Back pain treatments “useless”

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Most treatments for low back pain simply do not work, an international team of scientists writing in The Lancet has warned. The condition is now the world’s leading cause of disability: an estimated 540 million people are affected and that number is growing as populations age.

But back pain is not properly understood, the scientists say, and is being widely mismanaged, with many patients prescribed aggressive treatments including spinal injections, powerful opioids and surgeries that are of “dubious benefit” and may in fact do harm. They advise that for most types of back pain, the best advice is simply to remain active and remain positive: a positive attitude and job satisfaction are some of the strongest indicators of whether back pain will turn into serious disability, they say. Current NHS guidelines recommend exercise and therapy. However, this not what patients always want to hear, putting doctors under pressure to offer them non-existent cures. Many patients are sent off for scans that lead to surgery – although in most cases, surgery is no more effective than non-invasive treatments and it risks leaving patients worse off. A third are prescribed potentially addictive opioid painkillers, but there is evidence that these can make back pain worse. (The Week 31 March 2018)

Yes, I agree.  I have had back pain for six months and so far nothing has worked.  The last thing you need are painkillers, especially opioids.  At best they simply disguise the pain, and temporarily at that. I suggest an exciting detective movie or reading the last ten years of postings on this blog.  At least the latter will give you to a nice long sleep.

Signs of old age

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To the New Statesman
I can confirm Peter Wilby’s observation that old age creeps up unnoticed from my reaction on being offered a seat on the Tube by a stranger for the first time. The overwhelming emotions are those of surprise, indignation and insult, with gratitude a long way behind.
Some years later, I still try to avoid eye contact on a full Tube, so that no one makes what I continue to regard as an unnecessary offer. (Dr Graham Mott, Bishop’s Stortford, Hertfordshire)

No, no, no! That’s silly. It’s really nice to see young people (usually women, also American servicemen) proffer their seats for old people. It shows they are thoughful, well-mannered and well brought-up. Mostly, and understandably, they stand up for my wife, and get a nice smile and a big thank-you. There are not enough little human gestures like this. Glad Dr. Graham Mott is not my doctor!

Some thoughts from Emperor Marcus Aurelius, Epicurean

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Here are some thoughts, called “The Decent Life”, from the philosopher Emperor, whose beliefs were Epicurean:

Honour and revere the gods, treat human beings as they deserve, be tolerant with others and strict with yourself. Remember, nothing belongs to you but your flesh and blood – nothing else is under your control. 5.33

Make sure you remain straightforward, upright, reverend, serious, unadorned, an ally of justice, pious, kind, affectionate, and doing your duty with a will. The only rewards of our existence here are an unstained character and unselfish acts. (6.30)

The only thing that isn’t worthless is to live this life out truthfully and rightly. And be patient with those who don’t. (6.47)

Four principles:  ……Truth, justice, self-control, kindness…. (7.63)

Nothing is good except what leads to fairness, and self-control, and courage, and free will. And nothing bad except what does the opposite. (8.1)

Accept the things to which fate binds you, and love the people with whom fate brings you together, but do so with all your heart

Read more at: https://www.brainyquote.com/quotes/marcus_aurelius_148749

Is do-it-yourself gene editing wise and ethical?

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CRISPR, the cheap and easy technique for making precise changes to DNA, has researchers around the world racing to trial its use in treating a host of human diseases.

But this race is not confined to the lab. Last month, Josiah Zayner, a biochemist who once worked for NASA, became the first person to edit his own genes with CRISPR, in order  to remove the gene for myostatin, which regulates muscle growth, even though it might have led to  unintended consequences, such as  tissue damage, cell death, or an immune response that attacked his own muscles.

Other people are now starting to use gene modification for a variety of maladies such as colour blindness,  or implanting a gene for  a rare genetic mutation called tetrachromacy that is sometimes found in women and allows them to see in the ultraviolet spectrum.

Biohackers, as they are called, believe it is a basic human right to access and edit one’s own genome. “I am of the opinion that your genome is your own,” said one. “I think that it is important that people have the ability to choose what kind of gene expression they want for themselves. This ethos of “my body, my choice” is used to underpin arguments for health, reproductive and disability rights, but should it extend to the right to edit our own genes? What about the potential unintended effects of using untested technology? And will allowing broad access to CRISPR risk creating a group of “superhumans” with enhanced senses and abilities?

