An article in the New York Times of August 30, 2010 discusses the diagnosis of prostate cancer through the lens of a new book entitled "Invasion of the Prostate Snatchers" by Ralph Blum (a cultural anthropologist) and Dr. Mark Sholtz (an oncologist). http://well.blogs.nytimes.com/2010/08/30/a-rush-to-operating-rooms-that-alters-mens-lives/?emc=eta1
The scene depicted is not pretty. The gist is that the vast majority of patients with prostate cancer are over treated, that 80% of the surgery done for the disease is unnecessary and that a large motive for treatment is financial remuneration. Radical prostatectomy, the commonest surgical treatment is said to lengthen the life expectancy of one in forty-eight patients.
As a disclaimer, I have not read this book but the picture presented here deserves analysis. Some background studies--
Random autopsies show a rate of unexpected cancer of the prostate in about 30% of men in the groups around 45, 55 and 65 years of age. It trends higher in the age of 75 and higher in the 80's.
PSA, a protein made in the prostate at a predictable rate, rises in situations where blood vessels are increased in number, fragility and porousness and, for one or more of these reasons, shows up elevated in some prostate cancers.
The diagnosis of prostate cancer has historically been made on physical examination where the disease is found as a hard lump on the prostate. The prostate, when the exam is normal but the PSA is elevated between 4 and 10, has a positive biopsy in about 30% of cases.
PSA elevation generally precedes clinically detectable prostate cancer by 5 to 7 years. In clinically detectable disease, life expectancy without treatment in men under about 70 is less than those with treatment over ten years; in men over 70 the life expectancy is about the same.
Clearly, 30% of men under the age of 70 are not dying of prostate cancer but if the disease that progresses to clinical findings can be identified in these men, that should help. A big problem is this group cannot be identified. PSA is generally seen as evidence of tumor activity but that may not be so. Biopsy of men with elevated PSA may find a disease that was sleeping and will sleep on. Some evidence of aggressiveness is often assumed from the Gleason Number, a rather subjective grading of the tumor tissue's histological deviation from the norm, and further hints of presumed behavior can be gleaned from volume of disease in the biopsy and multiplicity of sites of involvement, again generalities. Youth with the diagnosis is a negative.
There is nothing written in stone here: This is a disease of context, indeed many diseases are. Chicken pox is annoying in children, fatal in the elderly. A heart attack might pass unnoticed in an older man where the younger man is struck dead. Who survived the Black Death and why? Current medical thought sees prostate cancer as a mosaic, a collection of tendencies, clinical leanings and statistics from which decisions have to be made.
And it is hard. But articles like this make it harder. And presumed scientists often do not help. Last year a study showed up from Europe that looked at two groups of men, those in whom PSA studies were done and those who did not have the studies. Using this information as a proxy for prostate cancer and the value of finding it early with PSA testing, the scientists followed the two groups for up to seven years and found no significant difference in survival rate. Their conclusion: PSA testing--early detection of prostate cancer--was of no value. But PSA elevation precedes clinical disease by 5 to 7 years and clinical disease takes a while to kill. How was this study meaningful over such a short time frame? It wasn't. And the scientists knew it. Why, then, did they publish it? Why, indeed.
How the authors of this book determined that 80% of surgery was unnecessary is not clear from the article but it will be wonderful to learn. This difficult mosaic, which so many struggle with, will finally be made clear. At least I hope it will be--although I am not sure where these insights have been hiding. I hope this is not just another financial enterprise created to take advantage of the classical American under education in science, preoccupation with conspiracies, slavish devotion to sensationalism and confusion of disrespect with independence.
Tuesday, August 31, 2010
Sunday, August 29, 2010
Pirate Logic
Over the last three years the Pittsburgh Pirates earned about 11 million dollars in profit annually, profit from a franchise recently valued a bit less than 300 million dollars. That return is about what the owners would get in a bond fund if they had sold the franchise and invested the money. A conservative return, certainly not a great return. Now with that knowledge, with 300 million dollars as the denominator, imagine how things would change if the owners changed the numerator, the earnings, by investing in players. How could the owners invest that profit, that numerator, so that the earnings would add more to the numerator than was spent? In other words, how could money from profit best be spent that guarenteed a net larger numerator?
This is a tricky question because the Pirates are paid to lose and such disincentives are extremely complex. The Pirates receive revenue sharing money from more profitable teams based on the money the Pirates do not make; if they start making more money, they receive less in revenue sharing. Moreover Bradbury's new book shows, according to him, that a team spending money to move from 60 wins to 70 wins actually loses money and the positive return doesn't appear until the team reaches the middle 80's in wins.
The problem, then, is more than improving the quality of the team, it must be improved in a quantum manner. Not only does money invested have to result in an improvement, that improvement must allow an improvement to at least 85 game wins. Under these conditions, a team owner must be very careful. Improving his roster may not help and may hurt his bottom line. Put another way, the team's success and the owner's success may not coincide. Indeed, they may be in opposition.
Consequently, the team cannot simply get better, it must get significantly better. Say, for example, Pujols decides to do missionary work in Pittsburgh and agrees to work for them for 5 million dollars a year. I doubt his addition, while interesting and entertaining, would make much difference; the opposition would pitch around him and offence is only part of the game anyway. The Pirates can't pitch either. But with Pujols' 5 million dollars--as much as a bargain as he would be--the ownership has already spent half--half--of the money they have to spend. Pujols is still batting fourth on a team with a lineup of seven other number six hitters and no, zero, pitching. And, if Bradbury is correct, with some luck and a few career years in the lineup the team could win 75 games, qualify for much less revenue sharing as a result and not even afford to pay the charitable Pujols the following year.
Building with free agents requires tremendous insight from scouts and the general manager. It also requires tremendous luck because the free agents would have to agree to a contract of more than a year or two. The available money would thus be tied up for years in free agents who would have to be had at a bargain, be willing to sign a long term contract and all of those investments would have to be successful. The team would be betting its solvency on several turnaround situations.
