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The Real Story Behind the Goldwater Rule
"The Presidency should not be used as a platform for proving one's manhood . . ."

"Inwardly he is a frightened person who sees himself as weak and threatened by strong virile power around him . . ."

"Since his nomination I find myself increasingly thinking of the early 1930s . . ."

"Unconsciously he seems to want to destroy himself. He has a good start, for he has already destroyed the Republican party . . ."

What sound like remarks that could have been made about Donald Trump were actually written by psychiatrists in response to a survey during the 1964 presidential campaign. This embarrassing incident led to the now-famous Goldwater Rule, which bars psychiatrists from diagnosing public figures long-distance. Yet in this election cycle physicians are commenting on what they regard as one of the candidate's medical problems without being sanctioned by the American Medical Association.

What explains this difference? For the answer one has to turn to the historical context of the Goldwater Rule.

The off-beat Fact magazine's September-October 1964 issue was called "The Unconscious of a Conservative." The editor-publisher, Ralph Ginzburg, opened the issue with a 19-page psychological essay that cited various facts, memoirs, and observations about Senator Barry Goldwater, followed by a number of excerpts from the survey results. In response to the question whether Goldwater was fit to be president, 2,417 out of 12,356 responded. Of those, 657 said he was fit, 1,189 said he was not, and 571 said they didn't know enough to answer the question.

Goldwater sued and won. Normally a public figure is not protected against libel. However, in this case the judge found that Ginzburg had malicious intent. For example, Ginzburg edited some of the supposed quotations from articles and from the psychiatrists.

So the Goldwater Rule was not a response to the legal case. Even before publication the medical director of the American Psychiatric Association had warned Ginzburg that the responses were not valid absent a "thorough clinical examination" of Goldwater. Six years later the American Psychiatric Association made that policy official, warning its members not to repeat that mistake.

But why did the American Psychiatric Association go beyond warning its members not to be malicious (something that shouldn't be necessary) and barring any comment on individuals' mental states without examining them? Why did the American Psychological Association not follow suit? And why has the American Medical Association not ruled that long-distance medical diagnosis by its members is also subject to sanction?

One reason for the difference is that there's still a stigma attached to mental illness that does not apply to "medical" conditions. But the backstory of the Goldwater Rule goes deeper than that.

To understand why the psychiatric association stands alone in its tough position, and why the Goldwater Rule is so unique, one has to appreciate the context of the 1960s and 1970s. At that time psychoanalytically oriented psychodynamic theorizing was the dominant style in psychiatry. In this period that gave rise to the young Woody Allen's neurotic character, sophisticates were far more obsessed with Freud and Freudianism than they are now. In the mid-1960s no one gave a thought to eliminating homosexuality from the diagnostic manual, as happened in 1980. Experimental neuroscience was vastly less developed and promising 50 years ago, especially in human beings. Other than some behaviorist therapy in massive mental hospitals psychoanalysis was the major game in town.

So psychoanalytic psychiatrists had serious clout in 1964, therefore they had much to lose by being embarrassed by association with amateurish psychological assessments and poor political prognostication - not to mention a scurrilous publication like Fact.

But there was yet another reason for professional psychiatry's reaction to the Goldwater debacle. For decades some psychoanalysts had dabbled in analysis of major figures, including those who were dead. Freud himself attempted to analyze Dostoevsky and da Vinci. In Moses and Monotheism he contended that Moses was really an Egyptian prince whose Jewish status was concocted by Jews, guilt-ridden about murdering their father figure.

Psychiatrists had long had mixed feelings about these practices. At the 1931 annual meeting of the American Psychiatric Association my father, the psychiatrist and psychodrama therapy founder J.L. Moreno, debated Freud's American representative, A.A. Brill, who diagnosed Abraham Lincoln as a manic schizoid personality whose depressive moods stopped short of mental illness. Turning the tables on Brill, my father questioned Brill's need to engage in the symbolic patricide of the Great Emancipator. A 2003 historical note in Psychiatric News said that "Moreno tore apart Brill's paper as being based on unproven and unsubstantiated conclusions."

The Lincoln episode made national news as other psychiatrists protested Brill's paper as unfair and even unpatriotic. What my father called "necroanalysis" was long a controversial practice in psychiatry. Three years after the Goldwater incident a former American diplomat and patient of Freud's, William C. Bullitt, published a psychoanalysis of Woodrow Wilson based on notes he made of conversations about Wilson with Freud. The book was roundly criticized by psychologist Erik Erikson in the New York Review of Books and by my father on national television.

Analysis of the dead is not a legal violation, but it nonetheless raises the question of fairness as the dead cannot defend themselves. To analyze a living person without data is not only bad practice, it also runs the risk of making the analyst look foolish if the individual later behaves in a way that the analysis didn't predict. If Goldwater had become president and didn't start World War III, more than a few psychiatrists would have had egg on their face.

Analyzing a political figure, living or dead, runs the risk of politicizing a whole field. In the Goldwater case, it was no surprise that many if not most psychiatrists turned out to be liberals who were ill-disposed toward Goldwater's tough rhetoric, but mixing politics with professional expertise was and remains toxic. On pain of inconsistency, the same standard should be applied to all physicians, regardless of their specialization.

Originally published on the Hastings Bioethics Forum.

