I'm traveling today, and sitting in Dallas/Fort Worth Airport.  As always, my frustration level soars as I go through the intricacies of airport security.  I'm glad we're secure, but I'm not always sure that the things we do make us more secure.  And I can't help but find comical irony in many of them.

For instance, the monitor in the security line has a list of things we can't bring aboard.  Pictures of guns (always a Glock!), knives, ball-bats, fire-works.  Why not a picture of a terrorist?  Oh, that's right, it would be judgmental and mean.  After all, what does a terrorist look like?  We aren't allowed to suggest.  Perhaps a picture of a very angry infant or threatening old lady...

And there's the pervasive checking of identification cards.  As if, after checking in at the front desk, someone will accidentally slip up and present the security guard with their Al Qaida Platinum Membership Card.  'Oops, sorry, here is my genuine American driver's license!'

But I digress.  As I went through the line and took off my shoes, yet again demonstrating that my footwear has no potential for dangerous, rapid expansion under high heat and pressure, I began to wonder.

We in medicine are expected to demonstrate at least some benefit of the things we do to our patients.  The government wants to have comparative effectiveness data to see what works and what doesn't, and what needs to continue being reimbursed.  I'm not sure that's always a good idea, but it is what it is.

So let me ask, 'how many shoe bombers have we now caught, except for the first one?'  Is there data?  Is there any suggestion that the enormous slow-down of the security lines that results from shoe removal and re-application causes any improvement in security?

Isn't it ironic that the government wants us to cut costs on unnecessary procedures, even as we have no real idea if all of the gesticulations we endure in airports have any bearing on our safety?

If someone has information here, please let me know!  I'm just tired of taking off my shoes, fumbling with my ID, unpacking all of my stuff and feeling my pulse in my temples.

Edwin

We live in an increasingly ‘green’ world.  If a man woke from a coma after thirty years, he’d honestly believe the Irish had taken over the world!  Turn on the television, open the newspaper, log onto your favorite news site or walk down the aisles of any store and the word ‘green’ will all but assault you.  Green homes, green cars, green industry, green hobbies, the concept is everywhere.  So I thought, ‘as an emergency physician, how can I make the world greener?’
    Let’s face it, hospitals are huge users of resources and power.  We throw away papers and dressings, organs and needles.  We burn waste, we use landfills, we aren’t very ‘environmentally friendly,’ shall we say.  Mind you, we take care of humans, but the idea that humans are part of the environment is now a bit ‘old school.’  Apparently, from what I read, humans are not part of the problem…humans are the problem!   Old planet earth is fairly infected with bipedal parasites of the Homo sapiens variety.  Since we in the ED see so many of those critters, and use so much of the planet’s coveted resources to look after the pesky varmints (thereby keeping them alive), how can we make things better for planet earth?
    Well, I can tell you, first and foremost we could just stop doing such a darn good job.  If we let a bunch more humans slip through our fingers (after appropriate tort reform), the earth would be a lot less populous.  Let’s face it, dying has a profound way of reducing one’s carbon footprint.  We save lots of lives every day, and if we just didn’t, they wouldn’t be exhaling nasty carbon dioxide like they have for their entire selfish lives.  There would be fewer cars driven, less fuel used, decreased need for that pesky, nature-destroying agriculture, less need to imprison, kill and eat animals, reduced industrial production and far fewer pharmaceutical chemicals poured into our ecosystems.  So, maybe as a group on the forefront of the ‘human problem,’ we ought to just let some more deaths occur.  Don’t we owe it to the earth?  (For an example of the power of this technique, just go read about the reduction in humans accomplished by the DDT ban!  Of course, most of them weren’t of Western European descent, so it’s really our turn now.)
    Similarly, if we had less doctors and nurses coming to work, there would be fewer miles driven and less greenhouse gas production.  (If fuel costs keep rising, that will be pretty easy to accomplish).  Patients would wait longer and, obviously, bad outcomes would occur.  But eventually people would settle down into a reasonable expectation that we just couldn’t save everyone, and they’d stop bothering hospitals for care.  A little resignation, a little acceptance of the harsh realities of mortality, and you’re back to suggestion one, above.  Less people!  I’m confident that before modern health-care was available, people just lived with dying and were grateful for the few years they had.  My grandmother lost a cherished baby brother to diphtheria, since there wasn’t much care back then in rural West Virginia.  But hey, that’s just how it went, right?  Less human animals due to death by natural causes; diseases are, after all, natural; despite the efforts we put into eradicating them.  And the earth wasn’t ‘in the balance,’ back then, was it?  Diphtheria did it’s work, I suppose, and made us all a little safer.
    You might have detected a little sarcasm there.  I read and enjoyed Jonathon Swift’s ‘A Modest Proposal,’ in high school.  The parallels are not insignificant.  What can I say?  I’m impressionable.  I believe that ultimately we ought to be very careful about the way we both impact, and manipulate, the environment.  Because the environment is necessary for a species close to my heart; my family, friends and me!  I’m a huge fan of survival.
    But beyond sarcasm, there are some things we could do to make the world better Let’s bring it home to hospitals.  How about reducing the amount of paper we use, and ultimately waste, by cutting back on unnecessary forms, documentation and oversight?  How many gazillions of reams of paper go into every imaginable, and quite a few unimaginable, bits of paper that waft through hospitals every day?  How many oversight and safety programs fill file-rooms with documentation of all sorts every day?  When I just look at the smothering weight of paper used in filing and fighting with insurers, or the charting nurses have to do, I’m aghast.  Forms for permission to treat, forms for promise to pay, forms for medical necessity of a procedure or drug, forms for restraints, sedation, commitments, blood, screening exams regarding nutrition, immunizations, abuse, language skills, drug and alcohol abuse.  The list is exhaustive and exhausting.  Hospitals, government and industry simply have too many people devising and overseeing too many forms on too many bits of paper.  What if they’re all computerized, you ask?  The computer doesn’t run on solar, does it?  
    So, let’s cut out great swaths of middle management in medicine and government.  I submit that federal programs and Joint Commission contribute mightily to excessive fuel used by forcing people to fly to Washington to defend themselves or lobby for changes; by causing doctors and nurses to drive to constant meetings, and by decimating the world’s trees with a surfeit of forms.  Don’t take my SUV!  Stop the madness of rules, regulations and forms.  (Oh, and make our representatives in Washington live in their homes states and work via the Internet.  It would result in reduced travel costs, reduced fuel and accessibility for the occasional tar and feathering.)
    Of course, if we radically change malpractice in America so that we don’t practice defensive medicine, we won’t have to fire up those X-ray machines, CT scanners or MRI’s all the time.  And we’ll have fewer forms to fill out.  We’ll be able to accomplish more and do less for the patient, and at the same time ‘green-up’ our hospitals and clinics to make the earth a happier place.
    It gets harder.  We could occasionally just tell people they aren’t sick, don’t have any of the many imaginary diseases modern man has concocted, and send them on their way without any extra chemicals or procedures needed.  They’ll be unhappy, but if we don’t have all of those ‘patient satisfaction’ forms to fill out, then no one will have to worry about it.  
    And we could honestly tell them to stop doing some of the ridiculous things they do that bring them to hospitals in ambulances in the first place; like drinking to excess, using drugs, fighting, ‘cruising’ in cars all night, having inappropriate sex or lying around playing X-Box instead of holding jobs.  I tried to figure out how reducing the ‘disability’ roles would help, but honestly, some of those people use and produce so little energy that it’s hard to see how they could damage the environment at all.  I guess we could make them into artificial reefs!)
    I know it’s a complex problem.  But I think that there may be some room for improvement here.  We in medicine, especially in emergency medicine, can give so much to improving the world if we just try.  I mean, so far all we have done is use up resources while desperately trying to keep people alive and well.  Who knew we were wrecking the world all along?  
    So get on board, my brothers and sisters!  Let’s save the planet!  And let’s turn those white lab-coats to green.  And in the process, let’s streamline what we do.  Maybe a little global warming is just the thing we needed to motivate us all along.
         