The other way is the draft, a longer but cheaper route although fraught with the uncertainties of untried youth. But the losses are limited, the players are locked up for 6 years and the luck is homogenized among the teams. And a team with good judgment of talent can succeed. The Marlins do it every cycle.
So the owners are making a reasonable return, they probably should not gamble in the free agent market and it seems likely their only option is the draft done with a good eye. They should hire a good eye. The city of Pittsburgh should be happy they can see major league baseball visit 82 times a year. And until the team management shows they can draft well the city will have to settle for pirogi races, nostalgia, mascots, fireworks, aging rock band performances and, generally, going to a county fair with a baseball team attached.
This is a tricky question because the Pirates are paid to lose and such disincentives are extremely complex. The Pirates receive revenue sharing money from more profitable teams based on the money the Pirates do not make; if they start making more money, they receive less in revenue sharing. Moreover Bradbury's new book shows, according to him, that a team spending money to move from 60 wins to 70 wins actually loses money and the positive return doesn't appear until the team reaches the middle 80's in wins.
The problem, then, is more than improving the quality of the team, it must be improved in a quantum manner. Not only does money invested have to result in an improvement, that improvement must allow an improvement to at least 85 game wins. Under these conditions, a team owner must be very careful. Improving his roster may not help and may hurt his bottom line. Put another way, the team's success and the owner's success may not coincide. Indeed, they may be in opposition.
Consequently, the team cannot simply get better, it must get significantly better. Say, for example, Pujols decides to do missionary work in Pittsburgh and agrees to work for them for 5 million dollars a year. I doubt his addition, while interesting and entertaining, would make much difference; the opposition would pitch around him and offence is only part of the game anyway. The Pirates can't pitch either. But with Pujols' 5 million dollars--as much as a bargain as he would be--the ownership has already spent half--half--of the money they have to spend. Pujols is still batting fourth on a team with a lineup of seven other number six hitters and no, zero, pitching. And, if Bradbury is correct, with some luck and a few career years in the lineup the team could win 75 games, qualify for much less revenue sharing as a result and not even afford to pay the charitable Pujols the following year.
Building with free agents requires tremendous insight from scouts and the general manager. It also requires tremendous luck because the free agents would have to agree to a contract of more than a year or two. The available money would thus be tied up for years in free agents who would have to be had at a bargain, be willing to sign a long term contract and all of those investments would have to be successful. The team would be betting its solvency on several turnaround situations.
The other way is the draft, a longer but cheaper route although fraught with the uncertainties of untried youth. But the losses are limited, the players are locked up for 6 years and the luck is homogenized among the teams. And a team with good judgment of talent can succeed. The Marlins do it every cycle.
So the owners are making a reasonable return, they probably should not gamble in the free agent market and it seems likely their only option is the draft done with a good eye. They should hire a good eye. The city of Pittsburgh should be happy they can see major league baseball visit 82 times a year. And until the team management shows they can draft well the city will have to settle for pirogi races, nostalgia, mascots, fireworks, aging rock band performances and, generally, going to a county fair with a baseball team attached.
Wednesday, August 25, 2010
Tiglons and Ligers, Oh My!
"The evidence is overwhelming that manufacturers are creating excess HFC-23 simply to destroy it and earn carbon credits," said Mark Roberts of the Environmental Investigation Agency, a research and advocacy group. "This is the biggest environmental scandal in history and makes an absolute mockery of international efforts to combat climate change."
This appeared as part of an article in the Huffington Post. HFC-23 is a particularly dirty carbon producer and the implication is that the production of carbon--even if that production is peripheral or has no relation to the industry in question at all--has become a separate pursuit of companies so they can be paid not to produce it.
The question is why is anyone surprised? A distortion in the market, a tilt of the playing field, has been created to reward some and not others, to benefit specific behavior that has only an accounting advantage, like depreciating steel plants but not investing to produce steel. People will rush in to take advantage of the bias. These Rube Goldberg economics probably work sometimes but rarely. Raise the minimum wage to benefit minimum wage workers: Decrease the number of minimum wage jobs. Subsidize ethanol to decrease the use of petroleum: Petroleum use increases to produce the ethanol. Balance the earnings between big earners like the Yankees and lesser teams: Pittsburgh Pirates. Decrease the spreads in the stock market trades to stabilize the market: Flash crash. In this instance, businesses will be paid not to produce something, ergo, they will produce as much of it as they can first. This will produce more of the offending substance and eventually leech more money out of the payback system and make it less effective.
Notice that a system, once interfered with--even with the best of intentions-- changes into something else. A minimum wage job changes a valuable employee into an economic burden on his employer. An energy producer produces fertilizer and proportionally less petroleum for energy. The efficient farmer becomes a part-time food producer and a grossly inefficient energy producer. Several good baseball teams create and underwrite a new strange game the Pittsburgh Pirates play. Decreasing the profit in stock trades by market maker intermediaries creates a market where only high volume computer trading is profitable. It is reminiscent of hybridization. A mule is neither a horse nor a donkey. It is new.
But it is close. Close. And that is the point. No chef would substitute salt for sugar because it was close in appearence; he knows there is more to it than that. But somehow intellegent people feel thay can mix-and-match economic and political components without fear. Administrators and legislators create programs in reaction to problems and it is like adding a unique, foreign piece to a puzzle. Everything changes. Now, with the new piece, nothing fits and the puzzle becomes something else, neither the problem nor the solution but something else. A mule that can not run like a horse, a tiglon very distinct from its parents and from a liger.
It's not "close enough for government work"; it's a new explanation, a new excuse. It's the excuse Heisenberg has cursed us with that justifies our compromises: The imprecision of our times.
But we have to do something, don't we?
