SATURDAY POETRY SERIES PRESENTS: AARON ZEITLIN

POETRY
by Aaron Zeitlin

Translated by Jon Levitow (2009)

Go become yourself the words,
Yourself the essence.

– Angelus Silesius

Poems should be like Elijahs
entering the homes of wretched brothers.
I wait for poems that turn into poets,
I wait for poets that turn into poems.

I wait for unexpected wonder,
when poets become the words they write,
each poem fills with blood and shows its face
and approaches people – as a poet.
New breath for old hearts!
Make cold frogs jump!
Let dry stumps blossom!
Proclaim Sabbath throughout all the worlds!

Aaron Zeitlin (1898 – 1973) was the son of the noted Yiddish writer and thinker Hillel Zeitlin. After an invitation to New York by director Maurice Schwartz for the production of his play Esterke (“Esther”), the start of World War II on 1 September 1939 prevented his return to his family, all of whom were murdered in the Shoah. He settled in New York City where he worked as a journalist and a professor of Hebrew literature at the Jewish Theological Seminary of America. Zeitlin’s literary writings include bilingual (Hebrew and Yiddish) poems, narratives, dramas, essays, and criticism. Noteworthy is his contribution from the Warsaw period. He was a moving force in the inclusion of Yiddish literature and Yiddish writers as members of the World PEN Organization (late 1920s), whose branch in Warsaw he chaired in the 1930s. Tragically, German militarism destroyed a number of his unpublished manuscripts and works in progress, including five volumes of poetry ready for publication. (Annotated biography of Aaron Zeitlin courtesy of Novelguide.com, with edits.)

Editor’s Note:
Today’s post was inspired by a combination of outside sources. First, my father challenged me to determine the meaning of “zeesh punim,” a yiddish phrase. While contemplating the meaning of this phrase, As It Ought To Be posted a poem that inspired and moved me, that piece being On This Earth What Makes Life Worth Living by Palestinian Poet Mahmoud Darwish.

I wanted today’s post to be by a Yiddish poet. Yiddish is the language of my ancestors, a dying language that was nearly wiped out with the Holocaust. I also wanted today’s post to be a celebration of poetry and life, as Mahmoud Darwish’s poem is. What these two poets have in common is the ability to celebrate life and poetry through tragic events, to see the beauty in life even amidst so much death and tragedy. May their spirits come together through poetry to shift the energy of the middle east and bring about peace between men who would otherwise be brothers.

Want to read more by and about Aaron Zeitlin?
YiddishPoetry.org
VoicesEducation.org
Novelguide.com

Felipe Alfau 1902-1999

    Felipe Alfau was Spanish-American writer who spent most of his long life in New York City. While not a prolific writer, he was one who was far ahead of his time, employing authorial techniques that would later be “discovered” by Postmodernists such as John Barth, Donald Barthelme, Thomas Pynchon, and Robert Coover.

   Alfau was born in 1902 to a prominent political and literary family.  His father was a lawyer and colonial official in the Philippines, and his sister had penned a novel before her twentieth birthday. For part of his childhood his family resided in Guernica in the Basque region of Spain. When he was fourteen, his family moved to New York City. Alfau loved music and hoped to become a conductor. After college, he became a music reviewer for La Prensa. Several years later he began to write journalism in English and became a translator for the Morgan Bank. His first novel Locos: a Comedy of Gestures  was completed in 1928, but was not published until eight years later.

   Locos is metafictive collection of stories, which, taken together, tell the story of the Bejerano family and their associates. The most important characters are Don Gil Bejerano; his brother Don Laureano, a wealthy beggar; Gil’s  elder son Gaston who is also known as the pimp EL Cogote; his younger son Pepe; his daughter Carmen who is both the seductress Lunarito and the nun Sister Carmela; Garcia, a poet turned fingerprint expert; the sensible Doctor Jose de los Rios; and Juan Chinelato, a Chinese wrestler and adventurer turned butterfly wrangler and theatrical producer. This cast of characters are habitues of the Cafe de Los Locos in Toledo, though most of the action takes place in Madrid, with some detours through China and the Phillipines. The Characters apply to the narrator (named Felipe Alfau) because they wish to appear in the novel. The subsequent plot, in which these characters collide, define themselves in opposition to one another, and eventually take on names and traits in common and blend together, examines the fluid nature of personal identity. Locos received critical acclaim at the time of its publication but met with popular indifference and soon disappeared.

   In the years after he finished Locos, Alfau wrote poetry which he did not attempt to publish , and completed a second novel in 1948, which was rejected by several publishers. Then in 1987, Locos was republished, after Steven Moore, then an editor at Dalkey Archive Press, found the book at a barn sale in Massachussetts, read it and contacted Alfau after finding his name in the Manhattan phonebook. The reprint edition generated enough  favorable attention to lead Moore to ask Alfau if he had anything else. Alfau produced the manuscript of Chromos, which had sat in a drawer for 40 years. Upon its publication in 1990, Chromos would be nominated for a Natioanal book Award.

   Chromos revives some of the characters from Locos, including Garcia, Doctor de los Rios, and Felipe Alfau, but it takes place in New York City. One important new character is Don Pedro, called the Moor, who, along with the other characters, frequents the Spanish expatriate bar El Telescopio. Chromos uses its setting among the Spanish and Latin American ex-pat community to examine the collective identity by which the group constructs itself, in this case through the ironic label of “Americaniards.”  As in Locos, the structure is one of apparently unrelated narratives which obliquely comment on one another: the first concerning the Sandoval family’s gothically grotestque rise and fall and the other following the life of John Ramos, an expatriate in New York who has the astonishing ability to jump forward over long periods of time. Both of these narratives are interwoven with the present day stories of El Telescopio’s Americaniards.

  In 1992, Alfau finally published the poetry that he had written throughout his lifetime.  Even though he had written his novels in English, he had written his poems in Spanish because “Poetry is too close to the heart while prose is a mental activity.” This collection was a bi-lingual edition entitled  Sentimental Songs/La Poesia Cursi. This would be Alfau’s last publication and he would die seven years later at the age of 97.

UNREMEMBERED

The book of things that I have forgotten contains most of my life. But then, what would we do without forgetfulness? I feel like there is hardly room for everything I do recall.

Sven Birkerts, my sky blue trades

It began with a mental image: Mr. Vaszily standing with his sleeve rolled up, the inner part of his forearm exposed to view, blue numbers tattooed across the skin. The image was sharp and clear. It came to me out of nowhere, while I was walking down an aisle in a Publix Supermarket in Clearwater, Florida in the spring, 2005. Nothing I was doing at the time – no writing, no reading, no thinking – was anywhere near the Holocaust. I hadn’t touched the Holocaust since 1999, when I was in Jerusalem and had visited Yad Vashem, the Holocaust Memorial. My former father-in-law, an Auschwitz survivor, had been dead for years. And Mr. Vaszily? He had died in 1972, when I was living overseas. I had last seen him alive sometime in the 1960’s.

So what, you wonder? We all remember things. Sometimes they pop up unexpectedly.The problem was, for the years I had known him, he had never rolled up his sleeves in my presence.

I met Mr. Vaszily – I did not know his first name, John,  until many years later – when I was six or seven years old. He and his wife lived in a small house down the hill from ours. He was probably 70 when I met him and did not work. Mrs. Vaszily went to work each day while he stayed home, tending his garden as well as the rabbits, chickens and ducks that he raised in his backyard, selling them to the many Italians who lived in the neighborhood. When the weather was good I would see him walk down the street toward an overgrown field in the middle of the village where he would scythe the tall grass to be used as bedding for the rabbits.

He stood out because of his garb: shirt buttoned to the neck, a vest, a kind of suit-jacket, sturdy work pants and boots, a fedora. Sporting a carefully trimmed mustache, he was bald and wore that hat to protect himself from the sun. Later, I would see pictures of men like him, prosperous farmers from Central Europe, perhaps from Hungary where, we were told, he was from.

