Walking in the Laurel Highlands

Last month, on the cool Saturday morning before July 4th, my brother convinced me to go with him for a hike in the Laurel Highlands. Despite the weekend celebrating national independence, fireworks somehow don’t quite answer the huddled masses “yearning to breathe free”… the need to breathe free seems now and then to compel a sabbath in the woods and on the hills.

There are times I feel wasted, weary of heart, spread thin, both puffed and pricked, a shadow of what a human being is born to be, wandering among shadows of images of things that are. The remedy is to return to a remnant of the wild world that was before my birth and will be after my death, where the reality of the present—however beautiful or cruel—is forever foremost. In the wild woods, my noise dies away echoing off the boulders, my hot air escapes as a trail of steam, and my soreness of spirit ebbs away to nothing worse than soreness of the thighs. And I come home knowing where I am and who I am and something of the wide world besides.

Here are a few pictures we took, accompanied by quotes from Thoreau’s essay “Walking”:

LaurelSummit-AlexI have met with but one or two persons in the course of my life who understood the art of Walking, that is, of taking walks — who had a genius, so to speak, for sauntering, which word is beautifully derived “from idle people who roved about the country, in the Middle Ages, and asked charity, under pretense of going a la Sainte Terre,” to the Holy Land… They who do go there are saunterers in the good sense, such as I mean.
LaurelSummit-BenWe hug the earth — how rarely we mount! Methinks we might elevate ourselves a little more. We might climb a tree, at least.
LaurelSummit-2Life consists with wildness. The most alive is the wildest. Not yet subdued to man, its presence refreshes him….in Wildness is the preservation of the World.
LaurelSummit-2.4We have heard of a Society for the Diffusion of Useful Knowledge. Methinks there is equal need for a Society for the Diffusion of Useful Ignorance, what we will call Beautiful Knowledge, a knowledge useful in a higher sense: for what is most of our boasted so-called knowledge but a conceit that we know something, which robs us of the advantage of our actual ignorance?
LaurelSummit-3…there are more things in heaven and earth than are dreamed of in our philosophy. … A man’s ignorance sometimes is not only useful, but beautiful, — while his knowledge, so called, is often worse than useless, besides being ugly. Which is the best man to deal with, — he who knows nothing about a subject, and, what is extremely rare, knows that he knows nothing, or he who really knows something about it, but thinks that he knows all?
LaurelSummit-4Above all, we cannot afford not to live in the present. He is blessed over all mortals who loses no moment of the passing life in remembering the past.
LaurelSummit-5So we saunter toward the Holy Land, till one day the sun shall shine more brightly than ever he has done, shall perchance shine into our minds and hearts, and light up our whole lives with a great awakening light, as warm and serene and golden as on a bankside in autumn.


Asclepiads and the DSM

(Click for credit)

Reading Plato’s Republic for my first undergraduate philosophy course, I am struck how often Socrates uses the doctor as an example of a particular craftsman and his body of knowledge, and how this is used to the benefit of himself and others in society. One such example produces a discourse that reminds me of the timeless importance of a good lifestyle over medical treatment, and of the difference between what might be called “infliction” and “affliction.” In any case, here is the passage:

And doesn’t it seem shameful to you to need medical help, not for wounds or because of some seasonal illness, but because, through idleness or the life-style we’ve described, one is full of gas and phlegm like a stagnant swamp, so that sophisticated Asclepiad doctors are forced to come up with names like “flatulence” and “catarrh” to describe one’s diseases?”

It does. And those certainly are strange new names for diseases.[1]

Plato develops the idea that a person with a good soul will take good care of the body, explaining that the education for guardians in his polis  would ensure physical training, “chiefly for the sake of the soul,” arousing the “spirited part” of human nature, the center of courage and toughness.[2]

Plato, via Socrates, says more of interest in the Republic about the best training for a doctor, medical treatment and the “quality of life,” and avaricious interests, but I’ll look at that more another time. I might end here quoting the Apology, on the primacy of the soul before the body: “I spend all my time going about trying to persuade you, young and old, to make your first and chief concern not for your bodies nor for your possessions, but for the highest welfare of your souls, proclaiming as I go, ‘Wealth does not bring goodness, but goodness brings wealth and every other blessing,'” of which we might mention health.[3] On its face, this dictum seems too simple, but I can at least agree for the present that health cannot last long without the remnant of goodness in habits and discipline.

