Archive for the ‘History’ Category

A meta-subject

I regard history as the single most important idea for our youth to take with them into the future. I call it an idea rather than a subject because every subject has a history, and its history is an integral part of the subject. History, we might say, is a meta-subject. No one can claim adequate knowledge of a subject unless one knows how such knowledge came to be. I would, of course, favor “history” courses (let us say, in American history), although I have always thought such courses ought to be called “histories” so that our youth would understand that what once happened has been seen from different points of view, by different people, each with a different story to tell.

— Neil Postman, Building a Bridge to the 18th Century: How the Past Can Improve Our Future

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The authors of the New Testament texts, most evangelicals believe, laid down all that Christians needed to know as a theological starting point and sent subsequent generations of believers forward with that knowledge and direction. They also modeled the substantial beginnings of believers working out what the gospel means in a particular sociohistorical context. All of that is absolutely crucial. But it is not the same as their having understood and worked out all the long-term implications of the gospel for theological knowledge, human life, and society. That they began. But their work was continued and developed in new ways by generations of Christians after the New Testament era, up until today.

What do I mean by this? For one thing, the authors of the New Testament did not fully work out precisely articulated doctrines of God and Christ. In fact, it took more than three hundred and fifty years after the death of the apostles to work out orthodox, catholic, christological, and trinitarian doctrines, which most evangelicals still affirm as theologically nonnegotiable today. That was done primarily at the ecumenical councils of Nicaea (AD 325), Constantinople (AD 381), Ephesus (AD 431), and Chalcedon (AD 451)—and, of course, in the theological wrangling that happened between those councils. The truths of the orthodox and catholic doctrines expressed in the decrees and creeds that resulted from those councils were located in the writings of the Bible. Scripture was a primary reference of the bishops and theologians who conducted the councils.

But—in the context of threatening misunderstandings and heresies in the early church—those biblical truths needed to be drawn out and very carefully formulated in doctrinal statements. What was embryonic in scripture needed to develop and grow into a more mature theological expression of what was there all along.

Take another example of the historical unfolding of the full meaning of the gospel for social relations: the authors of the New Testament did not understand and work out the clear moral implications of the gospel for the moral issue of slavery. They were, like all humans, limited in time, place, and range of vision. So for them, slavery was an unalterable fact of life and the gospel meant primarily that slaves should submit to their masters and masters should treat their slaves well (e.g., 1 Cor. 7:20–22; Eph. 6:5–9; 1 Tim. 6:1–2; Titus 2:9–10; 1 Pet. 2:18–19). At the same time, even during the apostolic era the gospel began to plant seeds of eventual emancipation, in the form of the then-radical idea that slaves and masters were equals and brothers in Christ (e.g., 1 Cor. 12:12–13; Gal. 3:28; Col. 3:11; Philem. 1:15–17), and indirectly through the theological equation of slavery with sin (e.g., John 8:34; Rom. 6:6; 7:14; 8:15; Gal. 4:3; 5:1).

But for those seeds to germinate and grow—that is, for believers to realize that the gospel, when elaborated, actually means the end of slavery—took a long time and a lot of struggle.

— Christian Smith, The Bible Made Impossible

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In the following months my father discovered that his reputation had been made by this therapeutic triumph. The word was out, all over town, that that new doctor, Thomas, had gifts beyond his own knowledge—this last because of my father’s outraged protests that his Blaud’s pills could have had nothing whatever to do with recovery from bloody urine. The man had probably passed a silent kidney stone and that was all there was to it, said my father. But he had already gained the reputation of a healer, and it grew through all the years of his practice, and there was nothing he could do about it.

Even now, twenty—five years after his death, I meet people from time to time who lived once in Flushing, or whose parents lived there, and I hear the same anecdotes about his abilities: children with meningitis or rheumatic fever whose lives had been saved by him, patients with pneumonia who had recovered under his care, even people with incurable endocarditis, overwhelming typhoid fever, peritonitis, what-all.

But the same stories are told about any good, hardworking general practitioner of that day. Patients do get better, some of them anyway, from even the worst diseases; there are very few illnesses, like rabies, that kill all comers. Most of them tend to kill some patients and spare others, and if you are one of the lucky ones and have also had at hand a steady, knowledgeable doctor, you become convinced that the doctor saved you. My father’s early instructions to me, sitting in the front of his car on his rounds, were that I should be careful not to believe this of myself if I became a doctor.

— Lewis Thomas, The Youngest Science

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In the big picture, technology offers us many benefits, but with one major pitfall: isolation. Isolation is both the promise and the price of technological advance. “The problem is that we invite loneliness, even though it makes us miserable,” writes author Stephen Marche. “The history of our use of technology is a history of isolation desired and achieved.”

The long story of isolation desired and achieved is retold by Giles Slade in his book The Big Disconnect: The Story of Technology and Loneliness. There he shows how many strands of technology and loneliness have been woven together in the history of various innovations, from street peddlers and phones to television and music.

As technology improves, machines replace people and automation replaces interaction. Street vendors gave way to vending machines. Fresh milk deliveries gave way to dairy products preserved in refrigerators. Bankers gave way to ATMs. Two hundred years ago, laborers were personally acquainted with their clients. In today’s technological society, many laborers work in remote locations, in industrial or business parks, serving faceless clients or nameless consumers from whom they are separated geographically or by a very long production chain.

Physically, we are drawn apart by other factors. Gathering around a fire gave way to central heating, which pushes heat to all the corners of the house. Gathering together for the local news at a pub gave way to the reading of newspapers, creating a paper wall shielding our faces from one another.

Isolation was later deepened by advances in video. The community cinema gave way to a large shared television in each family’s home, which gave way to portable televisions, and now to personal LED TVs in every bedroom.

