Map of life expectancy at birth from Global Education Project.

Sunday, February 25, 2018

Sunday Sermonette: Oh dry up . . .

Genesis 8, reproduced below in the New International Version, is actually two separate accounts, woven together clumsily. That's why you will frequently see a verse contradicted by the one following. But keep in mind that this is the nature of the Torah in general. At some point a scribe, or team of scribes, pulled together material from a number of scrolls of varying provenance. It is, in other words, a compendium, but the pieces aren't labeled.

But God remembered Noah and all the wild animals and the livestock that were with him in the ark, and he sent a wind over the earth, and the waters receded. 
Oh yeah, God smacks his forehead: "I almost forgot about that Noah guy floating in the ark . .. "

 Now the springs of the deep and the floodgates of the heavens had been closed, and the rain had stopped falling from the sky. The water receded steadily from the earth. At the end of the hundred and fifty days the water had gone down, and on the seventeenth day of the seventh month the ark came to rest on the mountains of Ararat. The waters continued to recede until the tenth month, and on the first day of the tenth month the tops of the mountains became visible.
 So the ark came to rest on the mountains after 7 1/2 months. 2 1/2 months later, the tops of the mountains become visible. In other words, verses 4 and 5 are from separate sources.

After forty days Noah opened a window he had made in the ark and sent out a raven, and it kept flying back and forth until the water had dried up from the earth. Then he sent out a dove to see if the water had receded from the surface of the ground. But the dove could find nowhere to perch because there was water over all the surface of the earth; so it returned to Noah in the ark. He reached out his hand and took the dove and brought it back to himself in the ark. 10 He waited seven more days and again sent out the dove from the ark. 11 When the dove returned to him in the evening, there in its beak was a freshly plucked olive leaf! Then Noah knew that the water had receded from the earth. 12

The raven and the dove are also probably from separate sources. Obviously, if the  earth had been flooded for either nine months or a year, there wouldn't be any olive leaves for the dove to pluck.

 He waited seven more days and sent the dove out again, but this time it did not return to him.
13 By the first day of the first month of Noah’s six hundred and first year, the water had dried up from the earth. Noah then removed the covering from the ark and saw that the surface of the ground was dry. 14 By the twenty-seventh day of the second month the earth was completely dry.
15 Then God said to Noah, 16 “Come out of the ark, you and your wife and your sons and their wives. 17 Bring out every kind of living creature that is with you—the birds, the animals, and all the creatures that move along the ground—so they can multiply on the earth and be fruitful and increase in number on it.”
18 So Noah came out, together with his sons and his wife and his sons’ wives. 19 All the animals and all the creatures that move along the ground and all the birds—everything that moves on land—came out of the ark, one kind after another.

The animals have a small problem: there is nothing to eat. The predators have no prey, and the herbivores no vegetation. The animals also have the small problem of getting to the appropriate places such as South America, Siberia, and the Pacific Islands.

20 Then Noah built an altar to the Lord and, taking some of all the clean animals and clean birds, he sacrificed burnt offerings on it. 21  

Whoops! According to Genesis 7:8-9, there were only two of each of the clean animals. Noah has exterminated them!

The Lord smelled the pleasing aroma and said in his heart: “Never again will I curse the ground because of humans, even though every inclination of the human heart is evil from childhood. And never again will I destroy all living creatures, as I have done.
22 “As long as the earth endures,
seedtime and harvest,
cold and heat,
summer and winter,
day and night
will never cease.”
So God destroyed the world because humans are wicked. They're still wicked, but he won't do it again. This story is of course, an oral tradition that was written down in two different forms which, as I say, the scribes compiled here. But the different numbers and species of bird don't really matter. The essence of the two versions is similar.

As you may know, because it is widely discussed, many cultures have flood myths that share some elements with the Genesis story.  Similar myths among Middle Eastern cultures may originate in an actual historical event which also inspired the Noah story. The city of Shuruppak on the Euphrates was destroyed by a flood around 3,000 BC, and this may be the origin of some of these myths. In general, changing hydrology and geology following the last glacial period resulted in catastrophic flooding events at various times and places around the world, which may have inspired their own myths.

Trying to determine any underlying psychological rationale or appeal for these myths is of course speculative. But the Noah myth, and others, ultimately have a reassuring quality. People who survived a catastrophe would want to be comforted by the thought that it isn't going to happen again. Sadly, while of course a world-destroying flood never did happen, and won't happen, localized disasters will continue to happen.


Friday, February 23, 2018

American Exceptionalism

I have commented before on the falling life expectancy in the United States, following two decades during which gains lagged those in the other wealthy countries. I previously linked to this editorial in BMJ by two Americans, and I emphasized their discussion of the opioid epidemic, alcohol abuse and suicide as key factors in the recent decline. I put less emphasis on life expectancy in the U.S. falling behind in the longer term.

