BLINK OF THE EYE

Audio-book Review

By Chet Yarbrough

(Blog:awalkingdelight)

Website: chetyarbrough.blog

The Overstory

THE OVERSTORY

By Richard Powers

Narrated by Suzanne Toren

RICHARD POWERS (AUTHOR, AMERICAN PROFESSOR OF ENGLISH)

RICHARD POWERS (AUTHOR, AMERICAN PROFESSOR OF ENGLISH)

Humanity’s years of life are but a blink of an eye.  Richard Powers, like Cervantes’ Don Quixote, tilts at a windmill that neither generates power, grinds corn, or pumps water.

You love Powers way with words but come away from “The Overstory” feeling like Quixote’s relatives–mourning his loss of sanity but rejoicing in his belief of love and life.

Humans think themselves the center of the universe.  To we puny creatures, no life is more important than human life.  Powers argues otherwise.

Humans are not the center of the universe.  Humans are part of an ecosystem; a system millions of years older.  A conclusion drawn by “The Overstory” is that the earth’s ecosystem will live millions of years after humans are gone.

TREE HUGGER

Powers tells a story that offers slim hope for humanity.  A congregation of misfits grow to understand the frailty of humanity and its essential need to support nature.  “The Overstory” begins in seemingly random stories of disparate characters who become part of a group of revolutionaries.  In some parts of the country, they are called “tree huggers”.

Powers forcefully develops the argument that trees are the foundation and future of life.  Every tree tells natures’ story of birth, life, death, and rebirth.  Every character in Powers’ story either supports forest preservation through protest or example.

TREE OF LIFE

Powers’ story is about the preservation of all life.

In Power’s story, a protest results in an accidental death.  It is a story of a husband and wife who symbolize the importance of a singular tree that cannot speak in a language that people can understand.

ECO-TERRORIST INCIDENT IN CALIFORNIA 2006

ECO-TERRORIST INCIDENT IN CALIFORNIA 2006

The protest is by a disparate group of eco-terrorists who sabotage a lumber harvesting company’s property.  One of the rebels dies from a firebomb meant to stop the harvest.  The consequence is the death of one, and the guilt carried by surviving rebels.  Those who survive, get on with their lives.  Many years after the incident, two of the participants are caught.  One chooses to implicate another to receive a lighter (7 year) sentence.  The other is sentenced to two seventy-year life sentences.

Powers’ symbolic example of human ecological ignorance is a highly successful corporate lawyer who has a stroke and cannot communicate with his wife.  He deeply loves his wife, but she insists on being free of any ownership by another, whether from love or physical possession.

The lawyer reminds one of trees that live but cannot communicate with humans.  His wife chooses to stay with him in his tree-like existence and begins to realize how he sees and understands without being able to clearly communicate.  She is free and begins to comprehend what freedom means when she looks out the window and interprets what her husband sees.

If there is revelation in Power’s story, it is not human centered.  The only slender hope Powers offers is for the language of trees to be understood by humanity.  The disparaging term “tree huggers” implies there is no hope.

In travels around the world, one sees our world in crises. Indigenous Chinese drink bottled water. An India’ guide notes his country is on the brink of ecological catastrophe. Why worry–our American President says global warming is a hoax.   It seems unlikely the world will wake up before it is too late.

THE LANGUAGE OF TREES

THE LANGUAGE OF TREES

Trees may have a language, but technology is unlikely to provide any translation that humanity will accept.  One hopes Powers’ imaginative story is a Cervantes’ tale;  not a prophecy.

REWIRING THE BRAIN

Audio-book Review
By Chet Yarbrough

(Blog:awalkingdelight)
Website: chetyarbrough.blog

Rewire: Change Your Brain to Break Bad Habits, Overcome Addictions, Conquer Self-destructive Behavior

rewire

Written by: Richard O’Connor, PhD

Narrated by: Fred Stella

DR. RICHARD O'CONNOR (AUTHOR, CLINICAL THERAPIST)
DR. RICHARD O’CONNOR (AUTHOR, CLINICAL THERAPIST)

In 1971, Brickman and Campbell coined the term Hedonic Treadmill to explain that people have a baseline level of happiness, regardless of what occurs in their lives.  That definition infers winning the lottery, or being diagnosed with cancer have opposite happiness quotients–one joyfully positive; the other horrendously negative.  The Hedonic Treadmill theory suggests happiness will return to a baseline level of individual happiness when the initial joy or sorrow subsides.

Toward the end of Richard O’Connor’s book, “Rewire”, the term Hedonic Treadmill is used to infer that America’s materialist predilection is like a psychological cul-de-sac; i.e. a mental trap with only one exit. O’Connor explains, in a different way, that the cul-de-sac is created by life experience that imprints memories that become automatic responses to current events.

