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Beyond the Hoax: Science, Philosophy and Culture

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Beyond the Hoax: Science, Philosophy and Culture seen from the radiation late 1980s, Cormack and oth- tral beams, the beam range is affected source. His stated intention for ers developed the concept of rather than the intensity. the book is to describe as sim- intensity-modulated radiation Radiation Oncology is neither a text- ply as possible from a physi- therapy (IMRT), in which in- book nor an autobiography: It provides cist’s perspective the use of ra- dividual beams of nonuni- a lucid account of some of the modern diation in the treatment of form intensity could be used technologies and methods in radiation cancer. In the attempt, he suc- to provide either uniform or therapy in which the author has been a ceeds admirably, but his ac- nonuniform dose distribu- leader. Although I am not aware of any count does not cover clinical tions in the target volume. The other texts quite like it, Goitein’s book issues; also, it exclusively em- advantage of that technique does have some similarities to People braces high-energy x-ray and compared with uniform- and Particles (San Francisco Press, 1997), proton-beam therapies, a focus that re- intensity radiation therapy is better con- a largely autobiographical account flects the author’s main interests in ra- formation of the dose to complex target written by biophysicist Cornelius To- diation oncology and major contribu- volumes, specifically concave ones, and bias and his wife, Ida. Goitein‘s avoid- tions to the field. For three decades improved sparing of surrounding nor- ance of mathematical formulas makes Goitein was involved in unique devel- mal tissues. The technique is now rou- his treatise easily readable. The foot- opments in those two treatment modal- tine in x-ray therapy and will find in- notes that elaborate concepts and defi- ities at Massachusetts General Hospital creasing application in proton therapy. nitions are useful, and the author ex- in Boston, and he is now a professor Radiation Oncology gives detailed plains concepts clearly and provides emeritus of radiation oncology at Har- discussions of the topics mentioned extensive illustrations and understand- vard University Medical School. above. Also covered are interactions of able diagrams. I found some of the fig- Treatment planning in radiation on- radiation with matter; uncertainty in ra- ures to be rather small, but they do not cology essentially involves designing a diation oncology quantities, a topic that really detract from the quality of the set of radiation beams to maximize the in Goitein’s view is often not adequately work. Goitein’s book presents excellent therapeutic ratio, the ratio between addressed; delineation of anatomy; ra- background and is an invaluable re- tumor-control probability (TCP) and diobiological issues; motion manage- source not only for the experienced normal-tissue complication probability ment; optimization in IMRT treatment practitioner but also for the radiation (NTCP). Until the 1970s it was only pos- planning; and confidence and quality oncologist, medical physicist, or sible to do such calculations by hand, assurance. dosimetrist who is new to the field. although some computer programs The rationale for using protons for Dan Jones were available to enhance the process. radiation therapy lies in their physical Cape Town, South Africa The treatment plan essentially involved properties, which result in near-zero a set of isodose contours superimposed dose beyond the target volume and on a hand drawing of a transverse cross thus provide the ability to conform the section of a patient’s anatomy. The in- planned dose more closely to the spec- Beyond the Hoax vention of whole-body computed x-ray ified target volume than is feasible by Science, Philosophy and tomography (CT), for which physicists photon techniques. The author was also Culture Allan Cormack and Godfrey Houns - responsible for developing and imple- field shared the 1979 Nobel Prize in menting new techniques for proton Alan Sokal Physiology or Medicine, and rapid therapy at the Harvard Cyclotron Lab- Oxford U. Press, New York, 2008. advances in computer technology oratory, where nearly 10 000 patients $34.95 (465 pp.). changed all of that. were treated. Furthermore, he was in- ISBN 978-0-19-923920-7 Goitein realized the potential of the strumental in establishing the Francis Alan Sokal was once my hero. His bril- new technology and led the develop- H. Burr Proton Therapy Center at Mas- liant parody of postmodern academic ment of three-dimensional treatment sachusetts General Hospital. Proton prose, “Transgressing the Boundaries: planning using CT images. Today 97% of therapy is a rapidly proliferating field Towards a Transformative Hermeneu- radiation-therapy treatments in the US and is now firmly established in radia- tics of Quantum Gravity,” appeared in involve CT imaging. Goitein is also well tion oncologists’ armamentarium. 