Lego grok
I used to love Legos, but I haven't paid much attention in the last 15 years or so. Apparently, there is a caveman figurine now, and builders are using it in inventive ways...
Breivik on Maslow: cultural Marxist
My relatives in Norway e-mailed right away to tell us they were okay. We didn't even know there had been a bombing in Oslo. Details are grim, especially of the shooting, and the bomb blast looks to have been quite devastating.
The bomber Anders Bering Breivik is the son of a liberal Norwegian diplomat and a nurse.
His fantastic self-styling as a latter-day Templar says to me that he was not quite in touch with reality. Perhaps not crazy, but so wrapped up in theoretical and historical concerns that he lost a sense of proportion. He wasn't stupid, though. As others have pointed out, he planned all this methodically, and he also hacked his mind and body with weightlifting, steroids, and meditation in order to maintain the motivation required to finish his plan.
He seems to have actually read scholarly works on intellectual history. His 1500-page manifesto, titled 2083: A European Declaration of Independance is available in its entirety as a PDF download from the Internet Archive.
In keeping with the main theme of this blog, I point to Breivik's comments on Abraham Maslow. Anyone who has been through an Intro to Psychology course has probably heard of Maslow's Hierarchy of Needs. The Hierarchy has been the basis of various theories of health and nursing.
In Breivik's perspective, Maslow was either a part of or a dupe of Marxist plans to overthrow western capitalism slowly, by undermining the cultural and spiritual basis of European civilization.
Although this sounds a little crazy, it's actually not. As I said, Breivik seems to have read scholarly works of intellectual history, and the connections he makes between Marxist revolution and liberal political correctness exist, even if they don't constitute a conspiracy. Here's an excerpt from 2083 on Marxism, feminism, and Maslow:
The bomber Anders Bering Breivik is the son of a liberal Norwegian diplomat and a nurse.
His fantastic self-styling as a latter-day Templar says to me that he was not quite in touch with reality. Perhaps not crazy, but so wrapped up in theoretical and historical concerns that he lost a sense of proportion. He wasn't stupid, though. As others have pointed out, he planned all this methodically, and he also hacked his mind and body with weightlifting, steroids, and meditation in order to maintain the motivation required to finish his plan.
He seems to have actually read scholarly works on intellectual history. His 1500-page manifesto, titled 2083: A European Declaration of Independance is available in its entirety as a PDF download from the Internet Archive.
In keeping with the main theme of this blog, I point to Breivik's comments on Abraham Maslow. Anyone who has been through an Intro to Psychology course has probably heard of Maslow's Hierarchy of Needs. The Hierarchy has been the basis of various theories of health and nursing.
In Breivik's perspective, Maslow was either a part of or a dupe of Marxist plans to overthrow western capitalism slowly, by undermining the cultural and spiritual basis of European civilization.Although this sounds a little crazy, it's actually not. As I said, Breivik seems to have read scholarly works of intellectual history, and the connections he makes between Marxist revolution and liberal political correctness exist, even if they don't constitute a conspiracy. Here's an excerpt from 2083 on Marxism, feminism, and Maslow:
In 1923, Lukacs and other Marxist intellectuals associated with the Communist Party of Germany founded the Institute of Social Research at Frankfurt University in Frankfurt, Germany. The Institute, which became known as the Frankfurt School, was modelled after the Marx-Engels Institute in Moscow...It's too bad Breivik didn't idolize the knights hospitaller rather than the knights templar. Then he might have joined the Most Sovereign Order of Malta and become a health care professional rather than a muderer.
The Frankfurt School’s studies combined Marxist analysis with Freudian psychoanalysis to criticise the bases of Western culture...
Through her book The Feminine Mystique, Friedan tied Feminism to Abraham Maslow’s theory of self-actualisation. Maslow was a social psychologist who in his early years did research on female dominance and sexuality. Maslow was a friend of Herbert Marcuse at Brandeis University and had met Erich Fromm in 1936. He was strongly impressed by Fromm’s Frankfurt School ideology. He wrote an article, “The Authoritarian Character Structure,” published in 1944, that reflected the personality theory of Critical Theory. Maslow was also impressed with the work of Wilhelm Reich, who was another Frankfurt School originator of personality theory.
The significance of the historical roots of Political Correctness cannot be fully appreciated unless Betty Friedan’s revolution in sex roles is viewed for what it really was – a manifestation of the social revolutionary process begun by Karl Marx. Friedan’s reliance on Abraham Maslow’s reflection of Frankfurt School ideology is only one indicator... The belief that matriarchy was the solution to patriarchy flows from Marx’s comments in The German Ideology, published in 1845...
Murdoch family anti-Paleo?
Rupert Murdoch is much in the news. Listening to RadioDerb today, I learned of the attempted pie-ssassination of Murdoch and his defense by wife Wendi Deng, now known as "Tiger wife." Here's an excerpt from Derb:
However, if we look her up on Wikipedia, we discover that Mrs. Murdoch is vegan.
For some people, this probably poses an ideological conundrum of the variety
At an opportune moment Mr Marbles stepped forward with his pie and started swinging it in the direction of Repurt Murdoch's kisser. Rupert's other kisser, which is to say his wife Wendi, was sitting right behind Rupert. Before Mr Marbles could connect pie with face, the enraged Wendi leapt to her feet, leaned forward over hubby, and gave the assailant an almighty smack upside the head. Quote from Mr Marbles, talking to reporters after security people had tackled him & led him away, quote: "I remember the rage in her eyes. I could see there was genuine emotion in her eyes. I wouldn't like to have a re-match with her."To me, that sounds pretty cool. I can't approve of trophy wives, but if you're going to have one, that's the kind to have. Wendi is no wilting flower, either.
However, if we look her up on Wikipedia, we discover that Mrs. Murdoch is vegan.Murdochs are vegan?!
For some people, this probably poses an ideological conundrum of the variety
Murdochs are vegan;For me, it is an altogether different sort of conundrum. Could it be that Wendi is still fit and pretty at 40 because she's a vegan? Or could it be that she has pretty much unlimited time and money to spend on healthcare? Hmmm... vegan, or unlimited access to drugs, supplements, cosmetics, trainers, and designers devoted to making her look youthful and healthy?
Vegans are good;
Ergo, Murdochs are good... arrrgh!
Dr. Jeffry Life
Previously, I posted the image of Cenegenics' Dr. Life from TIME magazine's article "Amortality" on longevity. Here is the photo from the print edition, not available online, of Dr. Life at age 72.
Of course, Dr. Life is using expensive supplements such as growth hormone and testosterone. However, it should be pointed out that he works out a lot; as bodybuilders will tell you, drugs and supplements are not an easy path to building muscle. Frankly, he compares well not only with the other 70 year old patients we get in the ICU, but with the 20yo patients we get, too. I know that having a beach body is not synonymous with health, but based on my experience so far it's a strong signal.
Of course, Dr. Life is using expensive supplements such as growth hormone and testosterone. However, it should be pointed out that he works out a lot; as bodybuilders will tell you, drugs and supplements are not an easy path to building muscle. Frankly, he compares well not only with the other 70 year old patients we get in the ICU, but with the 20yo patients we get, too. I know that having a beach body is not synonymous with health, but based on my experience so far it's a strong signal.
Health assessment textbooks: a brief review
Health assessment is the process by which health care professionals (HCPs) perform a physical exam, take a health history, and determine whether and in what way a patient is in ill health. Most people think of this simply as the physical exam. As a patient, undressing and getting poked and prodded by a doctor or nurse is the most distinctive part of a doctor's appointment or trip to the hospital. For a good HCP, the whole procedure is much more involved than poking and prodding. In order for the physical exam to be meaningful, it has to be joined by an adequate knowledge of the patient's background, lifestyle, and complaints. Thus, a textbook for teaching health assessment has to cover physical exam techniques for all the bodies' organs and physiological systems as well as common pathology (what does a cancerous mole look like compared to a non-cancerous one?) and advice on interviewing and interacting with the patient.
In school I was disappointed in my health assessment class, and although I thought our textbook was adequate, I was interested to know how else the course might have been taught and what other decisions might have been made about the content. So after school I ordered some alternate health assessment textbooks to compare with the one we had been assigned, Jarvis' Physical Examination and Health Assessment. I found Bates' Guide to Physical Examination and History Taking and Mosby's Guide to Physical Examination. Was Jarvis the best our program could have done, and did I learn anything abstractly about health assessment from comparing these books?
As a matter of fact, I think Jarvis' book was the best our program could have done. The three books--which I'll call Jarvis, Bates, and Mosby--from editions published in 2003-04--all essentially purport to serve the same purpose. The introductions say they are for beginning or first-year health students. I'm not sure who else bothers with physical examination than nurses and doctors/PAs. And I'm not really sure that medical education is framed with a single "health assessment" academic course the way a nursing program might be, although it seems to be implied by the introductions of these books. My guess is that medical schools vary in the way teaching of physical examination techniques are integrated into the curriculum. Since each of these books contains an overview of relevant anatomy for each system (cardiovascular, skin, etc), I find it hard to believe that a medical school would bother assigning any of these books after a gross anatomy course, but perhaps.
Moving on: the books are organized essentially the same way (an introduction to taking a health history with interpersonal and cultural considerations, etc, followed by sections devoted to the physical assessment of individual bodily systems), but with some characteristics that mark them distinctively. First is authorship. Bates is authored by medical doctors, while Jarvis is authored by a nurse practitioner, and Mosby authored by a mix of health professionals including doctors and nurses. The fact that Jarvis does not have a medical doctor as author clues us that its intended audience is nursing students, while the opposite is true of Bates. And these clues are supported by the second distinctive characteristics, which are the supporting or "extra" material. I refer here to the fact that Jarvis makes a point of including sections on NANDA-approved nursing diagnoses, while Bates includes information specifically related to the construction of a History & Physical document. Mosby, again, is sitting on the fence, but its inclusion of appendices giving definitions of abbreviations and word parts suggests that the intended audience has less education than a typical medical student.
One of the things I was interested in was the content of the books, and besides browsing the books, I took a closer look at the sections on cardiac and skin assessments. In general, the illustrations in Jarvis and Mosby were very similar (both are from Elsevier imprints) or the same, and superior to Bates, which used some unclear photos that looked like they might be left over from standard references of the 1960s. (Bates is now in a new edition, however, with new graphics.) In the cardiac section, I noted that while both Bates and Jarvis cover the same exam and assessment material, Bates is arranged and designed in a way that draws attention to defining distinctions in assessment (how do you rate heart murmurs?) while Jarvis' design highlights the connection between assessment findings and their meaning (a heart murmur may indicate a faulty valve). Again, the skin sections contain mostly the same material with a superiority in graphics and design in the Jarvis book.
The books were so close in content and design that I decided I needed only one. Which did I choose? I considered keeping Jarvis because it was the one I used for school. I considered keeping Bates because it was most different from Jarvis, which I had already read. In the end, I kept none of these three because I discovered that my critical care textbook contains sections on patient assessment that mostly duplicate the material in the health assessment texts.
Critical Care: A Holistic Approach by Morton and Fontaine has pretty much all I need to know about physical assessment to operate in an ICU. In fact, I think it would have been an adequate textbook for almost my entire course of study, useful in the Care of the Adult courses as well as in the health assessment course, all of which required their own textbooks at great expense to the student, who was paying down debts and paying for school out of pocket at the time.
In school I was disappointed in my health assessment class, and although I thought our textbook was adequate, I was interested to know how else the course might have been taught and what other decisions might have been made about the content. So after school I ordered some alternate health assessment textbooks to compare with the one we had been assigned, Jarvis' Physical Examination and Health Assessment. I found Bates' Guide to Physical Examination and History Taking and Mosby's Guide to Physical Examination. Was Jarvis the best our program could have done, and did I learn anything abstractly about health assessment from comparing these books?
As a matter of fact, I think Jarvis' book was the best our program could have done. The three books--which I'll call Jarvis, Bates, and Mosby--from editions published in 2003-04--all essentially purport to serve the same purpose. The introductions say they are for beginning or first-year health students. I'm not sure who else bothers with physical examination than nurses and doctors/PAs. And I'm not really sure that medical education is framed with a single "health assessment" academic course the way a nursing program might be, although it seems to be implied by the introductions of these books. My guess is that medical schools vary in the way teaching of physical examination techniques are integrated into the curriculum. Since each of these books contains an overview of relevant anatomy for each system (cardiovascular, skin, etc), I find it hard to believe that a medical school would bother assigning any of these books after a gross anatomy course, but perhaps.
