘s old friend Jonathan sends her this update of the University of Northern Virginia story.

In a sort of echo of American University’s Richard Berendzen, who, when president of AU, boasted, in a series of obscene phone calls, about sex slaves in his basement, the “chancellor” of “the University of Northern Virginia” (both chancellor and university are fake, making this story less thrilling than it would be if UNV were something other than a visa mill with joke accreditation) has an actual bondage and discipline dungeon in his basement.

A commenter on The Smoking Gun website says it all: “It’s good to see he’s maintaining a healthy work/life balance.”

… The Faculty Lounges (as in takes it easy — because it’s tenured) wants UD to review it, so when UD gets her copy she will rouse herself from her tenured stupor, read it, and write a review of it for Inside Higher Ed.

The book’s Amazon page features several reviewers saying horrible things about tenured professors. Pretty much the nicest is “this self-obsessed caste.”

Texas has been breathing down the neck of the tenured lately. Tenure doesn’t fit the corporate model.

For my money, Richard Chait’s work on tenure is the best around (his introduction to this collection sets out the pros and cons nicely), but I’m looking forward to finding out whether Riley has stuff to add to the debate.

… colon.

A reader writes, in response to Jonathan Leo’s essay about ghostwriting (go here for a link to the original essay):

Oh dear. That article is not very well researched, is it? They mention the European Medical Writers Association (EMWA) as sanctioning the practice of thanking writers for “editorial assistance”. I take it they haven’t actually read EMWA’s guidelines on the subject, since they have totally misrepresented EMWA’s position, and also fail to cite EMWA’s guidelines in their references list.

Here’s what the EMWA guidelines actually say about “editorial assistance”:

“Vague acknowledgements of the medical writer’s role, such as ‘providing editorial assistance’ should be avoided as they are open to a wide variety of interpretations.”

Anyone who wants to read EMWA’s guidelines can find them here:
http://www.emwa.org/Mum/EMWAguidelines.pdf

Leo et al also use a rather idiosyncratic definition of ghostwriting. Most people would consider a ghostwriter to be someone who is not acknowledged, not someone whose role is transparently declared. Whether medical writers should be listed as authors is a legitimate matter for debate, but the debate is not helped by writing such an emotive and badly researched article.

(Conflict of interest declaration: I was one of the authors of EMWA’s guidelines)

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Jonathan Leo responds:

Scientific Papers with Unnamed Authors = Ghostwriting

We are happy that Adam has responded to our article as it gives us a chance to clarify a couple of issues, and to highlight one of the major points in our essay. Namely, that some groups in academic medicine are trying to find ways to allow the presence of unnamed authors to be involved with scientific papers – a practice which most people would call “ghostwriting.”

In his posting Adam says that we misrepresented the EMWA stance on the appropriateness of thanking editorial assistants and he cites the EMWA guidelines. However, when we mentioned the idea that the EMWA condones the practice of mentioning editorial assistants as a way around ghostwriting we did not have the 2005 EMWA guidelines in mind, but instead had Adam’s 2007 editorial in mind where he does sanction this practice. We should have been clearer in our essay about this. We did assume that when he wrote his editorial that he was speaking in behalf of the EMWA. If he was not, then we apologize.

Adam’s 2007 Editorial

The story behind his editorial starts back in 2006 when Charles Nemeroff and his colleagues published a paper in the journal Neuropsychopharmacology. Their review article concluded that a useful treatment for depression was a vagus nerve stimulator manufactured by Cybertronics. The journal Science discussed charges that the article in question was ghostwritten because one of the main authors of the paper, Sally Laden, was not mentioned in the byline. Laden was also paid by Cybertronics. Adam’s subsequent editorial was very critical of the Science article and took the same dismissive tone with Science that he has taken with our paper. He has also taken this dismissive tone in the comments section of the BMJ and PLoS Medicine. In his editorial he never argued about the facts behind the Vagus nerve paper, Laden’s role, or who her employer was. The major point of his editorial was that the paper should not be labeled as ghostwritten because Sally Laden was mentioned in the acknowledgement section, and this is why we mentioned the EMWA. In his defense of Laden’s role he says:

“In fact, Ms Laden’s role, and the fact that the authors maintained final control over the content, were reported in the Acknowledgements section in these words [3]: ‘We thank Sally Laden for editorial support in developing early drafts of this manuscript. We maintained complete control over the direction and content of the paper. Preparation of this report was supported by an unrestricted grant from Cyberonics, Inc.’”

