This blog has moved

Its new home is www.NathanaelJohnson.org - there you will find this blog, as well as more information about the book and what I'm up to, all in a much more elegant form.

The Organic Food Study: Why so angry?

Beautiful produce shops like this one (at the base of the building we lived in) are scattered every few blocks throughout Buenos Aires. It's probably not organic produce, but it's delicious and cheap.

A couple people have asked for my opinion about this study that came out a couple days ago on the nutritional value of organic food. To summarize: The findings made for great internet - you could get the gist by reading just the headline (which made for easy tweeting and facebooking), and it was counter intuitive (which made it worth tweeting and facebooking): Organic no more nutritious!

Was this really news? I'd seen several studies with similar findings. And this new study turned out to be nothing more than a reanalysis of that past work. There have been a few critiques the study, but if you want my opinion (as someone that tries to sort substance from superstition about all things "natural") it's basically right. There's very little evidence that one person eating organic food is going to be getting superior nutrition. Yes, non-organic food has trace levels of pesticides (after reviewing the science, those don't worry me), and yes, non-organic meat is more likely to have antibiotic-resistant bacteria (this does worry me but it's primarily a public health problem, not a problem for individuals). But all the science really doesn't support the idea that organic food is a wonder drug that will keep you young.

At the same time, I think it's indisputably true that organic food is healthier. That is - if you are narrowly focused on how it will benefit you, about how the known molecules will interact with your metabolism for good for for ill, then organic and industrial food are pretty much the same (as far as we know with the current science). But if you take a broader view, things look different:

Don't screw this up

I've been getting a little flustered thinking about how to promote my book. Asking people their opinion of my work, makes me feel a little sick, let alone asking people I don't know at all to praise it, so the idea of soliciting blurbs is a little frightening. I've been thinking about a talk to give, about preparing for interviews, contacting editors about running excerpts, getting a little tour together... and I keep telling myself not to screw things up, which, paradoxically, makes me a little more likely to screw them up.
Then I tell myself not to get upset. My life is great. I'm in love with my wife. My daughter is delightful. My extended family is healthy and more sane than any of the families in the books.
Yes, but, I rejoinder, this is a big chance, I've got to make the most of it.
This conversation in my head took place as I was walking from the grocery store home, with my daughter in the carrier. It was the day before her first birthday. That year had just flown by. She closed her eyes and nestled her cheek against my chest. And I thought, I could say the same of this particular moment: This is a big chance, I've got to make the most of it. I wrapped a hand around the back of her head to keep it from bouncing. It's covered in cornsilk hair that sticks out in all directions. Don't screw this up, I thought, and that time, it didn't make me anxious.

How I changed my mind about vaccines

This is a follow up post to this one, about the books I've especially enjoyed in my research. There were four books I wanted to include about vaccines, but it's such a touchy subject that I found myself writing long on this section, and so I've broken it out as it's own post. It contains, just fyi, a bit of a spoiler for the fourth chapter of my book.
In researching the evidence about vaccines I started with David Kirby's Evidence of Harm. I should admit that going into this I was pretty sure that there was at least some kernel of truth in the suspicion of vaccines, and that the mainstream scientists were overlooking something. I wanted to start with this minority opinion in the hopes that it would contain some solid, overlooked, facts, or at least a legitimate hypothesis that I could flesh out by talking to scientists. It’s a riveting and well-reported

Good Reads

A couple people have asked me for a list of recommendations from the stacks of books that I've read in writing my own (now to be titled All Natural). The list below is not complete (my full source list is over 9000 words) and are in no particular order. These are just the books (and other forms of media) I found particularly entertaining and interesting. Nothing here that you *should* read if you can get around to it in here, and (with great difficulty) I've restrained myself from listing all the books that would make me look smart and might impress you. No, this is just the stuff that was a pure joy for me to consume.

The US is weird about breastfeeding

There's been so much buzz over Time's breastmilk-sploitation cover photo (milxploitation? boob-sploitation?) that I've decided the cover of my book should be an image of yours truly breastfeeding Jamie Lynne Grumet or some other suitably hot young mom.
Out of all of that though I found one particularly arresting graph that shows just how strange breastfeeding practices are in this country. As you can see, we are distinctly abnormal.

A comparison of age at weaning in the United States and in 64 traditional societies,
reproduced from Stuart-Macadam & Dettwyler (1995)

Eric Michael Johnson dug that up. You can read his parsing of the science here. Thanks to my editor at Rodale, Alex Postman, who brought my attention to this.

That place in the overlap is where I try to hang out. From Imaginary Foundation, via Brian Hayes.

Big Babies and Homebirth

Do 9-plus pound babies need to be born via C-section? That's the thing that stood out for me after reading Samantha M. Shapiro's story in this week's New York Times Sunday Magazine. I read this reprise on the homebirth debate with interest (and some dismay, since I talk about a visit to Ina May Gaskin on the Farm in my book). There are several things I liked about the article (the tone for instance), and several I didn't (the title - ugh). But undoubtedly the strangest thing about the story was this:

"When I reached my due date, an ultrasound estimated that my baby weighed 9.4 pounds. I didn’t have gestational diabetes and had gained an average amount of weight, and fetal tests showed my baby was thriving. But the baby’s estimated size, combined with the fact that he hadn’t yet descended into my pelvis, worried my midwife.

She wanted the baby out by 41 weeks, and to my surprise, she suggested I consider going straight to surgery without labor. She sent me to be evaluated by a doctor she worked with. “One way or another, this baby will be a C-section,” he said."

