book reviews

Now for some non-concrete thoughts.

I dislike Halloween. I especially hate yard decorations. For one thing, do you know how eerie a fluttering ghost or witch can be when you’re driving by in the dark, early in the morning, barely awake, trying to get to the hospital?

For another, I think covering your house in Halloween images is downright foolish. Witches, for instance, are not benign jokes. Sure, many self-titled witches today probably can’t accomplish much of anything. However, that doesn’t mean the concept isn’t real. In the Bible, for example, the witch of Endor summoned the spirit of the dead prophet Samuel, who accurately foretold King Saul’s death in battle. In general, the idea of trafficking with Satan should not produce warm fuzzy holiday thoughts. (And even if you want to talk about different kinds of magic, in the end any real magic, in this world, comes down to the same thing: rebelling against God’s providence and trying to control Nature and events through your own power.)

Ghosts? Only in modern American cotton-candy thinking are ghosts friendly. I don’t believe they actually exist (as opposed to witches, who are at least a theoretical/historical possibility); “it is given unto men once to die, and after that the Judgment.” But if they did, they have been portrayed from time memorial as unhappy spirits, either trying to escape from an unpleasant afterlife, or with some vengeful business to accomplish. There’s a reason haunted houses have been viewed with terror. Why would you try to bring that atmosphere to the house you live in?

Jack’o’lanterns: designed to scare evil spirits away from the house. Also not originally funny.

Spider-webs: yes, personally there’s nothing I detest more than a real live spider, no matter how small. So my view may be skewed. But are any of you really fans of spiders in the house? So why drape giant ones over the outside of the house?

In short, people who celebrate Halloween, and especially who decorate enthusiastically for it, are demonstrating a breathtaking lack of imagination. For a Christian perspective on the reality of evil and the supernatural, and its potential for devastating intrusions into the everyday, try Charles Williams’ Descent Into Hell or All Hallows’ Eve, which could be described (by extreme oversimplification) as a ghost story and a zombie story, respectively. For a (slightly) more upbeat approach, still involving a powerful and evil wizard, read War in Heaven, which is my favorite of his seven supernatural novels. (For those of you now questioning my literary taste, these are nothing like the current pulp vampire toxins flooding the market. Charles Williams was once a dabbler in black magic, who then converted to Christianity, and was a member of the Inklings, along with C.S. Lewis and J.R.R. Tolkien. So he knew what he was talking about, and he wrote as only an Englishman trained to write Latin verse from childhood can write English.)

The children’s hospital is not as bad as rumor painted it (although their computer system is strictly for the birds). There’s something to be said for having so many senior residents and fellows around that I am only responsible for floor patients – and I am by now very efficient at handling a large floor service.

It’s also fun to see entities which were previously the stuff of [textbook] legend showing up as large as life: gastroschisis, malrotation, intussusception, Meckel’s diverticulum - and lots of classic appendicitis. (Which is especially fun, because in pediatrics you try to avoid radiation as much as possible, so almost none of these kids get CT scans. Diagnosis and management are based on history and physical exam, with the occasional ultrasound. For a rarity, I got to book a patient for the OR simply on the basis of, “His abdomen is nearly rigid, and certainly requires urgent exploration.” No labs, no imagaing, just what my hands could tell me.)

For added fun, I stumbled across in the library (amazing how the books I like just pop up in front of me) an audio edition of Alison Weir’s Queen Isabella. Alison Weir is an English historian who writes detailed accounts of obscure medieval events, and manages to make them interesting. I first appreciated her for her defense of Richard III as innocent of the death of the Princes in the Tower (a private bias of my own; I always enjoy finding reputable evidence to support my romantic belief in Richard as hero). This book, while occupying 18 cds, and therefore valuable as promising to last for two months’s driving, seems a little biased. Admittedly, the story of Isabella (French princess, betrothed at 7, married at 12 to a homosexual 12 years older than her, she eventually ran away, took a lover, led an invasion of England, deposed (and allegedly murdered) her husband (Edward II), and ruled in her son’s name (Edward III) for years, till he came of age, killed her lover, and put her under house arrest till her death) lends itself to some feminist revision. However, the argument that we ought to regard Isabella in a better light, now that we can look back from the standpoint of modern sexual mores, seems a little weak. After all, Isabella did what she did in a society which certainly condemned adultery (especially by women, and regardless of excuses) and treason. The fact that 700 years later her behavior seems almost normal/rational/excusable doesn’t change the fact that it was wildly countercultural and dangerous at the time. Her choices were made in that setting, not under modern “enlightenment.” Nevertheless, I’m always up for a good story about international intrigue and the primal conflict between France and England (two nations that seem born to hate each other), and if Ms. Weir can stop mentioning male oppression in every other sentence (once a paragraph, perhaps?), this should be a fascinating book.