When he was scything that field, or working in his backyard, where I would often visit him, he would sometimes take off the jacket, maybe even the hat. But never did he roll up his sleeves in my presence.

There was nothing I could do about the “vision”, if you will, at the time it appeared. I was working in Florida for the semester, while the village where I had grown up, Croton-on-Hudson,  is north of New York City. I did call my mother, who had been a nurse for the doctor who had attended to the Vaszilys. She could not tell me anything.

I live not far from my childhood home. When I returned north I began to dig. With the help of some friends still in the village I was able to find out that he and his wife had been buried in the village cemetery. I found the gravestone, which is where I learned their first names: John and Elizabeth. He died in 1972, at 90. She died in 1984, at 89.

My first assumption was that he had ended up in a Nazi concentration camp during World War II and that they had come to this country after the war.  I knew he was Catholic:  he and his wife attended mass in the same church where I was an altar boy. I knew that the Hungarians had begun to cooperate with the German in dealing with the “Jewish question” only later in the war and I thought that perhaps he had been rounded up for helping the Jews. Or he had simply run afoul of the Germans or their Hungarian allies and ended up a prisoner. Or that he had been Jewish himself and later converted to Catholicism.

There was a problem with the theory that he had come to America after the war.  According to his obituary, and to the immigration records I was able to find, he had come to this country sometime around 1915 or 1916, had worked for the New York Central Railroad for many years as a car inspector and had retired not too many years before I first met him. Which left me holding feathers.

The Vaszilys had one daughter and I was able to find out that she had graduated from the local high school in the Thirties. She had married and had a son, Douglas, whom I would play with when he and his parents came up from New York City to visit the Vaszilys. Perhaps they could help me. But they had disappeared as well. More feathers.

I talked to as many people as I could in Croton, many of them old-timers who had worked on the railroad. None of them recalled the couple. One of them told me that at one time there had been a small Hungarian community in the village. Nothing remained of that.

I discovered that a friend’s mother had once held the deed on the Vaszily’s property, making me think that they had rented from her or her husband before purchasing the property. My friend questioned her about it; she recalled nothing.

A secretary at the same Catholic parish they had attended dug through her records, but informed me that while the church went back many years, some of the records had gone missing.

I sent out an SOS to friends who had grown up in the same neighborhood, asking for help. One of them was a woman who had lived perhaps a block from the Vaszilys and whose house looked out over the field where he scythed the grass. They, in turn, passed the message on to others. Nothing.

I even contacted Yad Vashem (the Israeli Holocaust memorial mentioned earlier), but they could not help me. Nor could they offer any suggestions.

If it weren’t for my mother,  who remembers them clearly and fondly, I would wonder whether I had made them up out of thin air. But I know that’s not the case. Mr. Vaszily had an air about him that I only later realized would be called gravitas. He was made of something very solid. And Mrs. Vaszily? She was his opposite, laughing where he was grave, embracing me whereas he would simply extend a hand and say hello. No less real, though.

Perhaps you are hoping at this point that something, someone appeared at the eleventh hour to solve the mystery. No.

Perhaps you are thinking that my vision was simply some neurons misfiring, crossed mental circuits. I don’t think so. As I said at the beginning, there was no reason for me to think about John Vaszily at all in 2005.

Or, perhaps it occurs to you, as it occurred to me, that he did have a tattoo, but that it was not what I thought it was. The problem with that theory is that I am confident that if he had had a tattoo – not the numbers – I would remember what the tattoo was.

Although I cannot prove it, I believe that John Vaszily’s arm was tattooed with numbers; that the likeliest explanation is that they were put there by the Nazis or their henchmen and that I, too young to know what they meant, had stored away the image against the day when the meaning would come clear. And that something in the spring of 2005, something I cannot reassemble, prompted the memory.

I have no one idea as to how John Vaszily got in the Nazis’ way. One possible explanation is that, during the Depression, he returned to his native country and was trapped there by the war. Another is that he returned to Hungary to rescue family members and was arrested and imprisoned in the process. There was never any reason for the Vaszilys to talk to me, a child, about this. And Mr. Vaszily’s habit of not exposing his forearms is consistent with the idea that he had something there that he did not want others outside his family to see.

John and Elizabeth Vaszily seem to be completely forgotten, the only record of their time on earth being a headstone in the Bethel Cemetery in Croton-on-Hudson, New York. Other than having the grass around it mowed by the cemetery caretakers, it is untended, while gravestones around it are replete with freshly picked or planted flowers. Later this month I will go down there to plant some bulbs – daffodils, most likely – and will try, as long as I live in the area, to see to it that the gravesite is tended. Perhaps I will even leave a note on the headstone, just in case someone wanders by who knew something about them, who remembers them at all.

On This Earth What Makes Life Worth Living

By Mahmoud Darwish

Translated by Karim Abuawad

On this earth what makes life worth living:

the hesitance of April

the scent of bread at dawn

an amulet made by a woman for men

Aeschylus’s works

the beginnings of love

moss on a stone

the mothers standing on the thinness of a flute

and the fear of invaders of memories.

On this earth what makes life worth living:

September’s end

a lady moving beyond her fortieth year without losing any of her grace

a sun clock in a prison

clouds imitating a flock of creatures

chants of a crowd for those meeting their end smiling

and the fear of tyrants of the songs.

On this earth what makes life worth living:

on this earth stands the mistress of the earth

mother of beginnings

mother of endings

it used to be known as Palestine

it became known as Palestine

my mistress:

I deserve, because you’re my mistress

I deserve life.

Mahmoud Darwish (1942-2008): is a Palestinian poet born in the village of al-Birweh, in Galilee. A few months before the declaration of the State of Israel, Darwish’s family was expelled to Lebanon. Upon their “illegal” return to Galilee in 1949, the family found their village razed, their property appropriated by the state. Darwish went into exile in 1970, returning to live in Ramallah, Palestine after the signing of the Oslo Accords in 1993.

He’s considered one of the most prominent poets writing in Arabic in the twentieth century. He made many contributions among which helping to popularize free-verse, a project championed by earlier poets to free modern Arabic poetry from the strict meter and rhyme that characterized the earlier traditional poetry.

Many of his poems have become lasting, and quite recognizable, songs, the most famous of which is the poem he wrote for Rita, the Jewish girl who was Darwish’s first love. The first line of the poem, which reads “There’s a rifle between Rita and me,” encapsulates this romantic encounter between a Palestinian living in Israel without citizenship and his lover who enlists in the Israeli army.

More recently, Darwish published the long poem Mural (2000), an extensive monologue where the poet talks to, and argues with, Death which has come to claim him several times before finally succeeding in 2008.

In June, 2010, the Council of Paris inaugurated “Mahmoud Darwish Square” in honor of Darwish and his artistic legacy. In the words of Paris mayor, Bertrand Delanoë, Darwish “is not just any poet [but] a Palestinian poet, a poet whose inspiration is born of his suffering in exile.”

Loving the Cyborg and the Mushroom


Two things:  Terence Mckenna’s insistence on the human desire to “shed the monkey body”  always scared me and then paradoxically  the cybernetically enhanced Borg of  Star Trek always seemed rather sexy.

Early one morning as I trawled fakecrack I found a friend’s post: an O’Reilly webcast by Amber Case entitled “Cyborg Anthropology: A Short Introduction”. Anthropology’s subject matter has leapt a paradigm since I sat in Joel Kahn’s class watching him smoke a million cigs as I tried to grasp his Marxist analysis of pre-capitalist states but I’ve never stopped being fascinated by the discipline’s theoretic overlay: the attempt to look, without ethnocentric bias, at human societies through a pseudo- philosophical/scientific lens, identifying social phemonena and describing cultural production protocols.  Nowadays cyborg anthropologists are looking at us human cyborgs, those of us (and that’s most of us) who are organisms, “to which exogenous components have been added for the purpose of adapting to new environments.”

