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The Turbo Encabulator. An important technical discussion

The Turbo Encabulator. An important technical discussion

The Sea's Strangest Creatures

Immigrants Taking British Jobs - Does The Math Add Up

chingalera says...

Yeah, a refreshing break anytime to hear the cadence, tone, color, of someone who can interpret poetry well...Even better if it's her own work, because as we all know, the cardinal rule of poetry is NOT TO READ YOUR OWN WORK...if you suck at it, which MOST do.

Thank god the poetry slam is DEAD!

robbersdog49 said:

Love the flow, love the message. Great sift.

TYT - 5 Shot at "Gun Appreciation Day" Celebrations

harlequinn says...

So an unloaded firearm with a flag in through the breach into the barrel is dangerous? Even when it's now impossible to have a round in the chamber?

Or a fully cleared firearm being cleaned is dangerous?

Have you ever sat through a firearms safety course?

Yeah you said it - and you're wrong. Period.

Most gun accidents happen to people who do not practice gun safety all the time. Go read the coroner's reports for a few of them. They all break one of the cardinal rules of firearms safety (yes there are a few) either through total ignorance or on purpose. Very rarely is it a competent safety practitioner suddenly forgetting and making a mistake.

As an example the state where I live in has a mandatory firearms safety course. The firearms accidents rate in my state is less than 1 per year. Other states nearby who do not educate in firearms safety have firearms accidents multiple times a year.

BicycleRepairMan said:

"you'll get judged by the actions of the minority that don't practice up to date strict gun safety"

Bullshit. Guns. Are. Dangerous. Period. Yes, I said it. And yes, they are more dangerous if you handle them recklessly, of course, but they are dangerous anyway, thats the whole point. Most gun accidents happens to people who normally DO practice strict gun safety, its just that people make fucking mistakes. ALL THE TIME. Thats the thing. You can, and will, also make mistakes with knifes, hammers and axes, but that probably wont instantly kill you, or someone 50 meters away from you. A gun might. Because they are fucking dangerous.

Oklahoma Doctors vs. Obamacare

MrFisk says...

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.

Star Citizen launch trailer

spoco2 says...

Yup, from their FAQ area...

Not a subscription but not free-to-play; rather a hybrid of these two business models. Much like ArenaNet's Guild Wars 2, you will purchase the PC game and pay no recurring subscription charges. Your purchase of the game will allow you to play in the universe for free, forever! The game will offer a variety of virtual items for purchase with in-game credits allowing you to spend money on items that offer more ways to express yourself, provide convenience, and customize your experience. But the cardinal rule regarding "in-game purchases" is: Players who spend money purchasing in-game credits will have no advantage over players who spend time!


Grrrr

Grrrr

Grrr

'Players who spend money purchasing in-game credits will have no advantage over players who spend
time'


Yeah, bullshit.

I can hope that the single player portion is untainted by in game purchasing, and that it's a great Wing Commander like experience, because that's all I care about really, have ZERO interest in online play.

Sufjan Stevens - Casmir Polaski Day

MrFisk says...

Goldenrod and the 4H stone
The things I brought you when I found out
You had cancer of the bone

Your father cried on the telephone
And he drove his car into the Navy yard
Just to prove that he was sorry

In the morning, through the window shade
When the light pressed up against your shoulderblade
I could see what you were reading

All the glory that the Lord has made
And the complications you could do without
When I kissed you on the mouth

Tuesday night at the Bible study
We lift our hands and pray over your body
But nothing ever happens

I remember at Michael's house
In the living room when you kissed my neck
And I almost touched your blouse

In the morning at the top of the stairs
When your father found out what we did that night
And you told me you were scared

All the glory when you ran outside
With your shirt tucked in and your shoes untied
And you told me not to follow you

Sunday night when I cleaned the house
I found the card where you wrote it out
With the pictures of you mother

On the floor at the great divide
With my shirt tucked in and my shoes untied
I am crying in the bathroom

In the morning when you finally go
And the nurse runs in with her head hung low
And the cardinal hits the window

In the morning in the winter shade
On the first of March, on the holiday
I thought I saw you breathing

All the glory that the Lord has made
And the complications when I see His face
In the morning in the window

All the glory when He took our place
But He took my shoulders and He shook my face
And He takes and He takes and He takes

Richard Dawkins on Creationists

spoco2 says...

