The Archbishop

The furor over the Archbishop of Canterbury's comments on Sharia law has been astonishing. I don't believe many people have read his lecture or even the transcript of his interview on the BBC

I have read both. I won't even attempt to summarize his lecture. It is an academic paper in an arcane area in which I have no expertise. Had it not been publicized on BBC radio, no one would have been aware of it. Most people who happened upon it would have given up reading it after the first paragraph. It is written in an academic style, full of subordinate clauses and parentheses, which does not make for easy understanding. To my mind it is badly written, since it seeks to obfuscate rather than aid understanding. I firmly believe that among the 1000 lawyers who were listening for hour to his lecture, fully two-thirds would have slumbered for part of the period.

The BBC interview is more accessible though itself not a model of clarity. Here is a quote that gets to the nub of the problem

"What we don't want I think is either a stand-off where the law squares up to religious consciences over something like abortion or indeed by forcing a vote on some aspects of the Human Fertilisation and Embryology Bill in the Commons, as it were, a secular discourse saying 'we have no room for conscientious objections'; we don't want that, we don't either, I think, want a situation where because there's no way of legally monitoring what communities do, making them part of public process, people do what they like in private in such a way that that becomes a way of intensifying oppression within a community and that happens; that happens. So how does the law engage critically and intelligently – the law of the land – with the custom, the imperatives, the principles of distinctive religious communities? It's a large question, much larger than the question about Islam and I think it's a question which the Church can quite reasonably be thinking about."

In other words what he is saying is that it is wrong to impose laws on people that do not take account of people's religious beliefs. I don't think I could live in a community which made it compulsory for doctors practicing in obstetrics to perform abortions. That's why the Abortion Act of 1967 contained a clause that allowed doctors to opt out for religious reasons.

There are also areas where the Law has no interest in what religious communities do. How many times should a priest genuflect before an alter. How exactly should an animal be killed to make meat halal? How many yards of cloth should go into a turban? And so on. The religious communities must be allowed to decide these things for themselves. But, and it's a big but, what they decide must not conflict with the human rights of the people at large. That's what he means by "we don't ... want a situation where because there's no way of legally monitoring what communities do".

There are certain conflicts that have arisen because of the tensions between community rules and the law of the land that show that such problems have not always been addressed. A good example would be in recent legislation defending the rights of gays. Catholic adoption agencies were not granted exemption that would allow them to refuse permission to place children with gay couples. The Bishop of Hereford was recently penalized for failing to give a job to a gay man even though he regarded homosexuality as something forbidden by the Bible. There are many other issues. Animal rights activists might well have a view on how animals are slaughtered for halal meat. There was the whole upset about the veil.

It is clear that religious beliefs can come into conflict with secular beliefs and I think that the Archbishop was trying to draw attention to this problem. By emphasizing the Islamic aspect of this, I suspect he was trying to avoid the charge of special pleading for Christians, but I believe it was a naive and silly decision.

Since 7/7 Britons have been afraid of the Moslems in out midst. Press referrals to Islam have concentrated on the abuses of civilized behavior committed by primitive Islamic societies like Saudi Arabia, Pakistan, Palestine etc. The countries may be rich in oil money or possess nuclear weapons, but they are still culturally primitive.

Sharia law, argues the Archbishop, is a way of looking at law - derived from the Koran. How that is codified is a cultural response. Primitive societies interpret Sharia in a way that is incompatible with modern Britain. But not to realize that the very mention of Sharia would connotate with amputations and beheadings demonstrates that the Archbishop's unworldliness is a serious defect for a man in his position.

Isaiah 44:22

I have swept away your offenses like a cloud, your sins like the morning mist. Return to me, for I have redeemed you.

God does not bear grudges, why do we? When we were forgiven our sins they are no longer remembered. God doesn't say, "OK, I'll forgive you this time, but I'll be watching you very carefully from now on, and the next time you show the merest smidgeon of rebellion, you're out." Instead he says when the Devil accuses us of past sins, "What sins? I laid them all on my son Jesus and he paid the full price for them. They are extinguished."

Not to say we don't keep on sinning. Of course we do. This side of glory we will never be sinless, but if we confess our sins he is faithful and just to forgive us our sins and to cleanse us from all iniquity. That's why we keep short accounts with God.

It is not a license to go on sinning. If we saw it as such we would not have repented of our sins. Our sins offend us and we want them dealt with. Daily He deals with them.

So if we are dealt with with such love why do we continue to hold other people's sins against them?

You know the sort of thing. He's OK, but once he cheated on his wife. It wouldn't be safe to leave him alone with yours. She's got a bit of a reputation for stealing. Didn't she once get arrested for shop lifting? Well, we'll know where to go if any of the spoons go missing. He could never be a deacon - his first marriage ended in divorce. Thirty years ago he was caught kissing the baby-sitter. That would debar him from ever becoming an elder. I'm not happy with him leading the singing. Once upon a time he jilted my daughter. Her daughter had an illegitimate baby; we couldn't allow her to teach Sunday school.

God be merciful to me, a sinner.

David Mason, RIP.

I am sorry to report that Professor David Mason of Oxford University has died following complications of routine surgery. David who was in his early sixties was the fifth most cited author in Oncology. He was responsible for many innovations in the immunological definition of lymphoid tumors and involved in formulating both the REAL and WHO classifications. I served with him on an LRF committee.

Boscombe

From 1974 to 1992 I worked at the old Victorian hospital at Boscombe. Today the site is given over to social housing. The other main employer in the area, the Danish Bacon Company, had closed a few years before the hospital. One of the results was that the Boscombe shopping center became increasingly run down. Some of the larger stores like Marks and Spencer and Safeway moved out and the Charity shops moved in. A small park became the home of drunks and drug addicts.

Now the council has decided to spend some money on the area. The seafront is being upgraded with the first artificial surfing reef in Europe. This should make Boscombe an attraction for surfers. A large amount of building is taking place with luxury apartments close to the beach and refurbishment of the pier.

This morning we went for a walk on the beach (it is 5 minutes from here by car). It was a completely cloudless day with the temperature in the sixties. The beach was deserted and we had a clear view of the Isle of Wight as well as the Isle of Purbeck. We walked back through a delightful garden to Shelley Park, which is being developed also. These are the grounds of Shelley House, once the home of Sir Percy Shelley, son of Percy Bysshe and Mary Shelley.

Whatever hapened to Yogic Flying?

The Maharishi has died aged 91. The old charlatan deceived the Beatles, who may have known a thing or two about pop music, but were hopelessly naive about living life. George Harrison funded the Natural Law Party which contested the 1992 General Election fielding a candidate in nearly every constituency and garnering 0.4% of the vote. Not enough to have kept John Major in power. That was accomplished by the Welsh Windbag falling over his feet on Bournemouth beach and tumbling face first in the surf.

The picture illustrates Yogic Flying, the NLP's answer to all human ills. After the demise of the NLP, its leader was interviewed by the BBC in his hotel room in the Bahamas.

Page 2

I phoned the ward and asked my houseman to arrange for his admission. There would be things to do; a bone marrow with samples sent for chromosomes, a chest X-ray, and swabs to check for infection. The houseman knew what to do. We follow a protocol these days; we don’t have to think.

I let my mind slip back to how it used to be when I first got into this game. The average survival time for children with leukaemia was ten weeks and for adults it was six weeks. We had no really effective drugs, blood transfusion services were rudimentary and the only antibiotics that we had were either ineffective against the germs that infect leukaemia patients or so toxic that you risked killing the patient if you used them. The first patient I treated had died from a brain haemorrhage after five days and the second had got septicaemia and died after two weeks.

Things were better now. We could all but guarantee Ronnie a remission of sorts if he decided to go for it, though how long it would last for might deter him from even trying for one. Of course, some patients could be cured with a bone marrow transplant, but at his age…

I snapped out of it. This was a long clinic and I had to get on.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

It had been quite a surprise to see June with Ronnie. She had recognised me, of course – I wasn’t the one who had a different name – but she made no comment. Perhaps she thought that I would not have recognised her, it had been more than twenty years since we had last had contact. We had met first at a party when I was a medical student and she was training to be a teacher. I’ve no idea whose party it was. We were both gatecrashers.

Students today would hardly have recognised it. For one thing we had short hair and no gel. It was before drugs became generally available; no pot, no ‘E’, not even speed. We took caffeine tablets to stay awake before exams. There was a lot of booze, but it was pretty foul stuff. I seem to remember drinking pints of British sherry; sweet, sickly and red.

They were playing “If I fell in love with you” by the Beatles; it was that era. She wore a black dress made of some sort macramé network that was more holes than substance. Skirts were very short that year. It’s hard to remember what a shock that was. Several accidents were caused by motorists taking a surprised second look at an abbreviated dress walking by. Tights had replaced stockings and this technical advance had enabled designers to be even more daring. Agony aunts debated whether knickers should be worn above or beneath the tights.

“Who is your favourite poet?” she asked.

“Bob Dylan.” I replied.

She scoffed at the idea that a singer could be a poet. She was studying Shelley, Keats and Wordsworth, about whom I knew next to nothing. I tried Wilfred Owen, which was met a bit more sympathetically and then Gerard Manley Hopkins, which impressed her. I think I passed out shortly after that and it was some weeks before I saw her again.

We had an on and off romance. I liked her a lot. We laughed at similar things. She introduced me to Rhythm and Blues and French film. I amused her with stories from the accident department and operating theatre. You have to understand that in those days young people didn’t just move in together. The pill was available but few were taking it. Having a girlfriend was more about frustration than sex.

June had been a Catholic, but had lapsed before coming up to University. You never lose the memory of that first communion, though. We didn’t agree about religion and I never met her parents. She wasn’t the only girl I was seeing either.

