Map of life expectancy at birth from Global Education Project.

Monday, December 31, 2007

Another Sermonette

Driving back from CT Saturday evening, I heard NPR interview a prospective Iowa caucus-goer who had decided to throw her support to Mike Huckabee after hearing him speak. Her rationale was that he was guided by faith, that everything flows from God, and that she knew that he would take his orders from the top.

Lady, we've had that for the past 7 years and as far as I'm concerned, it's long past time for God to shut the fuck up. He relies on faulty intelligence -- actually he cooks it. He hasn't kept up with the latest scientific developments since the Middle Ages. His moral code comes from a society of illiterate bellicose nomads, and it is extremely damaging to modern society which is far more complex, diverse, and dependent on individual creativity and initiative, not to mention scientific accuracy and open-mindedness, than God's thuggish band of marauding goat herders. (You don't like my description of the Chosen People? Read Deuteronomy.*)

I would have thought that the developments of this decade would have completely discredited the nonsensical belief in God and divine guidance once and for all. The fundamental insanity, the intellectual and moral rot at the heart of religion, have become so obvious and so terrifying to anyone with common sense that this finally just has to end, right? And yet we have all the presidential candidates, of both parties, furiously competing to out-flaunt the competition with their piety.

Here's my New Years' resolution: I'm going to dedicate myself to do whatever I can to exterminate the curse of religion from human society. Religion is evil. Religion is delusion. Religion is destructive, and ugly, and deadly to the human spirit. Let it perish. And let those greedy, narcissistic old men in their ludicrous archaic clothing find gainful employment.

I'm in a crotchety mood. On another occasion I might express myself more gently. But I'm not sorry for what I have said.

* Here's a sample for those who would also refuse to look through Galileo's telescope. Read on -- it only gets worse.:

31 The LORD said to me, "See, I have begun to deliver Sihon and his country over to you. Now begin to conquer and possess his land."

32 When Sihon and all his army came out to meet us in battle at Jahaz, 33 the LORD our God delivered him over to us and we struck him down, together with his sons and his whole army. 34 At that time we took all his towns and completely destroyed [c] them—men, women and children. We left no survivors. 35 But the livestock and the plunder from the towns we had captured we carried off for ourselves. 36 From Aroer on the rim of the Arnon Gorge, and from the town in the gorge, even as far as Gilead, not one town was too strong for us. The LORD our God gave us all of them.

Thursday, December 27, 2007


Much of the time, when people are furiously debating some question, it turns out they don't have any substantive disagreement after all -- they are arguing over the meaning of a word. On the other hand, it may not be quite that simple, because the words in question may be embedded in larger constructs, so that disagreements about their meaning can reflect differences in substance after all.

Sorry, this is a little bit complicated so bear with me. The field called public health is usually traced back to a mythologized incident in which the British physician John Snow traced a cholera epidemic to a public well pump on Broad Street in London in 1854. (Those of you who haven't already been thoroughly indoctrinated in this world historic event can read all about it here.) Public health emerged thereafter as a definite enterprise in the late 19th and early 20th century, on the part of physicians who were concerned with infectious disease control, with an initial emphasis on the water supply and hence a great interest in sewer construction, but expanding to other policies such as isolation and quarantine, restricting spitting in public (thought to spread TB), and so on. As antibiotics and immunization became available, the concerns of public health naturally followed the evolving technology and knowledge, but infectious disease remained at the core of public health research and practice through most of the 20th Century.

Inevitably, as infectious disease declined in importance, and as diseases of non-infectious origin, notably cancer and heart disease, correspondingly became more important to the disease burden and to mortality, public health increased its focus to modfiable risk factors such as smoking and nutrition. This fueled intense interest in how to influence people's behavior and required that social psychology be imported into public health. But these diseases area also bound up with social problems, for example corporate power verus regulation in the public interest, chemical (as opposed to fecal) pollution of water, and poverty. The belated observation that tuberculosis, before the era of antibiotics, was closely associated with social conditions, and then that human longevity in general followed a gradient in socioeconomic status -- education and income -- brought sociology and politics into the field as well. It is no longer accurate -- indeed it is preposterous -- to say that epidemiology is "the" science of public health, although a few people have still not gotten the message.

But a field which is now all about political issues and social problems is inevitably beset by philosophical conundrums, disputes that hinge on hidden value conflicts, and competing interests. The theme ingredient in this stew is, of course, the concept of health -- what is it we are trying to maximize after all?

The definition of health as used in the field of public health naturally gets mixed up with the concept as used in the field of medicine. Public health is concerned with health at the level of populations, and medicine, of course, with the individual. In both, the meaning of "health" is essential, and disputed, whether or not the disputants recognize that that is what they are talking about.

So, next time, I will review the evolution of the concept within medicine. Don't worry, this is all going somewhere. . . . I hope.

Sunday, December 23, 2007

Blog update

Sorry to have missed a couple of days -- I've had a bit of a cold, nothing major but it's left me at a low energy level and I've had to devote what I had to other projects. In the coming week, I'll be away from Your Intertubes quite a bit as well so I may post only on a couple of days.

From this end, that's probably good -- I need a break to regather my thoughts. In the real world, I've encountered some controversy about the basic concept of public health that demands some processing in the wetware. I often say that public health is everything -- a bit of an exaggeration, since the study of quasars in near ultraviolet doesn't have a lot to do with public health, but I mean that everything connected with human society, the human environment, and the human organism is within the domain of public health. I thought that was a progressive and liberating sentiment which honors toilers in the groves of academe who nowadays don't get the kind of respect and funding that is lavished on biomedical research, from political scientists to art historians. But evidently it can be taken as a kind of arrogance or imperialism.

An essential foundation of the claim is really a semantic point -- I don't think of health as a purely biological concept. Health is biological, psychological, social and yes, spiritual, which is a realm of just as much significance to atheists as it is to the religious, by the way. To think of the human organism in purely biological terms is ridiculous, although I agree that too large a percentage of NIH funding, and health care spending, is based on that obvious fallacy. In the coming year, I vow to be more rigorous in defining the concept of public health, and framing what I write within that definition. (I am allowed, of course, the occasional indulgence.)

So, as I usually say at this time of year, we'll be dark, or at least intermittently lit for a few days, then we'll be back bigger and better than ever. Or at least I hope so.

Thursday, December 20, 2007

Prediction for 2008: Excrement to hit ventilator

The frog boiling thing turns out to be a myth. As the temperature rises, the frog feels it and pretty quickly tries to escape. But apparently it's possible to slowly raise the temperature on the Murkan People and it takes them a long time to recognize that they are getting poached.

They're going to figure it out pretty soon. Jean Dixon is never accountable for her predictions but I will be. We'll check back this time next year and see how I did.

1) There will be a nasty recession. One way you can tell is that most of the financial commentators are busy telling us that there won't be, in spite of everything -- hundreds of billions of dollars evaporating in the mortgage mess, home values tanking, consumers tapped out to the max with no place left to borrow more, oil prices still high (and see below), food prices screaming upward, foreign investors getting wary of U.S. bonds and equities. And more. Big ouch. Unemployment. Personal bankruptcy. As a consequence . . .

2) State and local governments are really going to hurt. They are already facing serious backlogs in infrastructure maintenance and unfunded pension liabilities. In other words they have major structural deficits that they have swept under the rug. When tax revenues shrink, it's going to get ugly.

3) Iraq will turn out to be a bigger disaster than you think it is already. The recent lull in violence is not nearly what it has been made out to be by the corporate media. Check Iraq Today if you don't believe me. For example, there was a very successful attack on U.S. and Iraq security forces today that killed one U.S. soldier and injured a dozen or so, and killed a bunch of Iraqis. So far, none of the major U.S. networks -- CNN etc. -- are even mentioning it. That's what they do. They don't report the violence in order to wish it away, because that's the CentCom line right now. But with the political situation going backwards -- what reduction in violence has been achieved comes from balkanizing the country so that the central government is increasingly irrelevant -- the instability will just increase.

4) CentCom already admits that Afghanistan is heading downhill and has begged NATO for more help. They aren't going to get it.

5) Oil prices will be higher one year from now than they are today, in spite of the recession. (That's a tough call, by the way. I'm out on a limb on this one.)

6) Climate-related catastrophes will continue to increase. Keep an eye on the drought in the southeast, among other problems.

7) The Democrats in Congress will cave in every time the Occupant threatens to call them names.

8) The New England Patriots will win the Super Bowl. (That's the easy one.)

There's a lot of other stuff that might happen, but these are the ones I'm going to predict. Uh oh.

Wednesday, December 19, 2007


Last night I dreamed that some musician friends and I went down to the bottom of the ocean to play with John Coltrane. To get there, all we had to do was will ourselves to sink. At first, everybody was holding his breath but I realized we could breathe the water. It was a long way down. When we got there, the bottom was sandy. I was worried I might step on some life forms -- you could scarcely see as far as your feet -- but it was okay.

Pretty soon Trane showed up. I don't know how he knew we were there, and the ocean is mighty big, but somehow we were in the right place. He said sure, he'd jam with us. We started out with a standard blues. For some reason, we all just imitated the sound of our instruments with our voices -- only Trane really played. I guess my subconscious knew better than to have me blowing my sax with Trane. Anyway, he played straight ahead and didn't try to overwhelm us. Elvin Jones once said, to play with Trane, "You gotta be willing to die with the motherfucker," but Trane was cool, he was on our side.

