Vol. 259 July 1, 2021 Jargon Update Etc.

“True, it’s not over till it’s over.
And even when it’s over,
it just begins again.” — Kate McGahan

“Supervised Consumption Site”  sounds like it’s my kitchen table, but it’s a public center where people can consume illicit drugs with medical supervision as an innovative way to prevent overdose deaths. The city of Somerville, MA has been exploring this concept since 2019 and may be the first of two pilot sites in Massachusetts. Other attempts at this have failed in New York and Philadelphia, but the Somerville mayor is optimistic about their feasibility study just underway.

Gender Ideology, aka “identity politics”: a derogatory term for the proposed policies of the defenders of transgender rights. The difference between sex and gender identity has been vexing us for years. The word “transgender” first appeared in the 1990’s.  By 2018 the AMA adopted a policy of educating its members on the “medical spectrum of gender” and “that gender may differ from sex assigned at birth”. Modern technological developments as well as political, bureaucratic, and legal demands have increased the desire for clear-cut answers on this issue in criminal cases and the cultural ideal of marriage, . . . . and it ain’t getting any easier. “What counts as sex and gender is historically changeable, morally infused, and politically loaded.” (NEJM March 18, 2021)

Marijuana, NO; Cannabis, YES:  Some progressive marijuana industry people consider “marijuana”, originating in the Mexican Spanish language, as “racist’ and a device to label it a “Latino vice”. “Weed” and “pot” which imply “negligent and abusive behavior are equally unacceptable”. “Cannabis” is THE word.

Where Were Thee, Flu?   From September 2020 to May 2021 the U.S. recorded only about 2,000 flu cases instead of the expected average of 206,000 cases. Did the flu virus not evolve from 2019 as usual? Is it because we were all (or almost all) wearing masks and washing our hands frequently? Did the coronavirus compete with the flu virus, and win? Will next year’s flu epidemic be even milder? As one virologist said, “We’re in uncharted territory.”

Gain 7 pounds or Die Earlier?   A study of 17,000 smoking and non-smoking adults in Australia showed that those who quit smoking gained an average of 3 kg (nearly 7 lbs) over 6 years, BUT quitters had a significant reduction (25-33%!)  in deaths by all causes compared to those who continued to smoke. (JAMA Apr 1, 2021)

Medical AI, Artificial Intelligence, “Machine Learning”  The blush is off the rose of AI in medicine because of how machines learn and how artificial intelligence develops. Medical AI is created by feeding vast data bases of patient information into computer black boxes that recognize and spit out patterns, previously unseen, which could shed new light on both diagnoses and treatments. The first problem with medical AI is that algorithms (secret computer code instructions)  are proprietary, unavailable for peer review, and no one is really quite sure how they actually work. The second problem, recently discussed in detail, is that the data bases inputted into the black box contain all sorts of racial, ethnic, and socio-economic biases that are just now being appreciated. As a trivial example: if you are a white person living in an urban zip code that is mostly black , and you don’t have a mortgage on your house, an AI program might calculate that you are at the black persons’ higher risk for high blood pressure because the data base wrongly assumes you are black.

Oat Milk  A Swedish company (Oatly) making this plant-based product just raised $10 Billion on their initial stock offering. Oat milk is plant-based (very trendy) but is highly processed (not so trendy). Is the company worth that, and is oat milk healthier than cow’s milk? Critics call it “as healthy as Coca-Cola” since it contains 30% more sugar than dairy milk (but still considerably less than Coke). The sugar is maltose rather than sucrose, but “sugar is sugar” according to most nutritionists. It has the same number of calories as 2% cow’s milk. Its “milky richness” is from canola oil which is NOT a trans fat, and that’s good. (This Week June 4, 2021, pg.31)

Supreme Court Upholds Obamacare, Again   By a vote of 7-2 the Supreme Court (SCOTUS) dismissed a case brought before it by Republican governors trying to kill the whole Affordable Care Act since Congress in 2017 reduced the mandated penalty for having no insurance to zero. This is the third major attack on Obamacare that the Supreme Court has rebuffed. “The ACA is here to stay for the foreseeable future’” said Larry Levitt of the non-profit Kaiser Foundation. (Assoc. Press, June 18, 2021)  POTUS noted that  31 million people currently have health insurance under Obamacare.


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