As far back as 1941 at the inaugural Macy Conference, cultural theorists, including luminaries like Margaret Mead, discussed the potential impact of evolving technology on cultural reality.

Fast forward to 2010  where our cyborgian reality has developed to consume many of our conscious hours interacting through our exogenous devices, not just for work but also for play. Admittedly we are low-tech cyborgs, most of us are not permanently augmented by our technology- although  many smart phone users seem unwilling  to relinquish the close physical companionship of their hand-held devices. In 1985 in an eerie and precocious essay, “A Cyborg Manifesto,”  Donna Haraway wrote that as “hybrids of machine and organism” we were creatures of both fictive and lived social reality.

This rings very true in regard to online social networking  which is reaching endemic proportions in western society and let me make this quite clear — cyberspace connectivity is intrinsically different to our previous social pathways. Cyborg anthropologists theorize that online we create a “second self”, this is an identity generated in relation to others: if our body in virtual space is appealing to others they will approve and give our second self  “gravity”, for example a status update on Facebook which is “liked” by many increases gravity while being “de-friended” takes away from gravitational credibility. In cyberspace we sample ourselves and the bytes that we report are the ones which shape our identity. We consider our social networking to be useful for promoting ourselves and seek to appeal in our network, this means that we often make decisions not to articulate negative, contentious or questionable items which might also be described as personal truths.  Research from Intel suggests that current social networking protocols don’t often initiate successful new relationships but rather make those relationships  which already exist more visible. This visibility can become problematic, being peer-judged for the opinions of one’s  ‘second self’ might also impact your social reality in the offline world. I feel lucky that I’ve made one new friend through social networking,  I saw his comments on a mutual friend’s page & sent a request to be friended,  this positively counters my overwhelming personal trend of  getting turned off by network personas . Online our second selves are immature and tendencies toward discrimination, passive-aggressiveness and narcissism are often inadvertently exposed or created through sloppy memes, either way the outcome is as obnoxious  as halitosis in real-time.

I hear people offering up the platitude, “Facebook isn’t real” but I utterly disagree, it is hyperreal and what goes down on social networks can have grave implications: fifteen year old Phoebe Prince  killed herself last year after being harassed and abused on Facebook. Personally I feel that my second self and I are still very much conjoined and I don’t like exposure to haters on any platform. When I start to feel uncomfortable with an online friend I “hide” them and try and win a little distance back, after all, we have never been in such a high order of inter-connectivity as a species and while  most people are attractive at some distance, magnified and unedited they often become less appealing.  This kind of social interaction seems distorting and dangerous, the time-honored offline social etiquette which formerly mediated our social relationships is being thrown aside and emerging protocols are not yet beta-tested. Our lives online exist in an ocean of interactive sensations: ideas about time and space (we think nothing  of having multiple simultaneous conversations in different time zones), production of value (ever felt overwhelmed by opportunities to add more 99 cent apps?) social punctuation (like texting in company) or ambient online intimacy (the heady sensation of the collective now).  Offline life is changed by our increased connectivity too, public space now becomes private space when you are chatting on your mobile and places themselves can become “non-places” if we don’t have enough meaning invested in the location.

Fellow cyborgs, are we having fun yet?

It seems that we are amused and often we are engrossed: my husband’s recent edict that our house will go offline at weekends was met with a teen cyborg mutiny. We will not give up our technologically enhanced state of being but we owe it to ourselves to work on understanding what it is that we are doing and what it is we really want to do.

Terence McKenna believed that our species is evolutionarily longing for the Other – we yearn for the unseen mystery of the universe and alien playmates in particular. Our loneliness is as vast as infinity, as Heidigger  described so poignantly, “cast into matter, alone in the universe.” Connecting with each other’s second selves  24/7  helps us to feel better, we hum along to Kraftwerk’s gorgeous Computer Love while we look to artificially extend our ability to reach out into space.

McKenna’s search went off at a tangent into inner space exploration,  a place both vilified and sidelined for the last two thousand years of western culture, designated as the eccentric preserve of religious mystics. As an ethno-botanist studying plant-based shamanism McKenna researched psilocybin and became acquainted with the Other, which he calls the voice of the Logos. Psychedelic mushroom spores like stropharia cubensis can survive the harsh conditions of outer space and thus McKenna thought that maybe they came to us from distant worlds. When humans interact with the mushroom, the Logos communicates with us, drawing back the veils of dimensionality and revealing other realities, this ecstatic experience is fearful and generally undertaken by shamen, wise ones who can deal with this huge unchartered territory.  The historical importance of psychedelics has not yet been acknowledged, McKenna’s theory of human evolution into language through psilocybin use in early societies is regarded as renegade by  most academics. Times are a changing though: breaking news in the mainstream media this week tells us medical research into the treatment of  depressed, anxious, post-traumatic and dying with psychedelics is yielding positive results.   Lucky for us that adventurous McKenna and the Logos had an open bandwidth and his awareness as a scientist and theorist has enabled him to communicate the ideas and perspectives of the Other to us timid creatures in our empirically restrained culture.

In 1987 McKenna spoke of an emerging zeitgeist of hyperspace- he knew that electronic culture would add a dimension that would reverberate through our culture at every level and he saw our 21st century hyperdimensional collectivity coming. When I read Gibson, Dick, Vonnegut and M. T. Anderson  I can imagine the endgame of humanity as we know it. McKenna considered that first Neolithic age, imbued with the psilocybin experience had provided us with the essential tools which brought us to this point, and for him the re-emergence of the mushroom in contemporary times was the second Neolithic Age, the Archaic Revival: our chance to look through the hyperdimensional lens again. This opportunity could slip away from us he warned if we become too enmeshed in a hypertechnological dominator scenario.

Anderson’s  Feed is a futuristic tale of teenage cyborg-humans who have internet implants embedded borg-style in their brains, their software updates them constantly on what to buy, where to get it and who has already got it. This hypertechnological wasteland is highly imaginable and ultimately terrifying especially to those of us who seek the interconnected flipside trajectory for  our species.

It’s just a brilliant psychedelic idea that we can look out and the Other can look in when we commune with psilocybin. The fact that psilocybin  is part of our intrinsic brain chemistry should help us  little techno-monkeys understand that the mushroom  experience is valid. The dimensional envelope is awesome but like our ancestors who would have feared the wormhole of space and time that the telephone represents we stand like Tolkien’s hobbits at the border of the Shire, total scaredy cats. It is frightening to imagine the potentialities of the universe and thats reassuring: we only truly fear the real.

Amber Case “Cyborg Anthropology: A Short Introduction” http://www.youtube.com/watch?v=rCvMWZePS8E

Donna Haraway “A Cyborg Manifesto: Science, Technology & Socialist Feminism in the Late Twentieth Century” Socialist Review, 1985

Marc Auge “Non-Places: Introduction to an Anthropology of Supermodernity” 1995

Terence McKenna ” The Archaic Revival” HarperSanFrancisco, 1991

M.T. Anderson “Feed” Candlewick Press, 2002

The Coming Crisis of Global Food: High Costs, High Fats, and the Age of Globesity

By Liam Hysjulien

I’d like to begin today’s essay by venturing forth into the not-so-distant future and mulling over this prediction:  by 2050, the global population could surpass 9 billion people.  As it currently stands, the world’s population is sitting at around 6.8 billion, with one sixth of those people going to sleep hungry every night.  So far in my research, I have mostly focused on national and local food issues—the Food Stamp Program (or SNAP, as it is now called), the history of the United States welfare system (yes, it still exists), and various anti-hunger and community food security movements and frameworks—but I’m now stepping outside my academic comfort zone to view the global landscape of hunger, food prices, and obesity.   One of my professors, a brilliant political economists and critic of both neo-liberalism and civil society, once remarked, and I’m paraphrasing, that there is no beast quite like the beast of poverty in the developing world.   And while I would never downplay the devastating effect of food insecurities and hunger in the US, it is almost unfathomable to wrap one’s mind around the reality of global hunger.  In an article in last week’s New York Times, Shawn Baker, Regional Director for Africa of Helen Keller International, wrote “[in Niger] 2010 is actually worse than 2005, with recent surveys showing acute malnutrition rates of 17%” (Baker 2010).   Severe acute malnutrition (SAM) in children under five cannot be understood simply in terms of nightly hunger pangs, but a daily lack of nutrients so severe and prolonged that it results in physical stunting and increased susceptibility to preventable diseases.

