Monday, January 12, 2015

Peace - The Occasional State Between Conflicts

With every wish for a Happy New Year comes the additional wish for peace.  I'm not sure what most of the world regards as a "state of peace," but if its a world with no major conflicts, peace has not existed for any significant period of time since the beginnings of written history.  If it is a state of the world where most of it is at peace, and only a small part of it is at war - then we are at peace now - after all millions are not dying, only a few thousand here and there.

The history of our world is one of conflicts - wars, threats of war, skirmishes, battles, policies of mutual destruction and standoffs (Cold Wars), riots, terrorism, mass murder, genocide........and more.  Eras of real peace exist only for short periods between these non-peaceful events, which, in fact, provide most of the milestones by which history is studied.

All of civilization's major religions include "peace on earth" as an important, if not the most important tenet (well, maybe not all religions).  All philosophies, whether agnostic, atheistic, or theistic have peace as a central theme.   Despite all the preachings of love peace, etc., etc., etc. - it doesn't happen - it doesn't work. If God does exist, then his answer to requests for peace has always been a resounding "No!" All of history's preaching and philosophizing  has not had the intended effect.

Of course there is the age-old argument (specious, of course) that without prayer, etc. conditions would even be worse.  That's like saying the Holocaust could have been worse - we should consider ourselves lucky - after all it could have resulted in the loss of 12 million instead of 6 million Jewish lives.

Our species is not a peaceful one - never has been and, it seems, never will be.  We are battlers, we are constantly at war with one another, whether with weapons or with words.  I believe it is part of the human DNA.  We will continue to pray for peace, and some among us may actually find inner peace - but world peace - it is not who we are.

Remember - the enemy feels strongly that God is on his side. He feels he is in the right!  It is we who are the devils.  It is we who are wrong.

As this is being written, rallies for peace are taking place in Paris in reaction to the recent atrocities committed by radical Muslim terrorists.  How well I remember similar rallies after 9/11.  Think of all the peace rallies that have taken place - and then evaluate their long-term effectiveness.

Peace may come, not with a change in our behavior and attitudes as we know them, not with some awaited messiah, but perhaps with some future engineered alterations in our biological structure, alterations in our chemical and molecular makeup, alterations in our DNA!  This is not happening soon.  Peace is not around the corner.  Peace is not at hand.  There will be no peace in our time.

But yearning for peace will continue.  Yearning for the impossible, or the highly improbable, is what we do. When will we "beat our swords into plowshares and our spears into pruning hooks?" When will we see Utopia?

Yearn if you wish, but expect nothing.  Peace will continue to occur intermittently.   Peace is a manicured lawn left unattended.  The grass will grow wildly and the weeds of war, constantly lurking underground, await sprouting once again.  The lawn requires constant mowing and the weeds constant uprooting - and the cycle continues.

Monday, December 22, 2014

"All Lives Matter"

The ongoing controversies regarding the Ferguson and Staten Island issues of white-on-black police brutality have reached new heights (or maybe the proper word would be "depths).  A current article describes a recent incident at Smith College concerning a campus-wide e-mail circulated by Smith's president, Kathleen McCartney.

Dr. McCartney's e-mail announced her concern, and the concern of the Smith community about not "losing faith in the quest for racial equality, and how you fear for people of color."  It went on to speak about how violence of this nature serves as a reminder of the existence of racial injustice.  The president ended her note with the following:

"We are united in our insistence that all lives matter."

Apparently some Smithies interpreted this phrase as racist.  They argued that it "minimizes the anti-blackness of this current situation."  It was felt that McCartney, in using this phrase, was not sensitive to the problems that specifically befall African-Americans.

McCartney apologized for "drawing attention away from the focus on institutional violence against Black people......" and went on to commit herself to "learning from the lived experiences of people of color....."

We really have a problem when a statement proclaiming the equal value of all human life is considered insensitive and biased - and results in an apology.

Thursday, December 11, 2014

The Usefulness of Medical Data in Managing Disease

Dr. Sandeep Jauhar (Op-Ed NY Times, Dec 11) questions the use of standard accepted medical guidelines in the management of patients.  He is correct in pointing out that there have been such treatment guidelines published by a myriad of medical specialty organizations, outlining what current evidence indicates is the best method of evaluating and treating various conditions.  These organizations have committees of recognized experts in their respective fields who review all available published data that may pertain to a particular disorder/procedure.  Their conclusions are then published in the medical literature - not only as guidelines, but with "guidelines" as to how to evaluate the recommended guidelines.

The "guidelines" to evaluate the guidelines look at the statistical validity of the populations studied:  (A)were multiple populations studied,  (B)were there limited populations studied, or (C)were there only very limited populations studied.  Based on the data analyzed, the experts then classify procedures/treatments according to apparent benefits v. possible risks.  Class I indicates that the data clearly indicates that the procedure/treatment is very beneficial and is highly recommended.  Class II concludes that benefits are not conclusive, may indeed be worthwhile, but suggest additional studies.  Class III is comprised of treatments/procedures that have not been shown to be helpful or may actually be harmful.

Evaluating these criteria, and then following the suggested treatment/procedure outline is what is called evidence-based medicine.  This is the way to manage patients - this is the way to manage disease.  When a treatment/procedure is found to work in a significant majority of people (evidence-based), physicians should use it!  Denying the validity of such recommendations, is to deny the validity of using properly collected statistical data.  On what else can conclusions and recommendations be based?

Dr. Jauhar argues that such "homogenized health care" is not always the best treatment.  Of course not.  There are always times when any one individual will react negatively to a recommended course of therapy, or where it might be contraindicated for one reason or another.  He concludes that personalizing care is better.  Of course it is.  But until individual genomic analysis allows medicine to personalize care (and it is moving in that direction), so called "homogenization" is not to be denigrated.

