Book Review

Hallelujah Anyway

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I have been on an Anne Lamott kick lately. I’m reading her book on writing, Bird by Bird and I have checked out both Almost Everything and Hallelujah Anyway from the library. I managed to finish Hallelujah Anyway over the course of about 6 weeks of listening to it between sets while working out in the mornings. The book is about mercy, a concept greatly lacking in our modern world, one that if you were to ask the average human “Who is one person you wish you were more merciful with?”, they’d probably think you were deranged. This is unfortunate given its immense power to provide actual freedom, partially to the receiver but more importantly to the giver.

Mercy is defined as “compassion or forbearance shown especially to an offender or to one subject to one’s power.” Lamott’s book is almost entirely about mercy for ourselves even though where that often begins is with mercy with someone who has wronged us. The definition of the term implies a hierarchical relationship between two people as in a king and a subject or a judge and a criminal. In these instances, the ability to give mercy is built into the hierarchical relationship. A judge can show mercy on a criminal in certain circumstances. Perhaps it’s a first offense or a partially justifiable crime or any other situation that might warrant leniency. But the criminal cannot show mercy to the judge, not in the sense we might often interpret the word.

The beauty of Lamott’s book and her insight is that she turns this on its head by pointing out the fact that often when we need to impart mercy to someone in our lives, we have allowed the subject to hold the power over our freedom and our psychological health. We all have stories of people who have deeply hurt us. Many of us cling to these hurts as if they are treasure, building up a wall from them so that we can avoid being hurt again. The irony of this is that the offender often has no real power over us in the sense that a king or a judge has over those before them. We willingly give the offender the power to control our minds by focusing on what they have done to us, letting it fester or grow cancer-like for years. It consumes energy and causes anxiety. We become the slave, the subject, as if we need the mercy. We accept the sin against us as if it were a truth about our actual person.

Lamott shows in the book through her personal experiences with mercy how only by giving mercy to ourselves, often by first forgiving the original slight, can we gain back the wonderful freedom we had before. Instead of allowing the sin or slight against us to define who we are, convincing ourselves we really are dumb or ugly or fat or whatever else someone accused us of, we must show mercy to ourselves. Only then can we stop being the criminal in the transaction and become whole again. When we choose to cling to past hurts, we give up our freedom. The only way to regain that freedom is to forgive.

This is a powerful concept but not one found in wide use in our modern world of constant attacks, polarization, and antagonism framed as debate. The beauty of the concept is that once we become more merciful with ourselves, we become more merciful with the world. We become not weaker, which would be the common conception of someone who is merciful, but more powerful, able to withstand great events of fate that turn against us with grace and happiness. When we hold on to the hurts, we willingly take our freedom and give it away to ghosts that don’t even exist. To regain that freedom, we must be willing to be merciful, first with ourselves and then others.

I struggle with this a great deal. I have Imposter Syndrome about just about everything. I prefer justice, preferably fateful in nature, over mercy any day. Most people do. We have a keen sense of fairness as human beings and when we are hurt, we prefer to have the world make it right by imparting some justice for us. But this so rarely happens. Lamott teaches that it is ok to be an Impostor, that maybe, just maybe, you aren’t if you’d only allow yourself the right to forgive yourself for it all. It’s a battle but one worth jumping into because without it, my freedom is being given to people or things that don’t deserve it.

The book has a great deal more to it about regaining a sense of wonder and curiosity and joy through the power of mercy. It is a tonic for our modern world in many ways and definitely worth the read or listen. Lamott believes strongly in a spiritual, mystic Christianity but there is plenty in the book for people who do not. It’s a fast read and full of Lamott’s usual wit and subtle humor. If you are looking for a way out of the polarization and out of the trap of holding on to things that steal your freedom and joy, it’s a good start.

On A Life Well Played

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I recently finished Arnold Palmer’s autobiography A Life Well Played and it was a wonderful reminder of the man’s class, dignity and personality. In it, he remembers the great moments of his life as well as many of the worst. He talks about the influence of his father on his life and how that was the defining characteristic of every thing he did in life. His father was a typical man of the early 20th century. There was little softness in him but he clearly cared for and loved his family. He didn’t want to be his children’s best friend. He wanted to provide them the direction and the guidance necessary to have successful lives. Arnold followed his lead.

In today’s world of narcissism, it’s refreshing to hear stories of Palmer giving back to his fans, to his community, to society at large. He also tried to pass these values on to other people. One of the chapters talks about appearance and the way you are seen in public. Palmer was always conscious of his image, not because of how handsome he thought he was or to impress other people but as a way to express how things ought to be. He once ran into a young tour player who hadn’t gotten too close to the razor one morning before a practice round at Palmer’s tournament at Bay Hill. Palmer told him that he hoped the next time he saw him on the course that he would be clean shaven. Today, we see that as an invasion of someone’s right of expression. But perhaps we’ve gone too far in our relaxation of what is correct when it comes to public appearance. Maybe this relaxation of norms actually has deeper philosophical implications when it comes to self-discipline and self regulation.

