Saturday, January 29, 2011

Organ Donation

In one of those strange coincidences, the subject of organ donation recently came to my attention from two separate directions. First, the news reported that a man who had an organ donor card was critically injured in an accident, and when he was declared brain-dead, his family refused to honour his intentions and donate his organs. Second, I have been editing some academic research into attitudes towards organ donation. It was strange to be working on a subject that was also reported in the news.

I have been carrying an organ donor card for many years, and I want to explain here why I consider it important, and why I consider people's objections to organ donation to be irrational.

Medical science enables doctors to take organs from recently deceased people and transplant them into patients suffering from various medical conditions. In some cases, these transplants can save lives, while in others they improve the patients' quality of life.

In the modern world, we are living in a relatively safe and sterile environment, and many people are never exposed to death and serious disease. These subjects, part of the cycle of life, have become taboo to some people, who prefer not to think about them or discuss them. Some people even refuse to draw up a will, thinking that this could somehow hasten their death.

The decision regarding the treatment of dead bodies is usually made based on religion, or on traditional practices. The main traditional methods are burial, cremation, and disposal at sea. In Israel, dead bodies are buried (rather than cremated), so this is the burial type I will discuss here. Burials are ceremonies aimed at helping the deceased's surviving loved ones come to terms with the death, and they create a memorial where the deceased can be remembered.

Most religious leaders believe that saving a life is important, and support or even encourage believers to donate their organs after death. However, a minority of religious leaders and believers seem to think that organ donation is not acceptable to their religion, for various reasons.

First, there is the sensitive issue of brain-death. When the brain ceases functioning, this is completely irreversible. It seems that some people confuse this state with reversible states such as coma, and therefore consider the brain-dead person still alive, or think that a miracle could happen and the person could regain consciousness.

Second, the issue of how the dead body is treated is sensitive for those who believe in the afterlife and/or in some form of reincarnation. In my understanding of these religions, the soul is a non-material essence of the person, which leaves the body at the moment of death, and so the removal and transplantation of bodily organs after death should have no impact on the released soul. As for reincarnation, the idea that the body should be kept whole until burial seems strange, considering that the flesh decays. Religions that believe the dead will rise from their graves in their physical bodies must assume a lot of miraculous intervention to restore the flesh, and in that case, why not also restore the organs that were donated upon death?

Third, some religious believers seem to have a negative opinion of science and medicine in general, to the point of accusing scientists and physicians of "playing God". To counter this objection, I suggest that believers take into account that human cognition was, in their own view, given by God, and as an omniscient being, God should know how the gift of intelligence is being used. It should not be possible for humans to "play God" against God's own intentions.

Finally, some people seem to believe that patients carrying organ donor cards would be considered as organ banks, and would therefore receive less medical support than other patients, since the health care workers would hasten their deaths in the hope of obtaining organs for other patients. This is an offensive slur against the morality and integrity of hospital staff, who work hard to save lives and alleviate pain and suffering.

My own position is that once I am dead, my body is no longer of any use to me, and I would prefer to think that it might be of use to another human being, rather than to think that it was just buried and allowed to decay. If it were possible to use every one of my dead body's cells to save lives, with the result that there was nothing left of my body to be buried, I would still do this. My loved ones would be able to remember me without a slab of stone marking the spot where my remains were decaying.

In order to clarify this issue in the public mind, and increase the number of potential donors, the following steps should be taken:
  • A public information campaign explaining brain-death and showing transplant patients whose lives have been saved or improved.
  • Religious leaders supporting organ donation should educate their coreligionists who oppose it.
  • In some countries, I have heard, people renewing their drivers license have to opt out of signing an organ donor card, by ticking the box saying "I do not wish to donate my organs after death", which has increased the number of potential organ donors, compared with countries like Israel, where people have to opt in. This method is worth adopting.
  • In general, society would be healthier if people had a more open and rational attitude to death and disease, treating these as aspects of life and things that will impact all our lives at some point, rather than as taboo.

Tuesday, January 25, 2011

Neal Stephenson - Anathem

Neal Stephenson, Anathem, Atlantic Books, 2008.

When faced with a book by one of their favourite authors, many readers would rush to read it as soon as possible. I did the opposite, delaying gratification, knowing that the pleasure of the first read would only happen once, and would only last a given time. First, I waited for the book to be out in paperback, which I prefer to hardcover books, due to the size and feel of the book in my hands, storage space, and price. Then, when the book arrived, I delayed reading it until I had completed a project, and then a bit longer, knowing that it would be best to read when I was not too busy and could devote more time to reading without feeling guilty. It was worth the wait. I then had to reread it, to appreciate the entire book with knowledge of how it ended.

