Monday, December 6, 2010

Blog Revamp!

I have revamped my blog. I've redone the format (average monitor width, it seems, has increased since 2005) and used as a background image a picture I took at the Stanford Dish. I've always liked oak trees, perhaps because they remind me of Psalm 1. Oaks are really hearty trees. They are hardwoods, and so resistant to fires, and they have roots that go deep, making them resistant to drought. They're a true California plant. Also, they that lived near me when I was growing up, and we were friends in Boy Scouts. Maybe that's why. In any case, that's now my background: an oak tree at Stanford.

With the new layout, you can see popular posts, and a 'cloud' of the common things I have written about (to the right). Perhaps unsurprisingly, the two topics on which I've written most frequently are Christianity and Philosophy. As such, I've included some of my relevant pictures: a cross etched into the cliff walls in Turkey by early persecuted Christians, and the Thinker from atop Rodin's Gates of Hell at Stanford (who knew the Gates of Hell were actually located near the center of the Stanford campus?). I've also added a tag: Best Posts to indicate my own personal favorites since I started. 

It's interesting to read the work of Younger David. He's a thought-provoking thinker, rash at times, and ignorant of many things. But he is rational and passionate. He'd be a very interesting person to get coffee with. But, alas, he no longer exists; there is only Older David. I'm glad that some record of Younger David's thinking persists.

Sunday, December 5, 2010

Teaching High Schoolers "Real Science"

A few weeks ago, I had the opportunity to teach a group of high schoolers about whatever I wanted. The event was called Splash, and brought thousands of high schoolers and middle schoolers from the bay area in to Stanford to take short classes taught by Stanford students.

I decided to teach: "Real Science - What It Is and How to Spot BS" a lesson on what science was and what it could do. I had about 40 students over 3 classes, and it was a great time. The kids (grades 9-12 in my class) had a good time, and I did too. I am pictured above with Karl Popper.

My main points were:
1. Science works on matter. Matter's not all that matters.
2. Science works by experiments. Experiments have limitations.
3. Scientists are people. People are not objective.

These points are not all that controversial. I don't think many scientists who would disagree. But this revelation shook some of the kids pretty profoundly. Comment cards I collected at the end had questions like, "Then how do we know what is true?" and as if defeated, "Do all experiments have limitations?" It seems that many of my students believed in scientism. They believed that the only things that can be known are those that science can find out. And a better understanding of what science really was challenged this. Anyways, this goes along with what JP Moreland says about epistemology (ideas on how we can know things) being the central issue of our age. But that is for another blog post.

For more detail, my Powerpoint (with teaching notes!) can be found here (make sure you download the original to get the animations and teaching notes; click 'file' 'Download original').

Friday, December 3, 2010

Living an Extra Seven Years - Conclusion

Part 1  Part 2  Part 3  Part 4  Part 5
What is the conclusion of the matter? Church is good for you. You know it’s good for your soul. But now you also know it’s good for your body. Without looking at other factors, people who don’t go to church have an 87% increased chance of dying every year compared to those who attend more than weekly. This works out to a 7 year increase in life expectancy. Even after adjusting for risk factors, a 50% reduction in risk remains. The presence of this effect has been confirmed by many studies on over a hundred thousand people.

What should you do? If you’re in church, stay there. If you’ve left church, go back! It’s good for you! If you’ve never been to church, give it a try! I’m sure your religious friends would love to take you. Christians believe that God has built us to be in spiritual community. Is it any surprise that we operate better when live as we were made to?

In 1964, a group of doctors came together to critically evaluate the risks of smoking. They published their report and it, "hit the country like a bombshell. It was front page news and a lead story on every radio and television station in the United States and many abroad." News of a common behavior, smoking, increasing mortality by 70% was the public health crisis of our grandparents’ generation. Thousands of lives were saved by this information. Now the mantle falls to us. Our generation will be the one to make public this knowledge about church, to save the lives of thousands alive today and those yet to be born. We look at old movies and snicker because everyone is smoking; our children will look at our movies and snicker at people sitting at home on Sundays.

Thursday, December 2, 2010

Living an Extra Seven Years - Medical Implications

Part 1  Part 2  Part 3  Part 4  Part 5
Church abstinence is today what smoking was in 1954. Everyone who’s looked at this knows it’s bad for you. There is debate on the mechanism of action, but not on the effect itself. What do we do? Or perhaps a better question is: did the Surgeon General do the right thing in condemning smoking before it was fully understood?

Because this is a behavior and not an opinion or belief, we can, in good conscience, recommend it to everyone. An atheist can go to church without changing a single belief. He can attend church potlucks and volunteer with church members without agreeing to a single point of theology. It wouldn’t be easy; an atheist might get withdrawal symptoms like a smoker, but if this can be pushed through, it’s probably a good thing in the long run. Pushing belief on an unwilling person had ethical implications, but a doctor can push a behavior like attendance with no ethical misgivings.

Even if we don’t care about atheists (or are afraid of their anger at such a reasonable suggestion), doctors should have absolutely no misgivings with asking Christians about church attendance and encouraging them to increase it. We have very solid evidence to support such a recommendation.

In the Hippocratic Oath, Doctors swear to ‘do no harm.’ If you went to your doctor, it would be unethical for the doctor to ignore your smoking habit; he has information that could prevent you harm; withholding it is wrong. How is this information about church attendance different? Can we doctors, in good conscience, withhold this information from our patients? Would this be anything other than harm?

Unfortunately doctors are terrified of religion. An enlightening essay was published in the New England Journal of Medicine on this topic (5). The author (a non-physician) told physicians that they should not talk about religion. Even though 77% of hospitalized patients want physician to consider their spiritual needs and 48% of patients want their physician to pray with them, the authors explain, “Patients often ask for things that are unrealistic or that may not be in their best interests.” After all, “physicians are not trained to engage in in-depth conversations with their patients about their spiritual concerns.” In other words, doctors are so bad at spiritual conversations, they shouldn’t even try. This idea comes straight from the Hippocratic Oath; all doctors swear to, “Never attempt a thing I’m not already good at.”  Actually that’s a lie. We don’t swear silly things like that. And neither should we live by them.

It is clear to me that doctors ought to recommend church attendance to every one of his patients. It is likely that patients will ignore him as they do with smoking. But if he truly cares about their wellbeing, he must at least mention the risk his patient is taking by staying at home on Sundays.

Consider the magnitude of this public health problem. Every year in the US, 2.5 million people die; if we consider the frequency of church attendance and adjust robustly, the number of deaths that can be attributed to missing church is 568,000 (9, 11, 12, 13). Every year, half a million people die because they missed church. This is one-fifth of the total mortality rate. In 2004, a paper was published to try to calculate the actual causes of death in the US (14). They tabulated that smoking causes 435,000 deaths per year. Church attendance is more important than smoking. Inactivity and poor diet cause 400,000 deaths per year. Church attendance is more important than diet and exercise. Deaths attributable to car crashes, alcohol, illicit drugs, sexual behavior, microbes, and incidents involving firearms together add up to 324,000 deaths per year. Church attendance is more important than all of these combined. Church abstinence is the single strongest association with mortality in the United States, but it doesn’t even get mentioned in a paper on the subject.

[All references are listed under the first post]

Wednesday, December 1, 2010

Living an Extra Seven Years - Clarifications

Part 1  Part 2  Part 3  Part 4  Part 5
This effect is very interesting because it is so tightly linked to behavior, not belief. It doesn’t matter how ‘spiritual’ you feel or how religious you say you are (6). You only live longer when you actually go to church (though there is some suggestion that private religious practice counts). It’s very much like the behavior of smoking: people who do X, die. People who smoke, die. People who stay home on Sunday, die. It’s as simple as that.

Because the models have been adjusted, we can’t recommend anything other than the thing itself. For example, if it were the case that church only worked by reducing smoking, then we could say: either go to church OR quit smoking (if you can...). When they found out smoking was bad, they didn’t know entirely what parts of the cigarette caused the cancer; they could only recommend quitting altogether (today they understand the mechanisms better and sell ‘smokeless’ cigarettes). One day, that might be possible for church; but for today, we can recommend nothing but simply attending church.

