Textbooks: An Unnecessary Evil pt 2

Image result for Richard FeynmanWe are discussing textbooks, starting here with some preliminaries and what textbooks are.  The remaining two questions are:

2. Who gets to say what’s in textbooks

3. Why do we need them

Who gets to say what’s in textbooks? First, let’s consider a fairly recent and I think representative example. Richard Feynman was once on a textbook committee here in California. (Aside: the link above came up when googled for the Feynman essay. The commentary at that site is also worth perusing.) While his experiences date back 50 years, the situation has only become worse. So, who says what in them?

You see, the state had a law that all of the schoolbooks used by all of the kids in all of the public schools have to be chosen by the State Board of Education, so they have a committee to look over the books and to give them advice on which books to take.

Feynman getting a say in what’s in science and math books? Famous, brilliant, Nobel-winning teacher? Sounds about right. Buuuut:

Immediately I began getting letters and telephone calls from schoolbook publishers. They said things like, “We’re very glad to hear you’re on the committee because we really wanted a scientific guy . . .” and “It’s wonderful to have a scientist on the committee, because our books are scientifically oriented . . .” But they also said things like, “We’d like to explain to you what our book is about . . .” and “We’ll be very glad to help you in any way we can to judge our books . . .” That seemed to me kind of crazy.

A nice lady who’d been on the committee before told him how it worked:

They would get a relatively large number of copies of each book and would give them to various teachers and administrators in their district. Then they would get reports back on what these people thought about the books.

But this is Feynman we’re talking about! So:

Since I didn’t know a lot of teachers or administrators, and since I felt that I could, by reading the books myself, make up my mind as to how they looked to me, I chose to read all the books myself. . . .

If you know anything about government committees, you may be able to guess what happens. Feynman is the ONLY person on the committee who read any of the books. In one case, there was a book being rated even though it was blank:

We came to a certain book, part of a set of three supplementary books published by the same company, and they asked me what I thought about it.

I said, “The book depository didn’t send me that book, but the other two were nice.”

Someone tried repeating the question: “What do you think about that book?”

“I said they didn’t send me that one, so I don’t have any judgment on it.”

The man from the book depository was there, and he said, “Excuse me; I can explain that. I didn’t send it to you because that book hadn’t been completed yet. There’s a rule that you have to have every entry in by a certain time, and the publisher was a few days late with it. So it was sent to us with just the covers, and it’s blank in between. The company sent a note excusing themselves and hoping they could have their set of three books considered, even though the third one would be late.”

It turned out that the blank book had a rating by some of the other members! They couldn’t believe it was blank, because [the book] had a rating. In fact, the rating for the missing book was a little bit higher than for the two others. The fact that there was nothing in the book had nothing to do with the rating.

Read the whole thing, if you have the stomach for it. Feynman noted many egregious errors and obvious failings in the books that did have stuff in them, so much so that one is lead to wonder if the blank book would not have been an improvement (hint: yes). The rest of the essay is about the corruption of the selection process, where the publishers wine and dine the committee members to get their support, but given the nature and quality of the books, that qualifies as a secondary scandal.

So, to answer the question: who gets to decide what goes in textbooks? it’s ‘educators’ with the ‘help’ of politicians. In the above essay, the recommendations of the committee are largely overturned by the politicians allocating the state budget. The committee was instructed not to look at cost, so they couldn’t recommend a set of books within any budget, or have a hierarchy of which books to cut first if the money wasn’t there. Didn’t matter anyway, as the Education Department simply did what they wanted once a budget was determined. Feynman, a legendary teacher himself, is there just for cover – it’s not like he get to decide, or even have much of a say, despite his expertise.

Two things should be obvious from this story: first, educators, a class of people that did not exist until about 200 years ago (people were teachers, back then) decide what goes into the books. State education departments are and have always been staffed by educators and political hacks.

But the second thing is more perhaps more shocking: it doesn’t matter what goes into the textbooks, so long as it fails to teach! It is not like there are not many people out there who can teach algebra, say, and who could write a good, usable textbook on the subject.  I ran across one such book many years ago, and it was night and day. After taking the usual high school algebra courses, I could sort of do the math, but my understanding was limited. Then, in my mid-20s, in a few pages of a book I stumbled across in a library  written by a guy who understood and loved his subject, it was a mini Eureka! moment. Algebra wasn’t a series of tricks and rules, but rather a complete logical system. The fragments made no sense; the whole was beautiful.

