Cold nights are coming. Curl up with a good book

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The Amherst gymnasium, the site of JFK’s last speech.

 

Although Paul Dimond’s novel, The Belle of Two Arbors, appeared in April of this year, the epic story begins in the early twentieth century. Based on the temporal setting, the Weekly Packet can bring it to your attention without violating the underlying principle of reporting well-seasoned news.

I’ve just finished reading the 800-plus page story. I will admit that I am a “story” reader, not an “ear reader.” I skimmed lightly over many of the poems that Martha Buhr Grimes contributed to the novel in the guise of Belle, the central character.

Set primarily in what is now northwestern Michigan’s Sleeping Bear Dunes National Lakeshore, and in Ann Arbor, Dimond has constructed a rich story line with a dynamic female protagonist, a complex and powerful family, three world-famous poets – Frost, Roethke, and Auden – and the academic politics of two great American institutions, the University of Michigan and Amherst College.

The 200 to 250-page novel has become fashionable in recent fiction. Dimond’s 800-page story reminded me of Annie Proulx’s Barkskins. Both authors have created complex and fascinating families and followed them through generations. In both books, the author’s passionate commitment to the environment infuses the story, and each writer addresses the injustices done to native Americans.

The story of Belle and her family makes for the old-fashioned reading experience than I enjoy most: curling up in a big leather chair with a lap-blanket and escaping to another world for an hour or two in the evening as the story unfolds. Immerse yourself in it, and reap the rich rewards.

The author, Paul Dimond, is an Ann Arbor lawyer and writer, and an Amherst alumnus, Class of 1966. He, too, was in the audience in October, 1963 when President Kennedy spoke about poetry and power at the dedication of Amherst’s Robert Frost Library. Like many who heard that speech, Paul credits it with a long-lasting impact on his life and his career.

A fifty-four-year retrospective assessment of the impact of a single speech on a single day is fraught with hazard. The possibility of overweighting JFK’s words in the balance of long-ago decisions certainly exists. Nonetheless, I urge you to read The Belle of Two Arbors. As you enjoy the story, you’ll be amazed by the depth of Paul’s research and the clarity of his values. Surely with this sustained creative work, he has honored Kennedy’s proposition that, “art establishes the basic human truths which must serve as the touchstone of our judgement.”

One Fall Day

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Last week at this time, I was at the American Heart Association 2017 Scientific Sessions meeting in Anaheim, CA. I’m not going to risk a libel suit for telling you what I think about Anaheim.

I’m sure that anyone who has read my previous posts knows that events of only a week ago have not aged sufficiently to write about anyway. But being at the AHA brings back memories. I attended the 1977 AHA meeting that was held in Dallas, and I have never entirely gotten past it.

If you remember, President John F. Kennedy was assassinated in Dallas in November, 1963. The 1977 meeting was my first visit to Dallas, and the United States had just traded Gerald Ford for Jimmy Carter in the Oval Office. The loss of JFK was still fresh.

On a sunny but chilly day in early November, I walked the several blocks from my downtown hotel to the Texas School Book Depository building. At the time, the building was in a sort of renovation limbo, and it looked haunted. It was impossible to keep from looking at the sixth floor and wondering which window Lee Harvey Oswald shot from.

I’ve never felt good about Dallas, or the American Heart meeting since.

President Kennedy gave his last public address at Amherst on October 26th, 1963. I was lucky enough to be in audience. I have joined a group of classmates (some of whom are shown here) working on a documentary that looks at the content and impact of that speech, and offers some commentary on its relevance today. As part of the effort, our group met at Amherst College on October 28th   for a Saturday event called “Poetry and Politics, A Celebration of the Life and Legacy of JFK.”

The day was not unlike the October day in 1963 when the President spoke: a crisp, sunny fall day in New England, enough leaves on the ground to rustle as you walk, and enough still on the trees to stand out in color against the blue sky and high, thin clouds. After three outstanding presentations by current students and a panel discussion, the 150 or so of us who were “celebrating” gathered on the grassy quadrangle in front of the Frost Library, the building JFK had come to dedicate.

The keynote speaker looked familiar as he stepped vigorously up to the podium. Congressman Joseph P. Kennedy III is unquestionably one of “the” Kennedys. He looks more like his grandfather, Attorney General Robert F. Kennedy, than his great-uncle the President, but the resemblance is strong.

After the speech, I took a little private walk around the campus. I looked at the second floor of James dorm where I lived, at the Chapel where I had listened to Robert Frost say his poems, and the playing field at the foot of Memorial Hill where I had watched JFK’s helicopter land.