While the U.S. is among the wealthiest countries, it has a higher poverty rate than most others, and provides far less in the way of basic family support, educational opportunity, and health care access. It is true that ordinary people have felt that the federal government has largely ignored their problems and that many people have been drawn to a so-called "populist" message of protest. But the message they heard, and responded to, was a lie.

The struggles Americans face are not caused by immigration, or international trade, or tax money going to a secret welfare program that only Blah people can get. Here's the policy prescription from Woolf and Aron:

In theory, policy makers jolted by the shortening lifespan of Americans would hasten to correct these conditions. They would promote education, boost support for children and families, increase wages and economic opportunity for the working class, invest in distressed communities, and strengthen healthcare and behavioral health systems. But the pro-business policy agenda favored by elected officials rarely prioritizes these needs. On the contrary, recent legislation and regulations may prolong or intensify the economic burden on the middle class and weaken access to healthcare and safety net programs.
Exactly. The people who voted for the orange psychopath who now occupies the White House got hosed. But it seems they will never wake up to it.

Update: Here's Yale Historian Timothy Snyder talking with Chauncey DeVega:

Trump is not a populist. He does not actually deliver anything of an economic or socially positive nature. But he is delivering something psychological to his base. It's the sense that "maybe we're hurting, but other people are hurting worse, and that's what we like." The design of Trump is to change politics from a positive-sum game where the idea is that everybody's going to do a little bit better because we're going to have better policies, to a negative-sum game where you're not doing anything for people in Virginia or Pennsylvania or Ohio. However, Trump is going to offer them a spectacle in which other people doing worse. The public gets caught up in the spectacle and that is what people then begin to expect from politics.
For example, Americans on average are leading shorter lives -- which is completely anomalous in the developed world -- and that's going to keep happening. But meanwhile, some of the people who are suffering the most are immigrants or blacks or Muslims. The psychological pleasure and joy for Trump's public from this horrible situation means they feel like they are on the right side of things. It's about pain. Trump's public may feel like they are hurting, but their leader is hurting other people worse and that feels good.
Tell it like it is.



Tuesday, February 20, 2018

Now this is going to stir up the faithful . . .

A team at Stanford has inserted human stem cells into a sheep embryo. This is actually the second time scientists have successfully created what this article calls an "animal-human hybrid." That is not technically correct. A hybrid is a result of cross breeding such that every cell has DNA from each species. Examples are mules and Ligers. Humans cannot be hybridized with any living species (although Neanderthals are now known to have bred with Homo Sapiens).

This is actually what's called a chimera, having some sheep cells and some human cells, not a hybrid. The purpose of this research is to grow human organs for transplant inside non-human animals. That's still quite a bit far off, if not far fetched. The team destroyed these embryos after a few days. But I definitely predict this work will cause a shit storm if it gets much more publicity. This article does not say what kind of human stem cells were used -- it's going to create an even bigger shit storm if they were embryonic stem cells -- but you may remember that George Bush the Second actually spoke against this line of research in a State of the Union speech. So a lot of people don't like it.

However, I haven't really heard anyone articulate why or how this is unethical. I am curious what people may think.

Update: Okay, here are my thoughts on this. As far as the animal welfare question, at this point we have no idea whether the quality of life of say, a pig with a human liver would somehow be impaired. But it's a pretty good bet that said pig would be much better cared for than a typical pig raised for meat. As far as animal exploitation and suffering are concerned, if you object to this, then you will have to become a vegetarian. Which, by the way, I am, but it's because of the way livestock are treated in our industrial meat production system. Eating meat is not, in and of itself, unethical, that's human nature. So anyway, assuming the animals are treated humanely it's hard to make an argument against this on animal welfare grounds given what we already tolerate.

As far as human dignity, I'm missing that too. There's no human brain involved here. The only human being affected is the patient who ultimately gets the organ. However, the technology could conceivably be used in more problematic ways. We'd have to cross that bridge when we come to it. BUT . . .

This is most likely all moot because the prospect of growing human organs in an artificial environment is probably much more imminent. So this is unlikely to become a real problem.


Sunday, February 18, 2018

Sunday Sermonette: Utter Absurdity

Genesis 7 doesn't really add much information to what we already got in chapter 6, but it does give us the opportunity for further ridicule.