We worry about being too hard on our kids or possibly not being considered their friends. I think about this a lot now that I have a little genetic clone of myself running around the house. Somewhere along the past 100 years, social norms concerning child raising have changed, often drastically and in a way that leaves our kids unprepared for what they face outside the home. Palmer was prepared for life because his father had been laser focused on raising him to be a man regardless of the result of a pro golf career. He was taught sportsmanship and hard work and discipline. Then when the time came that he needed those lessons to lean on, he had them at hand.

Palmer once got mad during a junior golf tournament and threw a club. He ended up winning the tournament and was congratulated by his friends and the gallery. But on the ride home, his father told him that if he ever threw a golf club on the golf course again, he’d never play golf again. Self control and graciousness are more important than winning. I wonder how many fathers (or mothers) would do the same thing today in the same circumstance or with the same force.

Self discipline, more than any other characteristic, is how success is achieved. All other things equal, the ability to control one’s actions leads to success in health and life and business. These aren’t things we talk about anymore. We’ve elected a President with the self-discipline of a puppy. We’ve followed an economic path for years that is the opposite of any form of restraint. Our foreign policy in the last 20 years has been defined by rushing into situations without planning or consideration for possible long term implications and I fear, it’s about to get worse. It seems simplistic to think that our society’s relaxation of cultural norms like hard work, discipline and an empathetic understanding of the guy across from us on the 18th green or the business table or the world stage might be leading us into our current broken state. But I’m not sure how you can look at the events of today and not at least consider how things might be different with a nation of strong mothers and fathers teaching their kids not how to express themselves at every turn but instead how to restrain themselves. There is a time for expression. But there is more time for self regulation and we have lost that balance.

The irony of our cult of expression is that at the time we seem most free we are actually more restricted than ever. We carry more debt both as a people and as a nation than we ever have before. These debts restrict what we are capable of achieving. Our government continues to grow to sizes never envisioned by the Founders. A few corporations control huge portions of our economic and social life, directing our attention without us even realizing it. The “freedom” of social media actually makes us anxious and depressed.

Goethe said “It is in self-limitation that a master first shows himself.” I believe this is true in life as much as it is in art or music. A successful life comes from self-limitation by respecting your future self and delaying gratification of desires. Being able to control one’s own mind is critical to achieving goals. The question is, how do we teach our children this in a world where instant gratification is literally built into every thing we do? Not giving your child a cell phone is probably tantamount to abuse these days yet more and more data is emerging that says screen time for children is almost surely a net negative. We want our children to behave so we hand them a mobile device instead of the much more unpleasant option of forcing boredom on them.

When I think of a parent like Palmer’s father, a man who in today’s world would be considered cold and possibly even mean, I wonder if our norms haven’t changed too far. I want my daughter to love me but more than anything, I want to provide for her the tools necessary to succeed in the world. To me, these tools are self-discipline, empathy and the value of hard work though maybe not in that order. How that happens, I’m not sure yet. But it’s nice to read stories like Palmer’s where the clear influences of a strong parent had lasting impacts on the character of the child no matter how successful he got. That is the true measure of a Life Well Played.

The Wilderness Warrior

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I recently finished reading Theodore Roosevelt’s biography, The Wilderness Warrior written by Douglas Brinkley. The book is focused on the conservation crusade that Roosevelt embarked on to save millions of acres throughout the United States from logging, mining and private holdings. I had no idea the scope of the mandates Roosevelt handed down over his two terms. Many of the national forests and parks were set aside with executive orders during Roosevelt’s tenure. He strongly held that a life lived outdoors in the wilderness was the way to happiness. He called it the strenuous life and he was determined to provide places that future generations of Americans could lead lead that life among Nature’s beauty. I was struck throughout the book by TR’s understanding of the natural world.

He was a master orinthologist before he went to college at Harvard, able to recognize hundreds of birds not only by sight but also by the songs and sounds they made. He wrote papers on wolves and elk. Roosevelt essentially was the father of conservation in America from a political standpoint (there were many naturalists at the time like Burroughs or Muir but they were hardly in the position to implement change that TR was). He was also the first President to use the Executive Order as a policy means, implementing hundreds of federal bird reserves, national parks and national monuments without ever having to deal with Congressional approval. The next time you hear some political wag complaining about Obama’s or Bush’s usage of the Executive Order to implement policy, remember that TR used the EO a staggering 1081 times, a full 864 more times than the record at that time, Ulysses Grant (217).

