Willis at large, part 5

kw: book reviews, science fiction, stories, anthologies

The final two sections of The Winds of Marble Arch and other stories by Connie Willis are titled "And Afterwards" and "Epiphanies", and contain two stories each. "And Afterwards" purposely follows "Matters of Life and Death", and these two with "Epiphanies" contain most of her thinking of spiritual things.

• Service for the Burial of the Dead – A charming rogue attempts to attend his own funeral, but is stymied by a former paramour. Is he both alive and dead? His boating accident has saved another's life.
• The Soul Selects Her Own Society – This seemingly scholarly paper, subtitled "Invasion and Repulsion: A Chronological Reinterpretation of Two of Emily Dickinson's Poems: A Wellsian Perspective", examines the notion that the reclusive poet whose handwriting is still not reliably deciphered helped repulse H.G. Wells's Martians...a couple decades after her death.
• Chance – As in "another chance". Maybe some folds do get an opportunity to reverse prior bad decisions. The husband is one of the more oblivious monsters of Willis's creation.
• At the Rialto – A scientist trying her mightiest to determine her agenda at a conference hotel (a conference on quantum theory and chaos) finds it better to make "choices" at random.
• Epiphany – Exploring the idea that the second coming of Jesus will be more like the first than we suppose. It is a good thing that Ms Willis is a master of the unfinished ending; this one couldn't have reached a conclusion.

These stories in particular emphasize the author's ability to explore spiritual themes, which most writers of SF and Fantasy eschew. Je suis fini.

Willis at large, part 4

kw: book reviews, science fiction, stories, anthologies

The sixth section of The Marble Arch and other stories by Connie Willis, titled "Matters of Life and Death", has four stories:

• Samaritan – Exploring whether animals (here, an Orang) have souls in the Catholic sense, and whether they can receive spiritual insight and qualify to be baptized. A bittersweet story, that probably imputes more to the ape's mind than is really found there, but is otherwise based on solid research.
• Cash Crop – Another bittersweet story, of continuing human evolution. In this case, the environment appears to be a colonized planet.
• Jack – A different kind of vampire story, set in the London Blitz, a favorite milieu of Willis's. It ends ambiguously, as do a number of her strongest stories. She seems eminently able to violate Campbell's Dictum ("Pose a problem, then solve it.") with impunity.
• The Last of the Winnebagos – A dystopic near-future America: Dogs are extinct, it is a crime to kill any animal, even by accident, water is being trucked about the country (I suppose pipelines got too costly), and a hellishly intrusive "Society" has replaced the police force, mostly enforcing laws that harm all and help none. With this backdrop, a story of love and loss, in an unexpected direction.

To Ms Willis, life is like a game of Tetris. You gotta keep ahead of the falling blocks, until one falls on you.

Willis at large, part 3

kw: book reviews, science fiction, stories, anthologies

The fourth and fifth sections of The Winds of Marble Arch and other stories by Connie Willis are titled "Parking Fines and Other Violations" and "Royalty", and contain three stories each:

• Ado – Here the "violations" in question are imposed by every possible special interest group imaginable, making it necessary to edit any piece of literature before presenting it to a college class. In the case of Shakespeare, the only play with anything left is Hamlet, and there is a bit more remaining than the word ado, but not much. I call the story's style "hilarious tragedy".
• All My Darling Daughters – Ms Willis had a very strong message to get across, and found it necessary to use a horrifically corrupt background against which to make her case. With only slight exaggeration, a college stuck in an orbiting habitat is filled with kids who consider it normal to pursue a fresh orgasm about every twenty minutes, whenever they aren't in class or asleep. A new girl, seemingly innocent, reveals by far the most tragic background when she sends home a toothless, ferretlike animal bred as a male-fetish sex machine to her father, telling the protagonist she still has younger sisters, saying, "You don't really know what sin is."
• In the Late Cretaceous – Another tragicomedy, about budget cutting on another campus. The portrayal of student attitudes, faculty bemusedness, and administrative doubletalk are searingly accurate.
• The Curse of Kings – Another puzzler, as far as I am concerned. Which aliens had the planet first? Archaeological discoveries bring the question home, and the rubber really hits the road, when most of the scientists die of a very weird and horrifying virus...or poison.
• Even the Queen – A hilarious tale based on the idea that one day a medicine to safely eliminate menstruation will be discovered. Several strong women talk about their experiences "before" in the presence of a young woman who is committed to a "natural" lifestyle. This must be the author's most popular story. I've read it several times in different places. A hoot.
• Inn – If I read the subtext aright, Ms Willis's sympathies lie strongly with the liberal, established churches. On this background, we are asked to consider how Mary and Joseph might fare today, knocking on the church's door late on a snowy evening.

There remain nine stories in three sections. I find myself amazed already at the breadth of the author's reach. A word of caution concerning "Darling Daughters": there is an exception to every rule, and this is mine. Normally I don't read a story like this one. Having read it once, many years ago, when my standards were different from today, I remembered the point, and upon rereading I have to agree that its portrait of ugliness and depravity is the appropriate setting for its message.