The Lord then said to Noah, “Go into the ark, you and your whole family, because I have found you righteous in this generation. Take with you seven pairs of every kind of clean animal, a male and its mate, and one pair of every kind of unclean animal, a male and its mate, and also seven pairs of every kind of bird, male and female, to keep their various kinds alive throughout the earth. Seven days from now I will send rain on the earth for forty days and forty nights, and I will wipe from the face of the earth every living creature I have made.”
And Noah did all that the Lord commanded him.
Noah was six hundred years old when the floodwaters came on the earth. And Noah and his sons and his wife and his sons’ wives entered the ark to escape the waters of the flood. Pairs of clean and unclean animals, of birds and of all creatures that move along the ground, male and female, came to Noah and entered the ark, as God had commanded Noah. 10 And after the seven days the floodwaters came on the earth.
11 In the six hundredth year of Noah’s life, on the seventeenth day of the second month—on that day all the springs of the great deep burst forth, and the floodgates of the heavens were opened. 12 And rain fell on the earth forty days and forty nights.
13 On that very day Noah and his sons, Shem, Ham and Japheth, together with his wife and the wives of his three sons, entered the ark. 14 They had with them every wild animal according to its kind, all livestock according to their kinds, every creature that moves along the ground according to its kind and every bird according to its kind, everything with wings. 15 Pairs of all creatures that have the breath of life in them came to Noah and entered the ark. 16 The animals going in were male and female of every living thing, as God had commanded Noah. Then the Lord shut him in.
17 For forty days the flood kept coming on the earth, and as the waters increased they lifted the ark high above the earth. 18 The waters rose and increased greatly on the earth, and the ark floated on the surface of the water. 19 They rose greatly on the earth, and all the high mountains under the entire heavens were covered. 20 The waters rose and covered the mountains to a depth of more than fifteen cubits. 21 Every living thing that moved on land perished—birds, livestock, wild animals, all the creatures that swarm over the earth, and all mankind. 22 Everything on dry land that had the breath of life in its nostrils died. 23 Every living thing on the face of the earth was wiped out; people and animals and the creatures that move along the ground and the birds were wiped from the earth. Only Noah was left, and those with him in the ark.
24 The waters flooded the earth for a hundred and fifty days.
 Okay, we already noted that Noah was going to have a very difficult time collecting the 13 million or so species of metazoans, especially from places such as the Pacific islands, the arctic, China, and indeed the vast majority of the planet which he didn't even know existed. And he probably would have had trouble telling apart the male and female beetles. But let's move on ...

How does he know which animals are clean, and which are unclean? God doesn't reveal that information until Leviticus.

Remember Genesis 4? "4:20 And Adah bare Jabal: he was the father of such as dwell in tents, and of such as have cattle.4:21 And his brother's name was Jubal: he was the father of all such as handle the harp and organ.4:22 And Zillah, she also bare Tubalcain, an instructer of every artificer in brass and iron:" Well, after the flood there must not have been anybody who dwelled in tents and had cattle; or anybody who handled the harp and organ, because these are the descendants of Cain, whose line was exterminated in the flood. (Remember that Noah is a descendant of Seth.)

I don't think I need to go into the hydrology of the flood, but obviously, water flows downhill so it is impossible for a flood to cover all of the earth including the mountains. Floods can only occur locally in places where the water runs off more slowly than it accumulates. But leaving aside the impossibility of all this, why does God kill all the animals? What had they done to offend him? There's also the problem of the plants, which are not saved in the ark. Once the floodwaters are gone, what will the 30 million species of animals eat? On the other hand, God is happy with marine and aquatic creatures, which are evidently spared.

Did every living creature die in the flood. Apparently not, because as we will discover later, the Nephilim survived.

While one would have to be an utter fool to take any of this literally, the interesting question is what it might mean symbolically. Why is this story in the Bible? Why are we supposed to read it? What is it trying to tell us?

Friday, February 16, 2018

The T Word

Reporter James Risen has done some excellent work, and he has also gotten some things wrong. (Wen Ho Lee, for example.) But in this column in The Intercept, he is not doing original reporting but rather pulling together what we know and can fairly suspect about the relationship between the current white house Resident and Vladimir Putin. It's a bit surprising to see this in a publication overseen by Glenn Greenwald, who is consistently hostile to the suggestion that Russia had anything to do with our 2016 election or could conceivably be blackmailing its ostensible winner. But Greenwald is allowing this, so credit where it's due.

Risen, like a lot of us, has a pre-existing opinion about the state of the presidency:

 It is not that he is a complicated subject. Quite the opposite. It is that everything about him is so painfully obvious. He is a low-rent racist, a shameless misogynist, and an unbalanced narcissist. He is an unrelenting liar and a two-bit white identity demagogue. . . . Unfortunately, another word also describes him: president. The fact that such an unstable egomaniac occupies the White House is the greatest threat to the national security of the United States in modern history. Which brings me to the only question about Donald Trump that I find really interesting: Is he a traitor?
Risen proposes a four-part test. 1) Did Russia intervene in the 2016 election to help Trump? 2) Did Trump or his associates collaborate in this effort? 3) Did they obstruct justice by attempting to block or undermine the investigation into (1) and (2); 4) Are Republican leaders now engaged in a criminal conspiracy to further (3)?