Existing in a time before a 24 hour news cycle, TR was able to implement policy he deemed important and that policy was largely focused on setting aside millions of acres of forest throughout the western states of California, Colorado, Wyoming, Montana and Utah. On one day in 1908 (July 1st), he created 45 national forests just by signing his name with a pen. Of course it was a different time and place but today, even the slightest policy change effected by EO is railed against by the opposing party as if it were a personal attack. In an environment of increasing political divisiveness, I’m surprised Presidents, especially outgoing ones, don’t use the EO more to implement policy.

Roosevelt’s idea of the strenuous life is another idea missing from our world today. So little of what we do could be considered strenuous and this was one of TR’s greatest fears. He saw the increased urbanization of America as a scourge to fight against at all costs. Today in our world of ease and comfort, there is little that is strenuous. Manual labor, even skilled manual labor, is discouraged across all spectrums which Matthew Crawford wrote about in Shop Class as Soulcraft, another book I recently read. We choose leisurely careers, at least from a physical viewpoint, and we spend our leisure time doing mostly leisurely activities (says the guy writing a blog post on a computer). Roosevelt advocated the opposite, leisure time spent in the wilderness hunting, camping, ranching or birding. He regularly went on expeditions through the woods that were difficult. In fact, he seemed to grow happier during times of difficulty like hiking mountains during a snow storm or hunting bears in Louisiana.

The book is long, perhaps too long at 800 odd pages, but it’s eye opening for someone like me who long ago forgot the power of our 26th President. It’s also an excellent reminder of a time when a strong personality in the Presidential office resulted in sweeping changes that affected generations for years. TR’s emphasis on conservation changed both the physical and political landscape of America. As I go through the Texas Master Naturalist program, I see the effects of his policies even today with the focus on conservation of rangelands and prairies in Texas. I hope to continue living a strenuous life in honor of Theodore Roosevelt.

On Antifragility

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Une maison est une machine-à-habiter. A house is a machine for living in.” Le Corbusier in Vers une architecture (1923)

Le Corbusier was a French architect, urbanist and writer influential in the early 20th century on urban planning. He was an idealist who saw the slums of Paris and dreamed of imposing order on them. He saw the slums as crowded, dirty and lacking morality. Le Corbusier envisioned a Contemporary City with 60 story cruciform skyscrapers enshrouded in glass to house the homes and offices of the wealthy. These huge buildings were placed in large, rectangular green space areas. In his utopian city, as you moved farther from the city center of the skyscrapers, zigzag multistory buildings would house the less wealthy. Early on, Le Corbusier recognized the impact the automobile was going to have and his ideas influenced the modern urban planning zeitgeist of urban centers redeveloped to be high density areas connected to outlying suburban and rural lower income housing by freeways.

Le Corbusier looked at the randomness and disorderliness of the slums and longed to impose order and homogeneity on them. He saw inefficiencies in the organization of humanity and created a landscape that was efficient if nothing else. His greatest desire was to make things a machine as evidenced by the opening quote. Things should fit in a box in the most efficient manner possible. Of course, the problem is, in nature and in humanity, the efficient and the homogenous are delicately fragile. Something that is highly efficient has little redundancy built in and fails at the first wrench thrown into the works. Homogenizing the living arrangements of the poor results in even greater disparity in class structure, in modern times leaving a vacuum often filled with gangs, drugs and violence (see the Cabrini-Green Housing Project). We know now (though we have yet to internalize it at any real societal level) that separating the classes by gates, walls and miles of freeways leads to inhospitable cities lacking in vibrancy. It may be efficient to put all the offices downtown and have all the proletariats drive in from the suburbs but it leaves the city desolate and the people unhappy.

Antifragile: Things that Gain From Disorder is Nassim Taleb’s latest book dealing with concepts he has spent the last several years exploring. It defines a new term, antifragile, as the exact opposite of fragile, more than robust or resilient but actually a system, body or item that improves under stress. This new term is required in many ways as our language lacks the precise description of the concept. Robust is the closest we can achieve but this is lacking in that something robust deals with stress well, is neither harmed nor improved but doesn’t actually grow stronger under stressors.

The concept is fascinating and applies to many aspects of modern life, typically in the negative. For the past half decade or more, we have been marching away from the antifragile in politics, economics, medicine, personal health, personal and national financial responsibility and philosophy. Our systems are more and more planned and efficient, hallmarks of the fragile. We struggle mightily to remove the variability in the system whether that’s our economic system or our daily health. We bail out TBTF banks to prevent them from failing and causing a ripple effect on the world economic scene and we sit on the couch taking ADD medicine and Prozac to avoid the highs and lows of emotional daily life. We pore over daily status updates and Twitter feeds and empty news stories constantly increasing the noise and pointless information while decreasing the signal and meaningfulness in our lives. Every day, our society becomes more fragile and largely, so do we as individuals. If there is one thing nature hates, it’s a planned, efficient fragile system yet that’s what we are constantly striving to create. Avoiding the risks and bumps of a system by kicking the can down the road necessarily fails poorly.

