Clinical Trials

In the last 150 years, biological understanding has increased tremendously. Much is understood at the molecular level. Statistics on detailed populations and outcomes are massive and readily available. A doctor from the 1800s would be astonished .

Yet we cling to ancient rituals, reinforced by old legalities. Once upon a time “clinical trials” made great sense. They were truly a “gold standard” not only at seeing if something worked, but also if it caused harmful side effects .

True clinical trials required “equivalent groups”, one that receives treatment, one that does not. This is quite cumbersome and expensive – and for that reason is embraced by the pharma industry as a barrier to entry.

In fact with the modern state of knowledge and history, the “control group” is no longer necessary. There is a long detailed chart of what happens to those not treated. There is also a much better idea of what will happen because scientists understand mechanisms and do testing on animals .

Clinical trials have become an annoying barrier to progress. New remedies can be tested on those in need of them, with no necessity to subject another select group to the false hope of improvement .

Literature

An editorial in WSJ told young men they should read more fiction. Broaden outlooks, deal with inner complexities. A different editorial, written by a wealthy young twerp, advised that one’s 20’s should be completely devoted to the task of “becoming a billionaire”, after which, presumably we can live a decent life .

Spending one’s twenties (or any other decade) in a narrow obsession is madness. Believing one is in absolute control of the future is an immature fantasy. Perhaps literature is an antidote to that, or at least a window on alternatives. But there are other ways – falling in love, laughing with friends, having adventures. The list is of course endless .

We currently have made heroes of the wrong people. Life is a gift, not a test. It can only be “won” by living it fully and in balance. Hiding in an obsessive foxhole and thinking you are in charge of your fate will only earn scorn. And, of course, the premise is wrong. Reaching a goal does not mean the rest of your life is taken care of .

We all learn that eventually, unless we damage ourselves too much. Usually, such wisdom and reflections take time and effort. Literature, particularly fiction, offers a shortcut .

But the young rarely take the advice of the old. They know better .

I pity them .

Shrinking

Roman and Greek morality looked back at an imagined golden age in the past and sought to emulate its heroes. A massive outlook change in Western culture (maybe science, industrialization, Christianity, or phase of the moon) had us looking at imagined futures instead.

There is now little respect for those who do not plan future growth. Yet I’ve been shrinking physically for some time now, shorter by at least an inch. My mental agility is declining. As I passed through my ’70s energy waned, senses were less sharp, memories became more important. I accepted that as natural, but society does not .

Young “whippersnappers” tell elders how active they should be, how they must engage in hobbies, how they must struggle to be better. Apocryphal tales speak of “old” people suddenly starting companies and becoming wealthy (although the definition of old seems to be creeping downward into the ’40s …)

In my newly engaged art pastime., I’ve decided to do away with future marvels. I simply want to use my reduced situation – senses and skills – as valid restrictions to construct unique artifacts. If my sight is blurred, let my drawings also be so. If my hand shakes, utilize that in my lines .

Not to get better in the future. Just to enjoy being a shrinking being as much as I possibly can .

Lost Words

Young people tend to have nightmares or fantasies about old people (to be fair, old people reciprocate.) It is usually annoying to read “youngsters” giving us irrelevant advice, writing ridiculous entertainment scripts about elders, or solemnly discussing our plight.

It is true we have slowed down and become more careful. (But hardly so slow as the memory medicine ads would proclaim.) It is usually true that we gradually lose our taste for grand adventures – adventures occur all around us all the time, sometimes as simple as going to the store. We remain fully human, but (in spite of protestation) not as we were at 30 .

I feel a gradual degradation, which I accept (as I must, since – in spite of those ads for expensive medication – it is inevitable). Perhaps the most annoying are the constant little gaps in mind and memory. Particularly nasty are the constant stream of “lost words.” I know exactly what I want to say, know there is a word for it, know I know there is a word for it – but nothing but blank .

That clues me into other patterns I may not be quite aware of. Reflexes, adjustment to light changes, peripheral vision, and on and on .

In fact, what most amazes me in the whole process is how much I used to have, how much I can lose, and how I nevertheless remain me.

Almost Right

People like to seize on the clearest and simplest explanations of phenomena. Things fall to earth because they “want to be nearer to it”. The Earth is flat. Those explanations are, actually, almost right. They are good enough for everyday life. They only fail if one is trying to predict something or control it. Malaria was associated, rightly, with bad air and swamps. Which just happened to also be filled with disease carrying mosquitoes. Avoiding the bad air in season almost worked very well. But it was useless for an eventual solution which required either draining or spraying the swamps.

I’m reminded of this with the MAHA fanatics, who once again want clean, simple explanations to complex problems. They point out that “science was wrong” in believing that COVID 19 was spread by infected air particles (largely able to be stopped by masks) when it was actually conveyed by tiny free floating viruses (against which most masks were useless). MAHA doesn’t believe science should ever be wrong _ if science gives incorrect advice it’s because scientists have nasty secret agendas .

Probably science has become much too complicated for most of us to understand. And it is still notably wrong or incoherent or provisional in many matters of health. So if flat earth and bad air were good enough for our grandparents, folks are sure they should be good enough for us .

