The Way We Die Now

May I quote this case reported in a respected medical journal? This happened in a metropolitan English hospital.

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A 92-year old lady with multiple comorbidities was admitted to hospital from a residential home with community-acquired pneumonia.

She was judged to be at high risk of aspiration and was made nil by mouth (NBM) pending review by a speech and language therapist (SLT).    ....
She was given intravenous (IV) antibiotics at a rate that cannot be determined by retrospective examination of the medical notes.
On day 4 of her admission she was reviewed by an SLT, who advised keeping her NBM and consider an alternative mode of feeding.
On day 9, the patient was reviewed by a dietician.

The physiotherapist who treated her commented that she had grossly oedematous arms and legs.
On day 10 the patient received nasogastric tube feeding (NGTF) and was started on a low-energy feeding regimen (30 ml/hour for 16 hours) to avoid refeeding syndrome (RFS).
Intravenous fluids were continued for 1 day, and on day 2 of NGTF, serum magnesium was found to be low; 8 mmol of magnesium were given intravenously.
On day 3 of NGTF , the patient's respiratory function deteriorated, her antibiotics were changed and the feeding rate was increased to 75 ml/hour. The patient's phosphate had fallen to 0.5 mmol/L.
A further 6 days later, the patient pulled out the her feeding tube on the day she was judged clinically to be dying.
Intravenous fluids were discontinued and the LCP (Liverpool Care Pathway) was used to support her care.

Within 4 days she she had dramatically improved, was no longer oedematous or breathless, and was asking for a cup of tea. The LCP was discontinued.
However the patient continued to be at high risk of aspiration, so she was again kept NBM; as she refused NGTF, IV fluids were restarted to avoid dehydration.
Two days later, the patient deteriorated again and seemed clinically to be dying. She was again supported by the LCP and IV fluids were stopped.

Ten days later, the patient had improved so much that she started to eat and drink for pleasure - despite the high risk of aspiration.
The patient was eventually discharged to a nursing home, where she died 10 months later.

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This is defensive protocol medicine as practised in NHS hospitals. This old patient suffered the misery of all this intervention because the admitting doctor followed a protocol which said nothing by mouth - not even water or tea - until the risk of aspiration was evaluated by a speech and language therapist, who came 4 days later.
Note that her gross oedema was reported by a physiotherapist. Where was the ward sister, where was the house physician, where was the consultant in charge of her case? Was there any continuity of care, or was she managed by a succession of doctors on the "Medical Team"?
But the doctors did pick up her low serum magnesium. And no doubt all the boxes were ticked on the "Care Plan".

Words fail me. Is good, intelligent medical practice now made obsolete by fear of responsibility?
I'm glad I'm out of it.

A Question of Excellence

This is the text of an article I wrote for a medical journal some 25 years ago. At that time we had CT scanning only, and the facilities were few, tending to have long waiting lists unless the request was urgent. Nowadays NHS hospital policy would dictate an MRI headscan for every case of headache referred to the clinic.

"Errors happen when doctors use their clinical judgement." "A normal headscan gives final reassurance and is therapeutic." Such arguments are frequently heard.

Maybe. But the physician in me still questions the quality of management which devalues clinical judgement, and depends on routine, expensive investigation.

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What is medical excellence? Medical competence or incompetence may be recognisable, but these attributes can be judged on the grounds of safety and convention. Excellence is a judgment of quality. Its definition must be subjective. Like beauty it lies in the eye of the beholder. Medical practice is a creative activity: its assessment must have something in common with art appreciation. 

So who is to say that excellence was or was not achieved in the management of a specified case? The practitioner? His peers? The patient? A duly appointed committee of all interested parties?

The practitioner is best placed to know, but cannot judge objectively. His peers will very likely hold different opinions or values concerning some aspects of the case. The patient's views must be important, but we can each recall occasions when bungled or erroneous management produced embarrassing praise and thanks. Surely not a committee, earnestly seeking a diplomatic average view.

Perhaps medical excellence can be judged only by the professional conscience of each doctor for himself, a conclusion which many may find uncomfortable, but which may be unavoidable.

These thoughts and more have run through my head following a recent case.

My heart sank when I read the courteous and succinct referral letter from a general practitioner whom I know well and respect. A 17 years' old girl with intractable headaches. It was the last case on the list, the end of a long clinic. I was tired and running late. Sister had glanced at her watch.

Miss C entered and sat down. Quiet, mature, in school uniform with a prefect's badge, but uneasy, even a little hostile. Both parents came in too: well to do and worried. Father did most of the talking, prompted by mother. Their daughter sat and fidgeted, answering direct questions in monosyllables. The history was familiar.