The young Congressman gave a good speech. Not perfect, but perfectly adequate. He’s just 37; there’s time, and there’s hope.

Yankee Ingenuity

In previous posts on The Weekly Packet, I have offered the idea that fifty years is a good amount of time to gain perspective on issues.  As often happens, a recent trip has changed my thinking somewhat. Travel, of course, is a good thing.  That sounds straight out of Martha Stewart, so let’s turn to Mark Twain, who said, ““Travel is fatal to prejudice, bigotry, and narrow-mindedness, and many of our people need it sorely on these accounts. Broad, wholesome, charitable views of men and things cannot be acquired by vegetating in one little corner of the earth all one’s lifetime.”

So we (Katherine and I) took a short trip to get together with some of my Amherst fraternity brothers. The whole story of the Amherst fraternity experience (very benign in our era) will prompt another story.

Our travel took us to Old Saybrook, CT. where the 406 mile-long Connecticut River flows into Long Island Sound. Our host has a lovely old home on Ayers Point, and this is how we stumbled onto a bit of 246 year-old news to share with you. In Revolutionary War days, Ayers Point was the site for the fabrication of the Turtle, the first military submarine to attempt an attack on an enemy vessel. The standard information says only that Sgt. Ezra Lee, of the Continental Army was the operator of the one-man vessel, and that he unsuccessfully attempted to drill a hole in the hull of a British ship.

Actually, the story is considerably more interesting. David Bushnell, who had attended Yale, designed the Turtle and, enlisting a number of skilled craftsmen in the area, he solved a myriad of technical problems, not only constructing the boat, but also designing a timing mechanism to allow the boat to escape after attaching an explosive mine to the enemy vessel. But he needed someone with brawn to operate the boat. The operator had to move the boat forward and backward with a front propeller driven by a treadle and a hand crank and also supply the muscle required for a vertical propeller on the top of the boat that assisted with ascent.

Enter David’s brother, Ezra Bushnell. Younger and considerably stronger, Ezra must also have been either somewhat less bright or much more courageous. Perhaps he combined both attributes. Nonetheless, Ezra provided the crew and the power for the Turtle’s initial trials that took place just off Ayer’s Point. By all reports, Ezra became quite proficient at maneuvering the vessel.

The intrepid submariners loaded the Turtle onto a boat, and headed for New York Harbor, where the British fleet with its flagship, HMS Eagle, were anchored. Before they could mount an attack, Ezra Bushnell became seriously ill. This brought Sgt. Lee into the picture, as a volunteer to step into Ezra Bushnell’s spot. The Connecticut History website details Lee’s courageous but unsuccessful efforts against the Eagle.

The “news” from almost 250 years ago?

Invention, ingenuity, creativity, and craftsmanship combined to make the impossible happen; a submerged vessel with a single man aboard attacked the flagship of the British fleet.

The success of the venture depended on the skills of one man, who was laid low by illness, and a second, who made a gallant effort on short notice.

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Today, we may have more powerful technology, but we would be hard-pressed to match the mind and spirit of the Connecticut Yankees.

 

Note: see also Manston R.R., Frese F.J.,  Turtle: David Bushnell’s Revolutionary Vessel. Westholme Publishing

Goldilocks.

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The Coast Range, British Columbia

 

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The Bulkley River, British Columbia

 

This has been a busy summer! I spent a week in Brooklyn with my son as he underwent and initially recuperated from a total hip replacement. During my stay, I had the opportunity to read Goldilocks and the Three Bears not just once, but several times. Probably about 11 times.

My grandson, Walker, (think Walker Percy, the writer or Walker Evans, the photographer) obviously thinks highly of the story and so do I.

Actually, my interest in Goldilocks began some years ago when I was managing immunosuppressive medications. The trick with immunosuppression is, of course, not too little and not too much! Abstracted a bit more, the story tells us that in many of our activities, the relationship between a given parameter (temperature of soup) and a desired outcome (good taste of soup) is not linear. These relationships often take a U-shape or a J-shape, depending on how one draws the graph.

Walker lost interest when I tried to explain how to graph his story (increasing soup temperature on the X-axis, increasing tastes good on the Y-axis = upside down U.) You shouldn’t. This is how a lot of things work in life. Now we’re going to talk about one of them.

The August 22 issue of JACC (the Journal of the American College of Cardiology) has now completed preliminary seasoning. It has rested quietly in a stack of printed material on the breakfast counter, slowly making its way to the surface.

