Spirituality v. Magic

I am not a member of the Church of Jesus Christ of Latter-Day Saints (colloquially known as “Mormonism”). I have never been a member and have no plans of joining. I am an extremely content member of PCUSA (Presbyterian Church (USA)) which is a progressive wing of the Presbyterian Church.

However, the history of the Restoration Movement in the United States (which included the LDS church) is very fascinating simply because the LDS church has documented its history expansively. I live in Utah which is geologically beautiful. Beautiful geology plus an unusual religious movement settling in Utah leads to unusual outcomes. In this setting, I have been reading “Early Mormonism and the Magic World View” by D. Michael Quinn, published in Signature Books. Quinn (now deceased) was professor at USC, and he won many book awards in his lifetime.

Utah (Arches National Park)

This particular book is full of information not just about the early American Restoration Movement but also about the intricate association between early colonial America and books on magic. According to the book, a large number of Americans early on in the country’s founding were not religious. Such an idea makes sense. People often lived far, far away from any civilization which included churches.

I was intrigued by this quote from the book… “One traditional distinction is that religion is supplicative and magic coercive in intent. Anthropologist Lucy Mair wrote that ‘the difference between religion and magic…might be epitomized as the difference between communicating with beings and manipulating forces.'”

Whoa. Let’s think about these words.

I’m a religious person so I do pray. When I was much younger, I prayed for specific things to happen…to get a specific toy, to get a girl in school to like me. Weirdly, even before I went down the route of theological studies, I had quit praying for direct intervention by God. I can think of some reasons for this change to have happened.

I really came to understand that many of the stories in the Bible are mythic. Some readers of my blog are probably thinking, “DUH!”, but one would be amazed that even growing up in a highly educated home, people just can accept stories they hear in church. My parents knew these stories and told me these stories, but as I got older, I came to understand that my parents either never believed the stories or really didn’t care if they were real or not.

Moses Crossing the Red Sea

People talk about moments of the “dark night of the soul.” My “night” came about when I dug into the Exodus story only to realize that it didn’t happen. Sure, some small migration of individuals up to the Levant from Egypt may have happened. A small migration may have changed into a legend over time which consisted of millions of migrating Hebrews, but the events of the Exodus didn’t happen. There is zero archeological evidence.

In contrast, there is evidence of the Battle of Thermopylae which also has mythic dimensions, but there is no evidence of the Exodus. Hence, there is no evidence of “manipulating forces” based on all of the Exodus stories (i.e., magic).

Battle of Thermopylae

Second, my job in healthcare. Many people in healthcare take care of dying patients. It is no different in my field. Watching a patient die is especially tough when it happens to a child. Honestly, I’ve seen no miraculous healings, and I have met many, many wonderful families who got blindsided with the death of their child. Many of these families are religious. I have seen no evidence of prayer “manipulating forces” causing miraculous healings (i.e., magic).

So, why do I pray? I had to think about this aspect for my blog today. Let me give you some reasons.

I have tried the agnostic route. It didn’t work for me. Being agnostic or atheist works for many wonderful people, many of whom are my friends. It really didn’t work for me, although in the end, every human probably is agnostic as we can’t prove or disprove God. I guess my genetics, and more importantly, my epigenetics made me who I am when it comes to believing in God.

Bible stories often are mythic. Myth, in my opinion, is different than most fantasy stories. Myths tend to be very old, and although they may have magical qualities, they say something profound about the human condition. Much work on the importance of myth has been done here in the realm of sociology and psychology. See here and here. So, I pray in the setting of myths because ancient stories tell me deep truths about human nature and its relationship to a potential God.

Noah’s Ark

I pray in the setting of process theology which is one of my theological interests. I have posted many times about this type of theology. In other words, I pray that entities accept God’s lure for creativity. God lures; God does not force. As an example, if I pray for a war to stop, then I am praying for all involved combatants (especially their leaders) to hear God’s lure for the good…for war to stop. I realize it can be extremely difficult, especially for humans like myself, to hear God’s lure. In the setting of open & relational theology (which I also have posted about before), I am convinced that this lure is divine love.

Jesus Healing the Blind Man

Finally, perhaps there has been contact with Divinity in the past that makes me think God may exist. I’m a Christian, and if I believe in the hypostatic union (Jesus being fully God and fully man) of the Christ event, then perhaps in the extreme circumstances of God touching our species at specific events, it may be possible for miracles to occur. If miracles have occurred in history because our species has interacted with God, then perhaps praying is a way to communicate with God. I’m not convinced, of course. This idea is just a theological theory. A correlative idea would be in the Hadith when Muhammad had water miraculously gush forth from his hands. Some other ideas such as the Buddha having a massive tongue that could cover his whole face (as described in the Pali Canon) seem less likely. However, I am not going to judge this Buddhism story as I have enough crazy stories in my own religious tradition.

Image made by Gemini Advanced

Men’s Group and Whatever Comes Next

There has been a delay in my posting. My apologies. The last few weeks have been a bit crazy. First, my work as a physician is always a big impediment for my free time. I’m not complaining. Lack of free time is a big issue among physicians. Employment always takes priority over blogging.

Second, I went to Los Angeles to go to the first night of Rush’s last tour ever at the Kia Forum. Rush is a classic band. If you are familiar with their lyrics, then you might understand me a bit better as a human being — at least from an arts perspective.

Picture outside of the Kia Forum

The concert was indeed EPIC. I probably should write a post on the concert…maybe later.

Third, I am working on a new book. All chapters have been written. I still need to do the Introduction part. The feedback has been very good, so I am hoping to get it published in the next 9 months. I am in the tedious part of the book where I am making corrections. Very painful but necessary.

On Thursday this past week, I went to the new men’s group at my church. The typical men’s group at so many churches is set up for people who are quite a bit older than me. These older individuals at our church meet at a local pancake joint during a time when younger guys like me (uhhh…I am in my 50s) are still working at their jobs. This time constraint has been a problem, so we set up a new men’s group a few months ago that meets monthly in the evening after work. We have a meal, drink some beer or wine or whatever, discuss some Bible verses, and just talk about life. About a third of our members are LGBTQ+ which is beneficial for those of us existing in the cis/straight world. All viewpoints are needed.

By the way, the women’s group (for mainly working women such as my spouse) at our church has been going on for years. It is highly successful in maintaining a constant source of sharing lives. I hope our new men’s group will be equally beneficial. We shall see.

Anyway, the facilitator for this past men’s group went over some verses from Ecclesiastes in the Old Testament. In my 20s, I made the effort to start reading through the Bible in its entirety. I’ve read through the Bible a few times at this point. Currently, I’m taking a break from daily readings, but I do think Ecclesiastes may be in the top 3 of my favorite books in the Bible.

Ecclesiastes is not a happy book. Perhaps it has some stoicism aspects to it. I don’t know. I spent some time looking at the end of the book (Chapter 12). The book ends with this:

Fear God and keep his commandments,
    for this is the duty of all mankind.
For God will bring every deed into judgment,
    including every hidden thing,
    whether it is good or evil.

