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Comments by Dr Benway

Go to: Christopher Hitchens and Stephen Fry vs. The Catholics

Dr Benway's Avatar Jump to comment 259 by Dr Benway

We apologize for this off-topic notification:

LABOUR is driving through laws that will give the Church of Scientology tax breaks on its British missions.

While thousands of businesses face higher tax bills from April and homeowners brace themselves for rises in council tax, the wealthy church will be exempt.

The change is being forced by a Bill from Equality Minister Harriet Harman, which, for the first time, puts Scientology on the same footing as the Church of England and Roman Catholicism.
http://www.express.co.uk/posts/view/138928/Labour-gives-Scientologists-tax-breaks-

Harriet Harman's email = harmanh@parliament.uk

You know what to do.

Wed, 11 Nov 2009 18:43:00 UTC | #412827

Go to: 'Why Evolution Is True'

Dr Benway's Avatar Jump to comment 8 by Dr Benway

Oh hell. MacBook mousepad did something weird and flagged someone's post for something. I'm very sorry.

Wed, 04 Nov 2009 13:42:00 UTC | #411102

Go to: An Open Letter to Bill Maher on Vaccinations

Dr Benway's Avatar Jump to comment 239 by Dr Benway

If I have any questions or concerns about what I have seen, I ask my doctor about it during my next visit.


"Ask your doctor" may not be good advice now that they teach woo at med schools. From a current third year med student:
Yesterday a classroom of a dozen other students and I were asked how many of us would get the flu shot were it not required by the school. I was sad that not all hands went up, that not all of my classmates considered it a professional duty given our contact with immunocompromised patients, and that one even voiced the concern that the H1N1 vaccine was “rushed to market.”


http://www.sciencebasedmedicine.org/?p=2167

Wed, 21 Oct 2009 14:39:00 UTC | #407290

Go to: An Open Letter to Bill Maher on Vaccinations

Dr Benway's Avatar Jump to comment 237 by Dr Benway

Bonzai,

Some in the "evidence based movement" woke up to the point you're making about statistical limitations* when studies of magic water began appearing in prestigious journals.

Science-based medicine's message in a nutshell: data are only useful when the prior probability for the hypothesis under study is pretty good.

If we can't imagine a plausible mechanism for some therapy, we probably shouldn't bother with a controlled trial. The signal-to-noise ratio in medicine is low and without the constraint of plausibility, most positive results will be false positives.

"Evidence-based medicine" has been a gravy train for the pseudoscientists. Occasionally the magic water or the magic herbs seem to work. And even when they don't work, well, those federal dollars can make a facility look a lot more pretty.

SBM kicks EBM's ass. Too bad SBM is only like 12 dudes.
______________
*OK, not your exact point, which has more to do with access to first person data. But you were talking limitations, so I'm riffing on that.

Wed, 21 Oct 2009 12:53:00 UTC | #407258

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Dr Benway's Avatar Jump to comment 236 by Dr Benway

Say what you want about Big Pharma, but one thing is for sure---it's profits before people with these guys.

I hate saying anything in defense of BigPharma. It's like asking for an ass kicking. *sigh*

Before settling into the emotionally satisfying David side of the David-Goliath story, remember that "these guys" includes just about everyone with a 401k plan. And remember that the profit motive is capitalism --generally felt to be a good thing by Western democracies, provided that there is some public oversight and regulation. Few companies are more regulated than those that make pharmaceuticals.

The government is looting drug manufacturers right now. The government is desperate for money.

I haven't read the details about Pfizer. But the case against Lilly some months ago for the off-label promotion of Zyprexa did not impress me. Lilly got in trouble for some promotional materials put out over about a 3-month period that mentioned how Zyprexa might be useful for elderly psychotic patients with loss of appetite. This is in fact true. Zyprexa does reduce psychotic symptoms and it also gives people the munchies. However there's no specific FDA approval for this indication.

Lilly broke the rules. They should be spanked for that. But they were more than spanked, they were raped to the tune of 2.4 billion.

I like the fact that the major pharmaceutical companies do science, real science. I also like that they help fund medical training directly and indirectly. The training is expensive. And it's good to learn from those doing research on the cutting edge.

