Monday, February 20, 2023

Facts in Human Affairs


Facts in Human Affairs


Here are some thoughts that are very basic and which I am sure have occurred in some form to almost everyone at some point. But I think that they may still be worth noting. 

Facts in Quantitative Fields and in the Natural Sciences


In quantitative fields such as mathematics, basic physics, basic finance, etc., one can usually (though not always) be reasonably confident that published data, analyses and conclusions have undergone some scrutiny. 

What is more, in principle, if one has sufficient skill and time, one should be able to verify any given, claimed measurement or result oneself, directly, through careful observation, logic, computation, etc. This ensures that one cannot usually get away for long with "manufactured facts" or other nonsense.  

Does this mean that these fields are free of dogma, blindness, selective reporting or outright fraud? No. But usually these things cannot be maintained indefinitely. This is precisely because there is no "authority" in these fields, other than the test of verifiability or reproducibility. 

This gives us a bedrock on which we can build with at least some confidence. 

Numbers are of course things that are seen as having minimal fuzz, although they are almost never completely free of that. In any case, quantitative observations often provide a firmer basis than qualitative ones do for connecting our mental constructions with physical reality.

What happens, for instance, in the physical sciences, to a theory that predicts a number that does not match the number produced by repeated, careful measurements made in the "real world"?

Such a theory, however hallowed by earlier verifications of other predicted numbers and however venerated for elegance or intuitive appeal, has to be either modified or discarded. There is no way out of this. 

But even in those natural sciences that have traditionally been less quantitative, such as biology, observation that is replicable remains paramount. 

Limitations on Objective Methods


The natural sciences and the quantitative fields have great strengths. However, like everything else, they are limited in their range of applicability. No one in his/her right mind would try to apply these, for instance, to the purely subjective phenomena within an “individual sentience”. By definition, such phenomena are usually accessible only to the being experiencing these. They are not usually accessible to others. So these things are not objectively verifiable. 

I cannot, for instance, really feel your pain or your pleasure, although I may have some degree of connection with you and so also some empathy in this regard. It is the same, more generally, with all sensations, perceptions, emotions, thoughts, memories and imaginings. 

Indeed, identity itself cannot be identified through objective means. The “I” dissolves upon examination. Nor would “I” be able to find “you” anywhere in “your” body. And vice versa. 

Facts in Human Affairs


Be that as it may, what we find, in human affairs, is that the precision or replicability that one depends on in quantitative fields and in the natural sciences is rarely possible. What is more, human affairs can be greatly tangled and complex, with interactions, for instance, between psychology and finance, and more generally between expectations and results in every human field. 

It is difficult or impossible to disentangle this complexity, separate it into compartments, understand each part as best as we can and then put things back together to make the whole. 

The "analytic method" fails. There are too many interactions between the components. The whole is greater than the parts. This is at the cores of both the wonder of life and of society, as well as of their resistance to analysis.

One has also to be very careful about drawing definite conclusions based on anything other than first-hand, “eye-witness” knowledge. 

I learned that lesson very early on in my life. Even within the same house, two accounts of the same witnessed incident could vary quite a bit. And of course, with every retelling, things tend to be stressed, not stressed,  added, or left out. 

How much more potentially incomplete and distorted, then, are accounts of what happened a block away, across town, in a distant country or in the time of our grandparents or much earlier?

So, even with what may be reported and become generally accepted as factual, one has to be careful. 

History or Mythology?


From all the myriad events in a particular time period, even for a limited locality, a “recounter” or historian selects just a few. He or she repeats this for different time-sections, and then strings these selected events together into a sort of story, usually with just a few central characters, chosen out of the many possible. 

The persons who do this should not be unduly blamed. This is all that humans can usually do, trying to make some sense out of complexity. We tend to linearize or sequence, for instance, things that are fundamentally nonlinear or non-sequential in nature. This is also what  humans are most capable of comprehending. 

