As if my problems were not enough, my sons-in-law have been in the wars. Tim, Karen's husband has spent two evenings in Casualty with what sounds like acute angina, but hopefully might just be esophageal spasm and Stuart, Angela'a husband is in hospital this morning having a plate removed from his jaw (old sailing injury) as well as an impacted wisdom tooth.
Isn't modern medicine wonderful!
Random thoughts of Terry Hamblin about leukaemia, literature, poetry, politics, religion, cricket and music.
Tuesday, June 22, 2010
Health.
News at last. I am going into hospital on Thursday morning for an operation to by-pass the stricture, joining my ileum to the transverse colon. They doubt that the cancer will be resectable, but of course they will examine the possibility. Then perhaps further chemotherapy.
Please pray for me.
Please pray for me.
Monday, June 21, 2010
More on health
Not a very good few days healthwise. as I tailed off the steroids I began to get colicky abdominal pains again. I have been reconsidering my diagnosis. The official diagnosis was adenocarcinoma with unknown primary, mainly located in the right iliac fossa. The terminal ileum and cecum were fibrotic and wrapped around a mesenteric lymph node with small peritoneal seedlings at this site. The histology showed fibrosis and inflammatory cells but no mucosal cancer, though in the lymph node well differentiated adenocarcinoma which was CEA positive, even though the serum CEA was very low. No primary could be found on extensive laparotomy.
Treatment with 5-FU and folinic acid plus oxaloplatin, given with a dexamethasone dose for anti-emesis resulted in a 75% shrinkage of detectable CT imaged disease by 3 months and a further 4 courses resulted in a no further shrinkage.
I was well until about 3 weeks ago when colicky abdominal pain followed by gurgling took me into hospital. No change was apparent on the CT scan and there was no full blown abdominal obstruction. Symptoms settled on dexamethasone 8mg iv.but now on two occasions as I have tried to withdraw the steroids the symptoms have returned, although not so severely. I am also on a low-roughage diet and I suspect that the latest pain is from large rather than small bowel.
I want to consider the possibility that my original diagnosis was Crohn's disease, in which carcinoma has developed, as it does in 3-5% of cases.
Crohn's disease occurs in the terminal ileum/cecum area and leads to tethering of the bowel to adjacent tissue like I had. Mesenteric lymph nodes become involved and the histology shows inflammatory cells such as lymphocytes, plasma cells and macrophages. Granulomas may be seen but they are not a constant feature.
A complication of Crohn's disease is an inflammatory stricture. Treatment is high dose steroids usually for 4-6 weeks. My case is being reviewed at the multi-disciplinary team meeting tomorrow and we may get some news later. Options include further surgery to relieve the apparent blockage.
Treatment with 5-FU and folinic acid plus oxaloplatin, given with a dexamethasone dose for anti-emesis resulted in a 75% shrinkage of detectable CT imaged disease by 3 months and a further 4 courses resulted in a no further shrinkage.
I was well until about 3 weeks ago when colicky abdominal pain followed by gurgling took me into hospital. No change was apparent on the CT scan and there was no full blown abdominal obstruction. Symptoms settled on dexamethasone 8mg iv.but now on two occasions as I have tried to withdraw the steroids the symptoms have returned, although not so severely. I am also on a low-roughage diet and I suspect that the latest pain is from large rather than small bowel.
I want to consider the possibility that my original diagnosis was Crohn's disease, in which carcinoma has developed, as it does in 3-5% of cases.
Crohn's disease occurs in the terminal ileum/cecum area and leads to tethering of the bowel to adjacent tissue like I had. Mesenteric lymph nodes become involved and the histology shows inflammatory cells such as lymphocytes, plasma cells and macrophages. Granulomas may be seen but they are not a constant feature.
A complication of Crohn's disease is an inflammatory stricture. Treatment is high dose steroids usually for 4-6 weeks. My case is being reviewed at the multi-disciplinary team meeting tomorrow and we may get some news later. Options include further surgery to relieve the apparent blockage.
Afghan Christians
An Open Letter from the Afghan Christian Community to the Body of Christ Worldwide:
AN URGENT PLEA FOR HELP & INTERVENTION!
We need your help to stop the Afghan government from arresting Afghan Christians and condemning them to death by public execution!
The enclosed letter addresses recent events inside Afghanistan that have unfolded since May 27th, 2010 after an incendiary documentary showing photos and videos of secret “Afghan Christian Converts” aired on Noorin TV, an independent tv station based in Kabul. The documentary was the first of its kind to ever air publicly on national tv in Afghanistan, a country that considers itself to be 100% Muslim, and the controversial content revealing names and faces of supposed Afghan Christian converts sparked ongoing riots and demonstrations throughout Afghanistan in the days that followed (see media links below).
During the ensuing protests, demonstrators called on President Hamid Karzai and the Afghan government to take strong and decisive actions against these exposed Afghan Christian converts by enforcing the Afghan constitution, based on Islamic Sharia law, which clearly call for the arrest and public execution of anyone who leaves Islam for another religion.
According to an online report by the Associated Free Press dated June 1, 2010 (see links below), Abdul Sattar Khawasi, deputy secretary of the Afghan lower house in parliament, called for the execution of Christian converts from Islam saying, “those Afghans that appeared in this video film should be executed in public, the house should order the attorney general and the NDS (intelligence agency) to arrest these Afghans and execute them”. In another reported statement, Qazi Nazir Ahmad, a lawmaker from Herat, declared that killing a Muslim who converts to Christianity is “not a crime”. Waheed Omar, the spokesman for the President, told reporters that President Hamid Karzai himself was “personally” taking an interest in this case, and had ordered his interior minister and the head of the country’s spy agency to do a full investigation and "to take immediate and serious action to prevent this phenomenon".Reports from inside Afghanistan already tell of many arrests in recent days, frequent and ongoing searches of homes and businesses, as well as claims of torture by those under arrest in an effort to forcibly extract the names of other Afghan Christian converts and the locations of secret Afghan Christian “churches” and underground fellowships throughout the country.
In light of all these events, and the perplexing media silence on these atrocities occurring in plain view of the international community, we are pleading with the Body of Christ around the world to support our Afghan Christian brothers and sisters during this critical time by taking a firm and vocal stand against the severe and devastating wrongs being committed against them by their own government!
We ask that you please forward and share the enclosed “open letter to the church” with your friends, churches, prayer groups, human rights advocates, the media, your local representatives, senators and other government bodies and authorities… we need everyone’s help to make our voices heard!
We must make people aware that right now our Afghan Christian brothers and sisters are being subjected to forcible arrest, intimidation, fear, torture and certain public execution merely for choosing to be Christian! We must raise up a standard against these egregious injustices and blatant human rights violations by taking a strong and public stand against these unconscionable actions being perpetrated and condoned by the Afghan government from the parliament floor against its own people!
The enclosed letter was written on June 8, 2010 by Afghan Christians who are currently living in exile from their beloved homeland because they were forced to flee their country in order to save their life and the lives of their families, due to orders of execution issued against them by the Afghan government for choosing to convert to Christianity:
******
Letter to the Body of Christ around the world, written by members of the Afghan Christian community on June 9, 2010:
To the Body of Christ:
This letter is written by the Afghan Christian Community in New Delhi, India which is a small community of 150 Afghan Christian refugees and asylum seekers.
We left our country because we were sentenced to death on the account of our Christian faith (conversion), as Afghanistan is a Muslim Country, the Afghan Government is an Islamic government, and Islam is the only formal religion of the country, and according to the Constitutional law of the Afghan Islamic Republic, conversion is considered as a big crime, Christian are called pagans and infidels and are sentenced to death by the Afghan Government. Christians are considered criminals. Death penalty is waiting for all those who want to leave the darkness and come to the true light, repent from their sins, and put their faith on the Lord Jesus Christ, who is the Lord and Savior of all human being.
We believe that you (the Body of Christ) have already heard that some pictures and movies of the Afghan believers (from Delhi and Kabul) were shown by an Afghan Private TV (Noorin TV), this TV channel showed these picture in a especial program (Sarzameen Man), and the Government and people were encouraged and provoked to think about the issue of conversion, to make a stand against it and to take serious and practical measures and actions to destroy Afghan Converted Christians (Sons of God) and those who share the Gospel of Jesus Christ to the Lost.
The Afghan Parliament, Senate, Religious Council and Islamic Parties and leaders made statements that the Afghan Government has to search, find, arrest, deliver to courts and executes all Afghan Christians, and the Christian NGOs and Organization have to be stopped too. University students protested against Afghan Christians in Kabul and Herat Provinces, and the Afghan Government also made a statement that all Afghan Christians will be arrested and executed, and the Christian NGOs and Organizations which involved with the issues of conversion will be closed.
Mr. Mujajdi the Chairman Of Afghan Senate said that if the Afghan Government does not take serious action, he and other Islamic leaders will call and request the Afghan people to take practical measures to kill all Afghan Christians.
President Karzai himself showed his personal interest in this regard and said that all Afghan Christians will be arrested and executed and Christian organizations which are involved with this issue will be stopped. He ordered the Afghan security organs to take serious measure in this regard. The Afghan Home Minister and the Chairman of the Afghan Intelligence told to the Afghan Parliament that 4 Afghan Christian individuals and one family are arrested and they are under investigation, 13 NGO are recognized and suspended, names of the Afghan Christians are listed and the Afghan Intelligence agency is trying to arrest them. Two Church organizations by the names of WCA and NCA are closed.
As we are in contact with our brothers and sisters in Afghanistan, many believers are arrested, our houses are checked by police and intelligence people in Afghanistan, our families and parents (though they are Muslim) are under investigation and even arrested, and all Afghan believers are misplaced.
So, We (Afghan Christian Community) along with our other Afghan Christian brothers and sisters who are in
Afghanistan request you to:
1. Please pray for us and for this critical situation, pray for those who are arrested, and those who are under investigation.
2. Please come together and help your Afghan brothers and sisters in Christ, as we are sentenced to death, we are arrested, we are under investigation, the Afghan Government kills us because we believe on Jesus Christ, we know that we should consider it pure joy when we suffer
(James 1: 1 -4), and we are enjoying all suffering all joy. But we also know that faith without deeds is useless (James 2: 14 – 17), and this is the time to raise your voice for your brothers and sisters, for our children, for our old parents, for the execution of thousand Afghan believers. This is the day that all of us should come together and pray, think, help and raise our voices to the International Community, to put pressure on the Afghan Government to stop killing, persecuting and executing Afghan Christians, to give us freedom of religion, to respect and accept us as Afghan Christians.
3. We do not know how the whole world and especially the Global Church is silent and closing their eyes, while thousand of their brothers and sisters (Body of Christ) are in pain, facing life danger and death penalty, and are tortured, persecuted and called criminals because they believe on the Truth. We need to wake up, get up and speak up today, and to prove it that we are really in concern, and care for our brothers and sisters in Christ, we should help the persecuted part of the body of Christ, for His Glory. If we really believe that Lord Jesus Christ is God, then, He commands us to love Him and to love our neighbor, if our own brothers and sisters, are in pain and suffering, and we are silent and we ignore them and their suffering, then the question is that do we really obey Lord Jesus commandment of love Him and our neighbor?
So, dear brothers and sister (the Body of Christ), we (Afghan Christian Community in New Delhi) on behalf of all Afghan Christians request you to support us by your prayers and practical measures, lets tell to the Afghan Government, that we are not pagans and infidels, we are not criminal because of our Christian faith, and lets tell them not to sentence us to death.
May God bless you!
Afghan Christian Community
(Obaid S. Christ)
AN URGENT PLEA FOR HELP & INTERVENTION!
We need your help to stop the Afghan government from arresting Afghan Christians and condemning them to death by public execution!
The enclosed letter addresses recent events inside Afghanistan that have unfolded since May 27th, 2010 after an incendiary documentary showing photos and videos of secret “Afghan Christian Converts” aired on Noorin TV, an independent tv station based in Kabul. The documentary was the first of its kind to ever air publicly on national tv in Afghanistan, a country that considers itself to be 100% Muslim, and the controversial content revealing names and faces of supposed Afghan Christian converts sparked ongoing riots and demonstrations throughout Afghanistan in the days that followed (see media links below).
During the ensuing protests, demonstrators called on President Hamid Karzai and the Afghan government to take strong and decisive actions against these exposed Afghan Christian converts by enforcing the Afghan constitution, based on Islamic Sharia law, which clearly call for the arrest and public execution of anyone who leaves Islam for another religion.
According to an online report by the Associated Free Press dated June 1, 2010 (see links below), Abdul Sattar Khawasi, deputy secretary of the Afghan lower house in parliament, called for the execution of Christian converts from Islam saying, “those Afghans that appeared in this video film should be executed in public, the house should order the attorney general and the NDS (intelligence agency) to arrest these Afghans and execute them”. In another reported statement, Qazi Nazir Ahmad, a lawmaker from Herat, declared that killing a Muslim who converts to Christianity is “not a crime”. Waheed Omar, the spokesman for the President, told reporters that President Hamid Karzai himself was “personally” taking an interest in this case, and had ordered his interior minister and the head of the country’s spy agency to do a full investigation and "to take immediate and serious action to prevent this phenomenon".Reports from inside Afghanistan already tell of many arrests in recent days, frequent and ongoing searches of homes and businesses, as well as claims of torture by those under arrest in an effort to forcibly extract the names of other Afghan Christian converts and the locations of secret Afghan Christian “churches” and underground fellowships throughout the country.
In light of all these events, and the perplexing media silence on these atrocities occurring in plain view of the international community, we are pleading with the Body of Christ around the world to support our Afghan Christian brothers and sisters during this critical time by taking a firm and vocal stand against the severe and devastating wrongs being committed against them by their own government!
We ask that you please forward and share the enclosed “open letter to the church” with your friends, churches, prayer groups, human rights advocates, the media, your local representatives, senators and other government bodies and authorities… we need everyone’s help to make our voices heard!
We must make people aware that right now our Afghan Christian brothers and sisters are being subjected to forcible arrest, intimidation, fear, torture and certain public execution merely for choosing to be Christian! We must raise up a standard against these egregious injustices and blatant human rights violations by taking a strong and public stand against these unconscionable actions being perpetrated and condoned by the Afghan government from the parliament floor against its own people!
The enclosed letter was written on June 8, 2010 by Afghan Christians who are currently living in exile from their beloved homeland because they were forced to flee their country in order to save their life and the lives of their families, due to orders of execution issued against them by the Afghan government for choosing to convert to Christianity:
******
Letter to the Body of Christ around the world, written by members of the Afghan Christian community on June 9, 2010:
To the Body of Christ:
This letter is written by the Afghan Christian Community in New Delhi, India which is a small community of 150 Afghan Christian refugees and asylum seekers.