Actually, the Trump is a traitor question stops at (2). The other items are additional. In the linked column, Risen addresses item (1) and, consistent with what is basically common knowledge, finds it true. He says his analysis of item (2) is coming shortly. We'll see if he knows more than the rest of us about this.

What I will say for now, however, is that it is astonishing how few people are taking this question seriously, or at least are willing to do so in public. It is certainly a fair one.

Wednesday, February 14, 2018

Ideology vs. Science

Joshua Sharfstein in JAMA discusses the opioid abuse epidemic and what to do about it. This is an opinion piece that doesn't have references, but I can assure you that he is right on the facts. People with opioid addiction seldom succeed in maintaining long term recovery without what we call Medication Assisted Treatment. That means either methadone or buprenorphine, both of which are themselves opioids. As Sharfstein tell us, "Many still believe that those who take methadone or buprenorphine are 'trading one addiction for another,' 'in bondage,' or 'taking a cop-out.'" People who are using these medications may face reprisals from judges or social service agencies.

Here is the reality. People on Medication Assisted treatment don't get high, and are not impaired. These particular opioids have a pharmacokinetic profile (as we say) that keeps them at a fairly steady concentration in the blood for a long time, meaning that they can eliminate craving without the side effects of intoxication. That means people can work, go to school, take care of their families, whatever they need to do. They are no longer committing crimes or at risk for overdose.

There are lots of chronic diseases for which people have to take medications every day, for a lifetime. These include diabetes, HIV, high blood pressure, high cholesterol . . . If you are over 45 or so, you probably take at least one medication every day yourself. If you didn't, you would be at higher risk for death and if you are, say, an insulin dependent diabetic or have HIV, you will certainly die. Do you consider yourself to be "in bondage," or that you have an addiction? No. You're just stayin' alive.

Now, these are true facts about medication assisted treatment for opioid addiction. There is no defensible reason to oppose it other than an ideological commitment to the principle that "Drugs" (meaning some drugs, when used by some people, in some contexts) are evil. This is also the reason why people who are caught with small amounts of opioids are put in jail, thereby ruining their lives and making recovery all the more difficult. That is pointless, but it happens because people morally condemn addicts. And why is that? Nobody sets out to become addicted, just as nobody tries to become diabetic. It's a disease.

As Lawrence Gostin tells us in the same issue, the present administration has abandoned truth:

Science and technology have not been salient in the Trump administration, including taking longer than any other modern president to name a science adviser, tasked with providing scientific guidance in “areas of national concern.”7 The administration has fired or reconfigured several science advisory boards, including at the Environmental Protection Agency (EPA), Interior Department, and National Oceanic and Atmospheric Administration. Scientific information regarding climate change was removed from official websites at the White House, EPA, and Department of Energy. Lesbian, gay, bisexual, and transgender (LGBT) content was removed from White House and State Department websites, and HHS removed LGBT questions from its survey of priority health needs for older US residents. . . .

The administration plans to eliminate the ACA’s Prevention and Public Health Fund. In addition, the president proposed deep budget cuts to research agencies, such as the National Institutes of Health, CDC, and the Energy Department.
The reason is, of course, that reality has a well-known liberal bias. The Republicans want to take us back to the 12th Century, before the Enlightenment, where truth was what the Pope said it was and the sun went around the earth.






Sunday, February 11, 2018

Sunday Sermonette: Wickedness

Perhaps you have heard of Ark Encounter, a tourist attraction in Kentucky featuring what purports to be a life-sized model of Noah's ark. The theme park was built with the help of a subsidy from the taxpayers of Kentucky by Answers in Genesis, an organization led by Australian-American Ken Ham, that insists the Bible is literally true. Funny thing: the ark was constructed by 1,000 Amish craftsmen using more than 3 million board feet of lumber and 95 tons of metal fasteners.

Anyway, here's the story:

This is the account of Noah and his family.
Noah was a righteous man, blameless among the people of his time, and he walked faithfully with God. 10 Noah had three sons: Shem, Ham and Japheth.
11 Now the earth was corrupt in God’s sight and was full of violence. 12 God saw how corrupt the earth had become, for all the people on earth had corrupted their ways. 13 So God said to Noah, “I am going to put an end to all people, for the earth is filled with violence because of them. I am surely going to destroy both them and the earth. 14 So make yourself an ark of cypress wood; make rooms in it and coat it with pitch inside and out. 15 This is how you are to build it: The ark is to be three hundred cubits long, fifty cubits wide and thirty cubits high. 16 Make a roof for it, leaving below the roof an opening one cubit high all around. Put a door in the side of the ark and make lower, middle and upper decks. 17 I am going to bring floodwaters on the earth to destroy all life under the heavens, every creature that has the breath of life in it. Everything on earth will perish. 18 But I will establish my covenant with you, and you will enter the ark—you and your sons and your wife and your sons’ wives with you. 19 You are to bring into the ark two of all living creatures, male and female, to keep them alive with you. 20 Two of every kind of bird, of every kind of animal and of every kind of creature that moves along the ground will come to you to be kept alive. 21 You are to take every kind of food that is to be eaten and store it away as food for you and for them.”
22 Noah did everything just as God commanded him.

