One of my favorite movies of all times was Awakenings. It was my favorite for several reasons. It was based on a semi-autobiographical novel written by Oliver Sacks, a neurologist and brilliant writer. I knew his work well as I spent 38 years in neurology. I also loved the movie because it featured Robin Williams as the co-protagonist, one of my favorite actors, a favorite due to his versatile and deep talents. Robert De Niro also did an excellent job, although his roles tend to be more monochromic than Williams.
The story itself was inspiring and intriguing. It was about a group of people who had suffered neurologic catatonia for decades. The condition being caused by a brain infection called encephalitis lethargica (aka sleeping sickness). In this condition, you lose the ability to move . . . at all. You are statue like, but with a sound mind. This type of “locked-in” scenario has to be one of the most nightmarish things a human can experience.
But then the Robin Williams’ character, a brilliant and imaginative neurologist, Malcolm Sayer, starts to experiment with ways to help these, previously considered helpless, patients. He stumbles onto L-Dopa, a precursor to dopamine, a powerful neurotransmitter. It worked! These people who had been like statues for decades began emerging from their granite sarcophagi and becoming normal again. It was challenging for them to re-enter society after spending thirty years warehoused in a nursing home, no more animated than a piece of furniture. However, after a brief window of weeks of normalcy, L-Dopa started to lose its effectiveness. Raising the dose helped at first, but then the side effects became unbearable. Eventually, each of the individuals had to be taken off of the L-Dopa and drifted back to being encased in stone . . . somewhat like Han Solo in Carbonite, never to arise again.
I feel this kinship with these patients, of returning to a bit of normalcy after a period of hell on earth. And like them, at least toward the end of their freedom, realize that one day the window will close yet again. There’s a time bomb within my marrow. But it could not be for weeks, months, years, even decades. You can’t live within the shadow of that fear, because what if it were decades before I become seriously ill again? What a waste it would be to fret about that now. It is the realization that living in the movement is our only choice because living in the future, the “what might be” is too horrible to live with now. But, that is true for everyone, isn’t it? That is everyone who worries about the future, at least sometimes?
During their wonderful reprieve from catatonia, Leonard Love, the De Niro character, loved to dance. He took the other patients out to dances where they had a wonderful time, dancing the hours away into the small hours of the morning, within the utopian window of recovery. They were emotionally naked, without pretentiousness, didn’t know it was only a window at that juncture . . . thinking it was a door.
From Jan 2019 until about Nov 2020, my life was a living hell, so awful that I don’t even want to mention it now.
As I said before, now, I feel like dancing. The sky has never been bluer, the trees greener, Greta’s fur softer, fresh rainbow trout tastier, a down sleeping bag warmer, a long lost face of a friend more consoling, Denise’s love more faithful, air more rich with oxygen, the smell of black earth more rich, more organic, the blue mountains dipped in lacy icing more grandeur, and the soft yellow sun more comforting than it is now. Euphoria. Few blessed people ever enter hell . . . and leave again. Dancing in this window of time, the respite, the oasis from suffering. But there’s a dilemma.
During the worse of my experience, I reached out to an online Multiple Myeloma support group. In many ways, it was a breath of fresh air. There were some people who started just like me, just as grave, and now they were alive and doing okay years later. But it was the other people in the group that forced me to leave. No, not bad people. Good people. Well-meaning. Honest. There were two types of these people that I could not handle.
The first were those who were doing remarkably well, whose MM was diagnosed by a routine blood test and had never suffered symptoms. No broken bones, no renal failure. They were climbing mountains, traveling the world, starting businesses, preparing to run marathons. Shut the fuck up! I don’t want to hear about your damn wonderful life! Stop with your photos breaking the tape at the iron man finish line! Do you not understand I can’t walk to the car without assistance! A month previous, I was preparing to trek across Greenland. That’s the trouble with all social media isn’t it. People can show you a side of themselves that’s built in magical thinking. I know, selfish . . . profoundly selfish on my part to not want to share in the sunlight of their moment of glory.
Then there were the others, those who suffering was clearly WORSE than mine. Fractures in their cervical spines, quadriplegics, in severe unrelenting pain, locked up in an ICU bed or nursing home at age 55. I remember one woman describing her husband, who had been her hero, the bravest man she had ever known, screaming at the tops of his lungs, bawling day and night because the ugly cancer had invaded his brain. She was praying for his death . . . and that he could find a window once more. That could be me?
I pulled the plug on the support group.
So, while I’m not running marathons . . . yet, I am getting quite close to normal. If it were not for the 10 weeks of diarrhea and side effects from the steroids, which I’m taking to treat the diarrhea, and the diarrhea a side effect itself from chemo, I would be normal. Hmm, maybe it’s the steroids that adding to my euphoria? But regardless, I feel fantastic in body and soul. But here’s the problem. While I’m now in the glorious window of the normal, basting in glory of my own sunlight, for others I know, that window is closing. They are suffering. I feel this guilt. “Who the hell am I to relish in that warm yellow sun when others cannot?” Why don’t I shut the fuck up? Even others who come to this blog are suffering more than me right now, some, much more. I can’t feel their pain, truly, but well enough.