DAVID R. HAWKINS (1927-2012, DIED AT AGE 85, AUTHOR, PHILOSOPHER, MD, PSYCHIATRIST)
This reminds one of David Hawkins expressed belief in “Letting Go”. 

O’Connor argues that rational behavior is unconsciously modified by subconscious imprinting from early life experience. The only exit from the cul-de-sac is to leave the way you came, recall how and why you entered, and teach your brain not to take that turn again.  This reminds one of David Hawkins expressed belief in “Letting Go”.

More fundamentally, O’Connor infers American society is more materialistic today; and, as a consequence, Americans are more mentally unbalanced than in the past because happiness from material acquisition is a road to nowhere, a Hedonic Treadmill.

HEDONIC TREADMILL
O’Connor argues that Americans are more mentally unbalanced than in the past because happiness from material acquisition is a road to nowhere, a Hedonic Treadmill.

Rewire offers a great deal of information about causes and cures for individual mental dysfunction in America.  A reader or listener may disagree with O’Connor’s causal analysis but his examples of psychological dysfunction can be seen in one’s self and in others.  What makes “Rewire” interesting is O’Connor’s suggested cures, based on thirty years of experience as a therapist.

MAPPING THE BRAIN
What makes “Rewire” interesting is O’Connor’s suggested cures, based on thirty years of experience as a therapist. O’Connor endorses the belief that the brain’s functions can be rewired at any age with repetitive practice. 

O’Connor endorses the belief that the brain’s functions can be rewired at any age with repetitive practice.  As an example, he explains the utility of the 12 step program designed by Alcoholics Anonymous for addicts to avoid being trapped in a mental cul-de-sac.  The AA steps are 1) Admit powerlessness, 2) find hope, 3) surrender, 4) take inventory, 5) share your inventory, 6) become ready, 7) ask God, 8) make a list of amends, 9) make amends, 10) continue your inventory, 11) pray and meditate, and finally, 12) help others.

Though AA presumably requires a Supreme Being in their 12 step process, the point of the treatment is to train one’s mind to act differently when confronted with influences that make a person turn into a cul-de-sac rather than back to an individuated baseline happiness.

AA
Though AA presumably requires a Supreme Being in their 12 step process, the point of the treatment is to train one’s mind to act differently when confronted with influences that make a person turn into a cul-de-sac rather than back to an individuated baseline happiness. 

drug use in war
O’Connor suggests drugs are sometimes used incorrectly and become part of the patient’s problem. 

O’Connor suggests drugs may be used to treat mental illnesses like depression for immediate results but that underlying causes need to be revealed to change longer-term aberrant psychological behavior.

O’Connor notes that drugs are sometimes used incorrectly and become part of the patient’s problem.  With knowledge of triggering events for depression or addiction, behavior can be retrained to make the mind react differently.

O’Connor cautions the reader/listener to understand that negative triggers may be ingrained over years and will not disappear without repetitive behavioral training that avoids or consciously assesses negative emotional triggers.  The key to success is enough behavioral repetition to make curative responses to triggers for depression, or aberrant behavior, automatic.

BEHAVIORAL REPETITION
O’Connor argues the key to success in rewiring the brain is enough behavioral repetition to make curative responses to triggers for depression, or aberrant behavior, automatic.

O’Connor offers several mental exercises to change how the mind works.  Rewire is an insightful book but one wonders if O’Connor is not on the Hedonic Treadmill he criticizes.  After all, one presumes the book is only selling to people who can afford it, and read it.  Rewire seems unlikely to help all who are on the real American treadmill–those who cannot afford the book, pay a therapist, or practice its contemplative methodology.

COSMIC MIND

Audio-book Review
By Chet Yarbrough

(Blog:awalkingdelight)
Website: chetyarbrough.blog

Letting Go

LETTING GO

Written by: David R. Hawkins

Narration by:  Peter Lownds

DAVID R. HAWKINS (1927-2012, DIED AT AGE 85, AUTHOR, PHILOSOPHER, MD, PSYCHIATRIST)
AUTHOR–David R. Hawkins died in 2012.  He was 85 years old.

David R. Hawkins died in 2012.  He was 85 years old.    At turns, Hawkins transitioned from agnosticism to atheism to belief in God.  This progression seems correlated with education and experience but ends in philosophical belief.  In each transition, Hawkins uses his intellect to form a philosophy that has appeal to many in search of life’s meaning.  At times, Hawkins seems beyond reason but each step he takes offers insight to how one may live a more fulfilling life. Hawkins might be broadly characterized as a mystic.  Even so, he was a formally educated, practicing physician, and psychiatrist.

