Sunday, June 29, 2008

Praying to a God who knows everything

Psalm 139 is a prayer that glories in God's omniscience. "You have searched me and known me," prays David. It is fashionable these days to sing songs about God's emotions, but one emotion God cannot feel is surprise. He knows the end from the beginning. When I was young and went to the cinema, the performances continued one after another without clearing the auditorium at every showing. You could, on a cold winter's afternoon buy a ticket for one and ninepence and sit in the cinema from 2 in the afternoon until 10 at night, watching several showings. More often I would arrive half way through the second feature and watch until the end, then see the news and a cartoon, then the first feature and then the second feature again until we reached the part where we had come in. "Let's go," we'd say, "we know how it ends." (My young brother on being taken to his first football match on realising that it had already started asked my father, "Can we stay on and see the bit we missed?")

But God's omniscience doesn't come from having seen it all before. He sees the beginning and end simultaneously for he is outside of time. He even knows what would have happened had we made a different decision. There is an interesting story about David when he was battling against the Philistines and being hunted by King Saul. He had rescued the town of Keilah and was holed up there. He asks God, "Will Saul pursue me to Keilah and will the town surrender me to him?" When both answers came back in the affirmative, he left the town and Saul, on hearing of it, gave up the chase. God not only knows what happened, is happening and will happen, but also what would have happened. His omniscience is complete. (I Sam Ch 23)

David Pawson tells a story from when he was an Air Force Chaplain based in the Middle East. His Arab servant was discovered hidden in a wardrobe scoffing a cream cake during Ramadan; he thought God couldn't see him if he hid. In fact, God could not only see him in the dark, he not only knew his hiding place, he knew the very moment when the idea hit him that he could secretly satisfy his hunger.

"You perceive my thoughts from afar," writes David, "before a word is on my tongue, you know it completely." It is clear, then, that we do not need to pray aloud. Our unspoken thought may be prayers. Are you worried about the government eavesdropping on your e-mails? About CCTV cameras? How about the DNA database that can trace you wherever you've been? The truth for a Christian is that there is nothing that he does that is unobserved. Not a single action. Not a single word spoken. Not a single thought. We have no secrets from God.

But some may ask what is the point of praying? If God knows everything about us, if he knows our needs, our worries and our desires, if, more importantly, he knows what's best for us, why pray? are we not just making fools of ourselves, asking for what it is silly to ask for, exposing ourselves as idiots in the grand scheme of things?

In the end it comes down to this: we should pray because Jesus prayed. If you read the prayers of Jesus, it is clear that he had an intimate, conversational relationship with his father. In John 11:42 at the raising of Lazarus, Jesus says, "Thank you that you have heard me. I knew that you always hear me, but I said this for the benefit of the people standing here, that they may believe that you sent me."

We pray because Jesus prayed and our desire should be to develop that same intimate relationship with our Father.

Saturday, June 28, 2008

Praying when nobody seems to be there.

Are you troubled by cold calling? Every day we get a call. Someone with a strong Indian accent wants to help us with our debts (we don't have any), or a recording tells us how much money we have locked up in our home, or someone offers us free double glazing if we allow our house to become a show-house for them to demonstrate their wares, or a man with a Birmingham accent thinks we are not getting the best return on our investments. Yesterday, a rather nice lady with a Yorkshire accent asked me, "Do you have trouble getting out of the bath?"

How do you deal with them? Some people just put the phone down on them. Others get abusive. One lady I know replies, "No, I don't have any money worries, but do you know where you're going when you die?" and then continues, "Let me tell you about the Lord Jesus Christ..."

In the days when we called it 'junk' mail rather than 'spam' David Frost had a good idea. Inside most junk mail there is a prepaid reply envelope, that is only paid if it is posted. He suggested that we sent it back empty. That would deter them.

On the same principle, one fellow I know, just puts the phone on the table and lets them talk away. After all they're paying for the phone call. There's nothing to say you have to listen. I wonder how long it takes before they get tired at the other end of getting no response? If you are a fan of Fawlty Towers you will know all about telephone responses. Prunella Scales' brilliant portrayal of Sybil with her "Oohhh, I knoooooooow" and her braying laugh, which her husband compares to "someone machine-gunning a seal" sent the verbal signals to her friend Audrey that someone was listening.

When we pray we lack those verbal reassurances. Not only is God invisible to us, but he does not reply, "I know" down the telephone. There are times when we feel God is very close. Yesterday, I went to a meeting in a tent to celebrate the 60th aniversary of Moorlands Bible College. The music was led by Stuart Townend. Although I have some of his cds, the experience of singing his hymns with 500 people with him leading and his band sounding loud and clear was a magical one. Then hearing Alistair Begg, the Senior Pastor of Cleveland's Parkside Church, preach on the cross - its clarity, centrality and crucial nature - left me close to heaven. But at other times, as Philip Yancy says, God's baffling tolerance of the world's atrocities and my unanswered prayers, make me feel that I am talking to the ceiling.

The first thing to realise is that my feelings about the matter are not a measure of God's presence. Like the sun, he is always there though clouds hide his face. Wherever we go, not just in beautiful gardens or exhilarating mountain tops, God is with us. Think of the most disgusting place: a filthy prison without sanitation where the inmates are tortured by the guards or a 'hospital' in Africa without sheets or blankets, without medicine, where people lie waiting to die with undressed wounds and untreated fevers. It sounds like Hell - a place defined by the absence of God.

But listen to what Jesus said, "I was hungry and you gave me something to eat, I was thirsty and you gave me something to drink, I was a stranger and you invited me in, I needed clothes and you clothed me, I was sick and you looked after me, I was in prison and you came to visit me."
Then the righteous will answer him, "Lord, when did we see you hungry and feed you, or thirsty and give you something to drink? When did we see you a stranger and invite you in, or needing clothes and clothe you? When did we see you sick or in prison and go to visit you?'
"The King will reply, 'I tell you the truth, whatever you did for one of the least of these brothers of mine, you did for me.' (Matt 25:34-40)

When we visit such places He is already there. He is in the sick and hungry, the tortured and the oppressed, the weak and the lonely.

As the psalmist writes, "Where can I go from your Spirit? Where can I flee from your presence? If I go up to the heavens, you are there; if I make my bed in the depths, you are there. If I rise on the wings of the dawn, if I settle on the far side of the sea, even there your hand will guide me, your right hand will hold me fast. If I say, "Surely the darkness will hide me and the light become night around me," even the darkness will not be dark to you; the night will shine like the day, for darkness is as light to you. (Psalm 139:7-12)

We live by faith not by sight. We pray in faith; not from telephone responses.

Did you just notice that God spoke to us? He said, "Where can I go..."

CD30 - a lymphoma defining molecule

CD30 was originally defined as a member of the nerve growth factor receptor superfamily, but more recently has been redefined as a cell membrane protein of the tumor necrosis factor receptor family. The textbooks say this about it: It has five clearly identifiable Cys-rich repeats. The structure is interrupted after repeat 3 by a hinge sequence of about 60 amino acids. It first became important as a marker for Hodgkin's disease. Although, clearly a malignant disease, the majority of the cells in the Hodgkin's lymph node were not monoclonal. They were a mixture of T cells, B cells, macrophages and eosinophils, and all part of a reaction against the tumor. The tumor cells are the large, binucleate Reed-Sternberg cells - mononuclear forms also exist, though they are more difficult to identify. Years ago the nature of the Reed Sternberg (R-S) cell in Hodgkin's disease was unclear, but they stained with antibodies against CD30, and it was using this label that enabled scientists to manipulate single cells to discover what exactly they were. We now know that R-S cells are B cells, crippled B cells, to be sure, but B cells nevertheless. It is now clear that what is crippling the B cells is either a mutation in the immunoglobulin genes that makes the production of immunoglobulin impossible (such as a stop codon) or else an abnormality that inactivates the immunoglobulin gene promoter such as a deficiency of the octamer dependent transcription factor, Oct2, or its coactivator, BOB.1.

CD30 became an important marker for identifying Hodgkin's disease and there are even attempts to treat Hodgkin's disease with anti-CD30 antibodies and immunocongugates. But reliance of CD30 was shattered when it became apparent that not all CD30 positive lymphomas were Hodgkin's disease. Anaplastic large cell lymphoma (ALCL) is a T cell lymphoma consisting of cells that are large with abundant cytoplasm and often horseshoe-shaped nuclei. The cells are CD30 positive and usually stain for an enzyme - the anaplastic large cell lymphoma kinase (ALK). It accounts for 3% of adult non-Hodgkin's lymphomas and about 10-30% in children. It is about 6 times more common in males than females, especially in younger individuals. It involves the lymph nodes, but also skin (21%), bone (17%), soft tissues (17%), lung (11%), and liver (8%). In 30% of cases it can be detected in the bone marrow. Three-quarters of patients show systemic symptoms.

The ALK gene is on chromosome 2 and in most cases there is genetic interference with this gene, most commonly by the formation of a conjoined gene with the gene for nucleophosmin (NPM)caused by the t2;5 translocation. NPM protein is normally found in teh nucleus of the cell, and this is teh way that ALK gets into the nucleus. There are other translocations with for example chromosomes, 1. 3, 17 or 19, but as these do not involve NPM, the ALK stays in the cytoplasm.

