In Praise of Physicians and Scientists

As 2018 draws to a close, I want to make a strong statement about the tireless and often under-appreciated efforts of physicians and scientists.  It is a sad truth in our society that we love to be cynical and suspicious about motivations.  Sometimes this cynicism is warranted, but it is often a herd instinct that has no real foundation in fact or evidence.

Many of our brightest citizens pursue careers in medicine and science.  In doing so, they typically work longer hours, and in the case of scientists, receive lower compensation, than other professionals.  I would add engineers to this description, but since I am an engineer, it would be somewhat self-serving!  So I will simply reference a previous blog on this topic: http://rvgeiger.blogspot.com/2014/11/thoughts-on-panic-over-engineering-and.html .

Science, and medicine in particular, have advanced dramatically in the last two hundred years. They have brought us out of darkness, given us incredible mobility, freed us from many forms of drudgery and physical discomfort, developed untold numbers of new materials and products, and improved our health and longevity in dramatic fashion.  They have also unleashed terrible destruction in the form of weapons and have wrought changes on our society that sometimes seem unsettling and alienating.

It is fashionable to complain about physicians; to enumerate situations where diagnoses have been mistaken or where medical knowledge is incomplete; to conjure up an image of the revolving door doctor’s office, where little time is spent with each patient and the bills seem out of proportion to the services rendered.

To be sure, the cost and delivery of medical services is far from a perfect system.  And there are certainly some physicians who are compensated more generously than a truly equitable system would prescribe.  But the fact is that medicine has benefited human society incredibly and we owe much of the enduring joy of living to the herculean efforts of the medical community.

Many people who indulge in wholesale criticism of modern medicine tout the results from natural or homeopathic medicine, chiropractic, Eastern medical traditions such as Ayurveda, Chinese and others.  No doubt these have something to offer – we are far from knowing everything about health and the human body – but many of these traditions were around for the last several thousand years and didn’t result in a general advancement of human health.

One merely needs to recall a few of the horrors of 18th century life to understand the miraculous impact of allopathic medical progress in the last two hundred years: 

• ·         Child birth was practically Russian roulette – one percent of women giving birth died in the act.  If you had 10 children, you had a 1 in 10 chance of dying by one of those births.  Today the percentage is one hundredth of that, and the few deaths that occur would generally be preventable if medical coverage were more universal.
• ·         The chance of a child dying before its 5^th birthday were generally 1 in 5, or 20%.  Today, the rate is 2-3 in 1000, which is about 0.2%.  Most of those are in impoverished populations who don’t receive good medical care.
• ·         The overall life expectancy was about 38 years.  That is somewhat deceptive, because if you made it to 10 years old, that life expectancy jumped to 58.  Still, it is dramatically shorter than the current 80 years in most of the developed world.
• ·         Epidemics raged throughout Europe and the rest of the world in previous centuries.  Today epidemics are very rare and most of the diseases that were incredibly deadly in the past (plague, smallpox, polio, typhoid fever, cholera, etc.) have been either completely eliminated or dramatically curtailed.

In more recent times, the progress made in the reduction of cardiovascular disease (which, by the way, is one of the primary reasons for the increasing global longevity) and the treatment of cancer is truly remarkable.  Also, the life expectancy for many chronic diseases such as diabetes, cystic fibrosis and others is much higher in recent years.

These wonderful improvements are a combination of medical care, sanitation, pharmaceutical discoveries, and many other contributing factors.  But the basis for all of this progress is medical science and the scientific method.

The scientific method insists on a rigorous approach to attaining knowledge.  It does not take a few anecdotal results and draw conclusions.  How many of us have cited the case of a friend or acquaintance who had success from some unusual therapy and implied that this is ‘evidence’ of its efficacy?  True science does not rush to a result.  It insists on numerous trials and experimentation with unyielding objectivity and rigor.  It can be frustratingly slow and tedious, but it is the only way to arrive at a conclusion that will yield predictable results and successes.

A couple hundred years ago, death from illness was all around us.  No one grew up without experiencing the pain of losing a close friend or relative from an early death.  Today, most of us have had the joy of sharing life with family and friends with very rare intrusions of grief from a sickness or death.  We have a long line of physicians and scientists to thank.

Diet and Eating

In this season of eating and over-eating, I find myself once again amused by all of the self-help offerings on dieting and eating healthy.  As a somewhat analytical person, I find it difficult to give much credence to most of the advice. 

Many people say that diet is a simple matter of intake versus metabolic work.  If you consume X calories and the work that your body does is less than X, then you will gain weight.  If the work is more than X you will lose weight.  I have seen these types of calculations done based on the amount of exercise one does each day.  I don't buy it!

As an engineer, I think in terms of conservation of mass and energy.  Food is mass, but it is also stored energy.  Food and drink are consumed.  A certain part of this food and drink is excreted, either as urine or feces.  The amount of this excretion can vary dramatically from day to day or over longer periods.  Moreover, the amount of energy that is extracted from our food as it goes through our digestive tract may be up or down regulated based on the body's needs. The energy content of this excretion would be important in any calculation of net energy or caloric gains/losses.  Has anyone measured this?

The body also converts part of the food and drink into energy.  The energy used by the body might be characterized as typical daily metabolism and work (which may vary considerably or may be fairly consistent – does anyone really know?) as well as extra work that may be associated with exercise, stress, climate conditions and other external phenomena.

Some of the consumed food and drink may be converted to other forms of stored energy and deposited somewhere in the body.  And conversely, some of the stored energy in the body may be converted into energy to accomplish the work of the body. The control functions for these mechanisms are probably poorly understood, yet they are essential to a full understanding of the process.

Thus, there are many parameters in the diet equation – intake, excretion, exercise rates, various forms of metabolism and their rates, conversion rates and efficiencies, etc.  These parameters may vary dramatically from person to person and from week to week.   

Some of these parameters may be affected by the body’s desire to maintain an equilibrium state.  For example, I have been on several cruises where I have eaten massive quantities of rich foods.  Doing a basic energy equation of the type promoted by many diet experts would indicate that I should be gaining weight rapidly during the 10 days or so of that cruise. 

But my experience is that I gain no weight at all!  I do notice that my excretion seems to be at a markedly increased level, if I may be so indiscreet!  Can it be that my body is trying to maintain its current ‘form’?  I have no doubt that if I were to continue that type of culinary indulgence I would soon begin to gain weight, but I am not eager to run that experiment!

I suspect that the body has a certain inertia in terms of its weight and size.  As evidenced by the challenges facing dieters, it appears that the body fights change even when it is not in an ideally healthy state.  The good news is that this helps us avoid ballooning every time we go through a rough patch with food, but  the bad news is that if you are fat it may be more daunting to convince your body to stay trim even when you are successfully cutting your calories.  But in the end, if you eat less calories than you burn (assuming you can calculate these amounts correctly!), the law of conservation of energy will eventually favor your discipline with a good result!

Why I Hate Twitter (and other thoughts on Social Media)

Social media is ubiquitous.  Human beings are social animals, so it is logical that social media serves a purpose at some basic level of human need.  But with so many different forms available and the distractions growing exponentially, perhaps it is useful to take a close look at social media and understand what it accomplishes and what it may indeed damage in our human social fabric.

In the beginning, there was letter writing.  This was the original social media. Before letter writing the only way to interact with another human being was to engage them verbally, face-to-face.  Letter writing probably emerged as a way to communicate when people were not close enough to meet.  But as time progressed, writing a letter became something more than just a substitute for a conversation – it became a way of expressing one’s thoughts more profoundly and preserving them.

Letter writing required time and effort – finding pen (or quill) and paper, addressing some form of envelope or package, and interacting with some form of letter carrier system.  Thus, a letter was generally not simply a short note, but rather a thoughtful short (or even long) essay.  After all, every letter had the possibility of permanence, of being a legacy of some sort. Moreover, the number of letters one could generate was relatively limited, and it seemed prudent to avoid wasting one’s energy on frivolous or meaningless output.