Beginning in the 1960s with the uniquely titled “War on Hunger” agenda,  the US government decided that the only way to win the hearts and minds of various food crops in the developing world was to use a direct approach: A) massive amounts of pesticides; B) massive amounts of fertilizers; C) monocropping; D) importing genetically modified foods and seeds; E) repeat steps A through E; F) this step is on the horizon, but I’ll return to it  in next month’s article.   All political agenda aside—and I am positive, and hoping, that readers will hardily disagree with me—there is a compelling argument to be made for the necessary advantages that modern science and business offer in increasing global food production.  While I am a food purist at heart, I cannot, at least from the studies that I have read, believe that without some reliance—the degree of reliance being certainly debatable—on scientific (unlike McWilliams, I don’t see GMO and Roundup Ready seeds in this future) and industrial agricultural practices, we’ll be able to increase food production to the predicted 70% yield required to match population growth.  Again, I want to stress the importance of balance over what we have now—which is one of the most unbalanced, out-of-control systems ever created.  So instead of striking a harmonious cord between sustainable, no-till farming practices and modern logistical and scientific advancements, we have decided instead to be as reckless as possible with our global food supply and see where that takes us–for a current example see: half a billion eggs recalled for possible salmonella exposure.

So where has this reckless behavior taken us? I would posit that we are in all likelihood entering, or have always been in, a state of food plutocracy, by which the gap between average caloric intake for developed and developing nations is going to widen, while caloric intake –which had been rising for decades— will continue to remain stagnant and rates of hunger will begin to increase in many less economically developed countries.

The financial and food crisis beginning in 2007 is at the center of this increase in both global food prices and levels of hunger.  In a 2010 report by the United Nations Millennium Development Goal, the number of undernourished people between 2005-2007 rose to levels not seen since the early 1990s (Dhawan 2010).   It should come as no surprise that during this same period, “the international prices of wheat and maize (corn) tripled, and that of rice grew fivefold” (Braun 2008).  To put these numbers in real terms, the global price of rice in 2006 was $216.65 per ton and by 2008 that number had risen to $507.65 (FAO 2010).   As Paul Collier, the Director for the Center for the Study of African Economies at the University of Oxford, writes,

“The unambiguous losers when it comes to high food prices are the urban poor. Most of the developing world’s large cities are ports, and, barring government controls, the price of their food is set on the global market. Crowded in slums, the urban poor cannot grow their own food; they have no choice but to buy it” (Collier 2008: 68).

In the aftermath of these rapid increases in food prices, the food riots of 2007-2008 swept through the developing world, with Mexico, Haiti, and Egypt gaining the most international attention.  By the end of 2008 in Egypt, the price of food and beverages had risen by 27 percent (Salama 2008).

Where were the food riots in the United States?  As an estimated 200 millions people in the world starved, the American food plutocracy remained largely stable.  But why?  First, Americans spend on average ten percent of their income on food and of that merely seven percent of their income eating at home (Department of Labor 2010).  In many countries where people live on less than $1 per day, roughly one sixth of the world population, 50 to 60 percent of their income goes toward food (USAID 2010).  This is not to say that food prices didn’t fluctuate in the US.  As one fifth of the nation’s corn crops were funneled toward biofuel production, grocery prices in the United States increased by five percent during the summer of 2008 (Martin 2008).  As the US entered what is now known as the Great Recession, increase in costs of food were not equally distributed throughout the market.  As eggs went up by 25 percent and milk by 17 percent (Stevenson 2008), the price of junk food—high sugar, high fat foods with little nutritional value—decreased by 1.8 percent (Parker-Pope 2008).  Instead of food riots in the US, consumers were faced with having the to decide between buying cheaper, low-nutritional junk food or buying less, and increasingly more expensive, fruits and vegetables. Not surprisingly, we see during this time rates of obesity increase in 37 states (Washington Post 2008).   But food plutocracy is not simply about what types of food we consume, but the sheer number of calories that Americans intake on a daily basis.  This global bifurcation between daily caloric intakes is at the heart of the future of food debate.

In looking at 2004-2006 data from the Food and Agriculture Organizations (FAO), Americans, on average, consume 3840 calories per day (FAO 2010).  To place this in the global context: Mozambique – 2090; Kenya – 2060; Sudan – 2300 (FAO 2010). While none of these numbers are startlingly low, it is important to remember that the data was collected two years before the beginning of the global economic recession—when food prices were relativity low and stable.

It is also important to note that Americans weren’t always like this.  If you look at any graph on obesity rates in the US, starting around the early 1980s—hello, Reagan—is when that line begins to slowly move upwards.  Beginning in the 1970s, Americans consumption of caloric sweeteners increased on average from 123.7 pounds to 152.4 pounds in 2000. Not only do we have a serious sweet tooth, but in the same year, we also consumed on average 74.5 pounds of total added fats and oil as opposed to 53.4 in the 1970s.  We like our fat and oils too.

What is food plutocracy going to look like by 2050?  As scientist predict that global food production will need to become more mechanized, industrialized and genetically modified (the MIG), we are already beginning to see how drastic swings in food prices are causing ripples of misery and hunger throughout the developing world.   In this new age of population growth and food speculation, we could begin to see the world increasingly more divided between the globally obese and the marginally food insecure.   A couple month ago, PBS commentator Ray Suarez, in a report on the increasing rate of obesity in China, wrote “[in China] portion sizes are getting bigger, Western-style food is widely available in urban areas, and people are eating out more often”(Suarez 2010).  In looking at the FAO’s diet composition numbers, daily percentage of fat consumption in China has increased from 19.5 percent in 1990 to 28.2 percent in 28.2 in 2006.  Additionally, fat consumption per individual in China has increased from 57.9 grams per day to 93.6 grams per day in 2006.  As rates of severe acute malnutrition continue to rise in many African countries, the rest of the developing world seems to be following the United States down the path of a high sugar, high fat, and high empty calorie lifestyle.  Next month, I will continue this theme on global food inequalities, and tackle the rising, and largely under reported, trend of “land grabbing” in Africa. 

References

Baker, Shawn. 2010. “A Famine Looms In Niger”. New York Times. August 9.

Collier, Paul. 2008. “The Politics of Hunger: How Illusion and Greed Fan the Food Crisis.” Foreign Affairs 87(6):67-80.

Dhawan, Himanshi. 2010. “Hunger back to 1990 levels in South Asia: Un report.” The Times of India. June 23.

FAO.2010. World Food Situation.

—. 2010. International Commodity Prices.

Martin, Andrew. 2008. “Biofuels Getting Blame for High Food Prices.” New York Times. April 15.

Parker-Pope, Tara. 2008. “Money is Tight, and Junk Food Beckons.” New York Times. November 3.

Suarez, Ray. 2010. “Reporter’s Notebook: Obesity on the Rise in China.” PBS Newshour. June 1.

Salama, Vivian. 2008. UAE in Farm Talks with Egypt for Food Supply.” The National. July 7.

Stevenson, Kim. 2008. “Some Good News on Food Prices.” New York Times. April 2.

USAID. 2010.  “USAID Responds to Global Food Crisis.”

USDA. 2010. Agricultural Factbook 2001-2002.

von Braun, Joachim. 2008. “The Food Crisis Isn’t Over: Although the Credit Crunch has Lowered the Price of Food, a Global Recession Now Raises the Hunger Pains of the Most Vulnerable. The Stage is Set For the Next International Food Crisis.” Nature 456(7223): 701.