ALK positive lymphomas usually require treatment with chemotherapy, but the response rate is high and the 5-yeas survival about 80% Some ALCLs are ALK negative and these have a worse prognosis.

ALCL has to be distinguished from primary cutaneous anaplastic large cell lymphoma (C-ALCL). The cells here are CD30 positive but ALK negative. It is defined by being confined to teh skin as a tumor, nodule or papule. The diagnosis is confirmed by an extensive search that demonstrates that teh disease is not elsewhere. Treatment is by surgery or local radiotherapy and teh prognosis is very good.

CD30 may also be present on a variety of very rare lymphomas including Primary Effusion Lymphoma seen mainly in AIDS patients and associated with HHV8 infection, Lymphomatoid Granulomatosis, which is an angiocntric and angiodestructive lymphoproliferative disorder comprising EBV positive B cells and reactive T cells, and Celiac Disease-related T-cell Lymphoma.

Friday, June 27, 2008

Political humor

A car was stopped at a road block in Zimbabwe. On winding down the window the driver was informed that Mugabe had been captured by rebels. They were threatening to douse him with petrol and set fire to him unless a ransom was paid. The road-blockers were making a collection.
"How much are most people contributing?"
"About two or three liters."

Jokes are the last weapon available to the oppressed. They were common in satellites of the USSR. One story tells of a citizen who was disgusted at joining queues for unavailable staples. After spending a day in a queue on the unfounded rumor of the availability of tomatoes, he decides he must buy a gun. "I am going to shoot Brezhnev." In the evening he reurned despondent. He friend asked, "Well, did you shoot him?" "No, the queue was too long."

Anonymous witnesses

The House of Lords, Britain's Supreme Court, has ruled that prosecution witnesses cannot remain anonymous. The defence has the right under Common Law to know their identity and to cross-examine them. If their identities are not known then there cannot be a fair trial. These seems to be fundamentally correct. I have an absolute right to know who my accuser is and to show that he is lying. If he is anonymous my ability to do that is impaired.

Anonymous witnesses have been allowed in certain murder trials because witnesses were so intimidated that they did not give evidence for fear of their lives. The Law Lords decision means that several murder trials cannot proceed and that 40-50 convicted murderers may be let out on appeal.

Of course, this is not a new problem. In order to fight the Mafia's witness intimidation in America, witnesses were taken into protective custody and then given new identities and relocated. Relocation is much more possible in America where the vast distances and huge population allows it. It is believed that some British witnesses have been relocated to Australia and New Zealand. But even relocation is a cruel punishment on the innocent. How would you like to me permanently separated from your friends and family because you happened to witness a gangland killing?

The Justice Secretary is planning to bring in a law allowing anonymous witnesses but labor does not have a majority in the Lords and might find it difficult to get their Bill through that Chamber. Also the European Convention on Human Rights has now been incorporated into British law, and that Convention might well decree that anonymous witnesses are invalid.

Although civil liberty is in retreat in the UK, with concerns about the DNA database, identity cards and 42 days detention without charge being overridden by the government, and many people confused about how much weight to throw behind the protection against terrorism and how much to throw behind protection of civil liberties, this particular question is a longstanding one concerning the rule of law.

Evil men will seek to subvert the whole of a community to their will. The law is there to prevent it happening. But the law must be fair; it must not bring about a good end by illegal means. We can't have a regiment of 'Dirty Harrys' enforcing the will of the law in the way that evil men enforce their will with hit men, because what is to stop the law becoming corrupt? We know from past experience that it happens.

Consider this scenario. A local gang boss is responsible for a number of murders. A witness offers to testify against him on condition that he remains anonymous. He is given that assurance and so testifies. The gang boss is convicted, but the following year there is a new gang boss causing havoc. He is the witness who had testified anonymously the previous year and whose lying testimony the previous gang boss was unable to challenge.

It may be that the investigating magistrate of the Napoleonic system would be better adapted to prevent this sort of abuse.

Thursday, June 26, 2008


Inflation is supposedly running at 3.2%. Nobody believes the government on this. Fuel prices are up 40% on a year ago and food prices by about the same. Some things have come down in price, like iPods, flat screen televisions, and other electronic goods, but these are things you buy every several years, not every week like food and fuel. Their falling prices only make consumers angry that they bought theirs when prices were still high. Clothes are also cheaper, mostly because of the employment of child labor in the far east.

More important has been the growth of money supply which was 12% in the past year. Growth in productivity was about 2%, so the true inflation rate was 10%. It may still have to work through, but that is the bottom line. Most people would agree with that figure for personal inflation. The increased cost of imported goods is really a devaluation of our currency. The so-called increase in the demand for oil and fool is illusory. It has been made up by governments and speculators; the first to disguise how they are squandering our taxes, the second to short sell and make a fast buck.


Forty million Frenchman can't be wrong!

That's one of the cries of encouragement to go along with the crowd. In fact, when they followed Napoleon they were completely wrong. The millions of Germans who followed Hitler were similarly mistaken, and so it is repeated time and again all over the world. The majority is often wrong.

Of course the minority can be wrong too. I remember as an eight-years old at school standing up before the headmaster explaining why I was right and the rest of the class was wrong over a a simple mental arithmetic problem he had given the class. As I reworked the sum I realized that I had made an error. It taught me that I needed to be more careful at mental arithmetic, but I remembered to this day how good it felt to be standing up for what I believed was right no matter what the crowd believed.

Yesterday, I listened to a radio program on sociology. A learned professor was explaining his observations on violence. Violence occurs because of the local situation. When two fairly equally matched belligerents get into a quarrel, they may prance around making threatening gestures and rude remarks, but blows are seldom struck. The disorder quells. But where one is confronted by many, particularly if he stumbles or backs away, he is likely to be set upon by a crowd. It is the reason we see football hooligans. The presence of the crowd breeds violence.

It is very hard to stand for what you believe in the face of a crowd of unbelievers.

The Rechabites were a group of itinerant metalworkers who lived in tents, moving from place to place mending and repairing chariots and swords – a bit like tinkers. They traced their ancestry to Jonadab ben Rechab who lived in Israel at the time of King Jehu. Their lifestyle was dictated by a vow they had made 250 years previously. This is the way they put it:
“We have obeyed everything our forefather Jonadab son of Rechab commanded us. Neither we nor our wives nor our sons and daughters have ever drunk wine or built houses to live in or had vineyards, fields or crops. We have lived in tents and have fully obeyed everything our forefather Jonadab commanded us.”

At the time of the prophet Jeremiah, they had moved into the city of Jerusalem because of the danger of the Babylonians who were ranging through the countryside.

Performance art, as the term is usually understood according to Wikipedia , began to be identified in the 1960s with the work of artists such as Yves Klein, Vito Acconci, Hermann Nitsch, Chris Burden, Carolee Schneemann, Yoko Ono, Joseph Beuys, Wolf Vostell and Allan Kaprow, who coined the term happenings. In 1970 the British-based pair, Gilbert and George, created the first of their "living sculpture" performances when they painted themselves gold and sang "Underneath The Arches" for extended periods. Alongside pioneering work in video art by Jud Yalkut and others, some performance artists began combining video with other media to create experimental works like those of Chicago's Sandra Binion, who elevated mundane activities like ironing clothes, scrubbing steps, dining and doing laundry into living art. Binion has performed all over the world and is highly regarded as an artist in Europe.

Of course, as with so many other things the Old Testament prophets got there first. What Jeremiah did next was performance art. He hired an hall that was open to scrutiny by all and invited the Rechabites to dinner. He put before them flagons of wine. There was some pressure upon them. They were guests. They were on public display, There was a war going on and they were looking to their hosts to protect them. They did not wish to be discourteous. But as Jeremiah knew they would, the Rechabites refused the wine. They replied, "We do not drink wine, because our forefather Jonadab son of Rechab gave us this command: 'Neither you nor your descendants must ever drink wine.’”

This wasn’t the first time Jeremiah had staged a ‘happening’ In Jeremiah Ch 27 we read of him staggering through the streets of Jerusalem with an ox yoke on his shoulders. This was to tell the people that they were going to suffer just such oppression under the yoke of the Babylonians. In Jeremiah Ch 13 he made a show of going to the bazaar to buy a fine linen garment of the sort people wore for a wedding. With everybody anticipating that a special event was coming he buried it in a crevice of a rock. When he went back to retrieve it as if that special occasion had come, it was rotten and in tatters. It was a sign that God had purchased Israel at great expense, but the nation had become rotten and unfit for purpose.

So what was the meaning of this happening? Jeremiah was setting up the Rechabites as examples of obedience. Over 250 years they had kept their vow; they had remained faithful despite the demands of hospitality, gratitude and conformity. And pointing to the leaders of Israel he pronounces a verdict “But this nation has not obeyed me.”

Note that he doesn’t suggest that the Israelites should abandon their houses and live in tents or that they should dig up their vineyards and avoid wine. These were the promises of the Rechabites which they should obey. The promises of the Israelites were to have one God only whom they should love with all their hearts and minds and strength, and that they should love their neighbor as themselves.