On one occasion we broke up after an argument. I had been telling her about an incident in the accident and emergency department. In those days they used to employ medical students to stitch up wounds. We weren’t paid, but we got our board and lodging. I was penniless so that free food was incentive enough and besides it was hands-on experience that was a clear improvement on poorly attended lectures from reluctant teachers.

O’Brien was an Irish drunk well known to the Casualty Officers. This time he had been brought to the hospital with a scalp injury. The story was that he had heaved a half house-brick through the window of an Indian restaurant provoking three waiters to come out and beat him about the head with hockey sticks. He was rude, violent and incoherent and the Casualty Officer, a guy called Jeremy Stevens, didn’t fancy him at all. After a peremptory examination he detailed me to stitch up his head wound.

It was a bloody mess. I poked about a bit, but O’Brien was so uncooperative that eventually I just squirted some local in and started stitching up his scalp. It was a difficult wound, the tear going in three different directions. As I struggled to get the edges straight I pulled out a square inch of skull, exposing the mushroom coloured brain beneath. “What shall I do with this?” I asked Dr Stevens (who had been qualified for nearly two years).

“Just stick it back in and keep on stitching.”

And so I did. By the time I had finished, Corky had stopped his cussing and struggling and was sleeping peacefully.

Relieved that he had finally succumbed to the booze, I started to examine him properly. I asked Jeremy Stevens “Should he have different sized pupils?”

The cry of desolation.

And at the ninth hour Jesus cried out in a loud voice, "Eloi, Eloi, lama sabachthani?"—which means, "My God, my God, why have you forsaken me?"

This is among the most profound passages in the whole of Scripture. Jesus was quoting Psalm 22, but he was also expressing his own anguish. What was going on here?

It seems, at first sight, a mystery. How could the God/Man be perplexed about what was happening? Was He not all knowing?

Jesus was fully man and fully God. John's gospel tells us 'He was with God in the beginning'. We cannot understand the Trinity. How can God be both three and one? Still less can we imagine the Trinity ripped apart. But that seems to be what was happening.

The pictures of Hell in the Bible are either of a inextinguishable fire or of outer darkness. Some have described Hell as the total absence of God. We are familiar with the idea of common grace. God makes it to rain upon the just and unjust. Imagine that grace withdrawn. In The Great Divorce, CS Lewis imagines a place of outer darkness peopled with great villains like Napoleon who are completely separated not only from contact with God, but even with human contact. Jesus had already been deserted by his friends not be was abandoned by God. We have all felt abandoned by God, but none of has been. We were just unable to discern His presence, because of fault in us, not in Him. He has always been there. But Jesus had never been separated from the Father. Even from eternity past they had always been together.

In an inexplicable way God was incarnate in His second person, yet retained that special intimacy with the other persons of the Trinity. Now suddenly the Godhead was wrenched apart. How that occurred I do not know. Was the Son of Man separated from the Son of God? I do not know.

The Apostles creed tells is that, "He descended into Hell." Some have linked this to the text in Ephesians chapter 4 about descending to the lower, earthly regions and leading captivity captive, and that other text in I Peter Ch3 about Jesus preaching to the 'spirits in prison', but what it is really describing is this time on the cross when Jesus experienced for the first time in all eternity the absence of God.

We do not know we cannot tell what pain he suffered there
But we believe it was for us he hung and suffered there.

William Cowper was a great poet. His mother was a Donne and he is perhaps a descendant of the poet John Donne. He is the author of several of out best loved hymns including "There is a fountain filled with blood", "God moves in a mysterious way" and "Oh for a close walk with God". For mush of his life he suffered from severe depression and lacked assurance. Elizabeth Barrett Browning was moved that such a poet should be so depressed and wrote a poem entitled 'Cowper's Grave' these are the last two stanzas:

Deserted! God could separate from His own essence rather;
And Adam’s sins have swept between the righteous Son and Father;
Yea, once, Immanuel’s orphaned cry His universe hath shaken --
It went up single, echoless, “My God, I am forsaken!”
It went up from the Holy’s lips amid His lost creation,
That, of the lost, no son should use those words of desolation!
That earth’s worst frenzies, marring hope, should mar not hope’s fruition,
And I, on Cowper’s grave, should see his rapture in a vision.

How right she was. Because of Jesus' desolation, none should share it. How perverse that some should choose to do so.

Gender imbalances

Five years ago I retired from the NHS. My three days a week at Bournemouth were replaced by two consultants working between them ten and half days a week. I would like to think that this meant that I was practically irreplaceable, but in fact the hospital took the opportunity to expand and improve the service. I refrain from making the sexist point that it took two women to replace me, especially since back in the 1980s I got into trouble by raising alarm bells over the fact that the number of women going to medical school had massively increased. My point then was that the average woman worked for seven years after qualifying whereas the average man worked for 35 years after qualifying. No doubt the truth was that women would in future not work for a few years before marrying and retreating into a life of domesticity and the occasional family planning clinic.

So I was interested to see a new paper in the Journal of the Royal Society of Medicine (101:27-33) entitled 'Gender and variation in activity rates of hospital consultants'. The authors have surveyed the number of 'Finished Consultant Episodes' (FCE) attributed to various doctors in the NHS. The surprising finding was that male consultants were responsible for at least 20% more FCEs than female consultants in equivalent posts with equivalent case mixes. Other variables like age, specialty and hospital were taken into consideration. Indeed male doctors tend to have the more complicated casemix, and when workload is adjusted for this, the excess activity for males approaches 100%.

Similar results have been found in both the USA and Canada, but in these systems more work brings more pay, so that there is an element of choice in how much activity is undertaken. In the UK everyone is paid the same. Well, not quite. There is a system of discretionary points and merit awards which are supposed to reward those who work especially hard or are in other ways meritorious. And sure enough, doctors in receipt of those awards do work harder. However, protests have been made that fewer women than expected get these rewards and instructions have come from government to remedy this imbalance. It seems from this survey that the distribution of these awards is indeed fair.

Another finding of this survey is that doctors who have a private practice in addition to their NHS practice, actually work harder for the NHS than those doctors who don't have a private practice. This again contrasts with what the government has been telling us, that doctors who sneak off to Harley Street are neglecting their NHS patients.

Entry into Medical School in the UK is 60% female. Is this wise?

Darkness at the sixth hour Mark 15:33

I have written before about darkness at noon but now we come to this verse in the exposition of Mark's gospel. For those who are new to this series may I say that I have been listening to the sermons of Pastor Chris Kelly at Lansdowne Baptist Church, Bournemouth and then meditating on what I have learnt. As this series nears its end I do recommend that readers order the series on tape, CD or DVD from this site. I value this series of sermons particularly be cause Chris has devised a structure to Mark's gospel that I have never seen before and one that explains why there is an apparent lack of consistency between the various synoptic gospels.

Skeptics regard this miraculous happening as fiction. If such an extensive period of darkness occurred over such a large area, why was it not mentioned by contemporary writers?

Actually, it was. In AD 52 Thallus wrote a history of the eastern Mediterranean world since the Trojan War. Although his original writings have been lost, he is specifically quoted by Julius Africanus, a renowned third century Christian historian. Africanus states, ‘Thallus, in the third book of his histories, explains away the darkness as an eclipse of the sun—unreasonably as it seems to me.’

As Africanus recognized it is indeed an unreasonable explanation. Eclipses of the sun last for only a few minutes; certainly not for three hours. Even more significantly, it is physically impossible to have an eclipse of the sun at the time of full moon, and as everyone knows, the Jewish Passover, when Jesus was crucifies, takes place at the time of a new moon.

Phlegon was a Greek historian who wrote an extensive chronology around AD 137 writes:
"In the fourth year of the 202nd Olympiad (i.e., AD 33) there was ‘the greatest eclipse of the sun’ and that ‘it became night in the sixth hour of the day [i.e., noon] so that stars even appeared in the heavens. There was a great earthquake in Bithynia, and many things were overturned in Nicaea.’

Phlegon provides powerful confirmation of the gospel accounts. He identifies the year and the exact time of day. In addition, he writes of an earthquake accompanying the darkness, which is specifically recorded in Matthew’s Gospel (Matthew 27:51). However, like Thallus, he attempts to interpret the darkness as a direct effect of a solar eclipse.

Africanus composed a five volume History of the World around AD 221. He was a pagan convert to Christianity. His historical scholarship so impressed Roman Emperor Alexander Severus that Africanus was entrusted with the official responsibility of building the Emperor’s library at the Pantheon in Rome. This is what Africanus wrote: "On the whole world there pressed a most fearful darkness; and the rocks were rent by an earthquake, and many places in Judea and other districts were thrown down. This darkness Thallus, in the third book of his History, calls, as appears to me without reason, an eclipse of the sun. For the Hebrews celebrate the Passover on the 14th day according to the moon, and the passion of our Savior falls on the day before the Passover; but an eclipse of the sun takes place only when the moon comes under the sun. And it cannot happen at any other time but in the interval between the first day of the new moon and the last of the old, that is, at their junction: how then should an eclipse be supposed to happen when the moon is almost diametrically opposite the sun? Let opinion pass however; let it carry the majority with it; and let this portent of the world be deemed an eclipse of the sun, like others a portent only to the eye. Phlegon records that, in the time of Tiberius Caesar, at full moon, there was a full eclipse of the sun from the sixth hour to the ninth—manifestly that one of which we speak. But what has an eclipse in common with an earthquake, the rending rocks, and the resurrection of the dead, and so great a perturbation throughout the universe? Surely no such event as this is recorded for a long period."

What about other early historians such as Josephus, Tacitus, Suetonius, and Pliny the Younger, who all fail to mention the darkness? Arguing from silence is a hazardous profession. It is unreasonable to expect every contemporary writer to include every event that happened—and there are good reasons not to expect these specific authors to mention the darkness.

