Wednesday, September 30, 2020

Do for yourself with Love


Child of mine, I will never do for you that which I know you can do for yourself. I will never rob you of an opportunity to show yourself your ability and talent. I will see you at all times as the capable, effective, powerful creator that you've come forth to be. And I will stand back as your most avid cheerleading section. But I will not do for you that which you have intended to do for yourself. Anything you need from me, ask. I'm always here to compliment or assist. I am here to encourage your growth, not to justify my experience through you.


~A.

Laminectomy: Conditions Treated, Procedure Details, Risks & Recovery

Laminectomy: Conditions Treated, Procedure Details, Risks & Recovery

Laminectomy

What is a laminectomy?

Laminectomy is the surgical removal of a bony area of the spine called the lamina. The lamina is the back part of each vertebra of your spine and forms the back wall of your spinal canal. Your spinal cord runs through your spinal canal in the center of your vertebrae. Certain conditions of the spine can compress the spinal cord and cause pain. A laminectomy can relieve pressure in your spinal canal and on spinal nerves by opening up your spinal canal. This surgery is also known as decompressive laminectomy.

The word laminectomy is often used interchangeably with laminotomy. However, laminectomy is the removal of most of the lamina, while laminotomy is the removal of part of the lamina.

Laminectomy is an alternative to laminoplasty. Laminoplasty hinges the lamina like a door to create more space in your spinal canal without removing the lamina. However, because a laminectomy removes more bone, it may increase the need for spinal fusion, which can limit the movement of your spine.

Laminectomy is a common but major surgery with significant risks and potential complications. You may have less invasive treatment options available. Consider getting a second opinion about all of your treatment choices before having a laminectomy.

Types of laminectomy

When laminectomy involves one vertebra, it is called single level. When it involves more than one vertebra, it is called multilevel.

The types of laminectomy procedures include:

  • Cervical laminectomy is the removal of lamina in the neck area (cervical spine).

  • Lumbar laminectomy is the removal of lamina in the lower back (lumbar spine).

  • Sacral laminectomy is the removal of lamina in the back between your pelvic, or hip bones (sacral spine).

  • Thoracic laminectomy is the removal of lamina in the middle part of the back (thoracic spine).

Other procedures that may be performed

Your doctor may perform one or more other procedures in addition to a laminectomy:

  • Discectomy is the surgical removal of part or all of a spinal disc. A discectomy treats degenerated, herniated or ruptured spinal discs.

  • Foraminotomy is the widening of the opening where the nerve roots leave the spinal canal. Your doctor may use this procedure when the opening (foramina) is narrowed causing pressure on the spinal nerves.

  • Spinal fusion is the permanent joining together of two vertebrae. This procedure permanently stops movement between the two vertebrae and limits the motion of your spine. Spinal fusion is usually needed with multilevel laminectomy to stabilize your spine.

Why is a laminectomy performed?

Your doctor may recommend a laminectomy to treat a variety of diseases and conditions of the spine.

Your doctor may only consider a laminectomy if other treatment options with less risk of complications are not working. Ask your doctor about all of your treatment options and consider getting a second opinion.

Your doctor may recommend laminectomy when you have spinal cord compression with symptoms of myelopathy or spinal stenosis. Myelopathy is impaired function of the spinal cord. Symptoms include weakness, pain, numbness, clumsiness, poor balance, difficulty walking, and stiffness in the extremities. The goal of laminectomy is to relieve spinal pressure to stop myelopathy progression and allow healing.

Laminectomy relieves pressure on your spinal cord. However, completely removing the lamina makes your spine less stable. This increases the need for spinal fusion and the resulting loss of movement.

Your doctor may recommend laminectomy for persistent spinal or leg pain or other symptoms caused by:

  • Bone spurs, abnormal growths of bone on a vertebra, which can lead to compression of the spinal cord and nerves

  • Degenerative disc disease, a breakdown of the cushioning discs between the vertebrae, which can lead to compression of the spinal cord and nerves

  • Herniated spinal disc, displacement of the cushioning disc between the vertebrae

  • Sciatica, pain that runs down the buttock and leg due to compression of a nerve in the lower back

  • Spinal stenosis, a narrowing of the spinal column causing pressure on the spinal cord and nerves

  • Spondylosis, also called spinal osteoarthritis, which is caused by wear and tear on the discs in your spine

Who performs a laminectomy?

An orthopedic surgeon or a neurosurgeon will lead a surgical team to perform your laminectomy. Orthopedic surgeons specialize in the surgical treatment of diseases and conditions of the muscles and bones, including the spine. Neurosurgeons specialize in the surgical treatment of diseases and conditions of the nervous system, including the nerves of the spine.

How is a laminectomy performed?

