Have we forgotten how to die?

In a review of seven books on death and dying, Julie-Marie Strange writes:

James Turner was twenty-five when his four-year-old daughter Annice died from a lung condition. She died at home with her parents and grandmother; her sleeping siblings were told of her death the next morning. James did everything to soothe Annice’s last days but, never having encountered death before, he didn’t immediately recognize it. He didn’t know what to do or expect and found it hard to discuss things with his wife Martha. The family received many condolences but kept the funeral private. Losing a child, often described as the hardest bereavement to bear, changed James Turner forever.

Death in the twenty-first century is typified by the paradox contained in this story. Although we greedily consume death at a distance through fiction, drama and the media, we are hamstrung by it up close and personal. In 1955 the commentator Geoffrey Gorer declared that death had become more pornographic than sex. It was, he said, the new taboo and mourning had become “indecent”. Since then, matters have arguably got worse. The decline in institutional Christianity left a spiritual and existential vacuum, while the rise in individual materialism has fragmented family networks and communities. Shared rites of passage that publicly validated grief have receded, and the space of death has moved increasingly from the home to the hospital.

Focusing on the US and, to a lesser extent, Northern Europe, Haider Warraich’s Modern Death: How medicine changed the end of life identifies how far-reaching these changes are. A physician and clinical researcher, Warraich is well placed to observe the dubious implications of an expanded medicalization of death. Most people want to die at home, but the majority continue to die in hospital, surrounded by medical equipment. In general, life expectancy in the past century has increased, but so has the use of medicine to prolong it artificially. Definitions of death have grown more complicated – does it lie in brain function or in the heart and lungs? – and are openly contested. And despite what Warraich calls medicine’s “obsession” with preventing or delaying death, there is no clear provision for bereaved families. That task waits to be taken up. Kathryn Mannix agrees in With the End in Mind: Dying, death and wisdom in an age of denial, suggesting that it “has become taboo to mention dying”. Through a “gradual tran­sition”, Mannix says, we have lost the vocab­ulary for talking about death and depend instead on euphemism, lies and ambiguity; she wants us to “reclaim” a language of death.

This is a recurring theme among these seven books. For some, our inability to talk straight about death and dying is partly about the mystery of the end. Andrew Stark, in The Consolations of Mortality: Making sense of death, identifies the decline in religion in the West and the idea of the afterlife as pivotal to our lack of confidence in confronting death. Robert McCrum, in Every Third Thought: On life, death and the endgame, speculates that ageing and death present a particular conundrum to self-assured baby boomers, who try to give death the slip (“let’s talk about it another time . . .”). In From Here to Eternity: Travelling the world to find the good death, Caitlin Doughty expands the problem into a generic Western culture of death “avoidance” – we duck awkward conversations with the dying, hand our corpses to corporate professionals and, worst of all, treat grief with embarrassment and shame. Kevin Toolis, in My Father’s Wake: How the Irish teach us to live, love and die, describes a veritable “Western Death Machine”, in which public services, health professionals, the media and corporate bodies all conspire towards the removal of death and dying from the purview of ordinary people. A former war correspondent, Toolis has seen more than his fair share of death and is here to shake us out of our complacency. [Continue reading…]

Psychedelic medicine may become available sooner than you expect

Michael Pollan writes:

Just how soon might psychedelic-assisted psychotherapy be available aboveground, to the many people who stand to benefit from it? Before the F.D.A. approves a new medicine, the drug must survive testing for safety and efficacy in a three-stage sequence of trials, each of them involving a larger sample and more rigorous methods. When researchers recently brought to the F.D.A. the results of Phase 2 clinical trials of cancer patients who were given psilocybin and MDMA, they were stunned by the positive response of the regulators. Regulators told them they could move forward to Phase 3 with MDMA, the last step before F.D.A. approval. The F.D.A. is still considering when psilocybin trials can move into Phase 3. The agency wouldn’t comment on drugs in the approval process, but a researcher who attended one of these meetings told me the regulators seemed untroubled by the illicit status of the drugs in question or by the unique challenges of controlling studies of psychedelics. These meetings took place before a Trump-appointed F.D.A. commissioner was sworn in; it remains to be seen how the Justice Department under Jeff Sessions would respond to F.D.A. approval of psychedelics. The researchers felt heartened by the F.D.A.’s response. The message the scientists took away from the meeting was that they should raise their sights and not limit themselves to treating cancer patients, but rather test the drugs on the much larger population of patients suffering from major depression.