In it are some interesting data, along with a thoughtful editorial. (data, Xi et al, J Am Col Cardiol 2017; 70:913-922 and editorial Gaetano and Costanzo, pgs 923-925.)  The data are a re-confirmation of the J-shaped relationship between alcohol consumption (gm/day) and the relative risk of total mortality.

If one sets the baseline relative risk of dying at 1.0 for “never consumed alcohol” abstainers (this excludes problem drinkers who are abstaining for health reasons), the relative risk of dying from any cause actually decreases to about 0.85 for those who take a drink or two a day. Then it heads right on up, so that when you get to a half-dozen or more pops a day, your risk is well above 1.0.

What does this mean? However the Goldilocks story began, it means that the concept of getting something “just right,” whether it’s the dose of cyclosporine or the temperature of the soup, is something that humans have been working on for a long, long time. Probably almost as long as they have been fermenting stuff…

Note: 20170827-DSC02182.JPGThe two landscape photos are panoramas of multiple shots with my Nikon D7100, put together in Adobe Lightroom. Enjoy!

August at the Lake

It’s August at the Lake.

I should be writing about our recent houseguests, a family that includes two delightful teenagers. Yes, there are really nice teenagers. I know this from direct observation.

And, I would like to describe the clear cool water, the loons diving for their dinners, the four-pound smallmouth that took a surface popper on the first cast a couple of nights ago, and the eagle that has nested across the way. All these things are beautiful, lyrical, like the sky in the few minutes after sunset, still glowing with the memories of pleasant days.

But…I just had lunch. I fixed it and ate it by myself. It was a pretty mundane lunch: extra-crunchy peanut butter and mixed berry jelly on whole wheat with a small bottle of fizzy water. So, while I crunched, I entertained myself by reading the July issue of Nature Biotechnology.  This is not as technical as your average Car and Driver, but still, it’s pretty technical. The news items included a piece on chimeric antigen receptor T-cell therapy and another one on protein scaffold drugs, relatively small polypeptide chains that maintain the binding specificity of antibodies. Then I turned to another item describing the conjunction of artificial intelligence and drug discovery.

Then I stopped, and tried to think for a minute. What do these bits of news mean and, more importantly, what do they imply for the future? Of course, the future is an assumption highly dependent on the statesmanship of leaders like Kim Jong-un and Trump the Donald. As Nat King Cole wrote, “Tomorrow may never come/ For all we know,” and old Blue Eyes answered, “The fundamental things apply/As time goes by.”

I digress. First, these news bits show us the incredible pace of change in biotechnology. Remember, kids, it has less than 75 years since Pauling’s work on protein structure and just 64 years since Watson and Crick described the structure of DNA! What a ride!

But what does this news imply for the future? I don’t mean, what will the next rabbit to come out of the hat look like? Much more important than that, I mean what happens to our society when having a good job means that you have to understand some physical and organic chemistry, a smattering of X-ray crystallography, and have a nodding acquaintance with deep-learning algorithms?

I just spent a week with my younger son, Drew. While he recovered from a total hip replacement (so much for eugenics!), we had plenty of time to talk. He teaches young adults in New York City who want to attempt the TASC (Test Assessing Secondary Completion) exam that leads to a High School Equivalency Diploma. These students, and millions more like them across the country, are totally unprepared to deal with the STEM (science-technology-engineering, math) material that’s required today for employment in the modern world. They don’t have the academic skills, the basic reading and math knowledge, to learn STEM material.

Economic inequality is real, and it’s easy to measure and show on a graph  . But for tomorrow, the critical issue will be educational inequality. Yes, they are highly correlated, but they don’t have to stay correlated. We could try to make sure that the next generation has a chance to acquire better academic skills, that they don’t go to school hungry and come home to violence.

Oh, but that might take some government interventions. Whoops.

Are scientists innately boring and out of touch?

 

The popular viewpoint seems to characterize scientists as dull. The popular media often give the impression that scientists, a.k.a. “nerds,” or “geeks,” insulated from the real world of apps, ride-hailing, and rap by their glasses and pocket-protectors, aren’t much fun.

I’m working on editing a memoir that my friend, Bernie Witholt, left unfinished, and wildly unstructured, when he died two-plus years ago from pancreatic cancer. Bernie was a full-fledged scientist. He spent much of his life in the lab, studying the biochemistry of bacteria. PubMed lists 179 separate publications for him; he held many patents, and his colleagues remembered him as a remarkable salesman for his ideas.  “With visionary lectures, he convinced policymakers and companies to invest. He was a fantastic advisor for, and initiator of, numerous successful biotech start-ups, and was the founding father of the Zernike Science Park in Groningen. In 1992, he established [a laboratory] in the Institute of Biotechnology of Swiss Federal Institute of Technology in Zürich (IBT, ETH Zurich) and worked on alkane-degrading bacteria, biocatalysis and bioplastics until 2005 when he retired.”

