I know of a guy who got his undergrad degree at Portland State University, his medical degree at Imbler Health Sciences University (class rank #1) and now is doing his residency in anesthesiology at Harvard. Though he is an extreme case, I know plenty of people like this. What interests me, what about the people who move down in prestige? I think that this sort of transition is a good clue as to how important being a legacy, or person of privilege, is. Note below that New England blue-bloods Dean & Kerry went to one of the elite institutions in the country as undergrads, but made the transition for graduate level (professional) work at schools of lesser status. Contrast this with Wes Clark, who went from the US Military Academy (good) to Oxford (great). Edwards went from NC State (OK) to UNC (good). Lieberman, unlike Kerry or Dean the product of public schools, went to Yale, but stayed on to get his legal degree from Yale Law School.

John Kerry
Undergrad: Yale
Law School: Boston College

Howard Dean
Undergrad: Yale
Med School: Albert Einstein

Wes Clark
Undergrad: US Military Academy
Master’s: Oxford

John Edwards
Undergrad: North Carolina State
Law School: University of North Carolina

Joe Lieberman
Undergrad: Yale
Law School: Yale

Posted by razib at 02:36 PM

Head over to Paddy O’ Tater-tot to cast your vote for your favorite bloggers in the Blogger Animal House casting call.

Posted by TangoMan at 07:23 AM

For South Asian readers, I suggest this article on the nuances of caste, culture and history (yes, I know it is on a site that promotes Hindutva, but whatever the intent of presenting this article [Hindu unity], the facts, or at least the caution thrown over age-old preconceptions, seem correct from my readings of history & genetics).

Posted by razib at 01:15 PM

Here is an interactive guide to help you determine which Democratic or Republican candidate best matches your preferences. Fun little tool.

Posted by TangoMan at 07:04 AM

NEJM just published an article concerning research that should be familar to all those who read Bailey’s The Man Who Would be Queen. Here is the link: Discordant Sexual Identity in Some Genetic Males with Cloacal Exstrophy Assigned to Female Sex at Birth

Here is a news report:

In a new twist on the age-old question of nature vs. nurture, Johns Hopkins scientists following 14 boys who were surgically altered as infants and raised as girls found that the majority grew up identifying strongly as males.

Some of the patients spontaneously took on boys’ names and began wearing male clothing before anyone told them the circumstances of their births – while others decided to live as boys once they found out.

Warning against sweeping conclusions about the foundations of gender identity, the researchers noted that the study was limited to boys who were “assigned” to the female gender because of a severe birth defect involving the abdominal organs and penis.

But the doctors said their finding casts further doubt on a theory, made popular in the 1960s by a Hopkins sex researcher, that gender is largely a function of how you look and how you’re raised….

As a group, the patients ranged in age from 5 to 16.

Five of the patients were happily living as girls when questioned. Three were unclear about their sexual identity, though two had declared themselves as male. The remaining six had reassigned themselves, taking on boys’ names and dressing in masculine clothes.

“Even though mom and dad had told them they were girls and they had girls’ names, they still always felt they were male,” Gearhart said. In two cases, the patients had begun to live as boys before their parents told them the truth.

One child who had grown up feeling like a boy fought the doctor who tried to inject him with estrogen, a treatment designed to spur development of breasts, soft hair and other feminine traits.

“They tried to hold her down but that wasn’t possible,” said Reiner. “The endocrinologist was exasperated and said, ‘Why are you making it so difficult to give you these estrogen shots?’ “

“I’m not a girl. I’m a boy,” was the patient’s reply.

Posted by Thrasymachus at 03:43 PM

Reading this post by Godless on healthcare fired off some neurons in my brain about a proposal made in 1984 by Governor Richard Lamm of Colorado – the elderly have a duty to die.

I remember watching Lamm on 60 Minutes as he made his case and I followed with interest the firestorm that ensued afterwards. He spoke an unacknolwdged truth that people just didn’t want to hear, much like the issues surrounding Human Bio-Diversity.

