Sunday, September 8, 2013

What it is like to be a Man

A Discussion on the Subjective Experience of Masculinity

This week someone* had the experience of treating a patient with gender identity dysphoria, that is, someone who is transgendered. The standard treatment for female to male is treatment with biweekly testosterone injections. I reviewed the consent form for such treatment. The major focus of the consent was explaining the physical changes that would occur when taking hormones. No mention was made, with the exception of increased libido, of psychological or mental effects of testosterone. I considered this, and was rather surprised. If I were a patient considering taking hormones, I would be most concerned with what it would do to my mind. Bodily changes are important, but not nearly as important as how it would affect my thinking and behavior.

But what does testosterone do to the mind? There is very little research on this question. The only research I’m aware of is the work by Paul Zak. He showed that men will behave differently when given testosterone in certain economic/psychological games (the study was restricted to men, because of concerns for affecting women’s hormonal systems). The game most affected by testosterone is called the Ultimatum Game. This game involves two players: player A is given $10 and can choose to give any amount is that to player B. Player B decides whether to accept the offer or, if the offer is too unfair, to nuke the whole pot so nobody gets any money. When given testosterone, player B is more likely to reject unfair offers. Such punishing behavior is critical, Zak argues. He discusses another experiment where two groups compete with each other. One group is allowed to, at individual expense, punish free riders, while the other group is not. The group that is allowed to punish is wildly successful and out-competes the group that is not allowed to punish. Zak sees testosterone as a driver toward enforcing laws and fighting free riders, two essential functions for a functioning society.

As far as I know, this is the major work done on the psychology of testosterone. Why aren’t more people interested in this question? I think because we are just beginning to emerge from behaviorism. Since the cognitive revolution, we’ve started to think that ideas might impact behavior, that psychological experiences might actually matter. I remember a comment in paper comparing motivation to pleasure. The authors noted that the early work in the field was done by behaviorists who did not collect data on subjective mental states; as a result, the conclusions of the early work could not speak help separate motivation from pleasure. I think a similar thing has happened with testosterone. No one asked, after Thomas Nagel, what is it like to be a man? So we must start from scratch.

What is it like to be a man? The difficulty with this question is that comparisons are hard to find. It is difficult to identify individual subjective experiences and attribute them to one’s sex. How can one know if a particular state is common to men and women, or is a direct result of being a man? Further, are there subjective states that only men have that women do not? Or is it a more fluid thing? I think the experience of transgendered people can speak to these questions. For those who experience gender identity dysphoria (the DSM diagnosis), they often report feeling like a man, even though they were born genetically, anatomically a woman. I’ve spoken about this question with Ben Barres, a female to male transgendered individual and a professor in neurobiology at Stanford. The emphasis of his experience was on the social conventions surrounding the genders (e.g. preferring to dress up like a soldier rather than a princess). Transgendered people often go through operations and take hormones to change their physical appearance. They often report this reduces an enormous amount of anxiety and depression, as they now look on the outside how they feel on the inside. The feeling of being a man is an understandably difficult thing to define or describe, but from transgendered people, we learned that part of what it means to be a man is to look like a man; there is a mental state that is somehow incompatible or conflicting with breasts.

But what is that state? I recently had insight into this question when I had a testosteroney day. I’ve heard some argue that men have hormonal cycles as women do, but have not seen good evidence to this effect. Nonetheless, I experience certain days that I can describe none other than testosteroney. I’ve had others describe states of mind with the very same word. On one such day, I was pondering this question. I began to note the things that I did differently, or how I thought differently. When driving to work, I noticed that I drove a little faster, took a little more risk, and was ruthlessly just in traffic etiquette (if someone wanted to cut in the traffic line, I normally let them; on this particular day, I did not). At work, I was confident with my supervisors and patients. On my breaks my mind wandered to projects, solving world problems, launching businesses, and responding to arguments; this is somewhat typical for me, but on this particular day, my own individual concerns were afforded almost no attention. I also noticed on that day that the oh-so-difficult Christian command to not look at a woman to lust after her was especially difficult. When I got home from work, I did not procrastinate and was very productive.

I began to ask myself: when else do I feel like this? In parallel with this, I recalled the tiny bits of research on testosterone and things that increase it. Do I feel like this when my team wins? Yes! Do I feel like this when I handle a gun? Yes! Do I feel like this when I drive fast? Yes! Beside the research I’m aware of, are there other times I feel testosteroney? Competitive activities, lifting weights and summiting a mountain all seem to give this feeling. They also tend to be enjoyed more by men than women (at least more frequently). For some reason, climbing on top of large piles of rocks seems to be a stupidity associated with my sex.

What about women? Can they feel testosteroney? Of course! They also produce testosterone, and whether it is literally increased or not under the circumstances is an empirical question that has not been asked. Perhaps it is the case that women cannot increase their testosterone to the same degree as men; men certainly have anatomy to suggest that they might experience testosterone rushes of greater magnitude. But this is just speculation, and experiments need to be done.

In this rambling essay, I think my conclusion is that we just simply need to hunker down and do this research. What frustrates me is that the experiments have not been done. This essay has focused on male hormones, mostly because I have direct access to their release. I would guess that women’s behavior and psychology is also affected by hormones (female friends assure me that my guess is secure and that female behavior is not constant through the month; I have not had the opportunity to make these observations myself). What do hormones do to our psychology? This is a critical question for medicine if we intend to continue using hormone therapy. Our patients ought to be told all the risks and benefits of a particular treatment, including the psychological. It is inexcusable that we do not have this information. Let’s get to work.