So, because the earth is filled with violence, God decides to destroy nearly every living creature. That's quite psychopathic if you don't mind my saying so. Anyway, Noah, who lives in a desert and has presumably never seen a ship of any kind, does the work of 1,000 skilled craftsmen and builds a ship about 450 feet long. That's the size of the largest  wooden ships ever built -- which didn't come along until much later -- and they required metal straps to hold them together. This translation implies that there was an opening all around under the roof, but most translations have a single 18 inch window in the middle of the roof. In any case there is no ventilation on the lower or middle decks.

So, in order to get two of every kind of animal onto the ark, how many creatures would Noah need to round up? The answer, as best we can tell, is about 13 million. That is, the latest estimate is that there are about 6.5 million terrestrial metazoans. The vast majority of these live in tropical forests, and on continents far from Noah. Answers in Genesis also maintains that humans coexisted with the non-avian dinosaurs, who must also have been brought onto the ark but for some reason died out later. It would be awfully fun to have a T. Rex and a Brontosaur next to the marmosets!

While this story is obviously very silly, the sad news is that Ken Ham and a lot of Kentucky lawmakers and gullible tourists actually believe it. 

Friday, February 09, 2018

Not Staying Alive


I recently went into the deep history of human life expectancy. Now let's look at recent history in the U.S. vs. the rest of the wealthy countries.




















The OECD is the Organization for Economic Cooperation and Development. It actually includes some countries you probably don't think of as wealthy, such as Mexico and Latvia, but also western Europe, Australia and Japan. As you can see, in the mid-90s the U.S. was average among OECD countries. As life expectancy increased throughout the OECD in the early part of this century,the U.S. lagged behind, and then life expectancy in the U.S. stopped increasing entirely.


I snatched this graphic from an editorial in BMJ (formerly British Medical Journal) by Stephen Woolf and Laudan Aron, both Americans.  (No link due to paywall.) They note that this can  in part be explained by the opioid epidemic, suicides and alcohol abuse, which they call "deaths of despair." As have many observers, they link this to economic dislocation, particularly in smaller cities and rural areas, that has affected the fortunes of lower educated white workers. I think this is a bit facile.

I don't think that is a big part of the explanation for the opioid epidemic, which has been pretty indiscriminate in its victims. However, we are clearly doing something wrong. We are not investing sufficiently in our people, to put it broadly. If families are struggling, they don't need to be lectured to about takers vs. makers and have their food stamps and Medicaid taken away. They need educational opportunity, economic development, and health care.

That means doing the exact opposite of what  Republicans are trying to do. We need to tax the rich and invest the money in public education, free or at least affordable access to all levels of post-secondary education, renewable energy development, health care infrastructure and services, child care for working parents, family and medical leave, transportation infrastructure including mass transit -- all the stuff those other countries do where the people live longer, healthier and happier lives. All of this creates jobs. People can get jobs in education, health care, child care, transportation, renewable energy -- much better jobs than mining coal or bolting cars together all day, and those jobs are never coming back anyway.

The only way to make this happen is to never, ever vote for a Republican.

Wednesday, February 07, 2018

Unboggle your mind


History has gone so batshit crazy that our minds have stopped encompassing what is really happening. This long form piece by Kurt Andersen is worth your while, in which he recounts how the Republican party went down the rabbit hole to nutville.

This is how we get a "president" who, among innumerable other insanities:

  • Started out in politics by promoting the lunatic conspiracy theory that Barack Obama was born in Kenya. (More than half of all Republicans still believe this.)
  • Claimed that Supreme Court Justice Antonin Scalia was murdered.
  • Claimed that Ted Cruz's father was involved in the assassination of John F. Kennedy.
  • Says that Clinton aide Vince Foster was murdered to cover up some guilty knowledge about Hillary Clinton. (Investigations by two special prosecutors and two congressional committees all concluded that he committed suicide because he was depressed.)
  • Insists that he won the popular vote and that three million votes were cast for Hillary Clinton by illegal immigrants.
Andersen concludes:

Since then, of course, Trump has fired the FBI director and pushed out the deputy director, provoked a special counsel’s investigation, and conjured an anti-Trump conspiracy at the bureau—which of course many on the right now believe, with help from members of Congress and the Sean Hannitys of the world. Republicans by almost 2 to 1 disapprove of Robert Mueller’s work, and nearly half of them say they now have “not very much” or no confidence at all in the FBI. In other words, our first conspiracy theorist in chief is harnessing his party’s old conspiracist tic, originally Kremlin-focused, to discredit the existence of an actual anti-American conspiracy hatched in the Kremlin. History is filled with tragic ironies, and this is a colossal one.
 What you must keep in mind at all times is that the Resident is batshit crazy. Really. That is kind of, you know, dangerous.