That was the end of the dream, but it got me thinking about John Coltrane. He died much too young, proximally of liver cancer, but it went back to his youthful heroin addiction. He probably had Hepatitis C, and nowadays they would have diagnosed him and probably saved his life, but that was then. Trane's was about the last life you'd want to be cut short. His playing had a restless, searching quality and so did the overall development of his music. He was always changing, always growing. Every year was a radical break from the last one, as he kept looking for the answer in music, the meaning of it all. That spiritual quest started with his struggle to kick his addiction, and ended only when it reached out from the past to kill him. But too many people don't succeed.

There happens to be a serious heroin epidemic in this country right now, that started when the U.S. deposed the Taliban government of Afghanistan and much of the country devolved into narco-fiefdoms. Cheap heroin has been flooding the West every since. According to the annual National Survey on Drug Use and Health, last year was particularly bad -- the prevalence of heroin abuse increased from .0006 to .0014.* That's probably not quite accurate but it's a horrific number.

We don't hear much about this because it doesn't fit with the narrative of the War on Terra, which was supposed to make us safer. This is just one more way it's killing our children.

*I originally misplaced the decimal points because of the odd way in which SAMHSA reported these numbers. These figures are volatile because they are based on a small number of respondents; in fact it's unlikely the prevalence really doubled in one year. But there is plenty of evidence that we've had an upward trend lately, and this does add to the weight of it. At first I didn't worry about the technicalities too much because I was making a qualitative point, but I realized I owe my readers more rigor.

Tuesday, December 18, 2007

I don't believe in God . . .

but I do believe in Senator Dodd.*

However, the spectacle of a Democratic Senator filibustering against the Democratic leadership and most of the Democratic membership in order to preserve the constitution and the rule of law in the United States is disconcerting, to say the least. The lesson here should be obvious -- our biggest problem is not Christian dominionism or neocon fantasies of world domination, it is corporate power.

We don't have government of, by or for the people, we have a government of business corporations led by people whose personal wealth rivals that of small nations. That's why the FDA protects drug companies, not patients. That's why the U.S. invaded Iraq -- because Dick "Dick" Cheney promised the oil companies the Iraqi oil fields. That's why we're going to squander billions to make fuel out of food and help to starve the world's poor -- including our own -- in the process. That's why rich people don't pay taxes and you pay more and more every year for your health care.

And that's why Christopher Dodd will never be president.

*After I posted I realized this may be too obscure a reference for some. It refers to the song Draft Dodger Rag, by Phil Ochs, which happens to be very pertinent to our current crop of chickenhawks in DC, including the aforementioned Mr. Cheney. The Senator Dodd in the song is the current Senator's father Tom, who was a rabid anti-communist.

Monday, December 17, 2007

No post today

I'm too much foaming at the mouth over Holy Joe Lieberman, Mike Hucksterbee, and Harry "Traitor" Reid to say anything coherent. Maybe I'll be articulate in the morning.

Oh yeah: Go here. Sign the petition to impeach Darth Cheney. This is serious -- actual real members of the House Judiciary Committee are really, truly, honest to gosh doing this. Don't be a slacker. Don't be part of the problem.

Sunday, December 16, 2007


Down in Windham County yesterday, the guys with their big honking 4WD pickups were out plowing snow. One of them had carefully lettered on his tailgate, in bright red paint: "Hell -- the final separation of church and state."

I'm still trying to figure out what the, well, the hell, that is supposed to mean. Does he think that Hell has a first amendment -- that Satan allows people freedom to worship as they please, or not at all? If so, more power to The Evil One, and Hell is sounding better than ever. If separation of church and state causes people to go to hell, who does it cause to be damned? Presumably not the truck guy, or the people who believe what he believes and worship God in precisely the way he does; and presumably everybody else is going to hell anyway, separation of church and state or not.

What I find most odd about Christian dominionism -- or any other theocratic ideology -- is that one of the essential underlying premises is that God can't take care of himself. If God is omnipotent, he doesn't need the assistance of a guy from Willimantic who does odd jobs. If God can't see his will done unless his mortal followers seize state power, he's a pretty damn pathetic deity.

Anyhow, where this is all going is that I'm wondering how the Christonazis are feeling right now, after two consecutive elections featuring Justice Sunday and the re-election of God's Other Son, finding out that The Anointed and Consecrated George W. Bush didn't bring about the Kingdom on Earth after all, sodomites and blasphemers remain unstoned, the invasion of Iraq didn't lead to Armageddon and the rapture but to a stinking mess, and God lost the 2006 midterm election. Are any of them rethinking their notions? Just asking.

Friday, December 14, 2007

New Web Resource

The Prescription Project, who's material I have often referenced here, now has set up what used to be it's e-mail newsletter as a blog. Good idea. It's right here. This week, they include the observation that even though an FDA advisory committee has concluded that over-the-counter cough and cold medicines are not safe and effective for children under 6, only 34% of parents have stopped using them.

Why doesn't the FDA ban marketing these toxic substances to parents? It can't just issue a ban, as it turns out, but it can request that the companies stop, and it can sue them. But so far, no action. And the drug companies have no ethics, no shame, and don't give a FFOARD about you or your children, they exist only for greed. If this disgraceful episode doesn't prove it finally, once and for all, then nothing will convince you.

There are two possibilities

Either this is the most significant action that anyone has taken in human history (and you never heard about it before, by the way), it's extremely dangerous, and it's being done with no accountability whatever; or it's just a lot of crackpots having an impassioned debate about whether it's wise to provoke the malevolent pixies.

I'm talking about Alexander Zaitsev, a Russian scientist, who is trying to actively communicate with extraterrestrials. Prof. Zaitsev controls one of the world's most powerful radio transmitters, a radar system normally used to study the solar system, but he's using it to beam messages to nearby stars. Some people in the ET searching business consider him to be engaged in unauthorized diplomacy. Others are concerned that he may attract undesirable attention.

Personally, I don't think there's much chance that he will stir up any powerful entities more malevolent than the present occupants of 1600 Pennsylvania Ave., so I say go for it. Maybe they'll even bring the long-sought cure for male pattern baldness.

Thursday, December 13, 2007


I had my last class of the semester last night, which means I'm not quite out of the woods -- I still have to read the final projects and turn in the grades -- but this is always the occasion when I reflect on the educational enterprise.

Like most college professors, I have essentially no formal training in pedagogy. I've had to figure it out as I go along, and it hasn't been easy. One of the hardest lessons had to do with the recognition that they don't necessarily start out believing that I'm on their side, and some of them don't want me to be on their side in quite the way that I actually am. In other words, we may just have a different idea of what this graduate degree thing is all about.

Education in our society has at least two different functions which coexist uneasily. One is to help people develop their potential -- to learn facts and skills, such as critical thinking, intellectual creativity, writing, and skills specific to a profession. That's how I'm on their side. But the other function is sort people into categories of prestige and income, and the awful truth is, that's why a lot of people, maybe most of them, go to college and graduate school. If they don't learn the facts and skills I'm there to teach them, I will stand in the way of the magic label that will make them prosperous and respectable.

When this happens -- and I'm very happy to say it did not happen this semester -- they generally ascribe the cause to my arrogance, cruelty and elitism. The true cause is never their innate lack of ability -- by the time they get to me, it's generally the case that they have already established their ability to do school work. A few have slipped through with basic skill deficits -- you can get into medical school without being able to write an intelligible sentence -- but that won't stop them from passing my course if they'll acknowledge the problem and work with me to start fixing it. I don't judge you on where you came in, I judge you on how far you traveled.

No, the true cause of their failure is misunderstanding the purpose of the enterprise. People have experienced education as a process of judging, and sorting, and labeling. It's been adversarial, students against the system. It's left a lot of people as wreckage by the roadside. A lot of people perceive the purpose of attending college as getting a college degree, and that's why cheating is rampant. It's also why students have highly developed skills for wheedling, threatening and otherwise extracting grades from instructors by means other than working hard and conscientiously on their assignments.

I'm not involved in elementary or high school education but I can't believe that this obsessive focus on standardized testing is doing anything but making education less and less about developing human potential and more and more about sorting people into castes. Of course, there are benign and necessary reasons for sorting. People's aptitudes differ and we need some method of getting people tracked into careers that make sense for them. If we assign people to jobs they don't have the skills, talent, or personality traits to do well, we invite disaster, whether we're talking about a surgeon or an electrician.

The challenge is to engage positively and supportively with every child, adolescent and adult who is in the role of student, whatever that means for that person. But we really don't do that. We create winners and losers. We hurt people. We manufacture injustice.

Tuesday, December 11, 2007

Hey indeedy

by Philip E. Agre.

You can be a reporter for the New York Times . . .

... or you can get an honest job.

One Jill P. Capuzzo reports on a proposal in New Jersey to require children who attend pre-school to get flu shots. If you have been a regular reader here, you can probably guess the next part of the story: an uprising of angry parents who claim that vaccinations will make their children autistic.

Capuzzo evidently went to journalism school, because she knows that it's her job to assiduously avoid actually informing us about this issue, especially if the truth might make one side appear to be, you know, wrong. Nope, her job is just to write down what people on both sides say, and treat the sense and nonsense exactly the same. Capuzzo writes, "But not all the family and community members who attended the meeting agreed. Some parents of autistic children have argued that the vaccines already required of school-age children may be linked to autism, although many experts say that no solid evidence supports this view."