So, I know they’re out there. Textbooks written by people who understand and love their subjects are never used in the public schools, at least K-12. This is no accident. It’s not just the experts whose opinions are ignored. What parents might wish were in them is worse than irrelevant – it is to be actively shunned.

The compulsory, graded public school system was never envisioned as a means to educate. Fichte, Mann and their spawn hardly cared if the students learned traditional subjects. The system they dreamed up, realized and imposed with the police power of the state was intended from the beginning to form an obedient and docile population.  Textbooks that teach real knowledge do not help toward this end, and might hinder it. Better to not run that risk.

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2nd of July Update

A. Made a little progress on the 3rd year and running Never-ending Front Yard Brickwork Project of Doom:

IMG_5105
Got the forms removed, added a couple feet of brick walk. I needed to see how it looked before deciding exactly where to position the column that will hold up the fence. Thinking the column should be about 4-6″ in front of the wall, to add a little articulation. Yes, I’m that geeky and obsessive.  
IMG_5104
This gives some idea where we’re going with this. Column on the end where the rebar is sticking up, 8″ (2 bricks wide) wall along the front nearest the street, 12″ planter in the middle, 4″ wide wall in the back. 3′ tall iron fence runs down the middle of the 8″ wide 16″ tall wall, flanked at either end by a brick column. Then, after the gap for the water meter, an identical set up on the other side. Fearful symmetry. 
IMG_5111
Oh look! A row of bricks for the 4″ wall! The Caboose and I threw them down just now. 

It will be extremely cute, with a little orchard behind it and climby plants in the planters, maybe some rosemary hanging down. Hope I live long enough to enjoy it…

B. Speaking of which, still ill. Still think it’s at least partly the blood pressure drugs, but to be honest I’ve gained a frightful amount of weight over the last 25 years, to the point where I need to own that that’s most likely the root of the problems. So, I’ve cut calories by about 1/3. All I need to do is keep that up for a couple years,,,,

It would be good to get some regular exercise, but that’s tricky when I can’t count on feeling up to it at any regular time. Getting long walks in when I can. So I’m logging blood pressure readings several times a day, keeping track of when I take the meds and how I’m feeling. Then when my doctor gets back after the 4th, we need to talk.

No reading, very little writing – mostly just this blog. Concentration is intermittent. More apologies to my beta readers – I am grateful and will get back to you soon, I hope.

C. Finally, got laid off from my job of 21+ years. While not the prime cause, I don’t think, being unable to focus or even stay awake at work helped things. So now I have about 5 months to find another job before I have to start in on my retirement savings. Wish me luck. Say a prayer if you’re into that sort of thing. I’m in much better shape than most people who go through this sort of thing, thank God, and I’m frankly glad to get out of what has long been a deteriorating work situation. But it’s no fun.

Textbooks: An Unnecessary Evil pt 1

It has been the great tragedy of our time that people were taught to read and not taught to reason.

– Chesterton, of course

A fascinating comment on an old post that’s been getting some attention lately (by the lowly standards of this blog, anyway) got me to thinking about textbooks.

Three questions:

  1. What are textbooks
  2. Who gets to say what’s in them
  3. Why do we need them

After some preliminaries, we’ll treat each of these questions in turn over two or three posts.

Background musings: When reading a book, one is almost always forced, alas, to rely on some intermediary person’s understanding of the materials. Most works I read and want to read are compilations from other sources (almost all history) or are translated into English, or both. Works of fiction and the occasional first hand account written in a language you read are exceptions – in novels and front line stories, the writer is free, more or less, to tell it as he sees it, and you get to interact, as it were, directly with the writer.

Translations are perhaps the obvious challenge. I read a lot of books written in other languages, and am often acutely aware of being at the mercy of the translator’s understanding and biases. The couple years I spent studying German in high school left no trace; the 2 years of Greek and one of French in college (1) had the benefit of making me aware of how difficult the translator’s job is even with the best of intentions. Read any two translations of Dante, let alone Homer, and you will in places wonder if the translators are working from the same sources. I today read very, very little French and less Greek. And effectively no German. Sigh.

The intermediary in this case is the translator, who has a whole passel of challenges and temptations to deal with, not least of which is to simplify and gloss over stuff he may or may not understand. Some of the more intense discussions at St. John’s were occasioned by why Hippocrates G. Apostle (a well known and fabulously-named translator of Aristotle) had translated the same Greek word into more than one English word according to context, whether his assumptions about context were correct, and whether it was ever OK to read into a text in that manner. Many different translations were dragged out for comparison. “Sheer fantasy” was a comment made by one of the more linguistically skilled professors.