Thus encouraged, the Multidisciplinary Association for Psychedelic Studies (MAPS), a nonprofit that has been working for federal approval of psychedelics since 1986, will begin Phase 3 trials of MDMA-assisted psychotherapy this summer for the treatment of post-traumatic stress disorder, involving more than 200 volunteers at 16 sites in the United States, Canada and Israel. Later this year, pending F.D.A. approval, two Phase 3 trials of psilocybin — one for the treatment of major depression and the other for “psychospiritual distress” in cancer patients — are expected to get underway at Hopkins, N.Y.U. and a half-dozen other sites around the country.

Phase 3 trials, which typically involve hundreds of subjects at dozens of sites, can cost tens of millions of dollars — a cost ordinarily borne by the big pharmaceutical companies that stand to profit from approval. But Big Pharma has not demonstrated significant interest in psychedelics, and it’s not hard to see why: Psychedelic therapy is a rather square peg to fit into the round hole of psychopharmacology as we now know it. Patents on the molecules in question — LSD, psilocybin and MDMA — have long since expired (psilocybin comes from a common mushroom); the drugs, if approved, don’t need to be taken more than a few times; and as the C.I.I.S. program recognizes, psychedelic-assisted psychotherapy is a novel hybrid of pharmacology and talk therapy, making it uncharted territory for a pharmaceutical industry organized around the selling of pills.

But the obstacle of funding Phase 3 trials appears to have been recently surmounted. The Psychedelic Science Funders Collaborative (P.S.F.C.), a new Bay Area-based consortium of philanthropists including the hippie-soap entrepreneur David Bronner, the author and tech investor Timothy Ferriss and other donors both in and out of the tech community, has helped raise more than $63 million in charitable contributions, an amount that could be sufficient to complete the trials. The two main beneficiaries of these funds will be MAPS and Usona Institute, a nonprofit medical-research organization that is sponsoring forthcoming psilocybin trials. Rebekah Mercer, the Trump funder behind Cambridge Analytica and Breitbart, is also a donor to MAPS.

There is at least one corporation betting that psychedelic therapy will soon become a business. Founded in London by George Goldsmith, a health care industry consultant, and Ekaterina Malievskaia, a physician, Compass Pathways aims to become the world’s first psychedelic pharmaceutical company. (The couple, who are married, were inspired to expand access to psilocybin after Malievskaia’s college-age son was successfully treated by an underground guide with the drug for a debilitating case of depression.) Compass aims to be much more than a drug company, however. The company is developing a complete treatment package — consisting of a training program for therapists; protocols for orchestrating the entire experience; and the medicine itself — that it hopes to sell to health care institutions and national health services, first in Europe and then in the United States.

Its initial therapeutic target is treatment-resistant depression (patients who have failed to respond to at least two previous treatments); after an advisory process with the European Medicines Agency (the E.U.’s drug-regulating body), it has decided to conduct trials in eight to 10 sites across Europe. It is also in discussions with the F.D.A. to organize trials here. According to Goldsmith, Compass has already raised $13 million from investors in the United States and Europe, many of them from the tech community (Peter Thiel is an investor) but also institutional investors in the health care sector.

Phase 3 trials will take at least three years, but access to psychedelic therapy could come sooner than that. Under “expanded access” or “compassionate use” programs, patients who stand to benefit from therapies still deemed experimental can gain access to them before trials are complete. In the case of MDMA, this could happen as soon as 2020. [Continue reading…]

Glyphosate shown to disrupt microbiome ‘at safe levels’, study claims

The Guardian reports:

A chemical found in the world’s most widely used weedkiller can have disrupting effects on sexual development, genes and beneficial gut bacteria at doses considered safe, according to a wide-ranging pilot study in rats.

Glyphosate is the core ingredient in Monsanto’s Roundup herbicide and levels found in the human bloodstream have spiked by more than a 1,000% in the last two decades.

The substance was recently relicensed for a shortened five-year lease by the EU. But scientists involved in the new glyphosate study say their results show that it poses “a significant public health concern”.

One of the report’s authors, Daniele Mandrioli, at the Ramazzini Institute in Bologna, Italy, said significant and potentially detrimental effects from glyphosate had been detected in the gut bacteria of rat pups born to mothers, who appeared to have been unaffected themselves.