All was well until three months ago. Her school reports were always good, and she was in for four papers at "A" level next year. Her teachers had spoken of a sixth form career leading to university - Oxford, perhaps, even medical school.

But then the headaches started, and now all their hopes were in jeopardy. Each day she came home listless and pale, complaining of pain behind her eyes and round her head like a tight band. She would say that her head was going to burst. She was irritable and emotional. Sometimes she had sat with her head in her hands and wept because of the pain. Often she would go to her room and spend all evening just lying on her bed with the door shut. Homework was not being done.

Headache did not disturb sleep, and was little problem in the mornings, but waking and getting up were difficult. She had been late in school on several occasions, an event unknown before. She had lost all interest in other activities, and never played the piano now.

When Father began to describe his daughter's dysmenorrhoea I retreated to the examination cubicle.

There were no physical signs; indeed, she seemed to be in excellent health. She was no more forthcoming about her troubles when her parents were absent.

The diagnosis was clear: tension headache syndrome. She needed explanation, discussion of precipitating factors (if admitted), and reassurance. But it was going to be difficult. Heads are mysterious and important. Pain must mean something is wrong. Brain tumours can cause headaches, and rarely might present like this. Surely a brain scan should be done?

At such times I become aware of an angel whispering into my right ear, and a snake into my left.

The angel says that I am reasonably sure of the diagnosis. The roots of the trouble are in the parents as much as in the girl. To treat their anxieties and ambitions by ordering unnecessary X-ray examinations on their daughter doesn't make much sense. Young women should be protected from radiation. Only yesterday there had been that letter from the radiologist pointing out how the demand for brain scans had increased, and how small a fraction of all those done showed abnormalities.

The snake is a realist. Nothing that l say will finally reassure the parents. I admit l cannot be absolute about the diagnosis. The general practitioner has suggested that a scan might be necessary and the parents are expecting it. If I do not do it then no doubt there will be another referral to someone who will, probably that old so and so in the next town who will see them privately and discreetly imply that I am careless in such matters. What if new signs appear and there is a tumour? I might be sued.

It had been a long day. I shied from the hassle. I listened to the snake.

The scan was normal. I heard that she did well in the examinations, and that the headaches are much less troublesome, but I have not seen her since.

Her parents and their general practitioner were pleased and satisfied. I cannot speak for the patient.

l am not. I know that I failed to achieve excellence in this case. Worse, l suspect that I shall do the same again next time. It is always easier in medical practice to do something than it is to explain convincingly why it is unnecessary.

Perhaps medical excellence is impracticable.

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Beware of False Prophets 2

Here is a memorable quotation, with thanks to Michael Gilleland, master blogger:
[ http://laudatortemporisacti.blogspot.com/ ]

Fürchte dich vor jener transzendenten Ventriloquenz des Schwärmers, womit er dir glauben macht etwas was auf der Erde gesprochen ist käme vom Himmel.

Beware of that transcendental ventriloquism of the zealot, by means of which he makes you believe that something said on earth comes from heaven.

Georg Christoph Lichtenberg (1742-1799)

Beware of False Prophets

I do not accept that there are any books or bodies of doctrine which include the revealed words of God. None that I read include demonstrable, verifiable evidence of supernatural authorship. None include anything unknown by writers of their time and place. None, for example, teach that the earth is a planet orbiting a star, that Jupiter has moons, that an America lies over the ocean, even that the earth has ice-caps.

None, in short, reveals understanding of the realities of humanity's place on earth or in the cosmos.

All had human authors: these are books of human opinion, human wisdom, human speculation, human fantasy, human frailty. Their ethics and moralities derive from the dogmas prevailing in the societies in which their authors lived.

Indeed I would go further. To attribute divine authorship to a book is a subtle form of idolatry.

But probably a majority of mankind believe their own religion's book is God's word, having divine authority. Claims for a similar divine status of other books are rejected.

If you believe that a text has a supernatural author, then you must admit the author may be Satan, not God.

Priests, mullahs, rabbis - all agree that Satan is sly, deceiving, the whisperer, adept at persuading to evil. The gullible may be deceived into the greatest blasphemy - and do evil in the name of God. Examples abound.

Christianity must acknowledge guilt in such matters, but can argue with justice that all persuasions to evil are an aberration, incompatible with the recorded teachings of Jesus.

Islam has no such excuse. The Qur’an explicitly commands murder, cruel and sadistic punishments - even crucifixion, and phobic discrimination - against women, jews, unbelievers.

There is a remarkable passage in the New Testament: Matthew 7:15-20. Beware of false prophets; by their fruits you shall know them.

A book which persuades to satanic actions cannot have divine inspiration.