St. John’s College is weird. It also should be pointed out that reading anything like a literal translation of Aristotle is nearly as difficult to understand as it is for somebody with two years of Greek to try to read him in Greek. So, we were all sympathetic to Apostle, but I think we, in the end, didn’t much approve.

I tell the above story merely to illustrate how challenging translation can be, and how one must always exercise some degree of caution when reading translated works. In some cases, the translator’s introduction and footnotes can be very helpful in explaining his approach and sometimes biases, and in helping explain tricky words and passages. But sometimes not.

The other main intermediary is the compilers/re-tellers. When reading history especially, the reader is unpacking a Russian doll – there are the original sources which may or may not be brought to the fore, and all the other historians who have looked at the same materials whose influence may or may not be acknowledged. Exactly what you’re getting, particularly in popular histories where the writer is unlikely to let facts get in the way of the story, is difficult if not impossible for the lay person to grasp.

History is a challenging task, where the broad strokes may not be too controversial, but everything else is up for grabs. The trick is trying to capture both the telling details – and upon what criteria is this detail or that deemed telling? – while at the same time providing some context and overarching analysis without simply steamrolling those details.

Not easy – and that’s assuming you’re honest. Some are not, or at least their criteria for selecting and recounting details are biased to the point of lying. Gibbons and Wells spring to mind, the first applying the principle that anything the Catholic Church was involved in was by that fact alone evil, and the second deciding in advance that, according to Marxist principles, everything is marching forward in a completely non-religious way under the guidance of the totally not-God History toward a totally not a paradise myth Worker’s Paradise. In either case, any detail or even higher level events that failed to confirm their narrative, as the kids call it these days, was ignored or mangled until it did. (2)

Again, introductions and notes are often helpful or at least telling. When I read A History of Private Life a few years ago (well, most of it anyway) I had to deal with both translation – it was written in French – and marked biases among the various scholars who contributed. Some were openly Marxist, which means inclined to lie and ignore stuff the moment it becomes inconvenient to their pathology, while others had an Germanic, nearly obsessive fascination with details (I liked those guys – go figure). And some had no obvious agendas. Good series. It helped me at least to have a little heads up as provided by the introduction and notes.

That said, one’s main tool or defense in understanding and getting something positive from reading is having read and tried to understand lots of different kinds of books, particulary old books that introduce one to truly different cultures. (3) That’s what the exercise of a University education used to largely consist of – the reading and struggling with the ideas in books widely recognized as important. In no particular order, you learn or should learn:

  • Many old stories are beautiful. Our ancestors really knew a good story when they heard one, and how to tell it;
  • There are very, very few really new ideas;
  • Most of the really important ideas are thousands of years old, and never go away;
  • The smartest people today are not smarter than the smartest people of the past;
  • Using big words and plenty of them, and having good things to say are not the same thing.

There is a more complicated thing one might learn, about how an educated person sees the world. This is much harder to put into words. The effect is that one becomes aware of perspective, about how the world will look a certain way to someone who has had certain experiences and accepted certain premises. Crucially, one sees the interaction between beliefs, character and action. In many ways, great novels make this more clear than other types of books, although it’s a critical part of Homer and even of Aristotle. I suppose this is what is meant by being broadminded.

What are textbooks?

Simply put, and with notable exceptions, textbooks are meant to prevent learning any of the lessons a student might learn from good books.

Exceptions include attempts to condense and to some extent predigest the fundamentals of highly technical topics. Grammars, and some math and science texts fall into this class.  Textbooks of this type are sometimes highly original and creative in themselves. Euclid, for example, is sometimes considered a textbook on Greek mathematics, but the gradus ad Parnassum structure of the Elements, leading the student logically from simpler to more complex concepts and proofs, was at least perfected by Euclid, and is his greatest lesson.

Most modern textbooks are not exceptions. Consider the fundamental difference between modern textbooks versus the earliest textbooks use in America, say, McGuffey’s Readers. The Readers were literally textbooks, collections of texts written by what the compilers thought were great writers, typically expressing thoughts characteristic of the highest aspirations of the people whose children were to read them.  The readers are hard, at least much harder than the texts we expect children of similar age today to read.

Modern textbooks are not, as a rule, collections of challenging texts. Instead, the materials in them are fresh wrought. These materials tend to be very simple. This is one aspect of Pestalozzi’s methods (such as they are) that Fichte loved: all learning is to be broken down into atoms, and no student is permitted to move on to atom B until the teacher has determined that he has mastered atom A.

