Saturday, November 14, 2009

Forgiveness

A couple of days ago a 16-year old was jailed for raping a five-year-old boy. The offence took place just days after he had been spared a custodial sentence for a previous attack. The young man, who is said to have Asperger's syndrome, abducted and repeatedly abused the child only eight days after being shown leniency for the rape of a seven-year-old boy. The first victim's family were committed Christians and the court had heard that they forgave him and called for a "corrective" rather than punitive sentence.

During this week I have been watching a TV mini-series called Collision. A multi-car pile-up was being investigated by a cop who had lost his own wife in a car crash the previous year. His daughter had been paralysed in the same crash and was now in a wheelchair. During the course of the program, the drunken driver responsible for his wife's death was released from prison. He sought out the cop and explained that during his time in prison he had become a Christian and now felt that he ought to go to the cop and beg for forgiveness. The cop beat him up. As the story proceeded, exploring the lives of those involved in the crash, it was clear that each of them had done something reprehensible. What was noticeable was how wives forgave errant husbands so as to keep their families together. The cop's crippled daughter even suggested that he forgive the drunken driver. She had, after all, forgiven her father for his affair with a policewoman. She emphasized that without forgiveness he would never be able to move on.

So the question is posed, "Should we forgive?" Even more pertinent, should Christians forgive.

I think there are several points to make. You cannot forgive on behalf of someone else. Even the parents of the abused child cannot forgive on his behalf. They were themselves offended by the abuser's act and they can forgive that, but not really the harm done to the child.

Forgiveness may well be undesired. When the Christian in the play asked forgiveness of the cop, the cop pushed him away. The Christian then said, "I forgive you for pushing me." This raised the level of anger in the cop so that he almost killed him. The cop didn't want forgiving.

Forgiveness does take away responsibility. God's forgiveness may save us from Hell, but it doesn't save us from prison. The judge shouldn't have spared the rapist from jail after the first offence. The thief on the cross was forgiven by Jesus, but he still had to complete his sentence - he had to die.

In a recent episode of House, a young doctor murdered an African tyrant under his care and got away with it. However, it weighed on his Catholic conscience and he went to confession. The priest, quite rightly, says, "You can't be absolved by saying a few Hail Marys; you must go to the police."

Finally, forgiveness is ineffectual without repentance. And repentance means more than saying you're sorry. It means a whole change around in your life.

But isn't God's forgiveness unconditional? Doesn't the Bible say, "While we were still sinners, Christ died for us."?

The offer of forgiveness is unconditional. God made the first move without asking us to do anything first. We are not offered forgiveness because we have made amends, done some community service, given to the poor or spent years as a missionary. God describes all such attempts at atonement as 'dirty rags'. Forgiveness is free; the price has already been paid.

However, we are given the free will to reject the offer. Just like the cop in the mini-series we can give the person doing the offering a punch on the nose. Forgiveness is not forced upon us. As the cop's daughter implied, forgiveness is a great healer. It can induce repentance, but without repentance it is ineffectual.

What difference did it make to the young rapist that he had been forgiven by his victim's parents? None at all. There was no repentance (perhaps because of the diagnosis attached to him he was unable to repent. Perhaps he was like the soldiers at the foot of the cross - they know not what they do.) Whatever the answer he had to be locked up. A beast in a zoo does not know what it is doing when it attacks the visitors; it still needs locking up.

If your brother/son/mother were blown up by a suicide bomber, you would have a hard time forgiving the perpetrator; perhaps in forgiving Islam and everyone associated with it. So would I. A Christian must learn to forgive. "Forgive us our sins as we forgive those who sin against us." That does not mean that the man who planned the atrocity and those who funded and facilitated it are free from blame. They broke the law and must face the punishment that the law decrees. We do not operate under Shariah law, where the payment of blood money can absolve the crime. Our law demands a penalty (in different places, imprisonment or execution). Our ability to forgive doesn't come into it and should not influence the judge when passing sentence.

But being able to forgive unburdens the victim.

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Friday, November 13, 2009

ASH 2009

It is now possible to view the ASH abstracts for 2009. Although I have already broken the news that for the first time a first line treatment has been shown to improve overall survival, we can now view the details here.

We owe a great deal to Michael Hallek and his team for doing this trial, and we ought to ought to complain to the drug company for not doing the trial at an earlier stage. Their perfidy has deprived many people of what is the best available treatment for CLL.