A GOP insider reveals a conspiracy to prevent Ron Paul supporters from being heard at state and national conventions. It’s nice to have our suspicions confirmed (how come Paul was winning 10-15% in most primaries, a strong 3-4th place, and yet was almost never mentioned as a frontrunner, whereas Giuliani, who polled way behind him, was much more prominent? and how come someone who was winning 15-20% in the later polling states, with people deliberately coming out to register their objections to the McCain victory parade, is not getting any recognition from the national party?)

Anyway. It’s always special when a member of the conspiracy group (not that Doug Wead seems to approve of the general plan to silence Ron Paul and his supporters) admits that it exists.

My brother and I have been re-discovering one of Robert Heinlein’s less well-known masterpieces, The Moon Is A Harsh Mistress, about a Lunar colony which fights for independence from Earth. The revolution’s architects are a bunch of libertarian/anarchists, who speak a magnificent Russian-influenced English slang, participate in group marriages, and are assisted by a (secret) sentient computer. This is one of my favorite Heinlein books, right up with Starship Troopers. The way he manages to weave hard science and even harder political science into a novel set in a complete and believable future society with an action plot is amazing.

It’s amazing how good a solid night of studying makes you feel. I only got paged about urology issues, which are also very satisfying, since they call for a quick, relatively risk-free and painless procedure which makes the patient feel better pretty quickly.

So far I’m 30% of the way through The ICU Book (300/1000pp) (and only 3% of the way through The House Officer’s Guide to Urological Emergencies, which perhaps I ought to be reading more of, but somehow it’s not very gripping).

I’m starting to have mixed feelings about the book. On one hand, it certainly contains such wildly relevant and fascinating subjects as, five continuous intravenous vasoactive medications (otherwise known as the five pressors, which about half the ICU population are on, and about which I’ve been frightened and curious for the last nine months, but never before found a concise explanation of), and, three easy algorithms for managing acutely decompensated heart failure (as well as how to differentiate between right and left sided, systolic and diastolic, subjects which are of very little interest to surgeons, but of intense interest to the gremlins responsible for coding diagnoses in such a way as to extract the utmost amount of compensation from the insurance companies) (and one of these days when a senior resident remarks, “ah, ejection fraction of 65%, their heart is fine,” I will reply, “65% is actually a little high, and if you notice, the report also mentions left ventricular hypertrophy and decreased wall relaxation, which means actually they have a fair component of chronic left-sided diastolic heart failure;” so far, to my personal disappointment, I have faint-heartedly kept quiet at every such opportunity).

(Please I don’t want any commentary on the grammar of that paragraph; all the quotation marks and parentheses are closed; I am experimenting in the stream-of-consciousness style. . .) 

On the other hand, at least 50% of the book’s extensive cogitation seems to lead to the inexorable conclusion that sphygmomanometric blood pressure measurement is inaccurate and useless; direct arterial blood pressure measurement (in most circumstances) is inaccurate and useless; central venous pressure monitoring is inaccurate and useless; pulse oximetry is inaccurate and useless; pulmonary capillary wedge pressure measurement is inaccurate and useless; CPR is useless; crystalloid is useless; blood transfusions are useless and dangerous; pressors are useless and dangerous (with qualifications). You get the impression that only certain arcane measurements of systemic oxygen uptake, which require special bedside laboratory equipment, are of any value in directing patient care. Which makes me wonder, if everything the author is telling me about is so useless, why I’m taking the time to try to understand the equations with which he proves the futility and vanity of all ICU activity?

