The Eccentric Lipidologist Revealed

What’s a lipidologist? Well, immediately we can see that the term’s Latin roots indicate that a lipidologist is someone who studies lipids. Ah, lipids: the dreaded cholesterol, et al. That seemed simple enough. A friend told me that a lipidologist practiced in Santa Fe, the only one in the whole state of New Mexico.

Okay, it’s a small state, population around 2 million, about half that of the city of Los Angeles, California. Only about 400 lipidologists work in the entire U.S. Why are they so rare? After all, blood lipids are a big deal these days. Interestingly, there is very little information in Wikipedia’s entry on Lipidology.

Despite its simple bad reputation, cholesterol is far more complicated than a mere matter of suppressing “bad” cholesterol and supporting “good” cholesterol in the bloodstream. The drug companies have worked hard to popularize the idea that cholesterol is “bad.” We produce cholesterol in the liver and we ingest it in the food we eat.

So, why do they cast cholesterol in such a bad light? Think drug company profits. I won’t get into the complex disputes over the efficacy and dangers of statin drugs in attempting to control cholesterol in the bloodstream. Or the role statins play in minimizing the risk of plaque building up in the coronary arteries. Suffice it to say, it is not all science.

artery.crossectionPicture to the left is a  Micrograph of an artery that supplies the heart showing significant atherosclerosis and marked luminal narrowing. Tissue has been stained using Masson’s trichrome. As Dr. M. explained, old plaque is scar tissue, and may not necessarily cause such blockage. High performance on a stress test indicates no blockage of cornonary arteries. Unlike new plaque, old plaque does not flake off, risking heart attack or stroke, unlike new plaque. However, both contain calcium, so measures of plaque do not distinguish between the two. So, you can have a very high score for plaque, pass the stress test indicating no blockage, and have low risk. Yet most cardiologists don’t make such distinctions; they just prescribe statins. If my arteries looked like the one in the picture here, I could not have passed the stress test with ease, as I did.

Dr. M. occupies a modest office in the local cluster of medical practices near the only hospital in Santa Fe. When I went to see him, he seemed in no hurry and spent an hour and a half with me. We had a very informative (for me) conversation about heart disease, medical practice, and the flaws of scientific practice in medicine in the U.S., where so many decisions are controlled by the insurance companies and where medical practices are dominated by the drug companies – otherwise known as “Big Pharma.”

When Dr. M. described the complex of bio-chemical, genetic, environmental, and behavioral elements that are involved with the multiple variable factors in the way cholesterol acts, I was impressed. No cardiologist had ever mentioned any of this stuff to me. It had always been a simple, “if your LDL is too high, take [the latest statin drug].” End of story.

The practice of medicine is too often a high-volume assembly-line operation that executes the “standard of care” in conformity to the specifications of Big Pharma and the medical insurance industry. Dr. M. does not play that game. He and a few other practicing medical scientists carefully measure the complex of interacting factors that may be at play in each individual and adjust treatments based on re-testing of bio-chemical and genetic factors and patient characteristics. Such doctors epitomize the scientific practice of medicine.

Medicine, it seems to me, should involve the scientific study and practice of treatments, traditional as well as modern, of potential benefit to patients. It requires carefully testing the efficacy of each treatment for a particular problem and adjusting treatment to the conditions of the individual patient. It is far more labor intensive than simple prescribing pills in accordance with the “standard of care.” I know only one lipidologist, but if he is representative of others in the specialty, then lipidology represents the best practices in medicine.

Lipidology is to the “standard of care” in cardiology as prostate oncology is to the “standard of care” among urologists, who are surgeons.

What about how? What the sci-fi novels all miss

I have not read much science fiction. But the sci-fi books I have read usually fall into the “post-apocalypse” variety, such as The Road, Earth Abides, Parable of the Sower, World Made by Hand, and most recently, The Handmaid’s Tale. I read these stories out of my interest in what is likely to happen in the next few decades.

We are entering a New Great Transformation of the relationship of humanity to the complex of living adaptive systems (ecosystems) that some call Gaia – a sort of organism of organisms. The exponential growth of the global technosphere has forced that transformation and we must face its consequences.

Varieties of Dystopia

Some of the post-apocalypse stories are quite fascinating and imaginative. They all explore in one way or another what happens when individuals or small groups encounter an entirely new situation in which widespread devastation has become the “new normal.” They raise all sorts of human dilemmas, from simple survival and threats from others to the forging of new social relationships when the old institutions and infrastructure of the society they had known are gone.

dystopian image

Dystopia Maybe?