A child with the slightest interest in learning to read will get past the ‘See Spot run” level in at most a couple weeks. This step – giving kids simple sentences made up of easily sounded out words – seems to have, historically, been skipped. In America, large numbers of children learned to read from the King James Bible, which no one will ever accuse of being a collection of simple sentences made up of easily sounded out words.

The other feature of modern textbooks that must be noted: the answers are in the back or in the teacher’s edition. The answers are known, even in subjects such as ‘literature’ or history, where the meaning of any text or event is certainly not reducible to a single statement if it has any meaning at all. Even in math, people with any instinctual understanding of math recognize that while there may be one or one set of correct answers, there are usually many ways to get there. Yet the textbook will mark you wrong if you do not take the route described in the textbook. Even being correct isn’t good enough. Thus another defining feature of modern textbooks: by putting the acceptable answers in the teacher’s hands, textbooks place the teacher between the student and the materials, such that the materials to be learned are not allowed to speak to the student except as approved by the teacher

In general, excepting those textbooks that serve the purpose of collecting and organizing complex basics such as grammar and math, modern textbooks are collections of newly created materials, generally fragmented and simplified to some imagined lowest common denominator. They contain the often increasingly arbitrary acceptable answers to a set of predefined acceptable questions. These questions and answers are under the control of the teacher alone.

Next, we’ll discuss who gets to say what’s in them.

  1. Contrary to all expectation, including mine, I did pass the junior year French reading exam at St. John’s, so there was a brief period where I was a *certified* reader of French. Perhaps you’ve heard the story of St. Joseph of Cupertino? A man considered by his peers to be hopelessly stupid? Where, the story goes, in order to advance toward ordination, he needed to give a brief exposition on some scripture passage, and the examiner asked him about the Nativity narrative – the one point in Scripture upon which any of his religious brothers had ever heard him expound with any coherence. He passed, and ended being ordained a priest. Well, the St John’s College French test happened to be on a passage from de Tocqueville with which I just happened to be very familiar. (de Tocqueville also happens to be very easy French). As soon as I started trying to read it, I was all ‘oh, that passage!’ Luck? Divine Providence? You decide!
  2. Confession: it is unlikely I will live long enough to read Gibbons or Wells all the way through. I’m judging them here based on the snippets I have read and their reputations among people whose views on the matter I respect – e.g., Chesterton.
  3. I’ve long said that trying to understand the ancient Greeks and Hebrews is a greater and more fruitful cultural reach than trying to understand any current culture. The Greeks and Hebrews as deep beyond deep, and as alien in many ways as Martians. And yet, they are us!

Home Improvement: Build That (Little Garden)Wall

Health is variable, but I did get it together enough Friday and Saturday evenings and Sunday morning into the early afternoon to get started on a long-delayed project. Yesterday evening, with the trenches dug and the little forms and rebar laid in, the Caboose and I *finally* got the concrete poured for the first half of the long planned (over three years now!) little brick wall wall and walk along the street in the front of our house.

IMG_5101
Taken from the street. On the far left is the end of the brick walk and planters from 2 summers ago, now with attractive citrus tree!  In the center is the shade cloth for the poor suffering avocado trees. To right in the back are some of the many, many bricks I’ll need to finish this entire project (why yes, I am insane. Why do you ask?). Out of frame right is the water meter access that is the cause of not just pouring one 35′ footing  all the way across the frontage and being done with it. 

 

IMG_5091
The Caboose, 14 and very helpful, adds water. 
IMG_5082
Here I do a little preliminary smoothing. This shot reveals the plan a bit better: 8″ wide by 16″ tall wall in front, 12″ planter in the middle, 4″ by 16′ wall in back. My son stands on what will be a 24″ wide continuation of the brick walk.  Note the in-ground water meter (that gray rectangle) and yet more bricks in the background. 

The plan: after work from now until September, in the cool of the evening and with help of whatever kids are around and want to help, a wall gets built and a path gets paved. Also, an identical section of forms and rebar gets laid in on the other side of the water meter. Not sure what I’ll do about the meter – something like a 6′ diameter semicircle around it to give the meter reader (do those guys still exist?) plenty of room. Maybe I’ll mix it up and use stone? I got stone, too.

On top of the 16″ wall, I’ll put a 3′ wrought iron fence, like this:

fence 1
6 panels ordered from A Rustic Garden in rural Illinois.  Lovely stuff.  Imagine 2  12′ length between 1′ square brick columns at either end atop a 16″ brick wall….