Father William

“You are old, Father William…” (look up the Lewis Carroll poem if you don’t know it.) It pretty well captures my outlook and that of many of my more sane friends .

Young people think a variety of things about their elders. It’s natural, we did the same thing years ago. In some ways they revere what we have done, they think we have accumulated wisdom and gained perspective. In other ways they know we are irrelevant, stubborn, and often irritating, not to mention completely out of touch. All true .

But the key – as in the poem – is silliness. Elders can hardly take the future seriously (those of us who do so are the worst enemies of civilization.) Old people should be irrelevant to everyone but their immediate family. Our knowledge is vast and hard won, but hardly applicable to various modern crises. We enjoy our personal shell and bubble, but are well aware of how fragile it is. It won’t last very long …

So Father William jokes a lot and seems out of touch and a little sly. And yet – my days are joyful and my worries more immediate than they used to be. I think that attitude is appropriate for my age. But, of course, I would think so.

Fear

Fear or its equivalent is instinctually hardwired into most animals. A deer may not experience “fear” as we know it, but certain perceptions of sight, sound, or smell will provoke a flight response. Humans seem to inherit the whole range of abilities to be afraid of various things and provide actions to avoid or deal with issues .

A problem is that our overactive brains can invent many things to fear. Some are real – will that approaching car hit us? Some are imaginary – does that creaking tree contain a malignant ghost? It is useless to talk about rationality, because all fear is only probability, and my mind can manipulate anything to appear rational (at least to me) .

“Paralyzed by fear” is a real thing, often transmuted to “enervated by fear”. Today there are such fears everywhere, focused by attention-grabbing media or sales provocateurs. If we listened to them all, we’d never leave the house. We’d be deeply worried all the time anyway .

I think the greater danger is that all the minor trivial fears desensitize us to real problems. We have to learn to ignore so much that we cannot recognize something we really should do something about .

Like that deer caught in the headlights, we never react to the sound of the rifle being cocked. Our entire civilization is now paralyzed by the onslaught of the internet .

Face Value

Someone who accepts anything at “face value” is considered naive and shallow. We have been taught from the cradle that everything is complex, nothing is exactly as it appears, and if you trust your first impressions you will be in trouble .

A certain amount of cynicism is probably healthy. “Face value” is often only one aspect of anything. But – and this is the most important fact – it is usually the most important and obvious facet of anything. In many cases face value is all we need to judge things. A healthy looking apple is probably a fruit that is good for you. Something that quacks and looks like a duck is probably a duck .

One reason that everyone is so worried and nervous could be that they cannot take anything for granted. Maybe that apple is poisoned, or is overpriced, or represents terrible labor practices or elimination of nature or … Maybe that duck is really a clever robotic bomb. There is no end to the fractal, increasingly minor and implausible qualifications and contradictions .

And yet – we mostly exist at the level of “face value”. Sometimes it is a good idea to simply accept things as they appear to be, to not dissect them too deeply. Life and consciousness after all, are limited. Pursuing below face value may cost us much of our precious time, our happiness, and our sanity.

Like Sleeping Beauty, I’ll probably take a big bite of that delicious looking apple while the duck looks on and the hell with it …

High T

Ponce de Leon is alive and well! The fountain of youth (for men) has finally been discovered! More testosterone will make them young, vigorous, sculpted, sexy and – of course – much happier than they are .

It’s natural! (So is arsenic.) Pay no attention to those doctors behind the screen muttering about side effects. It’s your life! Make it better !

This culture lives on advertising. Usually I enjoy the commercials and realize that most people have been immunized enough by constant exposure to retain a degree of skepticism. Even when I grew up long ago, comic books had full page ads on how Charles Atlas could help you fight off bullies kicking sand in your face .

Ah, but bodybuilding requires work. Curing “low t” is just a matter of taking a pill or enduring injection. Just like drinking from the fountain of youth. Hey, this smiling face promises, and he looks pretty honest .

We have become a culture looking for easy solutions, maybe because we have little time or energy for complex ones. Slogans to fix social problems. Pills for physical issues .

Hope, if not exactly a fountain, springs eternal.

Infanticide!

There, that got your attention! And such is the real purpose of shock words these days – to condense a slur, rally a slogan, and sometimes promote a hidden message. I remember when students would shout “hey hey LBJ, how many kids did you kill today .”

Some issues are tangled, mysterious, insoluble. Abortion and women’s rights _ or potentially crippled-child rights _ is one of the toughest. Definitions are almost impossible. The world refuses to be solved .

For the record, I am in favor of all children, everywhere, being born normal, healthy, and into circumstances where they are well cared for until their late teens. For the record, in our real world, even if babies are born normal and healthy, society often lets them die or suffer from neglect, starvation, war, disease, or other violence. And genetic luck guarantees that many embryos do not produce normally healthy babies. It used to be far worse – nature was never kind .

But “baby killer” is an effective slur. Nobody wants to be so labeled. The problem is that those who use it are – like those anti-war demonstrators – really pursuing a deeper agenda One in which it is the duty of women to produce and raise children and leave the rest of the stuff to men.

I dislike such people and their agenda. Perhaps one day I too will have to find something simplistic to shout back. Isn’t that really the true problem with our civilization? Not stupidity, not evil, just fatigue at complex, seemingly insoluble, issues .