Border Collies, the only dogs who can do differential calculus!

NdGT and Bill Nye are both far better people than Newton was, but

• Calculus
• Gravity
• Newtonian motion

Jim's advice to "follow your passion" is, IMHO, a terrible idea and is, perhaps dangerous and destructive career advice. But who could expect Jim to suggest anything else, seeing as how he became highly successful doing what he loves?

How many people do what they love, but never achieve success? Probably far more than those that do, except we never hear from them, because they're never selected to give commencement speeches at universities...

This is particularly pernicious in tournament-style fields where there are only a few big winners in comparison to the many many losers (e.g., media, athletics, startups, etc.).

These students would be better advised to "Do what contributes" (i.e., focus on the beneficial value created for other people and not just to satisfy one's own ego). People who contribute the most are often ultimately the most satisfied with what they do — and eventually find their way into fields with high remuneration (i.e., tend to make the most $).

Sadly, advising people to focus on others rather than oneself is not all that popular, especially given the endemic narcissism that characterizes modern culture (and, to be sure, much of what's behind Jim's own 'performances'). Focusing on what is best for others, rather than oneself, requires us to delay gratification (and short-term happiness) and perhaps even toil for many years to get the payoff of contributing value to the world.

Too often, people follow their passions into fields that are simply too competitive for where their skills are in those things. Instead, one should "do what contributes" — follow the thing that provides the most value to others.

In other words, "Follow your effort," "Don't do what you love, love what you do," and other suggestions to adopt a more complicated if more realistic calculus of doing what you're good at so long as it gives you some amount of satisfaction.

IMO, the best commencement speech of the season is the one delivered by Adm. William McRaven, the head of U.S. special operations, at the University of Texas, who said, "You can't follow anything until you've made your bed."

it goes even further than that. Any person truly honest with themselves or has even the least bit a questioning mind at least asks themselves at one point "hey what if I'm wrong" I think pretty much every non-believer ever has asked themselves that question COUNTLESS times. And I think almost every one of them has come up with the answer that even if there is a creator, it's STILL a fucked up system and then you run into Pascal's wager where people are just believing out of fear or to cover their asses, which supposedly God can see right through that anyway so pretty much everyone ever born goes to hell.

It's virtually impossible for some people to question authority. God exists because their parents told them so and that's it. It shocks me to this day how many people don't know how to think critically or don't know what logical fallacies are.

I still remember one of the most important lessons I learned in high school from my calculus teacher. You have to learn how to learn. A teacher can teach you things and you can regurgitate them on command, but at some point you have to move past that and become your own teacher and become a problem solver.

All in all, I don't have a problem with religious people as a whole. There are plenty of religious people out there that are willing to live and let live and think god is based on love and not fear and those who think differently are not a threat. It's those...other people that try to legislate their religion that are a problem.

@enoch, I didn't see your response to me since you didn't "reply" to me, or "message me" ("@Trancecoach"), so I'm just seeing this now:

> you argue like someone who has found religion.

What is this, then, if not ad hominem? What has religion got to do with economics in this context? I'm willing to change my mind, if you can show me the flaws in my argument.

> and its not just you that never wants to address the dark side of capitalism.

So, please tell me what didn't get 'addressed?' Did I not respond to every point in your post? Where are your replies to my reply?

> disciples of free market capitalism never want to talk about their deformed child
> locked in the upstairs bedroom.out of sight..out of mind.

Again, what wasn't addressed? Free market capitalists love to talk about free market capitalism. Ok. So are you stuck on this such that you're unable to read/respond to my response?

Seems to me that you're projecting, because while you say that my responses are like a 'sermon,' this portion of your post actually sounds like a sermon:

> every system has its flaws.
> both positive and negative.
> and no system is a rigid single dimension but rather varying layers of slight
> differences.
> this includes every political and economic system thought of or just living in the
> realm of dreams.
> it is through discussion with people we may disagree in which new ideas can breed
> and grow.
> this was my ultimate goal in talking with you.
> instead i get a sermon.
> hope has two daughters.
> anger and courage.
> anger at the way things are,and courage to change them.
> i havent had a beer in ten years.
> gonna go grab me a beer or two.
> what a silly,sad old man i have become.
> old men should stop dreaming.....

Let's not degrade the level of discourse to ad hominem or sob stories. If you need help, ask for help. But don't blame me if you relapse. We are all accountable for our own thoughts, feelings, and behaviors.

> old men should stop dreaming

Dream all you want, but don't expect everyone else to take your dreams seriously just because you say so. (Why not address any of the points I made in my response?)

"The best argument against democracy is a five minute conversation with the
average voter." ~ Winston Churchill

I'm at a loss as to what response I can give you that would 'appease' your sensibilities? As far as I could tell, all of your questions were addressed. But you ignored my reply, and went back to "no one wants to talk about it" or whatever. So, what can be said?

It seems like you don't really want to "debate" or "converse" or whatever. If I refute your arguments, then you interpret that as meaning that I don't want to talk about it. Did I get that right? That doesn't make much sense to me. If not, please explain what I am missing here.

Also, what does it matter if you are old or young, or a dreamer or not, in terms of getting to the truth about socialism and capitalism?

> but you are blinded by dogma.

If so, why not show me what part of my argument is dogmatic or not epistemologically sound?
For example, what specifically about the right to and/or preference for non-aggression is 'dogmatic?' I don't like being bullied, so does that make me dogmatic? What about the impossibility of economic calculation under any sort of socialism is 'dogmatic?' And how so?

If someone doesn't understand calculus, they might call it 'dogma.' But if you understand it, then you can look at the equations and see for yourself if they make mathematical sense (or not). Was Galileo's contention that the Earth orbits the Sun dogmatic? What about the assertion that the Sun orbits the Earth, was that dogmatic? What's the difference?

> it is through discussion with people we may disagree in which new ideas can breed
> and grow. this was my ultimate goal in talking with you.

This is all very nice, but did you bother to find out what my 'ultimate goal' in talking to you was? Or is it all about yours?

Some-but-not-all people get upset when you point out how their beliefs do not correspond to the facts. Socrates was sentenced to commit suicide and Galileo died under house arrest.

I won't say whether or not this is true, or applies in this instance.

> every system has its flaws. both positive and negative. and no system is a rigid
> single dimension but rather varying layers of slight differences. this includes every
> political and economic system thought of or just living in the realm of dreams.

This, in itself is a dogmatic statement.