We were once Christian nations. Whether we are British, American, French, Dutch, Belgian, Italian, Spanish or German, our civilization was built on the Christian principles of loving God and loving our neighbor. How have we done? Have we been faithful? Or have we followed the crowd?

Tuesday, June 24, 2008

Hinton Ampner

A beautiful summers day, so we decided to visit a garden we had not seen before. Hinton Ampner is a National Trust property near Winchester. The house is nothing special but the garden is divine. It was put together by the last Earl of Sherborne from 1936 until he died in the mid 1980s. The topiary that you can see in the picture is very pleasing, but what is remarkable are the scents. The old English roses are strong smelling varieties and at the moment the Philadelphus or 'mock orange' is florid.

Monday, June 23, 2008

Weapons of war

How should we think about sophisticated weapons? I raise the question following the recent agreement to ban cluster bombs and an article in yesterday's Times about the AGM-114N Hellfire II missile, which the British army is apparently deploying in Afghanistan.

"Apache attack helicopters have fired the thermobaric weapons against fighters in buildings and caves, to create a pressure wave which sucks the air out of victims, shreds their internal organs and crushes their bodies." says the report and this weapon has raised the ire of Human Rights Groups.

Is this a legitimate protest? This is how the report describes its destructive action:

"it is unlikely anyone targeted by the missile would know much about it. The laser-guided missile has a warhead packed with fluorinated aluminium powder surrounding a small charge."

"When it hits the target, the charge disperses the aluminium powder throughout the target building. The cloud then ignites, causing a massive secondary blast that tears throughout any enclosed space."

"The blast creates a vacuum which draws air and debris back in, creating pressure of up to 430lb per sq in. The more heavily the building is protected, the more concentrated the blast."

"The cloud of burning aluminium powder means victims often die from asphyxiation before the pressure shreds their organs."

It certainly sounds brutal but the whole point of the weapon is to limit the damage done to non-combatants.

Just consider the ways of waging war around the world in the last 100 years.

Laying land mines all over Africa and Asia to be trodden on by children playing football long after the war is forgotten.

Dropping cluster bombs that kill people over a wide area, but leave unexploded bomblets that children pick up and play with.

Dropping thermonuclear devices on large cities leaving a radioactive legacy that causes cancer in future generations.

Herding people of a certain racial group into labor camps and letting them starve until a relieving army finds piles of rotting unburied corpses with an occasional person still left alive buried amongst them.

Sending poison gas to blow in the wind to kill your enemy or if not kill, leave him a respriatory cripple for decades to come.

Rounding up men of a certain religion and taking them outside their village, making them dig their own graves and shooting them in the back of the head. Then returning to the village and raping the women.

Hijacking airliners full of passengers and flying them into tall buildings full of office workers.

Herding people of a different racial group into refugee camps - then watching the camps for anyone who forages for food and water - if they do you shoot the men and rape the women. Soon only women venture out because rape is the lesser evil.

Strapping explosives to your torso and detonating them during the morning rush hour in bus or underground train.

Dropping huge bombs filled with high explosive on the general area that you think your enemy exists.

Dropping petroleum on an area and setting fire to it to destroy the vegetation your enemy is hiding in, and not particularly caring if it burns your enemy as well.

Identifying people of a different tribal group and attacking them with machetes, killing and maiming thousands.

Pictures portraying the victims of any or all of these weapons offend all who look upon them.

I think we can all agree that war is hell. Gandhi advocated meeting force with passive resistance. It was reasonably successful in India where his enemy had a conscience. A very similar strategy was adopted by the Jews in German occupied Europe with rather less success.

War is regarded as legitimate if it is waged in self defence or on behalf of a nation that has been attacked. The first Iraq war was thought to be legal since Kuwait had been invaded and its government enlisted the world's support against Saddam. World War II was similarly legitimate as Britain and France went to the aid of Poland, though interestingly not to the aid of Czechoslovakia, the Saarland or Austria, presumably on the grounds that these were the legitimate concerns of the German state - it was an internal matter.

Since the Peace of Westphalia which ended the Thirty years war in 1648 it has become accepted practice that nations do not interfere in the internal affairs of other countries. Widespread improvements in communication have meant that the internal affairs of nations cannot be kept secret and there is international indignation at these 'internal affairs'. What's to be done? The United Nations is stymied. The internal affairs of China or not beyond criticism and that nation can be relied upon to veto any Security Council resolution that has implications for its own human rights record. The United States has invoked the formula of 'coalition of the willing'. Such a formula has been used to fight on behalf of Moslems in Bosnia and Kosovo, and for some Moslems against other Moslems in Iraq and Afghanistan, but not to settle civil wars in Sudan or Zimbabwe, probably because they have had their fingers burnt already.

The wars in Afghanistan and Iraq have become asymmetric. Unable to defeat the American army by conventional means insurgents, who in effect comprise the opposition to the elected government, have resorted to a guerrilla war using suicide bombers, improvised explosive devices, hostage taking, assassination and the like. Such a tactic is difficult to counter, as the Germans found to their cost in World War II. The counter-terrorism tactics of the Nazis, included shooting ten villagers for every German killed, torture, attacking the families of 'freedom fighters' and obliterating whole villages, have been rightly condemned. However, it is unfortunately the case that the safety of the many is bound to imply limits to human rights.

One common tactic in asymmetric warfare is concealment among the ordinary population. This can be with or without the consent of that population. This tactic is common in Gaza and was used by Hezbollah in Lebanon. As a tactic it is outlawed by the Geneva convention, which in turn lays no blame for civilian casualties caused by retaliation against such an enemy. In real life, those who perpetrate this crime are seldom brought to book and the civilian casualties are a great propaganda weapon.

The AGM-114N Hellfire II missile is a counter-terrorism weapon. It is designed to kill combatants who are hiding in caves or buildings. It is a very effective killing machine. It does nor leave bomblets to maim future generations of children and no radioactivity is involved. It kills quickly and is much less likely than high explosives to leave behind injured and suffering victims. However, it will kill civillians if they are being used as human shields.

I am afraid that once insurgents involve civillians by firing and sheltering among them, nothing will spare the civillians from retaliation. If firing on an enemy hidden among civilians were outlawed, it would be a gift to any and every terrorist. Of course every effort must be made to preserve civilian life, but we have to accept that it is not always possible. Even attempts to disable everyone in a building can go seriously wrong as the Russians have found.

My preference would be for all wars to cease. It would be better if all disputes could be settled by negotiation, or failing that by a court of law. Alas, the nature of mankind does not allow it. Some have suggested that doctors by nature of their profession should be pacifists. I am not convinced. I would restrain the evil-doer by non-violent means if possible, but when it is not possible violence becomes necessary. The violent man seeks an advantage from the reluctance of the many to be violent.

When violence is certain, it is better to have an efficient weapon of war than an inefficient one.

Sunday, June 22, 2008


Galatians 3:26-4:7

Have you ever met royalty? I have twice met Princess Anne and once Princess Margaret. I have been 20 yards from the Queen in a crowd. Princess Anne I found sharp with a mind of her own and Princess Margaret a heavy smoker and drinker who liked a joke. I've never met a famous politician, though my local MP, whom I have met once, is shadow minister for culture and sport. I was once in the same bank queue with Harry Redknapp, a famous football manager, but apart from him the only sports star I have met is Frank Bruno, one of Britain's famous horizontal heavyweights. I know a member of a well-known rock band. Of course, I know a lot of doctors who are famous in their own circles. I have never met anyone from the world of culture apart from a second violin in the Bournemouth Symphony Orchestra and Natalie Clein, the cellist, though I knew her parents rather better than her. I have met a few well-known journalists, both professionally and socially, though the ones I knew socially are both dead. Even in the world of the Church the people I have met are pretty small fry - no bishops or archbishops. If we put it the other way round and asked all these people, "Do you know Terry Hamblin?" they would answer, "Terry who?"

Having established my insignificance the awesomeness of God is hard to contemplate.

In church this morning we sang this chorus 5 times:
Our God is an awesome God,
He reigns from heaven above,
With wisdom power and love,
Our God is an awesome God!

I was getting irritated at this 'vain repetition' but then it began to get to me. We need to realise just how awesome He is. Not Princess Margaret. Not even the Queen. Not Tony Blair, not even George Bush. Not Tiger Woods, Carl Lewis or even Micky Mantle. Not Mohammed Ali, not David Beckham, not Clint Eastwood or Robert Redford, not Nelson Mandella, not the Dalai Lama, not even the Pope. Their grandeur is a pale imitation. This is who created the earth, the sun the stars. Even our own galaxy seems impossibly large for us to imagine - just think of a universe with millions of galaxies. Yesterday, I was enjoying looking down my microscope at blood cells - 25 trillion in a spoonful of blood, but I knew that magnificent though the magnification of my microscope was, it could not see the smaller organelles within the cell. I would need an electron microscope to see mitochondria and nuclear membranes and the endoplasmic reticulum. Even smaller are the molecules strung together in proteins and DNA. But beyond that are subatomic particles that I cannot contemplate.

How awesome is a God who knows every hair on my head and cares for the raiment of the flowers of the field and holds the very sparrows in his hand. How tremendous He is who created this marvelous universe from the smallest electron to the mightiest star, who stands outside of time to see simultaneously a crystal form in Alpha Centuri and a murderous thought in the mind of a tribesman in the Kalahari.