Yeah, the last couple of times I've seen Dawkins in debates (here in Australia on our Q&A show in particular) he came across as a bullish dick. I really felt that he was doing more harm than good towards his own cause by the harsh way he was treating members of the audience who were asking questions and the way he responded to things.

I used to love him, now I wish he'd step aside and let someone with better people skills take over for public appearances as he's not doing the atheist cause any good. I'd be more happy with Sam Harris.

Republicans are Pro-Choice!

ReverendTed says...

I look back at that wall of text and realize I've violated a cardinal tenet of discourse: "Seek first to understand before speaking to be understood."
To me, it seems the fundamental point of disagreement deals with when (i.e.: at what stage of pregnancy) a person considers it acceptable to perform an abortion. Knowing that "when" and understanding the "why" of that belief would probably illuminate a great deal of why a given person believes what they do on this issue. So, in the spirit of productive discourse, I pose the following questions (which I will attempt to phrase in neutral language):

Assumption A: I assume we all agree that killing a child already born would be unacceptable under almost any circumstances. Is this assumption correct? (If not, why?)

Assumption B: I assume we all agree that prior to fertilization, individual sperm and eggs are not considered "life", and are largely irrelevant to this discussion. Is this assumption correct? (If not, why?)

The Big Two Questions:
1) Up until what point in a pregnancy (or fetal development) do you consider it acceptable to perform an abortion? (Does this change based on the circumstances?)
2) Why that point?

How Could Assange Escape the Ecuadorian Embassy?

How to Count Infinity

Why Christians Can Not Honestly Believe in Evolution

shinyblurry says...

Not only do I live in the US, but I live Oklahoma, one of the most religiously conservative states. I don't have a great deal of respect for that brand of religion, for sure. Which is precisely why it's so galling to see a video that suggests that's just what Christians have to be like--that Christians who reject the Bibliolatry and hermeneutic cutting and pasting of those idiots somehow aren't real Christians, that rejecting the sheep-like credulity of these so-called faithful means that the thoughtful ones haven't actually thought it through. And somehow it is averred that those who cling to the ancient traditions of Biblical understanding are inauthentically Christian, since they don't accept the quasi-heretical doctrines of 19th century upstarts.

Your characterization of bible literalists as "idiots" and people with "sheep-like" credulity and the "so-called" faithful, not-withstanding, I will agree that a disagreement on origins doesn't necessarily make someone less Christian. It doesn't say anywhere in the bible that you must agree on a literal interpretation of Genesis to follow Jesus Christ.

Calling the literal interpretation of Genesis a "quasi-heretical" doctrine of "19th century upstarts" is completely ridiculous, though. Almost as ridiculous as quoting Origen and Augustrine and claiming they represented the majority viewpoint of the early church. If you think the early church didn't believe in a literal Genesis, how do you explain Ephraim the syrian, or Basil of Caesarea? What about Ambrose of Milan, who was the mentor of Augustine? They all believed in a young earth, as did many others throughout the centuries.

Let us not also forget that Christ Himself was a bible literalist, who spoke about the narrative in the Old Testament, including Genesis, as literal history, and literally fulfilled the prophecies of the Messiah.

As far as dogmatic authority goes, I think that you're partly right about some religions. Specifically, the big Abrahamic religions--Judaism, Christianity, and Islam. It's important to remember that this is not the entire world of religion (even if they are important), so there are a number of statements about them that will be incorrect about other religions--in fact, most other religions.

It's true that the Big Three do indeed seem to require acceding to the truth of certain propositions in order to remain in their historical form: e.g., that the Torah was revealed by God, that Jesus lived, died, and rose from the dead, and that Mohammad received the Qur'an from Michael. (for each religion respectively) There is certainly an important sense in which certain very liberal theologians are still Christian, but this is something very different than historical Christianity
.

