The flesh of tetrapods

There are many good reasons not to eat meat -- something I have not done for 40 years, by the way. (I do eat some seafood.) But I'm a little nonplussed, if that's the word, by the massive global flapdoodle over this new publication by the World Health Organization saying that eating procesed meats (and probably any red meat) is associated with an elevated risk of cancer.

My nonplussedness is because we have known this for decades. All they are doing is restating epidemiological evidence that has been emerging since the 1980s. This is not a "study" as most reporters have been calling, but a systematic review of what we already know.

The truth is the absolute risk is pretty small, although it certainly pertains to amounts that carnivores do commonly consume. A steak or two strips of bacon a day is the kind of dosage they are looking at, and if you aren't a DFH you probably eat at least that much. This represents something on the order of a 1% lifetime increased risk of cancer. It's far more important not to use tobacco in any form, not to drink to excess, and to maintain a healthy weight. Steering clear of formaldehyde and nuclear waste are also good ideas but you're probably already doing that.

I think the public should be informed, of course. The problem is keeping things in perspective and in proportion. The meat industry is destroying the planet because it produces immense carbon outputs. Making a pound of beef takes 8 pounds of feed. If people ate the vegetable products directly, we'd multiply the product of our farmland, fertilizer, and machinery 8 fold. And we'd cut our risk of cancer by 1 or 2 percent.

 

Norlins

My hotel is at the corner of Bourbon and Canal St. and I have to say, I haven't had an opportunity to do any extensive exploration, but I'm disappointed so far. It's incredibly tacky around here, nothing but CVS, McDonald's, store selling junky tourist crap, and yes, strip clubs. Not the New Orleans  I expected at all. I'm sure I'm just in the wrong place.

Anyway, everybody here thinks like I do, which means so far I don't have a lot of revelations for you. But I will say this -- modern medicine is very complicated and it is legitimately difficult for doctors and patients to get on common ground, understand what's important from each other's perspective, and understand each other's explanatory models and reasons for feeling how they feel. And yes, doctors do have feelings -- yes they mostly do care about their patients but not necessarily in a good way from the patients' point of view, because they take it personally when people don't do what they want. Also, when that happens, they usually don't try to find out why.

I'll have more to say soon. At least it's stopped raining.

Jacamo Fina Ne

And I'm off to N'Orleans tomorrow for the International Conference on Communication in Healthcare. Never been there before, glad I'm getting a chance to go before it's under the ocean.

I'll be presenting some of my research on physician-patient communication. Long story short, and probably not a news flash, but doctors still aren't doing a lot of the stuff they should be doing to help us understand and remember what's going on, and make decisions together that work for us.

The way a medical visit ought to go is first, set an agenda. What do you want to accomplish today? And here's what I want to accomplish. If it's too much, what is the priority and what can wait? Then go through it in an organized way. The doctor should ask open questions to invite the patient to express concerns or ask questions of her own. The doctor should explain that there are alternatives, not just say what he or she thinks is best without explaining why. Patients should have a chance to say why they might find it hard to follow advice. They should have a chance to state their own relevant values and goals. The doctor should ask the patient to repeat back, in his or her own words, any important information and instructions. ("Do you understand?" is a waste of oxygen.) And there should be a wrap-up at the end that reviews the important points.

Doesn't sound too hard! Also hardly ever happens. Doctor visits are a disorganized mess and doctors just tell people what to do. And people only remember half of it without prompting. Even with prompting, if there are too many things to remember, people remember fewer of them.

Have you ever been frustrated by a visit with a physician? Why?

The Profoundest Evil

Yes, this will be the hottest year globally in recorded history, and it's accompanied by widespread drought in Africa, drought in Australia, a heat wave in India and Pakistan that likely killed several thousand people. It's already here, and it's just going to get worse.

Sorry Atrios, but your "worse humans in America" awards trivialize the real worst humans in the world. They are fossil fuel industry executives, including the executives of Exxon who have known since 1977 that their industry would eventually destroy much of civilization, and who chose to spend millions to cover up and deny this fact so they could keep getting richer.