Is there a moral difference between gene editing for medical therapy versus enhancing ordinary abilities?  Some, like John Harris, a bioethicist at the University of Manchester, UK,  does not believe there is a significant difference. He thinks the biohackers could hasten the safe use of CRISPR in humans.”There is a long and noble history of both doctors and scientists experimenting on themselves,” says Harris. “It has proven tremendously valuable in the public interest.”

“At home” gene editing is not at the moment illegal, (except in Germany, where CRISPR kits have been banned), and  none of the biohackers are actually practising medicine on anyone else.  Moreover , most people agree that  genome editing is not ready to be offered for sale to the general public.

The World Anti-Doping Agency is banning all forms of gene therapy, or gene doping, from international competitive sports from 2018. However, gene editing is very difficult to detect. Ishee  Günes Taylor, who also works with CRISPR at the Francis Crick Institute in London, believes that successful gene editing will be more difficult than the biohackers think, although there could be scientific benefits to monitoring how biohackers modify their bodies, giving us more information about how CRISPR works in humans. But the potential for harm implies that this would be unethical, and DIY experiments should be more heavily regulated.

At the moment the truth is that the biohackers are going to do it anyway, and in any case it’s hard to write regulations for people playing around with science in their garages. The biohackers believe it is a matter of choice, helping make genome editing safe and accessible for the wider public.

But how can we, the public, make sure the experimenters are responsible and that they acknowledge the possible consequences of spreading CRISPR widely?  The horse is virtually out of the stable, for good or evil.  Let us hope good prevails. It has a tough time in other areas of life.    I tend to think that Epicurus would say that the gene editors are playing god, and are not to be trusted, and that is scary.

(Based on an artcle by Alex Pearlman in New Scientist, but heavily edited for length)

War is not conservative: The hypocrisy of Trump and May

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Being politically conservative is a vague, hard to define notion that depends heavily on the context in which the term is used. To be a conservative in an Islamic theocracy is very different to being conservative in a communist dictatorship or a liberal democracy. Even within a country, the meaning of conservative can change over time. In Britain in 19th century, conservatives were avid protectionists. Nowadays, British conservatives champion free trade, with most scepticism of free trade deals coming from the left.

But conservatives have some general, if flexible principles. They are opposed to revolutions or radical change, preferring incremental reforms informed by the wisdom of the past. They value tradition, order and stability, particularly with regards to the family. Conservatives tend to be proud of their countries and their national cultures. Property rights, the freedom to do business and particularly in the English-speaking world, a small state, are paramount.

It ought to be obvious that war is not conservative. War is highly disruptive to society, rapidly changing it and in often unpredictable ways. Families become weaker as fathers go off to fight, and are permanently broken if those fathers die. The economy becomes weaker as taxes and borrowing rise to fund the war. The state becomes larger, more powerful and more intrusive. Traditional institutions are disrupted. Global trade becomes more difficult. It’s no surprise that after WW2, Britain elected Labour in a landslide. The people were so accustomed to socialism in wartime, they wanted it in peace as well.

Britain and America are both led by people who self-identify as conservatives. Yet their decision to bomb Syria is anything but. The bombing campaign will only prolong the civil war, which Assad will win. Civilian casualties will increase. More people will be made refugees. The Syrian nation, which has already endured catastrophic losses, will only crumble further. It will cost us money, increase anti-Western sentiment in Syria and the rest of the Middle East, and lure us closer to direct confrontation with Russia and Iran. Our leaders have no implementable vision for Syria. With the failure of the Iraq War now obvious, any attempt at regime change is politically impossible. Their only hope is that the bombing serves as an exercise in damage limitation: that Assad will stop using chemical weapons. But even if he did, he could still use more conventional methods to kill civilians. The air strikes could result in more dying than if we hadn’t intervened. Not intervening is the least worst option.