When you are speaking in real-time with another person there is no opportunity to carefully consider the topics at hand and employ all of one’s logical and emotional faculties in crafting responses.  There is simply not enough time.  A letter allows one the time and distance to explore an idea, sorting and weighing all of its components and antecedents, and finding the best way to articulate the result.

So letters became a way for people to interact with some depth, and we have volumes of historical letters – love letters, philosophical letters, letters of scientific inquiry, letters of conviction, humorous letters.  These inform much of the history of the human race.  They are a wonderful testament to the inventiveness and profundity of the human spirit.

But once the computer entered into our lives, the letter was soon replaced by email.  With the logistical overhead now virtually eliminated (no paper, no envelope, no stamp, etc.), the nature of this ‘letter’ changed dramatically.  A few words or a phrase could be typed and fired off with minimal effort. Email took away the motivation to carefully nurture thoughts and emotions before committing them to pen and paper.  It resulted in an exponential growth of remote, indirect communication, but it also cheapened it.

An email has no aura of permanence, even though it can of course be preserved and is occasionally a very embarrassing or damning piece of evidence.  Its ephemeral nature and ease of composition allows us to indulge our laziness.  We lose the discipline of organized thought and careful word crafting.  Email is generally a throwaway.

With the rapidity that has characterized this age of information, email soon spawned many new digital children –  initially texting and various forms of chatting through messenger services, and later the plethora of social media that now inhabit our personal devices – facebook, twitter, youtube, linkedin, snapchat, instagram and many others.

Many of these social media involve a different type of social interaction than traditional letter writing or even email.  Facebook, youtube, snapchat and Instagram all are primarily photo and video sharing, with some comments, humor and messages tossed in.  To some extent, these replace and extend the old social custom of inviting friends over to see your vacation slide show or home movies.  It is interesting to recall how painful these episodes were and how often they were ridiculed, yet we now willingly, or let us say, addictively, subject ourselves to an endless parade of photos, memes and videos day and night.

Much could be written about whether the proliferation of these photos and videos and their subliminal messages and ‘likes’ enhances our friendships, or about its effect on our self-image or happiness.  To the extent that these media allow us to maintain relationships or re-discover them, they offer some benefit.  But do we really want to immerse ourselves superficially in so many outside lives – voyeuristically participating but not truly sharing any of these experiences?   I have read studies that indicate that the addictive nature of facebook and other similar social media leads to depression and insecurity, as we find ourselves confronted with the dream world of our peers that often overshadows our own mundane existence.

But to me, the worst offender in the world of social media is twitter.  This form of social media is the lowest common denominator, the ultimate sound bite, the catalyst and amplifier of rage, indignation, spite, pretension, and mockery.  As opposed to a sincere, careful attempt to address an issue or develop an idea through an essay, article or blog, a tweet is a loose cannon, a reflexive and trivial missive, a cynical ploy to get views and provoke responses.  It does not seek to be thoughtful or erudite, only perhaps clever and provocative.

For politicians and celebrities of all stripes, twitter is another way to stroke one’s ego – the very thought that thousands or even millions of people hang on your every word, however banal and self-serving, is intoxicating.  Who are the legions of followers? Do they have so little of substance in their own lives that they must grovel in the twitter feed of potentates like peasants at a coronation?

And then there is the ‘fake news’ and the fantasies, conspiracies and hysteria that seep through social media like poison gas across a battlefield, sinking deep into the neurotic brain tissue of the masses and destroying all rational thought and analysis.  Twitter is the ultimate tool of the demagogues and their henchmen.  One has only to look at the corrosive effect of our tweeter-in-chief to understand that twitter is more foe than friend.

Social media is the modern Pandora’s box, the genie that will never, ever be stuffed back into its bottle.  It is, in my view, a recipe of one part goodness for five parts woe.  Is it not better to nurture a small number of deep social relationships than a surfeit of shallow ones?  At the risk of sounding curmudgeonly and like a sad voice crying in the wilderness, I say the arrival of the social media panoply is not cause for celebration, but rather a warning bell for our society, our relationships and our future. 

Ignorance: No Longer Bliss!

Americans are wonderful, energetic people.  We work hard, play hard and are typically friendly and generous.  But we have always been a bit ignorant.  Even though we have many of the world’s best scientists, mathematicians, computer programmers, economists, doctors and social scientists, and conduct much of the world’s research, on average we are woefully ignorant when compared to other industrialized nations.

We are proudly illiterate in geography, as so many studies have revealed.  Why learn about the rest of the world when so few of us will ever travel outside the country?  We have little use for foreign languages, probably for the same reason.  Less than 1% of Americans are proficient in a foreign language that they studied in the classroom.  Travel to Sweden and you will find that even farmers who rarely venture from their towns and villages can speak flawless English and perhaps French as well.

What about history?  Well, it seems that Americans know almost nothing about world history, and damn little about our own American history.  Even college students demonstrate depressingly little knowledge of history or any of the other social sciences, probably because they are primarily focused on football games, frat parties and an occasional business course (forgive me for a little spiteful hyperbole . . . . )

When it comes to math and science, the ignorance goes into warp drive!  Most Americans cannot do basic percentage arithmetic (calculating profit margins, discounts, etc.).  Most haven’t the faintest clue how all of the technology at their disposal works and are more or less helpless when it goes awry. 

Almost half of our citizens believe that God created the earth and human beings in their present form less than 10,000 years ago, a belief that flies in the face of two centuries of acquired knowledge in multiple scientific disciplines – geology, climatology, biology, genetics, etc.  This is compared to other industrialized nations, where generally less than 20% have a similar belief.

Why are Americans so ignorant?  One would think that with our wealth and freedom and energy and ingenuity that we would be the most knowledgeable country on earth!  But almost the opposite is true – we are indeed one of the least knowledgeable, and seemingly proudly so!

One might argue that for much of our history our ignorance was reasonably well-suited to the task at hand – we focused our energy and intellect on taming the land and building a formidable commercial engine to stimulate business progress and lifestyle improvements. We disdained the elitism and classism of our European forbearers, perhaps with the attitude that spending much time in intellectual pursuits was a waste of time and a distraction from the pursuit of material gain and being productive.  Ignorance was, for the time, bliss.

But over the last 100 years or so, as our nation has found its fate interwoven with that of the rest of the world’s in an ever more complex economic, political and scientific web, that ignorance has become a rather large liability.  Many of our citizens were easy prey for demagogues such as Huey Long, Father Coughlin, Joseph McCarthy and George Wallace.  Need I say that there is one more to add to this list?

When the Internet emerged as the great intellectual equalizer, there was hope that our citizens would tear themselves away from NFL football and reality TV shows just long enough to acquire a new awareness of the world around them.  But alas, in a sad but beautifully ironic twist, the Internet is doing just the opposite – it is serving up steaming piles of pseudo-knowledge that catalyze our citizens’ deepest fears and insecurities.

Manipulation of the mob has always been the goal of those that seek power and ignorance is its strongest ally. Now the Internet and social media provide a mouthpiece that reaches across the entire planet.  Our own made-in-America ignorance, once so innocent that it was almost quaint, is still rampant, but sadly it is no longer blissful.  If we are to avoid devolving into a banana republic of warring factions and paralyzed government, then we must seek out reputable sources of information and seriously embrace the responsibility of being world citizens.

Revolutionary Zeal

It must be discouraging these days to be a revolutionary!  What ideology can a revolutionary seriously embrace in this modern age? Is the age of revolution over?

Communism has lost its allure in the past thirty years or so, and capitalism has ascended to an unrivaled position as the king of the ideological hill.  In the U.S., Marxism and communism were only ascendant for a relatively short period of time during the first half of the 20^th century.  But aggressive repressive measures in the 20’s and again in the 50’s eliminated much of the popular support, even among intellectuals.

Socialism, which many in our country equate with communism, has also taken on pariah status in the post-Reagan political climate.  The mere coupling of the words ‘socialized’ and ‘medicine’ is enough to doom any effort for single payer healthcare!