See my post on how medical research confirms physicians' overall belief in the value of life, and how research furthermore confirms a belief in absolute truth.

Just follow the link. Thanks!

Edwin Leap, MD

http://edwinleap.com/blog/?p=361

Fascinating, isn't it?  All we here is cost-containment in medicine.  The need for rationing.  Tom Daschle said, some time ago, (and I paraphrase) that innovation was just too expensive.  We need to cut back, apparently.

Oops, the swine-flu arrived!  Suddenly, we want innovation, and we want it yesterday!  We want vaccines and medications on the fast-track!  We don't know why the last administration cut flu preparation!  Let's do more!  Where are the great minds at the CDC?  Who are the great epidemiologists and virologists?  What can they tell us?  Can we be saved from the pandemic?

Well, all in all we're probably over-reacting.  People die of garden-variety influenza every year.  Thousands of them, in fact.  Could this turn into a deadly pandemic?  Sure.  SARS could have as well.  But only time will tell.

My point is just this.  We should be careful cutting back on innovation.  We value our health, the lives of our children, the quality of our health-care.  We value them tremendously!  Innovation is good, as it saves lives.

It seems that cutting health-care dollars makes sense as long as the person doing the cutting isn't in danger.  Americans in large cities are freaking-out over every passing glance or brush of a Hispanic person.  Those Americans want the best of the best so that they can stay healthy.  Cutting costs is only good when you cut the money that other people spend. 

By the way, why are we worried?  Wouldn't some pandemic deaths cut the 'exploding population?'  Wouldn't it reduce green-house gases (after the initial wave of decomposition, that is)? 

Hmmm.  Maybe we aren't as over-populated as we thought.  Maybe, when faced with the possibility of death from something as mundane and insulting as 'swine flu,' even ardent human-hating, earth loving leftists are OK with the current population, and our general willingness to spend money to stay alive!

Edwin

We must be vigilant.  There is a movement in society to revoke the right of physicians to obey their own ethics and morals.  President Obama has already altered the conscience clause that HHS honored during the Bush Administration.  He say she won't change the right of physicians to follow their own beliefs regarding abortion.  But time will tell if he really continues to honor the deeply held beliefs of individual health-care practitioners, or if he once again caves to the radical-left interests that put him in power.

I had the privilege of sitting in the audience as Dr. James Dobson, of Focus on the Family, held a panel discussion on the Right of Conscience.  Here is a link to the broadcast.  I encourage everyone to listen and to contact their representatives in Washington about this critical issue.  http://www.citizenlink.org/dailybroadcast/A000009820.cfm

Isn't it odd that everyone has the right to do or believe whatever they want in modern America, unless their belief system is suddenly inconvenient?  Vegetarians aren't expected to kill animals for meat; atheist aren't forced to go to church; pacifists aren't compelled to carry firearms.  Each of these things might violate someone's sensibilities. 

But physicians might be forced to either perform or refer for abortions?  What utter madness.

Choice is important, right?  Unless your choice is the wrong one.

Listen to the broadcast and comments.  And be prepared to fight the battles of the future.