And just last year in a discussion about the most famous ghostwritten paper of all time, Study 329, Adam again used the “editorial assistance excuse.” In his words, “It’s also not accurate to describe this as a ghostwritten article, as I see that Sally Laden was acknowledged in the published version.” Yet, in this article, Laden was simply acknowledged for her editorial assistance. Our take is that Sally Laden should have been listed in the author byline of both the Nemeroff paper and Study 329. This is not really a very profound, or earth-shattering idea, nor do we think it solves the major problems in medicine with undeclared conflicts of interest. It just seems to be simple common sense.

EMWA Guidelines

We are glad that Adam has brought up the guidelines and we are happy to address those here. At one point in the EMWA guidelines they say, “The involvement of medical writers and their source of funding should be acknowledged. Identifying the writer, either as an author or contributor or in the acknowledgements section.” To us this seems to suggest that EMWA believes that mentioning editorial assistance in the acknowledgment section is considered acceptable. Later in the document, they do say, “Vague acknowledgements of the medical writer’s role, such as ‘providing editorial assistance’ should be avoided as they are open to a wide variety of interpretations” but it is important to point out that the EWMA is still trying to find a way to have unnamed authors on papers. Instead of using the term “editorial assistance” they are simply proposing another term. In their words: “We suggest wording such as ‘We thank Dr Jane Doe who provided medical writing services on behalf of XYZ Pharmaceuticals Ltd’.” However simply changing the term of “editorial assistance” to “medical writer” is just another way to keep deserving authors off the byline.

The acknowledgement section is traditionally seen as a spot to mention people who don’t rise to the level of “author” – for instance, colleagues who looked at the paper and made comments, a grammar guru who tweaked the composition, or Mom and Dad who provided the necessary motivation. The EWMA seems to be doing their best to figure out a way to include deserving authors in the acknowledgement section – something we have previously referred to as “an academic sleight of hand.” It is not that we are against the term “editorial assistance,” it is that we are against leaving a deserving author out of the byline. Keeping them in the acknowledgement section but calling them something else is just a way to sanction ghostwriting. What we should have said in our paper is that simply mentioning authors in the acknowledgement section as editorial assistants or medical writers or any other term is not a solution.

Legitimizing Ghosts

At the end of Adam’s posting he says that whether medical writers should be listed as authors is a legitimate debate, but why should this be considered a legitimate debate? If academic medicine allows papers to have unnamed authors, as Adam is saying, then they are sanction ghostwriting. Shouldn’t the ICJME just require that writers of papers be listed as authors? We did point out that we think ICJME has a loophole that can allow ghostwriting, but we don’t think their intention is to condone the use of unnamed authors, and we don’t think they are debating whether this should be allowed.

The Twilight Zone

This is a very weird discussion. It seems to us that we are the ones calling for increased recognition for a group of very bright and skillful people. Rather than be hidden in the shadows we think that their skills and intelligence should be given the credit they deserve by rising to the level of authors. Medical writers do provide a very valuable service and there is no reason they should not be used but why not list them as authors? Sally Laden is surely one of the brightest and most prolific people in the scientific literature yet a pub med search would not reveal this. Yet, for our efforts, this group’s spokesperson attacks us on the basis that his group is not deserving of this credit. Welcome to the world of academic medicine. Adam has taken on the task of attacking anyone in the medical literature who suggests that writers should be called authors. But he seems to be leading his organization down a path that we are not sure his constituency wants to follow. If he is not careful his organization is going to become the EMGWA -The European Medical Ghost Writers Association.

!!!!!!!!!

Harvard University’s Joseph Biederman, world’s biggest bi-polar diagnosis booster, is making life a little difficult for his psychiatry colleagues at Mass General. Short version: You don’t want to be too closely associated with his antidepressants-for-tots drive, his undisclosed financial conflicts of interest, and his influential insistence that zillions of American children, teens, and adults are bi-polar.

So let’s say you’re Harvard’s Andrew Nierenberg, and you want to light into Marcia Angell because you’re pissed that she’s down on antidepressants. Of course, you concede in a letter attacking her arguments, it’s “heart-breaking” that there have been some cases in which nightmarish damage was done to children who were over- or mis-prescribed these very powerful drugs… But a case here or there should in no way lead us to suppose that the harmful dispensing of such drugs is a serious trend.