This objection (the argument from silence)was first raised by Edward Gibbon and has been parroted ever since by skeptics who have never read Pliny or Seneca (neither have I, though I have read Josephus)

Pliny's work is entitled Natural History, and it is a multi-volume work covering a wide variety of subjects - geography, meteorology, mineralogy, zoology, and botany. Volume 2 of this work is concerned with cosmology and astronomy, and is the place we might expect Pliny to have recorded this event - if he indeed did intend to record all such events. He offers examples; he makes descriptions, but frequently from his own observations. There is no indication that his work is intended to be an exhaustive catalog of all possible relevant data. But he was a skeptic and a rationalist of the highest order. He wrote: "I deem it a mark of human weakness to seek to discover the shape and form of God. That that supreme being, whatever it be, pays heed to man's affairs is a ridiculous notion." Temperamentally he would not seek to confirm an event that supported a religious idea.

Seneca's work, Naturales Questiones is even less likely to mention the darkness. His book mostly comprises theoretical surveys of natural phenomena - by no means an attempt at an exhaustive catalogue of events - and he is far more concerned with drawing morals from what he records that with listing events, of which he does very little.

As for Josephus, he was writing for the favor of his patron Vespasian, whom he had credited with fulfillment of Messianic prophecy. He might be safe in mentioning that Jesus did miracles, but to ascribe to Jesus some sign that would have signified special status with God would likely offend his patron.

The phrase 'Darkess at Noon' was, of course, used by Arthur Koestler, the British writer of Hungarian origin, for his famous novel dealing with failings of communism. Koestler suffered from CLL and so may be of interest to some of my readership. But the idea of darkness as a prelude to a terrible event is much older.

In Exodus ch 10 the ninth of the Egyptian plagues is darkess that covered the land. It preceded the death of the first born and the Passover. In Amos 8:10 the LORD says, "I will make the sun go down at noon and darken the earth in broad daylight" as part of his wrath against his people. Darkness is a symbol of the absence of God. "The light shines in the darkness," says John, "the true light that gives light to every man was coming into the world."

Isaiah Ch 60 begins "Arise, shine, for your light has come, and the glory of the LORD rises upon you. See, darkness covers the earth and thick darkness is over the peoples, but the LORD rises upon you and his glory appears over you. Nations will come to your light, and kings to the brightness of your dawn." He sees in the darkness only the opportunity for God to enlighten it, and so it has proved. But before he does so we must visit Hell itself.

Snowdrops

After storms that caused a couple of shipwrecks and snow in the north, today was a still and clear day with bright sunshine. It was fairly cold but we wrapped up well and took a trip to see the Kingston Lacy snowdrops. There are six million snowdrops in the grounds of this Dorset stately home. The grassy banks are covered with them at a time when little else is flowering.

This was the first time that we had seen them and they are certainly spectacular, but when you have seen one flowery knoll you've seen them all and we got rather bored with snowdrops, looking instead for the occasional early daffodil, the odd clump of camellias or even the errant rhododendron, pink on the pale day. We examined the different types of trees; the enormous beeches, spectacular without their leaves, the gnarled oaks and the scruffy hollies.

Then we started looking at the people. I have never seen so many visitors at Kingston Lacy; there must have been three thousand there. What was remarkable was how similar they all were. There were some young ones in their fifties, the majority were in their sixties, quite a few were in their seventies, but the over eighties were also well represented. The local conurbation has over 450,000 people and one in three is over sixty years of age.

Everywhere we looked were grey haired couples in anoraks. This is apparently an annual pilgrimage. Thousand of people nearing the end of their lives troop to Kingston Lacy in the middle of winter to pay homage to the little snowdrop, the first sign that there will indeed be another year.

Fruits of the Spirit

Professor Howdy has a joke that he often recycles which purports to tell of a professor asking his class about opposites.

"What is the opposite of happiness?" "That would be sadness."

"What is the opposite of love?" "That would be hate."

"What is the opposite of woe?" he asks a particularly obtuse country bumpkin. "That would be giddy-yup."

Love, joy, peace, patience, kindness, goodness, faithfulness, gentleness, and self control are the fruits of the Sprit referred to in Galatians 5:22-3. If we have the Holy Spirit we have these fruits to show for it. Does that mean that if we do not have the Holy Spirit we will be full of hate, miserable as sin, given to warring, impatient, unkind, bad, unfaithful, rough and out of control?

You see, you have fallen into that trap haven't you?

If we lack the Holy Spirit we are not comic book villains. We are ordinary human beings. We walk by people in need, affecting not to notice. To be honest we don't really care much about Africa or Bangladesh; we are more concerned about what's happening to the economy.

We are not miserable. We're just not happy-clappy. There is enough in this world to get upset about and there seems to be no end to it. Sometimes things appear pretty hopeless, but perhaps Barack Obama will fix it (of Hillary or McCain or Romney).

We are not warlike, though if those Iranians continue to get uppity we might have to go to war. We're just a bit anxious about the future.

Silly to think of us as unkind. I treat people as I find them. If they're nice and polite, I can be reasonable too; but if they get aggressive with me I return it in spades.

I think of myself as a good man; I mean I pay my taxes and I wouldn't kick a dog or anything.

I'm faithful to my wife. There was that time at the office party, but that was just a snog; it didn't mean anything.

I wouldn't call myself rough and unthinking; mind you I'm nobody's sissy. I call a spade a spade and don't suffer fools gladly.

I suppose I've got a temper, but you have to provoke me. I don't go around shouting the odds, but sometimes - I mean that Bill O'Reilly (or Dan Rather if you’d rather).

The fruits of the Spirit are positive virtues. They are supernatural virtues. When we behave like normal human beings, they are missing.

Can I write fiction?

One of the things I am going to do in my retirement (if I get any encouragement) is write fiction. Here is the first page.

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Leukaemia isn’t a children’s disease. That’s just the fund-raisers’ bullshit. The pathetic little girl with no hair and black rings round her eyes makes good advertising copy, but it’s nowhere near the truth. Sure, we can cure a lot of kids these days, but mostly it’s a disease of old people.

The guy in front of me was typical. At seventy-four going on a hundred and fifty, he was grey and getting greyer. The bead of sweat on his upper lip could have been nervousness, but probably it was part of his illness. I’m sure it wasn’t because he recognised me. How could he? I’d grown up since then.

I’d recognised his name at once. Ronald Gottings – Ronnie; it’s unusual enough to encounter only once in a lifetime. I tried to recall his face as it was then, but it wouldn’t come. Memory is capricious.

It wasn’t my earliest memory; that would have been a visit to my great-grandmother’s house. She died before I was two and I can’t envisage her at all. I remember sitting on my daddy’s knees (I was still in napkins) and being asked if I wanted to play the piano. Who knows what a piano is when you're less than two years old? I was more interested in the radio on top of it, made of cream-coloured Bakelite. I knew I wasn’t allowed to touch the radio. Was “piano” like “radio” another word for wireless? I was confused and embarrassed and kept silent, which irked Daddy because he was there to show off his clever blond baby to Mummy’s grandmother.

I heard later that there was Jewish money there, but we never saw any of it. Mummy had skivvied there during the thirties, washing the old lady’s feet because she was too fat to reach them, and scrubbing the floors.

We were still very poor when I first met Ronnie. We lived in a one-bedroom basement flat across the road from the park. The Memorial Gardens was their proper name. The centrepiece was twenty-foot granite obelisk on which was carved the names of the fallen in the Great War. When I first met Ronnie they were writing the names of those killed in the second War and people were beginning to worry if there would be room enough for those killed in the next one.

The flat was very dark, quite cramped for the four of us – my baby sister had been born by then – and we had no garden, just a small yard surfaced with red house bricks and drain covers. We played in the park. There was next to no traffic then and always plenty of kids about. I guess there were bats and balls, and older girls who took us for walks. I was still a very pretty kid and more available than dolls. Ronnie was someone that the older boys talked about. He’d been to the war and come back.

I first saw him sitting on one of those green slatted park benches they used to have. He was surrounded by the other boys and smoking a Woodbine. I still can’t bring his face back. His jacket had leather patches on the elbows and his trousers were brown corduroys. The trouble with memory is trying to work out how much is true. Are we remembering what happened or simply our last memory of it? It’s like that prompt that comes up when you close down your word processor. Do you want to save the changes you made to this document? You didn’t know you’d made any changes. How much do we corrupt a memory every time we take it out and look at it before we put it away again? Alright, I couldn’t swear to the leather patches but I’m certain of the corduroys.

He seemed very tall, then. He wasn’t tall now, barely five foot seven, and stooped shorter. His doctor’s letter told of heart disease and alcohol abuse. His fingers told me the Woodbine habit had never died. His wife had had him back a fortnight previously. He’d been away for just a month this time. The tobacco and stale sweat smell were very familiar to me. Smokers get leukaemia twice as commonly as non-smokers.

There is no easy way to break the news. “Mr Gottings, I’m afraid that you’ve got leukaemia. I’m very sorry.”

His wife sucked in her breath and started weeping, but he said nothing. He still stared at the desk and wouldn’t meet my eyes.

“There are several types of leukaemia. This one is called acute myeloid leukaemia. We call it AML for short. I’m afraid it’s one of the worst sort.”

Funny how we use that word “afraid”. What was I afraid of? Not of Ronnie Gottings, though I had been once. Afraid of breaking bad news? I’d done it so many times. Afraid of hurting Ronnie? Afraid of Ronnie’s retribution? Better drop the “afraid”.

“Leukaemia is a sort of cancer of the blood cells. It grows in the bone marrow. You need to make about three million blood cells every second. Because the leukaemia is growing there you can’t make the good cells. Because you’re short of good white cells you’re liable to infections. You can’t make enough red cells either, that’s why you’re feeling tired and short of breath.”