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Weekend Roundup: Anti-Global Backlash Is Realigning Politics Across the West
The great sociologist Max Weber postulated that the birth act of modern capitalism was the secession of business from the household and thus the web of moral and ethical obligations that intimate form of human organization entailed. Zygmunt Bauman has called globalization the "'second secession'" in which unleashed capitalism has "'flown away'" from the constraints of the nation-state, in effect the larger household. Now, national households are clawing back their claims, reasserting sovereignty in an anti-globalization backlash that is profoundly realigning politics.

"Across the West," Nouriel Roubini writes, "establishment parties of the right and the left are being disrupted -- if not destroyed from the inside. Within such parties, the losers from globalization are finding champions of anti-globalization that are challenging the formal mainstream orthodoxy. Thus, the traditional distinction between center-right and center-left is breaking down." In the U.S. and Britain, he notes, working class voters traditionally aligned with the left, are joining the ranks of Trump and Brexit. In continental Europe, discontent with immigration and austerity has given rise to new parties on both the far right and the far left. "A new political alignment,' Roubini concludes, "erases the old left and right paradigms of labor versus capital, workers versus business, taxes and regulation versus free enterprise. Instead, the new alignment will be organized around pro and anti-global integration forces." As Roubini points out, support for globalization these days comes mainly from the emerging economies, which have largely benefited from foreign investment and access to global markets. While inequality has grown within the West, he notes, it has diminished on a global scale.

To the extent global integration has touched Brazil, pride rises with greater prosperity. As the Olympics wound down, Adriana Caitano vents her anger in an open letter from Brazil "to people who love to come here to enjoy the beaches and stare at women in bikinis, but disrespect the country that hosts them." She imagines what the "American swimmers [involved in the faux robbery scandal] must have thought: Of course it would be very possible for four foreign, white, tall, Olympians to be assaulted in Rio de Janeiro. Who would not believe it? This underdeveloped country can't even clean a pool the right way. They would never be able to find the truth. So we'll just go back to the American dream with our medals."

One can't speak these days of bikinis in Brazil without bringing to mind the controversy over banning the burkini in France, where local police this week forced a woman on a Nice beach to show more skin in her bathing wardrobe. Willa Frej reports on a man in France who has been paying the fines for women ticketed under the burkini ban. Nick Robins-Early examines what many regard as the weak reasoning behind the ban. And, indeed, by week's end, France's highest administrative court, the Council of State, suspended the ban in an initial ruling in a case brought by a human rights group. At the same time, former French President Nicolas Sarkozy, who is running for office again, pledged he would implement a nationwide ban on the burkini if elected.

During a visit to the beach in Izmir Province, Turkey, Ilgin Yorulmaz surveys opinion in that Muslim-majority country with a modern secular history. "With historical ties to France," she reports, "Turks are divided over their opinions of the burkini both in France and in their own country." Despite Canada's historic links to France, Prime Minister Justin Trudeau has made clear his country doesn't share France's secular fundamentalism. "We should be past tolerance," he says, and move toward embracing diversity. In a post from HuffPost Maghreb, Akram Belkaïd calls for, "open debate about this implicit requirement of total assimilation" behind the burkini ban. Writing from Germany where a debate is underway about banning the burqa, Christian Democratic Union politician Ruprecht Polenz similarly argues that. "underlying the burqa debate is the fear that we can never eliminate the differences in our society."

The repercussions of the Turkish coup continue to roil the geopolitical landscape. As U.S. Vice President Joe Biden visited Turkey this week in an effort to temper rising anti-Americanism fueled by a belated and tepid response by U.S. authorities to the failed coup, President Recep Tayyip Erdoğan doubled down on the demand to hand over Fethullah Gülen, who lives in the U.S. and whom he sees as the culprit behind the attempted overthrow of the government. Reviewing these developments, David Hearst asks, "Is America losing Turkey?" Doug Bandow thinks that it would be a good idea if America did lose Turkey. "The growth of Putinism in Ankara today is a terrible embarrassment, with no corresponding security benefit for America as compensation," he writes. "The U.S. should change its approach to reflect changing circumstances. Turkey's membership in NATO no longer serves America's and Europe's interests." Farah Mohamed examines the impact of the coup attempt on the long-festering conflict between Greeks and Turks in Cyprus. Resolution of that conflict is seen by many as a key stepping stone in Turkey's bid to join the European Union, a relationship now even more fraught as Europe is deeply wary of Erdoğan's even sharper post-coup turn toward authoritarianism. As one Cypriot told Mohamed, some islanders, "feel caught up in a fight that does not belong to them."

In an essay titled "Why China Fears a 'Color Revolution' Incited by the West," I argue that the U.S. should appreciate the resonances of China's history as a unitary state present in today's one-party system. By recognizing that system's legitimacy, the U.S. would allay the suspicion of China's leaders that it is seeking to foment regime change through the promotion and support of human rights activists. I further argue that, for the first time in the long history of China's "institutional civilization," an autonomous civil society is emerging because everyone now has the same information as those who rule them. "Whether China ends up on the wrong side of history or not depends on its ability to find a balance between rule from the top and an emergent civil society from below," I conclude. "We in the West should encourage China's effort to forge a new equilibrium out of its own experience, not seek to project our legacy onto their future."

Writing from Beijing, Peiran Wei asks, "Why are Chinese companies, which have long been playing catch-up with their U.S. counterparts, now leading the way?"

Finally, our Singularity series this week looks at how Harvard scientists have "radically rewritten" the E. coli genome, heralding a major step forward in synthetic biology.