We left our country because we were sentenced to death on the account of our Christian faith (conversion), as Afghanistan is a Muslim Country, the Afghan Government is an Islamic government, and Islam is the only formal religion of the country, and according to the Constitutional law of the Afghan Islamic Republic, conversion is considered as a big crime, Christian are called pagans and infidels and are sentenced to death by the Afghan Government. Christians are considered criminals. Death penalty is waiting for all those who want to leave the darkness and come to the true light, repent from their sins, and put their faith on the Lord Jesus Christ, who is the Lord and Savior of all human being.
We believe that you (the Body of Christ) have already heard that some pictures and movies of the Afghan believers (from Delhi and Kabul) were shown by an Afghan Private TV (Noorin TV), this TV channel showed these picture in a especial program (Sarzameen Man), and the Government and people were encouraged and provoked to think about the issue of conversion, to make a stand against it and to take serious and practical measures and actions to destroy Afghan Converted Christians (Sons of God) and those who share the Gospel of Jesus Christ to the Lost.
The Afghan Parliament, Senate, Religious Council and Islamic Parties and leaders made statements that the Afghan Government has to search, find, arrest, deliver to courts and executes all Afghan Christians, and the Christian NGOs and Organization have to be stopped too. University students protested against Afghan Christians in Kabul and Herat Provinces, and the Afghan Government also made a statement that all Afghan Christians will be arrested and executed, and the Christian NGOs and Organizations which involved with the issues of conversion will be closed.
Mr. Mujajdi the Chairman Of Afghan Senate said that if the Afghan Government does not take serious action, he and other Islamic leaders will call and request the Afghan people to take practical measures to kill all Afghan Christians.
President Karzai himself showed his personal interest in this regard and said that all Afghan Christians will be arrested and executed and Christian organizations which are involved with this issue will be stopped. He ordered the Afghan security organs to take serious measure in this regard. The Afghan Home Minister and the Chairman of the Afghan Intelligence told to the Afghan Parliament that 4 Afghan Christian individuals and one family are arrested and they are under investigation, 13 NGO are recognized and suspended, names of the Afghan Christians are listed and the Afghan Intelligence agency is trying to arrest them. Two Church organizations by the names of WCA and NCA are closed.
As we are in contact with our brothers and sisters in Afghanistan, many believers are arrested, our houses are checked by police and intelligence people in Afghanistan, our families and parents (though they are Muslim) are under investigation and even arrested, and all Afghan believers are misplaced.
So, We (Afghan Christian Community) along with our other Afghan Christian brothers and sisters who are in
Afghanistan request you to:
1. Please pray for us and for this critical situation, pray for those who are arrested, and those who are under investigation.
2. Please come together and help your Afghan brothers and sisters in Christ, as we are sentenced to death, we are arrested, we are under investigation, the Afghan Government kills us because we believe on Jesus Christ, we know that we should consider it pure joy when we suffer
(James 1: 1 -4), and we are enjoying all suffering all joy. But we also know that faith without deeds is useless (James 2: 14 – 17), and this is the time to raise your voice for your brothers and sisters, for our children, for our old parents, for the execution of thousand Afghan believers. This is the day that all of us should come together and pray, think, help and raise our voices to the International Community, to put pressure on the Afghan Government to stop killing, persecuting and executing Afghan Christians, to give us freedom of religion, to respect and accept us as Afghan Christians.
3. We do not know how the whole world and especially the Global Church is silent and closing their eyes, while thousand of their brothers and sisters (Body of Christ) are in pain, facing life danger and death penalty, and are tortured, persecuted and called criminals because they believe on the Truth. We need to wake up, get up and speak up today, and to prove it that we are really in concern, and care for our brothers and sisters in Christ, we should help the persecuted part of the body of Christ, for His Glory. If we really believe that Lord Jesus Christ is God, then, He commands us to love Him and to love our neighbor, if our own brothers and sisters, are in pain and suffering, and we are silent and we ignore them and their suffering, then the question is that do we really obey Lord Jesus commandment of love Him and our neighbor?
So, dear brothers and sister (the Body of Christ), we (Afghan Christian Community in New Delhi) on behalf of all Afghan Christians request you to support us by your prayers and practical measures, lets tell to the Afghan Government, that we are not pagans and infidels, we are not criminal because of our Christian faith, and lets tell them not to sentence us to death.
May God bless you!
Afghan Christian Community
(Obaid S. Christ)
The European problem.
For those who want to see the end of the Euro crisis, the solution is obvious: Germany must buy Greece. Our objection to the European project is simply that we want to remain a sovereign state, but frankly we don't care what happens in the rest of Europe and how they arrange their affairs. Things are always changing there. Germany used to be about 250 separate statelets a couple of hundred years ago and Italy is a very recent creation.
The Balkanization of Yugoslavia is a demonstration of how these cobbled together rearrangements so easily come apart and why should we worry if people make new alliances.
Greece and Germany fit together very well. Both begin with G. Both are the home of giant philosophers. Both have been the site of major religious movements. But what Greece lacks the Germans can provide - discipline, rigor, hard work, organization, technical expertise and engineering. What the Germans lack the Greeks can provide - sunny beaches, smashed plates and Ouzo.
Germans owning Greek Islands shouldn't provoke a Captain Correlli's Mandolin type objection. They are no longer a warlike people - indeed a German Mediterranean fleet operating out of Piraeus would be a very good thing. The Germans have imported 3 million Turkish workers - send them all home and replace them with Greeks - racially they are all the same and it gets rid of the Muslim menace. The Germans are very good at assimilating weaker economies viz. East Germany; but they like to get something when they pay for it. Imagine a VW factory in Salonika; benefits for all!
I think the Greeks will bow to the discipline; remember the Colonels. If the Germans were running the show, we could even trust them with the Elgin Marbles.
Pairing off countries like this might be a general solution. Perhaps the Dutch should take Spain. That would be a turnaround. And while we are about it perhaps England should have Italy. After all we practically created Italy with all those Grand Tours in the 18th and 19th Century. The English don't do foreign languages, but Italian must about the easiest to learn, so like Latin and you just pronounce it as you spell it. We already have an Italian manager for our footie team.
I'm not sure the French should be allowed anybody - the French are always better isolated, though you could say, take Scotland. As Punishment. For both of them.
The Balkanization of Yugoslavia is a demonstration of how these cobbled together rearrangements so easily come apart and why should we worry if people make new alliances.
Greece and Germany fit together very well. Both begin with G. Both are the home of giant philosophers. Both have been the site of major religious movements. But what Greece lacks the Germans can provide - discipline, rigor, hard work, organization, technical expertise and engineering. What the Germans lack the Greeks can provide - sunny beaches, smashed plates and Ouzo.
Germans owning Greek Islands shouldn't provoke a Captain Correlli's Mandolin type objection. They are no longer a warlike people - indeed a German Mediterranean fleet operating out of Piraeus would be a very good thing. The Germans have imported 3 million Turkish workers - send them all home and replace them with Greeks - racially they are all the same and it gets rid of the Muslim menace. The Germans are very good at assimilating weaker economies viz. East Germany; but they like to get something when they pay for it. Imagine a VW factory in Salonika; benefits for all!
I think the Greeks will bow to the discipline; remember the Colonels. If the Germans were running the show, we could even trust them with the Elgin Marbles.
Pairing off countries like this might be a general solution. Perhaps the Dutch should take Spain. That would be a turnaround. And while we are about it perhaps England should have Italy. After all we practically created Italy with all those Grand Tours in the 18th and 19th Century. The English don't do foreign languages, but Italian must about the easiest to learn, so like Latin and you just pronounce it as you spell it. We already have an Italian manager for our footie team.
I'm not sure the French should be allowed anybody - the French are always better isolated, though you could say, take Scotland. As Punishment. For both of them.
Saturday, June 19, 2010
The Atrocities of God: 2 The Flood
I’m not sure of the final death toll in the Haitian earthquake. On 10 February the Haitian government reported the death toll to have reached 230,000. However, an investigation by Radio Netherlands has questioned the official death toll, reporting an estimate of 92,000 deaths as being a more realistic figure. It’s still a lot of people. The Tsunami caused by the earthquake in the Indian Ocean supposedly killed over 230,000 people in fourteen countries,
These and many other disasters are often called ‘Acts of God’. Whether it is fair to designate them thus, there is one ultimate disaster that God does lay claim to: the great universal Flood that wiped out all humans on earth bar eight. Of course, we don’t know how many humans there were on the planet at the time, but I think we can assume that in ten generations from Adam, each generation living for hundreds of years, there were many millions.
How could God justify killing so many of his creatures?
Atheists reject the idea that morality should be based on God’s ideas. They believe that mankind has ‘evolved’ a higher morality by which even a supposed ‘god’ must be judged. They would not accept a ‘god’ defence if such a morality were transgressed. People like David Koresh or Jim Jones could not fall back on the excuse “God told me to…” any more than a suicide bomber could, and if the Israelis justified exterminating the Palestinians in the same way that they exterminated the Amalekites, then they believe the whole world would be justified in turning on them.
Of course, if you believe in a just and righteous God then you have other ideas. For a believer God is the fount of all righteousness and true morality, and if something about modern morality does not gel with God’s ideas then modern morality must have the flaw.
Atheists, who believe God is a figment of men’s minds, are in effect judging the actions of previous generations of men, and doing so outside the historical context. Their judgment will be human, not divine, and historically biased.
So on what basis would God judge? As before, he would do so on the basis of ownership and eternity. All creatures belong to the Creator. We are his to do with what he likes. Should the clay say to the potter, “Shape me this way?” It’s ludicrous. Secondly, our wisdom is temporal. We do not know the future, nor what is best for us. It is hubristic to believe that we do. In history there are many occasions when all the evidence would point a particular way for a course of action, but the unknowns, were they known would demonstrate those actions as foolhardy. Our decisions are always contingent on the knowledge available. Thus we have Truman’s decision to bomb Hiroshima and Nagasaki. Was he correct? Philosophers continue to argue over the morality of the nuclear strike. From a utilitarian point of view it might be seen as the lesser of two evils; from a pacifist point of view it might be seen as an act of wanton evil. What absolute decision can be made?
God, who knows the future must be relied upon to do what is right. The hymn says that he is ‘slow to chide and swift to bless’. Consider the Flood.
After the sin of Adam and Eve, humanity multiplied rapidly, filling the earth, but just as humanity itself multiplied, so also did the sin of humanity. The sin of humanity reaches a crescendo up to Genesis chapter 6 when things get so bad that God regrets that he made man. Far from disdaining the sin of Cain, Lamech multiplies it.
Now it came about, when men began to multiply on the face of the land, and daughters were born to them, that the sons of God saw that the daughters of men were beautiful; and they took wives for themselves, whomever they chose. (Genesis 6:1-2)
There is some controversy over who these “sons of God” were. Some consider the sons of God to be fallen angels inter-married with women. However, we know that angels do not procreate (Mark 12:25). In Genesis 4:26 it indicates that the family line of Seth were known by the name of the Lord. Therefore, ‘the sons of God’ probably refers to the lineage of Seth and Enoch. Enoch, the seventh from Adam warned of judgment to come, “See the Lord is coming with thousands upon thousands of his Holy ones to judge everyone and to convict all the ungodly of all the ungodly acts they have done in the ungodly way, and of all the harsh words ungodly sinners have spoken against him.” (Jude 14-15) But now Seth’s offspring were intermarrying with evil families, diluting the lineage that followed after God. As a result, with the exception of Noah and his family, Seth’s offspring are now just as evil as the lineage of Cain. Humanity is now so sinful that God could not tolerate their sin any longer. If he were to save any he must act.
The Nephilim, which literally means “to fall upon,” were powerful, mighty warriors who would “fall upon” others. They were violent men who, in the tradition of Lamech, routinely killed and committed violence upon others (Genesis 6:4).
Every intent and thought of man was wicked (Genesis 6:5).
The earth was filled with violence and corruption. Murder had become the order of the day. Humanity no longer gave any regard to the image of God, but routinely exterminated that image for their own benefit (Genesis 6:11-12).
At this point there was only one family remaining who walked with God. So in the midst of this wickedness, God calls out Noah. He calls him to build an ark in which his family would be preserved through an oncoming flood of water. For 120 years Noah prepares the ark according to God’s specific instructions.
Did you notice that 120 years? Imagine what people would have said about this strange guy who was building a huge boat on dry land. This boat was a visual image – a sermon in gopher wood. In Peter’s second letter, Noah is called ‘a preacher of righteousness’.
The patience of God is remarkable. Such is his love for his creation that it is not his will that any should perish, but that they would turn from their wicked ways and live. But he could not force it. Mankind has freedom not to choose God.
So the people disparaged Noah and would not harken to him. In the end the rains came and flood arose and Noah and his family spend a year and twelve days in the ark. When they emerge, there is no-one left. Noah is in a sense a second Adam, a new creation, a fresh start.
God waited for generations until the wickedness became so corrupt and so pervasive that there was only one family left which followed Him. He did not systematically punish those who were evil, but waited until the evil was so bad that all hope was only one family away from being wiped out. This shows the longsuffering nature of God and the protection God desires for those who follow him.
The sin of humanity reached such a critical point, where if he had not acted, Noah and his family would have been destroyed, and so with him, the destruction of the Messianic line. Without the ark, the seed which was to become the salvation of humanity would have been lost. So God delivers Noah and his family.
It shows that God does not haphazardly dispense judgment. He waited until there was only one righteous family left, and even then he spared this family, not a pristine family, indeed still sinners, but one from which hope would emerge.
Many today would look at the world around us and see the same evil intent on our society. When we see genocide and murder rampant in our world, and we watch the persecution of Christians in Africa and Asia, we wonder why God with holds his judgment on this world.
The apostle Peter, writing to persecuted Christians in the first century, reminds us of the forbearance of God. He is withholding his judgment from the world, so that there might be time for more to repent and be delivered from judgment.
“…in the last days mockers will come with their mocking, following after their own lusts, and saying, "Where is the promise of His coming? ….when they maintain this, it escapes their notice that …the earth was formed out of water and by water, through which the world at that time was destroyed, being flooded with water.
But do not let this one fact escape your notice, beloved, that with the Lord one day is like a thousand years, and a thousand years like one day. The Lord is not slow about His promise, as some count slowness, but is patient toward you, not wishing for any to perish but for all to come to repentance. (2Peter 3:3-9)
These and many other disasters are often called ‘Acts of God’. Whether it is fair to designate them thus, there is one ultimate disaster that God does lay claim to: the great universal Flood that wiped out all humans on earth bar eight. Of course, we don’t know how many humans there were on the planet at the time, but I think we can assume that in ten generations from Adam, each generation living for hundreds of years, there were many millions.
How could God justify killing so many of his creatures?