Besides, what I’ve gathered of surgical ICU care so far is rather simpler and more basic: we like fluids. Fluids are good. Push fluids. [cave-man accent, you understand] What’s a little pulmonary edema between friends? And don’t infuse pressors through peripheral ivs (a course of action which the MICU here pursues on a regular basis, leading to pressor extravasation into the hand and arm, which is not pretty; and then they consult plastic surgery, or vascular surgery for IJs in the carotid), or without placing arterial lines.

My senior resident this month is getting a little wary of mentioning procedures to me. He remarks that some stitches here, or a line there, might be useful, and when he turns around, I’ve done it. So far, so good; but perhaps next time I should wait to hear the end of the sentence (he had to go see an emergency, and I assumed he was done with the instructions). I think it’s a problem if even among the surgical residents I’m remarkable for liking sharp objects. I think the trick is to pretend to be a little more blase about it. On the other hand, I’m satisfied that I’m now competent at using the little throw-away suture removal kits as procedure kits. You open the kit, and arrange the paper cover and the little plastic tray in such a way that they make a tiny sterile field that you can put sutures and needles onto. Then you pretend that the flimsy blunt-tipped pickups are useful for holding tissue with, and you force the scissor’s jaws shut over the needle till they snap past each other and lock the needle between them. Then, if you move very carefully, this will hold the needle steady enough to take a stitch with it. This method is primarily desirable in that you don’t have to go hunt a procedure tray out of the OR or the ER (even most of the medicine floors have suture removal kits, though some benighted units don’t); you can throw the whole thing away when you’re done; and you can place a suture and cut the suture with the same instrument – versatility, you see. Plus, you feel like a surgical Boy Scout. (I believe there’s an Eagle badge if you perform an entire appendectomy in this manner.) Even a few months ago, I couldn’t handle the break-the-scissors-in-order-to-hold-the-needle maneuver, and always had to be fished out by a senior. I am now ready to teach this technique to next year’s interns.

Another slow day. My latest Charlotte Yonge novel, A Reputed Changeling, is turning out quite gripping. It’s set starting under Cromwell, and then the restoration of Charles II, and finally James II and William III. Yonge, as a good high-churchwoman, dislikes Cromwell and sympathizes strongly with Charles and James, but is loyal enough to the crown, and William III and his descendants as Defenders of the Faith, that she can’t make her main characters take sides in any of the uprisings, but just sit unhappily on the sidelines. The title character is a poor ugly boy of a gentle Puritan family who looks so unlike the other children that the servants declare he must be a changeling. He is so unhappy with his father’s strict government that he wishfully believes he really does belong to the fairies, and takes to acting as mischievously as possible. General unhappiness results. The heroine’s mother takes pity on him, and helps his uncle take him away to Europe, where he is well educated, and becomes quite Frenchified, to the disgust of his family and countrymen. The climax of the book occurs twenty years later: the changeling was supposedly killed in a duel with the heroine’s favorite gentleman, who then exiles himself to fight in the war against the Turks in Austria. Finally he returns home, having won his family’s permission to marry the heroine – when the murder of the changeling is discovered, and the knight looks like having to die for it. Of course, the changeling isn’t dead, just wounded and disappeared with some smugglers. He now kidnaps the heroine, and proposes, for the third time, that she should marry him and run away with him. She doesn’t appreciate the idea, but can’t see how to get out of it. At that point I had to go see a patient, so will pick up tomorrow.

I want to know: Did women back then, or in Victorian times, really become weak and faint at the drop of a hat, or at the slightest emotion? Or was it just so dramatically useful that all the authors use it (not just Yonge; Dickens and Austen and others too)? Perhaps there was so much mitral valve disease, and rheumatic heart disease, and hyperthyroidism, and of course undiagnosed anxiety attacks, that a fair number of women really did collapse easily. Or is it a matter of societal expectations: then the women were expected to be helpless, so they were; now we’re expected to be able to work and run the house and everything all at once, so we manage. Are perceptions and expectations that powerful?

