Sunday, October 17, 2010

Playing the Odds

From the insides of emergency rooms, you'd have to be nuts to drive a motorcycle. From the insides of the insurance industry, you'd have to be nuts to promote the insurance industry, knowing how you are instructed to deny claims at random whim. From the inside of having something wrong with you, you'd be nuts not to think that the paradigms within which our healthcare system works are at their turning point.

Once upon a time a pill had some predictable effect. On the model of antibiotics, it would cure you, even while it might have caused some bad taste along the way. Now, the explanations of the ways these pills work are so couched in obscure in-group language that you have no way to gauge the grip on reality of the person doing the prescribing. You might be able to do the math, to check the statistical calculations, but you would have to endure an entire degree program to learn the shorthand code for the conventions of the math in this particular field.

In the end, what you do know or can know or even must know is that the pills you take now are meant merely to change the odds. And they change those odds very subtly, even while you're somehow meant to imagine that they change the odds on the same pattern as those good old antibiotics used to. Doctors look for what they expect to see in response to bad events. And mostly they find it, the wages of overindulging, and can confidently prescribe the odds-changing treatments of statin drugs or blood thinners or a baby aspirin a day, and if you're smart or if you're susceptible you feel comforted somehow, like being tucked in by Daddy.

But reading through the layers of the esoteric onion, trying to understand at some expert level, you're still pretty sure that the net effect of the pills you're taking is to push the odds off in the right direction, but not really to the extent that improvements in your living habits or in the environment might. But theses are so hard to collate to correlate to find any sense in.

You know that population studies can quantify how many lives potentially lost have been potentially saved, although the statistics for non-compliance - not finishing the course of various meds - are pretty sobering in themselves. Whatever the proximate cause for that, you can be pretty sure it's a proxy for financial distress. Why else would people be too disorganized to take their meds?

The surgery is pretty effective when the inexorable does happen, but even then it's hard to know, isn't it? You can't fend of death forever.

But we're living on a planet now which shows the drastic impact of our lovely selves, gouging out the easy pickings, lighting them up, and looking for all the world like some dread disease process upon the very living planet. We are that, at the very least. A human strain of killer pathogen.

The same math which keeps you from understanding what your doctors (but not your nurses) presumably do understand, prevents you from understanding why we can be so certain that the Earth is warming, and that it's because of our lust for a good life here and now. Which isn't quite, but is almost, the same thing as wanting some reasonable comfort while we do our important work.

The economic arrangements render up our lusts much better and more efficiently than they render up our needs. What was that important work again? Not the paper pushing that you and I do surely, but the important stuff the scientific community accomplishes, maybe.

This ancient and somewhat tired now equation between the guts and the lowly and the brain and the ethereal - where the angels tread - fits perfectly here. It's hard and it's frustrating to be told you're maybe an idiot, but it sure does seem, intuitively, as though the Earth is far too big to be all that impacted by the way we choose to live. So some artist of emotion, some Glenn Beck or Rush or even Oprah, sends down to our guts good feelings which aren't in need of any mental math mediation to know their truth.

And Glenn Beck or Rush, but not Oprah, encourage you to rationalize your rage and frustration that you just can't understand what they're talking about, and you're pretty sure they're just trying to get theirs, since it's pretty demonstrable that all those Ivy egg-heads are only after theirs or else why would they insist on driving the ego cars and living in the ego mansions and squiring the ego-trophy-wives. That just makes sense to your guts, your lusts, and so your anger is justified, and you do so desperately want to go back to the way it was when you were safe and snug and warm and didn't really have to worry about your impact-by-proxy rendered up to disease proportions for the whole globe.

That same esoteric barrier against understanding prevents you from getting why it is that evolution is established fact and not some fanciful theory. You don't really buy that it has to be survival of the fittest, since if that were the case, then all these efforts to find the cure for this or that should be halted right now so that the fittest might survive, which just sounds an awful lot like what Glenn and Rush and those creationist cretins want us to believe. That God will guide that proper survival, and we should just stay out of it and let the unfortunate among us die out. Which just sounds a lot like traditional high-handed cruelty from the inside of some castle, but there you go!

Still on some level, you get that the great diaspora across the earth of man out of Africa is now coming to some conclusion. That even while we madly cater to the fears of each of us that we might just die unfairly, the so-called races are mixing it up again, which likely would be good for the longevity of the whole. Ideas are mixing, cultures are rubbing off on one another, and whole new categories of beauty to lust after are getting created.

And at the lowest level, which might really just be at the highest level, since who can know what these encodings might really mean, the DNA is mixing it up. The genes are mixing it up and the memes are mixing it up and the semes are mixing it up, and up and up and up until you might even get the wrong idea that the best among us are the ones meant to survive and define the brave new racist humanity.

Which isn't, I'm pretty sure, the way that evolution works. It might be the quirky ones which mesh best with the changed environment, but now the environment is almost all ours and no longer what might by reach be still called natural? Nutty people study ways to improve the human race, as though we might live forever or make our better selves still better, based, presumably on some normative exam of what it means to be best. Hire in ETS, which just sounds a lot like Hitler.

So one thing we do know is that we can't all survive the pressures from the environment which have been created by the pressures from us, which have been rendered up in proxy from our lusts and not our needs. You can count this pretty neatly just by counting heads, or mouths the way the Chinese like to do.

That's a guaranteed outcome of lusts, on the level of population studies, provided that you have something on the right side of a cruel civilization to catch the babies, which might be a toss-up most of the time. The ones who survive will be the lucky ones or the unlucky ones depending on the circumstances, as we can reflect by watching any one among umpteen movies or reading the end-time books.

Or if you read the Good Book, then it will be the ones who are saved and like to Jesus. But no question that those scientific methods have allowed and maybe even encouraged the survival of that many more of us, no matter their physical fitness for survival. No matter yours and mine.

Odds are we've blown it, and you might as well believe in fairy tales, since what else have we got?

Well, it was pretty odd in the first place for us to be here. Those, mathematically speaking,  odds are precisely one. Which is a funny mathematical sort of artifact when you think about it, which you won't want to do too much since it will make your head hurt. There's not really anything awfully pretty about that artifact, since it's just by very definition. Which it's really really hard to escape from, definition.

Still, for so long as there is life and lust and breath, it seems that the Earth might stand a chance. It would seem a crying shame if it were only the earth and no so-called consciousness, however. I mean, it's taken umpteen million years just to get here. You'd think we could start to take it easy after all. But after all, we can't and there remains so much important work to do.

Drive responsibly!!

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