Sunday, February 04, 2018

Sunday Sermonette: Sci Fi

As I mentioned when we started this endeavor, the divisions into chapters were made by medieval monks. They do not mark the original fragments that were cobbled together to form the Torah, and often they are otherwise illogical. Genesis 6 has two obviously separate pieces. I'll take only the first part today. It's fairly short.

When human beings began to increase in number on the earth and daughters were born to them, the sons of God saw that the daughters of humans were beautiful, and they married any of them they chose. Then the Lord said, “My Spirit will not contend with humans forever, for they are mortal; their days will be a hundred and twenty years.”
The Nephilim were on the earth in those days—and also afterward—when the sons of God went to the daughters of humans and had children by them. They were the heroes of old, men of renown.
There are numerous disputes about the translation of this passage. "Nephilim" is often translated as "giants." I note now that we are about to see everything and everybody exterminated in the flood except for five humans and two of every kind of animal. (Next week!) However, the nephilim will survive, as they turn  up again in Numbers 13 -- no surprise given the interpolation "and also afterward."

Then there is the question of who are the Sons of God. According to Christian theology, of course, there is only one, and it ain't these guys. Although the Gospel of John uses the term loosely to refer to Christians, obviously that isn't any help here. In Job, Satan and his friends are the sons of God; and they were also present at the creation. "Whereupon are the foundations thereof fastened? or who laid the corner stone thereof; When the morning stars sang together, and all the sons of God shouted for joy?" It is unclear whether the nephilim are the beings who  had sex with the daughters of humans, or their offspring; and whether they are congruent with the sons of God or whether there were two kinds of alien beings banging our daughters.

It is also unclear why God is "contending" (in other translations "striving") with humans,  and why limiting their lifespan to 120 years relieves this. (Again, this seems to approximately double the reality, which suggests some sort of error in transliterating numerals.) This sentiment seems to be inspired by his sons having sex with human women, but it is entirely obscure why he should feel this way.

This passage has tied theologians in knots. I won't go into it at any length since it's obviously complete bullshit, but one example is the so-called pre-Adamite interpretation. Since there are two creation stories, the pre-Adamites figure, let's go with that and assume that after the first creation, God allowed some time for the humans to multiply and establish a population before making Adam and Eve. That explains where Caine got his wife and other problems, although it creates many problems they do their best to ignore. For example, why is the pre-Adamite population cursed for Adam's fall? Did they know good from evil? Were they already mortal? And why create Adam and Eve? There doesn't seem to be any further distinction between their descendants and the pre-Adamites. The whole thing seems gratuitous.

In any case, many pre-Adamites argued that the sons of God were white pre-Adamites who were having sex with non-white descendants of Caine, and this was the nature of the "wickedness" the heart of the upcoming story we will get to next week. Seriously. If you buy that, Europeans aren't descendants of Adam and Eve at all. But they must be, because Noah and his sons are descended from Adam and Eve through Seth, and the pre-Adamites must be extinct, no?

This is theology, folks. This is what you get for studying the Bible while trying to believe in it.

Friday, February 02, 2018

Stayin' Alive

Last Sunday I showed you all those characters in Genesis who lived 900 years, and I noted that is about 20 times what folks could actually expect back then. The story is a bit more complicated than that. Here's a useful resource from Oxford University about historic life expectancy. (You might enjoy exploring the site which has all sorts of other information about humans and the planet.) This only goes back to about 1850, when reasonably complete records are available, but in fact the story in 1750 was not markedly different than it was in 1750 BC.

Life expectancy at birth, historically, has been around 37 year or so. However, this is a bit misleading if you don't know how it's calculated. It's the mean expected age at death assuming that the current death rate by age cohort remains the same throughout your future. So if one person dies in infancy and the other lives to be 74, that gives you the 37 year life expectancy. Infant mortality was indeed much higher in the past than it is now; but that's not the whole story. Life expectancy for a one-year-old was indeed the approximately 45 years that I stated. People who died in infancy, obviously, would not have made it into the genealogy. On the other hand, some people did live into what we would today consider old age.

As it turns out, that mostly meant privileged men. Here we see that the kings of Judah, Greek philosophers, Christian church fathers and other elite men of ancient times who made it to age 15 could expect to get to Social Security age, though not much past it. Women, however, were not so lucky until about 1780. Probably a good deal of this had to do with maternal mortality. Today, women live longer than men.