Washington Post. 2008. “Obesity Rates Up in 37 States: Report.”  Washington Post. August 19.

SATURDAY POETRY SERIES PRESENTS: KING SOLOMON




TO EVERYTHING THERE IS A SEASON / EXCERPT FROM KOHELET/ECCLESIASTES
by King Solomon


To every thing there is a season, and a time to every purpose under the heaven:

A time to be born, and a time to die; a time to plant, and a time to pluck up that which is planted;

A time to kill, and a time to heal; a time to break down, and a time to build up;

A time to weep, and a time to laugh; a time to mourn, and a time to dance;

A time to cast away stones, and a time to gather stones together; a time to embrace, and a time to refrain from embracing;

A time to get, and a time to lose; a time to keep, and a time to cast away;

A time to rend, and a time to sew; a time to keep silence, and a time to speak;

A time to love, and a time to hate; a time of war, and a time of peace.

King Solomon was, according to the Hebrew Bible, a King of Israel. The biblical accounts identify Solomon as the son of David. The Hebrew Bible credits Solomon as the builder of the First Temple in Jerusalem and portrays him as great in wisdom, wealth, and power. Solomon had seven hundred wives and three hundred concubines. The wives are described as foreign princesses, including Pharaoh’s daughter and women of Moab, Ammon, Sidon and of the Hittites. He is considered the last ruler of the united Kingdom of Israel before its division into the northern Kingdom of Israel and the southern Kingdom of Judah. According to Jewish tradition, King Solomon wrote three books of the Torah/Bible: Mishlei (Book of Proverbs), Kohelet (Ecclesiastes), and Shir ha-Shirim (Song of Songs). (Annotated biography of King Solomon courtesy of Wikipedia.org, with edits.)

Editor’s Note: Today’s post became most famous in modern popular culture for the version put to music (with six words added) by Pete Seeger in 1962 and made more famous in 1965 when recorded by the Byrds. Thus, today’s post continues our ongoing discussion about where the lines of poetry and music are blurred.

Today’s post takes that discussion a step further, by taking a look at how biblical text and mythology come into play in poetry. Arguably mythological stories and oral storytelling, which later became incorporated into the written word and went on to form important texts such as the Torah, Bible, and Koran (among many others) are the oldest form of poetry. Ideas became stories and songs, stories and songs became the written word, the written word was crafted as a form of art, that art informed and inspired others, and poetry as we know it was born.

On my paternal grandmother’s side of the family a family tree has been kept for so many generations that it traces our lineage to King David. That makes King Solomon my kin, and I am proud to honor him today by celebrating his poetry. Let’s hope his talent runs in the family!

Want to read more by and about King Solomon?
King Solomon on Wikipedia
Turn! Turn! Turn! on Wikipedia
U Penn / Song of Songs

“The Inevitable Waits” by Friedrich Dürrenmatt

Black Lawrence Press, 2010

THE INEVITABLE WAITS

(translated by Daniele Pantano)

The inevitable waits

It’s not coming. You are

You are the mouse. So

Don’t be a hero

When for the fearless

Even the avoidable

Is unavoidable

Fear. Stay human

What belongs to you, doesn’t

What belongs to all, does

The right thoughts

They are friendly

Even when they seem hostile

You cannot think them alone

You cannot check them alone

You don’t strike on them alone

Alone you appear in front of them alone

They are your judges and ours

We are wrong and you, not they

Love their verdict, use it

Perhaps then the dark animal

Lolling under a bed

Or purring, crouched by a street

Will perform humanely

Its inhuman day’s work

And not devour you

In a gas chamber

Friedrich Dürrenmatt (1921-1990) is commonly seen not only as the most prominent Swiss novelist, playwright, and essayist of the twentieth century but as one of the most influential authors of modern literature.

Daniele Pantano is a Swiss poet, translator, critic, and editor born of Sicilian and German parentage in Langenthal (Canton of Berne). His most recent works include The Possible Is Monstrous: Selected Poems by Friedrich Dürrenmatt and The Oldest Hands in the World (both from Black Lawrence Press, 2010). His next books, Oppressive Light: Selected Poems by Robert Walser and The Collected Works of Georg Trakl, are forthcoming from Black Lawrence Press, New York. For more information, please visit http://www.danielepantano.ch.

[The above translation is reprinted here with permission of the translator.]

THE INEVITABLE WAITS

The inevitable waits

It’s not coming. You are

You are the mouse. So

Don’t be a hero

When for the fearless

Even the avoidable

Is unavoidable

Fear. Stay human

What belongs to you, doesn’t

What belongs to all, does

The right thoughts

They are friendly

Even when they seem hostile

You cannot think them alone

You cannot check them alone

You don’t strike on them alone

Alone you appear in front of them alone

They are your judges and ours

We are wrong and you, not they

Love their verdict, use it

Perhaps then the dark animal

Lolling under a bed

Or purring, crouched by a street

Will perform humanely

Its inhuman day’s work

And not devour you

In a gas chamber

Not Your Median Patient: How A Climate Scientist Faced Cancer

Stephen Schneider
Stephen Schneider, climatologist and cancer survivor, died on July 19. Photo credit Patricia Pooladi / National Academy of Sciences; printed in Stanford Magazine, July/Aug 2010.

Not Your Median Patient:
How A Climate Scientist Faced Cancer
By John Unger Zussman

Stephen Schneider, the environmental scientist, died of a heart attack last month at the age of 65. He was a Stanford professor, a member of the Nobel Prize-winning Intergovernmental Panel on Climate Change, and a tireless and articulate advocate for action to counteract the threat of global warming. The blog Realclimate.org has posted a moving “scientific obituary” by Benjamin Santer of the Lawrence Livermore National Laboratory. There was even a tribute on the NPR program Science Friday.

What most of the obituaries mention only in passing (if at all) is that Schneider was a survivor of a rare and often deadly cancer called mantle cell lymphoma. He was diagnosed in 2001 and refused to accept both the medical establishment’s standard treatment and its dismal prognosis. Instead, he diligently applied to his cancer the same principles of decision analysis that he used as a climate scientist, and as a result persuaded his oncologist, Dr. Sandra Horning, to treat him more aggressively than the protocols dictated. In 2005, safely in remission, he published an account of that battle, The Patient from Hell.

I’ve written about cancer in these pages before, recounting what I learned when someone I love, “Bonnie,” was diagnosed with breast cancer, and discussing the role of environmental toxins in causing cancer. If you read that first piece, you might be surprised that Bonnie, who chose to “undertreat” her cancer, looked to Schneider, who chose to “overtreat” his, as a positive model. But she did, and in this essay I want to explain why.

Both Bonnie and Schneider found inspiration, in turn, from Stephen Jay Gould, the late, great evolutionary biologist. At age 41, Gould was diagnosed with abdominal mesothelioma, a cancer from which the median survival was only eight months after diagnosis. Two years later, he published a seminal essay entitled “The Median Isn’t the Message,” in which he interpreted that statistic and explained how he took hope from it. Beautifully written, it’s must reading—especially if you have been diagnosed with a serious illness.

The median, if you remember your college statistics, is a measure of the “average value” of a set of measurements that are distributed on a curve. It refers to the “middle” value if the measurements are sorted, high to low—half the scores are above, half below. It’s useful because it’s less sensitive to extremes than the mean, or mathematical average.

Gould realized that there was nothing magical about the median; it’s a measure of central tendency, but it doesn’t describe the distribution. His own survival might be any data point on that curve. Yes, 50% of abdominal mesothelioma patients survived eight months or less, but another 50% survived longer—some, given the characteristics of the distribution, significantly longer. Rather than despair, Gould set about figuring out how he could get himself on the long end of that curve.

And he did. He beat that cancer and had twenty more healthy and productive years—completing his magnum opus, The Structure of Evolutionary Theory—before he succumbed to an unrelated lung cancer in 2002.

