science


Somewhere in the last couple of years, I was near a city where the Body Worlds display (or one of the copy-cat shows) was stopping. After thinking about this for years, I’ve had enough of the ads (as it keeps travelling around the country), so here you go.

There are two primary ethical objections to these displays:

1) Our common humanity is denigrated by dissected bodies being displayed to public view as a matter of entertainment and moneymaking.

From a Christian perspective, the body is an integral part of what it means to be human. The Bible describes God forming Adam’s body and breathing life into it, and says that Adam was made “in the image of God.” To turn the human body into an object to be displayed for the enjoyment of crowds makes this crowning miracle of creation nothing more than any other animal displayed in a zoo.

But even if you wish to avoid a religious rationale, surely we can agree that the concept of Body World is of a piece with the modern entertainment culture, where horror films like Saw, Saw II, and Saw III (not to mention all the rest of their ilk) are viewed as acceptable amusements. Violence perpetrated on human bodies is now just a way to pass the time, not something revulsive. Similarly, Body World teaches us to accept the image of human bodies dissected, distorted, displayed – for our entertainment.

One of the greatest nightmares of medical school, gross anatomy, for centuries an illegal secret, and until recently at least a private activity, has been turned into mass entertainment for the crowds. I cannot express to you what it was like to cut up a human body, to destroy what another human person had used to live in, to love with, to see the sky from, the feel the ground by. . . At least I had the comfort, the excuse, that I was doing it for a reason – to be able to help hundreds of other people live, love, see, feel, a little longer, a little more comfortably. And it was, at times, a paltry excuse. To saw a skull open? To split a pelvis in half? To peel the skin off a face? To split a hand into useless threads? Who can do that calmly and claim to be still human himself? These phrases are the description of a monster’s activity. At least we had a reason; and I think our humanity survived. 

But what excuse is there, for the general public, to go and stare at bodies split open, splayed apart -amusingly posed? If you want to know what your inside is like, read Grey’s Anatomy; get a plastic model from the school supply stores; read Netter’s, if you prefer color. If you want to know how the thing works, there is no scarcity of physiology books, in all ranges of readability. The craze about Body World has nothing to do with a sudden hunger for anatomical knowledge. It stems from a fascination with the forbidden, the weird, the indecent.

Like the rest of the violence and indecency which is now commonplace in our society, the Body World displays serve the purpose of destroying our conscience and filching our reverence for humanity as something separate from the animal kingdom.

2) These particular humans almost certainly had no say in the disposition of their bodies; and even if you allow that it might be all right to use bodies this way, if their owners had knowingly and completely consented, it is wrong to participate in the exploitation of individuals who in their lifetimes were the victims of a cruel state.

We all ought to have known better than to think that Chinese bodies were come by honestly (and you had only to look at their faces to know they were Chinese). Recently ABC’s 20/20 removed the possibility of further self-deception by investigating the body-selling trade in China. Protest as he may, the inventor of plastination cannot deny that his original bodies came from a shady source, as he is now loudly promising not to use unethically obtained bodies anymore. The news stories mention thousands of people currently offering their bodies to be used in these displays, but the fact remains that there is no good documentation of the origin of the bodies that are currently touring the country. And for anybody who thinks any Chinese person whose body is being used actually freely consented to this arrangement, I have a bridge in Brooklyn to sell you.

But, even if all the unethically obtained bodies were cremated, the objections in my first point would still be reason enough not to see these exhibits.

For a much better-written exposition of the moral objections, please see Thomas Hibbs’ essay, “Dead Body Porn”.

Dr. Schwab’s Surgeonsblog is one of my favorite blogs ever. He has tremendous stories, and tells them very well, and I am inspired by his example as a caring and competent surgeon.

Lately, though, he’s taken to posting political and religious rants (his word) on the weekends. Creationists are a common target. I’ve got to respond to his latest post, but so many ideas came to mind I thought it would be better to write on my own blog.

Dr. Schwab’s post opens with an 8min clip of an ABC news segment on two creationist men who give tours of a Denver science museum to Christian homeschoolers, giving the creationist point of view in contradiction to the evolutionary teachings of the museum.