Your surgeon will perform your laminectomy by taking out the lamina, the back part of your vertebra. This relieves pressure in your spinal canal or on the spinal nerves in your neck or back. A laminectomy is performed in a hospital or surgical center.

Surgical approaches to laminectomy

Laminectomy is performed using one of the following approaches:

  • Microlaminectomy is a minimally invasive procedure. It involves inserting special instruments and an arthroscope through small incisions in your back or neck. An arthroscope is a thin, lighted camera that transmits pictures of the inside of your body to a video screen viewed by your surgeon as he or she performs the surgery. Microlaminectomy generally involves a faster recovery and less pain. This is because it causes less damage to tissues and organs. Your surgeon will make small incisions instead of a larger one used in open surgery. He or she can then thread surgical tools around muscles and other structures instead of cutting through or displacing them as in open surgery.

  • Open surgery uses a large incision in your back or neck over the affected vertebra. The length of the incision will depend on how many vertebrae need treatment. Open surgery allows your surgeon to directly view and access the surgical area. Open surgery requires a larger incision and involves more cutting and displacement of muscle and other tissues. Open surgery generally involves a longer recovery and more pain than minimally invasive surgery because it causes more trauma to tissues. Despite the potential for damage, open surgery may be a safer or more effective method for certain patients.

Your surgeon will determine which type of laminectomy is best for you and how long you need to stay in the hospital or surgical center based on a variety of factors. These include your diagnosis, age, medical history, general health, and possibly your personal preference. Learn about the different laminectomy procedures and ask why your surgeon will use a particular type of procedure for you.
Types of anesthesia that may be used

Your surgeon will perform your laminectomy using either regional anesthesia or general anesthesia.

  • General anesthesia is a combination of intravenous (IV) medications and gases that put you in a deep sleep. You are unaware of the procedure and will not feel any pain. You may receive a peripheral nerve block infusion in addition to general anesthesia. A peripheral nerve block infusion is an injection or continuous drip of a liquid anesthetic. The anesthetic flows through a tiny tube inserted near your surgical site to control pain during and after surgery.

  • Regional anesthesia is also known as a nerve block. It involves injecting an anesthetic around the nerves in the spine that transmit pain signals from the surgical area. You will likely have sedation with regional anesthesia to keep you relaxed and comfortable.

What to expect the day of your laminectomy

The day of your surgery, you can generally expect to:

  • Talk with a preoperative nurse. The nurse will perform an exam and ensure that all needed tests are in order. The nurse can also answer questions and will make sure that you understand and sign the surgical consent.

  • Remove all clothing and jewelry and dress in a hospital gown. It is a good idea to leave all jewelry and valuables at home or with a family member if possible. The surgical team will give you blankets for modesty and warmth.

  • Talk with the anesthesiologist or nurse anesthetist about your medical history and the type of anesthesia you will receive.

  • A surgical team member will start an IV.

  • The anesthesiologist or nurse anesthetist will start your anesthesia.

  • A tube will be placed in your windpipe to protect and control your breathing during general anesthesia. You will not feel or remember this or the surgery as they happen.

  • The surgical team will monitor your vital signs and other critical body functions. This occurs throughout the procedure and recovery until you are alert, breathing effectively, and your vital signs are stable.

What are the risks and potential complications of a laminectomy?

As with all surgeries, a laminectomy involves risks and potential complications. Complications may become serious and life threatening in some cases. Complications can develop during the procedure or throughout your recovery.

General risks of surgery

The general risks of surgical procedures include:

Potential complications of laminectomy

Complications of laminectomy can be serious and include:

  • Bone infection of the vertebra

  • Injury to the esophagus or intestines

  • Nerve and blood vessel damage

  • No pain relief or little pain relief following surgery

  • Recurrent symptoms, including back and leg pain

  • Spinal nerve injuries causing weakness, numbness or pain

Reducing your risk of complications

You can reduce the risk of certain complications by following your treatment plan and:

  • Following activity, dietary and lifestyle restrictions and recommendations before surgery and during recovery

  • Notifying your doctor immediately of any concerns, such as bleeding, fever, increase in pain, or wound redness, swelling or drainage

  • Taking your medications exactly as directed

  • Telling all members of your care team if you have any allergies

How do I prepare for my laminectomy?

You are an important member of your own healthcare team. The steps you take before surgery can improve your outcome after the procedure. You can prepare for a laminectomy by:

  • Answering all questions about your medical history and medications you take. This includes prescriptions, over-the-counter drugs, herbal treatments, and vitamins. It is a good idea to carry a current list of your medical conditions, medications, and allergies at all times.

  • Getting preoperative testing as directed. Testing varies depending on your age, health, and specific procedure. Preoperative testing may include a chest X-ray, EKG (electrocardiogram), blood tests, and other tests as needed.

