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Here is Pagels, explaining the real reason why the leaders of the early Church preached that Christ had risen bodily from the dead:

When we examine its practical effect on the Christian movement, we can see … that the doctrine of bodily resurrection also serves an essential political function: it legitimizes the authority of certain men who claim to exercise exclusive leadership over the churches as the successors of the apostle Peter. From the second century, the doctrine has served to validate the apostolic succession of bishops, the basis of papal authority to this day. Whatever we think of the historicity of the orthodox account, we can admire its ingenuity.

Following this cui bono style of reasoning, “we” soon discover a darkly political motive behind Christianity’s insistence on monotheism as well: “The doctrine of the ‘one God’ confirms, for orthodox Christians, the emerging institution of the ‘one bishop’ as monarch (‘ sole ruler’) of the church.” (As though there were no other reason for a faith founded by a Jewish messiah to insist on monotheism.) And then “we” can trace this consolidation of apostolic power backward to its likely source— none other than Simon Peter himself, whom Pagels insinuates invented both the resurrection story itself and the idea that he was to lead the disciples after Christ’s departure.

A somewhat less paranoid reader might wonder why, if the gospel accounts were really written to consolidate Petrine authority, Peter comes off as such an epic bumbler— and at the crucial hour even a kind of betrayer— throughout all four canonical texts. But Pagels is convinced that her reading of the gospels has delivered the true story of orthodoxy’s origins— a story which reveals that the leaders of first-century Christianity, while shepherding a persecuted and despised sect that courted martyrdom and expected the apocalypse, somehow found time to carefully construct their theology with an eye toward the day when their heirs would sit in the Vatican issuing anathemas.

To say that these kinds of briefs are unpersuasive is to understate the case. They speak the language of the conspiratorial pamphlet, the paranoid chain e-mail— or the paperback thriller.

— Ross Douthat, Bad Religion: How We Became a Nation of Heretics 

(Cross-posted from my medical Facebook page)

“Doctors are men who prescribe medicines of which they know little, to cure diseases of which they know less, in human beings of whom they know nothing.”

So said Voltaire.

While this is overstated (even in the 1700s when he wrote this and when medicine was indeed an infant science), there are times—more often than we would like—when our doctor doesn’t exactly know what’s going on.

The human body is an incredibly complex system. And while modern science has worked out a good deal of how it operates, and modern medicine has unravelled the mysteries behind many diseases and developed treatments for many of them, there is still a lot that is unknown.

Sometimes you will develop a symptom that will cause your physician’s forehead to wrinkle.

“I not sure what’s going on,” she will say.

Those words can be frustrating for a patient. Patients like certainty. We want to know the exact cause of that twinge in our leg or that tingling sensation around our belly button. However, sometimes, even after a careful history, examination, and appropriate investigations, the cause will remain elusive.

There are different ways that you might respond to this admission of uncertainty.

One is to give up on the physician who doesn’t seem to know what’s going on and to seek out another physician or another healthcare provider (naturopath, homeopath, etc.) who exudes more confidence, who offers concrete answers without hesitation.

While there will certainly be other physicians and healthcare providers with greater knowledge and expertise, sometimes the perceived confidence is actually over-cofidence.

In his book Thinking Fast and Slow, Daniel Kahneman points out, “A study of patients who died in the ICU compared autopsy results with the diagnosis that physicians had provided while the patients were still alive. Physicians also reported their confidence. The result: ‘clinicians who were ‘completely certain’ of the diagnosis antemortem were wrong 40% of the time.’”

He goes on: “Expert overconfidence is encouraged by their clients: ‘Generally, it is considered a weakness and a sign of vulnerability for clinicians to appear unsure. Confidence is valued over uncertainty and there is a prevailing censure against disclosing uncertainty to patients.’”

While you may gravitate to a healthcare provider who radiates unrestrained confidence and certainty, you should be cautious. As Sam Harris has pointed out, “The less competent a person is in a given domain, the more he will tend to overestimate his abilities. This often produces an ugly marriage of confidence and ignorance that is very difficult to correct for.”

Another response to the admission of uncertainty may be to insist on getting more tests. Perhaps a PET scan or another set of nerve conduction studies or another batch of bloodwork will make it all clear. However, there are downsides to over-investigating.

Investigations can have risks. For instance, repeated CT scans can increase the risk of developing a cancer. Colonoscopies can occasionally result in a bowel perforation.