Look, man. I like you. I appreciate your comments, your earnestness, and willingness to engage our discourse. I also appreciate your respect and appreciation (although I can't say I'm sure how I've earned or deserved it). You've apologized for what seems to me to be ad hominem and I appreciate and accept your apology. I, too, apologize if you seem that I've been terse or avoidant in authentic engagement in dialogue with you. But in keeping with the points and arguments themselves, I think we'll both be much better off in terms of learning and growing and avoiding going off-track or off-topic into commentary about the messenger as opposed to the message.

Mathematics

He says
"those god damn pakistanis and their goddamn corner shops
Built a shop on every corner took our British workers jobs
He says those godamn Chinese and their goddamn china shops
I tell him theyre from Vietnam but he doesn't give a toss
I ask him what was there before that damn Japan mans shop
He stares at me and dreams a scene of British workers jobs
Of full time full employment before the godamn boats all came
Where everybody went to work full time every day
A British Business stood their first he claims before the Irish came
Now British people lost their jobs and bloody turkish are there to blame
I ask him how he knows that fact he says because it's true
I ask him how he knows the fact he says he read it in the news
Everytime a Somalian comes here they take a job from us
The mathematics one for one, from us to them it just adds up
He bites his cake and sips is brew and says again he knows the spot
The godamn Carribeans came and now good folk here don't have jobs
I ask him what was there before the goddamn Persian curtain shop
I show him architectures plans of empty godamn plots of land
I show him the historic maps
A bit of sand, a barren land
There was no goddamn shop before those pakistanis came and planned
Man
I'm sick of crappy mathematics
Cos I love a bit of sums
I spent three years into economics
And I geek out over calculus
And when I meet these paper claims
That one of every new that came
Takes away ones daily wage
I desperately want to scream
"Your maths is stuck in primary"
Cos one who comes here also spends
And one who comes here also lends
And some who comes here also tend
To set up work which employs them
And all your balance sheets and trends
Work with numbers not with men
And all your goddamn heated talk
Ignores the trade the Polish brought
Ignores the men they gave work to
Not plumbing jobs but further too
Ignores the ones they buy stock from
Accountants, builders, on and on
And I know it's nice to have someone
To blame our lack of jobs upon
But immigrations not as plain
Despite the sums inside your brain
As one for one, as him or you
As if he goes, they'll employ you
Cos sometimes one that comes makes two
And sometimes one can add three more
And sometimes two times two is much much more
Than four
And most times immigrants bring more
Than minuses.

This is more narrative than fact, but it is a fun narrative; most notable the inverse square law came around 1687 and his calculus was claimed in 1666, but only published in 1696 long after the Leibniz/Newton calculus controversy had begun. Philosophy minded people always credit Leibniz with being one of the smartest people ever, and Science people with Newton and fall in line usually with how they feel about the invention of calculus and such. The facts are always a bit more complicated than simple, cause driven narrative like this, but he is pretty much known for this kind of stuff, so whatever, Ill just have fun

That (1:05) certainly wasn't the first problem I saw in calculus! In fact, I don't actually remember it from either maths or physics.

Interesting talk. Eugene Wigner made a somewhat similar observation in 1959/1960 (obviously not about string theory though, just about the relationship between mathematics and the real world).

I agree, and it goes beyond statistics and more to the core ideals that make a country. Fact is, even if I showed you clear evidence that soda pop basically kills people in the long run, that it has no redeemable value and is responsible for 10x the health related problems as guns, that still is absolutely no justification for passing laws about soda consumption.

The rule of law by statistical analysis and utopian/utilitarian calculus is very troubling to me. And while my personal decisions for my own well being use a form of this model, to start making laws based on this very relative and personal framework would be a travesty, and it is seemingly the only model I see used when talking about gun control both for and against.

It turns out, having the freest society might also be the most dangerous...but so the fuck what. What if it turned out that theocratic dictatorship results in the least amount of civilian deaths from guns, shall we burn down the vestibules of liberty and freedom for a single data point of valuation. Most arguments both for and against gun control come from this kind of marginal, statistical methodology that I find appalling in a discussion over laws.

http://www.nytimes.com/2010/06/20/magazine/20pacemaker-t.html?pagewanted=all

One October afternoon three years ago while I was visiting my parents, my mother made a request I dreaded and longed to fulfill. She had just poured me a cup of Earl Grey from her Japanese iron teapot, shaped like a little pumpkin; outside, two cardinals splashed in the birdbath in the weak Connecticut sunlight. Her white hair was gathered at the nape of her neck, and her voice was low. “Please help me get Jeff’s pacemaker turned off,” she said, using my father’s first name. I nodded, and my heart knocked.
Related

Upstairs, my 85-year-old father, Jeffrey, a retired Wesleyan University professor who suffered from dementia, lay napping in what was once their shared bedroom. Sewn into a hump of skin and muscle below his right clavicle was the pacemaker that helped his heart outlive his brain. The size of a pocket watch, it had kept his heart beating rhythmically for nearly five years. Its battery was expected to last five more.

After tea, I knew, my mother would help him from his narrow bed with its mattress encased in waterproof plastic. She would take him to the toilet, change his diaper and lead him tottering to the couch, where he would sit mutely for hours, pretending to read Joyce Carol Oates, the book falling in his lap as he stared out the window.

I don’t like describing what dementia did to my father — and indirectly to my mother — without telling you first that my parents loved each other, and I loved them. That my mother, Valerie, could stain a deck and sew an evening dress from a photo in Vogue and thought of my father as her best friend. That my father had never given up easily on anything.

Born in South Africa, he lost his left arm in World War II, but built floor-to-ceiling bookcases for our living room; earned a Ph.D. from Oxford; coached rugby; and with my two brothers as crew, sailed his beloved Rhodes 19 on Long Island Sound. When I was a child, he woke me, chortling, with his gloss on a verse from “The Rubaiyat of Omar Khayyam”: “Awake, my little one! Before life’s liquor in its cup be dry!” At bedtime he tucked me in, quoting “Hamlet” : “May flights of angels sing thee to thy rest!”

Now I would look at him and think of Anton Chekhov, who died of tuberculosis in 1904. “Whenever there is someone in a family who has long been ill, and hopelessly ill,” he wrote, “there come painful moments when all timidly, secretly, at the bottom of their hearts long for his death.” A century later, my mother and I had come to long for the machine in my father’s chest to fail.

Until 2001, my two brothers and I — all living in California — assumed that our parents would enjoy long, robust old ages capped by some brief, undefined final illness. Thanks to their own healthful habits and a panoply of medical advances — vaccines, antibiotics, airport defibrillators, 911 networks and the like — they weren’t likely to die prematurely of the pneumonias, influenzas and heart attacks that decimated previous generations. They walked every day. My mother practiced yoga. My father was writing a history of his birthplace, a small South African town.