This appeared as part of an article in the Huffington Post. HFC-23 is a particularly dirty carbon producer and the implication is that the production of carbon--even if that production is peripheral or has no relation to the industry in question at all--has become a separate pursuit of companies so they can be paid not to produce it.
The question is why is anyone surprised? A distortion in the market, a tilt of the playing field, has been created to reward some and not others, to benefit specific behavior that has only an accounting advantage, like depreciating steel plants but not investing to produce steel. People will rush in to take advantage of the bias. These Rube Goldberg economics probably work sometimes but rarely. Raise the minimum wage to benefit minimum wage workers: Decrease the number of minimum wage jobs. Subsidize ethanol to decrease the use of petroleum: Petroleum use increases to produce the ethanol. Balance the earnings between big earners like the Yankees and lesser teams: Pittsburgh Pirates. Decrease the spreads in the stock market trades to stabilize the market: Flash crash. In this instance, businesses will be paid not to produce something, ergo, they will produce as much of it as they can first. This will produce more of the offending substance and eventually leech more money out of the payback system and make it less effective.
Notice that a system, once interfered with--even with the best of intentions-- changes into something else. A minimum wage job changes a valuable employee into an economic burden on his employer. An energy producer produces fertilizer and proportionally less petroleum for energy. The efficient farmer becomes a part-time food producer and a grossly inefficient energy producer. Several good baseball teams create and underwrite a new strange game the Pittsburgh Pirates play. Decreasing the profit in stock trades by market maker intermediaries creates a market where only high volume computer trading is profitable. It is reminiscent of hybridization. A mule is neither a horse nor a donkey. It is new.
But it is close. Close. And that is the point. No chef would substitute salt for sugar because it was close in appearence; he knows there is more to it than that. But somehow intellegent people feel thay can mix-and-match economic and political components without fear. Administrators and legislators create programs in reaction to problems and it is like adding a unique, foreign piece to a puzzle. Everything changes. Now, with the new piece, nothing fits and the puzzle becomes something else, neither the problem nor the solution but something else. A mule that can not run like a horse, a tiglon very distinct from its parents and from a liger.
It's not "close enough for government work"; it's a new explanation, a new excuse. It's the excuse Heisenberg has cursed us with that justifies our compromises: The imprecision of our times.
But we have to do something, don't we?
Tuesday, August 24, 2010
Blagojevich and Libby
So the bathoic Blagojevich is convicted on one of twenty-four counts, lying to the FBI during the investigation. I don't know if this is an indictment of the jury, the electorate (sort of the same), how inept a crook Blagojevich is or Fitzgerald. There is a recurring pattern here, though. Some guy is rousted, investigated to death and the only thing they get him on is lying during the questioning. The same thing happened with Libby. Fitzgerald--again--knew who the leak source was but pushed on and trapped Libby in some inconsistency and sent him to jail. I have absolutely no sympathy for politicians of any stripe and believe they are all probable felons and traitors. But this catching an innocent man for what he does in the course of an investigation that exonerates him is creepy. Sort of like kicking in the door of the wrong house and then arresting the owner for resisting arrest.
Saturday, August 21, 2010
Hold Your Peace
America needs a debate over its very nature, that is--does it have characteristics distinctive from the animal qualities of other countries? Does it have a unique direction or is this just another nation trying to find its economic footing within a workable political framework? The New York mosque flap provides just such an opportunity.
Hurt feelings, bigotry, xenophobia and religious enthusiasm aside, this mosque debate should stimulate reasonable discussion about the boundaries of personal freedom policed by individual responsibility. The question is not whether it is legal to build it--it is--but rather whether such a building is appropriate, whether well meaning citizens should enforce their personal rights in the teeth of the overwhelming condemnation and discomfort of virtually everyone else simply because it is legal to do so. Some see this question as akin to desegregating a grade school, an African American personal right in the face of white condemnation and discomfort; this is more akin to the behavior of the "flying imams", gratuitous and malicious--albeit allowed by existing laws--done solely for the purpose of tormenting a social opponent. It is an area where good will is required, a willingness to put aside your personal right for the greater good. It is that crucial element in society that recognizes the individual's importance to the whole--and the whole's vulnerability to the individual: Self restraint. It is that quality in an individual that recognizes that on some level in this country he is participating in something large and important, something he shares in common with all others as opposed to the smaller and individual family, racial, blood type, skin color, cultural and religious variables that distinguish him from that large group.
Every marriage has that moment where the minister turns to the congregation and intones, "If any here gathered has reason why these two should not be joined together in holy matrimony, speak now or forever hold your peace." It is sometimes a signal in fiction for the picaresque hero to leap to the fore and abscond with an unwilling bride. In truth, it is a brilliant moment evolved from the Book of Common Prayer: The modern minister is not serious. The announcement is designed to give the individuals in the congregation the opportunity to put their objections aside, to allow the couple to proceed with their ritual and move on with their lives. To start anew. The people are being asked to withhold their right--even their presumed responsibility--to be destructive. It is saying to the congregation, "You are given the freedom and the opportunity to speak, to damage these people and this event; don't take it."
Yet someone will sometimes take it. The society is always plagued by the self-righteous, the bluenose, the puritan and the literal, often someone with a vindictive streak. Someone willing to destroy the whole to make a point. This mosque controversy is an opportunity to confront that person, to smoke him out and reveal him, to raise the important argument of social unity--the argument that must be resolved if this country is to solve the economic and security threats it will soon face.