You know what? That may actually be worse than Hitler.

I guess I shouldn't be so puzzled . . .

by the ability of serial sexual abusers and harassers to get away with it over many years. I have personally seen little of it at my own workplaces. Once a woman I supervised came to me with a complaint about a co-worker, but he was a low status employee and our executive director dealt with the guy quickly and decisively. We also had an executive who behaved inappropriately toward women but they fired him, mostly because of more general incompetence, I think.

I've been in academia full time for 10 years now, and part-time for 10 years before that, and I have to say that tales like that of Geoffrey Marcy and Colin McGinn came as a bit of a surprise. (Here's PZ on Mcginn, and we are talking about a world historical creep here.) So astronomer John Johnson, who had the opportunity to hear stories from many of his female colleagues, helps by explaining the enormous power senior academics have over junior colleagues, and the elements of human nature that make us reluctant to tell others when we have been conned or betrayed. There's a shame that goes along with it, we feel as though it's our own fault. Psychos like McGinn and Marcy know that, and they also know who the deans value more if it does come down to a she said/he said.

It seems this behavior is actually very widespread. If you read the comments on Professor Johnson's post on the Women in Astronomy blog, you'll get the impression that it's the norm in astronomy departments. I don't think I'm so obtuse that it's going on all around me in the School of Public Health, but I am certainly unaware of it. I don't think it's nuts to think that we have a somewhat different culture -- we aren't nearly so male dominated, there are lots of women in top faculty positions in public health. But I'm not so sure what's going on at the medical school . . .

Greatest Headline Ever

Man tries to put out garbage fire by driving over it in a van loaded with ammunition.

Yet another incident in the annals of responsible gun ownership.

Yet another one of those campus free speech/political correctness flapdoodles ...

...this time at an Ivy League university in Providence, Rhode Island which shall remain nameless. It seems a student whose real name is Emma Maier wrote two opinion pieces for the student newspaper, the [redacted color] Daily Herald, under the pseudonym (for some reason) M. Dzhali Maier. One of them, which apparently said the native Americans should be grateful for the European invasion, I have not been able to read because the Herald took it down, claiming they did not intend to publish it in the first place, but didn't get the word to the printer in time.

The other, which you can read here, accompanied by an editor's note repudiating it, recounts some largely (though not entirely) accurate history of how technological advances in southwest Asia and Europe led to Europeans being able to conquer distant lands. However, it puts a spin on this history which seems to endorse or justify colonialism and genocide as the privilege of the more technologically capable "race." You actually have to read it carefully to get that, it's not a blatant racist manifesto, but that does look to me like the subtle point.

So, there has been a lot of complaint about the diversity of the Herald editorial board and whether it is proper to publish stuff like this. It so happens that Columbus Day (or Dia de la Raza as others call it) was the occasion for Scott Lemieux to note that the late Christopher Hitchens made the same argument about how the Injuns should be grateful for the European conquest, and published it in The Nation magazine (which also was happy to run his aggressive promotion of George W. Bush's imperial conquest of Mesopotamia).

Of course, The Nation's editors didn't have to publish anything they didn't want to, nor does the Daily Herald, and one may rightly complain. However, once something is published I think the best response is to write your answer. The various statements and proclamations, from the university president and other senior officials, and from various campus organizations, don't really answer these essays so much as just condemn them by labeling them as racist, and insisting that racist statements should not be permitted at the University.

I don't actually agree with that. Racists don't think of themselves as evil, or mistaken. They have what appears to them to be a coherent world view. Not permitting them to express it on university grounds or within the formal means of communication characteristic of the university won't make their beliefs go away, it will just prevent anybody from explaining why they are wrong. So were I the university president, I believe I would have responded somewhat differently. I find this personally offensive, and many others do as well. Let them speak out. But we must be very clear that we don't suppress what we find offensive.

There are lines not to be crossed, of course, including gratuitous insults to specific people, and threats of violence. E.g., don't call people offensive names, don't hang up nooses, that sort of thing. But telling people they aren't allowed to express specific stupid ideas is counterproductive, not to mention a slippery slope. (No, the First Amendment does not govern the policies of a private university. But the rationale for it does apply here.)