I don't like the fact that drug companies may not publish negative results or might over-hype their data. However, I see these as fixable problems.

Now that taking money from BigPharma is uncool, med schools are taking money from the alties. Ergo, the woo fest of the now.

Rounding up the bad people will not save us, for we are the bad people. There are as many bastards working for the government as there are in industry. In fact, some of the most agenda-driven, shitty research I've read has been publicly funded.

And hey, where are my kickbacks? I never got none of those. *sniff*

Wed, 21 Oct 2009 12:25:00 UTC | #407254

Go to: An Open Letter to Bill Maher on Vaccinations

Dr Benway's Avatar Jump to comment 225 by Dr Benway

Maybe the legal battle with the chiropractors was the beginning of this mess.

For decades the AMA EXPEEEEEEEEEEEEEEEEEEEEELD!!!!!!!!!!! all the alties. Doctors used to openly call chiroprators, naturopaths, and faith healers "quacks." They wouldn't let them work in hospitals and any doctor who referred patients to them might get in trouble.

Then in the 1980s the chiropractors sued the AMA for trade infringement. The case went all the way to the Supreme Court, who ruled against the AMA in 1990.

That event was like Kitzmiller v. Dover, except with the pseudoscientists coming out on top.

It's an interesting thought experiment, imagining what the biological sciences might look like today had the creationists managed to break the authority of the scientific consensus in biology back in 1990. Imagine conferences on marine biology or ethology or genetics contaminated with wooly headed blather about the life force, the healing power of nature, the natural order, maleness and femaleness as energy fields, blah blah blah.

I don't know the arguments the AMA used in its defense. They probably didn't think to argue that chiropractic is a religion.

Like a Twinkie, all the alties have a faith based creamy center. Even the "biomedical" therapies for autistics --which sound quite sciency-- have a core belief system that is vitalistic. You just need to know where to look.

The alties must be EXPEEEEEEEEEEEEEEELD!!!! from medical science.

Dammit!

Wed, 21 Oct 2009 02:48:00 UTC | #407198

Go to: An Open Letter to Bill Maher on Vaccinations

Dr Benway's Avatar Jump to comment 224 by Dr Benway

hungarianelephant:

I'm in.

How?

I think we need to figure out what destroyed the authority of the scientific consensus in medicine between 1990 and now. Medical scientists used to denounce quackery as such, and none could gainsay them.

There's a third year med student, Tim Kreider, blogging at SBM. From today's piece:
...It advertised the “Holistic Series” offered this autumn by the School of Nursing. Listed were four day-long sessions:

* Reiki: Certification in Level 1 Attunement
* Holistic Nursing
* Nursing in Herbal Medicine
* Aromatherapy for the Healthcare Provider

...Our typical patients have few resources and little science education, and they trust us as one of the few sources of care accessible to them. I believe that such promotion of “unconventional” CAM philosophies does our patients a disservice. It is hard enough for healthcare providers to teach patients how to manage their complex chronic diseases like diabetes and AIDS without having magical thinking encouraged on the hospital grounds. Fine if you want to fight over the merits of QiGong in the halls of academia, but presenting homeopathy to the public as a noncontroversial treatment option seems wrong to me.
WTF?

Years ago this kind of woo was found in small storefronts and home offices, mixed with palm reading and psychic services. You would never, ever find this at a place like Harvard Medical School.

What happened? Why are we teaching the next generation of physicians and nurses "holistic" or "spiritual" healing practices?

Wed, 21 Oct 2009 01:58:00 UTC | #407196

Go to: An Open Letter to Bill Maher on Vaccinations

Dr Benway's Avatar Jump to comment 219 by Dr Benway

"Reassure the public" is clearly stupid. What doctor would say, "I'm about to do something that might make your child retarded. No worries, however, because if that happens you'll be set for life financially."

Neither individual patients, individual doctors, or individual court cases are adequate to establish cause-effect relationships between a medical intervention and its outcome.

In my opinion, a chaotic, international community of independent scientists capable of peer review and replication of each other's work, and capable of aggregating their collective experience into documents of consensus opinion, is the best trier of fact we can get. Our efforts should go toward protecting that community from extreme pressures to cheat or bullshit.