No Jill. It is not "many experts" who disagree, it is virtually every expert. And they don't say that "no solid evidence supports this view," they say there is no evidence for it whatsoever, solid, liquid, or gas. In fact, there is overwhelming and completely convincing evidence against it. The earth is not flat. Flu vaccines do not cause autism.

But for the rest of the article, we just get a he said, she said, with the she said being far more compelling -- the terrible travails of the mother of an autistic child who blames the whole thing on vaccinations. “Try having a child bite chunks of skin out of herself, or tell you she’s going to chop your head off, or smear feces over the wall,” said Ms. Downing, referring to the acts of her daughter and her best friend’s son, who also suffers from autism. “Something’s going on with these vaccines, and we don’t want any more mandated.”

It would be journalistically irresponsible, of course, to point out that however much sympathy we feel for Ms. Downing, she is mistaken. Jill Capuzzo's job is to tell us the facts, but not the truth.

Monday, December 10, 2007

Yes, we take requests

C. Corax is curious about my response to this study which suggests there may be a genetic component to religiosity. Unfortunately, I don't have on-line access to the Journal of Personality so I can only comment on this reporter's summary. Nevertheless, this is a good opportunity to make some general observations about, uh, observational studies in general, and twin studies in particular.

This study was based on questionnaires administered to sets of fraternal and identical twins -- all male, for some reason, and all born in Minnesota, for some other reason. They were asked to remember how often they went to religious services, prayed and discussed religious teachings when they were children, and how often they did those things today. The basic conclusion was that both kinds of twins were very similar in these respects as children, but the fraternal twins became less similar as adults while the identical twins retained their similarity. The summary doesn't give much quantitative information about these effects, except to say that the fraternal twins were "1/3 less similar [as adults] than they were as children," a statement which is essentially uninterpretable, but presumably the original report makes sense.

The researchers conclude that it is the identical genes of identical twins that keeps them similarly religious as they grow older. However, I can think of numerous objections to this conclusion. First, if genes are what makes people religious, the fraternal twins would not have reported similar religiosity as children. Obviously, the first and most cogent conclusion one can draw from this study is that it is not genes, but the family environment, that determines how religious people are as children. Odd, then, that all the spin is the other way.

Second, it is completely inappropriate to conclude that a genetically determined predisposition to religion keeps the identical twins more similar as adults. If genes are behind this, then it seems much more likely to me that it's a genetic predisposition to believing whatever the heck it is your parents told you to believe, not to religion specifically, that keeps the identical twins more similar. What is more, identical twins not only share the same genes, they have a more similar environment as children than do fraternal twins, because other people treat them more similarly; and it is plausible to suppose that they continue to have a more similar environment as adults, and also to remain closer to each other, than do fraternal twins. So I must say I feel the investigators, and reporters who have covered this study, are overinterpreting results which are merely suggestive and could have various explanations.

Finally, this might apply only to males from Minnesota.

Observational studies, alas, are very often misleading. There is a major article in the December 5 JAMA (subscription only) by Athina Tatsioni and colleagues, about the persistence in the literature of claims based on observational studies which have been contradicted by subsequent experimental evidence. These include the once widely touted claims that Vitamin E and beta Carotene prevent cancer, and that estrogen can prevent Alzheimer's disease. Alas, randomized controlled trials have found these supplements, on the contrary, to be harmful. (Stop taking them if you haven't alrady!) The problem is that the world is very complicated and when we try to look at the relaionship between X and Y observationally, we can't rule out that X is associated with a whole of other things -- call them A through W -- that are also influencing Y. Therefore the perceived association between X and Y may be entirely spurious.

There are some profounder things I could say about genes and personality. Essentially, genes don't determine anything. Genes interact with the environment through developmental processes, and it could be that a gene that predisposes to being fat in one environment predisposes to being thin in another. We are no doubt born with predispositions to various personality traits but that is assuming a particular context.

In the end, it is obvious that the principal source of religious belief is indoctrination. Children who grow up in Christian households become Christians, and children who grow up in Yezidi households become Yezidis. People who are inclined to figure things out for themselves, who have the courage and critical thinking skills to abandon old beliefs when they encounter new evidence, who have access to accurate information about the world, and who live in societies that tolerate independent thinking and do not impose excessive conformity, stop being religious. People who lack those advantages do not.

Apparently some people misunderstood me . . .

or I didn't make myself clear. I don't have any opinion whatsoever about the validity of Mormon vs., say, Southern Baptist Convention beliefs. My only point is this:

Mitt Romney has called on conservative Christians to join with Mitt and his fellow Mormons in ganging up on me, and excluding my beliefs from the public square, and excluding me and people who agree with me from political office. It's only natural, and perfectly within my rights in that situation, for me to ask people to consider whether Mitt's proposed alliance actually makes any sense, and if they think it does, to be clear about why.

If people want to use a comment thread here to argue about whether Mormons are actually Christians or how compatible or incompatible their doctrines are, go to it. I don't actually take any position on those questions, in fact I think they are nonsensical.

Sunday, December 09, 2007

What we aren't allowed to talk about

First of all, sorry for being away, it's end of the semester, student papers to read, proposals to write, conferences to attend -- blogging always ought to come first, but I'm just irresponsible I guess.

Anyhow, today's Sunday Sermonette concerns the greatest peculiarity of our faith-based politics. That is the idea that politicians have to continually proclaim their piety, but it doesn't matter what they actually believe, as long as they are religious. This was the essence of Mitt Romney's big speech last week -- in America, it doesn't matter what religion you believe in, as long as you believe in one. He was introduced by George Bush the First, who is on record as saying that atheists should not be permitted to hold public office in the United States.

A lot about this idea strikes me as odd, but probably the oddest thing is that people of different religions disagree as much with each other as they with atheists. Romney did not, in fact, give one single piece of information about Mormon belief in his speech. Apparently it doesn't matter. Here is a story from today's Boston Globe about Mormonism, which is all about how the history of the sect is disputed and how Mormon leaders aren't fully transparent about it, but which tells us almost nothing about Mormon history and nothing whatsoever about Mormon doctrine. This is precisely what all of the coverage of the question of Romney's religion is like -- nobody dares tell us what Mormon's actually believe.

Why is that? There's certainly plenty of talk about what atheists believe -- most of it completely wrong, of course, such as the commonplace assertion that we don't believe anything. If Christians are supposed to think that voting for an atheist is wrong, but voting for a Mormon is okay, shouldn't they be curious about what it means to be a Mormon?

Even when they do purport to say something about Mormon doctrine, the corporate media stop far short of telling the whole story. For example, here is Stephanie Simon in the LA Times. What she reveals is accurate, but she assiduously avoids any information that would seem really strange or offensive to Christians.

Fortunately, atheists are not bound by the cult of omerta. Here is a thorough background doctrine on Mormonism by an ex-believer, Richard Packham. You may be interested to read the whole thing, but he offers some bullet points that the LA Times doesn't think we ought to know about:

* God was once a man like us.
* God has a tangible body of flesh and bone.
* God lives on a planet near the star Kolob.
* God ("Heavenly Father") has at least one wife, our "Mother in Heaven," but she is so holy that we are not to discuss her nor pray to her.
* Jesus was married.
* We can become like God and rule over our own universe.
* There are many gods, ruling over their own worlds.
* Jesus and Satan ("Lucifer") are brothers, and they are our brothers - we are all spirit children of Heavenly Father
* Jesus Christ was conceived by God the Father by having sex with Mary, who was temporarily his wife.
* We should not pray to Jesus, nor try to feel a personal relationship with him.
* The "Lord" ("Jehovah") in the Old Testament is the being named Jesus in the New Testament, but different from "God the Father" ("Elohim").
* In the highest degree of the celestial kingdom some men will have more than one wife.
* Before coming to this earth we lived as spirits in a "pre-existence", during which we were tested; our position in this life (whether born to Mormons or savages, or in America or Africa) is our reward or punishment for our obedience in that life.
* Dark skin is a curse from God, the result of our sin, or the sin of our ancestors. If sufficiently righteous, a dark-skinned person will become light-skinned.
* The Garden of Eden was in Missouri. All humanity before the Great Flood lived in the western hemisphere. The Ark transported Noah and the other survivors to the eastern hemisphere.
* Not only will human beings be resurrected to eternal life, but also all animals - everything that has ever lived on earth - will be resurrected and dwell in heaven.
* Christ will not return to earth in any year that has seen a rainbow.
* Mormons should avoid traveling on water, since Satan rules the waters.
* The sun receives its light from the star Kolob.
* If a Gentile becomes Mormon, the Holy Ghost actually purges his Gentile blood and replaces it with Israelite blood.
* A righteous Mormon will actually see the face of God in the Mormon temple.
* You can identify a false angel by the color of his hair, or by offering to shake his hand.

I happen to believe that all religions are equally ridiculous. But I must ask my Christian brothers -- do you think that my reliance on evidence and reason makes my beliefs somehow more offensive than these? And I have the same question for Mitth Romney and his fellow Mormons. Christians think all of these beliefs are preposterous and blasphemous. How does that make them better than me?

Thursday, December 06, 2007

No, give me deeper darkness.

Money is not made in the light.

That is a quote from Shaw's Heartbreak House, set on the eve of WWI, whose protagonist holds off the doom of his estate and idle rich family by inventing weapons.

Jonathan Schell, among other important insights, discusses the strange darkness which envelops the reality of nuclear weapons. I highly recommend the entire interview, which reminds us of matters of great urgency which are simply never discussed in public.