WHO WE ARE

EDITORS: Nathan Gardels, Co-Founder and Executive Advisor to the Berggruen Institute, is the Editor-in-Chief of The WorldPost. Kathleen Miles is the Executive Editor of The WorldPost. Farah Mohamed is the Managing Editor of The WorldPost. Alex Gardels and Peter Mellgard are the Associate Editors of The WorldPost. Suzanne Gaber is the Editorial Assistant of The WorldPost. Katie Nelson is News Director at The Huffington Post, overseeing The WorldPost and HuffPost's news coverage. Nick Robins-Early is a World Reporter. Rowaida Abdelaziz is World Social Media Editor.

CORRESPONDENTS: Sophia Jones in Istanbul.

EDITORIAL BOARD: Nicolas Berggruen, Nathan Gardels, Arianna Huffington, Eric Schmidt (Google Inc.), Pierre Omidyar (First Look Media), Juan Luis Cebrian (El Pais/PRISA), Walter Isaacson (Aspen Institute/TIME-CNN), John Elkann (Corriere della Sera, La Stampa), Wadah Khanfar (Al Jazeera), Dileep Padgaonkar (Times of India) and Yoichi Funabashi (Asahi Shimbun).

VICE PRESIDENT OF OPERATIONS: Dawn Nakagawa.

CONTRIBUTING EDITORS: Moises Naim (former editor of Foreign Policy), Nayan Chanda (Yale/Global; Far Eastern Economic Review) and Katherine Keating (One-On-One). Sergio Munoz Bata and Parag Khanna are Contributing Editors-At-Large.

The Asia Society and its ChinaFile, edited by Orville Schell, is our primary partner on Asia coverage. Eric X. Li and the Chunqiu Institute/Fudan University in Shanghai and Guancha.cn also provide first person voices from China. We also draw on the content of China Digital Times. Seung-yoon Lee is The WorldPost link in South Korea.

Jared Cohen of Google Ideas provides regular commentary from young thinkers, leaders and activists around the globe. Bruce Mau provides regular columns from MassiveChangeNetwork.com on the "whole mind" way of thinking. Patrick Soon-Shiong is Contributing Editor for Health and Medicine.

ADVISORY COUNCIL: Members of the Berggruen Institute's 21st Century Council and Council for the Future of Europe serve as the Advisory Council -- as well as regular contributors -- to the site. These include, Jacques Attali, Shaukat Aziz, Gordon Brown, Fernando Henrique Cardoso, Juan Luis Cebrian, Jack Dorsey, Mohamed El-Erian, Francis Fukuyama, Felipe Gonzalez, John Gray, Reid Hoffman, Fred Hu, Mo Ibrahim, Alexei Kudrin, Pascal Lamy, Kishore Mahbubani, Alain Minc, Dambisa Moyo, Laura Tyson, Elon Musk, Pierre Omidyar, Raghuram Rajan, Nouriel Roubini, Nicolas Sarkozy, Eric Schmidt, Gerhard Schroeder, Peter Schwartz, Amartya Sen, Jeff Skoll, Michael Spence, Joe Stiglitz, Larry Summers, Wu Jianmin, George Yeo, Fareed Zakaria, Ernesto Zedillo, Ahmed Zewail and Zheng Bijian.

From the Europe group, these include: Marek Belka, Tony Blair, Jacques Delors, Niall Ferguson, Anthony Giddens, Otmar Issing, Mario Monti, Robert Mundell, Peter Sutherland and Guy Verhofstadt.

MISSION STATEMENT

The WorldPost is a global media bridge that seeks to connect the world and connect the dots. Gathering together top editors and first person contributors from all corners of the planet, we aspire to be the one publication where the whole world meets.

We not only deliver breaking news from the best sources with original reportage on the ground and user-generated content; we bring the best minds and most authoritative as well as fresh and new voices together to make sense of events from a global perspective looking around, not a national perspective looking out.

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Stop Being Ridiculous: We Agree On Animal Alternatives
While watching the games of 2016 -- not the Olympics, the U.S. presidential election -- I am reminded of the stare-down between drug companies and animal rights activists. Of this mounting conflict, you'd think the answer is simple -- that animals can and should eventually make their exit from so many labs and testing facilities. Alternatives are in the wings, if even in their earliest days.

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But as in politics, neither side is listening, and declaring moral victory seems more important than making progress. Like convention delegates, each side is being ridiculous. Here are a few reasons why:

ABSOLUTISM Animal rights activists don't tolerate ambiguity. The ethics behind captive orcas for theme park profits is somehow equivalent to, say, the use of macaque monkeys to develop life-saving vaccines. For this lack of clarity, they earn the wrath of serious scientists and are slapped with extremist and absolutist labels.

RATIONALISM By the same token, researchers who use animals to advance their work are imbued with an intellectual bias that conveys as conceit and a dismissal of pain and suffering. For this, they are packaged by activists as genocidal monsters. This is not an overstatement.

ENTERTAINMENT What activists NGOs, particularly The Humane Society of the United States (HSUS) and People for the Ethical Treatment of Animals (PETA), understand so well is that entertainment is core to their cause. They know, for example, that researchers are largely incapable of rebuttal in terms that are anything less than boring. I'm a scientist, not a media whore, their targets complain. They also know that inside corporations it's the legal department that trumps communications -- hence, the tone-deaf verbiage that accentuates the appearance of guilt. At BioDrug Corp we are committed to humane animal welfare... But you can't be committed when so much of the public sees you as disingenuous. And you can't credibly claim to be humane when your otherwise healthy animals don't fare so well.