Willis at large, part 2

kw: book reviews, science fiction, stories, anthologies

I've had plenty of time to read this Thanksgiving weekend. Here are a few more story reviews from The Winds of Marble Arch and other stories by Connie Willis, from the sections "Personal Correspondence" and "Travel Guides" (two stories each):

• A Letter from the Clearys – I've read this one before, a sad post-apocalyptic tale. I didn't understand it then, and don't now. Perhaps it is simple. The letter, found and re-found over and over again seems to embody denial.
• Newsletter – Ms Willis excels in ambiguity. Does Nan save the world from invading mind-controlling aliens that hide under hats?
• Fire Watch – One of her best-known, most powerful stories. Time travel makes history a real profession again...on the lines of learning sports writing by playing professional football or hockey.
• Nonstop to Portales – An homage to Jack Williamson, still writing, teaching, and speaking in 1996 at age 88 when the story was written. He lived another ten years.

Willis at large, part 1

kw: book reviews, science fiction, stories, anthologies

It takes me a little longer, per page, to read a story by Connie Willis. She wastes few words. Faced with a 700-page compendium of 23 stories—about half of them novelettes—I decided to review a few at a time. Though I've read about half of them already, they well bear re-perusing. The volume is The Winds of Marble Arch and other stories.

The stories are set in eight groups, which make convenient 'mini-books' on which to comment. The first four stories are headed "Weather" by the author. Though weather phenomena are a common thread, their themes are widely divergent:

• The Winds of Marble Arch – A tale of love, betrayal, misunderstanding, and farcical hedonism, proctored by mysterious winds in the tunnels of the London Underground that herald, not what is to come, but what you're heading for if you don't change directions.
• Blued Moon – With a backdrop of a shocking ecological premise (waste disposal in the stratosphere), a question: If "once in a blue moon" means rare coincidence, and that often unfortunate, will making the moon blue change your luck?
• Just Like the Ones We Used to Know – Christmas is white, everywhere, and I do mean everywhere. Two guys are researching global warming, and argue whether this is a true discontinuity, heralding a novel climatic era, or a rare combination of "normal" phenomena. On this backdrop, several people's fortunes change significantly, either for better or for worse.
• Daisy, In the Sun – A girl struggles to recover her memory, and wonders, are we waiting for the sun to go nova, or did it do it already, and my memories are all that is left?
  

Ms Willis is a master of making you care about a character, or several of them. If she were to confine her scenery to a corner of a room, the stories would be just as memorable. Yet the larger scenes in each story are thought-provoking in their own right. Amazing!

Black Friday, stayin' at home

kw: musings, holidays

We managed to foist off hosting a huge Thanksgiving dinner onto a friend. There were about forty folks in attendance, about a third of them noisy youngsters and teens: most of the church and then some. Since there were plenty of turkeys and hams promised, we mainly brought pies, plus some side dishes. Our apple tree bore huge, luscious fruit in abundance this year, so those pies were especially yummy. The pumpkins I grew were another matter; they'd somehow crossbred with a cucumber (think of a smooth orange gourd the size and shape of a watermelon), so I used canned pumpkin. But I know how to make a memorable pumpkin pie even with store-bought ingredients. The secret is in the crust.

(A background note: We eat together after the Sunday meetings, and the church is very international. English is the mother tongue for only six of us. A careful listen around the room during the meal will bring to your ear at least three Chinese languages, sometimes Japanese or Korean, and until recently, Telegu (from around Hyderabad, India)...that couple has moved to Boston. Our Nigerian newlyweds could speak Ibo, but only do so with their grandparents.)

So perhaps it is no surprise that among the leftovers we had with our brunch this morning, my wife and I had pumpkin pie and sushi.

Piers, you've gone too far

kw: book reviews, fiction, fantasy, xanth series, puns

In two prior posts I've reviewed three of the Xanth novels by Piers Anthony. I like them. If the author had shown a little more restraint, I'd have liked Air Apparent equally well. In its afterword he mentions being over seventy now. Perhaps that explains his lapse: to me, this book had a strong undercurrent, an attempt to justify overt pedophilia. To be charitable, perhaps failing inhibitions are leading to an authorial version of Tourette's Syndrome.

Xanth fans know that there is always a rather juvenile sexual tension, pitched at the level of ten-year-old boys, who think it the height of naughtiness to glimpse a girl's underwear. So what possessed him to close the first quest sequence with a grownup getting a solid double handful of a thirteen-year-old girl's bosom? Can having her magically aged by five years a few scenes later somehow make it all OK? I think not. And he manages to go downhill from there. The old dude's gone from a slightly risqué elderly uncle sort, to a dirty old man.

Sorry, Piers, you've lost a reader.

Pattern matching to the rescue

kw: book reviews, science fiction, space fiction, mysteries

I find it interesting how frequently space stories could have been rewritten to take place on contemporary Earth, or a reasonably near-future Earth, with nations substituted for planets, and other cultures and ethnicities substituted for the various aliens. When all the action takes place aboard a space liner, it is a simple step to transform the milieu to a cruise ship.

With the proviso that two of the protagonists are artificial personalities (emphatically not artificial intelligences, as explained at least twice), we have in Narcissus by Don D'Ammassa a straightforward mystery set in a constrained environment.

The emphasis here is not so much the Sci-Fi environment, nor the clash of social systems inherent in combining people and a very few aliens from sundry planets. It is primarily a showcase for the type of systems analysis the author calls pattern analysis. The mental peregrinations of "pattern analyst" Sandor Dyle and his associate Marym Dunnis, an equally skilled former police investigator, are the prime concern.