These words are at the very end of Ecclesiastes. I will try to make these words a bit more positive.

Before, I make these words perhaps more positive, I want to share a sad link from the local paper in Salt Lake City.

Here is the article:

Here is the open access link to the article. This article is so sad. People forget that measles causes significant suffering and death. I am doing a talk for an upcoming theology conference, and I found interesting research about the number of United States Civil War soldiers killed by measles. Measles is preventable by vaccination.

Image from the Civil War Monitor

I have so many thoughts here. As a physician, I have seen children get very sick from preventable diseases. I have seen children die from preventable diseases. Although I have done some medical work in Africa in the past, it is weird / ironic / even more tragic to see such illness and death occurring in children in my country (the USA) that has huge amounts of income. And yet…so many Americans really seem to be unaware.

I mean, I know many people care, but I don’t think they understand what preventable death looks like. I don’t believe in totalitarianism. For example, I do not think one should force parents to have their children undergo preventive care, such as vaccination, except in the event of life-threatening situations. I will never understand why humans cannot be more caring for each other. Perhaps we are more uncaring, more violent, and more prone to misinformation than I recognize. Perhaps, this aspect is the human condition.

Battle scene, painted by Antonio Gherardi

In the moments of seeing children die from vaccine preventable disease, I often have feel absolute helplessness in my place in the universe. The universe doesn’t seem to care. Time marches on infinitely and doesn’t care. The dead child is buried and is forgotten in about 2 generations or so.

What am I doing? Where is God here?

I have no answer, but I want to propose a possibility.

If God is love and if God desires the good but does not force, I think there is an eternal urge for good to come out of tragedy. Such good may not come about right away. It could take centuries, millennia, or perhaps at the time of the heat death of the universe.

This God that I think I believe in is always there in real time and in all space. This God is urging all of nature to do better, to be more creative. Nature (including we, as humans) can ignore or go along with this lure for the good. In the eternity of space and time, I do think justice is eventually served. Our species, H. sapiens, is just too short-lived and too limited in brain structure to ever understand this possibility. I know I am limited.

As our men’s group discussed Ecclesiastes, I thought of a corollary from 1 John 4:8.

Whoever does not love does not know God, because God is love.

If God exists in real time with us (and all of nature) yet is still eternal, then God’s love is all that remains when I have become dust, the sun has absorbed the Earth, and the universe slowly dies away. Love always remains.

For someone like me who is Christian but often aligns with agnosticism, I find comfort here.

Image made from Gemini Advanced

Good Article on Science Misinformation in the Religious Setting

The June 2026 issue of Perspectives on Science and Christian Faith (the academic journal of the American Scientific Affiliation) published a great article titled “Staying in Conversation: Review of Research on the Science Views of Evangelicals and Effective Ways to Respond.” It was written by Deborah Haarsma who was the president of BioLogos from 2013-2024. Dr. Haarsma is an astronomer and an extremely good writer. By the way, please consider joining and / or supporting the American Scientific Affiliation and BioLogos. Both organizations work very hard trying to get rid of the ridiculous idea of the “war between science and religion.” There is no war. Like any potential war in the history of humankind, most people do not want conflict. Typically, only sociopaths want war and the “fundamentalists” on both sides of the so-called war between science and religion desire destruction of the other side — even if it destroys their side. Such conflict is not helpful.

Dr. Haarsma’s article is very long. It is behind PSCF‘s paywall, but the paywall typically goes away 3-6 months after an article is published. So, you can read the article for free relatively soon. I highly recommend you read it.

Scopes Monkey Trial (1925): More of a town marketing event for Dayton, Tennessee

Although the PSCF article is lengthy, it is truly amazing. Although the article concentrates on dealing with the anti-science attitude of Evangelicals, I think it can be extended to other religious groups. By the way, I very much realize that not all Evangelicals are anti-science. Unfortunately, those that are anti-science make up a significant voting block in the U.S. which risks all sorts of problems when it comes to combatting global warming or making sure children get vaccinated.

Dr. Haarsma’s notes the recent data suggesting 36% of white, religious people in the United States now delay or avoid getting their children vaccinated. This percentage is very scary when you read about the consequences of whooping cough, diphtheria, measles, etc. prior to the invention of vaccination.

Image of diphtheria blocking the airway in a child (image from Dateline Health Africa). Preventable with vaccination.

She then goes on to the history of the anti-science movement in the United States and how this issue recently has been amplified to dangerous proportions recently. Honestly, I think social media acclerates the problem of pseudo-science. Pseudo-science is quite large in the field of health and medicine.

Whooping cough (image from Wikipedia). Preventable with vaccination.

The last part of Dr. Haarsma’s article discusses ways to address this problem. I am not going to go into great detail about her solutions. They are all good. They also are numerous, and I am doing a simple blog post.

Let me consider a few ideas, however.

Dr. Haarsma talks about “Kingdom conversations” which in Christian terminology means loving one’s neighbor no matter their political affiliation, nationality, race, religion, or sexuality (see Matthew 22:37-40). Honestly, I have always felt that if we followed this statement from Jesus and just took care of each other as opposed to harming each other for very stupid reasons, we would have all sorts of monetary revenue on our planet to cure diseases, remove poverty, build amazing computers, explore the solar system, and on and on. I sometimes think that the genetics / epigenetics of humans appear to be suggest that we will always be violent to each other, but one can only hope.

Assyrian war relief (British Museum)

Earning trust: This is a big one for me. Yelling at a person who has anti-vaccination beliefs never works. As Dr. Haarsma points out, just telling personal stories helps here quite a bit.

I have had personal experience here. When I talk to families that are vaccine hesitant, I just tell personal stories. I don’t necessaarily tell them stories about children who die from vaccine-preventable illnesses. I talk about my own children who have been vaccinated and who have done very well in life — college, careers, normal contributing lives to society, etc. I try to relate to such parents as I have been a parent of young children too. When you are a parent to young children, you can be a bit anxious about everything. I certainly was.

When I talk to close friends and family about these issues, the conversation often leads to a conversation about my religious faith. Specifically, many of my close friends and family are just as religious as I am, but they do not have my medical training. As a result, I have the opportunity to be very clear about medical science in a loving way. I can state that I am a Christian just as much as they are, and I believe vaccinating children is a gift from God.

Co-create

If I believe God and humans co-create with the capacity for the result to be good, then vaccinations and all of their life saving potential are certainly a miracle. Remember that Jesus could not perform many miracles in his hometown (Nazareth) due to the inhabitants’ lack of faith. Having faith in God is not just hoping God will step in. It requires understanding that God desires us to be creative with God. By being creative, we can be good and kind to our fellow humans and the rest of the planet. By being creative in science, we can make the world a better place in a setting equal to being creative in the arts. We can reduce suffering.

Vaccinating children to prevent their death is creativity and love via science. This is objective creativity. Objective creativity can go hand-in-hand with subjective creativity. For example, Brahms’ 1st symphony demonstrated that great music could be made after Beethoven. This is creativity and love via the fine arts. Objective and subjective creativity can complement each other to make the world even better.