Atheists reject the idea that morality should be based on God’s ideas. They believe that mankind has ‘evolved’ a higher morality by which even a supposed ‘god’ must be judged. They would not accept a ‘god’ defence if such a morality were transgressed. People like David Koresh or Jim Jones could not fall back on the excuse “God told me to…” any more than a suicide bomber could, and if the Israelis justified exterminating the Palestinians in the same way that they exterminated the Amalekites, then they believe the whole world would be justified in turning on them.
Of course, if you believe in a just and righteous God then you have other ideas. For a believer God is the fount of all righteousness and true morality, and if something about modern morality does not gel with God’s ideas then modern morality must have the flaw.
Atheists, who believe God is a figment of men’s minds, are in effect judging the actions of previous generations of men, and doing so outside the historical context. Their judgment will be human, not divine, and historically biased.
So on what basis would God judge? As before, he would do so on the basis of ownership and eternity. All creatures belong to the Creator. We are his to do with what he likes. Should the clay say to the potter, “Shape me this way?” It’s ludicrous. Secondly, our wisdom is temporal. We do not know the future, nor what is best for us. It is hubristic to believe that we do. In history there are many occasions when all the evidence would point a particular way for a course of action, but the unknowns, were they known would demonstrate those actions as foolhardy. Our decisions are always contingent on the knowledge available. Thus we have Truman’s decision to bomb Hiroshima and Nagasaki. Was he correct? Philosophers continue to argue over the morality of the nuclear strike. From a utilitarian point of view it might be seen as the lesser of two evils; from a pacifist point of view it might be seen as an act of wanton evil. What absolute decision can be made?
God, who knows the future must be relied upon to do what is right. The hymn says that he is ‘slow to chide and swift to bless’. Consider the Flood.
After the sin of Adam and Eve, humanity multiplied rapidly, filling the earth, but just as humanity itself multiplied, so also did the sin of humanity. The sin of humanity reaches a crescendo up to Genesis chapter 6 when things get so bad that God regrets that he made man. Far from disdaining the sin of Cain, Lamech multiplies it.
Now it came about, when men began to multiply on the face of the land, and daughters were born to them, that the sons of God saw that the daughters of men were beautiful; and they took wives for themselves, whomever they chose. (Genesis 6:1-2)
There is some controversy over who these “sons of God” were. Some consider the sons of God to be fallen angels inter-married with women. However, we know that angels do not procreate (Mark 12:25). In Genesis 4:26 it indicates that the family line of Seth were known by the name of the Lord. Therefore, ‘the sons of God’ probably refers to the lineage of Seth and Enoch. Enoch, the seventh from Adam warned of judgment to come, “See the Lord is coming with thousands upon thousands of his Holy ones to judge everyone and to convict all the ungodly of all the ungodly acts they have done in the ungodly way, and of all the harsh words ungodly sinners have spoken against him.” (Jude 14-15) But now Seth’s offspring were intermarrying with evil families, diluting the lineage that followed after God. As a result, with the exception of Noah and his family, Seth’s offspring are now just as evil as the lineage of Cain. Humanity is now so sinful that God could not tolerate their sin any longer. If he were to save any he must act.
The Nephilim, which literally means “to fall upon,” were powerful, mighty warriors who would “fall upon” others. They were violent men who, in the tradition of Lamech, routinely killed and committed violence upon others (Genesis 6:4).
Every intent and thought of man was wicked (Genesis 6:5).
The earth was filled with violence and corruption. Murder had become the order of the day. Humanity no longer gave any regard to the image of God, but routinely exterminated that image for their own benefit (Genesis 6:11-12).
At this point there was only one family remaining who walked with God. So in the midst of this wickedness, God calls out Noah. He calls him to build an ark in which his family would be preserved through an oncoming flood of water. For 120 years Noah prepares the ark according to God’s specific instructions.
Did you notice that 120 years? Imagine what people would have said about this strange guy who was building a huge boat on dry land. This boat was a visual image – a sermon in gopher wood. In Peter’s second letter, Noah is called ‘a preacher of righteousness’.
The patience of God is remarkable. Such is his love for his creation that it is not his will that any should perish, but that they would turn from their wicked ways and live. But he could not force it. Mankind has freedom not to choose God.
So the people disparaged Noah and would not harken to him. In the end the rains came and flood arose and Noah and his family spend a year and twelve days in the ark. When they emerge, there is no-one left. Noah is in a sense a second Adam, a new creation, a fresh start.
God waited for generations until the wickedness became so corrupt and so pervasive that there was only one family left which followed Him. He did not systematically punish those who were evil, but waited until the evil was so bad that all hope was only one family away from being wiped out. This shows the longsuffering nature of God and the protection God desires for those who follow him.
The sin of humanity reached such a critical point, where if he had not acted, Noah and his family would have been destroyed, and so with him, the destruction of the Messianic line. Without the ark, the seed which was to become the salvation of humanity would have been lost. So God delivers Noah and his family.
It shows that God does not haphazardly dispense judgment. He waited until there was only one righteous family left, and even then he spared this family, not a pristine family, indeed still sinners, but one from which hope would emerge.
Many today would look at the world around us and see the same evil intent on our society. When we see genocide and murder rampant in our world, and we watch the persecution of Christians in Africa and Asia, we wonder why God with holds his judgment on this world.
The apostle Peter, writing to persecuted Christians in the first century, reminds us of the forbearance of God. He is withholding his judgment from the world, so that there might be time for more to repent and be delivered from judgment.
“…in the last days mockers will come with their mocking, following after their own lusts, and saying, "Where is the promise of His coming? ….when they maintain this, it escapes their notice that …the earth was formed out of water and by water, through which the world at that time was destroyed, being flooded with water.
But do not let this one fact escape your notice, beloved, that with the Lord one day is like a thousand years, and a thousand years like one day. The Lord is not slow about His promise, as some count slowness, but is patient toward you, not wishing for any to perish but for all to come to repentance. (2Peter 3:3-9)
Why are we in Afghanistan?
From Ralph Peters RealClearPolitics
Within Afghanistan, only a single US program continues to do real damage to the Taliban and President Hamid Karzai wants it to stop.
Our special operations forces (especially, the Army's) have been gutting the Taliban's leadership. Karzai doesn't like that. He didn't like our use of airpower and artillery, either. The Taliban feared them too much and told wild lies about civilian casualties. Most fire support ceased. More soldiers and Marines died.
Now Karzai wants to put a stop to "night raids" by our special operators. If he were actively allied with the Taliban, he couldn't do the terrorists a bigger favor.
A source deep in the fight provided hard numbers-countering Karzai's claims that our strike teams wantonly kill civilians: - Our "most elite" SOF element struck 1043 high-value objectives over the past year, 80% during the hours of darkness. 45% of those black-ops missions-a very high percentage-were successes that "resulted in the capture or death of the targeted individual." - Only a third of those missions-366--required our troops to open fire. They don't go in with guns blazing. On the contrary, these are the most-disciplined soldiers on earth. And night raids limit casualties: An enemy taken by surprise is less likely to respond effectively, so you don't unleash a firefight in the streets.
- In over a thousand raids last year, 18 non-combatants died-because they were bunking with the Taliban and got caught up in a fight. Compare that full-year casualty rate to the 93 people killed in a single day in Mexico's narco-insurgency last week. - Last week alone, the Taliban murdered twice the number of civilians that our special operators killed in an entire year.
- Our top SOF element recently eliminated a half-dozen key Taliban commanders and sub-commanders, seriously disrupting the enemy's chain of command. Top Taliban leaders in Pakistan (protected by our Pakistani "allies") are scrambling to regain control in Afghanistan.
President Karzai's been briefed on these statistics. He ignores them and continues to rail about our SOF forces causing civilian casualties and "violating Afghan culture." Karzai stayed mum, though, about the Taliban's recent hanging of a seven-year-old boy as a "spy." Lynching kids is culturally acceptable.
The doctrine-for which soldiers and Marines are dying in growing numbers-assumes that we're partnered with a host government that has or can build credibility with its people, a government worth fighting for that has the interests of its people at heart. Instead, our troops serve as bodyguards for gangsters. President Karzai has all but dropped the pretense that he wants to defeat the Taliban. He's rushing to cut deals behind our backs.
To show good faith with our enemies, he's methodically stripped us of our military advantages. Air and artillery support were all but eliminated. Our "decisive" Kandahar offensive was neutered. Originally planned for May, the campaign's theme is now "See You In September." Maybe.
Now Karzai wants to halt our SOF strike missions-the only thing left that works in Afghanistan. While CIA drone missions across the border in Pakistan do great service, our troop surge is meaningless - because our troops aren't allowed to do anything useful. According to one officer on the ground, the Army's elite 82nd Airborne Division, which recently wrapped up a thirteen-month tour, "did not target one bad guy." Those splendid soldiers were wasted.
Only our special operators are still in the fight. The rest of our forces have been reduced to serving as pop-up targets. Billions in aid have been squandered. Drug lords rule. Our local "allies" rip us off at every turn.
We went into Afghanistan because the ruling elite were giving succor to a terrorist organization that was causing mayhem around the world. Our purposes were to defend ourselves by closing down the local support. The strategy of developing a Thirteenth Century tyranny into a modern state with energy supplies, agriculture and industry against the will of the local people has been a failure. Let's admit that.
The only sensible option is to withdraw and not waste our treasure and troops there any longer. We should leave with a threat. Any more interference with us and we will come back and bomb you indiscriminately.
Within Afghanistan, only a single US program continues to do real damage to the Taliban and President Hamid Karzai wants it to stop.
Our special operations forces (especially, the Army's) have been gutting the Taliban's leadership. Karzai doesn't like that. He didn't like our use of airpower and artillery, either. The Taliban feared them too much and told wild lies about civilian casualties. Most fire support ceased. More soldiers and Marines died.
Now Karzai wants to put a stop to "night raids" by our special operators. If he were actively allied with the Taliban, he couldn't do the terrorists a bigger favor.
A source deep in the fight provided hard numbers-countering Karzai's claims that our strike teams wantonly kill civilians: - Our "most elite" SOF element struck 1043 high-value objectives over the past year, 80% during the hours of darkness. 45% of those black-ops missions-a very high percentage-were successes that "resulted in the capture or death of the targeted individual." - Only a third of those missions-366--required our troops to open fire. They don't go in with guns blazing. On the contrary, these are the most-disciplined soldiers on earth. And night raids limit casualties: An enemy taken by surprise is less likely to respond effectively, so you don't unleash a firefight in the streets.
- In over a thousand raids last year, 18 non-combatants died-because they were bunking with the Taliban and got caught up in a fight. Compare that full-year casualty rate to the 93 people killed in a single day in Mexico's narco-insurgency last week. - Last week alone, the Taliban murdered twice the number of civilians that our special operators killed in an entire year.
- Our top SOF element recently eliminated a half-dozen key Taliban commanders and sub-commanders, seriously disrupting the enemy's chain of command. Top Taliban leaders in Pakistan (protected by our Pakistani "allies") are scrambling to regain control in Afghanistan.
President Karzai's been briefed on these statistics. He ignores them and continues to rail about our SOF forces causing civilian casualties and "violating Afghan culture." Karzai stayed mum, though, about the Taliban's recent hanging of a seven-year-old boy as a "spy." Lynching kids is culturally acceptable.
The doctrine-for which soldiers and Marines are dying in growing numbers-assumes that we're partnered with a host government that has or can build credibility with its people, a government worth fighting for that has the interests of its people at heart. Instead, our troops serve as bodyguards for gangsters. President Karzai has all but dropped the pretense that he wants to defeat the Taliban. He's rushing to cut deals behind our backs.
To show good faith with our enemies, he's methodically stripped us of our military advantages. Air and artillery support were all but eliminated. Our "decisive" Kandahar offensive was neutered. Originally planned for May, the campaign's theme is now "See You In September." Maybe.
Now Karzai wants to halt our SOF strike missions-the only thing left that works in Afghanistan. While CIA drone missions across the border in Pakistan do great service, our troop surge is meaningless - because our troops aren't allowed to do anything useful. According to one officer on the ground, the Army's elite 82nd Airborne Division, which recently wrapped up a thirteen-month tour, "did not target one bad guy." Those splendid soldiers were wasted.
Only our special operators are still in the fight. The rest of our forces have been reduced to serving as pop-up targets. Billions in aid have been squandered. Drug lords rule. Our local "allies" rip us off at every turn.
We went into Afghanistan because the ruling elite were giving succor to a terrorist organization that was causing mayhem around the world. Our purposes were to defend ourselves by closing down the local support. The strategy of developing a Thirteenth Century tyranny into a modern state with energy supplies, agriculture and industry against the will of the local people has been a failure. Let's admit that.
The only sensible option is to withdraw and not waste our treasure and troops there any longer. We should leave with a threat. Any more interference with us and we will come back and bomb you indiscriminately.
Friday, June 18, 2010
Why are we in Afghanistan?
On 31 May, the Deputy Secretary of the Afghan Lower House of Parliament, Abdul Sattar Khawasi, called in parliament for the public execution of the Afghan Christians shown in the TV programme. Other members called for proselytising groups to be expelled from the country.
On 1 June, a spokesman for President Hamid Karzai said that the president was taking a personal interest in the situation and had ordered immediate and serious action to prevent any more conversions. In the following days many Kabul homes were searched and dozens of Afghan Christians fled.
On 5 June Interior Minister Hanif Atmar said that they had been investigating the issue of conversions for the last two years. He announced that the government had a list of 23 people, Afghans and foreigners, whom they were seeking to arrest.
On 1 June, a spokesman for President Hamid Karzai said that the president was taking a personal interest in the situation and had ordered immediate and serious action to prevent any more conversions. In the following days many Kabul homes were searched and dozens of Afghan Christians fled.
On 5 June Interior Minister Hanif Atmar said that they had been investigating the issue of conversions for the last two years. He announced that the government had a list of 23 people, Afghans and foreigners, whom they were seeking to arrest.
Thursday, June 17, 2010
The Atrocities of God: 1 The fall
The atrocities of God
When we hear of events that turn our stomach being done by those who claim to have been instructed by God, how should we react? Recently, extreme Muslims in Afghanistan hanged a 7-year old boy after a kangaroo court found him guilty of spying for the Government. Apparently there had been a suicide bomber at a wedding in his village who had killed himself and 40 others. The boys grandfather, a village elder spoke up against the Taliban and in retribution the Taliban had the young boy executed.
This is but one of the unspeakable acts of horror committed by followers of extreme Islam, yet when we protest, Muslims are apt to point to the events of the Old Testament like slavery, stoning of adulterers, and various genocides as evidence that Christianity is not squeaky clean. How should we answer these attacks?
Liberal Christians have no problem. They see the stories of the Old Testament as simply stories, myths and legends told by a primitive people to explain their existence, to be given no more credence than the story of Romulus and Remus being suckled by a wolf at the foundation of ancient Rome.