But if we can for a moment cast aside our reflexive disdain for anything that hints of communism, it may be illuminating to try to understand why Marxism and all of its associated ‘isms’ appealed to so many people and whether there is something to be learned from the revolutions and upheaval that they spawned.  We have no doubt done these concepts something of a disservice by only viewing them through the lens of the violence and death that accompanied them.  After all, there is plenty of death and violence that one may lay at the feet of capitalism as well!

The world is not a perfect place, and there must always be people who dream of making it better than it is.  These are idealists.  Social, political and economic systems are the currency of dreamers, of idealists.  Without idealists, the world would never have progressed beyond the chaotic and tyrannical states that defined civilization for millennia.

Today finds the world in a more peaceful and economically stable state than ever before in history, despite a seemingly endless depiction of bad news in the media (which is merely performing the service that we demand –  that is, keeping a fickle public titillated with violence, sex and tragedy).  The simple fact is that less people die each year in violent conflict than ever before.  Less people die from starvation and disease.  There is less slavery (although it does still exist!), less persecution of minorities, less subjugation of women and more freedom of expression.  Even natural disasters have less impact than before, although this trend may be reversed as we produce more in the future through our impact on climate.

We continue to face many diverse challenges in terms of keeping conflict at bay and providing secure and stable environments for people around the world.  There are religious extremists and a few rogue states, and tensions between the great powers (Russia, China and the U.S.) are re-surfacing.  But clearly the last great hurdle in achieving a more peaceful and healthy world is the lingering social and economic inequality across all populations. 

In the developing world, there has always been a very small class of wealthy oligarchs – a plutocracy – that receives most of the wealth of the nation.  The good news that large numbers of people across the world have slowly clawed their way out of dire poverty does not change the fact that the political, social and economic structures in the developing world are generally rigged and corrupt, primarily benefiting a very few.  Sadly, there seems to be little or no improvement in this regard in most developing countries over the last 50 or 60 years.  Paul Theroux, a travelogue author of some renown who was a Peace Corps volunteer in Africa in the early 60’s and then made an extensive tour again in 2005, made a strong argument that Africa is actually in a worse state now than when he was there just after most states had claimed their independence.

Perhaps even more disturbing, there appears to be an increasing chasm between rich and poor in many developed nations that had previously built up very strong middle classes and seemed to be on the path to a very equitable distribution of wealth and opportunity.  There are several factors in this sad trend – automation, globalization/outsourcing, the gradual weakening of unions, and the extreme stratification of salaries to name a few.  This chasm has led to populist, nationalist and anti-globalization/anti-immigrant movements that threaten to re-route or even blockade the march to global peace and harmony.

Can the world continue to become more just and equitable in a steady, peaceful manner?  Are inequities, corruption and poverty entrenched and intractable, or can they slowly be eliminated by good people with noble motives?

Will the poor, as Jesus famously said, ‘always be with us’?  Well, as a side note, what Jesus actually meant in that passage is subject to much debate.  But it does beg the question – is income and opportunity disparity an inevitability?

Even generally good people with good intentions contribute to the bias in opportunity and wealth.  I do not take bribes or take part in any outright corrupt business practices, but I am complicit in certain areas of elite privilege.  For example, I readily take advantage of networking and connections to find jobs or opportunities for my family and friends.  I use my resources to provide advantages for my children in education and experience that others do not have.  These are relatively small things, and it is natural for a parent or friend to do such things, but who can argue that these small actions do not insidiously preserve the exalted positions of those with power and wealth?

And if these seemingly innocuous actions contribute to the continuing reign of the elite, then one can only guess at the impact of more venal efforts to rig the system.  The powerful and wealthy will naturally do everything they can to preserve their status, and they have many effective tools at their disposal.  Even very ethical people find it easy to rationalize their indiscretions.  The less ethical don’t even pretend.

The highly vaunted meritocratic nature of our society can certainly benefit high achievers and risk takers, but it is likely that this phenomenon has a narrow effect – mostly on a small group of top performers.  The bulk of the population is not particularly mobile either upwardly or downwardly due to factors of birth, family, education and social status.

Liberty and freedom are the most highly prized attributes of our society for many good reasons.  But they also contribute to some of our problems. We chafe against rules that dictate our behavior.  We believe that our good deeds must be done voluntarily, not forced by government or societal regulation.  For example, we are not forced by law to recycle.  It is voluntary.  We are reluctant to allow the government to dictate the gas efficiency of our vehicles – we love our SUVs!  We are free to send our children to expensive pre-schools, private schools and elite universities, and to organize internships and job opportunities through our connections.  We are free to separate ourselves from the poor and live in gated communities.  We are free to keep most of the money we get from our jobs or investments, regardless of how absurd the amounts may get.  These freedoms give the rich and powerful, and even the middle class, an incredibly potent tool to maintain their status and wealth.

If societies are indeed somewhat static and the inequities resistant to improvement, then the possibility of revolution arises.  The downtrodden are long-suffering, but eventually they will not be placated with empty promises of future good things.  The trickle-down, all-boats-rising tide of human development is a more comforting illusion to the consciences of the rich than to the hopes of the poor.  At some point, it all begs credulity.

Marxism emerged as a product of the industrial revolution in the euphoric vein of other scientific and pseudo-scientific theories.  The Age of Enlightenment seemed to guarantee that the physical world, and indeed, all human endeavor, could be understood by analysis of the laws of physics, chemistry, geology, evolution, or, in the case of Marxism, the laws of dialectic materialism and economics.  Much of the allure of Marxism, and consequently, communism, came from its apparent scientific inevitability.

The industrial revolution had also put human misery and injustice in stark relief for all to see.  There appeared to be no way to ‘evolve’ into a more equitable society and the capitalist class seemed hardened and intransigent.  Class warfare leading to a dictatorship of the proletariat sounded like a relatively good deal to factory workers performing 12 hour shifts six days a week under inhumane and dangerous conditions!

The first waves of revolution and union organizing had a sobering effect on the business owners and they slowly and reluctantly began to accede to some of the workers’ demands, while also aggressively pulling all of the levers necessary to brutally eliminate all revolutionary activities.  This shifted the balance just enough to avoid full-scale communist revolution in most of the industrialized world, where higher wages and better general living conditions tempered the revolutionary zeal.   But revolutionary ideologies and movements found fertile ground in the developing world, where poverty was horrific and injustice even more entrenched. , These revolutionary efforts were often buttressed by independence movements seeking to shed colonial or imperialist control.

In the west, we have found it convenient to characterize social and economic revolutions as ‘evil’, noting the reigns of terror, the purges, the lack of freedom and the frequent famines.

But for the revolutionaries who believed they were remaking the world into a better place, the ends justified the means.  They were merciless, but they believed they were heeding historical lessons that necessitated their behavior.  For example, Lenin saw how the generous treatment of the bourgeoisie by the Paris Commune in 1871 backfired and resulted in wholesale slaughter of the communards once the reactionary forces rallied.  He was not going to make the same mistake and thus the so-called ‘Red Terror’ was initiated.

Committing horrific acts (‘evil’) for a perceived greater good is something every society does and somehow justifies.  The Allies civilian bombing of Germany and Tokyo, which resulted in the deaths of millions of ‘innocent’ civilians, is a perfect example.  One man’s evil is another’s heroism.  In the view of revolutionaries, imperialists, militarists, fundamentalists and other zealots, there are no ‘innocent’ people.

A similar paradox can be detected in our view of freedoms.  We cannot comprehend how the Soviet Bloc and Cuba could justify preventing their citizens from emigrating to Western countries or how they could impose such rigid control of their societies.  But if you have the goal of creating a new society and radically changing the behavior of people – eliminating greed, competition, nepotism and selfishness – then it is expected that many will want to flee and it is the duty of the state to ensure that they stay and participate in the revolution.  From the perspective of the revolutionary, the curtailment of freedom is worthwhile if the ultimate goal is achieved – the new human and the new state! 