I feel things deeply. Always have. It is a gift and as Monk the homicide detective with OCD would say . . . “and a curse.” I don’t want to lose it. If I have any hope of becoming a decent writer at this age, it is because I feel profoundly and with great empathy for the experience of others. They say that if you as a writer don’t cry when you write, your readers never will. Compassion made me a good pain PA. It gives me some redeeming character as a person . . . a little. Yet, how to I merge this window of feeling so good, personally right now, with the brokenness I feel for the suffering in the world . . . and do it without guilt? I pray for them. I wish I could throw them a rope and pull them into my window . . . and we could dance together, emotionally naked, and hoping for a door.
I am still working on part II of my article on Pluralism, Relativism, and Tolerance. The part II will deal with tolerance by looking at its counterpart, intolerance. To heighten your interest, I will disclose that I have decided to be very specific for the sake of example, and that is looking at the psychological basis of religious intolerance of gays. I could have easily picked a general intolerance of people based on race or religion. So, it is taking so long with many rewrites because I know this article will be walking into a minefield . . . but it shouldn’t be.
But tonight, I will interrupt that train of thought to talk about the present war in Palestine. It is a war because missiles, bombs, and bullets are killing people. At last count, over 216 Palestinians have died and 12 Israelis. I wanted to mention two aspects of that chain of wars that are deeply troubling. The first is the idea of fatalism, both the atheistic and theological forms. To summarize, it is the statement that “There will be always be wars in the Middle East, certainly always between Israel and the Palestinians and therefore peace is hopeless.”
The atheists that hold the fatalistic or view, and I haven’t run into very many, do so from a deterministic view of evolution. The way things are, are the way that the laws of evolution have made them and because the universe is a long chain of irrevocable events, cause and effect, and we are hopeless to change history. Therefore, why try? Why make the effort to bring peace.
The second, theological fatalism, I find most troublesome. This is the idea that God is so sovereign and powerful that things are exactly the way that God planned them. But those who believe this, often apply it to things they don’t want to change or to justify their own responsibility in something. For example, as I spoke to several evangelicals and brought up Donald Trump’s unsavory character, they, who supported him, threw up their hands and said, “But God is in control. He would not be president if God had not wanted. It is all going to end soon as Jesus is coming back.” However, the same evangelicals did not believe that God put any Democrat in power.
The third, and most disturbing to me, is the “theological basis” of these wars. This goes beyond a simple fatalism. I could discuss the Orthodox Jewish view or the Islamic view (preserving the Dome of the Rock and it’s holy places). But the one that is most troubling is the one that is unique to American evangelicals. This is the idea that the Jews are still God’s chosen people, unique in all the world (although I’ve heard some evangelicals come up with the idea that American is chosen tribe, you know, God’s favorite) and anyone who has conflict with Israel is having conflict with God.
About 35 years ago, believe it or not, I traveled the country preaching in evangelical churches. We were preparing to be missionaries, specifically to work among refugees from Lebanon’s civil war, living in Cyprus. Most of them were Muslims, although there were Christian, Druze, etc. But often, after I spoke, I would have a member of that church where I was speaking come up and remind me that “Israel is God’s chosen people. The Muslims are the enemy of God because they are against Israel.”
I love history, because true history, not revisionist history, helps us make sense of the world in which we live. I will give a historical synopsis of this evangelical basis for tolerating the situation in Palestine. For the first 1850 years of the Christian church’s existence, Israel was considered having only historical significance. Jesus allude to, Israel had been replaced as “God’s chosen” by a new kind of kingdom of faith, rather than race. Many times within that 1850 year period, the church was even guilty of anti-Semitic views. Jews were swept up in several of the inquisitions, persecuted and killed as the “people who killed Jesus.”
An English theologian, John Nelson Darby, in the mid 1800s came up with the notion that God works with humans in grand epochs of approaches and we are near the final or seventh one, when God would, once again, choose Israel as his holy people and work through them. This was during a time of the great diaspora of Jews, scattered throughout the world, but no nation of Israel since about 70 AD. I will point out to reach these conclusions, you have to have a good imagination, pulling statements out of the Bible out of context.
An American lawyer, and swindler (based on his arrests) named C. I. Scofield picked up on Darby’s ideas, became enthralled with them. Eventually Scofield not only went around the country preaching this new theology, but wrote his own Bible, with the King James version of scripture, but his own notes printed in the margins explaining vague passages with this new idea of these epochs, when he called “dispensations.” Many readers didn’t know where scripture ended and Scofield’s words began.
Scofield’s Bible became the best selling Bible in America for a generation, and created this new theology as the backbone of American evangelicalism (no other church in the world adopted this view except for those churches planted by American evangelical churches). The last step was in the 1970s, Hal Lindsey wrote a best selling (the actual best-selling book of the decade of the 70s) called, The Late, Great, Planet Earth. In this book, Lindsey wrote out conspiracy theory after conspiracy theory on how we are living in the last days and that Israel will be the final great battle between Satan and God and that we must support Israel at all costs.