It goes without saying that the actions of the Syrian government, backed by Russia and Iran, are reprehensible. Assad should make Syria a democracy, gives the Kurds their own state and end the civil war. Being opposed to intervention doesn’t mean taking the other side. The non-interventionist view is the patriotic, conservative one- the view that keeps our economy, society and political life the healthiest. If the Syrian bombing campaign, conducted by the Right, goes badly wrong, Britain and America will move decisively leftwards.  The Vietnam War resulted in the hippie movement and draft-card burning. The Iraq War resulted in Obama and a Democratic landslide. This time, opposition to war could put a radical socialist in the White House and Jeremy Corbyn in Number 10. May and Trump should look at recent events, and think again.

 

Why not scrap elections entirely?

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This is NOT a party political issue, but one that concerns the welfare and peace of mind of everyone:

David Van Reybrouck in his book, “Against Elections”, argues that there is a more democratic alternative to elections: random selection of people to political office.

Incredulous? Well, think about it. The current situation is not working. Young people, by and large, are not interested and many don’t vote. The rate of voting generally is pathetic, and only countries like Australia, which have compulsory voting, have respectable turnouts. I won’t discuss the details of how disfunctional the American system is because it is getting into the realm of party politics.

The British system is not much better. The make-up of parliament does not reflect the distribution of population, and despite the Boundaries Commission. Britain is an elected dictatorship, depending on the occasional internal party revolt to get rid of the prime minister.

Given the caliber of Congressmen and Members of parliament in both countries, why not simply select ordinary people to political office totally at random? We couldn’t do much worse. In this way we would get a good cross-section of ages, genders, race, parts of the country, experience and careers). Gone would be the friends of friends, the people who turn up with personal agendas, the money in politics. There is even a possibility that the randomly chosen people would use their common sense, be pragmatic and be able to compromise to get things done.  Especially  they should address chronic inequality and money and gerrymandering in politics.  This idea is not only a sensible answer to our problems, but an Epicurean answer.

The ancient Athenians staffed their governments like this (although it didn’t stop them, disastrously, trying to establish an empire when they became successful). It seemed to work. But first we would have to do something about education, because the level of education is mind-blowingly awful, although most people don’t register the fact.

Why false news spreads fastest

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False news travels much faster online than the truth – and it’s all because of our craving for novelty.

In the largest-ever study looking at how news spreads on social media, researchers at the Massachusetts Institute of Technology analysed 126,000 stories on Twitter from between 2006 and 2017. They found that false stories were 70% more likely to be retweeted than those that were true, and that true stories took six-times longer, on average, to reach an audience of 1,500 people.

One surprise was that automated robots – or bots – played no part in this discrepancy. “False news spreads more than the truth because humans, not robots, are more likely to spread it,” said the authors of the study, which was published in the journal Science. They concluded that the high visibility of false stories is not necessarily the result of malign intent: fake news may get shared more than the truth simply because people find it more surprising or intriguing than the truth. “False news is more novel, and people are more likely to share novel information,” said co-author Professor Sinan Aral. (The Week. 24 March 2018)

Let us all avoid social media, resign, close our accounts!  We can’t uninvent  these unnecessary time-gobblers, but if a significant part of the population boycotted them the facts, opinions and statistics that Facebook et al steal from us will become unrepresentative and thus unreliable.  Advertisers will spend less money based on Facebook data, the share price will fall  and maybe a more ethical company will take them over, with full government oversight that ensures the exclusion of Russians.

Newspapers and TV stations broadcast false news, not necessarily deliberately, it is true.  Something has to be done about them, too, like apologies in big typeface on front pages or flashed on screens. Epicurus might have been philosophical about all this – news must have been unreliable and subject to word-of-mouth distortion in his day, but he would have rejected the idea of the mass dissemination of lies on our modern scale.

 

The Wreck, a poem about day-dreaming

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I sit gazing over the warm waters of Islamorada –
The seabirds, the distant lighthouse, the wind-surfers,
Kayakers, and jet-skiers skudding to and fro.
Islamorada is about relaxation, slowness
Extended time, warmth, sun and beauty.