Mysticism lies in Hawkins belief in human dualism, a belief dating back to Plato and adopted by many later philosophers.  Hawkins dualism is belief in a distinct separation between mind and body.  More precisely for Hawkins, it is a separation between mind and brain.

PLATO'S BELIEF IN DUALITY-BODY AND SOUL
Hawkins dualism is belief in a distinct separation between mind and body.  More precisely for Hawkins, it is a separation between mind and brain.

COSMIC MIND BELIEF
Hawkins becomes a mystic when he posits belief in a cosmic mind shared by all humanity.

Hawkins becomes a mystic when he posits belief in a cosmic mind shared by all humanity.  The power of this cosmic mind can cure all the maladies of humankind, both physical and mental.  Hawkins implies this cosmic mind can cure physical disease manifested in the body.  If you cannot see; if you cannot hear; if you cannot feel, your condition can be cured by a force of will that engages the cosmic mind.

This is a point at which Hawkins loses some believers.  However, before one gets to a point of rejection, Hawkins offers wise counsel on how to live life and approach a level of what Abraham Maslow labeled self-actualization.

SELF-ACTUALIZATION
Hawkins offers wise counsel on how to live life and approach a level of what Abraham Maslow labeled self-actualization.

Hawkins argues that everything that happens in one’s life is because of the mind’s interpretation of the world.  The mind gets trapped in Plato’s cave and only sees shadows of reality.  Reality is obscured by what the human mind tells them.  The mind’s interpretation of life’s events distorts reality.  A child remembers a father’s or mother’s rebuke as an eternal judgement when reality may have been to protect a child from harm.  The shadow is created and remains with the child for the rest of his/her life.

PLATO'S CAVE
PLATO’S CAVE (Hawkins argues that everything that happens in one’s life is because of the mind’s interpretation of the world. A child remembers a father’s or mother’s rebuke as an eternal judgement when reality may have been to protect a child from harm.  The shadow is created and remains with the child for the rest of his/her life.)

To escape the trap of Plato’s cave, Hawkins explains one must use their senses to accept the mind’s perception of reality and continually let it go until its negative power disappears.  An example would be one who gets angry over some event or action and accepts the anger; looks at it, accepts it, uses the mind to understand why there is anger, where it is coming from, and then letting it go.  In the process, one finds anger has no meaning other than what one’s mind gave it.

LETTING GO GRAPHIC
To escape the trap of Plato’s cave, Hawkins explains one must use their senses to accept the mind’s perception of reality and continually let it go until its negative power disappears.

With continual use of this process, Hawkins believes individual minds tap into a cosmic mind that shows the world as it really is; not simply as shadows on a cave wall.  There is wisdom in Hawkins’ perception of life and how one can more constructively deal with its vicissitudes. “Letting Go” is wise counsel for those troubled by emotional and/or physical trauma.  However, the principle of a cosmic mind takes a leap of faith.

CLIMATE CHANGE

Audio-book Review
By Chet Yarbrough

(Blog:awalkingdelight)
Website: chetyarbrough.blog

This Changes Everything: Capitalism vs. the Climate

This Changes Everythiing

Written by: Naomi Klein

Narration by:  Ellen Archer

NAOMI KLEIN (CANADIAN AUTHOR, SOCIAL ACTIVIST, FILMAKER)
NAOMI KLEIN (CANADIAN AUTHOR, SOCIAL ACTIVIST, FILMAKER)

A change of book titles comes to mind in reviewing Naomi Klein’s book, “This Changes Everything”.  A first thought is a title like “Beat the Drum.”   On second thought, it is the question “Who Gets to Decide?”  Ninety seven percent of “…actively publishing climate scientists” say climate warming trends are likely due to human activity.

TRUMP AND CLIMATE CHANGE
Deniers think current weather phenomena are a natural aberration that will be corrected by time. 

Deniers think current weather phenomena are a natural aberration that will be corrected by time.  Others are apathetically fatalistic and call global warming a myth.  But almost universally, science is saying climate warming is real.

GLOBAL WARMING
Deniers think current weather phenomena are a natural aberration that will be corrected by time. But almost universally, science is saying climate warming is real.

A “Beat the Drum” title is meant to convey appreciation of Naomi Klein’s studied effort to awaken the general public to the truth of global warming.  (She is not a scientist but a writer, researcher, and social activist.)  However, the title “Who Gets to Decide?” is meant to convey a monumental weakness in Klein’s spun presentation on solutions for the problems of global warming.

CAPITALISM-COMMUNISM
Klein’s argument that global warming is a consequence of capitalism is false.  Global warming is a consequence of human nature.