INFORMATION Consumed by regulations and allergic to negative media, those of the pro-research persuasion embrace an out-dated model to push their point of view and best practices: Social Education. But because media are drawn first to fire and second to Smokey The Bear, the defenses that pharmas and their surrogates mount are ignored, out-flanked or exploited for their wooden corporate-speak. Despite their lobbying and support of biomedical research associations, animal research and testing is out-gunned, easily ten to one by my estimates. The odds might be evened were it not for the consistent refusals of the super association PhRMA to snuff out the long fuse that is sparking toward its pharmaceutical member companies.

Indeed, national surveys confirm that activism works and activists are winning. For almost a decade, public approval of animal research and testing has dropped year-to-year, all to suggest that critical species will leave the labs, beginning with chimpanzees then others that society judges most cuddly and dear. It's a win for idealism and a disaster for commerce and healthcare.

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Looking for answers, pharmas and universities have hit the panic button. After all, taking animals out of the equation is a seismic shift that threatens vital pipelines and requisite profits. Their first instinct has been to call on law firms and PR agencies to defend their freedom to operate and mollify the rising public upset. This is not to keep bunnies in lipstick labs; this is to preserve compelling and life-saving work that contributes to the cures, therapies and vaccines of ravaging disorders and diseases. Think polio, epilepsy, HIV, hepatitis. The list is long and an awesome demonstration of applied science, not only for humans but also animals.

You might think the status quo, habit or laziness are what keeps mice, rats, dogs, cats, rabbits, lambs, pigs, primates and other species in air conditioned vivariums. But the costs to breed or buy, house and feed happy and healthy animals -- a necessity for sound research -- is exorbitant and a natural inhibitor to their use. What binds pharmas, academia and their networks of contract research houses to animals is the sheer effectiveness of non-human testing and, in recognition of this fact, the many legal requirements to use animals in drug discovery and trials. Consider the example of oversight committees, called IACUCSs, required in virtually every modern animal testing facility. By law, researchers and testers are mandated to apply and prove among other things a Three Rs standard to animal use -- Replace, Reduce and Refine. It's a logistical and costly requirement that ensures best practices and moves us incrementally toward animal-alternative research.

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Having stormed us with stunts -- some violent, even fatal to researchers -- activists are craftily now turning to supply chains and decision trees. They have easily gained the sympathies of shippers, particularly airlines on which researchers rely for safe delivery of their animals, and soft-hearted lawmakers who have produced what researchers regard as draconian, innovation-killing regulations.

Out of this handiwork have emerged two modes of strategy response by scientists and their employers:

-- Defensive, the default mode. This is the social education model, to inform and disseminate facts: Educate the public. Get into the classrooms. Issue PSAs. It's also the evasion strategy: Get to the legislatures. Find the work-arounds. Use trucks instead of planes. Start breeding. Start outsourcing. Start offshoring. And so it goes. But none of this is secret to activists who, again, are manifestly better mobilized, relatively unregulated, more focused, and simply better entertainers and storytellers. They are already lobbying, expertly. They are at work in China. And their cameras are everywhere.

-- Offensive, the counter-intuitive option. This requires vision, some courage and competitive instinct: Invest in alternatives. Ramp up synthetics (e.g., organs on chips). Focus on less sentient species (e.g., zebra fish). Tap big data and cloud computing to simulate outcomes. Partner with or fund in vitro and virtual medicine start-ups. It all sounds good, but ask any clear-eyed animal researcher and they'll tell you soberly that real progress to virtual testing and research is a lifetime away. Animals, they insist, will always be needed in some capacity and, besides, the human body is simply too sophisticated to ever accurately mimic.

But science surprises itself with unexpected regularity, particularly when pressure is applied or incentive is offered. Pick up your smart phone or take your morning pills for proof. My rebuttal, then, to the DVMs, PhDs and VPs who say we can't move that fast is this: You won't know until you really start trying.

Out of duty, I have detailed policies and competitive strategies that defend the forts of animal research and testing. But these are prophylactic, even unnecessary, because what underlies the animal research-versus-animal rights rivalry is in fact a shared value and vision: Quality of Life. Researchers are driven by curiosity and a unique delight in explaining and taming what is life-limiting. Activists are driven by compassion and a dream for a higher standard of humanity. In my experience, no researcher would rather probe than pet an animal. And no activist would rather lose their child to a disease than spare the mice and monkeys that help cure it.

PERFECT STORM, PERFECT OPPORTUNITY

Still, animal research and testing is treated as a crisis, never yet in my experience as an opportunity. It needn't be, because we all agree that the future in biomedical research is not in animals but in actual humans. Virtual humans, to be precise.

If activists and scientists agree that animal research and testing should go the way of strip mining and whaling, then why are corporations and institutions resisting the call? The answer lies in reputation, profits and pride, perhaps not in that order. Corporations have to perform, always to the satisfaction of investors. Investments to replace so-called animal models are expensive and their returns can only be trusted through experience and success. In the mean time, activists are determined to alienate customers from the brands whose benefits are ensured by lab animals. They test bunnies! They murder monkeys! The consequences are policies that manage and mitigate (mode 1 as described above) instead of lead and innovate (mode 2).