In short, they were seemingly among the lucky ones for whom the American medical system, despite its fragmentation, inequity and waste, works quite well. Medicare and supplemental insurance paid for their specialists and their trusted Middletown internist, the lean, bespectacled Robert Fales, who, like them, was skeptical of medical overdoing. “I bonded with your parents, and you don’t bond with everybody,” he once told me. “It’s easier to understand someone if they just tell it like it is from their heart and their soul.”

They were also stoics and religious agnostics. They signed living wills and durable power-of-attorney documents for health care. My mother, who watched friends die slowly of cancer, had an underlined copy of the Hemlock Society’s “Final Exit” in her bookcase. Even so, I watched them lose control of their lives to a set of perverse financial incentives — for cardiologists, hospitals and especially the manufacturers of advanced medical devices — skewed to promote maximum treatment. At a point hard to precisely define, they stopped being beneficiaries of the war on sudden death and became its victims.

Things took their first unexpected turn on Nov. 13, 2001, when my father — then 79, pacemakerless and seemingly healthy — collapsed on my parents’ kitchen floor in Middletown, making burbling sounds. He had suffered a stroke.

He came home six weeks later permanently incapable of completing a sentence. But as I’ve said, he didn’t give up easily, and he doggedly learned again how to fasten his belt; to peck out sentences on his computer; to walk alone, one foot dragging, to the university pool for water aerobics. He never again put on a shirt without help or looked at the book he had been writing. One day he haltingly told my mother, “I don’t know who I am anymore.”

His stroke devastated two lives. The day before, my mother was an upper-middle-class housewife who practiced calligraphy in her spare time. Afterward, she was one of tens of millions of people in America, most of them women, who help care for an older family member.

Their numbers grow each day. Thanks to advanced medical technologies, elderly people now survive repeated health crises that once killed them, and so the “oldest old” have become the nation’s most rapidly growing age group. Nearly a third of Americans over 85 have dementia (a condition whose prevalence rises in direct relationship to longevity). Half need help with at least one practical, life-sustaining activity, like getting dressed or making breakfast. Even though a capable woman was hired to give my dad showers, my 77-year-old mother found herself on duty more than 80 hours a week. Her blood pressure rose and her weight fell. On a routine visit to Dr. Fales, she burst into tears. She was put on sleeping pills and antidepressants.

My father said he came to believe that she would have been better off if he had died. “She’d have weeped the weep of a widow,” he told me in his garbled, poststroke speech, on a walk we took together in the fall of 2002. “And then she would have been all right.” It was hard to tell which of them was suffering more.

As we shuffled through the fallen leaves that day, I thought of my father’s father, Ernest Butler. He was 79 when he died in 1965, before pacemakers, implanted cardiac defibrillators, stents and replacement heart valves routinely staved off death among the very old. After completing some long-unfinished chairs, he cleaned his woodshop, had a heart attack and died two days later in a plain hospital bed. As I held my dad’s soft, mottled hand, I vainly wished him a similar merciful death.

A few days before Christmas that year, after a vigorous session of water exercises, my father developed a painful inguinal (intestinal) hernia. My mother took him to Fales, who sent them to a local surgeon, who sent them to a cardiologist for a preoperative clearance. After an electrocardiogram recorded my father’s slow heartbeat — a longstanding and symptomless condition not uncommon in the very old — the cardiologist, John Rogan, refused to clear my dad for surgery unless he received a pacemaker.

Without the device, Dr. Rogan told me later, my father could have died from cardiac arrest during surgery or perhaps within a few months. It was the second time Rogan had seen my father. The first time, about a year before, he recommended the device for the same slow heartbeat. That time, my then-competent and prestroke father expressed extreme reluctance, on the advice of Fales, who considered it overtreatment.

My father’s medical conservatism, I have since learned, is not unusual. According to an analysis by the Dartmouth Atlas medical-research group, patients are far more likely than their doctors to reject aggressive treatments when fully informed of pros, cons and alternatives — information, one study suggests, that nearly half of patients say they don’t get. And although many doctors assume that people want to extend their lives, many do not. In a 1997 study in The Journal of the American Geriatrics Society, 30 percent of seriously ill people surveyed in a hospital said they would “rather die” than live permanently in a nursing home. In a 2008 study in The Journal of the American College of Cardiology, 28 percent of patients with advanced heart failure said they would trade one day of excellent health for another two years in their current state.

When Rogan suggested the pacemaker for the second time, my father was too stroke-damaged to discuss, and perhaps even to weigh, his trade­offs. The decision fell to my mother — anxious to relieve my father’s pain, exhausted with caregiving, deferential to doctors and no expert on high-tech medicine. She said yes. One of the most important medical decisions of my father’s life was over in minutes. Dr. Fales was notified by fax.

Fales loved my parents, knew their suffering close at hand, continued to oppose a pacemaker and wasn’t alarmed by death. If he had had the chance to sit down with my parents, he could have explained that the pacemaker’s battery would last 10 years and asked whether my father wanted to live to be 89 in his nearly mute and dependent state. He could have discussed the option of using a temporary external pacemaker that, I later learned, could have seen my dad safely through surgery. But my mother never consulted Fales. And the system would have effectively penalized him if she had. Medicare would have paid him a standard office-visit rate of $54 for what would undoubtedly have been a long meeting — and nothing for phone calls to work out a plan with Rogan and the surgeon.

Medicare has made minor improvements since then, and in the House version of the health care reform bill debated last year, much better payments for such conversations were included. But after the provision was distorted as reimbursement for “death panels,” it was dropped. In my father’s case, there was only a brief informed-consent process, covering the boilerplate risks of minor surgery, handled by the general surgeon.

I believe that my father’s doctors did their best within a compartmentalized and time-pressured medical system. But in the absence of any other guiding hand, there is no doubt that economics helped shape the wider context in which doctors made decisions. Had we been at the Mayo Clinic — where doctors are salaried, medical records are electronically organized and care is coordinated by a single doctor — things might have turned out differently. But Middletown is part of the fee-for-service medical economy. Doctors peddle their wares on a piecework basis; communication among them is haphazard; thinking is often short term; nobody makes money when medical interventions are declined; and nobody is in charge except the marketplace.

And so on Jan. 2, 2003, at Middlesex Hospital, the surgeon implanted my father’s pacemaker using local anesthetic. Medicare paid him $461 and the hospital a flat fee of about $12,000, of which an estimated $7,500 went to St. Jude Medical, the maker of the device. The hernia was fixed a few days later.