Yet another smack down of libertarianism

Brad DeLong presents a quotation from Daniel Kahneman which evokes one of the deep problems with the idea of liberty. I want to dig even a little deeper. Go ahead and read the whole thing, it's just three paragraphs, but here is a snippet:

For behavioral economists, however, freedom has a cost, which is borne by individuals who make bad choices, and by a society that feels obligated to help them.

With respect to this observation, I have previously remarked on motorcycle helmet laws. If you suffer a traumatic brain injury in celebration of your individual liberty and personal responsibility, we the taxpayers are going to pay for your life-long institutional care. You have therefore deprived us of a bit of our liberty. If you have children, it's even worse. This, in a nutshell, is why we sometimes need the nanny state to make us more free, not less.

But it goes deeper than that. We obviously can make choices that we later regret. We want to save the biker from himself because, as Kahnemann points out, we will be obliged to take care of him if we do not. His personal misfortune is still left as his own problem.

But consider. A tobacco addict would be freer today had he never chosen to smoke that first cigarette. Many people with diabetes would have more liberty had there not been a soda machine in their high school, even though it gave them the liberty to drink soda at the time. (Let us presume they can pay for their own health care.) One can endlessly invent such examples. We often appreciate somebody saving us from ourselves, so why not the state?

The simple fact is it is always a tradeoff. There is no such thing as liberty. The universe always limits our possibilities. Granting me one liberty inevitably deprives me, and other people, of others. Whatever freedom I am granted to choose unwisely may cost me less freedom tomorrow.

You see? Moral philosophy is hard. That is why some people never seem to outgrow Ayn Rand.

The Nut Party

While Republicans are completely wrong, about everything, one of their weirdest wrongnesses has been the refusal of Republican-led states to accept the Medicaid expansion. While this obviously leaves a lot of vulnerable people unable to obtain medical care, it also does substantial economic and institutional damage to their states. That physicians and hospital owners and executives, who are well-to-do and often Republican, have been unable to howl loud enough to overcome the mindless ideological opposition to the Affordable Care Act, is disturbing.

Reiter et al, in Health Affairs, give us an idea where this might be going. States that refused the Medicaid expansion have a disproportionate number of poor, and rural residents. Since the ACA presumed that all the states would accept the expansion, it reduces federal funds that used to go to hospitals that served a disproportionate share of uninsured people. This means that those rural hospitals in the red states are coming under increasing financial pressure. They are financially vulnerable, often losing money, and may start to go our of business. As the authors write, "Policy makers need to formulate strategies for maintaining
access to care for rural populations residing in nonexpansion states."

Do yuh think? But that would mean, you know, spending money. Which Jesus specifically said not to do for the benefit of poor people. It's right there in the Republican Bible. But then what happens when the rich people who live in the same area lose their hospital?

The Ruling Class

I haven't posted here for a few days because I've been busy with events in Afghanistan, which have been quite outrageous. Anyway, I'm back here now with a different outrage.

You may recall a whiff of corruption affecting my employer, which I recounted a week ago. Well, the ever reliable BMJ is back with the subject for this Monday's post. It seems, according to Anderson et al, that of 442 publicly traded health care industry companies in the U.S. for which information on their Board members was available, 180 had at least one director who was affiliated with academic medicine. That includes 19 of 20 top NIH-funded medical schools. They include 8 medical school deans as well as 121 professors and 15 university presidents or provosts.

Oh yeah -- their average compensation was $193,000 per year. As far as I'm concerned, this is completely unacceptable. As David Rothman says in an accompanying editorial, if the companies want advice from these people they can get it without putting them on the board of directors and matching their academic salaries in exchange for attending a few meetings a year. This is bribery, and it has to stop.

A mighty wind

The current National Hurricane Center forecast puts the bullseye for hurricane Joaquin precisely on my ass. Fortunately for me, though possibly not for some other people, the meteorological blogger Jeff Masters at Weather Underground (no link because this is so ephemeral) explains that this is just splitting the difference between models that take it out to sea, and models that bury it in the mid-Atlantic. It's far too soon to know what will happen, but regardless they are predicting a lot of flooding rain and onshore wind.