In regards to Christianity, there is a mimimum requirement of belief, such as that Jesus was raised from the dead, to be a Christian.

Moreover, I myself don't think that moral authority is actually essential to religion. It's certainly related to religion, but as I'm sure you've observed--there's not much of a correlation between religious belief and moral behavior. Simple observation shows most Christians to be liars. Morality is not why they are Christian.

Simple observation shows most people, probably near the 99.9 percent mark, to be liars. There is no claim in Christianity that Christians are perfect. Far from it. Jesus was the only perfect man to ever live. Christians still sin, but hopefully they sin much less than usual. Christians living sanctified lives are comparitively rare, unfortunately. When you consider that half of the American church does not believe in a literal Holy Spirit or Satan, it isn't surprising.

Instead, I think it's something else--transcendence, and the promise of new states of being. Morality has almost nothing to do with this. The same man can be capable of the most holy ecstasies and raptures before the beauty of the God or gods that he prays to, a writer of the most delicately beautiful hymns and homilies--and the worst bastard on earth outside of church. Cardinal Richilieu was just such a person.

In Christianity, it is to know God personally. Christianity is about Jesus Christ and nothing else. If you subtract Jesus, you don't have anything. You automatically get a new state of being; when you accept Christ you are a new creature, and you receive the Holy Spirit. You also have your sins forgiven and obtain eternal life.

This is why we'll never get rid of religion, of course. But it's also why the monotheistic religions can be so dangerous. They incorrectly tie the ecstasies of the spirit to crude and intolerant dogmas, then demand that all others agree or face the sword or the pyre.

Which spirit? Satan can make you feel ecstacy and love; it wouldn't be a very good deception if it wasn't deceiving. The question you should ask is, where is this coming from, and who gave me a spirit in the first place?

As far as intolerance goes, Jesus made it clear:

John 14:6

Jesus saith unto him, I am the way, the truth, and the life: no man cometh unto the Father, but by me.

Those are His words, not mine. A Christian is only telling you what He said, which is that you will face judgment for your sins. If you reject Jesus, you are telling God you want to stand trial for your sins on your own merit. If you are rejecting Jesus, it's for a reason that has nothing to do with anything you have written here.

>> ^HadouKen24:

Why Christians Can Not Honestly Believe in Evolution

HadouKen24 says...

Not only do I live in the US, but I live Oklahoma, one of the most religiously conservative states. I don't have a great deal of respect for that brand of religion, for sure. Which is precisely why it's so galling to see a video that suggests that's just what Christians have to be like--that Christians who reject the Bibliolatry and hermeneutic cutting and pasting of those idiots somehow aren't real Christians, that rejecting the sheep-like credulity of these so-called faithful means that the thoughtful ones haven't actually thought it through. And somehow it is averred that those who cling to the ancient traditions of Biblical understanding are inauthentically Christian, since they don't accept the quasi-heretical doctrines of 19th century upstarts.

Clearly false. Yet that's the whole thrust of the video!



With regard to your last two paragraphs, I think we're starting to move away from straightforward commentary on the video. But that's alright with me, if it's okay with you.

As far as dogmatic authority goes, I think that you're partly right about some religions. Specifically, the big Abrahamic religions--Judaism, Christianity, and Islam. It's important to remember that this is not the entire world of religion (even if they are important), so there are a number of statements about them that will be incorrect about other religions--in fact, most other religions.

It's true that the Big Three do indeed seem to require acceding to the truth of certain propositions in order to remain in their historical form: e.g., that the Torah was revealed by God, that Jesus lived, died, and rose from the dead, and that Mohammad received the Qur'an from Michael. (for each religion respectively) There is certainly an important sense in which certain very liberal theologians are still Christian, but this is something very different than historical Christianity.

Nonetheless, this is something separate from moral authority. One may deny that there is anything correct about the metaphysical pronouncements of the Bible, and still accept that its moral teachings are profoundly important. This is precisely what philosophy Slavoj Zizek has done.

