Friday, January 27, 2012

Who Is It Still OK to Hate?

by Jon Cleland Host

Already now in January of 2012, at least two incidents of religious disagreement have brought our focus away from the long term trends we looked at in our review of 2011.  

Just last week, the months long effort by Jessica Ahlquist to have a religiously exclusive prayer banner removed from her public high school culminated in a judge ordering the banner’s removal.  

As news of the legal decision came out, she was reminded that atheists/non-believers are still one of the most discriminated-against groups in America: local Christians flooded the facebook and twitter accounts of this 16 year old girl with threats of rape, torture and murder. (See: “Religious Banner Opponent Jessica Ahlquist Stands Tall Despite Threats)

Even her state representative joined in, calling her an “evil little thing”.

This kind of human ugliness is disgusting to watch, but at least no actual violence has erupted yet.

In a similar vein, across the pond in Great Britain, 17 year old Rhys Morgan posted a relatively benign image of Jesus and Mohammad to support freedom of speech. The response was immediate and similar, with threats of violence from both Christians and Muslims. Unlike Jessica Ahlquist, this time the religious bullies won, with Rhys removing the image after his school threatened Rhys with expulsion.   

We are only a few weeks into 2012, and we already have seen these incidents.  Being an election year with a likely Mormon candidate, and a whole world moving forward with greater communication, more are likely on the way.  

Seen close up, with baby steps forward like the banner removal, or others being steps backwards (as in Great Britain), it is easy to be discouraged.  However, a wider view of their place in the overall trends of our world gives more hope.  

From the dawn of human consciousness (indeed, from before that!), we’ve seen ever widening circles of care and concern. Consider: Long ago, all of our ancestors (anywhere in the world) were first concerned only with their kin and local band, then with the larger tribe, then with those who espoused their same religious identity, and outward from there. 

People today fall on that spectrum too, but overall, the trend toward wider circles of care has been inexorable. (Just compare today with 1950, or 1900, or 1095, or earlier.)  It is our great privilege to be participants in this form of social and moral progress – to be able to contribute to this growing love by remembering that all people are brothers and sisters, and acting accordingly.  

In addition to the testimony of our daily actions in how we treat others, we sometimes have the opportunity to directly be involved in this history in the making.  For instance, we can directly thank Jessica for her bravery, and help show her that there are many people in the world who stand with her on the side of inclusion. How? By contributing to a college scholarship fund that has been established for her, here.

As 2012 unfolds, may we each begin to see opportunities for playing even a small part in the ongoing realization that all of us are an important part of the body of life on Earth, and that we are all on the same team, forging together a just, peaceful and sustainable world of the future for everyone.  Together, we are making progress — as a wider view shows. (See Steven Pinker's fabulous new book, The Better Angels of Our Nature: Why Violence Has Declined, if you need to be convinced on this point.)

By Jon Cleland Host, posted on January 27, 2012, by . . .

Friday, January 6, 2012

How Doctors Die: An ICU Nurse Responds

Note by Michael Dowd: A week ago a colleague sent me a link to an obscure blog that had “gone viral”:

“How Doctors Die — It’s Not Like the Rest of Us, But It Should Be"

Tremendously moved, I decided to do my part in spreading this sobering news and vital perspective. One of those who received my email was a young nurse, newly certified for working in the Intensive Care Unit. Below is her response (slightly modified for confidentiality).

Her story brought me to tears of joy and gratitude when I first read it. May there be ever more nurses with the training, the courage, and above all the heart exemplified by this unheralded young hero.


Response by a young “Intensive Care Unit (ICU)” nurse:

Thank you so much for this timely article. Only two months ago I participated in an "End of Life and Palliative Care in the ICU" class, where I was genuinely moved/tormented by the suffering my fellow nurses and I are surrounded with in the ICU.

A peaceful, gentle death is so valuable — and so rare.

I recently cared for a young adult cancer patient at the end of her life.  She came to the ICU after having a bone marrow transplant to deal with the "pre-leukemia" she had developed, owing to an aggressive chemo regimen initiated several years earlier for her breast cancer.

By now, her whole body had deteriorated to such an extent that she required a mask that forced air into her lungs in order to oxygenate.  She spent two weeks in our hospital’s ICU, with her lungs progressively worsening.

All the nurses knew she was not going to leave our unit. But her oncologist kept telling her to “fight it out!”

Finally, and this was on my shift, with her parents at her side, “Gloria” (the name I'll use) finally said that she just wanted the pain to go away.

Suddenly, everything changed.

I had just brought into her room her evening meds — literally thousands of dollars worth of antibiotics and anti-rejection medications.  None of it mattered anymore.

I took down all the unnecessary tubing, started a morphine drip and administered Glycopyrrolate (which dries secretions and softens the "death rattle").

This felt massive to me. I remember this mix of emotions: sadness, relief, and an overwhelming sense that I was a part of something huge.  I still cannot wrap my head around it.

I was able to help transition one profoundly suffering human being from a regimen of “Come on! Power through! Endure, endure, endure!” to, “It’s okay, Gloria. You fought so, so hard. Now close your eyes, let your pain fade, and rest.”

It was beautiful.