Blaise Pascal

One last thing. This part is from me. I have a huge issue with American politics. I think our current political structure accelerates the problems above. You may remember this quote by Blaise Pascal: “There is a God-shaped vacuum in the heart of each man which cannot be satisfied by any created thing but only by God the Creator, made know through Jesus Christ.”

I don’t know if agree with Pascal here, but I do think humans have a metaphorical “hole” in their heart that needs to be filled. Personally, I think it would be best if this hole was filled with love of the other, and it doesn’t matter if this love is religion-based or not. I think most humans, sadly, want this hole to be filled by power and especially immediate power over the “other.” Here is where American politics come in. Over time, we appear to have become very disturbed as a country when it comes to the spew coming forth from the two political parties. Loss of friends, loss of family — all over divisiveness caused by the two parties. This divisiveness is worsened when these two parties use pseudo-science or misinformation to carry their messages. Currently, I think one party is more problematic than the other although both parties have been crazy in the history of our country. Just think about the U.S. Civil War.

My point is that the anti-science movement which destroys creativity and the chance for people to thrive has come from both sides of the political spectrum over the course of time.

It has come from the right side of the political spectrum.

It has come from the left side of the political spectrum.

Being anti-science is equivalent to being anti-creative. Through the years, I have seen children get very sick and even die from vaccine-preventable diseases. As someone who is a physician but also is a theologian in the camp of process theology / open & relational theology, I feel strongly that being anti-creative makes the world a much worse place.

I don’t know what we should put in the proverbial holes in our hearts but being anti-science, believing in pseudo-science, and putting your complete faith in political parties is not the answer. Religious and non-religious people of all stripes should agree here. All faith systems, regardless of their background, should work for the improvement of our species, other species, and the planet.

Image created by Gemini Advanced

A New Review of My Book!

I have had a delay in posting as I have been on hospital call this week, and my free time to write for fun is always reduced during such periods. It then takes me a couple of days afterwards to recover, catch up on life, etc. So, I am back to posting!

I am a member of the American Scientific Affiliation which is a society working at the intersection of science and faith. It is a great organization and was founded in 1941. I highly recommend joining it if you are Christian working in a science or science-adjacent field. It was an early proponent of accepting biological evolution from a Christian perspective and had harsh critiques of so-called “flood geology.” Its professional journal is called Perspectives on Science and Christian Faith. It is a wonderful journal that I have subscribed to forever. PSCF is comprehensive and often is a great place to start for people interested in how science and religion can interact in good ways although keep in mind that the journal produces content from a Christian perspective. Other journals exist to help people in the other religious contexts.

My last book, A Theology of the Microbiome, was reviewed in PSCF‘s last issue. You can read the review online.

The review was pretty darn good, and I was happy about it. I have written book reviews for PSCF as well through the years, and I appreciate the freedom that the ASA allows with its authors of book reviews. In the review of my book, the author had one comment that initially bugged me, but then I became more chill about it over time.

He stated in the last paragraph:

“I recommend this book, especially chapter 3, for theologians and scientists who seek a greater understanding of recent advances in microbiome research, especially those who are interested in how microbes affect our health in both positive and negative ways. However, the theological perspective may be a hindrance to those not attuned to process theology. Although not espousing orthodox theology, it is a thought-provoking and interesting addition to one aspect of the current biology theology discussion.”

I’m going to ruminate a bit about “orthodox theology.” In particular, what actually is orthodox about any religion? I get the aspects of wanting to guard against heresies, but where is the line for heresies? Religious orthodoxy is not the same as physical laws. Fighting over consubstantiation versus transubstantiation is not the same as debating the merits of the Newtonian Law of Gravity versus General Relativity.

For example, I am a Christian. I am pretty “orthodox” about certain aspects of my faith — all of which are unprovable. I believe in the virgin birth, Jesus’s miracles, and a bodily resurrection of Jesus. I am also a Trinitarian which comes about as a codified theological idea a few centuries after Jesus’s life. Yep. I am orthodox here. At the same time, I believe in religious ideas (really, more faith ideas) that are absolutely not provable.

Do I think God is a Smurf? No. I guess that is a faith statement too. I think God or some type of divinity can create / co-create the universe. A blue cartoon character developed in the 1950s cannot create anything. Belief in God is a faith statement, but perhaps a faith statement with a great possibility of being true (i.e., God is more possible than a Smurf in creating / co-creating the universe).

The same idea goes with Bertrand Russell’s analogy of a teapot in an elliptical orbit going between Earth and Mars. The presence of such a teapot can’t necessarily be proven to be true / not true even with today’s telescopes. On the other hand, a teapot in such an orbit would make no sense. We have never sent a teapot into orbit, and it probably would be destroyed by space dust and debris even if we did send it into space. The faith statement of the teapot existing in space makes less sense (to me) than believing that God may have created / co-created the universe. By the way, the other problem with Russell’s argument is that he is describing an omnipotent God, which theologians of process theology and open & relational theology (like me) do not accept. That is a big caveat to consider when reading Russell’s well-written argument.

Mars, sans teapot

So, here are some questions.

Is Orthodox Christianity orthodox?

Is Catholicism orthodox?

Are the myriad of Protestant denominations orthodox?

Are the Creeds orthodox? I belong to a church that state the Creeds during worship service, but many Protestant churches do not do this.

What translation of the Bible is orthodox? Various Bibles have various books in them that are included or excluded.

I would assume believing that Jesus is the son of God is the base of all of Christianity, but then it perhaps gets tricky. For example, Trinitarianism (which I am a believer in) came about as an idea well after the life of Jesus. Is such an idea theological or philosophical?

I wonder if we should look at religion, at least in the Christian sense, as being orthodox in a pseudo-Popperian way. I made up this term. What do I mean by this?

Well, Karl Popper stated that a theory was scientific if it could be falsified. In other words, if one could come up with a way to show a theory was false, the theory was was scientific. Otherwise, the theory was pseudoscience or even a perfectly fine subjective idea. As an example one could potentially prove that General Relativity is a false idea. Such evidence has not happened although many physicists have proposed the General Relativity has a deeper level of understanding that we are missing.

Here is my pseudo-Popperian proposal that is VERY poorly defined at this point. A theology is not orthodox if it harms people in general. It might harm people individually, but if it risks harming people generally, then it is unorthodox.*

*I need to be careful here, but let me provide an explanation. Back to the Smurf analogy… If a child is scared of Smurfs by watching a Smurf move, that is sad. However, the idea of Smurfs in general do not worsen or harm the greater society. I hope my analogy makes sense.

For example, when Evangelicalism (not all of Evangelicalism) becomes associated with Christian nationalism, that part of Evangelicalism is not orthodox. I speak this idea as someone who was once an Evangelical. Christian nationalism is not Jesus-centered…just look at the Gospels. Christian nationalism puts the nation in front of Jesus as a rule. Christian nationalism is harmful and is not orthodox with the Christian faith.