I will point out that virtually none of Lindsey’s predictions came true in the subsequent 40 years. But it further enamored Israel in the eyes of the evangelical. In order to seduce the evangelical vote, the Republican party has very successfully picked a triad of token causes, anti-abortion, anti-homosexual marriage, and pro-Israel.
I did not even mention how the nation of Israel was formed after World War II, as that is another long story built on the evangelical notion of Christian Zionism and the rightful sorrow for what Germany had done to the Jews.
When I’ve had discussions about this with evangelicals, like when I was on my preaching tour, they would sometimes suggest that I was anti-sematic. My most cordial answer to that is, hell no. Of course the Holocaust happened, and it was worse than our feeble imaginations can conjure. Like all other peoples, I see the Jews as created in God’s image and worthy of our respect and love . . . but is same for the Palestinians. I do think the creation of the nation of Israel was one of many great blunders the west has imposed on the world, but I do not want its destruction now. What has happened in Israel since 1947 is a horrible racism and profound injustice. The evangelicals give a free pass to Israel for what they do because of their Scofield and Lindsay theologies.
Last year I had a virtual conversation with a Palestinian who had come to America to work. He asked me, “Why do Christians in American hate us? I don’t understand. What have we done to them to deserve this?” I answered the man with the same historical account as I posted above. His response was total disbelief . . . jaw dropping disbelief.
When respect and dignity is afforded to all people, it takes away the oxygen in which war breathes.
While the Bible says NOTHING about Israel becoming a nation again, it is profoundly clear from cover to cover about justice, about dignity, respect, and Jesus making it clear, love for all people. This is my calling. To do justice, love kindness, and try my damnedest to walk humbly.
We can bring peace to the world. When respect and dignity is afforded to all people, it takes away the oxygen in which war breathes.
I wrote this quickly as I meant to work on my previous article. But the death and destruction of both the Jews and Palestinians is heart breaking to me.
A long time ago, I attended a philosophical lecture with the same title as this piece. While I don’t remember all the details, the way the speaker approached this topic left a lasting impression on me. I am writing about this now out of my continuing concern about our collective loss of truth. This loss of truth is present throughout our western culture, but I think more so in America than the rest. This loss of truth has been a long time coming. You can trace the history of this trend going back at least two hundred years. It is also not the first time that western societies have divorced itself from the notion of truth. A similar thing happened during the Middle Ages.
Again, I will remind the reader that I’m talking about the general concept of truth, not particular truths. For example, I am not disturbed that people don’t believe x, y, or z, which I may believe. I hear my evangelical friends talk about how horrible people are these days because they no longer believe in “God’s truth.” That is not at all what I’m talking about. I’m talking about the loss of the aspiration of finding truth, any truth. I defined this philosophical truth as simply consistent with what is, not that which I agree with. There are plenty of truths that I don’t like but are consistent with what is. War makes some people rich, and as long as some people benefit from war, we will always have it. I don’t like that truth. I wish it were not true, but it is.
The way the pursuit of truth is being lost is within the moral desire for tolerance. Tolerance is a good thing, mostly. No, I don’t want to tolerate the child molester, but I do for most others. But before I dive into this topic, I want to define these three terms and how I will use them here.
Pluralism. The word is akin to diversity, however I would define pluralism as a simple state and diversity as an attitude that welcomes and cultivates differences. Pluralism is where people of different perspectives and beliefs inhabit the same space. That space could be as big as a country or as small as a family or community. With the internet, in ways the entire world has now become a confined space. The political tribalism that we have seen in America in the last ten years are attempts to escape the inescapable pluralism of our society.
A few years ago, Denise and I spent a week in a lovely palace within the old walls of Marrakesh, Morocco. That city enthralled me, so I spent a lot of time reading about its history. It is an isolated oasis city, surrounded by twenty-foot red adobe walls, that has existed for a thousand years or more. During that time, except for passing caravans of camels, crossing the Sahara from north to south, the desert cut the people off from the rest of the world. It is a Muslim city, so during that period of isolation I suspect that the population was near 100% Muslim. Maybe a stray Christian or Jew wandered in off a caravan. But to those inhabitants, their entire world was homogenous, sharing the same concept of God and religion. That is an example of a mono-culture, the opposite of a pluralistic one. Within that society, it was very easy to maintain a belief system because it was unchallenged.
Pluralism appeared in world history in certain spots prior to the modern age. One such example was when the Aryans entered the Indus Valley of what is now Pakistan and India 3500 years ago. They brought with them many polytheistic religions and cultures. As these different religions merged, pluralism’s reality caused an evolution within the local religious belief systems, ending in pantheism, which we now know as Hinduism. It was an adaptive change to accommodate contrasting views by broadening the concept of the divine to an infinity.
With the invention of the airplane, jet engine, and the internet, the entire world is experiencing this same melting pot of ideas as happened in the Indus Valley. Now, the evangelical couple in Arkansas may have neighbors on one side that are Muslim, and a Hindu married to a Sikh on the other side. Across the street, a gay couple, who is also Hispanic and on the other side, a black Catholic family.
Tolerance. Tolerance is love’s “gateway drug.” A starting point. While it is minimalistic, it means much more than just tolerating someone with different views. The way I used it is to accept, respect, and eventually love those who are different … even those who are very different. When you cut away all the cultural fluff, this idea was the cornerstone of the historical Jesus’s teaching. I think for the Buddha likewise.