Shapiro doesn't go for the prophylactic C-section, and that prophecy comes true:

This little shell (I assume a snail shell?) is really quite remarkable for two reasons. The first is that I found it in my desk-side fern (Fernando). I've had Fernando long enough that the surface of the dirt is covered with a layer of moss, so it's unlikely this shell came in with the dirt and I only just noticed it. Since it was on top of that surface layer it makes me think that I had a little snail crawling around. Where did he come from? Are there others? What does he eat, and who eats him? I started imagining the trophic food webs contained in this little pot--an ecosystem at my elbow. Rob Dunn and the other people at Your Wild Life have begun studying the creatures that live with us. Naturalists know a little about how bighorn sheep, and mountain lions, and say sagebrush interact, but we know surprisingly little about the life that thrives in our homes. We know so little in fact that when Dunn sent an undergrad to look closely at the species in New York City she discovered a new species of ant within three days. Here's the other remarkable thing about this shell:

The surface and the depths

On a superficial level the question I've been exploring here and in my book is: Is natural good? There are some people who tend to believe that what is natural is healthy, and there are just as many of their opposites who are inclined to believe whatever carries any mark of its natural origin is dangerous. For some the fish lifted moments ago from a lake is more wholesome than anything you could buy in a grocery store. For others, it is suspect, uncontrolled and unsanctioned by food-safety authorities. Getting beyond the gut reaction and sorting out the facts is fascinating to me and I think people who read the book will find it entertaining, I only call this stuff superficial because I think there's a deeper, more important level.
To start out, the question as I've just framed it (Is natural good?) presupposes a yes or no answer. But nature is wholesome, nurturing, and abundant at the same time that it is deadly. And the deeper problem has to do with that frame of mind that crosses its arms and says: "Well, which is it? It has to be one or the other." The people drawn to this binary distinction are the most extreme. They are the folks that take a wheelbarrow-load of herbs every day so that they will never die and they are also the people who demand surgery early and often in the vain hope that technical intervention will allow them to live, if not forever, at least until the next surgery can be arranged. These extremes--though at opposite poles when it comes to what they believe in--are strikingly similar in how they go about their lives.

Cholesterol (orange) buried within the transparent protein, including interaction with a lipid in the membrane (cyan). Credit: Grace Brannigan and Jerome Henin, University of Pennsylvania

In a good article on the confusion over cholesterol, Johan Lehrer gets at tendency to assume that when we have a lot of detailed information about something we understand it. We have wheelbarrows of data on cholesterol, but have almost no idea how its related to heart disease. Lerher writes:

Lunar eclipse of 2011 with infant

photo by matthewwu88

 

December 10, 2011 - Bernal Heights

Josephine woke up at 6 am this morning and was snuffling snotily. She still hasn’t gotten over her cold. I remembered that there was supposed to be an eclipse that morning and I grabbed my computer to see what time it was. Beth looked at my laptop with appalled dismay as if it was a goat or something I was hauling into bed.

The problem with inexpensive remedies

About three months ago my daughter was born, and aside from sometimes looking like ET, and sometimes like Paul Giamatti with a hangover, she was perfect in every respect. Then we noticed that she had some little white patches in her mouth, which I assumed were just fatty milk residue but then had to admit were thrush. Yeasty thrush infection in the perfect baby mouth! Imagine my outrage. It got worse and worse until finally we called the doctor who gave us the Rx for Nystatin, an antifungal. It was this awful, sticky yellow stuff that had a disorienting viscosity and would always drip right when the baby had turned her head. So it got everywhere, and we were supposed to give it every couple of hours, and I felt like I was ruining my daughters palate by making her first significant exposure to a new taste this horrible sugary stuff. Also, it totally didn't work. We fed her the stuff for over a month, carefully spreading it all around. It seemed to fertilize the thrush.

Why don't we have more midwives?

Last summer I made a trip to Kentucky to see what I could learn about an all-but-forgotten part of our medical history. The land on either side of the road grew steeper and greener, and by the time I reached Hyden, Kentucky, I felt I was at the bottom of a well with walls of beech wood and kudzu. This was true Appalachia, where dwellings clung to the rare plot of level ground, a doublewide up on a hillside ledge, a Dairy Queen in the bend of a river, a crook between hills provided enough resting place for the town of Hyden a handful of brick buildings clustered around a crossroads. The house I was looking for was tucked back in the forest, a manorial building of black logs and white chinking that stood above the Middle Fork of the Kentucky River. Hollyhocks were blooming in the yard. It was Mary Breckinridge’s house, and home of the Frontier Nursing Service.

Reading Journal: Mountain Gloom and Mountain Glory

The reason this book is interesting to me is that it gets at the argument that wilderness areas are worth saving when they are sublime. When people are in those high places, the argument goes, they are able to make contact with something profound and this contact is healing in the broadest sense - it improves lives, improves souls, improves us as humans. See Heidi.

But then there is the obvious counterargument that goes: wait a second, beauty is in the eye of the beholder. Yosemite may be sublime for you, but maybe an open-pit mine is sublime for me. It would be useful to know if we can move beyond or dismiss either argument. And next, it would be nice to know with some more specificity what we are really talking about with this feeling of the mountain high.

Is pain always indicative of injury?

My wife and I are in a childbirth class with a group of about 30 adults, and recently the question of pain came up. One student (apparently a scientist) argued that all pain was indicative of injury—the normal pain of childbirth, even emotional pain and grief involves small tissue damage in the brain. Fascinating! Who knew?

But as I thought about it that night, I found that there was something in the argument that didn’t sit right with me. The next morning I realized what it was: It’s one thing to point out that pain is linked to some kind of cellular rending as a clinical fact, but to claim that all pain is by definition injury is to step out of the magisterium of science and onto my turf—because at that point we are talking about the meanings of words.

The word injury carries with it a strong connotation of wrongness. It comes from the Latin injuria (in = not jus or jur = right, eg justice, jurisprudence). There are some types of pain that don’t feel wrong at all—in fact, they can feel very right. Exercise is one example. I think of the line from Chariots of Fire, when Eric Liddell responds to his sister’s demands that he give up his shot at the Olympics by saying. “God made me for a purpose, but He also made me fast. And when I run, I feel His pleasure.” I wouldn’t call it God, but I certainly have felt an overwhelming sense of rightness in my own running as I push up against the barriers of pain. Injury is an imprecise, misleading word if it describes something that feels right. (NB this is subjective. Running a 60-second 400 meters will be injurious for one person and sublime for another).

Bacteria are controlling your mind

More evidence that we are "superorganisms" of many creatures working together and against each other. Bruce German predicted this years ago. The study is pretty basic - they aren't showing that bacteria are responsible for Mozart's musical genius - but it provides proof of concept. There's a good plain-language write up here.

This is cool

The plant above is called La Llareta. It's a bush with millions of tiny, tightly-packed leaves. It's in Chile's Atacama desert, and it's more than 2,000 years old. Rachel Sussman is photographing the oldest living things in the world. It's interesting to see the type of things that have had the fortitude, or adaptability, or luck to survive from one epoch into a very different time.

Reading Journal: Politics of Nature

Update: Coincidentally there's an article in this Sunday's NYT Magazine on these issues. Latour is quoted about how his formulation against facts has emboldened attacks on climate change evidence.
 