Investigations can also reveal incidental but inconsequential findings that trigger further diagnostic cascades. For example, a CT scan of the chest might show an incidental thyroid nodule that then gets an ultrasound, and then a fine needle biopsy, and then a core biopsy, which often ends up being benign. But this string of investigations may not be benign, as it can be time-consuming and worry-inducing.

Investigations can also lead to red herrings. In the evaluation of back pain, an MRI of your spine might show a bulging disc. You and your physician may falsely attribute your symptoms to this “abnormality” when in many cases, it is an unrelated and unimportant finding. If you perform a spine MRI of healthy patients with no symptoms, you will find plenty of bulging discs, but none of them are causing any symptoms. Such red herrings can lead to inappropriate and ineffective treatment.

So what might be a better response to your physician’s admission of uncertainty?

You could ask, “Do you think that there is anything worrisome going on?” If your physician has done an appropriate evaluation and is not concerned about something sinister, ask yourself if the symptom is bothersome to you or affecting your functioning. If not, then perhaps just leave it alone. If it is bothersome, you can ask, “Do you think there is another care provider who could provide more clarity?”

When I run into a perplexing symptom presentation, but am satisfied that there is nothing ominous or concerning, I frequently find myself echoing a phrase that I heard from one of my teachers in medical school:

“I’m not precisely sure what is going on, but I don’t see any red flags. This will probably either go away on its own, or it will evolve and will declare itself. Then we’ll know what’s going on.”

Accepting uncertainty can be difficult, but sometimes it’s the best thing to do.

The limits of secular reason, the ordinary experience of transcendence in the arts, and the extraordinary experiences that rend the secular frames even of hardened atheists— all of these explain why religious belief keeps reasserting itself even in the heart of the secular West.

Actually, it is quite natural to human beings to move toward belief in God. As humanities scholar Mark Lilla has written: “To most humans, curiosity about higher things comes naturally, it’s indifference to them that must be learned.” Strict secularism holds that people are only physical entities without souls, that when loved ones die they simply cease to exist, that sensations of love and beauty are just neurological-chemical events, that there is no right or wrong outside of what we in our minds determine and choose. Those positions are at the very least deeply counterintuitive for nearly all people, and large swaths of humanity will continue to simply reject them as impossible to believe.

Many ask: Why do people feel they need religion? Perhaps now we see that the way this question is phrased doesn’t explain the persistence of faith. People believe in God not merely because they feel some emotional need, but because it makes sense of what they see and experience. Indeed, we have seen that many thoughtful people are drawn toward belief somewhat unwillingly. They embrace religion because they think it is more fully true to the facts of human existence than secularism is.

— Timothy Keller, Making Sense of God: An Invitation to the Skeptical 

Not only were things invested with significance in the premodern imaginary, but the social bond itself was enchanted, sacred. “Living in the enchanted, porous world of our ancestors was inherently living socially” (p. 42). The good of a common weal is a collective good, dependent upon the social rituals of the community. “So we’re all in this together.” As a result, a premium is placed on consensus, and “turning ‘heretic’ ” is “not just a personal matter.” That is, there is no room for these matters to be ones of “private” preference. “This is something we constantly tend to forget,” Taylor notes, “when we look back condescendingly on the intolerance of earlier ages. As long as the common weal is bound up in collectives rites, devotions, allegiances, it couldn’t be seen just as an individual’s own business that he break ranks, even less that he blaspheme or try to desecrate the rite. There was immense common motivation to bring him back into line” (p. 42). Individual disbelief is not a private option we can grant to heretics to pursue on weekends; to the contrary, disbelief has communal repercussions.

— Smith, James K. A.. How (Not) to Be Secular 

The aim of science is not to open the door to infinite wisdom, but to set a limit to infinite error.

— Bertolt Brecht

Indeed, given how much attention has been lavished on the supposed revelatory content of the lost gospels, it’s remarkable just how shabby and second-rate many of them turn out to be. To read them all back to back to back, in a collection like Ehrman’s Lost Christianities, is to feel curiosity give way to disappointment, and then to boredom. There are flashes of eloquence and insight, but as a general rule, the rival gospels are derivative in their substance, inferior in their art, and tedious in their embellishments. Some of their Jesuses are clearly just fairy-tale heroes, and the rest either make Jesus a flatter character than the Christ of the canonical gospels, or else (in the case of certain Gnostic texts) portray him as irritating and even repellent, dripping with smug disdain and spiritual elitism—“ like the ruler of a dubious planet in Star Trek,” as Gopnik memorably put it.