It is we evangelicals who have the difficulty with our assumption all Scripture is God-breathed and is useful for teaching, rebuking, correcting and training in righteousness. On the face of it we have difficulties with reconciling modern mores with all that slaughtering of the Amalekites that went on. Some of the punishments in Mosaic Law must give us pause. How are we to resolve this problem.
When we question God’s word, a good place to start is the Book of Job. Here Job got the chance to directly question God on what his motives were. God’s answer was not to explain himself but to ask Job what qualifications he had for deciding what was right and what was wrong. So this is where we should begin: from God’s perspective rather than our perspective.
In a sense the first great atrocity that we have to contend with is Adam and Eve getting thrown out of paradise.
This is where it all begins. Is this an arbitrary act by God? Is this unfair or unjust? Is it an atrocity?
Consider from the point of view of Adam and Eve. God made man in his own image. He made him, male and female to rule over the fish, the birds, livestock, over all the earth and every creature that moves over the face of the earth. . He gave them the instruction to be fruitful and multiply, to fill the earth and subdue it, to rule over it. He gave them every seed bearing plant for food, and every tree that has fruit for food. And God saw that it was very good.
God placed Adam in a garden that was well watered by a river. It was a garden that grew all manner of trees, trees that were pleasing to the eye and good for food. God introduced him to all the birds and beasts so that he could name them and gave him a companion, a helper suitable for him, a wife with whom he could become one flesh.
Only one restriction was put on man’s activities. “You may not eat from the tree of the knowledge of good and evil; for when you eat of it you will surely die.”
But the woman was tempted by a talking snake. “Did God really say?” “You will not surely die.” “Your eyes will be opened and you will be like God.”
She ate and gave it to husband to eat and innocence was lost. He blamed his wife (whom you put here with me) and she blamed the snake.
How was God to react? Should he give them a second chance? Should he deny what he said and say, “I was only joking”? Should his justice become a mockery?
No, the die was cast; some things cannot be undone. For the woman childbirth would henceforth be a painful experience and she should be ruled by her husband. For the man the ground would be cursed. There would be no more easy pickings. Food would be produced by painful toil. Thorns and thistles would grow where he wished for crops and it would take the sweat of his brow to provide for his family. And although he did not die that day, death for mankind entered the world that day. He would return to the dust from which he had been created.
So Adam and Eve were dismissed from Paradise.
Life thereafter was no paradise, but one of pressure, difficulty and pain; brutish and short. (I know 930 years seems long to us, but compared with eternity…) It was no longer life but a life sentence. The very ground was cursed. Paul tells us that the whole creation is subject to torment. Look around – China, Haiti, Turkey – you’ll see that it was and still is.
But even as they are expelled there is hope for a second chance. He says to the Devil “The woman’s offspring will crush your head and you will strike his heel.” It was a prophecy of Jesus Christ, the offspring of the woman, who would yet redeem Adam’s fallen race. And as they left the garden God provided clothing for them in the form of animal skins – which could only have come from the sacrifice of an animal. Here already was a type of the salvation to come from the shedding of blood.
In his justice he remembered mercy.
From Adam’s point of view he might try to absolve himself from the consequences of his disobedience (as he always does) but from God’s point of view his justice and veracity are the building blocks of the Universe. It would collapse like a house of cards without them. But he would find a way of escape.
When we hear of events that turn our stomach being done by those who claim to have been instructed by God, how should we react? Recently, extreme Muslims in Afghanistan hanged a 7-year old boy after a kangaroo court found him guilty of spying for the Government. Apparently there had been a suicide bomber at a wedding in his village who had killed himself and 40 others. The boys grandfather, a village elder spoke up against the Taliban and in retribution the Taliban had the young boy executed.
This is but one of the unspeakable acts of horror committed by followers of extreme Islam, yet when we protest, Muslims are apt to point to the events of the Old Testament like slavery, stoning of adulterers, and various genocides as evidence that Christianity is not squeaky clean. How should we answer these attacks?
Liberal Christians have no problem. They see the stories of the Old Testament as simply stories, myths and legends told by a primitive people to explain their existence, to be given no more credence than the story of Romulus and Remus being suckled by a wolf at the foundation of ancient Rome.
It is we evangelicals who have the difficulty with our assumption all Scripture is God-breathed and is useful for teaching, rebuking, correcting and training in righteousness. On the face of it we have difficulties with reconciling modern mores with all that slaughtering of the Amalekites that went on. Some of the punishments in Mosaic Law must give us pause. How are we to resolve this problem.
When we question God’s word, a good place to start is the Book of Job. Here Job got the chance to directly question God on what his motives were. God’s answer was not to explain himself but to ask Job what qualifications he had for deciding what was right and what was wrong. So this is where we should begin: from God’s perspective rather than our perspective.
In a sense the first great atrocity that we have to contend with is Adam and Eve getting thrown out of paradise.
This is where it all begins. Is this an arbitrary act by God? Is this unfair or unjust? Is it an atrocity?
Consider from the point of view of Adam and Eve. God made man in his own image. He made him, male and female to rule over the fish, the birds, livestock, over all the earth and every creature that moves over the face of the earth. . He gave them the instruction to be fruitful and multiply, to fill the earth and subdue it, to rule over it. He gave them every seed bearing plant for food, and every tree that has fruit for food. And God saw that it was very good.
God placed Adam in a garden that was well watered by a river. It was a garden that grew all manner of trees, trees that were pleasing to the eye and good for food. God introduced him to all the birds and beasts so that he could name them and gave him a companion, a helper suitable for him, a wife with whom he could become one flesh.
Only one restriction was put on man’s activities. “You may not eat from the tree of the knowledge of good and evil; for when you eat of it you will surely die.”
But the woman was tempted by a talking snake. “Did God really say?” “You will not surely die.” “Your eyes will be opened and you will be like God.”
She ate and gave it to husband to eat and innocence was lost. He blamed his wife (whom you put here with me) and she blamed the snake.
How was God to react? Should he give them a second chance? Should he deny what he said and say, “I was only joking”? Should his justice become a mockery?
No, the die was cast; some things cannot be undone. For the woman childbirth would henceforth be a painful experience and she should be ruled by her husband. For the man the ground would be cursed. There would be no more easy pickings. Food would be produced by painful toil. Thorns and thistles would grow where he wished for crops and it would take the sweat of his brow to provide for his family. And although he did not die that day, death for mankind entered the world that day. He would return to the dust from which he had been created.
So Adam and Eve were dismissed from Paradise.
Life thereafter was no paradise, but one of pressure, difficulty and pain; brutish and short. (I know 930 years seems long to us, but compared with eternity…) It was no longer life but a life sentence. The very ground was cursed. Paul tells us that the whole creation is subject to torment. Look around – China, Haiti, Turkey – you’ll see that it was and still is.
But even as they are expelled there is hope for a second chance. He says to the Devil “The woman’s offspring will crush your head and you will strike his heel.” It was a prophecy of Jesus Christ, the offspring of the woman, who would yet redeem Adam’s fallen race. And as they left the garden God provided clothing for them in the form of animal skins – which could only have come from the sacrifice of an animal. Here already was a type of the salvation to come from the shedding of blood.
In his justice he remembered mercy.
From Adam’s point of view he might try to absolve himself from the consequences of his disobedience (as he always does) but from God’s point of view his justice and veracity are the building blocks of the Universe. It would collapse like a house of cards without them. But he would find a way of escape.
Ethnic conflict
In the midst of such a bitter conflict, it is heartening to know that Christians are setting an example of love across ethnic groups. Let us thank the Lord for our Kyrgyz brothers and sisters who are so courageously helping Uzbek fellow-Christians, in the full knowledge that these actions make them targets for violence from their own fellow-Kyrgyz. Let us re-double our prayers in the light of today’s news that all Christians are now becoming a target, simply because of their faith in the Lord Jesus.
Wednesday, June 16, 2010
Bloody Sunday
Thirty eight years on, the Saville Report has been published about the events that took place in Londonderry in 1972. It exonerates the Civil Rights movement and blames the 1st Parachute Regiment, who clearly lied about what had happened. Bloody Sunday was a catalyst for the violence that followed in Northern Ireland, but it was not the start of the violence. Soldiers and civilians had already been killed. Many more were to die. More British soldiers were killed in the Northern Ireland troubles that the combined death rate in Iraq and Afghanistan.
The underlying problem was centuries old and probably goes back to the Romans who settled in the area around Dublin and built a fence (pale) around their settlement. Everything outside was 'beyond the pale'. Throughout history English rulers sought to subject Ireland to their hegemony with varying success. The summation of their efforts has not been glorious. The conflict induced by the Earl of Essex and Cromwell in the sixteenth and seventeenth Centuries, the conquest by King Billy at the end of the seventeenth Century, the potato famine and mass emigration can all be held to England's account. The reaction of the Irish has been nothing to be proud of. The support for Hitler by De Valera, the murder of Michael Collins, the priest-ridden society that admitted oppression of unmarried mothers and the abuse of children should all give shame.
The troubles started as a result of partition - what other solution was possible? In the North, the more freely-breeding Catholics were increasing in numbers but were second-class citizens. The Civil Rights movement wanted just that - civil rights, but young, hot-headed men knew their history. It was a time of violent uprising in many parts of the world. Weapons were easy to come by. A revolution fought with guerrilla tactics was on the cards.
A few days after the Bloody Sunday killings the IRA blew up a building in Aldershot, where the 1st Parachute Regiment was based. Seven people were killed and 19 injured. The dead included a Catholic priest, an elderly gardener and several cleaning ladies. My father had been in the building less than half an hour before. In November 1972 Noel Jenkinson was convicted of the murders and received a lengthy jail term, dying in prison of heart failure four years later. Afterwards a protracted bombing campaign began in England and many atrocities were committed.
One hopes that the Saville enquiry draws a line under the whole sorry mess. The civil rights that the original movement demanded have been granted. There is permanent power sharing between the Protestants and Catholic politicians. Murderers on both sides have been pardoned. Although two soldiers from the Parachute Regiment who took part in the undisciplined killings in Derry remain alive, little would be gained in prosecuting them; it is doubtful that they could have a fair trial and be convicted beyond reasonable doubt. With so many pardoned for worse crimes, what would be served by pursuing them?
It is the job of the majority to accomodate teh wounds of the minority, and Davic Cameron's statesmanlike comments in Parliament have done this. Time for it to end now.
The underlying problem was centuries old and probably goes back to the Romans who settled in the area around Dublin and built a fence (pale) around their settlement. Everything outside was 'beyond the pale'. Throughout history English rulers sought to subject Ireland to their hegemony with varying success. The summation of their efforts has not been glorious. The conflict induced by the Earl of Essex and Cromwell in the sixteenth and seventeenth Centuries, the conquest by King Billy at the end of the seventeenth Century, the potato famine and mass emigration can all be held to England's account. The reaction of the Irish has been nothing to be proud of. The support for Hitler by De Valera, the murder of Michael Collins, the priest-ridden society that admitted oppression of unmarried mothers and the abuse of children should all give shame.
The troubles started as a result of partition - what other solution was possible? In the North, the more freely-breeding Catholics were increasing in numbers but were second-class citizens. The Civil Rights movement wanted just that - civil rights, but young, hot-headed men knew their history. It was a time of violent uprising in many parts of the world. Weapons were easy to come by. A revolution fought with guerrilla tactics was on the cards.
A few days after the Bloody Sunday killings the IRA blew up a building in Aldershot, where the 1st Parachute Regiment was based. Seven people were killed and 19 injured. The dead included a Catholic priest, an elderly gardener and several cleaning ladies. My father had been in the building less than half an hour before. In November 1972 Noel Jenkinson was convicted of the murders and received a lengthy jail term, dying in prison of heart failure four years later. Afterwards a protracted bombing campaign began in England and many atrocities were committed.
One hopes that the Saville enquiry draws a line under the whole sorry mess. The civil rights that the original movement demanded have been granted. There is permanent power sharing between the Protestants and Catholic politicians. Murderers on both sides have been pardoned. Although two soldiers from the Parachute Regiment who took part in the undisciplined killings in Derry remain alive, little would be gained in prosecuting them; it is doubtful that they could have a fair trial and be convicted beyond reasonable doubt. With so many pardoned for worse crimes, what would be served by pursuing them?
It is the job of the majority to accomodate teh wounds of the minority, and Davic Cameron's statesmanlike comments in Parliament have done this. Time for it to end now.
Monday, June 14, 2010
Standing firm on Grace. 1 Peter 5:10-14
It's about eighteen months since I started in 1 Peter and now is the time to draw it to an end. I am reluctant to leave it since it is one of the most insightful books about the Christian condition and so practical in its application.
It is written by the apostle Peter, a man who came to Christ flawed and whom Christ left as one of the living stones in the Church.
There are caves in Somerset in England where Calcium Carbonate drips from the limestone stalactites in the ceiling onto stalagmites on the floor building up columns of calcium. Sometimes people bring soft toys like teddy bears to be dripped upon so that after a while soft cuddly teddy becomes tough teddy, bristling with firmness.
This is what happened to Peter, turned from soggy Simon into 'Rocky' Peter. We all need to be 'petrified' by our exposure to this letter. It won't be achieved by just reading it or even hearing sermons preached on it, we must apply it to our lives and walk the walk.
1 Peter 5:10-14: And the God of all grace, who called you to his eternal glory in Christ, after you have suffered a little while, will himself restore you and make you strong, firm and steadfast. To him be the power for ever and ever. Amen. With the help of Silas, whom I regard as a faithful brother, I have written to you briefly, encouraging you and testifying that this is the true grace of God. Stand fast in it. She who is in Babylon, chosen together with you, sends you her greetings, and so does my son Mark. Greet one another with a kiss of love. Peace to all of you who are in Christ.
Peter began his letter by explaining what grace is. Not an elegant way of moving, not a girl's name, but undeserved kindness. As human beings, right from an early age, our natural response is to try and justify ourselves. We are adept at pointing the finger and blaming someone else. If there is no-one to blame, then the sun was in my eyes or the ball hit a bobble, or these are new gloves that are not broken in yet. We are reluctant to make the confession that we just weren't good enough, that we made a mistake, to take the blame ourselves. The surprizing thing is that God understands that. He knows that in order to put things right between him and us, he has to make the first move. In fact, he has to make all the moves.
This is what he has done, in and through his son, the Lord Jesus Christ. We know the acronym, God's Riches At Christ's Expense. That pretty accurately sums up the meaning of grace. It is all about Christ. The very fact that God sent his son was an act of grace. He need not have done so; why should he not leave us to perish?
Jesus taught a perfect message. Philosphers who think him but a man revere him for what he taught. But in revealing himself like this, God was gracious. How could we know anything about God except he reveal himself?
