Thank you very much.

At one point in time I had hoped to get to 100,000 before mintbbb overtook me, silly me. I have slowed down too much in my old age. It won't be long until you overtake me as well with your super awesome votes/video ratio .

Cheers

Well, I think it seems more like she doesn't get it because she didn't have much experience or interest in sci-fi stuff, and didn't understand some of the basic concepts (like they were in a computer-generated reality). In other words, I don't think her "perception and perspective" are due to genre unfamiliarity rather than old age.

LOL trust me, I don't think it's old age that makes you less perceptive. The first time my GF saw The Matrix and hated it because she didn't know that they were inside a computer most of the movie and thought they were flying like in Crouching Tiger and she hates that stuff. But when I explained why they had those powers from 'hacking' the matrix which is a computer program they can enter into she liked the story alot more.

I really do not look forward to old age. God dammit. Is this really the perception and perspective that mortality has in store for me? All I want is to be 80 years old and commanding virtual star-fleets from my bed-toilet.

Harper's out after the next election. I agree with the sentiment that his broken promises should be exposed, but I feel that this narrow personal focus loses sight of the big picture. I figure there going to have to forward their old domain to one of:

shitmulcaredid.ca
shittrudeaudid.ca
shitmaydid.ca

Same shit, different colour. (Notice the Canadian spelling of colour, eh.)

Even with limits of corporate campaign donations in Canada, there are loopholes in the system. This is not to say we've reduced it to a free speech argument like Citizens United, but it's still damned shady. I don't see real change coming from any party, sorry.

The wealth gap is growing around the world and corporate cronyism is ruining the world economy. This isn't solely Harper's fault. Sure he's a stooge, but even Obama is little more than a puppet in the stalled house.

I must be getting cynical in my old age!

The question was for you.

Do you feel that today racism towards blacks is from Americas long history of unfair treatment of blacks? I feel that for the most part that is a thing of the past. I agree with you that there are some old folk that were born and raised with hate and will someday soon die of old age

If that is mostly true then what keeps today racism alive? Whose fault is it, whites, blacks or both?

Yes, sensitivity training of hiring professionals should be enough. They are professionals and are to see past race. You imply that even proper professionalism of HR they still discriminate.

BTW Guns are not a huge issue here - this talking head trying to create it as an issue boggles my mind - SERIOUSLY- guns, it's a subject that does not factor into my existence, because I am not american. I never even think twice about guns, guns guns guns, leave it to these guys to dredge up a non issue to try an americanize us. guess what? i walk around all over the place in canada without ANY fear of guns. don't think about them, don't fear them. noone fucking has handguns, not afraid of rifles on dark streets, noone shooting up the place. i find the level of violence in canada VERY ACCEPTABLE where we are a human civilization, humans enter into conflict, shit happens. most people here die in hospital of old age so don't think that your gun debate has anything to do with canada, it's a non issue, and you thinking that we're talking about it ILLUSTRATES YOUR UTTER DETACHMENT FROM REALITY.

Death from old age has a way of getting through to people.

That 40+% voting bloc you spoke of? a high percentage of that number are old (and white)

That's the sad disturbing reality. change is slow...painfully slow. Some people will never change their mind. all you can do is wait for them to die and be replaced by people who have opinions that reflect reality better.

We still have people who don't think women should vote. We still have people who think black people should be back in chains. Sure they're in the minority and they're going to be dead from natural causes relatively soon, but still.

No, they are not the same thing, and they are not creationist terms.

Yes, they are in fact the same thing, and yes, I know creationists didnt come up with the terms, predictably, since they have never come up with a single useful term or idea in the history of everything. They can be useful terms to describe the short-term and long-term effect of evolution, but creationist use the term to shield themselves from admitting that they deny reality. Lets just take one example: genetic variation, according to creationists then, genetic variation is real and actually happens, your genes are slightly different from other human genes, ie: there is variations within a species.

But this is the same kind of variation there is BETWEEN species, its the SAME FREAKING THING, but when the difference is large enough, individual organism can no longer breed to produce fertile offspring. That is in fact the definition of "species". Conceptually, there is no difference between the genetic difference between you and me and the genetic difference between you and a tomato, its just MORE difference.