Relativism. This is the term that devalues the concept of truth. It promotes the idea that all views are the same, simply different opinions. Did Donald Trump win the fair vote count in November 2020, or was the election stolen from him? In classical logic, both can’t be true. Math cannot lie. But in relativism, people who have opposing views of this specific matter may seek peace between themselves, harmony within families, by agreeing that it is all relative.
Tolerance is love’s “gateway drug.”
Relativism has eroded away our sense of truth to where reality itself is now ambiguous. This is the problem. But I want to put relativism within the concept of the other two factors, pluralism, and tolerance. While we have turned to relativism with an excellent motive, to find peace and tolerance, the resulting loss of the concept of truth will be as calamitous as it was in the Middle Ages.
Next time I really want to explore tolerance more thoroughly and the idea of maintaining an aspiration of truth while morally living in tolerance and love toward others who are different. I want to explore the real roots to intolerance, which masquerades as fighting to maintain “truth,” but is really something more primitive and ego-centric.
It is only fair, since you dear folks bore with me during the times I was contemplating putting a bullet through my head, that when there are times of good news that I should share that too.
First of all, I reported in January that my cancer had a sudden surge (one of about about four markers). My light chains suddenly tripled, which can often mean the cancer itself is coming out of remission. But then it plateaued and now it is back to the pre-surge level (still three times normal, but stable). I am deeply gratefully for that as it indicates my cancer remains in good-partial-remission since the bone marrow transplant.
My renal labs returned yesterday the best they have been since I got sick. In case you are medical, my estimated GFR was 26.7 (started at 4 two years ago). While this is still less than half of normal, it puts me further away from dialysis.
Related to improving renal function, my electrolytes are now staying very normal. When they were running high (a year ago) it created a culinary nightmare (a little melodrama okay, starvation is much worse). I had gone off meat. But then I couldn’t have any sodium (salt) and no foods, such as most fruit, many vegetables like tomatoes, that were high in potassium. I was eating plain noodles most of the time, with an egg thrown in for protein now and then. But now my palate has been liberated! I could eat spaghetti WITH SAUCE, three times a day. I am looking forward to making authentic Neapolitan pizza.
I am feeling very good for most part. My anemia, which I will always have now, limits me. But still I climb Mount Erie twice a week and do many other hikes in-between. I did my first 2-mile run. Not fast, but it felt good.
It was about as devastating for me as the cancer itself, being laid off by my employer when I tried to go back to work. My clinic lost money when I was sick (duh) and therefore I no longer had value to the institution. But, I’m recovering from that awful setback. I am volunteering doing COVID vaccinations for the county. I hope to do it even more when I get the diarrhea under control. So good to be with “patients” again. I love patients!
To keep my sanity during my forced retirement, I’ve been very busy. I just built a pizza oven, official Italian design and of restaurant size and quality. I am restoring my wooden sailboat, which was left delict in the weather during my illness. It had been taken over by a very pregnant squirrel, who found it accommodating. I just wish she didn’t have to chew up my sail for her nest. I’m almost done with that. I’m doing many other chores including getting our land ready for goats and a stone cottage, I hope to be building soon. As I mentioned last time, I’m taking a break from working on my new novel while a group of “beta-readers” (like a focus group) review it for suggestions.
I did have a set back of 5 weeks of continuous diarrhea, which was wearing me down. It is most likely colitis, which is a common post-transplant complication. However, going back on steroids seems to be working.
Lastly, my neurological symptoms, which were a friggin nightmare, continue to slowly improve. I have chunks of time, maybe an hour or so, with no twitching.
I want to thank you for your continuing prayer and support. I’m feeling some light, although the tunnel is still long.
I posted recently that I was looking for beta readers for my new novel Retribution (pre-published). I had an outpouring of interests from all walks of life, which make a good “focus group.” I have 45 people signed up for this project. I have plenty of help in this, so thank you for considering it!
I have just completed my eleventh draft of my new novel, Retribution. I am looking for someone who enjoys reading fiction and would be willing to be a “beta reader.”
The book is an “upscale” thriller, meaning in this case a thriller with a thoughtful backstory and believable characters. The story starts with an American medical worker in a Yemenis refugee camp and ends with . . . well, you will have to read the story.
While this is a late draft, it is not the final. I am not looking for someone to do the meticulous work of proof-reading or editing, which professionals will do later. The beta reader would leisurely read it and to give honest feedback. This will be my eighth book, and I’m trying to create my best book so far, and you can help me make sure I’m on the right path.
I can supply the manuscript in any form the reader wants. Hard copy, MS-Word, PDF, or Kindle. If you are interested, please send me a private message.
I am presently between my 10th and 11th draft of my new novel Retribution, time to come up for air and to get away from it. Breaks are good. I leave a draft thinking to myself, “Hey chap, you nailed it! A Pulitzer Prize nominee for sure.” Then I come back two weeks later, open the manuscript and read. “Holy crap! What was I trying to say? That’s clumsy. How did I miss that typo? Garbage!”