All that being said, this is funny:
A grass-roots movement among construction workers and unions asks Cordoba mosque supporters: Who do you expect to build it? The same people who built the World Trade Center perhaps? (IBD)
Hurt feelings, bigotry, xenophobia and religious enthusiasm aside, this mosque debate should stimulate reasonable discussion about the boundaries of personal freedom policed by individual responsibility. The question is not whether it is legal to build it--it is--but rather whether such a building is appropriate, whether well meaning citizens should enforce their personal rights in the teeth of the overwhelming condemnation and discomfort of virtually everyone else simply because it is legal to do so. Some see this question as akin to desegregating a grade school, an African American personal right in the face of white condemnation and discomfort; this is more akin to the behavior of the "flying imams", gratuitous and malicious--albeit allowed by existing laws--done solely for the purpose of tormenting a social opponent. It is an area where good will is required, a willingness to put aside your personal right for the greater good. It is that crucial element in society that recognizes the individual's importance to the whole--and the whole's vulnerability to the individual: Self restraint. It is that quality in an individual that recognizes that on some level in this country he is participating in something large and important, something he shares in common with all others as opposed to the smaller and individual family, racial, blood type, skin color, cultural and religious variables that distinguish him from that large group.
Every marriage has that moment where the minister turns to the congregation and intones, "If any here gathered has reason why these two should not be joined together in holy matrimony, speak now or forever hold your peace." It is sometimes a signal in fiction for the picaresque hero to leap to the fore and abscond with an unwilling bride. In truth, it is a brilliant moment evolved from the Book of Common Prayer: The modern minister is not serious. The announcement is designed to give the individuals in the congregation the opportunity to put their objections aside, to allow the couple to proceed with their ritual and move on with their lives. To start anew. The people are being asked to withhold their right--even their presumed responsibility--to be destructive. It is saying to the congregation, "You are given the freedom and the opportunity to speak, to damage these people and this event; don't take it."
Yet someone will sometimes take it. The society is always plagued by the self-righteous, the bluenose, the puritan and the literal, often someone with a vindictive streak. Someone willing to destroy the whole to make a point. This mosque controversy is an opportunity to confront that person, to smoke him out and reveal him, to raise the important argument of social unity--the argument that must be resolved if this country is to solve the economic and security threats it will soon face.
All that being said, this is funny:
A grass-roots movement among construction workers and unions asks Cordoba mosque supporters: Who do you expect to build it? The same people who built the World Trade Center perhaps? (IBD)
Friday, August 20, 2010
Results as the Opposite of Intentions
So the recent studies show that an increase in the minimum wage results in the rise in unemployment of minimum wage workers. Subsidizing the mortgages of homeowners results in the rise of bankruptcies and loss of homes. Attempts to pacify countries result in an increase in armed resistance. Programs that underwrite food expenses for hungry children results in an increase in the number of hungry children. The federal support of ethanol as a petroleum fuel substitute results in an increase in petroleum use. Taxes to stimulate jobs growth cause a decrease in gross domestic product. And how's the war on drugs going? Is it doing as well as the war on poverty?
Anybody see a pattern here? Is it true that our interference stimulates the problem we are trying to fix? Or are we seeing the bad administration of a good plan? Either way, it's a heck of a lot worse than Heisenberg interference which, at least, is neutral.
The debate over the proper role of government will never end. A new approach might be: What can government do right? One of the axioms of government seems to be that a program will never go away once started regardless of its effectiveness or success. How about the creation of a bureau that does nothing but analyze the effectiveness of governmental programs. Then we can analyse the role of government in the framework of its capabilities.
Probably wouldn't work.
Anybody see a pattern here? Is it true that our interference stimulates the problem we are trying to fix? Or are we seeing the bad administration of a good plan? Either way, it's a heck of a lot worse than Heisenberg interference which, at least, is neutral.
The debate over the proper role of government will never end. A new approach might be: What can government do right? One of the axioms of government seems to be that a program will never go away once started regardless of its effectiveness or success. How about the creation of a bureau that does nothing but analyze the effectiveness of governmental programs. Then we can analyse the role of government in the framework of its capabilities.
Probably wouldn't work.
Wednesday, August 18, 2010
The Black Hole of Bad Manners
This New York mosque controversy is not a circus, it is just another distracting and misleading tempest looking for an accommodating teapot. Anyone can build a building anywhere as long as it conforms to local regulations, is not in an area of eminent domain and conforms with the financial interests of politicians of import. If the mosque doesn't violate any of these restrictions, no one will have a logical objection.
And that is the point: The objections are not logical--but they are heartfelt and, somewhat, understandable. The Islamic movement in the U.S. has willingly joined what has up until now been the underclass' monopoly: Taking advantage of America's strange eagerness to reward bad social behavior. In 1999 two Muslim students on an American West flight were thrown off after wandering the plane cabin, refusing to respond to flight attendants, talking to passengers in ominous ways and trying twice to get into the cockpit. On Nov. 20, 2006 the six "flying imams" on a US Air flight from Minneapolis to Phoenix terrorized a passenger cabin by wandering the cabin, refusing to sit in assigned seats, speaking loudly in Arabic and voicing loud support for bin Laden and hatred for President Bush. They, too, were sent off the plane. Both these groups sued in court and got money.
I doubt any of these acts qualify as felonies or even misdemeanors but they are certainly obnoxious, antisocial and malevolent. Mutual concessions are mandatory in the civilized social world and pointed disdain for the comfort of others living responsibly under the social contract is a bit hard to take sometimes. While these people are only annoying and the problems minor, there is a larger point at stake. Societies--especially democracies--need a feeling of commonality of purpose. Diversity brings spice to the table but substance is always individual. People and groups with their black hole self importance will always ignore the common good. This mosque mosquito is just another such square religious/ethnic peg in the social round hole. And the opposition to it is little more than incoherent anger at sadistic jerks.
And that is the point: The objections are not logical--but they are heartfelt and, somewhat, understandable. The Islamic movement in the U.S. has willingly joined what has up until now been the underclass' monopoly: Taking advantage of America's strange eagerness to reward bad social behavior. In 1999 two Muslim students on an American West flight were thrown off after wandering the plane cabin, refusing to respond to flight attendants, talking to passengers in ominous ways and trying twice to get into the cockpit. On Nov. 20, 2006 the six "flying imams" on a US Air flight from Minneapolis to Phoenix terrorized a passenger cabin by wandering the cabin, refusing to sit in assigned seats, speaking loudly in Arabic and voicing loud support for bin Laden and hatred for President Bush. They, too, were sent off the plane. Both these groups sued in court and got money.
