Lydia Denworth is a little too quick to dismiss fears of the effects of social media on young people by setting up false equivalences in “The Kids Are All Right.” For instance, if fears of television have been unfounded, it doesn’t follow that fears of social media are parallel in a meaningful way. And I don’t think either that example or the others she cites have been unequivocally proved to be baseless. I thought it was fairly well established that too much TV is bad for developing minds. Further, one could easily build a case that city life (at least a congested one disconnected from a stable community) is comparatively detrimental to mental well-being. And clearly, Socrates was correct that the use of writing would affect the ancient practice of memorization: it’s unlikely anyone today would be able to recite the Iliad in its entirety.

JON FRAZE via e-mail

I find that one result of the growing use of social media is seldom addressed: When young people use it as their chief way to communicate, it seems they lose the ability to “read between the sentences.” How does one learn to decipher body language or hear expressions of joy, despair, fear or distress when reading texts? How does one express the depth of gratitude in the shortened and misspelled phrase “Thanx”? I fear that what will be lost is a richness of the spoken word and the subtlety of thoughts gained only through hearing nuanced sentences.

JOAN MCCRACKEN Billings, Mont.


Kirk J. Schneider has great points about how we might benefit from a new kind of national leadership to tackle our mental health crisis in “The U.S. Needs a Mental Health Czar” [Forum]. As a social worker and social work and mental health educator, I would like to also add a few more ideas to the discussion.

First, rather than having a single czar who is an expert on psychological approaches, we might consider the possibility of introducing a multidisciplinary team that would consider many interrelatedfactors we now suspect are associated with mental health. For example, social workers could add much to the assessment of, prevention of and response to mental illness by considering environmental factors that may contribute to the suffering of people today. Similarly, ecological scientists and biologists might, for instance, be able to help us understand how air pollution, traffic congestion and other urban stressors could be associated with human problems. And the addition of people who are skilled at assessing spiritual needs might also contribute. Such a team could be especially helpful in the primary prevention of mental illness through building new regulations, policies and social justice reforms.

Second, we have not only a national crisis but also a global one. For example, the widespread depression of individuals across the globe that the World Health Organization has repeatedly noted may reflect, at least in part, a reaction to such issues as climate change, displacement and preparations for war. Because the biological and psychological welfare of people in our country is interrelated with that of everyone else on our “shrinking” planet, the U.S. could work collaboratively with other nations to identify factors that may contribute to all human suffering.

DAVID DEREZOTES University of Utah


In “The Inescapable Casino,” Bruce M. Boghosian presents a scenario in which “Shauna” gambles on coin tosses. Each win increases her wealth by 20 percent, and each loss decreases it by 17 percent. It seems to me that the result of the simulation is implicit in the way it is set up: If Shauna’s wealth is $100 and she plays against a richer agent, then one win, followed by one loss, or vice versa, results in a net loss to her of $0.40, or 0.4 percent of her initial wealth. If she plays against a less wealthy agent, then she will gain 0.4 percent of that agent’s wealth. Thus, the net gain always flows to the wealthier agent. A 20 percent win and 17 percent loss do not represent a fair system. And replacing the latter with anything greater than 162/3 percent will produce the same results.


BOGHOSIAN REPLIES: Lysenko’s calculations are correct. In the yard sale model my scenario was based on, the fractions won and lost with each coin flip are the same, which even more clearly favors the wealthier agent. In the case where Shauna is the poorer agent, I decreased her loss percentage to emphasize that even when she has a positive expected gain at each flip, the longer she plays, the more likely she is to lose.

To underscore Lysenko’s point with simpler numbers, let’s change the poorer agent’s win and loss percentages to +100 and −75, respectively. Her expected gain in wealth is now (100% – 75%) / 2 = 12.5%, which is positive. But note that winning means doubling her wealth, and losing means quartering it. Hence, it takes two wins to compensate for a single loss. Because the coin is fair, she will lose in the long run, even though her expected gain in wealth at each toss is positive.

A different way to frame this apparent paradox is to note that the expected gain in the logarithm of the poorer agent’s wealth is negative. Supposing that we use base 2 logarithms: If she wins, her wealth is doubled, so its logarithm increases by 1. If she loses, her wealth is quartered, so its logarithm decreases by 2. Thus, the expected gain in the logarithm is (1 – 2) / 2 = −0.5, which is negative. The game is multiplicative, so the expected gain in the logarithm of wealth is a better indicator of success than the expected gain in wealth itself.

All of the above stays true if the amount won by the poorer agent is 20 percent of the ante and the amount lost is greater than 16 2/3 percent, just as Lysenko surmises. It will take the poorer agent longer to lose a given fraction of her initial wealth with those figures, but lose she inevitably and inexorably will. Only if the amount lost is less than 16 2/3 percent does the game become favorable to her in the long run.

I hope these observations make it less counterintuitive to contemplate a dynamic in which most people are likely to lose in the end even though their expected gain in each coin flip is positive.


“A Dilemma with New Drugs,” by Claudia Wallis [The Science of Health], brought back memories of my three decades of doing drug trials funded by both the National Institutes of Health and pharmaceutical companies. The article is correct in faulting our failure to accurately compare the effectiveness of new drugs with that of old ones. But the problem is much deeper. I stopped doing proprietary studies many years ago because it became clear that companies were not interested in finding better drugs but simply in putting out new ones under patent when the old patents expired. Advertising blitzes allow inferior and more expensive drugs to capture more than 80 percent of the market whether they are better or not.

Those ads are costly and certainly do not educate the consumer. Only two developed nations allow direct-to-consumer advertising of pharmaceuticals: the U.S. and New Zealand. And the U.S. is an outlier in expressly forbidding one of its federal programs—Medicare—from negotiating drug prices with manufacturers and in not regulating such prices overall. Consequently, we pay many times the price that other nations do. American pharmaceutical companies are much like an organized crime syndicate. Their campaign contributions to politicians have made our Congress guilty of aiding and abetting their crimes.

THOMAS M. VOGT Portland, Ore.