The net effect: about 25′ of 3′ high fence atop a 16″ high brick wall, interrupted in the middle by whatever I do about the meter. At either end on either side, I’ll put in little 4′ towers to tie the ends of the fence into.

Then throw a little rosemary, climbing things and flowers in the planters. The cute meter will be pegged. But the brick work itself is seriously manly, I trust we all can agree.

Science, Medicine & Me (or You)

One of the problems, or challenges, if you prefer, with medicine is that few people who become doctors do it because they love science. They become doctors typically because they want to help people, a very fine reason. But this means that when the situation calls for a more scientific examination of the evidence before them, or of the value or pertinence of this or that finding or practice, your doctor is likely operating at a disadvantage.

Ultimately, tradition, law, and their insurance companies all but force them to stick to conventional, approved approaches to everything. In general, this is not a bad thing – you certainly don’t want your doctor freestyling it when it is your health on the line. If doctors everywhere treat a given constellation of symptoms in a particular way, that would probably be the place to start. But it’s not in itself science.

I recall a couple decades ago that every time we took a kid to the pediatrician – and we loved our pediatrician – she would feel compelled to advise us not to let the little ones sleep with us, family bed style. I can just hear her teachers, or her professional bulletins or her insurance company telling her it was best practice, that kids die every year smothered in a bed with an adult, and just don’t do it. Now, of course, pediatricians in the US (it was never policy in the rest of the world) have come to realize that the benefits to both the child and the parents of having the child in the parent’s bed far outweigh the miniscule risks. Such risks effectively disappear if the child and parents are healthy and the parents sober, while the sense of comfort and attachment gained by the child and the extra sleep gained by the parents is a serious win-win.

Now a scientifically inclined person might ask about the data and methodology behind the claim that hundreds of thousands of years of natural selection had somehow gotten the whole baby sleeps with parents thing wrong.  Maybe it has – but the issue should have at least been addressed. But it wasn’t, in America, at least up until a few years ago. So every American pediatrician was expected to toe the official line, and our doctors did. For, what if you hadn’t advised parents against ‘co-sleeping’ and a baby died? You’d be asking for a lawsuit.

Another example I’ve mentioned before is salt intake. This one is a little different, in that for some people, there seems to be a fairly strong correlation between salt intake and blood pressure, so at least being concerned about it isn’t crazy.

For most people, however, there is little or no correlation between salt intake and blood pressure, at least within realistic levels of consumption. In one of the earliest studies, rats were given the human equivalent of 500g of salt a day, and their blood pressure shot right up! But humans tend to consume around 8.5g of salt a day. Um, further study would be indicated?

The science would seem to support some degree of caution regarding salt intake for people with high blood pressure. Instead, what we get are blanket recommendations that everybody – everybody! – reduce salt intake. It will save lives! Medicine cries wolf. People learn to ignore medical advise. Further, Medical Science! fails to consider what it is asking for – a complete overhaul of people’s diets. Few real people are going to do this without serious motivation. Wasting ammo on a battle not worth winning.

Again, if doctors were essentially scientists attracted to medicine for all the opportunities for scientific discovery human health presents, such errors and poor judgement might be more limited. But doctors became doctors to help people, not to debate scientific findings with them. They want to DO something. Thus, conventional medical practice is full of stuff to do for every occasion. Whether or not there’s really any science behind it is not as important, it seems, as developing practices to address issues so that medicine itself can be practiced. Clearly, for the average doctor, having *something* to do is better than having nothing to do, even when that something isn’t all that well supported or even understood.

These thoughts are on my mind because of all the trouble I’m having with blood pressure medicines at the moment. Since there’s an obvious trade-off here – somewhat higher blood pressure with a higher quality of life versus acceptably lower blood pressure but with lower quality of life – I decided I needed to do a little basic research. Here’s where I’m at after a very preliminary web search:

What I’m looking for, and have so far failed to find, is a simple population level chart, showing the correlation between blood pressure and mortality/morbidity. Of course, any usefully meaningful data would be presented in a largish set of charts or tables, broken out by such variables as age, sex, and body mass index.  But I would settle at this point for any sort of data at all, showing how much risk is added by an additional 10 points or 10 percent, or however you want to measure it, above ‘normal’ blood pressure.

For example, I’m a 60 yr old man. Each year in America, some number of 60 year old men drop dead by high blood-pressure-related illnesses. OK, so, base data is at what rate do 60 year old men drop dead from high blood pressure related diseases? Let’s say it’s .1% (just making up numbers for now) or 1 out of every 1,000 60 year old men. That’s heart attack and stroke victims, with maybe a few kidney failures in there, severe enough to kill you, a 60 year old man.