I honestly dont know how to respond to this time=miracle nonsense, the point is that because there is variation and mutations, speciation will happen over long stretches of time, now you might say "biologists sure needs lots of time for evolution to work" but the thing is that other, unrelated fields of study, like chemistry, physics and cosmology have independently reached conclusions about how old the universe is, and its billions of years old. We KNOW that, not from inventing a number large enough to allow evolution to work its "miracles", but because its the only logical conclusion based the available evidence.

The correlating data you are looking at is a hall of mirrors. Radiometric data is based on uniformitarian assumptions. The light travel time is based on similar assumptions. Embedded in all of the estimations of an old age are unprovable assumptions that have no empirical evidence to prove they are true. They are in fact unknowable.

Everything in that paragraph is wrong. These things are NOT based on assumptions, but empirical evidence, calculations and experiments. In fact, the knowledge has not only been confirmed by experiments and evidence, and as I tried to explain earlier, YOU ARE RELYING ON TECHNOLOGY BASED ON THAT KNOWLEGDE TO READ THIS SENTENCE. It is literally being proved right in front of your eyes.

Sigh. Orbiting earth is also hard, and there are hundreds of problems with it, which is why mankind went thousands of years without doing it. But long before we actually managed to do it, we knew that it should be possible, because we knew the earth was a sphere. I can imagine there was lots of heated discussions on how to do it, that would be little comfort to a flat-earther. "See! You cant put things in orbit, earth must be flat!" Like thats how stupid you sound when you go "Horizon problem! The universe must be 6000 years old!"

Why do you even bother reading about things like the Horizon problem? Are you seriously suggesting that this makes your case?

What I am suggesting is that both Creationists and secular scientists have an imperfect understanding of the problem, but Creationists do have a plausible explanation with evidence to back it up.

Whether the universe is six thousand or 13.72 billion years old is not in scientific dispute, ok? we might have to finetune it give or take a few million years, but there is no doubt about the general size of the number. If everybody has fucked up completely the last 100 years, then perhaps one could imagine the number needs to be trippled or cut in half or whatever (I really doubt it because we now have correlating data from so many fields) but 6000 years? Thats a JOKE. Its complete and utter nonsense, It's balls-out-clownshoes-and-two-fucking-trouts-on-your-head-barking-wackaloony-insane-babble-from-crazyland-wrong to the nth degree.

The correlating data you are looking at is a hall of mirrors. Radiometric data is based on uniformitarian assumptions. The light travel time is based on similar assumptions. Embedded in all of the estimations of an old age are unprovable assumptions that have no empirical evidence to prove they are true. They are in fact unknowable.

It's really not important to me to prove to you how old the Earth is. It's your worldview that the Earth is very old and it's intrinsic to how you view reality, and to try to excise that from your mind would be like trying to separate conjoined twins. All I really want you to know is that there is a God out there who loves you, and His name is Jesus Christ.

It's not that there is a 'war' on... it's that there are a bunch of non-scientists walking around saying they're 'creation scientists'.

Many creation scientists have advanced degrees and have published many papers. Why aren't they scientists? What makes a scientist a scientist?

You're absolutely correct, there is no research being done on 'young Universe'... but there is also no science being done to prove 'old Universe'. Science is done by taking small bits of knowledge that have little gaps, and filling those gaps in. We didn't figure out the half-life of Rubidium in order to prove the age of the earth, we figured out the half-life of Rubidium to figure out the half-life of Rubidium. Some other scientists had taken measurements of the natural occurrence of elements and their isotopes in various parts of the world. And then more scientists apply the knowledge acquired in both fields and try to find out what it tells us.

There was a very concerted effort, especially during the 19th and 20th centuries to come up with evidence for an old age of the Earth to support the ideas of uniformitarian geology and macro evolution. There was an ideological war going on, just as there is today, between those secular scientists who wanted to establish their own secular idea of origins to undercut the account of biblical creation. Up until that point, all geologists were flood geologists. Now a days, you're right, they are resting on their laurels, because as I said it has become conventional wisdom, which is not science but philosophy.