1. Republic, 405d, trans. G. M. A. Grube and C. D. C. Reeve

2. Ibid., 410c

3. Apology, 30b, trans. Hugh Tredennick.

The Purity of Psychology


Over lunch the other day I was hearing from a student taking developmental psychology about why certain TV shows weren’t funny at age 7 but were all the rage at 9, and how some particular new show was developed to appeal especially to those 23 and over. Two or three weeks before that, I had been obliged to attend a workshop dealing with, among other things, Myers-Briggs personality types, so I was feeling more than usually weary of what I will unfairly term the “know-it-all” demeanor of contemporary psychology, and had even checked out a library book with a title promising some catharsis, Uses and Abuses of Psychology.

Rather than day-dream of putting Freud’s upstart science in its place by enrolling in psychological experiments just to break the arbitrary rules with my own independent choice (like being an ESFP for a day), I have tried to do something constructive by digging out the old cartoon above.

This cartoon may exaggerate reductionist attitudes, but something like the “x is just applied y” line underlies many contemporary views on the natural and even social sciences, and not only of the mathematicians and physicists who think this gives them the most bragging rights. For the sociologists and psychologists removed by several layers of application from the purity of Euclidean certainty, it still seems a source of pride to point to the biological foundations of behavior and cognition.

Perhaps the pride of psychologists is partially explicable in terms of the misplaced gratitude of the victim for the least mercy shown by the oppressor: humans may be just hogs with hormones, but at least hormones can be “quantified” and researched, unlike other, more evanescent elements of humanity, the tears and laughter of our kind, that can only be experienced directly, and never captured, only partly suggested, and then in story, poetry, or art.

Am I overreacting to the character and claims of modern psychology or do you have similar thoughts?

Flesh, Grass, and God

“All flesh is grass”

Isaiah 40:6

“All this mass of flesh which we behold, came in at our mouths; this frame we look upon, hath been upon our trenchers; in brief, we have devour’d our selves.”

Thomas Browne, Religio Medici, para. 37.

Although our stomachs do not permit us to forget that we must eat, our minds often fail to think of why. For the comfortably established citizens of a country like ours, we eat more out of habit and for society and aesthetic pleasure than out of recognition of a fundamental necessity. Yet eating is a fundamental necessity, to provide us not only with our energy but even with our matter.

I recall watching a documentary claiming from isotopic analysis that over 50% of the carbon in Americans’ hair comes from corn. Whether or not this is true, 100% of the carbon in anyone’s body comes from the food he eats (excepting the very small portion that may remain from his birth). Like it or not, I am an earthly being with biological needs, as well as a mind now casting my favored projection into the anonymous global public of the Internet.

In a fully material sense, the earth is our nurse even if not our mother; she may not be the source of our life but she is intermediately its sustenance. Our name for our kind—human—evinces the connection: it is a cognate of humus, the organic matter of the soil that feeds us, a fact that ought to beget in us humility. And in the biblical language of Hebrew, the connection is even closer: adam is man and adamah is the ground, a closeness fully justified by our need for food.

Yet it is worth tracing the source of our matter and energy a few more steps backward. First, the fruitful earth is the beneficiary of the sun, the nearby star from which comes its needed light and heat. Second, the radiation of the sun derives from the fusion of hydrogen atoms. And whence the hydrogen atoms? An eternal universe? God?

The matter, then, that makes us up and which we may regard, clipped hair and nails aside, as fundamentally part of ourselves, comes from sources in the broader world we think of as entirely alien. So either our bodies are more alien to us, or we are more at one with the world, than we are apt to think. I prefer to suppose the latter.

Despite the continual material change in our bodies, is there some constant form with which we may identify ourselves? Our shape, of course, is not constant from babyhood to old age, undergoing a continuous transformation even as matter enters and exits the mold, but is there some more abstracted form that is really our own?

These questions remind me of the puzzle of the Ship of Theseus—a decaying Greek ship reportedly replaced board by board, till none of the initial wood remained. Did it remain the same ship, especially since even the shape remained constant? What if the structure were modified?

I intend no confident answers to these questions, except to deny the frequent claim that “you are what you eat.” Form transcends matter, and though you may be made, characterized, even judged by what you eat, it is an overstatement of materialism to say that you are what you eat.