The incompetent, pathologically dishonest and quite possibly insane individual who occupies 1600 Pennsylvania Avenue never says anything that is true and sensible, but one of his latest utterances is even more delusional than the norm. Yet the corporate media, as always, have allowed it to pass unremarked upon. He says that Iran cannot be permitted to have the knowledge needed to build a nuclear weapon.

At the center of Schell's discussion is precisely the bizarre disconnect between such thinking and reality. Mr. Bush's idea, that nuclear weapons technology can be kept secret, and monopolized by a few powers, is preposterous. I have the knowledge needed to build a nuclear weapon. That knowledge is as commonplace as the knowledge needed to make an automobile or a dishwasher. There are dozens of countries that could manufacture nuclear weapons within a few years or even months if they chose to do so. Iran cannot possibly be denied that knowledge, even by murdering every physicist and engineer in the country and continuing to murder them systematically as they graduate.

As I posted a few weeks ago, you can download designs for nuclear weapons from publicly available web sites. If I had enough highly enriched uranium, I could make a nuclear bomb in my basement. Making one that will fit on the tip of a missile is more difficult, but well within the capability of any nation with moderate industrial capacity.

As I said then, and Schell says now, the way to stop Iran from making nuclear weapons is the way, the only way, to stop proliferation in general, and that is abolition. That we are having this discussion about Iran without ever mentioning the nuclear arsenals of other nations -- including most relevantly those of Israel, the United States, and Sunni Pakistan, all of which are hostile or potentially hostile to Iran -- is just demented. We need to go beyond the delusion of non-proliferation and embrace the chance of disarmament. Our only chance. The last chance of humanity.

Wednesday, December 05, 2007

Well I never . . .

Is it possible there has been a massive shift in the zeitgeist? Last night I channel surfed to Hardball and got stuck there for a while. Tweety and Mrs. Alan Greenspan, of all people, were skating right up to the ultimate TV taboo -- not any of the seven words you can't say, but the one word you absolutely, positively, cannot apply to George W. Bush, and that is of course the L word.

In the greatest ice dance since Torvill and Dean, they showed clips of Chimpy chattering and then opined to the effect that "That just isn't true," or "It simply isn't credible," and even went so far as to tell us all the actual, real, valid, reliable, factual, concrete truth -- the stuff that happened, not the stuff that Republican politicians said happened. They still couldn't say the Simian-in-Chief was lying, that's still illegal, but even though they couldn't use the word, they wanted us to know what they were thinking.

And that's not all. Tweety was really, really pissed. He was hurt. It seems that he really believed all that crap about World War Three and he felt profoundly betrayed.

And then it got even better. Jellyfish Joe Biden came on and -- mirabile dictu! -- Jellyfish Joe has decided to join the phylum Chordata. I'm still going to call him Notochord Joe because he has a way to go to earn full credit for a vertebral column, but he's definitely no longer 100% soft tissue. He couldn't say the L word either but he did say something about misleading the public. And then Tweety asked him why the neocons invaded Iraq and why they wanted war with Iran.

Joe said it! He named that which shall not be named! He said that the underlying motive was to acquire permanent bases from which to dominate militarily the petroleum resources of the Middle East. Yes he did. (Tweety and Mrs. G. had been unable to even imagine such a thing -- they were musing about Iranian sponsorship for terrorism and stuff.) After I picked my teeth up off the floor, Senator Notochord made a vague promise to the effect that we would indeed see the so far censored portion of the Senate Intelligence Committee report on the Iraq war. And to top it off, he said that if Bush attacked Iran without congressional authorization, he'd call for impeachment.

Of course, nobody watches MSNBC and we all know what was going on over at Rupert Murdoch's RNC channel. Still, this was like waking up in a parallel universe.

PS: Then there's the question of what's really going on here. For months all we've been hearing is that the NIE was not going to be declassified and then suddenly, POW, right in the simian kisser. My guess? A mutiny by the military leadership, possibly with the concurrence of Sec. Gates. Declassify the NIE findings, or we resign and spill the beans. Now that's news.

Tuesday, December 04, 2007

I'm shocked, shocked, to find that ass covering is going on here

No doubt you've heard the news that nearly half of physicians surveyed say they have known about impaired colleagues but have not reported them. The principal investigator finds this absolutely astonishing, but what astonishes me is that he finds it astonishing. Everybody who hangs around the profession knows this -- not only do doctors not report impaired colleagues, they give positive recommendations when incompetent physicians seek work elsewhere. What surprises me is that only 45% will admit to this, when the true figure is probably much closer to 100%.

What's even more astonishing about this survey is that only 1 to 3 percent of respondents admit to not telling patients or family members about errors they have made themselves. Hah! Pish tosh. Balderdash. It has been well established that physicians have a deeply ingrained culture of excusing and minimizing errors among themselves, and not telling patients when they screw up. What is really happening in this survey is denial -- physicians not recognizing their own behavior.

It does surprise me a bit that 25% say it's perfectly okay to refer patients to imaging facilities in which they have a financial interest, since that is actually illegal in most states. I would have expected them to give the "correct" answer. Even if they routinely violate the law it's rather brazen to admit it.

Still, this survey was a useful exercise. Efforts are underway to promote transparency and constructive handling of mistakes in medicine. Mistakes will happen, so the professional culture and institutions need to put a stop to the coverups that are currently routine -- so deeply ingrained in the culture that, as I say, only 3% of doctors even admit in confidence to what they actually do, probably because they don't even recognize it -- and allow errors to be addressed openly so that lessons can be learned.

Many physicians will say that the problem is fear of being sued. However, that fear is misplaced. There is little or no relationship between the likelihood of a patient initiating a lawsuit and the reality of negligence or incompetence. Mistakes are not necessarily negligent and don't normally incur liability. But patients don't like finding out that they have been lied to, and they don't like being treated inhumanely or disrespectfully. Those are the real factors that trigger most lawsuits.

So come clean Doc. It will make you a better doctor and a more humane healer. As for Doctor Doofus or Doctor Thirsty down the hall, turn him in and get him the help he needs. It's the right thing to do.

Monday, December 03, 2007

The R word

The business and financial punditocracy is terrified of ever uttering the word "recession" because they think they'll get blamed for self-fulfilling prophecy if it happens. But now they are starting to utter it, in the required format "I don't think it will happen but it might," which means they do think it will happen. Some are even gloomier and are embedding the D word in breathy exhalations.

Now, I've lived through a couple of recessions. I remember the food in the college dining hall suddenly getting a lot worse when the recession of the early 1970s knocked back the endowment that had previously given us lobster newburg. (No joke.) And I remember that George Bush the First suffered mightily in his re-election bid from an economic slowdown. Bill Clinton's campaign motto was "It's the economy, stupid," and it worked. Neither of these events were a big deal though. The unemployment rate bumped up a bit, people got anxious, and then unemployment went right back down and we kept on being a rich country.

But now it's different. Workers' real incomes have been basically stagnant now for 20 years, a shrinking percentage of people get health insurance through employment and those who do are already paying more, and of course there are all those folks out there having trouble making their mortgage payments. A spike in unemployment next year will be a disaster that could easily feed on itself and spiral out of control. More foreclosures, and a wipeout of the construction industry. Fewer people with health insurance and the possibility of an actual contraction in the most reliable growth sector of the economy. A collapse in consumer spending and hard times for retail. The export driven economies of east Asia will suffer and all that capital investment in factories will suddenly be unproductive. A global slowdown will just exacerbate our problems here as demand for U.S. capital goods falls. State tax revenues will decline just as infrastructure problems are growing truly dangerous. Will we see Bushville squatter camps on the edges of our cities?

And what will this do to our politics? It ought to be good for Democrats, but when the Republicans in the White House and Congress find themselves staring at a massive electoral wipeout, the prospect of bombs falling on Iran is going to start looking even better to them. In the 1930s, we got Roosevelt and the Germans got Hitler. Which way would it go in the U.S. today?

Thursday, November 29, 2007

Primum no nocere

We've all heard of "First, do no harm," and we assume this is a fundamental principle of medical ethics. It is not. A physician who truly tried to live by that creed would be out of business. Medical intervention in general almost always carries some risk of harm.

For example, David Brenner and Eric Hall in the new NEJM remind us that those quick and easy CT scans, even though they make terrific pictures of our insides that doctors really get hot over, expose us to quite a bit of radiation. In fact, they estimate, up to 2% of cancers in the U.S. may be attributable to CT scans. That probably sounds worse than it really is for various reasons that I won't go into here because I'll do it another time, but still, it obviously isn't a good thing.

That certainly doesn't mean we should junk all the scanners, however, or that you should necessarily refuse one if your doctor thinks it's a good idea. Under many circumstances, a scan might be worth the risk. The issue is to understand the risk/benefit situation (I won't call it an equation or a ratio because it isn't that simple) and to make an informed decision that makes sense in your case. Since people like news you can use I will tell you that the single biggest parameter is age. CT scans create far more lifetime risk for children than they do for people over age 40 or so.

But rather than trying to make decisions based on a blog post, what you need to do is make your doctor look up the relevant information and discuss it with you. Mostly, they don't do that. Indeed, Brenner and Hall write that "In a recent survey of radiologists and emergency-room physicians, about 75% of the entire group significantly underestimated the radiation dose from a CT scan, and 53% of radiologists and 91% of emergency-room physicians did not believe that CT scans increased the lifetime risk of cancer."