St Paul pictures us a slaves; the most insignificant members of a household. We counted for nothing. We could have been bought or sold on a whim. Our lives or deaths meant nothing. We could have no access to the head of the household. Our complaints were as nothing; our desires meaningless; our lives pointless.

The idea of anthropogenic global warming for example is a joke. As if we could influence anything. What arrogance! What hubris! God laughs and has them in derision.

It is when we see our smallness and God's greatness that we can begin to appreciate what Jesus has done for us. "You are no longer a slave but a son; and since you are a son, God has made you an heir."

As a slave we could not pray. God was so remote. So 'up there' to our 'down here'. But as a son and heir we can say Father or even more intimately 'Abba' or 'Daddy' and know that he longs to listen to us.

Saturday, June 21, 2008

Abu Hamza's extradition.

Abu Hamza, the rabble-rousing Mullah at present in jail in Rngland, is wanted in America on terrorism charges. He is famous for his hooks. He had his hands amputated but why exactly is not clear. He claims it was the result of helping clear land mines in Afghanistan left behind by the Soviet Union. Some dispute this claim and offer alternative theories, including that his hands may have been cut off as punishment for theft in Saudi Arabia. Another claim is that he lost his hands in a nitroglycerin accident, in an al-Qaeda training camp in Afghanistan.

He is due to be extradited shortly, but is appealing against his extradition. Yesterday, his appeal was turned down by the Court of Appeal. The two judges who heard the case were Mr Justice Sullivan and Judge Judge. More amusing than that Judge Judge's full name is Sir Igor Judge. He's an Igor!

Fans of Terry Pratchett will get the joke immediately. Igors are perennial servants of strange households who do a nice line in spare parts surgery. They all look alike and have a lisp. One can imagine the conversation.

"Abu Hamtha, we are going to thend you to the You-Eth-Ay, but before you go we mutht get rid of thothe hookth. I alwayth carry a thpare thet of handth in my thuitcathe, tho if you will come back to my roomth, I will thtich them on for you."

Friday, June 20, 2008

Even more NHS nonsense

An amusing letter in today's BMA News. Dr Simon Landen writes, "My trust has just completed an extensive, disruptive and costly 'deep clean'. With this is mind, I visited a patient with a broken leg."
"She had a wooden stick with a hand-shaped hook. I asked her what it was for, and she replied that it was for scratching beneath her cast. She said it belonged to a lady two beds down, who had been using it to scratch beneath her cast and to pull back the curtains around her cubicle."
"Further investigations revealed that the stick had been used by five patients in the previous 24 hours."

With every body worried about MRSA and C.diff it is about time that someone on the ground observed what was actually happening rather than central government issuing edicts on how to clean hospitals.

Asymetrical warfare.

Despite superficial similarities between cricket and baseball they are very different sports. I don't suppose that the switch hitting of Kevin Pietersen made any headlines in America - after all Micky Mantle did it all the time. However, cricket is an asymetrical game in a way that baseball is not and 'left' and 'right' are very different.

Whether you are a left-handed or right-handed bat the 'leg' and 'off' side are very different and different laws apply (in cricket the rules of the game are known as laws). What happened was that as the bowler (pitcher) ran up to bowl (pitch) the batter switched from being a right-hander to a left-hander and promptly hit the ball for six (roughly similar to a home run). Why did he do it? Because the fielders were asymetrically spread. Instead of having 5 on one side and 4 on the other, there might be 7 on one and 2 on the other; by switching the imbalance comes into the batter's favor.

The real problem is that 'leg' (left for a right-hander) and 'off' (right for a right-hander) are treated differently under the laws. For example, Law 36.3, does not allow more than two fielders to be behind the bat on the leg side. On the off-side there can be as many as the bowler wishes behind the bat on the off side. Since it is the usual practice for there to be as many as 4 or 5 behind the bat on the off side, if a right-handed batter changes to a left-hander once the bowler has begun to bowl, he must still be treated as a right hander else the play would be illegal because of the two behind the wicket law.

All batsmen enjoy a measure of protection on the leg-side. He cannot be given out leg-before-wicket if the ball pitches (unlike baseball, in cricket the ball is meant to bounce before it reaches the batter, in order to give the batter a greater chance of missing it) the outside the leg stump. If he switched his leg stump becomes his off-stump (or does it?) and a the LBW law is confused.

Chobham armor was a development in the armor of battle tanks. It was designed as a way of stopping certain types of projectiles penetrating the tank. The projectile manufacturers countered by making heavier shells out of depleted uranium, which would have more momentum when they hit the tank. In fact the same manufacturers were often producing better armor and better projectiles at the same time as a sort of game. It's called the market.

Stephen J Gould wrote a fascinating essay on how in baseball the advantage would swing from batter to pitcher as the pitching mound was raised or lowered. Golfers also wage a constant battle with course designers - often you are better playing a course left handed as they are frequently designed so that the hazards mainly restrict right-handers. In cricket once a batsman gains supremacy the bowler will develop a new strategy to restrict him. In the famous 'bodyline' tour of Australia in 1932-3, the England captain, Douglas Jardine, developed what he called 'leg-theory' in an attempt to restrict the greatest batsman of all time, Don Bradman. by bowling at the body rather than the wicket. In the 1960s the West Indians took this to new lengths by bowling very fast at the batters' head. Batters retaliated by donning crash helmets. The early development of the 'googly' or 'Bosie', an off-break that looks as though it ought to be a leg-break was another strategy developed by bowlers to beat the batsmen, and the recent successes of spin bowlers Shane Warne and Muralitharan show how bowlers have gained an advantage.

Switch hitting exposes the batter to greater danger. Mike Gatting, a former England captain, tried in disastrously in the 1980s against the decidedly average spin bowling of Australian captain, Alan Border, and the subsequent reversal of fortune probably lost England the test match. Despite the difficulties with the laws, I think that switch hitting is here to stay and adds to the vitality of the game.

Wednesday, June 18, 2008

New cancer statistics

Cancer statistics for the UK were released today. Here in Dorset we have the highest incidence of cancer overall, but the lowest death rate for cancer.

These rather paradoxical results can be explained by several additional observations. This is a retirement area and cancer is commoner in old people. OK, but surely we should have a high incidence of deaths from cancer as well? Perhaps it's because Dorset has the best cancer doctors. modesty forbids me from answering that one, but there is another explanation.

That we have the lowest incidence comes from the types of cancer we have. Lung cancer used to be the commonest type of cancer, but in men it has been overtaken by prostate cancer and in women by breast cancer. But whereas lung cancer is fatal in 95% of cases, both breast and prostate cancer are less likely to kill you. In Dorset we have the lowest incidence of lung cancer in the country and the highest incidence of prostate cancer. Lung cancer mainly occurs in smokers; in Dorset we have the lowest incident of smoking in the country. Prostate cancer is mainly diagnosed from blood test in asymptomatic individuals and many cases never present clinically, the individuals living untreated to a ripe old age. It is the affluent who ask for the PSA test. Dorset is an area populated by the affluent middle classes who don't smoke.

Breast cancer occurs in women who delay their families, who don't have children at all, who take the contraceptive pill and who take HRT. It also is commoner in the overweight. This describes Dorset woman. There is also an element of better detection. Many cancers detected by mammogram would never have presented clinically. Wealthy women are more likely to attend for their mammogram.

Dorset also has the highest incidence of blood cancers that can be picked up in asymptomatic individuals, CLL and MDS.

Tuesday, June 17, 2008


Dinner in Copenhagen was interesting. I had a long conversation with Robert Peter Gale, a pioneer of stem cell transplants. Among the things we discussed was Michael Frayn's marvelous play about the Dane Niels Bohr and the German Werner Heisenberg. I had seen the play in Bob's home territory, New York, and he had seen it in London. There is, of course a BBC TV version which is well worth getting, starring as it does Daniel Craig (the new James Bond) as Heisenberg, Stephen Rea as Bohr and Francesca Annis as Margrethe Bohr.

Sitting on my other side was a member of Elsevier's staff, a young Moslem woman from Egypt. I attempted to discuss the Ed Hussain book about Islamists. I am afraid that I was unable to get her to talk about Islamic doctrines - it was like trying to get a member of the Church of England to talk about Christianity - they know that they are Christians, but don't know much about what Christianity stands for. I mentioned that Ed Hussain had returned to his roots as a Sufi Moslem. That did ring a bell. "It is the branch of Islam that is closest to Christianity," she said.

If you read Hussain's book, you will see that most of the ideas he now espouses are Christian ideals. Reading him you can see how some people see the three great monotheistic religions as similar. For him, though Christianity is a no go area because he could not believe that Allah (the name of God in Arabic, used by Syrian Christians as well as Moslems) could have a son. When witnessing to Moslems it is best to avoid using this metaphor to describe the relationship between the persons of the Godhead.

The other great joy of Copenhagen was meeting Anders Rosen, who was one of the presenters at the Eric meeting who spoke about the molecular targets of the immunoglobulin on the surface of CLL cells. Anders is a Christian whose parents were Baptist missionaries in China. I can't tell you good it is to meet another Christian who is working in science.