Here is an excerpt from an interview:

Lamm advocates age-based rationing of healthcare as a way to curb costs, because he views the aging of the population as the principal cause for those increased costs. He also wants an end to any more age-based benefit programs. Says Lamm, “Of course we have more of a duty to a 10-year-old than to a 60-year-old. Common sense says we should reserve the expensive medicines and technology for those who have the chance of a longer life.”

He set out a scenario of future intergenerational warfare, where the young and middle-aged, would be paying for an extensive, and expensive, health care regime for the elderly, because the elderly had more political clout, while at the same time increasing numbers of children couldn’t even get immunizations.

The macroeconomic conditions that precipitated Lamm’s comments back in 1984 are still existent today. As noted in Trickster’s post at tactitus health care now accounts for 14.1% of GDP and last year’s health care inflation grew at 7%. How long can health care costs grow faster than the economy as a whole before some type of rationing will have to take place?

Lamm was primarily concerned with Medicare:

He worries, “There is something terribly inappropriate about a society which does not even provide basic health care to millions of people and yet amends its Medicare regulations to pay for heart transplants, a number of which go to the wealthy elderly.”

Lamm’s concern was with the actuarial soundness of Medicare:

This year, Social Security and Medicare will account for 6.5 percent of gross domestic product (GDP). By 2030, those programs will grow to 11.0 percent of GDP. Moreover, the number of beneficiaries will grow much faster than the number of workers paying taxes to support those programs. The ratio of covered workers to beneficiaries will drop from about 3.4 this year to about 2.3 by 2030.

We must live in tamer times for I’m not coming across reform proposals that are as radical as Lamm’s. But then again the growing prominence of the right-to-die movement may be the slippery slope towards utilitarian life & death decisions that critics fear. For that is what Lamm advocated:

Lamm suggests that healthcare rationing be reconfigured on a utilitarian basis: in such a way that the greatest possible number of people receives the greatest possible amount of healthcare. Lamm advocates a healthcare rationing system that would provide the greatest good for the greatest number; he wants to “buy the most health care for our society.”

Of course, who makes those utilitarian decisions is left unmentioned. The fears are that bureaucrats or carved in stone regulations will be cutting short people’s lives. But then again is that necessarily worse than HMO administrators denying treatment?

What I think bothered Lamm the most was the HUGELY expensive treatments for the critically ill patients that only extended their lives for a period of months. There was no price rationing mechanism when analyzed with respect to the Hippocratic Oath. The immediate concern of the physician is the patient before him and it’s very difficult to assign value to the hundred thousand dollars expended on extending a 75 year old patient’s life for 2 months and then comparing the value that could be gained by denying such care and instead making the funding available to school children who are uninsured.

A major benefit of free-market health care is the vitality of the system and the diversity of choice available to patients and practitioners. Because Medicare is not based on a free-market model there is no checking mechanism to insure an overall societal good. Does the size of a voting constituency necessarily indicate the best decision? How come the elderly insure their selfish well-being via benefits to Medicare but allow some of their collective grandchildren to go uninsured?

What is to be done? The system is not firing on all cylinders for it cannot be efficient to have children be ill, and possibly have life-altering consequences from those illnesses that will affect them for the remainder of their lives, and impact on their economic and personal contributions to society, while at the same time devoting resources to a dying person.

If the answer is to find utilitarian value in these life & death decisions then this will play towards centralized decisionmaking and regulations which are inherent characteristics of socialized medicine (Medicare.)

Of course, the market could solve the problem of intergenerational health care issues by prohibiting intergenerational wealth transfer via taxation. If people had to pay for their own health care premiums and they could chose different policies based on life-time medical cost caps then the market could most efficiently arbitrate what may come to be a future problem.

