A bizarre critique of Christopher Hitchens: he wasn’t a skeptic about his cancer

April 15, 2013 • 6:01 am

Thanks to alert reader Michael, I’ve made my first visit to the Dublin Review of Books site, where you can read a review of Christopher Hitchens’s last book, Mortality. The review is by Seamus O’Mahony, who seems uniquely qualified for the task:

Seamus O’Mahony is a physician with an interest in medicine and literature. He has written pieces on AJ Cronin, Axel Munthe and Somerset Maugham for a variety of medical journals.

O’Mahony’s essay is called “The Big D,” which I presume refers to “death,” and it’s simply the most bizarre critique of Hitchens I’ve ever read.  We’ve all seen Hitchens attacked post mortem for his drinking, his promotion of the Iraq war, his “unthinking” atheism, and so on, but O’Mahony goes after Hitchens for—wait for it—being overly optimistic about surviving his cancer.  Yes, the skeptic Hitchens, says O’Mahony, was not so skeptical about the odds of beating his disease; in fact, he supposedly acquired a kind of faith that he would survive. So, in the end, Hitchens was quasi-religious after all.

It’s a disgusting allegation, one that demeans anyone who wants to survive a deadly disease.

The interesting part of the essay is O’Mahony’s professional assessment of esophageal cancer, of the kinds of treatment Hitchens received, and of Hitchens’s odds (apparently only 3% of those having stage 4 esophageal cancer survive more than five years).  As you’ll know if you’ve read Mortality or the Vanity Fair essays on which it’s based, you’ll know that Hitchens underwent a long regimen of surgery and chemotherapy, and even tried gene-based therapy with the help of his friend, Francis Collins of the National Institutes of Health. It all failed. O’Mahony thinks that Hitchens should have had a better appreciation of the odds.

Here are a few snippets to give the tone of the review:

I am intrigued by Mortality for one main reason, which is this: Hitchens’s beliefs about his advanced cancer and its treatment were, for a man whose fame rested on his scepticism, uncharacteristically optimistic. I hesitate to use the word delusional, as he admitted that he would be very lucky to survive, but he clearly steadfastly hoped, right to the end, that his particular case of advanced cancer might lie on the sparsely populated right side of the bell-shaped curve of outcome statistics. He famously mocked religious folk for their faith in supernatural entities and survival of the soul after bodily death, yet the views expressed in Mortality are just as wishful and magical. “The oncology bargain [oncology is that branch of medicine which deals with the treatment of cancer],” writes Hitchens, “is that in return for at least the chance of a few more useful years, you agree to submit to chemotherapy and then, if you are lucky with that, to radiation or even surgery.” Years? I must now confess to a professional interest. I am a gastroenterologist in a large acute hospital, and I have diagnosed many patients with oesophageal cancer. “Years” is a word not generally used when discussing prognosis in Stage Four oesophageal cancer, “months”, in my experience, being a more useful one.

About Francis Collins’s suggestion that gene therapy might be tried:

[Collins]This great humanitarian is also a devotee of the work of C.S. Lewis, and in his book The Language of God has set out the case for making science compatible with faith.”

Ironically, it is the Christian who has to lower the expectations of the sceptical atheist. Hitchens proposes to Collins that his entire DNA, along with that of his tumour, be “sequenced”, “even though its likely efficacy lies at the outer limits of probability”. Indeed. Collins is circumspect, conceding that if such “sequencing” was performed, “it could be clearly determined what mutations were present in the cancer that is causing it to grow. The potential for discovering mutations in the cancer cells that could lead to a new therapeutic idea is uncertain – that is at the very frontier of cancer research right now.” Diplomatically put, Dr Collins.

It could be argued that [Hitchens’s] approach to his cancer treatment was at odds with much that he previously professed to believe (or not believe) in. In God Is Not Great, he coined the withering phrase “the tawdriness of the miraculous”. . . His wife, his friends and his doctors might wish to remind themselves of what Hitchens wrote in God Is Not Great: “Those who offer false consolation are false friends.” In his memoir, Hitch-22, he was scathing of such wishful thinking: “I try to deny myself any illusions or delusions, and I think that this perhaps entitles me to try and deny the same to others, at least as long as they refuse to keep their fantasies to themselves.”