I have had this on my shelf for a long time. Every once and a while I take it down and work my way through a little more. Philosophy is always hard, and French philosophers in translation have scared me ever since some traumatic experiences alone in my college dorm room with no one to protect me from Jean Baudrillard. With Latour, unlike Baudrillard, I didn't get the sense that he was being deliberately difficult. But he still makes up an awful lot of words (or gives them special meaning which are different from their commonly understood meaning). Anyway - I've slogged through this enough that I think I can summarize in plain English. Though I'm sure I'm losing some of the nuance in translation. So here’s what (I think) Latour is saying in Politics of Nature:

A.O. Scott on "Safe"

A review of the great - and oh-so-close-to-home - Todd Haynes movie.

"Are these dangers really out there in the world, or are they just in our heads? Neither answer is likely to make us feel better, or make us feel safe."

Paleo Diet

Banksy's Caveman, photographed by Lord Jim

On Wed, Dec 22, 2010 at 7:12 PM, -- I got this email from a friend. She -- wrote:
Hey Nate, I keep hearing about this damn "Paleo" diet, and it reminds me of your investigation into whether what's "natural" is "good." Seemingly intelligent people claim that humans are in fact best suited to a diet consisting only of what a caveman would have eaten. It seems absurd to me -- I mean, we've physically evolved since that time (pinkie toes have gotten smaller in response to wearing shoes), so how could eating grains that we've cultivated for 10,000 years be bad for us? Not to mention that these same people drive cars, work in buildings, etc.

My response: I'm inclined to agree (with significant caveats).

Cool opportunity for Bay Area amateur naturalists

Academy of Sciences & Farallones Marine Sanctuary Seeking Naturalists

2011 Rocky Shore Naturalist Training Course

WHO:         The California Academy of Sciences and Gulf of the Farallones National Marine Sanctuary

WHAT:       Training as Rocky Shore Naturalists

WHERE:    California Academy of Sciences, and Farallones sanctuary offices, San Francisco

WHEN:       Saturday January 29th at 1PM, first of three field trips to Duxbury Reef
                    Classes February 2^nd from 6:30-9:00PM and February 2nd- March 23^rd from 6:30-9:00PM

Awesome things Bruce German says

As you may be able to tell from my previous post, I just got back from a day trip to Bruce German's land of wonders and curiosities (also occasionally known as UC Davis).
This is not your average food chemist. He has a razor scooter in his office. Also there is some evidence that he is still Canadian at heart: There's a wooden mountie holding up his iPhone charger and a big illustration of a hockey goalie above his desk. He studies lipids - namely the lipids in milk and writes papers about pretty incomprehensible things like the milk fat globule membrane (MFGM) and cis-9, trans-11 conjugated linoleic acid, and yet when he talks about this stuff he consistently blows my mind. The following is mostly just notes to myself. Very rough...

Things you find in a milk lab

The place where milk is broken down and examined piece by piece looks a lot like your high-school chemistry lab probably did, only more so - more pipes and cables swooping up past hanging fluorescent lights, more battered and mysterious machines crowding the faux-wood lab bench, more cool things that steam or blaze and could be induced to go boom, along with stern, though tattered, instructions forbidding blazing and booming pasted to the walls.
One in a red font that crams exclamation marks into every letter reads: "Danger invisible laser radiation Avoid eye contact or skin exposure to direct or scattered radiation." A freezer is marked, "Biohazard," and someone has taped two blue napkins to it with the words, "Do not open" inked fiercely in red on each. A digital display on the door shows the interior temperature to be -30 degrees Celsius.  Above the lab bench hangs a professionally carved wooden sign, the sort that on country houses display the surname of the inhabitants, which some wit has designed to say, "Spectrometry for the masses."
There are two blackboards on the wall covered in acronyms I don't understand with arrows pointing from one to the next. There is another freezer without frightening signs, and this one contains hundreds of test tubes and beakers and vials with frozen milk scabbed to the glass.
On the benches slim patches of workspace are scattered: a pair of blue cryo gloves (like oven mits), several blue pipettes, a plastic purple honeycomb half full of disposable pipette tips, a toaster-sized machine called the Mini Vortexer with a dial that goes from one to ten--it is turned to ten, and another machine for enzymatic cleaving. On the floor at the far end of the bench is a torpedo-like tank of helium, painted maroon. Next to it are two silver tanks of liquid nitrogen. A graduate student, her hair pulled back in tight braids opens the valve one one of these and then rests her elbow on top of the tank and watches as hissing ice clouds form around the hose leading to the big white mass spec machine which dominates a quarter of the room and looks as if it might have been stolen from the engine room of a steamship. This is one of the machined designed by Carlito Lebrilla, the man German calls "a wizard." This machine is essentially a scale, a scale so precise that it can divine the atomic composition of milk molecules simply by weighing them. "It's like weighing a battleship to see if there is a fly on the deck," German says, shaking his head in wonder.

Ioannidis profile in the Atlantic

Medical scientists are facing the fact that they have an evidence problem, according to this profile.
But some wonder if they should admit that publicly:

Already feeling that they’re fighting to keep patients from turning to alternative medical treatments such as homeopathy, or misdiagnosing themselves on the Internet, or simply neglecting medical treatment altogether, many researchers and physicians aren’t eager to provide even more reason to be skeptical of what doctors do—not to mention how public disenchantment with medicine could affect research funding. 

John Ioannidis, the subject of David Freedman's story (check out his very interesting blog here), says hiding uncertainty is the wrong approach.

We could solve much of the wrongness problem, Ioannidis says, if the world simply stopped expecting scientists to be right. That’s because being wrong in science is fine, and even necessary—as long as scientists recognize that they blew it, report their mistake openly instead of disguising it as a success, and then move on to the next thing, until they come up with the very occasional genuine breakthrough. But as long as careers remain contingent on producing a stream of research that’s dressed up to seem more right than it is, scientists will keep delivering exactly that.
“Science is a noble endeavor, but it’s also a low-yield endeavor,” he says. “I’m not sure that more than a very small percentage of medical research is ever likely to lead to major improvements in clinical outcomes and quality of life. We should be very comfortable with that fact.”