Now we ask: what effect does blood pressure have on these results? Perhaps those 60 year old men running a 120/80 BP die at only a .05% rate – one out of every 2,000 drops dead from heart attacks, strokes or other stray high BP related diseases. Perhaps those with 130/90 (these results and possible ages would be banded in real life most likely, but bear with me) die at .09% rate, while those with 150/100 die at .2% rate, and those above 150/100 die at a horrifying 1% rate, or 10 times as much as the old dudes with healthy blood pressure. These numbers would all need to average out to the .1% across the population, but a high degree of variability within the population would not be unexpected.

Or maybe something else entirely.  But I have yet to find such charts. I’ve found interesting tidbits, like FDR’s BP in 1944 when his doctor examined a by that time very ill president “was 186/108. Very high and in the range where one could anticipate damage to “end-organs” such as the heart, the kidneys and the brain.” So I gather BP in that range is very bad for you, or indicates that something else very bad for you is going on (FDR had a lot of medical issues and smoked like a chimney).

Then there’s this abstract, suggesting in the conclusion that my quest is going to be frustrated:

Abstract

Objectives

Quantitative associations between prehypertension or its two separate blood pressure (BP) ranges and cardiovascular disease (CVD) or all-cause mortality have not been reliably documented. In this study, we performed a comprehensive systematic review and meta-analysis to assess these relationships from prospective cohort studies.

Methods

We conducted a comprehensive search of PubMed (1966-June 2012) and the Cochrane Library (1988-June 2012) without language restrictions. This was supplemented by review of the references in the included studies and relevant reviews identified in the search. Prospective studies were included if they reported multivariate-adjusted relative risks (RRs) and corresponding 95% confidence intervals (CIs) of CVD or all-cause mortality with respect to prehypertension or its two BP ranges (low range: 120–129/80–84 mmHg; high range: 130–139/85–89 mmHg) at baseline. Pooled RRs were estimated using a random-effects model or a fixed-effects model depending on the between-study heterogeneity.

Results

Thirteen studies met our inclusion criteria, with 870,678 participants. Prehypertension was not associated with an increased risk of all-cause mortality either in the whole prehypertension group (RR: 1.03; 95% CI: 0.91 to 1.15, P = 0.667) or in its two separate BP ranges (low-range: RR: 0.91; 95% CI: 0.81 to 1.02, P = 0.107; high range: RR: 1.00; 95% CI: 0.95 to 1.06, P = 0.951). Prehypertension was significantly associated with a greater risk of CVD mortality (RR: 1.32; 95% CI: 1.16 to 1.50, P<0.001). When analyzed separately by two BP ranges, only high range prehypertension was related to an increased risk of CVD mortality (low-range: RR: 1.10; 95% CI: 0.92 to 1.30, P = 0.287; high range: RR: 1.26; 95% CI: 1.13 to 1.41, P<0.001).

Conclusions

From the best available prospective data, prehypertension was not associated with all-cause mortality. More high quality cohort studies stratified by BP range are needed.

Ok, so here is some information. Let’s chart it out as best we can. Here is the diagnostic banding used by the medical profession here in the US. I note it is unadjusted for age or anything else, which is fine, got to start somewhere:

  • Normal blood pressure – below 120 / 80 mm Hg.
  • Prehypertension – 120-139 / 80-89 mm Hg.
  • Stage 1 hypertension – 140-159 / 90-99 mm Hg.
  • Stage 2 hypertension – 160 / 100 mm Hg or higher.

The meta-study above further divides the prehypertension range into a high and low as follows:

  • Low Prehypertension – 120–129/80–84 mmHg
  • High Prehypertension – 130–139/85–89 mmHg

This particular study does nothing with Stage 1 and 2 hypertension – too bad. But it’s mostly those prehypertension numbers I’m worried about personally. Anyway, here’s what we’ve got so far.

BP graph 1

We will here ignore what looks like a bit of statistical hoodoo – we’re blending different studies, calculating p-values and confidence intervals to the combined results – um, maybe? Perhaps if Mr. Briggs or Mr. Flynn drops by, they can give a professional opinion. Me, I’m just – cautious. So, what’s this telling us?