“It shouldn’t be happening and it is quite remarkable that it is,” Mandrioli said. “Disruption of the microbiome has been associated with a number of negative health outcomes, such as obsesity, diabetes and immunological problems.”

Prof Philip J Landrigan, of New York’s Icahn School of Medicine, and also one of the research team, said: “These early warnings must be further investigated in a comprehensive long-term study.” He added that serious health effects from the chemical might manifest as long-term cancer risk: “That might affect a huge number of people, given the planet-wide use of the glyphosate-based herbicides.” [Continue reading…]

More than 95% of world’s population breathe dangerous air, major study finds

The Guardian reports:

More than 95% of the world’s population breathe unsafe air and the burden is falling hardest on the poorest communities, with the gap between the most polluted and least polluted countries rising rapidly, a comprehensive study of global air pollution has found.

Cities are home to an increasing majority of the world’s people, exposing billions to unsafe air, particularly in developing countries, but in rural areas the risk of indoor air pollution is often caused by burning solid fuels. One in three people worldwide faces the double whammy of unsafe air both indoors and out.

The report by the Health Effects Institute used new findings such as satellite data and better monitoring to estimate the numbers of people exposed to air polluted above the levels deemed safe by the World Health Organisation. This exposure has made air pollution the fourth highest cause of death globally, after high blood pressure, diet and smoking, and the greatest environmental health risk. [Continue reading…]

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The interstitium, the largest organ we never knew we had

Tanya Basu writes:

What is an organ? Anatomy textbooks are rather fuzzy about what defines an “organ,” requiring one to have primary tissue—parenchyma—and “sporadic” tissue, called stroma, which can be nerves, vessels, and other connective tissue. Organs are the necessary building blocks of organisms (hence, the name), and can be gigantic or microscopic. So long as cells clump together to form tissues, and these tissues organize themselves into organs that perform specific functions in the survival of an organism, that mass of tissues and cells can be called an organ.

Theise, Carr-Locke, and Benias weren’t sure what to call this space with its collagen bundles and fluid. The fluid itself appeared rich in proteins typical of lymphatics and serum, but the space was neither lymphatic nor vascular (meaning that it contained neither veins nor arteries), so what could it be?

That’s when it dawned on them that what they’d stumbled upon was actually talked about in medical textbooks, but that they were the first to actually define it.

This thing they were looking at, struggling to understand with its bizarre structure and rule-breaking form, was the interstitium, a space vaguely described in textbooks as where “extracellular fluid” is found, the fluid that isn’t contained within cells. What doctors had defined as “dense connective tissue” wasn’t dense connective tissue at all. In fact, they were all fluid-filled structures that only appeared to be densely compacted when tissues were made into slides, the fluid draining away, the collagen lattice collapsing onto itself.

They had a theory—that the space was the interstitium—and a way to prove it. They were on to something.

So far they had only recognized this in the bile duct. But Theise began to recognize through his daily lot of diagnostic slides from surgical resections and biopsies of all sorts of tissues and tumors that the dense connective tissue layers of other parts of the body also had the same appearance as this layer in the bile duct. He noticed it in stomach and intestine and esophageal specimens, then he saw it in fascia around muscles and in fat. And then he noticed it around veins and arteries. Then skin.

It seemed to be everywhere, and Theise realized the potential enormity of what they’d discovered, calculating that it was largest organ of the body by volume—larger even than that of skin due to its wrapping around every organ, including the skin. At about 20 percent of all the fluid of the body, and about 10 liters, it was gigantic despite the fact that it could only be seen by peering through a microscope: The cardiovascular system (heart, veins, arteries, and capillaries) weighed in at about a third of that volume, the cerebrospinal fluid 20 times smaller. [Continue reading…]

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The depletion of the human microbiome and how it can be restored

Tobias Rees and Nils Gilman write:

It is a crisis some scientists believe has similar proportions to climate change, but it gets much less coverage: Microbes are disappearing from our bodies.

You may have heard that trillions of microbes — bacteria, fungi, viruses, protists — live on every surface of your body as well as inside your mouth, other orifices and your gut. You may have also heard that these microbes make up the majority of your body’s cells.

But few are aware of how directly these microbes and their genes affect the functioning of our bodies. The human genome found in the nuclei of our cells contains roughly 20,000 genes, but the microbiome — the sum total of genetic material in the microorganisms that live in and on us — contains as many as 20 million genes, all of which are directly or indirectly interacting with and at times even controlling our genes.