Schneider’s insight was no less profound. He looked at the way the medical profession evaluates cancer treatments based on endpoints—survival or recurrence of the median patient at the end of a clinical trial of one treatment vs. another (or vs. a placebo). A good starting point, he said. But what if the disease is rare (like his) and there are no trials? Or what if a promising new treatment hasn’t yet been tested? Or what if you don’t resemble the median patient?

This situation reminded Schneider of climate science, in which you have a single patient (the Earth) whose symptoms are beginning to alarm you. Unfortunately, you lack good data on endpoints, your predictive models are imperfect, and the error ranges in your forecasts multiply upon each other. You have no other planets to run experiments with. “You can’t do controlled experiments on the future,” Schneider said in his last major interview. “What are we going to do, wait for it? Then apologize to posterity that we did nothing to slow it down?” Of course not. You collect as much data as you can about the climatic processes. You make your best estimates of the probabilities of each outcome, cognizant that they are only estimates, while continuing to monitor the data and update your models. And you make your best recommendations for policy that, you hope, will avoid the most catastrophic outcomes.

Applying these principles to medicine, in place of absent or inadequate clinical trials, or to supplement them, Schneider recommended process knowledge, Bayesian updating, and decision analysis. Process knowledge means that “your doctors should know how various treatments—both mainstream and not—work, how treatments for diseases similar to yours might work for you, what treatments are unlikely to be effective, and how your overall health could be affected.” Bayesian updating is a fancy statistical term for monitoring your response to treatment and adjusting it accordingly. Decision analysis means weighting potential outcomes, risks, and benefits by your doctors’ estimate of the likelihood of their occurrence as well as their confidence in that estimate.

Finally, Schneider, like Bonnie, insisted that his medical decisions were his to make. He treated his doctors as medical advisors, valuable for their knowledge, experience, and intuitions, but ultimately he had to make his own choices based on their advice.

If this sounds abstract, let me try to clarify with an example. One of the treatments Schneider’s doctors recommended, in addition to standard chemo, radiation, and a bone marrow transplant, was a new antibody drug called Rituxan. Rituxan targets a protein called CD20 that is expressed on the surface of B cells, the immune cells that cause mantle cell and other lymphomas. Essentially, Rituxan allows the body’s immune system to recognize B cells as foreign cells, which are then destroyed by the immune system’s NK (natural killer) cells.

The standard protocol was to administer a large dose of Rituxan (along with conventional chemo), then perform a bone marrow transplant, and then—to wait and see if the cancer came back, as detected by a CT scan. If it did—and 50% of patients on this protocol lost remission at least once within four years—they would try it again. But a second remission was harder to achieve than the first.

This didn’t sound like a good idea to Schneider. First, he questioned the means of monitoring his response to treatment. A CT scan won’t detect signs of cancer until there were already hundreds of millions of malignant cells and a detectable lump. Was there a way to monitor him more closely? It turned out there was, a highly sensitive molecular-based diagnostic test called PCR (polymeric chain reaction). PCR would provide a much more accurate measure of Schneider’s cancer cell count.

Schneider also realized that if the protocol didn’t kill the disease completely—and it was a coin toss whether it would—then the remaining cancer cells would keep reproducing, and in a few years he’d be right back where he started. Why not take a different tack, he reasoned, and presume the cancer is still present? It didn’t matter if his cancer was never cured, so long as the malignant cell count was kept below a dangerous level.

So Schneider requested what he called “maintenance therapy.” After the standard chemo, Rituxan, and bone marrow transplant, he wanted to receive low “maintenance” doses of Rituxan at periodic intervals. He also wanted periodic counts of his CD20 cells (to measure whether the Rituxan was wearing off) and cancer cells (via PCR), so that the dosage and interval could be adjusted if necessary. If his cancer cell count crept above negligible levels—signifying that his immune system wasn’t adequately controlling the cells—he would get another dose of Rituxan.

One of his doctors disapproved strongly. “We have no data whatsoever to suggest that low-dose interventions would have any benefit,” he said, “and operating without data would be foolhardy.” If there were no clinical trials showing that a particular treatment worked, it would be risky, idiotic, and even unethical to use it. Besides, side effects of the Rituxan might be damaging or even fatal.

So Schneider took his doctors through a decision analysis hypothetical. “Suppose you brought 100 people in off the street and gave them periodic maintenance doses of Rituxan,” he asked. “How many would die from the treatment?” The docs protested that they didn’t know because there were no trials. But Schneider persisted; he asked them to use their best clinical intuition and judgment. “Probably none, perhaps one,” Dr. Horning finally acknowledged.

“Now suppose you put 100 patients like me on the standard protocol,” Schneider asked. “How many would lose remission within five years?” “Probably eighty,” answered the docs. “And how many of those would not get back into remission with another chemo regime?” “Forty,” estimated the docs. “Who wouldn’t take that risk?” Schneider argued.

Schneider understood that he and his doctors were wandering into uncharted territory with Rituxan maintenance therapy. “There was no telling it would work,” he wrote in The Patient from Hell, “and no previous data that might help us develop a treatment plan.” But those are the risks you have to take when you are essentially running an experiment with incomplete data and a sample size of one. He viewed climate change the same way; with only one earth to experiment with, we’d better choose the treatment with the best chance of avoiding a catastrophic outcome.

This, I think, gives you a flavor of the way Schneider approached problems, both in climate science and in his battle with cancer. Ultimately, Dr. Horning agreed to put him on maintenance therapy—a low dose of Rituxan every three months—and it worked.

But Schneider was also an excellent writer and an engaging speaker, so I should get out of the way and let him explain it himself. Specifically, in 2008, Schneider gave a presentation at Stanford Medical School’s Café Scientifique entitled “Cancer and Climate Change: Parallels in Risk Management,” in which he outlined his approach to both issues. This talk is accessible and informative, and if you’re interested, I urge you to view it on YouTube or download it as a podcast from iTunes (available in the Medcast series from Stanford on iTunes U).

Near the end of the lecture (around 1:11), Schneider speculates, like Bonnie, that one reason doctors are so tied into the “standard treatment” has to do with liability issues. They are sometimes held accountable when, despite their best efforts, things go wrong. “I prescribed the standard treatment” is an almost universally successful defense against malpractice lawsuits. Schneider suggests that legislation is needed to exculpate doctors who, with their patients’ understanding and consent, depart from standard treatment to personalize their care.

One might wonder whether the aggressive treatment of Schneider’s cancer weakened his heart and eventually led to his heart attack. Of course, it’s impossible to know for certain. But it was a risk he took knowingly and voluntarily, believing that without that treatment he would likely be dead.

What Schneider and Bonnie share is their refusal to take the standard protocol on faith, their willingness to get their hands dirty with admittedly limited data, their insistence that their treatment be personalized, and their resolve to take responsibility for their own treatment decisions and outcomes. In the end, Schneider was able to spend his last nine years in good health, with his family, doing his life’s work—trying to make sure that we approach our climate the same way he approached his cancer. And that’s all any of us can ask for.

Copyright © 2010, John Unger Zussman. All rights reserved.

<!–[if !mso]> <! st1:*{behavior:url(#ieooui) } –>

Not Your Median Patient:
How A Scientist Faced Cancer
By John Unger Zussman

Stephen Schneider, the environmental scientist, died of a heart attack last month at the age of 65. He was a Stanford professor, a member of the Nobel Prize-winning Intergovernmental Panel on Climate Change, and a tireless and articulate advocate for action to counteract the threat of global warming. The blog Realclimate.org has posted a moving “scientific obituary” by Benjamin Santer of the Lawrence Livermore National Laboratory. There was even a tribute on the NPR program Science Friday.