I'm reading Bruno Latour's "Politics of Nature" right now, and he pins a lot of what's wrong in this world in our desire for science to deliver the answers relevantly and on time. We (mistakenly) think of the world as divided into two parts: nature and civilization. In civilization we talk a lot, we have opinions, we debate, we struggle over politics. Nature (according to this view of the world) has no talking, it's silent but it contains the truth. The trick then, is to send someone out into nature and bring back the truth to put an end to all the arguments. We call this person "a scientist."
The problem with this is that 1. Even scientists have trouble finding the truth (see above) and 2. They aren't above politics (see above again).
A more healthy system, according to Latour, would be to recognize that civilization is in nature and inextricable from it, and that science is not exempt from politics. He's not denying the existence of objective truth, but instead of saying X-Files style that "The truth is out there" he's saying "The truth is right here" but that we have to be honest about how little of it we can see - which means accepting that politics and debates about who's vision of the world is more correct are an essential part of governing. We can't hope for science to trump politics. Doing so get's us into a lot of trouble.


hat tip to Faith Gibson for sending the story to me...

A.O. Scott on Walkabout

That Tony Scott is a good writer. Nothing particularly fancy, just admirable, the way he's able to notice and then put into words. Which I suppose is the basic skill required of a writer.

Here are a couple quotes from his review of "Walkabout"
"The price of living in the modern world is a feeling that we have fallen out of touch with the natural world. We long for an innocence that may have never existed but still exerts a significant hold on our imaginations."

Perhaps that dream of innocence isn't from an earlier time in human history,  but in individual history - childhood. Or both. Perhaps in childhood we access a way of life closer to that in which our minds evolved.

Here's the video in full:

"Unmediated perception as if we were seeing the world for the very first time"

"Innocence is always lost but the memory or maybe the dream of our time in it is always with us."

A visit to The Farm

The Farm Midwifery Clinic

I like to pretend I'm a rolling stone from time to time, but it sure does feel good to roll back to the piece of earth that's come to fit my contours over the years. I'm back in San Francisco after more than a week traveling in Kentucky and Tennessee. My most significant excursion was a trip down to The Farm, a hippie commune that's managed to persist in fine fettle since 1971. They don't do a lot of farming at The Farm, unless you count growing forests, and deer, and meadows full of ground-nesting birds. What they really focus on down at The Farm is growing people, and officiating the front end of this process is a coven of midwives. These are the women I went to meet - they offer a radically different mode of maternity care. It's a form of medicine that would shock and dismay hospital administrators around the country. It's low tech, often taking place in the woman's own home, far away from the transfusions and pain medications and operating rooms that hospitals rely on to save lives when something goes awry. In theory, this midwifery center should be producing a higher than average number of catastrophes. But that hasn't happened. In the 40 years they've been catching babies, the midwives have accumulated a significant corpus of data (about 3,000 births) and the results are fascinating. The birth safety record is far, far better than the national average.
But is this a comparison of apple and apples? There's a certain amount of self selection that happens - ie it's only fairly bourgeois, health-conscious women who would even think to seek out a midwife. (There's a similar cause and effect mix up with multivitamins: People who take them are healthier, but only because unhealthy people usually don't take 'em). And that's probably affecting things at the farm a little bit: There are women who have flown in from as far away as Tokyo, and Cairo, to give birth there. Those mommas have got to be A. Far more committed to going the extra mile for health in every way, and B. Rich enough to pay for quality care and live without a lot of stress. But when I got to The Farm and started talking to people it became clear that there were two counterbalancing factors. First, some of the people traveling to The Farm are attracted because the midwives there are some of the only people in America who can reliably do higher-risk births (like breech babies, twins, and birth after a cesarean) vaginally - so they attract a more difficult population. Second, about one third of the babies born there come from the (economically depressed) surrounding area - a lot of these are Amish women who wear their long dresses through the entire birth.
Ina May Gaskin, the head midwife, says that about a third of the births are Farm babies, a third are from the surrounding areas, and a third travel in from farther away. I understand that the midwives are organizing their data for a report - I hope they include information about the demographics of their patients to allow this kind of parsing. But regardless of demographics, the statistics are impressive. They seem to indicate that, for a healthy middle-class woman, this can be a superior form of care. There's another impressive indicator: The Farm Midwifery Clinic is still in business - which (I think) means that they've never been sued. If this form of natural birth really was causing more cases of baby brain damage - or any sort of catastrophe - I think you'd see some lawsuits over the course of 3,000 births.
I'll be writing more about my visit - hopefully before all the mosquito-bites I got there fade away. But for now I've got to catch up on the work I left when I went on the road - while enjoying the feeling of air that's not 90 degrees and 80 percent humidity.

If I eat this it will put me in a junk mood

In honor of mother's day:
You wouldn't give your mama artificial love-
So why would you feast on artificial grub?
Full video below (if everything is working right...)


My favorite line:
This so called food aint meant for humans
If I eat this than my bowels won't be movin'

Word to Denis P. Burkitt.

A slight bone to pick with Freakonomics

James McWilliams cited this piece, which I wrote for Conservation Magazine, in his Freakonomics blogpost today on the NYT website. McWilliams was making the point that environmentalists often turn each environmental disaster into a cautionary parable (about some form of human folly) long before it's clear that the disaster was caused by said folly.

"...when an environmental problem has been identified, no matter how complex the underlying ecological factors, it’s often packaged as a morality lesson highlighting the impact of a single, human-driven environmental sin."

I totally agree. But it seems unfair to limit this critique to environmental groups. Every think tank (liberal or conservative) seems to fire off a volley of facile conclusions when something happens that touches their issues. Food and medical companies are quick to trumpet any shred of junk science supporting their products. It's how people work: We to try to make meaning from the seemingly random events occurring around us, to make theories about how the world functions, and then look for evidence (for, and even against if we're smart) in everything that comes up. And, it's worth noting, it's exactly what McWilliams did in his blog post.

The newest trends in food processing

The big new thing for the food industry in 2010? Not being big, or new - but instead being natural and old-feeling. Which is tough for the industry, because usually the way food businesses make money is offering something new. It's hard to persuade buyers to try your product if you are offering more of the same. And its even harder to grow your market (imagine this pitch: this year eat more! We need your help.) All this may account for the slightly rueful tenor of the FoodProcessing.com's write up of new trends for 2010. Witness:

At the risk of upsetting manufacturers of artificial preservatives, colorings and flavorings, Jane and Joe Sixpack simply cannot be more clear in their growing distaste for “chemicals” in their food. And yes, this trend is on track to grow.

That seems like it might be a positive indicator until we get to the next sentence:

Overtesting: This is interesting

From the NYT:

Growing awareness of the risks of scanning led F.D.A. scientists several years ago to begin demanding more and better information from manufacturers to prove that their devices actually were effective for such clinical applications as cancer screening and mapping blood flows in the brain.
But agency managers responded that suddenly changing the rules for the devices would be inappropriate and unfair to manufacturers, documents and interviews show.