What intrigues me is what seems to be a wreck,
Marooned on the outer edges of the reef.
From the beach it reminds me of the carcass of a
Giant Wildebeest on the Africa savannah,
Its gaunt ribs, bleached by the sun, pointing to the sky.

My imagination takes control. No, it must be old,
A large, wooden fishing boat, forlorn and abandoned.
What accounted for its demise, the summons of death?
Did a storm or a hurricane drive the boat ashore?

Is there some treacherous current out there?
Did the skipper, reveling in a good day’s fishing,
Take a lazy short-cut across a sandbar toward the jetty?
Were the crew celebrating the catch with one too many beers,
With the engine at full blast, the steersman inattentive.

As the boat grounds on the reef in a falling tide.
It stresses the keel and chines.
Chaos! Maybe broken planking in the hull?
Maybe water pouring in?
Broken glasses and whisky pouring from the bottle.
A sudden sobering up, a boat abandoned.

Or was it more sober, a simple mistake?
Perhaps a freshening gale and the need for a secure mooring
Led to a moment of distraction and impatience?
The water is shallow, no lives were at stake.

At worst the crew could reach land and struggle in
Through choppy waters, touching the weedy bottom.
Best get the boat straight to safety. A risk taken.
All at once the boat was so firmly lodged that
Nothing could refloat her.

That was a year ago and every day the sea claims
Another rib here or a grab-rail there,
As the fishing boat gradually disintegrates.

————————————————————

“The remains of that boat out there, offshore”, I ask.
“What is its story? Was there an accident or perhaps a storm?”
“A boat? There is no boat”, comes the reply. “Oh, that!
“That is no fishing boat; it is a
Tree,
Dislodged up-coast in a winter storm.
It floated down from Key to Key and settled upon
The sandbar, where now you see it”.

So much for my daydreaming! And my eyesight.
I still prefer the more exciting version.

Robert Hanrott

Brief thoughts on the gender pay gap

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In every country in the world, men are paid more than women. In the developed world, women tend to earn around four-fifths of what men do. In the developing world, it is common for men earn up to six times what women make, particularly in conservative Muslim countries like Iran. With the latter, it is obvious that institutional discrimination and legal barriers for women are preventing them from achieving pay parity. But in the developed world,  the issue is more complicated, largely because there are already anti-discrimination laws, with harsh penalties should the offending employer be found guilty.

The problem with the developed world is not overt discrimination, though I’m sure it exists to an extent. The problem is that having children costs women far more than men. Austria, where the gender pay gap is amongst the highest in Europe, provides very little support for women who have children. This means that women have to take more time off work to look after their newborns, robbing them of the experience and time in work needed to command a higher salary. In countries with a more comprehensive and flexible child welfare system, particularly the Nordic countries and Estonia, the gender pay gap is lower.

I write on the gender pay gap because the British government is currently very keen on eradicating it. But there are a few problems with the government’s approach. It is assumed that large employers are to blame for a lack of pay parity. There is very little evidence to support this. There are no financial incentives to discriminate against women- why not just pay everyone less? High-paying employers who have majority-male staff are victims of the fact most of their job applicants are men; this is particularly true in tech and finance. The government hasn’t considered making welfare more flexible as part of its approach. The situation is not helped by the British Left, which considers the gender pay gap to be a classic social justice issue with oppressors and victims, rather than a structural problem with the welfare state and men and women’s different career preferences. A significant reduction in the gender pay gap is perfectly possible. But it will require time and patience; there are no quick fixes.

Tech billionaire parenting

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“Melinda Gates’s children don’t have smartphones and only use a computer in the kitchen. Her husband Bill spends hours in his office reading books while everyone else is refreshing their homepage. The most sought-after private school in Silicon Valley, the Waldorf School of the Peninsula, bans electronic devices for the under-11s and teaches the children of eBay, Apple, Uber and Google staff to make go-karts, knit and cook. Mark Zuckerberg wants his daughters to read Dr Seuss and play outside rather than use Messenger Kids. Steve Jobs strictly limited his children’s use of technology at home.