As another example, when Christians of all leanings (liberal and conservative) become anti-science in their thinking, they are not orthodox by my definition. The anti-vaccination movement is a prime example here. Both “liberal” and “conservative” Christians have, at times, been anti-vaccine in their thinking and motivations. Harming children due to pseudo-science is not orthodox with the Christian faith.

Image from Homewood Community Church. I have no idea what this church entails. I just found the image.

Personally, I think Calvinism, especially 5-point Calvinism, is an extreme issue when deciding if the religious idea is orthodox. Is “limited atonement” really a thing? This type of theology is how God works? Really? I would argue that ideas surrounding much of Calvinism just produce anxiety in people and is not orthodox with the Christian faith.

This book clarifies my concerns about Calvinism.

What about “atonement theory”? Is this theory orthodox? I think the answer is decidedly “no.” It is a simple and popular theory, but there are many, many other atonement theories. Atonement theory is a big belief in the United States. Since so many atonement theories exist, atonement theory is not the only orthodox option.

I am a singular person out of the proposed 117 billion individual H. sapiens who have lived on our planet. I am in no way reliable in deciding what is orthodox religion when it comes to Christianity. If you want me to define my religious base of faith, I would say Christianity makes sense to me when I believe 1) Jesus was God, 2) Jesus was resurrected (human body, spirit, interdimensional — who cares!), and 3) we, as humans, need to follow Matthew 7:12 (“So whatever you wish that others would do to you, do also to them, for this is the Law and the Prophets.”). This is what I believe. It is a faith statement. It is not a scientific law.

Process theology and open & relational theology with some of their foundational ideas of 1) God being creative and all loving; 2) all of the Greek ideas of the “omni” God being incorrect; 3) God learning and changing over time; 4) the imperative of time; and 5) God co-creating with humans (as well as all of nature) in a non-forcing call to lure us to do the good / the creative / the novel make very good sense. This explanation of God sounds extremely loving to me. I have no idea if such ideas are orthodox or unorthodox. And I really don’t care.

But I guess I am forever unorthodox.

Image made from Gemini Advanced

The End of the Universe and Everything

I subscribe to the journal, Theology and Science, published by Taylor & Francis. Most articles in each issue are fairly interesting. In the latest issue, I read, “A New Hope for Christian Eschatology in Cosmic Perspective: Beyond the Predictions of Standard Big Bang Cosmology” by Hyung-Joo Lee. The author has expertise in theology (PhD, Graduate Theological Union) and cosmology (PhD, Korea Advanced Institute of Science and Technology). His article (unfortunately, behind a paywall) provides theological ideas about how to think about God while living in a universe that appears, based on current science, to have an unsatisfactory end point.

Our universe arose from the Big Bang, although physics equations break down when we try to understand the time before 5.39 x 10^-44 seconds after the Big Bang started. Additionally, the cosmic background radiation shows that our universe is homogenous in every direction. We know that the universe has been expanding and apparently expanding faster, in every direction over the past 13.8 billion years. What eventually happens to the universe?

Cosmic background radiation (image from Wikipedia)

Well, the universe may keep on expanding forever and ever and ever and ever and ever. This is a “flat” or “open universe” with no curvature and with the consequence of all useful energy being used up. The universe will eventually reach a temperature of absolute zero. Nothing happens at that point. All is dead.

On the other hand, the universe may eventually collapse back on itself. I believe that this is the minority view of cosmologists. When it collapses back on itself, the universe is simply destroyed. This is a “closed universe” model. Similar to the “open” idea, all is destroyed. All is dead.

Image from the University of Oregon

Both ideas seem to go against Christian eschatology or what happens when all of this ends — from a Christian perspective. An interesting article is here. It is rather depressing to me to think that any possibility, no matter how remote, of my being remembered will be forever gone. The possibility of our species or our planet or even our galaxy being remembered being forever gone may be traumatic to consider.

The Last Judgment

Lee challenges this assumption of all simply ending. Using the work of others, such as Robert Russell and Wolfhart Pannenberg, Lee discusses the idea that physical theories may be “descriptive” and not “prescriptive”. In other words, our physical theories in relativity and quantum mechanics are indeed brilliant but may be describing a reality while not yet reaching the actual reality of what is occurring. There is a long tradition here as described here and here.

Lee then proposes the following:

We know the universe is expanding faster and faster in all directions. Over time (really immense time), the quantum fields in such a gigantic space will still be present. I’m no physicist, but I would define a quantum field as points in all of space in which particles and forces arise simply as excitations of such fields. The electromagnetic field is such a field. The Higgs field is another field. There are others. These fields are possibly statistical (as far as we know currently). Thus, there is a chance, no matter how small, that something could arise in these fields over immense time and immense space.

A particle could arise with such fields over time in a large area of space. From a statistical standpoint, even something complex could arise from these fields. The Boltzmann brain is such a conjecture — not provable. Thus, perhaps even a new Big Bang could arise in such a setting. Heck, from a theological perspective, a “new heaven and a new earth” could arise (Revelation 21:1).

Boltzmann brain (image from Beyond Universe)

Lee looks at the theoretical cosmology idea of quintessence here. Quintessence is a theoretical idea that some type of field is associated with the universe expanding differently depending on the location. Such an idea is opposed to the current idea of the universe forever expanding per the Cosmological Constant.

Let’s think about such an idea in the realm of process theology or the more divine love-oriented open & relational theology. 1) If fields can vibrate to potentially produce anything (a conjecture), 2) if things (comparable metaphorically) to Boltzmann brains can occur in the setting of immense time and large space, and 3) if quintessence allows for the universe to not “die” by forever expanding or by collapsing, then there is the possibility of eternal creativity.

From a process theology / open & relational theology standpoint, this idea matches Christian eschatology. Those who work in process theology as well as open & relational theology use the idea of God desiring (not forcing) novelty or creativity as part of God’s nature (process theology) or as part of God’s nature of love (open & relational theology). Such ideas are basically a type of eschatology occurring over deep time and perhaps eternally. God is forever creative. God’s love desires, but does not force, creativity.

In my book, A Theology of the Microbiome, I express some of these ideas as follows:

“Finally, when one considers the idea of a “Boltzmann brain,” there
is the possibility that a new universe could form even as our current
universe continues onward with increasing entropy and less useful energy
over time. In the far future, thermal equilibrium is predicted to be
reached everywhere. Despite this event eventually occurring, there could
be a real, but incredibly small statistical chance, that particles would move
close enough to each other so that entropy would decrease momentarily,
and structure would form. The “Boltzmann brain” idea suggests that innumerable random particles in an immense universe with thermal equilibrium
over vast time could, simply by statistical chance, form a “brain”
for a few moments that would experience reality. The brain would then
dissipate into particles again as increased entropy once again took over.


Could a large fluctuation of such particles create a new universe in the
far future? It would be highly improbable but mathematically possible.
Dark matter changes, as well as other mechanisms, have been theorized
as potential causes for a new universe in such a setting. Also, the theory
of cyclic cosmology suggests that a new universe would occur regardless
in the extreme long-term future. All such ideas can aid one when thinking
about the unstoppable increase of entropy in the presence of eternal
creativity.”