Jesus lived a perfect life, not submitting to temptation, not even accepting glory, instead enduring suffering and shame and finally a disgusting death by torture. On the cross he suffered the separation from his Father; the Godhead torn in two. Why? Because we deserved it? Never!
In the grave he lay for three days before his glorious resurrection. It was a sign that it was sufficient! Had he stayed dead it might have been a precious martyrdom, a wonderful example, but who would have remembered 2000 years later? There have been plenty of martyrs. But in raising him from the dead, God declared "It is finished!" No more is needed. We need to bring nothing to the table because the table is fully furnished.
Nothing in my hand I bring; Simply to thy cross I cling, sang Toplady, and he was right. All, all is of grace. To try to add anything is to besmirch it. I brought my goodwill, I brought my acceptance, I brought my obedience, I brought my good works - anything I claim will tarnish grace.
But grace didn't end there. Jesus spent 40 days on earth when he could have left to join his father. He taught and instructed his disciples. He forgave them. He inspired them. He convinced them and when he ascended he did not leave them bereft but sent his Spirit on that wonderful Day of Pentecost when flame and wind and voices came, astonishing not only them but thousands gathered in Jerusalem.
Grace doesn't stop with undeserved mercy; it goes on acting with undeserved help. Do you find life difficult? Is life a struggle? Are you sick or sick of heart? Is your marriage hurting? Is it the kids? Are you lonely, longing for a life's partner? Do you mourn for a lost one? Does depression grip you? Are you unemployed or seemingly unemployable? Are you poor? Are you abused? Are you homeless? Are you afraid? Are you in danger? God is the God of all grace. Whatever your circumstances he is there for you.
You see he has called you. Just as he called Abram form Ur or little Samuel in the Temple, or Peter, Andrew, James and John from their nets, or Saul of Tarsus from the road to Damascus, so he has called you. It may not have been as dramatic as some, but it was a real call. Sometimes, as when he spoke to Elijah, the word is not in earthquake, storm or fire, but in a still, small voice. He may not have shouted at you, but he called you, and he called you to his eternal glory in Christ, into an inheritance that can never perish, spoil or fade - kept in heaven for you. Peter tells us in chapter one that we are shielded by God's power.
Those poor soldiers in Afghanistan are shielded by better and better armor in their vehicles yet the IUDs still maim and kill them; but we are shielded by God's power until the coming of the salvation that is ready to be revealed in the last time. Our future is secure. That too is part of God's grace.
He does not deceive us. After you have suffered a little while, he says. I am afraid that suffering is the human condition. Adam sinned and we live in a fallen world. How wicked is Satan! Blame him for the world as it is! He tempted Eve and then Adam and now we see the consequences, but Oh! the riches of God's grace that he should restore us so! And see who it is who does the restoring. "He himself will restore you and make you strong, firm and steadfast"
This is what he is doing now. As Peter's letter is applied to us so we become strong and firm and steadfast. No longer that floppy teddy bear, but petrified. No wander Peter exclaims, "To Him be the power for ever and ever, Amen" This isn't a prayer or petition. It isn't just an exclamation; it's an acclamation of praise to Almighty God.
In verse 12 he takes up the pen from Silas (or Silvanus). It is interesting to know that even Peter needed help to write his letter. We really do need each other, don't we? Silas also helped Paul write 1 and 2 Thessalonians - not bad to have on your CV eh? But Silas was more than a mere amanuensis. Peter calls him a faithful brother. Very likely he job was not only to do the 'typing' but to deliver the letter to the various Turkish addresses, to read it out and explain it. What did Peter mean by living stones? In what way are wives to be submissive? And Silas would patiently draw out exactly what Peter had said and why he said it. He would emphasize that this was the "true" grace of God.
Many times today we are given a false grace. There are many phony substitutes. You will be healthy, wealthy and wise. No, that's what comes out of a Aladdin's lamp not from true grace. It's exactly the opposite. You will suffer for a while, says Peter. Couldn't be plainer than that. Jesus tells us that we must take up our cross to follow him. He didn't mean one of those silver or gold necklaces. the cross is the symbol of suffering and shame. It was the ancient gallows. We must stand fast on that true grace and not be drawn into fakes.
In the Rumpole books and TV series the rapscallion lawyer referred to his wife as "She who must be obeyed." Who is Peter referring to by "She who is in Babylon"? Is it his wife? We know that he had one. It sounds like family greetings together with his son Mark, and in a sense it is. Babylon represented the exile and here might represent the Christian church as a whole, still in exile from heaven, or perhaps since Babylon was the home of the Emperor, it represents Rome, from where Peter probably wrote this letter. But the sentiment is that the whole church is in this together. We must recognize the Body of Christ, which is the whole church of Christ. Beware of factions, of denominationism and of division. We can have no truck with those who believe another gospel, but with those who trust in the redeeming blood of Christ we are brother in arms. And we must love the brethren.
Every day I receive messages from brothers and sisters who are suffering for the gospel. Here is today's message from Open Doors: A 14-year-old girl has accused two Muslim boys of drugging and then raping her after abducting her from her school in Kamboh colony, Lahore. The girl, whose name was withheld, said she was waiting for her younger sister after school on 6 May when Muhammad Noman and Muhammad Imran, both 17, overpowered her, took her away by motorbike and forced her to consume a soft drink containing tranquillisers. Shortly after being raped by each boy she lost consciousness. She was found on the road near the school gate by a neighbour after her mother raised the alarm.
We must work out how we express our love. I detailed above how many people are suffering. Is there some way you can be God's amanuensis in this struggle? A visit? A letter? A donation? A telephone call or e-mail. Perhaps you need to go? I honestly think that many times God answers prayer by moving in the heart of his people.
This invitation to kiss should not be taken lasciviously. It was the formal greeting among families. Whether you 'mwah' on one cheek, two or three, or if you shake hands or hug, do it with love and enthusiasm. Really mean it.
Finally, peace. 'Shalom' was the greeting for all Jews. It wishes God's best. Unity. "How good and pleasant it is when brothers live together in unity!"
It is written by the apostle Peter, a man who came to Christ flawed and whom Christ left as one of the living stones in the Church.
There are caves in Somerset in England where Calcium Carbonate drips from the limestone stalactites in the ceiling onto stalagmites on the floor building up columns of calcium. Sometimes people bring soft toys like teddy bears to be dripped upon so that after a while soft cuddly teddy becomes tough teddy, bristling with firmness.
This is what happened to Peter, turned from soggy Simon into 'Rocky' Peter. We all need to be 'petrified' by our exposure to this letter. It won't be achieved by just reading it or even hearing sermons preached on it, we must apply it to our lives and walk the walk.
1 Peter 5:10-14: And the God of all grace, who called you to his eternal glory in Christ, after you have suffered a little while, will himself restore you and make you strong, firm and steadfast. To him be the power for ever and ever. Amen. With the help of Silas, whom I regard as a faithful brother, I have written to you briefly, encouraging you and testifying that this is the true grace of God. Stand fast in it. She who is in Babylon, chosen together with you, sends you her greetings, and so does my son Mark. Greet one another with a kiss of love. Peace to all of you who are in Christ.
Peter began his letter by explaining what grace is. Not an elegant way of moving, not a girl's name, but undeserved kindness. As human beings, right from an early age, our natural response is to try and justify ourselves. We are adept at pointing the finger and blaming someone else. If there is no-one to blame, then the sun was in my eyes or the ball hit a bobble, or these are new gloves that are not broken in yet. We are reluctant to make the confession that we just weren't good enough, that we made a mistake, to take the blame ourselves. The surprizing thing is that God understands that. He knows that in order to put things right between him and us, he has to make the first move. In fact, he has to make all the moves.
This is what he has done, in and through his son, the Lord Jesus Christ. We know the acronym, God's Riches At Christ's Expense. That pretty accurately sums up the meaning of grace. It is all about Christ. The very fact that God sent his son was an act of grace. He need not have done so; why should he not leave us to perish?
Jesus taught a perfect message. Philosphers who think him but a man revere him for what he taught. But in revealing himself like this, God was gracious. How could we know anything about God except he reveal himself?
Jesus lived a perfect life, not submitting to temptation, not even accepting glory, instead enduring suffering and shame and finally a disgusting death by torture. On the cross he suffered the separation from his Father; the Godhead torn in two. Why? Because we deserved it? Never!
In the grave he lay for three days before his glorious resurrection. It was a sign that it was sufficient! Had he stayed dead it might have been a precious martyrdom, a wonderful example, but who would have remembered 2000 years later? There have been plenty of martyrs. But in raising him from the dead, God declared "It is finished!" No more is needed. We need to bring nothing to the table because the table is fully furnished.
Nothing in my hand I bring; Simply to thy cross I cling, sang Toplady, and he was right. All, all is of grace. To try to add anything is to besmirch it. I brought my goodwill, I brought my acceptance, I brought my obedience, I brought my good works - anything I claim will tarnish grace.
But grace didn't end there. Jesus spent 40 days on earth when he could have left to join his father. He taught and instructed his disciples. He forgave them. He inspired them. He convinced them and when he ascended he did not leave them bereft but sent his Spirit on that wonderful Day of Pentecost when flame and wind and voices came, astonishing not only them but thousands gathered in Jerusalem.
Grace doesn't stop with undeserved mercy; it goes on acting with undeserved help. Do you find life difficult? Is life a struggle? Are you sick or sick of heart? Is your marriage hurting? Is it the kids? Are you lonely, longing for a life's partner? Do you mourn for a lost one? Does depression grip you? Are you unemployed or seemingly unemployable? Are you poor? Are you abused? Are you homeless? Are you afraid? Are you in danger? God is the God of all grace. Whatever your circumstances he is there for you.
You see he has called you. Just as he called Abram form Ur or little Samuel in the Temple, or Peter, Andrew, James and John from their nets, or Saul of Tarsus from the road to Damascus, so he has called you. It may not have been as dramatic as some, but it was a real call. Sometimes, as when he spoke to Elijah, the word is not in earthquake, storm or fire, but in a still, small voice. He may not have shouted at you, but he called you, and he called you to his eternal glory in Christ, into an inheritance that can never perish, spoil or fade - kept in heaven for you. Peter tells us in chapter one that we are shielded by God's power.
Those poor soldiers in Afghanistan are shielded by better and better armor in their vehicles yet the IUDs still maim and kill them; but we are shielded by God's power until the coming of the salvation that is ready to be revealed in the last time. Our future is secure. That too is part of God's grace.
He does not deceive us. After you have suffered a little while, he says. I am afraid that suffering is the human condition. Adam sinned and we live in a fallen world. How wicked is Satan! Blame him for the world as it is! He tempted Eve and then Adam and now we see the consequences, but Oh! the riches of God's grace that he should restore us so! And see who it is who does the restoring. "He himself will restore you and make you strong, firm and steadfast"
This is what he is doing now. As Peter's letter is applied to us so we become strong and firm and steadfast. No longer that floppy teddy bear, but petrified. No wander Peter exclaims, "To Him be the power for ever and ever, Amen" This isn't a prayer or petition. It isn't just an exclamation; it's an acclamation of praise to Almighty God.
In verse 12 he takes up the pen from Silas (or Silvanus). It is interesting to know that even Peter needed help to write his letter. We really do need each other, don't we? Silas also helped Paul write 1 and 2 Thessalonians - not bad to have on your CV eh? But Silas was more than a mere amanuensis. Peter calls him a faithful brother. Very likely he job was not only to do the 'typing' but to deliver the letter to the various Turkish addresses, to read it out and explain it. What did Peter mean by living stones? In what way are wives to be submissive? And Silas would patiently draw out exactly what Peter had said and why he said it. He would emphasize that this was the "true" grace of God.
Many times today we are given a false grace. There are many phony substitutes. You will be healthy, wealthy and wise. No, that's what comes out of a Aladdin's lamp not from true grace. It's exactly the opposite. You will suffer for a while, says Peter. Couldn't be plainer than that. Jesus tells us that we must take up our cross to follow him. He didn't mean one of those silver or gold necklaces. the cross is the symbol of suffering and shame. It was the ancient gallows. We must stand fast on that true grace and not be drawn into fakes.
In the Rumpole books and TV series the rapscallion lawyer referred to his wife as "She who must be obeyed." Who is Peter referring to by "She who is in Babylon"? Is it his wife? We know that he had one. It sounds like family greetings together with his son Mark, and in a sense it is. Babylon represented the exile and here might represent the Christian church as a whole, still in exile from heaven, or perhaps since Babylon was the home of the Emperor, it represents Rome, from where Peter probably wrote this letter. But the sentiment is that the whole church is in this together. We must recognize the Body of Christ, which is the whole church of Christ. Beware of factions, of denominationism and of division. We can have no truck with those who believe another gospel, but with those who trust in the redeeming blood of Christ we are brother in arms. And we must love the brethren.
Every day I receive messages from brothers and sisters who are suffering for the gospel. Here is today's message from Open Doors: A 14-year-old girl has accused two Muslim boys of drugging and then raping her after abducting her from her school in Kamboh colony, Lahore. The girl, whose name was withheld, said she was waiting for her younger sister after school on 6 May when Muhammad Noman and Muhammad Imran, both 17, overpowered her, took her away by motorbike and forced her to consume a soft drink containing tranquillisers. Shortly after being raped by each boy she lost consciousness. She was found on the road near the school gate by a neighbour after her mother raised the alarm.
We must work out how we express our love. I detailed above how many people are suffering. Is there some way you can be God's amanuensis in this struggle? A visit? A letter? A donation? A telephone call or e-mail. Perhaps you need to go? I honestly think that many times God answers prayer by moving in the heart of his people.
This invitation to kiss should not be taken lasciviously. It was the formal greeting among families. Whether you 'mwah' on one cheek, two or three, or if you shake hands or hug, do it with love and enthusiasm. Really mean it.
Finally, peace. 'Shalom' was the greeting for all Jews. It wishes God's best. Unity. "How good and pleasant it is when brothers live together in unity!"
Health again.
Not a very good weekend. I woke up on Sunday morning with more colicky abdominal pain, similar to Tuesday though not quite so severe. I had been tailing off the steroids, so it was disappointing to have a recurrence of pain. I managed to get in touch with my oncologist and we agreed that I should raise the dexamethasone to 8mg a day again and continue for three days before tailing them off. I should also continue with buscopan and paracetamol.
I cannot think of any particular meal that might have precipitated this, though a lamb cutlet was a bit fibrous.
The pain subsided by the evening and I was able to manage some mashed potato and gravy. Today I have gone out and bought a liquidizer, so this should remove the possibility of solid particles causing a blockage.
I wasn't very ill and without the context I would probably have just sat it out and taken fluids only, but given the context I had to take it more seriously. Perhaps it was all a reaction to the soft goal that Robert Green let in. The Americans were completely outplayed in the match and were reduced to shooting from distance.