The problem is that these CT scans expose you to a lot of radiation, so a lot of scientists say we shouldn't use them unless we are pretty sure there is something wrong. But the manufacturers want everyone to use them, early and often, and they'd like the government to pay for it: "hundreds of millions of dollars annually."

General Electric, one of the biggest makers of the devices, told F.D.A. managers that the company wanted CT scans approved for colon cancer screenings because Medicare officials and private insurers were “actively discussing whether to reimburse for use of CTC for screening asymptomatic individuals” and “to assist their customers in reimbursement for procedures,” internal agency documents show.

 Great work Gardiner Harris!

Nice write up in "Antidote"

William Heisel who blogs at Antidote, posted the first part of an interview with me here and started off with this lovely introduction. I'd like to think it's apposite, and that's the reason it seems so well put to me (although perhaps I just like it because Heisel is so charitable). Either way, it's always pleasant to have people say nice things about you, and I'm usually overwhelmed with self consciousness when I try to sell myself - so I'm going to push through and paste his description here:

Nathanael Johnson, a Bay Area radio reporter and freelance writer, has made a nice career examining the many ways Americans go overboard – from the food that we eat to the health treatments that we seek. He has written about the Orwellian world of pork farming and the radical raw milk movement for Harper's magazine. He has written about the surge in "functional beverages" for New York magazine. And he has written numerous features, including an insightful piece on excessive medical treatments, for his day job at KALW News.
In February, the Center for Investigative Reporting's California Watch published an investigation by Johnson that made the entire state — and large news outlets such as ABC World News with Diane Sawyer — sit up and take notice.
The mortality rate of California women who die from causes directly related to pregnancy has nearly tripled in the past decade, prompting doctors to worry about the dangers of obesity in expectant mothers and about medical complications of cesarean sections. For the past seven months, the state Department of Public Health declined to release a report outlining the trend.
This investigation had all the makings of a blockbuster. Innocent victims. Shocking trends. And the specter of government malfeasance. But it also had something else lacking in most investigations of this scope: a measured tone. Johnson made sure to underscore how few women actually die every year and, by contrast, how many healthy babies go home with healthy mothers.

Nice huh? Thanks Bill!

People waking up to the problem

Amnesty International finally released it's report on maternal mortality in the US, calling the situation "scandalous," and "disgraceful."

Jennifer Block has a great piece timed with the release in Time Magazine.

And Gary Schwitzer summed it up with "A week of news on overtesting, overtreatment..."

Worshipping the power of tests to stave off death

Richard Ablin had an incendiary op-ed in the New York Times yesterday. He's the discoverer of prostate specific antigen and he writes: "I never dreamed that my discovery four decades ago would lead to such a profit-driven public health disaster. The medical community must confront reality and stop the inappropriate use of P.S.A. screening. Doing so would save billions of dollars and rescue millions of men from unnecessary, debilitating treatments."

Death in birth follow up

California Watch asked me to write a follow-up article about some of the families I talked to for this piece. Their stories had been squeezed out under the restrictions of newspaper writing. You can read about them here. In writing it, I passed a draft by "Steve" to make sure I didn't reveal anything that would hurt his family (it's usually frowned upon to show a source the story - but this was a small piece, purely about the emotions). He called me in response and left a message that reduced me to tears right there at the keyboard. He gave me permission to post it and you can hear it on the California Watch site.
I think this news is finally hitting home. The piece ran on the front page of half a dozen major California newspapers, and on public radio's California Report.  KCBS, the talk show Forum, and KALW asked me about it. Dozens of other outlets and scores of blogs reported on the story.

More women dying in childbirth

According to a report that the state has been sitting on for more than 6 months it's getting more and more dangerous to give birth. If the statistics are strictly interpreted, it means that my wife has a better chance of dying than my mother did. I hope to publish more about this, fleshing out all the nuances and giving it the attention it deserves in the first chapter of my book, but for now, here's the breaking news.

What happens when an economist understands ecology?

Dick Norgaard, being well versed in both economics and ecology, is one of those rare people who straddles the fault-lines of the disciplines. This means that - instead of believing that economic theory is immovable truth, or that the findings of the natural sciences are immutable - he can see how gracelessly these great tectonic plates rend at each other. From his vantage point, the faith that the invisible hand will solve our problems, and the belief that scientific progress is inexorably leading us to a bright future, look like especially primitive forms of superstition. If you want to know more, you might read this profile that Patrick Joseph had me write. Or look at his book, parts of which I found revelatory.

 (Patrick Joseph is one of those editors who is not only intelligent but also civil, kind even, who must be blessed and treasured.)

The adventures of yeastman: Part 2

Here's what you do if you want to make bread like this, bread with just enough spring against your teeth as you bite into it, just enough tension before it tears. Bread that is soft and elastic, which upon leaving the oven smells the way I imagine heaven should smell, if heaven were a small farm-house early on a December morning when you have awoken to find the kitchen already warm and the first snowfall of the season smoothing the earth's hard angles into curves. Here's what you do: You meet Laizu outside the bakery a little before 3:30 am. I was there before her, having hauled myself out of bed after a few hours of sleep and walking up through the sleeping houses. She pulled up moments later and shook her head at me as she got out of the car. "You really are interested in baking," she said. "you're early."

The adventures of yeastman: Part 1

I’ve been meaning to write about my initiation into the select novitiate of the dark arts of bread-making, but I was particularly busy in the days leading up to the holidays and then particularly lazy during. Now that they are ending I feel a stirring of the communal sap—now that other people are girding up for a real working Monday, it is much easier to brush off the feeling that there might be some richer form of amusement out there for me to capture. Amazing how persuasive is that sense that other people are working – or playing – in convincing me that I should be doing the same.
All that is to say that this happened more than a month ago. It started when Beth and I went to the Liberty Café Bakery one morning for coffee and pastries. I love this bakery. It’s on top of the hill, in the “downtown” of our neighborhood, but tucked back behind the row of shops on the street so that you have to slip down a three-foot wide passageway between the buildings to find it. The bakery’s existence in this secret garden would not be enough, on its own to secure a permanent right of tenancy in one of the chambers of my heart—that guarantee was ensured by the cinnamon rolls. And then by the custard-like quiche whose essence is infinitely rich yet light – ephemeral on the tongue and on the plate.