Our microbial genes are critical to the regulation of our metabolism, to the ability of our immune system to fight off infection and to the production of the neurotransmitters that power our brain and nervous system. The microbiome, just like our nuclear genome, is heritable. The majority of microbes are transferred from mother to child during childbirth, in a chain of transmission that reaches back to the earliest animals that evolved — which happen to have been microbes.

So why the crisis?

What we eat

The first major issue is the modern diet. Our hunter-gatherer ancestors mostly ate a plant-based and fiber-rich diet, which sustained a diverse microbial population in our guts that could produce all the metabolites our bodies and brains needed to grow and flourish. By contrast, most modern humans rely on a narrow, nutritionally impoverished and fiber-poor diet. This starves large parts of our microbiome and disrupts our health through typical “diseases of modernity,” such as obesity and diabetes.

The microbial diversity found in the guts of contemporary hunter and gatherer societies, such as the Hadza people in Tanzania or the Yanomami of South America, is roughly twice as high as the one found in the average European and American gut (independent of ethnicity). The good news is that in most cases, if we return to a diverse, fiber-rich diet before essential microbes are lost, some of the diversity of our gut’s microbial population can be restored. [Continue reading…]

For the individual, one of the most effective ways of restoring microbial diversity is by drinking kefir — but not the kind you can buy in a supermarket. Real kefir is made at home.

The consumer mindset is one in which we’ve been encouraged to believe that the easiest way of obtaining what we want is to pull it off a shelf, ready-made, attractively packaged, and ready for consumption.

Manufactured kefir not only involves complex, expensive, industrial processes — as shown here — but the end product is a pale imitation of the real thing.

If you make it yourself, once you’ve bought your first batch of kefir grains, you can continue recycling them indefinitely — my home brew is still going strong after a decade! And since I’m not a kefir purist, I don’t rely on raw goats milk or any other hard-to-find product — just organic whole milk, which seems to work fine.


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When the cure is the cause

Jeanne Lenzer writes:

Keiko Yamaguchi’s troubles began with diarrhea. After a few weeks, her toes went numb. The numbness and weakness crept up her legs, to her hips, and her vision began to fail. That was in early 1967. By the end of 1968, Yamaguchi, just 22 years old, was blind and paralyzed from the waist down.

She was one of more than 11,000 people in Japan, (with reported cases also occurring in Great Britain, Sweden, Mexico, India, Australia, and several other nations) who were struck by a mysterious epidemic between 1955 and 1970. The outbreak was concentrated in Japan where an estimated 900 died of the disease, which doctors eventually named SMON, for subacute myelo-optic neuropathy — myelo from the Greek word referring to the spinal cord; optic referring to vision; and neuropathy indicating a disease of the nerves.

The illness usually started with bouts of diarrhea and vomiting. Some patients, like Yamaguchi, became paralyzed and blind. (My efforts to track her down have been unsuccessful.) An uncertain number developed “green hairy tongue”: Their tongues sprouted what looked like tiny green hairs. Some of the afflicted developed green urine. Family members, too, came down with the disease, as did doctors and nurses who treated it. Approximately 5 to 10 percent of SMON patients died.

What was causing the outbreak? During the 1960s, Japan — where SMON was concentrated — launched vigorous research efforts to find out. Doctors thought an answer was at hand when a researcher studying SMON patients announced that he’d isolated the echovirus, which is known to cause intestinal problems. But soon other viruses were found in patients, including Coxsackie and a herpes virus. The herpes finding was compelling, since those viruses are known to affect the nervous system. But one by one, each claim was disproved when independent researchers were unable to replicate earlier laboratory findings.

Other possible causes were considered and shot down. No drinking water pathogen was detected. Pesticides? That hypothesis was discarded when a study found that farmers, who would have the greatest exposure, had lower rates of SMON than non-farmers. There was some excitement when researchers found that many victims had taken two types of antibiotics, but it seemed unlikely that two different antibiotics would both suddenly cause the same highly unusual disease. Besides, experts noted, some patients took the antibiotics only after developing symptoms of SMON.