I doubt any of these acts qualify as felonies or even misdemeanors but they are certainly obnoxious, antisocial and malevolent. Mutual concessions are mandatory in the civilized social world and pointed disdain for the comfort of others living responsibly under the social contract is a bit hard to take sometimes. While these people are only annoying and the problems minor, there is a larger point at stake. Societies--especially democracies--need a feeling of commonality of purpose. Diversity brings spice to the table but substance is always individual. People and groups with their black hole self importance will always ignore the common good. This mosque mosquito is just another such square religious/ethnic peg in the social round hole. And the opposition to it is little more than incoherent anger at sadistic jerks.
This mosque foolishness is a real opportunity. The social contract demands a concern for the common good. Purposeful defiance of the common good must be publicly discouraged, even when that defiance is legal. This country has a long history of confusing narrow personal political goals with how the country should be. Malicious social disruption might be legal but it does not have to be tolerated. This discussion should move away from debate over political and legislative tolerance to the social responsibility debate. It is time to draw some lines.
Tuesday, August 17, 2010
"Irony is Overrated" (Claudia Black, Speaking for all Women)
Illness in the United States is showing a pattern: Chronic illnesses are rising. Diabetes, cancer, coronary artery disease, hospital acquired infections, mental illness, childhood obesity and autism--all are increasing in the population. These changes are occurring in a culture that seems to be genuinely concerned about its health, a culture that diets, works out and whose insurance industry and government actively promotes healthy lifestyles. What possible explanation is there for this increase in disease despite sincere and advanced efforts to prevent it? Perhaps it is those very advances themselves. Parallel to this rise in disease is the rise in construction and technology, a growth in our industrial and living complexes unparalleled in history. More, these chronic illnesses seem to be exclusive to these growth areas throughout the world. The social and economic burdens of these illness trends may soon overwhelm the society's ability to respond. Clearly something must be done.
Civilization has been know to be a detriment to man in the West ever since Rousseau. The relationship we have with our environment, how our new world relates to our old world, can no longer be ignored. The interactions within these worlds would be denied only by the most uneducated. From psychology to entangled particles we have demonstrated our integration. Yet some of the more established Eastern societies have recognized this interdependence for centuries and we should call on their wisdom. I am speaking, of course, of the ancient Chinese Feng Shei.
Feng Shei (literally wind-water) is a Chinese belief founded in Taoist thinking and refined for 3000 years. It recognizes the interactivity of creation seen in the relationships among the five elements of fire, water, earth, metal and wood. The various combinations and mingling of these elements also interact with the surroundings and contribute to the health and well being of communities and individuals. Who hasn't walked into a room and felt welcomed by its structure --or not? Why are some towns charming and some not? Feng Shei takes these subjective feelings further so that structure, color, architecture and placement of all man's interventions work with, not against, the energy of nature. Man's energy and work would thus conform to the harmony of nature, not oppose it. Feng Shei is time honored and proven effective in countless experiences over eons.
This country has been built and developed without respect to nature for too long. Clearly our inharmonious relationship with the world is beginning to bear poisonous fruit in our health, our happiness, our lives and our international relations. And certainly things are getting worse. A serious crisis demands a serious response. My solution is Feng Shei credits. This would apply from suburbs to operating rooms. Communities developing without respect to Feng Shei would pay a tariff that would be redistributed to communities that observe Feng Shei techniques. Corporations and companies would do the same. Such an approach would favor developing nations which do not have existing inharmonious infrastructures and penalize those richer countries with existing offending infrastructures who can better afford the penalties for past failures and the overhead to update them. Feng Shei experts could act as administrators and, in the capitalistic tradition, a public market for Feng Shei credits could emerge.
The discomfort of the nation is palpable. We are at the tipping point. Undoubtedly there will be skeptics, conservatives content with what we have called "progress", fearful of change. And there will be many who will oppose these changes because they have something to lose, something personal to put before the whole. But we are in grave danger. Who can deny a malaise is abroad in the land? A renowned and revered culture offers us the solution, a culture so large it is, in itself, a consensus. Only reactionaries and xenophobes can disagree. We must act, and now.
Civilization has been know to be a detriment to man in the West ever since Rousseau. The relationship we have with our environment, how our new world relates to our old world, can no longer be ignored. The interactions within these worlds would be denied only by the most uneducated. From psychology to entangled particles we have demonstrated our integration. Yet some of the more established Eastern societies have recognized this interdependence for centuries and we should call on their wisdom. I am speaking, of course, of the ancient Chinese Feng Shei.
Feng Shei (literally wind-water) is a Chinese belief founded in Taoist thinking and refined for 3000 years. It recognizes the interactivity of creation seen in the relationships among the five elements of fire, water, earth, metal and wood. The various combinations and mingling of these elements also interact with the surroundings and contribute to the health and well being of communities and individuals. Who hasn't walked into a room and felt welcomed by its structure --or not? Why are some towns charming and some not? Feng Shei takes these subjective feelings further so that structure, color, architecture and placement of all man's interventions work with, not against, the energy of nature. Man's energy and work would thus conform to the harmony of nature, not oppose it. Feng Shei is time honored and proven effective in countless experiences over eons.
This country has been built and developed without respect to nature for too long. Clearly our inharmonious relationship with the world is beginning to bear poisonous fruit in our health, our happiness, our lives and our international relations. And certainly things are getting worse. A serious crisis demands a serious response. My solution is Feng Shei credits. This would apply from suburbs to operating rooms. Communities developing without respect to Feng Shei would pay a tariff that would be redistributed to communities that observe Feng Shei techniques. Corporations and companies would do the same. Such an approach would favor developing nations which do not have existing inharmonious infrastructures and penalize those richer countries with existing offending infrastructures who can better afford the penalties for past failures and the overhead to update them. Feng Shei experts could act as administrators and, in the capitalistic tradition, a public market for Feng Shei credits could emerge.