Moving on: the books are organized essentially the same way (an introduction to taking a health history with interpersonal and cultural considerations, etc, followed by sections devoted to the physical assessment of individual bodily systems), but with some characteristics that mark them distinctively. First is authorship. Bates is authored by medical doctors, while Jarvis is authored by a nurse practitioner, and Mosby authored by a mix of health professionals including doctors and nurses. The fact that Jarvis does not have a medical doctor as author clues us that its intended audience is nursing students, while the opposite is true of Bates. And these clues are supported by the second distinctive characteristics, which are the supporting or "extra" material. I refer here to the fact that Jarvis makes a point of including sections on NANDA-approved nursing diagnoses, while Bates includes information specifically related to the construction of a History & Physical document. Mosby, again, is sitting on the fence, but its inclusion of appendices giving definitions of abbreviations and word parts suggests that the intended audience has less education than a typical medical student.
One of the things I was interested in was the content of the books, and besides browsing the books, I took a closer look at the sections on cardiac and skin assessments. In general, the illustrations in Jarvis and Mosby were very similar (both are from Elsevier imprints) or the same, and superior to Bates, which used some unclear photos that looked like they might be left over from standard references of the 1960s. (Bates is now in a new edition, however, with new graphics.) In the cardiac section, I noted that while both Bates and Jarvis cover the same exam and assessment material, Bates is arranged and designed in a way that draws attention to defining distinctions in assessment (how do you rate heart murmurs?) while Jarvis' design highlights the connection between assessment findings and their meaning (a heart murmur may indicate a faulty valve). Again, the skin sections contain mostly the same material with a superiority in graphics and design in the Jarvis book.
The books were so close in content and design that I decided I needed only one. Which did I choose? I considered keeping Jarvis because it was the one I used for school. I considered keeping Bates because it was most different from Jarvis, which I had already read. In the end, I kept none of these three because I discovered that my critical care textbook contains sections on patient assessment that mostly duplicate the material in the health assessment texts.
Critical Care: A Holistic Approach by Morton and Fontaine has pretty much all I need to know about physical assessment to operate in an ICU. In fact, I think it would have been an adequate textbook for almost my entire course of study, useful in the Care of the Adult courses as well as in the health assessment course, all of which required their own textbooks at great expense to the student, who was paying down debts and paying for school out of pocket at the time.
Who is Mark Cohen?
If you found this blog as a health care professional, you might not really know what I mean by "Paleo," and you almost surely have never heard of Dr. Mark Nathan Cohen. But if you found this blog as a Paleo dieter, you might already read Stephan Guyenet's Whole Health Source, and so you might recognize Mark Cohen from the sidebar.
If you're a Paleo dieter and the name Mark Cohen means nothing to you, then I urge you to take a look at the list of speakers for the upcoming Ancestral Health Symposium. The fact that Dr. Cohen is speaking opposite Loren Cordain at the beginning of day 1 should tell you something about his standing within your own health paradigm.
Today I intend to give a short introduction and upload some photos to the Interwebs. The intro will be personalized as I can't speak with authority on anthropology's academic community...
teaching on Lake Champlain
Dr. Cohen is an emeritus professor of anthropology at SUNY-Plattsburgh, now more commonly known as Plattsburgh State University (PSU).
SUNY is New York State's bloated (see map above) public university system. PSU is in the far north-east corner of NY, opposite end of NY from John Durant & Melissa McEwen (see map above) and only a short drive from Montreal. To the east is Lake Champlain and to the west is the Adirondack Park.
academic work and honors
In addition to being emeritus, Professor Cohen is also a SUNY Distinguished Teaching Professor and SUNY Distinguished Professor of Anthropology. These are two different designations the university uses to honor professors, the higher being the Distinguished Professor, a rank reserved for "faculty having achieved national or international prominence and a distinguished reputation within the individual’s chosen field through significant contributions to the research and scholarship."
Mark Cohen's international prominence and significant contributions to the scholarship have to do with paleopathology, but here is where my introduction must lapse for not knowing more about the history of paleo-anthropology. My understanding is that Cohen was the first to explore (sometime in the 1970s) the inter-disciplinary work of comparing the essentially medical expertise of forensic pathology with the archaeological expertise brought to bear by anthropologists. It is from Cohen's pioneering work in paleopathology that we know about the relatively healthy nature of paleolithic lifestyles and about the changes in health brought about by the introduction of agriculture.
Typical of Cohen's work is the article I wrote about a few days ago, although he is better known for the several books he's written such as Health and the Rise of Civilization (1989) (Google book), which Stephan recommends in his sidebar, but also notably The Food Crisis in Prehistory: Overpopulation and the Origins of Agriculture (1971). He was also a contributor to and editor of Biosocial Mechanisms of Population Regulation (1980), Paleopathology at the Origins of Agriculture (1984), and Ancient Health (2007).
boyhood's missed opportunity
And here is where my introduction gets embarassing, because as a very fat young boy, I grew up in Plattsburgh and my dad worked in the university with Professor Cohen. I was one of those soft, round-faced lads that sucked down cold cereal, pasta, and bagels and toast, while carefully counting each gram of fat in the belief that wheat was man's "natural" staple food and that if I avoided those grams of fat, the fat could not get added onto my belly.
Why did I believe this? I don't know. I had heard of Mark Cohen, but throughout my youth, I knew nothing about his actual academic work. How close I was in geographical proximity to being the first Paleo dieter in existence. And instead I thought Shredded Wheat was the secret to health.
It wasn't until my post-college years that I had even heard of Atkins. Ironically the thing that made me most interested in the Atkins Diet was the discussion of Egyptian pathology found in the back of the Eades' Protein Power. And the Paleo angle I didn't get until the NY Times ran the piece on Durant and McEwen that I linked to above. Now after all these years, I am finally coming around to understanding what Mark Cohen's academic work was all those years ago when he actually would have been available as a resource to me.
a personal anecdote
I knew of Mark Cohen because his name was bandied about in the circles of PSU's academic families, but I've only laid eyes on him one time. It's a slightly humorous anecdote.
Cohen's reputation was as a genius with something of an ego attached to his duly deserved academic accomplishments. In the late 1980s and early 1990s, I used to hear stories of the students treating him sycophantically and of his classes being over-enrolled. As the son of a professor myself, I couldn't quite imagine students doting on a teacher.
Around 1999 or so, I was in the library at PSU attending a presentation of a SUNY Distinguished Teaching Award when I noted a gaggle of hippie-ish but nonetheless attractive young women who were crowded around an old white-haired man. They were treating him like a rock star, and the group was in its own world, not paying attention at all to the presentation. In truth, I was a little annoyed that, as the youngest and by all accounts best-looking man in the room, I wasn't getting at least a little attention from these apparently randy co-eds. I leaned over to the man sitting next to me and asked, pointing, "who is that man over there?"
"That's Mark Cohen."
Aha. That's Mark Cohen!
Plattsburgh Magazine profile
After Cohen retired, he was profiled in Plattsburgh Magazine, PSU's alumni magazine. I have scanned and uploaded the article for your reading pleasure as a PDF in Scribd. Hopefully, no one will make a fuss over the copyrights as I don't think these were available anywhere else.
On the web, Cohen's PSU faculty page can be found here, while his personal academic page can be found here, although it appears not to be in use anymore.
tracking him down today
I went to the anthropology offices at PSU a few weeks ago to see if there was a way I could contact Professor Cohen. He maintains a mailbox in Redcay Hall that is labeled in thick bold marker "PAPERS ONLY. NO MAIL PLEASE." No mail. Now there's a reason to be interested in the Paleolithic!
updated 8/11 with photo
If you're a Paleo dieter and the name Mark Cohen means nothing to you, then I urge you to take a look at the list of speakers for the upcoming Ancestral Health Symposium. The fact that Dr. Cohen is speaking opposite Loren Cordain at the beginning of day 1 should tell you something about his standing within your own health paradigm.
Today I intend to give a short introduction and upload some photos to the Interwebs. The intro will be personalized as I can't speak with authority on anthropology's academic community...
teaching on Lake Champlain
Dr. Cohen is an emeritus professor of anthropology at SUNY-Plattsburgh, now more commonly known as Plattsburgh State University (PSU).
SUNY is New York State's bloated (see map above) public university system. PSU is in the far north-east corner of NY, opposite end of NY from John Durant & Melissa McEwen (see map above) and only a short drive from Montreal. To the east is Lake Champlain and to the west is the Adirondack Park.
academic work and honors
In addition to being emeritus, Professor Cohen is also a SUNY Distinguished Teaching Professor and SUNY Distinguished Professor of Anthropology. These are two different designations the university uses to honor professors, the higher being the Distinguished Professor, a rank reserved for "faculty having achieved national or international prominence and a distinguished reputation within the individual’s chosen field through significant contributions to the research and scholarship."
Mark Cohen's international prominence and significant contributions to the scholarship have to do with paleopathology, but here is where my introduction must lapse for not knowing more about the history of paleo-anthropology. My understanding is that Cohen was the first to explore (sometime in the 1970s) the inter-disciplinary work of comparing the essentially medical expertise of forensic pathology with the archaeological expertise brought to bear by anthropologists. It is from Cohen's pioneering work in paleopathology that we know about the relatively healthy nature of paleolithic lifestyles and about the changes in health brought about by the introduction of agriculture.
Typical of Cohen's work is the article I wrote about a few days ago, although he is better known for the several books he's written such as Health and the Rise of Civilization (1989) (Google book), which Stephan recommends in his sidebar, but also notably The Food Crisis in Prehistory: Overpopulation and the Origins of Agriculture (1971). He was also a contributor to and editor of Biosocial Mechanisms of Population Regulation (1980), Paleopathology at the Origins of Agriculture (1984), and Ancient Health (2007).
boyhood's missed opportunity
And here is where my introduction gets embarassing, because as a very fat young boy, I grew up in Plattsburgh and my dad worked in the university with Professor Cohen. I was one of those soft, round-faced lads that sucked down cold cereal, pasta, and bagels and toast, while carefully counting each gram of fat in the belief that wheat was man's "natural" staple food and that if I avoided those grams of fat, the fat could not get added onto my belly.
Why did I believe this? I don't know. I had heard of Mark Cohen, but throughout my youth, I knew nothing about his actual academic work. How close I was in geographical proximity to being the first Paleo dieter in existence. And instead I thought Shredded Wheat was the secret to health.
It wasn't until my post-college years that I had even heard of Atkins. Ironically the thing that made me most interested in the Atkins Diet was the discussion of Egyptian pathology found in the back of the Eades' Protein Power. And the Paleo angle I didn't get until the NY Times ran the piece on Durant and McEwen that I linked to above. Now after all these years, I am finally coming around to understanding what Mark Cohen's academic work was all those years ago when he actually would have been available as a resource to me.
a personal anecdote
I knew of Mark Cohen because his name was bandied about in the circles of PSU's academic families, but I've only laid eyes on him one time. It's a slightly humorous anecdote.
Cohen's reputation was as a genius with something of an ego attached to his duly deserved academic accomplishments. In the late 1980s and early 1990s, I used to hear stories of the students treating him sycophantically and of his classes being over-enrolled. As the son of a professor myself, I couldn't quite imagine students doting on a teacher.
Around 1999 or so, I was in the library at PSU attending a presentation of a SUNY Distinguished Teaching Award when I noted a gaggle of hippie-ish but nonetheless attractive young women who were crowded around an old white-haired man. They were treating him like a rock star, and the group was in its own world, not paying attention at all to the presentation. In truth, I was a little annoyed that, as the youngest and by all accounts best-looking man in the room, I wasn't getting at least a little attention from these apparently randy co-eds. I leaned over to the man sitting next to me and asked, pointing, "who is that man over there?"
"That's Mark Cohen."
Aha. That's Mark Cohen!
Plattsburgh Magazine profile
After Cohen retired, he was profiled in Plattsburgh Magazine, PSU's alumni magazine. I have scanned and uploaded the article for your reading pleasure as a PDF in Scribd. Hopefully, no one will make a fuss over the copyrights as I don't think these were available anywhere else.