  • Losing weight before the surgery through a healthy diet and exercise plan

  • Not eating or drinking just prior to surgery as directed. Your doctor may cancel your surgery if you eat or drink too close to the start of the procedure because you can choke on stomach contents during anesthesia.

  • Stopping smoking as soon as possible. Even quitting for just a few days can be beneficial and help the healing process.

  • Taking or stopping medications exactly as directed. For laminectomy, this may include not taking aspirin, ibuprofen (Advil, Motrin), and blood thinners.

Questions to ask your doctor

Facing surgery can be stressful. It is common for patients to forget some of their questions during their doctor's office visit. You may also think of other questions after your appointment. Contact your doctor with concerns and questions before surgery and between appointments. 

It is also a good idea to bring a list of questions to your preoperative appointments. Questions can include:

  • Why do I need a laminectomy? Are there any other options for treating my condition?

  • Which type of laminectomy will I need?

  • How long will the surgery take? When can I go home?

  • What kind of restrictions will I have after the surgery? When can I return to work and other activities?

  • What kind of assistance will I need at home?

  • What kind of rehabilitation program or physical therapy will I need?

  • What medications will I need before and after the surgery?

  • How will you manage my pain?

  • When should follow up with you?

  • How should I contact you? Ask for numbers to call during and after regular hours.

What can I expect after my laminectomy?

Knowing what to expect can help make your road to recovery after laminectomy as smooth as possible.

How long will it take to recover?

You will stay in the recovery room after surgery until you are alert, breathing effectively, and your vital signs are stable. In most cases, your care team will have you up and walking once you are alert. You may have a sore throat if a tube was placed in your windpipe during surgery. This is usually temporary, but tell your care team if you are uncomfortable.

Laminectomy may be an outpatient procedure in which you go home the same day. However, you may need to stay in the hospital for up to four days if you have both a laminectomy and spinal fusion.

Recovery after surgery is a gradual process. Recovery time varies depending on the specific procedure and type of anesthesia, your general health, age, and other factors. Your doctor will likely recommend a course of physical therapy to help you recover. Full recovery times range from four to six weeks.

Will I feel pain?

Pain control is important for healing and a smooth recovery. There will be discomfort after your surgery. Your doctor and care team will manage your pain so you are comfortable and can get the rest you need. Contact your doctor if your pain gets worse or changes because it may be a sign of a complication.

When should I call my doctor?

It is important to keep your follow-up appointments after a laminectomy. Call your doctor if you have questions or concerns between appointments. Call your doctor right away or seek immediate medical care if you have:

  • Bleeding

  • Breathing problems, such as shortness of breath, difficulty breathing, labored breathing, or wheezing

  • Change in alertness, such as passing out, dizziness, unresponsiveness, or confusion

  • Chest pain, chest tightness, chest pressure, or palpitations

  • Fever. A low-grade fever (lower than 101 degrees Fahrenheit) is common for a couple of days after surgery and not necessarily a sign of a surgical infection. However, you should follow your doctor's specific instructions about when to call for a fever.

  • Inability to urinate or have a bowel movement

  • Leg pain, redness or swelling, especially in the calf, which may indicate a blood clot

  • Pain that is not controlled by your pain medication, worsening pain, or pain that is different or occurs in a new area, such as in your arm or leg

  • Unexpected drainage, pus, redness, tenderness or swelling of your incision

  • Weakness, numbness or difficulty moving a part of your body

How might a laminectomy affect my everyday life?

Laminectomy may reduce your symptoms so you can lead an active, normal life. For example, laminectomy may relieve or lessen your back pain. However, laminectomy will not cure your spine problems or reverse permanent nerve damage caused by long-term spinal cord compression.

You can help prevent further spine problems by:

  • Following your doctor's instructions about how to move, walk, sit and stand

  • Maintaining a healthy lifestyle including an appropriate body weight

  • Practicing good posture

  • Strengthening your back and leg muscles with exercises as recommended by your healthcare provider

  • Using proper body mechanics when lifting or carrying objects

Good luck, Charles Williams


~A.

10 Essentials - MyMedic

https://mymedic.com/pages/10-essentials


~A.

Funeral Planning Checklist - AgingCare.com

Funeral Planning Checklist - AgingCare.com

Funeral Planning Checklist

Funeral planning is an emotional and often costly process that is surrounded by a great deal of uncertainty. While it is best to discuss end-of-life wishes with loved ones ahead of time, many people shy away from this difficult conversation or never get the chance to have it at all. Without some guidance, the options and information surrounding funerals and interment can quickly become overwhelming at an already trying time.