Klein’s argument that global warming is a consequence of capitalism is false.  Global warming is a consequence of human nature.  To date, democratic capitalism is the only economic form of government that offers a degree of freedom for all Peoples subject to rule of law.  Democratic capitalism unleashes the power of human nature, both good and bad.  Until some better form of governance is created, the best chance for a global warming solution is captialism.  History shows freedom, subject to rule of law, is essential to a deliberative process that will provide best-case solutions to seemingly unsolvable problems.

GOVERNMENT
Capitalism is not the proximate cause of global warming.  It is the failure of the E.P.A., the President, and congressional legislators to do their job.

POLITICS AND SCIENCE
Global warming solutions lie in politics and science; not one or the other, but both.

Global warming solutions lie in politics and science; not one or the other, but both.

Einstein and fellow scientists prove that energy and mass are always equal.  That scientific proof leads to Nagasaki and Hiroshima’s atom bombs just as 97% of the scientific community’s proof leads to earth’s climate bomb.

Great Britain, France, Russia, and Germany were worn down by WWII.  American democratic capitalism makes the decision to end the war by using the atomic bomb.  One may argue that this decision is morally reprehensible but it ended a war that would have continued without definitive action based on the deliberative process of a democratic capitalist country. The same may be said for a pragmatic solution for global warming.

The world is suffering from a global warming war.  Eventually, that suffering will create a political consensus for something to be done to combat its consequence.  Evidence of something being done is everywhere.  By beating the drum Klein is creating sense of urgency about global warming.  What is misleading and spun by Klein is discounting of rich entrepreneurs, like Gates, Bloomberg, Branson, and Buffett, who are taking self-interested steps to curb global warming.  Yes, they are self-interested steps but self-interest is not inherently bad.  Self-interest is in the fight to abate global warming.

RICHARD BRANSON
Klein suggests that Branson expands his airline to make more money at the cost of further pollution.

Klein suggests Branson expands his airline to make more money at the cost of further pollution.  (In truth Branson did sell his airline in 2016.)  Branson is a pariah to Klein because of his self-interest in vertically integrating research for alternative fuels for plane travel.

Klein explains Branson is only spending two to four hundred million dollars for research on alternate fuels while having pledged three billion dollars over ten years.  One wonders, how many rich have spent one million dollars, let alone two to four hundred, on alternate fuels.  Klein infers Branson is all show and no go by reaping publicity benefit while raping the global environment.  Whatever Branson’s motive may be, two to four hundred million dollars for a less polluting fuel is better than doing nothing.

Klein vilifies Buffett for buying railroads because they are transporting coal.  Klein offers no suggestion that railroads are a more energy-efficient than some other forms of material transportation.  Klein infers Buffett made the railroad investment out of self-interest.  He probably did but that is not proof of a lack of concern about global warming.   Klein infers Buffett’s investment decisions should be dictated by whom?  Who gets to decide?

WARREN BUFFETT (NET WORTH 75.2 BIILLION DOLLARS)
Klein vilifies Buffett for buying railroads because they are transporting coal.  Klein offers no suggestion that railroads are a more energy-efficient than some other forms of material transportation.

Because people like Klein are beating the drum, the largest coal producer in the world has lost 95 percent of its stock value.  The investing public finds that the industry misleads investors on its liability as a climate polluter.  This is democratic capitalism in action.

Self-interest, good and bad, is the nature of human beings.  Klein and others need to continue to “Beat the Drum” but decisions on what is to be done will be from a political consensus and action from leaders of the world and the scientific community.  It is not what Klein says so much as how she says it.  Money, power, and prestige are human nature’s motivations.  It will be a matter of competing self-interests that reach a consensus on the preservation of life.

Klein and others should continue to raise awareness and sense of urgency but it is self-delusion to think human nature will change within the time frame of this world’s declining envionment.

In a free society, all realize they have “skin in the game”.  Those governments that validate individual freedom offer the best hope for a global warming solution.  The answer to the question of “Who gets to decide?” is best left in the hands of nation-states that validate individual freedom.  America is one that holds the hope for a solution to global warming, in spite of its democratic capitalist leaning and today’s inept Executive and Legislative branch leadership.

SUDAN’S RELEVANCE

Audio-book Review
By Chet Yarbrough

(Blog:awalkingdelight)
Website: chetyarbrough.blog

What Is the What

By: Dave Eggers

Narrated by Dion Graham

As Ronald Reagan famously said in his successful campaign against Jimmy Carter, “There you go again”.

Dave Eggers writes another book about a tragic human event. However, Eggers avoids character controversy like that which followed “Zeitoun”, a story about the Katrina disaster.

Eggers classifies “What Is the What” as a novel, without any claim to source-vetted facts or the integrity of its primary character.

SUDAN IN THE WORLD

SUDAN IN THE WORLD 

“What Is the What” is about Sudan and its 20th century genocidal history. This is a story of the complex religious, ethnic, and moral conflict that exists in Sudan and in all nations peopled by extremes of wealth and poverty.