Like liberals and conservatives, each side is lead by a point of view that is inarguable because it's based on a world view. It goes to philosophy and a life's purpose. So when one party is framed as a Frankenstein, or Pollyanna as the case may be, the natural reaction is to recoil and resist the impolite accuser. Because no one is wrong, no one can be right.

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I describe the phenomenon as a battle for the back row and total anonymity. And as a prescription, I argue for a lock-step advancement of sheepish pharmas to mount a collective defense. No one need stick out their neck if they shuffle ahead together.

But this is an incremental play, and it only slows the progress of both activists and their targeted corporations. Again, the irony is that both sides want the same thing, but what they seem to value more than results is to progress on their own terms and most especially without the goading advice of their disdained detractors. As with party politics, they want to be the winner and the other guy the loser.

Inside this perfect business storm is in fact a perfect competitive opportunity. With drugmakers uniformly obscuring their animal research and testing activities, there is an obvious but counter-intuitive option to bolt the party. The risk is only temporary because while the pharma that steps out might draw activist fire it can simultaneously pledge its support of activists, declare a moon shot to produce animal-free drugs, and challenge others to follow. The pharma that flees the flock can become a darling of PETA and HSUS, not an enemy. And even better, it can gain a significant advantage over its cowering competitors.

By degrees, and particularly with our much-loved chimps and other self-aware species, a few pharmaceuticals have made this move though in far too tentative steps to exploit and disrupt the norm. Novartis is notable, so too is GSK, but on the whole the progress toward animal alternatives is halting and inhibited by the extreme caution and considerable fear of CEOs and their risk-averse legal and communications chiefs.

What has been treated as a problem by the businesses, institutions and associations that participate in and defend animal research and testing is, in fact, a chance to do great things. If we approach it more as a potential for innovation than an exercise in risk mitigation, we can step out of the back row and advance a kind of discovery that propels our collective success and defines a higher form of humanity. It's a way to be reasonable instead of ridiculous.

Photo credits: Trailers From Hell, Shawn the Sheep

Graphics credit: Gallup

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Underwater Clarity

By Drs. David Niesel and Norbert Herzog

Have you ever opened your eyes while diving in the ocean without a mask and realized that you really can't see very well? Well, the children among a nomadic sea faring people known as the Moken can see underwater with total clarity, but what is really interesting is that other children can acquire this ability too in just a matter of weeks.

The Moken people have historically been totally dependent upon the ocean surrounding the Mergui Archipelago, a group of 800 small islands off the southwestern coast of Myanmar. The Moken people are Austronesians who are thought to have migrated from southern China about 4000 years ago. For 8 to 9 months of the year, the Moken live aboard their boats, known as kabang, living on land in temporary camps only during the monsoon season. They live on what they can harvest from the sea and the beaches and by trading the sea life they gather with Chinese and Malay neighbors. There may be as few as 1000 Moken still living the traditional way.

Moken children spend much of their time in the water and participate in the gathering of seafood starting at an early age. As opposed to most of us, the Moken children see everything with perfect clarity when diving underwater. A Swedish scientist, Anna Gislen, has been studying the Moken for two decades to learn how this is possible. She measured how clear the underwater vision of 17 Moken children was and compared that with 18 European children all aged 7 to 13 years old. The Moken children had more than twice the visual acuity compared with European children.

Gislen hypothesized that part of the reason they can see more clearly under water is their ability to constrict their pupils. Just like with a camera lens, if you constrict the pupil, you increase the depth of field. That is the distance between the nearest and farthest objects that will be in focus. Measurements proved that Moken children constricted their pupils underwater to the maximum known limit for a human. However, there had to be more to this, somehow, either consciously or unconsciously, Moken children had to also be changing the shape of the lenses of their eyes to improve the focus of an object, called accommodating their lenses. This is exactly what she found. This ability is retained into adolescence. What is fascinating is that European children could be taught to make these same changes to their eyes to improve vision underwater. After 11 training sessions over one month, they developed the same visual acuity as Moken children. How long this took was different for each child, but their vision would suddenly improve. Interestingly, seals and dolphins have similar abilities to adapt their eyes.

The traditional Moken culture is rapidly disappearing as a result in part from a 2004 tsunami that destroyed much of the Moken homeland. Governments are relocating them further inland for their safety and providing other employment. Sadly, the life of these sea nomads, as they are also known, is changing and their children may not develop "dolphin eyes" because they will not be spending so much time diving. However, this is a remarkable example of how adaptable the human body can be.

Medical Discovery News is hosted by professors Norbert Herzog at Quinnipiac University, and David Niesel of the University of Texas Medical Branch. Learn more at www.medicaldiscoverynews.com.

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This EpiPen News Is Part of A Disturbing Trend

The TV was on as we sat waiting to be called in for our check up. My son, who is 11, turned his head as he heard the anchor use the word “EpiPen”. He is in tune since he has a life threatening peanut allergy and the EpiPen has saved his life. His face was full of emotion as he listened to the anchor talk about how some people could no longer afford this life saving device. He shook his head and said “mom that can't be right, they can't be right, can they, everyone who needs an EpiPen should have one.”