It may be that all flesh is grass, but is all of man flesh? As has been said, “man does not live by bread alone.”



Leaves & Cuttings (9/12/15)

Lumps and Products

At risk of seeming trite, I observe that the difference between lump sums and growing products is a common theme in rational choice theory: do you take a salary of X or a wage of Y; do you buy in bulk for a discount or only the needed number, albeit at a higher unit price? Do you rent or do you purchase; do you choose the costly but lasting or the cheap but perishing; do you choose the immediate and dramatic (like bariatric surgery) or the small but progressing (like exercise and diet)?

Adding and Multiplying

Rev. Malthus is notorious for his pessimist view (which I somewhat exaggerate) that we are all doomed to a mean life of poverty and starvation in the end, because of the difference between arithmetic and geometric series. As he reasoned, our food supply only grows by an added increment, making an arithmetic progression of something like 2,4,6,8,10,…, while the number of mouths to feed grows by a multiplied proportion, making a generational geometric progression, assuming a two-child preference since Adam and Eve, of 2,4,8,16,32,… Under this hypothesis, the people at some point must scrape the bottom of the barrel, creating a Hobbesian sort of struggle for existence, which famously inspired Charles Darwin with elements of his theory of natural selection by survival of the fittest in the struggle for life.

Homo sapiens trimorph

Among the “lower” creatures it is common to reproduce asexually (as commonly in bacteria, strawberries, and aphids) or sexually not necessarily with a partner, both the male and female parts being present on the same individual (as with pea plants and some invertebrates). To take advantage, however, of the robustness deriving from exchange of genetic material with another individual, many animal species and quite a number of plants (e.g. holly trees) have separation of the sexes into two distinct male and female forms, and are thus known as dimorphic. As we know from experience with familiar vertebrates, the males and females may be different in many respects apart from their reproductive organs, as with the plumage of peacocks, and may even appear more different than two separate species would, while in other species, the two sexes appear identical in all external respects.

In some few species, there is yet another distinct form (a “trimorph”), most notably with social insects like ants where it is meaningful to think of the individuals in an anthill massing into some coherent thing with a life of its own, and in which the ants acquire specialized roles and where each is not a jack-of-all-trades, as is the lone scarab on his forays in carrion, or the intrepid wasp kidnapping caterpillars to feed her posthumous hatchlings. In any case, the trimorphism of ants, with the crown, army, and industry, made much of in Darwin’s Origin as a potential difficulty of his theory (the latter two morphs being sterile), has inspired me to perceive the evolution of trimorphism in our own species, which you must kindly pardon for being unimaginative: the android. Humans produce them, and how far is production from our already mechanical idea of reproduction? How far is a brainchild from the modern idea of a child? Androids sufficiently resemble humans, at least potentially, that it is worth asking if they belong to the same species. And finally, in the wild presaging of our science-fiction mythopoets, could not robots, like worker ants, become the permanent, all-purpose drudges of the race, while those of flesh and blood spend their earthly span reclining on couches of virtual unreality?

Cutting the Grass as a Selective Act


There are some spots in the lawn, or along its ambiguous borders, where the good old Kentucky bluegrass has clearly lost its turf war. In the front yard, dandelions, plantains, and crabweed have established their enclaves; in one of the side areas, there is a pebbly place, hardly mown, which yields almost entirely to speedwell and some half-wild asteraceaeous species (very gaunt and not worth picking); and in the back strip, in addition to one corner in the thralls of poison ivy, there are patches subject to outbreaks of red and white clovers, and a border firmly in the grip of ground ivy. Without bothering to count the groundhogs, sparrows, earthworms, springtails, nematodes, mushrooms, and soil bacteria, the lawn is quite a diverse ecosystem.

Regarding turf, Charles Darwin writes in his Origin of Species, as an illustration of the struggle for existence, the following:

If turf which has long been mown, and the case would be the same with turf closely browsed by quadrupeds, be let to grow, the more vigorous plants gradually kill the less vigorous, though fully grown plants; thus out of twenty species grown on a little plot of mown turf (three feet by four) nine species perished, from the other species being allowed to grow up freely.