On the web, Cohen's PSU faculty page can be found here, while his personal academic page can be found here, although it appears not to be in use anymore.
tracking him down today
I went to the anthropology offices at PSU a few weeks ago to see if there was a way I could contact Professor Cohen. He maintains a mailbox in Redcay Hall that is labeled in thick bold marker "PAPERS ONLY. NO MAIL PLEASE." No mail. Now there's a reason to be interested in the Paleolithic!
updated 8/11 with photo
St. Camillus de Lellis, part deux
As I mentioned on July 14, the 18th is the American memorial day for Camillus de Lellis, the Roman Catholic patron saint of nurses, hospitals, and the sick. Are there patrons of health care workers among other denominations or tutelary dieties? I don't know.
Here are an image and a link that are not easily found through Google searches:
The Saint Benedict center has a long biography of Camillus. There isn't much information available on the epidemic in Rome of 1590, although one source in Google books identifies an influenza epidemic of 1590-1591.
Here are an image and a link that are not easily found through Google searches:
The Saint Benedict center has a long biography of Camillus. There isn't much information available on the epidemic in Rome of 1590, although one source in Google books identifies an influenza epidemic of 1590-1591.
Brother Ass and the Dark Gods
...subtitled, "ancestral responses to ancestral principles in relationships"
John Durant of Hunter-Gatherer.com has recently made some comments on Game as an instantiation of evolutionary/anthropological wisdom, including a review of Athol Kay, RN's recent book Married Man Sex Life Primer. If you don't know what Game is, you might recognize it as "The Rules of the Game" or "Mystery Method" or be familiar with such web luminaries as Roissy, Roosh V, or Ferdinand Bardamu. If none of this sounds familiar, you have missed out on some serious social developments of the last decade or so. Let me fill you in: in short, Game is the attempt to define, systematize, and make reproducible the male seduction of the female in our species.
Roosh V., John Durant's secret identity?
game
Although Game purports to be based on research and development (or at least trial and error) and to apply sound scientific principles of evolution and psychology to the techniques of seduction, it is really much broader than that. Men (and women) who subscribe to Game tend to hold some implicit or explicit critiques of society that go something like this:
(1) Women are driven by evolution to choose the best mates among men based on results of male competition and dominance. (2) Animal and human research show that female choices for dominant males are on-going and not constrained by previous mating. (3) Western civilization constrained female choice with legal and social norms, such as marriage and the shunning of divorcees, that promoted male reproductive interests. (4) Feminism is the attempt to assert female reproductive interests by dismantling traditional legal and social norms and replacing them with new ones. (5) Because feminism is ascendant in today's society, men have lost control of such long-term reproductive interests as control of resources for child-rearing. (6) Therefore, men should not invest in reproductive relationships, but should instead pursue only short-term interests with low investment, such as one-night stands.
Game, therefore, is usually seen as a tool for maximizing short-term, low-investment interests for men at the expense of women. As you can imagine, this makes for some bitter men and women.
Nurse Athol Kay and Paleo celebrity John Durant represent a minority of Gamers who believe in the evolutionary principles behind women's choice and modern relationship crises but want men to use the techniques of Game to build better long-term relationships (or at least make them possible).
What have I to add?
on the wisdom of living by science alone
This last week, while Mr. Durant was, unbeknownst to me, reading Mr. Kay's book, I was, unbeknownst to them, reading The Four Loves, an extended essay by the late Cambridge professor Clive Lewis on the expressions of love identified by writers in classical and medieval times. The great value of Professor Lewis is that his work stands as a bridge to forms of thought common to humanity in past ages that have now been largely supplanted. Lewis is a master of self-questioning, self-criticism, definition, differentiation...: the qualities of honest and perceptive thought that were ideally cultivated by western educators from antiquity until the progressive German models of mass education became the world standard.
Although introspection, reflection, and philosophizing are properly relegated to a place secondary to research in psychology and psychiatry, the failure to deploy them at all does not lead to unbiased results, it simply makes us susceptible to being taken in by culture and memes, to becoming provincials of our age. For example, Mr. Durant takes women's choice as a given biological reality and wants us to ask how men can conform to this reality to build better relationships.
While at first glance this approach seems a culture-neutral one grounded in science, in fact the current state of women's reproductive choice is biological reality plus social construction. In fact, Mr. Durant asks us how men can conform to biology while also conserving all values and social assumptions proper to an early 21st century Harvard grad and NYC resident, what he himself is. The truth of this is made plain by the questions whether the men and women portrayed in Sex and the City would be subject to the same evolutionary constraints as the men and women portrayed in Lysistrata and whether the same relationship advice should be given all.
working together vs. evaluating friend's latest date
I would ask Mr. Durant on what basis we should accept his assumptions social, political, legal, ethical. My own view is that we have progressed linearly upward in our social organization about as well as we have progressed linearly upward in economies of food and nutritional science.
What I suggest is that there is a type of ideological monist fallacy in assuming that happiness must be compatible with the current state of gender relations if only men could figure out how to conform to the current regime. Perhaps it is compatible, but perhaps there are trade-offs built into the human condition such that the freedoms of no-fault divorce, deference in the court systems, sympathy of media, co-workers, friends and family, etc are not compatible with the happiness of most women with their relationships.
a Gilbert and Sullivan interlude
I am the very model of a modern Harvard graduate.
I've access to intelligents and many others hard-to-get.
I know all the great apes, and I can diagram our proper clade.
And then explain our co-eds choices 'bout who they will let get laid.
I think that we're all equal in the maths and in the sciences
(For Larry Summers did mistake that free thought privilege was his)
And should it seem that any girl's standard's hypocritical
I change my mind, for I know gender's legal and political.
For literary jargon, I've read Jacques Lacan and Derrida
To let me deconstruct great books with falderall and la-dee-da.
You see, in gender matters, I am not just a novitiate,
I am the very model of a modern Harvard graduate...
the revenge of imperfect information
To illustrate what I'm talking about, let me draw your attention to a review of Mr. Kay's book on Amazon. Reviewer PrincessSB complains that using techniques designed to trigger a woman's sexual interest is "manipulative" and "psychological warfare." But it takes only a moment's thought to realize that, as far as a woman's subservience to her own buttons goes, it makes no difference whether the techniques are conscious or not--i.e., a woman who falls for a man being unconsciously himself has fallen as much as a woman who falls for a man acting. There is no reason for sore feelings here, and crying foul is not an outcry over justice as much as one over the vagaries of human romance, fate, biology.
A woman's privacy and freedom of choice have not been tampered with by Game, only her ability to separate genetic wheat from chaff. PrincessSB says, in effect, that a man makes "psychological warfare" on a woman if he intentionally improves his ability to attract women vis-a-vis his "naturally developed" ability. This is a misandric and anti-romantic position as it suggests that men are worth little more than DNA on a stick and that any attempts at doting or seducing are irrelevant to a woman's interest. What could induce such strongly misanthropic views of life?
Any economist will tell you that the basis of markets and games is imperfect information. In a world where buyers had near-perfect information, the value of a product could be determined far ahead of time by a large computer isolated in an office. In reality, decisions are made as bets and based on probabilities. The meat-market of your local bar or of your marriage involves such decision-making about reproduction.
Women would like to have better information about a man's genetic assets, to increase their probability of making good choices, while Game creates static. PrincessSB's complaint is, in fact, that even with all the advancements women have made in getting control of their relationship circumstances, there are still biological and existential boundaries to their power.
mapping imperfect info, by Gershon
In fact, it could be that women have mistakenly gained power in ways that highlight these existential boundaries and that actually exacerbate the problematic feelings women have in entering into relationships. It is uncommon in life to find pure unalloyed and lasting happiness in anything; much more common to have mixed feelings and periods of waxing and waning. Perhaps our current social organization has primed women for the ebbs of feeling. Mr. Durant, would you be a misogynist in collaborating with such a system?
married man sex life
I ordered Mr. Kay's book from Amazon, and I won't write too much about it as it seems to be mostly a summary of his blog content. His basic message is that people are beholden to their biological drives and that men, in order to keep their wives happy, must (A) improve themselves by developing real characteristics of dominance and (B) learn techniques for piquing a woman's sexual interest.
As Mr. Durant notes, the science of semen competition is pretty wishy-washy. I would go further and suggest that the entire science of relationships as presented is wanting. For example, genetic similarity of the cellular Major Histocompatibility Complex (MHC) has been shown to increase female adulterous behavior by 60%. Since there is always some minority of people who do not cheat out of concerns having nothing to do with the desire to cheat, the number is probably misleading in under-predicting the impact of MHC compatibility on women's desire. For another example, take research that shows that the chemical reactions that occur during physical contact between people who are "in love" change after several years in a relationship. In essence, all people fall out of love or have their love change qualitatively into a more stable pattern akin to friendship. What findings like these suggest to me is that the biology of adultery is more complex than dopamine and dominance.
Also problematic is the fact that Mr. Kay's recommendations, while supported by some evidence, are essentially the results of his own experience. And he and his wife were virgins when they married--a very abnormal circumstance for today's man to find himself in.
Nevertheless, the book is not without value. I'm sure there are married men or men contemplating marriage who fall into some strategic errors that this book could help fix. It's just that I cannot accept the premises of Misters Kay and Durant that men should accede to the current age. They would plead sexual realpolitik, but there are other ways of weighting the outcomes, like moving out of New York City and the NE states, looking for love among the religious, or insisting on a ban on MSM, modern music and film, etc as a condition of marriage.
ye olde loves
Professor Lewis' The Four Loves addresses affection, friendship, Eros, and charity, which he presents as the four categories of interpersonal disposition that might be called love. Surprisingly, adherents of Game may find more in this book about antique and medieval philosophy than they would expect. Lewis is fully in communion with the idea that men and women have some fundamental psychological differences. And in his description of the origin of friendship as the banding together of primitive men for mutual advantage, Gamers will find a precursor to the evolutionary psychology that guides Game subculture. But it is really Lewis' discussion of Eros that will be of concern to us here.
What a modern Harvard graduate will tell you about Professor Lewis is that his method of investigating the loves, of starting with an inherited intellectual tradition and contemplating that tradition in light of one's own experience and observations, is likely to make one narrow, dogmatic, and culturally constrained. In fact, the discussion of Eros shows Professor Lewis to be worldly and cosmopolitan. Lewis lived with an older woman for quite some time and signed some of his early letters with a Latin pseudonym meaning, essentially, "The Spanker." His mythopoeic vision of religion allowed him to embrace pagan insights and perspectives on gender relations as well as ones from monotheistic religions and modern psychology.
Lewis is quite clear in distinguishing Eros from Venus, or love from sexual activity. He even asserts that Eros is no prerequisite for good Venus, and that Eros may even interfere with pure sensual pleasure. He has a rather lengthy discussion of the fact that Eros does not make for stable marriages and that the introduction of other forms of love such as affection is necessary for successful marriage as well as a dedication to sexual continence per se, rather than dedication to the beloved. Here is no starry-eyed romantic "Beta".
So how does the Four Loves relate to Misters Kay and Durant?
paleo perspectives on Game
One of Lewis' points is that modern life has become imbalanced, with sexuality concerning us far too much. He considers several approaches of the early church fathers to the body and sexual urges before he takes up Saint Francis of Assisi's perspective that his body is "Brother Ass," a fellow traveler in this life that--like a mule--is both useful and problematic, controlled with carrots and sticks, and with which one must deal with a certain amount of humor and nonchalance. What this means for modern man is not entirely clear, except that Lewis would tell us that the end of Eros is a very human and worldly occurrence that should not be treated as an existential crisis. My guess is that Lewis would even say that an adulterous affair was something not desirable but that does need to be taken in stride (as well as less likely to occur in a world where more women thought of their bodies as "Sister Ass," rather than being beholden to, in Game terms, "vag tingle").
This view is very similar to the one put forward by Julius Evola (no Christian, to be sure) in Ride the Tiger, that modern sexual mores are an essentially bourgeois phenomenon, and that for traditional (i.e., normal) people breaking a marriage vow should be a shame on an adulteress and not on a cuckolded husband. Here, again, is a more mature and balanced view of sexuality, one that sees life as something more than fulfilling evolutionary impulses while not denying the reality of evolution or its impact on our lives.