It is important to note that we don’t have final ‘proof’ that church causes lower mortality. ‘Proof’ in a modern medical sense demands a particular kind of study called a Randomized Control Trial. Correlation is not causation (4). We cannot be absolutely certain that this effect is caused by church. That is to say, if a doctor recommends a non-churchgoer to go to church, we are not certain that the effect would remain.

The skeptic might say that there might be some other effect (maybe a yet-unobserved healthiness factor) which makes people go to church and also makes them live a long time. But it’s also possible that smoking doesn’t cause lung cancer, but that there is some yet-undiscovered sickness factor which makes people who smoke get lung cancer (we could certainly have argued this in 1950). To silence the skeptic, we’d have to get a big group of people and have them each flip a coin. Heads gets treatment 1 (smoking/no church); tails gets treatment 2 (no smoking/church). The problem is that we have good reason to suspect that treatment group 1 is going to die, and for better or worse, we decided killing people for science advancement was generally a bad idea. And even if we weren’t sure, nobody objecting to recommendations on church attendance would support an experiment randomly assigning people to church or no church. The experiment is ethically impossible. We package cigarettes with a warning label and doctors push patients into smoking cessation programs without ever having done a perfect study on their deadliness. How is church abstinence different?

[All references are listed under the first post]

Tuesday, November 30, 2010

Living an Extra Seven Years - Adjustment

Part 1  Part 2  Part 3  Part 4  Part 5
My grandfather came to California from Oklahoma at 18 with a nickel in his pocket. He got a blue collar job working at Ralphs. It was good work that paid well enough, but the hours were long. The managers, wanting to be kind to their employees, gave them a smoke break. My grandfather, a nonsmoker, tried to take a break with his coworkers, only to be told that it was a smoke break, not a do-whatever-you-like break. So he took up smoking.

Imagine a researcher asked, “Does working at Ralphs cause lung cancer?” There are two ways to answer the question. You could say yes: working at Ralphs causes smoking, and smoking causes cancer. Statistically, this is called “un-adjusted risk.” Un-adjusted risks tend to be a less specific and so less convincing answer. The 87% increase in risk of dying from never going to church is unadjusted.

But maybe it wasn’t Ralphs’ smoke-break policies, but some other factor which causes lung cancer (maybe they used dangerous chemicals in the canning process). How could you tell the difference? You’d look at the non-smokers. Were non-smokers getting lung cancer, too? If so, you’d suspect that there was some other factor at the cannery. Using the data from the nonsmokers, you can “subtract” the effect of smoking from the smokers and find out for someone like my grandpa, if there was any “adjusted” risk of working at Ralphs. That is, you can find out if there is any effect outside of the known effect of smoking.

So can we tell if the 87% increase in life expectancy is just from Christians reducing known risk factors? The researchers in the papers subtracted the effects of age, gender, race, socioeconomic status, social support (e.g. marital status, number of friends, relatives), health risks (e.g. smoking, alcohol consumption). If church improved health by working through these things, after we’d subtracted the effects of bad behavior, there would be no difference between the churchgoers and the abstainers. We would conclude that the church is a really good way of changing unhealthy behaviors. But even after these risk factors were taken out, the effect remains. Church does indeed lead to healthier lifestyles (less smoking, drinking, etc.). After subtracting all these from the 87%, someone who never goes to church still has a 50% higher chance of dropping dead compared to a frequent churchgoer (6, 15). Church attendees live longer and we don’t know why.

There is speculation, but no solid data to support them. It might be volunteerism. Maybe it’s a more positive outlook on life. Perhaps there is some unidentified good of being in community (“psychosocial effect”). Or maybe there is actually something supernatural going on in church (7). For all we know, it could be the potlucks. But does it matter how it works? Or more accurately, for whom does it matter? Certainly researchers ought to pursue the Truth wherever it goes. But for the average American, mechanism is much less important. And for the average physician, an understood mechanism rarely comes before a treatment.

We have a very strong case for church attendance. Our case for church attendance today is stronger than our case against smoking was in 1950. Our statistical sophistication and our data collection have improved a lot since the 1950’s. But for the family practice physician, does it matter? To the policy makers, does it matter? We started lecturing patients and slapping warning labels on cigarettes before we knew how they were bad.

[All references are listed under the first post]

Monday, November 29, 2010

Living an Extra Seven Years - Introduction

Part 1  Part 2  Part 3  Part 4  Part 5
In 1912, Dr. Isaac Alder suggested that there was a link between smoking and lung cancer. Immediately everyone stopped smoking. Actually, that’s not true at all. He was promptly and almost universally ignored. It took another four decades before anyone really listened. By 1957, the evidence had accumulated and the Surgeon General declared that smoking caused cancer. One year after this announcement, 44% of Americans believed smoking caused lung cancer. In 1964, “Smoking and Health” was published, and laws started getting passed restricting smoking, from advertisements to taxes (8). In 1968, 78% of Americans believed smoking caused lung cancer. Unfortunately, knowing something is good for you is not the same thing as doing what’s good for you.

For decades we didn’t know for sure if smoking was bad for you. Movie stars and cool kids pushed the habit, and when we found out it was bad, it was too late. People were already addicted. For those who did quit, severe damage was already done. The slowness of the research, the industry lobbying, and the lack of will on the part of the government and public cost countless lives.

Smoking remains to be one of the most important risk factors for heart disease and cancer. It’s not just hypothetical risk. Life insurance, an industry which bets on your life and death, is keenly aware of this risk and charges smokers much more because of this high risk. A smoker has a 70% higher annual risk of death than a nonsmoker (8). Smoking is the single best observable factor in determining your risk of dying. Or at least it was. What if I told you that there’s another behavior that is even better at tracking with lifespan than smoking is?

People who don’t demonstrate this behavior have an 87% higher annual risk of than those who do (9). A 20 year old who did engage in this behavior throughout his life would live 7 years longer than one who didn’t (for blacks, it’s even better: 14 years longer). You might be thinking you know what it is: exercise! Nope. Exercise is good, but not that good. Those who do what the American Medical Association tells them to do (1400 calories per week of exercise; 30 minutes daily) (2) have a 29% lower annual risk of death(1). What about losing weight? Those who are normal weight (BMI <24) have a 25% lower annual risk of death compared to those who are overweight (BMI >26) (1). What could this behavior be? What could be more important than what our doctors talk about when we visit? What’s more important than smoking? What’s more important than exercise? What’s more important than weight loss?

Church attendance. People who never go to church(3) have an 87% increased chance of dropping dead compared to those that attend more than weekly. Statistically speaking, never going to church is worse for your health than smoking a pack a day for the rest of your life (9). I’m not joking. This is an effect that has been seen in dozens of studies over the last thirty or so years. Scientists really don’t like it, but it’s there, and it’s real.

We have lots of evidence that church attendees have a lower risk of dying. We have so much data in these studies, we can even ‘pool’ it, adding up the results of many studies into one “meta” analytic study. The best meta study that did this found, after looking at a total of over 125,000 people in 42 separate investigations, the odds of a churchgoer surviving were better than a non-churchgoer (10).

But how can this be? Perhaps churchgoers are just goody-two-shoes who never smoke or drink or cuss. To evaluate that theory, I need to tell a story.

