Grinding the Axe

In Crossing to Safety, by Wallace Stegner, the narrator Larry Morgan describes the pain in his past, writing the final chapters of his book in tears:

Yet now, having held in grief and resentment, and evaded thinking too much about the episode that changed my life with the finality of an axe, here I am exalted by having made use of it, by having spilled my guts in public.  We are strange creatures, and writers are stranger creatures than most.

We write what we know, and sometimes what we know is painful- perhaps not as acutely as an axe falling, but more chronically, like a corrosive acid.  When writing about and making use of the pain, it’s important not to let self-pity take charge.  There are several themes in Fourth World, motifs intertwined like strands of DNA.  One of these, I imagine, is almost a universal feeling:  that of not belonging, of always looking in from the outside, no matter what one accomplishes in life.  In my case, that came from moving back and forth, as a child, between countries with different dominant languages and cultures, histories and aspirations.  One country (Malaysia) had the history of being the colony of another (the UK, where the British held- and still hold- strong prejudices regarding their former colonial subjects).  Feeling like an outsider in London was- and is, for Indians, Bangladeshis, etc.- not imaginary.  And, believe it or not, California in the mid-1960s was not a friendly place for Asian kids either- especially those who kept their original names.  Even with English as my first language, a vaguely British accent was a source of humor.

Despite objective evidence to the contrary, immigrants are often told that they are being too sensitive; reassured that the prejudice they see every day is not really there; reminded that after years of living in this country, they have reaped the benefits.  But do they truly belong?  I’m grateful to live in the US and feel much more fortunate than the vast majority, but still sympathize (which literally means to suffer with) today’s immigrants, especially in the current hostile climate.

In my novel Fourth World, Benn Marr has it much worse:  he comes from an Earth colony on Mars!  Here’s his conversation with Lora:

Benn snorted.  “You know, I do try awfully hard to keep the weird behavior to myself.”

Lora spotted a segue opportunity.  “Actually, you might rephrase that:  trying so hard to keep to yourself is your weird behavior.”  Lora took a deep breath- it was as good a time as any to say it.  “This has been bothering me since Highland City.  Benn:  you are, without  doubt, an extremely difficult person to read.”

Benn, who had a history of stumbling badly where Lora was concerned, thought she was still teasing.  “You mean difficult to read, as in a boring novel?  I’ll try to spice up my plot.”  She met his grin with a blank look.

“Difficult because I’m written in a foreign language?” he tried again.

“Come on, Benn.”  Lora rolled her eyes.  “Not a foreign language.  But you do act like a foreigner.  I always get the feeling that you’re holding back, standing apart and watching, as though you don’t belong.”

“That’s because I don’t belong.  And you do?  I admit, you fit in much better than I do, what with having social skills and all.  I’ll be forever an outsider, Lora:  the colonial subject visiting the imperial capital, tolerated only as long as I have something to contribute.  Otherwise it’s ‘Back to the colony, boy, your permit’s been canceled.’”

“You don’t need to feel that way, Benn.  You see yourself as more of an outsider than others do.”

“Do you really suppose these folks consider us Martians their equals?  Back to the original subject, do you think Torch Halsey thinks of us as neighbors or alien freaks?”

“Halsey’s not a valid example; to him, everyone is a potential terrorist!”

 

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We Live in a Sci-fi World II

Stem cells are all the rage.  And why not?  There is the potential to generate tissues of all kinds (kidney, brain, eyes etc.) from these undifferentiated cells, and to transplant those tissues into humans in order to treat disease.  During national elections, the analogy would be to turn uncommitted voters into Democrats or Republicans and then to move them into districts where they’re needed to boost the Electoral College count.  Stem cells are pluripotent, meaning they can grow up to be anything you choose by design.  An uninformed, unenlightened, unfeeling cell can one day become President of the United States- oops, I mean a kidney!

But their promise comes with great risk (see POTUS, above).  As a sad example, three very unfortunate women with partial loss of vision due to macular degeneration recently went to a Florida clinic where stem cells were injected into their eyes in an unproven treatment, and that resulted in their total blindness!  The use of experimental treatments without adequate studies will only increase, now that stem-cell clinics are popping up like spring flowers, and funding for the National Institutes of Health falling like autumn leaves.  In the current climate (pun intended) of denying scientific data, turning to “alternate facts,” and stigmatizing knowledge and expertise as elitist, careful assessment of the risks and benefits will diminish, while opportunistic stem-cell providers, like those in Florida, will thrive.

In my novel Fourth World, I’ve tried to keep a balanced view of stem-cell technology and genetic engineering, acknowledging both the gains and the pitfalls.  Dr. Neelin, Professor of Recombinant Anatomy, has made a cause of pursuing what he calls quacks and quasi-sequencers.  This is from a cadaver demonstration that Benn Marr attends:

Neelin held his right hand up.  “I have one more example of quackery to show you.  Bob, you see, was a victim not only of technical incompetence, but of outright fraud.  Late in his life, he fell out of a Banyan tree while bird-watching in the district then known as Australia.  He sustained a pelvic fracture and had to enlist the help of a migrant clinic in the back country, in order to regenerate the broken bone.  They infused him with an unidentified stem cell, his diary shows, but the end result was only discovered at Bob’s post-mortem.”  Neelin appeared to be rummaging around in Bob’s intestines.  He finally pushed them toward the back with outstretched fingers, exposing two thin bony structures pointing upward from the pelvis.  Puzzled interns frantically interrogated their datadiscs, again without success.