I’ve attended many classes in my search for being a better writer. I am encouraged to know that even the talented writers go through this editing ritual. One such famous author said, and I can’t remember which one now, “I edit and edit until I come to the point of saying to myself, ‘It’s still messed up but I don’t know how to fix it,’ then I publish it.” My ambition is to write one excellent book before I die, so I’m taking my time with this one.
I looked at the articles that I have in draft form here at this blog and I counted 35. I thought about brining one of those to maturity and post it during this break, but, I’m going to bring snippets from several under the general theme of the three forces or tensions that permeate much of the universe, including human endeavors. This is long, so I titled each section and you can choose if is something that you want to read.
Four weeks ago, I was sitting on the sixth floor of the Seattle Cancer Care Alliance. Many of you, unfortunately, have had to go there (but it is great care if you need it). It is a lovely semi-circular building of aqua-tinted glass, on a hill overlooking the most scenic part of the north end of Seattle, Lake Union, and the Space Needle.
While I sat anxiously waiting on my appointment, anticipating the news that I was getting sicker and going suffer mercilessly and die . . . or I’m stable and will live awhile (the verdict is still out). You know, little things. Many of you can relate to that situation because you’ve been there. While trying to quieten my anxious heart (besides prayers riding on every breath) I watched the crew on the ground below building a fresh addition to the building.
On that day, I noticed the familiar pattern of triangles in the cranes, machines … and the entire universe around me. This started me on a fascinating journey, into patterns, like Alice stepping behind the looking glass. Just look for triangles in the photo below.
The Triangle in the Material World
The humble triangle is the fundamental form for engineering because it is the strongest simple form (see). It tempted me to say the reason is that we live in a three-dimensional universe, however, the triangle can fit neatly within a two-dimensional plane and still be strong. Put another one, perpendicular, then you have a pyramid. Maybe the engineers among you can explain it better.
We consider the Roman arch a engineering marvel upon which they built western civilization. However, it is nothing but a row of triangles with their hypotenuses in line.
A decade ago, a local bridge over I-5 fell into the river after a truck struck and broke just one of those triangles.
While the triangle is one of the most common shapes in nature (see), there are other mysterious patterns such as the Fibonacci sequence (see).
While one could argue these complex mathematical constructs in nature results from a very long period and random chance, or that humans have evolved to the point of imposing order on things they see, which have no intrinsic order, for me, they speak loudly of an universe with design. As I’ve said many times, mathematics is the native tongue of God. If you are a mystic, either atheistic-mystic, or theistic-mystic you cannot ignore the fact that this fabric of the universe is written in a mysterious code. The consistency of this math allows us to land a 2,000 lb SUV on a precise location in the Jezero Crater, or to discover new particles in physics using equations without experimentation. This grand order comforts me, even when facing serious news.
Besides the presences of triangles throughout physical nature, you can also examine most human endeavors through the prism of the triad of forces. Triangles are everywhere within the subjective and the objective. I may be oversimplifying these issues, but maybe that’s a good thing.
The Human Psyche/Soul (the words are from the same Greek root as do spiritual and emotional)
We humans have three basic parts, often in tension. The biological, emotional (aka spiritual), and reason. While the biologic is the superstructure of them all, reason is perceives and make sense of the external world, and emotions are there to enjoy or fear what reason learns.
Unfortunately, we run into most of our troubles when we allow emotions make sense of the world (emotional reasoning). Men beat their wives when they allow emotions to tell them that the wife is threatening to them (because they see the wife as better than themselves). The teenaged girl jumps off a high bridge when her boyfriend leaves her, via emotional reasoning, thinking that she is worthless and will never be happy again.
I know for mean, as much as I struggle against the flesh (the cancer in the material) I struggle in this emotional realm. It is a battle to maintain a sense of self-worth when I’ve lost my physical stamina and professional career. It is my emotional reasoning that is enticing.
The biological force can throw a wrench into the whole being when it does not function well. Many forms of mental illness have such a biological base, such as schizophrenia or chronic depression. So, there is a tension within along those three lines.
Christian apologists argue that the fact the Christian God has three balancing parts, Father, Son, and Holy Ghost, sets it apart from other religions and makes it more congruent with what we see in the material world. Rather than arguing for or against that position here, I will pivot and go to another topic entirely, using the Triune God argument only as a segue.
About twenty years ago, I attended a lecture by a professor of philosophy and comparative religions at Harvard. This man, while raised as a Hindu in Delhi, converted to Christianity. The title of his lecture was something like “The Superiority of the Christian Triune God.”
A Word About Harvard (here comes the awkward segue)
What drew me to this professor’s lecture wasn’t the topic as much as the man’s association with the university. Harvard is another one of those sacred places in my mind, having been on the campus only twice. The reason is, the motto for the college is “veritas,” meaning truth, or the pursuit of. I love truth, meaning that which is consistent with reality. I rubbed John Harvard’s brass foot as an act of a pilgrimage on my first visit.
John Harvard was a Puritan pastor and relic of the enlightenment. While he was dying in 1636 from TB, he gave a verbal will, donating his orchard, money, and crate of 400 books for the formation of the college. Those 400 books (you can see the original 1636 book catalogue of the donation here) were books of theology, science and literature. The books represented John’s own pursuit of truth and thus the motto of the school.