Stories are what we are told when we are young; stories are what we understand and enjoy. Stories are what we create or modify ourselves; they are what we use to make sense of the world. 

Given this, what should still be perceived clearly is that every historian has his/her biases and filters, these being dependent to various degrees on their own settings.

When I was still young, growing up in India, I began to try to listen to not just All India Radio or the BBC but also, when I could, to other radio broadcasts, including from countries with which India or the UK were at odds or in open conflict. I found that at times the same events were reported in ways that made one account look like the “photographic negative” of the other one, be the report from right across a common border or from a distant place. 

Over time, I came to realize that each nation-state constructs a national history that is a mix of selected facts and at times gross distortions of reality. So the “national histories” are to a degree “national mythologies”. Political events may, of course, lead to challenges to these mythologies. Unfortunately, too often, these are replaced by new mythologies that are just as distant from reality, if not more. 

Just as there are "national histories" that are in fact just as much "national mythologies", be these British, French, Russian, Indian, Chinese, Japanese or whatever, so also there are theological and ideological narratives and worldviews that are, to various degrees, also a mix of selected facts and things that are not factual. 

This has long been clear in theologies, and more recently perhaps in the political and economic ideologies that are in some ways their descendants.  

Whether it be Western-Mediterranean fascism, the more lethal German-Nazi variant of that, socialism in its various forms, communism in its various manifestations, or globalizing free-market capitalism in all its past and current incarnations, or the various mixes of religion, nationalism and politics that have arisen across the world, we can see that each of these are continuations of the attempts by humans to make sense of the world, including the human world, through the creating of simplified models of its complexity. 

This is what physicists and others have been doing now for awhile, with considerable success and usually with no ill-intention--whatever be the positive or negative uses to which their work is put.  However, this is also what kingdoms and empires have used to justify their existence and propagation and what political parties use, for instance, to either maintain the present order or to challenge it. 
 

The War in Ukraine


Currently, we may have noticed, here in the USA, a divergence in reportage on the Ukraine War between Fox News on the one hand and CNN or MSNBC on the other. This divergence used to be common for domestic affairs but was much less noticeable in foreign affairs. So also, many of those in India may have a different view of the war than most of those here in the USA or in the UK. 

Who is right, and who is wrong? The reality is that each group of presenters--be it of politicians, businessmen or media, is usually presenting a selection of facts that favors the interpretation or slant they are inclined to. Whether doing so consciously or not, they are "selling" or "marketing" what is essentially as much a subjective, human product as an objective, factual view of certain aspects of the human world.  

I do not wish to enter here into the debates regarding the Ukraine War. Like all wars, it is an ongoing horror that should never have begun and should be ended swiftly. I am only using it as an example of very recent events that are viewed, depending on one’s location and/or affiliations, in very different, indeed almost opposite, ways.

One could give numerous examples of other wars, carried out overtly or covertly, during just our own lifetimes, for which our opinions or even our “facts” would differ widely, depending on our circumstances. 

The terms we use reflect this. One person’s “terrorist” is another person’s “freedom fighter”. One person’s “invader” is another’s “liberator”. 

A “government” we dislike becomes a “regime”.

The Last Famines in India, 1943-1945?


Facts do exist in human affairs. The "Bengal Famine" of 1943-44 was not a fiction, nor the group of famines that followed it in Southern India in 1945.  Nor were the many famines that had occurred earlier in the subcontinent, when it was dominated by the British East India Company and later under direct rule by the British Crown, products of Indian nationalist imaginations. They were real and they were horrors.

The same may be said of many other famines the world over, with humans often playing a large role, as occurred in British India, in creating these disasters. And this also true of many great massacres, including even  genocides that were multi-continental in scope, that rarely get much attention or are even remembered. 