It may soon come to be that life extension technologies will become so expensive that the net assets of a patient may not be sufficient to cover the cost of treatment and the tempation for drawing more from society than one has contributed will be an irresistanble impulse, for one’s life itself will be at stake. The sharing of risk via insurance will become moot for every person will incur this cost rather than a statistical sample from the population, thus voiding the risk amortization principle.

I thought I’d offer this topic up for discussion because I wanted an excuse to practice posting (so I ask your forebearance if there are formatting errors.) I’m not usually concerned with health policy – my main interests are energy policy, space policy, demography and foreign policy. I hope to be posting more in the future.

David Franke writes about Dean for LewRockwell.com:

To me, he’s the Barry Goldwater of our time – that rare politician who speaks his mind honestly and passionately, without regard for the polls and the political technicians, and often too bluntly or clumsily for his own good. That doesn’t make either of those two men the ideal politician or presidential candidate, but it sure endears them to me on a personal level. It is rare to find a politician who is not scripted. As a right-wing libertarian, I disagree with Dean on virtually every issue, including war (I go further than he does), but I would feel safer with him in the White House than with any of the standard-issue politicians in either party. He could be counted on to repeatedly make the “mistake” of leveling with me and the rest of us, rather than lying and concealing. It’s in his nature. He hasn’t been reconfigured by living or working in Washington, DC.

Which brings us to that “awful” thing he did in his concession speech in Iowa. Am I the only person in America who can’t comprehend what was wrong with it? It was a pep rally with his followers, for goodness sake, and he was letting them know they weren’t going to accept this as a defeat and how much he appreciated what they had gone through together. It wasn’t a tirade of a mad man, it was a real man caught up in the moment, and bonding with his mostly young and very enthusiastic and idealistic fans. As a native Texan, I even liked the whoop at the end. Heck, we whoop more than that at the contra dances I go to every weekend.

Personally, I am more worried that Dean is a liberal nutcase, but I can see what Franke is getting at.

Posted by Thrasymachus at 09:22 AM

OK, follow-up on the dialogue that Abiola & I have been having. On many points of fact, we don’t disagree. For instance, I suspect we would agree on the following:

1) The early period of Judaism was characterized by a tribalistic faith, henotheism, rather than monotheism.
2) These West Semitic peoples were likely a coalition of tribes, with latecomers (for instance, the tribe of Dan), and not characterized by racial or ethnic awareness as much as cultural differences (Solomon married pagan women-but it was their heathenry rather than their ethnicity that was problem, see Ruth as a contrast).
3) Between 500 BCE and 500 CE a lot of varieties of “Jews” existed. It is possible that at one point 1 out of 10 inhabitants of the Roman Empire were Jewish, probably through conversion. The conversion of non-Jewish kings to Judaism was common-place in the “market-place” of religions, the family of Herod being a famous example, but others include the Jewish kings of Yemen.
4) Judaism existed as various affinal movements that are well known to us today (Pharisees, Sadducees and Essenes for instance). Others are less well known, for instance, the Hellenistic Jews and the “God Fearers.”
5) During this period, the “ethnic” identity of Jews was more cultural, and through the process of conversion, which entailed circumcision for men, one could become a part of the Jewish people. The Emperor Domitian made proselytization a capital crime for Jews likely because his own family members had converted (his older brother, the Emperor Titus, had a Jewish mistress).
6) The rise of the “daughter faiths,” Islam and Christianity, changed the Jewish religion and culture greatly. While the more “liberal” and “integrationist” forms of Judaism melted away (it is likely that Hellenistic Jews and “God Fearers” were prime candidates for Christian conversion), Rabbinical Judaism, now known as Orthodox Judaism, remained as the primary minority religion within Christendom & the Dar-al-Islam.
7) The various cultures that Judaism was formed under has had a big impact on transforming the tribal henotheism of the 8th century BCE into the tribal ethical montheism of the 8th century CE. The influence of Zoroastrianism is famous, while practices like matrilineal descent were probably picked up from Romans. It seems that the ideas of the afterlife that Jews like Maimonides espoused were influenced by the Greek, Christian and Muslim traditions.
8) At various points, Jewish groups became sharply reduced in number through forced conversion, and the injunction by the majority communities to not proselytize became part of custom & tradition, and a very important one for group survival. This resulted in the isolation of Jewish groups genetically from the surrounding population. For example, it seems that the Jewish Yemenite population does not have much black African mtDNA, and this might be the result of the fact that by the time of the major importation of slaves began during the high Islamic period, they had already been sealed off by marriage from the surrounding society (Jews might leave through converison, but no one entered the faith).
9) Between 1000 and the modern era, the vast majority of the world’s Jewry existed in communities where a relationship with a dominant religious ethos was important, whether that be Roman Catholic, Eastern Orthodox, Muslim or establishment Protestant.