Sunday, June 15, 2008

101 things to do before you die.

You know those lists - 101 things to do before you die? Run a marathon, snorkel on the Great Barrier Reef, drive a dog sled in Antarctica, enjoy a date beside a moonlit Taj Mahal, go white water rafting, ride a racehorse, swim with a dolphin, sleep under the stars - you know the sort of thing. These lists are based on the premise that you've only got one life so you'd better make the most of it.

It is a false premise.

No, I haven't turned Hindu and I don't believe in reincarnation.

Sometimes Christians are asked, "If heaven is so great, why are you clinging on to life?"

Here's a confession - I don't want to die and go to heaven. In fact, I don't want to go to some people's imaginings of what heaven is like at all. When heaven is presented as sitting around on a cloud with a harp and a halo with eons of choir practice, I definitely don't want to go there. I can see how some people opt for a hell which they envision as the lower pleasure gardens.

In fact, heaven is better than that. Jesus told the thief on the cross, "This day you will be with me in paradise". St Paul longed to be 'with Christ which is better by far'. Whether it is like a beautiful garden (which is what the word translated 'paradise' means) or simply in the presence of God in a way that none of us can comprehend, it is a wonderful place to be and the vast majority of Christians will go there. There will be some still alive when the Lord returns and every generation hopes that He will come in their lifetime. For these, heaven is not their destination.

It's a bit like flying to San Francisco with a stopover in Atlanta. No-one says I am going to Atlanta for my vacation. I am going to San Francisco via Atlanta. Heaven is like Atlanta. I bet no-one ever said that before. I mean it is an intermediate destination. It is a stopover until the new creation is prepared.

In Romans chapter 8, St Paul writes a lot about groaning. "The whole creation has been groaning as in the pains of childbirth right up to the present time" (v22). Some people are puzzled as to why the world is such an unsatisfactory place. Of course there are beautiful mountains and wonderful plains, glorious grasslands, magnificent desserts and majestic oceans; but there are also terrifying hurricanes, horrible typhoons, fearsome earthquakes and destructive floods. People are eaten by alligators, bitten by venomous snakes, stung by poisonous spiders and have their crops consumed by locusts. It's almost as though the world we live in is cursed.

Actually it is.

In Genesis chapter 3, after Adam had disobeyed God, God said, "Cursed is the ground because of you." The world is not perfect because it was 'subjected to frustration' (Romans 8:20). Adam's sin and ours has polluted the world and corrupted it.

It's not just the world. We ourselves, though we have the first fruits of the Holy Spirit (v23) groan inwardly as we await our adoption as sons. Our bodies are subject to corruption. Our hair falls out, our teeth fall out, our joints creak, our arteries fur up, our memories fail, we get skin cancer, bowel cancer, breast cancer, leukemia. It is all part of the same curse.

We wait eagerly for the redemption of our bodies. Remember your first attempts at cooking. Inevitably the mixture was lacking something. We might have thought that the goo was only fit for throwing out, yet somehow our mothers were able to do something to redeem it, to rescue it from the slop bucket. Similarly, the Lord does not consider us worthy of the slop bucket, but strangely he sees something worth redeeming.

Our future is not floating on clouds but living in a new heaven and a new earth. Paul spells out what it will be like in I Corinthians chapter 15. "The body that is sown is perishable, it is raised imperishable; it is sown in dishonor, it is raised in glory; it is sown in weakness, it is raised in power; it is sown a natural body, it is raised a spiritual body." "Just as we have borne the likeness of the earthly man, so shall we bear the likeness of the man from heaven." Or as John puts it, "What we will be has not yet been made known,. But we know that when he appears we shall be like him." (I John 3:2)

We cannot comprehend the glorious body of Christ, but we shall have a body just like that.

Listen, I tell you a mystery: We will not all sleep, but we will all be changed - in a flash, in the twinkling of an eye at the last trumpet. For the trumpet will sound, the dead will be raised imperishable and we will be changed." (I Cor 15:51-52)

Christ's body could walk through closed doors, yet it could be touched. It could speak, it could eat and could cook breakfast. It could appear and disappear at will and reappear many miles away. We will not be wraiths. We will somehow be more solid. Of course, we don't understand it, but we will be more not less; the new world will be more not less, but with all the sin taken out, the curse removed. There will be plenty of time for snorkeling, plenty of time to climb mountains.

I don't have to haul my creaking body onto a horse or brave the Antarctic or get fit for a marathon. There will be time enough for that when my body is renewed.

But there are some things that we won't be able to do. We won't be able to heal the sick. We won't be able to feed the hungry or give drink to the thirsty or visit the imprisoned or clothe the poor. We won't be able to lead someone to Christ. There's a 101 things to do before you die.

Saturday, June 14, 2008

ERIC: how to understand CLL little by little

The EHA meeting is on just now in Copenhagen. I went to Copenhagen on Thursday but only to attend the European Research Initiative on CLL (ERIC) meeting that was held at the same time and to co-host the Leukemia Research dinner in the evening.

Copenhagen is the largest Scandinavian city and as one would expect, clean, very white, and traffic-free. The public transport system is outstanding and fun to negotiate. The language is unintelligible but virtually everybody speaks English very well. Because I booked late, I had to stay in a remote Zleep hotel, but it was cheap, clean and functional. The only drawback was its distance from the center, but the trip by train, metro and bus was easy to work out and remarkably quick.

At the ERIC meeting Piers Patten presented his confocal microscopy work on CD38 in proliferation centers. As I played some small part in this I was glad to see it presented and I think I have already blogged about it, as I have about Christian Plass and John Byrd's work on DAPK in familial CLL.

There was a good presentation by John Gribben on The impact of microenvironment crosstalk for cell survival in CLL. This has also been recently published on-line at J Clin Invest .

Life in the proliferation center is fine for the CLL cell. The crosstalk between the CLL cell and the normal cells ensures that the CLL cells stays alive and proliferates while the normal cells functions poorly. The immune system is switched off. One of the effects is that the CLL cell is not rejected, but also immunity to pathogens is suppressed. John's paper begins to dissect the mechanisms involved. Engagement of the T-cell receptor should lead to major morphological changes in the T cell, characterized by changes to the actin cytoskeleton and the accumulation of F-actin at the site of contact with the antigen presenting cell (APC). This is termed the immunological synapse. B cells as well as dendritic cells act as APCs and in CLL, the CLL B cell is known to be defective in this respect. Experiments performed by the Gribben group demonstrated that autologous CD4+ and CD8+ cells from CLL patients have impaired actin polymerization at the immunological synapse; that defects in both B and T cells contribute to this; that CLL cells induce defective immunological synapse formation in healthy allogeneic T cells, that CLL cells induce defective recruitment of immunological synapse signaling molecules such as the integrin LFA-1, the tyrosine kinase Lck, and the actin regulatory proteins Cdc42, WASp, filamin-A and dynamin-2; that CLL T cells have reduced activation and effector function; and that the drug lenalidomide enhances autologous immune synapse formation in CLL.

Understanding what is going on in the proliferation center is integral to understanding CLL, and it is clear that this understanding has been enhanced by John Gribben's excellent work. American readers might be pleased to hear that John has just been elected to the Academy of Medical Sciences, the premier body in medical science in the UK. He becomes the fifth CLL specialist to be elected (after Freda Stevenson, John Cawley, Daniel Catovsky and myself). The Academy has about 800 members from across medical science.

Yet more NHS nonsense.

Go to see a specialist in Harley Street and he will be wearing a waistcoat, dark jacket and pinstripe trousers. He may sport a bow-tie, but probably only if he is a gynaecologist. His Rolex will glitter across the desk. He may even wear a monocle.

Visit the same man in an NHS hospital and he will be wearing an open-neck short-sleeved shirt and no watch. The reason? A public decree by the Oberfuhrer who runs the NHS.

No doubt to exert New-Labor egalitarianism, eh? You would be wrong if you thought so. the real reason is to prevent the spread of MRSA from doctors' dirty cuffs and watch straps.

Really? Is there evidence for that? No, no evidence, but there is a reaction to make and a headline to grab. The government must be seen to be doing something.

42 days and an Irish No.

The big news this week has been the Irish rejection of the Lisbon Treaty in their referendum and the humiliating victory of Gordon Brown on the Bill to extend to 48 hours the period that a suspect can be held without formal charge. They are obviously related.

The 42 day detention was passed by the House of Commons by 9 votes even though the Labor party has a built in majority of more than 60. There is no doubt that it will be defeated in the Lords and it will ping-pong back and forth until and unless the Government invokes the Parliament Act, which ensures the supremacy of the Commons over the Lords. It is conceivable that the Government might change before it becomes law.

The strange thing is that, despite the unpopularity of the Government, the 42 days has popular support in the Opinion Polls.