In every case, at least in the books I have read, the apocalyptic event(s) that caused the post-apocalyptic condition remains shrouded in mystery. Alluded to in various ways and extent, what actually happened is not very clear.

In The Road, for example, a father and son travel away from the center of devastation in search of some safe new place, scavenging as they go. We get the impression that some major act of destruction such as an intercontinental nuclear exchange wiped out most of civilization on the East Coast of the U.S.A. But we are given no specific information about the event.

In Parable of the Sower, we follow a young woman leading a small group north out of Los Angeles and the chaos of marauding gangs of bandits, violent neighborhoods, and unsafe gated communities, all of which are under siege in one way or another. Yet we never learn what caused that urban dystopia. It might have been a single catastrophic event or a gradual collapse of society; we are not told.

Earth Abides, highly acclaimed when first published in 1949, is a bit different. A young man comes back to the San Francisco Bay area from a personal retreat in a mountain cabin to find that nobody remains alive; a pandemic has hit the world and apparently killed everyone except him. He had accidentally become immunized to the disease by a snake bite from which he almost died. Eventually he finds a few other survivors and they confront a world as it was but without people. The story is a classic well-told adventure of coping. In this case, the cause was quite simple, if not fully explained.

In World Made by Hand, a New England village struggles in a dystopian condition in which many factors of human conflicts and political disorganization play a role. As competing groups vie for power where most modern technology was somehow lost or destroyed, we never find out what caused that condition or what could have prevented it as the characters struggle to shape a new local-regional political order. The conflicts in World Made by Hand has some of the flavor of an old western movie.

The most interesting question (for me at least) is, how would a transition to a post-apocalyptic world happen? The New Great Transformation of the world as we know it, which we have begun to experience today, involves the destabilization of ecosystems and climate our industrial economy has caused. The environmental chaos, now well on its way, has already begun to trigger economic, political, military, and social breakdowns of increasing intensity, all likely to interact and even reinforce each other.

The New Great Transformation and the Peril Ahead

The popular classics of the genre of dystopian novels all contain a combination of some of the following: a totalitarian or theocratic state, censorship, surveillance, erasure of history, anti-intellectualism, consumption and entertainment as escapism, extreme inequality, and destruction of individuality and aesthetics. Read 1984, Fahrenheit 451, Brave New World, even Hunger Games or Lord of the Flies, and you will see. Wait a minute, that list of dystopian characteristics sounds a bit too familiar…

Each post-apocalyptic novel I have read describes a different world than the others, but with often overlapping issues of human survival under extreme collapse of civilization and ensuing chaos or the rise of a totalitarian state. Some say science fiction is really about the present, but with imaginary advances in technology and totalitarianism.

Each post-apocalyptic novel I have read describes a different world than the others, but with often overlapping issues of human survival under extreme collapse of civilization and ensuing chaos. However, it seems to me that the most important and interesting question of the human condition today has to do with two things: 1) whether and to what extent people will finally realize that the world we have created is becoming un-survivable, and 2) what we will do about it.

Can we abandon our illusions of progress through corporate economic growth immediately in favor of a new creatively realistic response to the converging crises we face? Governments and corporations are the problem; they do not have the solutions. So is the industrial-consumer culture we have embraced. It is now up to people to counter the apocalyptic trend where we live. Our problem is not how to cope with an existing dystopia, but how to prevent the New Great Transformation from becoming one. That will require a great deal of hopeful realism.

Over the Ultimate City: To Live or Die in L.A.

It is always unnerving yet comfortably familiar to fly into LAX. I will need to do so again in a month or so. The vast urban landscape from Palm Springs westward to the Pacific shore is amazing to behold, if you really look at it. For about 125 miles, the mostly low-lying “built environment” stretches the entire way. It takes 2 or 3 hours…or more… to drive via the freeways, “depending on traffic.” Asphalt and concrete everywhere separates apartment complexes, commercial buildings, strip malls, mega-shopping centers, suburban neighborhoods, and elite “gated communities.” It has been over six months since my last visit. Still, it is never any less strange and prosaic despite my having lived and worked there for nearly four decades — until I retired over a dozen yeas ago.