If the gospels and the letters of Saint Paul didn’t make such extraordinary claims about Jesus’ miracles, his resurrection, and his divinity, it’s hard to imagine that many modern historians would spend much time parsing second-century apocrypha for clues about the “real” Jesus. The gospel of Thomas might attract some modest attention, but the later “lost gospels,” very little. For the most part, the argument over how the Nazarene lived and died would revolve around competing interpretations of the existing Christian canon, and the rough accuracy of the synoptic narrative would be accepted by the vast majority of scholars.

In the event, the synoptic gospels and Saint Paul’s epistles do make extraordinary claims, and modern scholars have every right to read them with a skeptical eye, question their reliability, and parse them stringently for propaganda and mythologizing. But if you downgrade the earliest Christian documents or try to bracket them entirely, the documentary evidence that’s left is too intensely unreliable (dated, fragmentary, obviously mythological) to serve as the basis for anything save interesting fictions and speculative forays. In this landscape, historical analysis can only deconstruct; it cannot successfully rebuild.

There’s nothing necessarily wrong with deconstruction. But if we’re honest with ourselves, we need to acknowledge where it leads— not to the beginning of a fruitful quest for the Jesus of history but to its end.

— Ross Douthat, Bad Religion: How We Became a Nation of Heretics

(Cross-posted from my medical Facebook page)

Suppose you just can’t shake that nagging ache in your knees, so you see a doctor about it. He advises that it is due to osteoarthritis and suggests you take some Ibuprofen.

You do, and while your knees start to feel better, you begin to have an upset stomach. You go back to the doctor, and he suggests that you take Omeprazole a stomach pill to help decrease acid and the discomfort from the Ibuprofen.

Off hand, he decides to check your blood pressure, and what do you know? It’s higher than it usually is. (Unbeknownst to you, this is also due to the Ibuprofen). So he also gives you a prescription for the blood pressure pill Amlodipine, which you dutifully fill.

But over the coming weeks, you get more and more swelling of your legs. So once again, you’re off to see the doctor. The first doctor isn’t available, so you see someone else. She gives you the water pill Furosemide.

It helps a bit…

But now you find yourself having a harder time controlling your bladder, and you feel a little bit weak.

You’re off to see another doctor. She decides to get some bloodwork and discovers that your potassium is low (from the water pill) and your Vitamin B12 is also low (from the stomach pill), so she prescribes you both a potassium and B12 supplement.

Being the conscientious patient that you are, you take both, but you find that now you’re getting nauseous (from the potassium supplement), and you’re still having a hard time getting to the bathroom on time with your urinary urgency (again from the water pill).

Yet another doctor’s visit, and yet another prescription to fix that!

You come away with two new prescriptions—Gravol for nausea and Oxybutynin for urge incontinence.

But then people start to notice that you’re just not yourself. You seem more confused, forgetful, less steady on your feet, less alert during the day, and sometimes agitated at night.

Your family hauls you off to another doctor. Before he gives you a prescription for Risperidone, a sensible medical student intervenes and asks if this mild delirium might be due to any new medication.

You admit that, yes, you have been put on several new medications in recent months. The intern looks over your pharmacy records, and carefully traces her way back through the dizzying pathway of side effects and new medications, and puts a stop to the whole prescribing cascade.

This example is a bit dramatic, but hopefully it serves to highlight two important points:

1) Medications often have side effects, and too often our default is to treat side effects with further medications, which in turn can have their own side effects. This can initiate a prescribing cascade that can turn you into a walking pharmacy. The more medications you are on, the higher the risk of interactions between medications and still further side effects.

2) Seeing multiple physicians makes it more likely to get caught in a prescribing cascade. A new physician is looking at a new symptom with a different set of eyes and may not be as likely to think of a medication change as the culprit.

The next time you have some new sustained symptoms, it might be reasonable to ask yourself and your doctor if it could be related to new medication—prescription or over-the-counter. This simple question might keep you off (or get you off) a prescribing cascade.

(This particular prescribing cascade was an example from a lecture I attended several years ago on Polypharmacy in the Elderly. I wish I could remember who the speaker was, so I could give him/her credit!)