*Because of HIPAA, I cannot tell you whether that person was me or not. Also, if I were to divulge that I treated a patient from “Northern California,” I would be in violation of HIPAA; the punishment for such an offense is imprisonment. I’m not joking. If you think this is unjust, please work to reform HIPAA.

Saturday, August 24, 2013

Rodin: A Genius Without Hope

Rodin: A Genius Without Hope

After completing a difficult rotation, I decided to spend the afternoon in the Rodin sculpture garden, and exploring the Rodin collection at Stanford’s Art Museum. First off, I must say that I love Rodin. He is able to masterfully express emotion in his sculpture. As an aspiring psychiatrist, I find such expression powerful.
One of the things that Rodin is famous for, is his ability to show motion in sculpture. My favorite piece that does this is called the Walking Man. The sculpture is after one of Rodin’s favorite models, the man whose face became John the Baptist. It also demonstrates Rodin’s habit of leaving a sculpture unfinished. His earned him much critique in his day, but I think had great effect here. Before Rodin, sculptors had to complete either a bust or a complete sculpture. With Walking Man, there is no head and there are no arms. The entirety of the viewer’s attention is directed at the torso and legs. And Rodin is able to give the powerful illusion that the bronze is in motion. It is a metaphor made of bronze.

This is common in Rodin’s work also: he is less concerned with accurately portraying a person or a character, and more concerned with the idea or ideas they represent. This earned him much malice from those who commissioned him to create a sculpture of themselves. While their friends often agreed that it really did look like them on the inside, warts and all, those who paid for them were often disappointed to have them revealed to the world. Unlike previous sculptors, Rodin would not be perfectly accurate in his portrayal of classic scenes. He would be more concerned with communicating the emotions, the ideas, or the morals of the story.

Regarding emotions, Rodin is a master of masters. He realized perhaps more than any other sculptor I have ever seen, that the whole body expresses emotion. He pays particular attention to hands. Whether it be a defiant fist, or an upturned hand of despair, or hand embracing a lover, there is often more emotion in the hands sculpted by Rodin than the faces sculpted by others. Perhaps my favorite piece, or collection of pieces, are the burghers of Calais. The inspiration of this piece is a situation during the Hundred Years War where the King of England put the town of Calais under siege. Six of its distinguished citizens, called burghers, went out to sacrifice themselves to the King while pleading mercy for their city. The piece demonstrates six approaches to defeat. The Stoic is present, who marches steadfastly into oblivion, gravity on his face, but nothing more. Another of them is despairing, another is confused, another is mourning with his head in his hands. My favorite among them is Jean d’Aire. Jean is defiant. His muscles are tensed, his jaw is tight, and his eyes are looking out with confidence despite his defeat. Of the six, I most wanted to be like Jean; I thought he represented the Christian response to defeat in this world.

I was discussing the piece with a friend, and she noted that Jean did not express joy, so was not really a Christian response. That got me thinking about the rest of Rodin’s work. Despite having an impressive collection, Cantor did not have a single sculpture by Rodin with a smile. Actually, there was one that I found after three hours of looking at Rodin. In his masterpiece, The Gates of Hell, a piece with hundreds of figures, there is a tiny two inch baby with a smile. I began to survey the emotions he did express. His most frequent emotion was sorrow or despair. Sensual emotions were also quite common; some of Rodin’s work is actually quite erotic. Amongst his subjects were Stoics, philosophers, dreamers, and artists. But none of them expressed simple joy. I realized that Rodin, in considering his work as a whole, expresses pre-Christian emotion. Rodin occasionally sculpts Christian subjects, but does not seem convinced them. The emotions expressed by Rodin are like pre-Christian philosophies: they fully express the truth that they see, but do not know the inexpressible joy brought by Christ. The Gates of Hell is perhaps Rodin’s most powerful piece; it captures the horror of the place, it is devoid of hope. Like the Greeks and Romans, I think Rodin was absolutely convinced of Hell, but doubted Heaven. Rodin’s genius in portraying the Gates of Hell may never be surpassed. We must wait for a Christian sculptor of equal genius to attempt The Gates of Heaven.


Because he is a much better writer than me, and because he discusses Rodin also, I will here share Robert Heinlein’s perspective. In his book Stranger in a Strange Land, one of the protagonists describes the rich meaning in two of Rodin’s pieces.

She Who Was the Helmet Maker's Once-Beautiful Wife
Anybody can look at a pretty girl and see a pretty girl. An artist can look at a pretty girl and see the old woman she will become. A better artist can look at an old woman and see the pretty girl that she used to be. But a great artist — a master — and that is what Auguste Rodin was — can look at an old woman, portray her exactly as she is… and force the viewer to see the pretty girl she used to be…. and more than that, he can make anyone with the sensitivity of an armadillo, or even you, see that this lovely young girl is still alive, not old and ugly at all, but simply prisoned inside her ruined body. He can make you feel the quiet, endless tragedy that there was never a girl born who ever grew older than eighteen in her heart…. no matter what the merciless hours have done to her. Look at her, Ben. Growing old doesn't matter to you and me; we were never meant to be admired — but it does to them. Look at her!