It’s astonishing if you think about it: the more money you make out of the tech industry, the more you appear to shield your family from its effects.”. (Alice Thomson in The Times)

Well, yes. These are very smart individuals and, clearly, good parents.  But, equally clearly, they also sound edgy and cynical about the products they created and maybe care little about their fellow men and women, otherwise thay wouldn’t be pushing all this waste-of-time and arguable divisive, potentially socially and politically harmful stuff at us (or, like Zuckerberg, promising improvements he either can’t or won’t make, hoping the criticism goes away).

In the name of ataraxia I will have nothing to do with Facebook et al.  My three youngest grandchildren don’t even know what they are.  Long may they remain in ignorance, read, educate themselves, play together and just be old- fashioned, well adjusted children.  If they are laughed at, so be it.

 

 

Anti-ataraxia joke. All too real!

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CALLER: Is this Gordon’s Pizza?

GOOGLE: No sir, it’s Google Pizza.

CALLER: I must have dialed a wrong number. Sorry.

GOOGLE: No sir, Google bought Gordon’s Pizza last month.

CALLER: Oh – OK. I would like to order a pizza.

GOOGLE: Do you want your usual, sir?

CALLER: My usual? You know me ?

GOOGLE: According to our caller ID data sheet, the last 12 times you called you ordered an extra-large pizza with three cheeses, sausage, pepperoni, mushrooms and meatballs on a thick crust .

CALLER: OK! That’s what I want …

GOOGLE: May I suggest that this time you order a pizza with ricotta, arugula, sun-dried tomatoes and olives on a whole wheat gluten-free thin crust?

CALLER: What? No! I detest vegetables.

GOOGLE: Your cholesterol is not good, sir

CALLER: How the hell do you know?

GOOGLE: Well, we cross-referenced your home phone number with your medical records. We have the result of your blood tests for the last 7 years.

CALLER Okay, but I don ‘t want your rotten vegetable pizza! I already take medication for my cholesterol.

GOOGLE Excuse me sir, but you haven ‘t taken your medication regularly. According to our database, you only purchased a box of 30 cholesterol tablets once, at Drug RX Network, 4 months ago.

CALLER: I bought more from another drugstore.

GOOGLE: That doesn’t show on your credit card statement .

CALLER: I paid in cash.

GOOGLE: But you didn ‘t withdraw enough cash, according to your bank statement.

CALLER: I have other sources of cash.

GOOGLE: That doesn’t show on your last tax return . Unless you bought them using an undeclared income source, which is against the law.

CALLER: WHAT THE HELL?

GOOGLE: I’m sorry, sir, we use such information only with the sole intention of helping you

CALLER: Enough already! I’m sick to death of Google, Facebook, Twitter, WhatsApp and all the others. I’m going to an island without internet or cable TV, where there’s no cell phone service and no one to watch me or spy on me.

GOOGLE: I understand sir, but you ‘ll need to renew your passport first. It expired 6 weeks ago…

Making people healthier

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People hate the idea of being forced to make healthier choices by the nanny state. The trick is not to tell them. Just ask Coca-Cola. In order to dodge the new tax on sugary drinks – much to the fury of libertarians – the soft drinks giant has recently been reformulating its products. It began by quietly reducing the calories in Sprite. Consumers didn’t seem to mind, so the company then secretly cut the sugar in Fanta by a third, which again had no impact on sales. “People literally didn’t notice.” So much for claims that the sugar levy would ruin much-loved brands.

This is how it always goes with health and safety interventions, from the introduction of compul­sory safety belts to the smoking ban. “Outrage turns to grudging acceptance, before mellowing into surprise that things were ever any different.” You have to get past that “initial wall of resistance, constructed of corporate inertia and knee-jerk irritation among consumers at being told what to do”. You often need laws to overcome the former, but, as Coca-Cola shows, you can get round the latter through more sly means. Call it “health by stealth”. (Gaby Hinsliff, The Guardian)

A bit of a jump, but that is what should have been done with the health insurance mandate, the American tax associated with Obamacare, and which the current government have ceased to enforce.  The right-wingers, libertarians and tax-haters loath the mandate that makes healthy young people contribute to the overall health of the nation. You and I know what this about – you pay while you are healthy because one day you trust that some healthy person will be paying so that you yourself can get healthcare at an affordable cost,  if you are ill.  It’s called “insurance”.