It is foolish and dangerous to commit your life and mind and identity to the dominion of doctrines which claim authority from supernatural revelation. Beware those so committed; beware their denial of facts inconsistent with their precepts, their ruthless hostility to all sceptical or contradictory arguments, and their vicious intolerance of even trivial deviations from their dogmas.

Especially, beware all whose incomes and careers depend on institutionalised doctrine. Above all, do not let them indoctrinate children: the first freedom is to grow up with an independent mind.

COKA: The Conjecture of Kosmic Autopoiesis

I offer no apology for this edited repeat posting. Rightly or wrongly, these ideas continue to fascinate me, and I find the emerging understanding profoundly satisfying.

Given enough hydrogen, enough space, and enough time;
by natural, spontaneous mechanisms
the complexity of matter will increase,
and life will begin;
as living things evolve,
their information processing will grow in scope and power,
until eventually conscious, creative, communicating cognition is born.

That statement is my Conjecture of Kosmic Autopoiesis. Let it be written on my tombstone.

***


This is an attempt to write down ideas which interest and excite me. It is a brief, preliminary, incomplete and inadequate outline. Obviously any conjecture demands precise exposition, careful elaboration, critical evaluation, and discussion. A lengthy task, but a start must be made.
At present I can argue as follows in support of the conjecture.

1. It is evident that the complexity of our planet earth has increased since its origin, maybe 4.5 billion years ago. A biosphere has evolved from an initial assembly of elements and simple compounds.
At least one member of the biosphere is now conscious, with the facility of intelligent information processing.
It has taken more time than the human mind can easily imagine, but there is no doubt that it has happened.

2. There is no evidence that earth's evolution requires an external designer or controller: all processes on the earth are intrinsic and spontaneous. Therefore the potential of self-assembly - autopoiesis - must be included in our studies of the properties of matter.
The mechanisms of autopoiesis are poorly understood. Our knowledge is best for the biosphere, but insights into pre-biotic evolution are beginning.

Autopoiesis is the theory of natural self-assembly, a conjecture, inferred from probabilities. Our special human interest is Gaia Autopoietika, the autopoietic Earth.

3. Gravity is the great creative force, causing the aggregation of materials and energy release necessary for autopoiesis. It is gravity which drives the sun and the other stars; it is gravity which creates planets from stardust; it is gravity which sustains environments in which life can evolve.
But it is gravity which now restricts the advancement of Homo beyond its home planet.

4. Why stop with earth? There is no sign that physics and chemistry might vary across the kosmos. Our sun is one of many millions of similar stars in our galaxy alone, and there are more than 100 billion galaxies in the kosmos we observe. The probability that earth is the only planet suitable for life is vanishingly small. What we perceive here may be a very small sample, but there is no reason to believe it is atypical or unique.
There is a high probability that life is abundant in the kosmos: conscious, intelligent life must be out there, and may well be common. We can but hope that eventually a means of communication across vast distances will be found; perhaps then we shall find a kosmos full of voices.

5. The increase in complexity from kosmic primordia to stars and planets extends autopoiesis back almost to the singularity which we believe was in the beginning.

6. In broadest outline, autopoiesis proceeds:

- from hydrogen gas to generations of stars, and synthesis of all other elements;
- from simple stars to complex star-systems, with planets of elements and compounds;
- from simple to complex planetary chemistry;
- from complex molecules to simple life;
- from simple to complex life, increasingly homeostatic [independent of the environment];
- in homeostasis increasingly complex neural structures, permitting functions of increasing sophistication;
- finally consciousness and intelligence.

7. This conjecture - an Autopoietic Kosmos - Kosmos Autopoietikos - may be the grandest of unifying theories. Much detail may still be mysterious, but the theory offers understanding of the emergence from chaotic matter and energy of order, life and mind. The consequent vision is majestic, but without comfort. It is mechanical, wasteful, cruel and unjust in its working; frequently creating diversions leading to extinction; yet somehow, marvellously and unexpectedly, the long-term trend is always to increase complexity.
Darwinian evolution is the prime mechanism of complexity increase, at the biological level at least.
That which succeeds, succeeds; that which fails is eliminated without mercy.

8. All life is subject to a ruthless and unrelenting struggle for survival and reproductive success. With the exception of photosynthetic and chemosynthetic organisms, all life feeds on other life, with no respect for status in the tree of life. Syphilis destroyed Schubert; tuberculosis bacilli killed Darwin’s 10 years old daughter.
Life’s evolution on earth survived mass extinctions, usually inflicted by asteroid impact and volcanism; blind physics damaging biology. Remarkably such events may accelerate autopoiesis, perhaps by clearing space for the next advance.
After the Permian mass extinction came the radiation of the reptilia and dinosauria; in turn they gave way to birds and mammals after the late Cretaceous extinction event.