And, finally, the last blow, implying that Hitchens was, at the end, not so very different from any religious believer:

As news of Hitchens’s cancer diagnosis first became widely known, evangelical Christians speculated on the internet about whether his illness would lead to a religious conversion. In Mortality, Hitchens scoffs at the notion. But in his time of “living dyingly”, he did find a kind of faith. This was not a return to the Anglicanism of his upbringing, or the Judaism of his mother’s family. Hitchens, the arch-mocker, the über-rationalist, the debunker of myth, found solace and consolation in the contemporary rites of genetics and oncology. Reviewing Arguably (Hitchens’s final prose collection), the philosopher John Gray observed: “That Hitchens has the mind of a believer has not been sufficiently appreciated.”

I find this manifestly unfair—in fact, a passive-aggressive claim that “Hitchens was religious, too!” masquerading as a dispassionate medical analysis.

Hitchens admitted openly that he didn’t want to die. He was only in his early sixties, and had tasks to do and children he wanted to watch grow up. His life was full, and I imagine must have been immensely fun.  Under such circumstances, is it analogous to religion to think that you might be one of those rare survivors of cancer? After all, there is a nonzero survival rate, and 3% is a probability much higher than that of God’s existence.

And I can’t help but think that Hitch really knew his prognosis. Remember how often people asked him how he was, and his answer: “Dying, like all of us.”  He was no slouch, and would have looked up the statistics. But if there might be a way to live, why not try it?

On top of all this, O’Mahony admits that Hitchens was certainly given false hope by his doctors:

Why did Hitchens harbour such unrealistic expectations? It is clear that his oncologists (he would appear to have consulted several) actively encouraged his misplaced optimism. Oncologists prefer the word “hope” to “delusion”. Over the years, I have witnessed many cancer patients, after protracted (and ultimately futile) therapies, facing death with all the preparedness of Carol Blue and Christopher Hitchens. These patients often experience a sudden deceleration in medical intensity from high-tech, invasive intervention to a side room, the morphine infusion and the chaplaincy service. Oncologists naturally tend to emphasise the positive, concentrating on the good news flashes, such as the “clear” scan. Most doctors will only impart the cold, bare facts when cornered and directly questioned, usually by patients with the necessary medical knowledge. As a profession, we are loath to appear “blunt” and “uncaring”.

Indeed, I experienced just this when my father died of lymphoma ten years ago. As an ex-Army officer, he was in Walter Reed hospital, and in bad shape.  We all knew the end was nigh, and we considered putting him in hospice care. But hospices in Washington require that admitted patients be no more than roughly six weeks away from death.  I tried to find out my father’s prognosis, and the doctors just shuffled their feet, hemmed and hawed, and talked vaguely about “well, it could be a few weeks, it could be months,” and so on. In other words, they talked about the tails of the survival distribution.  But I needed something more for the hospice care. I went up through the chain of doctors, and finally cornered the head surgeon in an examining room. “Yes, I know there’s variation,” I told him.  “But I want to know what the mean survival time is for someone in my father’s condition.”  (I would have said “mode”, but that may have been too arcane.) He finally admitted that it was less than two weeks.  My father died within a few days without ever having left the hospital.

Yes, I suppose patients should be given an honest assessment of their odds, and of the time that probably remains—if they want to know.  As O’Mahony notes, doctors with a terminal disease die very differently from laymen: knowing the odds, physicians often abjure the last-ditch treatments and “go gently.” But Hitchens was not a doctor: he was a patient who didn’t want to die young.  As most of us know who saw him or his videos, he bore his illness bravely, and, though he never said outright “I am going to die soon,” everyone knew that he would—including, I suspect, himself.