Uncle Everybodydies

This is fun. Though to be fair, I think it's only recently that "Mother Nature" has gained the cloying connotations. It comes from the mystery religions that position the mother as both the giver of life and the destroyer - the chthonic deities that facilitated the cycle of decay and growth.

Reading Journal: Contingency, irony, and solidarity

In the first part of this book Richard Rorty challenges the (almost universal) assumption that science is in the business of describing the truth. Instead of thinking of science as clearing the window that allows us to see truth, we should see it as providing tools that we can use to navigate our surroundings. I tend to bristle at this sort of thing: You wonder if the philosopher is pausing to check the implications of his tortuous argument against the world outside his head. But then, there have been a series of physicists doing exactly that - checking the implications of quantum mechanics against the world we can see and touch and coming to the conclusion that what we think of as reality may not be real. Crazy I know. To describe this sort of thing you really need a cranky old physicist with a french accent:

Reading Journal: The Cure Within

Most of this book is content to document the history of mind-body medicine without asking about efficacy. The story at the beginning and the list of "bodies behaving badly" at the end are interesting examples:
1. Children (even with their physical needs being met) can be physically stunted and developmentally retarded without love.
2. Mortality levels dip below expected levels for ethnic groups just before culturally significant days (Jews don't die the day before Passover).
3. The 200 women imprisoned by the Khmer Rouge who "cried until they could not see," seem to have been physically blinded by metaphor.

Reading Journal: Life is a Miracle

This was a good book to follow the other recent reads. Toulmin says we don't want a science that is based on the expectation of universal truth (and subliminally on controlling the populace). The question then is, what tool do you use to reliably make difficult decisions? Capra proposes to give a new vision of science - it's built on multiple pillars on knowledge and it uses reduction sometimes but not all the time, and it looks for patterns - but I'm still not clear as to how that helps me in figuring out how to counsel a friend who is skeptical of vaccines. In this book, Wendell Berry does a nice job of honing in on how you figure out what to do in a world without certainty, on where reduction is useful and where it's destructive, and on how these big ideas apply to quotidian human decisions.
Before I get into that though, I'd like to pause to acknowledge the design of this book. It was such a pleasure to hold, so agreeable to observe.

Avoid Manure Pit Explosions

Photo/Compassion in World Farming

This Thanksgiving pause for a moment to give thanks not just for the food but to the brave men and women who produced it. They risk life and limb to put that turkey or ham on your table. Case in point, the other day I got my regular Nutrient Management newsletter via email. (A couple of years ago I wrote a long story about the state of hog farming in America and I still get updates from the trade magazines). I don't always read these but this one was entitled, "Avoid Manure Pit Explosions." That seemed like a good idea. It begins:

Manure pit-related explosions or flash fires have occurred recently in both Minnesota and Iowa livestock buildings. Luckily, the explosions, to date, have mainly resulted in building damage, with few animal losses and no personal injuries or fatalities reported.

A couple other websites

...with similar sensibilities for future reference. Christina Seely's class at the CCA seems to be building a new sensibility simply be piecing together scraps from artists, thinkers, designers and engineers on the blog Metro Nature. The result is an aesthetic that is fascinated with nature and more than willing to dabble in awe, but not romantic - and at the same time relying on science without resorting to the rationalist tropes.

Then there's this travel blog, Uprooted, which I find interesting mostly because it's author describes herself as, "post-hippie: dedicated to sustaining and improving the condition of our planetary systems, but not particularly excited about drum circles." Which is a lot like what I'm trying to get at (I may be more extreme - the idea of drum circles just makes be feel sad and tired - with top notes of nausea). The question Uprooted seems to have at it's core is: How does this generation go out and make meaning of the world without ending up resorting to cheap, shallow meaning - something that turns out to be our own version of drum circles? Both the author (Jessica Reeder), and I come to this search by way of our childhood indoctrination: we were given clear evidence that the earth needed saving but no feasible methods for dong anything about it. Jessica is from "Nevada City, California where hugging trees was part of my classroom curriculum." So am I. We were in the same second-grade class.

Reading Journal: The Science of Leonardo

I was hoping this book (by Fritjof Capra who wrote The Tao of Physics) would describe a more humane form of science, one that does not forget richness and complexity as it travels down its reductive rabbit holes. Which seems to be what Capra is promising in the beginning: "What we need today is exactly the kind of thinking and science Leonardo da Vinci anticipated and outlined five hundred years ago, at the height of the Renaissance and the dawn of the modern scientific age." We do get some hints of what that would look like here and there. But mostly it's a biography of Leonardo da Vinci. Which is interesting. It's a nice lens through which to learn Italian renaissance history. But I'm going to focus here on the details that offer a model for a more humane, open-minded science.
Still not sure exactly what that is but Leonardo has some idea about what it isn't:

The overtreatment of America

My latest piece. So far most of the health care debate has been over quantity: how much care delivered to how many people. It looks to me like quality may be more important. Also, if you are a man (or know one you like) this case study is going to be useful for you at some point. We all get prostate cancer eventually. Meet the characters after the jump...

Reading journal: Cosmopolis

I read this book, by Stephen Toulmin, in search of direction for thinking about this whole man v. nature thing. I'm finding that it's the history that's most useful for me - as usual it's not enough to have the ideas, there has to be a story containing the ideas.
The story here starts with Henri IV of France, (Henry of Navarre) trying to make everyone just get along as religious tensions between Catholics and Protestants grew. At that time people thought in a way that is remarkably recognizable to people today: Henri talked about tolerance and pluralism, his compatriot Michel de Montaigne wrote in a style that still speaks to the modern ear. There's a reason for this Toulmin says: humanists like Montaigne were on to something that we are just now getting back to after 300 years of diversion. We were sidetracked when an assassin (Francois Ravaillac) dove

On Genius and Distraction

I'm reading Fitjof Capra's book on Leonardo da Vinci, which, as far as I can tell so far makes the case that Leonardo was a great "systems" scientist - the emerging field that embraces nature's messiness and looks for patterns within it rather than searching for one mathematical proof to rule them all. But that's not the point - Capra was making the case that Leonardo was a genius and he cites what (he says) psychologists agree are three traits of genius. Despite my better instincts I became hopeful that I'd find myself described in the following lines.

Sign #1 - Insatiable curiosity, and enthusiasm for discovery (okay!)

Sign #2 - Ability to memorize large amounts of information (...)