Edwin

The next four years will likely be a time of cultural battle over same-sex marriage.  Despite legislative victories like Proposition 8 in California,  it's likely that judicial fiat will overrule the desire of the people.  Worse, judicial rulings that overturn legislative bans on same-sex marriage summarily dismiss the ages old morality of West and East, as well as the learned morality and wisdom of the people.  The people, incidentally, who are considered unwashed, barbaric, judgmental masses when the vote the wrong way, but enlightened instruments of change when they vote correctly; in presidential elections, for instance.

But in contemplating all of this, I've realized something.  You see, there are often realities behind realities, and questions beyond questions.  And the question I have to ask is this:  if traditional morality is wrong, or oppressive, useless or outdated, then why the angst over same-sex marriage?  I mean this:  if homosexuals consider their activities to be morally reasonable because older forms of morality are outdated and pointless, then why does it matter if they are married or not?

Most persons, even most conservatives that I know, are willing to concede domestic partnership for the purposes of insurance, inheritance, next-of-kin, power of attorney and other such benefits and legalities.  Given that, why does it matter if a gay or lesbian couple is considered married?  Isn't marriage the domain of fundamentalists and right-wing conservative Christians?  And, even so, aren't we always reminded that even Christians suffer from divorces in their marriages?  Why does it matter at all?

I have a couple of ideas:

First, if national legislation deems same-sex couples married, then we all have to accept that legality.  If you can't win hearts and souls, you can always legislate acceptance, I suppose.

Second, if such occurs, and others speak against it, they will be deemed purveyors of hate speech.  So, tolerance of viewpoints and lifestyles will be ever-after a matter of fiat, not morality, not love, not true acceptance.

Third, and perhaps most controversial, everyone knows that old forms of morality aren't outdated and aren't worthless.  They are of inestimable value.  So, stricken with the internal dissonance that accompanies a lifestyle that is inherently in conflict with traditional morality and the traditional religions from which the morality springs, same-sex couples want to find a way to enjoy justification of their own lifestyles.  'Well look, I'm married, aren't I?  I'm moral, aren't I?  You can't judge me, can you?' 

Well, yes, we can.  We can love love them and must.  We can protect them from injustice and violence, for this is our duty for every citizen.  We can treat them as equal citizens, for they are and should always be.  But we can judge what we consider an immoral activity and we can refuse to approve of it by granting it legal acceptance.  This is not discrimination, but discretion.  And if it is discrimination, then we can no longer use infidelity as an argument in divorce proceedings, because all of the old moral orders that concern relationships and marriage will be apparently considered defunct.

So, the next time someone asks you about gay marriage, ask them this question:  'Why does it matter?'

I think it's a very relevant question.

 

I was at a local Oktoberfest celebration this past weekend.  It was a great mix of people, really.  Professionals and laborers, kids and adults, young and old.  It was just like the emergency room where I work.  It was a little slower than normal, possibly because of the economy, or the nearby Clemson University football game.  But it was still busy.

Looking around, I noticed something interesting.  Cell-phones were everywhere.  All over the field, adults, teens and smaller children were talking or texting on cell-phones.  Not just well-dressed people who obviously had money.  It was everyone, right down to muscle shirt wearing guys, Disney character wearing children, grandmothers, grandfathers and mini-skirt wearing high-school girls.

And it hit me.  How bad is the economy if everyone has a cell-phone, and obviously has an unlimited text-message plan?  Mind you, many of them would never even consider paying for health insurance.  The ones with nice phones come to my ER and say, 'my tooth hurts, but the dentist wants me to pay him, so I came here.'   Mind you also, many of them are seduced by the idea of 'spreading the wealth around,' as espoused by Sen. Obama. 

But with so many Oktoberfest celebrants smoking cigarettes, buying beer and using cell-phones, with nice trucks parked outside in the parking lot, I have to ask, 'just how bad is the economy?'  And then I have to ask, 'just how much change do you really want with the next president?'  Are things so bad that we need a change?  And what change will we get? 

(How about this change; instead of spreading wealth, let's also spread cell-phone minutes and text messages.  Everyone share, say 35% of their cell-phone time with someone who can't afford it.  If I suggested that at Oktoberfest, the results would have been worse than the rage I saw at 'line-cutting.' ) 

When cell-phones and their associated contracts can be the playthings of young people and the constant accessory of every adult, maybe things aren't so bad that we need a change anyway!

Edwin

For years now, I've been telling friends that I fully expect to land in prison one day; not because I knock over liquor stores, steal cars, cheat on my taxes or make inappropriate advances towards young ladies.  No, I'll end up there because I have the wrong opinions.  Take this post, cut it out and put it in the time-capsule.  Because we'll have political prisons in this country; probably in my lifetime. 

Why is that?  Because the freedom to express ideas is no longer valued by those on the political left.  Ironically, free speech was a traditionally liberal idea, in the old, noble meaning of liberal as something which advanced human liberty.  Now, free speech is an annoyance.  There are constant attempts to circumvent the 'wrong' opinions, whether through things like the fairness doctrine,  through 'speech police' on university campuses or as in other countries such as Canada and the UK, by calling unpleasant speech a 'human rights' violation and offering fines and imprisonment to those who speak out in unwelcome ways.  Read a bit about columnist Mark Steyn and his struggles in the Great White North,  read about the European and Canadian tendency to prosecute pastors who speak out against homosexuality from the pulpit; if you do you'll know that trouble is a-brewin'. 