However, while in school in Kolkata and later in Delhi, I learned naught about these more recent catastrophes, including the “Bengal Famine” of 1943-44 that had occurred, in my region of birth (Bengal), less than a decade before that birth. It is possible that I might have learned more about it, if I had taken, after class 8, the Humanities or Commerce streams rather than the Science stream as I did—but I am not at all sure about that.

As it happened, If I had not seen my father's photographs, I would not have known that this great famine affected not only Bengal proper but also adjoining Orissa/Od'isha or that, in 1945, further famines extended deep into southern India, devastating parts of what are now Andhra, Telengana and Karnataka—and even reaching what is now Kerala. 

I am sure there were other places that were also affected, missing from my father's reportage because he could not travel to those places. 

When one tries to investigate the causes of these famines, that of 1943-44 localized mainly in Eastern India and those of 1945 spreading into Southern India, one finds that one has a lot to learn, even about things that were so momentous, so local to many of us and so recent, occurring shortly before our births and so witnessed by those of our parents who were in the affected regions. 

South India Famine of 1945


Sometimes, events that occur simultaneously or in sequence need to be given a collective name to be even duly recognized and remembered. The term “South India Famine of 1945” (rather than the separate terms, “Andhra Famine”, “Famine in Mysore”, etc. that my father used to use earlier) might serve the purpose in this instance of the 1945 famines in these regions and adjacent ones.

Bengal-Orissa Famine of 1943-44


I still do not know much at all about the "South India Famine" of 1945 and it was only when I came across Madhusree Mukerjee’s ground-breaking work on the "Bengal Famine" of 1943-44—as recounted in depth in her book, "Churchill’s Secret War" (2010, 2018)—that I began to get a better idea of what had occurred during that famine, why it had occurred, the historical background for it that stretched back to the rapacious policies of the British East India Company and the wider connections of that particular famine with events in the world and in the subcontinent. 

< As this section had become perhaps too long, I have moved the central body, which is in many ways crucial, to an appendix at the end.  --AJ, 2023-02-21>

Ms. Mukerjee's revelations, including the active
role of Churchill and others in his circle in bringing about, worsening and prolonging the famine, have subsequently been taken up by others who have publicized these findings, with or without credit to the source, as is usual. 

People resident in the major cities, especially Kolkata, probably fared better by far than those in many rural areas, although they too saw people trekking in from the villages to the cities in search of food, only to die, in too many cases, in the streets there. 

Disconnections between Urban and Rural Areas and between Economic Classes


This disconnect between the typical upper middle class Bengali "bhadralok"  of Kolkata and their village countrymen and women was something even I had noticed as a young boy in Kolkata. Of course, just as visible, in Kolkata, was the disconnect between economic classes.

A partial counter-example that I found later was that of those Punjabi Sikhs who had remained in the north and who tried to maintain close connections with their villages, even when living in the cities. Of course, the partition of the subcontinent made that impossible for many. 

So much for "facts" in human affairs.

What about opinions?  These of course diverge even more widely. That is why one should be wary, for instance, of depending only on  selected medial “news” sources, or of avoiding uncomfortable facts and contrary opinions. 

2023 February 20th, Mon.
Berkeley, California

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Appendix: The Famine of 1943-44 in Bengal and Orissa/Od'isha


This famine of 1943-44 in Bengal and Orissa was directly connected of course with challenges of various degrees, real or perceived, to the British Empire, from within its dominions as well as from the Second World War. But the connections of the famine with other occurrences did not end with this.

Among other things, a cyclone had already inflicted much damage in parts of Bengal and adjoining areas, prior to the famine of 1943-44. The British rulers were concerned about rebels in Bengal joining up with the Japanese and Subhas Bose's INA (Indian National Army) if the latter succeded in entering the subcontinent from Burma (now Myanmar). They adopted, consequently, something akin to a "scorched earth policy" in parts of Bengal not in the vicinities of Kolkata and perhaps other major cities, buying up grains directly or through intermediaries, ostensibly for the military and the war effort, along with civilians needed in the cities. This of course produced predictable scarcities, driving up prices and increasing hoarding by merchants and landlords.  