That will cause a lot of damage, and maybe kill some folks, but it would be a lot less if congress didn't spend your money to encourage people to build houses in places where they will inevitably be destroyed. The National Flood Insurance Program is incredibly stupid for many reasons. Here, according to the General Accounting Office, is the first one:

The National Flood Insurance Program (NFIP) is a key component of the federal government’s efforts to limit the damage and financial impact of floods. However, it likely will not generate sufficient revenues to repay the billions of dollars borrowed from the Department of the Treasury (Treasury) to cover claims from the 2005 and 2012 hurricanes or potential claims related to future catastrophic losses. This lack of sufficient revenue highlights what have been structural weaknesses in how the program is funded. While Congress and the Federal Emergency Management Agency (FEMA)—the agency within the Department of Homeland Security (DHS) responsible for managing NFIP—intended that NFIP be funded with premiums collected from policyholders and not with tax dollars, the program was, by design, not actuarially sound. As of December 31, 2014, FEMA owed the Treasury $23 billion, up from $20 billion as of November 2012. FEMA made a $1 billion principal repayment at the end of December 2014—FEMA’s first such payment since 2010.

Another reason it's stupid is that it uses private insurance companies as intermediaries, rather than administering the program itself, and like all corporations, insurance companies are evil and they screw claimants even as 40% of premiums go to administrative expenses, most of that paid "to private insurance intermediaries who sell and manage flood insurance policies on behalf of the federal government but do not bear any risk."

Finally, of course, the sensible thing to do would be to retreat from the rising seas and allow salt marshes and barrier beaches to replace the shore front developments which keep getting wiped out and rebuilt with taxpayer dollars. That would also be good for the marine ecosystem, since the destruction of those regimes has meant loss of spawning grounds and marine biomass production. In the long run, it's inevitable.

But you know, people are stupid.

The Political Chronosynclastic Infundibulum

You Vonnegut fans know that is a distorted region of the space-time continuum where all possible opinions are true. Hmm.

Donald T. Rump continues to have a dominating lead among likely Republican primary voters even though, according to PolitiFact (yeah, yeah, they should fact-check themselves more often) of 100 statements by Trump they have fact checked, they find not one to be completely true and only 5 to be mostly true -- and those are mostly insults of other Republican candidates.

While Mitt Romney was running for president, he told 533 lies in 30 weeks. Yeah, he lost by 3% in the end but it wasn't because of lying, which the corporate media completely ignored.

Carly Fiorina just keeps repeating her lie about the "Planned Parenthood" video, which has a) nothing to do with Planned Parenthood, b) probably wasn't even made in the United States and c) does not depict an abortion but a non-viable pre-term delivery.

Obviously none of this matters to Republican voters, or to CNN or NPR. It doesn't matter if it's true, according to Cokie's Law, what matters is that "it's out there." In 2012, the New York Times "public editor" questioned whether the newspaper should be a "truth vigilante." It isn't the job of reporters to point out when politicians are lying, it's their job to channel the lies.

We are seriously screwed.

The Crazy Party

I'm finding it hard to blog these days because the country has simply gone mad. As Jonathan Chait tells us all too patiently and calmly, the U.S. Republican party is the only major political party on the planet that denies the reality of climate change and insists that nothing can or should be done about it. Obviously there are conservative parties all over the world, but not one of them takes that position -- even though many of them are in countries that have important fossil fuel sectors. (Of course the Middle Eastern monarchies don't have political parties per se -- he's talking about countries with representative government.)

As Chait also points out, even classic libertarianism recognizes the existence of environmental externalities and that there is justification for building them into the price structure. In other words, a carbon tax would be the conservative solution to climate change, in a sane conservative party.

