Beyond Frist's Stem Cell Flip-Flop

The big biomedical research news Friday was Sen. Bill Frist’s change of heart on embryonic stem cell research, which could prompt President Bush to exercise his first veto. But William Saletan, Slate.com’s national correspondent, ran a comprehensive, brilliant five-part series last week showing why this politically motivated flip-flop (Frist wants to run for President in 2008 and polls overwhelming show the public supports medically-motivated embryonic stem cell research) won’t be the last decision he and other politicians will have to make on this issue.

Saletan’s is the first journalist I’ve read who understands the difficulties scientists face in turning embryonic stem cells (or any other type of stem cell) into usable, transplantable tissues. These difficulties have been carefully hidden from public view amid the hype needed to pass state cell initiatives like California's Prop 71.

What are those difficulties? The cookbooks for growing those cells into heart cells (repair damaged hearts), neural cells (Parkinson’s, Huntington’s, spinal cord injuries, etc.), or pancreatic cells (diabetes) are at least a decade away. Moreover, there are signs that cells grown outside their “natural environment,” i.e. in the womb or a Petri dish that contains the whole developing embryo, not just its stem cells; do not properly differentiate into the types of cells that will be needed for these therapeutic interventions.

Saletan concludes that stem cell researchers will soon push to grow embryos longer than the 14-day limit imposed by most ethics rules, perhaps to as long as two months. That way, the cells can begin to differentiate naturally into the cell types of their eventual use. Moreover, he predicts these embryos will inevitably be clones of the patient’s DNA, since most scientists believe this is necessary to get around tissue rejection problems.

Saletan, author of “Bearing Right: How Conservatives Won the Abortion War,” concludes: "The definition of the embryo is blurring. Under a proposal by William Hurlbut, a member of Bush's bioethics council, a single genetic tweak could turn a would-be embryo into a 'clonal artifact, that 'might legitimately be developed within artificial microenvironments beyond 14 days. This would allow the production of more advanced cell types, the study of tissue interactions and the formation of primordial organismal parts.' Why has Hurlbut, a pro-lifer, invited scientists to grow and exploit near-embryos in artificial environments beyond 14 days? Because he knows that the demand for parts and tissues, combined with the difficulty of making them from stem cells, will build pressure to lift the 14-day limit on the real thing."

Dear Dr. Frist: Keep those flip-flops handy.

Hypertension Journal Cuts Ties to "Academic Businessmen"

The Wall Street Journal reported this morning that the editor of the American Journal of Hypertension severed the journal’s ties to its parent medical society because of the group's increasingly incestuous ties to the pharmaceutical industry.

The American Society of Hypertension is made up of 3,000 researchers and clinicians, mainly academics, who investigate new treatments for this widespread condition. One of its other main activities is running continuing medical education seminars for the nation’s practicing physicians. But those seminars have become “unacceptably dominated” by researchers who earn big fees for helping Big Pharma market its products, according to Journal of Hypertension editor John H. Laragh.

This stance may carry a hefty pricetag for Laragh. A prominent researcher at Weill Cornell Medical Center in New York City, Laragh earns $229,000 as editor. The journal gets most of its revenue through drug industry advertising and purchases of its supplements, which are often filled with reports on industry-funded clinical trials that are thinly-disguised marketing campaigns.

But apparently there are some things that even well paid editors can't abide. Since Thomas G. Giles took over as president of the American Society of Hypertension in 2004, the report claims, the Society has been trying to exert more control over the Journal’s content. In an editorial, Laragh lambasted the rise of “academic businessmen.” He also said he could no longer “live under the environment” created by Giles, who teaches at Louisiana State University School of Medicine.

The most immediate impact will be on the Journal's subscription revenue, which is generated in part from memberships in the Society. But the more interesting question will be whether Big Pharma begins pulling its ads, which represent the bulk of medical journal revenues.

Medical Reporting Beyond Hype and Hope

When I broke into the news business, the financial desk's primary source of breaking news was a Dow Jones wire clack-clack-clacking in the corner of the room. A bell rang whenever a major story broke. Sometimes two bells would go off, signaling a really big story. The day the stock market crashed in 1987, the newsroom sounded like St. Peters Square on Easter.

I imagine something comparable occurs these days when the advance copies of leading medical journals cross science editors' computer screens. Stories from the frontiers of medical research can make it onto page one—the most coveted real estate in daily journalism. News magazines have bolstered their sagging bottom lines with an endless stream of cover stories touting the latest breakthroughs in medicine.