The following list outlines an array of goods, services and logistics that are often included in a traditional funeral and/or memorial service. Many of these items can be arranged and even paid for prior to death, lessening the strain on grieving family members. However, other items cannot be pre-arranged and must be seen to following a loved one's passing.

Common Steps to Planning a Funeral

Keep in mind that these guidelines are provided in no particular order. In fact, many of these are entirely optional but may be worth considering to ensure that nothing is overlooked in the funeral planning process.

  • Obtain legal pronouncement of death from an attending doctor or hospice nurse or call 911
  • Arrange transportation of the body to the funeral home (or coroner if an autopsy is required)
  • Arrange embalming and preparation of the body if desired
  • Compile information for the obituary
  • Choose a funeral home
  • Decide on the type of disposition (e.g., traditional burial, cremation, green burial, interment in a mausoleum)
  • Select a casket or cremation container
  • Select a grave marker and inscriptions
  • Identify a location for interment
  • Identify a location for the service
  • Decide on the type of service (e.g., memorial, wake, military service, Jewish ceremony, celebration of life)
  • Choose a florist and desired flower arrangements
  • Pick photos to be displayed at the service
  • Prepare any other displays, videos or memorabilia for use at the service
  • Write the obituary or select someone else to write it
  • Communicate the preference for flowers, donations to charitable organizations, or both in the obituary or death notices
  • Submit the obituary to selected newspapers
  • Pick funeral music or songs to be played/sung at the service
  • Select clothing for the deceased to wear
  • Choose passages to be read at the service (e.g., scripture, poems, other meaningful readings)
  • Purchase and compile photos for a memorial register or guest book
  • Purchase memorial cards
  • Create and print memorial folders or programs for the service
  • Arrange transportation to and from the service for family members
  • Coordinate transportation for the casket
  • Choose an officiant to lead the service (e.g., religious leader, family member, friend)
  • Decide who will perform the eulogy
  • Decide who will read the chosen passages
  • Choose pallbearers
  • Obtain death certificates (multiple copies)
  • Identify any burial benefits or services the deceased may be eligible for (e.g., veterans benefits, military honors, religious groups, fraternal organizations)
  • Obtain a burial permit (sometimes referred to as a permit for disposition)
  • Set a time and date for the service
  • Arrange any food or beverages to be served during or after the service

Locating Funeral Instructions

If a loved one has pre-arranged or pre-paid their funeral arrangements, it is important to locate this information and contact the funeral home they worked with. Encourage loved ones who are still alive to complete a letter of last instruction as part of their elder care planning process. A letter of instruction is a document that simplifies the communication of instructions and desires at the time of an individual's death. This will save the family from having to make many of the funeral decisions (because they've already been decided on) and may have a significant impact on the cost of funeral services.

Understanding Funeral Costs and Pricing

The Federal Trade Commission (FTC) has mandated that funeral homes must provide consumers with an itemized statement of all costs for the goods and services that they offer. This is called a General Price List (GPL). In addition, the law enables consumers to select and purchase only the goods and services they want, rather than having to accept an entire package deal.

Funeral costs can be divided into the following categories:

  • The Basic Service Fee

    This universal fee covers services common to all funerals, including the use of the funeral home, the services of the funeral director and funeral home attendants, coordinating burial arrangements with a cemetery or other third parties, securing permits and death certificates, etc.
  • Optional Service Charges

    These fees are assessed for optional services, which may include transporting the body, embalming, use of the funeral home for viewing (or wakes), use of a hearse or limousine, burial containers, cremation and interment.
  • Cash Disbursements

    This fee covers goods and services that the funeral home buys from other vendors on your behalf with your consent. It may include the purchase of flowers, clergy services, obituary notices, pallbearers, and other service providers like musicians or caterers. An additional service fee may be assessed by the funeral home for making arrangements with these third parties.

Remember that consumers have the right to research and compare funeral homes and request clear and accurate pricing information throughout the funeral planning process. To learn more about your rights as a consumer, visit the FTC Funeral Rule website.



~A.

Tuesday, September 29, 2020

Half a Million Sharks Will Die for a COVID-19 Vaccine

Half a Million Sharks Will Die for a COVID-19 Vaccine

Half a Million Sharks Will Die for a COVID-19 Vaccine

While research for a COVID-19 vaccine pushes forward, one casualty that no one's talking about is the death of 500,000 sharks, whose livers are used to make squalene, an ingredient in some of the vaccines.

The livers produce an oil that scientists emulsify in water to produce something called squalene. Squalene is used in vaccines as an adjuvant to "turbo-boost" immunogenicity and reduce the amount of viral antigen needed to make the vaccine work. In rats, squalene has been shown to trigger chronic immune system inflammation.

