LEGACY OF LAUGHTER
Everyone is hoping that 2021 proves to be a better year than 2020. But some of the most depressing news I've seen was Steve Mirsky's announcement of the end of his Anti Gravity column in “The Real Deal.” In my opinion, Anti Gravity was the highlight of every issue. Such a sad thought to contemplate—having to face this new year and not having this column to cheer me up. Thank you, Steve, for your wonderful, humorous and insightful writing.
TRUDY DENTON via e-mail
All Scientific American subscribers should be bummed by learning of Steve Mirsky's departure. His wry view of the many, many farces in this world has always been greatly appreciated, especially by us technophiles. Presuming he has not turned into a giant cockroach himself, let's see his righteously cockeyed view of the world again as often as editorially possible. I'm sure his wife and cats can be convinced to agree.
BRADFORD KRUGER via e-mail
Steve Mirsky's column has always been the first thing I read each month when Scientific American reaches our home. For me, he'll never be an alte kaker. I will miss him.
ESTHER HECHT Jerusalem, Israel
I'm sure I speak for many when I say that I have thoroughly enjoyed Steve Mirsky's column for many centimeters of continental drift. Because he is just the kind of person who would enjoy this sort of pun: I've always remembered his name mnemonically as “Steve Mirthsky.” I wish him good luck on future endeavors!
DAVE DETLEFS via e-mail
Congratulations to Steve on a quarter of a century of Anti Gravity, a column I've looked forward to and enjoyed reading over the years. The puns aside (all are meant to be bad), his erudition and surprising perspectives have provided both wit and wisdom.
WILLIAM LANOUETTE via e-mail
MIRSKY REPLIES: My sincere thanks to everyone. But rest assured, I'll be everywhere. Wherever there's a creationist trying to screw up science education, I'll be there. Wherever there's a nincompoop on Twitter mansplaining to the scientist who did the research, I'll be there. And when Yankees fans yell bad things at Red Sox players too far away to hear them, well, I'll be there. I have free time now.
BIASED MEDICAL SCREENING
In “Racism in Medical Tests” [Science Agenda], the editors argue that health-care screening assessments that make race-based scoring adjustments are harmful to people of color. As a retired pathologist and medical laboratory director, I would certainly not argue that systemic racism does not exist in medicine, as it does in every other aspect of racist American society. But I have heard the opposite argument: that the failure to incorporate racial differences into decision algorithms also constitutes racism.
The editors' point that “race” has no biological meaning is well made, and it is a poor substitute for better genetic information. Nevertheless, it is usually all we have, and it is legitimate for clinicians to take this information into account. For instance, knowing that prostate cancer is more common in Black men than in white men, a urologist might have a lower threshold for doing a prostate biopsy based on a borderline elevated prostate-specific antigen (PSA) level in a Black man.
The predictive value of a laboratory test is based on “prior probability,” the likelihood that the patient has a disease before testing has been performed. Estimating that probability involves a certain amount of guesswork. Yet when a disease has a wide racial disparity in prevalence, it is legitimate to include it in the estimate. Specific algorithms are being tweaked and adjusted all the time, and one can certainly argue about some of them. But the basic methodology is sound.
THOMAS J. REED via e-mail
THE EDITORS REPLY: In medicine, as in the rest of society, ignoring race is not the answer to racism. Indeed, there are cases where a clinician should factor in race when assessing a patient's needs. But it is important to critically interrogate race-based adjustments in medical algorithms because some of them may exacerbate existing inequalities. For example, in the Maternal-Fetal Medicine Units (MFMU) Network's prediction calculator for people who wish to attempt a vaginal birth after previously experiencing a cesarean section (VBAC), Black and Latinx individuals are assigned a lower score than their white counterparts, making it more likely that they will end up with an unwanted C-section.
The race adjustments were based on data showing that nonwhite patients had a lower rate of successful VBACs. But the reason is societal, not biological—racism, not race, is responsible for the higher incidence of poor birth outcomes among people of color. So by using the race adjustment, doctors may be reinforcing the inequalities reflected in the data. As a result, at press time, the MFMU Network is developing a new VBAC calculator that omits race and ethnicity.
STRANGE STARS
“Explosions at the Edge,” by Anna Y. Q. Ho, describes a growing number of unusual supernovae that challenge the traditional view of stellar death. Physicists often simplify complex situations to make them computationally feasible. So I wonder whether Ho or any of her colleagues have modeled the consequences of small to large asymmetries in both stars and their environment (for example, the density variations that are visible in planetary nebulae).
I would expect large-scale homogeneity and symmetry but potentially significant extreme values (for example, locally dense or sparse environments). Would those deviations have observable effects and possibly explain some of what Ho and her colleagues are seeing in the unusual stars?
GEOFFREY HART Fellow, Society for Technical Communication
HO REPLIES: There is a lot of observational evidence that stellar explosions are asymmetric, but we are only just beginning to account for asymmetry in our modeling and simulations because of the large computational power required. For example, it is very difficult to get a spherical star to explode in a simulation, but including turbulence and asymmetry makes doing so much easier.
HOT LAVA, COLD ISLAND
In “Quick Hits” [Advances], Sarah Lewin Frasier reports that the record for the coldest outdoor temperature in the Northern Hemisphere was recently uncovered in data from December 1991 at a site in Greenland. It is important to note that six months earlier in the Philippines, Mount Pinatubo erupted, ushering in a couple of years of global cooling. Although the volcano is on the other side of the world from Greenland, and temperature changes were inconsistently distributed worldwide, overall data clearly show significantly cooler than normal temperatures in Greenland during the winter of 1991–1992.
FRED PORTER Carbondale, Colo.
CLARIFICATION
“Digital Medicine,” by P. Murali Doraiswamy [Top 10 Emerging Technologies of 2020], describes a children's health start-up called Odin. That company is now known as Luminopia.