The German CLL8 trial was a large one, involving 817 patients with CLL that needed treating. They were randomized to either FC or FCR in standard doses. The group receiving FCR had a higher response rate (95.1 vs 88.4%) and more complete remissions (44.1 vs 21.8%; p<0.001). and a longer progression-free survival 51.8 months v 32.8 months (p<0.001). We've seen this sort of result before, but do the patients live any longer? Note that the follow up is relatively short (median just over 3 years). The Overall Survival rate was 84.1% in the FCR arm versus 79.0 % in the FC arm (p=0.01).

They were able to do a multivariate analysis to look for what factors predict poorer survival. Several factors acted as independent prognostic factors for both progression-free survival and overall survival, including age, sex, FCR-treatment v FC treatment, receiving fewer or more than 3 cycles of treatment, response, 17p-deletion, serum levels of thymidine kinase and ß2-microglobulin and mutational status of the IGVH genes.

Adding rituximab seems to lead to more neutropenia, but this does not lead to more infections. I presume that the neutrophils are consumed by the CD20/anti-CD20 immune complexes. In fact there were more deaths in the FC arm (86/396, 21.7% versus 65/404, 16.1%). Most commonly death was cause by progressive disease (FC 48/86, FCR 33/65), but there were also more deaths from secondary malignancies in the FC arm (13/86 v 5/65). Of course in this age group there were also deaths from unrelated causes. Treatment related mortality was just 2.0% in each arm.

One strange finding was that the benefit of FCR did not reach statistical significance for stage C patients (Rai stages III and IV). Why this was so is not clear, but it might be due to the relative immaturity of the study or it may be that these patients, with a higher tumor load, need more intensive treatment. Since platelets falling to below 100 or HB falling below 10 are indication for treatment, perhaps a higher threshold for starting treatment should be adopted.

However in another study from the German group the better efficacy of the FCR regimen in terms of response rates and progression-free survival does not yet result in an improved quality of life.

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Thursday, November 12, 2009

Scientists rule. OK?

Would you trust a scientist? Quite apart from whether he is honest or not; is his opinion worth anything? I suppose, in this day and age when actors, pop-singers and sports stars are supposed to have the last word on everything, you might think that a scientist is a bit of an improvement.

The correct answer is, "If he knows what he's talking about." And for the purpose of this article so I don't have to keep writing his/her, let's assume that the male embraces the female.

I have always prided myself on reading widely and picking up scraps of information from many different places. However, if you got me on astrophysics then my opinion would be worth no more than that of Tiger Woods. On CLL though, I could wipe the floor with Stephen Hawking.

Even on CLL it is possible to disagree. Michael Keating and I, though agreeing on many things, had a fierce debate on one aspect of CLL on which we disagreed.

The best committee that I ever sat on was chaired by a non-specialist who had no detailed knowledge of the subject under consideration. He allowed debate to flow.

Scientists as a group dig very deep and narrow holes. They often know an awful lot about very little. Politicians, on the other hand, skim the surface from a large area. They can't be expected to know a subject deeply, but, if they are honest, they will look at a topic fairly and seek expert help over detail.

To go back to the topic of drugs. A complete libertarian would say that if someone wants to take a drug that harms his own body the let him; it is his, and only his, responsibility. On the other hand, if he has the same health insurance as I do, why should my premiums go up just because he indulges himself?

However, many drugs cause harm to the community. Alcoholics, apart from raising my insurance premium, beat their wives, cause motor car accidents, vomit in the streets, desert their children, reduce their families to penury and can't work properly. So what? Banning alcohol does not work; we saw how much harm it did during Prohibition. It just leads to an increase in criminal behavior. Look at it another way; legalizing it hasn't worked either. We still have wife-beatings, car accidents and poverty.

Scientists may tell us that cannabis is less harmful than tobacco and alcohol. How do they know? At first glance cigarette smoking seemed an attractive proposition. Actors, singers and sports stars endorsed the product. Even doctors agreed. Given, it did make your clothes stink, but it helped your cough, didn't it? Then in 1951, Richard Doll demonstrated that smoking caused lung cancer. The evidence was convincing enough to make him stop smoking. Nevertheless, it took many years before anybody believed him and many more before everybody believed him. Such convincing evidence is hard to obtain. There are no such studies for cannabis or ecstasy. People lie - either because of guilt of bravado - about their drug taking. How would you isolate the effect of one drug compared to another?