Gloria died the following day — not on my shift, but I felt so happy that I had been able to share the transition with her and her parents.

To think of everything we had put this woman through in hopes of an inaccessible cure is just ... sickening.

Medicine has gotten to the point where we've gone as far and as invasive as we can go. I wish people — both we professionals and the public at large — would begin to prioritize a dignified death above all.

Family members need to know that there is far more beauty in spending quality time (rather than simply a quantity of time in the hospital) with their unalterably disabled and ultimately incurable loved ones.

Sadly, when family members must make medical decisions, too often those decisions are influenced by a subconscious need to palliate our own emotional suffering. As well, an irrational fear that we will otherwise be guilty (or at least will feel guilty) spurs good people to say “yes” to absolutely every intervention that forestalls death.

Though I wish everyone could die at home surrounded by love and comfort, I know it is the nature of those battling cancer to often push themselves far past their ability to survive the journey home.

It is my duty to honor this incredible fight and allow them to pass peacefully, without pain — and to let them know that accepting death is the greatest victory.  

~ by an ICU nurse, posted by...

Wednesday, January 4, 2012

2011: An Evolutionary Retrospective

by Jon Cleland Host

Compared to our 13.7 billion year history, not much changes in a single year, right?  While that’s true, we can place the changes we’ve seen in the context of an evolutionary perspective - that grand saga of life, which has given us our world. 

On the grandest scale, the Universe continues to expand.  The most distant galaxies are rushing away from us at a blistering speed of over 100,000 miles every second, putting them 3 trillion miles farther from us than just a year ago.  And while we don’t know of any life outside of Earth yet, we have discovered many hundreds of extrasolar planets, most of them discovered in 2011 by the Kepler mission.  Much closer to home, our Sun has become more active, ramping up into the coming solar maximum, and sparking huge Northern Lights this past October 25th.

Our Earth is a planet that has brains, eyes, and the internet, and is a planet that has intentionally launched parts of itself into space.  In November, the most advanced probe to Mars ever made (the Curiosity rover) lifted off flawlessly, showing our continued advancement.  Also advancing, our global connections have greatly increased with at least tens of millions of new internet connections and new wireless hotspots in 2011 (if we have millions of both in just Great Britain, the worldwide total is easily in the tens of millions).  Whether or not this qualifies as a global brain yet is another topic for another day, but our progress is rapid, and who knows what the results will be in the future?  One possible result of our interconnections so far has been the 2011 Arab Spring.  Another has been the information explosion, with as much text written every few days now as humans had written in their entire history up to 2003, and more text written in 2011 than in any other year in our history.  Hopefully this information processing will help us handle the problems of the future, both expected and unexpected.

And we moved toward some of those problems in 2011 as well.  With 134 million new babies born in 2011, the world population continued to increase.  That many births means more mouths to feed, as well as a billion or more new mutations in our gene pool – most being neutral, some harmful, and some beneficial.  (Estimates of the mutation rate per generation in humans varies widely, so I used a very conservative number of around 10.  Some evidence suggests average mutation rates well over 100 mutations per birth.)  With natural selection reduced by our technology, the harmful ones are more likely to increase healthcare costs, and the beneficial ones may fail to spread to everyone.  It will be another challenge for future generations to figure out the best way to handle this constant mutational drumbeat.  That issue won’t really need to be faced for a while, especially compared to our unsustainable energy habits.  In 2011 we burned enough fossil fuel to add about 10 billion metric tons of carbon to the atmosphere, carbon that has been buried underground for millions of years, and now will contribute to global climate change.  Similarly, the rapid extinctions we are causing continue, with both headline losses like the Western Black Rhino, and the loss of at least hundreds of species in 2011, many before they could even be named by science.  Religious based hatred continued in many incidents, including the slaughter of dozens of teens in Norway by a person who wished to “return Europe to its Christian roots”.  Worst of all, I suspect that the majority of humans on our planet are unaware of the threat all of these are posing to our future generations, among so many other threats as well.    

There are also reasons for hope.  The information explosion mentioned earlier may bring the powerful force of our collective creativity to bear on these problems, before they are insurmountable.  The Arab Spring may have helped millions of people move from tyranny towards democracy.  The occupy movement in the United States may be partly driven by concern for future generations, and in 2011, the level of human concern for future generations appears to already exceed that at any point in our history.  Our circles of care continue to expand in many areas, one of which was shown by the repeal of the Don’t Ask, Don’t Tell policy.  Human action in 2011 also gave us a higher use of sustainable energy sources, like wind and solar, than has ever been seen.

Of course, this review of our evolution toward a just, peaceful and sustainable world surely misses a lot, even the most important points.  In addition to the events I simply forgot to mention, many of the most important events of 2011 are likely unreported in the news.  For instance, did millions of teens begin to see our place in this Great Story, and their role in crafting the future, in 2011?  Were there elementary kids who learned the basics of science in 2011 who will go on to use that understanding to find a cure for cancer, or a new solar cell technology decades from now?   We can’t know, but we can trust that this pulse of life, which has overcome even deadlier threats in the past, continues to surge now, in us, at the start of 2012.  May we each do what we can to live up to our potential, for ourselves and for future generations.

In hope - Happy New Year!

~ Jon Cleland Host