I know this is hard to imagine in this age of when evangelical Christianity has an anti-reason bias and is against objective truth, however, Harvard’s pursuit of truth, love of knowledge and science, was not despite his Christianity … but the result of.
This Harvard professor, twenty years ago, said something interesting, but totally missed the point. He used the example of the American army’s successful invasion of Iraq as proof of the superiority of the Christian triune God, the nature of the trinity reflected in nature. In summary, the American bombs, missiles, and bullets were so accurate because they could triangulate their targets, while the Iraqis fired randomly. The latter serving a monotheistic god.
The use of the mathematical triangle makes bombings precise (most of the time) through the GPS system. There was also a network of triangulated microphones which could pinpoint the source of enemy gunfire and thus return fire accurately. However, the use of such examples missed the point of humanity, or to borrow a Biblical metaphor, strained at a gnat while swallowing a camel.
During that lecture, I was sitting beside four Muslim men from an Arab heritage. I could tell from what they said to me, that they thought the speaker was saying the Christian God was superior to the Muslim Allah, because the Christian God is more efficient at murdering innocent civilians. “Why does such reckless brutality make one God superior to the next?” I tried to explain, that’s not what he’s saying but my words mute, damage done. As he connected to his audience, while he tried to use a rational argument (using the reason part of our psyche), this speaker unintentionally left a greater impact in the emotional realm by using such a poor example.
Of course, in America, we have three seats of power in government, the presidency, judicial, and legislative branches. Our founding fathers knew, philosophically, that a triune balance of power was the most efficient. Within the realm of political power on a personal level, there are also three major areas of tension, 1) Personal (Art of persuasion of the masses), 2) Money, and 3) Facts. The most power, unfortunately, often falls in that order, sometimes money first, facts almost always last.
To win elections, you must persuade people to vote for you. It takes money to persuade the most. Lies work better than truth, because you can cater reality to fit the voter’s wants or biases. This is especially true during our age of electronic media and short attention spans, where baseless soundbites work. This is how our society has produced the likes of Donald Trump, who is brilliant in using advertising and persuasive speech, and he had the money to reach the masses. So he could be a great success, although he treats truth and reality as extraneous. I’m afraid it may get worse, unless we figure out a way to put truth as the front of this triad.
Writing (applies to all fine arts).
Three forces occur in writing, art (creativity), science (technique), and business. Plenty of writers who are profoundly creative, who don’t follow all the rules of grammar (technique), and are lousy at business. Other writers who do fantastic at business (James Patterson) but, in my opinion, don’t have a lot of creativity.
I’ve entered creative writing late in life. I have tried to learn the business of writing the best I can. As I have entered the real inner circle of creative writing, I am finding the technology of writing (to have it published by a major publisher) oppressive . . . if not depressive. For one, the grammar has to be pristine. I’ve tried to be creative by (coloring outside the Chicago Manual of Style’s lines or rules of grammar) only to have editors smash me like a bug. But it is now beyond grammar. Now, there are formulas for numbers of adjectives, adverbs, nouns, pronouns etc. to have a “good manuscript.” I have three computer programs that look for these variations. But, if I want to get the attention of a major publisher, I have to play by these rules. The rules are so precise now, that people are saying that in the future, computers with A.I. will write all our novels and they will all be perfect. Lord, I hope not.
But it has not always been that way. Shakespeare created 1700 nonexistent words in his writing. I’ve tried to create one new word in a manuscript of 150,000 words and have an editor write me a nasty note, “You can’t do that. It’s not an actual word.” For example, if I wrote, “The bright yellow sun was dominating the azure sky with such an intensity that he had to drop his chores and get behind the wheel of his T-Brid and go convertibling on Highway 101.” The editor would send it back and demand that I delete the word, “convertibling,” although the reader would know what I mean. I find that sad. But If I had to choose, I would rather be creative than successful. I wish I could be successful just enough to pay for my expenses so I can continue. I love the work.
I wanted to write an informative article on the good and ills of the practice of medicine, both evidence-based and alternative medicine. I base this on my thirty-nine years of medical practice, and now my two years of being a high consumer of healthcare. Yet, so far, I have not found a concise way to discuss my observations. But I could summarize and simplify it through this filter of the triad of forces.
The three forces in health care are the science (facts), the art (the humanity), and the business (or money).
Science Vs Humanity
Evidence-based (what some call “western”) medicine is bold on science and weak on art/humanity. Alternative medicine emphasizes the art/humanity but is weak on science. Both are the victims of the business aspect.
I had a patient who had suffered a stroke when a chiropractor manipulated his neck. This is a very rare side effect from such manipulations. The patient was in my office in tears as he was loosing his livelihood because of the disability (I can now relate to the depression of loosing your career). I asked him if he was going to sue the chiropractor. His eyes became as round as saucers and he said, “No. Never! I love the guy, he’s one of my best friends. We go fishing together. But I am thinking about suing the hospital.”
“The hospital? Why them?” I asked.
“It took them a day to schedule my brain MRI.”