The expectation we have today, that a full life is at least 70 years -- and really nowadays it's a bit more than that -- is extraordinarily different from what the human condition has been for most of our history.



This is from the Oxford site. As you can see we didn't really get there until the middle of the last century. (That big spike down around 1918 is WWI and particularly the global influenza pandemic. You can see a much smaller dip corresponding to WWII.) It's difficult to contemplate what life would be like if most people, even in young adulthood, didn't figure on getting much past 50. We take it for granted that the death of a 45 or 50 year old person is a tragedy, but for most of history it was pretty much the norm. Make of it what you will.

Wednesday, January 31, 2018

None dare call it treason

I do. So does Rick Wilson. Read the whole thing but here's a taste:

The Republican Party’s head-first dive into breathless conspiratorial fantasies in defense of Donald Trump is a brand-defining moment as the Party of Lincoln morphs into the Party of LaRouche. Listening as members of Congress, the Fox News/talk-radio world and the constellation of batshit-crazy people drawn to Esoteric Trumpism adopt increasingly baroque theories to protect The Donald isn’t just depressing; it’s tragic. A diseased slurry of fake news, post-Truth Trumpism, and Russkie agitprop infects the Republican Party. It’s an ebola of wild-eyed MK-ULTRA paranoiac raving, spreading to every organ of the Republican body politic.

This loon-centric new world of crazy talk has dissolved the old ideological skeleton of the GOP and reduced it from the Conservative Party of Ideas to the Crackpot Party of Infowars. Covering up the connections among Donald Trump, his campaign officials, and family members with Russia, and this president’s efforts to obstruct justice and derail special counsel Robert Mueller will come at a still-untallied cost to our nation, our institutions, and the dignity and reputation of the GOP. It’s going to get worse as Mueller closes in.
Let's be clear about this. The Republicans in Congress -- not just Devin Nunes but all of the Republicans on the House Intelligence Committee, Paul Ryan, Mitch McConnell, and every single member who doesn't speak out loud and clear to denounce them, is a traitor. The Republican party spent decades representing themselves and the true patriots, denouncing Democrats as "soft" on Communism, then on terrorism.

Now they are working actively to undermine and cripple some of the most essential institutions and norms of democratic governance, including federal law enforcement, the judiciary, and the independent media, in order to prevent the nation from learning the truth: that the president was installed in office by a foreign adversary to which he continues to be a servant. That he is a stooge of Vladimir Putin and that our republic is in peril.

They are traitors. 

Update: John McCain, Not a Traitor. Credit where it's due.

Monday, January 29, 2018

Mirabile dictu!

Jeffrey Toobin finally admits what everyone outside of the Faux News bubble knows. The New York Time, however, is stubbornly oblivious.

CNN senior legal analyst Jeffrey Toobin says he regrets his role in pushing a “false equivalence” between Hillary Clinton's scandals and President Trump's controversies during the 2016 election. In an interview on Larry Wilmore’s “Black on the Air” podcast published earlier this month, Toobin told Wilmore that he feels he is “somewhat responsible” for a media climate that falsely compared Clinton and Trump.

“I think there was a lot of false equivalence in the 2016 campaign,” Toobin told Wilmore, the Washington Post reported Monday. “Every time we said something, pointed out something about Donald Trump, whether it was his business interests, or ‘grab 'em by the pussy,’ we felt like, ‘Oh, we gotta … say something bad about Hillary. I think it led to a sense of false equivalence that was misleading, and I regret my role in doing that,” he added.
The horrors about Cheeto Benito kept raining down at the rate of three to ten a day, and the press couldn't keep up. They'd report it and move on to the next one, while perseverating about the e-mails as if they were a  combination of Watergate and Benedict Arnold, because they had to "balance" everything they reported about Dump with something negative about Hillary. That is an insane concept of journalism. However, an apology is hardly enough.

Sunday, January 28, 2018

Sunday Sermonette: Gerontology edition

So what are the moral lessons of the Bible so far? They seem to be:

Revenge murder must go unpunished. Anyone who tries to punish someone who commits murder for vengeance will himself face severe vengeance.

Men can have multiple wives.

People should not know good from evil. That they learned good from evil was a crime for which humanity is eternally punished.

Women are subordinate to their husbands.

Did I miss something? Anyway, here is the next chapter of Genesis. It keeps getting weirder.