The Irish referendum defeat, by a surprisingly large majority, has thrown the EU into disarray. The history here is interesting. The Lisbon Treaty is virtually the same as the EU Constitution that was defeated by referenda in France and the Netherlands. It is likely that it would have been defeated in the UK and elsewhere in promised referenda, but after the French and Dutch rejected it all bets were off. The Constitution was amended, but the changes are chiefly cosmetic (such as removal of the word 'constitution') and designed mainly to allow governments to avoid their manifesto commitments to hold further referenda. Unfortunately for them, the law in Ireland does not permit this Treaty to be ratified by parliament; the people must have a say. There is no doubt that had other countries had referenda on the Lisbon Treaty, it would have been similarly defeated in many of them.

Although membership of the EU has greatly benefited Ireland, the Irish people have defeated the proposal for greater integration. Why is this? In part it could be the unpopularity of the Irish government itself, but all the political parties in Ireland save Sinn Fein and the Socialist Workers Party were in favor of the Treaty. I think that the real problem is the democratic deficit. The European Commission is unelected, and though individual Commissioners are appointed by elected national governments, there is no sense in which the Commission could be thrown out of office by the electorate.

Of course, the Lisbon Treaty, in part, was designed to remedy this, with an elected President and greater powers for the European Parliament. However, this was not much help. Politicians in Europe are not respected. Most people regard members of the European Parliament as on a prolonged gravy train. Their expenses are generous and not checked, and it is believed that they are widely abused. The bureaucracy is extremely expensive and very top-down. Everything seems designed to stop innovation and risk taking. Stultifying is a good word to define it.

In my view the original Common Market was a plot by France to enforce reparations on Germany without invoking a third world war in the way that reparation after WW1 forced WW2. It was a clever plot that ensured the end of Franco-German hostilities. Britain was well out of it. Our maritime history with a worldwide commonwealth of English-speaking nations would have been a far better future. Instead, a deluded Edward Heath, heavily influenced as a tank commander in WW2, sought entry to Europe at any price. It was an attempt to halt economic decline by hitching a ride with the booming German economy. The French exacted a high price.

Mrs Thatcher found a truer remedy for economic decline by sweeping away the stultifying socialist Luddites and releasing the vigor of capitalism. She also got us a large part of our money back from Europe.

She was betrayed by members of her own party who wanted closer integration with Europe. Seduced by the true rulers in Brussels, people who went to the best schools, the best Universities, the best opera houses, the best restaurants, the best art galleries - people like us - they plotted to lose the pound and inflict the Euro, until they learned the harsh lesson of Black Wednesday: you can't buck the market.

The European experiment cannot succeed. It is a true and enduring saying: people hate governments. The people will always exert their independence. They won't be told what to do.

So why is the 42 days detention Bill so popular with the people?

I was impressed by Helena Kennedy's points on the radio. Imagine the disruption to your life if as an innocent man you were held for 42 days on trumped up charges. You lose your job, your family, your income, your reputation. You become unemployable. People say, "Where there's smoke, there's fire." To serve 42 days in jail you must be sentenced to 3 months imprisonment - a severe punishment rarely meted out to someone of good character without previous convictions. Imagine it being inflicted because you voiced your political opinions on your blog or your facebook site.

There is clearly a fine line to be drawn between what is necessary for our safety and what must be protected of our liberty. The word 'liberal' has separate meanings in Britain and America. In America it is a near synonym for 'socialist': in Britain it means 'libertarian'. A British liberal would find much in common with a guy in Montana who lives with other like-minded people in a commune protected by an armory of machine guns and grows cannabis plants for his personal use. Liberals in Britain are often against Brussels and against 42 days.

Closed circuit TV cameras come in for criticism. It is said that Britain has the largest number of CCTV cameras in the world - an estimated 4.2 million. The figure is nonsensical. It comes from a survey of two streets in Putney (a suburb of West London). The parallel is drawn with Orwell's 1984. But the CCTV cameras are not owned and run by the government for the most part. They belong to property owners to protect their property - a thoroughly libertarian principle. Some are used on roads to judge traffic flow and control traffic lights. Some are used by the local authority to monitor and deter vandalism. Secret cameras to watch individuals are the stuff of spy fiction. As a Christian who believes that an all knowing God watches everything I do or think I can hardly object to CCTV.

The other element of the Liberty/Authority debate concerns identity cards. I don't know if you are a fan of the Lee Child books. His hero, Reacher, carries no ID, little money, wears his clothes until they must be replaced, has no cell phone or other electronic devise and disappears as soon as he leaves on Texan town for another. He travels light and is the ultimate in Libertarian heroes. His watchword is mind your own business.

Yet, most of us live in a world that is dependent on others. Someone else collects our garbage, delivers water to our house, disposes of out sewerage, sells us food, cuts our hair, drives our buses, generates our electricity, schools our children, and manufactures our shirt and trousers. Of course we could do all these things for ourselves. I remember as a young man suggesting to my boss that I was going to grow my own vegetables. He replied, "My dear chap, that's why we had the industrial revolution; so that you wouldn't have to."

It is called Society. Mrs Thatcher was famous for saying that there is no such thing as society, only people. But people perforce interact and that interaction generates society. We must always remember that societies consist of people and the people have to identify themselves. We jealously guard our identities. Identity theft is serious crime. Identity cards are one way of helping to protect out identities - I can see that they might not work to do that and might even facilitate identity theft. However, we are usually content to have passports, bank cards, credit cards, store cards, student ID cards and many other assurances of identity. Many a young person carries a card that allows them to buy alcohol. It's not the card, but the way it might be used that concerns libertarians.

The government wheels out the same argument for 42 days. It would only be used in the most dire circumstances. There would be judicial safeguards. Parliament must scrutinize every case. Nevertheless, there has never been a case where 42 days has been necessary. There is already legislation that could be used in exceptional circumstances. In my view there are other weapons against terrorism that could be employed. The use of a minor charge to hold a person while questioning continues is one option. Another concerns the admissibility of intercept evidence.

My view is that even 28 days detention without charge is excessive. Three cases apparently required 28 days, but in all three the information available at 7 days would have justified a charge.

Monday, June 09, 2008

CLL - is treatment getting better?

The SEER database is a wonderful tool for understanding cancer and the recent release of hematological data from 1973 to 2004 has prompted several studies including one in last month's Blood by Brenner et al from Heidelberg, Germany and Cornell, New York. The suggestion in this paper is that long term survival expectations of patients with CLL have substantially improved for patients over the past two decades.

Without wishing to discourage readers I am suspicious that this claim is at best exaggerated.

The SEER database is assembled from cancer registries in Connecticut, New Mexico, Utah, Iowa, Hawaii and Atlanta, Detroit, Seattle-Puget Sound and San Francisco-Oakland. It takes in about 30 million people. There were 20,491 cases of CLL diagnosed between 1974 and 2004, 12,120 men and 8371 women. There was a steady increase in the number of cases: 3642 between 80/84, 3969 between 85/89, 4236 for 90/94, 4191 for 95/99 and 4454 for 00/04. The changes in the age groups was rather strange. In the period 80/84 to 00/04 there was a 44% increase in the under 60s, a 3% reduction in those aged 60-69, an 18% rise in those aged 70-79 and a 41% increase in the over 80s.

The percentage surviving 5 years has increased over the same period by 6% and the percentage surviving 10 years has increased by 7% The improvement has been seen in both sexes and at all ages except that the 10-years survival if the over-80s has not improved at all.

They have also looked at relative survival, which means how did they do compared to people of the same age and sex who didn't have CLL? Again, here things seem to have improved from 69% to 75% at 5 years and from 46% to 55% at 10 years, but again for the over 80s there's been no improvement.

Now one explanation is that treatment has got a bit better (though with the over 80s only 30% as likely to survive for 10 years as the non-CLL population, things are not good).

However, there have been other changes over the past 20 years. Supportive care has improved, for example. It may be that we are better able to keep people alive who have CLL even if we can't do much to treat the disease.

Cancer Registries are notoriously poor at collecting cases of CLL. Patients are often not admitted to hospital, and there is usually no histology. Furthermore, the fact that the patient lived with CLL that never caused him any problems is often omitted from death certificates.

But I think that the biggest difference has been in the diagnosis of CLL. Immunophenotyping has meant that patients with lymphoma with blood spillover are no lnger diagnosed as CLL, and generally these patients had a worse prognosis than cases of CLL. But overshadowing all these is earlier diagnosis. It is interesting that patients under the age of 60 are more frequently diagnosed now. This might be because the disease is appearing at a younger age, but it also might mean that the disease is picked up earlier in its presymptomatic course. Patients might only survive longer now because they are diagnosed earlier. I believe this is very likely to be true. When the study started you needed a lymphocyte count of 15,000 to diagnose CLL, but the rules have changed and now you only need 5,000.

Islamic prayer

"Members knew that prayer was not our first priority." "We came home in the early hours of the morning, and went to bed, too tired to say our prayers." "Our work was more important than minor matters such as praying, reading the Scripture, giving to charity, or being kind to our parents and fellows."*

Does that sound familiar? It is the testimony of Ed Hussain, the Islamist, who has recanted from his former membership of Hizb ut-Tahrir. He describes a way of life that advocated the violent overthrow of Western governments and the introduction of Shariah law, while at the same time neglecting their personal holiness. At the mosque they put on a show for their followers, but their prayers were formal and ritualistic and meant nothing to them.

I do not absolve Christians from formal and ritualistic prayers, but this little illustration should serve as a warning to us. Without a proper prayer life we too might degenerate into violence and hate.