The media has exploded as word spread of some parents paying well over 600 dollars for this necessary life saving device. Headlines abound about big pharmacy greed and patients forced to pay outrageous prices, and this issue has enraged everyone. I am heartened to see food allergies being taken seriously in the mainstream media. As my son stated, everyone who needs an Epipen should have access to one. But food allergies are a topic that is underreported. Even when we are armed with our EpiPens, we have a long way to go in getting the public to recognize the real challenges of living in a world where respect for food allergies as a potential life threatening disease is lacking.

As founder of the No Nut Traveler, I collect the testimonials of food allergic passengers traveling on commercial airlines. Shockingly, many food allergic passengers are being ridiculed, spoken to rudely by the airline staff and most egregiously, sometimes asked to leave the airplane when disclosing a food allergy.

Last month, a food allergy mom sent me a testimonial via FaceBook with a heart-breaking photo of her child, as her family was asked to leave the plane by the pilot for disclosing her child's food allergy. She informed me that she had notified the airline ahead of time of her daughter's allergies. She brought their own food and a supply of medication. She said “We did everything humanly possible on our part. I do not know what else we could have done to prevent such a situation from happening”. She went on to tell me “a supervisor from JFK was called on board and he took our passports and boarding passes. We were then escorted out of the plane under the threat of calling security on us. We were publicly humiliated as we walked through the full airplane. My daughter was brought to tears. On the same airline the next day, a different pilot let our family fly. I find this kind of inconsistency and rudeness unacceptable.

Later in the month, a 22-year-old girl from New Jersey shared another disturbing encounter with me. She asserted that after asking for an announcement for her severe nut allergy, and asking for the surrounding rows to please refrain from eating nuts, the pilot told her that she was an inconvenience to have on-board, and that her thought process was selfish. She further asserted that the pilot said to her “You should be thankful to be allowed on this flight due to the huge risk and inconvenience you may cause to other passengers”. Her aunt, who was traveling with her, then asked what they would do if they had someone with a disability on the airplane and the pilot said they would accommodate them. She then asked why not her niece and he responded because a food allergy is not a disability.

When you receive the diagnosis of a life threatening food allergy, your life is irrevocably altered. Failure to treat a food-induced anaphylaxis quickly (i.e. within minutes) with epinephrine substantially increases the risk of death. No one asks to have this condition. There is the false perception that once you have your EpiPen, everything will be fine. But the truth is that sometimes the EpiPen can only buy you time. That is one of the reasons why you need to carry more than one-a reaction can require multiple EpiPens, and you always need to go to the ER to be monitored after using one.

There is no ER in the air and that is why, as allergic passengers, we ask for reasonable accommodations to make flying safer. Being able to pre-board, to clean the area from the last occupant, informing those around us to be cautious and asking politely not to consume what is deadly to us, and educating the airline staff of this potentially fatal disability, are reasonable requests for a legitimate medical condition. My greatest fear is that it will take a death in the air for meaningful change to occur.

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Proxima Centauri b: Earth-sized? Earth-like? Or Habitable?
Finally after decades of hope and hard work, astronomers finally discovered a planet orbiting the nearest star to our sun: Proxima Centauri. Describing it in human terms leads to some interesting problems!

The Alpha Centauri trinary star system, at a distance of 4.3 light years as the crow flies, has beckoned would-be interstellar travelers for decades with its golden sun-like star Alpha Centauri A, its orange star companion Alpha Centauri B, and the little red dwarf: Alpha Centauri C or 'Proxima'. Proxima, discovered in 1915, orbits A and B at a distance 300 times farther that Pluto orbits our sun, taking hundreds of thousands of years to complete its journey. Yet, despite its closeness to Earth, Alpha Centauri AB seem to be a celestial fizzle so far as planets are concerned despite decades of searches.

But suddenly things have changed.

For a long time the available data seemed to show there were no Neptune-sized or larger planets orbiting Proxima. It seemed doomed to be just as barren as its two brighter and more famous stellar companions. Then in 2013, astronomer Mikko Tuomi of the University of Hertfordshire uncovered a hint that Proxima was wobbling slightly as it traveled through space. Today we have the announcement by a team of ESO astronomers that this wobbling has been confirmed, and it is caused by an orbiting planet with a minimum mass about 30 percent larger than our Earth. It was also in an orbit that kept it comfortably in the red dwarf's liquid water zone. With an 11-day orbit and at a distance 20 times closer to Proxima than our Earth is to the sun, the view from its surface would be spectacular, although the planet would be gravitationally locked so that it only shows the same hemisphere to its star for eons at a time. Now comes a problem. How do we describe this world compared to Earth?

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Artist's impression of the exoplanet Proxima Centauri b. The Alpha Centauri binary system can be seen in the background. (Credit: ESO/M. Kornmesser)

Semantics problems.

The terms Earth-sized, Earth-like and habitable might sound very similar, but in fact they are not, and they are also not astronomically precise terms.

Earth-sized. Astronomers can certainly confirm that Proxima b has a mass slightly larger than Earth from the way that it wiggles the motion of its star. That is a mathematically precise statement. If we assume it is a rocky body similar to our Earth and the inner planets of our solar system, we can deduce that it probably has a radius about 10 percent larger than our Earth, and on its surface, gravity would be about 10 percent more, so a 150-pound person would weight 165 pounds. Again, the term Earth-sized can apply either to describe the mass of the planet or its radius. No problem so far. In fact, today we know of over 600 Earth-sized planets.