Sign #3 - Capacity for intense concentration over long periods of time (um, brb, the podcast I'm listening to just ended and I have to cue up the next one)

If you want to be sure your food is really all natural

... then grow it yourself. From scratch. That's the modest proposal Meghan Laslocky makes here. As yet there is no sign of outrage. What's wrong? Have all the tone-deaf people abandoned the Internet at once?

So cute I could just eat him! But medium well, okay?

Like A Natural Woman

Okay this is off topic, but my profile of San Francisco politician/police commissioner/future icon Theresa Sparks just came out in San Francisco Magazine. I suppose it is on topic if you stretch to consider how people use the term natural in moral arguments. To me Theresa represents another realization as well: Natural can connote a sense of comfort. She may not have the body nature gave her, but spend 5 minutes with her and I guarantee that you'll forget about that. The conversation feels perfectly natural.

Salt wars

An interesting paper came out last week in that delightful wellspring of whimsy - The Clinical Journal of the American Society of Nephrology (not actually one of the many periodicals I follow). It made a splash because the authors were saying that - despite the fact that nutritionists have been trying to cut back on salt intake - despite the fact that we're getting more and more salt in processed foods - that the country's nutrition experts have set recommended salt intake levels too low. It got picked up in a lot of papers because this is how health/science news works: Conventional wisdom is established with a few articles (and reinforced with simpering on morning television) and we all assume that we are dealing with certainty (Salt: Still Bad For You!) so we don't see it in the papers again until you get a study that perks everyone up by questioning that conventional wisdom. This is the structure that forces every science article to say "everything you knew is wrong." Furthermore - we should pause to note that two of the authors of this paper have buddied up to consult with the pro-salt lobbying group, the Salt Institute. Nevertheless, it's worth taking seriously for the following reasons:

The cure for health care coverage

If anyone is feeling confused about health care it's probably because you haven't listened to the This American Life episodes on the topic. They did a great job. And I say that as a reporter who is doing work on these same issues (actually preparing a radio piece that overlaps with their segment on PSA tests a lot). They zeroed in on the fundamental problem: skyrocketing costs. They explained exactly why they are so high. There are a lot of factors - but all in all it's not so complicated. The real mystery to me is why no one has done this before. Instead we get reporters running around in manic circles, yelling at the insurance agencies, or the doctors, or big pharma. Are we so oriented on rooting out the villains that we journalists lost the ability to do good reporting on this? It's as if we are back to the time when the crops fail (or premiums rise) and to solve the problem we tie some woman (or HMO executive) to a tree and light the fire.
Admittedly, there's a lot to health care reform that is utterly counterintuitive (eg more doctors competing drives the cost of care up, eg care can kill) and people like Shannon Brownlee have traversed this path before (actually it seemed like TAL was borrowing a lot from "Overtreated"). But still, hats off to TAL.

God travels back in time to thwart the collider

A fun essay by Dennis Overbye. I love it when science finds itself forced to confront first principles, it happens all too rarely. Often, scientists are like these lonely dwarfs, chipping away at the end of some tunnel that has wound down into some truly esoteric schist. If I try and pull them up to the surface to talk about how the little gems and fossils they've found contribute to the big picture, the stumble around in a kind of dazed cranky fashion, as if they are overwhelmed by the scale, aggravated by the light. Of course there are those scientists who have the disposition to do the small-scale chipping (the only way to make real progress) and also to pull back at the end of the day and think about what it all means, and why (or if) we should be digging in that spot at all. People like Stephen Jay Gould - cheers to them.

Is the Future our version of Heaven?

painting/Robert Shetterly

I'm reading Wendell Barry's "The Unsettling of America." He writes: "The modern mind longs for the future as the medieval mind longed for Heaven." These are the sort of profundities that he's able to jot off (with ostensible ease) that stop me in my tracks. This one especially because it hits close to home. I don't really believe in Heaven, but I do have a deeply ingrained belief that the future is a better place, that we are constantly making progress, moving forward, making the world a better place. But by what metric do you measure improvement? The number of people living in poverty has grown. Large portions of the earth have become much less hospitable for human living. We have just closed the door on a millennium red from tip to toe with genocide. We all can tick off the improvements:

That soaring feeling

One of the great things about living in San Francisco is that every once and a while I'll come across a prospect that just lifts me a bit, as if I'd achieved aerodynamic properties for a fraction of a second. That happened today as I was walking up Coleridge St. I looked out to the west where the Golden Gate is and instead saw towering clouds sweeping in from the sea. I get the same sort of surge at the sight of certain mountains, waterfalls, summer thunderstorms. I feel at once very small, and powerful. Small, because it's clear that whatever I'm looking at could crush me, and powerful because it doesn't, because in fact I'm warm and secure - despite the fact that nature is overwhelming and incomprehensible, and the fact that there's a stiff wind whipping in off the Pacific - I'm able to stand there looking into the closest approximation of the eye of God I can imagine, and then walk away unscathed.

 Olivia Judson offers this:

grasshoppers that have to take measures to avoid spiders grow more slowly and lay fewer eggs than grasshoppers in spider-free zones. In areas of Yellowstone where wolves are abundant, female elk give birth to fewer young. Birds that perceive their breeding area to be full of animals that will eat their eggs or young may skip breeding altogether, or lay fewer eggs than usual. In other words, predators keep prey numbers down simply by being scary.

But aren't there many more examples where the opposite is true - where predation urges growth? Where - even more counter-intuitively - predator and prey are cooperating on some level? As my teacher Michael Pollan elegantly demonstrated in Botany of Desire, predator prey relationships can turn into mutualism: The apple tree, rather than trying to poison its predator, instead pulls a kind of evolutionary judo move and uses the fact that it's being eaten to its benefit. Of course the apple did this by luck (the right configuration of genes at the right moment), but the fable of the apple seems useful in this recessionary world: When someone comes to eat you, the impulse is to react like the grasshopper - but if you can figure out a way to act like the apple, that looks like a far better strategy.

Death at sea

I did a story for Crosscurrents about the strange season we've been having off the California coast. In it - mea culpa - I sin by saying some of these animal deaths are natural while the "dead zones" are not. It's such a convenient shorthand for a 4 minute radio piece. You can see how it has become a convenient (though blinding) shorthand for our thinking.
But a fun story for those armchair naturalists who want to know why all these animals are having such a hard time this year.