I shall be writing a few articles on prayer in the next few weeks, but this particular article concludes with an incident from Michigan State University. Here the local Muslim group of students were planning a protest about teh Danish cartoons. This prompted a response by a Professor of Mechanical Engineering:

Dear Moslem Association,

As a professor of Mechanical Engineering here at MSU I intend to protest your protest. I am offended not by cartoons, but by more mundane things like beheadings of civilians, cowardly attacks on public buildings, suicide murders, murders of Catholic priests (the latest in Turkey ), burnings of Christian churches, the continued persecution of Coptic Christians in Egypt, the imposition of Sharia law on non-Muslims, the rapes of Scandinavian girls and women (called "whores" in your culture), the murder of film directors in Holland, and the rioting and looting in Paris France.

This is what offends me, a soft-spoken person and academic, and many, many of my colleagues. I counsel you dissatisfied, aggressive, brutal, and uncivilized slave-trading Moslems to be very aware of this as you proceed with your infantile "protests. If you do not like the values of the West - see the 1st Amendment - you are free to leave.

I hope for God's sake that most of you choose that option.

Please return to your ancestral homelands and build them up yourselves instead of troubling Americans.


I. S. Wichman, Professor of Mechanical Engineering

This apparently occurred in February 2006, and my source is a right wing blog. Many such stories turn out to be concocted for political polemic, but this story has been verified by

*I have slightly modified the quotes for stylistic effect. I wished to hide their Muslim nature from the reader until the point was made.

Sunday, June 08, 2008

More NHS nonsense.

While the BBC majors on a Tory shadow minister who paid her nanny from her parliamentary allowance 11 years ago headlines in the Sunday Times concentrate on a more pressing matter.

New cancer drugs do not usually become available to the NHS for a couple of years after they have been shown to be effective. Oncologists know that they work, but cannot provide them. Some people have the resources to fund their own treatment and will pay for their drugs. However, the Labor government has introduced a rule which says that if they do so then the NHS will not pay for any of their cancer care. Even mid way through a course of chemotherapy NHS treatment will be stopped the monment the patient takes a milligram of the forbidden medicine.

The Labor party is anyway beyond redemption, so it doesn't matter to them what they do. In a couple of years' time hundreds of Labor MPs will join the unemployment queues, and it is quite likely that they will be unemployable. However, this is so mean spirited as to be unimaginable.

It's even worse than that. Should a cancer patient decide to take a 'complementary therapy' that will do them no good and may even be harmful. it is quite permissable for them to have that and continue with their NHS cancer medicine.

Here's a confession. Twenty years ago I had a patient with terminal kidney cancer. His tumor was inoperable. He had large lymph nodes in his abdomen and chest. His lungs were so opaque on the chest X-ray that it was a wonder he could breathe. Both he and I had seen a television program about a new drug, Interleukin-2, which had produced remissions in kidney cancer patients. It was not available on the NHS but the drug company was willing to sell it to me for £9000 ($18,000).

His relatives clubbed together and raised the money. The hospital pharmacy had no means of receiving a donation of this sort, so he paid the money to a fund raising charity which I ran. The charity bought the drug and provided it for a small clinical trial that I set up. He had a miraculous response to the drug, entering a complete remission. Reader, he is still alive and cancer-free.

Saturday, June 07, 2008


How important is mathematics in the rearing of a child? Speaking personally, mathematics shaped me. The son of poor working class parents, living in a basement apartment in a strange town without relatives at a time when six years of world war had impoverished the nation, I was fortunate in having a father who believed in education. He took a second job to pay the £7 a term for me to go to a small private school at the age of 4. I could already read by the age of 2, though my reading matter was the football results in the News of the World. I cannot remember not being able to read and I was doing simple sums by the age of three.

At this little school I felt out of place because everyone else had nicer manners than I did, but I began to learn the acceptable way to speak, to write, to behave. I liked drawing best of all subjects, but I don't think the teacher appreciated my efforts. however, she did appreciate my arithmetic, and I quickly surpassed the other pupils. We learnt our tables by rote and the magic of numbers appealed to me. By the time I was seven I had finished all the textbooks that the school owned.

My father moved me to a state school then. Here the classes were much larger - as many as 48 in a form. Schools were very different then. Our desks were arranged in rows and silence was expected. Chalk and talk was the rule. To be honest, my favourite lessons were football and physical training, but I enjoyed all of the subjects, especially arithmetic. When I was ten I was given a silver pocket watch by the teacher after getting full marks in a mental arithmetic test for three terms. No-one had previously got as many as 95% in one.

These were the days of the 11+. The elite went to grammar schools and the rest to secondary moderns. If you went to a secondary modern you could look forward to life in a factory, (or digging the roads if you weren't clever enough for that). Girls could expect to work in a shop - the really talented aimed at being hairdressers. Grammar School gave you a start in life. In those days you could get to University if your parents were rich enough or if you won a scholarship by dint of hard academic work, but even some of the clever boys never went to University, because their parents expected an income from them. They aimed for an office job with the local council. Girls hardly ever went to University - perhaps half a dozen a year from our sister school for girls (all grammar schools were single sex). Bright girls were more likely to go to teachers' training college, though one woman in 7 went into nursing. Otherwise they could work in a bank or for an insurance company or perhaps in a library.

At the grammar school I was picked on by the maths master because my work was so untidy. He was nonplussed when I came top of the year for maths despite the untidiness. In the third year we had a choice between woodwork and applied maths. I would have preferred woodwork, but the maths master refused to let me go. 'O' levels consisted of exams in Arithmetic, Algebra and Geometry. I took them a year early. My final mark was 86%, much boosted by 100% in arithmetic and dragged down by my untidy geometry. For applied maths my mark was 92%. I did 'A' level maths a year early as well, but although I passed, I did not do as well as I might have. I was doing Chemistry, Physics and Zoology at the same time and found that the Maths teaching was sketchy. Most boys in the sixth form were sons of engineers (who worked at the nearby Royal Aircraft Establishment). They were taking a combined Physics, pure and applied maths course. Only three of us were taking the biology option and of the three only I was taking maths. The school was not really geared up for combination of subjects that I had chosen.

At Medical School, I might as well have never studied maths at all. I might well have improved my manual dexterity with woodwork.

Yesterday, Simon Jenkins in the Guardian seems to think that learning maths is a waste of time. He says:

I studied advanced maths to 16. I loved wandering in its virtual world of trigonometry and logarithms, primes and surds. I breakfasted on quadratic equations, lunched on differential calculus and strolled, arm in arm, with Ronald Searle's square on the hypotenuse.

It was a waste of time. I dedicated my next two years to Latin and Greek, which proved to be more useful (just). Most teenagers clearly feel the same. They must grapple with difficult techniques and concepts which hardly any of them will ever use, assuming they can understand or remember them.

I actually doubt that he studied advanced maths until he was 16. Only mathematical geniuses start advanced maths so young. Nevertheless, he does have a point that few people use the advanced techniques of mathematics.

A lot of what we study at school is about training the mind to think logically. maths does that, though so, in a different way, do Latin and English grammar. There are aspects of maths that are important for living in the modern world. If we are to be engineers then Calculus is very important, but I can't remember ever having used my Calculus in medicine. On the other hand understanding proportion, weighing up risk, estimating size and knowing about probability are essential.

For example it is very important to buy your lottery tickets on a Saturday rather than a Monday. The reason is you have a greater chance of dying during the week running up to the draw than you have of winning the jackpot. Still if you understood how unlikely a 1 in 14 million chance is, you wouldn't be playing the lottery in the first place.

When I first wrote papers that incorporated survival curves, I calculated the points on the graph using quadratic equations and log tables; nowadays I just load the numbers into the computer and press a button. Because a machine can do it quicker and more accurately, we don't bother with the longhand version. It's the same with children and calculators. Unfortunately, it is easy to throw out the baby with the bathwater and as a result so many people in public life are not only innumerate, but proud of it.

Friday, June 06, 2008


Vehicle Excise Duty or Car Tax is the annual fee for putting your car on the road. At the last budget the Chancellor doubled the tax on the cars with the greatest carbon emissions. It was already higher for new cars, but he has extended the tax to all cars up to those that are 6 years-old. Now I should declare a non-interest in this in that my cars are respectively 8 and 17 years-old and won't be heavily taxed, but it does seem to me unfair to retrospectively tax someone for a decision made 6 years ago. It is also a strange decision for a Labour government since poorer people are likely to have an older car, and previously the tax weighed more heavily on those rich people who changed their cars every couple of years.

There are two reasons for taxation. The first is to raise revenue for goods and services we have in common: the Armed Services, public buildings, schools and hospitals, the police and prisons etc. On this basis the fairest taxes are those which insist that those who have more pay more. Income tax is the best example.