I cannot think of any particular meal that might have precipitated this, though a lamb cutlet was a bit fibrous.
The pain subsided by the evening and I was able to manage some mashed potato and gravy. Today I have gone out and bought a liquidizer, so this should remove the possibility of solid particles causing a blockage.
I wasn't very ill and without the context I would probably have just sat it out and taken fluids only, but given the context I had to take it more seriously. Perhaps it was all a reaction to the soft goal that Robert Green let in. The Americans were completely outplayed in the match and were reduced to shooting from distance.
Friday, June 11, 2010
Where are we with prognostic markers today?
Who should have their prognostic markers done?
When I first started working in this area, I was motivated by the fact that many people were labelled as having leukemia who would never need any treatment for it. I spent a good deal of my career trying to figure out a means of distinguishing between those who would be in this bucket and those who definitely would need treatment. Many of these problems have been cleared up by the change in definition of CLL to require a minimum of 5000/cu mm B lymphocytes for the diagnosis. Many of those who had fewer than this would have been diagnosed as stage 0 CLL under the old definition. Now they are called monoclonal B cell lymphocytosis (MBL) and no-one thinks such people should be called leukemia patients or even followed up. They comprise about 4% of the population over-40 and no-one is going to contemplate making 4% of the mature population into invalids.
There is no reason to think that such people need their prognostic markers done.
What about people who really do have CLL. Experts are still recommending that outside clinical trials that the only prognostic indicator that makes any sense is the clinical stage. In other words, if you have Rai stage 0 or Binet stage A then that should be enough; you have a long period of life ahead of you.
I disagree. We know very clearly that Binet stage A patients who have unmutated IgVH genes will live on average 8 years (range 4-12 years). With better treatment this may be prolonged some, but it contrasts with an average survival of 25 years for those with mutated IgVH genes.
If any prognostication is to be done then the experts rely on the lymphocyte doubling time. Now, there is no doubt that unlike clinical stage, this is a dynamic indicator; it tells you something about the rate of progression. But it only tells you that when the disease progresses and it is unreliable. Because the blood compartment is only one of those where CLL cells accumulate, it does not tell you that your marrow cavity is filling up, nor that the lymph nodes that you cannot feel (like retroperitoneal nodes) are enlarging. In fact even the experts won't prognosticate on lymphocyte doubling times if the absolute lymphocyte count is less than 30.
The mutational status of the IgVH genes, on the other hand is a given characteristic of the disease, available at diagnosis.
Now this doesn't mean that I advocate that everyone with CLL should go out and get their IgVH genes done. If you are 90-years old, it hardly makes sense and people have to make their own decisions on how much information they want. Remember that these survival curves only predict averages and there is no such thing as an average person. Stephen J Gould, the Biology Professor at Harvard wrote a brilliant piece entitled 'The Median is not the Message' when he was diagnosed with mesothelioma and given less than a year to live. He survived for 17 years and died of something else.
It does make sense for the doctor looking after the patient to have this information since it could influence management, but I see no compelling reason that the patient should be burdened with it unless it is going to be acted on or unless he demands it.
In my previous article "You can't handle the Truth" I explained how difficult I found it to handle information about my CT scan. Patients want to be given hope and not despair. Too much openness is sometimes harmful. It used to be the case that the patient would leave the worrying to the doctor and in Japan they still do. Perhaps that's why people live longer in Japan.
If prognostic tests are to be done, which ones are useful?
For most tests, the results are not set in stone. In fact, the only unchanging test is the mutational status of the IgVH genes. The type of CLL you start with is the one you finish with. As far as I can determine this is not necessarily true for all other markers. But the effect of IgVH mutational status can be influenced by the other markers. It seems that the ability to signal through the B-cell receptor is what sets the pace of the disease, and in mutated IgVH cases this is impaired.
Proliferation in CLL occurs in proliferation centers in the marrow and lymph nodes and it is only when the cell is dividing that further genetic damage can occur. Every time a cell visits a proliferation center it up-regulates CD38 and possibly ZAP-70 as well. Every time it divides it shortens its telomeres and lays itself open to deletions and translocations on its chromosomes. There are simple serum tests like beta-2 M and thymidine kinase that give some indication of the rapidity of cell division, but they also measure tumor bulk, so that a high level might mean a slowly growing large tumor or a quickly growing small one.
This means that the baseline test that everyone who has full blown CLL should have done - whether or not they want to know the result - is the mutational status of their IgVH genes. Mutated and unmutated CLLs behave like two separate diseases and for the doctor not to know which one the patient has is like him saying the patient has lymphoma but time will tell us which type it is.
Why is it not done for everybody?
First, it is a matter of expense. The test costs $200 to do, though commercial labs charge $1000. You can get it done and interpreted in England for $200 plus the cost of the blood draw and a courier. Set next to the cost of one course of fludarabine let alone rituximab, this is peanuts.
What other reason? Sorry can't think of one.
This isn't a foolproof test. Being unmutated does not guarantee early treatment and being mutated doesn't guarantee late treatment or no treatment. I have written before that there are some borderline cases with 97% homology who tend to include some cases that are effectively unmutated and of course, those who use the V3-21 gene behave as if they were unmutated even when they are mutated. There is also the influence of other prognostic markers. Having a high CD38 or ZAP-70 can make the disease behave more badly. However, when patients come to see me I get this test done because it gives me greater insight into the disease than any other.
We know that whatever clinical stage you are in the mutational status of IgVH genes affects your time to first treatment, length of remission and overall survival, and it has a bigger effect than which type of treatment you get. So far this applies whatever type of treatment you receive, though there may come a time when there is a cure-all that acts well whatever your mutational status is - but we're not there yet.
Should other tests be done? You can make a case for CD38, ZAP-70, and Beta-2M. The trouble with CD38 is that the cut-off between positive and negative is disputed, Should it be 7%, 20% or 30%? And what about bimodal cases? In practice I do it because it can be incorporated into the flow cytometry picture necessary for diagnosis, but I find it most useful for cases of MBL. MBL with a CD38 less than 30% will almost never transform to CLL. The other thing about CD38 is that the percentage of positive cells tends to change during the course of the disease - in at least a quarter of patients - frequently when the disease relapses after treatment.
The trouble with ZAP-70 is finding a method that everyone can agree on. The concordance with IgVH mutations was over 90% using the first two published methods, but only 76% when the method developed in Tom Kipps lab was used. That paper suggested that it was a better prognosticator than IgVH mutations, but when it was adopted by commercial labs, very strange results indeed were apparent. Not only that, the Spanish group found that ZAP-70 levels changed in about 10% of patients during the course of the disease. Nowadays most labs don't trust ZAP-70.
Beta-2M is a good test except in renal failure. It is not just a test of disease activity since it also measures bulk. However I would do this test on all my patients.
The next test we should consider is FISH. This stands for Fluorescent In-Situ Hybridization, and it is a way for looking for particular chromosomal aberrations. It is not a perfect test and for 25 years in Bournemouth we preferred to do conventional karyotyping as well, since FISH only picks up the common abnormalities (del 13q, del 11q, del 17p and trisomy 12 - though sometimes del 6q is added). Conventional karyotyping also picks up the rarer abnormalities - trisomy 18, trisomy 19 for example and the unusual translocations - t(14;18) and t(14;19).
Although there is a famous hierarchical model which ranks cases according to prognosis according to FISH findings, this is not always helpful. It is very dependent on mutational status. Del 13q as an isolated finding mainly occurs in mutated cases, and the severity of trisomy 12 depends on whether the patient has mutated or unmutated IgVH genes. In clinical trials del 11q and del 17p almost universally occur in unmutated cases, but in untreated mutated cases we do see both of these FISH patterns in patients who do not have an aggressive disease, and indeed, may never need treatment.
Where FISH is important is in giving some idea of what is going to happen in patients who are treated. Patients who need treatment who are given either fludarabine or chlorambucil or any combination of purine analogue and alkylating agent, are not going to respond well if they have either del 11q or del 17p. Remissions are short with del 11q and almost non-existent with del 17p. If rituximab is added to the mixture then the adverse effect of del 11q seems to be removed, but it does nothing for del 17p cases.
Therefore FISH should be done before treatment since this could be determined by the FISH findings. Very few drugs work well with del 17p. High dose steroids, Alemtuzumab (Campath), flavopiridol and perhaps revilimid. A new drug in clinical trials, acadesine, also looks promising. Some people thing that ofatumumab might also be helpful, but this is not proven.
Del 11q and del 17p are almost always secondary findings and some years ago a |German study showed that almost always they developed in the unmutated cases rather than the mutated cases. All this reinforces my view that for most patients with CLL their doctors would benefit from knowing the mutational status of the disease.
When I first started working in this area, I was motivated by the fact that many people were labelled as having leukemia who would never need any treatment for it. I spent a good deal of my career trying to figure out a means of distinguishing between those who would be in this bucket and those who definitely would need treatment. Many of these problems have been cleared up by the change in definition of CLL to require a minimum of 5000/cu mm B lymphocytes for the diagnosis. Many of those who had fewer than this would have been diagnosed as stage 0 CLL under the old definition. Now they are called monoclonal B cell lymphocytosis (MBL) and no-one thinks such people should be called leukemia patients or even followed up. They comprise about 4% of the population over-40 and no-one is going to contemplate making 4% of the mature population into invalids.
There is no reason to think that such people need their prognostic markers done.
What about people who really do have CLL. Experts are still recommending that outside clinical trials that the only prognostic indicator that makes any sense is the clinical stage. In other words, if you have Rai stage 0 or Binet stage A then that should be enough; you have a long period of life ahead of you.
I disagree. We know very clearly that Binet stage A patients who have unmutated IgVH genes will live on average 8 years (range 4-12 years). With better treatment this may be prolonged some, but it contrasts with an average survival of 25 years for those with mutated IgVH genes.
If any prognostication is to be done then the experts rely on the lymphocyte doubling time. Now, there is no doubt that unlike clinical stage, this is a dynamic indicator; it tells you something about the rate of progression. But it only tells you that when the disease progresses and it is unreliable. Because the blood compartment is only one of those where CLL cells accumulate, it does not tell you that your marrow cavity is filling up, nor that the lymph nodes that you cannot feel (like retroperitoneal nodes) are enlarging. In fact even the experts won't prognosticate on lymphocyte doubling times if the absolute lymphocyte count is less than 30.
The mutational status of the IgVH genes, on the other hand is a given characteristic of the disease, available at diagnosis.
Now this doesn't mean that I advocate that everyone with CLL should go out and get their IgVH genes done. If you are 90-years old, it hardly makes sense and people have to make their own decisions on how much information they want. Remember that these survival curves only predict averages and there is no such thing as an average person. Stephen J Gould, the Biology Professor at Harvard wrote a brilliant piece entitled 'The Median is not the Message' when he was diagnosed with mesothelioma and given less than a year to live. He survived for 17 years and died of something else.
It does make sense for the doctor looking after the patient to have this information since it could influence management, but I see no compelling reason that the patient should be burdened with it unless it is going to be acted on or unless he demands it.
In my previous article "You can't handle the Truth" I explained how difficult I found it to handle information about my CT scan. Patients want to be given hope and not despair. Too much openness is sometimes harmful. It used to be the case that the patient would leave the worrying to the doctor and in Japan they still do. Perhaps that's why people live longer in Japan.
If prognostic tests are to be done, which ones are useful?
For most tests, the results are not set in stone. In fact, the only unchanging test is the mutational status of the IgVH genes. The type of CLL you start with is the one you finish with. As far as I can determine this is not necessarily true for all other markers. But the effect of IgVH mutational status can be influenced by the other markers. It seems that the ability to signal through the B-cell receptor is what sets the pace of the disease, and in mutated IgVH cases this is impaired.
Proliferation in CLL occurs in proliferation centers in the marrow and lymph nodes and it is only when the cell is dividing that further genetic damage can occur. Every time a cell visits a proliferation center it up-regulates CD38 and possibly ZAP-70 as well. Every time it divides it shortens its telomeres and lays itself open to deletions and translocations on its chromosomes. There are simple serum tests like beta-2 M and thymidine kinase that give some indication of the rapidity of cell division, but they also measure tumor bulk, so that a high level might mean a slowly growing large tumor or a quickly growing small one.
This means that the baseline test that everyone who has full blown CLL should have done - whether or not they want to know the result - is the mutational status of their IgVH genes. Mutated and unmutated CLLs behave like two separate diseases and for the doctor not to know which one the patient has is like him saying the patient has lymphoma but time will tell us which type it is.
Why is it not done for everybody?
First, it is a matter of expense. The test costs $200 to do, though commercial labs charge $1000. You can get it done and interpreted in England for $200 plus the cost of the blood draw and a courier. Set next to the cost of one course of fludarabine let alone rituximab, this is peanuts.
What other reason? Sorry can't think of one.
This isn't a foolproof test. Being unmutated does not guarantee early treatment and being mutated doesn't guarantee late treatment or no treatment. I have written before that there are some borderline cases with 97% homology who tend to include some cases that are effectively unmutated and of course, those who use the V3-21 gene behave as if they were unmutated even when they are mutated. There is also the influence of other prognostic markers. Having a high CD38 or ZAP-70 can make the disease behave more badly. However, when patients come to see me I get this test done because it gives me greater insight into the disease than any other.
We know that whatever clinical stage you are in the mutational status of IgVH genes affects your time to first treatment, length of remission and overall survival, and it has a bigger effect than which type of treatment you get. So far this applies whatever type of treatment you receive, though there may come a time when there is a cure-all that acts well whatever your mutational status is - but we're not there yet.
Should other tests be done? You can make a case for CD38, ZAP-70, and Beta-2M. The trouble with CD38 is that the cut-off between positive and negative is disputed, Should it be 7%, 20% or 30%? And what about bimodal cases? In practice I do it because it can be incorporated into the flow cytometry picture necessary for diagnosis, but I find it most useful for cases of MBL. MBL with a CD38 less than 30% will almost never transform to CLL. The other thing about CD38 is that the percentage of positive cells tends to change during the course of the disease - in at least a quarter of patients - frequently when the disease relapses after treatment.
The trouble with ZAP-70 is finding a method that everyone can agree on. The concordance with IgVH mutations was over 90% using the first two published methods, but only 76% when the method developed in Tom Kipps lab was used. That paper suggested that it was a better prognosticator than IgVH mutations, but when it was adopted by commercial labs, very strange results indeed were apparent. Not only that, the Spanish group found that ZAP-70 levels changed in about 10% of patients during the course of the disease. Nowadays most labs don't trust ZAP-70.
Beta-2M is a good test except in renal failure. It is not just a test of disease activity since it also measures bulk. However I would do this test on all my patients.