Fallen Caryatid with Stone
Now here we have another emotional symbol — wrought with exquisite craftsmanship, but we won't go into that, yet. Ben, for almost three thousand years or longer, architects have designed buildings with columns shaped as female figures — it got to be such a habit that they did it as casually as a small boy steps on an ant. After all those centuries it took Rodin to see that this was work too heavy for a girl. But he didn't simply say, 'Look, you jerks, if you must design this way, make it a brawny male figure.' No, he showed it… and generalized the symbol. Here is this poor little caryatid who has tried — and failed, fallen under the load. She's a good girl — look at her face. Serious, unhappy at her failure, but not blaming anyone else, not even the gods… and still trying to shoulder her load, after she's crumpled under it.

But she's more than good art denouncing some very bad art; she's a symbol for every woman who has ever tried to shoulder a load that was too heavy for her — over half the female population of this planet, living and dead, I would guess. But not alone women — this symbol is sexless. It means every man and every woman who ever lived who sweated out life in uncomplaining fortitude, whose courage wasn't even noticed until they crumpled under their loads. It's courage, Ben, and victory.

Monday, July 29, 2013

Side Effects: A Cure for Stigma and Call to Arms in Psychiatry

It is the rare film that takes something I’m already excited about and makes it even more exciting. But Side Effects achieves this: it is a Da Vinci Code for psychiatry, a whirling adventure that takes the viewer through the psych ER, the clinic and the hospital. I must tip my hat to its director, Steven Soderbergh, for he even made a literature review a thrilling, plot-changing scene. He demonstrates that modern psychiatry has all the ingredients of a high-adrenaline thriller: high stakes (pharmaceutical profits), complex character motivations, and a lot of ambiguity. With beautiful cinematography and masterful use of light and focus, the whole movie looked like an antidepressant commercial.

The thriller genre draws the audience along and succeeds in educating them “by the way.” Viewers see the many faces of modern psychiatry, including everything from pharmacotherapy counseling sessions to electroconvulsive therapy, and the attentive layperson can leave the theater with basic knowledge of depression and SSRIs, along with their side effects and what it’s like to be on them.

Psychiatry is an easy field to oversimplify. But Side Effects avoids both witch hunting psychiatrists and propagandizing SSRIs. Its critique of psychiatry is oblique. In 1975, Milos Forman aimed for psychiatry’s chest and unloaded both barrels with Nurse Ratched in One Flew Over a Cuckoo’s Nest. Side Effects used the facts of modern psychiatry as a mostly accurate (if somewhat exaggerated) background; it is a great film set against the intriguing tapestry that is modern psychiatry.

Side Effects seems to cover all the sticky issues in Psychiatry. Lesser movies would simplify the issues. Side Effects keeps them sticky, and uses the stickiness to make the plot gripping. It is uniquely able to do this because of its genre. In a non-thriller, the good guys and bad guys are usually pretty clear; the viewer’s sympathies rarely shift. In Side Effects, Soderbergh is able to give the viewer sympathy for good and bad psychiatrists, good and bad patients, and everyone in between; it is truly a full-spectrum emotional experience. The viewer gets to feel the deep sadness and isolation of depression, despair of suicidality, shame at having to see a psychiatrist, discomfort at a doctor’s “frivolous” prescription, hope that an antidepressant is actually working, and frustration at intolerable side effects. The viewer sympathizes with the psychiatrist’s guilt from a terrible patient outcome, anger at the malingerer, tiredness from overwork, and stress about finances. The viewer sees even the patient’s partner’s perspective, feeling their frustration and powerlessness.

The film powerfully combats stigma against those with psychiatric illness, and it does so by not combating it. In the late 1980’s, Jay Winsten and the Harvard Alcohol Project convinced popular TV shows (e.g. Cosby, Cheers) to donate several seconds of their scripts to including a “designated driver.” Without much finger-wagging or public education, the concept caught on and dramatically reduced the stigma of arranging to have someone drive you home. Side Effects does a similar thing with psychiatry. It doesn’t do much finger-wagging; it simply shows the pain caused by stigma and judgment and the dark road a depressed patient must walk down. The audience actually feels empathy for someone struggling with depression and the pain of judgment. Such empathy is very difficult to generate, especially for people who are “crazy.”

Despite its being a thriller, the film also touches on the deep philosophical question: who are we? A psychiatric patient is defended from a crime by claiming she was a, “victim of circumstance and biology.” The film asks us all, “Are we all victims of circumstance and biology?” Various high-performing not-mentally-ill characters seek medication to help improve their performance which, as one character explains, makes it, “Easier to be who you are.” Are we truly ourselves only when on our medications? And are medications the only defense we have against sadness and stress? In a poignant scene, a depressed character begins crying at a party. Her friend comes as if to console her, but ends up only offering a drug recommendation. The party guests look on the crying woman with embarrassment, unable to comfort or accept her, and she runs out of the party, ashamed.

The most important theme of the movie, and the crux of the plot, deals with diagnosis. The central tensions of the thriller are the daily questions of the psychiatrist: Who is really sick? Did this pill cause that? What should I, the doctor, do? These everyday uncertainties become matters of life and death, fame and disgrace. In the film, the stakes are very high for knowing if the symptoms are real. This fictional story reminds us that for patients, these are always matters of life and death. A correct diagnosis may well change a patient’s life.