It was a case study in what primary-care doctors have long bemoaned: that Medicare rewards doctors far better for doing procedures than for assessing whether they should be done at all. The incentives for overtreatment continue, said Dr. Ted Epperly, the board chairman of the American Academy of Family Physicians, because those who profit from them — specialists, hospitals, drug companies and the medical-device manufacturers — spend money lobbying Congress and the public to keep it that way.

Last year, doctors, hospitals, drug companies, medical-equipment manufacturers and other medical professionals spent $545 million on lobbying, according to the Center for Responsive Politics. This may help explain why researchers estimate that 20 to 30 percent of Medicare’s $510 billion budget goes for unnecessary tests and treatment. Why cost-containment received short shrift in health care reform. Why physicians like Fales net an average of $173,000 a year, while noninvasive cardiologists like Rogan net about $419,000.

The system rewarded nobody for saying “no” or even “wait” — not even my frugal, intelligent, Consumer-Reports-reading mother. Medicare and supplemental insurance covered almost every penny of my father’s pacemaker. My mother was given more government-mandated consumer information when she bought a new Camry a year later.

And so my father’s electronically managed heart — now requiring frequent monitoring, paid by Medicare — became part of the $24 billion worldwide cardiac-device industry and an indirect subsidizer of the fiscal health of American hospitals. The profit margins that manufacturers earn on cardiac devices is close to 30 percent. Cardiac procedures and diagnostics generate about 20 percent of hospital revenues and 30 percent of profits.

Shortly after New Year’s 2003, my mother belatedly called and told me about the operations, which went off without a hitch. She didn’t call earlier, she said, because she didn’t want to worry me. My heart sank, but I said nothing. It is one thing to silently hope that your beloved father’s heart might fail. It is another to actively abet his death.

The pacemaker bought my parents two years of limbo, two of purgatory and two of hell. At first they soldiered on, with my father no better and no worse. My mother reread Jon Kabat-Zinn’s “Full Catastrophe Living,” bought a self-help book on patience and rose each morning to meditate.

In 2005, the age-related degeneration that had slowed my father’s heart attacked his eyes, lungs, bladder and bowels. Clots as narrow as a single human hair lodged in tiny blood vessels in his brain, killing clusters of neurons by depriving them of oxygen. Long partly deaf, he began losing his sight to wet macular degeneration, requiring ocular injections that cost nearly $2,000 each. A few months later, he forgot his way home from the university pool. He grew incontinent. He was collapsing physically, like an ancient, shored-up house.

In the summer of 2006, he fell in the driveway and suffered a brain hemorrhage. Not long afterward, he spent a full weekend compulsively brushing and rebrushing his teeth. “The Jeff I married . . . is no longer the same person,” my mother wrote in the journal a social worker had suggested she keep. “My life is in ruins. This is horrible, and I have lasted for five years.” His pacemaker kept on ticking.

When bioethicists debate life-extending technologies, the effects on people like my mother rarely enter the calculus. But a 2007 Ohio State University study of the DNA of family caregivers of people with Alzheimer’s disease showed that the ends of their chromosomes, called telomeres, had degraded enough to reflect a four-to-eight-year shortening of lifespan. By that reckoning, every year that the pacemaker gave my irreparably damaged father took from my then-vigorous mother an equal year.

When my mother was upset, she meditated or cleaned house. When I was upset, I Googled. In 2006, I discovered that pacemakers could be deactivated without surgery. Nurses, doctors and even device salesmen had done so, usually at deathbeds. A white ceramic device, like a TV remote and shaped like the wands that children use to blow bubbles, could be placed around the hump on my father’s chest. Press a few buttons and the electrical pulses that ran down the leads to his heart would slow until they were no longer effective. My father’s heart, I learned, would probably not stop. It would just return to its old, slow rhythm. If he was lucky, he might suffer cardiac arrest and die within weeks, perhaps in his sleep. If he was unlucky, he might linger painfully for months while his lagging heart failed to suffuse his vital organs with sufficient oxygenated blood.

If we did nothing, his pacemaker would not stop for years. Like the tireless charmed brooms in Disney’s “Fantasia,” it would prompt my father’s heart to beat after he became too demented to speak, sit up or eat. It would keep his heart pulsing after he drew his last breath. If he was buried, it would send signals to his dead heart in the coffin. If he was cremated, it would have to be cut from his chest first, to prevent it from exploding and damaging the walls or hurting an attendant.

On the Internet, I discovered that the pacemaker — somewhat like the ventilator, defibrillator and feeding tube — was first an exotic, stopgap device, used to carry a handful of patients through a brief medical crisis. Then it morphed into a battery-powered, implantable and routine treatment. When Medicare approved the pacemaker for reimbursement in 1966, the market exploded. Today pacemakers are implanted annually in more than 400,000 Americans, about 80 percent of whom are over 65. According to calculations by the Dartmouth Atlas research group using Medicare data, nearly a fifth of new recipients who receive pacemakers annually — 76,000 — are over 80. The typical patient with a cardiac device today is an elderly person suffering from at least one other severe chronic illness.

Over the years, as technology has improved, the battery life of these devices lengthened. The list of heart conditions for which they are recommended has grown. In 1984, the treatment guidelines from the American College of Cardiology declared that pacemakers were strongly recommended as “indicated” or mildly approved as “reasonable” for 56 heart conditions and “not indicated” for 31 more. By 2008, the list for which they were strongly or mildly recommended expanded to 88, with most of the increase in the lukewarm “reasonable” category.

The research backing the expansion of diagnoses was weak. Over all, only 5 percent of the positive recommendations were supported by research from multiple double-blind randomized studies, the gold standard of evidence-based medicine. And 58 percent were based on no studies at all, only a “consensus of expert opinion.” Of the 17 cardiologists who wrote the 2008 guidelines, 11 received financing from cardiac-device makers or worked at institutions receiving it. Seven, due to the extent of their financial connections, were recused from voting on the guidelines they helped write.

This pattern — a paucity of scientific support and a plethora of industry connections — holds across almost all cardiac treatments, according to the cardiologist Pierluigi Tricoci of Duke University’s Clinical Research Institute. Last year in The Journal of the American Medical Association, Tricoci and his co-authors wrote that only 11 percent of 2,700 widely used cardiac-treatment guidelines were based on that gold standard. Most were based only on expert opinion.