O’Mahony’s essay is worth reading for the medical details, but in the end it’s a mean-spirited and misguided attempt to drag Hitchens down to the level of religious believers.  O’Mahony couldn’t do that by speaking about deathbed conversions, but he does it another way.

An amazing Japanese commercial (and a note on Tippett and Krauss)

April 15, 2013 • 4:33 am

Well, I thought I’d seen it all, but this Japanese commercial for a smartphone, brought to my attention by alert reader Jon, beats all. It’s a huge xylophone, placed in a hilly Japanese forest, that plays Bach’s Jesu, Joy of Man’s Desiring as a wooden ball rolls down it.  Fantastic—do not miss this one!

Imagine the labor involved in building that xylophone!  Here’s a short video about the construction:

Both of these videos, curiously enough, were highlighted on Krista Tippett’s “On Being” page. In case you don’t know of her, Tippett is an unctuous broadcaster on U.S. National Public Radio, and is always interviewing scientists and trying to get them to confess their spirituality.  She’s the Elaine Ecklund of radio and a diehard believer in belief; I am unable unable to listen to more than a few minutes of her show.

That said, some of her shows are supposed to be good—when she stays away from religion and spirituality.  Jon, in fact, found the commercial above while looking for a podcast of a recent interview she did with Lawrence Krauss (you can find the video here). Our reader liked the interview and said this about it:

I’m not a big fan of Krista Tippett’s program On Being, but sometimes I listen Sundays at 7:00 before I get up. This morning’s program was a rebroadcast of an outstanding interview entitled “Our Origins and the Weight of Space” she did with Lawrence Krauss last summer as part of one of the programs at the Chautauqua Institution in New York. The interview is mostly a solo act by Krauss and he didn’t allow Tippett to get away with any silliness.

I haven’t watched the interview, but if you have, weigh in.  Comments about the “On Being” show, either agreeing or disagreeing with me, are welcome.

Big fun today!

April 15, 2013 • 3:37 am

UPDATE:  P. Hitchens’s post is up, “The leagee of the militant godless strikes back” (LOL!). It’s more or less as expected, and I have nothing to say about it except this:  this man should learn the first lesson of being a literary figure, which is to avoid responding to criticism unless you have a very good reason.

______________

A comment from Peter Hitchens about my recent post, “The bad seed: Peter Hitchens blames atheism for Stalin and Hitler.”

I shall be replying to this ill-argued and poorly targeted diatribe on my blog (Google “Peter Hitchens Blog”), later today (Monday 15th April). I shan’t bother to reply here because it is a sad dead-end of angry closed minds, motivated by emotion more than by reason, and the only response will be yet more explosions of green bile and spittle-bombs. But contributors here are welcome to engage in rational argument over at my place.

I can’t wait! And let me save you the trouble: his blog is here.

The Jew in the plastic bag revisited

April 14, 2013 • 12:50 pm

Two days ago I posted this picture of an Orthodox Jew in an airplane, wrapped up in a plastic bag.  The picture came from The Gothamist, which explained that the man was a “kohen,” or a member of the priestly tribe of Jews, and kohens are forbidden from flying over cemeteries. The bag was apparently meant to protect this man from religious pollution as his plane passed over the graveyard.

41112plane1

I must say that this picture got a lot more attention than I expected, with a lot of humor of the “get-in-the-fooking-sack” variety, but it wasn’t explained to my satisfaction. Now, in a comment on the original post, which I’ve put above the fold here, alert reader Michael proffers an explanation. Being only a secular Jew, I can’t vouch 100% for its accuracy, but it sounds plausible, so here you go:

As a Kohen and also an orthodox Jew who lives in Israel and occasionally flies to the states I can clearly state that this is not normative behavior. The explanation is correct. However, we Jews do have some practices which can appear odd, it’s not exactly legitimate to take such a rare case of over-zealousness to make that case.