At this point, I will go on to make a few assertions that are more tenditious. Read more below….

Here is the ADL’s ire at Southern Baptist attempts to convert them:

The campaign launched by Southern Baptists to convert Jews to Christianity is an insult to the Jewish people and a setback for the cause of interfaith dialogue and understanding. We are very sad that emphasis would be placed on converting Jews rather than promoting a common ground and discourse between all faiths.

The ADL is a caricature of the modern American Jewry, but that allows us to examine in more detail the gross features of the American Jew and their outlook toward the world. I bolded a few points, note the constant switch between the conception of Jews as people (ethnos?) and a religion. Substitue “people” with “religion” and I think it seems a far less injurious “insult” for most Americans, after all, it is accepted that in our market-place of faiths individuals can convert from one religion to another. The ADL seems to be saying that to convert a Jew from one religion to another is somehow an insult that person’s ethnicity (ethnicide?)! Additionally, try and map this to the Christian context, it is simply strange to speak of the “Southern Baptist people.” It is interesting to note that traditionally Jews of no religion have been far more accepted as “Jews” than Jews of another religion (see here, page 20 of the PDF). It is a banal observation to say that Jews are both a people and a religion.

I believe this situation is somewhat problematic for Americans to understand. This is a culture where switching religions is common-place, where churches compete for followers, and individualistic tailored spirituality is the norm. The Jewish conception of an organic whole of religious peoplehood seems archaic, and it should, because I believe it was formed in a very different context, that context being pre-modern Europe and the Middle East.

Prior to the Protestant Reformation, and the eventually dominance of the conception that religion was a personal choice, Europe was nominally under the Universal Catholic Church. There was a schism between the eastern Church and the western Church, but within their own spheres, the two behaved in similar ways and evinced the attitude that they were the One True Church. Before the conversion of Constantine, Christians were a self-selected minority, strong in their faith. After the barbarian invasions, the model of Christianization became different, as elites were converted, while the masses were nominally baptized, but de facto pagan. Each priest has his “flock,” but the flock was simply an administrative division in the Universal Catholic Church-which was a monopoly elite faith. Until the Protestant Reformation it might be asserted that much of Europe was pagan on the ground. A historical survey of the early medieval period shows that bishops and notables were aware of the explicit paganism practiced by their serfs, but salvation was attained by a people, not through individual faith, so only the very devout would attempt to instruct their dependents on the One True Religion.

In this context, the idea of a Jewish people and faith makes sense. The Catholic Church had an ambivelant relationship to the Jews, as did the Muslims. Both groups agreed that the Jews had some relationship to God, but they asserted that their’s was the true faith. Though the Catholic Church was implicated in some attempts to convert the Jews to Christianity, in general it tended to grudgingly support the Jewish wish to continue existence as a separate religion and people (in fact, there is evidence that anti-Jewish pogroms were most effective where church and state power were fractured and weak, for instance, the Rhineland). The Church and the State had a relationship with the local Jewry as corporate entities.