I've had two abdomen scans in my life, both of them probably fully indicated, but still, I don't like to hear that. One of the most intractable problems in medicine, it seems, is just getting doctors to pay attention to what they are supposed to know.

Wednesday, November 28, 2007

Drive by observation

I'm at a meeting of grantees of a federal initiative called the National Child Traumatic Stress Network. This program, administered by the Center for Mental Health Services, aims at strengthening capacity within the U.S. to provide treatment to children who have suffered psychological trauma -- and no, it's not principally about drugs, but about evidence based counseling.

So far so good -- there's a lot of child abuse and neglect, child witnesses to violence, natural disasters, you name it, and kids get hurt. Oh yeah, there's also war. In the latest reauthorization, Congress directed some of the resources of the initiative to military families, but apart from that, I was really struck in my first day here by how many of the agencies just happen to have encountered a lot of children in military families that need their help. Obviously, it's tough on a child when Daddy disappears for a year and then comes home with half his face blown off, or dead, or just sullen and withdrawn and prone to explosive outbursts or drunk all the time. But short of such dramatic problems, the long separations, constant relocations, and anxiety, are very tough on families.

Military families have a lot of divorce, suicide, domestic violence. Let me tell you something, in case you didn't know. There is absolutely nothing, nothing at all, that is ennobling, or glamourous, or glorious, about war. War is ugly, and depraved, and destructive, for everybody it touches, victor or vanquished, liberator or occupier, aggressor or defender, right wrong or undecidable. War is evil. Warmakers are evildoers. Have no part of war.

Tuesday, November 27, 2007

The ninth circle

In case anybody noticed that I didn't post yesterday, it's because I was travelling to Richmond for a conference, and I expected to post after I got here. Foolish naivete.

What I mean to say is, I spent the day travelling, which is to say I spent the day in hell. My flight was only 2 hours late out of Providence, which means that according to the schedule I would miss my connecting flight but I wasn't worried, indeed my biggest problem was killing time in Philly. Philadelphia airport was a river of human misery, with the soundtrack provided by screaming, inconsolable babies. The people were sullen, exhausted, hungry, unhygenic, but their anger was buried in helplessness and apathy. Some stared vacantly like concentration camp survivors.

They always lie, of course, about when the planes are leaving. If they post a flight as half an hour late, you know that means at least 90 minutes. Then they pack the steel cocoons like slave ships, and then they just leave you there. In this case, the machine that loads bags into the cargo hold got stuck, and it took them an hour to figure out how to get it out of the way so they could close the cargo door. Once we finally did get to Richmond, we circled the city for 45 minutes, and when we finally landed, we had to sit there for half an hour until they got another plane away from the gate. Of course there were six open gates, but they couldn't use them, because we were assigned to one that was occupied.

The airline industry is the only industry, as far as I know, whose employees' attitude toward customers ranges from callous indifference through hostility to gleeful sadism. They actually hate us. We're a problem for them, and nothing more.

I could easily have driven from Boston to Richmond in the time it took me to fly. Next time, I will.

Sunday, November 25, 2007

Back to Civilization

How the hell does such unmitigated garbage get published in the New York Times? Here we have yet another idiotic apologia for religion, this time from the director of an entity called "Beyond, a research center at Arizona State University." Check this out:

SCIENCE, we are repeatedly told, is the most reliable form of knowledge about the world because it is based on testable hypotheses. Religion, by contrast, is based on faith. The term “doubting Thomas” well illustrates the difference. In science, a healthy skepticism is a professional necessity, whereas in religion, having belief without evidence is regarded as a virtue.

The problem with this neat separation into “non-overlapping magisteria,” as Stephen Jay Gould described science and religion, is that science has its own faith-based belief system. All science proceeds on the assumption that nature is ordered in a rational and intelligible way. You couldn’t be a scientist if you thought the universe was a meaningless jumble of odds and ends haphazardly juxtaposed. When physicists probe to a deeper level of subatomic structure, or astronomers extend the reach of their instruments, they expect to encounter additional elegant mathematical order. And so far this faith has been justified. . . .

Over the years I have often asked my physicist colleagues why the laws of physics are what they are. The answers vary from “that’s not a scientific question” to “nobody knows.” The favorite reply is, “There is no reason they are what they are — they just are.” The idea that the laws exist reasonlessly is deeply anti-rational. After all, the very essence of a scientific explanation of some phenomenon is that the world is ordered logically and that there are reasons things are as they are. If one traces these reasons all the way down to the bedrock of reality — the laws of physics — only to find that reason then deserts us, it makes a mockery of science. . . .

It seems to me there is no hope of ever explaining why the physical universe is as it is so long as we are fixated on immutable laws or meta-laws that exist reasonlessly or are imposed by divine providence. The alternative is to regard the laws of physics and the universe they govern as part and parcel of a unitary system, and to be incorporated together within a common explanatory scheme.

In other words, the laws should have an explanation from within the universe and not involve appealing to an external agency. The specifics of that explanation are a matter for future research. But until science comes up with a testable theory of the laws of the universe, its claim to be free of faith is manifestly bogus.

This is too easy for a hint, but in case anybody out there needs this spelled out: What the scientists are saying is that they do not know, ultimately, why the reality they discover is the way it is. How is this the same as "faith"? It is the opposite. Yes, there is much we cannot explain. Scientists leave it at that, and keep looking.

To state that because there is a gap in our understanding, the explanation must be God, is an act of faith. Elegant mathematical order is not an article of faith, it is a finding; the expectation that it will continue to be found as we probe deeper is not an article off faith, it is a hypothesis.

This is drivel.

Thursday, November 22, 2007

Gosh, how'd they do that?

I will be disconnected from Your Intertubes for a few days, probably until Sunday unless I happen to stumble across a portal to the placeless space.

Meanwhile, all I got is that while Your Intertubes really are pretty magical, after a long day of thinking too hard about stuff you really don't care about, while trying to expend an hour or so of unneeded consciousness I got caught watching a TV show which purported to be finding the greatest magician. I watched out of the fascination associated with a train wreck. The competitors consisted of uncharismatic performers doing the stupidest, crappiest tricks I have ever seen in my life. I wouldn't put up with that degree of idiocy at a third grade birthday party.

Here's one of the amaaaaaazzzzing illusions. The magician asks his assistant what kind of a sweet she would like. She says a chocolate chip cookie. He has her reach into the bag which has been sitting open in front of her on a table for the past five minutes and -- TA DA! -- it's a chocolate chip cookie. Are people really stupid enough that they're sitting there baffled?

But then I remembered how we got into Iraq. Dick Cheney would tell the New York Times that Saddam Hussein had Weapons of Mass Destruction™; the New York Times would print on its front page that according to anonymous senior administration officials, Saddam Hussein had Weapons of Mass Destruction™; Dick Cheney would go on TV and say, "See, you don't have to believe me if you don't want to, it's in the New York Times!" Then all of the members of Congress, the talking heads, and your Uncle Fred started screaming and yelling, "Saddam Hussein has Weapons of Mass Destruction™! You don't have to believe the Bush administration if you don't want to -- it's in the New York Times!"

So the magic trick is we're supposed to believe that the magician's assistant isn't working for the magician. Why would anybody believe that? Maybe because they want to be bamboozled.

Wednesday, November 21, 2007

A blast from the blastocyst

I haven't written much about the whole embryonic stem cell thing, partly because I never saw it as the most pressing issue. The media and the public are obssessed with the possibilities for dramatic, high technology biomedical breakthroughs, but what we're really talking about are procedures that in a decade or two might benefit a small number of people in wealthy countries who have uncommon injuries or degenerative diseases associated with advanced age. The vast majority of the earth's people will never be able to afford these treatments, and they already are lacking in far more basic needs. Even in the wealthy countries, as a matter of fact, we can accomplish far more public health benefit for far less money with simple measures that we don't bother with. So while I have thought that restricting stem cell research on putative moral grounds is absurd, and the opposite of moral, I have had more important things to worry about.

However, I feel I should say something about the news that investigators believe they have created embryonic stem cells by reprogramming somatic cells, rather than by the somatic cell nuclear transfer cloning technique that the Catholic bishops and conservative Christian preachers swindlers consider to be the destruction of human life. I don't know why nobody is willing to say this publicly, but it is obvious that there is no basis for this claim whatsoever in the Bible or in Christian theology as it developed over the first 1,980 years or so. Apparently they all have a personal hotline to God, who called them up one afternoon and said "Zygotes are human beings. You know what you have to do." In other words, they're pulling it out of their asses.

Like most sensible people, I feel that the qualities that make an entity human in a morally meaningful way depend on a functional cerebral cortex, which embryos obviously lack. The preacher's swindler's claim is that zygotes and the embryos that develop from them have the potential to become a recognizable human being, and that potential alone endows them with the moral status of human beings. This can be reduced to the absurd with ridiculous ease, but for now let's pretend to accept it.

The swindler's are ecstatic this morning because the news gets them out of an awkward position. Opposition to stem cell research is politically unpopular and it was hurting their candidates at the polls. Now they claim the whole thing is resolved, not a problem, and they don't have to carry that piano.

I have potentially bad news for them. If these truly are embryonic stem cells, then it should not be very hard to induce them to form embryos. After all, once the zygote divides, you have nothing else but two embryonic stem cells, and they go on to form an embryo. The researchers have no interest in making embryos, so they haven't even tried to figure out how to get it to happen, but somebody probably will, because that will be a method for cloning humans. Actually it will produce a true clone, which somatic cell nuclear transfer does not, since in the latter case the clone does not have the same mitochondrial DNA as the individual who supplied the nucleus.