Here it is in more detail as posted on a friend’s Facebook, if anyone is interested:

A huge area of Jewish law involved ritual impurity. It’s complex, and to the modern mind a little weird. Almost all of it was made irrelevant with the destruction of the 2nd temple 2000 years ago. Only one aspect of ritual impurity persisted, that which relates to Kohanim (“priests”, ie those descended patrilineally from Moses’ brother Aaron. They’ve actually identified a Kohen gene!) Basically a Kohen cannot come in contact with a dead body. With the exception of his close relatives or a body that has no one else to bury it. “Contact” includes direct contact and also being in proximity of the impurity. Proximity includes being under the same roof as a corpse or being over the corpse, like walking over a grave. The “roof” does act to stop the impurity.

So how do we get to airplanes? Basically you have the ingredients of the problem. A Kohen can’t be “over” a dead body. The Rabbis of the Talmud determined that the impurity emanating upwards from a corpse has no end. Except, of course if a structure interferes. So if you build a tree house over a grave the Kohen would be safe inside it. But isn’t an airplane such a structure that would impede the impurity? Well, the rabbis of the Talmud raised such a issue. They brought up the case of a Kohen being transported over a cemetery in an enclosed coach, say by being carried. Since the impurity goes all the way up it becomes irrelevant whether the “coach” is 5 feet off the ground or 35,000 ft (and is first class ). So, Joan, they didn’t need to know about airplanes to create a law that is applicable to them.

Now to our friend in the bag. As with many, most, issues discussed in the Talmud there are differing opinions. (I mean really, what do you expect with a book of Rabbis’ opinions?) One Rabbi held that the travelling coach does block the impurity just as if it was stationary and another held that because it’s in motion the blocking effect is not there. A thousand years later Maimonides (a doctor by the way) compiled the first organized codification of Jewish law which remains largely authoritative today. He decided this law in favor of the Rabbi in the Talmud who said that the moving coach does not block the impurity.

Since, for a time, all planes departing Israel’s only international airport flew over a huge cemetery directly West of the airport it was a certainty that Kohanim on the plane would be “exposed” to this impurity. (There is a lot of room for leniency in Jewish law if something is not “certain”.) Without getting into a whole other discussion, accept for now that a way to block the impurity, even while in motion is to have a material in very close proximity to the object you want to block. Thus the plastic bag.

All that said, as a Kohen myself, I certainly do not do this when I fly from Israel as it true with most Kohanim. There are two reasons, first the government ceded to requests to change the flight path, so that most of the time flights do not go over the cemetery. Second, and more import to me, there’s a general concept that, when possible, Jews shouldn’t do things that make Judaism look foolish. So since in the case there was a Talmudic opinion that the moving coach does block the impurity that can and should be relied on here.

Well, I guess there won’t be any orthodox Jewish astronauts in the ISS. They’d have to be constantly covered!

As for “Jews not doing things that make Judaism look foolish,” I could give a whole list of Orthodox practices, including shabbos goys, the 18-minute, rabbinically-ordained time limit for making Passover matzos, the eruv, and so on.

My squirrel

April 14, 2013 • 9:00 am

The squirrels that hang around the outside of my lab are being well fed: peanuts and sunflower seeds daily.  Yesterday I gave them a cut-up ear of corn, which puzzled them but seems to have completely disappeared by this morning.  They’ve built a rudimentary “nest” of sticks, lined with leaves, that one of them appears to use as a bedroom, but I don’t think they’ll reproduce there.

At any rate, I filmed one well-fed squirrel nomming sunflower seeds this morning.  They process them at an amazing rate: once this guy gets going, he eats 12 seeds in 37 seconds, or a rate of 3.08 seconds per seed. Let’s see you do that!

Why do people pretend that religion isn’t responsible for creationism?

April 14, 2013 • 6:16 am

If there’s one characteristic of faitheists and accommodationists when facing the issue of American creationism, it’s their refusal to see the palpable fact that religion is the source of that creationism. While this seems trivially obvious to those who have followed the creation/evolution controversy, people like Chris Mooney, Karl Giberson, Kenneth Miller and the like will blame almost everything but religion for the hold of creationism on American minds.  Yes, they will indict those nasty Biblical fundamentalists, but the 46% of Americans who are young-earth creationists aren’t all fundamentalist Christians! Indeed, although the Catholic Church officially accepts evolution, fully 27% of American Catholics think that modern species were created instantaneously by God and have remained unchanged ever since, while 8% do not know or refuse to answer. Those Catholics certainly aren’t seen as “fundamentalist Christians.”