The urban planning of Le Corbusier with its hope for utopia and imposed order on a functionally messy and disorderly system was doomed to be fragile. In a complex system, top down planning cannot hope to capture all the possible ramifications of decisions and outside effects. These decisions eventually will manifest themselves in novel and disturbing ways. Our economic system, protected by the elites of government from the variability necessary to make it stronger, failed magnificently in 2008 and nothing has changed. The interconnectedness and complexity of the economic system dictates that future variability and shock will cause unforeseen and disturbing effects.

I’m hoping to write several posts on the topics and ideas of this book examining the concepts of fragility and antifragility and how they relate to so many aspects of our current cultural, personal and socio-economic lives. To be fragile is to largely be miserable and while it is difficult, it is not impossible to move farther on the continuum away from fragility and towards a more robust and possibly antifragile life and culture.

Meditations On Meaning

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“I denied myself nothing my eyes desired; I refused my heart no pleasure. My heart took delight in all my work, and this was the reward for all my labor. Yet when I surveyed all that my hands had done, and what I had toiled to achieve, everything was meaningless, a chasing after the wind; nothing was gained under the sun.” Ecclesiastes 2:10-11

Once upon a time in a land far away, meaning in human life was simple (though not easy) to acquire. It was dictated to you, either physically because you were starving and living on the edge of death in the case of the earliest civilizations or culturally through your king, monarch, dictator or God. For the greater part of human history, the idea of finding meaning was as silly to most people as the idea of buying bottled water for $2 was to my grandfather. Before the huge advancements in quality of life, especially in the developed world in the 20th century, the idea of trying to find meaning in your life was limited to fulfilling the base needs of shelter and food in many cases. If you were lucky enough to have shelter and food, meaning was likely imposed on you through religion, at least in the Western world.

However, man’s search for meaning has always existed at some level in society as evidenced by the entire book of Ecclesiastes where The Teacher, at the end of his life, details his corporeal search for any meaning. He finds all secular meaning wanting-wisdom, pleasure, toil, riches, none of them infer any meaning on ones life. He concludes that only through God can we achieve meaning because it is only through God that we may experience life everlasting. And this is how it was for a long time, and still is for a great many.

Then the existentialists came along and screwed everything up. When Nietzsche surveyed the scientific and philosophical landscape known to man at the time and declared “God is dead”, he effectively killed off the only way we could impart meaning on our lives. Without God (and realize it’s a mistake to take Nietzche’s words literally; they represent the idea that we paltry humans had acquired enough knowledge to decide that the mythologies which had ruled our conscious for millennia were no longer necessary as explanations for our physical world) The Teacher from Ecclesiastes is left rudderless in a voyage to find meaning. Without God (or Buddha or Mohammed or Zeus or whatever theological implementation of a Higher Power the culture we were born into believes), who can we turn to embody our puny lives with meaning (and why is so important)? Or so Nietzche said albeit more poetically and eloquently.

The materialism of the late 20th century only served to make matters worse. As society became more secular in nature, farther removed from the thought of a meaningful God, it also became more materialistic. “Keeping up with the Jones” became the rule. But we found that with each thing we acquired, the amount of meaning it imparted on our lives lessened, like any addict can tell you about the particular drug of choice. The constant search for something else to acquire for our fix of externally provided meaning rapidly becomes an exhausting rat race as the materialistic pellets the dispenser keeps kicking out seem to be less and less potent. Whether we turned to material things, alcohol, drugs or sex, we found that meaning was always fading away from our grasp.

With God out of the way and our basest desires met by a continually increasing standard of living, we discovered that life was still empty. Theologians would argue that by turning our focus away from the internal face of God and focusing on the secular, external materialistic world, we effectively killed our chances of ever finding meaning. The Teacher in Ecclesiastes had to be on to something, right? And in fact he was though I can’t speak to what God has to do with it since if I could, I’d likely be a great deal more famous. What The Teacher was on to was the fact that meaning must be created from an intrinsic internal process that avoids the pitfalls of constantly chasing wisdom or riches or pleasure. Our chronic dissatisfaction with our lives in the face of increasing standards of living like health and physical comforts is one of the great paradoxes of Western civilization. Happiness, which in many ways is a synonym for meaning, comes not from the external pursuit of some goal but from the internal factors that we use to interpret our own reality. How we integrate the events of our lives internally dictates our level of happiness with those events. That’s why a lowly coal worker in the mines of West Virginia can seem like the happiest person on earth while a titan of business living on the Upper East side of Manhattan can commit suicide in despair in spite of everything he owns. Happiness cannot be acquired externally. It has to come from within through a set of characteristics that dictate how we view the events of our lives.