In her response, Angell points out the enormous influence Harvard, and Nierenberg’s colleague there (Joe), had on all those MDs giving all those children drugs. Biederman was – is! – the bi-polar man; he is almost singularly responsible for the astonishing inflation of pediatric bi-polar diagnoses and treatments in the United States in the last few years. Nierenberg co-authored papers, etc., with Biederman. Hence it’s a little on the disgusting side for Nierenberg to lecture us on the heartbreak of mis- and over-diagnosis without at least alluding to his own profoundly influential hospital’s financially compromised advocacy of the diagnosis.

Angell:

Nierenberg refer[s] to the death of Rebecca Riley, who was diagnosed with bipolar disorder as well as ADHD when she was just two years old, as a “tragic anecdote.” While that is true, I believe it should also be seen in the context of the extraordinary epidemic of juvenile bipolar disease that was stimulated largely by the teachings of some of Dr. Nierenberg’s colleagues [Biederman and two others] at the Massachusetts General Hospital. Three of them were recently disciplined by the hospital for not having disclosed some of their hefty payments from drug companies.

UD‘s advice to Nierenberg: Be like Australia. Distance yourself.

… Or maybe they feature a nature poem or something… Moving us up up and away, for a day, from the earthy immediacy of politics, corruption, conflict. But UD, at least this Sunday, seems to have started in on sex, so allow her to continue.

A public painting – it’s on a much-trafficked street corner in Taiwan – is generating some controversy and also some stupidity.

Here’s the painting.

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First, the stupidity.

In response to nearby residents complaining that they don’t want their kids having to walk by it all the time, the museum director explains that “nude does not necessarily represent sex.”

True. But sex represents sex.

In response to people taking offense at the political content of the painting – Taiwan’s getting fucked by China but cynically doesn’t mind – the artist (a professor at Taipei National University of the Arts) said that “the paintings [this one’s part of a series] were simply an expression of esthetics and that critics were overreacting.”

You don’t get to paint a political satire and then, when people get upset, say it’s a Jackson Pollock.

As to the controversy: Neighbors have a point about the public nature of an image this explicit. And in fact the painting will soon be moved to the museum’s interior courtyard.

On the business of the message upsetting people – well, yes, it would. But political art often wants to provoke in just these ways in order to prompt viewers to reexamine certain attitudes, etc. Nothing wrong with that. The artist, and the museum director, shouldn’t be coy and evasive. They’ve chosen to create and present provocative political art, and so be it.

… UD managed to wedge in, as a subject of conversation last night with a tableful of old friends at Cafe of India, a university issue. Maybe not the world’s biggest university issue, but one of interest, worth thinking about, etc.

UD‘s friend Bill had earlier that day sent her Public Radio about Adam and Eve, an online sex shop (toys, films) which is among the many financial contributors to the University of Minnesota’s Sexual Health Education Chair.

Joycelyn Elders, the US Surgeon General for whom the chair is named, writes: “The most common cause of poverty is children being born to children. Sexuality makes up such a great part of our lives, and yet we spend so little time talking about it, teaching about it, and educating our young people about it.”

The public radio guy is way shocked that the university accepted money from the porn biz. He interviews the head of the sexuality program, who says this is a responsible, law-abiding company that already sponsors a variety of sexual education initiatives. As to whether hardcore porn, as the reporter puts it, “distorts a person’s view of sexuality,” the program director says that “many individuals and couples enjoy erotica as part of their healthy sex relationship, and we have evidence where that can be helpful. We’re also aware some people get lost, and we treat people who have problems with internet pornography. It’s just like gambling. … This can be used responsibly or irresponsibly. Fortunately, the gaming industry devotes a lot of effort to helping people learn .. and … promote responsible use, and that’s what [Adam and Eve’s] intention is as well.”

The consensus at Cafe of India? Bad idea. Embarrassing for the university. “Universities,” one diner remarked, “are supposed to operate on a higher level than other institutions. This lowers them.”

Other diners were yet more disapproving. “Pornography is disgusting. It demeans women beyond belief. It’s terribly socially destructive. I don’t watch it. Ever. For a university to align itself with this industry is unconscionable.”

Well, UD brought it up last night because she ain’t so sure.

Comments welcome.