Last time I had a window seat aft of the wings. I can never resist watching the mega-city go by below. But I’ve seen it all many times, both as an airline passenger and as a private pilot. I learned to fly in 1976 over this same urban desert. The complexity even back then sure gave me a sense of the importance of the instructor’s official admonition to “stay well clear” of any nearby aircraft. It also instilled an appreciation of the complexity of the air traffic control system as a blend of highly skilled living beings interacting with sphisticated information technology that is always in need of an upgrade.

LA Sectional

LA Terminal Area Chart – LAX at west shoreline.

Whether as pilot or passenger, I experience both the air traffic control system and city below it as marvels of human ingenuity and collective coordination. Yet they seem ever more vulnerable to chaos and ultimate collapse. Sometimes around dusk, I used to fly my little Piper PA-161 from Compton Airport out to the north east below the LAX final approach path under visual flight rules, then west along the Santa Monica Freeway, passing downtown LA to my north, heading toward the Santa Monica shoreline.

That way I could take the coastal route north saving time by not having to file an instrument flight plan. It was quicker that way when controllers were so busy with “rush hour” airline and business-jet traffic and hardly had time to issue another clearance. The city lights of downtown LA, the sunset, the many other aircraft in all quadrants with their nav. lights and landing lights so easy to see threading their way through the geometrically parsed airspace as daylight receded were all so beautiful, yet so delicately tentative and dangerous.

On disembarking into the LAX terminal on my last trip, I faced a mass of humanity flowing haphazardly in all directions in the very large multi-gate concourse. A virtual sea of diversity was lining up at a Southwest gate to board the next flight. I had a sudden sense of the quantitatively unimaginable scale of worldwide over-population rarely mentioned among environmentalists or politicians these days as the consumption of resources and energy by the people of the industrial nations reaches truly crisis scale.

Even as Los Angeles still works, more or less, it is difficult to imagine how such intensity can continue much longer as so much fossil-fuel energy and so many resources reach their extractive tipping points. LA, with its 13.1 million people in the metro area, seems the epitome of the extent to which humanity can appear to overcome nature, then approach a dead end. Big changes lie ahead. Meanwhile, can we learn anything about our future from this glorious megalopolis that may soon die of thirst?

Urban Agriculture and the New Great Transformation

One of the most informative websites out there, if you are interested in the fate of humanity on the planet, is http://www.resilience.org. The site offers a wide range of original and republished articles on the full range of matters related to getting to a place where climate and the other converging crises of our time can be mitigated and human groups can become more resilient and prosper in a post-carbon world. I just read an article by Jody Tishmack there, which I consider well worth anyone reading. It is titled, “Urban and Small Farm Agriculture.”

Jody Tishmack reports on research showing that expanding agriculture into cities could improve food security, ecosystem health, and have other benefits as well. I would suggest that such efforts will become increasingly necessary as the global industrial agriculture system begins to collapse of its own fossil-fueled weight.

NYC.Riverpark.farm

Riverpark Farm, New York City

The developments Tishmack describes are certainly heartening, not only for the community spirit and potential for continued development of major local/regional movements in urban agriculture. They also represent something even deeper and more important than she acknowledges in this article. This kind of work not only IS doing something about climate change, it will be an ever more important component of the New Great Transformation of human social organization that at this point appears to be the only viable collective response to the converging global crises of climate chaos, ecosystem destruction, economic disintegration, and political corruption.

After over a decade of research on the emergence and acceleration of these crises, I have concluded that the greatest chance to act to counter them is to act locally and cooperate regionally. The exponential growth of the global economic system, including industrial agriculture, is definitively unsustainable, as is mathematically demonstrated in renowned physicist Geoffrey West’s important 2017 book, Scale: The Universal Laws of Growth, Innovation, Sustainability, and the Pace of life in Organisms, Cities, economies, and Companies.

The governments of the world are so far behind the exponential growth of the converging crises of our era that we cannot count on getting them to do anything serious to address them. They remain pawns of the petro-chemically driven corporate system of growth that refuses to face scientific facts. National protests over political catastrophes and corruption are important symbolic expressions of objection to such failures, then everyone gets in their SUVs and hybrids and goes home.

The.Druids.Garden_organic_farm

“Druid’s Garden” permaculture organic farm

We have already entered a New Great Transformation of the global economic, climate, and ecological systems, which barring massive intervention is leading to widespread collapse of living Earth systems, from local ecosystems to global climate. The primary question is whether we can act comprehensively and quickly enough to avoid widespread societal collapse. We will not be able to thwart the imminent collapse of industrial agriculture by convincing agribusiness to “go organic” or stop using neonic’s or GMOs. The most viable way to RESIST failing institutions is to turn away and create new social formations to REPLACE THEM.