“Is that where the white cells eat up the reds?”

They always say that. His wife was younger than him by more than twenty years, younger than me, even. She had that faded pepper and salt hair and slightly sagging skin that you see on women who have started to make an effort again after years of not trying. She’d put on a smart navy suit to contrast with Ronnie’s scruffiness.

He spoke for the first time. “Am I gonna die, doc?”

We’re all going to die. They ask us that stupid question as if we were soothsayers. Doctors see it as a trap; if we say they have a year, they die next week and the relatives complain. If we tell them they’ll be dead in a month they live for a year out of spite.

“They told me I’d die when I had the by-pass operation.” See what I mean.

“What have you done with your life? What was your job?”

“I’ve travelled a lot. Africa, Bangkok. Got the taste for it in the army.”

“You were in the war?”

“We all were, weren’t we?”

______________________________________________________

Let me know if you think I should continue.

Nature

'Natural' is a word that raises my hackles. A story is told of an old gardener who was confronted by the local parson who admired the garden.

"You and God have made a beautiful spot together." said the parson.

"Oh Ah," replied the gardener, "but you should have seen it when he had it to himself!"

Everything that's natural is supposed to be somehow superior, but even the bucolic scenes of yesteryear that we so admire were the product of technology. My attention was recently drawn to an aerial picture of the border between Israel and the Gaza strip. The land on the Israeli side has been tilled and planted, watered and harvested. The neat strips are the effect of applied technology. On the Palestinian side and indeed the Egyptian side, the absence of technology leaves chaos.

TB is natural and so is malaria. So is HIV. You don't need to postulate man-made global warming to inflict harm on the poor. Natural phenomena do it well enough.

Snakes are natural and so are crocodiles. So is the funnel web spider. The natural tiger will kill you given half a chance; so will the lion. Natural influenza in 1918 killed more people than the technological guns and bombs of the massed armies in Europe.

We live in a technologically replete world. There is no going back to horsepower, poultices and nightsoil. The chemicals we use are refined and pure, not the nasty, foul smelling mixtures our forefathers used.

Cold caves and contaminated springs are natural. We have insulated houses and clean water because of technology.

It seems that the world is warming. I would bet that it is a natural event rather than a technological disaster. The remedy won't be Luddism but technology.

CLL is a natural disease. The remedy won't be natural herbs, either as infusions or enemas, but technological chemicals cleverly directed at the natural disease by man's ingenuity.

Funeral Fable.

Maria lives in a village in South America with no water. Everyday she must walk 5 miles to the spring to fetch water. She carries her two water pots, Santos and Pueblo, suspended from a yoke across her shoulders. As she nears home her burden becomes lighter, because Pueblo is a cracked pot and water leaks out of him. By the time Maria reaches the village, Pueblo is only half full.

Pueblo is a very unhappy pot. He says to Maria, "I am so sorry that I cannot serve you as Santos serves you. You walk all that way to fetch water, but when we return I only bring half as much water as Santos brings."

Maria consols him, "Look at the path. You will see that all along the path are beautiful flowers that cheer me as I make the long journey. But the flowers are only on one side, the side that you water."

"Pueblo," she continued, "I know you for what you are and I decided to use you. I brought seeds and dropped them on the gound that you had watered. So even though you are not perfect and leak a little, I was able to use you to bring cheer and happiness to all who walk along this path."

Mark15:21-32

"Even if I have to die with you, I will not disown you." said Simon Peter.

Were you there when they crucified my Lord?

"Simon, carry my cross."

And Simon stepped forward. The Cyrenian was recruited to Jesus' cause when Peter had deserted him. The Carpenter must have been used to carrying wooden burdens, but the scourging had weakened him. He could have called on Angels to assist him. Instead, someone chose a North African, the father of Rufus and Alexander; the same Rufus of whom Paul wrote, "Greet Rufus, chosen in the Lord, and his mother, who has been a mother to me too."?

"Let one of us sit at your right and the other at your left in your glory." demanded James and John.

"You do not know what you are asking," Jesus said, "Can you drink the cup I drink or be baptised with the baptism I am baptised with?"

"To sit at my right or left is not for me to grant. These places belong to those for whom they have been prepared."

Were you, James and John, there when they crucified my Lord?

They crucified two robbers with him, one on his right and one on his left. Those who were crucified with him also heaped insults upon him.

Everyone had deserted him and fled. He was alone on the cross. One by one the prophesies were fulfilled. "Scorned by men and despised by the people. All who see me mock me; they hurl insults, shaking their heads. I am poured out like water, and all my bones are out of joint. My heart has turned to wax; it has melted away within me. My strength is dried up like a potsherd and my tongue sticks to the roof of my mouth. A band of evil men surround me, they have pierced my hands and my feet. I can count all my bones; people stare and gloat over me. They divide my garments among them and cast lots for my clothing. His appearance was so disfigured beyond that of any man and his form marred beyond human likeness. He was despised and rejected by men, a man of sorrows and familiar with suffering. Like one from whom men hide their faces he was despised and we esteemed him not. He was pierced for our transgressions and crushed for our iniquities and the punishment that brought us peace was upon him and by his wounds we are healed."

Were you there? No, of course not. Would you have been there? Only among the scoffers. Will you be there? By God's grace.

Give us the grace, O God, to stand alongside Jesus, to walk beside Him, to carry our crosses, to accept suffering and not to complain, to show forth His glory.

An annoying phrase

Am I alone in being irritated by the phrase, "We and others have found..."? You see it often in scientific papers, often those written by the also-rans. Whereas a work of art is often a unique conception, in science it seldom is. If you read the literature and are au fait with current scientific thought you can often predict what the next discovery will be. There are only so many possibilities and the application of the right technique will often reveal the answer. The discovery of the JAK2 mutations in myeloproliferative disease is a good example where several labs published the discovery at around the same time. Who first had the idea is obfuscated by the noise of many papers. Of course, this sort of thing is often a bit of concealed fraud, because nothing gets published without the refereeing process and referees have been known to delay a paper until they have dupilcated the work themselves.

To write, "We and others have found..." is not so great a sin, but it makes 'self' more prominent than is fair. You may wll have been in the race and only chance has made you second or third or sixteenth, but a more correct summary might be, "Others have found and we have confirmed...".

You see, even in science a little bit of genius is sometimes required.

Toothless punishment

Wailing and gnashing, a just desert
For long lives spent inflicting hurt.
But for the toothless what’s beneath?
The answer is, of course, new teeth!

First encounter

Do you recall the silver street
The moon had painted on the lake?
At last the contact was complete
And mutual signals no mistake.

Do you regret the hurried start
As time accelerated by?
Poorly prepared, the flurried heart
Confuses ‘how’ with ‘when’ and ‘why’.

What language is sufficient for
The first approach of tenderness?
Between the ‘like’ and ‘je t’adore’
Words hover like a brief caress.

What sorcery has been at play
To cast all cautious care adrift?
No magic but the nerve to stay,
To take and tender such a gift.

What future for this orphan heart?
And can it stay still far away?
But what could force it to depart,
When I have watched your eyes all day?

MCV

The mean corpuscular volume is the most important of the red cell indices. It measures the average size of the red cells.

A red cell is mainly made of hemoglobin with a membrane to go round it. Small round cells are caused by a lack of hemoglobin. There are only three causes of small red cells - there are two causes of too little hem and one cause of too little globin. The amount of hem is controlled by iron and the amount of globin is controlled by the genes you inherit from your parents. If you inherit dodgy globin genes you have thalassemia. There are several sorts, but they all result in small red cells.

If you have too little iron you can't make hem and you end up with small red cells. Too little iron may be the result of too little iron in the body - either because of not enough iron in the diet, which is very rare in most Western countries, or because of excessive iron loss - mainly due to bleeding. But too little iron for the red cells can be caused by the macrophages greedily hanging on to it and not releasing it to the forming red cells in the bone marrow. This happens with a wide variety of chronic disorders such as Crohn' disease, ulcerative colitis, rheumatoid arthritis, chronic infection and some cancers.

Raised MCVs have more causes. Everybody knows about megaloblastic anemia due to a deficiency of either folic acid or vitamin B12. These are relatively easy to diagnosed and it is important to rule them out by measuring B12 and folate levels, but in actual fact, these are relatively rare cause of macrocytosis, as too are the floppy membrane diseases - conditions where the size of the red cells is increased because there is too much membrane. Examples would be liver disease and thyroid deficiency. Alcoholics have large red cells, probably for a variety of reasons, and probably the commonest cause in older people is MDS.

However, we sometimes see raised MCVs in CLL and none of these reasons apply. I think that whatever fills the bone marrow spaces that shouldn't be there causes an increase in the MCV. You certainly see it in myeloma, but why this should be is unknown.

Mockery

The graffito was discovered in 1857, when a building called the domus Gelotiana was unearthed on the Palatine Hill. The emperor Caligula had acquired the house for the imperial palace, which after Caligula died became used as a Paedagogium or boarding-school for the imperial page boys. Later the street on which the house sat was walled off to give support to extensions to the buildings above, and it thus remained sealed for centuries. The graffito is today housed in the Palatine antiquarium in Rome. Said to date from the third century AD, some scholars put it as early as 85 AD, just six years after the destruction of Pompeii.



The image depicts a man with the head of a donkey who appears to be attached to a cross. To the left is a young man raising one hand in a gesture suggesting worship. The inscription reads "Alexamenos worships his god". The general consensus is that the graffito dates from some time in the third century, although dates as early as AD 85 have been suggested.