Kay and Durant would likely still argue for gender realpolitik. My Paleo perspective is that, if we seriously consider Evola, Lewis, and our early ancestors, can we as men say that we honestly want to pursue a relationship with a product of modern times, with a woman who reads women's magazines, watches TV, listens to Lady Gaga and is obsessed with facets of modern life like Facebook? If we, as our ancestors, try to live a good life, defined as balance and as fulfillment of obligations and as other values inimical to modern times, can we really fall in love with such a woman?
Another of Lewis' leitmotifs in The Four Loves is the Dark Gods. This is Lewis' way of acknowledging that we are still great apes and subject to the purely physical and compulsive forces of nature, that we can lose ourselves in beliefs and actions that cannot be reconciled to civilization or to the company of people who have not themselves embraced the Dark Gods. The pagans called this Bacchanalian while Camille Paglia calls it chthonic forces. Our great ape cousins like chimps and bonobos engage in forced sex, bisexuality, gang bangs and other practices that people have repressed for centuries but that have now broken out into civilization again under the protective guise of pornography.
For most people, the Dark Gods are unacknowledged or remain lurking in the psychic background of fantasy and dream. But more and more, they confuse us and act as a de facto measure of sexual fulfillment. My model here is Bobbi Starr, a burgeoning professional oboeist who was re-directed into a life as a pornographic actress. Her Amazon wish list includes books by the likes of Foucault on sexuality and society. But examine her recent comments on the sex she had with porn star Rocco Siffredi*. This educated woman is not able to tell us anything about the emotional or psychologic impact of her experience, despite having her head stuffed in a toilet.
Compare this with Toni Bentley's Surrender, a book-length investigation of the normal (vis-a-vis the range found in porn) sexual act of anal intercourse. My point here is that Starr, comparatively, lacks self-knowledge. She cannot tell us about her sex with Rocco Siffredi because she can't really put it into words--she acts without entirely knowing why, a devotee of the Dark Gods.
My Paleo take on the Dark Gods is that our ancestors understood them better than we do. Rather than denying the reality of their power or pathologizing them, our ancestors sought to control their destructive influences on our communal life through taboos and through the confinement of their expression to rites and festivities. By exiling the Dark Gods, they changed the way we as individuals measure sexual fulfillment within the contraints of communal life.
The Dark Gods are not the Gods of Game. The evolutionary forces that produced modern sexual psychology might encompass the Dark Gods but they are primarily the product of compulsions that can exist parasitic on communal life without killing it.
The Dark Gods act as an alternative to utilizing Game in two ways: (1) they might represent an actual alternative lifestyle; (2) like "Spanker" Lewis, we can consider them Dark Gods and consider them taboo rather than simply embarassing or an expression of civil rights. To do this internally and also publicly in spite of the anonymity afforded by digital culture and our sprauling cities is the road back to the consideration of sexual fulfillment on grounds other than compulsion and personal expression.
Barring the adoption of these ancestral perspectives, I think men have two choices--utilize Game a la Roissy for short-term, non-reproductive relationships or live a life of low-level anxiety constantly watching over your shoulder to see if you are falling prey to more dominant males. This latter strategy is the one suggested, however unintentionally, by Kay and Durant.
* From the BobbiStarr.com blog:
"One of the members of BobbiStarr.com asked about what it was like to be 'sensually' abused by a legend.
"Since I’m all about my fans, I’m more than happy to share my first hand experience of being fucked by Rocco Siffredi...
"I found myself alone with Rocco, and I told him that I wanted to fuck him. I really didn’t care if he shot it [on film] or not, I just wanted some quality time with Porno Jesus — and that is what I got. The memory of the scene was a blur (he did shoot it) and there may or may not have been another woman involved in the scene and there may or may not have been a miniature Statue of Liberty involved. Like I said, it was all a blur.
"It was hard, rough sex that landed my head in a toilet. At the very least having my head dunked in a toilet is something I’d want to know about beforehand, but he was Rocco and I looked at it as kind of a baptism...
"And that, dear reader, is the scene with a legend that I will always remember. When I’m 90 and Skynet and the Terminators have taken over and I’m telling my little grandchildren/resistance fighters what I did in my 20s, that is the story I will tell."
John Durant of Hunter-Gatherer.com has recently made some comments on Game as an instantiation of evolutionary/anthropological wisdom, including a review of Athol Kay, RN's recent book Married Man Sex Life Primer. If you don't know what Game is, you might recognize it as "The Rules of the Game" or "Mystery Method" or be familiar with such web luminaries as Roissy, Roosh V, or Ferdinand Bardamu. If none of this sounds familiar, you have missed out on some serious social developments of the last decade or so. Let me fill you in: in short, Game is the attempt to define, systematize, and make reproducible the male seduction of the female in our species.
Roosh V., John Durant's secret identity?game
Although Game purports to be based on research and development (or at least trial and error) and to apply sound scientific principles of evolution and psychology to the techniques of seduction, it is really much broader than that. Men (and women) who subscribe to Game tend to hold some implicit or explicit critiques of society that go something like this:
(1) Women are driven by evolution to choose the best mates among men based on results of male competition and dominance. (2) Animal and human research show that female choices for dominant males are on-going and not constrained by previous mating. (3) Western civilization constrained female choice with legal and social norms, such as marriage and the shunning of divorcees, that promoted male reproductive interests. (4) Feminism is the attempt to assert female reproductive interests by dismantling traditional legal and social norms and replacing them with new ones. (5) Because feminism is ascendant in today's society, men have lost control of such long-term reproductive interests as control of resources for child-rearing. (6) Therefore, men should not invest in reproductive relationships, but should instead pursue only short-term interests with low investment, such as one-night stands.
Game, therefore, is usually seen as a tool for maximizing short-term, low-investment interests for men at the expense of women. As you can imagine, this makes for some bitter men and women.
Nurse Athol Kay and Paleo celebrity John Durant represent a minority of Gamers who believe in the evolutionary principles behind women's choice and modern relationship crises but want men to use the techniques of Game to build better long-term relationships (or at least make them possible).
What have I to add?
on the wisdom of living by science alone
This last week, while Mr. Durant was, unbeknownst to me, reading Mr. Kay's book, I was, unbeknownst to them, reading The Four Loves, an extended essay by the late Cambridge professor Clive Lewis on the expressions of love identified by writers in classical and medieval times. The great value of Professor Lewis is that his work stands as a bridge to forms of thought common to humanity in past ages that have now been largely supplanted. Lewis is a master of self-questioning, self-criticism, definition, differentiation...: the qualities of honest and perceptive thought that were ideally cultivated by western educators from antiquity until the progressive German models of mass education became the world standard.
Although introspection, reflection, and philosophizing are properly relegated to a place secondary to research in psychology and psychiatry, the failure to deploy them at all does not lead to unbiased results, it simply makes us susceptible to being taken in by culture and memes, to becoming provincials of our age. For example, Mr. Durant takes women's choice as a given biological reality and wants us to ask how men can conform to this reality to build better relationships.
While at first glance this approach seems a culture-neutral one grounded in science, in fact the current state of women's reproductive choice is biological reality plus social construction. In fact, Mr. Durant asks us how men can conform to biology while also conserving all values and social assumptions proper to an early 21st century Harvard grad and NYC resident, what he himself is. The truth of this is made plain by the questions whether the men and women portrayed in Sex and the City would be subject to the same evolutionary constraints as the men and women portrayed in Lysistrata and whether the same relationship advice should be given all.
working together vs. evaluating friend's latest dateI would ask Mr. Durant on what basis we should accept his assumptions social, political, legal, ethical. My own view is that we have progressed linearly upward in our social organization about as well as we have progressed linearly upward in economies of food and nutritional science.
What I suggest is that there is a type of ideological monist fallacy in assuming that happiness must be compatible with the current state of gender relations if only men could figure out how to conform to the current regime. Perhaps it is compatible, but perhaps there are trade-offs built into the human condition such that the freedoms of no-fault divorce, deference in the court systems, sympathy of media, co-workers, friends and family, etc are not compatible with the happiness of most women with their relationships.
a Gilbert and Sullivan interlude
I am the very model of a modern Harvard graduate.
I've access to intelligents and many others hard-to-get.
I know all the great apes, and I can diagram our proper clade.
And then explain our co-eds choices 'bout who they will let get laid.
I think that we're all equal in the maths and in the sciences
(For Larry Summers did mistake that free thought privilege was his)
And should it seem that any girl's standard's hypocritical
I change my mind, for I know gender's legal and political.
For literary jargon, I've read Jacques Lacan and DerridaTo let me deconstruct great books with falderall and la-dee-da.
You see, in gender matters, I am not just a novitiate,
I am the very model of a modern Harvard graduate...
the revenge of imperfect information
To illustrate what I'm talking about, let me draw your attention to a review of Mr. Kay's book on Amazon. Reviewer PrincessSB complains that using techniques designed to trigger a woman's sexual interest is "manipulative" and "psychological warfare." But it takes only a moment's thought to realize that, as far as a woman's subservience to her own buttons goes, it makes no difference whether the techniques are conscious or not--i.e., a woman who falls for a man being unconsciously himself has fallen as much as a woman who falls for a man acting. There is no reason for sore feelings here, and crying foul is not an outcry over justice as much as one over the vagaries of human romance, fate, biology.
A woman's privacy and freedom of choice have not been tampered with by Game, only her ability to separate genetic wheat from chaff. PrincessSB says, in effect, that a man makes "psychological warfare" on a woman if he intentionally improves his ability to attract women vis-a-vis his "naturally developed" ability. This is a misandric and anti-romantic position as it suggests that men are worth little more than DNA on a stick and that any attempts at doting or seducing are irrelevant to a woman's interest. What could induce such strongly misanthropic views of life?
Any economist will tell you that the basis of markets and games is imperfect information. In a world where buyers had near-perfect information, the value of a product could be determined far ahead of time by a large computer isolated in an office. In reality, decisions are made as bets and based on probabilities. The meat-market of your local bar or of your marriage involves such decision-making about reproduction.
Women would like to have better information about a man's genetic assets, to increase their probability of making good choices, while Game creates static. PrincessSB's complaint is, in fact, that even with all the advancements women have made in getting control of their relationship circumstances, there are still biological and existential boundaries to their power.
mapping imperfect info, by GershonIn fact, it could be that women have mistakenly gained power in ways that highlight these existential boundaries and that actually exacerbate the problematic feelings women have in entering into relationships. It is uncommon in life to find pure unalloyed and lasting happiness in anything; much more common to have mixed feelings and periods of waxing and waning. Perhaps our current social organization has primed women for the ebbs of feeling. Mr. Durant, would you be a misogynist in collaborating with such a system?
married man sex life
I ordered Mr. Kay's book from Amazon, and I won't write too much about it as it seems to be mostly a summary of his blog content. His basic message is that people are beholden to their biological drives and that men, in order to keep their wives happy, must (A) improve themselves by developing real characteristics of dominance and (B) learn techniques for piquing a woman's sexual interest.
As Mr. Durant notes, the science of semen competition is pretty wishy-washy. I would go further and suggest that the entire science of relationships as presented is wanting. For example, genetic similarity of the cellular Major Histocompatibility Complex (MHC) has been shown to increase female adulterous behavior by 60%. Since there is always some minority of people who do not cheat out of concerns having nothing to do with the desire to cheat, the number is probably misleading in under-predicting the impact of MHC compatibility on women's desire. For another example, take research that shows that the chemical reactions that occur during physical contact between people who are "in love" change after several years in a relationship. In essence, all people fall out of love or have their love change qualitatively into a more stable pattern akin to friendship. What findings like these suggest to me is that the biology of adultery is more complex than dopamine and dominance.Also problematic is the fact that Mr. Kay's recommendations, while supported by some evidence, are essentially the results of his own experience. And he and his wife were virgins when they married--a very abnormal circumstance for today's man to find himself in.