Consider purchasing my book. : )

So…I like this article.

At the same time, I have some pushback.

1)Boltzmann brains may not be possible if there are no fluctuations in quantum fields (i.e., if quantum mechanics is essentially deterministic). A good reference is here. Determinism would rule out creativity both objectively and subjectively.

2)Here is my biggest problem. I think science and theology can help each other but cannot stand in for each other. I’m not a believer in non-overlapping magisteria per Gould even though Gould is one of my heroes. Science informs theology so that we understand aspects of God better in the setting of potential divinity in the world. I’m rather cataphatic here. Most of the world is religious, and good theology informs science in the setting of morality or ethics. For example, does God want us to have nuclear weapons? Does God want us to be anti-vaccine? Does God want us to ignore famine? Does God want us to ignore war? Does God want us to deny climate change? I think the answer is decidedly “NO.” Thus, Lee’s work adds on to the perspective of God’s continuing desire for creativity (process theology) via divine love (open & relational theology).

I do not think it is in human capacity to understand what happens when we die or when a “new heaven and new earth” arise. As a Christian, I can believe in the hypostatic union of Christ Jesus, but I cannot understand it fully. I never will. I hit a wall beyond which no comprehension is present. We can make metaphors, but we are limited by our human brains — both objectively and subjectively.

Lee’s article is very good and should be read.

Good theology recognizes brain limitations of our species — both objectively and subjectively.

Image made by Gemini Advanced

More of a Comment Than a Question

It is kind of a truism in medical conferences (and all sorts of academic conferences) that some people pretend to ask a question after a presentation, when in reality, they just want to give a mini-talk themselves. Typically, such “mini-talks” are ways for people to act like they are important. “More of a comment than a question” is the equivalent of trying to take over a meeting. The statement has become kind of a humorous meme about scientific meeting Q&A periods after a presentation.

Unfortunately, I somewhat did a “comment more than a question” recently on Substack. Matthew Segall has a great Substack account. It is expansive and quite wonderful in the realm of explaining philosophy especially regarding the realm of metaphysics. I highly recommend following his account.

On April 27, Dr. Segall interviewed a person associated with the Discovery Institute. I don’t want to identify this person directly (you can watch the interview) as this individual falls into the camp of Intelligent Design which, in my opinion is a rather spurious belief system. I would rather criticize Intelligent Design (ID) than the individual.

Dr. Segall did nothing wrong. His interview was completely fine. He was much more patient than I could ever be. He was pointing out how different belief systems can converge and diverge. Dr. Segall is an expert in process philosophy which can align theologically with process theology (PT) as well as open & relational theology (ORT). I find myself in the camp of PT and ORT. PT / ORT are definitely religious in orientation and they are very pro-science. People like me may believe in God, but we also have no issues with randomness in evolution, Big Bang cosmology, the weirdness of quantum mechanics, accepting the spectrum of human sexuality, acknowledging the problem of evil, etc.. I’m not sure I believe in non-overlapping magisteria as I quite sure that science can inform one’s belief in God.

ID is very different. ID is basically a Young Earth Creationism (YEC) adjacent movement. ID may state that the universe is old and perhaps biological evolution happens, but it then runs off the rails as being science adjacent. ID often relies on the term “irreducible complexity” in which biological mechanisms or structures are so complex that there is no natural mechanism to explain how the complexity occurred. Additionally, once ID says that a mechanism/structure is “too complex” to be explained, then the obvious answer is “God did it. Don’t ask any more questions.” ID also seems to be very much into guided evolutionary processes from an anthropomorphic perpective. I’m not talking about ideas surrounding evolutionary pathways (such as convergent evolution) which may have underlying physical laws. Convergent evolution is definitely real, and it may have an underlying physical law basis not yet understood. What I am talking about is the awful continuing movement in the United States (and to some degree in other countries) to trying to replace science with specific types of religious thought which includes fundamentalism, YEC, and ID. When one tries to put such constrained religious systems into the realm of science by defining fundamentalism / Y.E.C./I.D as a type of “science”, one will start going down the road of the anti-vaccination movement and climate change denial.

Convergent Evolution, image from the Natural History Museum (London)

So…my comment is more than a question. After watching the interview between Dr. Segall and the person who represents the ID movement, I posted a long comment which I will break down below. Again, Dr. Segall did nothing wrong. He was exposing people to a belief system that they may not be aware of, and I am all about public exposure of belief systems and free speech. He was letting people form their own opinion. I think what he did was wise. I’m just writing this post to expand on my subsequent opinion which I posted on his Substack account.

A. “Good interview, Matt! Intelligent design (IMO) has not progressed since 1998. 1) No matter how hard we try, we cannot prove / disprove God. ID is a tiresome continuation of this argument.” I agree that Dr. Segall did an excellent interview. I did some background work, and it does appear that the ID movement likely started in 1998. I’m sure the book, Darwin’s Black Box, by Michael Behe influenced this movement. The book is well written (I read it when it first came out), but it has some fallacies especially when it comes to ideas surrounding irreducible complexity. In my opinion, humans need to move on from debating if God exists or does not exist. We have so many other problems going on in our world politically and environmentally. I’m a Christian and believe in God. However, I can’t prove that God exists. Atheists can’t prove God doesn’t exist. And the conundrum is perfectly fine. Ultimate meta-physical questions such as the existence of God / No God are metaphysical questions that are influenced by one’s upbringing and societal influences over time. ID is a continuation of this argument and makes the argument even sillier in the setting of pseudo-science.

B. “ID is not Popperian so its validity to, say, biology, chemistry, medicine, etc. makes it definitely not a scientific field. It can be a theological or philosophical construct, but it cannot be science.” Personally, I believe that there is a line that exists in the setting of falsifiability in science, but the line is dependent on the scientific field. Medicine (my field) is very, very hard because the human body is complex, and we need very objective research to identify a body mechanism or pathology, to prove that a lab test works, or to prove that a medication works. One can read the New England Journal of Medicine to see how complex such research can be. By trying to be as objective as possible, a medical study allows for falsifiability. The problem is that medicine is filled with quacks throughout the world who promote pseudo-science that borders magical thinking (chiropractors and homeopaths come to mind). Their work allows for no falsifiability and is essentially “magic.” Chemistry research is very strict in its protocols. Thus, outcomes in chemistry research can typically be falsified, if needed. Karl Popper has been very clear here about falsification in science.

Karl Popper

However, there are fields that are science yet not Popperian. Theoretical physics such as in the field of string theory and Everettian mechanics come to mind. Such fields are still science as they are exploring the edges of what humans know. Ideas in theoretical physics often cannot be falsified because the objective data would need be obtained with high energy experiments beyond current human capacity. I get that aspect. One thing that theoretical physics does not do is state that the answer to complex questions in the field of physics is God. Medical research does not state a patient is cured due to God, yet chiropractors often talk about “body energy” — whatever that is (likely magic). ID as well as YEC typically state evolution happens due to “God.” Sorry. God is a very important concept for humans. God is a very important theological concept. BUT God is not a scientific concept.