Move forward to the 21st century, the United States. The Church is fractured, and resembles more the jostling of businesses attempting to win clients, while individual choice is paramount in both economics and politics. The Jewish leaders can no longer negotiate with centralized powers, but rather have to face a host of various actors, from liberal denominations willing to respect them, to evangelical ones who wish to convert them. While the Universal Catholic Church prior to the Reformation tended to de facto accept the concept of salvation of a people, so that the paganism of most of their rural flock was no great worry, Justification by Faith Alone and the religious individualism sparked by the Reformation, and its Counter-Reformation, made Christianity much more concerned about everyone’s individual beliefs (as was the case during the pre-Christian Roman period when society was damned in any case). The United States is the end point of this revolution.

Modern American Judaism has adapted to some extent, offering various avenues of religious expression, from Reconstructionism to Hasidism (with Reform, Conservative and Modern Orthodox in between). This is in sharp contrast with most of the rest of the developed world, where the choice tends to be between Orthodox and Secular (with a “Liberal” rump here and there). In countries where religious feeling is low (such as northern Europe), or de facto religious monopolies are in effect (Catholic southern Europe), the old Jewish ways of religion & people work. Similarly, they work in Israel as well, where there is little viable competition. But in the United States, they simply can not keep up with more aggressive religious firms.

The fact is that American Judaism must become just another denomination. Certain business practices, including proselytism, that were not appropriate (or possible) in a world of guilds, Church and nobility, must be revived for the American Age. The Jewish establishment, which is already fractured in comparison to the past, can not negotiate a modus vivendi with 1,000 religious denominations. The cartel mindset must go!

But can it? I am skeptical, both from reading, and my experiences with secular Jews. Of course, there are those disagree with me, but in the end, I don’t care really if the Jewish faith comes or goes.

Sources for some of the historical assertions:
Europe: Was It Ever Really Christian?
Before France and Germany: The Creation and Transformation of the Merovingian World
One True God : Historical Consequences of Monotheism
The Germanization of Early Medieval Christianity: A Sociohistorical Approach to Religious Transformation
PAGANS & CHRISTIANS

Posted by razib at 04:12 PM

Abiola & I have been having a discussion about where Jews are on the people -> religion spectrum over at his blog. Kind of silly-an African African American (had to type that!) and a South Asian American debating about Jews. GNXP readers are encouraged to contribute their opinions-particular the Judaic ones.

But-I would appreciate it if readers browsed some of the links below. Much research on Jewish genetics has come out in the past few years (most readers have read press releases of course)-

Y Chromosomes Traveling South: The Cohen Modal Haplotype and the Origins of the Lembathe “Black Jews of Southern Africa”. This full text article confirms that the Lemba group of southern Africa does have some genetic connection to the world Jewish Diaspora, their traditional priestly class carries the traditional Jewish priestly marker (“The Cohen Modal Haplotype”). Here is the site of the NOVA documentary on this issue.

India’s children of Israel find their roots. This popular press article reports on the research by Tudor Parfitt (who also did the research on the Lemba above) that indicates the Bene Israel, a Jewish community in India that traditionally has resided in the region to the south of Bombay, also exhibit the “Cohen Modal Haplotype,” in other words, they too have genetic connections with the world Jewry.

The Y Chromosome Pool of Jews as Part of the Genetic Landscape of the Middle East. Full text article asserts:
1) Kurdish and Sephardic Jews cluster
2) Ashkenazi Jews “slightly, yet significantly,” different from the above two Jewish groups (posit gene flow from European populations)
3) The Jewish groups resemble groups from the northern part of the Fertile Crescent (Turks, Armenians & Kurds) more than Arabs, at least according to the measure of a major Y chromosomal haplogroup.

High-resolution Y chromosome haplotypes of Israeli and Palestinian Arabs reveal geographic substructure and substantial overlap with haplotypes of Jews. Basically many Arab and Jewish paternal lineages have a relatively recent comment ancestry, though Arabs in particular have some lineages that are absent among Jews at high levels, indicating recent admixture (this sort of pattern was found in the above article).

Y-Chromosome DNA Haplotypes in Jews: Comparisons with Lebanese and Palestinians. Sephardic Jews, but not Oriental Mizrachi or Ashkenazi, share certain haplotype frequencies.