Then there's universal health care, which is universally supported outside of the U.S. There's, you know, evolution. The cold fact that U.S. military power is limited in what it can achieve. That most people who get nutrition assistance are in fact working (or children or disabled) but their jobs don't pay enough to keep them fed. That fetuses are not babies. I could go on but these people are just completely nuts, and they control our legislative branch, most state legislatures, and get completely respectful treatment by the corporate media.

We are, in other words, in very big trouble. And I'm not sure how we got here.

More on the People's Car

Belle Waring agrees with me that a lot of VW employees must have known about the rigged emissions tests. The commenters, most of whom as far as I can tell don't have any particular expertise, are of varying opinions about that, with some claiming a small group of software engineers could have done it. I don't buy that, because the engineers who designed the engine would have known perfectly well what it was capable of. And executives, regardless of whether they came out of engineering or marketing or manufacturing, would have to know enough about the technology to have a pretty good clue, even if they maintained plausible deniability.

So CEO Martin Winterkorn, who either knew or didn't know, whichever you think is worse, walks away with at least $32 million and maybe twice that much. The poor man, he's out of a job. On the same day we learn that VW rigged the emissions test on 2.8 million vehicles in Germany.

"The manipulation of diesel emissions by Volkswagen is forbidden and illegal, there's no doubt about that," Alexander Dobrindt, the government's top transport official told lawmakers.

So guess who is going to pay for this world historical psychopathy. Employees who will be out of work as the company's sales collapse, shareholders who obviously knew nothing about it, and the thousands of people who are sick or dead from breathing UFP and NOx. Also the owners of the vehicles, whose property is now worthless and who may not even be able to get their registrations renewed.

Meanwhile, a woman is doing ten years for taking a single valium.

Fuckoververgnugen

I'll get to the evil part in a minute, but first I have to say that the stupidity of Volkswagen's executives is incomprehensible. Obviously they were going to get caught eventually. While corporate psychopathy is the norm, the billions of dollars drug companies make from fraudulent research and illegal off-label marketing far exceeds the fines they end up paying. They don't care about their brand image because people don't buy prescription drugs for the brand name, their doctors prescribe them.

This is different. VW is going to end up losing far more than any ill-gotten gains from selling a few more cars than they might have otherwise. I must also note that hundreds, if not thousands of VW employees must have known about this, but nobody ratted them out. That speaks to German efficiency and discipline, for sure.

Now, as for the evil part. I know that your average Republican thinks that regulating tailpipe pollution is tyranny, and that we have a God-given right to breathe oxides of nitrogen and ultra-fine particles. But here's the cold truth from my friends Doug Brugge and Wig Zamor. "PM2.5" means particles smaller than 2.5 microns. When motor vehicle fuel burns (gasoline or diesel, but diesel somewhat more so) vapor comes out of the tailpipe which then condenses into tiny particles -- you could call it hydrocarbon steam. Here's what Doug and Wig have to tell us:

[T]he most recent estimates still suggest that more than 100,000 Americans die each year, mostly from cardiovascular disease, from breathing in the (reduced) levels of PM_2.5 that remain in our air. Indeed, PM_2.5 appears to have health consequences similar to the effects of second hand smoke, an exposure that the public will no longer tolerate.

Most Americans are unaware that particulate pollution is the single most deadly pollution they face (and the pollutant of greatest economic consequence). Nor is there much awareness that existing regulations are inadequate. EPA is likely to propose lowering the PM_2.5 standard modestly as part of a legally mandated review, a reduction that would save lives, but not eliminate the hazard. Despite the cautious nature of this proposal, EPA is under attack for “killing jobs” rather than lauded for trying to saving lives.

So the regulations aren't stringent enough, but VW was grossly violating them. That means they were killing people. For money. Throw the bastards in jail.

You may become obssessed .. .

. . . with the open tree of life. The link leads to a page which you may find to be unprepossessing, but it is in fact the very broad outline of the evolutionary relationships among the three major kingdoms of the terrestrial biota. On the left is a node labeled "cellular organisms," which represents the last common ancestor. You will then see three more levels -- bacteria in the middle, archaea at the top, and scroll down for the eukaryotes. Click on a node and it expands to show the relationships further out on the tree, and of course you can keep going.