'But isn't that extreme?  Political prisons in the land of the free?'  Not a bit.  The reason I know is that I have tried to have conversations or correspondence with ardent liberals, and the interactions often end in shouting, profanity and the ubiquitous, inflammatory word 'whatever,' on the part of the so called progressive. 

Well, if these folks come to power, do you think they'll tolerate engaging and enlightened dialogue?  No, they'll fine first, then censure, then call for re-education and ultimately, for those of us who are 'hard cases,' they'll imprison.  The reason being, 'tolerance' doesn't exist.  And since a good society can't 'tolerate' the wrong opinions, the only way to manage those opinionated folks will be to lock them away and deny them access to other more enlightened humans, or to media outlets. 

If you think I'm wrong, that's fine.  Maybe I'm just too paranoid.  But go to a group of liberals and tell them you don't believe in anthropogenic global warming, tell them you think abortion is murder and tell them you think that homosexuals should not be allowed to marry or form civil unions because it violates scriptural guidelines. Tell them that any sex outside of marriage between a man and woman is sinful.  Tell them that profit is good and socialism is bad; and that you have the historical evidence to prove it. 

Then sit back and watch the lather form.  They won't pull out texts or articles.  For all their scientific atheism and love of rational thought, they won't refute you calmly, or engage in 'dialogue,' over a glass of Merlot while referring to scholarly articles.  They'll fairly explode. 

When intolerance of another opinion becomes that vicious, the only way people (without a spiritual bed-rock of concern for human equality) can manage it is to shut it up and put it away. 

So, reserve my room in the prison.  I think and say all of the wrong things.  And eventually, as is already happening in modern democracies elsewhere, people like me will end up in deep trouble. 

At least I won't have to worry about whether I put away enough money for retirement!

Edwin 

I realized, not long ago, that the modern  hospital emergency department is much more than meets the eye.  Sure, it's the place where the severely ill and injured receive modern, timely care by well-trained professionals.  Obviously, it's the place where many Americans receive their primary care, due to their inability to pay, or their lack of insurance (voluntary or involuntary). 

And yes, it's the place where physicians and nurses wrestle the drunks, the drug abusers, the overdoses, the arrested felons with 'seizures,' and manage many of society's other problems when no one else wants to deal with them.  This includes looking after the homeless when shelters aren't available or willing, caring for the schizophrenic and suicidal when all the psych beds are full and they have no insurance (most of them, incidentally), helping with nursing-home placement for frustrated family members of demented elderly men and women; the list goes on and on.

And of course, let's not forget that the emergency department is the source of a huge amount of the illegal prescription drugs that circulate in America, thanks to modern medicine's acceptance of the already-tired dogma that we should always treat everyone's pain, and never doubt their story.

But more than all of these things, the modern emergency department is a kind of social sciences laboratory.  In fact, about 30 years into the existence of the specialty of emergency medicine, I feel comfortable saying that we have shown.with remarkable precision that the more radical social revolutions of the 20th century were abject, stunning failures.  And the reason I can say it is not based on carefully designed studies, or because I've observed it from the comfort of the ivory tower of academia, but because I, and many others like me, treat the casualties of those social revolutions day, after day, after day.  Some examples, you ask?

'Drug use is normal, good, relaxing and enlightening.  Only Puritans and other fundamentalists have any problems with drugs.' 

I see the scars from years of injecting heroin and methamphetamine.  I see the lifeless, pointless existence of heavy marijuana users, who don't have the inertia to do much of anything.  I see the agitated misery, heart attacks and strokes of cocaine users.  I see the endless somnolence of narcotic abusers who are 'hurting so bad,' even as they fall asleep begging for another prescription for Oxycontin, Percocet, Vicodin, Methadone, Morphine or whatever their narcotic of choice may be.  I see the shattered parents, the displaced children, the wounded spouses, the frustrated police officers.  I see the way they drain society of patience and money; and the horrible way their lives were ruined, when they could have been happy and productive.  Drugs are liberating?  I don't think so.

'Sex is natural and anyone who tries to limit sex is an old-fashioned prude; probably a Puritan or fundamentalist...see above re: drugs.'

Well, there's nothing more exciting and liberating than a fresh, painful case of herpes in a teen-age girl.  I just saw one.  She was in pain, and she was crying, and she knew that it would never be cured.  'Well, sure, but if she used a condom...'  If she used a condom, she'd still be faced with the reality that condoms are only 50% effective at preventing STD transmission.  She was 17 and had already given birth to one child.  Sex certainly liberated her.  See, in the emergency department we see the painful pelvic infections women endure, the infertility they develop, the mistrust between partners when one has an STD and another does not.  We see embarrassed young men with burning infections.  We see the depressed and anxious who are suffering from infidelity.  We see the unplanned, undesired pregnancies and the children left behind by infidelity.  We see those teenage girls with the exploding rates of STD's.  (Half of all African-American teen girls have a sexually transmitted infection.)

The mantra of 'free love' that began in the 60's wasn't about liberation; it was about enslavement to the desires of those who started it and who wanted no restraint on their behavior.  The echoes of that movement still sound today in the weeping of patients with non-lethal infections and the grief of those with HIV.  Nice work guys!  We're finally free from sexual restraint.  And more miserable than ever.  Not to mention the marriages broken by infidelity and pornography.  The 'liberated' women all but enslaved in the pornography industry, or trapped in lives of prostitution where they develop diseases, or are victims of violence, and eventually end up in the emergency room themselves, liberated from health and self-respect.

'The way to fix poverty is to give services, food and money to them, so that they will feel compelled to improve themselves.'