Experts are as vulnerable to conflicts of interest as researchers are, the authors warned, because “expert clinicians are also those who are likely to receive honoraria, speakers bureau [fees], consulting fees or research support from industry.” They called the current cardiac-research agenda “strongly influenced by industry’s natural desire to introduce new products.”

Perhaps it’s no surprise that I also discovered others puzzling over cardiologists who recommended pacemakers for relatives with advanced dementia. “78-year-old mother-in-law has dementia; severe short-term memory issues,” read an Internet post by “soninlaw” on Elderhope.com, a caregivers’ site, in 2007. “On a routine trip to her cardiologist, doctor decides she needs a pacemaker. . . . Anyone have a similar encounter?”

By the summer of 2007, my dad had forgotten the purpose of a dinner napkin and had to be coached to remove his slippers before he tried to put on his shoes. After a lifetime of promoting my father’s health, my mother reversed course. On a routine visit, she asked Rogan to deactivate the pacemaker. “It was hard,” she later told me. “I was doing for Jeff what I would have wanted Jeff to do for me.” Rogan soon made it clear he was morally opposed. “It would have been like putting a pillow over your father’s head,” he later told me.

Not long afterward, my mother declined additional medical tests and refused to put my father on a new anti-dementia drug and a blood thinner with troublesome side effects. “I take responsibility for whatever,” she wrote in her journal that summer. “Enough of all this overkill! It’s killing me! Talk about quality of life — what about mine?”

Then came the autumn day when she asked for my help, and I said yes. I told myself that we were simply trying to undo a terrible medical mistake. I reminded myself that my dad had rejected a pacemaker when his faculties were intact. I imagined, as a bioethicist had suggested, having a 15-minute conversation with my independent, predementia father in which I saw him shaking his head in horror over any further extension of what was not a “life,” but a prolonged and attenuated dying. None of it helped. I knew that once he died, I would dream of him and miss his mute, loving smiles. I wanted to melt into the arms of the father I once had and ask him to handle this. Instead, I felt as if I were signing on as his executioner and that I had no choice.

Over the next five months, my mother and I learned many things. We were told, by the Hemlock Society’s successor, Compassion and Choices, that as my father’s medical proxy, my mother had the legal right to ask for the withdrawal of any treatment and that the pacemaker was, in theory at least, a form of medical treatment. We learned that although my father’s living will requested no life support if he were comatose or dying, it said nothing about dementia and did not define a pacemaker as life support. We learned that if we called 911, emergency medical technicians would not honor my father’s do-not-resuscitate order unless he wore a state-issued orange hospital bracelet. We also learned that no cardiology association had given its members clear guidance on when, or whether, deactivating pacemakers was ethical.

(Last month that changed. The Heart Rhythm Society and the American Heart Association issued guidelines declaring that patients or their legal surrogates have the moral and legal right to request the withdrawal of any medical treatment, including an implanted cardiac device. It said that deactivating a pacemaker was neither euthanasia nor assisted suicide, and that a doctor could not be compelled to do so in violation of his moral values. In such cases, it continued, doctors “cannot abandon the patient but should involve a colleague who is willing to carry out the procedure.” This came, of course, too late for us.)

In the spring of 2008, things got even worse. My father took to roaring like a lion at his caregivers. At home in California, I searched the Internet for a sympathetic cardiologist and a caregiver to put my Dad to bed at night. My frayed mother began to shout at him, and their nighttime scenes were heartbreaking and frightening. An Alzheimer’s Association support-group leader suggested that my brothers and I fly out together and institutionalize my father. This leader did not know my mother’s formidable will and had never heard her speak about her wedding vows or her love.

Meanwhile my father drifted into what nurses call “the dwindles”: not sick enough to qualify for hospice care, but sick enough to never get better. He fell repeatedly at night and my mother could not pick him up. Finally, he was weak enough to qualify for palliative care, and a team of nurses and social workers visited the house. His chest grew wheezy. My mother did not request antibiotics. In mid-April 2008, he was taken by ambulance to Middlesex Hospital’s hospice wing, suffering from pneumonia.

Pneumonia was once called “the old man’s friend” for its promise of an easy death. That’s not what I saw when I flew in. On morphine, unreachable, his eyes shut, my beloved father was breathing as hard and regularly as a machine.

My mother sat holding his hand, weeping and begging for forgiveness for her impatience. She sat by him in agony. She beseeched his doctors and nurses to increase his morphine dose and to turn off the pacemaker. It was a weekend, and the doctor on call at Rogan’s cardiology practice refused authorization, saying that my father “might die immediately.” And so came five days of hard labor. My mother and I stayed by him in shifts, while his breathing became increasingly ragged and his feet slowly started to turn blue. I began drafting an appeal to the hospital ethics committee. My brothers flew in.

On a Tuesday afternoon, with my mother at his side, my father stopped breathing. A hospice nurse hung a blue light on the outside of his hospital door. Inside his chest, his pacemaker was still quietly pulsing.

After his memorial service in the Wesleyan University chapel, I carried a box from the crematory into the woods of an old convent where he and I often walked. It was late April, overcast and cold. By the side of a stream, I opened the box, scooped out a handful of ashes and threw them into the swirling water. There were some curious spiraled metal wires, perhaps the leads of his pacemaker, mixed with the white dust and pieces of bone.

A year later, I took my mother to meet a heart surgeon in a windowless treatment room at Brigham and Women’s Hospital in Boston. She was 84, with two leaking heart valves. Her cardiologist had recommended open-heart surgery, and I was hoping to find a less invasive approach. When the surgeon asked us why we were there, my mother said, “To ask questions.” She was no longer a trusting and deferential patient. Like me, she no longer saw doctors — perhaps with the exception of Fales — as healers or her fiduciaries. They were now skilled technicians with their own agendas. But I couldn’t help feeling that something precious — our old faith in a doctor’s calling, perhaps, or in a healing that is more than a financial transaction or a reflexive fixing of broken parts — had been lost.

The surgeon was forthright: without open-heart surgery, there was a 50-50 chance my mother would die within two years. If she survived the operation, she would probably live to be 90. And the risks? He shrugged. Months of recovery. A 5 percent chance of stroke. Some possibility, he acknowledged at my prompting, of postoperative cognitive decline. (More than half of heart-bypass patients suffer at least a 20 percent reduction in mental function.) My mother lifted her trouser leg to reveal an anklet of orange plastic: her do-not-resuscitate bracelet. The doctor recoiled. No, he would not operate with that bracelet in place. It would not be fair to his team. She would be revived if she collapsed. “If I have a stroke,” my mother said, nearly in tears, “I want you to let me go.” What about a minor stroke, he said — a little weakness on one side?