What most of the obituaries mention only in passing (if at all) is that Schneider was a survivor of a rare and often deadly cancer called mantle cell lymphoma. He was diagnosed in 2001 and refused to accept both the medical establishment’s standard treatment and its dismal prognosis. Instead, he diligently applied to his cancer the same principles of decision analysis that he used as a climate scientist, and as a result persuaded his oncologist, Dr. Sandra Horning, to treat him more aggressively than the protocols dictated. In 2005, safely in remission, he published an account of that battle, The Patient from Hell.

I’ve written about cancer in these pages before, recounting what I learned when someone I love, “Bonnie,” was diagnosed with breast cancer, and discussing the role of environmental toxins in causing cancer. If you read that first piece, you might be surprised that Bonnie, who chose to “undertreat” her cancer, looked to Schneider, who chose to “overtreat” his, as a positive model. But she did, and in this essay I want to explain why.

Both Bonnie and Schneider found inspiration, in turn, from Stephen Jay Gould, the late, great evolutionary biologist. At age 41, Gould was diagnosed with abdominal mesothelioma, a cancer from which the median survival was only eight months after diagnosis. Two years later, he published a seminal essay entitled “The Median Isn’t the Message,” in which he interpreted that statistic and explained how he took hope from it. Beautifully written, it’s must reading—especially if you have been diagnosed with a serious illness.

The median, if you remember your college statistics, is a measure of the “average value” (central tendency) of a set of measurements that are distributed along a scale. It refers to the “middle” value if the measurements are sorted, top to bottom—half the scores are above, half below. It’s useful because it’s less sensitive to extremes than the mean, or mathematical average.

Gould realized that there was nothing magical about the median; it’s a measure of central tendency, but it doesn’t describe the distribution. His own survival might be any data point on that curve (constrained by the shape of the distribution). Yes, 50% of abdominal mesothelioma patients survived eight months or less, but another 50% survived longer—some, given the characteristics of the distribution, significantly longer. Rather than despair, Gould set about figuring out how he could get himself on the long end of that curve.

And he did. He beat that cancer and had twenty more healthy and productive years—completing his magnum opus, The Structure of Evolutionary Theory—before he succumbed to an unrelated lung cancer in 2002.

Schneider’s insight was no less profound. He looked at the way the medical profession evaluates cancer treatments based on endpoints—survival or recurrence of the median patient at the end of a clinical trial of one treatment vs. another (or vs. a placebo). A good starting point, he said. But what if the disease is rare (like his) and there are no trials? Or what if a promising new treatment hasn’t yet been tested? Or what if you don’t resemble the median patient?

This situation reminded Schneider of climate science, in which you have a single patient (the Earth) whose symptoms are beginning to alarm you. Unfortunately, you lack good data on endpoints, your predictive models are imperfect, and the error ranges in your forecasts multiply upon each other. You have no other planets to run experiments with. “You can’t do controlled experiments on the future,” Schneider said in his last major interview. “What are we going to do, wait for it?” Of course not. You collect as much data as you can about the climatic processes. You make your best estimates of the probabilities of each outcome, cognizant that they are only estimates, while continuing to monitor the data and update your models. And you make your best recommendations for policy that, you hope, will avoid the most catastrophic outcomes.

Applying these principles to medicine, in place of absent or inadequate clinical trials, or to supplement them, Schneider recommends process knowledge, Bayesian updating, and decision analysis. Process knowledge means that “your doctors should know how various treatments—both mainstream and not—work, how treatments for diseases similar to yours might work for you, what treatments are unlikely to be effective, and how your overall health could be effective.” Bayesian updating is a fancy statistical term for monitoring your response to treatment and adjusting it accordingly. Decision analysis means weighting potential outcomes, risks, and benefits by your doctors’ estimate of the likelihood of their occurrence as well as their confidence in that estimate.

Finally, Schneider, like Bonnie, insisted that his medical decisions were his to make. He treated his doctors as medical advisors, valuable for their knowledge, experience, and intuitions, but ultimately he had to make his own choices based on their advice.

If this sounds abstract, let me try to clarify with an example. One of the treatments Schneider’s doctors recommended, in addition to standard chemo, radiation, and a bone marrow transplant, was a new antibody drug called Rituxan. Rituxan targets a protein called CD20 that is expressed on the surface of B cells, the immune cells that cause mantle cell and other lymphomas. Essentially, Rituxan allows the body’s immune system to recognize B cells as foreign cells, which are then destroyed by the immune system’s NK (natural killer) cells.

The standard protocol was to administer a large dose of Rituxan (along with conventional chemo), then perform a bone marrow transplant, and then—to wait and see if the cancer came back, as detected by a CT scan. If it did—and 50% of patients on this protocol lost remission at least once within four years—they would try it again. But a second remission was harder to achieve than the first.

This didn’t sound like a good idea to Schneider. First, he questioned the means of monitoring his response to treatment. A CT scan won’t detect signs of cancer until there were already hundreds of millions of malignant cells and a detectable lump. Was there a way to monitor him more closely? It turned out there was, a highly sensitive molecular-based diagnostic test called PCR (polymeric chain reaction). PCR would provide a much more accurate measure of Schneider’s cancer cell count.

Schneider also realized that if the protocol didn’t kill the disease completely—and it was a coin toss whether it would—then the remaining cancer cells would keep reproducing, and in a few years he’d be right back where he started. Why not take a different tack, he reasoned, and presume the cancer is still present? It didn’t matter if his cancer was never cured, so long as the malignant cell count was kept below a dangerous level.

So Schneider requested what he called “maintenance therapy.” After the standard chemo, Rituxan, and bone marrow transplant, he wanted to receive low “maintenance” doses of Rituxan at periodic intervals. He also wanted periodic counts of his CD20 cells (to measure whether the Rituxan was wearing off) and cancer cells (via PCR), so that the dosage and interval could be adjusted if necessary. If his cancer cell count crept above negligible levels—signifying that his immune system wasn’t adequately controlling the cells—he would get another dose of Rituxan.

One of his doctors disapproved strongly. “We have no data whatsoever to suggest that low-dose interventions would have any benefit,” he said, “and operating without data would be foolhardy.” If there were no clinical trials showing that a particular treatment worked, it would be risky, idiotic, and even unethical to use it. Besides, side effects of the Rituxan might be damaging or even fatal.

So Schneider took his doctors through a decision analysis hypothetical. “Suppose you brought 100 people in off the street and gave them periodic maintenance doses of Rituxan,” he asked. “How many would die from the treatment?” The docs protested that they didn’t know because there were no trials. But Schneider persisted; he asked them to use their best clinical intuition and judgment. “Probably none, perhaps one,” Dr. Horning finally acknowledged.

“Now suppose you put 100 patients like me on the standard protocol,” Schneider asked. “How many would lose remission within five years?” “Probably eighty,” answered the docs. “And how many of those would not get back into remission with another chemo regime?” “Forty,” estimated the docs. “Who wouldn’t take that risk?” Schneider argued.

Schneider understood that he and his doctors were wandering into uncharted territory with Rituxan maintenance therapy. “There was no telling it would work,” he wrote in The Patient from Hell, “and no previous data that might help us develop a treatment plan.” But those are the risks you have to take when you are essentially running an experiment with incomplete data and a sample size of one. He viewed climate change the same way; with only one earth to experiment with, we’d better choose the treatment with the best chance of avoiding a catastrophic outcome.

This, I think, gives you a flavor of the way Schneider approached problems, both in climate science and in his battle with cancer. Ultimately, Dr. Horning agreed to put him on maintenance therapy—a low dose of Rituxan every three months—and it worked.

But Schneider was also an excellent writer and an engaging speaker, so I should get out of the way and let him explain it himself. Specifically, in 2008, Schneider gave a presentation at Stanford Medical School’s Café Scientifique entitled “Cancer and Climate Change: Parallels in Risk Management,” in which he outlined his approach to both issues. This talk is accessible and informative, and if you’re interested, I urge you to view it on YouTube or download it as a podcast from iTunes (available in the Medcast series from Stanford on iTunes U).