The most viable response to the converging catastrophic crises we face is to re-organize human groups into local eco-communities, both urban and rural, that in that process REPLACE the global industrial-consumer economy with local eco-communities, in part by RESTORING the ecosystems where we live. I have rambled on in various posts on this blog, TheHopefulRealist.com and at www.resilience.org awhile back as well, which has led to the book I have prepared for publication in the coming months. An early effort in that regard is found at http://www.resilience.org/stories/2014-12-24/becoming-indigenous-settling-a-population-adrift-in-an-unstable-world/ You can find many other useful discussions of such matters at resilience.org.

Now we just need for the work Jody describes to grow exponentially…

Gun Violence: Theirs and Ours

AR-15

The Parkland school shooting raises questions that have so far not gotten into the public discussion of American gun violence. In particular, it is widely known but largely ignored that most gun related deaths do not occur during school shootings. Such concentrated killings, especially of the young, naturally draw our attention. The less spectacular gun deaths on the streets and in homes are far less noticeable though far more numerous.

School shootings are focused and visual, lending themselves easily to mass media coverage. Not to mention the utter outrage one naturally feels in response to such tragic pain for the young. This time, we have the added attraction of many highly motivated articulate kids taking direct political action to express their outrage at the violation of their childhood by the indifference of so called political leaders.

Yet, what of all the other gun violence in the one nation in the world that puts so-called gun rights above public safety and the rights of victims? The evidence is clear and overwhelming. The implementation of regulations on gun ownership reduces gun violence in direct proportion to the severity of the restrictions. In any case, most gun violence and death occurs in the homes and streets of America. However spectacular and newsworthy, school shootings comprise a small percentage of the total carnage due to firearms.

Student Delaney Tarr was one of the most articulate and committed to express herself to legislators, saying among other things, “We are coming after every single one of you and demanding you take action.” The clarity of her vision as she spoke to the politicians through the assembled press was remarkable. Nobody could doubt that she meant what she said, as she made it eminently clear that she and her peers would not put up with patronizing politicians. She would only accept action. Furthermore, these kids are sticking to their quest.

A mother of one of the survivors of the Parkland massacre took a new stance toward teenage rebellion. In an Upworthy article she proclaimed:

“I never would have thought I’d be rallying for my kids to throw a tantrum. But I am. I’m rallying for the entire country of teens to have fits because their channeled fury just might be the thing that solves this.

It dawned on me the other day when my kids were talking about their walkout plans that my oldest will be 18 when November 2020 rolls around.

So will a whole slew of teens who are taking to the streets today. Politicians better listen and respond like their jobs depend on it.

These kids aren’t going anywhere.”

(http://www.upworthy.com/her-kids-are-throwing-a-fit-about-guns-a-mom-s-message-for-all-adults-is-a-must-read)

It is clear to many by now that our political system is moribund and virtually unable to do anything in the interests of public safety. It is not able to do much else either, unless it involves doing the bidding of the Koch brothers, the gun lobby, or the fossil-fueled military machine of empire. None of it, of course, is in the public interest in life, liberty, or the pursuit of happiness.

Not surprisingly, the glimmer of hope, so articulately stated by the young victims of gun trauma, will come from the actions they take to force the political system to act in the public interest. What a refreshing change that will be!

Craftsmanship for Creative Productivity

~ ~ ~ Another in the Mad Jubilado series ~ ~ ~

It seems a lot of retired men take up woodworking. At Santa Fe Community College (SFCC) I have met quite a few. Some are immensely talented and/or just have a huge storehouse of knowledge and experience. As with many fields of endeavor, only time and talent limit the depth and breadth of understanding possible in woodworking.

Description d un menuisier en travailOne of the most skilled of those I’ve met at SFCC is a woman who retired from a career as an ethnographer. In the typical class of 12 in the woodshop, ‘elder’ know-how is balanced by some very creative younger talent. It is a great experience to work with these folks. The environment is remarkably cooperative and supportive. Ideas and knowledge are shared; polite critiques and useful suggestions organically emerge from conversations about how to approach a problem of joinery, finishing technique or aesthetic design as a project evolves. It brings to mind an ideal image of how apprenticeships might have worked in shops producing for local communities and regional trade in the pre-industrial pre-corporate world of clear-air and artistry.