Nevertheless, the book is not without value. I'm sure there are married men or men contemplating marriage who fall into some strategic errors that this book could help fix. It's just that I cannot accept the premises of Misters Kay and Durant that men should accede to the current age. They would plead sexual realpolitik, but there are other ways of weighting the outcomes, like moving out of New York City and the NE states, looking for love among the religious, or insisting on a ban on MSM, modern music and film, etc as a condition of marriage.
ye olde loves
Professor Lewis' The Four Loves addresses affection, friendship, Eros, and charity, which he presents as the four categories of interpersonal disposition that might be called love. Surprisingly, adherents of Game may find more in this book about antique and medieval philosophy than they would expect. Lewis is fully in communion with the idea that men and women have some fundamental psychological differences. And in his description of the origin of friendship as the banding together of primitive men for mutual advantage, Gamers will find a precursor to the evolutionary psychology that guides Game subculture. But it is really Lewis' discussion of Eros that will be of concern to us here.
What a modern Harvard graduate will tell you about Professor Lewis is that his method of investigating the loves, of starting with an inherited intellectual tradition and contemplating that tradition in light of one's own experience and observations, is likely to make one narrow, dogmatic, and culturally constrained. In fact, the discussion of Eros shows Professor Lewis to be worldly and cosmopolitan. Lewis lived with an older woman for quite some time and signed some of his early letters with a Latin pseudonym meaning, essentially, "The Spanker." His mythopoeic vision of religion allowed him to embrace pagan insights and perspectives on gender relations as well as ones from monotheistic religions and modern psychology.
Lewis is quite clear in distinguishing Eros from Venus, or love from sexual activity. He even asserts that Eros is no prerequisite for good Venus, and that Eros may even interfere with pure sensual pleasure. He has a rather lengthy discussion of the fact that Eros does not make for stable marriages and that the introduction of other forms of love such as affection is necessary for successful marriage as well as a dedication to sexual continence per se, rather than dedication to the beloved. Here is no starry-eyed romantic "Beta".
So how does the Four Loves relate to Misters Kay and Durant?
paleo perspectives on Game
One of Lewis' points is that modern life has become imbalanced, with sexuality concerning us far too much. He considers several approaches of the early church fathers to the body and sexual urges before he takes up Saint Francis of Assisi's perspective that his body is "Brother Ass," a fellow traveler in this life that--like a mule--is both useful and problematic, controlled with carrots and sticks, and with which one must deal with a certain amount of humor and nonchalance. What this means for modern man is not entirely clear, except that Lewis would tell us that the end of Eros is a very human and worldly occurrence that should not be treated as an existential crisis. My guess is that Lewis would even say that an adulterous affair was something not desirable but that does need to be taken in stride (as well as less likely to occur in a world where more women thought of their bodies as "Sister Ass," rather than being beholden to, in Game terms, "vag tingle").
This view is very similar to the one put forward by Julius Evola (no Christian, to be sure) in Ride the Tiger, that modern sexual mores are an essentially bourgeois phenomenon, and that for traditional (i.e., normal) people breaking a marriage vow should be a shame on an adulteress and not on a cuckolded husband. Here, again, is a more mature and balanced view of sexuality, one that sees life as something more than fulfilling evolutionary impulses while not denying the reality of evolution or its impact on our lives.
Kay and Durant would likely still argue for gender realpolitik. My Paleo perspective is that, if we seriously consider Evola, Lewis, and our early ancestors, can we as men say that we honestly want to pursue a relationship with a product of modern times, with a woman who reads women's magazines, watches TV, listens to Lady Gaga and is obsessed with facets of modern life like Facebook? If we, as our ancestors, try to live a good life, defined as balance and as fulfillment of obligations and as other values inimical to modern times, can we really fall in love with such a woman?
Another of Lewis' leitmotifs in The Four Loves is the Dark Gods. This is Lewis' way of acknowledging that we are still great apes and subject to the purely physical and compulsive forces of nature, that we can lose ourselves in beliefs and actions that cannot be reconciled to civilization or to the company of people who have not themselves embraced the Dark Gods. The pagans called this Bacchanalian while Camille Paglia calls it chthonic forces. Our great ape cousins like chimps and bonobos engage in forced sex, bisexuality, gang bangs and other practices that people have repressed for centuries but that have now broken out into civilization again under the protective guise of pornography.
For most people, the Dark Gods are unacknowledged or remain lurking in the psychic background of fantasy and dream. But more and more, they confuse us and act as a de facto measure of sexual fulfillment. My model here is Bobbi Starr, a burgeoning professional oboeist who was re-directed into a life as a pornographic actress. Her Amazon wish list includes books by the likes of Foucault on sexuality and society. But examine her recent comments on the sex she had with porn star Rocco Siffredi*. This educated woman is not able to tell us anything about the emotional or psychologic impact of her experience, despite having her head stuffed in a toilet.
Compare this with Toni Bentley's Surrender, a book-length investigation of the normal (vis-a-vis the range found in porn) sexual act of anal intercourse. My point here is that Starr, comparatively, lacks self-knowledge. She cannot tell us about her sex with Rocco Siffredi because she can't really put it into words--she acts without entirely knowing why, a devotee of the Dark Gods.
My Paleo take on the Dark Gods is that our ancestors understood them better than we do. Rather than denying the reality of their power or pathologizing them, our ancestors sought to control their destructive influences on our communal life through taboos and through the confinement of their expression to rites and festivities. By exiling the Dark Gods, they changed the way we as individuals measure sexual fulfillment within the contraints of communal life.
The Dark Gods are not the Gods of Game. The evolutionary forces that produced modern sexual psychology might encompass the Dark Gods but they are primarily the product of compulsions that can exist parasitic on communal life without killing it.
The Dark Gods act as an alternative to utilizing Game in two ways: (1) they might represent an actual alternative lifestyle; (2) like "Spanker" Lewis, we can consider them Dark Gods and consider them taboo rather than simply embarassing or an expression of civil rights. To do this internally and also publicly in spite of the anonymity afforded by digital culture and our sprauling cities is the road back to the consideration of sexual fulfillment on grounds other than compulsion and personal expression.
Barring the adoption of these ancestral perspectives, I think men have two choices--utilize Game a la Roissy for short-term, non-reproductive relationships or live a life of low-level anxiety constantly watching over your shoulder to see if you are falling prey to more dominant males. This latter strategy is the one suggested, however unintentionally, by Kay and Durant.
* From the BobbiStarr.com blog:
"One of the members of BobbiStarr.com asked about what it was like to be 'sensually' abused by a legend.
"Since I’m all about my fans, I’m more than happy to share my first hand experience of being fucked by Rocco Siffredi...
"I found myself alone with Rocco, and I told him that I wanted to fuck him. I really didn’t care if he shot it [on film] or not, I just wanted some quality time with Porno Jesus — and that is what I got. The memory of the scene was a blur (he did shoot it) and there may or may not have been another woman involved in the scene and there may or may not have been a miniature Statue of Liberty involved. Like I said, it was all a blur.
"It was hard, rough sex that landed my head in a toilet. At the very least having my head dunked in a toilet is something I’d want to know about beforehand, but he was Rocco and I looked at it as kind of a baptism...
"And that, dear reader, is the scene with a legend that I will always remember. When I’m 90 and Skynet and the Terminators have taken over and I’m telling my little grandchildren/resistance fighters what I did in my 20s, that is the story I will tell."
TNR: fewer cures, more free lunches
Hunter-Gatherer points to an article in The New Republic by Daniel Callahan that advises an extensive multi-year study of the US health system in order to make a complete overhaul. In principal, I agree with Hunter-Gatherer's intuition that large comprehensive studies tend to be bad ways to conduct medicine and medical policy. However, there are other problems with the article, too.
(1) High health care costs are not necessarily a problem of old age. This is true in two ways.
First, in a general sense, chronic diseases of aging are probably less a problem of aging than a problem of accumulated modern life. The prevalence and cost of cardiac and cardiovascular diseases, and probably cancer as well, would be reduced by healthier lifestyles without withdrawing medical care. When I say prevalence and cost, I mean that not only would there be less of, for example, coronary artery disease, but recovery from procedures would be faster and management of the disease more efficient.
Second, in a specific sense, people in the 80yo+ category are generally our healthier citizens. When I worked on a PCU, it was easy to note fat patients and elderly patients, but no fat elderly patients were there recovering from cardiac catheterizations. To quantify this point, take kidney dialysis--an expensive medical cost that Callahan points out is predicted to increase by 150% soon. As the prevalence numbers from the US Renal Data System (here) indicate, diabetes and hypertension--essentially lifestyle diseases of modernity--alone count for about 3/5 to 2/3 of cases of End Stage Renal Disease, and the numbers for age of patient really kick in during the 50s and start dropping off for elderly people. What this tells us is that your average dialysis patient is not an oldster trying to hang on to a few more weeks of paltry life, but a middle-aged person who has been basically inactive, eats poorly, probably smokes.
(2) Non-coercive public health is maxed out. Callahan wants us to cut costs by spending more on "public health" and "primary care." But the numbers are in and public health is ineffective. Yes, it does a good job with cholera, but with chronic diseases, no. More public school breakfast programs and education campaigns are not going to cure problems caused by Captain Crunch and the couch. Public health officials know this, which is why they are eager to resort to coercive and semi-coercive methods. So, note: shifting attention to public health means giving un-elected officials the power to levy partially invisible and non-transparent taxes, fines, etc.
(3) You can't start preventing things in old age. Callahan wants us to increase preventive care for the elderly rather than spending a lot of money extending their last months of life after they get sick. Other than ensuring people get pneumonia and flu vaccines and get some excercise and nutritious food, what preventive care are you going to perform in the elderly? Does he have a magic bullet to prevent GI bleeding (one of the main reasons elderly people are admitted to our ICU)? No, I don't think so.
(4) Primary care is over-rated. Everyone wishes your dermatologist was a general practitioner, as if there were a connection between your zits and your higher insurance bill due to your neighbor's colon cancer that could have been solved more cheaply by more primary care office visits. This flies in the face of the "costly last few months of life" analysis of our health care system. While treating a cancer earlier might be more cost effective, it will be there whether it is caught early or late. If you are determined, as Callahan is, that cures for the elderly should be phased out, the cost-effectiveness of early treatment is a nullity. See this July's JAMA for a study showing that areas with more primary care physicians have higher costs for a very, very small reduction in mortality.
(5) Health care is over-rated. Callahan wants to see a series of neighborhood clinics with GPs, paramedics, and nurses instead of having people go to the hospital. This is stupid because the high cost of going to the ER is not due to intrinsic costs to the hospital. Take an EKG for your chest pain: your ER bill might be over $500 for an EKG, which involves hooking up a computer with electrodes. The disposable parts are 12 small stickers and a couple pieces of paper. The EKG is generally administered by unlicensed personnel making close to minimum wage and takes about 10 minutes. The paper is examined by a nurse for about 15-30 seconds, and then, only if something is amiss, by a doctor for another 15-30 seconds. The cost is not due to amortization of the EKG computer (~$15,000... in a busy ER, the computer might get used 30 times every few days). It is from the way the hospital spreads around billing in order to make an overall profit when it loses money on other procedures. In short, it is an accounting problem, not a you-used-expensive-ER-resources problem. If you go to an urgi-care clinic rather than an ER for chest pain, it isn't going to solve the problem of expensive ER resources, but if you're having a heart attack, it will mean getting examined by the ER again after your urgi-care clinic uses their paramedics to transport you there and lose you precious minutes in "door-to-table" time, a measure of how fast your heart attack gets solved.
(6) Research has large potential pay-offs. When a person develops Alzheimers we lose not only the cost of caring for them, but the economic benefit they bring to the community, which might range from still being able to work at white-collar jobs to letting younger people work by baby-sitting. Finding a one-off cure for Alzheimers would be a huge financial payoff, not to mention that the emotional eleviation would probably be worth even a large cost without financial benefit. The principle of vaccination was discovered in the 1790s, but the polio vaccine wasn't discovered until the 1950s. Alzheimers Disease wasn't even defined until 1910, and its cause was still a mystery. Giving up significant amounts of research into diseases like Alzheimers because we haven't found a cure in the last couple decades seems to me very ignorant, like a school-child saying they can never complete their homework because its too hard, and very stupid, like choosing to spend rather than invest.