I agree, you absolutely should question scientists with an agenda, but I've NEVER heard a non-christian suggest that there is scientific evidence for the earth being younger than 4-5 billion years old.

I grew up in a secular home with a great love for science, and I very activiely pursued studies in astronomy and biology. In all of my studies, I never heard so much as a peep about the controversy. There is an information filter on this subject, and it had kept me in the dark about the whole thing most of my life.

You want to cast doubt on scientists by saying that there are millions of dollars and reputations on the line, but this reasoning is more destructive if you aim it at the young-earthers: Their religion has made explicit claims as to time-spans that occurred 'in the beginning'... their religious leaders have made explicit claims as to the literalness of the Bible. And most church leaders have been explicit that other denominations of Christians may not be allowed into heaven... So you have a large group of individuals who are not only risking their reputation, but what they believe is their eternal soul, on something that they didn't discover, but have worked backward to find evidence to prove that their book is correct.

None of this has anything to do with the question of salvation. The conflict you're seeing is coming from a liberal movement within the church which tends to embrace secular values and rejects traditional interpretation of scripture. As numbers go, it is a small amount of people. As a recent survey shows, the majority of Americans (ie 46 percent) believe in creationism:

http://www.huffingtonpost.com/2012/06/05/americans-believe-in-creationism_n_1571127.html

These views get overreprented in the media by liberals sympathic to their causes. It gets presented in such a way that it looks like it is the majority view when it is actually the minority view.

As far as what Creation scientists have to lose..not much. They already lost much of what they had to lose by becoming a creation scientist in the first place.

Young-earthers each, individually, have much more to lose than scientists. And let's be clear... religions have enough money to staff up scientific R&D labs and fund their own research if they wanted. In fact, the Vatican DOES have it's own, world-renowned observatory. So, how old does this Priest thing the Universe is?
http://www.youtube.com/watch?feature=player_embedded&v=OwWqrXGtrRs#!

I don't agree with the catholic church on practically anything, let alone this.

So, to be clear, it's not Scientists vs. Christians. It's Scientists AND Christians vs. People Who Don't Trust Science.

It's actually the wisdom of God versus the wisdom of man.

And I expect this. Christians have long fought against persecution, and it thrived while it was being persecuted. Now that it's the dominant religion, many of the teachings have lost their luster. Members who believe that the Bible has something personal to say to them will pick up on the persecution aspect, which was intended to help those in the year 200AD... not 2012. So they make up bogey-men and pick a fight with anyone who says something that isn't explicitly allowed in the Bible (and is convenient for them)... hence the anti-Gay-Marriage protests, but no anti-shellfish protests.

Over 200 thousand Christians are martyred every year for their faith, all over the world.

You're a product of your environment, shinyblurry... you're as predictable as Islam producing suicide bombers... and just as pathetic in your misunderstanding of the Universe.

All I'll say to this is that ad hominem attacks reveal more about your character than they do mine.

There are plenty of theists who believe in an old age of the Earth; however, they have to compromise scripture in a big way to get it to work. Also, and I've said this before, I used to be a firm believer in an old age of the Earth, but I changed my mind because of the evidence, not in spite of it. I had always believed there was very good evidence proving it was true, as that was the way I was taught and raised. I found out this was not so, or even close to it, and when I found out I would have to put more faith in the assumptions being made than I would in the bible, I chose to put my faith in scripture. I am fairly sure most of the people of this site were at the place I used to be, believing it because that is what is taught in school and mirrored endlessly in the culture. You see it in movies, books, televisions show, reinforcing it over and over again. But when I took the time to understand the actual evidence I found that they have taken some very big leaps of faith, completely unjustified, and actually contrary to the evidence that they find.

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.

Does anyone else think that Bill Nye has the right facial features to play a very convincing Abraham Lincoln?

Anyhow, I know that I am on sacred ground here at videosift, so instead of arguing with you, or the video, I'll just say why I believe in Creationism.