Neal Stephenson's work is always intelligent, and draws on a wide range of knowledge in several areas. It is aimed at readers who enjoy an intellectual challenge, and find great satisfaction in the meeting of minds, rather than those readers who need to be spoon-fed.

This is the first of Stephenson's novels to be set on a different planet. Approaching the story without any foreknowledge, the reader has to wonder about the existence of humans on another planet - are they humans from earth, who settled the planet at some point in the past, or did they evolve there? In this case, it is made clear that humans evolved on the planet Arbre, which already raises some interesting questions to be answered later on. An author's note clarifies that the species of plants and animals mentioned are Arbre native, and are only given the names of Earth species to avoid saying something like "dog-equivalent" or inventing new names for everything. The reader is expected to assume that the planet and its evolution are similar to what we know.

A timeline in the author's note gives a history of about 7,000 years, which is somewhat longer than earth's human history recorded to date. It soon becomes clear that during this time, science and technology on Arbre have developed beyond our current level here on earth, but that there have been repeated efforts to slow down this development for social reasons.

Scholars have been separated from the rest of society, forced to live in monastic communities, and have had restrictions imposed on their research, to prevent the rapid development of advanced weapons, nanotechnology, genetic engineering, and other sciences. They have been denied the use of computers and experimental devices, and as a result, they live a sort of medieval existence, writing by hand and developing the sort of sciences that result from abstract thought rather than experimental research.

The scholarly communities are known as "concents", and are inhabited by male scholars, "fraas", and female scholars, "suurs". In most places, sexual relationships are permitted, but the males are kept infertile, so there are no families. The concents adopt unwanted babies from the surrounding communities, and admit children and adults who wish to study. Each concent has several sections, each with a different period of total separation from the outside world. In one part of the concent, the gates open each year for ten days, and people who join commit themselves to staying inside and following the discipline for one year. This section is often used as a sort of college for members of the general community, who study for one or more year in this way, and then return to the outside world. Another section is closed for ten years at a time. Children who join this section grow up within the concent. Then there is a section that only opens its gates once a century, and another that only opens once in a thousand years. Scholars can move upwards if they wish, and the research that happens at the higher levels is considered more advanced and abstract than at the lower levels, since they have less access to current news.

The concents are also home to another class of people, the Ita, who operate the technology still permitted to the scholars, such as clocks and telescopes. They keep strictly apart from the scholars.

The story's protagonist, Fraa Erasmas, joined the concent at age 8, and is now 18. As the story starts, his section of the concent is preparing to open its gates for the first time in ten years. This great change in his life is just a prefiguring of the greater change that the whole society will experience later, when an alien star ship is detected. By the end of the book, the entire social order on the planet has undergone a dramatic change, and even our understanding of the way the world works can no longer be the same as before.

On one level, the story is a quest and an adventure story. Erasmas must leave the concent and travel, with a varied group of companions. On another level, the scholars must recognize the implications of the arrival of the star ship. This is a vast undertaking, both in practical terms and in the way people think. This is not just a simple case of first contact (not that first contact could ever really be simple), but something stranger and more challenging.

The characters are vividly drawn, and they develop as the plot progresses. In some cases, it seems frustrating that they never seem to say all that needs to be said in a particular situation, due to their habitual awareness that they might be under surveillance and subject to the discipline, or due to political considerations. However, this does advance the plot.

As with all Stephenson's work, the world building is impressive. Few novels provide such a comprehensive overview of a planet's history, geography, economics, and society. Some details are deliberately left vague, as the viewpoint character would not be an expert on everything, and so describes mainly what is relevant to the story. But I certainly feel that I have spent time in Arbre, and it is as real to me as the best fictional worlds I have visited. I would have appreciated a map. I know that some readers believe a map is redundant when the geographical descriptions are good enough, but I happen to like maps and do not consider a visual aid as detracting from the writing.

The language created for this book, often based on Greek and Latin roots, or on variations on English words, was a pleasure to experience. I particularly liked the concept of "upsight" (instead of insight), and the idea of an "avocation" (a sort of hobby or occupation the fraas and suurs adopted in addition to their field of studies). The terms are explained in a glossary, and there are several dictionary entries scattered throughout the book, but I am certain many readers will find it easy to understand all the new terms just from the context.