[Note: this is the first of a 5-part post. The references for all 5 will be posted here in the first post]


(1) Paffenbarger, RS; Hyde, RT; Wing, AL; Lee, IM; Jung, DL; Kampert, JB. The Association Of Changes In Physical-Activity Level And Other Life-Style Characteristics With Mortality Among Men. NEJM, 328 (8): 538-545 Feb 25 1993.
(2) Pate RR; Pratt M; Blair SN; Wilmore JH; et. al. Physical Activity and Public Health: A Recommendation From the Centers for Disease Control and Prevention and the American College of Sports Medicine. JAMA. 1995;273(5):402-407.
(3) Most of the studies are representative US populations and so are literally measuring church attendance. Others look at ‘religious service attendance’ and find the same thing. I will use ‘church attendance’ in this article as these results do not have enough data to religious services of other faiths (though it is my belief that this would be true).
(4) Correlation doesn't imply causation, but it does waggle its eyebrows suggestively and gesture furtively while mouthing 'look over there' – . Also, I am among those who are not happy about the monopoly that the Randomized Control Trial has on science. It’s a good technique, but not the only good technique.
(5) Sloan, RP. Should physicians prescribe religious activities? NEJM 342(25): 1913-1916 JUN 22 2000
(6) Powell, LH; Shahabi, L; Thoresen, CE. Religion and spirituality - Linkages to physical health. AMERICAN PSYCHOLOGIST, 58 (1): 36-52 JAN 2003
(7) I say supernatural not to give up the search, but to focus it. The effect might be mediated through an undiscovered non-classical mechanism; perhaps it is a hyper-dimensional effect, perhaps it is quantum mechanical. With regard to unsolved mysteries, we must always be ready for a paradigm shift to be hiding underneath it.
(8) “The Reports of the Surgeon General” <>
(9) Hummer RA; Rogers RG; Nam CB; Ellison CG. Religious Involvement and U.S. Adult Mortality. Demography 36(2): 273-285 May 1999
(10) McCullough ME, Hoyt WT, Larson DB, Koenig HG, Thoresen C. Religious involvement and mortality: a meta-analytic review. Health Psychol.19(3):211-22 2000 May
(11) FASTSTATS. Accessed on 10/23/2010. Centers for Disease Control. <>
(12) American FactFinder. Accessed on 10/23/2010. US Census Bureau. <>
(13) US Population: 310,546,653. US Mortality rate: 803.6 per 100,000.

(14) Mokdad AH; Marks JS; Stroup DF; Gerberding JL . Actual Causes of Death in the United States, 2000 JAMA. 2004;291:1238-1245
(15) This trend is supported by the meta-study (reference 10) but with a smaller magnitude. It reports that the increased chance of survival for those who attend is 25% after adjustment. The difference is probably because of a dose-effect in the Hummer paper (reference 9); they didn’t just measure attender/non-attender, but the frequency of attendance. Running 50 minutes every day is better for you than running 5 minutes, and so it seems that going to church more than weekly is better for you than going only on Christmas and Easter. The data in the Hummer paper does appear to agree with the more modest 25% if you ignore the dose-effect and pool all church attenders together.

Friday, November 12, 2010

Venipuncture and the Essence of Love – Conclusion


Perhaps the two definitions are not different. Maybe we just are bad judges at what ‘benefit’ is. Indeed, our modern working definitions of ‘relationship’ seem to give us an average of one year of pleasure before it’s used up and we need to move on (slightly longer in ‘marriage’).

Is it really “more blessed to give than to receive”? That is, are we happier when we give to others, or when we get? In a materialistic world, this statement is sheer insanity. Anyone who has truly given something knows the truth of this statement. Even Derek Zoolander knows this is true, “The other day I was thinking about volunteering to help teach underprivileged children to learn how to read. And just thinking about it was the most rewarding experience I've ever had.”

Maybe the best marriage is one around giving. And that means that it doesn’t matter what the other person is doing. If either party is getting more pleasure out of giving than getting, their happiness is independent of the other person. If you get when you give, and you get when you get (instead of just getting when you get), there is no reason not to give. It’s like an easy game theory problem:

On Sacrifice Theory

(Husband) Give
(Husband) Don’t Give
(Wife) Give
(Wife) Don’t Give

On Benefit Theory

(Husband) Give
(Husband) Don’t Give
(Wife) Give
(Wife) Don’t Give

The jump from this situation to a political system is not that long. An employer and employee:

(Employer) Pay Well
(Employer) Don’t Pay Well
(Employee) Work Hard
(Employee) Don’t Work Hard

Why doesn’t this happen in relationship or the workplace? Because we’re operating under the benefit theory. We think the way we get happiness is getting stuff. Like trying to drive a car on the highway in reverse, we’re doing it wrong. The car has nothing wrong with it; there is just ignorance that can easily be repaired with knowledge.


Jesus says, “Love thy neighbor as thyself.” This, if it requires anything, requires sacrifice. When asked to expound on this, Jesus tells the parable of the Good Samaritan. The Samaritan finds a Jew robbed and beaten, and gives him oil and wine, lets him ride on his own donkey, and then pays for his stay at a first-century hospital (the inn). This is a story of sacrifice. Sacrifice is the essence of love.
If this is true, then we should seek to love and make love abound in every aspect of life. It seems to me that God has arranged the world to permit us to sacrifice for each other. I think that we should order our relationships, our careers and our society after the same pattern. If the essence of love is sacrifice, then we have a lot of work to do in our own lives and in the world.

Part 1, Part 2, Part 3, Part 4


As if in honor of Stanford's second years studying the reproductive health block right around now, a big sex study was published a month ago: the "National Survey of Sexual Health and Behavior (NSSHB), a nationally representative study of the sexual and sexual health related behaviors of 5,865 adolescents and adults in the U.S." How I didn't hear about it until now given how Facebookable this is, I don't know. Here are some of the interesting findings:

1. Single people report using condoms ~33% of the time; 14-17 year old boys are highest (80%), and white women are lowest (20%).
2. Male orgasm correlates with a consistent partner; female with sex variety (i.e. vaginal/oral).
3. 8% of men, 7% of women identified as being gay; between 8-15% (depending on type of sex, age, male/female) have ever tried it.
4. In 16-17 year old boys/girls, 30%/32% have ever had sex, 79%/54% have ever masturbated; in 18-19 year old boys/girls, 60%/61% have ever had sex.

This was pulled from Time's webpage here:
I intend to go through the primary literature here (Stanford med proxy):

Sunday, November 7, 2010

P-Zombie Apocalypse

[This is a beta version of the story. Please tell me how it can be improved, what is lacking, what you want to know more about, even typos. Your help is much appreciated.]

I opened my eyes and it was dark. Very dark. Too dark. Where was I?

I was lying down and it was cold. I sat up and felt around. It seemed that I was sitting in what felt like a bathtub. I felt that there were some wires attached to stickers on my chest. EKG leads? Perhaps a hospital? Where was I?

I tore them off and stood up, trembling. I had seen enough movies to know that waking up in a darkened medical facility with no recollection of why you were there was a bad sign. I felt around the room and discovered it was small, the size of a bathroom. A door! I turned the handle and it opened. But it was still too dark to see. I looked left but saw nothing. But wait! To my right was something, maybe. I walked right, leaning on the wall with my left hand, my right hand in a fist, ready. But ready for what?

My left hand passed over door after door. This was evidently a hallway. The something ahead of me got brighter. I could faintly make out the corner of the hallway. I approached it cautiously and looked around it. In the darkness, I saw a lobby lit by starlight through two large glass doors. Nothing looked awry. No broken glass. No corpses. Everything was in its place; it looked like it would be opening in the morning. The glass had the building name engraved into it: “Abundant Life Suspended Animation Center.”

The jingle for this place came to mind, “Don’t Die, Delay!” I remembered the reports that the technology was new, and could not be guaranteed to keep a person’s memories intact. The hope was that people would be woken up when their terminal diseases had cures.

As I reflected, a shadow crossed by the edge of my vision. I picked up the heavy slab of stone that the secretary was using as a paperweight. Then I waited for the moan of grief and horror. But it never came. I was prepared for it if it came, but it never did. It just walked in silence. The anticipation drove me crazy. My confidence immediately evaporated, and I hid behind the desk. No movie could have prepared me for what I saw. It was hideous, covered with filthy clothing, its face obscured by a tangle of blackened hair. Long fingernails grew from skeletal hands. My courage broke, and I tried to run; I knocked the stapler onto the ground. It hit with a loud clang, echoing in the silence. It turned at me yellowed eyes. And I had a split second to wonder what kind of zombie it was.