“Their treatment provided Bob, bless his original heart, with these two extraneous bones, which you see protruding here.  These bones did nothing to help Bob with his pelvic fracture, but he would have found them useful- very useful indeed- had he… been… born… a…”  Neelin paused expectantly.

“A kangaroo!” shouted Benn triumphantly.

Neelin released Bob’s intestines with a loud flop and whirled around to face Benn.  “A kangaroo or any marsupial- excellent!  Young man, you are the first intern in over two decades to recognize these as epipubic bones:  their function is to support a marsupial’s pouch.  Excellent!”

Sanctuary II

 If you really change your ways and your actions and deal with each other justly, if you do not oppress the alien, the fatherless or the widow and do not shed innocent blood in this place… I will let you live in this place, in the land I gave your forefathers for ever and ever”. – Jeremiah 7: 5-7 NIV 1984

There is a heavy sense of urgency.  In the church-centered meeting I attend, everyone means well and wants to help in some way.  The threat of deportation facing thousands of undocumented immigrants is the impetus for the meeting, so that providing sanctuary is the goal.  But there is (frankly, unexpected here in the Bay Area) a political divide, with a small minority dismayed at the anti-Trump atmosphere, so it’s resolved to avoid any political or divisive comments.  Even the word “sanctuary” is felt to be too evocative of previous conflicts in the 1980’s, so the effort will be labeled “hospitality” instead.   Then some feel “illegal immigrant” should be changed to all immigrants, and it is further suggested to change our goal to helping all those in need.   But wouldn’t that dilute the effort, if we lose sight of the risk of deportation- our impetus, after all?  And what about nonviolence, when an immigrant is rounded up on a farm without due process, and a rapid-response volunteer is called upon to assist? Where to draw the line:  video the arrest?  Form a human chain?  Shoving and fistfights?  Will there be training on how to handle confrontations?  Someone points out that demonstrations should not break the law; individuals are free to practice civil disobedience, but the church should not be involved in illegal activities.  Where have others drawn the line?  Best practices?  Are there outcome measures, once we define our goal (becoming foggier by the minute)?  And so goes the discussion:  clearly, it’s complicated!  And it’s all important, all reasonable, but we need to know where to begin (see my earlier post on this blog, Show Me Your Papers, Old Man).

I want to mention a local organization, the Interfaith Movement for Human Integrity, which coordinates Nuevo Esperanza.  In collaboration with faith and community groups, this initiative provides resources and practical assistance to immigrants, along with friendship and moral support.  Their address is 1814 Franklin Street, #325, Oakland, CA 94612.  Our church group will try to learn from their experience, which should be better than re-inventing the wheel.

Terminal Twitterrhea

The White House effluvium is notorious by now, and shows no signs of letting up.  Maybe the tweeted bombshell accusation that Barack Obama wiretapped Trump Tower will finally get the President’s handlers to say, rather urgently, “Sir, we need to talk…”.   They are furiously back-pedaling and doing damage control, for example, finding creative ways to interpret “wiretap” to mean any potential form of surveillance:  microwave ovens, TVs etc. so that the lack of evidence for wiretaps still doesn’t rule out “wiretaps.”  

Okay, that’ll hold them awhile.

Bad (or sick) dude!  Total disaster!  Totally rigged!  Nazis!  McCarthyism!

Mr. President?

Insurance for everyone!  Failing, dishonest, low-life…

A question, Mr. President?  Regarding your campaign’s contacts with Russian…

Total disaster!  Jail time!  Total meltdown!  Neurotic dope!  Totally rigged!

Uh… contact with Russian…

All talk, talk, talk- no action or results!  Enemy of the people!  Very sad!

Russian…

Fake news!

At last, a diagnostic clue that makes sense:  bewildering, unfounded claims; intentional obfuscation (see my earlier post on this); and conspiracy theories generated by the President’s White House associates, certain talk show hosts, Steve Bannon’s Breitbart News, and others in his circle.

Diagnosis:  fake news poisoning, resulting in terminal, and yet interminable, Twitterrhea.  Another possibility is a neuropsychiatric condition caused by genetic and environmental factors, characterized by uncontrollable tics of speech or movement, often associated with attention deficit and obsessive-compulsive behavior:  Twittourette Syndrome.

Prognosis:  unfortunately, grim.  Adding moral fiber to the diet might help.

So Who Asked You?

Besides our Chaos President, does anyone think Scott Pruitt, the new head of the EPA, is qualified to judge the scientific data, and to reject the opinions of the vast majority of climatologists?  Last week he said that carbon emissions are not a primary cause of global warming, despite much evidence to the contrary.  How did he reach that conclusion?  He is an administrator, not a scientist.  He is a lawyer who was Attorney General of Oklahoma, and as such, spent years defending the interests of oil companies and businesses with the potential to increase carbon pollution.  Now he plans to roll back limits on vehicle tailpipe emissions, which will certainly please the auto industry while worsening the air that we breathe.  The extent to which CO2 and other heat-trapping products of fossil fuel consumption (e.g. by power companies, car/truck manufacturers, and other human activities) contribute to climate change is determined by scientific research, not by the financial interests of those companies.  Or so one would think.