Read this excellent article, "The New Plague." It's about fear and the anti-vax movement. But one might replace "anti-Vax" with any number of popular anti-science camps: intelligent design, AIDS denialism, global warming deniers, anti-BigPharma, etc. The common theme is misunderstanding of how science works and mistrust of the scientific consensus.

"The true meaning of the word skepticism has nothing to do with doubt, disbelief, or negativity. Skepticism is the process of applying reason and critical thinking to determine validity. It’s the process of finding a supported conclusion, not the justification of a preconceived conclusion."

Tue, 20 Oct 2009 16:26:00 UTC | #407058

Go to: An Open Letter to Bill Maher on Vaccinations

Dr Benway's Avatar Jump to comment 217 by Dr Benway

Interesting, hungarianelephant. I'm taking what you're saying about drug development oversight and thinking about the problem of oversight in medicine more generally.

Where to invest authority? And who polices the authority? And who polices the police? What is the cost of oversight verses the benefit?

I'm not happy with amatures in the police role. It's so time consuming, explaining yourself to someone who hasn't read the books, etc.

The third party oversight people have made my job nearly impossible. Private practice is going the way of the dinosaur. The administrative overhead is too much.

I hardly ever spend time with patients now. I'm on my ass looking at a glowing screen, making pretty book reports. This is a crazy, costly, inefficient way to do things.

Let me be the first to say that my colleages often do not impress me. Some oversight is good thing.

The tort system is one way to it. But it's so expensive. Lawyers aren't cheap. And any given trial will be about a case or set of cases apart from the background of public health. You don't get sued for ordering too many tests and bankrupting the community chest. The tort system has made doctors so risk adverse they're spending us into the poor house.

Further, courts resolve conflict but are no guarantee of justice or truth, in my humble experience.

Anyway, getting back to the vaccinophobes, the Autism Omnibus hearings have largely ruled against the vaccine-autism link. The Hannah Poling case is an exception, although that child has a mitochondiral disorder, not autism. Still, she's a poster child for the vaccine injury camp.

Governments have set aside funds for children injured due to required vaccinations, to reassure the drug companies they wouldn't be sued out of business, and perhaps to reassure the public. But attorneys after that pile of money in this country and the UK have been at the heart of the recent increase in anti-vax feeling. Note how many guys on the NVIC link I gave are lawyers.

Unintended consequences, I guess.

Wow, this rambles. And shit, I'm late for work.

Tue, 20 Oct 2009 14:17:00 UTC | #407011

Go to: An Open Letter to Bill Maher on Vaccinations

Dr Benway's Avatar Jump to comment 207 by Dr Benway

k1mgy:

The National Vaccine Information Center...
NVIC aren't nearly as batshit as whale.to, but they're close. Below is a link listing the speakers at their recent conference in DC:

http://www.nvic.org/Events/speakers.aspx#WAKEFIELD

Yes, Andy fucking Wakefield. The dude hired by a vaccine litigation attorney who made up a fake study filled with fake data that got published in the Lancet. The dude who started the MMR scare in Britain.

The rest of the list reads like a clown-car of crazy.

Tue, 20 Oct 2009 01:12:00 UTC | #406876

Go to: An Open Letter to Bill Maher on Vaccinations

Dr Benway's Avatar Jump to comment 205 by Dr Benway

Bonzai:

What do you mean by the prior probability for flu vaccine,what would the posterior probability represent?

Yeah, I guess I kinda condensed my meaning beyond all intelligibility.

What I meant to convey was this: We understand the molecular mechanism of provoking an antibody response in exquisite detail. Plus we have 60 years of cooking up annual flu vaccines. We may not be able to precisely predict how many vaccinated individuals will be protected by the vaccine. But we can predict a range that will be a very safe bet.

So when people complain that the swine flu vaccine was rushed and not adequately proven safe and effective, I kinda don't really care.

Tue, 20 Oct 2009 00:53:00 UTC | #406871

Go to: An Open Letter to Bill Maher on Vaccinations

Dr Benway's Avatar Jump to comment 204 by Dr Benway

Sarmatae1:

By your criteria we should not accept any premise that Hitchens has on evolution because he is not a biologist.
How is Hitchens at cladistics? Evo-devo?