They have to deal with teasing out the actual crime(s) from two horrific actions—a sabotage and a murder—that may or may not be related. In the end (did you doubt it?) neither crime is what it seems.

The book is subtitled "A Sandor Dyle Novel", the second such after Scarab. The title Narcissus provides a strong clue to the astute reader. Perhaps the same is true of the former novel.

Will versus Reason at the end of time

kw: book reviews, crime fiction, fantasy, science fiction

I find I've reviewed four of Matthew Hughes's books (This search ought to bring them all up, plus this post). Between Baro Harkness, Guth Bandar, and Filidor Vesh, he has quite a stable of characters, with quite diverse personalities, to explore the Archonate for us.

I must have read Majestrum or a sister novel at some time in the past, but don't remember; it was pre-blog. I did remember Henghis Hapthorn and his dilemma—maintaining paid employment as a discriminator (detective) of impeccable empirical skills, while the age changes to one in which magic takes the place of logic. In The Spiral Labyrinth we find Hapthorn sharing his body with his intuitive side (which he'd previously denied having); a personality who's taken the name Osk Riever.

Together with his integrator (PDA), now become an animal "familiar" called a grinnet, he/they locate a missing merchant, who is found to be captive of a telepathic fungus on a small, cold world. Freeing the captive serves to close the introduction to the story, but our heroes are far from done with the fungus.

Rather than flog the tale, however, I find it more interesting to contemplate the question Hughes is asking through Hapthorn: If magic is the application of will plus skills by a trained, intuitive person, how is this different from a situation in which logic rules, given that will and skill is also needed to succeed?

It is sort of like the "irresistible force versus immovable object" of classical logic: There is no definitive answer, but there are sure to be plenty of interesting side products.

In this story, Hapthorn having lost Osk Riever, the now completely unintuitive discriminator finds that, whenever he can be coerced or tricked into speaking a magic spell, he has sufficient will to see its accomplishment, usually in a spectacular way. The grinnet supplies the magical knowledge, stored in it by Riever, who has been studying magic diligently since he became separate, but within. Yet Hapthorn is no magician, which is verified when he meets some real ones.

At story's end, the two halves of Hapthorn are resident in different bodies, and the grinnet, having found a will of its own, has been granted re-"decanting" into a mechanism; it's tired of being a small mammal, considered prey by an unfortunate variety of larger critters. I reckon Hughes has further adventures up his sleeve, perhaps leading to a reuniting of Hapthorn and Riever, perhaps not.

The riskiest element

kw: book reviews, nonfiction, nuclear materials

Shortly after moving to South Dakota for graduate school in 1978, I attended a forum and debate about storage of nuclear waste from electric power reactors. There was quite a bit of local controversy regarding the Union Carbide mine near the Black Hills. At one point, one of my Geology professors was explaining just what a "spent power module" was, and the problems that need to be solved to safely store one (or a few thousand of them) for many generations. He said the module was physically about the size of an oil drum, produced 10 kilowatts of heat, and would continue to do so for a few thousand years.

I stood and asked, "Can I have one to put in the crawl space of my house? My floors are really cold!" It didn't break the ice as much as I'd hoped. Folks whose fear outstrips their knowledge have little humor.

Seeing pictures like this one a few years later, during the debate over using Plutonium power sources for satellites in low orbit, did little to calm their fears. This sphere is somewhat smaller than a tennis ball, contains about half the amount needed to make a bomb, and is nickel-plated to prevent spontaneous combustion because it is as hot as a stove heating element, about 500 degrees F. It is a source of a few hundred watts of heat, that will emit about the same amount of energy for thousands of years.

Plutonium is actually much better, engineering-wise, as a heat source than as a source of explosive power. This is because of its very strange metallurgy. In a steam-generating application, you use it as a source of steady heat. In a bomb, it has to collapse—prompted by a spherical, surrounding TNT explosion—readily and smoothly in a fraction of a millisecond to a "supercritical" density. Pure Plutonium metal won't do this unless it is first heated to a few hundred degrees, into its "delta" (δ) state. In its cooler "alpha" (α) state, it is brittle and shatters instead. Precise alloying is needed to stabilize the δ state at lower temperatures, and keep it that way as the metal ages due to its internal radioactivity. Think about the implications for a thirty- or forty-year-old bomb core.

In Plutonium: A History of the World's Most Dangerous Element, physicist Jeremy Bernstein takes us through the history of radioactivity and radioactive elements, particularly the transuranics, those elements with nuclei containing more than 92 protons. He also details the chemical and metallurgical dilemmas posed by Plutonium.

A nucleus of Plutonium, symbol Pu, has 94 protons. These numbers, 92 and 94, are the Atomic Numbers of Uranium and Plutonium, respectively. Transuranic elements with Atomic Numbers up to 118 have been produced, but only named up through element 111; folks are still fighting over who gets to name the most recent ones (based on my experience in academia, scientists love to argue).

Dr. Bernstein shows how a greater-than-usual number of missteps occurred on both sides of the European Theater of WWII, as neither Germans nor English-speaking scientists realized how similar the chemistry of the cluster of elements from Uranium onward would be. Early speculative articles about elements such as 94 (not named at first) declared that separation of the new element from Uranium ought to be "simple and easy." It is anything but.