Over the ages, many types of zombies have been described and imagined. My hope was that this would be a classic Day of the Dead zombie, slow-moving and stupid. They are powerful only in great numbers and can be re-killed rather easily with head trauma. Their bite is infectious, but I figure once you’re a zombie, you don’t care too much about wishing you were human. My worst fear was that this would be a 28 Days Later zombie. It was also infectious, but it had superhuman strength and speed.

My split-second question was immediately answered as it began running toward me with terrible speed. I realized my weapon would be useless, and I would certainly get bitten even if I did manage to kill it. There was only one way out, and it was coming through it. Once it was inside, I threw my slab of rock at its head and ran for the door. It must have glanced its head, because it wasn’t able to catch me as I ran past, but it lost only a few seconds in its pursuit of me.

I was on the street and I ran with all my strength. Fortunately, the suspended animation process, with the use of high-dose steroids and electrical muscle stimulation, had left me in decent shape. I ran down the street, looking for some place to bar myself into. Maybe a mall? There are all kinds of ways to beat zombies in a mall. But there was no mall.

The zombie would certainly gain on me on this straight street. Perhaps being a zombie wouldn’t be too bad. Maybe I wouldn’t even know I was a zombie. Maybe being a zombie was better than being a human. But my animal survival instinct overrode my philosophizing when I saw a manhole cover ajar. I climbed down the ladder, and replaced the cover just in time. It clawed in vain at the cover.

To my surprise, I could see. It was not completely dark. There was a little bluish light at the base of the ladder. I climbed down and saw a little camp: an open can of beans, a handle of whiskey and a little LED light! Signs of human life! Maybe that’s why the manhole cover was off. Smelling the beans I realized I was ravenously hungry, and feeling cold, I eyed the whiskey. I helped myself to the remainder of the beans and washed them down with the whiskey.

I noticed a little book by the light and I opened it. It was a journal. “Day 37: The zombies have overrun the city. I have taken refuge underground. They don’t go underground… I hope.” I flipped ahead, “Day 337: I have finished the last of the vegetable cans. I dare not leave the city where there is no underground, and there are no supermarkets that are safe. The abandoned liquor stores are plentiful, so I must resort to getting my calories there. This will make my reflexes dull and decisions clouded, but I need the food.” “Day 971: The jaundice is getting worse. I know I cannot survive much longer like this. Perhaps things will change. This cannot last forever, can it? After all, how long can zombies live?”

And then everything went black. It must have been instantaneous because I woke up and saw the zombie standing over me, its long, hideous teeth, sunken cheeks and terrible yellow eyes. The reek that must have come from his rotting flesh was overpowering. I gritted my teeth and prepared to be eaten.

“Who are you?” asked the zombie.

I was on my side and I saw the rock that had bounced off my head; it seemed that he had returned the rock I threw at him earlier. Then I saw that he wasn’t alone. There was not just one zombie, but ten. All of them looked as he did. Some, perhaps, had been female in their real lives.

“Pardon me?” I said by instinct.

“Who are you?” repeated the first zombie.

Maybe dementia is the first sign of zombie infection. Maybe he already bit me and this was the beginnings of my brain being eaten away by the zombie virus. So be it. No sense in fighting it now. I might as well play along.

“My name is Joel. It’s a pleasure to meet you,” I said.

“I’m Robert. These are my friends, and the pleasure is mine,” replied the zombie who was apparently named Robert. “You’re not a zombie,” he said, looking deep in thought. This impression of so hideous and obviously mindless a creature looking thoughtful further convinced me that I was approaching zombiehood at an incredible rate. But I wasn’t there yet. I was still self aware, still thinking myself.

“No. At least not yet,” I replied.

“How did you escape the Zombie Apocalypse?” he asked.

“I think I slept through it. I woke up an hour or two ago at the Abundant Life Suspended Animation Center,” I said. He looked at me accusingly. “From there, I was chased by a zombie into this sewer. And if I’m not mistaken, the zombie looked very much like you, good sir.”

“Yes, that was me who chased you. I needed to get you underground and safe, away from the real zombies,” said the zombie.

I laughed. “Do I look like a zombie? I have full muscles and skin that is not rotting. I have white eyes and clean teeth. I don’t have a ghoulish reek about me, as you do.”

“You must be from a time where you thought of zombies only from the outside. The true zombie is not the man who is a zombie on the outside, but who is one on the inside. The man who has lost himself, the part that makes him human, is a zombie. I am no zombie,” the zombie said. But its philosophical assertion made me think. It was probably right: the rotting flesh was only a symbol for what had happened to his personality.

“So Mr. Zombie, why do you think you’re not a zombie. How do you explain the rotting flesh and yellow eyes?” I asked with a smile.

He smiled back, “Because I make choices. I choose to live in this sewer with my wife and friends.” He gestured to the zombies standing around him. “I choose sacrifice. I chose to risk my life above ground, looking for survivors of the apocalypse. Zombies do not make choices. My skin is rotting because I likely have scurvy, my teeth are rotten and long from gum disease. We have run out of food and have been getting most of our calories from alcohol. I look like a skeleton because I am very, very hungry and my eyes are yellow from jaundice. The liver disease also has given me very, very bad breath. Before Z-Day, I had an alcoholic friend whose doctor said he had Fetor Hepaticus, medical jargon for ‘breath of the dead.’”

“Come, now, Mr. Zombie,” I continued. “You have bitten me and I will soon be a zombie. It’s as simple as that.”

“You are confused. My name is Robert and I am a human being. I have not bitten you; you cannot become a zombie through a bite. Check yourself and you will find no bite marks. Zombie is not a disease of the body, but of the soul.”

I checked myself all over, and I could not find any marks. Maybe he was right. “OK, Robert. Maybe I’m not a zombie, and maybe you’re not a zombie. But then who is a zombie?”

“Everyone else.”

He said it with a doom that hung in the air, as heavy and rank as the breath on which the words traveled. I had

“What happened?”

“The Zombie Apocalypse. Or, more accurately, the P- Zombie Apocalypse. It was an event that was a century in the making. It started toward the end of the Twentieth Century. People began to realize the grave consequences of freewill and choice. After the death of God in the University and the passage of the 66th Amendment, the so-called ‘Freedom from Religion and Liberty for All Amendment,’ society had no ability to inspire people to virtuous living. The only legal way to change the behavior of people was through rational ‘evidence-based’ incentives. Preachers and salespeople were both neutered. The leaders of the free world realized that freedom could only exist if people behaved properly. People, it seemed, would not choose to behave properly. So, little by little, choices were eroded. It started innocently enough. They fined people who didn’t wear seatbelts. Then they started taxing ‘unhealthy’ foods. But they cut away at the freedom of humanity through things more subtle and powerful than these. For example, everyone had to go to training centers called ‘college’ to gain employment; there they were taught about how there was no soul, no will and no choice. To have standing in society, they required people to take enormous burdens of debt to buy houses. The debt then made sure that people behaved properly and kept working. They were kept from most choices through financial pressure.”

“But people still had choices. I made plenty of choices. For example, I used to give generously to charity,” I interjected.

“Really? How generously? Up to 1% of your income?” Robert inquired.

“Well, not that much. But I was extremely generous!” I argued.

“You are like your people. You haven’t chosen charity, only the appearance of it. And it’s not your fault; you had no choice but to give either 0% or 0.5% of your income. The other 99.5% had to go to home loans, car payments, insurance and taxes; or at least this is what they convinced you of. You didn’t choose charity, so the government mandated it. It took money from the rich and hired people to do charity. People didn’t choose courage, so it paid them well to take the dangerous jobs in the military. People didn’t choose temperance, so it taxed intemperate options. People didn’t choose prudence, so they were fined for imprudence and their place in society was withheld until they attended a learning institution to gain it. People didn’t choose justice, so they instituted a progressive tax. These pressures increased through the Twenty First Century and precious few choices were left. But then came the master stroke.”