Cannabis apparently induces a degree of intoxication. How long after smoking a joint is it safe to drive? If you were stopped, what test would the policeman use to determine whether you were safe to drive? Supposing you had popped an 'E' and later on smoked some pot. Are you safe to fly your aeroplane tomorrow? A scientist who has opinion on such a thing had better couch it in conditional clauses if he doesn't want to be sued.

If the question is a simpler one such as, "Do cannabis users develop schizophrenia more commonly than non-users?" then the answer is yes, but asked how commonly, a wise scientist will demur. Remember the guy who won the Nobel Prize for inventing the transistor? This was a proper Nobel Prize; not like the Mickey Mouse ones they gave to Gore and Obama. Well, he turned out to espouse the discredited science of Eugenics, and even started a sperm bank for geniuses. Do you want to be ruled by scientists? I don't. There is a quote from the New Testament where Festus, the Roman governor says to the Apostle Paul, "Your great learning is driving you insane!" We would be insane to be ruled by scientists.

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Wednesday, November 11, 2009

How long to train a surgeon?

Concern has been raised about the training of doctors. Gretchen Purcell Jackson and John L Tapley, pediatric surgeons from Nashville, have just published an article in the BMJ which suggests that our surgeons are in danger of being seriously undertrained. Typically, a surgical training takes 5 years to obtain the necessary skills to be come a general surgeon with extra years for research and subspecialty training. Educational psychologists have shown that acquiring an elite level of expertise or performance requires 10 years of intense involvement and 10,000 hours of practice. This would be true for musicians, chess players or Olympic divers. The authors suggest that surgery, which requires both manual dexterity and cognitive understanding, needs twice that amount of training.

In the States surgeons are rejecting the idea that an 80 hour working week is sufficient to train a surgeon while in Europe the working-time directive is insisting on a 48 hour week. Sleep researchers have demonstrated that heavy night call, defined as every fourth or fifth night, compromises attention and vigilance as much as alcohol intoxication. One institution that introduced the 80 hour week found it produced happier trainees with a better quality of life but it also may well have compromised the surgeons' educational experience.

5 years at 80 hours a week does give the necessary 20,000 hours, but only if no more than 2 weeks holiday is taken. How can Denmark train its surgeons with a 37 hour week?

Although, the prime purpose in reducing surgeons' hours has been to enhance patient safety, it seems to have had the opposite effect where it has been tried. at one center preventable and non-preventable complication rates increased significantly after the introduction of an 80 hour week. In New York, where Teaching Hospitals adopted the 80-hour week but non-teaching hospitals did not, there were increases in unintentional punctures and thromboembolic events in those with the hours restrictions. The extra duties have to be done by someone - the answer is often moonlighting or else lying about hours.

When I think back to my own training, in the early days I worked alternate nights and then on a 1 in 4 rota. Hematologists in the UK have to obtain both the MRCP like internal medicine specialists and then the MRCPath like pathologists. They are also expected to publish. I completed my training 6 years after qualifying, but I did take work home. It may well be that surgeons need a longer period of training because of the 'piano practice' required. Musicians don't expect their instruments to start hemorrhaging uncontrollably.

When I was younger there were trainee surgeons in their early forties. Such were the rewards in private practice that they were prepared to put up with this extended training. Nowadays we see consultant surgeons appointed in their early thirties. They do far fewer operations than their forbears, both in range and number. I know one surgeon who never opens an abdomen, but is an expert in taking out lymph nodes and removes spleens through a laparoscope. Perhaps they are all a lot more talented than they used to be.

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Tuesday, November 10, 2009

Apologies

Never complain; never explain; never apologize. The words are variously attributed to Neville Chamberlain, John Wayne and Benjamin Disraeli. But someone who should perhaps have taken them to heart is our esteemed Prime Minister, Gordon Brown.

We have learnt that Gordon Brown takes it on himself to hand-write a personal letter to the relatives bereaved by a soldier's death in Afghanistan. One mother, who has lost her son, complained loudly (to a tabloid newspaper) that the letter sent by GB was illegible, and spelt both her and her son's name wrong. Mrs Janes was addressed as Mrs James and her son, Jamie, as James, though GB did score through the terminal 'es' and replace it with 'ie'. Later Brown telephoned to apologize, blaming it on his bad writing (it is very bad and he writes in a thick black felt-tip). There are some spelling errors that can be put down to his bad writing - he tends to omit the letter 'e' near the ends of words as they finish in a terminal squiggle, but the excuse seems lame since he called the family 'James' when announcing the death of the son at Prime Minister's Questions in the Commons, and he clearly realized that 'James' should be 'Jamie', but rather than trying to correct it, he should have wasted that piece of paper and started again. It does give the impression that this was a hurried scribble.