9. Autopoiesis - to what end? A question we cannot answer. That the kosmos has meaning and purpose must be assumed, for now. That is the only item of faith I can accept in my kataphusin philosophy. It is the first axiom for any evidence-based theology.
Some may argue that autopoiesis is evidence for the existence of a creating, controlling and sustaining entity, towards which all is evolving, and in which all eventually will reach fulfilment, be made plain, and justified. This conjecture has no demonstrable base in the knowledge of reality which now we possess, nor can it be proven by argument - or disproven.
But the denial of such arguments implies that material, mechanism and chance are the total and final causes of all the marvels we perceive, and that the kosmos we inhabit has no deep meaning or ultimate significance. The more I experience and understand, the more absurd those conclusions seem.
Could it be that all we are is just a tiny increment in the autopoiesis of a future kosmic organism, endowed with knowledge, understanding and capabilities beyond our comprehension?

We can but hope.

Dis-Ill-EU-sion

This morning I found a letter I wrote to my [New Labour] MP in 2008. It tells the evolution of my opinions on the Common Market / European union. Since writing my opinions have hardened further: disappointment and frustration led to anger, and now outrage.

So here it is repeated. I think the public demand for a referendum will be an important issue at the next election, and that a referendum must eventually be held. The "democratic deficit" in the EU erodes its authority and stability, as do its attempts to preserve the euro by illegal means.

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Thank you for your letter arguing New Labour's case against a referendum on the Lisbon Treaty. It does not address the central issue.

You were elected on a manifesto which made a clear, simple, unqualified commitment to a referendum on this treaty. You would argue the benefits of increased British commitment to Europe. You appeared confident you could win the argument and the referendum.

In the event this commitment will not be honoured: a serious betrayal of trust. New Labour's contract with its electorate is broken.
So the further arguments you develop are worthless. Each point you make is open to challenge. In refusing a referendum you tacitly declare no confidence in your own case.

In practice we all know and accept that manifesto promises are mostly electoral propaganda, as reliable as Lenin's pie-crust. But this commitment is different: the issue affects the future of democracy in Britain.

In the beginning I strongly advocated Britain's membership of the Common Market, but experience has convinced me this was a serious mistake. On European questions our politicians have a record of evasion, economy with the truth, and, on occasion, dishonesty. I have been taught Euroscepticism, indeed Eurocynicism. I call it dis-Ill-EU-sion.

I am now convinced Heath lied about some of the terms agreed for Britain's entry. I remember pro-Europeans stressing that we were joining a Common Market, not a European Union. On this basis many of us voted “yes” in the referendum of 1975. We have had ample time to reflect how badly we were mistaken. I joined the derision of Mrs. Thatcher, when in 1990 she declared her doubts about a single currency, a European central bank, and admission of Eastern European countries. She foresaw wealth and jobs flooding east through Europe, and a tidal bore of migrants coming west.
I owe her an apology.

For the EU is indeed ill. It is corrupt; it has not returned audited accounts in a decade. It fails to create a fair environment for competition, even such basics as harmonized fuel taxation. It is authoritarian and hubristic. The Euro-bureaucracy will increase its power by right means if it can, if not, by any means. It is hugely expensive for Britain.
New Labour consents to this. Indeed it goes further than most, advocating EU membership for Turkey and the states of the North African littoral, seemingly oblivious to the political, cultural, economic and demographic consequences.

We should refuse the Lisbon treaty. We should seek to repatriate powers to our own democracy. Norway should be our model for engagement with Europe, not France or Germany. We can renegotiate our European commitment from a position of strength: Europe is the main beneficiary of British EU membership.

Reality can be denied, but will eventually break through. A thorough, critical review of our experience of EU membership is needed. A referendum would provide the opportunity for such a review and a debate on the best response to the facts revealed.

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Two Predator Poems

Leo

The lion's life is grim and hard,

With pride and cubs to keep;

Each day he paces round on guard,

All night he dare not sleep.

One day he'll face a fresh young male,

When he is spent and hurt,

He'll fight for cubs and pride, and fail,

Fall bloodied in the dirt.

[And all because the ladies love a winner]

Orca

The killer whale, with dorsal sword,

Is Orca gladiator;

Pied pack-wolf from the ocean broad,

The cruelest sea predator.

Young whales and seals they tear and bleed,

And feast, their bellies filling;

But then hunt on, in sport, to feed

Satanic lusts for killing.

[Did He, who made the lamb, make thee?]

Fashions in Naming.

A local newspaper records the recent death of a lady of 91. It lists the names of her family over four generations.

She was Maisie Ruth, her husband was Leslie; her brother is Ronald.

Her daughter Beryl married Barrie; her son Malcolm married Lilwen.