“What was the master stroke? Was it a mind-eating virus?” I asked.

“It was a virus of sorts. It wasn’t a mind-eating virus, but a soul-eating one. The people were infected with pleasure, and the entire society ended up bending itself around to maximize it. The mechanism was a technology that gave immediate feedback, immediate punishment and reward for behavior. This is what finally laid freedom to rest. The brain sciences developed a wearable device which measured brain-waves in real-time that could tell what people were thinking about. Employers bought these NeuroScan devices, and employees were required to wear them at work. They paid employees for high mental performance and right thought. Employees had a small display that showed them their hourly wage multiplier with alerts and alarms which informed them of their good or bad thoughts. There were legal fights, of course, but ultimately the evidence showed that people that had them were more productive, got paid more, and worried less than those who didn’t (after they got used to it).

“People argued this didn’t increase productivity in ‘creative endeavors’ but since the artists couldn’t quantify what they meant by ‘creative endeavors,’ they were ignored. People argued that life wasn’t about maximizing output and the pleasure that resulted; they said that ‘right thought,’ could not and should not be rationally decreed by an employer or a government. But they couldn’t provide objective evidence for their subjective ideas, like ‘freedom’ and ‘virtue’ and so they were ignored.”

“The government got into the game and, with a huge tax cut to those who agreed to be monitored, incentivized ‘proper’ behavior. It taxed improper behaviors and thoughts (everything from speeding to buying unhealthy foods). For the particularly resistant, they gave them a heroin drug pump that released low-dose heroin throughout the day. Proper behaviors were rewarded with a shot; improper behaviors were punished with withdrawal. Many tyrants tried to subdue the will of men, but they always resisted. But it was because they lacked the technology allow man to do what he always wanted: to sell his freedom for comfort.”

“With immediate reward and punishment, people no longer had to make decisions. People had only to do their duty, nothing less and nothing more. There was no place for sacrifice; all that was needful was provided. People no longer needed to exercise their freewill. Any deviation from the proper resulted in immediate pain, and so there were no deviations. Parents realized they could also use these tools, and an entire generation was born that lived their entire lives without making a decision.”

“The soul of man shriveled, and virtue was lost. But the greatest tragedy of all is the death of love. That ages-old wonderful thing written of by the poets has perished up above. There is perfect comfort; no one can do anything for anyone else. No one can lay down his life for his friend, because there is nothing to lay it down for. Violence and crime are ended, so there are no bullets to jump in front of. There is no poverty, so there is never a need to sell your car to provide for your friend. Sacrifice is ended, and so too is love. The old saying, “No greater love hath a man than this: that he lay down his life for his friends” became “No greater love hath a man than this: that he benefit his friends maximally.” People marry, but it is a relationship of convenience and mutual pleasure. Their NeuroScans make sure that they never think badly about the other, and that sex is maximally pleasurable for both. “If you want to save your life, you must lose it,” has become, “If you want to save your life, you must
save it.”

“But a world without crime and poverty is everything we hoped and dreamed we could achieve! Perhaps it was worth it?” I exclaimed.

“And because the world was convinced that pleasure was the purpose of life, our race has ended. The idea that the Good is comfort is a plague that has infected us and, but for we few survivors, has driven us to extinction. Zombies now rule this planet. Either you are hiding underground with a wasted and inhuman body, or you live above ground with a wasted and inhuman soul.”

There was a great silence. I couldn’t keep from staring at the hideous creatures around me and thinking about how sad they looked. Not that they looked sad; they looked rather alert and strangely content (if such an expression could be used of a zombie). Perhaps I mean to say that I was sad for them; they were pitiable.

Robert continued, “You now have a choice to give up choosing. What will you choose? Freedom or slavery? Do you want to join us and remain a human, or will you forsake your race and become a zombie?”

I stood there, looking at the degenerate form before me. I saw his little camp and the misery in which he lived with his fellows. And I then I saw in my mind’s eye the glorious pleasures to be experienced up above. Above our heads was a Garden of Eden, expect without the tree of the Knowledge of Good and Evil to tempt. What is my will and why is it important? I don’t remember having used it much in my old life anyways. Perhaps Robert’s was something worth saving; it must be, if he was willing to live as he did to keep it. But I don’t think I’ve got what he does.

Don’t get me wrong; I’m a pretty good guy. I’ve made my mistakes, but I’ve never really hurt anyone. Am I virtuous? Probably not in the sense that he means it. But why does he care so much about it? People up above were living with far better behavior than this zombie clan. In fact, if he describes them properly, they were living perfectly. What did he think he had that they lacked?

He’d probably say something philosophical. But philosophy isn’t something I can hold onto. I can hold onto clean skin and full flesh. I can hold onto a green, juicy apple; a soft, warm bed; a hot steak. I can hold on to health. I can hold onto comfort. And I think I will hold onto them. Philosophy hasn’t gotten him very far.

“Thank you, Mr. Zombie, sincerely for your concern, but I think I’d better be going.”

Then he said something that I will never forget. It sent shivers down my spine, more than on first seeing him. Ten years have passed since that day, and I still don’t understand what he meant. Maybe I never will. He said to me, “May the chains of comfort rest lightly upon you. Goodbye, Mr. Zombie.”

Friday, November 5, 2010

Venipuncture and the Essence of Love – Miscellaneous Implications


I think most modern people (or at least most of my peers) operate from a Utilitarian framework: the greatest good for the greatest many. It makes The Good into something at least conceptually measurable, appealing to our science instincts. But fundamentally, I think the reason so many of my peers believe in it is because they hold the second definition of love: to benefit maximally. About a third of my generation thinks Socialism is a better economic system than Capitalism. In a Socialist system, benefits (health care, housing, etc.) are universal. It is the State that sacrifices, not the People. And (assuming Socialism worked) this would clearly be the optimal solution. It is a society with the greatest benefit-love. However, with benefit maximized, opportunities for real sacrifice to neighbors are minimized. To maximize sacrifice-love, there needs to be more suffering available to bear, and people need to have more freedom to bear it.

I think I have finally discovered the root of my support for small government. A country with a small government demands that people sacrifice-love one another. It is a dangerous place, and a place exactly as beautiful as the people who reside in it. A big government benefit-loves its people. It is a safe place, and a place that is neither very beautiful nor very ugly.


Doctors avoid suffering. We are taught to turn off our emotions because it hurts. We’ll ‘burn out’ if we empathize with patients. A benefit-love for our patients is curing them; no empathy is necessary. If we do not suffer for our patients, then our job is simply a job; we have shown no sacrifice-love. A friend of mine in nursing was too close to a patient in the psychiatry emergency room. The charge nurse told her to keep her distance and to protect herself; she advised my friend to treat the patients like “rabid dogs.” You can benefit-love a rabid dog through cure; you cannot sacrifice-love one.

Problem of Evil

Why is there suffering? This is a profoundly important question that I can only give superficial treatment to here; I recommend that you look at the many other great resources on it (Job from the Bible asks this; contemporary philosopher William Lane Craig gives a good talk on it; Dostoyevsky’s Grand Inquisitor from the Brothers Karamazov also discusses this question). How can God permit suffering? Let us ask an easier question: how can a father permit his child to suffer (say, by needlestick)? He, if he is good, must have some morally justifiable reason for it (like immunization). God, if He is good, must have some morally justifiable reason for it. Since the evaluation of this question requires a full accounting of all people in all time, this is a question we are woefully ill-equipped to answer. This is a point of human ignorance; we cannot draw any logical conclusion from it. We don’t have a complete fossil record and never will but it does not follow that Evolution did not occur; it is valid to fill in the gaps with inference. We can bridge gaps in knowledge by anchoring on things we do know (this is called in science a ‘theory’ and in religion ‘faith’).