In the film, one of the psychiatrists points out that the cardiologist can see the heart attack coming because he has tests, and then asks, “What test there is for sadness?” I hope that this is the last decade that such a film can be set. “The Sting,” a film set in the 1930’s, shows a central dupe which required the protagonists to delay telegraph information. When I saw it, I smiled at the quaint idea of slow information. I hope that our children can look at Side Effects and remember the quaint time when mental illness could not be diagnosed except by interview.

Sunday, July 21, 2013

Pinching Patients - Pain, Consciousness and Practical Neurology

How to Solve the Problem of Consciousness With Pinching

I’ve just completed two weeks with Neuro Critical Care in the Neurological Intensive Care Unit (NeuroICU) taking care of very sick patients. The NeuroICU, like the hospital in general, is not the sort of place you want to end up in. You get to spend time with us if you’ve had a bleed in your brain, or had a massive stroke, or had severe head trauma. There are many things I could say about my experience, but I will focus here on one that is philosophically relevant.

Depending on what service you happen to be on, you report different things. Surgeons are concerned about bowel stasis after abdominal surgery, so are very interested in things like pooping and passing gas (woe unto you if you forget to report to your team whether your patient pooped since last they saw her). Cardiologists care about heart sounds and psychiatrists care about mood. But what about doctors in the NeuroICU?

Many of our patients had sustained brain injury to the point of being unable to speak. How do you assess whether things are getting worse or getting better in the brain, especially when the patient can’t talk? Do we need to perform an operation, do a procedure, or give another drug? First, we check to see if the patient can move despite not being able to talk. “Mr. Johnson, move your fingers. Mr. Johnson, move your eyes.” But sleeping people also wouldn’t follow commands. What’s the difference between a sleeping person, a comatose person, and a dead person? How can you separate these three? How do you know if “anybody’s in there”?

One of the best (and only) tests we have is response to noxious stimulation. That is, we try to hurt them and see how they respond. Every morning, my job was to approach my comatose patient and, to see how she was progressing, pinch her on each of her extremities. Neurologists, I found, are quite adept at causing pain and I was a quick study. A patient might not respond at all (this is a bad sign). A patient might respond, but do so in a “decerebrate” or “decorticate” fashion, that is, their response is a brain stem or spinal cord reflex and not a conscious decision [1]. In other words, some people will respond to a pinch on the inside of the wrist by pulling in toward the pain rather than away from it. Still further, a person who was particularly awake would make some effort to stop the pain. A patient who tries to bat away the pinch is in relatively good shape.

I’m also reading on the philosophy of mind, and I realized that this crude test is actually an experiment demonstrating several things. Minds (whatever they are ontologically) have various capacities and experiences including sensation, thought and intention. I realized that our pinching test is trying to answer these questions. Is the patient experiencing the sensation of pain? As Stanford pain expert Sean Mackey likes to say, “The strain of pain lies mainly in the brain” (i.e. is the “noxious stimulus” of the pinch making it to the brain and consciousness?). Movement, facial grimacing, or increased heart-rate all suggest the sensation of pain is intact. Is the patient thinking about where the pain is? Does the patient intend to free herself from the pain by movement? If she moves away from the pinch, it would suggest both that she has knowledge about where the pain is coming from and intends to stop the pain. Batting at the pinch indicates higher-order knowledge of location and how to stop it.

The “pinch test” has obvious limitations, the most concerning of which is for patients who are “locked in.” Patients who lose the connection between brain and body will “fail” the pinch test, but may still be entirely conscious. Patients we have declared “vegetables” by our crude tools might actually be awake but unable to communicate. The most intriguing work that I know about in trying to improve these tools is Adrian Owen. He put “vegetables” (patients in “minimally conscious states” and “persistent vegetative states”) into fMRI scanner, a machine that can read where blood is flowing in the brain, and asked them to perform various well-characterized tasks. He would say things like, “If you can hear me, imagine swinging a tennis racket.” In their sample of 50 patients, 5 of them could. But ability to follow a simple command, even in the brain, is far from fully conscious. So he tried to go further. Using this strategy, he asked various yes or no questions, and found that one patient was able to respond correctly to personal information. Owen continues his work in this area and is trying to do the same thing with EEG (which would be much cheaper and more scalable).

Pinching is a pretty crude way to answer the Problem of Consciousness. But it is a strategy in line with the core of medicine that I have long loved: it’s about helping patients. Medicine since the time of Hippocrates has been an empirical profession; at our core, our job as doctors is not to discover answers to the deep questions of nature or philosophy. Doctors qua doctors use whatever science or art we can to help patients. Unfortunately in 2013, the best tool we have to assess consciousness is a well-placed pinch. Would it be nice if there were better tests? Sure. But we've got what we've got and there’re sick people to take care of right now. So let’s get busy.

[1] I think it is a fair question to ask how we know for sure that a “decerebrate” response is truly “unconscious.” I’m skeptical that this has been rigorously tested. As with many things in medicine, there is (necessarily) a lot of tradition. Even things as basic as prognosis are notoriously under-studied and even well-trained physicians are exceptionally poor at prognosticating. I read one study of cardiac arrest victims who were given a “poor” or “grave” prognosis: 21% recovered, 54% were supported and died or had poor recovery and 25% had support withdrawn and died. This suggests that on the order of 5% of the total population died because a doctor said they wouldn’t live.