All good traditional British names, but then:

her grandchildren are Gary, Tracey and Jason;

and her great-grandchildren are Connor, Taylor, Blu, Tyler, Kaya and Zeph.

Maybe there is an Australian flavour about those bizarre fourth generation names?

Times change, and I must change with them, I suppose, but I can't understand why parents would so ignore their childrens' cultural legacy.

Like tattoos, such names are a passing fashion. They will disappear in the next generation.

A Document to Remember and Respect

I understand that tomorrow, January 16th., is to be Religious Freedom Day in the United States, by presidential decree.

It is to mark the anniversary of the Statute of Religious Freedom, passed by the government of the state of Virginia in 1786. Thomas Jefferson wrote the document, and was justifiably proud of his achievement.

It is a most important contribution to human civilisation, institutional religious authority proving so often the cause of social stagnation, legalised barbarism, and conflict.

It is a document I would commend to all young people, for study and reflection. Here is the text: I have marked in bold the passage I consider fundamental.

>> Whereas Almighty God hath created the mind free;

that all attempts to influence it by temporal punishments or burthens, or by civil incapacitations, tend only to beget habits of hypocrisy and meanness, and are a departure from the plan of the Holy author of our religion, who being Lord both of body and mind, yet chose not to propagate it by coercions on either, as it was in his Almighty power to do;

that the impious presumption of legislators and rulers, civil as well as ecclesiastical, who being themselves but fallible and uninspired men, have assumed dominion over the faith of others, setting up their own opinions and modes of thinking as the only true and infallible, and as such endeavouring to impose them on others, hath established and maintained false religions over the greatest part of the world, and through all time;

that to compel a man to furnish contributions of money for the propagation of opinions which he disbelieves, is sinful and tyrannical;

that even the forcing him to support this or that teacher of his own religious persuasion, is depriving him of the comfortable liberty of giving his contributions to the particular pastor, whose morals he would make his pattern, and whose powers he feels most persuasive to righteousness, and is withdrawing from the ministry those temporary rewards, which proceeding from an approbation of their personal conduct, are an additional incitement to earnest and unremitting labours for the instruction of mankind;

that our civil rights have no dependence on our religious opinions, any more than our opinions in physics or geometry;

that therefore the proscribing any citizen as unworthy the public confidence by laying upon him an incapacity of being called to offices of trust and emolument, unless he profess or renounce this or that religious opinion, is depriving him injuriously of those privileges and advantages to which in common with his fellow-citizens he has a natural right;

that it tends only to corrupt the principles of that religion it is meant to encourage, by bribing with a monopoly of worldly honours and emoluments, those who will externally profess and conform to it;

that though indeed these are criminal who do not withstand such temptation, yet neither are those innocent who lay the bait in their way;

that to suffer the civil magistrate to intrude his powers into the field of opinion, and to restrain the profession or propagation of principles on supposition of their ill tendency, is a dangerous fallacy, which at once destroys all religious liberty, because he being of course judge of that tendency will make his opinions the rule of judgment, and approve or condemn the sentiments of others only as they shall square with or differ from his own;

that it is time enough for the rightful purposes of civil government, for its officers to interfere when principles break out into overt acts against peace and good order;

and finally, that truth is great and will prevail if left to Herself, that She is the proper and sufficient antagonist to error, and has nothing to fear from the conflict, unless by human interposition disarmed of Her natural weapons, free argument and debate, errors ceasing to be dangerous when it is permitted freely to contradict them:

Be it enacted by the General Assembly, That no man shall be compelled to frequent or support any religious worship, place, or ministry whatsoever, nor shall be enforced, restrained, molested, or burthened in his body or goods, nor shall otherwise suffer on account of his religious opinions or belief; but that all men shall be free to profess, and by argument to maintain, their opinion in matters of religion, and that the same shall in no wise diminish enlarge, or affect their civil capacities.

And though we well know that this assembly elected by the people for the ordinary purposes of legislation only, have no power to restrain the acts of succeeding assemblies, constituted with powers equal to our own, and that therefore to declare this act to be irrevocable would be of no effect in law; yet we are free to declare, and do declare, that the rights hereby asserted are of the natural rights of mankind, and that if any act shall be hereafter passed to repeal the present, or to narrow its operation, such act shall be an infringement of natural right.

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Unexpectedly, a similar doctrine appears in the Qur'an, 2:256 -

>> Let there be no compulsion in religion: truth stands out clear from error.

Unfortunately this is contradicted, both in the Qur'an and in the Hadith, by commands to fight and kill unbelievers and jews, and to punish apostasy by death.

Hardy on New Year's Eve

Here is Hardy, in quizzical mood, disguising bleak perceptions of our human world as whimsy.