Hitchens can be a secondary source. He can teach what he understands about evolution. But he can't be a primary source.

Hitchens is a well-educated person, and he might be able to spot a few problems in primary sources. But a lot will go over his head. Scientists who've fully mastered the relevant material are in the best position to review another scientist's work.

Shannon Brownlee's credentials in this area are really beyond reproach.
There are a few journalists in the habit of repeating disparaging canards about medicine*, usually followed by "therefore homeopathy," or the like. Shannon Brownlee is one of those, sadly.

Hey, I hate rich corporations as much as the next guy. Boo BigPharma! But Jesus H. Christ, please don't convince the public that everyone's opinion is just as good as all those pointy-headed scientists. We need the authority of a scientific consensus. It's the only weapon we've got against the uber-powerful who would love to ignore basic rules of evidence.
_________________
*example: "...how many people are aware that LESS THAN FIFTY PERCENT (50%) of western medical practice is based on valid scientific evidence and some experts estimate that number is low as FIFTEEN PERCENT (15%)." Meh.

Tue, 20 Oct 2009 00:37:00 UTC | #406869

Go to: An Open Letter to Bill Maher on Vaccinations

Dr Benway's Avatar Jump to comment 188 by Dr Benway

Ok, now I seriously must get work done.

HEY RICHARD DAWKINS!

Just want you to know that even though the Maher thing got me really upset, I'm still your biggest fan. Hope I made you laugh a little. Please be well.

:o)

The Tufted Titmouse

Mon, 19 Oct 2009 16:16:00 UTC | #406750

Go to: An Open Letter to Bill Maher on Vaccinations

Dr Benway's Avatar Jump to comment 185 by Dr Benway

AlinMoraru,

The flu vaccine admittedly offers the greatest room for debate. But the matter has been well addressed elsewhere. Here's one example:

http://scienceblogs.com/effectmeasure/2009/09/seasonal_flu_why_i_got_vaccina.php

Few here have the background needed to participate in a technical discussion over the risks and benefits of flu vaccine, which I might point out is a *voluntary* vaccine. They must rely upon heuristics. Source quality is one heuristic. Scopie's law is one heuristic.

Here's another heuristic for those familiar with Bayes' theorem: the prior probability for any seasonal flu vaccine is effin' HUGE. It's so huge that the results of individual epidemiological studies hardly matters.

It might be fair to say that our understanding of vaccine mechanism of action trumps just about every other proposed mechanism used in medicine.

The CDC represents a consensus of hundreds of independent scientists. Why would you reject their opinion? Why would you presume to know more?

jrod: So called Dr Benway, smallpox was already on the decline prior to the introduction of the Salk vaccine in 1955. 35 cases per 100,000 in 1952 to less than 15 per 100,000 prior to the vaccine being introduced. Next...

jrod, you're just embarassing yourself with your own ignorance now. It's like watching a first grader trying to talk about calculus.

Mon, 19 Oct 2009 15:48:00 UTC | #406742

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Dr Benway's Avatar Jump to comment 182 by Dr Benway

jrod, you need to admit that you are ignorant regarding vaccines. Then, perhaps, you might learn something.

Jesus cannot give the little children smallpox anymore. Thank precious, wonderful, life-saving, sweet sweet vaccine goodness for that.

Mon, 19 Oct 2009 15:28:00 UTC | #406736

Go to: An Open Letter to Bill Maher on Vaccinations

Dr Benway's Avatar Jump to comment 176 by Dr Benway

Wow, just as I was about to walk away I see this from jrod0725:

http://www.whale.to/a/pdf/geier.pdf


AAAHAHAHAHAHAAHAAAAAAA!

Whale.to is one of the most notorious sources of pure concentrated batshit on the webs. jrod's use of it allows us to invoke Scopie's Law:

In any discussion involving science or medicine, citing Whale.to as a credible source loses you the argument immediately... and gets you laughed out of the room.


http://scienceblogs.com/insolence/2008/06/the_nuttiness_that_is_whaleto.php
___________________________
Orac, your web site is so handy!