According to the New Zealand Herald, as many as 3 million sharks a year are already killed for existing vaccines. COVID-19 vaccine development trials are expected to cause the slaughter of another half-million to harvest the livers' oils — and conservationists are worried that this could push some shark species to the brink of extinction.

SOURCE: NZ Herald September 27, 2020



~A.

Monday, September 28, 2020

41 Best Breathable Face Masks for Running and Walking Outside | Vogue

41 Best Breathable Face Masks for Running and Walking Outside | Vogue

The 41 Breathable Face Masks To Shop Now

Image may contain Clothing Cap Baseball Cap Hat and Apparel

Wearing face masks in public has now become routine. After months of acclimating to the new normal, procuring breathable face masks for summer's hotter, more humid days feels pertinent now more than ever. Nobody wants to spend summer sweating under a mask, and it can get confusing to know which face coverings strike the right balance between breathability and safety. As it turns out, reaching for a too-thick mask in lieu of a more breathable option may be more harmful than helpful.

Dharushana Muthulingam, M.D., M.S., an infectious disease physician and public health researcher at Washington University in St. Louis, recommends cloth masks that find a happy medium between fabric density and comfortability for the summer months. "There is unfortunately an inverse relationship between protection and breathability," Muthulingam tells Vogue. "Generally, you don't want to see light between the fibers when you hold them up to the sun, but the mask should also be breathable, especially in warm months." While studies have shown that tightly woven cotton fabrics, like quilter's cotton, batik, and even tea towels are the best overall choices, they aren't always the most comfortable fabrics when humidity and heat are added into the mix. "If the mask is uncomfortable, research has shown people just touch their face even more," Muthulingam says. "Aim for compromise to get 'good enough' protection that also lets some amount of air in to make wearing the mask tolerable." Lighter cottons, polyesters, or performance fabrics are acceptable and safe to use.

The shape of the mask is also an important consideration. Many runners prefer wearing balaclavas and bandanas that they can pull up or down when six feet away from other people. While cloth masks that mimic surgical masks with comfortable ear straps and a secure fit are preferred, Muthulingam says "the key is to eliminate gaps between your skin and the mask, however that is achieved. It has to cover your nose and go below your chin."

With more and more options on the market, it is no surprise that people are investing in breathable masks for the summer. Here, 41 breathable masks in breathable fabrics like cotton, polyester blends, and other performance textiles that you can wear for all your outdoor activities and throw in with your laundry too.



~A.

Transferring Assets

Transferring Assets to Qualify for Medicaid

Transferring Assets to Qualify for Medicaid

June 29th, 2020

Transferring assets to qualify for Medicaid can make you ineligible for benefits for a period of time. Before making any transfers, you need to be aware of the consequences. 

Congress has established a period of ineligibility for Medicaid for those who transfer assets. The so-called "look-back" period for all transfers is 60 months, which means state Medicaid officials look at transfers made within the 60 months prior to the Medicaid application. 

While the look-back period determines what transfers will be penalized, the length of the penalty depends on the amount transferred. The penalty period is determined by dividing the amount transferred by the average monthly cost of nursing home care in the state. For instance, if the nursing home resident transferred $100,000 in a state where the average monthly cost of care was $5,000, the penalty period would be 20 months ($100,000/$5,000 = 20). The 20-month period will not begin until (1) the transferor has moved to a nursing home, (2) he has spent down to the asset limit for Medicaid eligibility, (3) has applied for Medicaid coverage, and (4) has been approved for coverage but for the transfer. Therefore, if an individual transfers $100,000 on April 1, 2017, moves to a nursing home on April 1, 2018 and spends down to Medicaid eligibility on April 1, 2019, that is when the 20-month penalty period will begin, and it will not end until December 1, 2020.

Transfers should be made carefully, with an understanding of all the consequences. People who make transfers must be careful not to apply for Medicaid before the five-year look-back period elapses without first consulting with an elder law attorney. This is because the penalty could ultimately extend even longer than five years, depending on the size of the transfer.

Be very, very careful before making transfers. Any transfer strategy must take into account the nursing home resident's income and all of his or her expenses, including the cost of the nursing home. Bear in mind that if you give money to your children, it belongs to them and you should not rely on them to hold the money for your benefit. However well-intentioned they may be, your children could lose the funds due to bankruptcy, divorce, or lawsuit. Any of these occurrences would jeopardize the savings you spent a lifetime accumulating. Do not give away your savings unless you are ready for these risks.

In addition, be aware that the fact that your children are holding your funds in their names could jeopardize your grandchildren's eligibility for financial aid in college. Transfers can also have bad tax consequences for your children. This is especially true of assets that have appreciated in value, such as real estate and stocks. If you give these to your children, they will not get the tax advantages they would get if they were to receive them through your estate. The result is that when they sell the property they will have to pay a much higher tax on capital gains than they would have if they had inherited it.