Given time and a bit of education (hah!) the public would have become used to the mandate and would have blessed it when a family member had to have a heart by-pass. The lack of community commitment and involvement is  astonishing – and un-Epicurean.    Selfishness rules.

Classical mistake

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To The Daily Telegraph

The head of the Royal Philharmonic is making a serious error by believing that abolishing the term “classical music” will suddenly attract thousands of young people into our concert halls.  The leadership of the RPO seem to be suffering from a crisis of confidence in their art form – brought on by our society’s obsession with making everything “accessible” or, rather, watered-down.

Even during the years of Soviet communism, Russian musicians and orchestras – with the encouragement of the state – maintained the most elitist rituals, even when playing before industrial workers in factories, positively rejoicing in classical music and all of its white-tie-and-tails rituals.
It is very sad that in modern Britain, serious art and culture of all kinds is being dissolved into a supposedly democratised mass of nothingness. That such ideas should come from the RPO – the orchestra of Sir Thomas Beecham – is beyond belief.  (Stuart Millson, classical music editor, The Quarterly Review, East Malling, Kent)

Yes, watered down.  Just as there is some truly dire popular music there,  is also dull and unimaginitive classical music.  In my personal opinion serious orchestral music hit the buffers in the railway station when it went atonal and eschewed melody and the ability to tug at the heart.  The audiences fled, understandably.  But there is a huge amount of truly beautiful music, operatic, orchestral, chamber and solo instrumental music that carries you away to another place, stirs the imaginatination, calms you then excites you, spurs the imagination, leaves you happy that life isn’t forever ordinary and humdrum.  Put  aside the cellphones and Facebook and experience it!  It will be an Epicurean moment.

P.S:  My ears are assaulted on a Sunday by noise from the spin cycling class next door. This class is accompanied by loud, repetitive and unimaginitive music of horrendous tedium.  The chord sequences are I-V-I- V-I-V for a solid hour.  Talented writing it is not.  I feel like handing out to the cycling exercisers free tickets to a Chopin recital  – if only they could cycle to Chopin.  This is , of course, a matter of taste – as an Epicurean I stoutly defend the right of the cyclist to listen to whatever they like, preferably behind carefully closed doors.

Will Christianity decline but be re- born?

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The Guardian of March 30, 2018 carried an article by Peter Ormerod that suggested that  “In the light of widespread rejection among Europe’s young people“, Christianity as a default, as a norm, is gone, and is probably gone for good.”

He suggested that this might, long term, actually be good news for Christianity, which started as a radical political and spiritual movement, but was coopted by forces of oppression and militarism. (and by the Establishment. Ed). Becoming a default or a norm drained it of much of its energy. Despite repeated efforts by minorities to resist the trend, the institutionalization of Christianity has done it a disservice.
Young people have not abandoned an appetite for community, loyalty and even tribalism, and not all, of course, have become self-obsessed. On the contrary, they tend to reject the aridity of a culture where everything is numbered, quantified and processed into heartless data. Many also reject the the internet culture where how you look, how popular you are, what you have and what you wear are the most important things. They also dislike the bullying and the need to be “perfect”.

One can therefore see the possibility of a revived church that can offer meaningful relationships to young people, reassurance and love. Authenticity is the key, not trying to join or conform to the mass obsession with Facebook et al. Maybe the message of the church will get through once again, but not be part of the establishment, touting uniformity.

Meanwhile, Epicureanism shares much of the good, positive things about Christianity but without the supernaturalism, the angels, the choirs, the confessions, the outdated language sometimes used, the stress on guilt and sin. If you are looking for mystery, Epicurus cannot offer it. But if you are looking for  love, understanding, inclusivity, common sense, consideration for others and a gentle reflective refuge from modern life, Epicureanism is an answer*.   There are no popes or bishops telling you what to think – just human common sense.

*Note:  I say “an answer”. There are plenty of people out there peddling the “answer to everything”, all wanting control.  Our belief is that you should try many things in striving for contentment, moderation and happiness.  Epicureanism is  one of them.