C. “The continuing appeal to ‘irreducible complexity’ by ID always runs into walls when we are discovering how the eye has evolved, how flagella have evolved, how DNA may have formed, how cytoskeletons may have formed, and on and on. ID seems to always ‘move the goalpost’ once we make scientific progress on a subject once deemed irreducibly complex by ID.” I’m the first person to state that I don’t think that our singular species on one little planet in a unremarkable solar system in an unremarkable galaxy will solve every scientific problem in the universe.

The “pale blue dot” of Earth seen from Saturn. Image from the BBC.

However, that fact doesn’t mean that we shouldn’t try to advance science. And we have made progress. We have a great understanding about eye evolution. We have a great understanding about flagella evolution. We are starting to understand how DNA came about. The evolution of the cytoskeleton is becoming more clear. Indeed, if one follows ID writings (which is a painful endeavor), ID simply moves on to another subject without ever acknowledging the science that has been done to go against their hypotheses. It is an unending cycle of willfully ignoring work that has been done by the scientific community. ID is very frustrating here.

D. “ID is a weird variant of positivism. Instead of saying that proof only exists when we experience a concept via the sensory process (i.e., measurement), ID states that proof [of God] only exists if we can’t measure a concept.” Positivism basically means that a thing is true if it can be objectively proven to be true, preferably by the scientific method. Any other potential topic such as God would not be true since the concept is not provable. Metaphysics is not compatible with positivism. A good review article is here.

Rudolf Carnap, a famous proponent of positivism

I like to think that positivism abounds in objective ideas but fails in subjective thought. It also may fail in some parts of science, such as theoretical physics (see above). ID is kind of a variant or even, dare I say, a reciprocal of positivism. Instead of stating that facts are true only if we can prove them through deduction or observation as in positivism, ID states that one specific “fact” (i.e., evidence of God) is true if we haven’t been able to observe / measure a concept. This ID fallacy easily can be seen in the concept of “irreducibly complex.” One simply cannot say “God is here” if one cannot find a solution to a physics/chemistry/biology problem. Time and research progress have not been considered! As I have shown above, prior ID ideas surrounding the evolution of the eye or the flagella have been shown to be demonstrably false.

E. “As you know, I’m a religious person. I have a hard time believing that ID is helping people believe in God.” Some atheists (not all of course) may read this post and be shocked to learn that I am a Christian. But I am. I have been a Christian for a long time, and I find that working in the field of science has increased my belief in God. What do I mean? Working in science has allowed me to see amazing progress, especially in the medical sciences. Seeing patients now recover from once deadly diseases allows me to have awe about the human body as well to be impressed as to how humans have advanced scientific knowledge. This “awe” makes me think that God being the strut in a matrix of complexity and progress makes sense. Readers of my blog know that I think there is the presence of a Creator although such a Creator is not involved in forcing human progress (God may simply lure). Quantum physics, biological evolution, the cosmic background radiation are all examples of my personal experience of “awe.”

Cosmic background radiation. Image from Wikipedia.

However, in the interview with Dr. Segall, the representative for the Discovery Institute states that the public is finding their work helpful. Now, such a statement is interesting and may not be accurate. Data have demonstrated that churches that are antagonistic to science are causing young people to leave church. In a manner similar to “Release the tapes!” (see the 1972 Watergate break-in), places like the Discovery Institute and the Creation Museum never seem to release their data as well as how such data was collected when they make such claims. In other words, “release the data!” I strongly believe that places like the Creation Museum, the Ark Encounter, and the Discovery Institute more than likely do the exact opposite of what they are claiming. A good video which supports my thoughts is here. Just release the data and how the data were collected.

Science done well improves the human condition. Theology done well also improves the human condition. Our species and the planet always does well when science and theology inform each other.

And please read Matthew Segall’s Substack account. It truly is informative and excellent.

My AI image of “More than a comment, than a question.” Image made by Gemini Advanced.

The Missing Third Circle

This past weekend I was a speaker / moderator / advice-giver at the 2nd year fellows’ conference for the North American Society For Pediatric Gastroenterology, Hepatology & Nutrition (NASPGHAN). NASPGHAN is the international association of all pediatric gastroenterologists from Mexico, the United States, and Canada. As background, a “fellow” is a trainee who subspecializes after residency. In the case of pediatric gastroenterology, a fellow spends 3 years in training (after a 3-year pediatric residency) before they can sit for their pediatric gastroenterology board exam and become an official pediatric gastroenterologist.

This year, I taught at the 2nd year fellows’ conference in Inverness, Colorado. I have taught at the first, second, or third year conferences something like 10-12 times in my academic career. It is always rewarding. This year, my talk was titled, “Balancing Work and Life?”. I have given this talk many times before. Basically, the lecture is about working as a pediatric GI fellow (which is a VERY hard job) while trying to balance life outside of work.

Me…speaking at the fellows’ conference this year

I added one slide to this year’s presentation. In the slide, I added the figure below which I made on Google Gemini.

Academic medicine works best when there are 3 equal parts contained within it. The three parts are: 1) Clinical work (taking care of patients), 2) Clinical education (teaching medical students, residents, fellows, and even other faculty), and 3) Clinical and basic science research.

Think about what would happen if one of those interacting parts went missing. Medicine would suffer. In fact, medicine is currently at risk of significant deterioration (at least in the U.S.) when we think about how medical education has slowly been degraded over time. Medicine also is at risk of deterioration when we think about the massive reductions in NIH funding. Of course, clinical work declines when science in general has become less trusted in the United States with the horrible rise of the anti-vaccine movement as well as other problems.

Graph from the Los Angeles Times

Thus, the 3 wheels of academic medicine (clinical, education, research) work best when working together like a well-run clock.

A three-wheel clock

Let us extend this idea to another realm? What about theology and specifically, what about the interaction of science and religion? Does a well-run clock metaphor work here? Absolutely. The problem currently is how viable this interaction exists when considering how science and religion currently engage with each other. There is no “war between science and religion.” This so-called war is quite silly as humans have always been objective (sensory based regarding the environment, science, engineering) as well as subjective (metaphysics, art, literature).

So…I have made this Gemini image for this post.

We need some kind of interaction between the real and ideal…between the objective and subjective…between science and religion. The problem with doing this interaction well is similar to the problem of doing academic medicine well. If one of the circles is not emphasized, the whole prospect of increased human understanding, cooperation, and love can be damaged. I put a “?” in one circle as I think one of the essential interactions of this model is currently missing in the world. Such resultant crippling effects can be seen in how terribly we treat each other when we try to make life difficult for people of different religious backgrounds, ethnicities, human sexualities, etc. Such crippling effects also can be seen when humans use religion to deny the importance of scientific concepts such as global warming, biological evolution, and miracle of vaccines. Finally, such crippling concepts can be seen in the setting of war.