That’s the premise of a book I just finished reading called Flow – the psychology of optimal experience. Essentially, to be truly happy, our goals must be independent of the cultural environment we find ourselves in. Our goals and the achievement of them must be intrinsicly derived and not set based on our beliefs about what society or anyone else thinks is appropriate. Buying a new car to impress the neighbors will result in that familiar feeling of reaching a long-sought goal only to discover the happiness accrued is fleeting and meaningless. Materialistic goals are inherently risky for this very reason. But mental or physical goals are equally dangerous.

Most of us know the feeling of achieving a long term goal. Maybe we want to run a marathon or learn a new language or travel to a new country. A great deal of effort goes into achieving this goal and when we do, we are strangely let down. So we set another goal and work towards it. The inherent problem with this approach is the entire focus is on the future. We are taught and molded from the beginning of our conscious days that things in the future are worth striving for. We study so that we can go to college. We go to college because it will allow us to get a better job. We work hard in our job so that we might get promoted. We save money so that we might retire. This focus on the future is evident in all cultures but it is ingrained in Western civilization. Of course, our culture dictates this because a civilization filled with people who care nothing for the future won’t last very long. Society is the benefactor of our focus on the future at the expense of our ability to create an enjoyable life.

An enjoyable life, both at the micro and macro level, is built through a focus and attention on the present. This doesn’t mean avoid all long term goals. But to imbue meaning on life, the achievement of those goals must involve the ability to focus on and enjoy the day to day steps required to reach them. Someone who trains for a marathon without actually enjoying the training will be able to cross it off her bucket list but the overall event will be meaningless. A person who learns a new language without being fully focused and attentive to the small steps along the way will be disappointed in the result. Enjoyment and meaning come from doing something for its own sake and nothing more. As soon as we decide to do something for any other extrinsic reason, meaning is impossible. This is what “Flow” is.

The general discontent that is so prevalent among humanity in the face of increased standards of living is created because we have always assumed that if we could just [insert any particular goal you care about here], then we’d be happy. But it turns out the old saw about how life is a journey not a destination is in fact true. Without the ability to treat everything along life’s path as a journey to be experienced and enjoyed, the destination will always be disappointing. And in fact, once we can turn attention to the actual journey, the destination becomes irrelevant.

The existential anxiety, that existential hum that Kurt Vonnegut talked about and said only went away with heroin use, is our constant companion because something within us expects our life to be meaningful but we are ill equipped to create that meaning ourselves. So we constantly chase something in the future, a new car, a new job, a new wife, a new religion, only to find out that that new thing is just as devoid of meaning as the last one was because we cannot learn to focus on the present and all the wonders it affords us. The psychological evidence presented in the book points to happy, fulfilled people as those who can find enjoyment in the journey regardless of the destination. There are people who have been in harrowing circumstances who still report enjoyment and fulfillment because they are able to focus their attention on the present and work their way out of the predicament while others immediately fail and die because they cannot see beyond their situation. Meaning doesn’t just come from the enjoyable times in life, it’s present always in lives of this nature.

I’ll admit, happiness and enjoyment have not been what you might consider hallmarks of my life. I have always been focused on the future either through the potential of a job that might be better, a relationship that might be better or more money that might afford something else to acquire. My ability to focus on the present has been retarded though hopefully not stunted. Nine months ago, I left a job in hopes of finding something that could make me happy. Now I realize I was on the wrong journey, that nothing in the external world could make me happy. I’m about to start a job that those same nine months ago would have sounded uninteresting and unsexy. Today, after a great deal of learning, I’m genuinely excited to be working there. I’m looking forward to working with a good friend on challenges I don’t yet know anything about. I’m still not good at getting over that existential anxiety but I’m getting better at it. This book has helped a great deal in realigning my focus on what increases meaning in life but it’s going to be hard. Still, I’m looking forward to the challenge.

I’m hoping to have several more essays come out of what I’ve read and learned from this book. For now, I highly recommend it to anyone who finds their current lives full of despair or anxiety. It’s a fantastic exposition on what the attributes and characteristics are of filling your life with enjoyment and meaning.

Book Review – The Great Cholesterol Con

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Let’s go on a little journey. Imagine if you will the following situation. A US pharmaceutical company, always on the outlook for ways to improve people’s lives, creates a drug that is exceptionally good at treating patients with chronic and acute pain particularly in cases of arthritis. The drug is submitted to and approved by the US Food and Drug Administration (FDA), that bastion of public protection, created to protect and promote public health. The drug gains worldwide acceptance among physicians who are treating patients with chronic pain. Over 80 million people worldwide prescribed the drug at some time. The pharmaceutical company has sales revenues of $2.5 billion in the fourth year of its acceptance because of its amazing success. This is clearly a story of the system working correctly, no? The research and development of a drug that is widely accepted, approved safe by the governmental agency designed to protect the public from rogue agents has to be a great success story.