“What Is the What” is a tautology exemplified by a story of one who has something, knows it, and another that has nothing, and knows not why. 

Valentino Achak Deng, the hero of Eggar’s story, tells of his father. Achak’s father explains the story of “What is the What”.

God offers man a choice of cows or something called the What.  God asks, “Do you want the cows or the What? 

But, man asks, “What is the What”?  God says, “The What is for you to decide.” 

Achak’s father explains that with cows a man has something; he learns how to care for something; becomes a good caretaker of a life-sustaining something, but a man who has no cows has nothing, learns nothing about caring; and only becomes a taker of other’s something.

By mixing truth with fiction, Eggers cleverly reveals the story of Sudan’s “lost boys”, refugees from the murderous regime of President Al-Bashir in Sudan.  At every turn, Achak is faced with hard choices. 

Omar Al-Bashir is deposed in April 2019 after almost 30 years in power.

Omar Al-Bashir, a Muslim Sudanese military leader who becomes President, releases dogs of war by condoning the rape and pillage of indigenous Sudanese by Muslim extremists.  It is partly a religious war of Muslims against Christians but, more fundamentally, it is about greed.

Greed is engendered by oil reserves found in southern Sudan in 1978.  Bashir strikes a match that ignites a guerrilla war.  Eggers reveals the consequence of that war in the story of Achak, one of thousands of lost boys that fled Sudan when their parents were robbed, raped, and murdered.  Bashir’s intent was to rid Sudan of an ethnic minority that held lands in southern Sudan.

Eggers cleverly begins his story with Achak being robbed in Atlanta, Georgia.  But, this is America; not Sudan.

Robbers knock on Achak’s door with a request to use his telephone.  Achak is pistol whipped, tied, and trapped in his apartment while his and his roommate’s goods are stolen.

There is much to be taken from the apartment.  The robbers leave a young boy to guard Achak while they leave to get a larger vehicle to remove the stolen goods.

SUDAN'S LOST BOYS

Achak identifies with the young boy.  Achak recalls his life in Sudan and his escape to America; i.e.the  land of the free; the land of opportunity.  Achak sees the young boy as himself, victimized by life’s circumstances, hardened by poverty, and mired in the “What” (the takers of other’s something).

Eggers continues to juxtapose the consequence of poverty and powerlessness in Atlanta with Achak’s experience in Sudan. Achak’s roommate returns to the apartment to find Achak tied and gagged in an emptied apartment.  He releases Achak.

They call the police to report the robbery and assault.  An officer arrives to investigate.  The police officer listens, takes brief notes, offers no hope for the victims, and leaves; i.e., just another case of poor people being victimized by poor people.

The episode reminds one of the Sudanese government’s abandonment of the “lost boys”.  They are citizens governed by leaders who look to rule-of-law for the rich, and powerful; not the  poor and powerless.  They are leaders of the “what” (takers of other’s something); rather than leaders of all citizens.

Crowded emergency room waiting area.

Achak has been injured in the robbery.  He goes to a hospital emergency room for help.  Achak waits for nine hours to be seen by a radiologist.  He presumes it is because he has no insurance but it is really because he has no power. 

He has enough money to pay for treatment but without insurance, this emergency room puts Achak on a “when we can get around to it” list.  The doctor who can read the radiology film is not due for another three hours; presumably when his regular work day begins.  Achak waits for eleven hours and finally decides to leave.  It is 3:00 am and he has to be at work at 5:30 am.

As Achak waits for the doctor he remembers his experience in Sudan.  When the Muslim extremists first attack his village, many boys of his village, and surrounding villages are orphaned.  These orphans have nowhere to go.  By plan or circumstance the lost boys are assembled by a leader who has the outward-appearing objective of protecting the children.  The reality of the “what” (takers of other’s something) raises its head when the children are recruited by this leader for the “red army” of South Sudan (aka SPLA or Sudan People’s Liberation Army).

SUDAN'S BOY ARMY

The reality of the “what” (takers of other’s something) raises its head when Sudanese children are recruited by this leader for the “red army” of South Sudan (aka SPLA or Sudan People’s Liberation Army).

SUDAN'S 700 MILE WALK

These are boys of 8, 9, 10, 11 years of age.  This army-of-recruits begins a march from South Sudan to Ethiopia, a journey of over 700 miles, gathering more orphans as they travel across Sudan.  Along the way, they become food for lions, and crocodiles; they are reviled as outsiders by frightened villagers and, unbeknownst to Achak and many of the boys—they are meant to become seeds of a revolution to overthrow Al-Bashir’s repressive government.  These children are to be educated and trained in Ethiopia to fight for the independence of South Sudan.  They are led by leaders of the “what” (takers of other’s something).