Here are some alternative suggestions for health care savings:
(A) Throw out the idea of equality in treatment. Callahan wants us to start recognizing inequality between elderly and young, but he hasn't given up the idea equality altogether. Let's go several steps further. Let's figure out what the cost of certain behaviors and characteristics is so we can give patients a "health cost burden score." Are you obese and a smoker when you know perfectly well that you have a family history of heart disease and early cardiac death? Maybe your insurance company should deny you a heart catheterization. Do you come from a family of people who regularly live into their 90s? Maybe you should be treated for a condition in your 80s that a person from a family of people who live into their 70s should not be treated for in his 80s?
(B) Expanded use of mid-level providers. Without going into it too much, I'm pretty sure medical training is overkill for what many doctors do most of the time with most patients. Much of care is now algorithmic and much can be learned by PAs and NPs (or even RNs)--even minor surgeries. Mid-level providers get paid less and can be graduated faster than MDs.
(C) Increase research funding and allow researchers and companies more leeway legally and ethically to pursue cures and bring them to market.
(D) Allow people more access and control over their own care: if I can get my own BP cuff and order my own labs, I don't need to pay a doctor's office to be a middle-man for those things.
(E) Let food prices rise. For most of human history, people have expended most of their resources on obtaining food. Why should things be so different for us? Maybe if the cost of food rose significantly, more people would start "victory gardens" and decrease their consumption.
I don't pretend this is a comprehensive plan, but these are some alternatives to Callahan's plan. It strikes me that Callahan is quite old now. His message is essentially, "well, my generation tried to live forever and failed, so everybody should stop trying now and shift money into social welfare programs to take care of us." Guess what, Mr. Callahan--I have a good thirty or more years left before I have to start worrying about Alzheimers seriously, and I'll be damned if I'm going to let you defund my chances of staving off that horror. Up yours!
(1) High health care costs are not necessarily a problem of old age. This is true in two ways.
First, in a general sense, chronic diseases of aging are probably less a problem of aging than a problem of accumulated modern life. The prevalence and cost of cardiac and cardiovascular diseases, and probably cancer as well, would be reduced by healthier lifestyles without withdrawing medical care. When I say prevalence and cost, I mean that not only would there be less of, for example, coronary artery disease, but recovery from procedures would be faster and management of the disease more efficient.
Second, in a specific sense, people in the 80yo+ category are generally our healthier citizens. When I worked on a PCU, it was easy to note fat patients and elderly patients, but no fat elderly patients were there recovering from cardiac catheterizations. To quantify this point, take kidney dialysis--an expensive medical cost that Callahan points out is predicted to increase by 150% soon. As the prevalence numbers from the US Renal Data System (here) indicate, diabetes and hypertension--essentially lifestyle diseases of modernity--alone count for about 3/5 to 2/3 of cases of End Stage Renal Disease, and the numbers for age of patient really kick in during the 50s and start dropping off for elderly people. What this tells us is that your average dialysis patient is not an oldster trying to hang on to a few more weeks of paltry life, but a middle-aged person who has been basically inactive, eats poorly, probably smokes.
(2) Non-coercive public health is maxed out. Callahan wants us to cut costs by spending more on "public health" and "primary care." But the numbers are in and public health is ineffective. Yes, it does a good job with cholera, but with chronic diseases, no. More public school breakfast programs and education campaigns are not going to cure problems caused by Captain Crunch and the couch. Public health officials know this, which is why they are eager to resort to coercive and semi-coercive methods. So, note: shifting attention to public health means giving un-elected officials the power to levy partially invisible and non-transparent taxes, fines, etc.
(3) You can't start preventing things in old age. Callahan wants us to increase preventive care for the elderly rather than spending a lot of money extending their last months of life after they get sick. Other than ensuring people get pneumonia and flu vaccines and get some excercise and nutritious food, what preventive care are you going to perform in the elderly? Does he have a magic bullet to prevent GI bleeding (one of the main reasons elderly people are admitted to our ICU)? No, I don't think so.
(4) Primary care is over-rated. Everyone wishes your dermatologist was a general practitioner, as if there were a connection between your zits and your higher insurance bill due to your neighbor's colon cancer that could have been solved more cheaply by more primary care office visits. This flies in the face of the "costly last few months of life" analysis of our health care system. While treating a cancer earlier might be more cost effective, it will be there whether it is caught early or late. If you are determined, as Callahan is, that cures for the elderly should be phased out, the cost-effectiveness of early treatment is a nullity. See this July's JAMA for a study showing that areas with more primary care physicians have higher costs for a very, very small reduction in mortality.
(5) Health care is over-rated. Callahan wants to see a series of neighborhood clinics with GPs, paramedics, and nurses instead of having people go to the hospital. This is stupid because the high cost of going to the ER is not due to intrinsic costs to the hospital. Take an EKG for your chest pain: your ER bill might be over $500 for an EKG, which involves hooking up a computer with electrodes. The disposable parts are 12 small stickers and a couple pieces of paper. The EKG is generally administered by unlicensed personnel making close to minimum wage and takes about 10 minutes. The paper is examined by a nurse for about 15-30 seconds, and then, only if something is amiss, by a doctor for another 15-30 seconds. The cost is not due to amortization of the EKG computer (~$15,000... in a busy ER, the computer might get used 30 times every few days). It is from the way the hospital spreads around billing in order to make an overall profit when it loses money on other procedures. In short, it is an accounting problem, not a you-used-expensive-ER-resources problem. If you go to an urgi-care clinic rather than an ER for chest pain, it isn't going to solve the problem of expensive ER resources, but if you're having a heart attack, it will mean getting examined by the ER again after your urgi-care clinic uses their paramedics to transport you there and lose you precious minutes in "door-to-table" time, a measure of how fast your heart attack gets solved.
(6) Research has large potential pay-offs. When a person develops Alzheimers we lose not only the cost of caring for them, but the economic benefit they bring to the community, which might range from still being able to work at white-collar jobs to letting younger people work by baby-sitting. Finding a one-off cure for Alzheimers would be a huge financial payoff, not to mention that the emotional eleviation would probably be worth even a large cost without financial benefit. The principle of vaccination was discovered in the 1790s, but the polio vaccine wasn't discovered until the 1950s. Alzheimers Disease wasn't even defined until 1910, and its cause was still a mystery. Giving up significant amounts of research into diseases like Alzheimers because we haven't found a cure in the last couple decades seems to me very ignorant, like a school-child saying they can never complete their homework because its too hard, and very stupid, like choosing to spend rather than invest.
Here are some alternative suggestions for health care savings:
(A) Throw out the idea of equality in treatment. Callahan wants us to start recognizing inequality between elderly and young, but he hasn't given up the idea equality altogether. Let's go several steps further. Let's figure out what the cost of certain behaviors and characteristics is so we can give patients a "health cost burden score." Are you obese and a smoker when you know perfectly well that you have a family history of heart disease and early cardiac death? Maybe your insurance company should deny you a heart catheterization. Do you come from a family of people who regularly live into their 90s? Maybe you should be treated for a condition in your 80s that a person from a family of people who live into their 70s should not be treated for in his 80s?
(B) Expanded use of mid-level providers. Without going into it too much, I'm pretty sure medical training is overkill for what many doctors do most of the time with most patients. Much of care is now algorithmic and much can be learned by PAs and NPs (or even RNs)--even minor surgeries. Mid-level providers get paid less and can be graduated faster than MDs.
(C) Increase research funding and allow researchers and companies more leeway legally and ethically to pursue cures and bring them to market.
(D) Allow people more access and control over their own care: if I can get my own BP cuff and order my own labs, I don't need to pay a doctor's office to be a middle-man for those things.
(E) Let food prices rise. For most of human history, people have expended most of their resources on obtaining food. Why should things be so different for us? Maybe if the cost of food rose significantly, more people would start "victory gardens" and decrease their consumption.
I don't pretend this is a comprehensive plan, but these are some alternatives to Callahan's plan. It strikes me that Callahan is quite old now. His message is essentially, "well, my generation tried to live forever and failed, so everybody should stop trying now and shift money into social welfare programs to take care of us." Guess what, Mr. Callahan--I have a good thirty or more years left before I have to start worrying about Alzheimers seriously, and I'll be damned if I'm going to let you defund my chances of staving off that horror. Up yours!
St. Camillus de Lellis
Camillus de Lellis (1550-1614) is the Roman Catholic patron saint of nurses, hospitals, and the sick. The anniversary of his death is July 14, and this is also the day of his official memorial (everywhere except in America, where it is July 18 due to a Native American saint that takes precedence on July 14).
Camillus was a mercenary soldier who converted and began attending the sick in hospitals. His work during the epidemic of 1590 in Rome is most famous. His bio is of course at New Advent. Here are other links:
Return July 18 for an image and link to a bio that isn't readily found in a Google search!
Camillus was a mercenary soldier who converted and began attending the sick in hospitals. His work during the epidemic of 1590 in Rome is most famous. His bio is of course at New Advent. Here are other links:
Return July 18 for an image and link to a bio that isn't readily found in a Google search!
Population density as a guide to eating
A chapter by Dr. Mark Cohen in the volume Biosocial Mechanisms of Population Regulation addresses the question of the human population explosion at the beginning of the Neolithic period. Or, rather, its slower growth in the pre-Neolithic. As Cohen relates, early anthropologists chalked this up to Malthusian constraints (i.e., low caloric availability) in the Paleolithic, although current evidence (circa 1980) suggested that hunter-gatherer peoples were not in a severe caloric deficit vis-a-vis their early farming descendants.
Cohen considers and rejects that low average pre-Neolithic growth rates could be due to periods of negative growth. He also considers cultural restraints, but points out that the speed with which the Americas were colonized far exceeds average growth rates for hunter-gatherers, suggesting that in periods of super-abundance no cultural constraints apply and therefore are not likely to exist.
Cohen suggests that the growth rate of early peoples was constrained by birth spacing--how frequently women had children--and that birth spacing is affected by physiological factors such as mother's body fat composition. He cites studies of modern hunter-gatherer peoples to demonstrate that female body fat has an effect on birth spacing.
In his model, female body fat is affected by population density. Presumably, as populations became more dense, available calories diminish in a given area and births decline until some part of the population dies or moves away, at which time available calories increase and births speed up. Beyond body fat, he suggests that the ratio of calories to overall nutritional availability might also act as a signaling mechanism.
As this article is from 1980, there may be more up to date research and thinking on this topic. Without knowing what that might be however...
As Cohen points out, while the modern !Kung fit his model, other populations with marginal caloric availability do not (i.e., they do not respond to decreased availability with slower birth rates). His explanations for this deviation from his theory are two: (1) perhaps, body fat is only a "signal" to women; (2) the mechanism is short-circuited in modern times by unnatural diets. Presumably by (1) he means that there could be cultural factors that override physiological ones (although it seems to me that, if the physiological mechanism were so weak, pre-Neolithic cultural factors could have just as easily overpowered them).
His greater interest seems to be in (2). Why do third world populations, he asks, continue with high fertility rates in the absence of the protein they need to be successful at these rates? Because, he says, excessive starch in Neolithic cultures fools the body into thinking that there is a greater caloric abundance in the environment than what there really is.
If this explanation is correct, it implies that, regardless of overall caloric intake, starches are the mechanism the body uses to determine whether or not to store fats. If body fat = environmental abundance & environmental abundance is measured by starches, then body fat = starches.
For our own purposes, the model of eating this suggests for us is to pick a level of adequate protein intake, eat that consistently, and modulate starch intake based on our activity levels/BMI. It strikes me that this is what Dr. Kurt Harris found by experimenting on himself (see his posts on Rice Crispies.) Perhaps if you are very fat, then as Dr. Atkins suggests you may need a period of VLC induction if you can fix your regulatory mechanisms at all.
Cohen considers and rejects that low average pre-Neolithic growth rates could be due to periods of negative growth. He also considers cultural restraints, but points out that the speed with which the Americas were colonized far exceeds average growth rates for hunter-gatherers, suggesting that in periods of super-abundance no cultural constraints apply and therefore are not likely to exist.
Cohen suggests that the growth rate of early peoples was constrained by birth spacing--how frequently women had children--and that birth spacing is affected by physiological factors such as mother's body fat composition. He cites studies of modern hunter-gatherer peoples to demonstrate that female body fat has an effect on birth spacing.
In his model, female body fat is affected by population density. Presumably, as populations became more dense, available calories diminish in a given area and births decline until some part of the population dies or moves away, at which time available calories increase and births speed up. Beyond body fat, he suggests that the ratio of calories to overall nutritional availability might also act as a signaling mechanism.