Unfortunately that’s not the case. The drug described above is Vioxx. After 5 years on the market, it was voluntarily withdrawn by Merck after data in multiple studies showed that there was a dose-dependent increased risk of myocardial infarctions (heart attacks) among users of Vioxx. Over the course of its 5 year usage, it is estimated that Vioxx caused between 88,000 and 139,000 heart attacks, 30 to 40 % of which were fatal. There is some evidence that Merck either withheld data or reported it in a suspiciously favorable way that showed an increased rate of overall mortality from the FDA. At the very least, what we have here is an incident where a major pharmaceutical company had a drug that was exceptionally profitable. That drug was on the market for 5 full years before anyone managed to notice that it was definitely causing an increase in cardiovascular events and possible reducing the overall mortality of people taking it long term. The system does not protect us and can be easily manipulated by those most likely to profit.

This incident occurred through the usage of selective reporting of data in studies sponsored by the pharmaceutical company. Unfortunately, this is the norm in our current health environment. Studies and study authors are often directly sponsored by the pharmaceutical industry. Many times, the study data is directly interpreted by the industry. Since it is in their interest to present their products in the most positive light possible, it should come as no surprise that an incident like the Vioxx one came to be.

As it turns out, it’s entirely possible that another incident is ongoing except that it is 10 times as large as the Vioxx one above. Statins are a class of cholesterol lowering drug that had total sales revenues in 2009 of over $25 billion. They are led by atorvastatin (Lipitor) with a sales revenue in 2008 of $12.4 billion. The current thinking in the health industry today is that cholesterol is associated with cardiovascular disease (CVD) and thus, statins are prescribed to lower cholesterol in an effort to lower the risk of CVD. Unfortunately, the evidence to support such a conclusion is mixed at best and quite possibly not supportive of the conclusion at all.

That’s the thesis of the book The Great Cholesterol Con. The book’s author, Dr. Malcolm Kendrick, goes into great detail about the studies that have been used to support the cholesterol causes heart disease theory. He very clearly shows that the data is not nearly as ironclad as the pharmaceutical industry says, especially as it relates to cholesterol causing heart disease.

The main principle under discussion is the Diet-Heart Hypothesis which says that if you eat too many foods with saturated fat and cholesterol, the level of cholesterol in your blood will rise which will be deposited in the arterial walls causing them to thicken and harden which over time will lead to a heart attack or stroke due to a blockage in one of the arteries. This has been the main hypothesis for heart disease for many years. Unfortunately, it’s completely wrong.

It is Dr. Kendrick’s assertion that the hypothesis is flawed in two ways. First, the level of cholesterol in your blood has nothing to do with what you eat. The second, and more important, is that that doesn’t matter because cholesterol doesn’t cause heart disease. In support of the first point, the book uses a two pronged approach in support. The first is an analysis of what happens in individuals who have Smith-Lemli-Optitz Syndrome (SLOS) which is a an abnormally low cholesterol level. If you go to the above link, you’ll see that having abnormally low levels of cholesterol is horribly bad for us. And yet, we are being prescribed medicines by the millions to artificially lower our cholesterol. The second prong is explaining what the body actually uses cholesterol for. As it turns out, cholesterol is in high demand in the body, such high demand that you can’t possibly eat enough cholesterol to provide your body with the requisite amount. So the liver synthesizes 4 to 5 times the amount you eat just to keep up. If you eat less cholesterol, your liver has to make more. If you eat more, your liver makes less. This is called downregulation. It makes no sense at all that by eating less saturated fat and cholesterol, we’ll have less of it in our bloodstream because the liver is always going to produce the amount the body needs to function properly.

Regarding the idea that cholesterol and saturated fat don’t cause heart disease, Dr. Kendrick presents multiple examples of instances where either the saturated fat and cholesterol intake of populations drop but the rates of heart disease increase or vice versa. The two main studies here examine the effects of rationing on WWII Britain and the French Paradox. In WWII Britain, rationing forced the population of the UK to eat much less saturated fat and more vegetables and fish were eaten. During the 12 years this happened, the rate of heart disease trebled. The French Paradox is obviously one that most people are aware of. The French eat lots of meat, lots of cheese, lots of things that, if the diet-heart hypothesis were true, should mean an increase in heart disease across the population. Instead, the French actually have a much lower incidence of heart disease relative to other populations. There is other evidence presented in the book but these two alone provide data that how we are treating heart disease is wrong.

Returning to statins, the book argues that statins actually act not through a cholesterol lowering mechanism but through some other as yet unknown mechanism. Several studies are presented that show statins have an effect on heart disease regardless of cholesterol level in the study participants. In other words, even if you already have a low cholesterol level, statins occasionally protect you from heart disease. The presents a problem in the theory that the cholesterol lowering effects of the statin are responsible for the lower incidence of heart disease. Dr. Kendrick does believe that statins have some positive effect on the incidence of heart disease but that it is not because they lower cholesterol and the evidence he presents is compelling.