The next test we should consider is FISH. This stands for Fluorescent In-Situ Hybridization, and it is a way for looking for particular chromosomal aberrations. It is not a perfect test and for 25 years in Bournemouth we preferred to do conventional karyotyping as well, since FISH only picks up the common abnormalities (del 13q, del 11q, del 17p and trisomy 12 - though sometimes del 6q is added). Conventional karyotyping also picks up the rarer abnormalities - trisomy 18, trisomy 19 for example and the unusual translocations - t(14;18) and t(14;19).
Although there is a famous hierarchical model which ranks cases according to prognosis according to FISH findings, this is not always helpful. It is very dependent on mutational status. Del 13q as an isolated finding mainly occurs in mutated cases, and the severity of trisomy 12 depends on whether the patient has mutated or unmutated IgVH genes. In clinical trials del 11q and del 17p almost universally occur in unmutated cases, but in untreated mutated cases we do see both of these FISH patterns in patients who do not have an aggressive disease, and indeed, may never need treatment.
Where FISH is important is in giving some idea of what is going to happen in patients who are treated. Patients who need treatment who are given either fludarabine or chlorambucil or any combination of purine analogue and alkylating agent, are not going to respond well if they have either del 11q or del 17p. Remissions are short with del 11q and almost non-existent with del 17p. If rituximab is added to the mixture then the adverse effect of del 11q seems to be removed, but it does nothing for del 17p cases.
Therefore FISH should be done before treatment since this could be determined by the FISH findings. Very few drugs work well with del 17p. High dose steroids, Alemtuzumab (Campath), flavopiridol and perhaps revilimid. A new drug in clinical trials, acadesine, also looks promising. Some people thing that ofatumumab might also be helpful, but this is not proven.
Del 11q and del 17p are almost always secondary findings and some years ago a |German study showed that almost always they developed in the unmutated cases rather than the mutated cases. All this reinforces my view that for most patients with CLL their doctors would benefit from knowing the mutational status of the disease.
Aphorisms 11
If you think health care is expensive now, wait until you see
what it costs when it's free. -- P. J. O'Rourke
Americans can always be counted on to do the right thing...after they have exhausted all other possibilities. – Winston S Churchill.
A bank is a place that will lend you money if you can prove
that you don't need it. - Bob Hope
It is amazing what you can accomplish
if you do not care who gets the credit. - Harry S Truman
Middle age is when your age begins to show around your middle – Bob Hope
Sometimes I wake up grumpy; Other times I let her sleep
He who laughs last thinks slowest
To play a villain requires a good actor; to play a hero only requires a good orthodontist.
Don't forget that people will judge you by your actions, not your intentions. You may have a heart of gold - but so does a hard-boiled egg."
Why repeat past mistakes when there are so
many new ones to commit?” - Descartes
what it costs when it's free. -- P. J. O'Rourke
Americans can always be counted on to do the right thing...after they have exhausted all other possibilities. – Winston S Churchill.
A bank is a place that will lend you money if you can prove
that you don't need it. - Bob Hope
It is amazing what you can accomplish
if you do not care who gets the credit. - Harry S Truman
Middle age is when your age begins to show around your middle – Bob Hope
Sometimes I wake up grumpy; Other times I let her sleep
He who laughs last thinks slowest
To play a villain requires a good actor; to play a hero only requires a good orthodontist.
Don't forget that people will judge you by your actions, not your intentions. You may have a heart of gold - but so does a hard-boiled egg."
Why repeat past mistakes when there are so
many new ones to commit?” - Descartes
Thursday, June 10, 2010
The end times for Lost, 24 and Ashes to Ashes
Several long-running TV series have come to an end. After 6 years of nerve-tingling, cliff-hanging excitement "24" has finished its TV run though at least one movie is planned. Jack Bauer has taken his morally ambivalent torturing to a large screen.
The series has suggested that there is evil in high places and that power and compromise with evil are inescapable. In such an environment can the torture of evil men be wrong? If there were some foolproof way of defining evil that might be an argument. However, all too often the definition of evil is 'those who are opposed to us'. Probably his time had come. After the end of Bush-Cheney perhaps the question no longer needs to be asked. I would appreciate feed back on this point.
Then we have seen the end of three similar series: "Lost", "The Prisoner" and "Ashes to Ashes".
In all three there was a resemblance to the doctrine of purgatory. In "Lost" we followed the adventures of a group of people who apparently survived an air crash on a remote and untraceable island in the Pacific. The characters were all flawed, though most had attractive features at heart. We were met with improbable happenings like dead men coming back to life, polar bears in the tropics, black smoke that could be summoned by certain individuals to destroy their enemies with brute force, people who ostensibly immortal who never aged and time travel. The whole thing had an air of mystery. Again the series seemed to be about the conflict between good and evil, with the time on the island being about purging the evil from the good characters. There was even an alternative universe where people who were killed during the series met up had the issues resolved before assembling in a multi-religion 'church' acting as an ante-room to a great white light in the sky.
'The Prisoner' was an attempt to revive the Patrick McGoohan cult classic with Jim Caviezel, last seen as Jesus speaking Aramaic in "The Passion of the Christ" reprising the McGoohan role. Here the alternative universe appeared to be in dreamland and the series didn't really work.
"Ashes to Ashes" was a follow-on from "Life on Mars" which didn't work in the American version with Harvey Keitel but was awesome in the UK version. The setting was a 1980s police station run by an unreformed copper, Gene Hunt, who was sexist, racist and brutal, but who knew the difference between white hats and black hats. Beneath his hard exterior he was all strawberry cream. It turned out that was a place where cops killed in the line of duty went to sort out their 'issues' after death. Gene Hunt was the 'ferryman' sent to guide them to the bright light on the 'other side'.
What these shows demonstrate is a dissatisfaction and frustration with the injustice that is apparent in this world and with people's inability to live up to their ideals. This is precisely what the Christian message gets to the heart of.
We are all sinners and try as we might we cannot do what is right. We continually fall short and no matter how many second-chances we get we will always fall short. But God has provided a way that we can become clean. His son, Jesus, lived a perfect life and was then sacrificed on the cross to take the punishment our sins deserve. In an act of incredible grace he offered this payment for all. For those who accept this free gift there is an eternal home with God, for those who don't there is judgment to come. But he delays that judgment until all who will come do come. Why are we suffering now? Because of the patience of God in not inflicting retribution on those who given umpteen chances may yet repent.
The series has suggested that there is evil in high places and that power and compromise with evil are inescapable. In such an environment can the torture of evil men be wrong? If there were some foolproof way of defining evil that might be an argument. However, all too often the definition of evil is 'those who are opposed to us'. Probably his time had come. After the end of Bush-Cheney perhaps the question no longer needs to be asked. I would appreciate feed back on this point.
Then we have seen the end of three similar series: "Lost", "The Prisoner" and "Ashes to Ashes".
In all three there was a resemblance to the doctrine of purgatory. In "Lost" we followed the adventures of a group of people who apparently survived an air crash on a remote and untraceable island in the Pacific. The characters were all flawed, though most had attractive features at heart. We were met with improbable happenings like dead men coming back to life, polar bears in the tropics, black smoke that could be summoned by certain individuals to destroy their enemies with brute force, people who ostensibly immortal who never aged and time travel. The whole thing had an air of mystery. Again the series seemed to be about the conflict between good and evil, with the time on the island being about purging the evil from the good characters. There was even an alternative universe where people who were killed during the series met up had the issues resolved before assembling in a multi-religion 'church' acting as an ante-room to a great white light in the sky.
'The Prisoner' was an attempt to revive the Patrick McGoohan cult classic with Jim Caviezel, last seen as Jesus speaking Aramaic in "The Passion of the Christ" reprising the McGoohan role. Here the alternative universe appeared to be in dreamland and the series didn't really work.
"Ashes to Ashes" was a follow-on from "Life on Mars" which didn't work in the American version with Harvey Keitel but was awesome in the UK version. The setting was a 1980s police station run by an unreformed copper, Gene Hunt, who was sexist, racist and brutal, but who knew the difference between white hats and black hats. Beneath his hard exterior he was all strawberry cream. It turned out that was a place where cops killed in the line of duty went to sort out their 'issues' after death. Gene Hunt was the 'ferryman' sent to guide them to the bright light on the 'other side'.
What these shows demonstrate is a dissatisfaction and frustration with the injustice that is apparent in this world and with people's inability to live up to their ideals. This is precisely what the Christian message gets to the heart of.
We are all sinners and try as we might we cannot do what is right. We continually fall short and no matter how many second-chances we get we will always fall short. But God has provided a way that we can become clean. His son, Jesus, lived a perfect life and was then sacrificed on the cross to take the punishment our sins deserve. In an act of incredible grace he offered this payment for all. For those who accept this free gift there is an eternal home with God, for those who don't there is judgment to come. But he delays that judgment until all who will come do come. Why are we suffering now? Because of the patience of God in not inflicting retribution on those who given umpteen chances may yet repent.
Why we are in Afghanistan
Folloeing a suicide bombing which killed 40 people at a wedding, Taliban militants have executed a seven-year-old boy they accused of being a spy, it emerged today.
The child was abducted from his home and taken to a neighbouring village where he was put on trial.
His captors found him guilty of working for the government.
The child was then hanged in public in the village of Heratiyan, in the southern Sangin district of Helmand province.
The child was abducted from his home and taken to a neighbouring village where he was put on trial.
His captors found him guilty of working for the government.
The child was then hanged in public in the village of Heratiyan, in the southern Sangin district of Helmand province.
Wednesday, June 09, 2010
Health problems: an answer to prayer.
I have just spent a couple of days in hospital. It began on Monday night. I was woken about 2 am with colicky abdominal pain. The pain started in the middle of my tummy building rapidly to a crescendo lasting about 5 seconds before a loud gurgling sound relieved it. Five minutes later the same pattern repeated itself. So it continued through the night stopping me sleeping. It was not improved by anti-spasmodics and around 7 am I phoned my oncologist who told me to get myself into hospital.
When I arrived I was clerked and examined, blood tests were taken and I had an abdominal X-ray followed by a CT scan.
My presumptive diagnosis (and that of the oncologist) was that the cancer had returned and was causing intestinal obstruction.
The good news was the CT scan showed no obstruction and indeed no change over the past 3 months.
Today I am back home and pain free. The surgeon who did my operation was consulted and his view was that I have a narrowed ileo-cecal junction - either from the original cicatrizing lesion or secondary to scars formed after the chemotherapy. Obviously a food bolus found the gap to narrow to pass. As the small bowel propelled the bolus again and again against the narrow orifice a degree of inflammation was set up that caused the wall of the bowel to swell and the hole to get smaller.
They treated me with a large dose of steroids (dexamethasone 8mg iv) and over the course of 8 hours the gap opened and everything started passing again.
Blame has been attributed to a mushroom omelet, mushrooms often pass through the bowel undigested. Some dietary adjustment is called for, but if this recurs the surgeon tells me he will be able to by-pass the critical area. I can't say that I am looking forward to more surgery but it is another string to the bow. Most encouraging is the fact that the cancer is not spreading and if it is growing it is growing very slowly indeed. I feel that I can begin to make plans again.
A lot of people have been praying for me. We were supposed to be taking James and Wendy out to lunch yesterday, but that had to be cancelled. Instead they were praying for us. Wendy told a few strategic prayers and they also prayed. We have the decorators in and John Dawson, our painter is a keen Christian. Not only did he make our bed for us, but he began to pray as he painted.
One of the few Christian hematologists that I know is Alison Brownell, wife of the Pastor of East London Tabernacle, Ken. She had e-mailed me the previous day about something else and I had shared my situation with her, especially that I was worried that my next scan would show progression. She and Ken promised to pray for me.
Then in church on Sunday evening were David and Audrey Abernathy. David had acted as Moderator in the church during the long period when we had no pastor and I was one of the Elders. I was not intending to go to church on Sunday evening as I felt unwell, but I had a commitment to speak to the under-25 group about creation and evolution, so I had to go. I explained my situation to David and Audrey and they told me they would also pray for me.
Countless other people in the UK and around the world have been praying for me. Hardly a week has gone by recently without somebody telling me that they were praying for me. How do prayers work? I'm not claiming a miracle. I'm not suggesting that if the CT scan had been taken before the latest round of prayers it would have shown progression, but I do believe that my cancer is being kept at bay because people are praying. God is not bounded by time. Prayer is not a shopping list. But he tells us that we should pray and I am certain that because we pray good things happen, even if the benefits that we ask for must have been initiated before we prayed. Just as the blood of Jesus covers out past present and future sins, so he who know the future acts on our behalf because he knows we are going to pray.
So thank you to all those who have been praying for me and please don't stop.
When I arrived I was clerked and examined, blood tests were taken and I had an abdominal X-ray followed by a CT scan.
My presumptive diagnosis (and that of the oncologist) was that the cancer had returned and was causing intestinal obstruction.
The good news was the CT scan showed no obstruction and indeed no change over the past 3 months.
Today I am back home and pain free. The surgeon who did my operation was consulted and his view was that I have a narrowed ileo-cecal junction - either from the original cicatrizing lesion or secondary to scars formed after the chemotherapy. Obviously a food bolus found the gap to narrow to pass. As the small bowel propelled the bolus again and again against the narrow orifice a degree of inflammation was set up that caused the wall of the bowel to swell and the hole to get smaller.
They treated me with a large dose of steroids (dexamethasone 8mg iv) and over the course of 8 hours the gap opened and everything started passing again.
Blame has been attributed to a mushroom omelet, mushrooms often pass through the bowel undigested. Some dietary adjustment is called for, but if this recurs the surgeon tells me he will be able to by-pass the critical area. I can't say that I am looking forward to more surgery but it is another string to the bow. Most encouraging is the fact that the cancer is not spreading and if it is growing it is growing very slowly indeed. I feel that I can begin to make plans again.
A lot of people have been praying for me. We were supposed to be taking James and Wendy out to lunch yesterday, but that had to be cancelled. Instead they were praying for us. Wendy told a few strategic prayers and they also prayed. We have the decorators in and John Dawson, our painter is a keen Christian. Not only did he make our bed for us, but he began to pray as he painted.
One of the few Christian hematologists that I know is Alison Brownell, wife of the Pastor of East London Tabernacle, Ken. She had e-mailed me the previous day about something else and I had shared my situation with her, especially that I was worried that my next scan would show progression. She and Ken promised to pray for me.
Then in church on Sunday evening were David and Audrey Abernathy. David had acted as Moderator in the church during the long period when we had no pastor and I was one of the Elders. I was not intending to go to church on Sunday evening as I felt unwell, but I had a commitment to speak to the under-25 group about creation and evolution, so I had to go. I explained my situation to David and Audrey and they told me they would also pray for me.