First, two things about the video: the two men, while I applaud their beliefs and their activism, are not the best possible spokesmen for young-earth creationism. When asked how long the period was between Adam’s creation and Noah’s flood, they stumble, and end up guessing that there were six or seven generations. In other instances, I agree that their responses are simplistic. If they know of the scientific evidence for creation, they’re not adept at mentioning it when called on. In their defense, this could be due to the young age of the children; most of them look to be in early elementary school. A disquisition on carbon-dating would be over their heads. I would bet that if you filmed an elementary school tour led by an evolutionist, there wouldn’t be much more sophisticated discussion than there was here. However, the ABC producers slanted the segment nastily. When the two creationist spokesmen guessed that there were six or seven generations of 800-yr olds between Adam and the flood, they multiplied 800 x 7 and got 5000+ years, making the creationists look ridiculous. Actually, the egg should be on ABC’s face. You don’t multiply generations like that. Each generation ought to start 20-40 years after the previous one. Better informed young earth theorists add up the genealogies in the Bible to make 1500 years between Adam and the Flood. There are other ways, as well, in which the producers went out of their way to pick soundbites that would make the creationists look bad. You might also notice that their claims, and those of the evolutionary scientist at the museum, are equally without evidence – in this video. Those watching this news segment were being asked to choose between creation and evolution based simply on the mockery of the museum’s scientist and of the producers.

(For further information on all kinds of questions regarding creation science, check out Answers in Genesis (specifically the answers page) and the Institute for Creation Research, which give much better evidence-based and Bible-based reasoning than the tour leaders in that video were able to do.)

 Now, to Dr. Schwab’s comments. He says,

My reaction to the above video goes beyond anger: it makes me sick. These kids are deliberately being deceived. Brainwashed. And, yes, abused.

My question to Dr. Schwab is, who doesn’t brainwash their kids, by his definition? Children sent to public schools and taught to believe that the entire universe sprang into existence on its own (where, after all, did the material for the Big Bang come from?), and that random atoms then coalesced into organic molecules, which then arranged themselves into the infinite complexity of data coding which is DNA, and that information was somehow progressively added into the system, making more and more complex organisms, until their own intelligence randomly developed – are they not being “brainwashed” as well? They’re told that these are the facts, this is how life is, this is what they should believe, and the alternatives are mocked and laughed at, if they’re even mentioned at all. All parents want to teach their children the same things that they believe. That’s not abuse, that’s good parenting. If you, as an adult, believe that you know what is true, you want to protect your children and save them from the painful errors that you yourself may have made. I’m sure Dr. Schwab would not be thrilled to let a creationist lecture to his children. Neither would creationists want evolutionists teaching their young impressionable children – although most of us do encourage the study of the theory of evolution for older children, say highschoolers.

But this is the part that really annoys me:

They are being led to extremism which differs not from the kind that creates believers in paradise filled with virgins. And we know where that leads.

I respect Dr. Schwab’s right to believe whatever he wants about the origin of life and the universe, and to make his arguments for what children should be taught. But to accuse Christian creationists of being morally on a par with Islamic suicide bombers is – I think slander is the right word, although more loaded than I’d like for a polite discussion. There is nothing, nothing, nothing in orthodox Christian teaching which would in any way condone the killing of other innocent people simply to make a point. You cannot show a single instance in recent history of Christians, acting on teaching which has anything near polite acceptance in the Christian community, killing other people. (The rare instances of killing abortionists don’t count: the number of Christians who would approve of this is vanishingly small, too small to count in a percentage.) Islam, on the other hand, teaches repeatedly and clearly, throughout the Koran and the hadiths, and among the vast majority of imams, that it is not only right, but necessary, to kill unbelievers. Creationism, which teaches children that they were made in the image of God (and therefore they should respect and value their own bodies and the lives of others) comes nowhere near this kind of violence.

Dr. Schwab continues:

These are the people putting religious tests to our potential leaders, proclaiming their holiness above mine . . . banning books and destroying public education. Rioting over cartoons. These are the people claiming our country needs more religion, even as their religion-above-all attitude is subverting the very foundations of our democracy and aiming us toward societal failure by substituting indoctrination for education.

What can I say? I learn from the Bible to proclaim, not my holiness, but my sinfulness – and God’s holiness and mercy. My homeschooling family, and those like us, are not destroying public education, but trying to rescue our children from an educational system which has already failed disastrously (school shootings on a regular basis, drugs available in schools, high school graduates who can’t read or do simple math, high schoolers who can’t compete with most other developed countries in math and science, schools which spend more time teaching young children how to have sex than telling them basic facts about American history). When our religion is mortally insulted (as in the demeaning and gross “art” exhibits in New York a few years ago, which were far more insulting to Jesus than those cartoons were to Islam), we didn’t riot. We wrote polite letters to the editor.