The lost boys are victims of believers in the “what”.  Achak and other Sudanese’ refugees walk, run, and swim a river to arrive in Kenya, hundreds of miles south of Ethiopia.  Some Sudanese were shot by Ethiopians; some were eaten by crocodiles; some died from disease and starvation.

KENYA'S REFUGEE CAMP

Then, in 1991, Ethiopia’s government changes.  The lost boys, a part of an estimated 20,000 Sudanese’ refugees, are forcibly ejected by the new government.

The Sudanese’ refugees arrive in Kakuma, Kenya.  Achak says Kakuma is a Swahili word for “nowhere”.  In 1992, it becomes home to an estimated 138,000 refugees who fled from several different warring African nations.  The SPLA remains a part of the refugee camp but their recruiting activity is mitigated in this new environment.  The camp is somewhat better organized but meals are limited to one per day with disease and wild animals as ever-present dangers.  Education classes are supported by Kenya, Japan, and the United Nations to help refugees manage themselves and escape their past.

Achak survives these ordeals and reflects on his unhappiness in Atlanta, Georgia.  Achak clearly acknowledges how much better living in America is than living in Africa. However, Achak makes the wry suggestion that Sudanese settlement in America changed his countrymen from abusers to killers of their women.

He suggests Sudanese killing of their women is because of freedom.  He explains freedom exercised by women in America is missing in Sudan.  In Sudan, Sudanese women would not think of doing something contrary to wishes of their husbands.  Achak infers Sudanese women adapt to freedom while Sudanese men feel emasculated.  The emasculation leads to deadly force in Sudanese families; a deadly force that includes murder of wives or girlfriends and suicide by male companions.

AMERICAN DREAM

Eggers successfully and artistically reveals the tragedy of Sudan.  Cultural and religious conflict in the world and American freedom are called into question.  The cultural belief of parts of the Middle East, Africa, and America drive Achak from nation to nation.  Achak, despite misgivings, appears to love America.  But, American democracy is no utopia. Achak realizes no system of government is perfect.  His ambition is to educate himself and his home country.  Achak realizes education is the key to a life well lived.

What is the What?  Ironically, it is more than cows; it is education that combats cultural ignorance and celebrates freedom and equal opportunity for all.

Eggers story implies America needs to re-think its policy on immigration.  We are a nation of immigrants.  Achak’s story highlights what is wrong with America and other parts of the world.  But it also shows the “what” (“the ‘what’ that is for you to decide”) can be made better because it is more than cows.

TO A HAMMER, EVERYTHING IS A NAIL

Audio-book Review
By Chet Yarbrough

(Blog:awalkingdelight)
Website: chetyarbrough.blog

The Emperor of All Maladies, A Biography of Cancer

By Siddhartha Mukherjee

Narrated by Fred Sanders

SIDDHARTHA MUKHERJEE (AUTHOR, PHYSICIAN)

Dr. Siddhartha Mukherjee examines the history of cancer in “The Emperor of All Maladies”.

cancer death rates rising

The Centers for Disease Control and Prevention reports heart disease and cancer are the two leading medical causes of death.

At first glance, one thinks–so what?  We are living longer, and everyone dies of something.  However, Mukherjee notes a study showing cancer deaths are rising: i.e. they decrease in one age group only to be offset by increase in another.  The net effect is a rising number of cancer cases.

RADICAL MASTECTOMY IN THE 19TH CENTURY

In researching the history of cancer, Mukherjee exposes the arrogance of medical specialization.  Mukherjee shows early attempts to cure cancer were led by surgeons who removed cancerous growth.

“The Emperor of All Maladies” reminds one of the saying—”To a hammer, everything is a nail”. 

Cancer is a slippery killer.  The hammer, in the early days of treatment, is a scalpel wielded by surgeons who cut deeper and deeper into the body until the patient is physically disabled, in limited remission, or laboring toward death.  The surgeon believes he has removed the cancer only to find it returns in weeks or months later.

Surgery works but the scalpel is a hammer that only works when cancer is localized and non-systemic.

Radiation Effects

The next specialty is radiation.  Here the physician replaces the scalpel with focused radiation; another hammer. Radiation cannot kill systemic cancer without killing or diminishing a patient’s health.

CANCER AND CHEMOTHERAPY

Next up is the internal medicine specialist, the oncologist.  This specialty argues that cancer can best be treated with designer drugs to specifically attack or starve cancer cells.  The problem is medicines that kill cancer cells are generally toxic; i.e. they kill both good and bad cells.

The final specialization is immunotherapy which ranges from bone marrow  and blood antigen enhancement to bone marrow transplantation. The purpose of immunotherapy is to make the body more resistant to cancer cell growth.