So these embryonic stem cells, as surely as cells derived from a zygote, are potential human life. The only distinction is that they have not started to form an embryo -- but neither has a zygote, which the swindler's claim is a human life merely because it has the potential to yield an embryo. As do these cells. So the moral parsing they are doing just gets finer, and finer, and more and more absurd. Thwart the potential of an embryonic stem cell to become a human being, and you're fine and dandy, still going to heaven. Thwart the potential of a zygote to become a human being, and you're a murderer, going to hell. How do we know this? Well, it must be in the Bible somewhere, you just have to look harder.

Tuesday, November 20, 2007

The Age of Denial

John Kenneth Galbraith's popular economic history of the first part of the 20th Century is called The Age of Uncertainty. My history of the present era -- once I get done with the other three books I keep meaning to write -- will be called The Age of Denial.

The presidential campaign we are now enduring is utterly surreal. Barack Obama, rightly, has gotten a major wacking for talking about a Social Security crisis, when there actually isn't one. But helloooooooooo Barack, Hillary, John, Chris, all you characters -- there really are crises out there, major problems that we need to acknowledge and get to work on. I don't expect the Republican candidates to be connected in any way to reality, but somebody has to be.

Medicare and Medicaid: Yes, a for real, honest to gosh, big bad crisis, embedded in the broader crisis of a dysfunctional and increasingly unaffordable health care system in genera. Y'all are talking about various ways of increasing the number of people who have health insurance, but forcing people to buy insurance they can't afford is to ignore the real, fundamental problem. Actually it just makes it worse. Oh yeah, it isn't progressive either.

Debt: Both public and private. Social Security can pretty much pay for itself, with a little tweaking, but the rest of what government does is hugely underfunded. In fact, by any rational accounting, the United States is bankrupt. And so are a lot of it's people, who have been living on credit card and home equity debt. The dollar still has a long way to fall, and all that bad debt is just starting to peek out from the arcane and obscure books of financial institutions. It's gonna get uglier and uglier.

Decaying infrastructure: And while we're living beyond our means, we haven't bothered to maintain the house. All those highways and bridges and water treatment plants and schools and airports and water mains and what all built mostly in the 1950s, and some before that, are ready for the scrap heap. We must pay.

Nuclear weapons: Don't get me started. The problem is not that Iran might get them some day. We need to eliminate the ones that already exist.

Peak oil: Nothing to see here, move along. Oh, okay, let's make ethanol from corn . . .

Global climate change: Yeah, the Democratic candidates occasionally mention this. They want to make ethanol from corn. Aside from that, nada. In fact, the issue is no longer just carbon emissions -- the horse has left the barn, folks. We need to plan and prepare for the consequences. It is happening, now.

Sustainability of the human population: The price of food is already going up with the price of the fossil fuel used to grow, transport and process it, and now it's going up even more sharply as we start to cook food into fuel. Malthus was actually right, you know -- we just got a break for a century and half or so with the demographic transition in the wealthier countries and rapid technological advances in agriculture. There isn't another ace in that deck, believe me.

Drug resistant pathogens and emerging infectious diseases; grotesque economic inequality in the U.S.; declining real incomes of American workers; the needs of a growing population of elders, including more and more extremely old people; and more stuff I could think of.

We aren't talking about any of this! We're obsessed with a non-existent threat of the Islamofascist movement taking over the world, the moral status of zygotes, the invading brown Mexican hordes who are going to make us all eat tortillas and play giant guitars or something -- in the worst case scenario, they might even get driver's licenses -- and how we can cut taxes on investment income.

Oh well, you won't get elected by bringing people down.

Monday, November 19, 2007

A Readin' Fool

I was going to explain that I've been a little light on posting lately because I've been trying to catch up on my reading. Unlike your average highly paid pundit, I have this idea that I ought to know what I'm talking about before I spout off in public. Then I came upon this news from the National Endowment for the Arts, which reviewed recent academic studies to conclude that young people today aren't reading. Some highlights, as reported by the Boston Globule's David Mehegan:

Only 30 percent of 13-year-olds read almost every day.

The number of 17-year-olds who never read for pleasure increased from 9 percent in 1984 to 19 percent in 2004.

Almost half of Americans between ages 18 and 24 never read books for pleasure.

The average person between ages 15 and 24 spends 2 to 2 1/2 hours a day watching TV and 7 minutes reading. . . .

Apparently, things are not much better among college students. In 2005, almost 40 percent of college freshmen (and 35 percent of seniors) read nothing at all for pleasure, and 26 percent (28 percent of seniors) read less than one hour per week. Even among college graduates, prose-reading proficiency declined from 40 percent in 1992 to 31 percent in 2003.

Now this goes a long way toward explaining why we're in so much trouble. No wonder politics is all about who you want to have a beer with and the way Hillary laughs. Most voters don't know the difference between Medicare and Medicaid and think we stood shoulder to shoulder in World War II with our valiant German allies against the Stalinist threat to take over the world. They not only think Saddam Hussein had Weapons of Mass Destruction™, they think he used them against U.S. troops. They don't know Sunni from Shiite from Shinola. They believe the Bible is literally true but they haven't read it and they have no idea what's in it. (Which, by the way, is the only way a sane person could believe that.) They have vague impressions that there are problems out there but they have no basis for understanding or thinking critically about competing policy proposals -- which leaves us wide open for demagoguery and outright lying by politicians. And that's what we get.

Death to television!

Friday, November 16, 2007

Are you thinking what I'm thinking?

Tom Engelhardt is, but even he seems to stop one step short of the abyss.

What happens if, three months from now, or even a year from now, the people in metropolitan Atlanta - almost 5 million of them - open their faucets and nothing comes out but air? Engelhardt seems unwilling to follow through on the thought experiment, apparently because he's afraid he might be missing something, but I'm willing to be educated if what seems obvious to me really is not.

With no water in the pipes, people cannot flush toilets, bathe, do laundry, wash dishes, clean kitchens, bathrooms, hospitals -- not that there would be much point because all of those facilities would be useless. Obviously every restaurant would have to close, but so would all of the factories and offices, regardless of whether they use water in their operations, because the workers would be unable to perform the bodily functions of excretion.

Are you with me here? You could, conceivably, truck in drinking water for 5 million people, but all that would accomplish is to keep them alive long enough for the miserable death that awaits them, from starvation, infectious disease, fire, or the violence attendant on the collapse of social order. There would be no functioning economy. No-one would have an income. It would be nearly impossible to prepare food. Human excrement would pile up in the parks and front yards and gutters. There would be little or no health care, no local tax revenues. It would be impossible to extinguish fires; immense conflagrations would sweep whole neighborhoods. Atlanta would be uninhabitable. All of those 5 million people would have to be evacuated. And then, even if the rains came, they would not be able to return. The city would be destroyed.

If Sonny Perdue's prayer rally doesn't work, that's his Plan B. Why isn't anyone saying so? For the same reason the Boston Globe featured an in-depth story last week about the high price of oil, with all their expert analysts blaming it on rising demand and predicting that world-wide demand for petroleum will be 120 million barrels a day by 2020. No, it won't, because that much oil will never be extracted, not in 2020, not in 2030, not in 3030. Yes, demand has increased, but the reason that has caused such a price spike is because supply cannot increase in response. But they won't say so because they don't want to have to think about the consequences.

As Englehardt discusses, climate change is bringing drought to many parts of the earth, not just the Southeast. This is probably not, in many if not most cases, a temporary crisis. It is a long term change. Ultimately, water stores in many areas will be gone. The vegetation will burn. The people will have to leave. That just might turn out to include parts of the U.S. Southeast -- including densely populated, urbanized places with many trillions of dollars of fixed capital, all of which would be lost. Nobody is lifting a finger to make even the slightest plan of preparation for such a contingency. We knew damn well what a major hurricane would do to New Orleans, and nobody did a damn thing to get ready. Are we going there again?

And yes, it might not happen; enough rain might come in time. But nobody knows that; it's not in the forecast. Hope is not a plan.

Wednesday, November 14, 2007

House veto override is scheduled for tomorrow

Tomorrow being Thursday. Please don't forget to contact your representative and insist on a vote to override the veto of the the FY 2008 Labor-HHS-Education Appropriations conference report.

Enter your zip code in the Capitol building icon right under Chimpy, click and off you go. Do it for the children.

UPDATE: Veto override failed in the House by 2 votes. No spending bill until after Thanksgiving. If your representative voted against the override, make sure to move heaven and earth to get the baby killer voted out of office in 2008.


I hope no-one minds a little thumb sucking today -- anyhow that's all you're going to get.

The rest of the world may already have noticed that Boston of late has become a paradise for aficionados of large men performing useless feats of physical prowess. I, shamefully, number myself among them. We have the Red Sox, World Series champions for the second time in 4 years; the Patriots, who are going through the NFL like a McCormack Reaper and are widely predicted to end the season undefeated; the New England Revolution are playing in the MSL championship game on Sunday -- and they need to win it just to get on the front page of the sports section. The Celtics, long a laughing stock, went out and acquired two superstar players in the offseason and now they are off to a 6 and 0 start. The Bruins are still mediocre but hockey is well on its way to second tier status anyway.