As a rule, never transfer assets for Medicaid planning unless you keep enough funds in your name to (1) pay for any care needs you may have during the resulting period of ineligibility for Medicaid and (2) feel comfortable and have sufficient resources to maintain your present lifestyle.

Remember: You do not have to save your estate for your children. The bumper sticker that reads "I'm spending my children's inheritance" is a perfectly appropriate approach to estate and Medicaid planning.

Even though a nursing home resident may receive Medicaid while owning a home, if the resident is married he or she should transfer the home to the community spouse (assuming the nursing home resident is both willing and competent). This gives the community spouse control over the asset and allows the spouse to sell it after the nursing home spouse becomes eligible for Medicaid. In addition, the community spouse should change his or her will to bypass the nursing home spouse. Otherwise, at the community spouse's death, the home and other assets of the community spouse will go to the nursing home spouse and have to be spent down.

Permitted transfers

While most transfers are penalized with a period of Medicaid ineligibility of up to five years, certain transfers are exempt from this penalty. Even after entering a nursing home, you may transfer any asset to the following individuals without having to wait out a period of Medicaid ineligibility:

  • Your spouse (but this may not help you become eligible since the same limit on both spouse's assets will apply)
  • A trust for the sole benefit of your child who is blind or permanently disabled.
  • Into trust for the sole benefit of anyone under age 65 and permanently disabled.

In addition, you may transfer your home to the following individuals (as well as to those listed above):

  • A child who is under age 21
  • A child who is blind or disabled (the house does not have to be in a trust)
  • A sibling who has lived in the home during the year preceding the applicant's institutionalization and who already holds an equity interest in the home
  • A "caretaker child," who is defined as a child of the applicant who lived in the house for at least two years prior to the applicant's institutionalization and who during that period provided care that allowed the applicant to avoid a nursing home stay.

Last Modified: 06/29/2020
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~A.

The Baloney Detection Kit: Carl Sagan’s Rules for Bullshit-Busting and Critical Thinking – Brain Pickings

The Baloney Detection Kit: Carl Sagan's Rules for Bullshit-Busting and Critical Thinking – Brain Pickings

The Baloney Detection Kit: Carl Sagan's Rules for Bullshit-Busting and Critical Thinking

Necessary cognitive fortification against propaganda, pseudoscience, and general falsehood.

Carl Sagan (November 9, 1934–December 20, 1996) was many things — a cosmic sage, voracious reader, hopeless romantic, and brilliant philosopher. But above all, he endures as our era's greatest patron saint of reason and critical thinking, a master of the vital balance between skepticism and openness. In The Demon-Haunted World: Science as a Candle in the Dark (public library) — the same indispensable volume that gave us Sagan's timeless meditation on science and spirituality, published mere months before his death in 1996 — Sagan shares his secret to upholding the rites of reason, even in the face of society's most shameless untruths and outrageous propaganda.

In a chapter titled "The Fine Art of Baloney Detection," Sagan reflects on the many types of deception to which we're susceptible — from psychics to religious zealotry to paid product endorsements by scientists, which he held in especially low regard, noting that they "betray contempt for the intelligence of their customers" and "introduce an insidious corruption of popular attitudes about scientific objectivity." (Cue in PBS's Joe Hanson on how to read science news.) But rather than preaching from the ivory tower of self-righteousness, Sagan approaches the subject from the most vulnerable of places — having just lost both of his parents, he reflects on the all too human allure of promises of supernatural reunions in the afterlife, reminding us that falling for such fictions doesn't make us stupid or bad people, but simply means that we need to equip ourselves with the right tools against them.

Through their training, scientists are equipped with what Sagan calls a "baloney detection kit" — a set of cognitive tools and techniques that fortify the mind against penetration by falsehoods:

The kit is brought out as a matter of course whenever new ideas are offered for consideration. If the new idea survives examination by the tools in our kit, we grant it warm, although tentative, acceptance. If you're so inclined, if you don't want to buy baloney even when it's reassuring to do so, there are precautions that can be taken; there's a tried-and-true, consumer-tested method.