Sadly, none of the communist revolutions have had much success in achieving this goal.  Violence seems to beget more violence, and it generally produces ruthless leaders prone to megalomania and paranoia.  Additionally, the centralized planning and control of economies, and the elimination of individual ownership of businesses and property, produced very poor economic results.  Either the ‘new man’ was never properly formed, or it may simply never be possible to create such a being given the idiosyncrasies of human nature.

But the notion of human beings sharing the earth and its bounty in a more equitable fashion can still stir the soul. The current stymied state of progress in social justice has begun to spark new revolutionary movements.  Marxism will no longer be the foundation of such movements and to date no adequate replacement has been proposed.  Like the Populist movement, modern revolutionaries are more likely to define themselves in terms of what they detest than what they embrace – Occupy Wall Street and the Antifas are good examples.  This type of revolutionary model is more angry than romantic, and will struggle to attract the necessary critical mass for any real change.

What seems clear to me is that violent revolution is no longer a good option for achieving positive change.  Violence amplifies the unpleasant traits of humankind and destroys the civil basis for progress.  Instead, we must slowly chisel and grind away at the stone of society like a renaissance sculptor, trusting that a form of great beauty will eventually emerge. But part of this effort to free our better angels must be a more enlightened understanding of the history of human revolution and the quest for social justice.  As in all human endeavor, much evil was afoot, but there were also many noble intentions.  We must learn from all of it.

Sickness and Injury

I have hurt my back again.  I cannot bend over without sharp pains and I am unable even to put on socks or shoes without help.  I have started my McKenzie exercises and hopefully this will accelerate my recovery.  I have had episodes of this nature every 7 to 10 years since my college days, when I played a handball match on a cold winter’s day without warming up adequately.  Some of these episodes curtailed my activity for months, but more recently I have been able to limit the impact to 4 or 5 lost days and then a week or two of limited disability.

I seem to fall prey to many ills!  I say this not to court pity or sympathy, because I don’t really find those things very helpful. It is simply a fact.  My primary malady, a disease I have had all my life, is PCD (primary ciliary dyskinesia).  The cilia in my lungs and sinuses do not ‘wave’ as normal cilia should, but simply ‘vibrate’.  I saw this with my own eyes under light microscopy when I had this diagnosis confirmed in 1999 at the University of North Carolina. Before that I was uncertain why I was getting sick all the time.

The lack of ciliary motion means that the stagnant secretions in my respiratory tract are enthusiastic hosts for bacteria! Thus, I have had a lifelong battle with respiratory infections.  I carry antibiotics wherever I go and have had long periods when I was continuously on antibiotics.  One year my diary logged over 80 days when I had a fever.

I was fortunate to grow up in the golden era of antibiotics, and I was very active athletically all my life, or I might be far worse off.  My lung function is currently about 70% of the expected for my age. I run several times a week and do daily nebulizer treatments to stave off additional damage (bronchiectasis due to colonized bacteria).

As if this wasn’t enough of a reminder of my mortality and all-to-human frailty, in about 2005 I began having serious migraine problems.  No one in my family has a migraine history, and I had never had one before.  At first, they came infrequently, but slowly they became more frequent and now I must take medication (triptans) between 7 and 15 times a month to abort the episodes.  If I am not quick enough, the ensuing migraine is totally disabling and I end up in an agonized state, vomiting and losing anywhere from 12 to 20 hours of life!  Fortunately, I have become quite adept at managing this and I rarely succumb to the full migraine these days.  But I have had to give up alcohol, chocolate and a variety of other foods that are guaranteed triggers for this condition.  I have now added triptans to the pharmaceutical lifeline that I carry with me everywhere I go.

But it doesn’t stop there!!  In my efforts to identify a cause for my migraines I became aware of the fact that I have degenerative disk disease in the cervical spine (my neck).  It is unclear whether this is in any way connected to my migraines, or whether the more or less permanent sinus infection in my frontal sinuses plays a role.  At any rate, in the last year this has become an additional nemesis and I have daily pain in the area of my cervical-thoracic junction.  Physical therapy has helped a little but not much.

It is easy to fall prey to self-pity when one is sick or hurt, but it is hard and futile to indulge it over the long term.  I know that there are multitudes who are far more stricken with health issues than I am, and I know that my own life has been blessed with undeserved good fortune on many fronts.  We all battle with our own individual demons and we can only guess at the circumstances that others must face, which can be both visible and hidden.

Life goes on, doesn’t it?  And to be quite honest, I don’t really feel like my quality of life is any worse for all of the problems that I face.  Somehow my psyche adjusts for the pain, discomfort, lost days and other ramifications of these health impairments.  I am always aware of them – asking myself off and on throughout each day, as I have always done, whether I am starting to get a respiratory infection or whether the first signs of a migraine are present – but somehow this awareness does not generally weigh me down or depress me. 

This is the beauty of the human spirit!  It can seek joy and optimism even under fairly challenging circumstances, and reward its owner with a relatively positive life experience.  I hope and trust that I shall be able to carry on with the courage that each life imbues on its mortal denizen.  And I will seek every interesting and fulfilling moment that the rest of my life can provide!

Thoughts on Monuments to the Confederacy

The events in Charlottesville and the ensuing disappointing response from President Trump (which later was doubled down to a frightening defense of the hate-mongers who initiated the violence) have dominated the news in recent days.  No doubt there are some, perhaps many, who once again lay blame on the ‘fake media’ for misinterpreting Trump’s remarks or for whipping the 'libs' into a frenzy on this issue.

The march of the white supremacists and neo-Nazis in Charlottesville was prompted by the prospect of the city taking down a statue of Robert E. Lee.  This poses a question about the general purpose and value of such memorials and whether there is indeed a justification for removing them.

At first blush, one may think that it is foolish to try to erase the past by taking down memorials of Confederate heroes.  Isn't this a part of history and doesn't the south have a right to celebrate its war heroes?

But as I have thought more deeply about the question of civil war memorials and honoring historical events and people, I have come to the conclusion that most of these monuments should indeed come down.  There is of course the danger of trying to ‘purge’ historical memory or rewrite history.  But in reality, the monuments extolling the virtues and heroic efforts of Confederate leaders are the real ‘whitewashing’ of history.

The simple fact is that the primary reason, the casis belli, for the Civil War was slavery.  The Southern nostalgia for the pre-Civil War era and its sentimental regard for confederate soldiers is misplaced at best and a complete delusion at worst.  The ‘lost cause’ was not the genteel way of life that one sees in romantic mythology like ‘Gone With the Wind’ and it was not states’ rights.  The ‘lost cause’ - the primary reason that the south seceded - was to avoid what they saw as the inevitable abolition of slavery were they to stay in the Union.  Pure and simple.

Was it tragic that millions of young men lost their lives and that terrific hardship was visited upon the south?  Of course it was.  Were there heroic men, heroic gestures and heroic sacrifices in the war?  Of course there were.  Just as there were many heroic deeds by German soldiers in World War II.  But do you see monuments and statues in Germany extolling the virtues of their soldiers and the ‘lost cause’ of the third Reich? 

It was a bitter pill to swallow, but the Germans faced up to the fact that the best way the suffering by their own people in WWII could be idealized, memorialized or sanctified was to put up monuments honoring the truly helpless victims – the Jews and the Gypsies and all the others that the Nazis exterminated.  And the best way to honor the suffering and sad loss of so many Germans was to vow to never let hatred, extreme nationalism and prejudice take root again in German culture.

This should have been the approach of the post-Confederacy south – an honest recognition that an immoral embrace of human slavery was the cause of their downfall - not the propagation of a myth about a noble ‘lost cause’ and the tragic destruction of the plantation lifestyle, which quite frankly was only possible because of the horrific enslavement and exploitation of Africans.  Monuments are, to put it simply, not appropriate.