The idea that Christians worshipped a man born of a donkey who was judicially executed was quite a common one in the Roman Empire. The early Christian Father, Tertullian, wrote about it, "In this matter we are [said to be] guilty not merely of forsaking the religion of the community, but of introducing a monstrous superstition; for some among you have dreamed that our god is the head of an ass, an absurdity which Cornelius Tacitus first suggested",

In Mark 15:16-20 Jesus was mocked by the Roman soldiers. They dressed him up in an old scarlet robe that had turned purple with age, they plaited a crown from thorns and placed it on his head and gave him a staff in his hand as a mock sceptre. They bent down and called out to him, "Hail, Jesus, King of the Jews!" Then they took the staff and beat him about the head repeatedly with it and spat upon him.

Mockery is too mild a word for it. It sounds like a bit of tomfoolery, badinage or banter, but this was vicious. Ridicule, derision, insult; those are more appropriate terms. The soldiers weren't just drawing a caricature or making catcalls, they were bullying Jesus in a humiliating way. A crown of thorns is painful and draws blood. Beating around the head with a stave hurts. Remember this was a man who had just been flogged.

Some Christians with tender consciences read this and think, "Is my worship of God a mockery?" When I sing "All to Jesus, I surrender," am I guilty of mockery because I know I hold things back?

The answer is no. This passage is not directed at them. It is pointed at unbelief. Unbelievers still scoff at Jesus and those who follow him. Why is that? Who scoffs at Hindus? Who laughs at Buddhists? Mike Huckabee draws the ridicule of the BBC but Mitt Romney doesn't. Why is that? Who makes jokes about Moslems? (Who would dare?) If they mocked Christ, why would they stop at his followers? The Alexamenos graffito demonstrates that this is something that has always gone on.

How should we react? When the BBC decided to screen "Jerry Springer - the Opera" there were more protests from viewers than for any program ever. The BBC rejected the complaints and this was upheld in the High Court and the Court of Appeal. When Danish cartoonists drew cartoons that mocked Mohammad there were worldwide violent protests by Moslems and the media, for the most part, caved in.

How did Jesus react? He stayed silent and absorbed it. Don't doubt he could have called down legions of Angels. He could have made these mockers scorched shadows on the earth. Yet he withheld his power. Later on the cross he was to pray, "Father, forgive them, for they know not what they do."

A story is told of a group of people standing in line awaiting the opening of a bank at 9 a.m. when a man walks straight to the front of the line and is first in to be served. The people waiting in line make no protest. You see the man who queue-jumped was carrying a white stick and was guided by a dog. He was blind to the fact that there was a line.

Jesus was not willing to punish people for ignorance. There will come a time when they will be judged, but there was a time when we were ignorant. If we understand why the man queue jumped we are able to forgive him. Jesus looked at the scoffers and understood them and loved them. He loved them so much that we died for them.

Do you love your enemies? Do you do good to those who despitefully use you? When people mock you for being a Christian, forgive them, love them, pray for them.

A full month.

I am flying to Boston the day after tomorrow for a couple of days. This is to do with a Campath trial that I am helping to supervise. I have almost completed a similar role in a rituximab trial and will be traveling to Frankfurt in a couple of weeks for a similar meeting. After a long career treating patients and organizing a health service, my life has moved on. January has been a very busy month, but one that is very different from what I have done most Januaries in my career. I have done a good deal of refereeing. Several medical journals including Blood, British Journal of Haematology and Haematologica have sought my advice on publishing different scientific articles. This is a difficult task. Reading the paper is often hard work. Then you have to test it for scientific validity, then you have to consider it in the context of what has already been done. Is it novel? Or just confirmatory? Is it mere repetition? Finally, is it important or merely trivial?

Then I have reviewed a couple of grant proposals (and still have two more to do). This is a responsible task. Someone's livelihood is at stake, but often the cash to support them is hard won - someone has been shaking an awful lot of tins.

Then there is GTAC. I have served on the Gene Therapy Advisory Committee for 6 years. These proposals are even more complicated. The science is very hard, but more than that the proposed treatment is potentially lethal. We are not only a scientific review committee, but also an ethical committee. I have reviewed two GTAC proposals this month and have a meeting coming up before the end of the month to discuss the future of the committee. Should we expand or limit our activities? Have some sorts of gene therapy now become routine? Are we able to take on stem cell therapy?

Then I have been editing Leukemia Research. this involves selecting referees for submitted papers (I have had 25 so far this month) and when teh reviews come in, deciding whether or not they should be published.

I also finished off a chapter I was writing on MDS and started a new one on CLL.

I have also spent time this month in my capacity of Treasurer of the MDS Foundation, trying to set up a Euro account that can be manipulated over the Internet. This seems impossible.

Quite apart from these intellectual activities, I have this month cleaned out the gutters on one side of the house, helped my daughter move out of her apartment, twice swept the drive of fallen leaves, been to the gym nine times, read the latest fantasy novels of Terry Goodkind and Stephen Donaldson and the Iain Banks novel 'Dead Air', watched the first two of the Helen Mirren 'Prime Suspect' series and watched the Justine Waddell version of 'Tess of the d'Urbevilles'.

Lancet lies

Back in 2006 in time to influence the congressional election the Lancet published a report estimating that the casualties in Iraq had exceeded 650,000. At the time I reckoned this to be a load of hogwash. Last week the Wall Street Journal published an article about the report. It turns out the Lancet study was funded by anti-Bush partisans and conducted by antiwar activists posing as objective researchers.

The Lancet death toll was more than 10 times what had been estimated by the U.S. and Iraqi governments, and even by human rights groups. It now appears that the Lancet study was funded by billionaire George Soros's Open Society Institute. Mr. Soros is a famous critic of the Iraq campaign and well-known partisan, having spent tens of millions trying to defeat Mr. Bush in 2004. Soros made much of his money by speculating against the pound sterling, forcing it out of the European monetary system.

Two co-authors of the report, Gilbert Burnham and Les Roberts of Johns Hopkins University, told the reporters that they opposed the war from the outset and sent their report to the Lancet on the condition that it be published before the election.

Lancet Editor Richard Horton agreed to rush the study into print, with an expedited peer review process, without seeing the surveyors' original data. I have met Richard Horton and took an instant dislike to him. He spoke at a meeting of the European Association of Science Editors that I attended. At first I thought it was just his youth that made him a conceited show-off, but as he has grown older I see that this is his nature. I cancelled my Lancet subscription shortly afterwards. Here's a quote from him, "The axis of Anglo-American imperialism extends its influence through war and conflict, gathering power and wealth as it goes, so millions of people are left to die in poverty and disease." You might remember Horton as the man who published the scandalous lies about the MMR vaccine.

The key person involved in collecting the Lancet data was Iraqi researcher, Riyadh Lafta, who has failed to follow the customary scientific practice of making his data available for inspection by other researchers. Mr. Lafta had been an official in Saddam's ministry of health when the dictator was attempting to end international sanctions against Iraq. He wrote articles asserting that many Iraqis were dying from cancer and other diseases caused by spent U.S. uranium shells from the Gulf War. These too were politically derived lies.

What sort of theologian are you?

What sort of theologian are you?You might like to try this questionnaire. I came out as somewhere between Karl Barth and St Anselm, and nor very different from Martin Luther and Jean Calvin.
That link doesn't seem to work. Try http://quizfarm.com/test.php?q_id=7092N

Different religions; different roads

All roads lead to God don't they?

Christianity is different from other religions. In every other religion you are required to do something for God. In Christianity God has done something for you.

All roads don't lead to God. Remember those puzzles we used to do as children, where a jumbled maze of lines had many entry points, but only one led to the prize? Some of the lines came very close, only to veer away at the last moment. In the Sermon on the Mount Jesus talked about a broad road that led to destruction which had many people on it, and a narrow road that leads to life which only a few find.

Jesus is very exclusive. "I am the way the truth and the life;" he said, "no one comes to the Father, but by me."

Note that it is to the Father that Jesus is taking us. In John's gospel we read, "Yet to all who received him, to those who believed in his name, he gave the right to become children of God." If Jesus is the one and only son of God, how can we become children of God?

The answer is simple; He adopts us.

People have favorite chapters in the Bible; among mine are Ephesians 1 and Romans 8. In both Paul writes of our adoption as sons. "In love he predestined us to be adopted as his sons through Jesus Christ." and "We wait eagerly for our adoption as sons."

Unadopted roads soon become shabby as lack of maintenance leads to puddles and potholes. Adopted roads are well maintained and you reach your destination safely.

Some complain that this is too exclusive. What right has he to hide this road from the great mass of people who take the broad road? But the entrance to the narrow road is not hidden. It is not a concealed entrance, it is as plain as can be. Goodness me there are crosses everywhere! It is not hidden, but it is very low and you have to stoop to get through. All it requires is to get down on your knees and recognize that there is nothing you can do to save yourself. Then accept it; it is a gift.

God is not willing that any should perish and He has done everything necessary to save everyone. This is not like the Titanic where there were not enough lifeboats, and it is not a case of women and children first, though in many churches it seems like that. But He will not force anyone into the lifeboat. If you prefer to swim for it on your own He will just warn you that you will not make it; if you escape the sharks, the freezing water will get you.

Are you saved?

Some people resent the question; others are amused by it. What am I supposed to be saved from? An onrushing train?

We are saved from sin. Sin is a term in archery that means 'missing the target', especially by falling short of it. Paul writes to the Romans, "for all have sinned and fall short of the glory of God". It's worse than that, for he goes on to write, "For the wages of sin is death".

God has set a standard and the pass mark is 100%. Here's a challenge: try and live a perfect life. Give up? I tried and couldn't do it. Just one sin is all it takes. Miss the bullseye just one time and you fall short of the standard required.