I don’t want to make this sound like boasting, but in the homeschooling creationist community nationwide that my family is part of, there are many young people becoming doctors and nurses; we are acing the SAT and ACT, and are competitive applicants to the best universities in the country. My friends from college, creationists like me, went on to become biochemical researchers.

Dr. Schwab, your indignation would be better spent on the disaster that is the public school system, and the teachers’ unions who refuse to allow any changes, and the truly dangerous religious extremists (Muslims) rather than on a group which is simply trying to raise their children in peace to be good and productive citizens.

What else is there to say about work? The amazing storm of OR cases continues. I feel bad because they’re two-person cases, which means the medical student is lucky to scrub, and certainly gets to do nothing whatsoever during the case. I remember how frustrating that was, especially going to the OR, haunting the holding area, waiting and hoping that the resident wouldn’t show up, and how crushing it was when they would blithely wander in and take over everything. That doesn’t prevent me from – wandering blithely in and taking everything, though.

I read Bongi’s post about assisting the surgeon yesterday, and consequently thought very carefully about my actions today. I think I did fairly well, not that it was a complex case. But even after just a week at this, I’m getting better at telling what the attending wants to do, and what direction the tension, or suction, or light, needs to go to help that happen. I read a fascinating article somewhere once about how the human brain can calculate what another person is going to do next. Apparently, when one watches another person’s motions, one’s own motor cortex lights up as if performing that action. So you can almost feel what’s going to happen next, because you can tell what your body would do next, if it were in that position. For example, someone holds a glass, and you can tell if they’re going to put it down, or drink from it, from just a split second of movement. You can watch someone walk down a hallway, and tell where they’re going to turn before they actually pivot. Similarly, with more experience, I can start to see where the surgeon’s hands are going next, or what part of the field they’re heading towards, before it actually happens. Fun.

I love AAPS. For one thing, Ron Paul is a member. For another thing, they send out delightfully informative, heretical, subversive pieces of news like this one: A major study shows that Zetia has no preventive effect on heart disease or heart attacks. This article also reviews the fact that most of the statistics showing benefit for statin drugs (and also for many other famous medications) are only impressive when given as relative risk reduction. The absolute risk reduction for many medications is not at all persuasive. This is the difference: if 100 people take a pill, and 100 take a placebo, and in the placebo group two people die, or have a heart attack, or develop angina, and the medication group only one person has that bad outcome, the relative risk reduction is 50%: half as many people died when they took the medication. The absolute risk reduction is 1%: 1 out of 100 was significantly affected by having taken the medication. Now if the effect you’re measuring is death, 1 in 100 may be a good cost/benefit ratio. But if the effect you’re measuring is just reduction in cholesterol, or slower development of coronary artery disease, and you can’t even show a survival benefit, it starts to look worse. Also bear in mind that the side effect rate is probably at least 2-3%, and probably higher, depending on what you count as significant side effects. This is why I can’t stand medicines.

(And yes, to be fair, I’ll apply this to surgery too: We say that you will get very sick if you have appendicitis, and don’t let us take it out. Similarly with gallbladder disease, and sigmoid diverticuli, and so on. But I suspect that the mortality/morbidity rate for these diseases untreated, or treated only with antibiotics and never with surgery, is not as high as we give patients the impression it would be. Or perhaps I’m underestimating the amount that surgical diseases contributed to the low life expectancy prior to this century. At any rate, it would now be impossible to do any kind of study of what happens to appendicitis if not surgically treated. And, the mortality can indeed get quite significant if you add in a few other medical problems. So I’ll keep doing these surgeries. But I’ll feel quite happy about not reording zocor and the rest for my patients who are hospitalized for a couple of days. If I get their blood pressure within reasonable limits, that’s enough.)