Remember - what works well for the significant majority of a population will, in the vast majority of instances, work well for you too!  Though you are an individual and have your own personal genetic makeup, your genetic similarities to others is vastly greater than any differences - and you are  far more apt to have the same benefit/risk result to a recommended guideline as your neighbor.

Monday, December 1, 2014

Government and Ebola

Physicians may not always be unbiased when it comes to issues such as the Affordable Care Act and similar subjects that govern how they work and how their incomes may be affected. The non-medical community may certainly and rightly differ with their points of view.   But when it comes to evaluating the facts regarding science-based health issues, physicians whose medical and scientific expertise is well recognized should be listened to, and their recommendations generally followed.

A recent editorial in the highly regarded New England Journal of Medicine (Nov 20) discusses the matter of Ebola virus and quarantine.  It points out how the 21-day quarantine on health care workers returning to the United States from West Africa is "unfair and unwise, and will impede essential efforts to stop these awful outbreaks....."  Government should listen to the presentation of the facts and not "drive a carpet tack with a sledgehammer."

1.  Ebola is transmitted via contact with bodily fluids.
2.  Viral transmission occurs only when the viral load is very high, which is why asymptomatic individuals are not considered contagious.
3.  Fever precedes the contagious stage.
4.  The blood test for Ebola only becomes positive 2-3 days after the onset of fever or symptoms, supporting absence of contagion prior to that time.

It is important to remember that only those individuals caring for Thomas Duncan (the American who died in a Texas hospital from Ebola) at the time of hospitalization, when he had a very high viral load, became infected, while his family members, exposed during the very early start of his illness, were unaffected.

Government officials who ignore the facts and follow their "instincts" in order to achieve what they believe to be "the greater good" for their constituents, must provide the public with some evidence to support these unscientific and unsubstantiated programs which, in fact, are more harmful than helpful.

Monday, November 17, 2014

Is Israel a Democracy?

The meaning of democracy is equality before the law.
How can Israel say that everyone is equal before the law – that you’re equal before the law – when the law defines Judaism as the cultural, national and legislative basis for the state?

These are the words of Yair Lapid, Israeli Finance Minister, as reported in a recent issue of The Jerusalem Post.

Israel isn't going to be a democratic what?

These are the words of American Jewish philanthropist Sheldon Adelson.

I believe they are both saying similar things, though the tenor of the two quotes differs dramatically.  Adelson is rather blunt.  Lapid is more diplomatic.

Can Israel truly be regarded as a democracy?

Israel may be a democracy, but perhaps a "democracy" with certain provisos.  David Kretzmer, a law scholar at Hebrew University has pointed out the peculiarly Israeli dichotomy between nationhood and citizenship.  In Israel these are not interchangeable terms.   You can be an Israeli citizen, but, if not Jewish, you are not a member of the "nation-state of the Jewish people," which, after all, is how Israel defines itself.

Can you imagine a non-Jewish Prime Minister or President?  Could such an official deal with the religious laws and religious officials of the state?

Yes, one man, one vote - but a clearly defined difference among its citizens - some included in the nation-state, some not.

Wednesday, October 29, 2014

"Klinghoffer Re-visited"

The Metropolitan Opera has posted the libretto of "Death of Klinghoffer" on it web site.  Here is a piece sung by one of the terrorists.  Do you really believe that these words are not anti-Semitic (though, admittedly, they are the ravings of an outraged, angry and hateful terrorist)?  If similar disparaging words had been used to denigrate blacks or Muslims - do you think an opera including such words would have been written, no less performed?

You are always complaining Of your suffering
But wherever poor men Are gathered they can

Find Jews getting fat.
You know how to cheat
The simple, exploit
the virgin, pollute
Where you have exploited, Defame those you cheated, And break your own law With idolatry.
Is one big Jew.
What did you say?
You are old and ugly.
Not for one day
Will your children miss you. I hear a belly growl;
The voice of your soul.
Go on then, kneel,
Beg me, beg me to permit You something to eat
And a chance for a piss.
I see you cross
Your swollen legs.
Nobody begs?
That was your last chance. Just this once
You can befoul yourselves. You are all wolves,
Wolves without teeth.
You should think of death, But you meditate
On dirty meat,
And your own unclean flesh. Are you English?
Your Balfour Declaration Led to the partition
And the dissolution
Of the Palestinian nation.

Where English is spoken You will find perversion And all kinds of filth Not practised by stealth Late at night,
But on the street
During the day.
You wink at sodomy. You laugh at blasphemy. You give no charity

To the oppressed.
What did your watch cost?
Is it solid gold?
How many mouths could be filled If this were sold.
Your wrists are thick
But I can make
Bigger ones crack.
There. You may have it back. 

Tuesday, October 21, 2014

Considering a Sexual Encounter? - Bring Along the Required Documents

There has been much written about sexual harassment and rape accusations at colleges.  I thought it would be interesting to share portions of a 44-page document on sexual conduct and misconduct issued by California's Claremont College for its students (as reported in The Weekly Standard  Oct 20)

Effective consent consists of an affirmative, conscious decision by each participant to engage in mutually agreed upon (and the conditions of) sexual activity.  

The Essential Elements of Consent:
1.  Informed and Reciprocal
2.  Freely and Actively Given
3.  Mutually Understandable
4.  Not Indefinite
5.  Not Unlimited

All parties must demonstrate a clear and mutual understanding of the nature and scope of the act to which they are consenting, and a willingness to do the same thing, at the same time, in the same way.

Withdrawal of Consent can be expressed 'no' or can be based on an outward demonstration that conveys that an individual is hesitant, confused, uncertain, or is no longer a mutual participant."

Don't forget to bring signed documents and lawyers along on your next date!