The book contains many detailed discussions and explanations of "big ideas" from the realms of philosophy, science, and mathematics. This should not deter readers who lack formal education in these areas, provided they are open-minded and patient in their reading. While these ideas are obviously related to some ideas proposed by thinkers here on our earth, there is not necessarily any one-on-one equivalence between the fictional theorists and any in our world, so no prior knowledge is required. I enjoyed these discussions, and found the climactic scenes involving quantum poly-cosmic consciousness impressively conceived and executed.

This is the second book I have read recently that discusses the idea of multiple universes, and here the theory is presented cohesively and given a somewhat far-fetched portrayal that was still very enjoyable. It does require suspension of disbelief, as do the best fictional ideas.

Not surprisingly, I consider this one of the best books I have read in a long time. It is probably not for everyone, but I strongly recommend it to readers willing to invest in a challenging and rewarding, intelligent, horizon-broadening read.

Saturday, January 22, 2011

Kim Stanley Robinson - Galileo's Dream

Kim Stanley Robinson, Galileo's Dream, Voyager, 2009.

This novel explores the life and scientific discoveries of Galileo Galilei, along with a far-future plot line that considers the importance and implications of Galileo's role in the history of science.

Galileo is a compelling character, with a stark contrast between his intellectual integrity and his emotional flaws of pride and stubbornness. We follow his scientific progress and the politics surrounding his career. He is committed to discovering and teaching the true nature of the universe, and is frustrated by the unwillingness of others to change their minds when superior evidence is presented. He is quoted as saying, "There is no hatred like that of ignorance for knowledge", a statement that is still true today. He keeps his faith in God throughout, and his problem with the religious authorities is their insistence on the literal truth of scripture. He believes that humans are capable of discovering the truth through the evidence of their senses and the power of thought, all of which are parts of God's universe.

The SF part of the story comes when Galileo is transported, at several points in his life, to a far-future era and embroiled in a political struggle on the moons of Jupiter, where humans are making first contact with an alien intelligence. His experiences there, and his gradual exposure to various alternate versions of his life and the impact he has on the progression of history after his era, are used to explain the choices he makes back in his own time.

The book cites in italics passages from Galileo's writings, and those of his contemporaries, and in some cases the citations seem to be explained in the context of the fictional future plot line. This is an interesting way of linking the historical novel to the SF content, but in some cases it felt rather forced.

This was the first of two books I read recently that used the idea of multiple universes, in very different ways. Here, Galileo sees many possible futures of his life, and wishes to alter one in which he is burned at the stake. It seems to me that a person understanding the multiple universe theory would realize that even if it were possible to prevent a certain outcome in one universe, this would not change others where it still happened, just add one new universe to the many that still exist.

As with many novels that contain two main plot lines, the reader is left wondering what is going on in the other plot line and waiting for the next section of the other plot. Each story line is read in light of what has been happening in the other.

The future part of the novel was interesting, but had a dreamlike remoteness. A society with such advanced abilities, such as time travel through alternate pasts, would be motivated by different ideals than ours. The characters are strongly drawn, but the reader gets the impression that they know much more than Galileo, or current readers, can possibly understand. This makes them hard to identify with, and Galileo is manipulated by them in a way that leaves him powerless and frustrated. The clear parallel between his struggle with the Inquisition and his involvement with future Jovian-system factions creates sympathy for Galileo's situation(s), even when his attitude and behaviour make him a flawed hero. All he can do is maintain his confidence in his discoveries and his world view, while others around him distort his words and intentions, kidnap and imprison him. The portrayal of such a strong-willed person becoming so helpless is touching.

The novel is beautifully written, with vivid descriptions of places, events, and characters alike, and an interesting plot and structure. The ideas raised are of interest in today's society, where the conflict between science and religion, or between rationality and dogmatism, seems as strong as ever.

Tuesday, January 18, 2011

Memories of the Gulf War 1991

This week marks 20 years to the start of Operation Desert Storm, part of the Gulf War. The Israeli media have not been marking this anniversary very much, and it was an article about a popular satirical television series at the time that reminded me and brought back memories.

It all started on August 2, 1990, when Iraq invaded Kuwait. Since this was my 21st birthday, when I first heard this news, I remarked: "I have been given a war for my birthday". As time passed and we witnessed the planned international response to this invasion, it became increasingly clear that Israel would be attacked. I remember saying to someone: "Of course Iraq will attack Israel, they have nothing to lose".

In January 1991 I was a student at Tel Aviv University, and we were planning an archaeology trip to Masada, which happened to be scheduled for a day or two after the start of Desert Storm. I remember saying to a friend: "See you on the trip, unless there is a war!". Of course, this trip never took place. The population had been given boxes containing gas masks and atropine injectors, and everyone had prepared "sealed rooms" that were supposed to keep out chemical weapons. As the allied attack started, Israelis were ordered to stay at home in preparation for attack.