Though each specialization advances cancer remission, specialists lauded their own treatments and ignored each other’s accomplishments. 

CANCER AND MULTIFACETED TREATMENT

Specialists were historically proprietary about their treatments.  Some went so far as to distort their results with false clinical studies.  They felt their treatment was the best way of attacking “The Emperor of All Maladies”.

Specialists exclusively pursue their singular research, treatment, and reporting until a few physicians argued all disciplines should be enlisted to cure cancer.

CANCER AND EVOLUTION

The cure begins with physician attention and empathy for the patient.  Mukherjee infers cancer therapy is not for physician self-congratulation.  Hubris is a failing in physicians; just as it is in all human endeavors.  Cancer is an eternal war.  It changes with the environment and life’s evolutionary laws.

Mukherjee’s history explains how the chain of discovery for a cancer cure can be broken at different levels. 

There is physician self-delusion about how effective their treatment is for cancer.  There is the integrity of research studies and how they are conducted.  There is industry and government support of industrial waste production that is proven to be carcinogenic.

The door is opened to interdisciplinary research by philanthropists who created foundations to clinically study causes and cures for cancer.  Mukherjee addresses the continuing need for funding to expand cancer research.  He is not Pollyannaish about the need.  He acknowledges cancer research is not going to be like America’s race to the moon in the 1960s.  There is no definitive goal. The goal is not fixed like a mission to Mars.  Cancer’s etiology evolves.  It is unlikely for there to be a single-bullet solution that will cure cancer. 

Mukherjee expands on the difficulty in curing cancer because of capitalist resistance to scientific research, and discovery. 

MARLBORO MAN

Mukherjee recalls the battle with the cigarette industry when research clearly shows a correlation between cancer and smoking.  The cigarette industry lies to the public about their own studies correlating lung cancer with smoking.

Cigarette industry lobbyists influence legislation that delays concerted action by the government to curb the addictive characteristics of smoking.  Money talks, cancer proliferates.  (This reminds one of the gun lobby and their insistence that guns designed only to kill people are a right that should not be infringed upon.  Though gun use may not be addictive, there is a distinct correlation between the number of deaths in one incident and the proliferation of fully automatic weapons designed only to kill people.)

Mukherjee also recounts the incidence of cancer in England for chimney sweeps that inhaled carbon and asbestos from cleaning chimneys.  Today’s confrontations are carbon, other cariogenic, and environmental contaminants created by industry.

The National Institute of Health reports an estimated 1,735,350 new cancers will be diagnosed in the United States in 2018.  Of that number, 609,650 will die.  Worldwide, NIH reports 14.1 million new cases were identified in 2012.  8.2 million died.  The only killer more prolific than cancer is heart disease, and only by a small margin (In 2009, the CDC reports 610,000 people die every year from heart disease.)

PHYSICIAN HEAL THYSELF

Mukherjee implies all physicians need to step back, abandon their professional bias, and pursue treatments that are based on scientific research, symptoms, and reports of their patients.

Physicians need to listen, do no harm, and when necessary, offer palliative treatment—until, hopefully, a lasting cure is found.

U.S. HEALTH CARE

Cancer research and experimentation is costly.  Mukherjee’s history shows the weakness and strength of capitalism and human nature in supporting what humanity needs to defeat cancer.  His history should be required reading; particularly for physicians, and researchers, but also for the general public.

NATIONALIZED MEDICINE

Audio-book Review
By Chet Yarbrough

(Blog:awalkingdelight)
Website: chetyarbrough.blog

Do No Harm: Stories of Life, Death, and Brain Surgery

Written by: Henry Marsh

Narration by:  Jim Barclay

HENRY MARSH (BRITISH NEUROSURGEON AND AUTHOR)

HENRY MARSH (BRITISH NEUROSURGEON AND AUTHOR)

An interesting insight offered by Henry Marsh’s memoir, “Do No Harm”, is a contrast between American and British Medicine.  Marsh’s candor about his life and profession surprise his audience and endear his curmudgeonly personality.  The surprise is in Marsh’s profound empathy and personal conflicts over neurosurgical decisions.

Marsh’s endearment comes from explicit “f-word” rants about incompetence, technology, and bureaucracy.  In addition to his rants, Marsh endears himself to an audience by explaining the distinction between a physician’s self-confidence and hubris.  Marsh suggests physicians need understanding and competence; not undue preciousness, and pride-full medical knowledge.  Jim Barclay’s narration perfectly suits the tone of Marsh’s memoir.

Caduces

Marsh is able to enter into medicine with little pre-medical education in the sciences.

Either by dint of a formidable intellect or a quirk of the British education system (maybe both), Marsh takes all his science courses after deciding to become a doctor.  One doubts an American medical school would have considered his application in the 1960 s.