This is the written account of Adam’s family line.
When God created mankind, he made them in the likeness of God. He created them male and female and blessed them. And he named them “Mankind” when they were created.
When Adam had lived 130 years, he had a son in his own likeness, in his own image; and he named him Seth. After Seth was born, Adam lived 800 years and had other sons and daughters. Altogether, Adam lived a total of 930 years, and then he died.
When Seth had lived 105 years, he became the father of Enosh. After he became the father of Enosh, Seth lived 807 years and had other sons and daughters. Altogether, Seth lived a total of 912 years, and then he died.
When Enosh had lived 90 years, he became the father of Kenan. 10 After he became the father of Kenan, Enosh lived 815 years and had other sons and daughters. 11 Altogether, Enosh lived a total of 905 years, and then he died.
12 When Kenan had lived 70 years, he became the father of Mahalalel. 13 After he became the father of Mahalalel, Kenan lived 840 years and had other sons and daughters. 14 Altogether, Kenan lived a total of 910 years, and then he died.
15 When Mahalalel had lived 65 years, he became the father of Jared. 16 After he became the father of Jared, Mahalalel lived 830 years and had other sons and daughters. 17 Altogether, Mahalalel lived a total of 895 years, and then he died.
18 When Jared had lived 162 years, he became the father of Enoch. 19 After he became the father of Enoch, Jared lived 800 years and had other sons and daughters. 20 Altogether, Jared lived a total of 962 years, and then he died.
21 When Enoch had lived 65 years, he became the father of Methuselah. 22 After he became the father of Methuselah, Enoch walked faithfully with God 300 years and had other sons and daughters. 23 Altogether, Enoch lived a total of 365 years. 24 Enoch walked faithfully with God; then he was no more, because God took him away.
25 When Methuselah had lived 187 years, he became the father of Lamech. 26 After he became the father of Lamech, Methuselah lived 782 years and had other sons and daughters. 27 Altogether, Methuselah lived a total of 969 years, and then he died.
28 When Lamech had lived 182 years, he had a son. 29 He named him Noah and said, “He will comfort us in the labor and painful toil of our hands caused by the ground the Lord has cursed.” 30 After Noah was born, Lamech lived 595 years and had other sons and daughters. 31 Altogether, Lamech lived a total of 777 years, and then he died.
32 After Noah was 500 years old, he became the father of Shem, Ham and Japheth.

These are actually the descendants of Seth, we have seen information about Cain's descendants earlier. Here we have another reminder that God is a lousy prophet. He warned Adam that if he ate the fruit of the tree of knowledge of good and evil, he would die the same day, but he lived 930 years. One suspects that an error of some kind occurred in transliterating numbers. I have tried to do some research on this and haven't had any luck finding an explanation. We know from archaeological evidence that the average life span among people in that area and age was about 45, that is 5% of the typical ages we are seeing here. The maximum lifespan of humans was not much less than it is today, it was generally considered to  be about 70, but we wouldn't expect all but one of these people to be so lucky. I was able to determine that the numbering system was derived from the Egyptian hieratic system, which uses powers of ten but doesn't have place values like the decimal system. Rather, there is a separate hieroglyph for each power of ten. The symbol for 10 resembles the letter n, so 40 would be nnnn. There is a different symbol for 100. Possibly some scribe misread these symbols and people's ages also got exaggerated a bit. Anyway this is all awfully silly. 

Thursday, January 25, 2018

Physician, heal thyself

Two essays in today's NEJM about physician burnout, which they are allowing you unsubscribing rabble to read. Wright and Katz put a lot of blame on electronic health records, which is a common sentiment. EHRs were supposed to make life easier for physicians, but apparently the demands of documentation take a lot of time and come between the physician and humane contact with patients. The argument is often presented unclearly -- after all, physicians had to create paper records in the past, and if anything EHRs ought to make documentation easier. But the problem seems to be that the functionality of EHRs has caused health systems to demand more of physicians in the way of clerical work. I think EHRs may be something of a scapegoat -- in general the days when physicians were independent entrepreneurs is largely over. Now they are salaried employees of big corporations that are incentivized to squeeze more productivity out of them, even as Medicare and particularly Medicaid are screwing down levels of reimbursement.

Dzau and colleagues discuss some of the consequences of burnout, which include harm to patient care and even suicide. Physicians are at high risk for suicide. We think of the profession as highly lucrative, highly prestigious, and glamorous. The first two are certainly true, but the third generally is not. It's an extremely demanding job and for people who take it seriously and care about their patients, it can be very emotionally burdensome.

I think that solutions have to start with redefining the job. We can't afford to pay more for health services in the U.S., so we aren't likely to decrease the clinical load any time soon, but we can take  a lot of it off of physicians and put it onto nurse practitioners and physician assistants. This crisis is mostly located in primary care and there are lots of ways to reorganize primary care to make it more effective, and more patient centered, while actually reducing the M.D. workload. We can also have more scribes doing documentation in appropriate circumstances, although this needs to be carefully managed. Continuing to improve the design of EHRs can't hurt. We also need to re-align financial incentives to get more medical school graduates pursuing primary care careers. I'm happy to hear other thoughts about this. But it's an under-recognized crisis that threatens to be a serious problem for public health.