By analogy, the so-called Rare Earths, which are not so rare, and are metals (but their oxides were called Earths), all have very similar chemistry, because their outer electronic configuration stays the same while added electrons (to balance the added protons) go into an inner shell that has little influence on chemical behavior.

For the uninitiated: Chemistry is all about how the outer few electrons of an atom attract another atom's electrons as atoms approach one another. This can be complex, mainly because there are 90-plus different kinds of atoms, and each has its quirks. But there are regularities. The "alkali metals", Lithium, Sodium, Potassium, Rubidium, and Cesium, behave in similar ways, including their ability to burn on contact with water; however, Lithium is the mildest, while Cesium's reaction is rather explosive. This is because all have a single loosely-bound electron that does all the chemistry for them, and the binding is looser (so reactivity is greater) for the heavier members of this set.

By contrast, Sodium is element 11, and Magnesium is #12, but while both are reactive, Magnesium is less so than Sodium, even less so than Lithium. Magnesium is more similar to Calcium (#20), which has an outer electron configuration like Magnesium's: two outer electrons, not at loosely bound as Sodium's singleton.

The politics, chemistry, physics, engineering, and metallurgical conundrums encountered as Pu was produced, first in microgram quantities, then in milligrams, grams, kilograms, and finally by the ton, have formed an undercurrent of the past two generations' history, from 1938 onward. Today there are a 150 or so tons of "weapons grade" metal stored by half a dozen countries, and perhaps 1,700 tons of "reactor grade" mixes of Pu isotopes (versions with different numbers of neutrons, but all having 94 protons). The author makes the point that reactor grade plutonium can also be used to fabricate a bomb. It just takes more of it...and another 70 tons are produced every year.

In the current world climate, some things are likely to get very, very bad before politicians have to bow to social realities and take very, very good care of the stuff!

A fractal-edged discworld

kw: book reviews, science fiction, science fantasy, world-building, alien empires

The hyper-nobility and hyper-venality of Heinleinesque characters; a quest worthy of Galahad; a universe where you can travel by "train" and "boat" farther than starships travel in ours; a collection of ETI's beyond the imagination of Lucas (or his screenwriter)...

Or perhaps it's Terry Pratchett's Discworld, writ large...very large, crossed with a Star Wars or Lensman milieu. Whatever you call it, the author is Kay Kenyon with Bright of the Sky: Book One of The Entire and the Rose.

A jacket blurb calls the book "high concept." That used to be derogatory. In a way, I suppose you can state the premise in a sound bite: Another universe exists, intersecting ours at various 4-D points; one man went there, seemingly by accident, and returned with few memories; he left behind a wife and daughter, and now has the chance to return for them.

If you're going to do high concept right, charactization is everything. The plot can be simple, as this one is: a straightforward quest, with few divergences, so it expresses the very, very linear nature of the Titus Quinn. Yet he has his complexities, as do his supporting cast: Anzi, a Chalin (ersatz Chinese) woman and warrior; Cho, an alien clerk with a soft spot for Quinn; even the cruel, paranoid Yulin, Anzi's uncle, who vacillates between deciding to drown Quinn or to help him. His daughter Sydney, the blinded rider of an Inyx, a sort of telepathic tricera-horse, is equally strong in vignettes that show her rise to co-lead in the realm of the Inyx.

However, Quinn eventually returns to his home universe, to Earth, without finding either wife or daughter. A host of threads are left untraced, leaving plenty of room for for sequelae (a quadrilogy is planned).

What is the Entire? A strange realm: a flat plain, universe-sized, but finite. It has to be; if I did my math right, no matter how thin the plain may be, if it were infinite, its gravity would be infinite, regardless how high you ascended "above" it.

It is also not really a disc. It appears to be analogous to the Mandelbrot Set, but with fivefold symmetry. The five "arms" may be millions (billions, quadrillions?) of miles long, but they have one edge that divides and subdivides, with cusps through which "our" universe can be glimpsed, and perhaps visited. The opposite edge, if I read aright, is bounded by a "river" that can get you to the center in very little time.

And the sky overhead: As the title implies, it never darkens, though it dims to support a daily rest cycle. The Entire has no planets, so it has no stars. The sky is a seething river of light and heat called the Bright.

But the creatures! Mantislike "Tarig" rulers, creators of the Entire, and perhaps of the Rose, as our universe is called. Their purposes are almost unfathomable, as is their technology: sky ships that alone can approach the Bright, and are found to be enslaved creatures from the Heart, the universe of the Tarigs before they created Entire.

The humans of Entire are long-lived "simulacra" of Earth humans. The many other sentient creatures, having many, or six, or four, or two, or no legs, hint at planets other than Earth that supplied models. As the subject species live in the presence of their creators, one would think they have no other gods. But they do, a "Miserable God" that is universally feared and hated. The main blessing one bestows is, "May God not see you."

In such a realm then, Titus Quinn must pursue his quest as his memories return.

Sudden Fogs

kw: nucleation

I've had two experiences of a similar phenomenon. The more recent occurred at 6:11 this morning. I'd just heard on the radio that there was heavy fog in the area. Before going out to get the morning paper, I looked through glass storm door, and clearly saw the streetlight across the way.