I kept my mouth shut. I was there to get her the information she needed and to support whatever decision she made. If she emerged from surgery intellectually damaged, I would bring her to a nursing home in California and try to care for her the way she had cared for my father at such cost to her own health. The thought terrified me.

The doctor sent her up a floor for an echocardiogram. A half-hour later, my mother came back to the waiting room and put on her black coat. “No,” she said brightly, with the clarity of purpose she had shown when she asked me to have the pacemaker deactivated. “I will not do it.”

She spent the spring and summer arranging house repairs, thinning out my father’s bookcases and throwing out the files he collected so lovingly for the book he never finished writing. She told someone that she didn’t want to leave a mess for her kids. Her chest pain worsened, and her breathlessness grew severe. “I’m aching to garden,” she wrote in her journal. “But so it goes. ACCEPT ACCEPT ACCEPT.”

Last August, she had a heart attack and returned home under hospice care. One evening a month later, another heart attack. One of my brothers followed her ambulance to the hospice wing where we had sat for days by my father’s bed. The next morning, she took off her silver earrings and told the nurses she wanted to stop eating and drinking, that she wanted to die and never go home. Death came to her an hour later, while my brother was on the phone to me in California — almost as mercifully as it had come to my paternal grandfather. She was continent and lucid to her end.

A week later, at the same crematory near Long Island Sound, my brothers and I watched through a plate-glass window as a cardboard box containing her body, dressed in a scarlet silk ao dai she had sewn herself, slid into the flames. The next day, the undertaker delivered a plastic box to the house where, for 45 of their 61 years together, my parents had loved and looked after each other, humanly and imperfectly. There were no bits of metal mixed with the fine white powder and the small pieces of her bones.

Katy Butler lives in Mill Valley, Calif., and teaches memoir writing at the Esalen Institute in Big Sur.

So your saying that I have gained the whole world and lost my soul because I seek to understand the meaning of existence without the bible? Since you can't show that I have a soul, I think that is a good trade! Joking aside, quoting scripture to me is a pretty useless thing, why would I care? We are talking science, and since we are talking about science, and the bible isn't a science book you are just quote bombing with no real usefulness, your knowledge of scriptures that pertain to your own believe structure aren't very useful in a conversation with others. It would be like me quoting the Koran to you, why would you care?

The topic of the video is what academics think about God. And when they're talking about God, they are really talking about the Christian God, so it is relevant to the conversation.

I don't know what you just don't stay out of science threads, it is obvious you have no respect for it, and all the advantages in life you that gain because of it you just toss aside with a mental gymnastics that should earn you a gold medal. You have no moral problems with using the technology that science creates while simultaneously saying we are twice as damned because of our pursuits.

Psalm 19:1-3

The heavens declare the glory of God, and the sky above proclaims his handiwork.

Day to day pours out speech, and night to night reveals knowledge.

There is no speech, nor are there words, whose voice is not heard.

I don't have any problem with science. I think the exploration of the creation reveals the glory of the Creator, which is something I highly esteem. I only take issue with the hubris of men who exalt mans position in the Universe over God. It's kins of like that joke..

"God is sitting in Heaven when a scientist says to
Him, "Lord, we don't need you anymore. Science has finally
figured out a way to create life out of nothing. In other
words, we can now do what you did in the beginning."

"Oh, is that so? Tell me..." replies God.

"Well," says the scientist, "we can take dirt and
form it into the likeness of You and breathe life into it, thus
creating man."

"Well, that's interesting. Show me."

So the scientist bends down to the earth and
starts to mold the soil.

"Oh no, no, no..." interrupts God, "Get your own dirt.""

As for evil, what I do see is a time in man that we are finally closer to understanding and coaxing human nature away from immorality with science. We are starting to confidently grasp the physiological, neurological, and chemical elements of our existence that determine our behavior. And for many decades now, medical science has been helping people of all faiths with very measurable success rates in problems that in the past were relegated to prayer and usually suffering followed by death (god left infant morality rates much higher than science and technology has).

What's different in the world? 30 thousand people starving to death every day in a world that has a 70 trillion dollar GDP. The inequity in the world today is greater than at any other time. Most people aren't aware, and don't really care about anything which is happening outside their limited sphere of interest. There is no actual difference between the man of yesterday and the man of today. If anything, he is even more corrupt than ever.

As far as infant morality rates, God didn't create the world like this. It became this way because of sin.

It is important that you don't think I hate religion, but maths are what enabled Newton to formulate his theories, not bible calculus or some methodology set forth from the bible...it was all Newton and his brain. Religious value is at best intangible is what I mean, the fruit of Newtons efforts are entirely repeatable without any religious interactions at all.

It doesn't really matter if you hate religion, it's whether you love Jesus that is important. Did you?

Newton gave the credit to God, and said all of his inspiration came from Him. The value of his faith in God was very tangible to him, and the fruit it bore benefited all humankind.

Your 2 most important questions are also not only answerable with scientific inquiry, but also not really the 2 most important questions.

What scientific inquiry will answer them?

There are no "most important questions", only questions a specific person find important. I personally obsess over knowing "Truth", others just care to know how things work mechanically, others still to be a good father or wife or husband, others still how to cure global poverty...all of these quests are good, and all have answers that can be found outside biblical answers. Not to mention that most of the Christian world has vastly different ideas even though they read the same bible. So while you think your are quoting universal truth at me, Christians are as dis-unified in their believes as to make me question your main thesis of the "2 questions"; I doubt any significantly large group of christian's actually shares that those 2 questions alone are the most important 2 questions in a christian's life.

The vast majority of Christians have agreement on all of the core teachings of the bible, going back to the early church.

I don't expect you to agree with me that they are important; you of course have your own ideas about what is important. However, God did put you here for a reason, and you can only find that reason out from Him. If there is no God, there is no purpose, truth or meaning for anything. Did you catch this video?:

http://videosift.com/video/The-Truth-about-Atheism

I notice that you put the word truth in quotation marks. Do you know what truth is? Without truth, you are living in a world of uncertainty. You are staring down a hall of mirrors, not knowing which is the true reflection.

There are only two routes to know what truth is. One is that you're omnipotent. Two, is that you are given revelation of the truth by an omnipotent being. I am claiming the second option; that's the only way I know what the truth is. What is your route to the truth?