Sunday, June 30, 2013

Pain, Atheism and Truth

Pain, Atheism and Truth

Why do we feel pain? What is it for? Pain tells us when something is wrong. It is an incredibly powerful set of millions of sensors disbursed throughout our body to alert us to a problem so that we can take action. Foot tissue being destroyed? Alert the brain! "OUCH!" which leads to the foot being retracted. 

For dubious philosophical reasons, we assume our senses have evolved to provide us with accurate information about the physical world. Pain is a particularly salient kind of information and usually does a good job of keeping us alive. Of course, it seems like we're getting more and more  chronic pain conditions in which the sensors seem to be broken or malfunctioning. But the big picture is that they're really useful (as leprosy patients will tell you).

But humans have the ability to feel more than just physical pain. We also have evolved the ability to feel psychic pain. For some reason, it is assumed that, while the physical pain is useful for alerting the organism to a problem, the psychic pain is pointless. We often treat it (a likely very expensive adaptation) as always malfunctioning. In an article on Christians having more positive Twitter accounts, the Jezebel author explained
atheists' rational thought "diminish[es] the capacity for optimism and positive self-illusions that typify good mental health.
The underlying assumption (by the atheist) is that the atheists are seeing the real world while Christians are believing in illusions. But imagine the same thing were said of physical pain: "Atheists' foot immobility diminishes the capacity for painlessness and un-charred flesh that typify good foot health."

Why are atheists in pain and Christians not? Why do we assume that the psychic pain sense is the only sense that leads us wrong? Might it be that the psychic pain is telling the organism some useful information? If we are to be scientific and follow our senses, why ignore this one? Why shouldn't we move in a direction that we, even if we were dumb animals, would follow to escape pain?

I have the utmost respect for the atheist virtue of valuing truth so highly. It is the virtue of Thor and other Norse mythical heroes who, knowing defeat to Ice Giants is certain, fight on. It is the virtue of the stoic, who knows the gods will win, but doesn't give them the satisfaction of seeing him in pain. And so may atheists soldier on valiantly, without hope of afterlife and without cosmic meaning in this one, enduring the pain that only "self-delusion" would palliate. But what if the pain wasn't necessary? What if life could be lived with satisfaction and without pain? What if all of our senses pointed us toward truth? What if reason and faith could, like estranged lovers, meet in a long-overdue embrace?

Saturday, June 29, 2013

The War of Prophet, Priest and King: Christmas Conspiracy (part 3 of 3)

The Christmas Conspiracy

In the darkest hour of the War, something happened. There came a group of men, members of a secret society, who conspired to bring peace to the endless War. A tiny number of emissaries from the various races of men gathered together symbols of the Kings’ pragmatism, the Priests’ mysticism, and the Prophets’ eternal truth. They journeyed together to commission one who would bring balance to the world. He would be a pragmatist, and he would set up a system undeniably more pragmatic than any kingdom. He would be a mystic, speaking in riddles and telling stories that would thrill the heart of man; moreover, he would be a myth, the satisfaction of all the yearning for a hero that came before. Finally, he would be Truth, building so secure a foundation for reason that it would never be shaken. And so, guided by the stars in the sky, the words of ancient prophets, and (unlike men today) by asking for directions when they got lost, they found the one whom they sought. And so, in the clandestine setting of a stable, they presented their gifts to the one who would end the War and unify both Man and men. They gave him gold, the most pragmatic of metals, so valued by men that it could be exchanged for anything; frankincense, the fragrant spice of the priests, thrilling the nostrils and exciting ancient memories; and myrrh, the ancient anesthesia and embalming spice, speaking to the foundation of all philosophy: remembrance of mortality. With these, the Peacemaker was commissioned.

He lived a model life, bringing together in himself the prophet, priest and king. He healed the sick, he taught the Truth, and he preached the Mystery. The Peacemaker was killed after only a few years by an alliance of the reigning powers. But his death was like the planted seed. Though few realized the implications of his short life at first, the fruits soon became apparent. Before his death, he started a Family and adopted pragmatists, idealists and existentialists into it. And in this Family, the three Powers had to learn to love one another as brothers. And so they did.

The Peacemaker’s story satisfied the myth-seekers because it was a good story and it satisfied the truth-seekers because it was a true story. It satisfied the pragmatists because belief in the story yielded benefits to the individual and the group. And so the Family grew like a vine, the diverse Powers being added like grafts. The Family was the first thing big enough and durable enough to include all types of people and their professions. The family had room for the pragmatic classes of soldiers and merchants and kings. It had room for the mystics and priests and mythmakers. It had room for philosophers and scientists and prophets. They were bound together as Family by the Peacemaker. And so it was, for the first time, that the philosopher could critique the story of the poet because it was not true, and the poet could critique the truth of the philosopher because it was not beautiful. Because, for the first time, they were working on the same thing; their investigations were directed at the same thing. This family came to the exhilarating conclusion that Justice was Justice: Justice in government was the same as Justice in narrative and the same as Justice in Heaven.

On the home front, the mystical groping of the Id could finally see whom it had been ever dreaming about in the Peacemaker. The Superego discovered that it existed in the same world as the Id, and that no natural desire was given in vain. It found that all that the Id had been hungering for could be satisfied in the Family. The Ego became a jury no more, but an interpreter between the Id and Superego. Sexual desires, or desires for food did not have to be crushed, or did not have to reign, but could find proper expression.

The War of the Powers and the War of the Psyche were ended when the Treaty of the Peacemaker was signed in the 33rd year of His reign. Peace began spreading throughout the world as news of this novel solution spread. And so it continues to spread today.