Cardiology continues very quiet. Dr. B takes me into his office every now and then to look at EKGs, or asks me what the female attending was lecturing about, and then quizzes me about it, to our mutual satisfaction. In one way cardiology fascinates me, because of all the medical disciplines I’ve seen so far (no experience with nephrology, which might compare) it comes closest to the surgeons’ quest for absolute, authoritative knowledge. They get called for very sick patients, and learn to deal in an offhand way with situations that make the other physicians very worried. I like that. I like how they can pick up an EKG and snap off a reading immediately; I might get most of the same features, but it takes me and the residents a good five minutes to figure that out. It reminds of the surgery residents in the trauma bay glancing through neck and abdomen CTs, and immediately picking up the important points, without a radiologist. But I don’t like how cardiology is ruled by protocols: there’s a decision tree and clinical processing diagram for everything. Acute coronary syndrome? Here. Angina? Here. Pre-op evaluation? Here. Atrial fibrillation? Here. Heart failure? Here. There seems to be a rule and a committee recommendation for everything.

Or maybe my problem is with modern medicine in general. More and more, the Committees are creating Standards, and pretty soon all you’ll have to do is feed the patient’s statistics into a computer, and a robot will come up with the answer. I hate robots. I never understood before the rioting in Asimov’s robot novels, but now I feel ready to join in.

The whole roomful of residents and fellows and I tumbled into a discussion of national healthcare today, precipitated by someone else, not me, discussing Hillary Clinton. The resident sagely observed that she can’t win the national election because the swing voters contain a lot of soccer moms, and most soccer moms, as well as many career women, hate Hillary. I don’t know for myself, I’m not a fair sample, but I hope he’s right. (Maybe it would be better if Mrs. Clinton were given to fainting fits. I would feel safer.) So then we had a long argument about healthcare policy. It scares me that people are so ready to give everything into the government’s hands, and trust Uncle Sam to take care of them. There’s a reason 1984 needs to be required highschool reading. Not just because of its impenetrable symbolism, but because it describes a real danger. Allen Drury’s sequels to Advise and Consent sound paranoid, but maybe he had reason to be. Why does everybody go to sleep when the danger is looming? Our society is so easily hypnotized into relinquishing all personal responsibility, all sense of individual identity and choices.

People! Do you not care about liberty? Does that word not mean anything to you anymore?

After all, it was only ever a minority idea, between the Greeks and the Celts. No other society ever really took hold of it. For all their current “democratic” governments, freedom and liberty as they were understood in ancient Greece, or among the Scots and Irish, never really entered the heads of the French and Germans; and the Russians have never dreamed of it, on a national level. The rest of the world doesn’t even come into the discussion. Maybe this is just a private fantasy that the Athenians dreamed up, and Scots-Irish in the Founding Fathers picked up on it; but nobody else can dream that way. It’s too bad. I like their dream. I wish there were enough other people who shared it; we could do something together still.

The night was quiet until I washed my hair. Then of course the phone went off. I beat Dr. Mark to the ER, and went to say hi to the patient, a pretty teenage girl who had somehow dislocated her jaw while doing nothing at all. After a couple milligrams of Versed, she seemed pretty sleepy, and Dr. Mark easily manipulated her mandible back into place. She smiled and opened her mouth to say thank you; Dr. Mark gasped, and her mother screamed – and the mandible fell right out of place again. To be sure, it went back fairly easily too, but it was obvious that the problem was not completely fixed. Dr. Mark wrapped her head up with ACE bandages till she looked like something out of “The Mummy,” because nothing else would stay on her beautiful smooth hair. Now she has to go to school for several days looking like that. I couldn’t help smiling at the way she looked – which was horrible, of course, because she knew she looked like a Halloween costume, and I wasn’t helping. I tried to make a conversation about her career plans, which made her smile and talk – opening her mouth, which she wasn’t supposed to do. Tsk, Alice, get a straight face!

While we stood around waiting for another patient to be put in a room for us, I made the mistake of admitting to Dr. Mark that I have a stash of novels in my Palm Pilot. Unwise thing to tell the attending! He didn’t care, at least not right now, and we got into a discussion of Charlotte Yonge (whom I mainly keep in the PDA, because she’s semi-religious, so it’s not a total waste of time, and she’s Victorian, so out of copyright, and I don’t have to pay for the etexts).