Well, sure.  Plenty of families need help.  I love helping them.  I don't care a bit when I don't get paid by a family in need.  But plenty of families are lazy; and have been lazy for generations, thanks to the welfare state.  We see them come to the ER en masse, an entire family with cold symptoms or insect bites, all checking in because 'we might as well, since we're here.'  They call ambulances for prescription refills but never do the things that might help them, like giving up cigarettes.   They over-eat, over-drink and under-move, all the while collecting welfare to support their obesity; disability for 'nerves' or 'anxiety' or some unverifiable pain, all the while working on cars, partying, hunting and having the physical capacity to make multiple children, all supported by the state, all supported by the tax dollars of the gainfully employed.  Their children?  Rarely are they ever taught that there is value to education, value to knowledge for knowledge sake, seldom are they aware that a home can be a place of hope and encouragement, progress and comfort.  Great idea; give people just enough to keep them from starving, but don't expect enough from them to let them lift themselves up from their low estate. 

'Families can be defined in any way, and frankly, men are entirely unnecessary except as 'sperm donors;' and how hard is that?'

Do you know why I see children who are anxious and afraid?  Do you know why children seek each other out for sex, and hafve children of their own at such a young age?  Because they are terrified. Why is that?  They lack the peace of safe and stable families.  They lack the boundaries and discipline, born of love, that proper families give.  They want the protection, wisdom, affection of a man and woman, together for the long haul.  Without those things, we see what we do; teen mothers, teen fathers, irresponsible parents shifting sexual alliances from week to week, month to month, moving in with lovers and moving away from them.  The children are circling in a whirlpool of pending disaster, and they know it.  They are depressed, fearful and lonely.  They have sex inappropriately for their ages; they use alcohol and drugs; they mark their bodies with tattoos and piercings, seeking to make themselves interesting, or beautiful, or acceptable to someone, since they don't have that acceptance at home, where the definition of family changes from week to week, fad to fad.  The ER is full of young people, and adults, who are so devastated by the lack of family that they can barely function.  Is family necessary?  Absolutely.  Are we just as well off without it?  Not a chance. 

'Religion is an impedance to modern thought, and we need to be liberated from it.'

Great!  Now, when someone's child is crushed in a car wreck, when someone's spouse is murdered, when cancer is discovered on a routine exam, when death comes suddenly and unexpectedly, you scientific folks go and comfort them with the knowledge that their loved ones will merely fertilize the earth for future generations.  What?  Too busy to hang out comforting the sick and dying?  Right, I understand. 
Well, how about the people who were from those broken homes, who were and are addicted, who lived as hookers and thieves, or the ones whose families were intact but unkind.  What about all of those who hear the voices that say, 'you're not good, you're worthless!'  What say you to them?  'Well, if you try hard enough, you may be worthwhile and do something useful.  Here are some financial handouts to help you along.  Take these pills and see a psychiatrist if you can afford one.'  How about this, for all those broken hearts I see day in and day out?  'The God of the universe says you're his beloved, and wants you to know that your sins are forgiven if only you'll accept the gift!  Your past will be wiped away, and you will be new.  It won't be easy, but the church will do its best to love you, and you can know in your heart that your heavenly Father adores you.'  That's better.  At least it offers hope without any request of performance, and without the fickle approval of human beings.

See, the ER is the laboratory where we have seen the truth.  And the truth is, America lost its way.   Read research from sociologists if you want.  Study academic journals over a cappucino.  Wax poetic about the masses and their struggles, about the judgmental 'religionists.'  Seek higher taxes as if money were the balm for all suffering.  Tell jokes about drugs and sex; watch some porn, smoke some pot.  Relax over a glass of wine and plan ways to make America even more free, more fair, more progressive.  But take it from a guy down in the mud, it's a hurting world; and hurt all the more by social revolutions that led, ultimately, to disaster; disasters seen with crystal clarity in America's emergency departments. 

Edwin

Today I was watching television and saw a 'celebrity fact' list; the kind used as filler on so much of the vacuous television that airs today.  It had to do with actor Will Smith.  It went something like this:  'Green Facts about Will Smith.'  It listed a few good things the actor had done, including donating to the Martin Luther King, Jr. museum.  None of the things listed had to do with the environment. Hmmm.

So I realized that I was witnessing the evolution of language; but unlike the theory of evolution, it was not an unguided, random process.  The word 'green' is being used to denote virtue.  Of course, it might just as well be the word 'purple' or 'bookshelf.'  But I see a trend; it isn't that you're green or purple, it's that you aren't.  If one is not green, one is not virtuous.  We know that to refuse to bear the banner of environmentalism leaves us branded earth fascists and nature-haters.  But who knows what will follow?  'He's not very green,' will stop meaning I don't recycle or drive a hybrid.  It will mean that my definitions of virtue are no longer valid.  It will mean that I have failed the modern tests of virtue by failing to adopt ideology and world-views that are considered good and wholesome by an entire generation (or series of generations) to whom virtue has nothing to do with Divine authority, the worth of mankind or any hint of objective truth.  I will be, initially, 'un-green' for failing in my duties to theearth and the non-human creatures and plants that inhabit it, as well as to the 'spirit' of earth that underlies the views of those atheists and agnostics who treat earth as a deity. 
 
But soon enough, I will be less than green for intolerance of gay marriage, support of absolute truth claims; for denying the right to abortion and unfettered sexuality of youth, and for ultimately denying the neo-socialist rhetoric that has young America, and much of old America, in it's red-gloved fist.

I'm not very green.  But I'm good.  And I refuse to accept that transformation of my language.  Green may be a political viewpoint.  And it's certainly a color I love.  But I'm not green.  Because when Kermit said 'it ain't easy being green,' he was more prophet than frog.