There is a story of Moses coming down from Mount Sinai and saying to the Children of Israel, "It's no good; I couldn't get him to budge over the adultery thing, but I did manage to get us one day off a week."

Moses was given the Law, not so that we could live by it but to show how impossible it is. Because some people believed they could, Jesus demonstrated how superficially they were interpreting the commandments. Murder? It's as bad to be angry against your neighbor. Adultery? Whenever you look at a pin-up or fantasize over a film star you've as good as done it already. This is Paul to the Romans again, "There is no one righteous, not even one." Jesus saves us from sin because he did live a completely sinless life. Someone once said to me, "I am not phased by the resurrection or by any of the miracles, but I can't believe that anyone could live a sinless life." The Bible tells us that Jesus did just that, and here's the proof: when they tried to kill him, Death spat him out again. Death is the wages of sin, not sinlessness.

Sin is something we need saving from and there is only one savior.

We are saved from the presence of sin, but also from the power of sin. Once we have a grip on Christ (or rather He has a grip on us) sin loses its attractiveness. It doesn't happen all at once, but the things that used to enthrall us begin to seem petty dull. Of course, they don't go overnight; some of them are hooked into us pretty deep. Some of them we have to pray pretty hard about. But even though we might still fall for them we begin to hate ourselves for doing so. Once you have been saved you can never be a happy sinner again. Take it from me, you'll never be completely free from sin in this life. There's a story told of a dinner guest of CH Spurgeon who proudly told his host that he had at last achieved sinless perfection. Whereupon, Spurgeon chucked a jug of water over him. The man's temper flared, "What do you think you are doing?"

"It's as I thought," said Spurgeon, "the Old Man's not dead, just sleeping."

In order to free us from the power of sin Jesus sent His Holy Spirit when he returned to heaven. It's the Spirit's job to sanctify us, to strip away the sin and make us fit for heaven. It can be a hard job and painful when we resist Him, but it's worth it.

There should always be three 'P's and the third one is punishment. Jesus saves us from the punishment of sin. God's wrath, they used to call it, though 'wrath' is a very old-fashioned word. What it means is God's righteousness in action. It's fashionable these days to think of it as a sort of involuntary reaction, like 'nature abhors a vacuum'. Vacuum flasks consist of a double layer of silvered glass with nothing in between - no air, no nitrogen, no oxygen. Smash the glass and the whole thing implodes. The air rushes in to fill the empty space, sucking the broken glass in with it. People say that God's nature is such that He abhors sin, and that He can't be in the same place as sin. they say that His wrath is His natural reaction against sin.

But I think that that is a lame attempt to absolve God from being angry. God is angry. There is such a thing as righteous anger. Suppose you saw a pedophile torturing a child, would you not be angry? There is nothing evil about being angry at such a happening. That is righteous anger. And God is angry at sin. Why are there young women from Eastern Europe in London working as prostitutes? It's because of sin. Why are there children in Africa starving? It's because of sin. Why are children cast into care as their parents' marriage is broken up? It's because of sin. Why are young black kids gunned down on the streets of our cities? It's because of sin. It's wholly right to be angry about these things. We mustn't think of God as just a passionless force; He has feelings.

And the greatest of these feelings is love. He loved us so much that He sent His one and only son to receive the punishment for our sin in His own body. This wasn't 'child abuse' as Richard Dawkins called it. Jesus volunteered for the job. There was no difference between the pain of the son and the pain of the father. What was described for us in the Bible in the flogging and crucifixion was a picture of the greater desecration of the Godhead torn asunder. Jesus cried out, "My God, my God, why have you forsaken me?" but what was God the Father feeling at that moment? We can perhaps try to imagine what it is like for Jesus to be separated from His father; it is sometimes called a cry of dereliction. We think of abandonment. Hell is said to be the total and absolute separation from God. When we say that Jesus went through Hell for us, we can begin to imagine what it meant. But how can we imagine what it was like for the Father?

I think of a mother whose baby is ripped from her womb by a Janjaweed bayonet in Darfur. I think of a mother whose child is stolen from her bed as she slept by a pedophile. I think of a father and son at sea when the son is lost to a mighty wave. I think of the parents of that beautiful, Godly young man stuck down and murdered by drunken louts on his way home. I think of the mother who sees her daughter bleeding in the bus queue when a drunken driver has ploughed into her and her baby carriage. I think of the father holding the hand of his dying daughter blown up by a terrorist bomb in Enniskillen. None of these real incidents is enough.

Our salvation is precious because it was bought at such a price.

How deep the Father's love for us,
How vast beyond all measure
That He should give His only Son
To make a wretch His treasure

How great the pain of searing loss,
The Father turns His face away
As wounds which mar the chosen One,
Bring many sons to glory

Behold the Man upon a cross,
My sin upon His shoulders
Ashamed I hear my mocking voice,
Call out among the scoffers

It was my sin that held Him there
Until it was accomplished
His dying breath has brought me life
I know that it is finished

I will not boast in anything
No gifts, no power, no wisdom
But I will boast in Jesus Christ
His death and resurrection

Why should I gain from His reward?
I cannot give an answer,
But this I know with all my heart
His wounds have paid my ransom

Stuart Townend

Transplants in CLL

I thought you might be interested in this provisional guideline for when to do a transplant in CLL.

1. Very high risk CLL defined as CLL with >20% cells showing del 17p or purine analogue refractory. These patients should be treated with p53 independent therapy such as high dose methyl prednisolone and/or alemtuzumab to maximum response and then allografted if possible in first complete remission.

2. High risk CLL defined according to EBMT criteria:{Dreger, 2007}
(i) Relapse within 6 months of Purine Analog therapy
(ii) Relapse within 2 years of intensive therapy including Purine Analog/alkylator combinations, chemo-immunotherapy or autologous transplantation, in second complete remission.

3. Richter's transformation in first complete remission.

It would be standard therapy to treat all of these categories of patients with either a sibling or volunteer matched transplant with reduced intensity conditioning.

4. Other indications. Includes patients not fulfilling criteria 1 or 2 who are in second or subsequent relapse with at least one of the other commonly recognised adverse features listed below:
(i) Bone marrow failure according to Binet criteria
(ii) Unmutated VH genes (<98% germline or V3.21)
(iii) ZAP 70+ (>20%)
(iv) CD38+ (>7%)
(v) Del 11q

For this category a reduced intensity conditioning sibling or volunteer donor transplant is not standard, but might be ordered by a CLL expert.

Umbilical cord blood transplants are experimental and should only be performed in the context of a clinical trial in patients for whom no adult donor is available.

Autografts are generally not recommended.

A sense of justice

When I came home from church I flipped on the TV to find them showing an old Audrey Hepburn film, "How to steal a million". Gentle stuff - one of those 'caper' movies that were so popular then. The sex comprised a very chaste kiss with Peter O'Toole and nobody profited from the crime.

Back then that was the rule. In the movies no-one was allowed to get away with it. Life isn't like that. Most crimes go undetected and unpunished.

I remember a TV series back then which starred Margaret Lockwood as a barrister (courtroom attorney for the Americans). A rich guy employed her to defend him in a drink-driving case. After he was acquitted he received her bill. He commented, "That's an awful lot to pay for justice."

She replied, "But you didn't get justice, Mr Smith, you got off!"

You may have gathered that this is just a roundabout way of introducing Mark chapter 15.

Pontius Pilate wasn't much concerned with justice either, he was concerned with order. We don't know much about Pilate. He was for 10 years Prefect of the Roman Province of Judea but where he came from and how he died are the subject of myth and legend. He was canonized by the Ethiopian Church and his wife was canonized by the Coptic Church. At various time he has been blamed and exonerated for the death of Jesus. An inscription found in 1961 confirms his historicity. We have to answer the question of how Matthew knew of his wife's dream, so perhaps there is some truth in the suggestion that she at least was converted afterwards.

Jesus did not defend himself. The NIV translation, "Yes, it is as you say." is a disputed one. The NASV has "It is as you say.", the KJV "Thou sayest it.", the Good News Bible "Those are your words,", The Message "If you say so."

If I were to paraphrase it, the sense is, "You're not wrong, but I wouldn't put it like that."

There are two reasons why Jesus does not defend himself. One is to fulfil prophesy, "as a sheep before her shearers is silent, so he did not open his mouth." Isaiah 53:7, but the other reason is that the death of the Christ had to be voluntary. If he was killed simply as a result of an injustice then he would not be a substitute; he would just be another martyr.

The Jews were familiar with the idea of a substitute. Every day there were sacrifices in the Temple. A lamb or a bull or a couple of pigeons were killed as a substitute for somebody's sins. But they could not suffice. As the writer to the Hebrews put it, "The law is only a shadow of the good things that are coming — not the realities themselves. For this reason it can never, by the same sacrifices repeated endlessly year after year, make perfect those who draw near to worship. If it could, would they not have stopped being offered? For the worshippers would have been cleansed once for all, and would no longer have felt guilty for their sins. But those sacrifices are an annual reminder of sins, because it is impossible for the blood of bulls and goats to take away sins." Hebrews 10:1-4.

Barabbas could not have been the substitute. Everyone knew that Barabbas was guilty. But everyone knew that Jesus was innocent. Pilate knew, "it was out of envy that the chief priests had handed Jesus over to him." (v 11) The sacrifice had to be of a lamb without blemish, a picture of the sinless Christ. Pilate released Barabbas to appease the crowd and then asked the same crowd, "What shall I do with Jesus?" In many ways it is the perfect question.

What will you do with Jesus? What you can't do is watch and wait. Just as with CLL you can watch and wait too long. There will come a time when it is too late for decisive action. A famous atheist was asked what he would do if he met the risen Christ after death. He replied that he would complain to him, "Sir, you did not leave enough evidence."