Right now I’m on “Magnum Bonum: or, Mother Carey’s Brood,” which is about a girl who marries a doctor and has six children before he dies working in a typhoid epidemic in the London slums. He leaves her as a dying charge his secret experiments (nature unspecified), which he thinks will be a great boon to humanity, but which his colleagues think can never succeed. That’s just the first two chapters. The book follows the family as the mother tries to raise the children and prepare at least one of them to take up their father’s great work. The catch is that, unlike him, she doesn’t really know God, and so is unable to give the children a good foundation. The eldest son becomes a lazy gentleman of leisure; the second becomes an atheistic scientist, too involved in natural science to care for medical problems; the third child is a girl, who overheard her father’s secret, and longs to succeed where her brothers are obviously failing. At one point she confronts her mother and demands permission to get medical training (1870s) and eventually take over her father’s notes. The mother, who has grown wiser over time, responds,

“My child, you do not know what you ask. Remember, I know more about it than only what you picked up on that morning. It is a matter he could not have made sure of without a succession of experiments very hard even for him, and certainly quite impossible for any woman. The exceeding difficulty and danger of the proof. . . My dear Janet, it is not a question of worthiness; it is not a thing a woman could work out.”

Now, I enjoy many aspects of Victorian social life; but this bit drives me crazy. Just like I never realized what segregation was like until I read books from the 1940s, and found flat references to “negroes,” where they were treated as kind of a homogeneous lump, nonentities, instead of individual characters; or what proximity to enemy air raids meant till I read Churchill’s description of their anticipation of German attacks at the beginning of the war; I can’t really grasp the idea of oppression of women, except in books like this. Even the oldest, crustiest surgeons I’ve met don’t say things like this. I don’t know whether they think it; but they don’t say it. I mean, I ask you: what about a scientific experiment could be beyond a woman’s powers? It’s not like an expedition to Africa or Mongolia were required, or any physical strength. The idea that a woman would not be able to follow a line of scientific reasoning, if she set her mind to it, simply floors me. Similarly, the way the women characters in these books get pushed around by the men, even when their plans are equally worthy, or even better thought-out; the men are the legal guardians and direct the property, and that’s the end of it. Maybe I need to be just a little bit more respectful of Gloria Steinem and her ilk. Or maybe just Elizabeth Blackworth (first woman doctor) and Susan Stanton.

Of course, Janet pursues her course regardless of her mother’s objections, and eventually steals her father’s notebooks. I’m not sure where the story goes after that, but I’m quite certain that it ends tragically for Janet.

It doesn’t help that one of the big ad blitzes in town these days features a billboard, which I have to drive past twice a day, with the slogan: “We can’t all be surgeons. [go do xyz instead]” Talk about a downer. I felt like it was talking directly to me. It took me three trips past it to grasp what it was really saying.

An Air Force friend was sharing stories about his days in the Air Force Academy, and then test pilot school. A lot of them centered on harassing the few women students, or scaring them with stunts that he insists wouldn’t have fazed the guys. He’s a real Southern gentleman, and I respect him; but he had no sympathy whatsoever for these women.

Tell me why I’m doing this, again? I agree with him that the women shouldn’t have been there. So why am I trying to get into a similar place?

I am as good as the guys; I am as smart; I can think as fast; I know as much; my hands are at least as good as theirs. That’s what I told myself during every interview day. Just because they’re taller, and stronger, and look more like a doctor than I do – that doesn’t mean anything.

Is that what this comes down to? A five-year contest to prove that that’s true? Because what I left out was: a cool head. That I don’t know about.

Jesus, maybe it would be better if I don’t match in surgery, if I have to scramble for an ob/gyn spot. But that’s one reason why I have to do it: to see if I can. I feel like I caught a rollercoaster ride, and it’s wild and scary, but I want to find out what the second half is like. Can’t let go now.

Can we skip to March 15?

Among my stack of vacation books, which includes Knife of Dreams, the eleventh of Robert Jordan’s Wheel of Time series (delightfully, it returns to the smaller print of the earlier books, so it’s longer than the previous three), and 1776 by David McCullough, is Eurabia by Bat Ye’or, the French-speaking Jewish expert on dhimmitude. (See her book of that title.)