The man had a deep personal relationship with his chiropractor . . . none with his hospital or his evidence-based provider. This is where art can trump science.
If my quarrel with evidence-based medicine is the loss of a personal relationship between provider and patients (It would not surprise me if one of my providers hope for my demise, just so I would not be on their schedules with my complex disease), I argue with “alternative medicine” because of their lack of science.
Alternative medicine often claims a scientific basis, but with testimonials rather than true science. They built true science around the double-blind study that eliminates personal bias (emotional reasoning) which contaminates testimonials. Most of the time they just make things up, “This works for that.”
I ask, “How do you know that?” The answer is almost never from a study but from a person, a guru in alternative medicine who said so.
I am most disappointed that alternative medicine practitioners often spread conspiracy theories to discredit evidence-based medicine such as “the corruption of big pharma.” I wish that alternative medicine was truly complimentary. I think evidence-based medicine has a lot to learn from them.
When I was a member of the American Headache Society, I was a member of the CAM (complimentary and alternative medicine) sub-group. I really wanted to find “natural” treatments for migraine, but those that were proven to work. But we did not make things up.
The Business of Healthcare
I would be naïve to say that business is a bad thing in healthcare. Would healthcare providers work for free? I think not. There has to be a monetary exchange to make it function. But it’s the misapplication of business that’s the problem. This problem with the business model is not greed. Yes, you will find a few people within all aspects of medicine that are overpaid (e.g. insurance executives that earn annual salaries in the tens of millions of dollars, a very few medical providers in both evidence-based and alternative medicine). But its not the driving force.
In a nutshell, the business of healthcare is now dictated, for the most part, by insurance companies. The original purpose of insurance companies is to level the cost of healthcare across society, as those costs skyrocketed. Costs were driven up, not by greed so much, but by the complexity of medicine (meaning our growing understanding of the complexity of disease and the treatments thereof). Things we knew about disease and treatment 50 years ago were the low-hanging fruit. Now, diagnosis is far more complex, as is the treatment. Before insurance, if a treatment was expensive, you had to choose to die or go bankrupt. With no insurance, you hope and pray that you never get sick.
Society has two ways of spreading out the costs, through taxes and government paying for the care, or through private companies and premiums. America opted for private companies.
You can debate the cause of the super inflation of healthcare cost, but the driving force is the advancements in technology. I am a perfect example of this. My healthcare cost in 2019 was over one million dollars. With my $15,000 per capsule of my present chemotherapy, this year it will be in the hundreds of thousands. It is because these treatments are complex and costly to develop. If it was not for the insurance companies averaging out these costs over thousands of subscribers, I could not afford it and would have no choice but to die.
I used to demonize health care insurance companies. After all, they caused the downfall of my own medical practice. My goal was to bring the humanity back into headache care. However, 70% of our fees were left unpaid by the insurance companies, plus the cost of doing business with them was overwhelming. However, watching them pay these enormous bills for my personal care has dampened my hostility toward them.
Here’s the negative influence that insurance companies have had on the delivery of healthcare. As a VP of a major health insurance company told me (when I was confronting him on this issue), “I lay in bed at night thinking about our stockholders. For every penny we don’t pay on claims, it is a penny we return to our investors.”
Insurance companies have a monopoly on health care. Health care providers don’t have clout to fight back against them, unless they are huge, for example, the University of Washington in Seattle’s insurance market, or Mayo Clinic in the Minnesota insurance market. For that reason, almost all private practices have disappeared. In the future, unless something changes, medical practices will continue merging into even larger systems. It is inevitable in this present climate. Larger systems dehumanize patients because of the dilution within the volume and for the sake of efficiency (the Henry Ford effect).
It is more than the insurance companies paying less to a provider for a patient’s appointment. It is a chess game, where the insurance companies are constantly changing the rules to their favor. The more complex the rules are for a medical provider, the more difficult it is for them to comply, and therefore more money the insurance company can keep.
Enter The EMR
A new metaphysical phenomenon occurred within healthcare in the 1970s. Malpractice lawsuits were becoming more and more lucrative. The lawyers were able to win cases based on documentation alone.
For example, if you were a nurse and up put the rails up on the bed of Ms. X as you left the room, but did not write that you put the rails up, then Ms. X falls and breaks her hip, they could sue you for not putting up the rails. The mantra was, “If not documented, it didn’t happen.”
The insurance companies have now adopted the same metaphysical reality. They pay for what you have documented doing . . . not for what you’ve done. There are x number of points that must the provider must document, for the insurance company to reimburse them for the visit. To document these things, the provider has to focus more on the record than the patient. It isn’t because of callused providers but for hospital groups to stay in business, the pressure to conform to insurance mandates often damages the patient-provider relationship (the art).
When I was a small boy, I remember going to my pediatrician, Dr. Brown’s office. You could walk in, Saturday mornings were only walk-ins. The doctor saw 40-50 patients in a day. He charged 25 dollars a visit and did well. He also had a relationship with my family and me, knowing me by my first name and what happened our previous visit. However, his note was one or two sentences written by pen, taking less than a minute. The medical knowledge was much more limited, treatments simpler. Now we know five times as much so diagnoses and treatments are far more complex.