Want to find yourself? Click as follows: Eukaryota --> Holozoa --> Metazoa --> Bilateria and Placazoa --> Deutorostomia and Protostomia --> Tunicata and Chordata --> Vertebrata --> Euteleostomi --> Tetrapoda --> Amniota --> Mammalia --> Theria --> Eutheria --> Euarchontoglires --> Primates --> Happlorhini --> Simiiformes --> Cattarhini --> Hominidae --> Homininae --> Homo.

But you can digress anywhere along the way. This is dry stuff I suppose, and you won't know what most of the words mean, but they have a lot of other resources to explore. Just click around! Check out the blog, and the more accessible educational sites under construction.

This is put together from innumerable studies and is always growing. Right now it lists 1.8 million species, and all of their proposed evolutionary relationships. It took more than 3 billion years for all this to happen, but we've figured a lot of it out.

Aren't you lucky that you have the curiosity and imagination to understand and explore this, and don't have to live in the narrow, cramped world of creationists? This is the truth folks, and it's wondrous.

This is seriously ugly

And, it concerns my employer. A study published in 2001 reported that the anti-depressant paroxetine was safe and effective for treating depression in adolescents. Long story short, it isn't either one. The trial failed to show any significant benefit over placebo, and it failed to report on the very troubling association of paroxetine with increased suicidality and self-harm.

Although many critics recognized that the trial did not seem to support the conclusions, two million off-label prescriptions for the drug were written for children and adolescents in 2002 alone. In 2012, GlaxoSmithKline, the study's sponsor and the drug's manufacturer, paid a $3 billion fine for several criminal violations regarding off-label marketing, the most important of which pertained to paroxetine.

The occasion for this post is that the BMJ has published a re-analysis of the data establishing with precision and rigor that the original report was fraudulent. But, the journal has not retracted it, despite many calls to do so over the years, and the principal author's university has taken no action whatsoever and has stonewalled all inquiries. That happens to be Brown University.

There is a "circle the wagons" mentality in academia, unfortunately, which does a disservice to the public and to the mission of the university, obviously; but also to our students, and to our investigators who work with integrity. I'm disappointed to find it here.

Food for Thought

The online journal Democracy is one of the best free things on Your Intertubes. The new edition is up and as always, I recommend you check it out. While there are several far more important issues I could comment on, for now I'll riff off of Michael Tomasky's speculations on the future of Foobaw.

Like Tomasky, I'm a lifelong fan. It's just something Americans with Y chromosomes absorb through the pores, and I was into it as a little kid. But now that we know it's turning the players' brains into oatmeal, we have a major problem. We tell ourselves that the new concussion protocols that sideline players until their symptoms clear up will fix it. Well, at least with new rules and stricter enforcement to reduce the frequency of brain injuries. And maybe having kids start later, and have less full-contact practice, and new helmet designs . . .

But maybe not. Probably not. It's not just symptomatic concussions that cause problems, it's the cumulative effect of unnoticed milder head bumps. Maybe the proportion of players who end up with encaphalopathy and Parkinson's and Alzheimer's and chronic depression will be lower, but we don't actually know how much lower it can be. Can we comfortably sit in our living rooms snarfing down nachos, knowing that some substantial percentage of the young men performing for our mindless titillation are going to end up veged out or shooting themselves? Yes, this is a problem.

Tomasky envisions future political consequences, not only because of this minor question of traumatic brain injury but also because of the legal and ethical issues swirling around the college football business model and the compensation of college players. He foresees blue states banning first youth football, then high school football. And NCAA football with players getting paid can only work where there's enough revenue, and that mostly means the South and redder states of the Midwest. (Actually he does make one mistake, I think, which is that the liberal Pacific coast could probably sustain big-time NCAA football at such institutions as USC and Oregon.)

The result, Tomasky fears, is that working class families will blame liberals and Democrats for destroying their beloved cultural heritage. I think that's quite speculative, but I do see foobaw becoming more of a divisive cultural and political issue. As if we needed another.

Still, I'll be watching on Sunday.

Alternate Reality?