But the kit, Sagan argues, isn't merely a tool of science — rather, it contains invaluable tools of healthy skepticism that apply just as elegantly, and just as necessarily, to everyday life. By adopting the kit, we can all shield ourselves against clueless guile and deliberate manipulation. Sagan shares nine of these tools:

  1. Wherever possible there must be independent confirmation of the "facts."
  2. Encourage substantive debate on the evidence by knowledgeable proponents of all points of view.
  3. Arguments from authority carry little weight — "authorities" have made mistakes in the past. They will do so again in the future. Perhaps a better way to say it is that in science there are no authorities; at most, there are experts.
  4. Spin more than one hypothesis. If there's something to be explained, think of all the different ways in which it could be explained. Then think of tests by which you might systematically disprove each of the alternatives. What survives, the hypothesis that resists disproof in this Darwinian selection among "multiple working hypotheses," has a much better chance of being the right answer than if you had simply run with the first idea that caught your fancy.
  5. Try not to get overly attached to a hypothesis just because it's yours. It's only a way station in the pursuit of knowledge. Ask yourself why you like the idea. Compare it fairly with the alternatives. See if you can find reasons for rejecting it. If you don't, others will.
  6. Quantify. If whatever it is you're explaining has some measure, some numerical quantity attached to it, you'll be much better able to discriminate among competing hypotheses. What is vague and qualitative is open to many explanations. Of course there are truths to be sought in the many qualitative issues we are obliged to confront, but finding them is more challenging.
  7. If there's a chain of argument, every link in the chain must work (including the premise) — not just most of them.
  8. Occam's Razor. This convenient rule-of-thumb urges us when faced with two hypotheses that explain the data equally well to choose the simpler.
  9. Always ask whether the hypothesis can be, at least in principle, falsified. Propositions that are untestable, unfalsifiable are not worth much. Consider the grand idea that our Universe and everything in it is just an elementary particle — an electron, say — in a much bigger Cosmos. But if we can never acquire information from outside our Universe, is not the idea incapable of disproof? You must be able to check assertions out. Inveterate skeptics must be given the chance to follow your reasoning, to duplicate your experiments and see if they get the same result.

Just as important as learning these helpful tools, however, is unlearning and avoiding the most common pitfalls of common sense. Reminding us of where society is most vulnerable to those, Sagan writes:

In addition to teaching us what to do when evaluating a claim to knowledge, any good baloney detection kit must also teach us what not to do. It helps us recognize the most common and perilous fallacies of logic and rhetoric. Many good examples can be found in religion and politics, because their practitioners are so often obliged to justify two contradictory propositions.

He admonishes against the twenty most common and perilous ones — many rooted in our chronic discomfort with ambiguity — with examples of each in action:

  1. ad hominem — Latin for "to the man," attacking the arguer and not the argument (e.g., The Reverend Dr. Smith is a known Biblical fundamentalist, so her objections to evolution need not be taken seriously)
  2. argument from authority (e.g., President Richard Nixon should be re-elected because he has a secret plan to end the war in Southeast Asia — but because it was secret, there was no way for the electorate to evaluate it on its merits; the argument amounted to trusting him because he was President: a mistake, as it turned out)
  3. argument from adverse consequences (e.g., A God meting out punishment and reward must exist, because if He didn't, society would be much more lawless and dangerous — perhaps even ungovernable. Or: The defendant in a widely publicized murder trial must be found guilty; otherwise, it will be an encouragement for other men to murder their wives)
  4. appeal to ignorance — the claim that whatever has not been proved false must be true, and vice versa (e.g., There is no compelling evidence that UFOs are not visiting the Earth; therefore UFOs exist — and there is intelligent life elsewhere in the Universe. Or: There may be seventy kazillion other worlds, but not one is known to have the moral advancement of the Earth, so we're still central to the Universe.) This impatience with ambiguity can be criticized in the phrase: absence of evidence is not evidence of absence.
  5. special pleading, often to rescue a proposition in deep rhetorical trouble (e.g., How can a merciful God condemn future generations to torment because, against orders, one woman induced one man to eat an apple? Special plead: you don't understand the subtle Doctrine of Free Will. Or: How can there be an equally godlike Father, Son, and Holy Ghost in the same Person? Special plead: You don't understand the Divine Mystery of the Trinity. Or: How could God permit the followers of Judaism, Christianity, and Islam — each in their own way enjoined to heroic measures of loving kindness and compassion — to have perpetrated so much cruelty for so long? Special plead: You don't understand Free Will again. And anyway, God moves in mysterious ways.)
  6. begging the question, also called assuming the answer (e.g., We must institute the death penalty to discourage violent crime. But does the violent crime rate in fact fall when the death penalty is imposed? Or: The stock market fell yesterday because of a technical adjustment and profit-taking by investors — but is there any independent evidence for the causal role of "adjustment" and profit-taking; have we learned anything at all from this purported explanation?)
  7. observational selection, also called the enumeration of favorable circumstances, or as the philosopher Francis Bacon described it, counting the hits and forgetting the misses (e.g., A state boasts of the Presidents it has produced, but is silent on its serial killers)
  8. statistics of small numbers — a close relative of observational selection (e.g., "They say 1 out of every 5 people is Chinese. How is this possible? I know hundreds of people, and none of them is Chinese. Yours truly." Or: "I've thrown three sevens in a row. Tonight I can't lose.")
  9. misunderstanding of the nature of statistics (e.g., President Dwight Eisenhower expressing astonishment and alarm on discovering that fully half of all Americans have below average intelligence);
  10. inconsistency (e.g., Prudently plan for the worst of which a potential military adversary is capable, but thriftily ignore scientific projections on environmental dangers because they're not "proved." Or: Attribute the declining life expectancy in the former Soviet Union to the failures of communism many years ago, but never attribute the high infant mortality rate in the United States (now highest of the major industrial nations) to the failures of capitalism. Or: Consider it reasonable for the Universe to continue to exist forever into the future, but judge absurd the possibility that it has infinite duration into the past);
  11. non sequitur — Latin for "It doesn't follow" (e.g., Our nation will prevail because God is great. But nearly every nation pretends this to be true; the German formulation was "Gott mit uns"). Often those falling into the non sequitur fallacy have simply failed to recognize alternative possibilities;
  12. post hoc, ergo propter hoc — Latin for "It happened after, so it was caused by" (e.g., Jaime Cardinal Sin, Archbishop of Manila: "I know of … a 26-year-old who looks 60 because she takes [contraceptive] pills." Or: Before women got the vote, there were no nuclear weapons)
  13. meaningless question (e.g., What happens when an irresistible force meets an immovable object? But if there is such a thing as an irresistible force there can be no immovable objects, and vice versa)
  14. excluded middle, or false dichotomy — considering only the two extremes in a continuum of intermediate possibilities (e.g., "Sure, take his side; my husband's perfect; I'm always wrong." Or: "Either you love your country or you hate it." Or: "If you're not part of the solution, you're part of the problem")
  15. short-term vs. long-term — a subset of the excluded middle, but so important I've pulled it out for special attention (e.g., We can't afford programs to feed malnourished children and educate pre-school kids. We need to urgently deal with crime on the streets. Or: Why explore space or pursue fundamental science when we have so huge a budget deficit?);
  16. slippery slope, related to excluded middle (e.g., If we allow abortion in the first weeks of pregnancy, it will be impossible to prevent the killing of a full-term infant. Or, conversely: If the state prohibits abortion even in the ninth month, it will soon be telling us what to do with our bodies around the time of conception);
  17. confusion of correlation and causation (e.g., A survey shows that more college graduates are homosexual than those with lesser education; therefore education makes people gay. Or: Andean earthquakes are correlated with closest approaches of the planet Uranus; therefore — despite the absence of any such correlation for the nearer, more massive planet Jupiter — the latter causes the former)
  18. straw man — caricaturing a position to make it easier to attack (e.g., Scientists suppose that living things simply fell together by chance — a formulation that willfully ignores the central Darwinian insight, that Nature ratchets up by saving what works and discarding what doesn't. Or — this is also a short-term/long-term fallacy — environmentalists care more for snail darters and spotted owls than they do for people)
  19. suppressed evidence, or half-truths (e.g., An amazingly accurate and widely quoted "prophecy" of the assassination attempt on President Reagan is shown on television; but — an important detail — was it recorded before or after the event? Or: These government abuses demand revolution, even if you can't make an omelette without breaking some eggs. Yes, but is this likely to be a revolution in which far more people are killed than under the previous regime? What does the experience of other revolutions suggest? Are all revolutions against oppressive regimes desirable and in the interests of the people?)
  20. weasel words (e.g., The separation of powers of the U.S. Constitution specifies that the United States may not conduct a war without a declaration by Congress. On the other hand, Presidents are given control of foreign policy and the conduct of wars, which are potentially powerful tools for getting themselves re-elected. Presidents of either political party may therefore be tempted to arrange wars while waving the flag and calling the wars something else — "police actions," "armed incursions," "protective reaction strikes," "pacification," "safeguarding American interests," and a wide variety of "operations," such as "Operation Just Cause." Euphemisms for war are one of a broad class of reinventions of language for political purposes. Talleyrand said, "An important art of politicians is to find new names for institutions which under old names have become odious to the public")

Sagan ends the chapter with a necessary disclaimer:

Like all tools, the baloney detection kit can be misused, applied out of context, or even employed as a rote alternative to thinking. But applied judiciously, it can make all the difference in the world — not least in evaluating our own arguments before we present them to others.

The Demon-Haunted World is a timelessly fantastic read in its entirety, timelier than ever in a great many ways amidst our present media landscape of propaganda, pseudoscience, and various commercial motives. Complement it with Sagan on science and "God".



~A.

🤖Gates of Hell🤡