No, the problem is obviously far more than just a few pesky snake-handlers and Bible-thumpers. Evolution strikes at the heart of many religious people’s beliefs. As I note in my talks on this subject, people see evolution as inimical to religion in three important ways:

  • It overturns scriptural views of human origins and our supposed “specialness” in God’s scheme.
  • It takes the idea of purpose and meaning out of God’s hands and forces people to confect their own reasons for living.
  • It sees morality as an evolved and/or cultural phenomenon rather than as a package of commands approved by God.

These make people uncomfortable, and explain, to me, why there are so many “liberal” religionists who still reject evolution. It also explains why faitheists and accommodationists waffle when trying to pinpoint the source of creationism. They simply can’t bring themselves to admit that it’s more than just fundamentalists who reject neo-Darwinism.

If one faced the problem honestly, one would have to say that the biggest source of antievolutionism in America—nay, the world—is religion in general.  You can have religions without creationism, as in the ultra-liberal faiths, but you never have creationism without religion. Or, rather, you almost never have creationism without religion. I can count on the fingers of one hand the prominent opponents of evolution who aren’t religious: David Berlinski (though I think he’s really a secret believer) and the philosophers Thomas Nagel and Jerry Fodor.

The reason people give religion a pass as the cause of creationism is simple: if they indict religion for this, then they indict many religions, not just fundamentalism.  Religious people are often self-protective, seeing an attack on one person’s faith as an attack on all faiths.  (Granted, more enlightened believers don’t feel this way). In the end all religions are, at bottom, superstitions, and if a religious person criticizes one for being an “improper” faith, he’s implicitly casting doubt on his own faith. For there is no reason to think that one religion, or one set of religious tenets—is more “proper” than another. There’s no way to decide which religious beliefs, if any, are “true.”

This is also why believers are loath to blame religion for horrors like the Inquisition or the suicide bombings of Islamic terrorists. It’s all politics, they say, or Western oppression, or poverty—anything but religion. The Galileo affair? Nothing to do with religion, just an internecine dispute over power.  These arguments make me ill. As George Orwell said, and I repeat endlessly, “One has to belong to the intelligentsia to believe things like that: no ordinary man could be such a fool.”

And so we get foolish articles like the one by Uncle Emeritus Karl Giberson in Wednesday’s HuffPo Science section, “Why Americans love creationism.” Giberson, an evangelical Christian, is distressed at the intransigence of antievolutionists in America, and was “sobered” when watching a half-hour HuffPo Live video with evolution activist Zack Kopplin, pastor Becky Fischer, a Pentecostalist from North Dakota, Michael Zimmerman, head of the Clergy Letter Project, Zach Carter, a HuffPo Political Economy reporter, and Bill Devlin, an evangelical pastor in New York. (Do watch the video, especially to LOL at the vigorous, mindless, and tedious arguments of Fischer against evolution, and her fulminations against “academians.”)

Giberson gives six reasons why antievolutionism is so entrenched in America. Several of these (including #2 and #3) are pretty much identical, and all are mentioned by Fischer and Devlin in the video.

1. Antievolutionism appeals to “America’s democratic impulse” by claiming that evolution is forced down schoolchildrens’ throats against their and their parents’ wills.

2.  It violates the American qualities of fairness and tolerance by appearing to censor creationist views that should be aired in schools.

3.  It prevents students from hearing both sides of a “scientific” controversy.

4. There are “big names” attacking evolution, like the famous list of 800 antievolution “scientists” mentioned in the video.

5.  Scientists themselves censor new and revolutionary ideas like Intelligent Design by refusing to publish them—or even consider them for publication—in scientific journals

6.  Academics who reject evolution feel humiliated by their intolerant colleagues.

Note that religion isn’t mentioned here. There’s not one word about America being not only the most religious First World country, but also the one whose citizens are most resistant to evolution.