Solid.Wood.Furniture.Production.Factory

Industrial Furniture Production

Craftsmanship is not quite a lost art, though it might seem so. Industrial production, with its outsourced cheap mostly unskilled labor and highly automated production processes, has resulted in an overabundance of unimportant transitory products. Have you ever really thought about why a cable-television program such as “Storage Wars” exists?  So many people in so many suburbs across America have accumulated so much stuff, that a whole industry has developed just to store the overflow.

The glut of unused abandoned yet “valuable” consumer products that people are not yet willing to call waste, produces the ‘demand’ for all those commercial storage lockers. Without such ‘pre-waste’ there would be no need to find space for the overflow from garages where no cars can be parked because of the clutter.

Excessive extraction of materials needed to produce all that stuff, using gigantic mining and earth-moving equipment is seriously straining many living Earth systems, disrupting otherwise stable ecologies. The quantities of energy used, from mining to shipping to manufacturing to shipping again to warehousing to super-store display, are hard to grasp. It is all mechanized and automated to reduce labor costs in order to supply cheap stuff to feed the consumer culture. And they call it “progress.”

The whole global process is, of course, disrupting climate to a point fast approaching catastrophic collapse and global chaos. Too many “environmentalists” think we can fix the problem with new technology and substituting depleting resources with new materials. Instead of cutting back on their profligate consumerism, they want to “fix” the environment by recycling over-used materials and using just as much energy from more “sustainable” sources.

Instead, they could choose to live a less carbon-intensive “low-tech” life, buying only what they really need, goods the production of which is labor intensive rather than capital intensive. That would, of course, entail more work and more jobs. It would also entail a new great transformation in the way we live in relation to the planet and each other.

What if we all re-focused on smaller scale production of higher quality useful goods that last and require us to apply craftsmanship in their making? Many human-scale tools are available that require no energy inputs except those of the human head and hand to get the same work done.

Organic.produce

Nutrient Rich Organic Produce

Oh, but that would take more time to produce. Yes, and that would mean jobs, jobs, jobs! Everyone could have one. More people are turning to human-scale production. As it turns out, small organic farms are significantly more productive than giant factory farms are. They also restore soils to a natural state in which they provide the nutrients missing in industrial agriculture. Given the power of the neo-liberal corporate industrial economy, making the transition to a viable low carbon emissions future is the hard part. We have the tools. We just need to figure out how to transform extractive economies into ecological communities.

The experience of making meaningful things (or performing meaningful services) is exactly what is missing in our declining perpetual-growth industrial economy and is exactly the economic model needed for mitigation of climate chaos and for ecological restoration. Look for hand-crafted products, locally made. Become a “locavore.”  It’s our choice: Creativity or Catastrophe.

Running Toward Danger

As I watch the seemingly endless cable news video recap of the Parkland Florida high school shooting, I watched the fully swat-outfitted police move toward the danger of an “active shooter” who had set off the fire alarm to bring out his victims for execution—17 dead, 14 wounded at last count. These officers were willing and trained to risk their lives to save the children.

Melissa Falkowski

Brave Teacher Melissa Falkowski ~ MSNBC

Brave teacher Melissa Falkowski herded her students into a closet, hiding them for half an hour, painfully hanging up on a call to her mother so she could hold it together for her kids. A hero of protection was Mellissa, rising to the very highest level of her duty.

School officials had implemented safety protocols and had trained teachers in emergency procedures. In any case, Melissa became a hero of circumstance who had sufficient resources, presence of mind and spirit to save her students from this moment of modern depravity. Her heroism was the kind that saves others from danger and death.

A father came on scene to see the force of terror on the faces of others as he looked for his daughter’s face among those fleeing death. He immediately knew that image would be with him forever.

The police who rushed toward the shooter were heroes of a different sort, exercising the heroism of confronting killers. They ran toward danger to shut it down so fewer would die. They risked their lives directly by seeking to confront the killer with their own deadly force.

As I watched this deadly drama unfold, in its cable-news configuration, it occurred to me that an entirely different, but maybe related, form of running toward danger is happening in this entire nation of violence.

We as a nation seem unable to stop running toward the greatest danger of all — another form of violence we have created ourselves. It is the self-destruction of denying that we are killing each other and ourselves by destroying the very basis of our own existence—the living Earth systems upon which we depend for our sustenance and survival.