When does the scientists' nose end?

I ask this of myself as a kind of reference to the adage of "my right ends where you nose begins" when considering the matter of how far a scientist is reasonable permitted to profess his or her craft. When does a person speak out of order? When does respect for personal choice and culture override the need to use reason and fact to describe something?

I was brought to consider this question after pondering masturbation. No, not WHILE doing it, but while considering the causes and reasons for the activity in terms of personal comfort and psychological state. I was actually doing a Google search, one of my favorite pastimes on history of non-pharmaceutical anxiety treatment to find a curious article about generalized anxiety and "habitual masturbation" which later led me to discover some very "exciting" links on the subject from informed points of view:

http://couragerc.net/Masturbation.html

http://www.cathmed.org/assets/files/H&H%202010%20Pages%20for%20Website.pdf

The first is a guide for pastoral care for treating confessing habitual masturbators, so I do not consider it a scientific source, although it is written from the relevant point of view of a Catholic Priest. The second links to a *.pdf for medical professionals on how to deal with masturbation and individuals expressing Same Sex Attractions, something they label (SSA), tendencies.

Obviously this bothered me otherwise I would not be writing this. I consider this completely unacceptable. The priest writing about masturbation in adolescents is one thing, the opinion of a religious official whose role is in advising people who choose to practice a particular faith. However, a medical professional being encouraged to express an opinion that a person who feels attraction to the same sex is obligated to pursue a life of chastity and service to God while distancing himself/herself from homosexual feelings is UNACCEPTABLE to me. These things are unacceptable not only because I find them personally very silly, but because it is not supported scientifically (that homosexuality results from abuse or gender confusion), it is not supported socially (that you may feel SSA if you are very lonely and desperate), and it is not supported applicably (that individuals feeling homosexual attractions usually choose abstinence and pray for help from God). It is simply absurd, and the fact that actual licensed, practicing physicians in the United States of America are permitted to advise individuals in this way really bothers me in the same way that a hot poker in the face bothers me.

In my opinion, and this is absolutely not held universally by many scientists and academics, it is our duty as well educated well-read individuals to object to this travesty and terminate it. This is not a matter of faith - it is about abuse of the truth to force pseudoscience into the medical community. It is about the manufacture of evidence to reinforce a cultural and moral (and political) position. The word "truthiness" rings in my head when I read about this supposed condition, 'SSA'. I stated once to a fairly stunned group of people that if I was a member of a person's PhD committee, presumably in my area of the biological sciences, and they publicly denied evolution, I would refuse to sign off on their candidacy. I stand by this position. It is equivalent of stating as a student of mathematics that arithmetic order of operations is unimportant. Or as a chemist that electrons form attractions to protons because they really like being around each other. If I stated as a sociologist that American black culture was entirely unaffected by slavery, I would be laughed out the door.

Why are we as scientists not allowed to demand individuals whose decisions are made based on scientific research and evidence hold themselves to the same standards we do? While it is true that medical science cannot afford to hold itself to confidence intervals that we do, they should be expected to maintain a standard of discipline that includes advice confined to scientifically supported opinion. Their diagnoses should be expected to conform to accepted, culturally neutral frameworks intended to preserve and protect human health. Those who do not wish to withhold their personal opinions can and do cause harm to innocent patients who look up to doctors, holding their advice in high regard. This damage permeates a society and festers over long periods of time, retarding human advancement. In my opinion (note that I'm declaring that this is a personal statement) doctors who choose to bring their religious affiliation or mores into the clinic do not belong in medicine.

As I was sitting in my new favorite bar which just happens to have a delicious all-you-can-eat wing special on Monday nights, the bartender and I got to talking about life, drinking, the meaning of functional alcoholism and (oddly) her chemotherapy treatments. Being of medical science background, I became interested when she declared that her taste for things, especially spicy food, had completely changed after her treatments has concluded. I was fascinated and asked about as many probing questions as possible without being downright rude.

Chemotherapy generally targets rapidly dividing cells in an effort to poison malignancies that exhibit unrestrained cell growth. These drugs are rarely specific so tend to attack the metabolism of all rapidly diving cells, resulting in the common hair loss, GI difficulty, nausea, ect. As olfactory cells (odor chemoreceptors in the sinus) and gustatory cells (receptors in taste buds) must be replenished regularly, they are on this list of rapidly diving cells and both become sickly and decrease in number. So, it's easy to understand why someone would lose their acute sense of taste and smell. But it does not explain why totally different tastes/preferences would take over later.

Which brings me to my question. Is there a CNS (central nervous system) reason behind this? It is widely accepted that the great majority of cells in our brains do not divide beyond early childhood. In fact, many cognitive psychology experimenters consider "general cognitive decline" to occur after age 21 in males. Our brain cells will only decrease in number over time. However, there are cells in the hippocampus near a place called the dentate gyrus that seem to continuously divide into adulthood. These are generally thought to have a role in memory formation, emotional processing, and experiential learning, although there is some uncertainty. If these cells are affected by chemotherapy drugs and connected to memories whose shared storage includes odor references, it might explain a partial or total loss of taste/odor preferences. This is my speculation.

How many people have studied this? Zero. There are a few clinical studies examining taste changes in chemotherapy patients and they have basically found that yes, chemotherapy drugs do seem to harm your ability to taste foods as well. But then they stop! Why? The clinician's primary concern is to ensure health and safety of the patient, i.e. getting them to eat a nutritious diet. They don't particularly care why it happens, so long as the patient is aware and can either move through it or find a preferred flavor enhancer. I want to know why, mechanistically, this happens. Maybe the hippocampus has absolutely nothing to do with it, but I am bothered that clinical research often falls short of actually probing for a conclusion. Retrospectives are great, but do not challenge the medical science community to move beyond treating a symptom. If we instead examine a mechanism, the least we will do is learn more about the root cause; we can hope to elucidate an effective treatment to mitigate the negative consequences for future patients.