(On the other hand, I’m disgusted with myself for losing interest in general medical problems. I used to swear I would try to maintain some knowledge about overall medicine: thyroid disease, basic cardiac issues, diabetes – all that. For the first few months here, I did try to handle that stuff as much as my seniors would let me. Now, I’m beginning to care as little as the next surgeon. Diabetes? Sure, consult endocrine. Bad COPD? Sure, consult pulmonary. (Not that the consult does much good. Pulmonary always recommends nebulizers and pulmonary toilet, things we order reflexively in smokers and asthmatics. Endocrine puts the patient on insulin, and adjusts based on fingerstick results, which is really fairly basic math: addition and subtraction. And then they do their usual battery of tests (pulmonary function, or TSH/T4/ionized calcium/HgbA1c/microalbuminuria), which by this time I can predict, but admittedly have little interest in interpreting. I’ll quote you a cardiology consult I got the other day: “Recommend decreasing iv fluids when appropriate per surgery service.” Do tell. Usually when the patient has been resuscitated after surgery, we tend to turn the fluids down the next day or two, of our own accord. Thanks for that scintillating insight.) I’m studying for Step 3 right now, and am having great difficulty mustering any interest in the subject whatsoever. The review book has no chapter on general surgery. I looked three times. No wonder we get urgent consults for asymptomatic gallstones.)

(Ok, I’ll stop there, and get ready to duck the comments.)

I was working on a presentation on Addison’s disease that the attending wants for tomorrow (I don’t know why he had to pick a post-call day, we’ll be in the hospital forever as it is) and took a break to surf the news. 

Last week I discovered a series of books called The Shadow Children, starting with Among the Hidden, by Margaret Petersen Haddix. The books are set in a near-future dystopia, where several years of famine have led to a totalitarian government which has made it illegal to have more than two children, because a third would consume too much food. Third children are killed whenever they’re found, along with anyone who’s been protecting them. I thought the writing was decent for the age level it’s aimed at (young teens); my main complaint was that the plot seemed forced. Who could imagine a modern, civilized country descending to killing children just because they’re born third?

Apparently the British organization Optimum Population Trust is heading that direction. Here’s their press release and summary of a report to be released today which essentially concludes that having children contributes to global warming. The key number seems to be three: If you have three children, you’re helping to destroy the world. Having only two will, according to the OPT, save 750 tons of carbon dioxide (whatever good that does) over the ~80 years that that extra child might have lived.

As a member of a family with many children, and one who hopes to have even more myself, some day, I am astonished and infuriated by this report. Honestly, you know what? If the OPT is so concerned about how much carbon dioxide each living person produces, how ’bout they and their environmentalist buddies stop making hypocritical reports, and take some definite action: go jump off an iceberg ensemble, and let the rest of us enjoy our lives and our children without their fussing and worrying. Fifty years from now, it will be plain to see that they are no more than Chicken Littles running around, screaming about the sky falling, heading straight for the mouth of the hungry fox (big government). Jesus said that whoever offends a little child would be better drowned with a millstone. Logically enough, the OPT’s goals (scroll down to population policy for the UK) include encouraging abortions. Would you enviro-Nazis please stop making CO2, already? Just stop. The edge of the iceberg is right this way!

As long as I brought the topic up: I just came across some more splendid articles, all tending to prove the point that the “fact” of global warming is not at all universally accepted, but is actually strongly debated by many credible scientists.

Start off with an article by Mark Steyn (who must have doubled as the Pope in a previous existence, he’s so close to infallible) reiterating the theme that climatologists have a long and glorious history of being badly mistaken in their predictions.

Nigel Calder, former editor of New Scientist, collects alternative explanations for temperature observations, as well as some experimental evidence.

Here is an extensive study published by the National Center for Policy Analysis documenting the evidence for a 1500-year warming cycle driven by solar changes. One particularly appealing bit of historical evidence: The Romans made wine in England, and so did the Anglo-Saxons, as documented by the Domesday Booke. During the Dark Ages, and the later Middle Ages, there was no wine in England. Recently, some brave Britons have started trying to grow grapes again. I am sure G. K. Chesterton would approve entirely. (Please see the only two of his bibulous poems I could find online (what a mistake to leave my collected poems at home!): The Logical Vegetarian (“You will find me drinking rum/ Like a sailor in a slum,/ You will find me drinking beer like a Bavarian./ You will find me drinking gin/ In the lowest kind of inn/ Because I am a rigid Vegetarian.”), and Wine And Water; and I will try to correct the error of not including all of his drinking poems here when I get back to my books.)

And finally, we can conclude with three thundering essays by Thomas Sowell (just as infallible as Steyn, but not as humorous; more gravitas, you might say): Part 1, Part 2, and Part 3.

I didn’t know that people talked like this outside of science fiction books.