1996 in the cultural studies journal So- known for his development and practi- Goitein’s treatment of the topic is clear cial Text. The journal’s editor took the ar- cal use of a variety of other tools, such as and easy to follow, and he highlights ticle seriously; I thought it was the fun- digitally reconstructed radiographs the differences between proton and x- niest thing I had read in years. But a (DRRs), which are radiographs from any ray therapies. He divides the subject joke is easily ruined if you explain it too direction computed from a set of CT im- into two separate chapters that make up much, and Sokal has done just that— ages of the patient (a beam’s-eye view is about 25% of the book: chapter 10, “Pro- first in a long article in Lingua Franca an- an example of a DRR); biophysical mod- ton Therapy in Water,” for the ideal sit- nouncing his hoax and then repeatedly els for assessing TCPs and NTCPs; and uation, and chapter 11, “Proton Ther- in other publications. dose-volume histograms for assessing apy in the Patient,” for the clinical and Now, the superb parodist has be- treatment plans and deriving relevant far more complex scenario. The book come a parody of himself. His new dose statistics for a specific plan. contains full descriptions of all other book, Beyond the Hoax: Science, Philoso- Until the 1990s a goal of radiation relevant topics, including the produc- phy and Culture, is anything but new. It therapy was to provide a uniform dose tion and delivery of passively scattered consists almost entirely of reprints of distribution in the target volume. Treat- and scanned beams, dose distributions, previously published articles, includ- ment plans to accomplish that objective treatment planning, and assessment of ing two pieces co-authored with theo- were constructed from individual the effects of tissue inhomogeneities. retical physicist Jean Bricmont. Perhaps beams, each with uniform intensity, That last topic is critically important in more troubling is that the reprinted ar- with some exceptions usually involving proton and other charged-particle ther- ticles say the same thing over and over wedges or compensating filters. In the apies, because unlike the case with neu- again. Sokal, a professor of physics at 56 December 2008 Physics Today www.physicstoday.org New York University, has in the past tember 1998, page 29). Beller 11) was fascinating—a genuine decade made a second career out of showed that much of the un- exchange of views that, in the peddling just one idea. deniable humor in “Trans- end, led to actual clarification It is perhaps unfair to say there is gressing the Boundaries” and new insight on both sides. nothing new in his book. Sokal presents came from the quotes by Niels Sokal might have men- not only his original hoax article but Bohr and Werner Heisenberg, tioned his collaboration with also his own running commentary on it, which were crucial to setting Collins in The One Culture? A including a whole new set of footnotes. up the equally silly remarks by Conversation About Science In case you missed a joke in the origi- Jacques Lacan and Jacques (University of Chicago Press, nal, he explains every single one of Derrida. And if so, then, as her 2001); Collins and Jay A. them at some length. He even tells read- title asks, at whom are we laughing? Labinger edited the book, to which ers which of his jokes are his favorites. What does it mean when famous physi- Mermin and I also contributed articles. Amply displayed in his volume is an in- cists are responsible for convincing the Yet there is nary a mention in Beyond the tellectual mean-spiritedness that might world that physics can be used as a Hoax of Sokal’s three articles from that surprise readers familiar only with the source of far-fetched analogies for spec- edition. Evidently, the constructive and original hoax article. Sokal’s method re- ulation about the widest possible range respectful tone of the discussion in The lies on finding the most ridiculous pos- of nonscientific subjects? One Culture did not fit with the tone of sible passages—real quotations from David Mermin’s work is also shame- high dudgeon that characterizes Sokal’s scholars—to lampoon. He has not the fully neglected in Sokal’s book. For ex- new book. Nor did that earlier collabo- slightest interest in finding any re- ample, in March (page 11) and April ration stop Sokal from repeatedly (three deeming qualities in the academic (page 11) of 1996, Mermin wrote two times by my count) quoting out of con- works of those he quotes, because it Reference Frame articles in PHYSICS text a half-sentence of Collins’s from a would undermine his unshakeable be- TODAY concerning the sociology of sci- 1981 article in the journal Philosophy of lief that we scientists are surrounded by ence.
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