If I’m reading it correctly – not a given by any stretch – we’ve determined the total relative risk or RR (a term of art, but sorta means what it seems to mean) at the base state and the three partially overlapping prehypertension states based on both systolic and diastolic BP ranges, both on a ‘All Causes’ and a cardiovascular diseases basis. What this appears to say is that a meta analysis of 13 studies of nearly a million people over several decades shows that your risk of illness from any cause increases .03 RR points, or 3% over the base value, if your BP runs a little high, but that your risk of cardiovascular  disease increases 32%. Which doesn’t exactly make sense if one assumes cardiovascular diseases are part of ‘All Causes’ – and why wouldn’t they be? – unless slightly high BP somehow reduces the sum of all other risks. Also, the analysis run over the two sub-ranges of low and high prehypertension do not look like they could possibly add up to the values over the entire prehypertension range – which could well be an artifact of the statistical analysis used. If that is the case, does not logic indicate that the results are quite a bit less certain than the p-values and confidence intervals would suggest? Again, I am very much an amatuer, so I could be a million miles off, but these are the questions that occur to me.

The critical piece missing for my purposes: what scale of risk does the RR here represent? A 32% increase in a .01% chance of Bad Things Happening is hardly worth thinking about; a 32% increase in a 20% risk of Bad Things is a whole ‘nuther kettle of fish.

I’m about researched out for the moment, will continue to google around for more information when I get a moment.

UPDATE:

Is it obvious enough that I’m a LITTLE COMPULSIVE? Just found this, at the Wiley Online Library: 

BP chart 2

Don’t know if this is annualized (per year) numbers, or a total across the entire age range, that ‘all significant’ part worries me a little, but: this seems to be saying that I, a 60 year old man, could expect a 1.8% chance of cardiovascular disease (however that’s defined) if my blood systolic blood pressure falls between 120 and 139, or, more important to my purposes, minisculely more risk than if my BP was the more desirable 120.

This is in line with what one would expect from the data in the previous chart.

Still a lot more work to do here.

Planning on Being Stupid?

It seems I’m planning on being stupid. Alas, I am not alone. On a grand cultural and political level, it often seems that stupidity is not always spontaneous, but rather many people plan and then execute being stupid. Examples include borrowing vast sums for degrees that will in no way aide you in making the vast sums you’ll need to pay back the loans. At no point in the process did the thought arise that this might not be a good idea? Politics presents many such examples: this time, the panic-driven government action will result in a solution to whatever (largely ginned up) crisis is being hard-sold today; this time, the various police institutions can/cannot be trusted more than anybody else; this time, our loyalty will be repaid by something other than the claim that the other guys would have done worse.

At some point, after enough repetitions, enough time to think it over, enough examples of the outcomes, one would almost have to conclude that either people are really, actively blind in a truly scary way or that the continued hope that, this time, the results will be different is, effectively, a plan of sorts. Perhaps these options are not mutually exclusive nor exhaustive…

But I digress. This is all about ME! And how stupid I’m planning to be.

At the moment, the plan is as follows: As soon as I get home, throw on some work clothes and head out front to work on prepping the forms for a small concrete pour (maybe 8 cubic feet) that is the next step in the Front Yard Improvement Project that was begun, oh, 3 years ago? If I can get it ready tonight, maybe I can pour this weekend when my teenage son will be available to help. He helped me pour the last somewhat larger stage:

IMG_3892
The concrete underlay for the ramp up to the front door, last year’s May/Junes project. David helped a lot, hefting bags, adding water, just doing stuff. He’s a year older and bigger this year, too. So I’ll get him to help this weekend when he gets back from a week’s camping.

This current step requires a bunch of hands-and-knees work measuring, laying out, hammering in stakes, laying in some rebar, as well as some digging (very little at this point). With luck and not counting the inevitable run(s) to the hardware store, maybe 3 hours of work? I tend to overestimate my efficiency, so – 4?

For many years, I’ve done stuff like this. Today, however:

  • it’s near 100F outside;
  • I’m 60 years old;
  • In possibly related news, my hands, back and knees have about a 2 hr limit on stuff like this. Any more than that, and I’ll pay for the next several days.

Why now, why not put it off? You might prudently ask.

These are the days, for next 2 months, where it is light enough after work to do anything. If I can get the forms & rebar done, I can pour concrete this weekend, then start in laying bricks in the evenings when I come home during the week. This stretch is nice and straight and orderly, so that I can mix a bag of mortar, put in 20-30 bricks in a couple hours, clean up and be in before dark. Do that a couple times a week for a few weeks, and I’m done.