So, like it or not, I'm forced to pay attention to the role of sports in culture and society. I really haven't quite figured this out. What's it all about, anyway? Why do tens of thousands of people blow a week's pay to cram themselves into a giant salad bowl and yell at steroid abusers in plastic armor beating the shit out of each other?* Why is half of the reporting staff at a major metropolitan newspaper dedicated exclusively to these pointless endeavours? Why do people's spirits soar and crash with the thud of a ball to the right or left of an arbitrary yellow line, or the visual hallucinations of a cranky old man with a whistle?

When the Red Sox rolled down Boylston Street a couple of weeks ago in a caravan of WWII era amphibious assault vehicles (yes), we are told that a million people lined the sidewalks to yell and scream and faint for joy. The City spent tens of thousands of our tax dollars for police overtime, and closed down a major traffic artery for much of the day, but nobody would even have remarked upon it if they had spent 2 million dollars and closed down the whole city.

So what were the economic and public health consequences of the Red Sox winning the World Series? Well, it undoubtedly increased sleep deprivation, consumption of alcohol and empty calorie salty snacks, workplace and school absenteeism, and quite possibly acute cardiac and cerebrovascular events. The NFL has been moving all the Patriots games to night time, so we're getting the same effects every week now through January.

On the plus side, however. . . uhm. Hmm.

But you know, cities that don't have a major league sports franchise are second class, and their citizens feel deprived. I dunno. Can anybody explain it?

*I more or less stole that from somebody but I can't remember who.

Tuesday, November 13, 2007

No shortage of fools, anyway

We may be running short of oil, water, top soil and seafood, but the supply of dupes and dolts is infinite. It seems the Creation Museum needs to expand because the current facilities can't handle the crowds.

Meanwhile, back when Sonny Perdue scheduled his prayer meeting for today, the long range forecast called for rain in Atlanta tomorrow -- the only day in the forecast with rain penciled in. Just a coincidence of course. Alas, the forecast has been changed, the rain is missing them to the north, so it appears the prayers had the opposite of the intended effect.

What the Governor should have done, of course, is hire a guy to dress up in feathers and dance with a rattle. That actually works. As for the Creation Museum, if Noah could build a ship bigger than a modern supertanker all by himself out of gopher wood, I don't know why they need half a million dollars to enlarge the parking lot. Mike Zovath just needs to get out there with a shovel.

Compassionate conservatism update

As I warned a few days ago, the Emperor of Mesopotamia has gone ahead and vetoed the HHS funding bill, claiming it's fiscally irresponsible. Jennifer Loven of AP is actually reality based, as opposed to fair and balanced, in her discussion of budgetary issues:

Since winning re-election, Bush has sought to cut the labor, health and education measure below the prior year level. But lawmakers have rejected the cuts. The budget that Bush presented in February sought almost $4 billion in cuts to this year's bill.

Democrats responded by adding $10 billion to Bush's request for the 2008 bill. Democrats say spending increases for domestic programs are small compared with Bush's pending war request totaling almost $200 billion.

The $471 billion defense budget gives the Pentagon a 9 percent, $40 billion budget increase. The measure only funds core department operations, omitting Bush's $196 billion request for operations in Iraq and Afghanistan, except for an almost $12 billion infusion for new troop vehicles that are resistant to roadside bombs.

Much of the increase in the defense bill is devoted to procuring new and expensive weapons systems, including $6.3 billion for the next-generation F-35 Joint Strike Fighter, $2.8 billion for the Navy's DD(X) destroyer and $3.1 billion for the new Virginia-class attack submarine.

Huge procurement costs are driving the Pentagon budget ever upward. Once war costs are added in, the total defense budget will be significantly higher than during the typical Cold War year, even after adjusting for inflation.

I don't know why Ms. Loven has joined me in hating America, but if you're an America-hater too, enter your zip code and click on the capitol dome, and let your representative and Senators know that you demand a veto override. The vote in the House was three votes short of 2/3, so we only have to swing three more reps into the America hating column to get this done.

Monday, November 12, 2007

Time for Plan B

As I'm sure you know, the Intergovernment Panel on Climate Change has opened a conference to produce what amounts to an executive summary of its work. Most people don't know that the term "executive summary" refers to a summary of a study intended to guide action - hence "executive" as in "execute," to carry out. That's what this report is intended to accomplish -- to provide policymakers with a basis for action.

Alexander Cockburn, the increasingly bizarre Nation columnist, is convinced that global warming is a hoax engineered by the nuclear power industry. How Bechtel and General Dynamics managed to suborn 1,500 scientists in a wide range of disciplines from more than 100 countries, with nobody blowing the whistle, is not clear to me and Cockburn isn't saying. In any case, even if the scientists are making the whole thing up, whether to collect their secret payments from the nuke builders or to get themselves bigger and better grants, the report is going to be heavily diluted and toned down by political pressure from a few countries -- notably the United States, China, and Saudi Arabia -- that don't want any interference with our God-given right to burn fossil fuels.

I'm afraid I have some bad news: it doesn't much matter because it's too late, much too late, to avoid major effects of anthropogenic carbon release. You can screw compact fluourescents into every light socket on earth, get every commuter from LA to Shanghai into car pools, bring every last soldier, marine, sailor and airman home from Iraq and put the entire $100 billion a year into building wind farms, and it will barely make a difference. It's coming -- and probably bigger and faster than anybody was predicting five years ago. Sure, let's do what we can to cut down on using fossil fuels - it's equally important because we're going to run out some day, and because it doesn't make sense for the U.S. to be trying to conquer the world just to assure access to supplies.

But, as far as climate change is concerned, we need to be preparing to deal with it, not deluding ourselves into believing that we can stop it. The terms of debate need to shift, radically, and very soon.

Georgia Governor Sonny Perdue is holding a mass prayer meeting tomorrow to ask God to send rain. He says that rain is plan A, plan B, and plan C. In other words, there is no plan whatsoever for the day when Atlantans open their faucets and no water comes out. Maybe the Governor's prayers will be answered and that won't happen any time soon, or maybe it will happen in a couple of months. Think about it -- nobody in Atlanta will be able to bathe, flush a toilet, wash clothing, wash dishes, cook a meal. And nobody is doing one single damn thing to plan for that day, a day that very well might come before the Atlanta Falcons end their season. But Sonny is no crazier than the rest of us -- he is a perfect representative of the whole damn world.

Friday, November 09, 2007

Current events

Got a tip from reader Kathy about a little business as usual at a health insurer in Cal that ducked $35.5 million in expenses by dumping sick people. Yeah, that's what the God-given Free Market does folks. The scandal, as far as the LA times is concerned, is that their head hit-woman was given the assignment of wacking 15 sick people a month, and paid a bonus for exceeding the goal. That's not a scandal, that's how insurance companies work. The scandal is that she only got 20 grand for screwing over 301 people and saving the company $6 million bucks. Come on, Health Net, have a heart.

In other news, the American Public Health Association wants you to know that a House-Senate conference committee has reached agreement on the FY 2008 Labor-HHS-Education Appropriations bill. The bill includes increased funding for public health -- and remember, that's about 2% of what we spend on health care -- so the Occupant has promised a compassionately conservative veto. Enter your zip code and click on the capitol building right under Chimpy to let your Senators and Representative know that they need to make sure the bill gets a veto-proof majority.

And, in what may be the most important news in the history of the planet, or the least important news since Conan O'Brien was stalked by a priest, former Arizona Governor Fife Symington says the ETs have visited. You'll have to make up your own mind about that.

Thursday, November 08, 2007

The consolation of philosophy

My thanks to the commenters on my post about my father -- and thank you particularly for sharing some of your own stories. I try to let my personal life intrude minimally here, but as a disciple of the late Irving Kenneth Zola I take very much to heart his insistence that sociology can only be called objective when we disclose ourselves. It may seem paradoxical but only if you haven't thought about it very hard. Obviously, I have a personal stake in the issues I write about here. You should only conisder me credible to the extent I reveal it.

I've often wondered whether some readers might consider me a bit morbid because I write about death a fair amount, but the fact is, in the field of public health, it is unavoidable. Death is, after all, one of the central facts of life. One of the chief metrics of population health is life expectancy, and that is synonymous with death expectancy. Furthermore, bereavement is the lot of all of us and so our response to it as an important contributor to our quality of life. Death is also an important problem in public health because, in our society anyway, it just costs so damn much. It's a big burden on our health care financing and delivery systems, and when we worry about the future sustainability of Medicare and Medicaid, in one way or another it's a central issue.

So, as we continue the Thinking Deep Thoughts project, it's time we turn to what, for many, is the deepest thought of all. What should we consider to be the goal of public health? That is essentially equivalent to asking what we value about human existence. It's as fundamental as it gets.

Obviously the answer is not the maximum possible life span for every human. I'm sure that if we devoted the NIH budget to achieving that it would not be long before we could keep the colonies of cells that originated as human organisms alive indefinitely. That blob on the bed with the tubes sticking out of it might be nothing but a mass of cancer cells or a circulatory system nourishing a body with no cerebral cortex, no heart pumping and no gas exchange happening in the lungs but by God, human life is sacred.

But short of such a reductio ad absurdum, it does become a puzzle, given the reality of scarcity and competing interests. The Ayn Rand objectivist/libertarian view which is popular in the high tech industry is that we should each try to get whatever we want and not give a shit what happens to anybody else unless we just happen to feel like helping somebody out. The Christian -- and Republican -- version of that philosophy these days is that it extends to everybody who has a functioning cerebral cortex, but we need to extend the protection of the law to entities with human DNA that lack human consciousness.