However, while you might be thinking that since they have a positive effect, it shouldn’t matter whether they act on cholesterol or some other mechanism, the reality of the situation is much less positive. Here are three facts supported by multiple studies concerning statins:

  • Statins do not reduce overall mortality in women.
  • Statins do not reduce overall mortality in men without heart disease.
  • Statins do not, therefore, reduce overall morality in >95% of the adult population.

What does all that mean? It means that even if you take statins and even if they reduce the incidence of heart disease, overall mortality is unaffected in 95% of the population. In other words, taking a statin will change what they write on your death certificate under “Cause” but the “Date” portion will remain unchanged. That means that while statins lower the incidence of death by heart disease, they increase the incidence of death by other factors. What you get out of years of paying through the nose for a statin prescribed to prevent heart disease is not a longer life but just a different kind of death.

Additionally, statins have a list of side effects and contraindications long enough to scare practically anyone that reads them closely. Remember how the body needs cholesterol to function properly? There are multiple incidences of people taking statins who suddenly have acute memory loss. This would make sense because one of the uses the body has for cholesterol is in the brain synapses. Statins are known to cause muscle pain and even rhabdomyolysis. The reduction of cholesterol in pregnant women may lead to very serious birth defects. The list goes on and on. And yet there are leading “experts” out there who think we might ought to put statins in the drinking water.

The pharmaceutical industry has a vested interest to the tune of over $25 billion in revenues in keeping statins at the forefront of the fight against heart disease even though it is abundantly clear that they have an almost negligible effect on overall mortality. This book goes into great detail the problems with statins, their minimal benefit to the greater part of the population and the grave dangers that are being overlooked in the widespread use of them. As in the Vioxx case, just because the pharmaceutical industry and the FDA says it’s good for you doesn’t actually mean it is. If you are on a statin or have been told by your doctor that you should be taking one, you owe it to yourself to read this book to see what you’re actually getting yourself into.

Book Review – Roads by Larry McMurtry

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I picked Roads – Driving America’s Great Highways up on a lark at the Wylie library on Tuesday and finished it Wednesday. Larry McMurtry is an excellent author and that transfers well from his more familiar fiction to this semi-travel book on driving the major roads of the United States. He starts off the book with an explanation of why he’s writing the book and the genesis for it. Many of the great American travel stories are about the backroads and their people, always the people, their lives and how they interact with the road. McMurtry has no interest in this and in fact expects to talk very little to people. His is more of a wanderlust, an exploration of the major arteries of the nation at the end of the 20th century, what those lifelines provide and mean to the country more as a whole and less at an individual level.

The book is arranged into chapters by the month in which the trip was taken, January, February (2), March, April, May, June (2), July, August and September. His pattern is to fly into a major city, pick up a rental car and take off. Many of the trips are planned ahead of time while others just have a beginning and an end with several options on getting from Point A to Point B. McMurtry isn’t concerned with lengthy trips and seems to average well over 700 miles a day when he’s on the road. Again, these are not leisure trips in the normal sense of the word, they are journeys to see and relate things seen along the major highways of America.

This would be a difficult book for most people to make interesting but McMurtry is so widely read and seems to have such an encyclopedic understanding of the authors of our country that he engages the reader by continually mentioning authors whose backgrounds or stories are based in the cities or states that McMurtry travels through. Many of the authors are long forgotten to most but McMurtry relates their literature as if he read them yesterday. This moves the book along, not as a series of roads that he is driving but a collection of authors that he has read and known, their strengths and weaknesses. Even when the authors aren’t related to the area in some way, McMurtry tightly intertwines them into the trip. Nelson Algren appears in the first chapter on I-35 from Duluth to Oklahoma City, “a valuable if flawed midwestern writer” by McMurtry’s own words, brought into the story based on a quote about where to eat.

He drives many roads that he is familiar with, in particular those coming from the East back to his home in Archer City. He lived in Washington, D.C. for an extended time and made the drive from there to Archer City many times. He chooses to mostly retrace that same route for the book, following the 66, the 81, the 40 and the 30 to get back home. His time in D.C. seems to have been both extremely positive and extremely negative. He opened a bookstore there with Marcia Carter and by all accounts was very successful for over 30 years. He talks about being fortunate to open the store in a period where the rare book market was starting to gain popularity, especially in a city of such history as D.C. But D.C. is also where he had heart surgery on December 2nd, 1991. He makes it very clear that he feels like he died personally and spiritually if not physically then. He left soon after and this trip for the book is one of the few times he’s returned since.