The discomfort of the nation is palpable. We are at the tipping point. Undoubtedly there will be skeptics, conservatives content with what we have called "progress", fearful of change. And there will be many who will oppose these changes because they have something to lose, something personal to put before the whole. But we are in grave danger. Who can deny a malaise is abroad in the land? A renowned and revered culture offers us the solution, a culture so large it is, in itself, a consensus. Only reactionaries and xenophobes can disagree. We must act, and now.
Monday, August 9, 2010
Shards
Today is the anniversary of the murder of Sharon Tate by what the press called, strangely, "The Manson Family". I knew of the actress only through my passing interest in terrible movies, specifically "The Fearless Vampire Killers", but the story was riveting. The circumstances of her murder were particularly gruesome but the arresting aspect of the event was the nature of the attackers: They seemed on the surface to be totally mad yet they were organized and moved like a pack. Manson himself was less interesting than the others; he was never physically involved in the killings and his influence in the events only highlighted the main problem. By themselves the murderers were inexplicable but, as agents, the pitiless blood drinking lunatics were impossible.
Madness is a terrible curse only exaggerated by our misapprehensions of it. We sniff around its edges, sometimes come to ridiculous cultural conclusions and submit the victims to more of the same. We have tried to frighten madness out, boil it, burn it, exorcise it, reason with it and more recently stun it with pharmaceuticals. Yet of all its diverse appearances, one thing is constant: The madman never organizes, never joins. His illness separates him spiritually from others, isolates him not because he is shunned but because he is unable to form bonds. He is alone with his illness, castaway and marooned. Contrary to fanciful social allegories, there is never a revolution in a madhouse.
Yet here we have a group of total crazies planning and executing an attack on several families over several weeks. Many had previous psychiatric diagnoses and one later made a motiveless attempt on Gerald Ford's life. How could these people organize? How did they group and integrate towards an end? Is there some new pathology afoot? Or has the culture become so large and so forgiving that, at its edge, otherwise inexplicable social behavior--like snake handling--can find a home.
Madness is a terrible curse only exaggerated by our misapprehensions of it. We sniff around its edges, sometimes come to ridiculous cultural conclusions and submit the victims to more of the same. We have tried to frighten madness out, boil it, burn it, exorcise it, reason with it and more recently stun it with pharmaceuticals. Yet of all its diverse appearances, one thing is constant: The madman never organizes, never joins. His illness separates him spiritually from others, isolates him not because he is shunned but because he is unable to form bonds. He is alone with his illness, castaway and marooned. Contrary to fanciful social allegories, there is never a revolution in a madhouse.
Yet here we have a group of total crazies planning and executing an attack on several families over several weeks. Many had previous psychiatric diagnoses and one later made a motiveless attempt on Gerald Ford's life. How could these people organize? How did they group and integrate towards an end? Is there some new pathology afoot? Or has the culture become so large and so forgiving that, at its edge, otherwise inexplicable social behavior--like snake handling--can find a home.
Sunday, August 8, 2010
Why Dr. Karen Woo Died
http://www.guardian.co.uk/world/2010/aug/08/british-surgeon-karen-woo-afghanistan
From the days of The Waters of Mullalla through the Heroes of Beslan to the Glorious Defeat of Dr. Karen Woo there is nothing more characteristic of the desperate, homicidal and primitive nature of the peripheral, armed ideologue than the precise, savage attack on the helpless. A hospital target is preferable and if a nunnery is attached, all the better. Rarely a school is available but that, of course, is usually too much to hope (or pray) for. That is the nature of certainty--or sometime the desperate, homicidal and primitive all by itself: The right --or need--to exploit the greatest leverage possible. Who can forget the wild-eyed terror in the eyes of the children in the Beslan school as hard, experienced guerrillas cut them to pieces. And one can easily imagine the similar fear mixed with an adult incomprehension as Dr. Woo and her companions died because they did not know the protective magic phrases from the Koran that their fellow knew.
Total war is easy for the winners to defend. But the losers did not go to war because they were mad in spite of their enemies' slander. The losers had their reasons, formulated in their minds and conferences. And at the core of every homicidal conflict is inevitability, the belief that the combatants have no other option. War is the option to their annihilation.
Years ago the Iroquois, pressed on all sides by the relentless European immigrant, decided to go to war. But trapped as they were against the Great Lakes in the northwest by the bulk of white settlers they needed a second front, preferably in the southwest. They turned to the Creek, a large and well ordered tribe they respected and sent their famous war chief, Tecumseh, to convince them to join their war. Tecumseh stood at the council for three days, silent until the white government observers left. Then he gave a speech that ended thus: "Make war on their men! Make war on their women! Make war on their children! Make war on their dead!" The Creek rose in a rage, joined the Iroquois and fought to the death. Many of the battles had 98% mortality rates with only the leaders escaping to raise another force. One of the white leaders, Andrew Jackson, cemented his reputation in these horrific wars.
"Make war on their dead"? Tecumseh was not mad either. His war was not with these settlers and he knew it. His war was with history. His war was with a culture and its progress; no less a victory over the entire movement of history would protect the Iroquois and the Creek. They were doomed and total war was their only answer. They were in the endgame. They killed everyone they could find, farmers, traders' wives, settlers' children. And the settlers responded in kind. Every battle was to the death; there was no quarter and no surrender. When the military position was overrun, the camps and villages were next and all the women and children were killed. And then they were gone.
A society, a culture, a people backed into a corner will fight like a trapped beast to the death. So will an outlaw. It is very important that a society be able to distinguish between the two. No society wants to be in an endgame with an enemy and not know it.