I stepped out the door, and exhaled a foggy breath. That tiny cloud spread quickly, and by the time I got to the driveway, the same streetlight was indistinct in a foggy gloom. It thickened a little more as I returned to the house.

The air had cooled slowly and was in a metastable state, with humidity over 100%, "supercooled." I happened to supply the trigger.

Thirty years ago, living in Anaheim, I took my usual (for then) morning shower, noting the clear sky through the window. After the shower, I opened the window to let the steam clear, and saw fog spread through the neighborhood in seconds, resulting in a real pea-souper (P.S. These days, I bathe at night, preferring to sleep clean).

I feel privileged to have witnessed supercooling and sudden condensation on a scale larger than a test tube.

Doctor, heal thyself

kw: book reviews, nonfiction, medicine, psychology

I had to save my own life. Seven years ago I was dying of cancer...but I didn't know that yet. I went to my doctor because of "stomach pain"; it hurt just below the rib cage about, two inches above and left of the navel. I said I thought I might have "an ulcer or something." The doctor's mind fixed on my guess at a diagnosis, and five minutes later I had a prescription for something to help an ulcer. This was in August, 2000.

My doctor's error? "Anchoring", a type of attribution error. Doctors are taught to seek the simplest solution. Though he did vaguely mention the possible need for a colonoscopy, given my age (53), that moment passed quickly, almost unnoticed.

Two weeks later, I was in the emergency room because of "running at both ends". The attending doctor collected a stool sample (right out of my "stool"), then came in and said, "There is blood in the stool, with a very high white cell count, but we can't yet identify an organism," meaning he thought I had an infection. I was thinking, "No bug? Sounds more like cancer!", but I was too weak to speak and my own fear made me shy away from saying anything later.

I took Cipro for a week (by the way, that sensitized me, and a dose earlier this year of the related Levaquin nearly killed me with anaphylaxis. It also cause minor, but permanent, hearing loss). Had I been a bit stronger, I'd have demanded a colonoscopy on the spot. But, the doctor having committed an error of availability—I seemed to have gastroenteritis—was sure it was an infection. He'd been taught, "Hoofbeats don't mean zebras."

A few days after the ER visit, my doctor phoned to say they'd identified Enteromonas in the stool. Maybe I'd caught that on a trip to Japan in June? When I looked into it, I wondered how that rare bug could have a 3-month incubation. I've concluded since that the bug was from ER contamination. That hospital is full of it!

After another visit to the ER, with a similar outcome, I simply dropped by the doctor's office and asked his receptionist (also his wife...is that a red flag or what?), "Dr. B has mentioned getting a colonoscopy. Who does he usually send people to?" She gave me the name, agreed to phone in the needed referral to Aetna, and I managed to see the Gastroenterologist three weeks later.

Funny thing, there, one of his first questions was, "How'd you get in here so soon? I have a 3-month backlog. Did you tell then you are bleeding?" I said I had. He looked me full in the face and said, "I can see that. Your blood count must be about 9." Normal is 12-16.

He was straightforward. I saw him on a Monday. His usual day to do colonoscopies is Thursday, but the coming Thursday was Thanksgiving, so he scheduled it for Wednesday, pushing aside other scheduled stuff. He said there were two or three possible diagnoses, including cancer, but that he was hoping it was "only" infectious colitis. By Noon Wednesday, I had a photo of a cancer the size of my fist. By the way, the pain was mis-located. I have nerves that hook up in a funny way; I should have felt pain lower and to the right.

I could go on and on with this story. The gastroenterologist was the only doctor in the whole year-long saga (until the end of my Chemo in June 2001) who would answer questions "normally". For example, rather than talking vaguely of "better chance" and such, he said, "After you have this removed, you'll have a 15-40% chance of 5-year survival. With Chemo, you can add another 25% chance of survival."

Later, when I told him how many cancerous lymph nodes (7 out of 42) were there, he said, "This is grave. One-year survival is 15%, and only 35% with Chemo." I know some people don't like to hear things this bluntly, but I am an analyst (compulsively so, according to friends). Numbers help me plan, and boy, did I need to plan! I had a 12-year old son who might be soon orphaned (He's in college now).

But the point here is, I had to push, prod, and bully at least three doctors to get, first a proper diagnosis, then timely treatment. I forced myself on a surgeon, to the point that I got my operation on the day he'd originally planned for a "first visit." I spent the three days prior to the operation in hospice care, being fed via IV with 3 days' nutrition per 24 hours, to make me robust enough to survive the operation. The hospice was ready to "dispose" of me if I weakened instead. How many people do you know who were in a hospice, and came out alive?

This experience is but one, and the most nearly terminal, that showed me I must be my own "best friend" when I contact the medical profession. My present family doctor is better than most. When I see him, it's not "10 minutes and out" as the insurance company would prefer. He takes time to discuss and to consider alternatives. I prefer them a but pushy, I can always push back if I think he's too aggressive. But I hate dragging a doctor uphill.

However, more than most, his office is full of drug paraphernalia. That is: calendars, pens, and notepads with prominent advertising messages, and two stacks of "educational" flyers supplied by the drug dealers...er, pharmaceutical representatives. His examination rooms are plastered with colorful anatomiacal posters, all supplied by drug companies and proudly proclaiming it. To me, these are Demosthenes' [oops; a friend pointed out it was Diogenes. See comments] Lantern: Exposing a not-quite honest man. I'm still looking for a doctor with a "clean" office and exam rooms.