One of the theories is that the morally justifiable reason God allows suffering is freewill. God may permit suffering because only by it can humanity have true freewill. Only in a world of suffering can God show His sacrifice-love for us, and only in a world of suffering can humans truly sacrifice-love each other.

Part 1, Part 2, Part 3, Part 4

Saturday, October 30, 2010

Showdown at Pizz’a Chicago

“One: if God does not exist, objective moral values do not exist. Two: objective moral values do exist. Three: therefore, God exists,” I said, explaining the moral argument for the existence of God to my a few Christian classmates over Pizz’a Chicago. This argument is one of the oldest and best available to the Theist; for those interested in the argument itself, I would commend you to the work of William Lane Craig. We had just finished a wonderful hike in the mist and trees of the Santa Cruz Mountains and warming up around a fire at my place. We were beginning a lively philosophy discussion. For anyone who knows me, you know that there aren’t too many better possible days. The pizza was delicious (the “Al Capone”; who’d have thought pecans go well on pizza?), and it was looking like it would be the perfect end to a perfect day.

Then there was a person standing over us at the end of our table. It was the man from the next table. He was a short man in his fifties, balding slightly, wearing a full beard with flecks of grey. Surprised, I gave him my attention. He said, “We can hear you from over there. And, you’re wrong!” I suppose I had been a bit loud; it was a pizza joint, after all, and I had to raise my voice to get it across the table. I wondered which of the two premises he disagreed with (I guessed it was the first; this is the approach most Atheists take). I started gesturing for him to join our conversation, but he had already turned around and returned to his seat, next to what appeared to be his high school-aged son and elementary school-aged daughter.

He shot a glance over to me, to see what effect his breach in manners had caused. Perhaps he was hoping for shock, outrage or anger. I don’t think he was expecting polite curiosity. “Which premise?” I asked him. “Both of them!” he shot back, surprised and not looking at me. “Please explain,” I offered politely, again gesturing to the empty seat next to me. At this point, the man came to his senses. He did the most rational thing a mature thinker could have in such a situation: he utterly ignored me.

After this brash interruption of our conversation, I composed myself. I soon continued my exposition of the argument to my friends and the conversation continued pleasantly. All the while, in the back of my mind, I was thinking how to repay this guy. He had interrupted my conversation on a topic which was extremely important. He tried to embarrass me in public and in front of my friends. He wanted to make me look bad and show off to his kids. And then I thought of a way. He’d be so pissed. It would shame him in front of his kids and he’d never be able to get me back. He’d never forget me. Ever. It was perfect.

I called the waitress over, gave her my credit card, and quietly paid for his family’s dinner.

My friends and I finished our pizza, and got up to leave. I walked over to the man’s table while they were still unaware of what I had done and I said warmly, “Enjoy your dinner!” For those unaware of American customs, the proper response would have been something like, “Thank you.” Perhaps this courtesy had shocked the man into silence, or perhaps he was still ignoring me. Maybe his mouth was full. In any case, it was his son who responded with an accusatory tone that ought to be reserved only for the basest of criminals, “You can’t prove God! It’s not falsifiable and therefore false!” Recovering, the man, with what he must have thought was an irrefutable disproof of my argument, said with the confidence of a mathematician delivering the conclusion to a proof, “William of Occam.” Now for those of you who are not experienced in Philosophy, William of Occam is a man and not himself an argument, or at least the words “William of Occam” do not compose a well-formed or convincing argument. But it seemed to be offered as one, which might suggest conversation was actually possible.

I started to respond that proof was possible, but they weren’t listening. I cannot now remember how I knew that they were not listening and desperately wanted me to leave. I don’t have a memory of them covering their ears with their hands, or shouting to drown out my words, or shooing me away like a dog, but however they did it, they communicated as much to me. Then the most unexpected thing of all happened: the daughter, in stark contrast to her family, showed me kindness. She stood up, walked over to me, and gave me a paper craft she had been working on all through dinner.

I walked out of the restaurant smiling. The man and I had battled in the pizza parlor, and I think both of us will remember the day for years to come. And I will treasure my prize, his daughter’s paper craft.

Freewill and Fate in Photos

How can the sovereignty of God and Man coexist? How can God be omniscient and man retain freewill?

In focus: the Sovereignty of God

In focus: the Sovereignty of Man

Friday, October 29, 2010

Venipuncture and the Essence of Love – Relationships

In my last post, I talked about how Christian love was, at its essence, sacrificial. This is in sharp contrast to the common understanding of love which seems to be, at its essence, for the benefit of the other. If love is as Jesus defined it, then it changes everything. The first thing it changes is what is for most people where they will experience the deepest love: the romantic relationship.

This Christian view on love turns relationship on its head, or at least it turns what we’ve been calling relationship on its head (I feel like I’m late to the party on this one; St. Paul seemed to already understand this 2,000 years ago). We Americans believe that relationships (that is, sexual relationships, both “boyfriend/girlfriend” and modern “marriage”) are about love, and love is about pleasure. Both parties get peace/happiness/pleasure by entering the relationship, and so long as that peace/happiness/pleasure endures, so does the relationship. This theory of relationship is supported by data collected by the dating site MyCupid that shows that people of my generation have an average of about 1 new sexual partner per year from the time they’re 18.

On the American definition of love, Biblical passages on marriage like Ephesians 5 sound terrible: “Wives, submit yourselves unto your own husbands, as unto the Lord… Husbands, love your wives, even as Christ also loved the church, and gave himself for it” (Eph 5:22,25). Why should the wife have to submit when the husband only has to love?

But what if love was not pleasure? What does a marriage entered into under Christian terms look like? It is not about pleasure (or at least not directly), it’s about suffering and sacrifice. Suffering and sacrifice are not things that must be endured for the love. They are the love. Today, suffering is a red flag, it’s a sign that we are in the wrong relationship; we try to minimize our own suffering. Christians would rather forget about the Godly marriage of Hosea who was commanded to marry a prostitute named Gomer, and stay married to her while she stayed a prostitute. For that matter, we want to forget about Christ, who did the same thing except we, the Church, are the prostitute.

On Christ’s definition of love, the Ephesians passage takes on an entirely different meaning: women have to serve men; men really have to serve women. CS Lewis explains, “The husband who gets this verse is the one whose marriage most feels like a crucifixion…This verse is most embodied in the husband whose wife receives most and gives the least.”

Then how do we pick our partners? Could we maximize suffering by picking the least compatible person possible, a person who hated us? Would that lead to happiness?

To answer that question, I think I need the council of St. Ignatius. Christians in the first and second century died violent deaths with such joy that it was inexplicable to the world. This witness was so dramatic that it became a major factor in the conversion of the brainy Justin Martyr (whose given last name gives some clue as to the fate he himself would later ‘suffer’). People were legitimately asking, “If you like death and martyrdom so much, why don’t you actively seek it out, or commit suicide?” Ignatius, on his way to his own martyrdom, wrote that it is something that must be borne, but not sought. As a warning, he tells the story of another Christian who volunteered for martyrdom, but apostatized at the moment of truth. He denied Christ; he chickened out. So we should not seek martyrdom, neither in the lions' den nor in the bedroom.

So the question remains. How do we pick our partners? Well, how does Christ pick the Church? It seems arbitrary, following no pattern that we can understand. We, the Church, certainly aren’t intrinsically beautiful; we have nothing to offer, neither dowry nor wealth. Contrary to all reason, Jesus chooses us nonetheless. What does that sound like? Could that be anything but romance?

Surely all of our desires can honor God when used properly, even (perhaps especially) romance. Romantic feelings seem to follow no rules, pairing up people that really have no rational business with each other. In a culture without arranged marriages, I think this is as good a pairing rule as any. The important part is not who you pick, but how willing you are to sacrifice for the person you’ve picked.