But is this news all that it is cracked up to be? Have the reporters properly weighed the importance of the studies they're touting? Have they asked the tough questions of the researchers and their sponsors to figure out the significance of the results? Have they presented the data in a fashion that is meaningful to health-care consumers? And in an age when most clinical trials are sponsored by private companies, have they fully informed their readers of the researchers' conflicts of interest?

Too often, the answer to these questions is no. Take recent reports from the American Society of Clinical Oncology, which met in mid-May in Orlando. One leading paper reported on a Veterans Administration review of the experience of over 40,000 women in the south central U.S. “The women taking statins were half as likely to have breast cancer as women who were not taking the drugs,” the paper reported. Put that way, it sounds like a dramatic reduction. But elsewhere in the story, it was reported that 12 percent of the women were taking the cholesterol-lowering medications and that only 1.4 percent of the total group contracted breast cancer. Only by massaging the numbers could one figure out that physicians would need to put 700 women on statins to eliminate one cancer case (in medical parlance, this is called number needed to treat). It sounds a lot less impressive that way. But the number needed to treat would be a lot more meaningful to women, especially those on tight budgets wondering if it is worth $1,000 a year for a prescription.

Reporting of surrogate endpoints instead of primary endpoints is another way that readers get misled. Reports on cancer drug trials often fall into this trap. A “lifesaving” drug that shrinks tumors by 50 percent sounds a lot better than a chemotherapy agent that prolongs life by two months. The same can be said for bone density and fractures, blood pressure and strokes, and cholesterol levels and heart attacks. While there may be a minor yet statistically significant reduction in the primary endpoint, the trial sponsors prefer to promote the more dramatic-sounding secondary endpoint. Too many reporters prominently feature the less meaningful number, while leaving out or delaying until late in the story the real bottom line.

Sadly, the media have only lately come around to taking seriously the issue of conflicts of interest in medical science. Last July, the National Heart, Lung, and Blood Institute's National Cholesterol Education Project updated its guidelines for cholesterol management. The update, touted in the front page of every major U.S. paper, called for a dramatic reduction in the cholesterol levels now considered optimal for people who have never had heart disease but are considered moderately at risk. Prescribing physicians using these guidelines will likely put millions more Americans on these drugs in the next few years.

Yet three days after the report came out, reporters at Newsday broke the story that eight of nine physicians on the National Cholesterol Education Project panel had financial ties to statin manufacturers, which had the most to gain from the new guidelines. Writing in the Washington Post, former New England Journal of Medicine editor Jerome Kassirer asked, “Why should we swallow what these studies say?” The ensuing uproar contributed to a change in policy at the New York Times, which last fall circulated a memo to all reporters encouraging them to always report conflicts of interest of quoted sources in science stories, a policy that leading science and medical journals have had in place for many years.

In recent years the pharmaceutical and biotechnology industries have responded to complaints about the high cost of drugs by claiming they are needed to finance the medical miracles that are just around the corner. Meanwhile, the increase in life expectancy in the U.S. has slowed and still remains far below other advanced industrial countries. The number of new drugs coming out of industry labs, despite a slight uptick last year, is actually down from a decade ago. In a health-care environment that is increasingly cost-constrained, it shouldn't be too much to ask that medical reporters get beyond the hype and hope when reporting on the latest “breakthrough.”

This article first appeared in the Public Library of Science's PLoS Medicine in July 2005.

Chemicals in Our Midst

I was struck by two stories in this morning's papers: one in the New York Times reporting that Congress' energy bill will probably limit law suits against oil refiners for MTBE pollution; and the other a thorough report on the front page of the Wall Street Journal (subscription required) about the health effects of low-level industrial chemicals in the environment.

Limiting the MTBE lawsuits isn't just about money. In an era of deregulation, trial attorneys may be the last line of defense for getting corporate records about the persistence of this chemical in the environment, its leakage into groundwater, the unknowns about its long-term health effects, and the true costs of cleaning it up. The tobacco lawsuits proved that big companies often sit on documents that regulators -- and the public -- never see until forced out in the open by the legal system.

As I sit here getting ready for another day of play with my grandchildren, the Journal story makes me worry about the long-term effects of hazards like MTBE. We have no idea what they may be getting exposed to every day as the crawl through their early development stages.