Now, he did not need to write a personal letter and no doubt he was in a hurry. A prime minister's job is a hard one and he can't behave like Campbell Bannerman did in 1906 and take a nap in the afternoon. But apologize? PG Wodehouse once wrote, "It is a good rule in life never to apologize. The right sort of people does not want apologies, and the wrong sort of people takes a mean advantage of them.”

This is certainly what happened to GB. The mother, no doubt at the behest of the tabloid newspaper, taped the phone call. She did not accept the apology and easily pointed out the inherent lie in his excuse. She further turned the complaint into what was probably bugging her in the first place. Her son didn't need to die. Had a helicopter been available he might have been evacuated in time, but there weren't enough helicopters.

The transcript of the telephone call was plastered over the tabloids this morning. Although the public reaction is slightly in Gordon Brown's favor, he would have been wise to have kept his head down. People understand that he went the extra mile in writing the letter, but he has appeared maladroit in the way he has handled himself, and who wants a clumsy Prime Minister.

So what are rules about apologizing?

First: don't apologize for something you are not responsible for. It has been unseemly and nauseating to see politicians apologizing for things that happened 200 years ago when standards were different. Even when standards are the same. Young Germans should not apologize for Hitler - he was Austrian anyway. What's done is done. Nothing will change the past. Get over it; that's the way things are. Anyone ever thought of criticizing the Italians because Nero burnt Christians to light his arenas?

Second: if you are responsible for something, apologize in person, face to face to the offended party; but don't make a public spectacle of it. Do it quickly. Don't have it dragged out of you.

Third: don't make excuses. If you are truly sorry it is because it is your fault - not the fault of the weather, your work being too onerous or some other fool putting you off.

Fourth: do better in future.

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Monday, November 09, 2009

A woman without her man.

I have just finished reading "My Grammar and I (or should that be 'Me'?)" by Caroline Taggart and J.A.Wines. I have always liked grammar because it is full of little jokes.

Take the section on tautology, for example. What could be funnier than 'honest truth'? Dishonest truth? Similarly what nonsense are 'PIN number', 'HIV virus', 'new innovation', 'free gift', 'skin rash', 'unconfirmed rumor', '8 p.m. in the evening', 'climb up' and 'fall down'!

Indeed, the examples scattered through the pages make us want to laugh out loud.

The longest sentence in English literature is spoken by Molly Bloom in James Joyce's Ulysses. It contains 4,391 words, which makes it far too long to be quoted here, even if the subject matter were not a bit dodgy (but it is).

Note the use of the subjunctive!

As far as I am concerned, whom is a word invented to make everyone sound like a butler.

A college professor wrote on a blackboard: A woman without her man is nothing.
He then asked the class to punctuate it. All the men in the class wrote: A woman, without her man, is nothing. All the women wrote: A woman: without her, man is nothing.

A linguistics professor was lecturing to his English class.
"In English," he said, "a double negative forms a positive. In some languages, though, such as Russian, a double negative is still a negative. However, there is no language where a double positive can form a negative."
"Yeah, right," piped a voice from the back of the room.

But my main purpose of this article is a plea in favor of retaining the semi-colon, which is going out of fashion.

It is there to connect two or more independent clauses that don't quite justify being sentences in their own right. For example: 'I have tickets for the match. I bet it rains.' This is correct, but an immature, jerky style makes it unattractive. 'I have tickets for the match, but I bet it rains' is clumsy. Far better is, 'I have tickets for the match; I bet it rains.'

Semi-colons can also be used to break up items in a long and complicated list. An example from Charles Dickens's A Christmas Carol illustrates this.
'... there were bunches of grapes, made, in the shopkeeper's benevolence, to dangle from conspicuous hooks, that people's mouths might water gratis as they past; there were piles of filberts, mossy and brown, recalling, in their fragrance, ancient walks among the woods, and pleasant shufflings ankle deep through withered leaves; there were...'; I am sure you get the idea. It is especially useful when a list has too many commas for comfort.