Fortunately, it seems that when the reverse occurs—when a wild plot is mown—it can be subdued into something like tolerable turf (whether with an increase or decrease of species diversity, I can’t say, but at least with a considerable change). I was struck the other day, mowing the family lawn and comparing notes with Darwin, how much effect a weekly shortening of the grass stems has on the community of life under out feet. There is, for instance, a portion of the backyard, designated for play, which had once been annually smothered in wood mulch, with the plant life kept under control by the unrelenting children’s footsteps, but which now is annually smothered only in snow, and thus is subject to rank grasses, thistles, Velcro weed (id estGalium aparine), foxtails, smartweed, ragweed, cherry and tuliptree sprouts, and a number of other undesirable species which my guilty disgust has caused me to overlook. I have, however, for the last month or so, included convenient parts of this overgrown area in my mower route, and the effect has been noticeable. Species like thistle and anonymous prickly weeds, which clear a radius of a few inches with their large leaves and require many weeks of growth to flower and reproduce, are going extinct in the mown tract, and the evacuated space is filled by smaller plants with means of asexual propagation. The clover and coarser grass which had grown there before are changing shapes from large, spaced clumps to a continuous low carpet, which I hope will eventually be washed over by the advance of runners and rhizomes from the more civilized bluegrasses a few yards to the west.

Darwin is expansive on the subject of how mowing or grazing grass applies selective pressure to an ecosystem. I excerpt at length an account of the cows and fir trees on the Staffordshire heath:

Many cases are on record showing how complex and unexpected are the checks and relations between organic beings, which have to struggle together in the same country. … In Staffordshire, on the estate of a relation, where I had ample means of investigation, there was a large and extremely barren heath, which had never been touched by the hand of man; but several hundred acres of exactly the same nature had been enclosed twenty-five years previously and planted with Scotch fir. The change in the native vegetation of the planted part of the heath was most remarkable, more than is generally seen in passing from one quite different soil to another: not only the proportional numbers of the heath-plants were wholly changed, but twelve species of plants (not counting grasses and carices) flourished in the plantations, which could not be found on the heath. The effect on the insects must have been still greater, for six insectivorous birds were very common in the plantations, which were not to be seen on the heath; and the heath was frequented by two or three distinct insectivorous birds. Here we see how potent has been the effect of the introduction of a single tree, nothing whatever else having been done, with the exception of the land having been enclosed, so that cattle could not enter.

But how important an element enclosure is, I plainly saw near Farnham, in Surrey. Here there are extensive heaths, with a few clumps of old Scotch firs on the distant hill-tops: within the last ten years large spaces have been enclosed, and self-sown firs are now springing up in multitudes, so close together that all cannot live. When I ascertained that these young trees had not been sown or planted I was so much surprised at their numbers that I went to several points of view, whence I could examine hundreds of acres of the unenclosed heath, and literally I could not see a single Scotch fir, except the old planted clumps. But on looking closely between the stems of the heath, I found a multitude of seedlings and little trees, which had been perpetually browsed down by the cattle. In one square yard, at a point some hundred yards distant from one of the old clumps, I counted thirty-two little trees; and one of them, with twenty-six rings of growth, had, during many years tried to raise its head above the stems of the heath, and had failed. No wonder that, as soon as the land was enclosed, it became thickly clothed with vigorously growing young firs. Yet the heath was so extremely barren and so extensive that no one would ever have imagined that cattle would have so closely and effectually searched it for food.

Here we see that cattle absolutely determine the existence of the Scotch fir… .

As an even more extreme example of species interdependence, Darwin notes how cats determine the frequency (even existence, perhaps) of red clover and heartsease: Only bumblebees have long enough probisci to pollinate these flowers, and bumblebees are only safe from the villainies of field mice in the presence of a sufficient cat population.

I really have to wonder what will happen as a result of mowing the backyard under the swing set.

Image Credit: Albrecht Dürer, Great Piece of Turf

Leaves and Cuttings, 4/25/15

Edwin Leap, “The Value of Religious Faith in the Practice of Medicine
Notes from an address by Dr. Leap to medical students, showing how doctors need faith for loving the more difficult exemplars of humanity, for enduring suffering, and for ultimately having hope amid tragedy and loss. He includes several excellent quotes from G. K. Chesterton, Blaise Pascal, Nicholas Wolterstorff, and C. S. Lewis.