Imagine if a lawyer from a tobacco-producing southern state who has spent his career promoting the tobacco industry suddenly became the Secretary of Health and Human Services.  This administrator, who has no knowledge of epidemiology and public health, then declares that the mountain of evidence linking cigarette smoke to cancer is insufficient, unconvincing, and invalid.  Henceforth warning labels would be removed, age limits on cigarette purchases rolled back, smoking in restaurants and public spaces allowed.  Imagine the howls of protest and accusations of corruption that would ensue!

Career researchers and consultants for the EPA must feel a bit like Commander Peter Annenkov, who, in this excerpt, has just been issued orders by a civilian on board his ship, in my sci-fi novel Fourth World:

There were a dozen men in plain black uniforms, some standing at attention while others faced control panels.  An irate-looking blond man with a sharp face and small mustache, dressed in a gray uniform with red stars on his shoulders, sat in a dominant position raised two steps above the surrounding modules.  This was certainly a warship, and Benn was looking at it through another person’s eyes.

“Carefully, now, Comrade Peter.  Use a slow approach,” Benn heard himself saying in a tone usually reserved for small children.  The ship’s commander, the blond man named Peter (last name Annenkov, gleaned from the mind Benn was occupying) glared at Benn- or rather at the speaker- making no effort to disguise his simmering anger.  He was master of one of the fastest and deadliest ships serving the PWE, and here was a mere civilian bureaucrat, pulling back on the reins of his charger, urging a slow approach?  This corrupt health official, this creature of the pharmaceutical industry!  Giving orders in front of Peter’s crew.  Intruder!  Pirate!  With each of these thoughts, Peter’s red aura issued a small eruption, like a solar flare.

 

 

A Day Without Women

It’s International Women’s Day, and across the US, there will be numerous Day Without a Woman protests and strikes, bringing attention to violence against women, pay inequality, hostile work environments and other issues.  As with the Women’s Marches in January, focus will be important in getting the message across, as opposed to stretching the umbrella to cover too many causes (see my earlier post on this blog, Hope Marches On).  Of course life is much more complicated now than when Aristophanes wrote Lysistrata:  the women in that play “only” demanded the end of the Peloponnesian War, but a battle of the sexes predictably ensued.  I think men nowadays are not only more supportive, they are active participants in the protest.

It’s a theme that occasionally inspires literature.  On the very first page of the sequel to Fourth World, Dr. Carla Patel, Director of the Dept. of Wellness, suddenly goes missing, and all hell breaks loose.  Let’s hope today’s demonstrations are even more disruptive.

 

Bringing True Art to Medicine

Doctors shouldn’t forget to tap their inner artist with each patient encounter- it does help!  Everyone knows that medicine is an art as well as a science:  that speaks to the unexplained diagnostic insights, or sudden hunches based on gestalt, that we hope will supplement the objective data, as well as the individual tailoring of approaches to treatment.  But what about traditional arts, in the form of painting, sculpture, music and literature?

The most recent issue of the alumni magazine Yale Medicine addresses this aspect of the medical school, including the Program for Humanities in Medicine (begun in 1983, alas, two years after I graduated), the med school symphony and theater group, writing programs for students and medicine residents, literary salons, and visual arts at Yale.  The richness that humanities bring to the lives of med students enriches, in turn, those doctors’ encounters with their future patients.  That is, if they don’t forget to tap their inner artist, when faced with busy schedules and sometimes difficult personalities.

In Fourth World of 2196, Benn Marr fights a feeling of being irrelevant, as he prepares for medical school.  Here’s an excerpt:

The medical field essentially consisted of tailoring and applying these peptides in clinical situations.  Diagnostics had long ago been relegated to machines, which scanned, analyzed, and diagnosed the patient.  They even prescribed the appropriate therapeutic plan.  Frankly, the production of theragenomic peptides could also easily have been taken over by- and, in fact, seemed particularly suited to- the medical computers.  What remained were the sensitive tasks- acknowledged haltingly by the most advanced teaching hospitals- of deciphering patients’ wishes and guiding them through the pitfalls of treatment.

“Wishes” meant the patients’ attitudes toward both disease and treatment, resulting from a global summation of their personalities, prejudices, neuroses, education, religious beliefs, family dynamics, and a host of other factors not amenable to analysis by computers.  After all, physicians had to balance the purely technical or algorithm-driven approach with personalization of care.  Didn’t they?  Wasn’t the admirable desire to do something for the patient best complemented by a healthy skepticism and sensitivity to the patient’s wishes?  In Benn’s application essay, “The Vanishing Role of Humans in Medical Practice,” he had pointed out that technology did not supply social awareness, creativity, or idealism.  Wasn’t the physician also a humanist? he had asked.  A historian, digging out, interpreting and telling individual stories?