In addition to his science, Bernie was an avid oarsman. We rowed together at Amherst, and for the summer of 1963 we rowed a double scull for Vesper Boat Club in Philadelphia. He continued rowing in Zurich with gusto and considerable competitive success.

He and his second wife, journalist Renske Heddema, were an elegant couple with an active social life.

My task in editing his memoir is to communicate the joy of living the scientific life and of asking questions and finding one answer that leads to a dozen new questions. But beyond that, the real scientist also finds joy and excitement in seeing how the world fits together, in knowing about history and the arts as well as science.

Christine Rosen, writing in The New Atlantis in 2006, said, “It is not, alas, the stuff of great memoir, so severed has the actual practice of science become from the broader concerns that animated many early scientists — the wonder at life in its fullness, the observable mysteries of the natural world.”

She nailed the issue! Today’s science involves questions that require detailed technical knowledge that the general public does not have. Yet many of the scientists I know do, indeed, “wonder at life in its fullness.”

I would be delighted to hear from readers who have ideas or suggestions about successfully writing about scientists.

Summer Reading. (Not required, but worthwhile)

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What did you think about over the past two major holidays, Memorial Day and the Fourth of July?

As I often do, I spent a lot of time wondering how we got to this strange point in our national history, and a smaller time hoping that the federal bureaucracy, in its nautical role as our national ballast, has sufficient inertia to hold the course in foul weather.

I’ve just finished reading two books that I want to recommend; both are appropriate for the packet. They are not new, but ripe for reading now.

The first is Fredrik Logevall’s Pulitzer Prize-winning Embers of War, a history of Viet Nam that focuses on the period from the end of WWII to 1959, at the beginning of the second Viet Nam war, the one the US fought.

The three main players of the story include war-weakened France, struggling to retain its colonial domination over Viet Nam, a home-grown independence movement desperate for military and economic support, and the suddenly superpower, the cold-war United States, operating on the basis of the “domino theory” and committed to halt the spread of “Communism.”

As Logevall tells the story, the players cannot shed the blinders that limit their vision and condemn them to act out their roles, no matter what the consequences. France poured blood and treasure into Viet Nam that could have helped stabilize her in Europe. Ho Chi Minh made a Faustian bargain with the Chinese, after his efforts to lead his country to independence were rebuffed by the US. Meanwhile, with the US caught up in the madness of McCarthyism and the “loss of China” political finger-pointing, the irrational political pressure to support first the French and then Ngo Dinh Diem and the South Vietnamese was overwhelming.

Logevall, a history professor, writes clearly and unobtrusively. As events unfolded, as a reader I could only shake my head, wondering, “Why?”

The second recommendation is Jean Edward Smith’s Eisenhower in War and Peace. Smith focuses much of the book on Eisenhower’s military career, an important approach in order to understand how Ike functioned as President. Eisenhower was extraordinarily fortunate throughout his career in gaining brilliant senior military men as mentors, probably because they recognized his extraordinary capabilities.

Smith emphasizes Ike’s skills at the card table, his perspective in structuring “carrot and stick” decisions for both his peers and his subordinates, and his ability to delegate responsibility.

The two books, taken together, help to clarify the complex path that led to the United States involvement in Viet Nam. The relationship between Eisenhower and DeGaulle, the political pressures within the Republican Party, the pressure to use tactical nuclear weapons, all played a role.

What’s my message here? We live with our successes, and with our mistakes. Americans should celebrate the 4th of July. The essential document of the day, the Declaration of Independence, stands as a remarkable example of our successes. And on Memorial Day, the Civil War and the Viet Nam War stand as stunning examples of the consequences of our mistakes. It takes about a half-century, a reasonable time for the dust to settle, to see how the mistakes were made.

The photos are all from Havana, Cuba. I think they speak to some of the issues. The lady in the rain was photographed on the grounds of the Hotel Nacionale in a sudden downpour. The red Buick was originally, I believe, a 1954 Roadmaster. The missile is an SA-2 Guideline surface-to-air missile of the type that shot down Rudolf Anderson’s Lockheed U-2 aircraft over Cuba on October 27, 1962,during the Cuban Missile Crisis. The wrecked engine of the U-2 is displayed below the missile.