As this article is from 1980, there may be more up to date research and thinking on this topic. Without knowing what that might be however...
As Cohen points out, while the modern !Kung fit his model, other populations with marginal caloric availability do not (i.e., they do not respond to decreased availability with slower birth rates). His explanations for this deviation from his theory are two: (1) perhaps, body fat is only a "signal" to women; (2) the mechanism is short-circuited in modern times by unnatural diets. Presumably by (1) he means that there could be cultural factors that override physiological ones (although it seems to me that, if the physiological mechanism were so weak, pre-Neolithic cultural factors could have just as easily overpowered them).
His greater interest seems to be in (2). Why do third world populations, he asks, continue with high fertility rates in the absence of the protein they need to be successful at these rates? Because, he says, excessive starch in Neolithic cultures fools the body into thinking that there is a greater caloric abundance in the environment than what there really is.
If this explanation is correct, it implies that, regardless of overall caloric intake, starches are the mechanism the body uses to determine whether or not to store fats. If body fat = environmental abundance & environmental abundance is measured by starches, then body fat = starches.
For our own purposes, the model of eating this suggests for us is to pick a level of adequate protein intake, eat that consistently, and modulate starch intake based on our activity levels/BMI. It strikes me that this is what Dr. Kurt Harris found by experimenting on himself (see his posts on Rice Crispies.) Perhaps if you are very fat, then as Dr. Atkins suggests you may need a period of VLC induction if you can fix your regulatory mechanisms at all.
- Cohen, M.N. (1980) "Speculations on the Evolution of Density Measurement and Population Regulation in Homo sapiens" in Cohen et al (Eds) Biosocial Mechanisms of Population Regulation. Yale University Press: New Haven.
Best American Medical Writing 2009
I read this book during my recent trip to Denver, finishing most of it on airplanes, in airports, and in the little coffee shop near my brother's house. I picked it up hoping it would give me an overview of "what happened in medicine" in 2009. If a series of such books existed, it would be a great boon to health care professionals. The other "Best American ... Writing" series invite guest editors to choose from a pool of articles written in the previous year and collected by the series editor. Pauline Chen is a surgeon and NYTimes bestselling author.
S: The essays in The Best American Medical Writing 2009 lacked the originality and interest associated with the "Best American ... Writing" series. The topic, for example, of contagious cancer in Tasmanian devils is one I've seen on the web and in print several times previously. The article on using virtual reality to treat PTSD doesn't delve into the hows and whys enough to do more at the end than leave the reader with a piece of trivia: "they are using virtual reality to treat PTSD." Although guest editor Chen makes the old analogy between prose and music, she reveals herself to have something of a tin ear, choosing articles that sound like literary attempts by journalists or that simply fail. An article from Glamour magazine written in the first-person is so riddled with "I"s that the pages look like streams of binary code. Judged on its writing, the best article in the book is by Alok Khorana, an Indian immigrant whose contribution reads like a model of English essay composition compared with the other articles, including just the right amount of self-revelation, humor, reflection, etc, written at just the write length, and with actual literary prose. (Having been educated in India, I suspect he received a much better and more traditional training in English composition than the American writers.)
O: Of 23 articles, there are 3 articles about gender, 2 articles about the environment, and 1 each about race, class, sexual orientation, immigration, health insurance, and the war in Iraq. There is also an article touting electronic medical records and central planning in health care, which are progressive issues within the health care community. There are two articles on AIDS (although these duplicate the ones on race and sexuality). Of the remaining articles, 2 deal with mental health, 2 deal with mis-diagnoses, 2 with the patient experience, 2 with care-giving/nursing, 2 with medical research, and the last focuses on the problem of drug addiction among doctors. Other than actual professional journals, the articles have been chosen from the New York Times (3), the New Yorker (2), New York Magazine (2), the New York Review of Books, the American Prospect (2), Harper's, Glamour, the New Republic, Tufts Magazine, Philadelphia Magazine, the Cleveland Plain Dealer, and Newsweek (2).
A: The articles in this book comprise a tour of progressivist topics and concerns, as well as progressivist thinking in medicine. They have been chosen to fit quotas and not on the basis of their merit as writing about the practice of medicine. The articles have been chosen to "educate the public," not only the reading public but also the writing and editing public, about what and how to think about health care in the US rather than being chosen to shed light on medical practice. Although not all without merit, as a collection the essays fail. They don't actually educate the public so much as re-inforce establishment opinion. An Amazon reviewer who said that the articles were challenging to the medical establishment was incorrect as the two that show a dark side to medicine portray irresponsible and self-destructive doctors who are dealt with fairly by the legal system as victims.
P: Although there are some worthy articles, I cannot recommend this book to readers. As of the writing of this review, no subsequent volumes in this series have been produced. What more can I add?
S: The essays in The Best American Medical Writing 2009 lacked the originality and interest associated with the "Best American ... Writing" series. The topic, for example, of contagious cancer in Tasmanian devils is one I've seen on the web and in print several times previously. The article on using virtual reality to treat PTSD doesn't delve into the hows and whys enough to do more at the end than leave the reader with a piece of trivia: "they are using virtual reality to treat PTSD." Although guest editor Chen makes the old analogy between prose and music, she reveals herself to have something of a tin ear, choosing articles that sound like literary attempts by journalists or that simply fail. An article from Glamour magazine written in the first-person is so riddled with "I"s that the pages look like streams of binary code. Judged on its writing, the best article in the book is by Alok Khorana, an Indian immigrant whose contribution reads like a model of English essay composition compared with the other articles, including just the right amount of self-revelation, humor, reflection, etc, written at just the write length, and with actual literary prose. (Having been educated in India, I suspect he received a much better and more traditional training in English composition than the American writers.)
O: Of 23 articles, there are 3 articles about gender, 2 articles about the environment, and 1 each about race, class, sexual orientation, immigration, health insurance, and the war in Iraq. There is also an article touting electronic medical records and central planning in health care, which are progressive issues within the health care community. There are two articles on AIDS (although these duplicate the ones on race and sexuality). Of the remaining articles, 2 deal with mental health, 2 deal with mis-diagnoses, 2 with the patient experience, 2 with care-giving/nursing, 2 with medical research, and the last focuses on the problem of drug addiction among doctors. Other than actual professional journals, the articles have been chosen from the New York Times (3), the New Yorker (2), New York Magazine (2), the New York Review of Books, the American Prospect (2), Harper's, Glamour, the New Republic, Tufts Magazine, Philadelphia Magazine, the Cleveland Plain Dealer, and Newsweek (2).
A: The articles in this book comprise a tour of progressivist topics and concerns, as well as progressivist thinking in medicine. They have been chosen to fit quotas and not on the basis of their merit as writing about the practice of medicine. The articles have been chosen to "educate the public," not only the reading public but also the writing and editing public, about what and how to think about health care in the US rather than being chosen to shed light on medical practice. Although not all without merit, as a collection the essays fail. They don't actually educate the public so much as re-inforce establishment opinion. An Amazon reviewer who said that the articles were challenging to the medical establishment was incorrect as the two that show a dark side to medicine portray irresponsible and self-destructive doctors who are dealt with fairly by the legal system as victims.
P: Although there are some worthy articles, I cannot recommend this book to readers. As of the writing of this review, no subsequent volumes in this series have been produced. What more can I add?
Denver... shhhhhhh... it's a secret
My gallbladder was out last Friday, and over the weekend I was convinced to go visit my brother in Denver, CO. It was a risk, being only two days out from surgery, but drugged out from PO Dilaudid, flights went smoothly despite massive abdominal distention and various pains.
Well, let me tell you, Denver is a well-kept secret. The west coast is famous for having places that people want to move to in order to live certain lifestyles. Seattle, SF Bay, LA... I had always thought of Colorado as a place for cowboys and skiers. Turns out, it is a hidden paradise. A Shangri-La of the Continental Divide.
My brother had been telling me for months about how great the weather is, and it is. The place is just dry enough and just sunny enough to be warm and have perfect humidity on most days while having just enough rainfall to keep the city green. Unlike my home near Montreal, where we had 3 straight weeks of rain or clouds earlier this summer, Denver only gets rain in spurts of a few minutes. On my last day there, a heavy rain lasting a couple hours made the city shut down. My brother's girlfriend got seriously upset. I laughed.
Of course, the Rockies are not too far away. On the 4th of July, my brother drove me to see Loveland Pass and the Arapahoe Basin ski area, where skiers were getting in their Independence Day runs. The mountains rise out of the plains in a way you don't find on the East Coast. On this merit, Boulder, CO, is even more beautiful than Denver, but Boulder feels exactly like Burlington, VT--i.e., a college town full of college students who can afford to be hippies because someone else is paying their bills. I have always hated Burlington because it is full of possibilities that are low in quality but high in the style necessary for social signaling. Boulder feels the same way, but Denver is too mainstream and diverse to pigeonhole this way.
The city itself is handsome. Apparently it burned down at one point and was rebuilt in brick and stone. There are a lot of what seem to me beautiful old stone and brick homes, even in my brother's neighborhood, which is Denver's "ghetto." Having lived in Washington, DC, and Philadelphia at various times, I can tell you that Denver does not have a proper ghetto. My brother's neighborhood is a mix of houses of southwestern design, brick boxes, and old well-cared-for homes like the one in the photo below.
Among large shade trees, there is a community coffee shop a couple blocks from my brother's house that serves on an outdoor patio espresso at 7AM and wine at 7PM. Awesome. If you walk your dog there at 6:30AM, you will meet 4-5 slim young women walking their own dogs. If the community coffee isn't good enough for you, you can drink at Pablo's, the center of Denver's small but thriving hipster population--an easy bike ride away from my brother's house (as is any other location in Denver). Pablo's is the second-finest coffee I have had, taking a back seat to Cafe Myriade in Montreal.
If hipsters are not your thing, you may be interested in the REI headquarters or one of Denver's many professional sports teams. My brother says that several apartment complexes next to the baseball stadium are prized housing by baseball fans. You have to be a real fan to choose to live next to the stadium, but it would cut down on getting stuck in traffic, a problem at game time that makes it difficult to eat at the many Mexican restaurants in the downtown area. (BTW, Casa Bonita is a real place, and I only barely managed to avoid going there as all Denver locals who were asked said the food is terrible.)
And if you're not into fried tacos with modelo or margharitas, you may care to dine at Le Central, my brother's favorite restaurant. They specialize in mussels but had also flown in lobsters from Maine when we were there. It was my first experience of St. Germaine--mixed with soda water, champagne, and a twist of lemon it was delicious. The only thing that detracted from Le Central (other than their crappy website) is their bread. But this is a chronic problem in Denver. At 5000+ft., you cannot bake there. Want a New York style pizza? Forget it.
But I forgive Denver its baking deficiency, for it offers at least three homemade ice cream shops--each with distinct styles of ice cream, and all worth eating. Plus, I don't eat bread.
Is there a deficiency to the place? Depending on your views, you may disturbed by the many outlets for purchasing medical marijuana. But the real problem is a lack of lake. If you come from New York, Minnesota, or another state with many waterways, you will be highly disturbed at being unable to swim at a beach during the 90-100 degree temps. But, again, it is a dry heat.
On the last night, I went with my brother and his roommate, "Bildstein", to The Walnut Room, a fine restaurant-bar-venue where I could drink Knob Creek on the rocks before leaving for DIA to board my JetBlue flight.
In this time of Tour de France, let me leave you with a video of my brother riding at Boulder's velodrome, a 30 minute drive from Denver and only $5/hr.
Well, let me tell you, Denver is a well-kept secret. The west coast is famous for having places that people want to move to in order to live certain lifestyles. Seattle, SF Bay, LA... I had always thought of Colorado as a place for cowboys and skiers. Turns out, it is a hidden paradise. A Shangri-La of the Continental Divide.
My brother had been telling me for months about how great the weather is, and it is. The place is just dry enough and just sunny enough to be warm and have perfect humidity on most days while having just enough rainfall to keep the city green. Unlike my home near Montreal, where we had 3 straight weeks of rain or clouds earlier this summer, Denver only gets rain in spurts of a few minutes. On my last day there, a heavy rain lasting a couple hours made the city shut down. My brother's girlfriend got seriously upset. I laughed.