Sacrificial love completely transforms relationship. It’s no longer about maximizing your own benefit, but your own sacrifice to your partner. If this is love, it does not need to be bi-directional; one partner can always give and never receive, and still have love. But of course, the most loving relationship is one where both parties are sacrificing completely to each other. How often would we cheat on each other if our eyes were perpetually fixed on sacrifice instead of pleasure? How many arguments would be averted? How many tears of sadness prevented? How many more tears of joy would we shed? How happy we would be if we stopped obsessing so much about pleasure, and thought more about love, that is, about sacrifice!

Part 1, Part 2, Part 3, Part 4

Wednesday, October 27, 2010

Venipuncture and the Essence of Love – Introduction

[This is a working "paper." I’m not sure all this (or the connected posts) is right, and would really love feedback on it]

Today we were practicing drawing blood on each other (everybody’s favorite day in medical school). My partner (who shall remain nameless), had trouble hitting a vein, and so I encouraged them to try again. And again. I now have 13 holes in my skin.

The person felt terrible. Part of it was pride (not being rock star doctors after 11 months of medical school instruction is infuriating for most of us here at Stanford). But part of it, and I would venture to say most of it, was because of the pain that the person caused me. I said that I was happy to be of service. And I really meant it. I was legitimately happier after the session; I was in a significantly more pleasant mood having served the person in this way (and, indirectly, a patient who would not have to get poked). The pain was significant, but the pleasure in service was far greater. But why? What theory of pleasure/pain was I working under? I’m no masochist; pain did not directly become pleasure. I searched for something encouraging to say. I said, “It’s an important part of my religion to love my neighbor as myself, and there aren’t too many opportunities to serve my classmates.” I’m not sure it helped much.

Later in the day, I thought about what I said. Why was it that I connected love with service, and service with pain? I thought of Jesus’ words: “No greater love hath a man than this, that he lay down his life for his friends” (Jhn 15:13). Christ was no hypocrite; He gave up His life for us day by day in Palestine, and then literally, dying on the cross. But why is that the greatest love? Why isn’t it, “No greater love hath a man than this, that he benefit his friends maximally”? Why was suffering so connected to the Christian definition of love? This is a really important question that I do not have a good answer for yet but will be praying and thinking about in the days, weeks and probably years to come.

The why is still a mystery to me. But the what is clear: love as Christ defines and demonstrates it, is sacrifice. But if that is true, it changes everything. Everyone agrees with “love thy neighbour as thyself,” but the statement has entirely different meanings if love is sacrifice or if love is benefit. We all seek love, and to a lesser extent, we seek to love in relationships and in society. Jesus’ flip of the definition of love threatens to change everything that we thought we knew. Over the next few posts, I’ll discuss some of these implications.

Part 1, Part 2, Part 3, Part 4

Monday, October 25, 2010

How Glenn Beck convinced me to leave the Republican Party

Yesterday, I was a Republican. Today, well, I’m still a Republican, but that’s only until I can re-register. Glenn Beck, the anathema of everybody and the very popular host on Fox News, convinced me to leave the Republican Party. If you’ve read this far, it probably means Glenn Beck wasn’t who you thought he was: just another crazy Republican. He’s not who you think he is, and his ideas aren’t as crazy as you think they are. He wrote a book called “Common Sense,” and is what it claims to be. Before you make another snipe at everyone at Fox News or call him crazy, read this book; see if it makes sense. Try to understand him and this position; it’s the Democratic thing to do. But even if you care only for Democrat/Republican power, this opinion is surging in popularity and it would be prudent, even for strategic reasons alone, to read it so you know how to fight it.

The great thing about being convinced through reason is you don’t have any hard feeling about it. In fact, you’re somewhat grateful to the convincer because your old ways were wrong and erroneous. This has happened to me many times, but it has happened acutely twice. The first time was in listening to Bill Clinton on a proposition for clean energy a few years ago. I wanted to see him speak (convinced that I would vote against the bill). After his speech, I had completely changed my mind. And I was happy I did it.

Today, a similar thing happened. Glenn Beck talked about the Corrupt Two Party System. I’ve often talked about the Corrupt Two Party System. You’ve often talked about the Corrupt Two Party System. It’s bad. Congress has 13% approval ratings, 95% of incumbents get reelected. There is a serious problem with this system! Beck asks why we are playing into it. He says we’re playing into it every time we vote against someone or some party. We’re not voting for leaders; we’re voting for colors. We ought to judge candidates not by the color of their party, but by the content of their character.

It is all a game. They’re both the same. They both want the government bigger and you more dependent on it. The vilification of the other side is a red herring. The issues which make blood boil (gay marriage, abortion) are making us hate each other and not see/notice/have time to care about the massive increases in debt and spending that are going on, the erosion of our rights and incomes in exchange for peace, safety and comfort. We owe $13 trillion (every one of us owes ~$43,000). We have another $100 trillion in unfunded liabilities (e.g. social security). We have a spending problem, and this problem is turning us and our children into the servants of our debtors.

Bush spent trillions on a war because it, “woulda’ been worse if we didn’t.” Obama spent trillions on a bailout because it, “woulda’ been worse if we didn’t.” This game has been going on for a century. One crisis to the next, there is always some urgent need for our money. And when that ran out, the crises didn’t. We started spending our children’s money. There always has to be a crisis for the system to survive. It reminds me of the need for perpetual war in Orwell’s 1984: “War is Peace.” But instead of wars with guns (we have some of those, too) the war is Red vs. Blue. “Sure my party lacks principles, but at least the right color is in power.”

Make politicians into public servants again. Give them term limits (some of our congress people have served longer than Fidel Castro). Fairly redistrict. Move tax day right before election day (ever notice how they’re as far apart on the calendar as can be?). Hold them equally accountable for the laws they pass (no get-out-of-jail-free cards for ‘errors’ on taxes).

All that to say: I’m independent. I want out of the Corrupt Two Party System. I’m returning to common sense and I’m voting for people who can balance a budget, red, blue or neither. I’ll start there. Once we’re out of the spending tailspin, we can start to talk about other issues. I want comfy incumbents, safe with campaign contributions and gerrymandered districts, to be afraid of We the People; I want unaffiliated candidates to be viable. And I will work to bring this about with my pen and my ballot. All the other issues which the parties talk about are important, but not if our country collapses under the weight of its own debt or if our freedom and livelihoods are corroded away, right by right, dollar by dollar, into nothing, by fear of class warfare/terrorism.

There is a way out of the Corrupt Two Party System: leave your party.

Tuesday, September 14, 2010

Why I Should Be Able To Sell My Kidney

Today in class we learned about organ donation. We found out that there is a huge need for organs, and that 5,000 people are dying annually waiting for kidneys. Then we talked about how people can get kidneys and organ markets were mentioned. The message on them was, more or less, that they’re bad, but some people think they’re a good idea. The ethics professor and doctor who presented were both very strongly and ethically against the black organ market and a legalized true market (i.e. “Buyers’ Market”), and moderately opposed to legalizing government organ purchases (“Sellers’ Market”) in the US (6).

I’ve generally believed that markets can solve most resource problems when allowed to do so. This shortage of organs is artificial. We have hundreds of millions of spare kidneys in the US. It’s like the government making farming illegal and creating a food shortage. There are plenty of healthy people who would donate a kidney, but they just have no reason to do so. If markets existed, we’d have more than enough supply to meet the present (and growing) demand. I was surprised to see so great a need contrasted to so little support for the idea. In my mind, society should try to ethically maximize the number of years its citizens are alive and well; it seems that organ markets would do that. I figured that there must be compelling ethical reasons to prohibit organ markets.

My professors brought many objections to the idea. Some of the reasons seemed minor or question-begging (e.g. “Commoditization of organs is objectionable”)(9). The two real objections to organ markets that I want to focus on are on issues of equity and undue inducement. First, would rich people benefit more than poor people? Second, would more poor people sell their organs and thus get coerced into taking bad risks?
Superficially, this seemed not utterly different from a normal trade. It’s a voluntary transaction. In general, people should be allowed to trade something they value less for something they value more. That is the essence of every Starbucks purchase, every home sale, and the foundation of our economy: trading your labor for money, and that money for stuff. And indeed, it does seem likely that if people were allowed to sell their organs, poor people would do so more than rich people. But is there a problem with that? Let’s imagine an analogous situation.