Mon, 19 Oct 2009 15:02:00 UTC | #406726

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Dr Benway's Avatar Jump to comment 171 by Dr Benway

jrod0725, you didn't find those links on your own. You didn't even read the one you posted on vaccinosis. You copied that stuff from some web site.

Fess up.
_______________________
Allow me to point out that non-experts must rely upon source credibility as well as prior plausibility and evidence. Weighing the evidence may require some technical skills beyond the average reader. When that happens, source credibility trumps evidence.

If the vaccine thing has anyone worried, consider this: On the one hand, Jonas Salk. On the other, jrod0725, MCrnigoj, and AlinMoraru.

Now I've got to get back to work. Hopefully this little demonstration of proper woo spanking technique will be of use to some of the skepticos here.

Mon, 19 Oct 2009 14:33:00 UTC | #406717

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Dr Benway's Avatar Jump to comment 168 by Dr Benway

It took 60 years before the the medical community switched from whole cell pertussis vaccine to acellular.
Yes, those stupid doctors.

But what about those stupid electrical engineers? Did you know that it took just about as long before they switched from analog to digital broadcast television?

Mon, 19 Oct 2009 14:28:00 UTC | #406714

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Dr Benway's Avatar Jump to comment 164 by Dr Benway

jrod0725,

You are clearly not a scientist. You're passing along information you picked up from some other source. Please tell us your source so we can have a look at it.

Mon, 19 Oct 2009 14:06:00 UTC | #406708

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Dr Benway's Avatar Jump to comment 163 by Dr Benway

AlinMoraru's post is an excellent example of crank magnetism in action:

...Bill Maher is right to question vaccines.

...why are the skeptics so eager to jump on the MSM bandwagon when it comes to 9/11?

...Why is the science in on global warming...

...It seems the AP was a "birther" organization way back in 2004.

"Crank magnetism is the phenomenon in which a person who is a crank in one area very frequently tends to be attracted to crank ideas in other, often unrelated areas."

Mon, 19 Oct 2009 14:03:00 UTC | #406707

Go to: An Open Letter to Bill Maher on Vaccinations

Dr Benway's Avatar Jump to comment 143 by Dr Benway

It's a tough project.

Nearly always the person challenging you with health nonsense will be a non-expert just like you. They won't have a deep understanding of pharmacology or physiology. They'll merely be echoing some other more primary source.

So ask the person, "Where do you get your health information?" It's a fair question. If they quote research papers, tell them that you can see they aren't scientists. Their references are copypasta from elsewhere. So where?

Many alt.med ideas can be traced back to a few web sites filled with the most apalling bullshit. If the source happens to be one of these sites, your have win. Just look around for one example of supernaturalism (e.g., homeopathy, Reiki, qi, prayer, the "innate intelligence of all living things," etc.). That's sufficient to destroy the entire web site's scientific credibility.

But wait, you say. Isn't slagging the source an ad hominem? A logical fallacy?

No. You can't dismiss an argument just because it comes from a dodgy source. But you can dismiss any factual claim from an untrustworthy party. Because acceptance of a factual claim implies acceptance of the credibility of the person making the claim.

A horselaugh is well within your rights in response to anything from a web site that tries to sell you homeopathic remedies.

Edit: I just remembered that Prince Charles dude sells homeopathic remedies. LOL!

Mon, 19 Oct 2009 04:50:00 UTC | #406627

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Dr Benway's Avatar Jump to comment 139 by Dr Benway

jrod0725's copypasta gambit has given me an idea.

As mentioned above, I'd set aside a few spare neurons to work on the problem of weaponizing non-medical skeptics so that they might assist the medicos in their epic battle with the woos.

Predictably the enemy will throw a lot of sciency references and terms at the non-meds. He will bring on a medical version of the Gish Gallop --an overwhelming shotgun of stupid, perhaps in bullet-list form. He knows that the non-meds can't begin to research all the crap he spews. Note that he will not seem to care about being understood. Be ready for the unpleasant sense of confusion he provokes.

Strategy 1:

Pick a keyword from the mess he presents and Google it with "Orac." Odds are Orac was there already. Read what he says, link to it, call it a day.