The obvious solution, if you want evolution to be accepted in America, is to weaken the grasp of religion on our country—or at least those religions (and there are many) that lead 46% of Americans to young-earth creationism. Telling religious people that evolution is perfectly consistent with their religious beliefs—the strategy of Michael Zimmerman and of BioLogos, the organization once run largely by Giberson—hasn’t worked, because those three implications of evolution hang over religion like the sword over Damocles.

But Giberson can’t bring himself to indict religion. His sole mention of the issue is that the six points above were raised by “conservative Christians.” Since he can’t see the obvious solution to antievolutionism—i.e., active atheism or secularism on top of science education—he wrings his hands and can’t see a way around the six arguments above:

This rhetorical strategy contains great synergistic power; polls show that Americans are not coming around to accept evolution, even as its scientific credibility has grown to point of certainty. The conservative Christians in the video above have heard and embraced all of these arguments. In their view, they have a strong case and every right to press it.

Dismantling these arguments takes more time than assembling them. And the process often sounds like little more than special pleading and self-serving prejudice. Science, of course, is not a democratic process — and it shouldn’t be — but explaining why is a bit tricky to an audience that values democracy so highly. High school students are not capable of adjudicating the validity of anti-evolutionary arguments — they have enough challenges simply learning the material and taking time to put fringe ideas in their heads is not reasonable. Restricting education to well-established knowledge is certainly not intolerance, but you can’t tell that to someone who rejects well-established knowledge.

Science education in America is in trouble.

Well, if science education is in trouble, it’s because rationality is in trouble, for it’s constantly beleaguered by faith. Most state education standards are actually quite good about evolution, but biology teachers won’t implement them. As a 2011 paper by Berkman and Plutzer (reference below) shows, only 28% of science teachers consider themselves advocates of evolutionary biology when teaching the issue in the classroom, while 13% advocate for (i.e., teach) creationism, and fully 60% advocate neither evolution nor creationism, either waffling on the subject, teaching both, watering down the evolution, or teaching neither).  And that’s because either the teachers themselves are religious, or they’re afraid of pushback from outraged parents. Here are Berkman and Plutzer’s figures, broken down by whether the 969 teachers surveyed teachers had a course in evolution:

Picture 2
Self-reports of qualifications of teachers, classified by approach to
teaching evolution. Based on responses from 926 U.S. public high school biology teachers.

I submit this to Dr. Giberson: the reason why creationism is so prevalent is because of people like you—people who believe in ludicrous things because it makes them comfortable. Yes, Karl, you’ve managed yourself to overcome your own religious bias with respect to evolution, and have even tried to turn your coreligionists toward Darwinism. But you’ve failed, and now you see no solution, although that the solution is right under your nose. It’s to weaken religious belief. Until the grip of faith on America is loosened, we’ll always be putting out these brushfires, fighting rearguard battles against creationist incursions into public education.

We would have none of these problems if America weren’t so full of observant Christians like yourself. Why can’t you see that, Karl? It’s not just the fundamentalists.

___________

Berkman, M. B., and E. Plutzer. 2011. Defeating creationism in the courtroom, but not in the classroom. Science 331:404-405.

True facts about the sea pig

April 14, 2013 • 6:14 am

Zefrank1 has just come up with another “educational” video about a weird creature, the sea pig, a group of holothurians (sea cucumbers; genus Scotoplanes) in the phylum Echinodermata, which also includes starfish and sea urchins. It is in fact the only holothurian with “legs,” which are homologous to the tube feet of starfish and have become large and able to be inflated with water.  They can be seen as analogous to vertebrate legs (they do the same thing) but not homologous to them (they have independent evolutionary origins based on different genes).

Another true fact: I’ll eat almost anything, but reject the odious sea cucumber, which is a staple of Chinese cooking. It is in fact the most disgusting thing I’ve ever put in my mouth.