Listen to me, people: Doctors are HUMAN. YOU must be your own advocate. YOU have to ask—at the very least—three questions:

• "What else could it be?" – Prod the doctor to consider other possibilities, and to test as needed to eliminate the most dangerous ones first.
• "Is there anything that doesn't fit?" – Like the lack of a bug in my bowel: I had the right diagnosis, but lacked courage to state it; the doctor's incorrect diagnosis caused nearly two months' further delay.
• "Could there be more than one problem?" – Some people with chest pain have both acid reflux and angina. In fact, they frequently occur together in overweight people.

I got these questions from the Epilogue to a wonderful book, How Doctors Think by Jerome Groopman, M.D. Though studying the psychology of physicians isn't his main line of work, he has thought deeply about his own mistakes, and gathered the best thinking of the best thinkers in the field.

Along the way, he makes the subject clear: both doctor and patient are human, with emotions, fears, unique histories and experiences that color everything. How many doctors have forgotten the advice of Dr. F. Weld Peabody in 1925: "The secret of the care of the patient is in caring for the patient" (My emphasis; quote on p54)?

How many remember that "what we know is based on only a modest level of understanding" (p134)? There are three problems:

1. Not everything is known. There is much that doctors don't know.
2. No doctor knows everything that is known.
3. A doctor's prior experience, and the disorders that are most common in his or her current environment, cause some things to come to mind and not others, so only a part of the knowledge a doctor does have is brought to bear on the case at hand.

This fact doesn't appear in the book: Medical errors cause about 100,000 premature deaths in the U.S. yearly, that is more than twice the number of deaths due to auto accident. I spend 200 hours or more driving each year. I spend between two and five hours in a doctor's presence. Just from statistics and basic math, the average doctor is about one hundred times as dangerous as the average auto!

Dr. Groopman relates his own saga of six doctors and four diagnoses, leading to surgery on his own hand. Is such a case unusual? Not really. Had he not been a doctor himself, he might have presisted a little less, and perhaps taken the first treatment offered, and been sorry of the result. But he recounts several stories of patients or friends of patients who wouldn't take a first diagnosis when it didn't pass the "gut test", and finally got a better outcome.

Medicine, like democracy, requires the participation of an educated public. It is of too great value to leave only in the hands of the "professionals". Do not be a "passive patient." Be a consumer. My doctor is a consultant, not the god of my medical care. It took a long time for me to gain this viewpoint. We need to instill it in our children.

Also, like democracy, to quote a proverb, "It's the worst system there is, except for all the others." Thanks to Dr. Groopman for producing a guide to safer navigation!

Niven's two-headed camels strike again

kw: book reviews, science fiction, space opera

More than thirty years ago, Larry Niven got tired of all the humanoid aliens, and the arguments that only "our" body type could evolve into an intelligent, space faring species. The Pierson's Puppeteer was his answer: an herbivorous, three-legged, two-headed cameloid (or centauroid) with three sexes and a brain in a cranial dome under the mane between the necks. The tripeds' name for themselves translates "Citizens."

This image is a negative rendering of a white-on-black image from Niven's web site (link above). I cannot discern the artist's name; should I find out, I'll give credit.

Many of Niven's novels are collaborations; his latest, with Edward M. Lerner, is Fleet of Worlds, set roughly midway in the timeline of Niven's "Known Space" series. I think I've read all the prior books, and I am relieved that this novel is the least "horny".

Niven's cameloid tripeds were, at first, the only non-bipeds in Known Space. Later, aliens based on other non-human body plans were added. In Fleet of Worlds he adds the Ch'own, sea-cucumber like critters that tend to group in fives (and thus look like starfish), but can "hook up" in myriad ways in larger groups to perform group computations, like a group mind. They can apparently think in both analog an digital modes with equal ease, unlike our analog-bound, digitally-handicapped brains. They don't need computers like we do; a couple dozen of them, suitably linked, are a super (or hyper) computer.

The Known Space books are also packed with ideas in a more scientific arena. Central to this and a few others is the gravitational rosette, initially five planets co-orbiting the Citizens' home star. Such a rosette is dynamically stable, but cannot arise naturally. The aging of the star (larger and hotter than Sol, and so going to red giant stage sooner) prompts them to propel the rosette away from it, and eventually on a path right out of the Galaxy. All the planets but the original home world, Hearth, are given groups of artificial suns to light and heat them; Hearth's ecology runs off the waste heat of more than a trillion Citizens.

Here the science falters a bit. A trillion bodies will certainly put out a lot of heat, but only by oxidizing foodstuffs. Where does the energy come from to produce the foodstuffs? No star lights Hearth now. Maybe Niven will explain better in a later book. Also, in a few scenes, the various planets co-rotating with Hearth about a mutual center of gravity are mentioned in various phases, as crescent or first quarter. At this point, the rosette is a light-year from the red giant, its former center. What star lights these phases? I suppose the artificial suns could do the trick, but it seems odd. I can't get my head around the dynamics.

Meanwhile, the main story is one of oppression and rebellion. Citizens consider bribery and blackmail to be early stages of negotiation. They are rather aggressive in "business". So it is no surprise that their explanation of the origin of a million or so humans on one of the rosette's planets, to those humans, leaves a bit to be desired.