In the middle of the night, we heard explosions and woke up. After a few minutes, the sirens started up. We put on our gas masks as instructed, turned on the radio and listened anxiously to hear what had been hit. During those first minutes I was imagining that clouds of nerve gas were spreading outside, and that life would never be the same. It turned out that Iraq was firing conventional long-range Scud missiles, but we could never be sure that the next attack would be conventional.

The missile attacks came every night for the next six weeks. After that first night, we went to stay with my parents, whose sealed room seemed more secure. We developed a routine of sleeping late in the morning, spending much of the day reading newspapers and watching the news on television, and then awaiting the attacks at night. Sometimes we were woken up several times in a night, particularly when it was cloudy in Western Iraq, allowing the missiles to be launched without being observed by allied planes. Each time we heard the sirens, we would rush to the sealed room, tape down the edges of the door, put on the gas masks and wait for the explosions, and later the all-clear siren. The radio stations had a silent frequency at night, which only broadcast the siren warning and then played news and music until the all-clear. I remember clearly that our dog Fluffy always knew just before the siren warning came on air, and started running to the sealed room whining, so often he woke us just before the radio did.

It was a strange war, because Israel was being attacked for no reason other than the Iraqi leadership's hatred, and the IDF was not involved in fighting, only in protecting the civilian home front. For once, Israel could feel, and present itself, as an innocent victim.

Six weeks is a long time to be in a stressful situation. It left its mark on my psyche (and that of everyone else, I assume). My routine was disrupted, with the university closed for the last week of the semester and the exam period. That semester we were given essays to write at home instead of taking exams, and my concentration was ruined. The feeling of being unsafe in my own home and the fear of sudden noises have continued to accompany me, in varying degrees, ever since.

Since then, I have lived with the threat of suicide attacks on public places and public transport during the Second Intifada (2000-2005) and survived the missile attacks on my city, Haifa, during the Second Lebanon War (2006). Experiencing war as a civilian is unfortunately part of the life of all Israelis. I can only hope that all parties in the region see reason and work together to reach a rational accommodation. Everyone deserves to live in peace, and I hope future generations will never have to share similar experiences.

Saturday, January 15, 2011

Language as a Life Skill

I recently heard a discussion about teaching young children from underprivileged backgrounds life skills. The project took children of kindergarten age and over, and taught them martial arts, chess, and music. These subjects taught the children the life skills of self-discipline, logic, and creativity, and vastly improved their self-esteem.

This is admirable, but I would like to propose another additional and important subject to teach life skills to children: language. For a very long time, language has been undervalued as a subject and as a way of thinking. People who understand language and use it correctly have a clarity of thought that semi-literate people lack. Proper use of language gives a precision and accuracy to expression and thought, and opens up the entire written-word culture of that language to the user.

Since the 1960s, many countries have been neglecting the teaching of languages, influenced by an ideology whereby "children learn their own language naturally and don't need to be corrected or taught". I believe this policy has been shown to be a disaster. What is needed now is a movement to improve the teaching of languages. We need teachers who can understand and explain the grammar and syntax of a language, and make the rules and exceptions part of the children's way of thinking from an early age. Language teachers with a passion for language and its importance can change the way language is taught and perceived.

Children who learn grammar and syntax properly will, for example, differentiate between the subject and the object of a sentence, thus knowing (in English) when to use "and I" and when to use "and me". Properly-taught Israeli children will know when to use masculine and feminine numbers and adjectives to agree with the masculine and feminine nouns in Hebrew.

Of course, the level of language-use is a strong social identifier, so using language correctly would separate underprivileged children from their social group more clearly than their skills in martial arts, chess, or music, but that is the whole point. If they are to become the first people in their family to attend university and have a white-collar career, they need to be considered and consider themselves part of educated society, and they could also serve as role models to others in their communities.

I also strongly support learning a second language as early as possible. Being able to speak, think, and read in more than one language gives the brain an elasticity that mono-linguals probably lack. A second language provides the user with another culture to explore. I am always impressed by people from certain European countries, such as the Netherlands, Belgium, Switzerland, and Luxembourg, many of whom become fluent in three languages by the end of high school. Imagine a world where everyone spoke several languages fluently!

I would like to call on language professionals and language lovers everywhere to consider how to promote the serious teaching of languages in all countries, in order to raise standards everywhere.