A Tribute to Glen Campbell

Glen Campbell died yesterday.  He was 81, but had suffered for a lengthy period with Alzheimer’s.  For many reasons, he inhabits a special place in my musical constellation.

I first became aware of his music when his big trio of hit records crossed over from country to pop – Galveston, Wichita Lineman, Gentle on my Mind.  I was in my rock and roll prime, a high school student with little patience for slick pop songs or overly orchestrated ballads.  So of course I was dismissive of him and his music.  But something in his voice and the songs captured my attention much more acutely than the typical pop song and I found myself furtively seeking out his songs on the radio.

In early 1979 I stopped in Reno for the night with my Mom, who had joined me on my way out to California to report for duty with the USS Seawolf.  She suggested we go to a Vegas-style show with Glen Campbell and I acquiesced, though not particularly eager for what I thought would be a stylized and phony glamour display.

Much to my surprise, for the next three hours I was mesmerized by the talent and energy that this amazing man displayed.  He played the guitar and the banjo with effortless virtuosity and his singing was powerfully melancholic and inspiring.  He performed songs from numerous genres, including a medley of Beach Boy tunes from his days replacing Brian Wilson on one of their tours in the mid-60s.  The range and breadth of his repertoire astounded me.  When he sang his trademark Wichita Lineman, I could feel the aching need and loneliness of every human being in those perfect lines:

 ‘and I need you more than want you, and I want you for all time’

I left that Reno theater with a stunning epiphany.  All my prejudices and pretensions were false!  Glen Campbell was not some glitzy country crooner, but rather a musical genius and he had a much more profound message and impact than I could ever have imagined.  I soon discovered that Glen had been one of the most sought after studio musicians in LA in the 60's and that he was considered one of the era's best and most versatile guitarists before his singing led him to stardom.  I had totally misread him!

But it wasn’t just Glen Campbell that I had been wrong about.  I suddenly realized that the depth I had missed in him was also the depth I was missing in every person I was too smug to learn more about or too busy to engage with.  Not many people have the amazing talents that Glen had, but everyone is deeper and more interesting than we realize – and has more to offer than we are apt to believe.

Last night I listened for hours to youtube videos of Glen’s canon, tearing up as his aching, yearning tenor and flawless guitar filled my heart.  I saw snippets of his farewell tour, when the ravages of his Alzheimer’s had taken much of his mental acuity, but somehow his singing and playing fought through the haze and shone brightly.

I am grateful for the life and music of Glen Campbell, and in debt to him for teaching me an invaluable lesson about people and prejudice.  

The Market-Based Healthcare Fallacy

One of the primary goals of the Republican effort to ‘repeal and replace’ Obamacare is to achieve so-called ‘market-based’ healthcare.  In the conservative world view, every complex social problem can be solved by the magic of the ‘free market’.

Of course everyone understands that government tends to be bureaucratic and inefficient and that market-based, competitive industries are preferable to monolithic, centrally-controlled bureaucracies.  But selling toothpaste and providing healthcare are two very different things, and there are certain things in a society where market forces are not as efficient nor as compelling.  For example, we do not generally outsource our military to the free market or our legislature (though perhaps that might be a good thing . . . ).

The free market and associated market forces work best on commodities, products or simple services in direct buy/sell relationships.  A consumer purchases a product or service based on a combination of quality and price, and the competition for the consumer’s dollars causes the supply chain – retailer, manufacturer, etc. – to become more efficient and the products and services of higher quality to earn the business.

But healthcare is not a simple buy/sell relationship.  Consumers do not directly buy healthcare services – they are too costly.  Instead, a consumer buys an insurance plan that pays for the services.  But how much healthcare service a consumer utilizes is a complex interplay between healthcare providers (doctors and hospitals), the patients (consumers) and the insurance companies.  Efficiency, quality and cost reduction are not simple concepts here.  Having a consumer visit doctors less frequently or having the doctors prescribe fewer tests or drugs might seem like good cost reductions and improvements in efficiency, but the result might be long terms problems and massive increases in the cost.  It is not likely that these very nuanced and long term aspects of the healthcare relationship will be comprehended and improved by a short-term, profit-oriented market approach.

When we talk about market-based healthcare, we are talking about competing healthcare insurance programs.  At first blush, this sounds like a good thing – as insurance companies compete for healthcare dollars they would in theory become more efficient and find cheaper ways to deliver healthcare for their customers. 

But the question is how would they reduce those costs and gain efficiencies?  The insurance companies have four primary cost factors – (1) their own administrative costs, (2) hospital costs, (3) physician costs and (4) the ‘use’ of the insurance by their customers – i.e. how sick they are and how much healthcare they utilize.

The easiest and most lucrative way for insurance companies to be more competitive and ‘efficient’ is for them to control the 4^th factor – how much their customers utilize – by enrolling a relatively healthy set of customers, excluding people with chronic healthcare problems and denying or restricting services.  This is what insurance companies have been doing for years. 

A relatively small amount of benefit can be obtained from controlling the first factor, administrative costs, though I imagine it is the one advantage that this structure has over a single payer system. 

The insurance companies can pay hospitals and doctors less and insist that they become more ‘efficient’, but that is a very indirect process and it is not at all clear that a multiplicity of insurance companies with varying schemes of healthcare policy can impact those areas as well as a single payer with a unified vision can.

Giving the insurance companies and consumers a ‘free market’ with few restrictions will work great for the healthy and those who work for generous employers who are willing to foot the bill for great healthcare benefits.  But as seen in the past, this system will be a nightmare for people with chronic issues or sudden catastrophic illnesses, or those who are under- or un-employed.

A fairly large percentage of U.S. citizens already receive healthcare from a single payer system – the U.S. military, government, Medicare and Medicaid – more than 30% of the population.  No one will claim that these systems are efficient, and their costs continue to grow dramatically.  But that is the challenge that all healthcare provisioning systems face in a time of increasing human longevity and medical complexity.

The biggest question that Americans need to answer about healthcare is whether our society is obligated to provide at least a minimum of healthcare to every member.  If the answer is yes, then a single payer system available to all, with a private insurance system in parallel would probably be the best way forward.  We need only to look at the EU healthcare systems for excellent examples.  These systems are far from perfect, but they are generally valued by their constituents as preferable to the U.S. system.

A market-based healthcare system would almost certainly not be the panacea that our conservative members of congress claim it will be.  This is one area where capitalism’s profit motive will create more problems than it will solve.  Medical costs will ultimately need to be reined in, but the free market is not the mechanism to accomplish this.  Medical providers and community health experts need to drive the future of healthcare, not accountants and MBAs!

The Culture War - Is there a Way to Move Forward?

An integral factor in the continuing saga of political turmoil in the USA is the culture war.  This conflict may be framed as follows: 

One side sees the USA in cultural and moral decline as characterized by the following:

•  changes in sexual morality, including sexual promiscuity, rampant pornography, and the liberalization of attitudes on homosexuality, gay marriage and gender transformations
• the weakening of the American work ethic and increase in entitlements
• the over-emphasis on perceived racism and its use as an excuse for criminality and the breakdown of the family in African-American society
• increased drug use and a decline in law and order and respect for the police
• the rejection of religion (specifically the Christian religion) and the weakening of its moral impact on our society
• the domination of a liberal elite with their liberal media ridiculing alternative viewpoints and promoting political correctness
• a foolish naivete that embraces too many immigrants and allows dangerous religious groups into our society without demanding conformity to our values
• a worldview and foreign policy that diminishes American exceptionalism and panders to a feckless UN and various bad actors in the international community

The other side sees the USA in the dangerous grip of a simplistic populism and ignorance that manifests itself in the following:

• ethnic and religious bigotry that is sadly reawakening and becoming culturally acceptable
• a hardhearted and misguided perception of the poor and disadvantaged as pariahs and parasites rather than victims
• misplaced and hypocritical religious zeal that is based on outdated moral codes rather than social justice
• a perverse obsession with guns that has derailed all reasonable discourse and study about sensible gun control and violence in our society
• a blind nationalism that ignores the intertwined fate of all nations and peoples
• an overly aggressive focus on law and order that has resulted in the USA having the largest % of its citizens in prison in the world
• an active rejection of peer-reviewed science and other forms of knowledge that makes the US population woefully ignorant and easily brainwashed
• a misinformed public that blames the poor, the immigrants and free trade for economic woes rather than demanding initiatives to decrease wage disparity

These viewpoints are dramatically different and seem irreconcilable.  It is hard to believe that people can view the same world and come to these radically different perspectives on what is happening.  Yet it is indeed the situation we are in.