I’m very familiar with sci-fi, because I’ve read a great deal more of it than is good for me. I read all but Robert Heinlein’s most obscene books, most of Asimov’s books, the early Dune books by Frank Herbert, Poul Anderson, and on and on. I stopped about a year ago when I found I’d read all the classics that were easily accessible in my library system, and was beginning to wander into more modern authors, who are simultaneously more indecent and more depressing after you plow through to the conclusion. Frederic Pohl, for instance.

I also became frustrated by how all science fiction plots seem to rest on two assumptions: evolution, and the insignificance of Christianity. Evolution, so that you can get all those weird, exciting, and dangerous other intelligent life-forms, and so that we can have some pressure on the human race to explore space, and change as it does so. And the insignificance of Christianity, because in most of the books Christianity doesn’t even exist anymore, or if it does, the only representatives are a bunch of nasty puritanical types who are either villains, or very peripheral to the plot. Those two assumptions are so counter-factual that they ruined my enjoyment of even the most plausibly-imagined future worlds (Asimov’s structure in the robot books seems more and more likely). I did try to write a few sci-fi stories myself, on Christian and creationist assumptions, but they really didn’t fly. If humans are the only intelligent race, then there’s not much to do in space, except spread yourself farther and farther, with no real danger driving; no races of giant bugs going to attack you (Starship Troopers, Ender’s Game), no real chance of human extinction, and evangelism just becomes that much more difficult as people get farther apart.

So, I felt as though I had wandered into a sci-fi book come alive when I picked up Friday’s edition of the Wall Street Journal and started reading the editorial “Colonize the Moon,” by William Burrows (professor of journalism and author of The Survival Imperative: Using Space to Protect Earth).

“Osepok, a character in Buzz Aldrin and John Barnes’s futuristic novel “Encounter with Tiber,” is the female captain of a huge intergalactic space cruiser. (I suspect they made Osepok a woman because women ask for directions.) She justifies the incredibly long voyage this way: ‘There’s not a place in the universe that’s safe forever; the universe is telling us, “Spread out, or wait around and die.” ‘ . . .

“. . . [T]he truly compelling reason to build a lunar base is not for adventure, though there will be plenty of that. Nor is it to mine resources to gain riches, though that will eventually happen. The overriding reason to establish a colony on the moon is humanity’s survival: Darwin achieves liftoff.

“Osepok had it right. It is abidingly dangerous out there. . . But we have to establish a foothold there anyway, or risk extinction. . . Earth has been pummeled by asterouds and probably comets, large and small, throughout its existence. The dinosaurs are thought to have met their end because of a huge asteroid that hit roughly 65 million years ago. . . As the old saw has it, the giant beasts would still be around if they had had a space program. . .

“NASA’s motives for wanting a permanent lunar colongy run the gamut. . . Left unmentioned – because it would be a psychological downer – is the fact [fact?? -- Alice] that what happened to our reptilian predecessors could happen to us unless we take Osepok’s advice and spread out.

“It was for that reson that a few individuals, myself included, started a group called the Alliance to Rescue Civilization (ARC) several years ago. . . ARC has been absorbed by the lifeboat foundation, a group of likeminded people who are trying to make certain that we can survive a truly awful world-wide occurrence. . .”

I guess it’s naive of me to keep being shocked when people take their atheistic, evolutionary assumptions to a logical conclusion. I suppose if you really think the world has existed for more than 65 million years, and that the dinosaurs were killed by a comet instead of a Flood, it would be reasonable to make plans to avoid a similar fate. If you really believe that humans evolved, you have to consider that we could become extinct too.

Since I know that God made us, only several thousand years ago, and then took the extraordinary step of becoming human himself, I don’t think we need to worry about extinction. Jesus is coming back, sometime, and he’ll be coming to this earth. We do not live in a random universe, where comets and meteors fly around wild. On the contrary, all things hold together by the will of God; and he has promised that “while the earth remains, seedtime and harvest, and cold and heat, and summer and winter, and day and night shall not cease.”

Creation vs. evolution is not merely a scientific debate, or even just a religious debate. It has a direct impact on national policy decisions.

(Although, secretly, I’m all in favor of space programs, and don’t mind the government spending my money on that, as much as I mind most of the other things they spend it on. But I know that’s just because I read too many sci-fi books at an impressionable age, and would love for some of that to become real, not because I have a really good reason for it – like, save our species from extinction!)

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