Habitable: To be habitable is more restrictive than to be merely Earth-sized. The presumption is that some kind of organic life has to be able to survive on its surface. Astronomers usually calculate for a star the size of the zone surrounding it where the temperature of a bare planetary surface can support liquid water. This is often called the liquid water-zone or the habitable zone (abbreviated 'HZ'). Being in The Zone, however, does not guarantee that liquid can exist on the surface if the planet actually has no atmosphere. Our moon is in the habitable zone of our sun but nothing can live there! So, to really be habitable, the planet needs to have an atmosphere that provides enough pressure to keep water in a liquid state. But when you look around our solar system, atmospheres can be anything from pure hydrogen and helium (Jupiter) to pure carbon dioxide (Venus, Mars). Too much atmospheric carbon dioxide or water vapor would turn even Mars and Earth into uninhabitable planets in the 'habitable zone' of our sun. A habitable planet has to toe a very narrow line by being in the right place, with the right mass/size, and the right amount of atmosphere so that something like extremophile bacteria could survive on their surface, though not necessarily a human. Today, we have identified 12 planets that are close in size to our Earth, and in their habitable zones.

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The atmosphere of the Jupiter-sized planet WASP-39b showing water vapor, carbon monoxide, potassium and sodium.(Credit: WASP Planets )

Earth-like: This is the most restrictive classification of them all. It means that not only is the planet Earth-sized and in its habitable zone, but its atmosphere has just enough greenhouse gases to keep the temperature in the liquid-water state and at a pressure close to what we experience at sea level. But there is more. If you were to visit this Earth-like world, would you expect to be able to walk its surface without breathing gear? Would a truly Earth-like world force you to live out your entire life inside a sealed habitat? To be Earth-like seems to mean that you could walk around without a cumbersome suit and your habitat need not be sealed. But this is only possible if the planet has oxygen in its atmosphere. Oxygen is a product of living organisms, so any Earth-like planet will already have a living biosphere and a recognizable oxygen-rich atmosphere.

Although we have discovered Earth-sized and habitable planets (at least survivable on their surface with spacesuits and sealed habitats), we have yet to discover an Earth-like planet. For now, the terms habitable and Earth-like remain interchangeable without any penalty. You will see this yourself in the many articles to follow the announcement of Proxima b.

But in not too many years we may actually discover our first Earth-like world. When that happens, we will have even more cause to celebrate, and no semantic problems at all!

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Can Biotech Companies Save The Rhinos?
To help stem the tide of rhino poaching, some biotech companies such as Pembient are seeking to develop and manufacture synthetic horns that are biologically identical to the real thing. The thinking behind this is that the availability of bio-identical fake horns at a substantially lower price than wild horns would cause demand to shift towards the synthetic substitutes, which would reduce people's incentives to poach rhinos.

I have argued previously that--from the perspective of what would be most effective in curbing poaching--the synthetic horns should not be made to be perfect fakes, i.e., bio-identical. Instead, the synthetic horns should be engineered to be (i) difficult to distinguish from wild horns but (ii) undesirable or unappealing in some respect so that buyers would place little value on them. This proposal makes use of a phenomenon in economics known as adverse selection, which occurs when buyers in a market are unable to distinguish between high- and low-quality products, and their lack of information drives down demand--and, hence, prices--enough that high-quality products (which would be wild horns in the context of rhino horns) cease to be supplied by sellers.

For conservationists and others who are concerned about the fate of the rhinos, it is critical to understand why biotech companies would prefer making bio-identical synthetic horns--rather than undesirable fakes--because of the implications this has for conservation policies. Simply put, it would be more profitable to produce and sell perfect fakes rather than synthetic horns that would be considered undesirable. All else being equal, putting out undesirable fakes that buyers cannot distinguish from the real ones, by reducing demand for horns, would lead to lower prices in the horn market compared to the case with bio-identical synthetic horns. This, of course, would generate less revenue for the producers of synthetic horns.

Proponents of making perfect fakes could argue that bio-identical synthetics would be no less effective than undesirable fakes in bringing about adverse selection in the horn market and driving out sellers of wild horns. This is true if buyers view bio-identical synthetic horns to be significantly inferior to wild horns. However, as reported in The Guardian last year, Pembient's market research in Vietnam--one of the biggest markets for rhino horn trading--found that nearly half of the survey respondents who consume rhino horn for medicinal purposes would consider bio-identical synthetic horns to be suitable substitutes for wild horns. Moreover, a co-founder of Pembient suggested in the same article that perfect fakes could actually be better than wild horns due to their lack of contaminants. Therefore, bio-identical synthetic horns may not be undesirable or unappealing enough to drive out wild horn suppliers through adverse selection. In fact, if buyers consider perfect fakes to be more desirable than wild horns, the availability of synthetic horns could actually encourage more rhino poaching by driving up horn prices.

Advocates of making perfect fakes could also point out that--even if buyers do not consider bio-identical synthetics to be substantially inferior to wild horns--as long as there are enough bio-identical synthetic horns in the market, horn prices would be driven down to the point where wild horn sellers would be forced from the market. A rigorous theoretical analysis of this issue shows that it is not necessarily in the financial interest of synthetic horn producers to drive out all wild horn sellers; instead, they may prefer to prop up horn prices by keeping the production of synthetic horns at a relatively low level.