The question is whether there is some mechanism to bridge the chasm in these worldviews and come to some sort of compromise and way to move forward.  As a person who tries to confront problems with a rational and logical approach, I believe that the only way to achieve progress is to present people with the data that are relevant to these topics and then have an in-depth public analysis of each area.

For example, the ‘black lives matter’ movement and its focus on racial profiling have generated a typical response from the left and the right, with the right dismissing the movement as another example of black people playing the race card and not being willing to confront the rampant criminality in their neighborhoods, and the left righteously proclaiming that the videos of police shootings are dramatic evidence of what black people have been saying for generations – that the police are routinely harassing and targeting them.

These are ‘polemical’ positions.  What needs to be done is a deliberate and comprehensive analysis of police shootings and confrontations across all races and ethnic groups as well as an in-depth look at violent crime. This data needs to be collected, evaluated by an impartial group and then presented to the public in an easily understood manner.  Statistics and data may not tell the full story, but they will certainly get us a lot closer to a better understanding of what is happening.  Anecdotal, isolated incidents give a strong impression, but they may or may not be indicative of the true situation.

While it is true that different people will view the same set of data and come to different conclusions - especially in non-scientific subjects such as human behavior and economics -  a detailed look at the numbers behind a problem will certainly bring people to a more nuanced view of the problem and hopefully defuse some of the incendiary rhetoric around the issue.  A departure from the shrill tone of today’s political discussion would be the first step in finding an acceptable common ground.

Sometimes

Sometimes when I see a headline of yet another senseless shooting;

sometimes when I hear a politician make outrageous remarks with the clear objective of getting headlines;

sometimes when I see incomprehensible numbers of refugees and migrants desperately seeking safety;

sometimes when I hear a CEO try to justify the fact that his salary is 350 times that of the average worker in his company;

sometimes when I hear someone claim that the science of climate change isn’t yet ‘settled’;

sometimes when I see another video of a policeman shooting an unarmed man;

sometimes when I hear of a random shooting of a policeman;

sometimes when I reflect on the hopeless nature of Mideast violence;

sometimes when the inevitability of human conflict seems overwhelming and the results seem to be growing ever more catastrophic . . .

I start to despair.

But then I find these prophetic words: 

“We cannot understand the moral Universe. The arc is a long one, and our eyes reach but a little way; we cannot calculate the curve and complete the figure by the experience of sight; but we can divine it by conscience, and we surely know that it bends toward justice. Justice will not fail, though wickedness appears strong, and has on its side the armies and thrones of power, the riches and the glory of the world, and though poor men crouch down in despair. Justice will not fail and perish out from the world of men, nor will what is really wrong and contrary to God’s real law of justice continually endure.” – Theodore Parker, Unitarian Minister, Abolitionist, Transcendentalist 1810-1860.

And I am somewhat comforted.

Indeed, for all of its evils and failings, the world is becoming more moral, more tolerant, more equitable.  There are many challenges, and the practicalities of creating less war and more social justice are daunting, but the recognition of what is right and good is widespread, and we need only find the courage and energy to put conviction into action.

Indeed, the fact that civilization has triumphed in no small measure over chaos, war, selfishness, vengeance, envy, demagoguery and greed is a miracle of the first order.  When one observes the rage that appears daily with such minute cause on our roadways, one can only marvel at the fact that we have a society that functions as well as it does.

Think of the ways that our morality and social conscience have been transformed!  We no longer view war and conquest as something to celebrate.  We are repulsed by the idea of slavery.  An ever-increasing part of the world respects women and provides them opportunities to live any type of life they choose.  We are becoming more accepting of religious and cultural diversity (the recent populist and anti-immigrant fever notwithstanding).  We seek to comfort and aid the disabled, mentally ill and sick rather than cast them out coldly into the dark.

Sadly, though, the change does not come fast enough.  What can an individual do to hasten its progress?  We are confronted daily through all manner of media with all of the remaining evil and misery in this world and it is intolerably discomforting to be aware of it and do little or nothing about it.  This is the anguish of the modern age.

The only recourse for most of us is to lead our lives in good faith, resisting the impulses that we know will contribute to injustice or hostility, and play whatever small role we may be offered in helping our fellow human beings along the way.

Healthcare Challenges

Last week’s attempt to repeal Obamacare and replace it with what by pretty much all accounts was a rather pathetic package of half-measures, brings the challenges of healthcare back into clear focus.  Unfortunately, the solutions to these challenges are not nearly as clear as the challenges themselves.

Healthcare is a multi-layered problem, which makes it particularly resistant to easy fixes.  Cost and efficacy are interwoven in a complex web.  There are numerous basic contradictions or paradoxes at the heart of the issue.  Here are some of them:

Should healthcare be considered a right for every citizen, regardless of income level or status?  I find it difficult to understand how one can argue against this proposition in a modern, developed nation.  One can debate how much healthcare is guaranteed, but basic healthcare should be provided for everyone.  Someday soon we will be shocked that we once allowed people to go bankrupt with healthcare expenses or denied life-saving measures to people who could not afford them, just as we are now amazed that we once condoned slavery.

Should everyone in society participate in healthcare insurance?  This also seems irrefutably logical to me.  If we are willing to require participation in a social security system and medicare system for later years, then it only makes sense to extend this to the entire lifetime of healthcare provision.  How else can we conceivably fund the care of the sick if we do not have full participation?  This is simply an extension of the basic concept of shared risk and communal responsibility.

Do patients have certain obligations as recipients of societal healthcare?  Of course they do!  They should use this scarce and finite resource wisely, being careful not to waste it on frivolous practices.  They should attempt to lead healthy lives so as to minimize their own necessary usage of healthcare.  They should diligently follow the instructions of their healthcare providers. 

Is there any way to motivate or even force people to act responsibly in this regard?  That is a more difficult question.  There must be certain safeguards put in place to monitor and control usage.  Co-pays, deductibles and various other financial mechanisms should be carefully crafted to ensure that healthcare usage is not frivolously engaged, but also is available and encouraged when truly needed.  Moreover, there should be a strong public service ‘indoctrination’ for every citizen about how to lead healthy lives and how to use healthcare services effectively and economically.

There is a fine line between encouraging citizens to use healthcare services energetically to minimize disease and using it too much as a self-indulgence. 

What kind of responsibilities do healthcare providers have?  They must have both ethical and economic incentives to provide the best possible healthcare with as much frugality as possible.  These are often contradictory goals and fine tuning them will be a constant and intricate process.  ‘Playing it safe’ for a healthcare provider will often mean ordering excessive tests.  But with the threat of malpractice lawsuits ever-present, it is difficult to curb this tendency.  Malpractice reform seems to be necessary if we are to control the arms race of lawyers and doctors/hospitals.  Doctors must have the freedom to manage their patients and their practices, but they must also be held to reasonable standards of both patient care and healthcare expense.

End of life expense control must become a priority, or we will be spending a large percentage of our medical dollars on a period of life that quite candidly provides very little return on investment.  The predisposition of elderly people to over-utilize medical services is well known, whether out of boredom, loneliness or understandable frustration with a rapidly deteriorating body.  Hard decisions have to be met regarding how much healthcare can be provided for an ever-increasing number of senior citizens.

The concept of free market components of healthcare has been trumpeted as the way to control costs, avoid bureaucracy and increase efficiency.  In general, competition does indeed create more efficient delivery of goods and services.  However, here again there are paradoxical elements that make a free market approach somewhat problematic.