Her thesis in this most recent book that Europe has essentially entered the cultural “sphere of influence” of Islam, and been taken over by it, just as Asian and African countries were taken over by the colonial powers. She persuasively argues that jihad is a fundamental part of the Islamic framework; that it existed before the Crusades, and cannot be excused as a response to them; that it has shaped Islam’s relationship to its borders ever since the beginning. According to Bat Ye’or (who is a meticulous scholar, and quotes several Islamic authorities, past and present, for each of her premises), the juridical philosophy of jihad allows for three possible conditions of a nation: 1) Those who are at war with Islam. This is the natural condition of all infidels. In Islamic thought, they  must declare peace when it occurs, but war is assumed. 2) Those who have a truce, and can trade peacefully. Truces are only allowed when the Islamic forces do not have the ability to conquer the territory at this time, and wish to regroup, or if the other country is paying tribute. The truce can only last for ten years, and must be renewed after that. Any actions derogatory to Islam automatically break the truce. (This would be Europe in its current condition. Bin Laden specifically referred to a truce with Europe in some of his messages, and the broken truce can be seen in the recent cartoon furor.) 3) Nations which have surrendered, have accepted dhimmi status. They are protected from outright violence, but are subject to economic and social sanctions. This is where all the formerly Christians civilizations of the Middle East and North Africa have gone, and Europe is rapidly following. 

Bat Ye’or traces the centrality of this vision of the world to Islamic thought, and shows how Europe has been gradually falling into submission to Islam for the past several decades. Moreover, Muslims see themselves under an obligation to fight evil. By definition, anyone not submitting to Mohammed and Allah is evil. Therefore they are morally obligated to fight – and not in the pietistic, self-improving manner so sweetly expounded to PC Americans – to fight infidels.

My own thoughts: The humanism and relativism of the West has made many pundits and thinkers incapable of recognizing the force of absolute moral conviction. True outrage at evil is so foreign to their thought processes that they cannot fathom the dedication which such a conviction produces in Muslims. Much as I hate it, I feel a kinship with Muslims in this area. I also believe that there is absolute evil in this society, and absolute evil in people refusing to worship the true God. I suppose one could say it’s humility which makes the big difference here. I don’t presume to be able to correct all this evil. I don’t think that even with a whole lot of my friends, if I went around shooting and blowing things up, could I fix the problem. God is the only one who can redeem fallen man. No one comes to the Father unless the Father draws him; and whoever he has given to the Son will surely come to him, and by no means be lost. For people who profess belief in fate, and absolute predestination, Muslims seem to have little practical faith in God’s providence.

I’ve only read the first two chapters so far; more to follow.

I just finished reading Falls the Shadow by Sharon Kay Penman, a lawyer-historian turned novelist. The book is set during the reign of King Henry III of England, son of the infamous John Lackland. The two most important protagonists are Simon de Montfort, Earl of Leicester, a most unfairly unknown champion of liberty, and Llewellyn Prince of Wales, who is also fighting for his country’s liberty from English domination.

If you have the slightest interest in medieval history, it’s a fantastic book (although definitely not recommended for children). Plus, I love any book that’s more than 600 pages long. Penman has obviously researched the period in depth, and gives a detailed account of the real historical events – battles, councils, courts – as well as developing several well-rounded characters. She uses a little bit of medieval language – a few oaths, “mayhaps,” and so on – but for the most part safely avoids the temptation to add “-eth” to the end of every verb. (Howard Pyle is the only author I’ve ever known who can assume and maintain a medieval style throughout the book. Everyone else seems to think that adding “thee” and “eth” everywhere covers it, not realizing that that ending is just part of the conjugation, and should only be used in the third person.) She does fall a little more into the trap of using modern cliches – eg  “is that a choice you can live with?” – but it’s not unbearable.

The story is a captivating one, especially for Americans, whose system of government is rooted in the concessions that men like Simon de Montfort won from the kings of England. The book begins while Henry III is still a young man, and the memory of the Magna Carta is still fresh, a tremendous struggle won by the barons against his father John. As the years pass, Henry develops from an impulsive young man into a completely disastrous ruler, who is swayed by the latest advice, and who cannot be trusted to keep his promises or pay his debts. Simon, married to the leading female figure, the King’s sister Nell, suffers a great deal from this, as he digs himself deeper into debt to fight the King’s wars, never receiving any of the promised reimbursements, and having all his official decisions overturned by the King who empowered him to fight rebels in Gascony.