The semi-colon is in danger of being usurped by the dash (an en-dash in British English and an em-dash in American English).

Finally, readers always like to catch out grammarians at their own game. I have found an error in this book. When talking about the apostrophe, they say that it's is only correct when it is short for it is. Not quite right. In the sentence clause 'it's been said' it's is short for it has.

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Sunday, November 08, 2009

Respect authority; do good. 1 Peter 2:13-17

Is our society breaking down? I remember getting the cane at school. The headmaster had made a new rule which I and several of the boys thought unreasonable. We deliberately flouted it in front of the teachers to demonstrate that whatever they said about it we didn't agree. We were not sly or underhand about it, we were not deceitful; we did not lie about it. The consequence was that we were all caned to demonstrate that there was a certain hierarchy in the school and we had to submit to it.

On another occasion a boy in my class deliberately flouted a rule that said we couldn't buy ice creams from a van parked outside the school gates. He didn't even want an ice cream; he just wanted to demonstrate that he didn't think the rule was reasonable. He too got his comeuppance.

This was back in the 1950s when society was more ordered. Today we tolerate campaigners for the environment breaking into power stations and chaining themselves to railings with their posters and slogans. We acquiesce to demonstrators shouting abuse at the police. Recently, individuals who have attempted to stop queue-jumpers or litter louts have found themselves cautioned by the police. We are supposed to allow this sort of societal disorder.

When they made the film Titanic they showed the 1st Class passengers behaving like louts, elbowing others out of their way as they made for the lifeboats and having to be restrained by a crew member firing his revolver. In fact it never happened. The 'toffs' of Edwardian society behaved impeccably, holding back to ensure that women and children were saved. Rich men like Colonel John Jacob Astor IV and Benjamin Guggenheim stood aside. Guggenheim and his manservant helped women and children into lifeboats. When all the boats had gone they changed into their best clothes and prepared to "Die like gentlemen." Astor kissed his wife good-bye as she was put in the lifeboat. Astor said: 'I resign myself to my fate' and saluted in farewell." Of the 175 male first class passengers, only 57 survived whereas 140 of the 144 women and 5 of the 6 children lived. Such acts of heroism and self sacrifice were omitted from the movie because they did not fit the spirit of the age, where only the steerage class could be heroes. A contemporary witness wrote, "A third-class passenger who tried to climb in the boats was shot and killed by a steward. This was the only shooting on board I know of." Another said, "The behavior of the men was magnificent. They stood back without murmuring and urged the women and children into the lifeboats. A few cowards tried to scramble into the boats, but they were quickly thrown back by the others. Let me say now that the only men who were saved were those who sneaked into the lifeboats or were picked up after the Titanic sank."

This sort of historical forgetfulness is an indication of how society has changed and it is with this in mind that I hesitate to open up the next passage in 1 Peter chapter 2.
Submit yourselves for the Lord's sake to every authority instituted among men: whether to the king, as the supreme authority, or to governors, who are sent by him to punish those who do wrong and to commend those who do right. For it is God's will that by doing good you should silence the ignorant talk of foolish men. Live as free men, but do not use your freedom as a cover-up for evil; live as servants of God. Show proper respect to everyone: Love the brotherhood of believers, fear God, honor the king.

Submission is not something we take easily to. In a rather strange passage in Matthew 17 (24-26) Jesus argues that sons of the king are exempt from tax. Some have argued that the sons of the King of Kings should not be under the authority of earthly kings. But Jesus has them pay the Temple tax so as not to give offence, and here Peter exhorts us to submit to earthly rulers. The authorities in Peter's day would have been Nero and Claudius - hardly benevolent dictators. In fact they were two of the most arbitrary and cruel kings that have ever lived. Yet Peter tells us to submit. We are free of earthly ties, yet for the Lord's sake we should submit. AS we proceed we will see how it is in the Lord's interest that his servants should submit.

The NIV translation here is a paraphrase. Literally, we are to submit to every 'human creation'. But the word 'creation' has within it the implication of a formed building, something constructed according to rules and physical law. Not a tumbledown shack made of grass and bamboo, but a brick built construction with foundations and perpendicular walls. Thus, the KJV has every human ordinance, the RSV and ASV and NEB 'institution' and the NIV and Good News Bible have 'authorities'. The emphasis is on an ordered society.