<<<<<<< Previous: The War Among Men

Friday, June 28, 2013

The War of Prophet, Priest and King: The War Among Men (part 2 of 3)

The War Among Men

The War in the soul among these three needs led to the rise of these three powers: the Kings, the Philosophers, and the Priests. These three rulers each saw their own domain as the dominant one, and so fought with the other two for the allegiance of the men. So, not long after the dawn of Man and the rise of the powers, the War of the Powers began. Priests would denounce the Truth of philosophers, and philosophers would mock the Mystery of the priests. The kings, fearing the power of them both, would have them censored or punished or killed. In exchange, the Philosophers would tell the people of the Righteousness of rebellion, and the Priests would excite their passions to fight.

For most of history, this War was a Cold War, with the Kings content to rule in their palaces, the Philosophers to ponder in their huts, and the Priests to celebrate in their temples. As their domains were often non-overlapping, each had dominion over some part of most men. The same man would pay his taxes, feast in the temple, and often unconsciously, believe the philosopher. Each power would rarely risk this to make a grab at more power.

The War smoldered for long forgotten centuries, occasionally flaring up in rebellions or conquests, with no hope of peace. Finally, a man came who saw a way of reconciliation. His name was Plato, and he suggested Philosopher-Kings, men who would be both pragmatic and govern by Truth. Plato never got a chance to try it out himself as nobody trusted him to run a kingdom. But Akhenaten, King of Egypt, did try it when he attempted to usurp the priesthood with his philosophy of a singular God, Aten. Marcus Aurelius, the Roman Emperor, was a Stoic philosopher, and studied Plato himself. Confucius, perhaps as close as the world has ever come to a philosopher-king, built a rational and incredibly pragmatic system. Siddhartha, perhaps noblest of all, renounced his own kingdom and lived the model life of the philosopher. But Akhenaten’s sterile monotheism did not satisfy the hunger for Mystery, and the priesthood was thrust back into power after his death. Marcus Aurelius’ philosophy, true as it may have been, was impotent; in the end, he wrote his thoughts in private and in public, surrendered to popular enthusiasms. Confucius’ codes could not speak with authority as from Heaven, and the hunger for Mystery had to be satisfied with other systems. Buddhism came very close, but either sacrificed Mystery for Truth (Theravada) or Truth for Mystery (Mahayana), with the full benefits of either system reaped only by those few who could endure monasticism. In the end, none of these were able to achieve a broad alliance in these domains.

And so the War raged on in the two theaters: in the soul of man, and in public. It was a war of perfect and terrible balance, one without hope for end or peace. The hungers were fixed from the birth of man; the powers grew out of these. If one was killed and the flag dropped, the human hunger would pick it up immediately. And so the king in his palace, the priest in his temple, and the prophet in his hut battled one another for the affections and attention of mankind.

>>>>>>> Next: The Christmas Conspiracy
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Thursday, June 27, 2013

The War of Prophet, Priest and King: The War Within Men (part 1 of 3)

The War Within Men

New Hungers

Out of a whirlwind of birth and death, tooth and claw, blood and sweat, a man woke up as a man. It was a thing that had never happened before. The creatures who were before him were all unique in their own way, a kaleidoscope of colors and claws. And even though he did look funny himself, he was different because he was awake. He found himself in possession of an enormously expensive adaptation: consciousness. And like a more complex animal requiring more complex foods, this new adaptation needed caused in him a hunger for two things: Mystery and Truth. It seems that the capacity for Mystery and Truth had been building for some time; the symphony of species had prepared the way. The apparatus for Mystery seemed partly developed in dogs who dream, and the apparatus for moral Truth seems to be foreshadowed in the complex and sometimes altruistic social instincts of Prairie Dogs.

It must have been a wonderful day (probably a Friday; Friday’s are good days) when that which was foreshadowed finally appeared. On that day, the swirling chaos of instinct and id finally had an opponent; it had to convince the ego against its strange newborn enemy, the superego. On that day, the War of the Psyche was declared in the mind of man.


“…man seeks not so much God as the miraculous. And as man cannot bear to be without the miraculous, he will create new miracles of his own for himself, and will worship deeds of sorcery and witchcraft, though he might be a hundred times over a rebel, heretic and infidel.” – Dostoyevsky, The Grand Inquisitor

But the War was a unique one for the man was a unique creature. The Id, long a chaos of instinct, had a new element to it. Swirling in with the senseless instincts appeared a sensible story. The dreams, expressions of inner hopes and fears, began to produce stories that were strangely consistent. The men lost the ability to forget their dreams. In fact, they became convinced that the bizarre hallucinations contained profound meaning. They began to share them with one another, and even to tell of their daydreams. They told of men who were greater than men, men who were not content simply to wrestle against terrestrial threats. Otherworldly demons and monsters were remembered from the night who would fight against the super men in a thousand, thousand stories. The heroes were celebrated in feasts no less than if they were real men of great honor, and the villains were appeased and warded against no less than if they were real monsters. Such telling of stories, honoring of heroes, and warding of evils became an obsession for the men. As the race increased, and as they spread across the face of the earth, the hunger for Mystery was so intense that every group of them found it necessary to set aside some men who would focus entirely on celebrating the heroes and appeasing the villains. These men became the mythmakers, the poets, and the priests.