Atomic bomb at Hiroshima, Japan. Image from University of Pennsylvania.

Religious institutions that do not provide at least a minimal but accurate science education risk having their religious leaders or laity believing an inaccurate fact-based belief system as opposed to dealing with of the real problems of the world.

Scientific institutions that do not provide some education about the subjective belief of our species risk sounding pompous and uninformed regarding how most humans (not all, of course) want some type of divinity in their lives. This aspect also leads to an inaccurate belief system which blocks progress when dealing with the real problems of the world.

We need a good interaction here. Of course, some religious institutions are great at understanding science, and some scientific institutions are great at understanding that people are often religious.

What we need is better translational work between religion and science. Theology often can be helpful here, but theology is not helpful if the theology is poor. I believe that in the current political climate of our country as well as in many parts of the world, translating between these two spheres of thought is more needed than ever. There are people who work in this intersection of belief systems. I try to do work at this intersection — sometimes well, sometimes not well. These 2 belief systems are not diametrically opposed. They can be synthesized into ways which improve the human condition, the condition of other species, and the condition of our planet in many ways. Such synthesis can include:

  1. Advancement of science
  2. Improved funding of science / funding of science education.
  3. Improved education of non-scientists about the importance of science
  4. Improved education of accurate science
  5. Increased religious engagement with science to potentially improve the ethics of science
  6. Increased religious engagement with science to properly educate religious groups in the setting of a church, mosque, temple, or synagogue.

The album, “Hemispheres” by Rush. Even though the album was produced in 1978, the A side of the album still is very relevant today. Also, I am a huge Rush fan.

Perhaps this critical connection between science and religion, when done well, may be one of the most important things that our species should be doing currently. I don’t know. However, the pathways leading to potential disease prevention, poverty prevention, war prevention, and prevention of pollution or global warming all seem to stream mightily from this interaction.

Theology Journal Club!

Graduates from the Open & Relational Theology program at Northwind Theological Seminary do an on-line journal club every few weeks. This past week we read “Evolution: Like any other Science it is Predictable” written by Simon Conway Morris and published in Philosophical Transactions B. Luckily, this article is open access. Here is the link.

Dr. Morris is a widely known paleobiologist who has done groundbreaking work on the Burgess Shale which is a rock formation in the Canadian Rockies. The Burgess Shale is a geological area that provides immense information about the Cambrian Explosion which is when life on Earth likely began to diversify very rapidly.

Cambrian Explosion — Image from Nature

Morris has written many articles and books. One of his interests is trying to determine if biological evolution has specific laws — similar to physical laws. Two aspects are to be considered here: 1) Do species become more complex over time? and 2) what does convergent evolution tell us about the potential of nature to repeat itself? His ideas suggest the potential for biological “laws” and thus perhaps concise mathematical statements about patterns in evolution and in life. There have been some attempts at making laws in biology such as Bergmann’s Rule.

Example of Bergmann’s Rule — Wikipedia

You can read Morris’ RSTB article for yourself since it is open access. However, I found certain aspects fascinating.

A. Morris is a better writer than I am. Here is a main part of his thesis: “The basis of this view relies on the phenomenon of evolutionary convergence. This concept is, of course, not only entirely familiar to evolutionary biologists, but also provides
some of the strongest arguments in favour of adaptational explanations. However, much less appreciated is the ubiquity of this convergence, with examples spanning the entire biological hierarchy from molecules to social systems and cognitive processes.”

This statement is interesting. Basically, he thinks evolutionary convergence extends from biology but perhaps to social systems which could be part of group selection. Theologically, one could state his idea lends itself to God being deterministic.

However, consider the concept of Open & Relational Theology (ORT). When considering ORT, one is exposed to the idea that the future is open to God. God also is relational to all of nature. This relation is one of creativity, and this creativity encompasses all of its many forms, including the potential of evolutionary convergence. In my book, A Theology of the Microbiome, I discussed the theological concept of “lim Δ;” i.e., “a limit [lim] to change [Δ].” I state, “As an example, limits to creativity are observed throughout nature. God has the attribute of desiring eternal creativity while existing in time and in an open future. As part of this desire, God prioritizes nature’s freedom even if nature itself puts limits on its creativity.”

I think ORT and lim Δ work well metaphysically with evolutionary convergence.

B. Morris states, “Thus, when we consider the origin of the birds, the story of Archaeopteryx and its theropod connection, not to mention the spectacular
evidence of subsequent bird evolution in the Cretaceous…” We recognize Archaeopteryx as a dinosaur with wings and feathers, but did you know that birds already existed in the Cretaceous before the tragedy of the K-Pg event? Yes, Archaeopteryx (a transition fossil) and animals that we would recognize today as birds co-existed. Here is a good article explaining this discovery. The air was a niche space to be filled and was already being filled with insects and ancient flying lizards like the pterosaurs. In other words, evolutionary convergence has a long history.

Archaeopteryx — image from Live Science

C. Another paleontologist that I respect greatly is Stephen Jay Gould. Gould did many amazing things in his lifetime, and similar to Morris, they both write like English professors when discussing science. Just brilliant. Gould believed that if one replayed the “tape of life”, different outcomes in life would occur. Personally, I think Gould’s idea makes perfect sense. However, there is some possibility that he is wrong.

Richard Lenski has a long and distinguished history of growing E. coli (the bacteria) over time and isolating subsequent colony generations from each other to follow evolutionary change. It is a long story, but basically he has found evidence that life, at least among bacteria, tends to repeat itself. He (and others) have found that when older E. coli generations are isolated and exposed to similar stressors (for example, exposure to citrate), the subsequent generations in general figure out a way to utilize citrate. They don’t die off. These isolated strains all proceed in a similar manner through their generations and through time. Good references to read are here and here. This evidence seems to point to the idea of convergent evolution. Bacteria are not charismatic megafauna, but the work of Lenski and others suggests the potential for evolutionary convergence and directionality occurring in larger forms of life. Perhaps God lures but does not force life to go in a certain direction?

E. coli — Image from the CDC

D. Morris states “Just as the present evidence indicates a monophyletic
origin for animal musculature, so too the nervous system is restricted to the eumetazoans. Once again, however, we can see significant precursors that point
to a deeper inevitability. Thus, it is not particularly surprising to find among the sponges, which evidently lack any nervous tissue, a series of proteins that (with
some notable absences) are otherwise central to the post-synaptic configuration in higher animals (Sakarya et al. 2007). These proteins have been identified in a
distinctive group of flask-shaped cells and the fact that they display molecular mechanisms that are also the hallmark of neurogenesis…”

If evolution does eventually lead to a neurological system, then is evolution directed towards eventual conscious awareness? I have no idea, but it is fascinating to consider. Such a suggestion would seem to be metaphysical in context. In the setting of the theological (and philosophical) idea of “panpsychism” or perhaps “panexperientialism“, then all small droplets of experience might combine and lead to things such as human consciousness. The evolution to human consciousness would take probably millions if not billions of years as life comes out of non-life materials and biological evolution proceeds. If God is in the mix here, then panexperientialism (which I prefer to panpsychism) would be the effect of all of nature having some type of experience with the material as well as with God. Since God is in / around / through all entities (panentheism), the idea of all creatures communing with God and every entity communing with God would make sense.