Humans, called "Colonists", are more curious than even the most insanely curious Citizen. Citizens, being herbivores, experience a level of paranoia we'd consider pathological, but which is quite justified in the average rabbit or antelope. Curiosity is a way to become lion food (Pronghorns in Wyoming may still sometimes be drawn by curiosity to a handkerchief tied to a bush, but this common hunter's trick has pretty much eliminated the trait). As a result, the Citizens fail to account for just how driven humans are, on the chase for clues, so of course the truth is exposed.

Just how the humans survive once they have embarrassed their hosts closes the current Known Space book with quite a twist.

When to hold and when to cut and run

kw: book reviews, nonfiction, psychology, relationships, emotional abuse

In the classic film "Gaslight", a predatory husband tries to make his wife believe she's insane, so he can get control of her inheritance. Part of his scheme is a secret valve that he uses to dim or brighten the gaslights in the house. When she remarks upon it, he claims the lighting hasn't changed. She spirals toward a breakdown until a visitor tells her he also sees the changing light.

Dr. Naomi Wolf has seized upon the term "Gaslighting" to describe a type of emotional abuse in which a person with a powerful need to be right tries to convince a victim who initially disagrees. Her book The Gaslight Effect: how to spot and survive the hidden manipulation others use to control your life, written primarily for women, describes the process and effects, and techniques and attitudes needed to overcome this kind of abuse.

I was in my forties before I realized that some people can only "succeed" in their world-view if they can get you to feel guilty for your virtues. This is their hold by which they can control others. I developed two aphorisms for those whom I counseled: "Never apologize for being good" and "Those who live by their conscience are preyed upon by those who do not." I also pointed out that Jesus said, "Be wise as serpents, but harmless as doves." You gotta think like a snake, even if you prefer not to act like one.

I realized near the end of the book that those who become victims of Gaslighting also have a powerful need to be right, but fall prey to abuse because they also feel the need for their abuser to praise them. In other words, both predator and victim are of the same species; one simply has more power than the other, and thus can gradualy force the other to bend to his (less frequently, to her) version of reality. Ironically, the influence of "women's liberation" has led many women to fall victim, precisely because of their new self-image as good and capable adults, a view denied by the abuser.

At least one of the pair must make significant changes to break the cycle of abuse. Unfortunately, there is no incentive for the more powerful member to do so, so it is up to the victim.

Why does this happen so much? I've been victimized myself, and speaking for myself, there are two answers: the victim either loves or needs the abuser. Victimized children grow to be victimized adults with a built-in love of an emotionally controlling parent; a victimized wife (sometimes husband) is in love with the spouse—or remembers being in love, fondly; a victimized employee needs the abusing boss's approval to retain a job.

Strangely, while the greatest arena for this kind of abuse is schools, this is nowhere mentioned in the book. My wife and I feel fortunate that we had the wisdom and the power to remove our son from a couple of toxic classroom situations in which a teacher's main "technique" to "manage" (i.e. control) students was subtle belittling and discouragement of their spontaneity. We feel very chagrined that we were unable to deal with one of these situations, which led to our son's math abilities being stunted.

Dr. Wolf's book is not simply a descriptive text. It contains plenty of self-help information, quizzes, tips and resources. It is a call to action. She shows how, in four cases (probably composites, but based on her clients), some victims must terminate the relationship, some can limit contact (like seeing your mother less frequently, or only with friends present), and some victims are able to help both themselves and their abuser change in healthy ways. My mother once told me, in a rare moment of candor, that my marriage would be stablest if I moved a couple thousand miles away. She never forgave me for doing so, yet our relationship (mine with her) became much healthier as a result.

For me, I'd worked out the dynamics in the past, using the two aphorisms above. In addition to putting a continent between self and Mom, I've been able to completely cut the cord in one case, and in another, I changed from victim to abuser: I decided to stop walking on eggshells, and to make the other the eggshell-walker, just enough to keep him at arms' length. It is possible to convince a boss that he is in more jeopardy than you are. Turning into an old curmudgeon has its benefits!

At this rate, our grandchildren will ALL have asthma

kw: book reviews, nonfiction, medicine, allergies

Human "progress" is a tragicomedy of "five steps forward, four steps back", and the occasional "ten back, eleven forward...much later". Medical practice has always been a mixture of keen observation and tragic speculation. As an example of the first, the large TB sanitariums set up, primarily in the 19^th Century, in sunny locales based their treatment on the concept that sunlight helped "consumptives." This concept is right, and recent study of the many helpful effects of Vitamin D₃ have just about proved it (See the November 2007 issue of Scientific American). So, too, the "clean air" maps made in the late 1800s of places that were best for a "hay fever vacation". More recent study has shown that those which still exist are remarkably free of pollen and mold spores.

On the other hand, with allergy in mind, the affliction was thought to be primarily nervous, caused by stress, to the point that many doctors favored extracting afflicted children from their families for extended periods of time, and some even recommended "parentectomy"!

All three practices are mentioned within a few pages of one another in Breathing Space: How Allergies Shape Our Lives and Landscapes by Gregg Mitman. The book traces the history of allergy and asthma, primarily since about 1800, though there is a some historical record from Roman times. The writing is so overloaded with facts that I grew numb in the reading. Only when the author, in the last two chapters, came to his own experience and the medical landscape he experiences, did the writing gain passion and engage me.