The chapter written in August is the most personal, detailing the roads of his youth around the ranch in Archer City where he grew up. In this chapter, we see what it was like to be a child growing up in rural Archer County, unnamed dirt roads as the main thoroughfares. He speaks matter-of-factly on the change from transportation as a half day adventure via horseback to the feeling of entitlement we experience today getting on a jet and traveling halfway around the country in 2 hours. This chapter is a personal examination, not just of his youth but of the changes that have occurred in transportation. He has written a book around the premise of driving 700 miles a day, seeing many things superficially. His father lived or worked on this ranch his whole life and saw one thing, the country, deeply and with meaning. Transportation is much the same. We hustle and bustle to get somewhere and then continue the hustle and bustle once we get there, never stopping to drink in what surrounds us. As he ages, McMurtry is beginning to see those changes clearly and with some nostalgia.

The final chapter goes from Seattle to Omaha and is one of the best. It’s a road that he hasn’t driven before. Most of his trips seem to end up gravitating back towards the plains. In that sense, this one is no different. Along the way, he finds the perfect road for those of us who love and appreciate the openness and stark beauty of the plans. His writing grows more introspective in this chapter and because the most of the book has lacked that, this chapter has a power to it that is fascinating.

This is a story of the major highways in America as they relate to McMurtry, the literature of the states and an examination of the meaning of those roads. If you appreciate a road trip, I think you’ll like this book.

Book Review – When The Cheering Stopped

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I recently finished reading When The Cheering Stopped, an account of the last years of Woodrow Wilson. This is the hardcover edition, published in 1964. K found it when going through some of her late father’s things and gave it to me since she knew I like history books. Based on the inscription, it was a gift from a classmate. It’s a well-written, slightly dated book that is worth reading to see the inner details of what went on in the last years of the Wilson Presidency as he tried to bring America into the League of Nations both before and after his stroke on the campaign trail for the League.

The title is a reference to how Wilson was received after The Great War in Europe where he was hailed as a savior, cheered on the streets of Paris and revered as a man who saved Europe from the catastrophe of war. The book is broken into three parts, a description of the President with insights into his views of the War and his reactions to sending America’s young men to battle in Europe. It describes the loss of his first wife Elly and we get a glimpse into the intensity of the man, his complete and total love for his wife and his near total inability to function after her death. He was a man of strong convictions, both in his politics and in his personal life and it comes through in this book.

Eventually, his grief fades and he is introduced to Edith Bolling Galt, the future Mrs. Wilson. The story of their courtship is touching and personal, one made difficult by the fact that he is President. It’s interesting to see how it unfolds, always with a Secret Service man in close proximity. This chapter also details the beginnings of the fight for America’s entrance into the League, supported so strongly by the President and opposed equally as strongly by Senator Henry Cabot Lodge. After it became apparent that he would never be able to strong-arm the Senate into ratifying entrance into the League, Wilson decided to take his argument directly to the American people in a whistle stop tour across the country. The details of the trip are striking in this day and age where so much distance is kept between our leaders and the commoners. Wilson was always close at hand, eventually having to be stopped from shaking the peoples’ hands because of his weakness. Throughout the trip and recounting, it is clear that his health is greatly declining. He suffers from terrible headaches and is obviously weakening as the trip continues. Eventually, in Pueblo, he suffered the stroke and the trip was cancelled. The touching moments when it becomes apparent to the First Lady how badly the President has been affected and the inner strength of the woman in the coming pages is remarkable.

The second section of the book is about Mrs. Wilson and her total and complete devotion to her stricken husband. Some have called her the first female president of the United States because for the remainder of his Presidency, he was largely incapable of any real work and everything, every decision, every bill, every meeting was funneled through Edith Wilson. At the time, little was divulged of the President and the public was largely kept in the dark regarding the seriousness of the President’s stroke. The Vice President, Thomas Marshall, was a weak man, actively prevented from decision making and the thought at the time of him assuming the Presidency was regarded as impossible. In fact, he wanted to have nothing to do with it. The descriptions of these people and their inner thought processes is remarkable. The quality of research that went into the book to make all this evident is extraordinary. Mrs. Wilson kept an iron grip on the access to her husband and it’s a fascinating juxtaposition with today’s requirements for instant information about every single detail of the political life. That a sitting US President was confined to his bed for months and even then, could only work for a few moments of the day is a fact almost unthinkable to us now.

The final section of the book covers the time after the Presidency when they lived on S Street in Washington. The book details the daily interactions in the family. It is an intimate account of the remaining years of Wilson as he slowly declined in health. The people of Washington were still exceptionally supportive of the former President and multiple instances occur of people writing him to express their gratitude or love. People founded clubs at their University in his honor. The fact that so many of the American people loved and supported the ex-President comes across clearly in the anecdotes and details of the book.

The book is largely supportive of Wilson and certainly has to be read from that viewpoint. But it is well-researched and written and offers an striking view into both the end of a man’s life and the end of a national era. Never before or since has something like this at the highest level of American politics happened. It is a detailed look at the convictions of both the man and his wife, convictions that affected our history on a political level. But it’s also a human story, one of love and personal triumph and grief that is worth reading.