Edwin

I am a physician, as my bio says.  Modern medicine is driven by a constant barrage of 'evidence-based' medicine.  What this means is, researchers look at data on illnesses, injuries and treatment, and use statistical analysis to find the best evidence for the best practice.  The idea being, rather than practice based simply on personal experience, we use science in order to give patients the best possible opportunity to be healed, whole and well. 

This approach is fraught with some danger, for in many instances it becomes 'practice by authority.'  'Dr. Whatzit is at Stanford, and everyone knows those Stanford doctors are really smart, and so his idea must be right.'  Often, however, it does result in very good changes in medicine, that are more cost-effective and more successful.

However, the search for truth being what it is, I have to wonder about the future.   Barak Obama's theology suggests that one's search for spiritual truth is relative, and depends on one's own desires and interests.  He holds to a 'many paths to God' worldview.  This is comforting to some, and certainly easier to discuss at parties and political events.  But in terms of the search for truth, it leaves much to be desired. 

The problem is that Western man has decided, quite falsely, that there are two paths in the search for truth.  The spiritual one is more nebulous and ultimately less important, man now seems to say.  On the other hand, the scientific one is critical, holds the key to the future of humanity, and is objectively attainable.  However, our ancestors knew that the search for truth was all part of one effort.  As science increasingly suggests, many of the things we innately believe are right, or believe are right based on spiritual traditions, are in fact scientifically confirmed.  The big-daddy of all of these things being the discovery of the 'Big Bang' theory of cosmology, which reflects the words of Genesis.  'In the beginning, God created the heavens and the earth.'

So where does the search for truth go?  If post-modern man accepts the relativistic view of spiritual truth, how long until he accepts the same about scientific truth?  Well, it's already happened.  Progressive scientists are always willing to 'follow the truth wherever it leads;' until, that is, it leads to a church door, a piece of holy scripture, an unpopular scientific finding or anything that isn't consistent with the tenets of the progressive faith. 

Science is intrigued by the wonders of homosexuality until we see that homosexual men have remarkably shortened lifespans. We aren't to discuss that.  Science tells us that men are naturally polygamous in order to 'spread their genes.'  Science is silent on the cultural disaster of fatherless homes. Science thinks abortion is perfectly safe and healthy, until it finds increased suicidality, subsequent fetal demise, or increased cancer rates in women who had abortions.  Science is also silent on the genocidal nature of abortion among blacks, which is, incidentally, the exact effect desired by Margaret Sanger, patron saint of Planned  Parenthood, who was a racist and eugenicist.  Science knows we need energy to make life better; until it may involve nuclear power, or anything other than wind, wave, solar and geothermal. 

Our leaders increasingly appease those of differing opinions, because 'everyone's truth is their own.'  And even our scientists are willing to avert their eyes from 'truths' that annoy. 

The future of truth, in the West and in the world at large, is in peril.  Because if we don't care, and if there is no objective truth, what's the point in science at all?  And who will define right and wrong?

It may seem glib for a presidential candidate to offer the option of many truths being equal.  But it reflects a larger disdain for truth; or at the very least a larger sense of intellectual sloth and cowardice.  As inheritors of the culture most concerned with truth in the history of all the wide world., we should be petrified. 

Edwin

Tonight our church started its annual Vacation Bible School. It's a long tradition in Christian churches, with many different faith traditions doing something similar. Catholic to Presbyterian, Lutheran to Pentecostal, Methodist to my own Southern Baptist, we all like to take a little time in the summer, when the kids are out of school, to educate and evangelize them.

My own memories of VBS go back to the church where I grew up, South Side United Methodist Church, in Huntington, West Virginia. The memory tastes like grape Kool-Aid, heavy on the sugar; it tastes like potato chips and sugar wafers. It sounds like the balls thrown back and forth in the good-old-days of dodge ball. It feels like the towel we brought to nap on when I went to VBS in first grade.

It was a lovely thing; a holy, tender thing. The layout of the church is still in my mind, though I am taller and older. I could probably find the very rooms where I first learned the ancient stories of my faith. I wonder, if I walked through them, if I wouldn't somehow fall back through time, if only briefly, and feel the safety of my childhood in that great red brick building. They're tearing it down, you know; some of my past will collapse in the rubble.

But VBS remains. The lessons planted in my heart grew and bloomed. I walk in the path I was taught. My children attend VBS the way I did, and the way my wife did as a child. Tonight, she taught kindergarten kids in a room decorated with 'island' colors, cardboard birds, beach balls and a giant, inflatable monkey. My oldest, Sam, who is 13, helped his mother herd the little ones back and forth to different crafts, snacks, lessons and to me, where I helped organize games in the gym. The men I was with all guided the children through obstacle courses and let them play volleyball. We gave them bamboo poles to carry in a kind of relay. We laughed as they spun around, dizzy, and fell down smiling.

And I realized what a precious time it is. You don't have to be a Christian to see the value of men and women giving their time to children. The many children who attend the church were there. But there were also children from local neighborhoods who road the church bus for lessons, snacks, or simple diversion from difficult lives and situations.

What all of them saw was a group of youth, women and men in bright green shirts, wearing flowers and captain's hats, acting silly, dancing and singing and smiling at them. What they saw was a group of people exhibiting interest in the children by offering them fun, insight, faith, hope and a framework for their lives.

I see the value of it. Oddly, I used to feel a little uncomfortable evangelizing children. Not anymore. I've seen the children of wrecked world-views. I've seen the children with empty eyes. I've seen the children of disease, abuse, drugs and alcohol. And I know that, without any doubt, the evil things of the world evangelize them with a passionate fervor.