To me, the lesson of the book reflects I Timothy 6:10, "...love of money is a root of all kinds of evils." Note: not the only root, not of "all" evil, but a highly significant factor. In medicine, it is a rare physician who makes decisions for medical reasons only. I am still looking for an honest doctor: one whose office bears not a single advertisement from a drug company; one that has no cabinet of "free samples"; one who tries the simplest tests first.

A case in point: One third of all cases of infertility are caused by low thyroid. A test for T3, T3, and TSH costs little, and leads to a cheap ($10/month for Thyroxine supplement) treatment. I have met but one honest gynecologist, the one who, when we moved to a new state 20 years ago, gave my wife a full physical, including above the neck, and within ten minutes, said "you have a lump on your thyroid". Ten years of various and expensive and painful tests in our prior place, and no doctor had ever touched her neck! None had ordered a single blood test!! After two months on Thyroxine, my wife conceived.

In the same way, the first thing most doctors do if you present yourself with wheezing and other allergy or asthma symptoms, is go to the "free sample" cabinet, grab whatever is most abundant among the inspirators, and give it to you, "Try this for starters." If it works, you get a prescription that'll take about half your discretionary income. Little thought is given to finding if something might work even better, and perhaps cost less.

It seems the human race is undergoing a slow evolution to adapt to urban life. Some people adapt well already; the rest are getting asthma and dying young. This frightening affliction, once confined to 1-2% of the population, is now seen in about 20%!

Well, I did read through the whole book. It shows how, over and over again, that as soon as a place is found with air that is good for allergic people, a "blue-gold rush" ensues, and the resulting development ruins the air. Humans are really good at fouling their own nest! I may rant on the indoor air business on another occasion.

Honey by the gram?

kw: opinion, bees, disorders

If you haven't heard of Bee Colony Collapse Disorder (CCD), it's time you did. This article in Wikipedia, a comprehensive treatment with 79 references, provides a grounding. There was also a recent presentation on PBS's Nature program on CCD.

Briefly, although the numbers of active hives of Western (i.e. mainly European) honeybees has been slowly falling for thirty years, the past 14-16 months has seen the sudden loss of 25% or more. Theories abound, and the salient fact is, there is no explanation yet. However, two things stand out:

Firstly, the honeybee is an intensively managed critter, with beekeepers trucking hives, hundreds to thousands at a time, to locations where farmers and growers pay for the pollination services. In the wild, bees of all kinds space their colonies, and two colonies of the same species are seldom found within the same acre. Whatever the cause of CCD, it is exacerbated by this intensive management and crowding.

Secondly, adult bees literally work themselves to death in a matter of a few months. They are a highly-tuned organism, and only a small hindrance to their efficiency will cause them to die much too soon, leading to problems maintaining hive population.

Why is this important to us? All non-grain botanic agriculture depends on honeybees. The "green revolution" had two parts, only one of which is generally known. One was the use of chemical fertilizers and pesticides to produce huge increases in grain crop yields. The other was the conscription of an entire species, the European honeybee, to produce significant increases in the yields of non-grain crops: all fruits and vegetables are pollinated by insects, mainly bees.

Every apple, pear, peach, orange, grape, and melon, every bean, pea, broccoli head, and brussels sprout you eat was produced by a plant that is pollinated by bees.

Growers that "hire" bees for pollination report that, where exceptional losses of hives have occurred, their crop yields have dropped by about half. In some of these areas, 90% or more of the honeybees have vanished.

Now here is an interesting question: Are other insects able to take up some or all of the slack? Most likely, yes.

Total yields will probably drop a little, but the bigger effect will be greater variation year-to-year. If we can keep honeybees from going extinct, one major method must be a change in how hives are managed, with litte or no trucking of bees from state to state, and more maintenance of local hives, kept at a distance from one another. Bees don't do well with the kind of crowding that is now common.

I have an apple tree. Its yield varies a lot from year to year, mainly because of varying weather. This year was the best year ever. It started out like other years, but a long, cool Spring and delayed Summer allowed young fruit to "set". In most years, an early "hit" of drought will cause the tree to shed most of the young fruit. HOwever, in late April, every year, the tree looks about the same, filled with marble-sized apples. So pollination doesn't seem to be the main factor in final yield.

I usually watch the tree a few times during flowering season, and I had noticed, almost subliminally, that in recent years I saw few honeybees, but larger numbers of other, wild bees. After seeing the Nature program a couple weeks ago, and reading up on the subject (including the Wiki noted above), I took a look at my fall flowers.

We have some Mums in bloom right now. Bees love them. I watched one plant, with hundreds of yellow blooms, for a half hour last Sunday afternoon. I didn't see a single honeybee. I did see two larger bee species, and more than twenty species of smaller bees, down to the tiny (6mm) greenish ones. I also saw four species of flies, plus two beetle species that eat the anthers, but spread pollen anyway when they go to another bloom.

In my small corner of the state, at least, there is no shortage of pollinators, just a shortage of honeybees, the bees one can hire out for money. I expect, over time, if honeybee numbers drop drastically and stay down, that honey will become a pricey commodity, but I don't expect insect-pollinated crop yields to drop as much as people are direly predicting.