Bengal, especially the eastern part that is now Bangladesh, is a riverine terrain, with seasonal floods that made travel by roads impossible. Grain and other foodstuffs were also usually moved through the rivers, traditionally utilizing the tides, winds and human labor. The British government purposely seized and burned barges used to transport grains in parts of Bengal. This could either be seen as a punishment meted out to rebel areas or part of the scorched earth policy that resulted in the famine--or both.

Hindu-Muslim divisions in Bengal were deepened by the famine of 1943-45. There had also been rebellions against the British in places such as Midnapore/Midnapur/Medinipur, including against the forcible procurement of stocks of grain for use by the military and for exports. These rebellions were brutally suppressed, at times further inflaming communal animosities. As it happened, not coincidentally, Medinipur district was among the areas that were worst-hit by the famine. 

Winston Churchill's active role in all of this, as well as that of others in his circle (at a time when there were bumper crops of wheat all over the world and Britain itself was very well stocked with imports, including from India) is well documented in Ms. Mukerjee's book,  "Churchill’s Secret War" (2010, 2018), mentioned earlier in the main text, in the section on the famines. 

Churchill, in his recorded notes and other writings, exhibited a great aversion to Indians in general and seemed to relish their travails and deaths. He and his advisors repeatedly rejected requests by British governors in India to help prevent the famine and then to help lessen it. 

This included the rejection of a desperate plea to divert a few grain-laden ships steaming through the Indian Ocean to docks in India. In addition to the extra grain, and probably more importantly in at least the short term, this would have helped to drive down prices and to release hoarded stocks within India.

Yet, Churchill is still venerated through much of the world, including even in Bengal, mainly for his perceived (and well-publicized) heroic role in WWII. 

One should note that India's population was far from being the only one that suffered from Churchill's views and actions. So should he simply be reviled instead? 

Neither would suffice to completely describe the man, his mindset and his positive and negative contributions to the welfare of our species. Churchill is no exception in this. 

Personal Note


Again, I had never learned much about this, even from my father, the photographer Sunil Janah, although his family was from the hard-hit Medinipur district and he had traveled there during the famine that many had foretold and that broke out subsequently.  

Because of the wartime alliance with the USSR against the Axis powers, the British had temporarily lifted the ban on the CPI--the Communist Party of India--during the war, making the travel possible as well as the subsequent reporting--although of course in very restricted ways.  

However, the report on the famine by P.C. Joshi, who was then the general secretary of the CPI, was published in the party journal, People's Age/People's War, in English as well as in the major Indian languages, along with photographs taken by my father and sketches made by the artist Chittaprosad, these two being among those who had accompanied Joshi in his tour of the famine-stricken areas. 

This allowed news of the famine to spread beyond the confines imposed by the British censors, including through socialist and communist journals to the rest of the world, with perhaps some positive effect on relief supplies and efforts. 

My father and Chittaprosad became lifelong friends and P.C. Joshi and his wife Kalpana (born Dutta, with a remarkable story of her own during India's freedom struggle) were also close friends of my parents, both while we were in Kolkata and later when both our families had moved to Delhi.

A Book Burning and a Reincarnation


A note should be made here about a remarkable book of Chittaprosad's sketches on the famine, titled "Hungry Bengal" and subtitled "A Tour through Midnapur District, by Chittaprosad, in November 1943". This book, with the sketches unforgettable once seen, was printed in the 1940's, only to have almost every copy confiscated and burned by the British government in India, before the book could be released to the public. 

Uncle Chitta, as I called him (in Bengali), retained a personal copy--perhaps the only surviving one--that was probably passed on eventually to his sister and then his niece. Long after Uncle Chitta's  passing, this surviving copy was used by Ashish Anand and his team at DAG (formerly Delhi Art Gallery) to reprint copies of that book of sketches and bring it into public circulation again, along with Chittaprosad's other works. 