Photo by Chad King/NOAA

Surgery versus therapy

If you carefully squint at the top right corner of this picture you'll see me running the upper North Fork of the Kaweah. I love kayaking. But as a kid I popped my right shoulder out doing it - a lot (I had some bad habits - plus I've always had loose shoulders). By the time I was in college my shoulder would slip out if I so much as made an expressive gesture ("Just go that way, over th-aargahhaaaaaa!"). So I got surgery. The doctor told me he "tightened everything up" and "cleaned it out" and he gave me the video to prove that he hadn't just been messing with me while I was under. So I gobble Vicodin, wear the sling for a few months, and am not allowed to kayak for a full year. That was spring of 2000. And all was well until spring of 2009.
We were up in Downieville to run Pauly Creek (I don't have pictures but there are great ones here). It's a short run with lots of waterfalls and I was feeling great. I ran the big (20 foot or so) drop at the bottom which I'd never done before (because my friend Eric nearly died there and his stories spooked me). It was still early in the day so we drove back up to the top and I convinced a small contingent to hike a couple miles upstream to get a little more for our money. None of us had ever seen it before, and the light was starting to turn amber with evening as I led the crew down the first drop. Things went well until about the fifth rapid. I had lined up to charge from right to left, break through a hole, and end up in an eddy on the far side of the creek. But just as I reached for my first paddle stroke a hidden rock caught the downstream edge of my boat and stopped it dead. The rest of my body rotated around that pivot point like a cracking whip. As I went under, the paddle blade caught the water. You are supposed to have a loose hand - so that you release the paddle shaft in these situations were the opposing forces are getting big. I had a death grip. (more after the jump)

David Brooks calls some attention to that Goldhill article. He's saying - look: enough with futzing with the window treatments, we've got to do something about the sinkhole under the corner of the house. I feel the same way, and yet...

There's a tendency for us journalists to crave fundamental change - because it's exciting. And because we like to believe that good ideas can change the world (because that's our stock and trade). History is full of examples though, of big changes leading to big problems. There's more success when the changes are of the tinkering sort - a gradual sort of coevolutionary growth between insurers, government, business and medicine.

The all-natural-Heidi-force in me wants big change of course. It wants a system that doesn't push treatment (and kill hundreds of thousands a year with overtreatment). The inner Heidi applauds Bruce McCall's Shouts an Murmurs:

Did You Know: Human illness adds two trillion dollars annually to America’s gross domestic product. Are you contributing your fair share?

and this brilliant miniature:

Q. & A. of the Month
Q: My current statement lists two hundred and thirty-one charges for “brain surgery,” even though I have had no brain surgery. How can I rectify this?
A: Invalid question. Brain surgery is not covered under your plan.

People think doctors are all-knowing

Just got off a call going over the release of a poll by the Campaign for Effective Patient Care. The biggest takeaway for me was this: 65 percent of people in California think that their medical care is backed up by solid scientific evidence. Of course in reality - as Shannon Brownlee writes in the group's report -

In a landmark 2008 report, the prestigious Institute of Medicine reported that at most half of the care that doctors deliver is evidence-based.

This is important to the health care debate - people have been awful upset about comparative treatment reviews (the extremists think looking at how effective something is and how much it costs will lead to death panels). But at the same time nobody wants care that's not effective - we all want our doctors to know what treatments work and what don't. How to explain this contradiction? Well this poll explains it. People oppose comparative effectiveness research because they (65 percent) think their doctor already knows what's best for them. So a minority that sees this research as cover for a rationing regime is not drowned out by the reasonable majority who should be saying we want to stop spending so much (and being injured by) care that doesn't work.

How health care killed David Goldhill's dad

The Atlantic recently published a great piece of contrarian thinking on health care. David Goldhill points out that all the incentives in our medical system encourage more treatment - and that's making us sicker (plus, it killed his dad, or at least made the end of his life unpleasant).

All of the actors in health care—from doctors to insurers to pharmaceutical companies—work in a heavily regulated, massively subsidized industry full of structural distortions. They all want to serve patients well. But they also all behave rationally in response to the economic incentives those distortions create. Accidentally, but relentlessly, America has built a health-care system with incentives that inexorably generate terrible and perverse results. Incentives that emphasize health care over any other aspect of health and well-being. That emphasize treatment over prevention. That disguise true costs. That favor complexity, and discourage transparent competition based on price or quality. That result in a generational pyramid scheme rather than sustainable financing.

So far so good. I'm pretty convinced that we have too much medical treatment and that there are some foundational problems causing that. But Goldhill thinks these problems all come down to one thing: Lack of market pressure. It's an interesting point, but one that I think has some problems. But before I get to his proposal, here's one more interesting critique:

Blog neglected, but plants thriving

So I was on vacation recently - away from the blog - and when I got back all my editors suddenly wanted drafts. The first breaths of the brisk winds of fall, I suppose. In any case I've been doing a lot of writing these days - for which I'm actually paid (rather than the prospective research and navel gazing that feeds this project). So spending a lot of time writing hurts the blog... but it does wonders for the plants that sit in the window to my right - just past the mouse. When I'm sitting there trying to force my brain to figure out a way to make a particularly improbable transition - or how to breath some narrative life in to a sterile series of facts - it sometimes plays tricks on me to get out of the chore. One of my brain's favorite tricks is the classic "OMG what's that!" caper. It usually plays out something like this:

Pregnancy related death

KALW just aired two pieces that I did on the rising rate of pregnancy related deaths and the black-white disparity. You can see a longer post from June. I'm hoping this will get more media attention - it's a particularly troubling example of the broader problem that Atul Gawande and others (and still others) have identified. How does this tie in with Nature? Well when you live in a world we look to science for all the answers, science sometimes ends up providing best-guess answers when it should just be saying - "we don't know enough about that yet."

Romantic? Rational? Or machinist?

Finished Daniel Botkin's book "Discordant Harmonies" last night. It has a lot to offer, but what I'm most interested in is Botkin's perspective on the trajectory of thought on nature. We start out with competing myths: The earth is a divine creation with everything made according to a plan to foster life (Jewish creation story) - versus - The earth is a living organism passing through different stages of life (pagan/animist). And then around the industrial revolution - when people had complex machines available to refer to in their metaphor making, and when Newton's breakthroughs offered a vision of a universe governed by an elegant set of simple rules - a new myth grew and dominated the others: The earth is just an piece of machinery. There are several implications if you think of the world this way. The most important implication (to Botkin) is that the world tends toward a steady state - it should just keep chugging along unless we really screw things up.