Us non-Christians, who feel empathy for our fellow human beings and some loyalty to the species have various approaches to the problem. One is to invoke a concept of basic needs -- some fundamental level of entitlement that each person is granted. If kids are dying before their 5th birthday, that is unacceptable -- except, of course, to Christians, because we're talking about children who have already been born. We should make sure that everybody has adequate nutrition, some minimal standard of housing, education, meaningful employment, and health care.

In contrast to such a rights based view, there are theories of distributive justice. These are more difficult to describe because it is not easy to formulate a theory of deserts -- maybe people who work harder or contribute more should get more back, but of course we can contribute in a lot of ways, including being nice, or nurturing, or amusing, as well as doing things that make money in the marketplace.

Then there are utilitarian theories, in which we try to define the good in some measurable way and maximize the quantity of it. "The good" usually includes some amount of justice, and basic rights, of course, so they get more than a bit mixed up, but they represent different starting places.

In public health people try to quantify the good through concepts such as Quality Adjusted Life Years and Disability Adjusted Life Years. Survey a bunch of people and ask how much life span they would give up to avoid going blind at age 55 or developing crippling osteoarthritis or whatever, and discount years of life in said condition by the appropriate amount. Alas, how people answer these questions depends on culture and circumstances. People who don't expect to live to be 55 anyway can't exactly answer it. We need some degree of justice before we can even undertake this exercise; the only way to break out of the inherent circularity is by starting with a basic rights formulation, and trying to figure out how we can toward justice or the good from there.

So what does all this mean when we are contemplating bereavement, or our own mortality? My view is that we should ask ourselves what is, to us, the good, and then ask what we can do to contribute to it in the time we have. When we can no longer do so, our time has been enough. We hope that it has been well spent.

Wednesday, November 07, 2007


Tom Lehrer retired from performing because, he said, satire became obsolete when Henry Kissinger won the Nobel Peace Prize. If that killed satire, by now it has been consigned to eternal damnation, and forever forgotten.

But now I'm starting to think that words have become obsolete, along with rational thought. Pat Robertson endorses Rudy Giuliani for president? Now to me, that's equivalent to an endorsement from Charles Manson, but Rudy is happy to have it. I see a syllogism here:

Pat Robertson believes that the 9/11 attack happened because God withdrew his protection from the U.S. as punishment for our tolerance of homosexuality and abortion.

The abortion and homosexuality tolerating Rudolph Giuliani's main claim to the presidency is that he is the best candidate to protect the U.S. against another terrorist attack.

Ergo, Pat Robertson believes that Rudy Giuliani is more powerful than God.


Of course, we don't expect the free press, guardian of our liberties, to point that out. Why should they? Diane Feinstein voted to confirm Michael Mukasey as Attorney General because she's afraid of the prospect of "diminished transparency" in the Justice Department. Dana Perino, referring to Pervez Musharraf, tells the assembled guardians that it is never reasonable to restrict civil liberties in the name of fighting terrorism.

If they started pointing out that stuff politicians say doesn't make sense, why there would be no end to it, would there?

Tuesday, November 06, 2007

This time it's personal

Nobody close to my family reads this blog -- hell, my mother doesn't know your Intertubes from the Pony Express -- so I feel okay about posting this here. It's private, but it's nothing to be ashamed of anyway.

My father has advanced frontotemporal dementia. It happens to be of the variety called primary progressive aphasia, not that it matters. It isn't the same as Alzheimer's disease but it ends up in the same place, for all practical purposes. He is in a nursing home. He has long been incontinent of urine and feces, has been unable to carry on a meaningful conversation for a long time, and is now unable to speak, does not appear to recognize my mother, barely responds to stimuli, is essentially unable to walk, and recently he became unable to feed himself, so they have to spoon feed him. There is some concern that he has difficulty swallowing.

Unfortunately, there basically isn't anything else wrong with him. I say unfortunately because that means he could live forever, without a functional frontal cortex, if they just put in a feeding tube when he finally becomes unable to eat. By that time, he will also undoubtedly be permanently bedridden and unaware of his surroundings. Remind you of any prominent public issue of the past couple of years?

I had a conversation with my mother, who has his health care proxy and is legally entitled to make decisions about his care, about what the goals of care should be and what ought to be done in certain contingencies. She agrees with me that the goals of his care should be comfort and dignity. She does not want any procedures that would conflict with those goals solely for the purpose of extending his biological functioning, what "Christians" call his "life."

However, my mother does not believe it is up to her after all. Among the practical considerations is what to do if he acquires an infection, such as pneumonia or a urinary tract infection, and it can't be managed at the nursing home with oral or intramuscular antibiotics. The alternative would be to send him to a hospital for IV antibiotics. In the hospital, they aren't interested in spoon feeding him so they would put in a feeding tube, also a urinary catheter, no doubt. Once it goes in, it's a major deal to take it out. Jamming a tube up his nose and down his throat is not consistent with his comfort and his dignity. Since he is unable to consent to it, and undoubtedly would not want it, it is a violation of his rights.

But, the staff at the nursing home told my mother that he recently became agitated and started flailing his arms. They found this disturbing and had difficulty calming him down. The next time it happens, they said, they will call 911 and have him transported to a hospital. They did not ask my mother, they told her. The reason, although they did not say so, is that the ambulance crew will strap him to a board and at the hospital, they will have no qualms about tying his limbs to the bed. That's before they jam the tube down his throat. She doesn't think she can refuse this. I told her yes she can too, but she doesn't believe me. She has a meeting scheduled with the nursing home staff tomorrow, so we'll see what comes of it.

Oh, did I mention that the home has been purchased by a large, for-profit chain? Recently she got a Medicare statement showing the services they had billed. They included five sessions with a psych nurse from something-or-other behavioral health associates. A psych nurse? He can't talk, and he isn't taking any psych meds. They also billed for a podiatrist to drain a hematoma on his foot, even though he has never had a hematoma on his foot or anywhere else.

Now, let's get back to Bill Frist and the rest of the Republicans in congress, George W. Bush, Jeb Bush, the Catholic Bishops, the evangelical preacherscon artists and the rest of the raging mob who tried to turn Michael Schiavo into a criminal for doing what was right for his wife, in the process forcing the taxpayers of Florida to squander more than $100,000 a year to indulge their sanctimonious hypocrisy and their hatred of human life. They do not have "moral values." They only way they care about the weak and vulnerable among us is as a resource to exploit for their own enrichment and aggrandizement.

I love my father. When his disease finally kills him, it will do it by stopping him from eating, just as Terry Schiavo's disease killed her, and that will be right for him, as it was for her. It's too bad that we have to die, but we do. When the time comes, it comes. Anybody who truly respects human life respects that. James Dobson, George W. Bush, and the Cardinals in their silk robes and fat gold rings despise human life, they despise the dupes who enrich them, and they despise me and you. They are vile, foul, and profoundly evil.

Monday, November 05, 2007

Long slow slide -- then you hit the ground

Few Americans remember the Great Depression. For my grandparents, it was an essential formative experience, but for people of my parents' age, it's a childhood memory, with little impact on their understanding of the world. Since World War II, Americans grew accustomed to a steadily rising material standard of living and eventually came to take it for granted that the average person would always be wealthier than people of a decade before. However their own dreams had fallen short, people invested not merely optimism, but faith, in the greater well-being and achievements of their children.

But now workers' real incomes have been stagnant for the better part of 20 years. Greater labor force participation by women kept the boats rising for a while, but that spring ran dry a while ago. People turned to borrowing against their home equity, but now they're tapped out. Economic growth means greater and greater enrichment for the very few, but little or none of it flows to ordinary people, who are running and place and increasingly vulnerable to an illness, a job loss, an insurance company that won't pay off for a fire or a flood.

Right now we see people beginning to respond to political appeals for greater economic justice. The Democrats' push to expand S-CHIP is very popular, and the Occupant's rhetoric about socialized medicine is not resonating. Talk about raising taxes on the wealthy no longer scares people, because they no longer imagine that they will be wealthy one day.

But what will happen when stagnation turns to deterioration? I don't have the crystal ball that tells me whether the U.S. economy will enter a period of overall contraction soon, but the possibility of a real short-term catastrophe from the confluence of rising oil prices and financial collapse is certainly non-trivial. What I do know, however, is that there is no real possibility that the decline of the American middle class will suddenly be reversed under the Hillary Clinton administration. We have profound, long-term structural problems that nobody -- and that includes John Edwards and Christopher Dodd and Dennis Kucinich -- is talking about.

We have done absolutely nothing to prepare for peak oil or global climate change or the catastrophic water shortages that will soon plague the fastest growing parts of the country; upward pressure on food prices; relentless increases in health care costs; the relentless decay of the 1950s era national infrastructure. We are still a very wealthy country and we can save our collective asses with a crash program of investment, but we aren't going to do that because we're spending half a trillion dollars a year desperately trying to maintain global military domination -- to what end, no-one can tell us.

I haven't heard a single Democratic candidate for president even hint at the true choices which face us. But what will happen to our political culture when frustration with stagnation turns into desperation as ordinary Americans can't afford to heat their houses, send their kids to college, or pay for health care? As more and more of them have trouble buying clothing and groceries and keeping their cars running? Are we finally going to confront reality and enter an era of honest political discourse, or are we going to have a demagogue rise up by promising to conquer our way out of our difficulties?

Stay tuned.