“Outside of a dog, a book is man’s best friend. Inside of a dog it’s too dark to read.” ― Groucho Marx

About a year ago, two reviews of Annie Proulx’s novel, Barkskins, appeared in the New York Times. Neither was particularly favorable.

I bought an audiobook recording of the novel and have listened to it, all 26 hours of it, while driving up and down I-75 from Ann Arbor to the Upper Peninsula. I finished the last disc a few days ago driving west on M-28.

Two of Proulx’s previous works, The Shipping News and Brokeback Mountain, have won a Pultizer Prize and a National Book Award. Barkskins probably won’t scale those heights. Nonetheless, the book appealed to me at several levels.

First, Proulx is now over 80, and any octogenarian who has the dedication and energy to write and publish a 717 page novel spanning 300 years is OK in my estimation. Second, the tale is a prolonged, slowly intensifying, protest against the wholesale exploitation of natural resources for corporate profits. It’s a protest that might be more effective at a fraction of the length, but it certainly conveys the intensity of her feeling. At this stage of life, having intense feelings about issues seems to me extraordinarily admirable. And from time to time, she delivers positively lyrical descriptions.

Finally, though, I was drawn to her failure to get the story ended. I’m sure we have all sat through to one or another piece of classical music in which the audience raises its’ collective arms, ready to applaud and get the damn thing over with, only to have the orchestra continue on, repeatedly swelling toward but not achieving a grand finale. In the last chapters of Barkskins, Proulx just can’t stop the music.

Most stories often have natural endings. The detective solves the crime. The traveler returns home. The horse wins the race. But Barkskins won’t end for Annie.

I find that appealing. She doesn’t want to hang it up, to say, “There, that’s all I have to say about that.” Good for her!

I don’t think many Weekly Packet visitors will head to the local bookstore to buy this very long novel. You just won’t have time to read it. So, here’s an offer you can’t refuse. Anyone who is facing a long drive, for instance, New York to Los Angeles by way of New Orleans, can let me know. I’ll send the audiobook to the first reader I hear from. You’ll enjoy it.

Aargh! By AARP

 

 

 

 

 

 

I have several medical journals open on my desk with interesting topics that I thought I might mention in “The Weekly Packet.” By and large, the open journals are now properly aged, like pieces of meat at a fine steakhouse.

Nonetheless, they will have to wait. The most comment-worthy item to come along this week was in the AARP weekly flimsy.  Painful truth: my wife and I joined AARP to get the substantial discount offered by our local optometrist’s shop on new glasses. Even more painful truth: I was pulled in by the headlines about “why do drugs cost so much?”

I did not have high hope for a rigorous exegesis in the AARP journal, but the presentation was actually quite balanced. The writers covered the long timelines from drug discovery through clinical trials and the FDA approval process, and even covered phase 4 studies. They also touched on the vast amount that “big pharma” spends on marketing. In all fairness, they at least mentioned that Medicare cannot, by law, negotiate drug prices and touched on the strange role that “pharmacy benefit managers” play in the US system.

What’s my point? An AARP member who actually spent some time carefully reading the article would have a basic vocabulary, would become familiar with some of the players in the market, and would have been introduced to two key facts: pharmaceutical costs are only about 10% of overall health care costs, and big pharma spends as much on marketing as on basic research. Not bad. Although the authors did not point out to their readers that without this industry, their diabetes, high blood pressure, high cholesterol, and cancers could not be treated.

More importantly, what the AARP reader would NOT know, struck me last week when I attended the Clinical Leader Forum in Philadelphia. The pharmaceutical industry, particularly the clinical research organizations that have proliferated in the past couple of decades, exemplifies the new economy.

Let me try to explain. In one lifetime, mine, pharmacology has gone from a collection of empiric facts about medicinally useful herbs like digitalis or compounds, like sulfa, to an integrative science and technology focused on identifying “drug targets” in pathophysiologic processes.

From this point of view, the new drugs that pharma generates are the physical tokens, the representation of knowledge and of enormous amounts of data. The patients are not really paying for the drugs, they’re paying for the data. I think eventually, we will work out something more functional for drug pricing. But take a step back, and look again.

Kids who under-achieve academically will not find jobs in this industry. What I saw during last week’s meeting was a relentlessly driven technological and sociological wedge splitting the workforce into those who could deal with complexity and those who could not.

And I’m sure that other industries are similar.

There is no going back. No matter how much we would like to idealize the post-WWII economy, it’s gone.

Here’s the really scary thing; there’s good evidence most AARP members don’t understand what this kind of industry means for our society.

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