Besides, been putting it off all spring. Truth is, I’ve been not feeling well. This has been going on for months or years, depending on how you want to count it. Think it has something to do with the array of blood pressure meds I’m on, but I’m not sure. Went through the whole stress test/EKG/bloodwork etc. maybe 9 or 10 months ago, and they seem to think I was fine. Yet, here I am, dragging around, falling asleep in the middle of the day, getting woolly-headed (a particularly discouraging thing for a guy who lives in his own head as much as I do), feeling generally weak and tired. Tasks both physical and mental that I used to throw myself at now seem to wear me out promptly or too difficult to even try.

However: Never give up! Never surrender!

So I think I’ll try, again, to muscle through it and see how it goes. Put on a hat, bring a big pitcher of water, and do it. Wish me luck.

It should be more like 90F by the time I get started. Balmy!

 

Update of the Random Sort

Last night, the lovely Mrs. YardsaleoftheMind and I went out for dinner. This is not all that remarkable in and of itself, but there’s a story:

A few months ago, we arranged an anniversary getaway to a cabin at Elim Grove attached to Raymond’s Bakery, in Cazadero near where the Russian River enters the Pacific. We highly recommend it if you find yourself looking for a B&B among the redwoods only a couple hours from San Francisco. Our dear son thought he’d send us out to dinner, so he searched for nearby restaurants, and set us up with reservations at El Paseo in Mill Valley

This was a lovely and kind thought. However, while Mill Valley is not all that far from Cazadero as the crow flies, it’s over an hour away as the car drives. Our dear son, who has not driven that area, would not know this.

I did not check this out before we left. So, after having driven the couple hours up to the cabin, we find out there’s no practical way to make it back down to Mill Valley that evening for dinner. We had to postpone it. Until yesterday evening.

The 40 mile drive from Concord to Mill Valley takes anywhere from just under an hour to an hour and a half or more depending on traffic. Bay Area traffic can be and often is evil, so we left in plenty of time to spare. And got there in a little over an hour.

With time to kill, we walked around beautiful, quaint and well-moneyed Mill Valley, a old city nestled in the Marin hills, beloved by hippies, former hippies and would-be hippies with money. That odd and frankly crazy blend of wealth and counter-culture that characterizes much of California’s self image is nowhere better expressed than here. Just as the hippies aged into the Greed is Good crowd on Wall Street in the 80s while somehow still imagining that they were not The Man to whom they had lately imagined they were sticking it, elderly boomers with millions grab will grab an organic frozen yogurt here and browse the boutiques for natural hemp clothing and handmade South American art. Their high priced lawyers will be engaged to sue to prevent some other resident’s latest act of architectural self-expression interfering with the view. And so on, after the manner of their kind. But it sure is beautiful and quaint – great place to stoll and grab dinner!

As we headed up Blythe (one of the main drags) we spotted an enormous, ugly church, which I immediately would have bet money on being Catholic. Sadly, I was right.

This picture of Our Lady of Mt. Carmel is very flattering. Built in 1968. The 60s live in Mill Valley in many ways.

The Lord’s ways are not our ways, it is always good to keep in mind. We walked up and tried the door – locked. As we walked around the building, we tried the various side doors. Finally, on the far left, the last door was open! We went inside to look around.

One woman knelt in the middle section of pews, but otherwise the church was empty. Coming in at a weird angle far off to one side, it took me a minute to notice the monstrance atop the tabernacle – Adoration was in progress! All the sudden, that became a very beautiful church!

We knelt and prayed for a bit, then took a look around. I walked past the lady in the pews, who smiled and whispered, asking how I knew Adoration was being held – I told her we didn’t know, just lucked into it. She said they were doing an all night Adoration.

As we left, another woman was arriving. God bless them – and I’m sure He does! – for being there for Him. How beautiful that these parishioners keep this devotion.

As we headed out, I noticed the epiphany chalk inscription above the door of what appeared to be the rectory. Cool! So, whatever the architectural and artistic limitation, the people at Our Lady of Mt. Carmel seem intent on keeping the faith. God bless them all!

We descended down to our dinner. El Paseo is heavy on the quaint in keeping with Mill Valley city ordinances no doubt, set back from the street accessible via a brick passage and pateo and ensconced in an old brick building. Sammy Hagar, who you might have heard of and who fits in marvelously with the overall 60s sort of vibe of Mill Valley, bought and renovated the restaurant some years ago. I honored him by refusing to drive 55 on our way there and back.

All in all, a lovely evening was had by my beloved and me. The food and service were excellent, and Mill Valley is still beautiful. Our son’s kind deed was finally realized.