CBS News is not normally my go-to source but this description of the scene at the Rowan County courthouse makes me feel like I'm there, so props to the anonymous scribe.

Because most people are religious in some way, and I am unable to comprehend religious experience or understand why anybody would literally believe in religious teachings, I suppose I must have a form of disability. Maybe it's an autistic spectrum disorder. And it's not for lack of a proper education. My uncle was a minister and my mother taught Sunday school. We went to church every Sunday, I was in the Christmas pageants and I was even thinking about confirmation and then it occurred to me that it is all a total crock. Which should be obvious to anybody.

Let me just make a few points to Ms. Davis and her fans, which I'm sure would bounce off them like nerf balls. But what the heck.

In the first place, if God in fact doesn't like homosexuals (despite having, you know, created them) and doesn't want same sex couples to marry, why do you have to get involved? Can't God take care of his own problems? If all these sinners go to hell or whatever, it doesn't affect you. God's on the job, right?

In the second place, how do you know what God wants you to do? If you find it in the Bible, he wants widows to marry their brothers-in-law, as a second, third, or fourth wife. Also, men can have sex slaves ("concubines") in addition to their wives. So what are you planning to do about that?

In the third place, just for one example, same sex marriage has been happening in Massachusetts since May 17, 2004, and so far God has not gotten around to smiting what remains one of the most prosperous places on earth.

I do not see how anybody can avoid noticing that religion is just made up. There are thousands of different religions and not one of them has any way of distinguishing its truth claims from the claims of any other. The only reason you pertain to any given religion and believe what you believe is because you were indoctrinated as  child. The person next to you was indoctrinated differently, and therefore has a different religion. It's completely arbitrary. Some Christians think same sex marriage is fine. God hasn't smitten them either.

I could go on but I just don't get it. What I am proposing here is just common sense. How can anybody with an otherwise functional brain not see it?

Exodus

Our dean has asked us for our thoughts about the refugee crisis currently afflicting the world and what the School of Public Health can do about it. I'm not sure how to answer because this is, obviously, fundamentally a political problem, with three major dimensions.

It doesn't take any particular public health expertise to see that, in the short term, the 60 million or more refugees on the planet, need water, food, shelter and sanitation. As Nicholas Kristof points out today, regarding those 650,000 or so refugees currently causing so much turmoil in Europe, you ain't seen nothing yet if the UN can no longer feed the millions of Syrian refugees in Lebanon, Turkey and Jordan. Which it basically can't -- the World Food Program just cut off 229,000 refugees in Jordan because it ran out of money. So that's dimension number one. The multiple crises, with Syria and Iraq being the worst but far from the only major ones, are draining the coffers of the international humanitarian infrastructure. If the millions of people currently harbored in the countries neighboring Syria all get desperate enough to try to make it to Europe or somewhere, anywhere, that they can survive . . .

So that's the second political problem. Ultimately, we can't warehouse all these people in wretched tent cities and truck in flour and cooking oil to keep them biologically alive. They need to be settled in communities, as human beings, with the chance to make a living and make a home. But the influx is, predictably, bringing out the worst as well as the best in people. It's obviously bringing out the worst in Americans. John Kerry says we should accept 100,000 people next year, but don't hold your breath. Not when this is happening.

Kristof touches on the third political problem: we have to stop the war in Syria, and while he doesn't say so, obviously by extension the various other circumstances around the world that are forcing people to flee their homes. Patrick L. Smith has something to say about that. The Syrian civil war, the Afghan civil war, the anarchy in Libya, the desperate poverty in central Africa and Central America that have brought about civic collapse -- these are all the legacy of colonialism and neo-colonialism, the presumption by European civilization that it can and should run the world. This is a lot of complicated history and it's not the story we are taught in school or see on the nightly news. While Kristof is obviously right in principle, I very much doubt that the western powers will ever try the right solution, which doesn't involve freedom bombs or giving weapons to "moderates," meaning our bastards --  until they turn on us.

Oh yeah, climate change. It was actually drought that precipitated the Syrian civil war. If you think 60,000,000 refugees is a lot, just you wait.