Hopelessness, nihilism, cruelty, promiscuity, drugs, alcohol, violence, abuse, every negative thing in the world hides itself in flashy images on television, or in classrooms, in the lyrics of music or in the ideals of a political party. The children of the world are constantly, shamelessly evangelized to grow up too fast, to ignore their families as irrelevant, to seek the solace of name-brands, money and fame. They are preached the gospel of success along with the gospel of self-loathing. You don't have to agree with my faith to agree that we need to offer the children something more than all of that.

At Vacation Bible School, in a medium sized church in a little town in South Carolina, we're evangelizing. And I'm OK with it. I hope the children come away with their own memories, like mine. Memories of diet soda, pizza, trail-mix, silly hats, smiling faces, ridiculous games and a place where they were taught, by adults and young people, their inestimable worth in the eyes of the Creator.

Those are memories worth having. Just like my own recollections of grape Kool-Aid.

Edwin

I'm an emergency physician.  I have spent a huge portion of my life taking care of sick and injured people, and trying to help them through life crises like suicide attempts, psychotic breaks, homelessness, alcoholism and drug addiction.  As such, I'm always intrigued when politicians tell the country how interested they are in fixing health-care, caring for the sick and meeting the needs of the most down-trodden.  Because my partners and colleagues and I have been at it for a very long time, and remarkably, we never have any 'after-hours' numbers with which to contact caring politicians or policy-makers.  Heck, we never have any numbers to call during regular business hours.  I suspect that the heady business of fixing America's health-care crisis, and managing America's inefficient, unsafe, uncaring, rapacious physicians must require oodles and oodles of meetings, working lunches and happy hours, so that the bulk of caring for the sick is left to the aforementioned uncaring doctors like myself.  Oh well, it's a burden we'll just keep bearing until politicians and policy wonks swoop down and fix us good and proper.

But there is some striking evidence that it isn't only politicians, but the entire progressive movement, could really care less about the health and well-being of human beings.  And that lies in the reality of their typical platforms.  For instance, their insistence on fixing 'the system,' rather than the individuals.  Their willingness to sacrifice individual freedoms and choice for 'the good of the country.' And more particularly, their uncaring attitude about specific issues.  When DDT was banned, and untold millions of Third World persons died fo Malaria, the typical response was like the one I got from an ardent liberal:  'But if we hadn't done it, we'd have had less beautiful African animals!' 

Of course, a common mantra of the progressive left is that assisted suicide is a great thing!  Let's allow some old folks to go ahead and die!  It's good for the economy and good for the environment, right!  Wait and see how assisted becomes suggested becomes mandated if we develop a single payer system of health-care.  Then it will be our duty to die, right?  After all, it will be good for the country and good for the earth.

How about abortion, in which one million children are killed in the womb, or in the birth canal, every year?  The culture of life is really a culture of death.  Let's look at drugs.  For as long as I can remember, the left considered free, open drug use a societal good, while nasty fundamentalist, moralist nasties wanted to make the world a black and white drag.  I've seen drug abuse.  I've seen the pain and hopelessness in the eyes of men and women who wanted to die to escape their addiction, and the sorrow in their parents' faces.  It isn't cute or fun.  It's horrible.  What about HIV and other STD's?  As one liberal put it, when I said that 50% of African American teenage girls have an STD, 'well, isn't most of it just HPV?'  Yeah, the one that causes cancer deaths.  Liberals would rather cut off their own body parts than suggest that gay men have shortened lives due to diseases like HIV, or that promiscuous behavior results in HIV,  HPV, Herpes and other diseases leading to pain, infertility and death.  Death is OK, if your worldview is intact, it would seem.

The left has always been opposed to censorship, preferring the fantasy that pornography is a healthy choice of career that free-minded people engage in, unencumbered by the moral fabrications of religious oppression.  But it appears, more and more, that those who are engaged in the sex industry often are victims of what amounts to a lifetime of abuse and assault, often begun in childhood.  Do diseases and depression, drug abuse and suicide, infertility and dysfunction arise from that life?  You bet.  But does the progressive left care about that misery?  Not if it conflicts with 'freedom,' free love and their view of the world, they don't.

And what about energy?  If people can't drive to work to pay their bills, or engage in healthy lifestyle activity like health-care visits, so what?  At least the environment is safe.  And let's face it, in the end, the death of humanity is what most good liberals really want.  Well, except for them.  The death of annoying conservatives, brown people, drives of SUV's, religious nuts and anyone who opposes free love, free drugs, abortion and the gay agenda.  The death of those people would be good for earth, right? 

The left, far from caring about the health and safety of America or the world, could care less.  Their opposition to war is a joke; an enormous irony.  Their posturing about health reform, or even the environment, is nothing but that; posturing  Their worldview is a culture of acceptable death; of everyone else

Excuse me while I go back and try to save some more lives.  It's nasty, and it involves touching humans and learning to love them and even mourn them, but hey, somebody has to do it.  Maybe I'll catch a disease or be stabbed, and clean up the environment by dying in the process!