Imagine that I am the CEO of a drug company. My company invents a drug that cures breast cancer. The production cost is high and I decide to set the price near the cost of production. Nevertheless, only a tenth of those with breast cancer can afford it. As an act of corporate responsibility, I also donate free treatment to 1% of the poor with breast cancer. Also imagine part of the high cost of the drug is because it’s made out of a rare mineral found in the oceans and I have to hire a crew of 35 fishermen for a year to find enough for one cure (3). The work is non-technical, dangerous, and well-paying; thus I attract mostly poor people to do it. Is this situation unethical? Is the disparity in rich and poor so bad as to prohibit this from happening? Are the fishermen being unduly induced to do the dangerous work?

How does this connect to kidneys? If we are trying to save life, how could we do the best job at it? A kidney transplant recipient will live, on average, about 15 years longer than on dialysis. A healthy kidney donor will have minimal adverse health effects, certainly no more than 1 year of lost life on average (that is, some may die in surgery, others from later complications but almost all of them will live without complication; as far as I know, it has not been accurately measured but is presumed small). There are ~5,000 people dying on the transplant list every year. This list is thought to be biased toward the rich who can push and connive their way onto lists(7). So, every year, we’d roughly save 70,000 life-years annually if we had enough kidneys. Even assuming only 1 in 10 on the transplant list was poor, and everyone donating a kidney was poor, that would still be net 2,500 life-years saved for the poor.

This breast cancer cure story above is ethically equivalent to organ markets in terms of life-years lost by the poor and gained by the rich. 70,000 life years are saved amongst the diseased (breast cancer victims; people on the waiting list), 7,000 of which are for the poor (charity recipients; poor on the waiting list). To deliver this treatment, the poor are voluntarily exchanging risk for money and collectively losing 2,500 life years (fishermen; poor donors). The sick rich are living longer; the sick poor also are living longer. The only people who lose life years are the fishermen/donors who voluntarily take a risk for high pay.

It seems that this situation is equivalent to those which we now permit. Even without my imaginary company’s charity (that is, assuming the poor didn’t benefit in life years at all), it’s hard to argue that we should prohibit the saving of some lives by the voluntary action of others. Shall we pass laws like, “No one shall run into burning buildings to save people, especially not if one is being paid by rich people to do it?” On the contrary; we have government-run public safety systems that pay poorer people to take risks for richer people. It’s not movie stars who come to the rescue when Malibu catches fire. We permit dangerous jobs, and we permit poor people to do them. We consent to this system of risky jobs every every time we order a pizza or use a piece of paper; delivery servers and lumber workers have among the highest mortality rates (4). If allowing the poor to take risks for pay is absolutely unethical, then I ask you: how many drops of the blood of the poor are you comfortable having mixed into your pizza sauce, and how bloodstained is too bloodstained for your white paper?

What does losing 70,000 life-years mean? That means that this question is a big deal. To give you a sense of scale, in 2004, there were 42,000 life-years lost in Iraq and Afghanistan, 79,000 to fires and 86,000 to drowning (5). In other words, far more life is lost because of the government-created kidney shortage than to terrorist bullets and IEDs; the benefit of a kidney supply is about as good as preventing every lethal fire, or throwing a life preserver to every would-be drowning victim.

This is a big ethical fork in the road, and we should not change course without a compelling reason. 70,000 life-years annually is a compelling reason. It’s like someone invented a $1 cure for uterine cancer and we’ve outlawed its use for ‘ethical’ reasons (5). We’d better have a good ‘ethical’ reason to let people die. And they are dying, about 12 a day, because we’re worried about the equity of some rich people living a bit longer than they should, or poor people taking risks that they shouldn’t. If we legalize organ markets two things would happen: 1. Rich people and poor people would live longer 2. A lot of rich people’s money would end up in poor people’s pockets. Why is this bad?(8)

(3) Fisherman mortality: 71 deaths per 100,000 Assuming an average US age of 36.7, and an average life expectancy of 78.2 years, and a mortality rate of fishing of 71.1 per 100,000 per year. That works out to A x (78.2-36.7)x71.1/100,000= 1 life-year (where A is the number of people exposed to this risk to equal 1 life-year). A = 33.9 fishermen working for a year together lose 1 life-year. Round to 35.
(4) Timber workers have a mortality of 117.8 per 100,000 and delivery servers have a mortality of 37.9 per 100,000.
(5) WHO BOD – 2009; US data from 2004. Breast Cancer: 612,000 DALYs. Uterine Corpus Cancer: 75,000 DALYs.
(6) The only difference, it seems to me, is not an ethical but practical. Organ donors would only get a fair price or have adequate supply in one of those two systems. Governments don't have a very good track record at setting prices.
(7) Another essay could be written on the economics of a market. With the amount that Medicare already spends on the poor for dialysis, it could probably buy the kidneys, transplant them, and have lots of money left over. There very well might not be any gap in rich and poor, at least when it comes to kidneys. In this case, the money flow would still be from rich (through taxes) to poor (after a stop in a Medicare account).
(8) This analysis is from a policy perspective, making assumptions about people acting out of self interest. Much more could be said about the virtue of self-sacrifice. I hope to write more on sacrifice, its virtue, and how medicine tends to prevent it. More on that later.
(9) The argument seemed to be of the form: 1. Commoditization is unethical 2. Selling organs is commoditization 3. Selling organs is unethical. This argument gives no actual insight into the problem, but simply confuses it with an econom-ethic word to obscure meaning. Why is premise 1 true?

Sunday, March 7, 2010

The Solomon Scale (6 of 6)

Dear Grandmother,
First, I am thrilled to hear the news about your neighbor! The angels in heaven are rejoicing over it! And it fits in nicely with this letter; it seems like He has thought this through.
I’m excited to write this letter to you! I have not been able to share these insights with many others, as most in my lab are atheists, and the Christian community is still skeptical this science and of me in particular. I’m glad that I have someone like you who is interested and can ask such good questions.
Last week I told you about the results of our paper. What excites me most about these results are their implications, some of which you have already guessed. I think this slipped past most people, because they might be very upset otherwise. It’s also interesting think about this in terms of eternity. Think about a normal person at 26.3S and -0.01S/year and no acceleration. Consider what would happen to that person if he continued along that track. In just 1000 years, he would be what most murders test at, 16.3S. After two, he would be morally equivalent to a dictator, 6.3S. Before three millennia come, he will have reached absolute zero. There will literally be no goodness in him at all. And what happens to a soul when it is utterly corrupt? Does it even remain human? Can something even exist without Goodness?
And on the opposite side, consider a reforming Christian. Let’s assume that the moral acceleration of true convert to Christianity we measured is actually true. Consider a perfectly normal person who truly converts to Christianity on his deathbed, dying at 26.3S with a velocity of -0.01S/year and an acceleration of 0.017S/month2. Where would he be after a millennium? His Solomon score would top 5000S. Can you even conceive of that? He would be thirty times more righteous than the current world record holder. That is the power of Christianity: not to make bad men nice, for any religion can do that; but to make Old men New.
I think this is what Lewis was talking about. There is a big difference between a murder and your friendly neighbor (~20). But that difference is miniscule when compared with the difference between even the most saintly on earth and one who has been accelerating for 1000 years. If God’s goal were to maximize the number of Solomons in the universe, then there is no means but Christianity that He should use. Certainly a billion people improving linearly in Islam is very good. But that goodness would almost be swallowed up by a tenth that number accelerating even within a thousand years, not to mention eternity.
And so we shall go on, approaching the likeness of God at ever increasing speeds.
Thank you for continuing this correspondence with me. I hope that is might continue.
Your loving grandson,
Jeremiah Paul
Part 1   Part 2   Part 3   Part 4   Part 5   Part 6