The second reason is to change behaviour. Years ago we had a purchase tax of 33% on luxury goods. Since most luxury goods came from abroad, this not only helped the trade deficit (since it discouraged spending abroad) but also concentrated our minds on buying essentials rather than fripperies. Now we have VAT which adds 17.5% to the price of everything except food, children's clothes and educational materials. This is a little more unfair since it taxes essentials that even the poorest must have like domestic heating and transport. The best examples of taxation to change behaviour are taxes on tobacco and alcohol. There is clear evidence that the more expensive cigarettes are the less they are smoked. In the past there have been attempts to discriminate between different types of alcohol. Wine has been heavily taxed (foreign and drunk by the middle classes), but beer (the working man's tipple) and whisky (Gordon Brown is Scotch) less so. Now the booze culture is getting out of hand and the last budget raised taxes on these significantly. The rise in VED is an attempt to make is use cars that produce less CO2. Oil at $135 a barrel is already doing that, but some 53% of the cost at the pump is government taxation. It doesn't carry much weight at OPEC when more than half the oppressive cost of fuel amounts to taxation.

I do not buy into anthropogenic global warming. The world seems to have been cooling since 1998 and if its true that there were grapes growing in Greenland in the Twelfth Century, the theory seems shot with holes. I do believe in markets, though. What is happening just now is largely caused by panic in the futures market creating an oil bubble just as we had a property bubble last year. The oil price will collapse and speculators will get their fingers burnt as usual. By that time the originators of the bubble will have got out of the market. Here's a warning: don't invest in this market; it is already too late.

Nor do I think it worth converting my car to LPG, which is 50% cheaper than petrol and only 15% less efficient. At today's prices it would take me 6 years to recoup the investment. It might make sense if you can pick up an already converted large car that is guaranteed to last, something like a Mercedes, or if you were given such a car it would probably be worth spending the £1750 on the conversion (less if you can do it yourself).

In the meantime why not tax things that it would really be desirable to stop: a large tax on pointed knives, for example, or a much greater tax on vodka-laden soft drinks, or a tax on having a baby if you're not married (instead of the incentive of a local council-provided two bedroom apartment), or a tax on the take-away food wrappings that comprise so much of our street litter. What would you like to tax heavily? I welcome suggestions.

What's the point?

The headline is ANOTHER TEENAGER STABBED IN LONDON. Knife crime is becoming an increasing problem in our big cities. Knife amnesties have turned up thousands but still it continues. The Prime Minister announces that 16 year-olds found in possession of a knife will be prosecuted with the full weight of the law.

When I was 16 every boy had a scout knife with a large steel spike for removing debris from horses' hooves. It would have made a killing weapon had we been so inclined. My children had Swiss-Army knives with 17 blades including scissors, screwdrivers and toothpicks. I still have a pearl-handles pen knife that I inherited from my father-in-law.

However, the commonest weapon in these stabbings is a kitchen knife. We all need knives in our kitchens, so it is hard to see how these can be restricted. Then I saw a suggestion that kitchen knives don't really need a point. You couldn't really stab someone with a bread knife. We have several kitchen knives with sharp points. I asked my wife whether she really needed them and probably she doesn't. A TV chef suggests that you need the point for filleting fish, but whoever fillets fish these days. We buy fish already filleted.

So, how about a redesign for kitchen knives, removing the point?

I suppose we would then have an outbreak of stabbings with screwdrivers and meat skewers.

Wednesday, June 04, 2008

Ed Hussain - The Islamist

I have been reading The Islamist by Ed Hussain. I am only one third through, but already I can say, "Buy it and read it."

Ed Hussain is the son of an Indian Muslim immigrant who settled in London's East End. His parents were devout Muslims of a traditional sort, well integrated into British Society, members of the Labour Party, believing that religion and politics were quite separate. Mohamm(Ed)Hussain was a well brought up young man, devout, but an outcast from his school where the young Bangladeshi immigrants were only interested in Bollywood movies. He got sucked in by the infamous East London Mosque that was under the control Jamat-e-Islami and the Young Muslim Organisation (YMO). Here he was politicized and followed the teachings of Abul Ala Mawdudi, a Pakistani journalist and amateur theologian. Mawadi, who died in 1979 on a speaking tour of America, reinterpreted the Koran, departing from classical scholarship and rebranded Islam as a political ideology. Stupidly, the standard textbook in British secular schools for religious education on Islam was and is Islam: Beliefs and Teachings by Gulam Sawar, a lecturer in business management and follower of Mawdudi. If I know the British government they chose this book because it was a job lot going cheap. Pretty certainly no-one concerned with policy ever read it.

Sarwar was an activist for all the Islamist political organisations that have caused us such trouble, yet here was his book (and still is) the basic introductory text for young Muslims in schools. Talk about shooting yourself in the foot.

Tower Hamlets College is a large further education college in Tower Hamlets, London, England, one of the poorest parts of London and dominated by Bangaldeshi immigrants. It was here that Ed Hussain became president of the Islamic Society and began politicizing it. The book Milestones by Sued Qtub became the Bible of the movement. Hardened by racialism in America and Nasser's Socialism in Egypt Qtub's book declared that Islam is the answer for oppressed people everywhere. Tortured in Nasser's jails and hanged there in 1966, Qtub became a martyr for the cause. Now, not only Christians and Jews, but ordinary Muslims had become the enemy. Qomen began to wear the Hijab as a political statement. This was not enough for some who insisted on wearing the jilbab which covered the body and the niqab which covered the face. The boys called these girls the ninja sisters, but they were not figures of fun. they were the portal of entry for Wahhabi preachers from Saudi Arabia. These men, with their red chequered head scarfs, black bushy beards and knee length trousers preached a return to 7th Century Arab lifestyle. It was their proposition that 1200 years of Muslim scholarship had been a by-way and that Muslims should return to the original.

The atrocities of Bosnia provided a springboard for the next development. Neither Wahhabism nor Qtubism provided a remedy for the persecution of Muslims in the Balkans. What was needed was not simply the conversion of moderate Muslims to a politicized agenda, not just Muslim lands for Muslims, but a restoration of the Caliphate, and the organisation to bring it about was Hizb ut-Tahrir. In their view democracy is an invention of the devil. They desire a theocracy, one Muslim nation to rule the whole world under Allah. Not just the former Muslim areas that include Spain, but the whole world, Britain, Western Europe and the USA included. The preacher who espoused these ideals to Hussain was Omak Bakri. You can read all about him here.

Sunday, June 01, 2008

Acts 4:29-31

"Now, Lord, consider their threats and enable your servants to speak your word with great boldness. Stretch out your hand to heal and perform miraculous signs and wonders through the name of your holy servant Jesus." After they prayed, the place where they were meeting was shaken. And they were all filled with the Holy Spirit and spoke the word of God boldly.

One area of our lives that we are least likely to be open about is a our prayer lives. I have reason to suspect that they are weak and feeble. My reason is that the world is such a wicked place. Evil triumphs. Corruption conquers. Wickedness wins. If we really prayed it would not be so.

James tells us that we do not receive because we do not ask.

What is wrong with our prayers?

Many of us 'say our prayers' religiously; every night before sleeping. I remember "God bless Mummy; God bless Daddy ... and all the starving children in the world. Amen" Perhaps, like CS Lewis, we have memorized great chunks of the prayer book. Cranmer's prayers were great prayers, but they were Cranmer's prayers. I had a phase (like 2.5 million others who bought his book) of reading the prayers of Michel Quoist; they have the advantage of reading like a real person thinks, rather than being a set piece in sixteenth century English, but they are Quoist's prayers, not mine. Such prayers become perfunctory. We go through the motions of praying. The result? God goes through the motions of listening.

Some people pray impressively in church, but these are performance prayers; meant to impress our friends and colleagues. I am sure God applauds the performance.

Mature Christians, convinced of the sovereignty of God, fall into the Calvinist trap. If God knows everything before it happens, what difference does it make whether I pray or not? He will do what he will do; nothing that I can do will make any difference.

We forget that God in his Word has instructed us to pray. Paul, writing to the Ephesians says, "Pray in the Spirit on all occasions with all kinds of prayers and requests." "In the Spirit" does not mean that we go into some sort of trance or get ourselves worked up with songs and choruses, it means that we pray with the help of the Holy Spirit and according to the will of the Holy Spirit.

Now, how do we do that? I guess we have to get to know the Holy Spirit. Shouldn't we know that already? Doesn't the Holy Spirit live inside every true believer? I am assured that He does, but many of us seem to be quenching his presence and power.

I doubt that I could explain the Trinity, but I know this: when the disciple asked Jesus to show them the Father, he replied, "If you really knew me you would know my Father as well." He had previously told them, "I and the Father are one." Paul, writing to the Colossians called Jesus, 'the image of the invisible God', and the writer to the Hebrews refers to him as 'the radiance of God's glory and the exact representation of His being." The unity of the Trinity insists that the Holy Spirit is similarly just like Jesus. The Paraclete is 'one (who is the same as the other one) who stands alongside'. The role of the Holy Spirit is to draw attention to and glorify Jesus.

So to know the Holy Spirit we have to practise the presence of Jesus. And to do that we must know all there us to know about him. That's why it is essential that we read the Bible. Prayer without knowledge of Jesus is whistling in the wind.

Read about Jesus. Talk to him. Rely on him. Take him at his word. Don't make up your own Jesus. Don't rely on a picture of a man in a white nightdress with fair hair and blue eyes. Get to know the authentic Jesus. When you do, you will want to include him in all your conversations, whether with yourself or with your friends. That's praying.