>>

"I have finished another year," said God,
"In grey, green, white, and brown;
I have strewn the leaf upon the sod,
Sealed up the worm within the clod,
And let the last sun down."

"And what's the good of it?" I said.
"What reasons made you call
From formless void this earth we tread,
When nine-and-ninety can be read
Why nought should be at all?

"Yea, Sire; why shaped you us, 'who in
This tabernacle groan' -
If ever a joy be found herein,
Such joy no man had wished to win
If he had never known!"

Then he: "My labours - logicless -
You may explain, not I:
Sense-sealed I have wrought, without a guess
That I evolved a Consciousness
To ask for reasons why.

"Strange that ephemeral creatures who
By my own ordering are,
Should see the shortness of my view,
Use ethic tests I never knew,
Or made provision for!"

He sank to raptness as of yore,
And opening New Year's Day
Wove it by rote as theretofore,
And went on working evermore
In his unweeting way.

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Unweeting appears to be correct - I take it to be a poetic version of unwitting, needed in this form for reasons of stress and meter.

Is Human Activity Warming Our World?

Is human activity increasing the carbon dioxide content of the atmosphere? Does an increased carbon dioxide content trap heat in the atmosphere?

A powerful prevailing opinion answers 'yes' to both these questions, and demands huge expenditure to reduce our carbon dioxide production, stressing urgency if global climate catastrophe is to be avoided.

This is the theory of Anthropogenic Global Warming - AGW.

In Britain, Europe, Canada and (increasingly) America politicians are convinced by the prevailing opinion, so AGW is the issue dominating political, economic and social policies.

Contrary opinions are heard, but so far have failed to raise significant doubt in the minds of our rulers. Indeed doubters are often dismissed as ignorant, cranks, or worse, and dubbed 'deniers'.

A sound theory is established by analysis of data, and critics rebutted similarly. Attacks on the probity or sanity of critics must always arouse suspicion that their criticism cannot be answered by argument based on evidence.

So what evidence is there to support the theory of AGW?

There is useful summary of the various data sets available here. [The slider above the diagrams permits the time span to be adjusted.] The following facts are difficult to challenge.

1. Global temperatures increased steadily from 1960 to 2000. After 2000 temperatures stabilised.

Between 1880 and 1940 temperatures were reduced, with a minimum around 1912.

The total temperature increase between 1910 and 2000 was approximately 0.7 degrees. The increase during those 90 years was not regular: between 1940 and 1970 the net change was about zero.

2. Atmospheric carbon dioxide increased from 320 to 390 parts per million during the 50 year period 1959 to 2009. The upward trend shows some acceleration during this time.

The increase is about 30%, but is only 70 parts per million in the atmosphere. The contribution to atmospheric heat content is negligible, especially set beside the contribution of water, also a 'greenhouse gas', and much more abundant in the atmosphere.

I am sure that a statistical analysis would show an excellent correlation between global temperature and atmospheric carbon dioxide concentration, but correlation is no proof of causation - and the naive belief that it is can cause serious errors. Thus in the twentieth century I would expect good correlation between global temperature and the number of muslims in Europe, and a good inverse correlation between atmospheric carbon dioxide and the number of whales in the oceans, but it would be absurd to suggest such correlations prove cause and effect.

The observed correlation of temperature and carbon dioxide is consistent with at least 4 hypotheses, as follows.

1. Increasing atmospheric carbon dioxide increases global temperatures.

This hypothesis is basic to any attribution of global warming to human activity.

2. Increasing global temperatures increase atmospheric carbon dioxide.

This is the inverse of 1.

Warming oceans release carbon dioxide. Studies of polar ice cores give some support to this hypothesis. Over thousands of years warm periods show higher atmospheric carbon dioxide values than cool periods. There is also a hint that temperature changes lead carbon dioxide changes.

3. Global temperature and atmospheric carbon dioxide are not linked directly, but each is affected by some third factor.

4. The correlation is a coincidence.

This seems unlikely.

The data do not permit a decision between these alternatives. Clever computer manipulations may add detail, but there is insufficient information to allow a firm conclusion.

Similarly computer modelling is prone to errors, including programmers' bias, ignorance of the relative importance of the many factors affecting climate, lack of data, and the critical impact of unpredictable items.

Correct predictions improve confidence in computer models. Prediction performance so far is, well, unimpressive.

Our climate has never been constant. Climate change is a fact of our environment. Human activity may now be sufficient to influence climate, but this remains a hypothesis. Doubt and scepticism are rational responses at our present level of knowledge and understanding.