For the record, here's what the National Institute of Environmental Health Sciences has to say about MTBE, a gasoline additive since 1979 that only recently was phased out and persists in the environment:

"Animal studies have shown adverse effects on the nervous system ranging from hyperactivity and incoordination to convulsions and unconsciousness. Human health effects of long-term exposures to smaller amounts of MTBE also are not known. Animal studies have shown kidney damage and adverse effects on fetal development. There is also some indication of cancer development in animals."

And Congress' and the administration's main concern in the face if these knowns and unknowns is to limit lawsuits and push the cost of cleanups onto states and municipalities.

Letter Writer Scores Daily Double

While the world wonders who is Judge John G. Roberts, avid readers of letters-to-the-editor sections are wondering this morning who is Josh Goldberg?

This Chicago lawyer, an associate at the corporate law firm of Winston & Strawn, wrote identical letters on Judge Roberts' Supreme Court nomination in today's New York Times and Washington Post. His point? This self-described "knee-jerk" liberal said the Senate has to "live with the choice that President Bush has made" because he won the election. So much for the advice and consent clause of the constitution, according to lawyer Goldberg.

While quick to pronounce Judge Roberts "eminently qualified," barrister Goldberg is clearly not qualified on the ethics front. Both papers ask letter writers for exclusive rights before publication. Unfortunately for the editors at those papers, this is impossible to check in this age of instant communication.

I suspect we won't be hearing from Goldberg -- at least in those two papers' letter-to-editor section -- anytime soon. Unless, of course, he changes his name, which is always possible. As Goldberg's daily double this morning proves, there's nothing more irresistable to editors and pundits than knee-jerk liberals ready to surrender without a fight -- or even a hearing.

Unsound Science

A friend sent a mind-altering article my way this afternoon. The L.A. Times reports that Jim Tozzi, a renowned Beltway lobbyist whose clients over the years have ranged from Big Tobacco to almost every major chemical company seeking to void EPA, OSHA and other health and safety regulations, has joined up with medical marijuana activists to reverse federal prosecutions against people who use the banned substance, prosecutions that were recently upheld by the Supreme Court.

Steph Sherer of Oakland-based Americans for Safe Access wants to use Tozzi’s “Data Quality Act” to claim the government ban ignores reams of medical evidence that smoking dope can ease pain, ameliorate migraines and mitigate the symptoms of chemotherapy. The Data Quality Act, a single paragraph that Tozzi slipped into a 2000 appropriations bill on behalf of his clients, allows anyone to challenge scientific findings that lead to government regulations. It's primarily a tool for big business.

I was enjoying thinking about Tozzi's involvement in this creative use of his pernicious law (Tozzi, now 67, was a budding jazz musician in his formative years; is he trying to recapture some of the joys of his youth?). But then the latest issue of the American Journal of Public Health crossed my desk. An article by Lisa Bero and her colleagues at the University of California at San Francisco entitled “Legislating ‘Sound Science’: The Role of the Tobacco Industry” documents how Philip Morris in the 1990s initiated a campaign to discredit the researcher who documented the connection between second-hand smoke and lung cancer. The capstone of that campaign was Tozzi’s Data Quality Act.

In the past several weeks, the Republican/big business sound science campaign hit a new low. Rep. Joe Barton (R-TX), chairman of the Energy and Commerce Committee, launched an investigation of three scientists who have been on the forefront of documenting the rapid rise in temperatures across the globe. Barton's merely “seeking data,” according to the committee spokesman.

In other words, rather than letting the normal processes of peer-reviewed science and exchange of data between scientists drive the scientific process, the pro-oil industry lobby has borrowed a page from Big Tobacco. First get your hands on the data, and then turn it over to friendly scientists to recast it as either wrong or indeterminate while you publicly castigate the researchers as propagating “unsound science.” When you release your "findings," do it preferably via press release from a friendly Congressional committee, rather than trying to get it published in a refereed scientific journal.

Earlier this week, fellow Republican Sherwood Boehlert (R-NY), chairman of the House Science Committee, demanded Barton call off the dogs in his “misguided and illegitimate investigation.” Apparently, even some Republicans are getting tired of right-wing attacks on the Enlightenment.

The Post gets it right on drug research!

Responding to a story that appeared two weeks ago in the New York Times, the Washington Post on Sunday editorialized that paying for a quadrupling of prices on cancer therapies that may extend life by a few months may not be a wise expenditure of public funds. There has to be major debate about this issue before the Medicare drug benefits goes into effect next year. Here's the upshot of the editorial:

"So, the appealing assumption about medical research -- that more is always better -- turns out to be wrong. Huge research budgets, financed by sky-high drug prices that reflect an absence of market discipline, come at the expense of diminished corporate competitiveness, stagnant wages, growing numbers of Americans who can't afford insurance, and higher taxes. The way to fix this problem is to create a health care market that pays for only cost-effective treatment; price signals would then refocus the research establishment on producing useful therapies."