Saturday, February 18, 2023

A Dilemma in Medicine in the USA

 

A Dilemma in Medicine in the USA

This below was my response to a question about an alternative treatment for cancer that had been administered to a U.S. resident who had been diagnosed with a cancer that was advanced and for which there was no approved treatment that could save him in the U.S.A.  So he had gone to Mexico and had been treated there, using a drug not approved for cancer treatment in the U.S.A. This had resulted in a truly significant improvement. However, on return to the U.S.A., his physician refused to approve continued treatment with the drug, despite being presented with the documented evidence. 

Physicians in the USA will only prescribe or openly go along with treatments using drugs approved by the FDA. Federal oversight of medicines and treatments is of course needed. There have always been a lot of scams around, including lethal ones.  However, the FDA is not always right. For instance, how often has a licensed MD you have gone to here in the USA prescribed or even suggested the use of herbs as a treatment or preventive?  Yet this happens quite frequently, I am told, even in countries such as Germany, home to some of the biggest pharmaceutical companies. But in this country this could get the MD into a lot of trouble. 

When it comes to cancer, the paradigm that has been very successful in the treatment of infectious diseases--that of identifying a pathogen and then trying to kill it--is flawed for obvious reasons. The "invading organisms" are the body's own cells. If the cancer is localized enough and identified early enough, then surgery and/or localized radiation may get rid of it. If it has spread, various forms of chemotherapy and in some cases wider use of radiation are utilized, often with many adverse and even lethal consequences. 

While there have been advances in immunotherapy and even gene therapy, there is a basic lack of understanding of the more general reasons behind the growth of cancers (which are part of the lives of most multicellular organisms, with various direct or indirect causes). 

We also do not have any real understanding of how to try to "normalize" cells that are behaving abnormally. In most cases, this is not from any damage or mutation to genetic material. Genes have been switched on and off and we do not know how to enable the body to communicate better with the affected cells to reverse these changes.

It should also be clear that cancers have become much more prevalent in our times, especially in areas that have become industrialized or urbanized or where there have been major changes in diet and/or heavy use of pesticides and herbicides in agriculture. This remains a crucial issue, even taking into account increases in average life span and improvements in detection. 

So a certain degree of humility and openness to other approaches is needed in this and other matters.

Of course, there is no substitute for replicable evidence. 

But here we run into a problem that arises out of the fields of finance ans economics. In order to get FDA approval for the use of a drug in humans, a company has to invest, typically, many millions of dollars in research and development, especially in field trials with humans. Why should any commercial company do this if the treatment cannot be patented? It would be a hugely expensive investment in altruism. That is not what commercial companies are built to do.

Higher levels of homocysteine (a product of protein metabolism) in the blood have long been known to be associated with increased rates of heart attacks and strokes. 

Folic acid (a B vitamin, also marketed as folate) has also long been known to reduce the level of homocysteine in the blood, without any adverse affects--although B12 levels should also be monitored as folic acid can mask the effects of B12 deficiency.

But how many MD's would prescribe folic acid for this purpose? Is it because they are ignorant or perverse? No, it is because such a treatment is not an approved protocol in which they have been trained in medical school. Nor do any of the pharmaceutical company drives they are exposed to during their practice bring this to their attention. 

There is no point in blaming the company executives, the physicians, or even the government. They are all to blame in part for the situation but there is little they can do individually about it. 

So one should of course be very wary of unusual cancer treatments. But one should not have a closed mind about those, whether they are FDA approved or not, provided one has at least some evidence to go on.

Substances meant to cure parasitical infections appear unlikely to help treat cancers. The only general way they might work that I (with very limited knowledge) can think of is that cancer cells may be more adversely affected by the substance than normal tissue cells.

So again, caution is needed, along with some degree of openness. In a case where conventional treatment offers no hope, it may not be imprudent to try other approaches, with due caution.