“For the secret of man's being is not only to live but to have something to live for. Without a stable conception of the object of life, man would not consent to go on living, and would rather destroy himself than remain on earth, though he had bread in abundance.” – Dostoyevsky, The Grand Inquisitor

On the other front of the War of the Psyche was the newborn superego. Social organization had long since existed, but a new element was present. The prairie dog was content to allow the instincts to war with one another. If and only if the herd instinct was stronger than the survival instinct, the animal would act ‘altruistically.’ The Man now had the two competing instincts brought before the Ego as before a jury tried before the judge of the Superego. The instincts would have to appeal to the Ego by presenting evidence admissible to court, namely that of Truth. The jury was by no means perfect, and justice was not always done. But for the first time in the history of life on the planet, a trial was occurring. Then something even stranger occurred. The men began to assert that the judgment in the court of their own mind applied to foreign courts. The men began to appeal to one another on the assumption that they all possessed the same court rules. “It’s not fair” and “You wouldn’t like it if…” became valid accusations, like grievances of a plaintiff against a defendant before a higher judge.

The Truth-Seeking part of Man, when it wasn’t serving as a judge between the Ego and Id, was far from idle. Without ceasing, it looked for patterns, to see the “reality” behind the appearance. It regarded the eyes, the only windows of truth for every other creature under the sun, as deceptive. The eyes, it knew, were only able to see shadows on the wall of a cave, when the light of reality was blazing bright outside. With a pair of feet utterly unique to the biosphere, it sought to stand on something more solid than matter. Matter, it thought, was as unstable as a flowing river. Forms, Numbers, Justice, Truth, God, the Cosmos; many concepts were proposed as the ultimate foundation, discovered by reason, meditation, or revelation.

In every group of men, there were some in whom the Hunger for Truth was ferocious. If a group found themselves lacking in Truth, they would hunt for it like a deer and would not stop until it was caught. They were not content to hold popular ideas; their Truth was as cold as stone, and as firm. Unlike the poets, these men did not suggest that their ideas were simply a good story enjoyable to some men in some places, but that they were True for all men in all places. And maybe because the societies were anemic and really did hunger they were tolerated and sometimes even believed. But usually their food was divided long after they were dead. These men were the prophets and philosophers.


“Turn them into bread, and mankind will run after Thee like a flock of sheep, grateful and obedient, though for ever trembling, lest Thou withdraw Thy hand and deny them Thy bread...In bread there was offered Thee an invincible banner; give bread, and man will worship thee, for nothing is more certain than bread.” – Dostoyevsky, The Grand Inquisitor

These new hungers for Truth and Mystery were present alongside the older hunger for food. Men yearned to be freed from the tyranny of chance in hunting and gathering, and so came together through agriculture and civilization. Men arose who promised security to the people. They led others to build granaries where food could be secured. They defended themselves with walls and gates. They raised armies to increase the practical power of their group, and in war, could reap where they had not sown. The practical necessities which each organism fought for on its own or with a small band of close relatives had now were provided by the super-organisms of the city and kingdom. The men who were the heads of these new entities included the concerns of the Prophet and Priest to support practical politics. But the ultimate concern was power, and their power depended on their ability to provide practical necessities to the people; they were pragmatists. These men were the kings.

>>>>>>> Next: The War Among Men

Tuesday, June 18, 2013

Superman: Man of Steel, a Review

[Spoiler Alert]
It is not often that one gets the privilege of watching truly epic Sci-Fi. But you get to with Man of Steel. Like The Dark Knight, is able to communicate good messages without making it a boring movie. And, finally, it does what all the old Superman movies never could (or wanted to) do: epicly strong characters beating on each other. Mid-air fights, awesome punches, and an impressively animated destructible environment makes for great fun.

Flight, for whatever reason, rarely feels real on camera (and in video games, I might add). But this does. Like so many of our dreams we wish were true, Superman really takes flight. And so does this movie. Great acting, spectacular cinematography, awesome script, and a Hans Zimmer soundtrack with lots of drums made for a spectacular movie experience.

The movie opens on Krypton and spends exactly enough time showing you the planet and politics there. It makes you care about the place and the people (and even the poor strange animals), and when then time was ripe, the planet was destroyed and you felt sad. There were some awesome Kryptonian battles, with Russell Crowe (as Jor-El) inspiring manliness with his words and punches before the planet dies. The movie continues to show all the classic Supermanly locations of Smallville and Metropolis, with characters that were true to the original spirit, but not simple copies, of the originals. Henry Cavil (who?) does a solid job as Superman, at displaying cool confidence through most of the movie, but some powerful scenes of questioning his identity and showing moments of despair.

I am no purist, and I hope some of the sci-fi faux pas were because of Superman orthodoxy. Superman’s powers come from his cells absorbing the “younger” sun’s energy. Though able to fly in space, he loses his powers in a Krypton-like “atmosphere.” The DNA of his entire race was put into his cells (the animation for this showed red blood cells, which are one of the few cells in the body that don’t have DNA). But, aside from these gripes, I can accept Superman as Sci-Fi with an emphasis on the Fi. At least we didn’t have to hear about mitochlorians.