From the days of The Waters of Mullalla through the Heroes of Beslan to the Glorious Defeat of Dr. Karen Woo there is nothing more characteristic of the desperate, homicidal and primitive nature of the peripheral, armed ideologue than the precise, savage attack on the helpless. A hospital target is preferable and if a nunnery is attached, all the better. Rarely a school is available but that, of course, is usually too much to hope (or pray) for. That is the nature of certainty--or sometime the desperate, homicidal and primitive all by itself: The right --or need--to exploit the greatest leverage possible. Who can forget the wild-eyed terror in the eyes of the children in the Beslan school as hard, experienced guerrillas cut them to pieces. And one can easily imagine the similar fear mixed with an adult incomprehension as Dr. Woo and her companions died because they did not know the protective magic phrases from the Koran that their fellow knew.
Total war is easy for the winners to defend. But the losers did not go to war because they were mad in spite of their enemies' slander. The losers had their reasons, formulated in their minds and conferences. And at the core of every homicidal conflict is inevitability, the belief that the combatants have no other option. War is the option to their annihilation.
Years ago the Iroquois, pressed on all sides by the relentless European immigrant, decided to go to war. But trapped as they were against the Great Lakes in the northwest by the bulk of white settlers they needed a second front, preferably in the southwest. They turned to the Creek, a large and well ordered tribe they respected and sent their famous war chief, Tecumseh, to convince them to join their war. Tecumseh stood at the council for three days, silent until the white government observers left. Then he gave a speech that ended thus: "Make war on their men! Make war on their women! Make war on their children! Make war on their dead!" The Creek rose in a rage, joined the Iroquois and fought to the death. Many of the battles had 98% mortality rates with only the leaders escaping to raise another force. One of the white leaders, Andrew Jackson, cemented his reputation in these horrific wars.
"Make war on their dead"? Tecumseh was not mad either. His war was not with these settlers and he knew it. His war was with history. His war was with a culture and its progress; no less a victory over the entire movement of history would protect the Iroquois and the Creek. They were doomed and total war was their only answer. They were in the endgame. They killed everyone they could find, farmers, traders' wives, settlers' children. And the settlers responded in kind. Every battle was to the death; there was no quarter and no surrender. When the military position was overrun, the camps and villages were next and all the women and children were killed. And then they were gone.
A society, a culture, a people backed into a corner will fight like a trapped beast to the death. So will an outlaw. It is very important that a society be able to distinguish between the two. No society wants to be in an endgame with an enemy and not know it.
Friday, August 6, 2010
Giving War a Bad Name
On August 6, 1945, the Americans attacked the city of Hiroshima with an atomic bomb, the first such attack ever. Interestingly, its anniversary is not well remembered. At least 140,000 people were killed in the initial attack; the lingering effects are myriad.
There are countless topics that can be derived from this event but there is a specific modern American peculiarity whose origins I have always pondered: The reluctance to fight wars seriously. Since the Second World War the United States has gone out of its way to sanitize combat. It fights wars as a community effort--as part of coalitions or the United Nations--as if there is "nothing personal". They place limits on objectives, they never participate in the time honored purposes of war--slaves and booty--and often will compensate or rebuild the enemy after the fact. Most significantly, they try to distance their own citizenry from the combat. From a volunteer military to the creepy draft lottery the average citizen is moved as far as possible from the war. Indeed this compartmentalizing of combat seems to dictate policy as the government limits action and objectives to limit domestic impact.
The attempt to isolate foreign war as a domestic policy is, of course, impossible. The American inflation chart follows the war chart point by point. Worse, the people become inured to the violence and destruction, like the gradual therapeutic desensitizing to an allergy. But the worst point is the nation's military purpose and its domestic purpose are allowed to diverge. In the Vietnam War American troops were under a greater threat because several sites of enemy troop operations could not be violated for diplomatic reasons, because the war might expand and become a risk to the citizens at home. No nation should allow its sons to be under fire without being willing to commit completely to their defense and well being. That is, no nation should allow its sons to be under fire without risk to itself.
War is too terrible to be dabbled in. The soldier is immersed in total war; his society should be too. That the soldier is a volunteer is no excuse. If every action was supported with a war tax, if gasoline was diverted or food sold for the expressed purpose of troop support, if the citizen were made to suffer, to participate in the actions of their military children in some--even symbolic--way there would only be serious efforts undertaken.
War is an active, inevitable evil. Yet it cannot be softened or cleaned up. No politician can tweak it to make it more gentle. It is vicious and lethal. Even in the strange Aztec "Flower Wars" everyone died in the end. The citizens of Hiroshima knew this. They lived and died it. It may be that their lesson is too hard for us to face.
There are countless topics that can be derived from this event but there is a specific modern American peculiarity whose origins I have always pondered: The reluctance to fight wars seriously. Since the Second World War the United States has gone out of its way to sanitize combat. It fights wars as a community effort--as part of coalitions or the United Nations--as if there is "nothing personal". They place limits on objectives, they never participate in the time honored purposes of war--slaves and booty--and often will compensate or rebuild the enemy after the fact. Most significantly, they try to distance their own citizenry from the combat. From a volunteer military to the creepy draft lottery the average citizen is moved as far as possible from the war. Indeed this compartmentalizing of combat seems to dictate policy as the government limits action and objectives to limit domestic impact.
The attempt to isolate foreign war as a domestic policy is, of course, impossible. The American inflation chart follows the war chart point by point. Worse, the people become inured to the violence and destruction, like the gradual therapeutic desensitizing to an allergy. But the worst point is the nation's military purpose and its domestic purpose are allowed to diverge. In the Vietnam War American troops were under a greater threat because several sites of enemy troop operations could not be violated for diplomatic reasons, because the war might expand and become a risk to the citizens at home. No nation should allow its sons to be under fire without being willing to commit completely to their defense and well being. That is, no nation should allow its sons to be under fire without risk to itself.