Insurance companies will naturally attempt to increase profits by limiting what procedures or care they pay for and limiting their clientele to the healthy rather than the sick.  If we are to create free market conditions, then the rules must be constructed such that any profits are derived from efficiencies in healthcare delivery and management, not from limiting care or rejecting people with less fortunate health profiles.  This, of course, is not easily tracked or accomplished.  There are certain aspects of society that do not easily lend themselves to free market implementations.  For example, we would never allow our military defense to become a free market commodity.  We have seen that private prisons are also not necessarily a panacea. The question is whether healthcare falls into this category as well.  The fact that we spend more dollars per person in the U.S. for healthcare than other developed nations with single payer systems certainly begs this question.

If our leaders would evaluate the healthcare challenge as a policy issue and avoid the polemics and demagoguery, then it might be possible to craft a plan that can meet the needs of society without the expense spiraling out of control.  There are numerous reasonably successful models in Europe and Canada to analyze.  The U.S. may be different than those nations, but it can certainly learn from them if we can for once humbly acknowledge that we are not always the most perfect nation on earth!

On Wisdom

Over the years, if one is honest with oneself, the fallacy in the old adage that we acquire wisdom with age becomes shockingly clear.  This realization is just one of a myriad of disappointments that cause one to careen through mid-life from crisis to crisis, but it has some profound implications and merits a closer look.

What is wisdom?  The dictionary definition is: ‘the quality of having experience, knowledge, and good judgment’.  Does one become wise over one’s lifetime?  Everyone has ‘experience’, and most people acquire more ‘knowledge’ as they go through life.  But does that make them wise?  How can we define ‘good judgment’? 

I will make the case that wisdom is a somewhat over-simplified concept and that what we generally call wisdom has a very narrow scope in our own lives and almost no application to others.

The question is whether we truly become wiser as we collect life experiences, or whether we simply become more ‘experienced’ or ‘knowledgeable’.  Our experiences shape us in some respects, but any lessons learned may only be applicable to the specific circumstances of our own lives (which will probably not repeat themselves) and not really general wisdom that would be of benefit to anyone else.  It is tempting to believe that we are wiser, but if we had the opportunity to repeat our lives I wonder whether we would prove any more adept at navigating life’s challenges than we were the first time through.

Of course we become more capable in certain aspects of our lives as we grow older – our business or professional skills may improve somewhat (which may, sadly, be an anachronism if the frenzied pace of technological change continues to increase); we may become more adept at certain hobbies; our physical capabilities and skills will peak at some point and then begin to wane.

But if one considers wisdom to be a deeper understanding of life and the choices that define our lives, then I am not at all convinced that older is wiser.

It is often said that people don’t really ever change.  That may be an exaggeration, but it seems to have a large kernel of truth.  I look at myself and those I know fairly well, and I see the same basic character traits – the charms, the foibles, the strength of character, the neuroses, the idiosyncrasies, the ethics, etc – that we have carried since early adulthood, and often from early childhood.

These character traits are a critical component of the template of our lives, and they are unique to each of us.  Add to that the unique circumstantial factors that impact every life experience and decision and you have a very specific set of conditions that each person confronts in his or her life.

Do life experiences make us wiser?  Who in good faith truly believes that their life experiences justify them preaching to others about how to conduct their lives?  Isn’t each life so unique that it can only be planned and critiqued by its owner?  And isn’t it highly presumptuous to believe that our own life’s joys and sorrows offer any sort of blueprint for someone else?

Of course there are extremes where good counsel is appropriate.  The recovered alcoholic or drug addict certainly has some good advice for those unfortunates who are heading down a similar path. 

But there are other types of so-called sage advice that require a second look.  Advising against rash life decisions such as getting married young or resigning from jobs to travel may sound like wisdom, but who can say for sure that these decisions are unwise?  Of course the probability of an early marriage succeeding or a travel hiatus from a career leading to future success may be low, but there are factors to consider that only that person can know.

Parents may earnestly advise their children on a number of topics as they grow into adulthood, but most children blithely ignore this free wisdom.  As the old Cat Stevens song Father and Son goes: ‘if they were right, I’d agree, but it’s them they know not me’.

Who in good faith can tell the aspiring actor not to leave that small town and journey to Hollywood, or the musician with dreams of rock and roll fame not to leave school and hit the road?  You can tell them the odds aren’t good, but they probably know that already and there may be enough fulfillment in the journey even if wild success is not the outcome.

There are self-help books by the thousands that peddle well-worn platitudes for achieving success or happiness served up as new and innovative concepts.  If nothing else, the never-ending supply and demand for these tropes serve as strong evidence that wisdom is neither easily acquired nor easily dispensed.

Perhaps one of the beauties of life is its enigmatic nature.  There is no manual for living, no secret formula for success, fulfillment or happiness.  One man’s wisdom may be another’s folly.  We outsource our life decisions at our own risk.  Live life with courage and energy, and wisdom be damned!

Optimism

Trump’s victory in November shocked me and put me in a rather discouraged state of mind.  I worried that this was the beginning of a downward spiral of demagoguery and the decay of American values, ideals and civility.

But in recent days I have seen a rising tide of resistance and resolution that gives me hope for the future.  Trump’s victory, his incredibly childish antics and his mean-spirited directives have awakened a broad movement of outrage and activism.

The political pendulum swings to and fro.  That is the nature of American politics and it is generally a satisfactory if not inspirational phenomenon, sacrificing speed to avoid radical, potentially de-stabilizing changes.  The American experiment has never been a revolution, but rather a continual tinkering with the detailed machinery of governance and public policy, full of compromises and experimental half measures.  The general trend has been toward a more equitable, enlightened and appealing life for all Americans, though certainly there has always been much to improve.

The U.S. citizenship is split almost 50/50 on many of the large policy issues of the day.  This has almost always been true and it must reflect some basic crossroad of human development when one’s sentiments begin to veer in one direction or another and soon the other path is in the murky distance and hardly recognizable.

When the people are at loggerheads on basic issues, it is difficult to gain consensus and it may be impossible to push forward.  This stalemate is frustrating, but perhaps it is better than moving aggressively on new policies and potentially alienating large groups to a point of no return.

Trump and the Republicans have no mandate from the American people.  The fact that the Senate is slightly Republican is a strange artifact of the red state/blue state distribution.  Most of our least populous states are conservative.  They still have two senators.  Even the distribution of representatives has some very peculiar demographic attributes that make it more likely that conservatives can win.  The true picture of how the American people are divided is best portrayed by the popular vote, which despite Trump’s petty claims, show a fairly substantial majority of Americans are opposed to either him, his platform, or both.

It appears that Trump will be at least partially frustrated in his efforts to act upon his campaign promises.  This is only fair, because most of those promises are anathema to a majority of Americans.  His refugee directives, which make no sense whatsoever and are an affront to basic American values, should never be allowed to stand.  Hopefully the judiciary will stand firm and the congress will oppose any new legislative efforts to circumvent the courts.

The efforts to roll back financial and environmental regulations will probably have some success, because these are also Republican hot buttons.  But there will be strong resistance, especially on the environmental front.  Americans are finally waking up to the reality of global climate change, and there is the beginning of an internal Republican challenge to the ‘drill, baby, drill’ mantra.

Health care changes will also be hard fought.  The Republicans have been successful at making the abstract generality of ‘Obamacare’ a bogeyman, but once the details have to be hammered out they will find that sleight of hand will no longer suffice.  In the end, I will not be surprised to see congress only tinker slightly with Obamacare, change the name, confuse the hell out of everyone and declare victory.

It is on foreign policy that Trump is most dangerous and unpredictable.  Here, we can only hope that his early missteps and embarrassments will serve to create a braking action on his tweets, hapless phone calls and pronouncements.  His advisors may be a motley crew of billionaires and Alt-right zealots, but hopefully there will be enough common sense on hand to avoid catastrophic errors.  The U.S. will cease to be a leader in the world for these four years and transition to the role of a bully, but perhaps the damage will be only temporary.  It may actually be healthy for other nations such as Germany, the UK, France and Japan to become more influential and active as leaders in the world.