Edwin

I'm an emergency physician.  I have spent a huge portion of my life taking care of sick and injured people, and trying to help them through life crises like suicide attempts, psychotic breaks, homelessness, alcoholism and drug addiction.  As such, I'm always intrigued when politicians tell the country how interested they are in fixing health-care, caring for the sick and meeting the needs of the most down-trodden.  Because my partners and colleagues and I have been at it for a very long time, and remarkably, we never have any 'after-hours' numbers with which to contact caring politicians or policy-makers.  Heck, we never have any numbers to call during regular business hours.  I suspect that the heady business of fixing America's health-care crisis, and managing America's inefficient, unsafe, uncaring, rapacious physicians must require oodles and oodles of meetings, working lunches and happy hours, so that the bulk of caring for the sick is left to the aforementioned uncaring doctors like myself.  Oh well, it's a burden we'll just keep bearing until politicians and policy wonks swoop down and fix us good and proper.

But there is some striking evidence that it isn't only politicians, but the entire progressive movement, could really care less about the health and well-being of human beings.  And that lies in the reality of their typical platforms.  For instance, their insistence on fixing 'the system,' rather than the individuals.  Their willingness to sacrifice individual freedoms and choice for 'the good of the country.' And more particularly, their uncaring attitude about specific issues.  When DDT was banned, and untold millions of Third World persons died fo Malaria, the typical response was like the one I got from an ardent liberal:  'But if we hadn't done it, we'd have had less beautiful African animals!' 

Of course, a common mantra of the progressive left is that assisted suicide is a great thing!  Let's allow some old folks to go ahead and die!  It's good for the economy and good for the environment, right!  Wait and see how assisted becomes suggested becomes mandated if we develop a single payer system of health-care.  Then it will be our duty to die, right?  After all, it will be good for the country and good for the earth.

How about abortion, in which one million children are killed in the womb, or in the birth canal, every year?  The culture of life is really a culture of death.  Let's look at drugs.  For as long as I can remember, the left considered free, open drug use a societal good, while nasty fundamentalist, moralist nasties wanted to make the world a black and white drag.  I've seen drug abuse.  I've seen the pain and hopelessness in the eyes of men and women who wanted to die to escape their addiction, and the sorrow in their parents' faces.  It isn't cute or fun.  It's horrible.  What about HIV and other STD's?  As one liberal put it, when I said that 50% of African American teenage girls have an STD, 'well, isn't most of it just HPV?'  Yeah, the one that causes cancer deaths.  Liberals would rather cut off their own body parts than suggest that gay men have shortened lives due to diseases like HIV, or that promiscuous behavior results in HIV,  HPV, Herpes and other diseases leading to pain, infertility and death.  Death is OK, if your worldview is intact, it would seem.

The left has always been opposed to censorship, preferring the fantasy that pornography is a healthy choice of career that free-minded people engage in, unencumbered by the moral fabrications of religious oppression.  But it appears, more and more, that those who are engaged in the sex industry often are victims of what amounts to a lifetime of abuse and assault, often begun in childhood.  Do diseases and depression, drug abuse and suicide, infertility and dysfunction arise from that life?  You bet.  But does the progressive left care about that misery?  Not if it conflicts with 'freedom,' free love and their view of the world, they don't.

And what about energy?  If people can't drive to work to pay their bills, or engage in healthy lifestyle activity like health-care visits, so what?  At least the environment is safe.  And let's face it, in the end, the death of humanity is what most good liberals really want.  Well, except for them.  The death of annoying conservatives, brown people, drives of SUV's, religious nuts and anyone who opposes free love, free drugs, abortion and the gay agenda.  The death of those people would be good for earth, right? 

The left, far from caring about the health and safety of America or the world, could care less.  Their opposition to war is a joke; an enormous irony.  Their posturing about health reform, or even the environment, is nothing but that; posturing  Their worldview is a culture of acceptable death; of everyone else

Excuse me while I go back and try to save some more lives.  It's nasty, and it involves touching humans and learning to love them and even mourn them, but hey, somebody has to do it.  Maybe I'll catch a disease or be stabbed, and clean up the environment by dying in the process!

Edwin

Today I was teaching sunday school, where the topic was 'how can a good God send people to hell?'  As I was preparing for the lesson, I realized that one of the great objections modern men and women have to the Christian faith is that Christianity is about punishment and guilt, and as such, isn't any fun and is obviously droll and untrue.  Real people don't need to be punished, because they know they haven't done anything wrong.  Or so the logic goes.

As I considered all this, I realized that hell is entirely reasonable because everyone wants to be punished.  It's true!  In fact, punishment is a basic tenet of modern liberal thought.  We must be punished, the rationalization goes, because we have to much, use to much, own too much, judge too much, hate too much, eat too much, use resources too much, are too free, talk too much about taboo topics, etc.  The list goes on and on of the things for which we should be punished.  How are we punished?  Taxes, laws, programs, political correctness, intellectual and social banishment for speaking truths that violate proper thought, in some cases physical assault, and of course the over-arching punishment that can never be taken away, constant guilt. 

Modern man is overwhelmingly guilty...or rather, feels that he is.  Modern man is guilty about all of the things I listed above.  Modern man feels guilty for his very existence.  And so, punishment is in order.  Populations have to be limited.  Food has to be distributed fairly.  Incomes have to be confiscated. Children have to be aborted.  Children have to be given over to dark gods of sexuality and drugs because 'they'll do it anyway, everyone does!'  Modern man offers sacrifices of his joy, his money, his family, his ethics, his freedom and his very humanity on the altar of unrelenting guilt, which can never be atoned except by more work, more giving, more guilt, more surrender of every freedom of heart, soul, mind and body.

Hell?  Well it is punishment, though a punishment for which God provided a pardon in Christ.  But if modern mankind thinks that hell, or punishment itself, is a uniquely Christian invention, then modern mankind is dead wrong. 

Mankind has always wanted to be punished.  They just refuse to accept the deliverance from guilt that is available from our Father.

Dr. Deacon