Countless other people in the UK and around the world have been praying for me. Hardly a week has gone by recently without somebody telling me that they were praying for me. How do prayers work? I'm not claiming a miracle. I'm not suggesting that if the CT scan had been taken before the latest round of prayers it would have shown progression, but I do believe that my cancer is being kept at bay because people are praying. God is not bounded by time. Prayer is not a shopping list. But he tells us that we should pray and I am certain that because we pray good things happen, even if the benefits that we ask for must have been initiated before we prayed. Just as the blood of Jesus covers out past present and future sins, so he who know the future acts on our behalf because he knows we are going to pray.
So thank you to all those who have been praying for me and please don't stop.
Monday, June 07, 2010
Current affairs
I haven't said much about the oil spill. I dislike intensely the way that the big O emphasizes the British Petroleum, when the company has been called BP for more than 10 years and probably the majority of its investors are American. Any direct responsibility lies with Transocean, the American company that owned and operated the well, but which is based in Switzerland for tax purposes. Though does my memory play me tricks or didn't the big O himself buy in to offshore drilling?
The loss of life and environmental damage pales into insignificance compared to the disaster in Bhopal caused by the American company, Union Carbide. The official immediate death toll was 2,259 and the government of Madhya Pradesh has confirmed a total of 3,787 deaths related to the gas release. Others estimate that 8,000 died within the first weeks and that another 8,000 have since died from gas-related diseases. Some 25 years after the gas leak, 390 tons of toxic chemicals abandoned at the UCIL plant continue to leak and pollute the groundwater in the region and affect thousands of Bhopal residents who depend on it, though there is some dispute as to whether the chemicals still stored at the site pose any continuing health hazard. Union Carbide is now owned by Dow Chemical Company. I notice today, that some Indians (but no Americans) have been sent to prison over the incident. The parent company washed its hands of the affair for 460 million dollars, less than half what BP has spent so far to clear up the mess in the Gulf. The mess remains in Bhopal and people are still dying.
I don't want to be anti-American, but perhaps BO should consider the words: pot kettle and black before being so disparaging.
I haven't said much about the Israeli attack on the Turkish ship. Both sides are milking it for all the propaganda they can get. Difficult to know whom to believe, but the Palestinians have a track record of manipulating the media during the war in Lebanon. However, I must say that I am enjoying the Wallender series of films in Swedish. Henning Mankell, Wallender's creator, was on board the ship as a 'peace protester'.
In the UK more people were killed by the vicious gunman in Cumbria. It now appears that the immediate trigger for his madness was his being dumped by his Thai girlfriend whom he paid to bring over. The man had a criminal record and was being investigated for tax fraud. It's a wonder that he had a license to own a shotgun and a rifle.
The loss of life and environmental damage pales into insignificance compared to the disaster in Bhopal caused by the American company, Union Carbide. The official immediate death toll was 2,259 and the government of Madhya Pradesh has confirmed a total of 3,787 deaths related to the gas release. Others estimate that 8,000 died within the first weeks and that another 8,000 have since died from gas-related diseases. Some 25 years after the gas leak, 390 tons of toxic chemicals abandoned at the UCIL plant continue to leak and pollute the groundwater in the region and affect thousands of Bhopal residents who depend on it, though there is some dispute as to whether the chemicals still stored at the site pose any continuing health hazard. Union Carbide is now owned by Dow Chemical Company. I notice today, that some Indians (but no Americans) have been sent to prison over the incident. The parent company washed its hands of the affair for 460 million dollars, less than half what BP has spent so far to clear up the mess in the Gulf. The mess remains in Bhopal and people are still dying.
I don't want to be anti-American, but perhaps BO should consider the words: pot kettle and black before being so disparaging.
I haven't said much about the Israeli attack on the Turkish ship. Both sides are milking it for all the propaganda they can get. Difficult to know whom to believe, but the Palestinians have a track record of manipulating the media during the war in Lebanon. However, I must say that I am enjoying the Wallender series of films in Swedish. Henning Mankell, Wallender's creator, was on board the ship as a 'peace protester'.
In the UK more people were killed by the vicious gunman in Cumbria. It now appears that the immediate trigger for his madness was his being dumped by his Thai girlfriend whom he paid to bring over. The man had a criminal record and was being investigated for tax fraud. It's a wonder that he had a license to own a shotgun and a rifle.
Friday, June 04, 2010
The Blathereen
As an avid BBC watcher I have uncovered a sinister plot to take over the world. Has it escaped your notice that several of their reporters are morbidly obese? I give you for example Gary O'Donoghue
, whom we often see lingering in Downing Street. That's Gary in the left hand picture on the right with his partner, Sarah and daughter, Lucy.
Then there is the BBC political reporter who covers Scottish affairs, Brian Taylor
Mark Mardell who once gorged himself on Brussels sprouts is now making do with more substantial American portions. Even Huw Edwards is a possible.
Finally there is the grand old daddy of them all, John Simpson, the World Affairs correspondent.
What nobody realizes is that they are Slitheens, the monsters featured in the science fiction series, 'Dr Who', these monsters, are a family of massive, bipedal extraterrestrials of living calcium, hatched from eggs and native to the planet Raxacoricofallapatorius. Raxacoricofallapatorians are eight feet tall with long forearms and powerful claws. They do not appear to have eyelids, but have a nictitating membrane. They have a highly-developed sense of smell, able to track a single target across a few city blocks, smell adrenaline and hormones in people, and can sense if one of their own dies. Female Raxacoricofallapatorians can produce poisons within their bodies which they then use against their enemies. Known methods of delivery include a poisoned dart that is formed in the finger and then fired and exhalation of poisoned breath.
The Slitheen disguise themselves by fitting into the skins of their victims, using compression fields created by a collar worn around their necks to squeeze their huge size into a slightly smaller space. The degree of compression is limited so that they seek out obese people to inhabit. The exchange of gases that compression entails also builds up within the acquired skin, causing a condition similar to flatulence in humans (the expelled gas smells like bad breath, which the Doctor noted was a form of calcium decay).
Members of the Slitheen family have green skin, though there is variation in the skin tone of other Raxacoricofallapatorian families. In the 'Dr Who' spin-off, 'The Sarah Jane Adventures', Sarah Jane encounters a different family of Raxacoricofallapatorians, the Blathereen, who have orange skins. I suspect that BBC reporters, famous for their blather, are inhabited by Blathereen.
It does seem that Raxacoricofallapatorian technology has moved on so that they can now occupy the skins of short thin people. They still emit a lot of hot air, however, so it's anyone's guess where they have got to now.
, whom we often see lingering in Downing Street. That's Gary in the left hand picture on the right with his partner, Sarah and daughter, Lucy.
Then there is the BBC political reporter who covers Scottish affairs, Brian Taylor
Mark Mardell who once gorged himself on Brussels sprouts is now making do with more substantial American portions. Even Huw Edwards is a possible.
Finally there is the grand old daddy of them all, John Simpson, the World Affairs correspondent.
What nobody realizes is that they are Slitheens, the monsters featured in the science fiction series, 'Dr Who', these monsters, are a family of massive, bipedal extraterrestrials of living calcium, hatched from eggs and native to the planet Raxacoricofallapatorius. Raxacoricofallapatorians are eight feet tall with long forearms and powerful claws. They do not appear to have eyelids, but have a nictitating membrane. They have a highly-developed sense of smell, able to track a single target across a few city blocks, smell adrenaline and hormones in people, and can sense if one of their own dies. Female Raxacoricofallapatorians can produce poisons within their bodies which they then use against their enemies. Known methods of delivery include a poisoned dart that is formed in the finger and then fired and exhalation of poisoned breath.
The Slitheen disguise themselves by fitting into the skins of their victims, using compression fields created by a collar worn around their necks to squeeze their huge size into a slightly smaller space. The degree of compression is limited so that they seek out obese people to inhabit. The exchange of gases that compression entails also builds up within the acquired skin, causing a condition similar to flatulence in humans (the expelled gas smells like bad breath, which the Doctor noted was a form of calcium decay).
Members of the Slitheen family have green skin, though there is variation in the skin tone of other Raxacoricofallapatorian families. In the 'Dr Who' spin-off, 'The Sarah Jane Adventures', Sarah Jane encounters a different family of Raxacoricofallapatorians, the Blathereen, who have orange skins. I suspect that BBC reporters, famous for their blather, are inhabited by Blathereen.
It does seem that Raxacoricofallapatorian technology has moved on so that they can now occupy the skins of short thin people. They still emit a lot of hot air, however, so it's anyone's guess where they have got to now.
Tuesday, June 01, 2010
Age of wonder
I have been reading "The Age of Wonder" by Richard Holmes - how the Romantic generation discovered the beauty and terror of science.
It is an extended series of short biographies of major scientists operating from the end of the eighteenth century to the early part of the nineteenth. These scientists were the contemporaries and often the friends of the romantic poets, Wordsworth, Coleridge, Shelley, Keats and Southey. The scientists include Banks, the botanist/explorer, Herschel the astronomer, the French balloonists Montgolfier, Charles and Blanchard, the explorer Mungo Park, the chemist Hunphrey Davy, the engineer Charles Babbage and the physicist Michael Faraday.
William Herschel was a musician from Hanover who emigrated to England in the wake of the Elector of Hanover who became King George the First. It was George the Third who befriended and funded him. Using a reflector telescope that admitted far more light the conventional refractor, Herschel meticulously scanned the night sky and discovered the planet Uranus. Although this brought him fame, more important was his discovery that the Universe was far larger than anyone had suspected and that light had apparently been coming from the farthest stars for millions of years.
This discovery upset the clergy who had determined that the world was created one afternoon in September in 4004 BC.
Actually, I think too many assumptions are made to set so precise a date on the creation, but one thing the Bible is clear on is that the world had a beginning and that it was created 'up-and-running'.
Thus Adam was not created as a baby, but as a fully grown man and Eve as a fully grown woman. The stars were visible at creation, they did not have to wait for millennia for the light from those stars to reach planet earth. The photons streaming from the stars were part of the Biblical creation.
This argument was put forward in the nineteenth century by Philip Gosse, whose memory has been traduced by his rebellious and unbelieving son, the critic Edmunde. Philip Henry Gosse (April 6, 1810 – August 23, 1888) was an English naturalist and popularizer of natural science, virtually the inventor of the seawater aquarium, and a painstaking innovator in the study of marine biology. Without a University position and without wealth or noble background, he was unusually made an FRS. He was also a leading light in the Plymouth Brethren and his evangelical beliefs led him to publish a book 'Omphalos' which stated that the only way of reconciling the immense age of the earth, implied by astronomy and geology, was to postulate that the earth as created had an implied history that in real life had never happened. Thus, Adam though never born in a conventional way (and therefore in no need of a navel - omphalos) did indeed have an umbilicus, implying that he had been born with an umbilical cord.
He was attacked for this 'outrageous' view. His friend, Charles Kingsley (The Water Babies), exclaimed that God would surely not deceive us in this way.
Yet since God has quite precisely had it written down how, exactly, he created the world, no deception is involved. It is merely a matter of believing what God has said rather than what man conjectures. Is it to be believed that had Adam taken an axe to the Tree of Knowledge of Good and Evil in the Garden of Eden, that it would have had no tree rings?
Scientists have scoffed at Gosse but they can only do so for prejudiced reasons. However, Martin Gardner, in Facts & Fallacies (1957), agrees that Gosse "presented a theory so logically perfect, and so in accordance with geological facts that no amount of scientific evidence will ever be able to refute it."
Gosse's thesis is not, of course, "scientific." While it may be true, it is not testable, nor does it suggest future research projects. It is a dead end. Gosse recognized this. Nevertheless, he urged his fellow scientists to continue as if unreal history were real and to construct their theories independent of his thesis.
It is an extended series of short biographies of major scientists operating from the end of the eighteenth century to the early part of the nineteenth. These scientists were the contemporaries and often the friends of the romantic poets, Wordsworth, Coleridge, Shelley, Keats and Southey. The scientists include Banks, the botanist/explorer, Herschel the astronomer, the French balloonists Montgolfier, Charles and Blanchard, the explorer Mungo Park, the chemist Hunphrey Davy, the engineer Charles Babbage and the physicist Michael Faraday.
William Herschel was a musician from Hanover who emigrated to England in the wake of the Elector of Hanover who became King George the First. It was George the Third who befriended and funded him. Using a reflector telescope that admitted far more light the conventional refractor, Herschel meticulously scanned the night sky and discovered the planet Uranus. Although this brought him fame, more important was his discovery that the Universe was far larger than anyone had suspected and that light had apparently been coming from the farthest stars for millions of years.
This discovery upset the clergy who had determined that the world was created one afternoon in September in 4004 BC.
Actually, I think too many assumptions are made to set so precise a date on the creation, but one thing the Bible is clear on is that the world had a beginning and that it was created 'up-and-running'.
Thus Adam was not created as a baby, but as a fully grown man and Eve as a fully grown woman. The stars were visible at creation, they did not have to wait for millennia for the light from those stars to reach planet earth. The photons streaming from the stars were part of the Biblical creation.
This argument was put forward in the nineteenth century by Philip Gosse, whose memory has been traduced by his rebellious and unbelieving son, the critic Edmunde. Philip Henry Gosse (April 6, 1810 – August 23, 1888) was an English naturalist and popularizer of natural science, virtually the inventor of the seawater aquarium, and a painstaking innovator in the study of marine biology. Without a University position and without wealth or noble background, he was unusually made an FRS. He was also a leading light in the Plymouth Brethren and his evangelical beliefs led him to publish a book 'Omphalos' which stated that the only way of reconciling the immense age of the earth, implied by astronomy and geology, was to postulate that the earth as created had an implied history that in real life had never happened. Thus, Adam though never born in a conventional way (and therefore in no need of a navel - omphalos) did indeed have an umbilicus, implying that he had been born with an umbilical cord.
He was attacked for this 'outrageous' view. His friend, Charles Kingsley (The Water Babies), exclaimed that God would surely not deceive us in this way.
Yet since God has quite precisely had it written down how, exactly, he created the world, no deception is involved. It is merely a matter of believing what God has said rather than what man conjectures. Is it to be believed that had Adam taken an axe to the Tree of Knowledge of Good and Evil in the Garden of Eden, that it would have had no tree rings?
Scientists have scoffed at Gosse but they can only do so for prejudiced reasons. However, Martin Gardner, in Facts & Fallacies (1957), agrees that Gosse "presented a theory so logically perfect, and so in accordance with geological facts that no amount of scientific evidence will ever be able to refute it."
Gosse's thesis is not, of course, "scientific." While it may be true, it is not testable, nor does it suggest future research projects. It is a dead end. Gosse recognized this. Nevertheless, he urged his fellow scientists to continue as if unreal history were real and to construct their theories independent of his thesis.