On the economic front, Trump’s chest-beating and saber-rattling over trade policies and outsourcing will probably have minimal impact.  The economy will evolve, as it almost always does, somewhat independently of the policies that are targeted, with great fanfare, to impact it. 

It seems to me that there is an unavoidable fact that automation is steadily reducing the number of available middle class jobs, and that there is probably no way to compensate by creating ‘new’ industries or jobs.  This is a characteristic of the way that the global economy is evolving and the genie has long since been out of the bottle.  The problem is massive and it will become ever more massive.  Demagoguery, bullying and threats will not solve it.  We can either study it and try to socially engineer changes to lessen or thwart its impact, or we can allow it to create chaos and catapult us into a morass of unstable political and social turmoil. 

I believe Donald Trump has had his moment of glory. It is going to be a long, painful four years, and Trump will tweet himself into ever more pathetic absurdities as he confronts his impotence.  As for his rabid supporters, they will grind their teeth in fury at the resistance that thwarts his every move, but eventually they will grow weary of the Donald’s ineptitude and realize his supposed business acumen either never existed or is totally unsuited for running a country.  They will no longer believe his preposterous claims of being the one and only possible savior.  They will no longer thrill to the inarticulate ravings of political incorrectness that they once somehow found courageous, and they will realize, though probably never admit, that he is just a desperately insecure man who has managed to bully and connive his way to a fortune and hoodwink a lot of people in the process.

Religion From the 'Other Side'

When I try to rationalize the theology and dogma of the many religions that human beings have concocted throughout history I find it useful to attempt to view them from God’s perspective – from the ‘other side’.  This may sound presumptuous and perhaps even blasphemous, but we humans have an intellect and reasoning power, so it would be surprising for God to fault us for employing that intellect in such an exercise. (The fact that Adam and Eve were supposedly banished from Eden for pushing the envelope in the knowledge department might make one think otherwise, but I am going on the assumption that this metaphorical version of the creation is not an indication that God does not want us to use our given intellect!)

Conceptualizing God is a fool’s errand of course.  Historically mankind has envisioned deities in anthropomorphic fashion – Gods with human form and human foibles.  Now that we have some idea of how vast and unfathomable the universe is, our past fantasies seem somewhat foolish.  If God created man in his own image, as the bible surmises, then is God just a super-sized human being with super powers?  Even with a healthy dose of ‘blind faith’, that concept seems rather absurd and unlikely.

If there is indeed a God or some form of divinity, and I, for one, am hopeful that there is for a variety of reasons, then I imagine that God would be more amorphous and less tangibly physical than we envision.  But the form of God isn’t really that germane to our discussion, so its mystery can safely be left unraveled.

So God, in whatever form, creates the universe, in whatever manner – big bang, evolution, and any other mechanisms that may be useful.  A first question might be why he even wants to create the universe.  For sake of later questions and argument, let us just say that it is God’s nature to create.

The next big question is: What is God’s purpose in specifically creating human beings? Are human beings truly unique in our possession of a self-conscious state?  Is God uniquely interested in our activity as opposed to the rest of his creation, simply because we are self-conscious and have free will?  These are already tough questions, but in order to move forward with this analysis, let’s assume that God does regard us as special creatures.  What does he want from us?

Is our chief end, as the Judeo-Christian faith speculates, ‘to glorify God and to enjoy him forever’?  Did God create man for his glory?  Is our sole purpose to ‘worship and love God with all of our heart, soul, strength and mind’? 

What does all that really mean?  It seems to ascribe a very human narcissism and vanity to God.  Does a God that can create a universe really need a fan club?  Does God need glory from his creation?  Whom is he trying to impress?  Is there a competition with other universes and Gods?  These questions may sound flippant but I believe they are worth asking.

I interpret all this worshiping and glorifying purely in the context of God wanting humans to bend their hearts and behavior toward Godly things.  God doesn’t need worship or glory in the sense that is normally associated with those words. 

Now if one understands this idea of a relationship between God and humans to be one of mutual love, and that by ‘worshiping’ and loving God, as well as loving other human beings we are reflecting the love that God represents and instantiates in the universe, then that would be much more plausible and palatable.  It seems like the kind of thing God might want.

It is reasonable to believe that if there is a God and he created the universe, then he must have created the universe and human beings for some higher reason than to simply have a functioning machine that would run in a predictable manner like a huge train set in his basement.  If so, then he would be curious and perhaps even passionate about creating beings that have free will and the capacity for both creation and destruction, good and evil, love and hate, compassion and cruelty.  This is the line of reasoning that people use when trying to explain why there is evil and calamity in the world if God is a loving God.

Perhaps God is interested in simply seeing how humans progress with their free will and intellect.  But apart from the pure curiosity of seeing how his creation evolves and how these beings with free will act, what would he expect from this creation and how would he interact with it?  If God is love, and love is the goal and motive force in his creation, then perhaps God would seed the whole enterprise with some mechanism for inspiring this love and animating it in the non-deterministic elements of the creation – the human creatures.

And out of this love would come a sense of morality and an inclination toward ethical behavior that would somehow be innate or at least periodically suggested through some link to the divine – a soul or a spirit perhaps.  And maybe God would be intrigued, even passionately determined, to have the creatures hearken to this call of love and ethical behavior.  Wouldn’t it be logical that God would want his creatures to evolve toward a more loving and compassionate state? 

But what seems highly improbable is that God would be insistent on humans having a specific set of abstract beliefs about the nature of God or the universe, or that he is terribly interested in whether his creation formally acknowledges his existence, given his penchant for avoiding direct contact or communication with his creation! 

Is it really likely that God cares whether we believe in the inerrancy of various forms of scripture?  Can we really believe that God will test us on our knowledge of the trinity?  Is it rational to think that ‘accepting or following Jesus’ (whatever that might mean in practical terms . . . ) is a litmus test that determines whether we go off to eternal damnation or bliss?  Is God likely to care whether we embrace love and compassion via Jesus, Isaiah, Mohammed, Buddha, or through a friend or teacher or self-study?

We trivialize God and strain credulity when we claim that he cares about things like whether we:

• ·         eat pork or shellfish
• ·         believe that Mary was a virgin
• ·         believe that Jesus performed miracles
• ·         believe that Mohammed was God’s last and greatest prophet
• ·         believe there is one ‘chosen people’
• ·         believe that there was actually a flood and Noah’s ark housed representatives of every species on earth
• ·         swear
• ·         doubt God’s existence (as Bertrand Russell famously said: Not enough evidence, God, not enough evidence)
• ·         wear a burka, hajib, yarmulke, veil or any other garment
• ·         keep a certain day holy
• ·         pray in schools
• ·         Or a thousand other laws, customs, dogma and idiosyncrasies that religions have decreed as necessary for membership that do not move us any closer to a spirit of love and compassion

Wouldn’t it be reasonable to believe that the only things God truly cares about are things that mold and refine our hearts and actions to be in tune with the morality that every religion as well as secular movements have slowly embraced over thousands of years?

Religious metaphors and traditions, and the cultural heritage associated with them can be wonderfully enriching aspects of our lives and communities, and to the extent that they bind us together in communal life and nurture our interest and search for God’s message of love and compassion they can be very positive forces.  But they are not the essence of our quest to seek God and they should certainly not encumber us in our search or prevent us from reaching out to one another in a spirit of common humanity.

The ‘arc of history is long but it bends toward justice’.  This must be the arc that God wants to see, because justice implies love and it implies compassion.  And all of the human baggage that gets in the way – the divisive religious squabbling and exclusivism, the arrogant, self-righteous insistence on having the ‘one true’ understanding of God – must be jettisoned along the way if this arc is ever to complete its travel.