Clyde Kilby, “10 Resolutions for Mental Health
This list of resolutions by an English professor with a “pastoral heart and a poet’s eye” is classic and I was glad to re-encounter them last week in John Piper’s The Pleasures of God. Here are three of the resolutions that are particularly related to the enjoyment and appreciation of the natural world:

1. At least once every day I shall look steadily up at the sky and remember that I, a consciousness with a conscience, am on a planet traveling in space with wonderfully mysterious things above and about me.

6. I shall open my eyes and ears. Once every day I shall simply stare at a tree, a flower, a cloud, or a person. I shall not then be concerned at all to ask what they are but simply be glad that they are. I shall joyfully allow them the mystery of what Lewis calls their “divine, magical, terrifying and ecstatic” existence.

7. I shall sometimes look back at the freshness of vision I had in childhood and try, at least for a little while, to be, in the words of Lewis Carroll, the “child of the pure unclouded brow, and dreaming eyes of wonder.”

I would encourage reading the whole list.

Wendell Berry’s Life Is a Miracle

Credit: Amazon.com

Credit: Amazon.com

Wendell Berry is a writer from Kentucky whose years have ripened on a farm where he writes his poetry, novels, and essays. Though I know little of Mr. Berry besides the fingerprints he leaves on his books, I appreciate and trust his good craftsmanship, warm sense of local community, and apparent Christian faith.

After finishing a fine novel of his, Jayber Crow (on which Anthony Esolen wrote an essay appropriately titled “If Dante Were a Kentucky Barber”), I am now reading a small non-fiction book, Life Is a Miracle, in which he ventures out to criticize the modern science-technology-industry complex and specifically Edward O. Wilson’s book Consilience, which aims to unite all knowledge around science.

The most apparent virtues of Mr. Berry’s book are that it is a short, poetic, and unequivocal essay written by a man who is an outsider to scientific jargon and professional blindness and an insider to what matters to the rest of us.

Mr. Berry is a conservative, culturally and ecologically. He asserts that “life is a miracle” against those who would say that life is a machine. He insists on the transcendent and the irreducible, the local and the poetic, against the materialist modern Babel of the sciences, which in its hubris reduces everything to physical law or denies the existence of what it cannot reduce.

Mr. Berry, as a conservationist, cautions other conservationists who succumb to the reductionist language of science (e.g., “the ecosystem” or “riparian plant community”) in describing the very things they are trying to save from its overreach. Particular rather than general language is a good prescription for anyone. He writes:

But when I try to make my language more particular, I see that the  life of this place is always emerging beyond expectation or prediction or typicality, that it is unique, given to the world minute by minute, only once, never to be repeated. And then is when I see that this life is a miracle, absolutely worth having, absolutely worth saving. We are alive within mystery, by miracle.[p. 45]

As I read this book, I thought of one of the great piles of adjectives in Jayber Crow, which I would have underlined, starred, and dog-eared where the book not a library copy: “every body was living its small, short, surprising, miserable, wonderful, blessed, damaged, only life.” Thomas Hobbes, the materialist, may use another string of adjectives for the same noun—”solitary, poor, nasty, brutish, and short”—but Mr. Berry has my sympathies. (By the by, Thomas Hobbes was another of those who think of life as a machine—he begins his work The Leviathan comparing the state to man, which he equates with a machine.)

The title, Life Is a Miracle comes from a line in Shakespeare’s tragedy King Lear, where the unrecognized and outcast Edgar delivers the reminder to his suicidal and blinded father, the Earl of Gloucester.

One more quote to share, of interest for its relation to medicine, to end this miscellaneous and disconnected post:

The frequent insultingness of modern (scientific-technological-industrial) medicine is precisely its inclination to regard individual patients apart from their lives, as representatives or specimens of their age, sex, pathology, economics status, or some other category. The specialist to whom you have been “referred” may never have seen you before, may know nothing about you, and may never see you again, and yet he or she presumes to know exactly what is wrong with you.[p. 40]

Why I Want to Become a Doctor

This is an essay I wrote for an early medical school admissions program. The duty of writing large quantities of similar essays for various college and scholarship applications is one major reason for the prolonged silence.

There is an old photograph of me standing no higher than a doorknob, grinning up at the camera with fake red-rimmed spectacles and a plastic stethoscope. The stethoscope and the spectacles are long gone, but my apparent intention in wearing them, however mixed with play, remains. My intention has not led me straight or speedily, yet molasses that I am, today I aspire to become a doctor.