There is much more to say about this, but I think that evidence medicine training has erased empathy (the art or humanity) by the science and the business. My dream is that we can restore it despite those pressures.
I will mention one more thing in closing about the way science has pressured out the humanity in medicine. It is from how they teach evidence-based medicine. They taught us in our PA school, which mimicked the medical school, that we cannot fraternize with the patients. Unlike the example above with the man and his chiropractor, they taught us it damages our objectivity if we see patients as friends (or see our family as patients). The fear is it skews our judgement.
In the later years of my practice, I made the point of asking about one personal (non headache) issue with my patients during our visit (e.g. How’s your son whose studying math). I would put that in the note to remind myself to ask more about it on the next visit. I wanted to see my patients as my personal friends. Maybe this is the reason I was never successful in medicine … from a business standpoint.
I came here to delineate the problem and it would take much more space to come up with remedies.
I am so sorry but it was brought to my attention that the number I published last time for Dr. Moren’s new headache clinic is wrong. I doubled checked and I had one digit wrong. Here is the correct number (and I made my list and checked it twice): 360 392 3917.
As I have a few of my old patients who monitor this website, I thought this would be the best way to communicate. Just a few weeks ago I announced the death of our old headache practice. I am please now to announce that Dr. James Moren (my previous partner) will be restarting a headache clinic in Bellingham. You can start making appointments on March 15, 2021 at the following phone number: 360 392-2917.
Will I be joining him? Not at this time. It is quite expensive starting a new practice (malpractice insurance to name one) and at this juncture it would be prohibitive for me. In the future, if Dr. Moren becomes very busy and needs help, I may reconsider . . . as the state of my health permits. I am keeping up my PA license and certification just in case.
I hope the best for you. Most of you have seen Dr. Moren in the past, if you have not, he is superb in the area of headache management (board certified in headache medicine, which no neurologist in our area holds) and he shares my compassion for headache sufferers.
The first time I came across the secret was when I learned that my dear aunt Helen, who was like a second mom and always inebriated on joy, had a horrible past life. She lost five immediate family members (three sisters and parents) before she turned 18. Then she married a man who did not want kids, and she loved kids. Like in a sad TV show, years later she found out her husband had another wife, and a kid, in another city. Painful! When she left this man, he tried to kill her. I will never forget that night because I was under the bed when he came to our house looking for her with his gun. My dad, her brother, took his gun out and they had a standoff in our yard.
I can’t remember seeing Helen without a smile . . . unless it was a laugh. She found joy in every moment of her long life. It was a paradox, an enigma.
In college I met a holocausts survivor. She was so much like my aunt, constantly laughing. I didn’t take history seriously at the time and didn’t understand what happened in the Nazi camps.
This type of smile differs greatly from the smile described in the song, Smile. In that song, (lyrics below) the smile is pretentious. Helen’s smile and laughter were authentic. But this kind of happiness, the joy of the survivor, has a secret. It’s a secret that I’m just figuring this out.
Smile though your heart is aching Smile even though it’s breaking When there are clouds in the sky you’ll get by If you smile through your fear and sorrow Smile and maybe tomorrow You’ll see the sun come shining through For you
Light up your face with gladness Hide every trace of sadness Although a tear maybe ever so near That’s the time you must keep on trying Smile- what’s the use of crying
To make sure there is no misunderstanding, I am not a cancer survivor. Mine is considered incurable. I’ve had people who don’t understand the diagnosis, say such. My cancer is like an old drunk man, passed out in an easy chair in my marrow. One day will awake and try his best to murder me. Is he waking now?
Multiple Myeloma will have a cure someday, and I may or may not live long enough to realize it. It is even possible that the cure may be here now. A few new treatments have profound initial responses, but they just don’t know how long it last. It involves reprograming the patient’s immune system (T cells) to fight the cancer.
But when I look at where I’ve been, I am a survivor of suffering. My story is not unique, as most of you have survived something dreadful.
I didn’t think I would ever leave the intensive care of a hospital two years ago. Kissing the mud when my feet got to touch ground again. I still love the dirt, the grass, the trees, the water, the mountains, the sky . . . and all that is part of this incredible creation. I have always loved the out-of-doors, but now it is intimate, its personal. Having suffered beyond what I thought a human could bear, the lack of such is profoundly delightful. That’s the survivor’s secret, having tasted the loss and having another chance at it.
I can’t even talk about my family without exploding with joy.
I was thinking about this yesterday when I drank a glass of orange juice. It was straight from Florida, thick with pulp. Little ovoid pieces of pure citrus ecstasy, that stick to your teeth. I love orange juice and this was my first glass in two years. When I first got off dialysis, a year and a half ago my electrolytes were so high, I had to forgo all fruits (including tomatoes), meat, and was down to plain noodles and oatmeal. Now, I can have fruit, tomatoes, can eat a little chicken but no red meat. Now, to me, a slice of a tomato is like the thickest and juiciest steak you can imagine.
In summary, I have a type of joy with the ordinary that I’ve never experienced before. I know what it is like to be without. That’s the survivor’s secret. But don’t say it. No, I’m not better off now that I’ve experienced cancer . . . it still sucks like a Hoover.