To see the question of Christ as a puzzle that can be solved by scientific experiment or the application of reason or by the experience of life is a conclusion of arrogance. All that is required is a simple faith; something available to the peasant who walks behind a plough in Patagonia, the child who sits in an mud hut in Malawi, the factory worker in Pittsburgh, the Inuit in an ice-hut in Alaska, or the banker in a board room in Manhattan. "Where were you when I laid the foundations of the earth?" asks God of Job when the patriarch dared to question Him.

Pilate was found wanting. He handed over Jesus to be flogged and crucified. If you have seen "The Passion of the Christ" you don't need a description of a Roman flogging. If you have a tender soul don't watch it. It was criticised by many as revelling in the blood. All I can say is that the research for the film was accurate.

We cannot imagine the pain of crucifixion. The word 'excruciating' derives from it. There is a Latin verb cruciare which means 'to torment'.

Have you been found wanting. Are there occasion when you did not do what was right because you needed to 'please the crowd'? Do you squirm when you think of them? I do.

What is a Christian?

What makes a Christian? Most people believe in God, but the God they believe in is often some mystical being about whom they have very little knowledge and understanding. They may turn to the Church, but how do they know whether what the church says is true when different churches say different things? And why believe in the Christian God? Why not follow Islam or one of the Eastern religions?

How can anyone, simply by looking at the world know God? Sure, you might see a pattern in creation and assume a creator. Sure you might look at your inner feelings of justice and right or wrong and believe that there is a moral structure to the universe, but how can you know God.

It is perplexing until you recognize that Christianity is a revealed religion. Christians believe that Holy Scripture is the Word of God; not just 'contains the word of God'. Without the Bible, we would know nothing of God, and certainly nothing of Jesus. Although Jesus is referred to by contemporary historians Pliny and Josephus, they tell us nothing about him. It is only the Bible that reveals him to us.

You sometimes hear it said, "My god is like ..." But only the God of the Bible is the real God, and the Bible tells us that if we want to know what God is like then we should look at Jesus.

There are many myths about the Bible and many challenges to its authenticity, but they are spurious. I shall produce evidence of this over the coming weeks, but if you take my advice you will save yourself the trouble. Just believe that the Bible, and you can take most modern translations rather having to learn Hebrew or Greek, just believe the Bible is the Word of God.

Drunken driving

About 100,000 British people are convicted every year of driving under the influence of alcohol. For men the numbers have stayed the same over the last 10 years, but for women the figures have increased by around 50%. However, there are still 8 men convicted for every woman.

Women have still a long way to go to be the equal of men.

God in the dock

In the Daily Telegraph today a columnist was making fun of Mike Huckabee. Apart from the fact that he is a Republican Candidate for the Presidential nomination I know nothing about him. However, he wears his religion on his sleeve, and this is something no British politician would dare to do. When Tony Blair was asked whether he prayed with George Bush, his minder replied, "We don't do God." Despite this Tony Blair was a devout man who has since followed Cardinal Newman to Rome.

Blair thought he would be a laughing stock if he spoke about his faith and the Telegraph columnist seeks to poke fun at Huckabee. The particular issue was a commercial in which the candidate wished everybody a 'magnificent Christmas'. Like many of his readers, I fail to find anything remotely amusing about the ad. But I would go further. I find it offensive that anyone should make fun of someone's sincerely held beliefs about God.

I am reminded of Psalm 2:

Why do the heathen rage, and the people imagine a vain thing? The kings of the earth set themselves, and the rulers take counsel together, against the LORD, and against his anointed, saying, Let us break their bands asunder, and cast away their cords from us. He that sitteth in the heavens shall laugh: the LORD shall have them in derision.

God does not need defenders; he can take care of himself. As CH Spurgeon said, "I would sooner defend a lion." But His people do need defending. I am sure Mike Huckabee can take care of himself, but believers whose faith is frail may cower beneath such cynicism. Christians should stand up for their brothers and sisters.

The forgotten father

Who are you trying to impress?

I have had it said to me in a derogatory manner; I expect you have too. When I was a child I was trying to impress my father. He was a severe man and not easily impressed. He always expected more. When he died in 1980 I was cast adrift. Who should I try to impress? Who was the arbiter of my performance?

Dad never lived to see me appear on television, become a professor, lecture to an audience of 5000, travel the world, become famous in my field. Most of my achievements came after he died. Who was I trying to impress?

In the Sermon on the Mount, Jesus wants us to impress out heavenly Father. I had never noticed it before but the reason we are to love our enemies is so that we may be 'sons of our Father in heaven'.

We are to do good secretly. If we boast about it we will have no reward from our Father in heaven. When we give to the needy we don't want to impress men but we should give secretly so that our Father, who sees what is done in secret, will reward us. When we pray we should go into our room and pray secretly, "Our Father...". Our Father knows what we need before we ask, so we don't need to babble - or pray eloquent prayers that impress the congregation. We should honestly and sincerely forgive others who offend us - because if we don't our Father will not forgive us. We should not make a show of our religion. It is the unseen Father who will reward us.

We should not be concerned by this world's goods or its rewards. If we are not careful they will master us. Our true Master has different priorities. And we can't serve two masters. In any case why worry about what we will eat and drink or what we will wear. Our Father knows our needs and will surely provide for them - and all that time wasted on worrying ...

Whatever we need, simply ask the Father. My father was austere, but he always provided for me. Will not my heavenly Father out-father my dad?

God is love

Many years ago I had invited quite a famous broadcaster to speak at the local medical society. Over lunch we got talking about religion. "I can sum up my view of God in three words," he said, "God is love."

That is many people's view of God, but they couldn't say where it come from. It actually appears in chapter 4 of the first epistle of John, verse 8. The whole verse says "Whoever does not love does not know God, because God is love."

And the context is "Dear friends, let us love one another, for love comes from God. Everyone who loves has been born of God and knows God. Whoever does not love does not know God, because God is love. This is how God showed his love among us: He sent his one and only Son into the world that we might live through him. This is love: not that we loved God, but that he loved us and sent his Son as an atoning sacrifice for our sins. Dear friends, since God so loved us, we also ought to love one another. No one has ever seen God; but if we love one another, God lives in us and his love is made complete in us."

Taken by itself the three word answer can seem rather slushy, but in its context it reminds us of our need for a savior that was foreseen by God who made provision for our salvation even before we were aware of our need. It is a salvation that demands a response from us that we love one another, because it is only in this that God's love is made complete in us.

Secondary malignancies

An underlying genetic disorder is suggested for those cases myelodysplastic syndrome or acute leukemia that seem to have been caused by environmental toxins or exposure to cytotoxic drugs. The term “molecular epidemiology” was coined by Perera and Weinstein in 1982. It is defined as “the science that deals with the contribution of potential genetic and environmental risk factors identified at the molecular and biochemical level, to the etiology, distribution and control of disease in groups of relatives and in populations”. Polymorphisms of genes coding for proteins involved in DNA repair, DNA synthesis and drug and toxin metabolism have all been implicated in the causation of primary MDS and treatment-related MDS/AML.

Although decline in nucleotide excision repair, telomere maintenance and non-homologous end-joining leading to diminished stem cell functional capacity is a natural consequence of ageing It has been recently demonstrated that some patients with MDS have an inactivating Ser327Cys polymorphism in the gene coding for 8-oxoG DNA glycosylase (hOGG1), a key component of the base excision repair pathway. Other genetic polymorphisms that increase susceptibility to these diseases include the G/C variant at position 135 in the 5’ untranslated region of the RAD51 gene and the Thr241Met variant of the XRCC3 gene. Both genes are involved in DNA repair. These are but the latest examples of a huge area of research. Over 520 different amino acid substitution variants have been identified in the systematic screening of 91 human DNA repair genes for sequence variation. At least a third of these are classed as possibly or probably damaging.

The methylene tetrahydrofolate reductase (MTHFR) enzyme directs tetrahydrofolate towards methionine synthesis and away from dUMP synthesis, which is required for DNA synthesis and repair. Two MTHFR polymorphisms, C677T and A1298C, are associated with reduced enzyme activity. In a recent publication, both have been associated with the development of treatment-related MDS/AML.

Metabolism of cytotoxic drugs and potentially carcinogenic compounds is two-stage process. In phase I the substance is converted to its maximally mutagenic metabolite by cytochrome P450 enzymes. These enzymes are encoded by polymorphic genes. For example, the most abundant component of the cytochrome P450 system in human liver is CYP3A, which metabolizes etoposide, teniposide, cyclophosphamide, ifosphamide and the vinca alkyloids. A variant in the 5’ promoter region of the gene (CYP3A-V) diminishes production of the epipodophylotoxin catechol metabolite, which is a precursor of the DNA-damaging quinine. This variant is much less likely to be present in patients with treatment-related MDS/AML.

The phase I hepatic enzyme CYP2E1 metabolizes benzene to benzene oxide which spontaneously forms phenol and the same enzyme further metabolizes this to hydroquinone, a potent genotoxin. Detoxification of hydroquinone requires a phase II enzyme, nicotinamide adenine dinucleotide (P)H:quinine oxidoreductase (NQO1). Defects in the NQO1 pathway lead to accelerated telomere shortening and clonal hematopoiesis. The NQO1 polymorphism at codon 187 was studied by Naoe and his colleagues. The homozygous Ser/Ser genotype was significantly more common in treatment-related MDS/AML than in de novo AML or healthy individuals.