For most other religions, the number of specific propositions that must be accepted is few to none. Pronouncements about gods or salvation are amenable to multiple interpretations. The ancient Greek philosophers, for instance, were quite religious on the whole. Yet read a book on Epicureanism, Stoicism, and Platonism, and tell me what proposition about the gods that they agree on. You'll find it quite difficult.

The same can be said of Shinto, Hinduism, Buddhism, Western Pagan revivals, etc.

Moreover, I myself don't think that moral authority is actually essential to religion. It's certainly related to religion, but as I'm sure you've observed--there's not much of a correlation between religious belief and moral behavior. Simple observation shows most Christians to be liars. Morality is not why they are Christian.

Instead, I think it's something else--transcendence, and the promise of new states of being. Morality has almost nothing to do with this. The same man can be capable of the most holy ecstasies and raptures before the beauty of the God or gods that he prays to, a writer of the most delicately beautiful hymns and homilies--and the worst bastard on earth outside of church. Cardinal Richilieu was just such a person.

This is why we'll never get rid of religion, of course. But it's also why the monotheistic religions can be so dangerous. They incorrectly tie the ecstasies of the spirit to crude and intolerant dogmas, then demand that all others agree or face the sword or the pyre.

>> ^shveddy:

@HadouKen24 - All that you say is very dandy and very well may be true, but you'd be shocked at how widespread it is to cling to 19th century literalist beliefs. I'm not sure what country you're from, but here in the US it's remarkably common and even presidential candidates manage to think it despite pursuing the most powerful office in the world. I grew up in a particular Christian denomination, one of hundreds, and we had an official statement of faith that stated the absolute, literal, inerrant nature of the bible. This particular flavor of Christianity has about 3 million adherants, and again, this is only one of hundreds - many of which are even more conservative in their biblical interpretation.
When you say that it has been common for some time to regard sacred texts in a metaphorical sense I think that's definitely true, especially in the case of liberal theologians. However, when you take away the literal interpretations and leave interpretative metaphor all that remains is an interesting and influential piece of literature that has no specific authority. And I think this is a good thing. But the fact of the matter is that it lowers it to the same level as Moby Dick, Oedipus, Infinite Jest and Harry Potter - all of which are books that have interesting, moralistic metaphors just like the bible.
Let's face it, religion needs the teeth of absolute truth and the threat of moral superiority to have any privileged relevance over other interesting, moral works. I see neither in any of its texts.


Richard Dawkins and Lawrence Krauss: Something from Nothing

shinyblurry says...

I'll direct you to his own words. Here is Kraus talking about redefining what the word nothing means:

"And I guess most importantly that the question why is there something rather than nothing is really a scientific question, not a religious or philosophical question, because both nothing and something are scientific concepts, and our discoveries over the past 30 years have completely changed what we mean by nothing.

In particular, nothing is unstable. Nothing can create something all the time due to the laws of quantum mechanics, and it's - it's fascinatingly interesting. And what I wanted to do was use the hook of this question, which I think as I say has provoked religious people, as well as scientists, to encourage people to try and understand the amazing universe that we actually live in."

Here is Krauss describing how empty space could create the Universe:

Empty space is a boiling, bubbling brew of virtual particles that pop in and out of existence in a time scale so short that you can't even measure them. Now, that sounds of course like counting angels on the head of a pin; if you can't measure them, then it doesn't sound like it's science, but in fact you can't measure them directly.

But we can measure their effects indirectly. These particles that are popping in and out of existence actually affect the properties of atoms and nuclei and actually are responsible for most of the mass inside your body. And in fact, really one of the things that motivated this book was the most profound discovery in recent times, and you even alluded to it in the last segment, the discovery that most of the energy of the universe actually resides in empty space.

You take space, get rid of all the particles, all the radiation, and it actually carries energy, and that notion that in fact empty space - once you allow gravity into the game, what seems impossible is possible. It sounds like it would violate the conservation of energy for you to start with nothing and end up with lots of stuff, but the great thing about gravity is it's a little trickier.

Gravity allows positive energy and negative energy, and out of nothing you can create positive energy particles, and as long as a gravitational attraction produces enough negative energy, the sum of their energy can be zero. And in fact when we look out at the universe and try and measure its total energy, we come up with zero.