The Two Common Mutations Causing Factor XI Deficiency in Jews Stem From Distinct Founders: One of Ancient Middle Eastern Origin and Another of More Recent European Origin. Full text of an older article (1997) indicating the common origin of the world’s major Jewish communities.

MtDNA evidence for a genetic bottleneck in the early history of the Ashkenazi Jewish population. Study of mtDNA of the Ashkenazi, the maternal lineage, indicating an early (~100 generations before present) population bottleneck, after which there was rapid expansion.

Multiple origins of Ashkenazi Levites: Y chromosome evidence for both Near Eastern and European ancestries. The Levites, the helpers of the Cohens, have a (possibly) more diverse ancestry than the Cohens, and don’t dovetail as easily into the religio-historical narrative of the Jews.

Founding Mothers of Jewish Communities: Geographically Separated Jewish Groups Were Independently Founded by Very Few Female Ancestors. Full text of the article that contends that the various Jewish communities have local maternal lineages and but common paternal lineages. With groups like the Lemba, Bene Israel and Black Cochin Jews of India, this seems pretty hard to dispute. With Sephardic and Mizrachi Jews, making these sort of assertions through visual inspection are more difficult since the host populations are far closer together in phenotype, while Ashkenazi are somewhere in between.

Origins of Falasha Jews studied by haplotypes of the Y chromosome. Concludes that the Falasha/Beta Israel are converts to Judaism (note that Ethiopian Orthodox Christianity is in practice closer to Judaism than the more Hellenized variety that we are familiar with).

Here is a site listing many studies and popular presentations of them (on the Khazaria site-buyer beware).

There are many more studies out there-but I hope that the above citations will disabuse the two binary alternatives presented by ideologues:
1) Jews are an alien people among their hosts, by blood, custom and confession.
2) Jews are socially constructed, local gentiles that took up the Torah and Talmud, who have no genetic connection transnationally.

Posted by razib at 05:39 PM

Tuskegee re-examined

My own interest in learning more about the Tuskegee syphilis study began with a dinner conversation with a friend, who is a doctor. Earlier that day I had received a communication from the head of an IRB committee indicating that ‘Tuskegee’ was reason enough to have all research questions and procedures at the University of Chicago screened and approved by an IRB. Although I knew relatively little about the details of the Tuskegee Study, I had somehow acquired the impression that many decades ago during the days of unregulated medical science the US Public Health Service had actually infected black men with syphilis. This is a not uncommon belief among black and white Americans who have heard of ‘Tuskegee’.

But my friend told me: ‘Nobody was given syphilis in the study.’ All the participants (black sharecroppers in Macon County, Alabama in 1932) already had syphilis, ‘but they were not treated for the disease’. I then asked him how syphilis was treated in 1932 when the study started. ‘There were some horrible, painful, expensive long-term treatments around but I don’t think they really worked’, he said – ‘there was no effective therapy at the time’. ‘Had there been an IRB system in place in 1932, applying the medical research norms of those times, would the IRB have approved the project?’, I asked. ‘I am not sure, but they might have’, he said. I began to suspect that there was both less and more to ‘Tuskegee’ and the political role it now plays in popular consciousness than has met the public eye.

So I began to read the now standard literature on the topic, as well as some of the scientific reports by members of the Tuskegee project, a sociological study of Macon County conducted in the early 1930s, and websites of various kinds (1). Eventually I discovered a Thucydides-like historical account of the medical belief system that informed the research (2). And the more I read, the more suspicious I became about the standard horror-story.

I would recommend reading the rest, though it is dense.

My own feeling is that there were serious ethical problems with the Tuskegee syphilis study. People would go to jail were it done in 2003. But it was not done in 2003. By any reasonable account, I think, the interpretation that the black population was being used as medical guinea pigs cannot be sustained.

Posted by Thrasymachus at 05:51 PM