The Father of Superman

The aspect of the movie which was so endearing was the relationship between Superman and his two fathers, Jor-El and Jonhathan Kent. His adoptive father (played by Kevin Costner) tells him after he resists his teenage impulse to murder a bully, “You just have to decide what kind of man you want to grow up to be, Clark. Whoever that man is, he's going to change the world.” But how? Clark Kent leaves home and for years wanders through the wilderness of trivial jobs and superficial relationships. We see ourselves in the young man searching for his identity. We all want to know: “Who are we? Why are we here?” We have a renewed hunger for such answers. Sure, he helped people along the way, but he didn’t really know what would finally satisfy him, how he could truly use his powers to their limit.

Batman Begins was about mental and physical training. Man of Steel was about moral training. What is the good life? The next section of the movie was a very tender telling of Clark Kent’s early life in wrestling with his identity and powers. It shows him struggling to both hide his powers while developing his virtues. These are some of my favorite scenes in the movie, with Kevin Costner (as Jonathan Kent) raises and mentors his son through normal rebellions with the added twist that if Clark goes bad, it would alter the course of the world. Jor-El tells him, “You've grown stronger here than I ever could've imagined. The only way to know how strong, is to keep testing your limits.” This is the inspiration for one of the coolest “learning to use your superpowers” scenes in all movie history: Superman learns to fly. After his first hop, skip and jump, he “falls” into a mountain. And then out of it on the other side. And then the damage he does to it crumbles the top of the mountain. Then there is an extended flight through canyons and valleys, up to space, back to the canyons, all the while having the exhilarating music of Hans Zimmer making it all the more engaging.

The Superman problem is a tough one. What does one do with (near) unlimited power? Is the old aphorism “Power corrupts” actually true? Superman finally accepts his mission from his father Jor-El, “You will give the people of earth an ideal to strive towards. They will race behind you, they will stumble, they will fall. But in time, they will join you in the sun.” Superman’s job is not to fix all the problems in the world, but to lead humanity, to provide an example. He is to be what we all aspire toward.

The Ethics of the Man of Steel

Superman: Man of Steel is appropriately titled.  Superman is a super man; that is, he is the embodiment of masculine virtues. He is physically and emotionally strong. He is bold and confident, but not arrogant. Time and again, he allows others to insult him without fighting back. He is a defender of the weak. He is willing to sacrifice himself for those he cares about and even those who are strangers to him. Most of all, he shows his masculinity with laser vision (a power which definitely gets an upgrade in this movie). OK so maybe laser vision doesn’t make a man.

The central virtue of Superman is his sacrificial compassion. He cares deeply about humanity. This is a virtue which both Jor-El and Jonathan Kent demonstrated, each by laying down their own lives for him. At an early crisis of the movie, General Zod demands Superman reveal himself and surrender or he would make earth suffer. Superman seeks the counsel of an anonymous priest. Should he give himself for the sake of humanity? In this dialogue with the priest, there are large stained glass images of Jesus in Gethsemene (where Jesus wrestles with whether or not he should sacrifice himself for humanity) and Jesus the Good Shepherd (where Jesus is in the role of gentle leader and guide) in the background. The priest tells him “You must take a leap of faith. Trust will follow.” And so he does. He gives himself up to humanity, who, in turn, gives him up to Zod. Despite the humans constantly trying to get control of Superman, he continues to gently remind them (i.e. by taking down a drone that is spying on him, or by breaking out of handcuffs) that he will help them but, “It’s got to be on my terms.” The Man of Steel teaches us that the only way to approach a super man is on his terms.

In addition to these moral themes, the plot wasn’t without its philosophy. General Zod was no stereotypical crazed villain; he was a patriot for Krypton and, in his political theory, a Platonist. The conflict was between Zod, who wanted to give Krypton another chance and Superman, who didn’t want to extinguish earth’s chance. Zod was fighting for Krypton’s system, with children born into their given roles as scientists, soldiers or leaders; Jor-El wanted to let his child make his own path. And, while reading a book by “Plato,” young Clark Kent resists using his powers and, throughout his life, rejects the crown of the Philosopher King.

Man of Steel, Christianity and Myth

Check out this trailer. There are enough lines that make explicit comparisons to Jesus that, when they are all edited together, it’s pretty clear that the Director wanted Christians to look at his Superman and say, “That’s just like Jesus.” They’ve posted a website with sermon notes and other resources to aid pastors in preaching about The Man of Steel. CNN writes about this with an emphasis on the greedy movie studio (which, as it turns out, is owned by the same greedy parent company as CNN) trying to extract money from unwitting Christians. On this subject, I would like to say the following to Hollywood: What took you so long? I’m thrilled that you’re finally making an effort to produce something that we like and want to see. Some of the $125 million that came in this opening weekend (i.e. the biggest June opening in cinema history) came from people going directly from pew to theater after hearing the pastor talk about the parallels between Jesus and Superman. Keep it up. Tell stories of heroes that look like Jesus, and help us out by telling us what you’re doing. We’re totally into that. We’ll reward you with our dollars.

The wonderful thing about mythology is that, like Jor-El, Superman’s corporeal existence is not necessary for him to accomplish his mission. He can lead us as Homer’s Odysseus and Virgil’s Aeneas have led us. Superman’s original mission was to uphold, “Truth, Justice, and the American Way” and as any cultural hero, we have poured into him our goodness and virtue. Superman, as our first superhero, represents us on the mythological scene. I am proud to stand behind the man in the red and blue. In a great scene, Lois asks him what the “S” stands for. He explains, “It’s not an ‘S’. On my world it means ‘hope.’” And let us look to that symbol which we first raised in the darkness of the Great Depression and take its meaning to heart. Let us have hope.