As members of a society, we must obey its laws. If women go to Saudi Arabia they should cover their head, not because covering the head is honoring to God, but because it is the local law and to flout authority is to dishonor God. Incidentally, we should expect Muslims coming to Europe or the US to obey our laws. There are indeed somethings in which we must choose to obey God rather than men, but we must recognise that if we do so and fall foul of what we see a an unjust law, we must accept the consequences. While we may detest abortion and we may protest against it inasmuch as the law allows, we should not break the law in our protests. By all means lobby Congress or Parliament. March or wave a placard, but don't shoot abortionists or blow up clinics.

In Ephesians 5:21 Paul writes "Submit to one another out of reverence for Christ." It is this basic politeness that is crucial to an ordered society. I once read a book about the cardinal virtues, written by an atheist. He proposed that the first basic virtue was politeness, because without it no society could exist. How can you hold a conversation unless you allow the other fellow to speak?

A child in arms who grabs candy at the supermarket checkout must submit to his mother; she must not submit to him. The meter maid who hands you a ticket when you park illegally must be submitted to. She doesn't have to submit to you. The soccer player must submit to the referee. It is positively evil when players crowd round him in an attempt to force him to change his mind. It is not that the child is worth less to God than his mother, or the motorist than Rita, or the footballer than the referee. There is a hierarchy of authority not of value. The footballer may be paid millions of dollars every year, far more than the referee, but on the pitch the player must submit to the authority of the ref.

The other night was Guy Fawkes night when we celebrate the uncovering of the Gunpowder Plot of 1605, when Catholic revolutionaries attempted to blow up parliament. With the recent scandals concerning MPs expenses where they have used taxpayers money to have their moats dredged or to build duck islands on their lakes, some have wished that Guy Fawkes had succeeded. But Parliament legitimately has authority over us. That doesn't make them better than us or of more value to God, but we have to submit to them. A famous blogger has called himself Guido Fawkes after the revolutionary bomber, but he restricts himself to lampooning the government - a legitimate tactic. We will have the opportunity to vote this government out if we disapprove of it, but blowing them up is not honoring to God. Even petty bureaucrats are part of the governing machine. Their pettifogging restrictions have to be submitted to. Protest and point out their deficiencies all you like, but in the end you must submit.

But it is more than submitting. Verse 15 tells us that it is also God's will that we do good. Why? To silence foolish men.

Have you read recently how commentators equate evangelical Christians with fundamentalist Muslims? They would not have done so in the nineteenth century, when the evangelical Christian William Wilberforce was battling to abolish the slave trade and the evangelical Lord Shaftesbury (incidentally a local family) reformed society with the Ten Hour Bill; the 1842 Mines Act; reform of the lunacy laws; abolition of child chimney-sweeping; improvements in public health and slum housing; institution of ragged schools; improvements in the the plight of agricultural labourers; and training for destitute children, when the evangelical William Booth rescued people from alcoholism and prostitution and Dr Barnardo established orphanages. Foolish men who equate suicide bombers with works of charity, selflessness and goodwill are foolish indeed.

Do we keep up the good work? Modern evangelicals sometimes criticise good works as 'the social gospel', which they despise. We do not criticise liberal Christians for their opposition to cruel regimes, for fighting hunger, disease, oppression and slavery, for their zeal in rescuing women from servitude to their husbands, children from sexual abuse, people from poverty and prisoners from torture. We approve and join them as co-belligerents against evil. No, we criticise their neglect of the gospel and their subjugation of men's souls to their bodies. It is not a question of either preach the gospel or do good works. We should do good works because of the gospel.

We are free men, but we must never abuse that freedom. We are free to do good, not to do evil. We are free from the subjection of men, but we are slaves of God. The Roman soldier had the authority to compel any citizen to carry his load for a mile, but after a mile he had no right to compel that individual further. A christian, according to Jesus, should offer to go an extra mile, not because he is a slave of the Roman soldier, but because he is a slave of Christ.

We should show respect to everyone. A story is told of a missionary waiting in his house while murdering rebels outside went through the town killing civilians for the fun of it. When the dread knock at the door came he invited them in for a meal. Because he showed them respect they left his home intact. A soft answer turns away wrath. You must have found it so. Bullies complain "He never showed me no respect!" as they shoot an adversary. Show proper respect for everyone.

But love the brethren, and fear God. Because you fear God, you will honor the king.

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