Of course, the Rockies are not too far away. On the 4th of July, my brother drove me to see Loveland Pass and the Arapahoe Basin ski area, where skiers were getting in their Independence Day runs. The mountains rise out of the plains in a way you don't find on the East Coast. On this merit, Boulder, CO, is even more beautiful than Denver, but Boulder feels exactly like Burlington, VT--i.e., a college town full of college students who can afford to be hippies because someone else is paying their bills. I have always hated Burlington because it is full of possibilities that are low in quality but high in the style necessary for social signaling. Boulder feels the same way, but Denver is too mainstream and diverse to pigeonhole this way.
The city itself is handsome. Apparently it burned down at one point and was rebuilt in brick and stone. There are a lot of what seem to me beautiful old stone and brick homes, even in my brother's neighborhood, which is Denver's "ghetto." Having lived in Washington, DC, and Philadelphia at various times, I can tell you that Denver does not have a proper ghetto. My brother's neighborhood is a mix of houses of southwestern design, brick boxes, and old well-cared-for homes like the one in the photo below.
Among large shade trees, there is a community coffee shop a couple blocks from my brother's house that serves on an outdoor patio espresso at 7AM and wine at 7PM. Awesome. If you walk your dog there at 6:30AM, you will meet 4-5 slim young women walking their own dogs. If the community coffee isn't good enough for you, you can drink at Pablo's, the center of Denver's small but thriving hipster population--an easy bike ride away from my brother's house (as is any other location in Denver). Pablo's is the second-finest coffee I have had, taking a back seat to Cafe Myriade in Montreal.
If hipsters are not your thing, you may be interested in the REI headquarters or one of Denver's many professional sports teams. My brother says that several apartment complexes next to the baseball stadium are prized housing by baseball fans. You have to be a real fan to choose to live next to the stadium, but it would cut down on getting stuck in traffic, a problem at game time that makes it difficult to eat at the many Mexican restaurants in the downtown area. (BTW, Casa Bonita is a real place, and I only barely managed to avoid going there as all Denver locals who were asked said the food is terrible.)
And if you're not into fried tacos with modelo or margharitas, you may care to dine at Le Central, my brother's favorite restaurant. They specialize in mussels but had also flown in lobsters from Maine when we were there. It was my first experience of St. Germaine--mixed with soda water, champagne, and a twist of lemon it was delicious. The only thing that detracted from Le Central (other than their crappy website) is their bread. But this is a chronic problem in Denver. At 5000+ft., you cannot bake there. Want a New York style pizza? Forget it.
But I forgive Denver its baking deficiency, for it offers at least three homemade ice cream shops--each with distinct styles of ice cream, and all worth eating. Plus, I don't eat bread.
Is there a deficiency to the place? Depending on your views, you may disturbed by the many outlets for purchasing medical marijuana. But the real problem is a lack of lake. If you come from New York, Minnesota, or another state with many waterways, you will be highly disturbed at being unable to swim at a beach during the 90-100 degree temps. But, again, it is a dry heat.
On the last night, I went with my brother and his roommate, "Bildstein", to The Walnut Room, a fine restaurant-bar-venue where I could drink Knob Creek on the rocks before leaving for DIA to board my JetBlue flight.
In this time of Tour de France, let me leave you with a video of my brother riding at Boulder's velodrome, a 30 minute drive from Denver and only $5/hr.
My gallbladder came out
My gallbladder came out a week ago. You probably think it's my fatty diet. I'd like to dispel that notion.
Last September, I got up to go to work and had a tummy ache. As I showered and rode my bike down to the hospital, it got progressively worse until I was doubled over and feeling short of breath. I went to the ER, worried I was having a heart attack, but 2mg of morphine and an ultrasound later I learned I had passed a gallstone. All was well after a day's rest.
A few months later, I had two hamburgers and went to bed. Waking up in the middle of the night, I recognized the pain this time and went straight to the ER for morphine. But this time, 6mg of morphine, 3mg of dilaudid, an ultrasound, and a CT scan later, I didn't have an answer. Luckily, I refused to be sent home (the ER physician wanted to send me home with percocet when 3mg of IV dilaudid was just letting me sit still!!). A hospitalist was consulted, and a HIDA scan ordered. No passage into the gallbladder.
Having now seen several routine surgeries go wrong, with patients ending up in the ICU, I elected to have the laparoscopic cholecystectomy done at another hospital: my co-workers were already joking about charging admission to my room. Having the gallbladder out was not something I wanted to do, but the increased risks of pancreatic complications swayed me.
what the gallbladder does
People who have even a passing notion of human physiology understand that the gallbladder is a storage unit for bile, which the liver excretes to help digest fats. The gallbladder contracts when fats enter the digestive tract, excreting bile into the small intestine.
Bile is composed of salts of cholesterol, which, as everyone knows, is also a substance that the body absorbs. So there is actually a cholesterol utilization loop in the body: the liver excretes cholesterol into the small intestine in the form of bile; when bile has done its work, the cholesterol is re-absorbed and sent back to the liver to be turned into bile again.
Occasionally, the bile in the gallbladder will solidify into gallstones, which can get stuck in various ducts and keep the bile from entering the small intestine. In this case, it is often advisable to have the gallbladder removed.
If the gallbladder is removed, bile enters the small intestine directly from the liver. Rather than being stored in the gallbladder, the bile gets sequestered by an intestinal sphincter.
gallstones and diet
Since bile helps digest fats, it would seem intuitive that eating more fat would lead to increased bile production, increased bile storage in the gallbladder, and that, subsequently, you would have an increased risk of gallstones from eating a high-fat diet. And if you've had gallstones previously, you've probably had a doctor tell you not to eat high-fat meals. But the reality is more complex and less intuitive.
If you've had a doctor tell you not to eat high-fat meals, it is not because the doctor thinks you will avoid developing a gallstone by eating low-fat. If your doctor actually told you this, either he is an idiot or he is simply lying to you so that he doesn't have to try to explain any more physiology than he already has.
In reality, gallstone formation is a complex process. Much more complex than simple more bile=more gallstones. There is more than one type of gallstone, and the medical community is not entirely sure why some people get them and some don't.
Your doctor is telling you not to eat high fat meals because the gallbladder contracts in response to fat entering the digestive tract. Your doctor's idea is that if you eat low-fat, you may avoid having the gallbladder push a gallstone into a duct. This is like a duck-taped, fix-up response to gallstones, but it isn't actually a solution and doesn't mean low-fat diets=gallbladder health for the general population.
The way to establish that high fat diets increase gallstone problems is through epidemiology, and according to the surgical textbooks available in Elsevier's MDConsult database, the relationship isn't established. Although I haven't looked at actual research papers, my guess is that there isn't any evidence of a connection, but that some people would like there to be and keep looking for one. In one paper abstract from PubMed, vegetarianism had no effect on gallstone formation, while alcohol consumption decreased risk: 20802339
In fact, what there is evidence of is increased risk of gallstones from weight loss and use of statin medications. So stick that in your pipe and smoke it. (Actually, don't.)
that's all I got
I had originally wanted to make this a research-based post, but I find I have not nearly as much time these days as I had. As I was thinking about this post, I thought of a great series of research-based posts, debunking the evils of dietary fat on an organ-by-organ basis. Maybe if I lose my job someday I'll do that.
I didn't die from the laparoscopic cholecystectomy. About 40% of patients have to convert to an open surgery, but I had begged to please, please not do that. Apparently, my gallbladder was very scarred and entangled and probably the surgeon would have normally converted, but instead he spent a long time working on me and finished without opening me up.
In the course of the surgery, they had to put me in reverse-trendelenburg position (head above heels), which means a lot more of the CO2 they put into your abdomen went into my upper body than would normally happen. So I had about 3-4 days of intermittent excruciating pain in my Right shoulder and still have some ongoing RUQ pain. But other than that, things seem to have gone smoothly.
Last September, I got up to go to work and had a tummy ache. As I showered and rode my bike down to the hospital, it got progressively worse until I was doubled over and feeling short of breath. I went to the ER, worried I was having a heart attack, but 2mg of morphine and an ultrasound later I learned I had passed a gallstone. All was well after a day's rest.
A few months later, I had two hamburgers and went to bed. Waking up in the middle of the night, I recognized the pain this time and went straight to the ER for morphine. But this time, 6mg of morphine, 3mg of dilaudid, an ultrasound, and a CT scan later, I didn't have an answer. Luckily, I refused to be sent home (the ER physician wanted to send me home with percocet when 3mg of IV dilaudid was just letting me sit still!!). A hospitalist was consulted, and a HIDA scan ordered. No passage into the gallbladder.
Having now seen several routine surgeries go wrong, with patients ending up in the ICU, I elected to have the laparoscopic cholecystectomy done at another hospital: my co-workers were already joking about charging admission to my room. Having the gallbladder out was not something I wanted to do, but the increased risks of pancreatic complications swayed me.
what the gallbladder does
People who have even a passing notion of human physiology understand that the gallbladder is a storage unit for bile, which the liver excretes to help digest fats. The gallbladder contracts when fats enter the digestive tract, excreting bile into the small intestine.
Bile is composed of salts of cholesterol, which, as everyone knows, is also a substance that the body absorbs. So there is actually a cholesterol utilization loop in the body: the liver excretes cholesterol into the small intestine in the form of bile; when bile has done its work, the cholesterol is re-absorbed and sent back to the liver to be turned into bile again.
Occasionally, the bile in the gallbladder will solidify into gallstones, which can get stuck in various ducts and keep the bile from entering the small intestine. In this case, it is often advisable to have the gallbladder removed.
If the gallbladder is removed, bile enters the small intestine directly from the liver. Rather than being stored in the gallbladder, the bile gets sequestered by an intestinal sphincter.
gallstones and diet
Since bile helps digest fats, it would seem intuitive that eating more fat would lead to increased bile production, increased bile storage in the gallbladder, and that, subsequently, you would have an increased risk of gallstones from eating a high-fat diet. And if you've had gallstones previously, you've probably had a doctor tell you not to eat high-fat meals. But the reality is more complex and less intuitive.
If you've had a doctor tell you not to eat high-fat meals, it is not because the doctor thinks you will avoid developing a gallstone by eating low-fat. If your doctor actually told you this, either he is an idiot or he is simply lying to you so that he doesn't have to try to explain any more physiology than he already has.
In reality, gallstone formation is a complex process. Much more complex than simple more bile=more gallstones. There is more than one type of gallstone, and the medical community is not entirely sure why some people get them and some don't.
Your doctor is telling you not to eat high fat meals because the gallbladder contracts in response to fat entering the digestive tract. Your doctor's idea is that if you eat low-fat, you may avoid having the gallbladder push a gallstone into a duct. This is like a duck-taped, fix-up response to gallstones, but it isn't actually a solution and doesn't mean low-fat diets=gallbladder health for the general population.
The way to establish that high fat diets increase gallstone problems is through epidemiology, and according to the surgical textbooks available in Elsevier's MDConsult database, the relationship isn't established. Although I haven't looked at actual research papers, my guess is that there isn't any evidence of a connection, but that some people would like there to be and keep looking for one. In one paper abstract from PubMed, vegetarianism had no effect on gallstone formation, while alcohol consumption decreased risk: 20802339
In fact, what there is evidence of is increased risk of gallstones from weight loss and use of statin medications. So stick that in your pipe and smoke it. (Actually, don't.)
that's all I got
I had originally wanted to make this a research-based post, but I find I have not nearly as much time these days as I had. As I was thinking about this post, I thought of a great series of research-based posts, debunking the evils of dietary fat on an organ-by-organ basis. Maybe if I lose my job someday I'll do that.
I didn't die from the laparoscopic cholecystectomy. About 40% of patients have to convert to an open surgery, but I had begged to please, please not do that. Apparently, my gallbladder was very scarred and entangled and probably the surgeon would have normally converted, but instead he spent a long time working on me and finished without opening me up.
In the course of the surgery, they had to put me in reverse-trendelenburg position (head above heels), which means a lot more of the CO2 they put into your abdomen went into my upper body than would normally happen. So I had about 3-4 days of intermittent excruciating pain in my Right shoulder and still have some ongoing RUQ pain. But other than that, things seem to have gone smoothly.
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