I strongly support policies and engineering to reduce human pollution of the atmosphere, not least because such measures will demand more sanity in our economics. But I am not convinced that the AGW theory is correct. Certainly the case for huge expenditures and dramatic forced changes in human society cannot be justified on present evidence.

Our climate is driven by the sun. Solar energy output is not constant. Solar radiation and magnetic fields vary with the sunspot cycle. Solar maxima became exceptionally large during the second half of the twentieth century, in the period when data showed global warming.

We know from past data that periods of absent solar maxima are associated with global cooling. The current solar cycle, number 24, is currently running at least 2 years late, and solar activity continues to be well below the predicted values.

The number of days free of sunspots was much greater during the recent solar minimum than it was in the previous one.

We may be entering a period of reduced solar activity, after the intense activity in the past century. We may be at the beginning of a 'Maunder Gap' - another period free of sunspots. If that proves to be the case the problem will be global cooling, certainly sufficient to affect human life, maybe seriously.

But on this too, there is insufficient evidence to be sure. But I note that weather forecasting which includes solar data has proved more successful than the conventional techniques of our Meteorological Office.

Hardy on Christmas Eve

This is a favourite poem by Thomas Hardy, published the 24th. December 1915.

Christmas Eve, and twelve of the clock.

"Now they are all on their knees,"

An elder said as we sat in a flock

By the embers in hearthside ease.

We pictured the meek mild creatures where

They dwelt in their strawy pen.

Nor did it occur to one of us there

To doubt they were kneeling then.

So fair a fancy few believe

In these years! Yet, I feel,

If someone said on Christmas Eve

"Come; see the oxen kneel,

In the lonely barton by yonder combe

Our childhood used to know,"

I should go with him in the gloom,

Hoping it might be so.

My best wishes to all at Christmas, and may we all be granted health, peace and prosperity in 2011.

In particular may the abomination of war and the barbarism of terrorism be banished for ever from this good earth.

For Golden Girls

I have a new vocation: poet laureate to my grand-daughters.
So far only the two older girls have been honoured with limericks from Grandpa. No doubt the younger two will be warned what may come their way.

These are for Lizzie, 9 in January, reluctant to learn to read at first, now a voracious reader - a true bookworm. Just as her father was at that age.

"They said reading is hard, but it's easy",
Said a blue-eyed blonde bookworm called Lizzie;
"These books that I'm reading
Are all that I'm needing,
So don't interrupt me, I'm busy".

"I'm eight now" said Lizzie "that means
My long legs need serge bleu de Nimes;
Leave frilly pink dresses
For fairy princesses:
Tantara, kids, it's Lizzie blue-jeans".

And, in The Emperor chinese restaurant.

"I'm crackers for crackers" said Liza,
Prawn crackers, my top appetizer.
At an Emperor lunch
I crunch and I munch,
If the waitress brings more I'll surprise her."

For her younger sister, Catherine, who declared she was The Spotty Princess, so all around should wear spotty clothes.

Catherine Emma said "Grandpa, confess!
Your green tie has no spots like my dress.
You choose with more care
The clothes that you wear
When you visit the Spotty Princess."

And, for their mother Pam, an enthusiastic runner of marathons.

Top Mum Pam came home from her run,
Saying "O that was good, I had fun.
On the riverbank road
I raced Mr. Toad -
And would you believe it, I won!'

Having a doting grandpa / father-in-law has its disadvantages!

The Price of Experience

I have removed the text of this posting. I may repost this tragic story in a more appropriate future context.

Athos 7: The Greek Religion

Jesus, like Socrates, wrote nothing. His first language was Aramaic, in the Galilean dialect, as it was for his disciples.

But Greek is the first language of Christianity, not Aramaic. Greek in its 'koine' vernacular was spoken and understood widely through the eastern Mediterranean in Jesus' time, and he and his disciples may well have been familiar with it.

Still, it is unexpected to find the gospels are in Greek. The disciples are presented as working men, of uncertain literacy, not expected to be capable of writing fluent Greek: the Gospel and Revelation of John are especially remarkable. Greek was a common language, but Aramaic was widely spoken and written too. Why did the gospel writers choose not to record Jesus' teachings and life in his and their native language?

Maybe Jesus' message was reckoned too subversive to present in the language of the high priests and the scribes.

The choice of Greek permitted the fusion of Jewish messianic prophecy with Hellenic science and philosophy, to create the rich and vigorous hybrid of Christianity. Perhaps, too, it brought into the new religion the Greek love of debate; of meticulous analysis and discussion; of reasoned, eloquent argument: maybe, too, the Greek tendency to discord and fission.

Greek gave Christianity the advantage of perhaps the finest language for the creation and expression of precise, detailed thought. Classical Greek has complex grammar and syntax, permitting refined and subtle thinking, and a huge dictionary. Greek writers created an unequalled legacy of intellectual and artistic literature, an unparalleled tradition for those developing the new religion.