Rhino poaching numbers are climbing, and rising income levels in China and Southeast Asia--where demand for rhino horns is strongest--will almost certainly make matters worse in the near future if no significant changes occur. Economic principles tell us the availability of synthetic horns can decrease the supply of wild horns and reduce the amount of poaching. Since the development of undesirable fake horns or flooding the market with perfect fakes is incongruent with the profit motive, the real issue is just how big the effect of synthetic horns on poaching would be if the companies developing them are interested in profiting off of their products.

What policies can governments or conservation groups implement to ensure that the impact on poaching numbers is maximized when the biotech industry is ready to roll out bio-identical substitutes? To drive out wild horn suppliers using synthetic horns, the key would be to depress horn prices sufficiently. Here are a few suggestions for doing that. One is to subsidize the companies that produce synthetic horns--this would incentivize them to increase production and thereby drive down prices. Another option is to promote competition on the production side of synthetic horns. Financial incentives or policies that encourage more firms to enter the synthetic horn market would also put downward pressure on prices by raising the market supply. A third possibility is to make it easier or less costly for a non-profit organization to invest in or acquire the technology for producing synthetic horns since the non-profit entity could try to shut down the rhino horn market through adverse selection by making undesirable fakes.

The science and technology to produce high quality synthetic horns are within our grasp. Let us not, however, assume that the biotech companies with these capabilities, in pursuit of their own interests, would necessarily solve the rhino poaching problem. Let us keep in mind that steps may need to be taken to structure the market for rhino horns so as to fully realize the potential of synthetic horns to save the rhinos.

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Cincinnati Zoo & Wildlife Safari Team Up to Ensure Survival of the Most Genetically-Valuable Cheetah Cub in North America
Cheetah mom at Cincinnati Zoo's breeding facility adopts cub

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Six-year-old cheetah, Kathleen, has adopted the most genetically-valuable cheetah cub in the North American zoo population, born at Wildlife Safari in Oregon on May 15, and is raising her alongside the four cubs she gave birth to on May 10 at the Cincinnati Zoo & Botanical Garden's off-site cheetah breeding facility.

When the only litter mate of the cub born at Wildlife Safari died shortly after birth, staff at the Oregon breeding facility, knowing that cheetah moms do not raise single cubs, had to make a quick decision. The lone cub would have to be raised by hand or cross-fostered (a term used to describe the transfer of an animal from one dam to another). Because of the animal's unique genetic value, cross-fostering was the best option.

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It was important to try to keep this cub in the breeding population" said Christina Gorsuch, Curator of Mammals at the Cincinnati Zoo. "Cheetahs raised by humans generally become ambassadors for their species, an important contribution, but do not breed. The best chance for future breeding success was to put the cub with another mom and litter mates."

Between the nine facilities in the cheetah Breeding Center Coalition (BCC), due dates frequently coincide. So, if there are single births, or litter mates die, there is usually a good chance that another facility will already have a litter or be expecting one. Cross-fostering should occur within two weeks of birth, so Kathleen was the perfect surrogate mom candidate for Sara Roy, the name given to the cub from Oregon.

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The situation was ideal, but there was no guarantee that Kathleen would accept the cub. "Several things can go wrong when trying to introduce a cub to a litter. Cheetah moms can be very nervous," said Tom Tenhundfeld, head keeper at the breeding facility. "She might ignore the cub or remove it from the litter. She could move the whole litter. She could injure or kill the cub or not allow it to nurse."

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Fortunately, none of those things happened to Sara Roy. The ten-day-old cub arrived at Cincinnati Zoo's breeding facility on May 20 and was placed with the other cubs while Tenhundfeld distracted Kathleen with food. "Before leaving her in the nest box, Christina rubbed bedding and the original cubs on her to transfer the scent. I let mom back outside as if nothing had just occurred. She patrolled around the nest enclosure for several minutes then went in to shelter, looked and sniffed around and lay down to allow the cubs to nurse. The cub went right towards belly and did some nursing as if she'd been there all along, mom didn't mind and didn't seem to notice she had an extra mouth to feed! It was awesome," said Tenhundfeld.

Physical exams earlier this week confirmed that all five cubs are in good health. They are boisterous, energetic and starting to eat meat. "You can't tell them apart by looking at them at this point, but each has had a transponder chip, about the size of a grain of rice, implanted for ID purposes," said Gorsuch.

Earlier this year, a male cub from Wildlife Safari came to the Cincinnati Zoo under similar circumstances. At that time there were no nursing moms at the Zoo's breeding facility, but there was a litter of cubs being hand raised in the Zoo's nursery. The BCC determined that this was the best place for Donni, the name his Cincinnati keepers gave him, and he is now thriving as a Cat Ambassador Program rookie.

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Donni with puppy companion Moose at the Cincinnati Zoo.

Since 1990 the Cincinnati Zoo's Angel Fund, named after our first cheetah ambassador, "Angel," has directly supported cheetah conservation in Africa. From South Africa and Namibia in the south, up through Kenya and Tanzania in East Africa, The Angel Fund has contributed more than $1 million in support for cheetahs in the wild.

Cheetahs are endangered, and their population worldwide has shrunk from about 100,000 in 1900 to an estimated 9,000 to 12,000 cheetahs today.

The Cincinnati Zoo is one of nine institutions accredited by the Association of Zoos and Aquariums (AZA) that participate in the BCC. Working closely with the AZA's Cheetah Species Survival Plan (SSP), the BCC's goal is to create a sustainable cheetah population that will prevent extinction of the world's fastest land animal.

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