When it comes to music, this technological trajectory is even clearer. Attending a live orchestra performance on a Saturday evening was, for many people, replaced by the stationary phonograph (or record player) in the family room, which was replaced by a large transistor radio, which was replaced by a portable transistor radio, which was replaced by a boom box with open speakers carried on the shoulder, which was replaced by a Walkman clipped to the belt, which was replaced by a tiny iPod clipped to the sleeve. Music went from a social community experience to a shared family experience to a private earbud experience. Technology is always drawing us apart, by design. Our isolation is desired and achieved.

— Tony Reinke, 12 Ways Your Phone Is Changing You 

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It is not enough for the skeptic, then, to simply dismiss the Christian teaching about the resurrection of Jesus by saying, “It just couldn’t have happened.” He or she must face and answer all these historical questions: Why did Christianity emerge so rapidly, with such power? No other band of messianic followers in that era concluded their leader was raised from the dead—why did this group do so? No group of Jews ever worshipped a human being as God. What led them to do it? Jews did not believe in divine men or individual resurrections. What changed their worldview virtually overnight? How do you account for the hundreds of eyewitnesses to the resurrection who lived on for decades and publicly maintained their testimony, eventually giving their lives for their belief?

Nothing in history can be proven the way we can prove something in a laboratory. However, the resurrection of Jesus is a historical fact much more fully attested to than most other events of ancient history we take for granted. Every effort to account for the birth of the church apart from Jesus’s resurrection flies in the face of what we know about first-century history and culture. If you don’t short-circuit the process with the philosophical bias against the possibility of miracle, the resurrection of Jesus has the most evidence for it.

— Timothy Keller, The Reason for God: Belief in an Age of Skepticism 

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One dickens of a motivator

I know this goes without saying, but Stonehenge really was the most incredible accomplishment. It took five hundred men just to pull each sarsen, plus a hundred more to dash around positioning the rollers. Just think about it for a minute. Can you imagine trying to talk six hundred people into helping you drag a fifty-ton stone eighteen miles across the countryside and muscle it into an upright position, and then saying, “Right, lads! Another twenty like that, plus some lintels and maybe a couple of dozen nice bluestones from Wales, and we can party!” Whoever was the person behind Stonehenge was one dickens of a motivator, I’ll tell you that.

— Bill Bryson, Notes from a Small Island 

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(Cross posted from my medical Facebook page)

It’s not infrequent to hear this type of exasperated complaint.

“Years ago, my doctor told me to lay my infant on her back to sleep. Then a few years later with my next kid, I was to lay him on his front. And now you’re telling me to lay them on their back. Can’t you guys make up your mind?

Or “I thought you said I shouldn’t eat eggs because of the cholesterol, and now you say that I can? Are you sure you know what you’re talking about?”

Or “My last doctor told me I should take a baby Aspirin to help prevent heart attacks, and now you’re telling me I shouldn’t. Why is medicine always changing its mind?”

It’s true. Medicine has issued a broad range of advice and recommendations that it later went on to retract (and then, perplexingly, sometimes to reassert). This waffling, this flip-flopping of opinion is often frustrating for patients.

And even a glance through a volume of the history of medicine can be disquieting to say the least. Widely employed treatments from bloodletting to trephination were advocated by physicians of the day with a confidence that staggers imagination.

During my training, I came across a fascinating article that summarised the peculiar and often frightening history of reviving newborn babies. I’ll offer one of the more astonishing paragraphs:

“Techniques advocated and used to resuscitate newborns during this period [mid to late 1800s] included: swinging the infant upside down; squeezing the chest; … rhythmic traction of the tongue; tickling the chest, mouth, or throat; yelling; shaking; dilating the rectum using a raven’s beak or a corn cob; immersion in cold water, sometimes alternating with immersion in hot water; rubbing, slapping, and pinching; electric shocks; nebulisation of brandy mist; insufflation of tobacco smoke into the rectum.”

Some patients today may, perhaps not unjustly, wonder which of their current medications, in centuries hence, will be regarded as the equivalent of a raven’s beak suppository.

Certainly, medicine’s dubious history and the flip-flopping of today’s physicians cast a long enough shadow to perhaps undermine a patient’s confidence in the enterprise of medicine as a whole.

However, seen from another perspective, medicine’s frequent changing of position—its retractions and revisions—is profoundly, if paradoxically, comforting. It shows that medicine is tireless in its quest for improvement. Instead of uncritically accepting the inherited teaching, it is willing to question, to scrutinize, to upend the conventional wisdom when new evidence demands. And this initiative springs from its own ranks.

Modern medicine is by nature self-critical and self-corrective, which unfortunately cannot be said of some other institutions and enterprises.

It takes time for data to be collected and analyzed, and sometimes the initial conclusions that are drawn from available data sets seem justified, but are later revised because the initial data were, if not inaccurate, at least incomplete.

Sometimes medicine flip-flops its position because the initial analysis of the data was faulty. For instance, for many years the medical literature suggested that moderate coffee consumption was associated with increased risk of death and cardiovascular disease. However, it was subsequently discovered that an underlying confounder hadn’t been taken into consideration: coffee drinkers are more likely to be smokers than non-coffee drinkers. When this confounder was identified and weeded out, subsequent analysis and studies showed that moderate coffee consumption (3-5 cups per day) was not only not associated with increased risk of death but actually associated with lower risk of death, heart attack, and stroke. While the data can’t convincingly say that the coffee is itself the protective factor (the studies just show correlation, not causation), it is certainly reassuring for someone like me who enjoys his daily joe.

Yes, the shifting of opinion, the waffling, the flip-flopping, the retractions, the revisions are understandably frustrating. However, they represent an underlying commitment to progress, a willingness to admit error, and a dogged pursuit of the truth that actually give me more—not less—confidence in modern medicine.

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