Perhaps the idea of directionality towards an eventual nervous system and even consciousness matches what has been explained by Information Integration Theory (IIT). I don’t know.

“Convergence”, Jackson Pollock

My conclusion: I believe in God, and I am a Christian. However, I don’t know if we can take the potential for evolutionary convergence or evolutionary directionality as evidence for God. I have no clue. I worry that humans are built to look for patterns — perhaps we see a pattern here in biology (expressed by Morris) that does not exist. For example, we think we see patterns in the art of Jackson Pollock when they really may not be there.

However, Morris’ ideas are fascinating from a scientific, philosophical, and theological perspective.

Image generated by Gemini Advanced

Altruism, Evolution, and Late Stage Capitalism

The New England Journal of Medicine had a recent article titled, “Physicians, Corporatization, and the Unmeasured Quality of Care.” written by Lawrence Casalino (Division of Health Policy and Economics in the Department of Population Health Sciences at Weill Cornell Medicine, New York). The article, unfortunately, is behind a paywall. Perhaps your local library has a free link.

I love this article for many reasons. The basic premise is that financial measurement of compassionate patient care should be considered in United States healthcare. If you can’t measure it, you can’t reimburse it accurately. This issue leads to the bigger problem of the ethics of “paying” for compassion in medicine.

Let me give you an example. Replacing a knee in an older person is a very complex and important orthopedic procedure. After becoming proficient, this procedure for an orthopedic surgeon understandably becomes rote in how the procedure works. A typical knee replacement takes 90 minutes and reimburses an average of $30,000 with a cost range of $15,000 – $50,000.

Let me give you another example. A pediatrician in the clinic setting has a child come in with malnutrition and who also has experienced potential child abuse. This issue takes a LONG time…examination, labs, talking to the hospital about potential hospitalization, finding a dietician that works with the family’s insurance (or lack of), finding appropriate social services, and even calling the police department. Keep in mind that it is hard to find reimbursement costs for pediatric care because children aren’t covered by Medicare. However, this 90 minute – 120 minute visit which takes significant mental concentration will reimburse anywhere between $150 to $350.

Both the orthopedic surgeon and the pediatrician can be extremely caring people and probably are wonderful. However, should their reimbursement be the same? Should it stay so different? No one really knows. I have strong opinions here, but I could be quite wrong.

This is one of the points of the article. Mainly, can we actually pay for altruistic care?

A quote from the article: “In a classic article, Nobel Prize–winning economist Kenneth Arrow argued that physician ‘behavior is supposed to be governed by a concern for the customer’s welfare which would not be expected of a salesman.'” By the way, here is the open access article originally written by Arrow.

Casalino also states, “My colleagues and I recently used a well-established type of economic experiment to measure altruism, assessing the extent to which people shared money available in the experiment with an unidentified person. We found that although only one third of physicians acted highly altruistically, the average physician acted more altruistically than members of the general population and much more altruistically than the average highly educated, high-income person. We also found evidence that patients of physicians categorized as altruistic had fewer potentially preventable emergency department visits and fewer potentially preventable hospital admissions than patients of other physicians.”

I was interested here and pulled up the study that Casalino and others performed. Thankfully, this article also is open access.

What do we make of all of this? Let me put down some thoughts.

  1. Physicians who are altruistic probably are safer. Of course, there are so many variables here. A very altruistic neurosurgeon still will have complications because she often takes care of the sickest patients in the hospital. This aspect is NOT her fault. The problem arises with inherent patient pathology.
  2. Current medical care in the United States does not pay for altruism. It pays for patient volume and pays for procedures. I am a pediatric gastroenterologist. This problem is quite true in my field. I am not saying necessarily that universal / nationalized health systems are better. These systems have their own issues with outcomes, patient wait times, and intractable problems with emergency services. However, universal healthcare is not terrible. As an example, patients with cystic fibrosis in Canada seem to live 10 years longer than patients with cystic fibrosis in the United States. Here is the open access link. Keep in mind that cystic fibrosis care is extremely expensive yet much cheaper in Canada compared to the U.S.
  3. If we emphasize patient volume and procedure volume in the United States, are we also emphasizing quality care? Not always. Are we emphasizing altruism? Definitely no.
  4. Late stage capitalism: I pretty much define this term as capitalism that has become so out of control (i.e., too expensive) that eventually the system needs to change. In fact, it is forced to change due to the downstream effects of income inequality, food insecurity, and other related issues. A good review of this terminology from Canada is here. A good review of how late stage capitalism has affected higher education is here. I have no issues with capitalism. I DO have an issue when it gets so out of control that people go bankrupt because of medical debt. I frequently see this tragedy in my medical practice.
  5. Is human altruism connected to making money? I don’t think so. Is human altruism connected to late stage capitalism? No. They are antithetical to each other.
  6. Altruism: I think there are two perspectives here. From a genetic perspective, altruism can be defined as caring for others at the expense of one’s survival and/or at the expense of one’s genetics in term of passing one’s genes to further generations. Altruism, as a result, can improve the survival of one’s relatives, one’s species, or one’s society at the expense of the individual. There also is a subjective component here. Humans often demonstrate altruism due to simply caring for or loving the other with no strings attached. It has even been argued that humans can prefer to practice altruism at the expense of our survival. I’m not sure this fact is true. I have no clue.
  7. However, it may be true if there is a metaphysical aspect here. Suppose we are altruistic because we think or we know God wants us to care for the other. This yearning is not about getting an “award” in the afterlife. This yearning is simply loving the “other” with no strings attached. Suppose we are altruistic because we think or we know that promoting love of the other (family, non-relatives, other types of life, our planet) promotes creativity and promotes love in nature. I think this statement is very true. It seems to be a big part of our religions. Matthew 25: 40 states, “Truly I tell you, whatever you did for one of the least of these brothers and sisters of mine, you did for me.” I’m a Christian, so this verse is important to me. In Islam, Quran 51: 19 states, “And in their wealth there was a rightful share ˹fulfilled˺ for the beggar and the poor.” In Buddhism, Itivuttaka 75 states, “Having rightly amassed wealth attained through initiative, he satisfies rightly with food and drink those fallen into the homeless state.” All of these verses are profound.
  8. Perhaps our tendency to follow our holy books throughout a significant portion of humanity’s history combined with the genetic aspects of altruism is an epigenetic phenomena.

But consider…just perhaps altruism is humanity’s drive to align with the Divine for love and creativity. For the love of other humans. For the love of all of nature.

Our current healthcare system (at least in the United States) is not built for the love of the other. Late-stage capitalism, no matter how it is defined, does not seem to align with the love of the other. We all have a choice to care for the other, individually or societally, even when market forces work against us.

Image from Our World in Data

Another image from Our World in Data

Image made by Gemini Advanced