Monday, August 23, 2010


I have discovered in myself a new response to novels, when I glance at rows of them in the library. It's ridiculously naïve: but this is not real. This is all made up. I used not to mind that; I used to prefer it. Now there seems something dangerous about it. We are already prone enough to make it all up: why encourage each other? I am hungry these days for fact. I read mostly nonfiction. The more facts the better. How many people died of diphtheria in Cairo in 1908? That's the sort of thing I want now. Maybe it's because I am aware now of how hard facts are to come by. When I was a boy it seemed that facts were all over the place. My father was an inexhaustible fund of them. How far away was the moon? How much more likely were smokers to get cancer? What was the real, indisputable, Latin name for St John's Wort? My father knew all those things, and made sure that I did too. My world teemed with authoritative facts.

He meant no harm by this, of course, and in the long run I think it was good for me. I inherited, anyway, his respect for facts, and I learned early that much of “what everybody knows” is dead wrong. But it left me with the impression (which was easy to get anyway, growing up in the sixties) that the fact collection was all under control and proceding splendidly. My help would not be needed.

And what I could see, but it seemed that my father could not, was that all these facts were curiously helpless. My father steered by them, his own idiosyncratic course, but nobody else I knew did. Everyone else steered by stories. Even if they were obviously false stories: the stories in Genesis that my father found so ridiculous, or the New Testament miracles of walking on water, of loaves and fishes – my father, it sometimes seemed, was the only man in the world to whom it mattered that these stories were manifestly false. And I very gradually learned – for I was a voracious and indiscriminate reader – that most of the bedrock stories, the founding of America, the high nobility of the Civil War, and even my father's favorite stories of the religious persecution of science, were mostly false, or at least tendentious. My father, I decided, much as I admired him, had missed the point. What mattered was not whether stories were true: it was whether people wanted them to be true. Or rather needed them to be true. Many people did not at all want a fearsome avenging God: they knew they'd sinned, and that God was going to smite them. But somehow they needed him anyway. And so I wandered away into stories, as the things of real power, the things that really caught people by the throat and made them change their lives.

And I turned – partly I suppose out of sheer rebelliousness against the dominion of fact – to fantasy. It seemed more honest, somehow, to say right up front that you were talking about places that never were just because your heart yearned for them, or about imaginary phantoms just because you dreaded them. Others might mistake the Shire for the kindly England of Tolkien's childhood, but I knew better. Tolkien grew up like any American child, rootless and homeless, a fatherless, Catholic, South African colonial come home to precarious suburbs and a new school every year, a permanent alien and outsider. Tolkien could describe home with such overwhelming feeling, so convincingly, precisely because he had never had one and didn't know anything about what homes were really like. All he knew was what he longed for. I wasn't looking for the Shire to be real. I just wanted to know that someone else missed it, too.

Now that I'm sidling back into science, because I'm on the outskirts of medicine and I really need to know things – such as, does massage assist the metastasis of cancers? – I'm finding that facts are not so easy to come by after all. Good science no longer seems like the juggernaut driving all before it: it seems more like a delicate, fragile lighter-than-air craft, as threatened by its duller-witted partisans as by its enemies. I want to go back to school, or at least get some textbooks, and get a good scientific education. I didn't pay proper attention in the statistics class for my computer science degree: and the fact that I got an A makes me very uneasy about the general state of research. How many people actually know what they're doing out there? I haven't done a lab, nor written a science paper, since the the 8th grade. I read abstracts of papers and get only the vaguest sense of how important their results are: for my own field of massage research I've been relying heavily recently on Paul Ingraham, of, but I have only his word for it that he knows how to evaluate these things. I ought to be able to evaluate them myself.

It used to be thought that massage was not appropriate for cancer patients, because it would push the lymph around, and that might spread the cancer. There was never any evidence that this happened: it was just a plausible hypothesis, and one that nobody wanted to test. (For good reason: “Hey, let's take a group of sixty cancer patients, do massage on thirty of them, and see if their cancer progresses more rapidly!” is a study that's hard to get enthusiastic about.) I read a book about it a couple years ago that emphatically denied massage could do this, and it seemed to be the standard modern book on massage and cancer, but I don't recollect what research it rested on, if any. Even back then my common-sense response to the idea that massage might help metastasis was that if you were relying on your lymph standing still to save your life you were a dead man anyway: but common sense isn't always a very good guide in medical matters.

But you see? An untested hypothesis became a standard medical protocol (“no massage for cancer patients!”) And the scientific basis for my present conviction that massage is fine for cancer per se (though radiation or chemo may contraindicate it) rests on information I no longer remember, derived from research which (if it exists) I couldn't reliably evaluate even if I did read it. And I'm one of the science-minded massage therapists. Oy.

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