My interest in doctoring began with simple curiosity in the human body, probably at the age of six or seven. As my childhood scribbling tended towards realism, I somewhere found anatomy diagrams to copy in life size on continuous sheets of fax paper, which stimulated me to a much greater interest in the subject of my drawing than in the drawing itself. For to a child, the idea of the unseen internal body systems was a wonderful one, and I am willing to wager that Henry Ford and Rube Goldberg together could not have concocted something at once so efficient and so outlandish. Adding to medicine’s anatomical allure were my own early and perilous experiences with group B streptococcus and a ruptured appendix, and in the glowing vision of youth, I could imagine myself as a physician brilliantly sifting through voluminous knowledge to bestow long-sought cures on grateful patients.

As I came to know medicine in practice rather than imagination, however, I could not maintain my naïve attitude for long. Medicine may be methodical, but it is also messy, and for every disease that has a cure, there is another that does not. The human body is a masterpiece, but what the doctor sees most often is the decay of that masterpiece. Doctoring has its attendant joys, but the dominant world of the doctor seems to be one of illnesses acute and chronic, depression, addiction, violence, mishap, senility, and death, and also one of nitrile gloves, electronic medical records, aseptic glare, and non-compliant insurance companies. I remembered the hospitals I had visited as a patient and worked in as a volunteer, and amid fonder impressions, I felt oppressed by both their sterility and the suffering they contained. At the extreme of disillusionment, I had heard of physician suicide and, though I still knew the value of medicine in my mind, I could not at that time make myself feel its appeal.

Compelled to resolve my ambivalence, I began reading what doctors themselves have written about their vocation. I discovered that even if doctors have notoriously sloppy script, many of them are wonderful writers, and I have benefited from reading works by Thomas Browne, William Osler, Lewis Thomas, and Atul Gawande, as well as many physician blogs. They all were frank about the failures and difficulties of medicine, but they also revealed a depth of insight and human feeling that I had not seen before in doctors. Slowly I realized that a wearisome concern for everyone in general and nobody in particular is far from the only way to practice medicine. There are doctors who can recite Homer as well as hydrocarbons, and who care as much about comforting the patient as about curing the disease. My marginalia and reflections on medicine soon evolved into a blog where I have explored how medicine connects to literature, ethics, politics, economics, natural science, and daily life. Completing my persuasion in favor of doctoring were the conversations and email correspondence I have had with practicing physicians, as well as two days shadowing one silver-haired GP who majored in English and satisfied my imagination’s rôle for an ideal doctor quite as well as it seems the fictional Marcus Welby has done for many current practitioners.

So at last I recall the plastic stethoscope and set out to become a doctor. Family medicine, specifically, calls me: I would be delighted to care for generations of people in one community and provide quality primary care in a health system that is badly in need of more. Doctoring looks like hard but fruitful work, and as William Osler said, it is “a calling in which your heart will be exercised equally with your head.” I could ask for nothing better.

Don’t Waste Your Worry: Medical School Admissions

It appears that even if you are attempting Lewis Thomas’s regimen of Transcendental Metaworry, you may not be able to find good material for your gloomy forebodings in medical school admissions, at least not the degree often expected.

My brother sent me an article from the “Study Hacks” specialist, Cal Newport, which offers a simple plan for preparing for medical school admissions. While neither Mr. Newport nor myself have any particular credentials for discussing the subject, I believe he is right. Mr. Newport did, by the way, talk to admissions officers at an undisclosed elite medical school. This is some of his advice:

  • “Major in whatever you want.” “[I]t’s not a bad idea to avoid majoring in biology or chemistry all together.”
  • “Don’t participate in any time-consuming extracurricular activities during the school year.”
  • “Every summer, focus on something that exposes you to the real world practice of medicine.”
  • “Start studying for the MCAT very early.”

I tend to lose such simplicity and focus. I proliferate projects, have crazy notions that I need to do a hundred things where one would have been better, and begin feeling like Bilbo Baggins: “thin, sort of stretched, like butter scraped over too much bread.”

Mr. Newport’s advice, I think, is good. In college, you must have enough margin for curiosity. As Mark Twain said, you must not let your schooling interfere with your education. You must identify the things that are necessary and do them well.