The only salvation the bible offers is from the own hell that it proclaims, it is saving you from the hell that isn't visible with a cure that isn't testable in a sea of other religious that claim similar and dissimilar truths. There is no reasonable argument (an argument that is undeniable from a logical standpoint) that can lead you to faith in any religion, it has to come from some other place that isn't your brain (and by this I mean reason and thought, not the brain technically)...and to me, this isn't worth investigating any further than when I did when I was a christian. Faith is ultimately irrational, and I have given up on indulging irrational behavior inasmuch as it is in my power.

These are rational beliefs until you are given revelation by God, and then you throw these theories out the window and start over. That's where I was at before I was saved, because I didn't grow up in a Christian home like you did. I grew up in a secular home without religion, and I thought along these same lines, and I was equally skeptical about all supernatural claims. It's only because God had mercy on me and showed me He is there that I know that He is.

The way it works is, God gives you enough information/revelation to know that He is, and then He puts the onus on you to seek Him out. You probably believe you are rejecting God for intellectual reasons, but you're really not when it comes down to it. You are rejecting God because of the sin in your life, because sin is what separates us from God. Sin corrupts your intellect and twists your logic just enough to keep you from seeing reality. If you honestly want to know the truth, and are willing to give up everything in your life to have it, then you will find it:

John 14:6

Jesus answered, "I am the way and the truth and the life. No one comes to the Father except through me.

Jesus is the truth. Those who are seeking the truth end up on his doorstep. The way you know God is true is when God reveals Himself to you through personal revelation. Would you give up everything in your life to know the truth?

A Christian is someone who has surrendered their life to Christ. It sounds like you, like many others I've spoken to, grew up in a Christian home and were never taught how to have a personal relationship with Jesus Christ. You had your parents faith and didn't really understand why you believed. When you encountered the skepticism of the world, you found you couldn't justify your belief to yourself and fell away. Does that sound about right?

You don't become a Christian through osmosis from your parents; you need to be born again. Without the internal witness of the Holy Spirit, you won't have any reason to believe. You have nothing to stand on if your entire experience of Christianity is is going to church, reading the bible, and praying. Why would you do any of it if you didn't experience the tangible presence of God? To know God is to know Him personally, and those who worship Him must worship in spirit and in truth.

Perhaps I am mistaken, perhaps there is some undeniable bit of logical truth that leads to Christendom and if I were ever exposed to such knowledge I would gladly embrace truth of any kind. I highly doubt such incorruptible knowledge exists, however, so Agnosticism for the duration of my life is the only reasonable thing to do. Do you know of some undeniable claim that can't be logically refuted that leads to Christianity as the answer?

Now this is interesting, what you're saying here, when you mention "incorruptible knowledge". I'd like to explore this, but before we do, could you answer two simple questions?:

Tell me one thing you know for certain, and how you know it.

Could you be wrong about everything you know?

>> ^GeeSussFreeK:

@shinyblurry So your saying that I have gained the whole world and lost my soul because I seek to understand the meaning of existence without the bible?

@shinyblurry So your saying that I have gained the whole world and lost my soul because I seek to understand the meaning of existence without the bible? Since you can't show that I have a soul, I think that is a good trade! Joking aside, quoting scripture to me is a pretty useless thing, why would I care? We are talking science, and since we are talking about science, and the bible isn't a science book you are just quote bombing with no real usefulness, your knowledge of scriptures that pertain to your own believe structure aren't very useful in a conversation with others. It would be like me quoting the Koran to you, why would you care?

I don't know what you just don't stay out of science threads, it is obvious you have no respect for it, and all the advantages in life you that gain because of it you just toss aside with a mental gymnastics that should earn you a gold medal. You have no moral problems with using the technology that science creates while simultaneously saying we are twice as damned because of our pursuits.

As for evil, what I do see is a time in man that we are finally closer to understanding and coaxing human nature away from immorality with science. We are starting to confidently grasp the physiological, neurological, and chemical elements of our existence that determine our behavior. And for many decades now, medical science has been helping people of all faiths with very measurable success rates in problems that in the past were relegated to prayer and usually suffering followed by death (god left infant morality rates much higher than science and technology has).

It is important that you don't think I hate religion, but maths are what enabled Newton to formulate his theories, not bible calculus or some methodology set forth from the bible...it was all Newton and his brain. Religious value is at best intangible is what I mean, the fruit of Newtons efforts are entirely repeatable without any religious interactions at all.

Your 2 most important questions are also not only answerable with scientific inquiry, but also not really the 2 most important questions. There are no "most important questions", only questions a specific person find important. I personally obsess over knowing "Truth", others just care to know how things work mechanically, others still to be a good father or wife or husband, others still how to cure global poverty...all of these quests are good, and all have answers that can be found outside biblical answers. Not to mention that most of the Christian world has vastly different ideas even though they read the same bible. So while you think your are quoting universal truth at me, Christians are as dis-unified in their believes as to make me question your main thesis of the "2 questions"; I doubt any significantly large group of christian's actually shares that those 2 questions alone are the most important 2 questions in a christian's life.

The only salvation the bible offers is from the own hell that it proclaims, it is saving you from the hell that isn't visible with a cure that isn't testable in a sea of other religious that claim similar and dissimilar truths. There is no reasonable argument (an argument that is undeniable from a logical standpoint) that can lead you to faith in any religion, it has to come from some other place that isn't your brain (and by this I mean reason and thought, not the brain technically)...and to me, this isn't worth investigating any further than when I did when I was a christian. Faith is ultimately irrational, and I have given up on indulging irrational behavior inasmuch as it is in my power.

Perhaps I am mistaken, perhaps there is some undeniable bit of logical truth that leads to Christendom and if I were ever exposed to such knowledge I would gladly embrace truth of any kind. I highly doubt such incorruptible knowledge exists, however, so Agnosticism for the duration of my life is the only reasonable thing to do. Do you know of some undeniable claim that can't be logically refuted that leads to Christianity as the answer?

I'm not sure why people seem to think this is an elementary problem. I seriously doubt that most people in this discussion studied anywhere near the math and physics required in the calculation in middle school, or even high school, or college for that matter. Having studied physics and math at all those levels, I know that wind turbines were NEVER part of the discussion. After looking up the relevant equations, I can see why -- they're certainly not trivial, and would probably required significant calculus to understand (derive). In university my physics courses were directed towards electricity, so I didn't get a chance to play with wind tunnels -- although I'd still love to!

Applying the oversimplified version of laws that you learned in early physics classes to reality can often leave you in stunned silence when reality seems to defy them. Things like the dimples on golf balls or sailing ships moving upwind are classic examples of things that you wouldn't expect to even be conceivable unless you saw it in action.