-- Washington Post editorial, July 17, 2005

Kass Flunks His Own Yuck Test

If President Bush needs more evidence that his arbitrary limit on stem cell research has lost mainstream support, he got it over the past week. Parade Magazine, the AARP Bulletin and the latest National Geographic to hit the stands all ran major stories praising the promise of this emerging medical technology. A survey published in Parade showed 59 percent of Americans now back federal support of stem cell research.

Yet right-to-life organizations continue to seek protection for embryos at in vitro fertilization clinics, which, once they are no longer needed by the prospective parents because they’ve gotten pregnant, are discarded as medical waste. Instead of having them donated to science, the right-to-lifers would presumably keep them on ice forever.

The absurdity of the right-to-life position was highlighted at a Senate subcommittee hearing today. Senators Arlen Specter (R-PA) and Tom Harkin (D-IA) are sponsoring legislation in the Senate that would remove the Bush administration’s limitations on the National Institutes of Health. A similar bill passed the House last month.

The Bush restrictions, instituted in 2001 to please the right-to-life crowd, limit federally-funded stem cell research to the 22 viable lines that had been created before that date. Not only are those lines inadequate because many have been contaminated by mouse genetic material, but scientists now say that limiting them to just those lines will not allow them to develop new lines that genetically match their patients, which is one of the major therapeutic benefits of this still unfolding field. It also won’t allow them to study the evolution of cells taken from people with genetic diseases, which promises to be a major research tool produced by stem cell research.

With a vote expected any day, Specter called today’s hearing to allow proponents of alternative methods of developing stem cells to have their say. These methods, which were highlighted in a January report by the President’s Council on Bioethics, range from extracting single stem cells from the frozen embryo in a way that won’t damage the zygote to deprogramming adult cells to become stem cells.

Writing in today’s Washington Post, Leon Kass, the chairman of the President’s Council and a fellow at the right-wing American Enterprise Institute, put his faith in one particular method called altered nuclear transfer. The current preferred method for developing embryonic stem cells involves taking the genetic material from an adult’s skin cell and infusing it into a fertilized embryo that has been denuded of its own genetic material. After zapping it with electricity and allowing it to divide several times, scientists harvest the embryonic stem cells, which have the ability to grow into any part of the body.

Scientists who are experimenting with altered nuclear transfer remove one of the genes from the adult DNA before they put it into the egg. The missing gene makes the embryo incapable of developing beyond the stem cell stage. William Hurlbut, a bioethicist from Stanford and a Kass ally on the President’s Council, told Specter and Harkin that this is a “less morally unacceptable” approach to developing stem cells for research. The resulting spawn wouldn’t, he said, “have the moral status of a human embryo.”

The two senators were openly contemptuous of his – and by extension the President’s – logic. The bioethicists would forbid removing stem cells from healthy embryos, but allow scientists to bioengineer a defective embryo and then remove its stem cells. Is something that has been bioengineered to be defective the best material for research? And if the right-to-lifers insist that life begins when the sperm and egg meet, won’t they also say that this defective zygote has the same rights as frozen, normal embryos?

Indeed, most people would probably say that this bioengineered product flunks Kass’s famous “yuck” test for determining the moral acceptability of modern biotechnology techniques. “What is this Frankenstein thing we’re creating if we take a gene out?” Harkin asked. “What is it?”

It All Depends on What the Meaning of the Word 'Naming' Is

The outing of Karl Rove as at least one of the sources that revealed CIA agent Valerie Plame's identity is escalating quickly. The press corps at today's White House briefing was all over the issue so we should be hearing a lot more about this on the evening newscasts and tomorrow's papers.

I found this passage from today's Wall Street Journal to be especially prescient with regard to the next line of defense for President Bush's top political and strategic adviser. "It isn't clear whether Mr. Rove mentioned Ms. Plame by name to Mr. Cooper (the Time Magazine journalist) or even knew she was undercover, which special prosecutor Patrick J. Fitzgerald would need to know to prove Mr. Rove violated the law, known as the Intelligence Identities Protection Act," wrote Journal reporter Joe Hagan. "That law says it is a crime to knowingly expose the status of an active-duty CIA agent, and it is unclear whether 'naming' would literally have to be the person's name."