I like to think of it as the difference between, say, a savvy stockbroker and an embezzler. The savvy stockbroker will buy stocks on margin with more money than they have, and as long as they get that money back in there before anyone notices, and in fact if the stocks go up, they end with money where they didn't have any before, whereas the embezzler, of course, is discovered.

Well, the universe is a savvy stockbroker. It can borrow energy, and if there's no gravity, it gets rid of it back before anyone notices. But if gravity is there, it can actually create stuff where there was none before. And you can actually create enough stuff to account for everything we see in the universe.

But, you know, it's more than that because some people would say, and I've had this discussion with theologians and others, well, you know, just empty space isn't nothing. You know, there's space. How did the space get there? But the amazing thing is, once you apply in fact quantum mechanics to gravity, as you were beginning to allude again in the last segment, then it's possible, in fact it's implied, that space itself can be created where there was nothing before, that literally whole universes can pop out of nothing by the laws of quantum mechanics.

And in fact the question why is there something rather than nothing then becomes sort of trite because nothing is unstable. It will always produce something. The more interesting or surprising question might be why is there nothing. But of course if we ask that question, well, we wouldn't be here if that was true.

-----------------------------------------

What he said in this video is completely misleading; I'll show you his slight of hand. When he says you can take away everything, even the laws and still get a Universe, he has redefined "absolutely nothing" as a complete absence of this Universe, but not as we will see, a complete absence of anything. To explain the laws of quantum mechanics popping into existence, he postulates an external entity: the multiverse:

Well, you know, that's something I deal with at the end of the book because, you know, it's not a concept that I'm pretty fond of, but it - we seemed to be driven there by our theories, and it does suggest the last bit, because some people, indeed when I debate this question of nothing, they say, well, look, you can get rid of space. You can get rid of stuff in space, the first kind of nothing. You can even get rid of space, but you still have the laws. Who created the laws?

Well, it turns out that we've been driven both from ideas from cosmology - from a theory called inflation or even string theory - that suggests there may be extra dimensions - to the possibility that our universe isn't unique, and more over, that the laws of physics in our universe may just be accidental. They may have arisen spontaneously, and they don't have to be the way they are. But if they were any different, we wouldn't be here to ask the question. It's called the entropic idea, and it's not - it's - it may be right.

It's not an idea I find very attractive, but it may be right. And if it is, then it suggests that even the very laws themselves are not fundamental. They arose spontaneously in our universe, and they're very different in other universes. And in some sense, if you wish, the multiverse plays the role of what you might call a prime mover or a god. It exists outside of our universe.

So, again, the question is not answered. In his book, some chapters of his book are: "Nothing is something" and "Nothing is unstable". He has redefined nothing as empty space or a quantum vaccum, and when pressed, he offers up a multiverse, but fails to explain where the multiverse came from. Nothing is not something, it is not unstable, it is not empty space, it is not a quantum vacuum, and it is not a multiverse. Nothing is nothing. From nothing, nothing comes. It has no states, no properties, no existence. He has not explained how something came from nothing. All he has done is redefine nothing into something. Of course something can come from something. All he doing is playing a masquarade with definitions





>> ^xxovercastxx:
16:08-16:38

"...you could start with absolutely nothing; that means, unlike the Cardinal said and unlike some people argue, no particles, but not even empty space -- no space whatsoever, and maybe even no laws governing that space and we can plausibly understand how you could arrive, without any miracles, without any need for a creator, without any supernatural creation, you could produce everything we see."
If you expect to lie to people who do not trust anything you say, you would do well to make sure the truth is not so easy to find.
See you in hell.>> ^shinyblurry:
In any case, no the problem is not covered in the discussion. What Dr. Krauss is referring to when he is talking about "nothing", is not actually nothing as it is defined in the dictionary. Nothing is the word that he is using to refer to an entity, that entity being empty space or a quantum vacuum. Neither of those things are actually "nothing"; they are something. Empty space is not really empty, and a quantum vacuum has states and properties. Nothing is a universal negation; it has no states, no properties, no existence. What Dr Krauss is referring to is something, not nothing.




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