Greek is written using a detailed, complete alphabet. The reader knows how to say each word.

By contrast, the first and only language of Islam is Arabic. Compared to Greek, Arabic is simple and limited. For example, the Arabic verb has only two tenses, denoting incomplete and completed action: there is no formal future tense in Arabic. But the imperative is well developed.

Arabic is written from right to left, in normal use omitting short vowel signs; so pat, pet, pit, pot, put, would each be written pt.

Lucretius complains of the difficulty of presenting Greek thinking in Latin (1): translation into Arabic is more difficult still.

Many Greek texts were translated into Arabic in the Caliphate, but not into the Arabic of Mohammad. Hourani, in his History of the Arab Peoples, pages 75-76, describes how Christians, Jews and Zoroastrians translated Greek texts into Syriac (a language related to Aramaic) and then into Arabic. He tells how their Arab rulers knew little of 'the languages of thought', and 'the Arabic language had not yet acquired the capacity to express the concepts of science and philosophy in a precise way'.

In the second to fourth centuries after Mohammad translation was intensive, mostly by Christian scholars.

'An essential part of their work was to expand the resources of the Arabic language, its vocabulary and idiom, to make it an adequate medium for the whole intellectual life of the age.'

It isn't clear that they succeeded. Still today it is difficult to translate English texts precisely into Arabic. In 'Oman our students had to be fluent in English to read textbooks. Despite huge expenditure by Arab governments on education, there are few textbooks in Arabic - neither originals nor translations.

Arabic-English dictionaries are few.

Arabic is a male language: it suits the master, the didact and the demagogue.

Here is the Greek Lord's Prayer, the central text of Christianity, in English transliteration. Nouns are in bold, verbs are in italics; ē is long ee (eta), ō is long o (omega).

The Lord's Prayer has been translated into almost every language on earth. I can safely assume any reader is familiar with it.

Pater hēmōn ho en tois ouranois,

agiasthētō to onoma sou,

elthetō hē basileia sou,

genēthētō to thelēma sou,

hōs en ouranōi kai epi gēs.

Ton arton hēmōn ton epiousion dos hēmin sēmeron;

kai aphes hēmin ta opheilēmata hēmon,

hos kai hēmeis aphēkamen tois opheiletais hēmōn;

kai mē eisenegkēs hēmas eis peirasmon,

alla rusai hēmas apo tou ponērou.

There are 57 words in total, of these 8 are verbs, and 12 are nouns.

Here is the nearest equivalent from the Qur'an, the 'Opening Surah', the Surah al Fatihah, again transliterated to English. Again nouns are in bold, with some difficulty, since Arabic may not always distinguish noun and adjective. Verbs are again in italic.

This is chanted millions of times everyday, in Arabic only. Translation is not approved. Many muslims can recite this with little or no comprehension. In Muscat Aziz, a muslim from Kerala, told us he could recite most of the Qur'an, but understood little of it. "O no, it is not for me to say what it means, the mullah does that."

Bismillahi ar rahmani ar rahimi

In the name of God the compasionate one, the merciful;

al hamdu lillahi rabbi al alamina

praise to God, lord of the worlds,

ar rahmani ar rahimi

the compassionate one, the merciful;

maliki yawmi ad dini

king of the day of judgement;

iyyaka na'budu wa iyyaka nasta'inu

you we worship and your aid we seek;

ihdina as sirata al mustaqima

show us the right way;

sirata al ladina an'amta 'alayhim 'gayr al maqdubi 'alayhim wala ad dalina

the way of grace, not the way of those of your anger, nor of those who stray.

In 41 words, 17 are nouns and 3 are verbs.

This is primarily a dedication, a commitment. The last line is usually taken to mean the Jews, who suffer God's anger, and Christians, who have strayed from the truth. Note that judeophobia is visceral in Islam.

The muslim message is simple: fear God and obey Mohammad - a terrible fate awaits those who do not.

The muslim aspires to be Abd-al-Lah: slave of the God.

The Christian message is truly a prayer. We are each the child of a heavenly father. We must love God, and serve him in the love of one another.

The christian prays to God the Father; the muslim prostrates before God the Führer.

And the original Christianity is in the Orthodox.

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(1) Lucretius, De Rerum Natura, 1:136-140

Nec me animi fallit Graiorum obscura reperta

difficile inlustrare Latinibus versibus esse,

multa novis verbis praesertim cum sit agendum

propter egestatem linguae et rerum novitatem;

I know how hard it is, in Latin verse, to tell the deep discoveries of the Greeks,

Chiefly because our narrow speech must find the new terms needed to explain their originalities.