The story continues: "The unmasking of Mr. Rove marks an important milestone in the case. On the one hand, the details of Mr. Rove's discussion with Mr. Cooper -- especially if he didn't name Ms. Plame -- may exculpate him of the intentional, illegal disclosure of the identity of a covert CIA operative. Much will depend on whether Mr. Rove truthfully described any conversations in testimony before the grand jury. If he did, that would clear him of even a perjury charge and any criminal liability."

Over the weekend, Michael Isikoff, the Bassett Hound on the Monica Lewinsky scandal, revealed the essence of Rove's non-naming naming strategy in the latest edition of Newsweek. Here's what Rove said when first confronted about allegations that he was involved in leaking Joe Wilson's wife's name -- Valeria Plame -- to Robert Novak, the conservative columnist who gladly did the White House's bidding. "I didn't know her name. I didn't leak her name," Rove told CNN last year. The memo that Time Magazine's editor turned over to the federal prosecutor last week said that Rove told Cooper that Wilson's "wife" was behind his trip and that any intelligence it generated wasn't to be trusted.

I guess it will all depend on what the meaning of the word "naming" is.

Congress Moves to Further Erode Workplace Safety and Health

Less than a week after the latest terrorist assault in London, our business-friendly Congress has other things on its mind -- like screwing workers.

This week, the House of Representatives will consider a suite of bills aimed at reducing the Occupational and Safety and Health Administration's ability to enforce the nation's workplace safety laws. Rep. George Miller (C-Cal.) and Rep. Major Owens (D-NY) last week sent out a "dear colleague" letter outlining the stakes in the four bills. I'm reprinting the letter below. For more on this issue, and to learn more about workplace safety activists' efforts to stop these bills from passing, you can visit the Confined Space blog, which is a must-read for anyone concerned about the 5,500 Americans who die and the hundreds of thousands who get injured every year on the job.

Here's the letter:

COMMITTEE ON EDUCATION AND THE WORKFORCE
U .S. House of Representatives

July 8, 2005

OPPOSE Bills that Weaken Enforcement of Safety and Health:
Let's Make the Workplace Safe for America's Workers

Dear Colleague:

On Tuesday, July 12th the House is expected to consider four bills amending
the Occupational Safety and Health Act - H.R. 739, H.R. 740, H.R 741, and
H.R.742. Taken together, these one-sided bills rollback safety and health
protections for millions of American workers. These bills are strongly
opposed by the AFL-CIO. We urge you join us in opposing these OSHA
rollbacks.

Every day, fifteen workers are killed as a result of occupational injuries.
Almost 6,000 workers a year die due to workplace accidents. Another
estimated 50,000 to 60,000 die every year due to occupational illnesses.
12,000 workers a day are injured or made ill as a result of workplace
accidents or exposures. Liberty Mutual, the largest workers' compensation
insurance company, estimates that the direct cost of occupational injuries
and illnesses is $1 billion a week. These bills are intended to do
absolutely nothing to reduce this horrendous cost. Neither do any of these
bills address the heightened need to improve safety conditions on-the-job
for Americans. Instead, they make it easier for employers to challenge OSHA
citations, unnecessarily expand the Occupational Safety and Health Review
Commission (OSHRC), undermine the enforcement authority of the Secretary of
Labor, and punish OSHA for substantially justified enforcement actions if
the agency does not completely prevail.

H.R.742 poses the greatest threat to worker safety and health. The bill
requires OSHA to pay attorney's fees and costs for employers with 100 or
less employees and a net worth of $7,000,000 or less in any administrative
or judicial proceeding in which OSHA does not prevail. OSHA, as is almost
every other federal agency, is already required by law to pay attorney's
fees and costs in any proceeding in which the agency's charge is not
substantially justified. H.R. 742 singles out OSHA, alone among all federal
agencies, to require it to pay attorney's fees and costs in any proceeding
in which it does not win, regardless of why it loses and notwithstanding the
fact that the position of the agency was substantially justified. In
effect, unless the agency can guarantee that it will win every case it
brings, H.R. 742 punishes the OSHA for trying to enforce the law. The OSH
Act does not afford workers a private right of action. If OSHA fails to
enforce the law workers have no other means of doing so.

H.R. 741 provides that OSHRC shall have deference to override the Secretary
of Labor's reasonable interpretations of her own standards. OSHRC is a
quasi-judicial review commission. It is not a regulatory agency and should
not have regulatory authority. The Commission is already empowered to
disapprove and nullify or correct unreasonable actions of the Secretary of
Labor. However, in a unanimous decision the Supreme Court has said, because
interpreting regulations is a necessary adjunct to the rulemaking and
enforcement powers that are vested in the Secretary, the Secretary should
receive deference with regard to her reasonable interpretation of the
regulations that she has issued.

