Accidental Blogger

From the New York Times Well Blog, first, a story about tamoxifen.  Tamoxifen is an antagonist of the estrogen receptor in breast tissue, and some breast cancer cells require estrogen to grow.  It cuts the risk of developing breast cancer in half.  The story mentions other chemopreventions drugs, too.  Apparently, these aren't popular.  This quote stuck out to me:

The pill is tamoxifen, and Ms. Birkhold, now 52, was considered an
ideal candidate for it: she tested positive for a breast cancer gene,
her mother had ovarian cancer, and her aunt had breast cancer. Yet
rather than take tamoxifen, she opted for surgery to remove her breasts
and ovaries.

“I even went so far as to get the prescription” for tamoxifen, she
said. “But then I started reading more and decided this isn’t the way
I’m going to go. I don’t like to take drugs.”

I'm not sure anyone likes to take drugs, at least if they're not fun drugs, but who likes to have surgery?  Or do nothing, if already at a high risk for breast cancer? 

Second, a story about avoiding injury while skiing.  New ski equipment increases the injury risk.  This quote stuck out to me:

Similarly, while helmets have reduced the total number of
skiing-related head injuries by 30 to 50 percent, Mr. Shealy says,
“when you look at the really serious head injuries, helmets aren’t much
help.” If you hit a tree at “speeds common in skiing” — 30 miles per
hour or more on steep slopes — “you will exceed the capacity of the
helmet to save you.” Helmets also “may promote reckless behavior,” Mr.
Shealy says. “It’s just human nature.” Skiers still should wear
helmets, he adds, but should also practice restraint and common sense
on the slopes, the primary means of reducing your risk of injury
anyway. “The message,” he concludes “is not: Don’t wear a helmet. It
is: Don’t hit a tree.”

The fact that wearing helmets encourages riskier skiing shouldn't be surprising, but what surprised me is that helmets aren't equipped to prevent injury at speeds common in skiing.  Sounds kind of useless.  So why is this guy recommending wearing one?  Yes, it doesn't cause injury, except to the extent it negatively alters behavior, but if it's not going to do any good anyhow, what's the point in wearing one?

As suggested by the title, I find irrationality in both of these stories, the first with regard to patient behavior, the second with regard to safety advice.  I don't have anything profound to add beyond that — maybe a behavioral economist would — but it is interesting to me.