A parallel story-line is the struggle of Llewellyn, grandson of Llewellyn Fawr [the Great], the first Prince of Wales, as he fights family jealousy and English greed, trying to keep Wales an independent principality. Again and again he is defeated, forced to pay humiliating homage to Henry, and yield more and more land, but he never gives up hope, until the time that an alliance with Simon finally turns his fortunes.

Simon de Montfort was the leader in forcing Henry to agree to the Oxford Provisions, corollaries to the Magna Carta, essentially requiring the King not to turn over lands and positions of influence to foreigners, and to honor his commitment to the Magna Carta. Of course, Henry doesn’t keep these promises, and civil war results. Penman does a good job of showing the other barons

Today I went and bought about $70 of used books. This has been my scheme for celebrating summer vacation for a couple of months now. I took my brother and sister to restrain my spending impulses. We drove around town for a couple of hours, because my list of used bookstores off the internet and an old yellow pages was rather outdated, so my siblings got to put up with me swerving around the downtown. Every time we found an address, we passed it, so there were a lot of u-turns.

Eventually, we arrived at a large bookstore, and discovered all sorts of things: Ngaio Marsh paperbacks, Happy Hollisters mystery books (Nancy Drew type, but with a cast of five siblings, now rare and difficult to find in libraries), and several Robert Heinlein paperbacks (I managed to buy only three). Then we drove to a small bookstore, which turned out to be Christian, with a collection of every book ever published on the topic of creation vs. evolution, and most books ever written about America’s Christian heritage. Excellent and edifying, but not exactly what I was looking for. We did buy a book by Ray Comfort: “God doesn’t believe in atheists: proof that they don’t exist” as a birthday gift for a homeschool graduate.

Next, we drove to a small town inhabited by left-over hippies, who stroll the streets in 60s garb, wearing long hair and flowers. The shops are of a kind: new age music, pottery, health foods, coffee beans, and a book store with lots of comics and anime. The bookshelves here were stacked almost to the ceilings, and there were rows of books laid along the floor, as well as stacks spilling over here and there. Nowhere near as neat as the big chain store, but lots more fun. Here, I found several paperbacks of Margery Allingham (inventer of Mr. Campion), and obliged myself to take only six, the earlier or rarer books. (Traitor’s Purse is the best spy/mystery story ever, set in England during WWII, but don’t read it first, because you have to know Mr. Campion before it makes sense. Mystery Mile is the first.) Also several collector’s editions of Heinlein, Tom Swift, and Dune, but I didn’t buy those. When I asked for Whittaker Chambers’ Witness (it’s so long, I’ve run out of library renewals), the guy directed me to the fiction section. What you’d expect in that town, of course. I was disappointed not to find any of Leslie Charteris’ Saint books. I’ll have to wait till I accumulate more money from tutoring, and then buy some over the internet. I also bought a couple of Trollope books (only $4 each – can’t miss those), some more Happy Hollisters and Five Little Peppers sequels (that ought to take care of birthdays and Christmases for a while). At least I resisted the temptation to buy a complete set of hardbacked Agatha Christies (twice – both bookstores had one!), several Horatio Algers, lots and lots of Hardy Boys, and miscellaneous retellings of King Arthur. I also didn’t buy any books by Tom Clancy. (This is how I explained the large influx of paperbacks to my parents.)

So by the time you count it all up, 23 books for $70. That’s not bad. I just realized. They’re almost all pocket editions. Is it ethical to put mysteries in your coat pockets when you’re on rounds? No. Absolutely must not. I hope I won’t want to. First and second year students, when they spend time with doctors, get incredibly bored, because there’s nothing they can do (if there’s anything simple and scutty enough, the third years and interns get it). So I spent a fair amount of time on my electives leaning against the desk while the doctor charted. But now that I will (hopefully) be charting and doing scut work of my own, I won’t need books in my pocket. I guess that means I’d better go read them all right now.

(I’m trying to limit my consumption of Anthony Trollope, so I’ll still have a few of his books to read this fall. They come in a very convenient pocket size, as thick as they are wide, which will fit in my white-coat pockets, unless I have too many notes and formulas in there instead.)