Then, in late 1970, three years after the drug theory was dismissed, a pharmacologist made a forehead-slapping discovery. The two presumably different antibiotics, it turned out, were simply different brand names for clioquinol, a drug used to treat amoebic dysentery. The green hairy tongue and green urine, it turned out, had been caused by the breakdown of clioquinol in the patients’ systems. One month after the discovery, Japan banned clioquinol, and the SMON epidemic — one of the largest drug disasters in history — came to an abrupt end. [Continue reading…]

The immobilization of life on Earth

One of the defining characteristics of life is movement, be that in the form of locomotion or simply growth.

What is inanimate is not alive and yet humans, through the use of technology, are constantly seeking ways to reduce the need to move our own limbs.

We have set ourselves on a trajectory that, if taken to its logical conclusion, will eliminate our need to possess a fully functioning body as we reduce ourselves to a corpse-like condition sustained by a multiplicity of devices.

As Amazon advances on its path to gobble up the retail market, its next step, sweeping away the last vestige of foraging (mindlessly pulling food off supermarket shelves and then transferring them from one wheeled vehicle to another) is the introduction of grocery deliveries in two hours.

(Amazon Go offers a stepping stone in the deconstruction of the physical marketplace where shoppers no longer need be troubled by the need for human interaction.)

Just as automation in manufacturing has driven the growth of unemployment rather than leisure time, dispensing with the need to go out grocery shopping is likely to make people more sedentary rather than more motivated to exercise.

The maximization of customer satisfaction will be that Amazon Prime Now customers can quietly rot away in the comfort of their own homes.

Noteworthy are the efforts Amazon’s competitors are making to impede its rapacious growth by countering with the acquisition of drug stores. A hidden rationale here may be that retail corporations hope to ensure their survival by servicing the growth market of diabetes — a disease that afflicts 25% of Americans.

We are turning into creatures who have forgotten what it means to be alive, as we succumb to a torpid state that prizes ease above anything involving discomfort.

Paradoxically, this addiction to ease is now at the root of many of the most prevalent forms of human disease.

In the context of this life-denying human condition, it’s hardly surprising that our loss of appreciation for the core attributes of life is having a devastating impact on the lives of other creatures.

As walls get built to obstruct human migration, we are also blocking the migratory pathways of animals across our planet through an evermore intricate web of barriers, pipelines, and highways. Likewise, in our relentless quest for resources, we plunder and destroy vast regions of wilderness.

What we often think of as a world defined by its networks of connectivity, is increasingly a world sliced up by a matrix of divisions.

Where in the wild, animals once moved across continents in behavior patterned by terrain, climate, and the availability of food, their lives are now subject to constraints defined by economics and human desires.

As the New York Times reports:

Snow comes early to the Teton mountain range, and when it does the white-bottomed pronghorn that live here get the urge to move.

Following an ancient rhythm, they migrate more than 200 miles to the south, where the elevation is lower, winter is milder and grass is easier to find. Come the spring green-up, they make the second half of the round trip, returning to the Grand Teton National Park.

After thousands of years, biologists are concerned about the future of this migration pattern. While there have been efforts to protect the journey, such as highway overpasses and antelope-friendly fences, some new barriers are looming. Most immediate is the prospect of 3,500 new gas wells planned on federal land at the southern end of the pronghorn’s migratory path. And then there’s the nearby Jonah Natural Gas Field, which is already intensively developed.

“The challenge is understanding how many holes you can punch in the landscape,” said Matthew Kauffman, a professor of wildlife biology at the University of Wyoming, “before a migration is lost.”

Room to move is critical for a wide range of species, but it has long been difficult for researchers to capture where and when they travel.

But a new and growing field called “movement ecology” is casting light on the secretive movements of wildlife and how those habits are changing.

A global study of 57 species of mammals, published in the journal Science, has found that wildlife move far less in landscapes that have been altered by humans, a finding that could have implications for a range of issues, from how well natural systems function to finding ways to protect migratory species. [Continue reading…]

Mass shootings highlight nexus between masculinity and gun violence

Laura Kiesel writes:

The year 2017 brought the deadliest mass shooting in modern history to the United States, which has become home to more gun massacres than any other country in the world. The response offered by many of our political leaders, both Democrat and Republican, has been to focus on the role of mental illness in such shootings. The day after Stephen Paddock took to a hotel room in Las Vegas with 23 firearms and murdered 59 people this past October, President Donald Trump told reporters that Paddock was “sick” and “demented,” even as evidence suggested Paddock did not have a confirmed mental health disorder. Trump was also quick to blame mental illness on the mass shooting at a Texas church in early November, saying at press briefing the following day that it the tragedy was not “a guns situation” but instead “a mental health problem at the highest level.”