@hpqp
Good points, all.
However, the "cognition is sacred" (as opposed to "human life is sacred") viewpoint has a hole in it about the size of human consciousness. (Oh man, tangent time!) Some loudly proclaim the presence of a divine soul or spirit, but there is certainly something else there, aside from the physical form.
Obviously, human (and for that matter animal) experience and behavior is influenced by the physical brain and its processes. Damage to it predictably and reproducibly changes behavior and perception. As much as some of us would like to think otherwise, the physical structure and function of the brain influences who we are and what we do as individuals. I would honestly have no problem accepting that the physical universe as we've modeled it functions precisely as it has, autonomously. (Right down to fruitless debates between individuals on the Internet.) Evolution is a real thing. The brain has developed as yet another beneficial mutation that promotes the propagation of its host organism. Input in, behavior out, feedback loop. Click click click, ding.
But the problem is that we experience this. Somehow this mass of individual cells (and below that individual molecules, atoms, quarks) experiences itself in a unified manner, or rather something experiences this mass of matter in a unified manner. No matter how far down you track it, there's no physical accommodation for consciousness. To give a specific example, the cells in the eye detect light (intensity and wavelength) by electrochemical stimulation. The binary "yes\no" of stimulation is routed through the thalamus in individual axons, physically separated in space, to the visual cortex, where it's propagated and multiplied through a matrix of connections, but all individual cells, and all just ticking on and off based on chemical and electrical thresholds. The visual field is essentially painted as a physical map across a region of the brain, but somehow, the entire image is experienced at once. Cognition is necessarily distinct from consciousness.

What this means, practically, is that we must attribute value to cognition and consciousness separately.
Cognition may not be completely understood, but we can explain it in increasingly specific terms, and it seems that we'll be able to unravel how the brain works within the current model. It absolutely has a value. We consider a person who is "a vegetable" to have little to no current or expected quality of life, and generally are comfortable making the decision to "pull the plug".
Consciousness, however, is what we believe makes us special in the universe, despite being completely empty from a theoretical standpoint. If sensory input, memory, and behavioral responses are strictly a function of the material, then stripped of those our "unified experience" is completely undetectable\untestable. We have no way of knowing if our neighbor is a meaty automaton or a conscious being, but we assume. Which is precisely why it's special. It's obviously extra-physical. Perhaps @gorillaman's tomatobaby (that is, the newborn which he says is without Mind) has a consciousness, but it isn't obvious because the physical structure is insufficient for meaningful manifestation. I have difficulty accepting that consciousness, empty though it is on its own, is without value. "So what," though, right? If you can't detect it in anyone but yourself, what use is it in this discussion? Clearly, there IS something about the structure or function of the brain that's conducive to consciousness. We are only conscious of what the brain is conscious of and what it has conceived of within its bounds. So the brain at least is important, but it's not the whole point.
Anyway, there's that tangent.

The "stream of potential life" argument has its limits. Any given sperm or egg is exceedingly unlikely to develop into a human. For a single fertilized egg, the odds shift dramatically. That's why people seek abortions, because if they don't do something, they're probably going to have a baby. The probability of "brewin' a human" is pretty good once you're actually pregnant. The "potential for human life" is very high, which is why you can even make the quality of life argument.

Obviously, you realize how those on the anti-abortion side of the debate react when someone who is...let's say abortion-tolerant ("pro-abortion" overstates it for just about anyone, I suspect) says that they're considering the "quality of life" of the prospective child in their calculus. They get this mental image: "Your mother and I think you'll both be better off this way, trust me. *sound of a meatball in a blender*"
I appreciate that we're trying to minimize suffering in the world and promote goodness, but I think it's over-reaching to paint every potential abortion (or even most) as a tragic tale of suffering simply because the parent wasn't expecting parenthood. Quality of life is much more nuanced. Many wonderful humans have risen from squalor and suffering and will tell you earnestly they believe that background made them stronger\wiser\more empathetic\special. Many parents who were devastated to learn they were pregnant love their unexpected children. And holy crap, kids with Downs, man. What's the quality of life for them and their parents? Terribly challenging and terribly rewarding.
No, I'm not trying to paint rainbows over economic hardship and child abuse and say that "everything's going to be finnnnneeee", but quality of life is a personal decision and it's unpredictable. Isn't that what "It Gets Better" is all about? "Things may seem grim and terrible now, but don't kill yourself just yet, you're going to miss out on some awesome stuff."

Hrm. Thus far we've really been framing abortion as being about "unready" parents, probably because the discussion started on the "mother can choose to have sex" angle.
You've got to wonder how confused this issue would get if we could detect genetically if a fetus might be homosexual. Would Christians loosen their intolerance for abortion if it meant not having a "gay baby"? (Even if it would fly in the face of their belief that homosexuality is a choice.) Would pro-choicer's take a second look at the availability of abortion? Would it still be "one of those terrible things that happens in a free society"?

On western aid, you're spot on. It's so easy to throw money at a problem and pretend we're helping. Humanitarian aid does nothing if we're not promoting and facilitating self-sufficiency. Some people just need a little help getting by until they're back on their feet, but some communities need a jump-start. As you say, they need practical education. I've only been on handful of humanitarian missions myself, so I give more financially than I do of my sweat, but I'm careful to evaluate HOW the organizations I give to use the funds. Are they just shipping food or are they teaching people how to live for themselves and providing the resources to get started? Sure, some giving is necessary. It's impossible for someone to think about sustainable farming and simple industry if they're dying from cholera or starving to death.

@Boise_Lib

My first answer is definitely wrong because it assumes that the increased displacement of the boat due to the anchor's mass is equal to the displacement by the anchor's volume when it enters the water. This is demonstrably false, as a 5kg lead anchor would cause a boat to displace as much water as a 5kg iridium anchor in the same boat, but the lead anchor would displace about twice as much water as the iridium anchor when thrown in the water.

Let's say my anchor is iridium, and is massive enough it almost sinks the boat. The boat is now displacing much more water than the anchor will when I throw it overboard, so the answer is the water will fall. In my thought experiment, I now decrease the density of my imaginary anchor and increase its size such that the boat is always just barely afloat. When I toss the anchor overboard, the water will fall less and less, but as long as the boat is floating (not much of a boat if it doesn't float) and the anchor alone is denser than water (not much of an anchor if it's not denser than water, I believe the anchor will always cause the boat to displace more water in the boat than outside the boat. I'm sure I could use limits to prove this, but I'm just going to assume I'm right without doing the calculus. So my new answer is: the water will always fall.

Thanks for the mental exercise.

(How did I do?)