Strategy 2:

Ask the enemy who he represents. If he claims he's just a concerned citizen, tell him he's clearly not an expert. He's simply repeating something he's been told. So what's his source? What web site does he visit to learn about medical issues?

The tender religious underbelly of the woo will be hiding at its source. Once you uncover it you'll find your feet on familiar territory. And victory will be yours.

Mon, 19 Oct 2009 02:35:00 UTC | #406615

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Dr Benway's Avatar Jump to comment 137 by Dr Benway

Uh, jrod0725... Read your own references.

Here's the concluding sentence from your vaccinosis link:

The issue of the risk of vaccination remains a philosophical one, since to date THE ADVANTAGES OF THIS POLICY HAVE NOT BEEN REFUTED (i.e.,"vaccines good"), while the RISK FOR AUTOIMMUNE DISEASE HAS NOT BEEN IRREVOCABLY PROVED ("risk tiny").


"Vaccinosis" on PubMed is amusing.

Why are you in this fight, jrod0725? Clearly you're no scientist. Are you selling something?

Mon, 19 Oct 2009 01:46:00 UTC | #406612

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Dr Benway's Avatar Jump to comment 133 by Dr Benway

So you guys can take on faithheads like black belts but medical woo makes you feel like white belts.

Ok, then perhaps this strategy might work for you:

1. Find the religion within the woo
2. Kill it with fire

You will need some help spotting the faith-based bits, as they're usually well hidden. I'll give the matter some thought.

Sun, 18 Oct 2009 23:09:00 UTC | #406577

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Dr Benway's Avatar Jump to comment 129 by Dr Benway

Hey that's better, gfl. I agree with many of your points.

PTSD, for example, has a robust literature describing a distinct pattern of hyper-arousal alternating with emotional numbing.

Sun, 18 Oct 2009 19:40:00 UTC | #406505

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Dr Benway's Avatar Jump to comment 128 by Dr Benway

For a layman, it's hard to be able to rebut the fancy sounding claims of some alties, at least where regard to the efficiacy of real medicine is concerned.
Yeah I can see that.

Dammit! It's not fair.

I'm but one tiny titmouse with a day job.

Who will save de Urfs?

Sun, 18 Oct 2009 19:35:00 UTC | #406504

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Dr Benway's Avatar Jump to comment 126 by Dr Benway

Evidently, even George W. Bush never took any of this too. Surely, he knows something we don't know.
Nearly everyone at RD.net is careful to consider, "What would GWB do in this situation?" before making any important decision.

Sun, 18 Oct 2009 19:29:00 UTC | #406501

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Dr Benway's Avatar Jump to comment 125 by Dr Benway

If ScienceBasedMedicine is just a collection of writers promoting their own reactionary, biased views to different medical stories, then I think their name is misleading and likely to reinforce the worst prejudices about science.
You are angry, I can see that.

And you're clearly an intelligent person. Forgive my unsolicited advice: If you read an article containing some bit you feel is wrong, quote that bit and explain what's wrong with it. Generalizations about the character of the writer or the web site will only serve to derail productive conversation.

Sun, 18 Oct 2009 19:25:00 UTC | #406500

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Dr Benway's Avatar Jump to comment 120 by Dr Benway

CFS,

1. I think you're saying that Dr. Sampson has concluded CFS is psychological. I read him as expressing a bias or an expectation that CFS will, in most cases, be caused by psychological factors.

2. The problem with an unsconcious cause is non-falsifiability. Yet we know unconscious processes exist. So when no physical etiology is found, we're left with the possibility some unknown physical process accounts for the problem, or some unconscious process may be causing the problem.

3. Sometimes we can prove an emotional factor is associated with the symptoms. But sometimes we later discover a physical cause also. The reverse can be true, too.

4. I know of no good way to construct a "we don't know" category that does not convey a sense that unconscious factors may be involved.

5. One day this argument will be moot, as mind will reduce to body. But that's just my bias, not an assertion of fact.

Sun, 18 Oct 2009 19:03:00 UTC | #406490

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Dr Benway's Avatar Jump to comment 118 by Dr Benway

Bonzai! How goes it up there in the great white north?

Sun, 18 Oct 2009 17:20:00 UTC | #406470