But as we begin a new year, it’s time to have a more nuanced discussion about what might really be to blame for the trend of mass shootings in America—as well as the gun violence epidemic more broadly. No, it isn’t mental illness. It’s gender. If we want to stop the problem of mass shootings, we need to fix the problem of toxic masculinity.

If you take time to dig into the research, you’ll find that mental illness doesn’t play the role in mass shootings and other gun violence that many, especially our politicians, seem to think it does. Serious mental illness has been found to be conclusively present in a minority of mass shootings—only 14.8 percent of all of the mass shootings committed in the U.S., defined as a shooting which injures or kills four or more people, between 1966 and 2015. (Another study focusing on different data collections of generalized “mass murder” from 1949 to 2015 attributes 23 percent of those incidents to the mentally ill.) Studies have also found that those with serious mental illness are responsible for just 4 percent of the incidences of interpersonal violence and less than 1 percent of all gun-related homicides annually in the United States. Generally speaking, people with mental illness are far more likely to be victims of firearm violence than commit it.

Yet, while most mass shooters in the past 35 years have not been found to have a serious mental illness, nearly all of them do have one thing in common: their sex. Of the 96 mass shootings committed since 1982, all but two were committed by men. (Most of them were white.) [Continue reading…]

A new year — a new direction

The greatest thing you’ll ever learn
Is just to love and be loved in return.

Nature Boy” by eden ahbez

“I don’t think she’s getting the attention she needs,” a nurse told me as my wife remained in the Emergency Room six hours after doctors said she needed to be transferred to the Intensive Care Unit.

On Christmas Day I almost lost the love of my life, Monica — we’ve been married for 17 years.

Over the holidays we were away from home, visiting Greenville, South Carolina, and staying at an Airbnb.

Late that afternoon, after I left the bedroom where Monica was taking a nap because she felt unwell, I returned to find her speaking incoherently to no one. She rambled in a strange mix of meaningless words sounding at turns Italian and English.

Holding an imaginary phone, she was immersed an imaginary conversation that persisted into the middle of the night.

To my eyes and to my alarm, Monica seemed in the grip of a catastrophic neurological breakdown from which at that moment I feared she might never recover.

She had plummeted into a netherworld, oblivious to her surroundings, lost in a delirium triggered (I would later learn) by a life-threatening drop in serum sodium levels.

An on-call doctor I reached by phone initially diagnosed a “drug-induced psychosis” caused by a sleep medication Monica had just started taking (at the prescribed dosage). He said the only remedy would be for the pharmaceutical to wash out of her system. He anticipated the crisis would have largely resolved by the morning.

What neither he nor I were aware of at that time was the severe imbalance in Monica’s electrolytes posing acute danger to her brain.

I spent the following eight hours trying to make sure she didn’t hurt herself, hoping to see signs of recovery as dawn approached. As the hours past, however, I became afraid my effort to provide a safe space could have the opposite result. Inside Monica’s body, havoc had been let loose, and as I waited (hoping this neurological storm would soon pass) with each passing hour it seemed like the harm might become harder to reverse.

By 2AM, I couldn’t risk waiting any longer and called 911.

Over the previous decades, Monica was more often hurt than helped by medical care and I knew a trip to the emergency room was her worst nightmare. Yet I had no choice — had I not called an ambulance, I don’t think she would have survived. With a sodium level of 109 mEq/L, it’s remarkable she hadn’t already fallen into a coma or suffered seizures.

Five days earlier, when I stopped posting updates here, I made reference to “highly unpredictable events,” yet had no notion what might follow.

For weeks, Monica had insisted to me she was in a life-and-death predicament and yet it was hard for me to understand why.

Now, in spite of my own scientific prejudices, I’m inclined to think she had some kind of visceral sense of what was around the corner.

Likewise, on December 20 it seems that when I stopped trawling the news and updating War in Context, I somehow knew that I couldn’t afford any distractions from attending to the demands of a critical moment.

Nothing has the power to reshape ones priorities more forcefully than sudden proximity to death.

While most of us take comfort in the knowledge that medical care saves lives, medical error causes grave harm far more often than we would care to imagine.