Near the end of the lecture (around 1:11), Schneider speculates, like Bonnie, that one reason doctors are so tied into the “standard treatment” has to do with liability issues. They are sometimes held accountable when, despite their best efforts, things go wrong. “I prescribed the standard treatment” is an almost universally successful defense against malpractice lawsuits. Schneider suggests that legislation is needed to exculpate doctors who, with their patients’ understanding and consent, depart from standard treatment to personalize their care.

One might wonder whether Schneider’s aggressive treatment of his cancer weakened his heart and eventually led to his heart attack. Of course, it’s impossible to know for certain. But it was a risk he took knowingly and voluntarily, believing that without that treatment he would likely be dead.

What Schneider and Bonnie share is their refusal to take the standard protocol on faith, their willingness to get their hands dirty with admittedly limited data, their insistence that their treatment be personalized, and their resolve to take responsibility for their own treatment decisions and outcomes. In the end, Schneider was able to spend his last nine years in good health, with his family, doing his life’s work—trying to make sure that we approach our climate the same way he approached his cancer. And that’s all any of us can ask for.

Copyright © 2010, John Unger Zussman. All rights reserved.

Raving On: The Archaic Revival in 2010


On a  recent sunday afternoon my husband was taking a disco nap reclining on faux-fur cushions in a gazebo bedecked with hanging saris and tie-die fabric. Some fifteen hours before he’d been playing records stage left of here, illuminated by crazy visuals projected onto a panoramic screen behind him.

I’m delighted and impressed to see that since 7am, when we left the dirt dance floor and now, a clean up crew has been through and meticulously lifted every cigarette butt and denuded the altar of many beer bottle offerings. We are guests in the un-incorporated town of Belden which used to host biker parties back in the day and has recently embraced the rave scene, giving a new home to the Sunset campout, the favorite event of the year for a crew who throw free parties, boat parties, and club parties all year round. The venue which runs by the side of the Feather River is thoroughly occupied by around seven hundred party people who are either drifting between outdoor dancefloors,  their pop-up tents and the bathrooms  or floating in the cool green river. Hakim Bey would be proud of us; this is a dedicated Temporary Autonomous Zone – folks are eager to do their rave thing, especially their ritual hours on the dancefloor: getting on with being in the moment for as long as the moment can last.

On the cushions here, while dad augments his hour and a half morning snooze  (no more was possible in our unshaded tent) I sit smoking and thinking about how relevant or interesting writing about a rave in 2010 might be. It has been over twenty years since the advent of rave culture when house music, acid house and techno brought  a new all-night underground dance experience replete with mind-expanding  psychedelics  to the masses. The first rave I went to was in an old school building in south London which had been squatted and groovily adapted as a venue. My life transformed as my mind tuned into unknown sensations and my body became a medium for music that drew me and my two left feet into a space I had never imagined existed. My fervor for this experience led me away from the preoccupations of the commercial art world where I’d been busy curating “warehouse shows” this had all seemed quite radical until I segued with rave culture, whose creative modus operandi went far and beyond my callow hopes of  art world success. Raving constituted a full visceral and intellectual experience for me and nothing could hold a candle to it: I threw out my trendy Wittgenstein and Derrida and turned to McKenna and Leary who held the roadmap and the ciphers to this type of boundary-dissolving social phenomena.

Rave never had so much as a honeymoon with the mainstream media, the shock horror stories of Ecstasy use and unlawful, unregulated parties have been standard fare since the get-go. By 1994 in the U.K. the Criminal Justice Act was passed and raves were essentially outlawed, heavy penalties were meted out to organizers and the party scene migrated to the confines of commercial clubs and venues. Though this somewhat compromised the rave atmosphere, there was no going back for many: the combo of  house music, techno and MDMA induced an inexorable desire to dance, laugh, love everybody, wonder fearlessly – basically engage in that elusive boundary-dissolving activity that humans enjoy so much.

Unlike the countercultural movement of the Hippies, whose ideals have entered the mainstream and are seen to have enriched society, Rave has a lousy reputation for irresponsible hedonism.  Despite the tenacity and global reach of the rave scene and the undisputed originality of electronic music, ravers are largely considered to be epicurean knackerbrains of the first order.

So I set aside my notebook, gloomily noticing a spent whippet nestling in the cushions as I liberated a copy of Harpers from underneath my slumbering, raved-out partner.

As I turned pages I could hear the bass bins of the sound system down by the river and imagined the afternoon dance floor teeming with dancers who’d sporadically cool off with a dip in the river or another chilled beer from the cooler.

As soon as I saw the article “Improvable Feasts” I felt the flutter of a synchronic moment in effect—one of those nanoseconds where a glint of the hidden weave of the multi-dimensional cloth of life is revealed.

In this cleverly titled piece, Alain De Botton, ruminates on what greases the wheels of a well-functioning society. Feasts, he believes, were the origin of communal worship; once the average serf was well-fed he was disposed to think more kindly upon the societal strictures which bound him to both neighbor and god. Alain also favors the Judaic mechanism of Yom Kippur, the annual Day of Atonement where a touch of confessional humility will win the man-god’s absolution from most crimes.

I agreed with Alain on the failure of modern social locales (restaurants, nightclubs, art galleries) to promote community or companionability while projecting a simulacrum of that potentiality, but I don’t agree with his analysis of The Feast of Fools. He argues that this festum fatuorum, The Feast of Fools, was like a doctrinal safety value for both the Church and the wider dominator society, where everybody got  to participate in sanctioned anti-social behavior. The priest was at liberty to cavort around with an outsize woolen phallus strapped on, the mothers got loaded and ran off to the woods and the donkey pissed on the altar — after the fest the populace settled back down to another year of medieval drudgery, apparently satiated.

Wild feasting in the name of god and community is a pleasing idea but I believe those early feasts, for example the Agape feasts of the early Christians had other components, perhaps more important than the fatted lamb on the menu. De Botton chooses to ignore the significance that Agape translates as love and that if the fare of these festivals was just food why did the Council of Laodicea in 364 A.D. ban them from the religious calendar? It was the free-form carnal exuberance of Agape that the early Christians sought to eradicate; the vestiges of our ancient pagan practices, our boundary-dissolving  goddess worship that they cleaned up and reinvented as the Eucharist. The medieval incarnation of the festum fatuorum might well have been presented to the peasants as a “chance to be naughty and get away with it” and this is clearly De Botton’s take, but I believe its roots were older and pagan and not anti-social at all. Terence McKenna, beloved of ravers, had a radical theory about human consciousness and societal evolution: he believed that psychedelic excursions on psilocybin and other plants were the catalyst for our adventurous step into language which then gave the means to create the ecstatic rituals, which like social glue, bound us deeply together.

Mckenna and Leary, and other counterculturalists made a point of alerting our raver generation to the importance of boundary dissolution and the nature of psychedelic experience: in the psychedelic landscape we are explorers stepping outside of our cultural programming, looking for usable ideas and perspectives to bring back to our dominant physical reality for consideration.

This lofty task, the heady territory of the ancestors, is a place that boundary-dissolving  ravers are equipped to negotiate, but this rite of dimensional passage is not necessarily for every brain.

Terence often referred to Marshall McLuhan, the philosopher and communications theorist who wrote prophetically in the year I was born that “the medium is the message” – he believed that our contemporary means of communication were the pertinent subject to study rather than what was actually being said.

Thus, as the DJ awoke, craving a vegan wrap and requesting a last late trip to the dancefloor, I grasped the essential idea that has kept so many of us endeared to rave.

The medium is dance and boundary-dissolution – the ecstatic building blocks of culture which has served us throughout time. These psychedelic tools held our early cultures together, in times when true loving kindness,  charity and selflessness were essential to survival.

So turn up the bass, brothers and sisters, we need real community in the face of our imploding dominator society, and the vibe we share on the dancefloor is the one to take home to Mama.

fabulous foto courtesy Alyson Kohn