Marsh graduates and begins his career in medicine under the guidance of experienced physicians.  As he acquires experience, he chooses to specialize in neurosurgical medicine under the supervision of a Consulting Neurological Physician.  The Consultant (a neurology physician trainee’s guide) works within the English national health care system as a qualified physician who supervises aspiring neurological physicians.  This consultant chooses cases for trainees; under varying levels of supervision.

Though a neurological procedure may be done by a trainee, the consulting physician is responsible.  This appears to be similar to internships in the United States.  However, an interesting difference is in the insurance for interns.

MEDICAL INTERNSHIP

MEDICAL INTERNSHIPS- English hospitals carry a trust to protect physicians from mistakes made in treating patients.

The UK’s physician-group self-insurance may be a distinction without a difference but, as in all medical insurance systems, mistakes do occur, and patients are harmed. The difference between physician-group self-insurance and American physician’ private insurance raises the specter of limited settlement for egregious mistakes.  On the other hand, it suggests British physicians are more likely to be more forthcoming on mistakes that are made.

Marsh completes his trainee experience and decides to become a Consulting Neurological Physician in the national health care system.  Marsh interestingly reveals several mistakes he and his trainees make during his years of consultancy.  In revealing those mistakes, a listener pauses to think about risks of patients who depend on English’ or American’ medical services.  Marsh’s stories of mistakes reflect on medical training, family apologies, and personal anguish over patient’ quality-of-life and death issues. 

MEDICAL MALPRACTICE IN THE UNITED STATES

Marsh explains, at best a Consultant Surgeon expects to learn from surgical mistakes to avoid repetition. 

The worst, for Marsh, is the apologies to families for the mistakes that are made.  In contrast to Marsh’s way of addressing mistakes, American physicians seem more likely to avoid family apologies; while hiding behind legal and insurance company shields.

MEDICAL TREATMENT-WAITING FOR TREATMENT IN ENGLAND

A more subtle message in Marsh’s book is the failure of the English National Health Service to provide adequate care for the general population; e.g. its long lines of patients who wait for attention when rapidly growing tumors are destroying a patient’s neurological system. 

Doctor/patient ratios in 2016 were 2.6/1,000 people in America. In 2018, the doctor/patient ratio was 2.8/1,000 in the United Kingdom. This raises the question of how long would Americans have to wait in line with a national health care system? Some argue physician assistants could be trained to take care of less serious medical issues. That would spread the burden of patient treatment.

Marsh complains of inadequate bed availability for patients that need operations.  Financing for the National Health Service is inadequate for the number of patients that need help. This seems a likely consequence of an American national health care system.

Marsh notes that he carries private health insurance to supplement his family’s medical needs.  At the same time, he infers private hospital services tend to gouge patients for their medical service; in part, from charges for unnecessary tests and superfluous operations. 

Marsh attacks the bureaucratic nature of the National Health Service that hires hospital administrators who are directed to reduce costs; regardless of patient’ load or patient’ need.  Technological improvements for England’s National Health Service are delayed because of lack of financing, poor administration, and inadequate training. These are maladies that will plague a national health care system in the United States.

U. K. HEATH CARE SYSTEM

Marsh leavens his criticism of England’s national health care by writing of his experience in the former U.S.S.R. (specifically Ukraine) where problems are monumentally greater. 

In the end, America’s effort to improve national health care is tallied in one’s mind against the current English picture painted by Marsh.  For medical patients, the English system seems riskier than the American system.  Doctors in England seem more insulated from medical mistakes.  If doctors are more insulated, they may take more risks; i.e. risks that can lead to patient’ disablement or death.  The American system, if one can afford the service, seems more conservative and less likely to take risks.

It seems England’s national health care offers a level of societal comfort because there is hope for affordable treatment.  On the other hand, Marsh clearly shows how government bollixes National Health Care with inadequate funding and a bumbling administrative system.  Some would say this is why the U. S. should not nationalize health care.

Marsh notes England’s private system has not met the needs of citizens who can afford additional service.  The private system suffers from human nature’s folly; i.e. the lure of wealth at the expense of fairly priced or truly needed medical treatment.

U.S. HEALTH CARE

Marsh suggests the private system suffers from human nature’s folly; i.e. the lure of wealth at the expense of fairly priced or truly needed medical treatment.

Is medical health service a human right or privilege?  One draws their own conclusion about British and American Medicine.  Marsh shows the monumental problems of affordable health care in England. 

A listener of “Do No Harm” infers problems of the British system for medical care will challenge America’s desire for universal health care. Dr. Marsh’s answer seems to revolve around empathy for all human beings; i.e. regardless of whether a country has a nationalized or private health care system.