Men in Black, by Mark Levin, is a concise, fact-filled documentation of the development of judicial tyranny in America. It was eye-opening to me, since, read as much history as I can, I am still relatively young, and thus deeply influenced by modern assumptions. I actually thought the job of the Supreme Court was to review and strike down laws. According to Levin’s quotations from the Federalist Papers and other writings of the Founding Fathers, the courts are meant only to deal with interpretation of the law: has it been broken, or has it been applied correctly; not with whether the law ought to be the way it is, or not. This philosophy is so radically different from what has been practiced by the Supreme Court and other high courts for at least the past 60 years, if not more, that I had to keep stopping and reminding myself of it as I was reading.

Imagine that: if a legislature votes something, it stays that way. What a weird idea. You mean nine men (or sixteen, or whatever) in black don’t get to overrule the elected legislators? Think about it. That means if the legislature says this is how the election works, the court doesn’t get to fix it. If the legislature says gays can’t get married, the court can’t fix it. If the legislature says babies can’t be aborted this way, the court can’t fix it. Wow. If the people pass a referendum saying no affirmative action in state college admissions, the court can’t fix it.

Wouldn’t it feel strange if our representatives actually got to make the laws themselves? Wouldn’t it be interesting if the people decided the law, not an oligarchy of men in black?

This book introduced me to a powerful new concept of what freedom really meant to the Founders, and at the same time revealed how far we’ve fallen, how much liberty we’ve already lost, and what an uphill fight it will be to get any back. I was both excited at the idea of individuals exerting such control over their own lives and businesses, and depressed at the realization that, just when I’m beginning to understand, this freedom is slipping away, almost beyond redemption.

Levin documents a number of areas (church and state, abortion, homosexuality, affirmative action, immigration, terrorist prisoners, political speech, election process) where the Supreme Court has over the last several decades arrogated to itself greater and greater powers of review and dictation, which override the clearly stated desires and intentions of the people and their elected representatives. This book is a valuable resource because it collects all these noted cases, plus many less well-known precedents, giving clear quotations and summaries from the actual decisions and dissents.

However, the more evidence I see of judicial tyranny, the less I hope I see of escaping. Basically, the judiciary branch of government has assumed the right to second-guess and override the decisions of the legislative and executive branches. And our elected legislators, governors, and president(s) have allowed the judges to do this. Even so-called conservative politicians assume that judges are always right. Somewhere along the line, we have conceded that judges, unelected, unaccountable as they are, are infallible, whereas representatives and executives, subject to frequent elections and investigations, are more fallible and prone to misinterpret or abuse the law. Regarding two Supreme Court decisions allowing the courts to review the executive’s decision to hold enemy prisoners, Levin writes:

The Supreme Court somehow believes that courts are more qualified or trustworthy to rule on detentions. Butt why is that? Why is it assumed that judges are more competent in weighing the rights of individuals against national-security needs? The ingrained bias against the elected branches and their ability to make well-reasoned and just judgments is destructive to the entire notion of representative government. If elected officials cannot be trusted to make wise decisions about national security, then they cannot be trusted to make decisions at all.

Another example of this can be seen the tragic case of Terri Schiavo. As I believe, the judges were allowing a woman to be tortured and murdered. Now, admittedly, it doesn’t matter so much what I think. But the Florida legislature and Governor Bush also believed that she was being murdered, or at least that she was not being adequately protected. However, they were so overcome by deference to the judicial branch that they did nothing to save her, even when they were firmly persuaded that justice was not being served. The courts were wrong to rule as they did regarding Terri Schiavo, and the Governor was even more wrong, in that he submitted to them. All branches of government are responsible to uphold the laws and constitution. But when two branches agree to submit themselves to the third, what can we do? To whom shall we look for redress?

Two suggestions: 1) Stop looking either to courts or to elections for salvation. Trust in God’s providence, raise up Godly children, build Godly communities, and wait for the false worldviews of humanism and socialism to bring about their own destruction. Then, in 300 years or so, Christian freedom and republican government can arise from the ashes. Too bad we probably won’t live to see this.

2) More immediately, move to New Hampshire. The Free State Project is a group of libertarians who have studied the separatist movement in Quebec, made calculations on the ratio of dedicated to separatists to total population, and concluded that in a state the size of New Hampshire, a group of 20,000 libertarians can sway the state government enough to reestablish liberty there, and eventually defy the federal government if necessary. I will be looking out for residency programs in New Hampshire.

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