Right now my first priority is helping Monica find her way back to health.

While deemed “medically fit” for discharge from the hospital five days after her admission, by the time we reached home it was clear that recovery remained a long way off.

“Take me home,” Monica pleaded to me, unable to recognize our house from the outside or the inside.

The following days and weeks have been like Alzheimer’s in reverse — a process of reclaiming and reconstructing a world and a life that was stripped of so many of its most familiar details.

“Learning to live again,” is the way Monica describes the enormous task she is grappling with each day as she traverses the bewildering territory of a fractured memory.

During the most challenging period of Monica’s life and mine, this has also seemed like a time of creative destruction and renewal.

Now, I feel, it’s time for me to take a new direction on the web.

After sixteen years of blogging, I’ve decided to jump off the hamster-wheel of never-ending news updates. Finally, as the tagline at War in Context has long declared, I want to give all my attention to the unseen.

On Trump, never-ending wars, the Middle East, democracy, racism, human rights, Russia and many other topics that dominate the news, the coverage there has arguably become redundant.

Although I may have contributed some editorial nuance to the news mix, on my blog as elsewhere, there is a numbing repetitiveness to coverage of daily events — the more we know, the less we feel.

As Henry David Thoreau wrote in 1854:

I am sure that I never read any memorable news in a newspaper. If we read of one man robbed, or murdered, or killed by accident, or one house burned, or one vessel wrecked, or one steamboat blown up, or one cow run over on the Western Railroad, or one mad dog killed, or one lot of grasshoppers in the winter—we never need read of another. One is enough. If you are acquainted with the principle, what do you care for a myriad instances and applications?

Life is an intensely personal business in which each of us faces a unique predicament. Even so, to the extent that I’ve used blogging as a medium for expressing my own voice, I’ve tended to do so in a fairly low-key and impersonal way.

One of the persistent ambiguities in my rarely interrupted effort to document these troubled times is that while I’ve been driven by my faith in life, the output on my site has mirrored the prevailing pessimism that marks this era.

Paradoxically, however, I couldn’t have contributed to such a grim portrait of our world and avoided succumbing to despair if I wasn’t also convinced that human virtues possess improbable resilience. We might be on the road to hell but it isn’t inevitable that we get there.

Even though I don’t have confidence in happy outcomes in this world or faith in eternal bliss some place else, I do believe in the intrinsic value of truth: that the more accurately we perceive the conditions of our existence, the more capable we are of crafting positive adaptations.

Some years ago, after attaching the cryptic tagline to my site, with attention to the unseen, I offered a vague explanation. I also started using “Attention to the Unseen” as a byline on a posts covering a diverse range of topics, but my exploration of this theme remained tentative.

The new direction I’m now going to pursue will make this the foreground instead of background.

Within its scope I include a cluster of interconnected ideas underpinning the content of my new website, Attention to the Unseen:

  • that nature is built on symmetries — a mirroring of the micro and the macro; an endless interplay between creation and destruction, light and dark, order and chaos, within a cosmic system that lacks nothing;
  • that our human world is unbalanced because it has physically and psychologically dislocated itself from the wider and wilder living world upon which we depend and within which we exist;
  • that when William Blake referred to being able “To see a World in a Grain of Sand,” he was giving expression to a perception of reality that comports more closely with the way things are than do most of the flimsy constructs that generally fill our minds;
  • that the things that bring us together most intimately in human relationships have no material form;
  • that whatever is of real value cannot be possessed or shaped by force;
  • that humanity cannot sustainably control nature and our efforts to do so threaten life on this planet;
  • and that human beings have lost their bearings in the world by becoming progressively more attached to and dependent upon technologies by which we are now enslaved — that Thoreau spoke even more clearly of our times than his own when he declared that “men have become the tools of their tools.”

As a child of the psychedelic ’60s, I always liked the slogan, make love, not war, even if it was often expressed in a naive or superficial way.

To simply say no to war, is not enough.

To stand in opposition without taking the risk of standing up for some kind of vision, is to lean towards what seems like a Bartleby incapacitation; it is to effectively disengage from a world we don’t like but thence advance nowhere.

In a world fractured by divisions, injustice, and turmoil, in mere opposition we risk succumbing to our own sense of powerlessness, yet in dark times such as these, there has never been a greater need that we nurture and share our visions of a better way of living and deeper appreciation of life.

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