No, it's not because I believe the bible. Unlike many of the Christians that you know, I was not raised in the faith, or any faith, and I converted later in life. My default position was agnosticism, and I was a firm believer in evolution and the old age of the Earth. When I became a follower of Jesus Christ, I automatically didn't ditch those beliefs. I assumed, probably like many atheists turned Christian, that these things were absolutely proven scientifically and there was no room for doubt. Therefore, I further assumed that where the bible differed from the conclusions of science, either the bible was wrong, or it had to be looked at metaphorically.

I was very comfortable with this position, and would have remained there if I hadn't been challenged about the accuracy of this belief. What I found out was that my assumption that science was correct and evolution from universal common descent was absolutely proven was not based on my understanding of the theory, or the evidence behind it, but rather my cultural indoctrination into it.

If you grew up in a secular home like I did, then you might know what I am talking about. It's what they teach you in school, first of all. All of the textbooks you read about science support this theory, and so do your teachers. It's all over the culture as well. It's in the books that you read, the movies that you watch, and the music that you listen to. It's in conversations, it's in euphamisms, basically, it's everywhere. It's always presented to you as a proven fact and you have no reason to ever question it. I had no idea, really, that so many people (40 percent of our population) do question it.

In any case, I started investigating it. I studied the history of how this theory came to be accepted as truth, the evidence that supports it, and how it interrelates with many different branches of science. What I was shocked to find, and I do mean shocked, was that the absolute proof of the theory that every authority in my life who taught on these things told me was there, wasn't there. What I found was that, when it came to the evidence, sooner or later you came upon a giant assumption (read: leap of faith). What I found was that the case for evolution was not resting on a bedrock of proof, but rather a mountain of circumstantial evidence.

The only logical conclusion at this point was that if I was going to continue to believe in evolution, I would have to take it on faith. Instead of doing that, I decided to put my faith in the bible instead. So I changed my mind because of the evidence, not in spite of it.

Now, I said I am not going to argue with Bill Nye, but I will address a point that he brought up. Specifically, deep time. Deep time is the fundamental assumption which much of modern science is built upon, but what is the proof for deep time?

Well, the first proof that is usually brought up is radiometric dating. When someone hears "radiometric dating" they associate the very mention as conclusive proof, as if the rock being dated had a timestamp on it, and radiometric dating just reads it. Nothing could be further from the truth. Radiometric dating has a few assumptions built into it:

1. Constant decay rate
2. Ratio of daughter to natural
3. Beginning conditions known
4. No leaching or addition of parent
5. No leaching or addition of daughter
6. All assumptions valid for billions of years

If all of those assumptions are valid, the date can be trusted. The problem is that there is no way to determine whether all of those assumptions are true or not. And that is, if there were just one date. The experiment actually gives a range of dates, which is then further interpreted by what is called "field relationships" between the rocks. There are many technical problems with this, but I won't get into them here. There is also the problem that different dating methods give different results for the same rock, and that when we measure things we know the age of, we get incorrect dates. If we get incorrect dates for things we know the age of, why should we trust the dates it gives for things we don't?

So, it's not so cut and dry. Evolution should be questioned; after all, that's how new theories are made. If you want to teach children that evolution shouldn't be questioned, then you are teaching them something antithetical to science. What it comes down to is what is true. You can argue creationism vs evolutionism all day long. You can know it's true simply from the bible. What proves the bible to me is that when I gave my life to Jesus Christ, He sent me the Holy Spirit to dwell within me, and He supernaturally changed my life and made me a new person. The bible says this is exactly what will happen, and it did happen. It proves that what Jesus said is true, which validates the Old and New Testament, since Jesus personally validated all of the major facts of the Old Testament. Intellectually, I can pick these theories apart, but in the end, God proves Himself. It is nothing you have to speculate about because God will personally demonstrate it to you.

get back on your own lawn then gramps... i have a wide range of musical tastes, from classical orchestral to native drums to country to death metal to rap, and i immediately find what to appreciate in this BALLER-ASS SONG.

Listen to it on a real stereo, read the lyrics... unless of course, you are unable to expand your mind. There are others like you. Maybe you can vote together in your old age.