War is too terrible to be dabbled in. The soldier is immersed in total war; his society should be too. That the soldier is a volunteer is no excuse. If every action was supported with a war tax, if gasoline was diverted or food sold for the expressed purpose of troop support, if the citizen were made to suffer, to participate in the actions of their military children in some--even symbolic--way there would only be serious efforts undertaken.
War is an active, inevitable evil. Yet it cannot be softened or cleaned up. No politician can tweak it to make it more gentle. It is vicious and lethal. Even in the strange Aztec "Flower Wars" everyone died in the end. The citizens of Hiroshima knew this. They lived and died it. It may be that their lesson is too hard for us to face.
Thursday, August 5, 2010
Blind Bathoes and Elephants
A number a years ago a woman held up my neighborhood bank with a handgun. She was quickly arrested, tried and convicted. The judge--a bathoes character if there ever was one--sentenced her to nursing school.
I have never forgotten this story because it so typifies modern thinking. The judge felt that nurses were as a group upstanding, responsible, hardworking citizens. The distinguishing characteristic that separated nurses from others was their nursing degree. Therefore, he reasoned, this criminal would be improved by a nursing degree. You can catch almost anything in a hospital, why not responsibility and integrity. Indeed perhaps the entire community would be improved if everyone was conferred a nursing degree at birth.
Observations lead to generalizations. Sometimes these are brilliant, like Darwin. Sometimes they are only bigotry, like blacks are lazy or Asian girls can't drive. No observation is worth anything unless it is confirmed, critically. Science is not consensus, it is contentious. It is the battlefield of argument over inference. Information never, ever, implies; we infer. It is only after brutal analysis that information becomes meaningful.
Our current culture does not understand this and we will suffer for its ignorance. We look at home ownership and see that people who are homeowners seem to be better invested in their communities. We ask no further questions; we assume --infer--that home ownership is beneficial in itself. We ignore all the other possibilities--the buyer saved for his down payment so he was disciplined, the buyer did not buy until he had a good and stable job, the buyer had a stable family--all perfectly reasonable circumstances that might contribute to the successful homeowner demographic success. No, the house is the thing. People with college degrees earn more than their fellows without a degree, thus a degree is good for you. (Not a nursing degree this time around.) Do we have any idea if a 120 IQ woman with a degree out earns a 120 IQ woman without a degree? No, that study has never been done. So we slog on and encourage home ownership and college degrees with only the most superficial evidence.
Poor scientific thinking is more than erroneous, it distracts us from the truth. It misleads us as surely as an intentional, malicious lie. Years ago a seminal study was done on the mortality rates in cities versus farm communities in Great Britain. It showed a significantly higher mortality rate in urban communities. The conclusion was that pollution was very bad for you and plans were initiated to curb smog. Now it might well be that smog is terrible for one's health but the study omitted one point: It did not correct for smoking. When the statistics were later reviewed to eliminate the factor of smoking among the subjects, the difference went away; the survival rate among the two communities was identical. Smog might be bad for you but there was no evidence in this study for that; but there was real evidence that cigarettes were killing people.
We are less insightful than we think. And we are less kind. Basing plans and programs on shoddy thinking traps everyone in the shoddy results. More, it distracts us from the true answers to our questions. One can hope that with time we, as a community, will get better at this thinking but one worries. Shoddy thinking, like bigotry, is easier.
I have never forgotten this story because it so typifies modern thinking. The judge felt that nurses were as a group upstanding, responsible, hardworking citizens. The distinguishing characteristic that separated nurses from others was their nursing degree. Therefore, he reasoned, this criminal would be improved by a nursing degree. You can catch almost anything in a hospital, why not responsibility and integrity. Indeed perhaps the entire community would be improved if everyone was conferred a nursing degree at birth.
Observations lead to generalizations. Sometimes these are brilliant, like Darwin. Sometimes they are only bigotry, like blacks are lazy or Asian girls can't drive. No observation is worth anything unless it is confirmed, critically. Science is not consensus, it is contentious. It is the battlefield of argument over inference. Information never, ever, implies; we infer. It is only after brutal analysis that information becomes meaningful.
Our current culture does not understand this and we will suffer for its ignorance. We look at home ownership and see that people who are homeowners seem to be better invested in their communities. We ask no further questions; we assume --infer--that home ownership is beneficial in itself. We ignore all the other possibilities--the buyer saved for his down payment so he was disciplined, the buyer did not buy until he had a good and stable job, the buyer had a stable family--all perfectly reasonable circumstances that might contribute to the successful homeowner demographic success. No, the house is the thing. People with college degrees earn more than their fellows without a degree, thus a degree is good for you. (Not a nursing degree this time around.) Do we have any idea if a 120 IQ woman with a degree out earns a 120 IQ woman without a degree? No, that study has never been done. So we slog on and encourage home ownership and college degrees with only the most superficial evidence.
Poor scientific thinking is more than erroneous, it distracts us from the truth. It misleads us as surely as an intentional, malicious lie. Years ago a seminal study was done on the mortality rates in cities versus farm communities in Great Britain. It showed a significantly higher mortality rate in urban communities. The conclusion was that pollution was very bad for you and plans were initiated to curb smog. Now it might well be that smog is terrible for one's health but the study omitted one point: It did not correct for smoking. When the statistics were later reviewed to eliminate the factor of smoking among the subjects, the difference went away; the survival rate among the two communities was identical. Smog might be bad for you but there was no evidence in this study for that; but there was real evidence that cigarettes were killing people.
We are less insightful than we think. And we are less kind. Basing plans and programs on shoddy thinking traps everyone in the shoddy results. More, it distracts us from the true answers to our questions. One can hope that with time we, as a community, will get better at this thinking but one worries. Shoddy thinking, like bigotry, is easier.
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