H.R. 740 unnecessarily expands the size of OSHRC from three to five members
and unjustifiably seeks to ensure that only lawyers are appointed to the
Commission. The Commission has functioned with three members since its
establishment in 1970. The authors of the OSH Act did not feel there was
sufficient work to justify more than three members and experience has not
shown otherwise. Experience has also shown that there is no basis for
limiting Commission membership to those with "legal training" and that, in
fact, the Commission has benefited from the participation of knowledgeable
non-lawyers.

Finally, H.R. 739 creates a legal loophole for employers' obligation to meet
the 15-day deadline for contesting an OSHA citation or notice of a failure
to abate a hazard. The deadline for an employer's response was set at the
15-day mark to encourage both the timely correction of cited workplace
hazards and expeditious handling of cases. The Commission already has
authority to review any missed deadlines on a case-by-case basis in a manner
that protects both employers and workers. H.R. 739 alters this process in a
one-sided manner that disadvantages workers, encourages litigation, and
undermines health and safety protection.

In summary, these four OSHA bills would impede the enforcement of worksite
safety and health provisions at the very time when more and more Americans
have identified safety as one of their foremost concerns. According to a
poll conducted in April by NBC and The Wall Street Journal, six out of ten
Americans want Congress to pass legislation that ensures greater workplace
safety and health. By seriously weakening the enforcement of U.S. safety
standards, these bills would take us in exactly the opposite direction. We
strongly urge you to join us in opposing and voting against H.R. 739, H.R.
740, H.R. 741, and H.R. 742.

Sincerely,
/s/
/s/
GEORGE MILLER
MAJOR OWENS
Senior Democratic Members
Committee on Education and Subcommittee on Workforce the Workplace Protections

Unscientific polling

Why do media outlets do this?

The latest issue of National Geographic has a well-written article on the prospects for stem cell research. But the magazine's website includes along with the article an instant poll that asks this question: "The future of embryonic stem cell research is being debated all over the world. Are you in favor of this research?" I clicked my answer: Yes. The website immediately told me that the "No"s were winning by a nearly 10-6 margin with about 16,400 votes cast. I then clicked again, and the "Yes"s had one more vote. Then I clicked again. . .

Car Wars

I was surprised that this morning's papers made no mention of the biggest downside to the emerging automobile price war: the Big Three are borrowing from future sales to liquidate yesterday's production. The entire focus was on internet savvy shoppers now accustomed to getting the best deals. But the motivator behind the huge price cuts is the fact that all the car companies have huge unsold inventories. GM, which kicked off the price wars, was successful in eliminating about a quarter of its million-plus stock of cars and light trucks (a euphemism for suddenly unfashionable SUVs). One analyst suggested this good news meant that GM would resume full production, probably in the fourth quarter, and that it would extend into next year.

Maybe. The other way to read these economic tea-leaves is that today's price wars are bringing people into the market who might otherwise have waited until next year for their next new car. With high gasoline prices showing no signs of abating, those good deals today could be a harbinger of harder economic times ahead.

Hava Cuppa Jo

While the negative results for Vitamin E and aspirin grabbed headlines, another important story in today's Journal of the American Medical Association involved that ubiquitous drug caffeine, or more specifically, coffee. The journal reports that regular drinkers reduce their risk of Type II (late onset) diabetes. That's good news to this regular. Think I'll go to the kitchen and get myself another cup.

Where's Novak?

Today's Wall Street Journal lead editorial applauds Time Magazine's decision to turn over Matt Cooper's notes to federal prosecutors. Besides breaking ranks with the journalism fraternity, the editorial hits a new low in how far conservatives will go to cover up the crimes of the Bush administration.

The editorial never once mentions the name of Robert Novak, the columnist who printed the administration leak of CIA agent Valerie Plame's name, a clear violation of the Secret Agents Secrecy Act. The as yet unidentified administration officials wanted to punish Joe Wilson -- Plame's husband -- after he wrote an op-ed in the New York Times contradicting administration claims before the invasion of Iraq that Nigerian uranium had found its way into Iraqi hands. The editorial dismissed Plame as a "office-bound spouse." This from the newspaper that fumed for years about Whitewater, the un-scandal that eventually led to President Clinton's impeachment.