Anemic episodes preceding the development of acute leukemia after exposure to ionizing radiation were reported anecdotally in the early literature. Survivors of the atom bomb attacks in Japan exhibited features in their blood that would be today termed as MDS. It is now well established that secondary MDS occurs following bone marrow injury by alkylating agents and ionizing radiation. It is important to recognize that treatment with other cytotoxic and immunosuppressive agents may also lead to the development of MDS. The effect of the topoisomerase II inhibitors such as the epipodophyllotoxins and the anthracyclines and mitoxantrone in generating chromosomal translocations, particularly affecting the MLL gene at chromosomal band 11q23, are well known. Less familiar is the effect of antimetabolites such as 5-fluorouracil, azathioprine and fludarabine. Furthermore, the use of G-CSF for neutropenic support or to generate autologous stem cells for peripheral blood harvest has been implicated in the causation of secondary MDS.

The molecular epidemiology of MDS is extremely complex and we little understand how silent polymorphisms interact with unknown genotoxins to produce the disease. In the next decade we must expect that greater unraveling of this conundrum will lead us to both prevention and therapy.

The unchangeable nature of God

Does God change his mind?

There are several occasions where the King James version of the Bible says that God repented. In the NIV the word repented is avoided because God is unchanging in his purpose and intent, has complete foreknowledge and is not taken by surprise.

"He who is the Glory of Israel does not lie or change his mind; for he is not a man, that he should change his mind." I Sam 15:29

If you ever think that you are not good enough, that you need to try harder, that you have forfeited your salvation through lack of effort, do not despair. It is His purpose to bring believers into the full enjoyment of their promised inheritance. It is not His purpose for us to be constantly worrying about the future.

"Because God wanted to make the unchanging nature of his purpose very clear to the heirs of what was promised, he confirmed it with an oath. God did this so that, by two unchangeable things in which it is impossible for God to lie, we who have fled to take hold of the hope offered to us may be greatly encouraged. We have this hope as an anchor for the soul, firm and secure." Hebrews 6:17-19.

I am weak but he is strong

The whole of Scripture could be summed up by. "Look at yourself; look at God." We have an opportunity to do just that in Mark 14:53-72.

First "Look at God"

Mark's version of the trial of Jesus is an abbreviated one. We do not the preliminary hearing before Annas, nor the appearance before Herod. The final meeting of the Sanhedrin is condensed to one verse (15:1). But the bones of the case was before Caiaphas, the real power among the Jews and this is what we have here.

There is first false testimony against Jesus. Just as today we get false testimony. Jesus is a freedom fighter. Jesus was one of the Essenes who married Mary Magdalene. Jesus was a magic mushroom. Just as then their testimonies do not agree.

Then there is misinterpretation of what he said. Did he say that he would destroy the Temple and rebuild it in three days? He certainly said something like that, but it is taken out of context. he was talking about his body which would be struck down then raised in three days. Just like today, we have JWs and Mormons and even Muslims quoting scripture at us, out of context and misinterpreted. And just as then their testimony does not agree.

Finally Caiaphas asks him "Are you the Christ, the Son of the Blessed One?"

Jesus answers, "I am."

Notice how Caiaphas says "Son of the Blessed one" to avoid using the name of God - I am that I am.

Jesus is not afraid, "I am," he replies. Then he quotes from Daniel 7:13 "one like a son of man, coming with the clouds of heaven" and Psalm 110:1 "The LORD says to my Lord: Sit at my right hand " with the implication of Daniel 7:14 " He was given authority, glory and sovereign power; all peoples, nations and men of every language worshiped him. His dominion is an everlasting dominion that will not pass away, and his kingdom is one that will never be destroyed."

Caiaphas might have fallen on his face to worship him, but he had other plans. He uses this statement to condemn him.

Look at Jesus and we see God in all his power and glory.

Look at ourselves.

In the second half of this passage we look at ourselves through Peter. Don't think that you would have done better. We are very prone to that. When we watch a dropped catch at baseball or a missed punt at football, we are prone to exclaim, "I could have done that!" But could we? Honestly? Peter was a giant among men. Think of his speech in Acts chapter 2. Could you have done that? Peter was a great leader of men. Would you like someone else to represent you?

Yet Peter denied Christ. Not once, but three times, and each time more vehemently. Finally when the slip of a girl accuses him, the big fisherman called down curses on himself and swore, "I don't know this man you are talking about!"

Then the cock crowed.

And Peter wept bitterly as he remembered - not his vain boasting - not his denials - but the words of Jesus.

Have you had a cock-crow moment? A moment when you realized you were in the wrong. The prodigal son's cock crowed when he found himself eating pigswill. Jonah's cock crowed in the belly of a great fish. For some it has found them drunk in a gutter. Others have found themselves splattered over a tabloid newspaper or locked in prison or bankrupted by debtors, or injured by drugs or diagnosed with AIDS.

Pray that it doesn't take any of these to bring you to your knees.

There is a legend that Peter wept every time thereafter that he heard a cock crow. I think it more likely that he praised God. For it is when we are brought low that we recognize our need of God and just as Peter was restored on the beach of Galilee, so the father is watching from the rooftops to welcome us, and when we are far off he will run to greet us and will throw his arms around us and put rings on our fingers and there will be angels rejoicing in heaven.

The grace of God is measureless and free.

The whole of the Gospel is looking at ourselves and seeing a sinner and looking at God and seeing a savior.

Secondary MDS and acute leukemia

As patients with CLL live longer they are experiencing a higher risk of secondary malignancy. The well known risk is of Richter's transformation in which an aggressive lymphoma supervenes. It seems that most cases are related to the immune defect that is present in CLL and that at least half are due to an inability to control the EB virus. However, it has come to light that patients who have autologous transplants have at least an 15% chance of developing MDS or AML. This is similar to what is found for patients with breast cancer and non-Hodgkin's lymphoma, and seems to be related to the chemotherapy used to induce remission or to condition the patient for the transplant. Moreover, patients treated with FCR or even plain fludarabine also have an increased risk of developing MDS or AML.

Why is it that some patients can receive this sort of chemotherapy safely and others are at risk of a second malignancy. The answer lies in the genes.

Despite the human genome having been sequenced, it is clear that everyone differs slightly from everyone else. These differences are due to polymorphisms. Some of us are blood group A, some B, some AB and some AB. We have different versions of a gene for blood groups. All differences between individuals have such an origin. Big ears, blue eyes, no ear lobes, red hair? All down to our genes. Some of these differences are due to a single amino-acid substitution in a protein. The best known is sickle cell disease. Here the substitution of a valine for a glutamic acid at position 6 in the beta chain of hemoglobin is sufficient to cause a crippling disease. However there are hundreds of similar substitutions in the hemoglobin molecule. Many of them cause no ill health whatsoever, but others cause various malfunctioning of the hemoglobin molecule.

Every other protein in the body is susceptible to the same sort of damage. I remember being astonished to discover when I was a junior doctor that the enzyme glucose-6-phosphate dehydrogenase has at least 160 different polymorphisms and that most don't cause a disease. In patients likely to develop MDS or AML after chemotherapy the polymorphisms mainly affect the enzymes concerned with DNA repair or toxin metabolism. Theoretically it should be possible to screen for these polymorphisms before administering cytotoxic drugs. We just need a little more time to be sure we fully understand all the mechanisms. I will write some moreabout the specific mechanisms as I study them, but here is something about gluthathione-S transferase:

A good example is the enzyme glutathione S-transferase (GST), which is involved in the detoxification of carcinogens such as alkylating agents and epoxides by catalyzing their conjugation to glutathione. It has been postulated that deficiency of this enzyme might be associated with a greater risk of MDS. Both GST M1 and GST T1 genes have a “null” variant allele in which the entire gene is absent. Chen et al found an odds ratio of 4.3 (95% CI, 2.5-7.4) for the GSTT1 null genotype and this was confirmed by Sasai et al who found that in individuals with the GSTT1 null genotype the odds ratio for disease risk were raised to 2.65 (95% CI 1.27-5.52) for de novo MDS, 4.62 (95% CI 1.48-14.4) in therapy related AML and 2.94 (95% CI 1.07-8.07) in AML with trilineage dysplasia.

On the other hand Davies et al found the GSTT1 null genotype similarly distributed in MDS patients as in a healthy population, but an odds ratio of 2.0 (95% CI, 1.3-3.1) for the GSTM1 null genotype in patients with AML/MDS compared with controls. Subsequently, three groups have demonstrated that the double null GSTT1/GSTM1 genotype to be overrepresented in Caucasian, Asian and Hispanic patients with primary and secondary MDS, AML and aplastic anemia.

Seek the Lord while he may be found.

I have just ordered some books from Amazon that deal with the question of militant atheism personified by Sam Harris and Richard Dawkins. Today I do not want to discuss "Did God make Man?" but "Why did God make Man?"

The answer is given in Paul's sermon on Mars Hill. where I stood early last year alongside the Acropolis. "God did this so that men would seek him and perhaps reach out for him and find him, though he is not far from each one of us." Acts 17:27.

This closeness of God to us is something we neglect at our peril. We are like the ostrich who buries its head in the sand. We imagine that because we cannot see God, he cannot see us. The prophet Jeremiah tells us, "I, the Lord, search the heart and examine the mind to reward a man according to his conduct according to what his deeds deserve." Jeremiah 17:10. In Psalm 139 David tells us that we cannot hide from God. We might think that in the vast universe we would be too insignificant to be noticed. We fail to recognize that space is silent. Our sins boom like a beacon across infinities of time and space.

Is there any hope? Jeremiah also tells us, "You will seek me and find me when you seek me with all your heart. I will be found by you ... and bring you back from captivity. " Jer 29:13-14.

Lines written on the first chapters of Genesis

Look at the sky, that vast expanse;
The mottled, dappled, mackerel sky;
The canopy for past romance
Where lovers wept their last goodbye.

Or burning blue, without a flaw,
So they, like we, might clearly feel
The scything sharpness of the Law;
Hard as a mirror cast in steel.

On other days to show His power
He made the lion and its prey,
But for the backdrop of this hour
He made the sky for one whole day.