There is nothing either good or bad but thinking makes it so.

If I’m brutally honest with myself, I suspect I side with Goldilocks in her preference for the just-right-baby-bear stance: not too hard, not too soft. I have always been more comfortable in the middle of the Bell Curve with lots of wiggle room on either side; I’m not really cut out to be an extremist. And I was always taught to be sensible and use things wisely: buy good quality and look after whatever I bought so it would last. But times change, I guess, and as the price of goods declined with improved production, and fashion began to favour frequent change, the temptation to buy and replace increased.

Still, making-do was what my parents did, although perhaps it was easier in the days when planned obsolescence was just an economic dream. Unfortunately, now I replace things more often than I reuse them -and more often than I really need to, as well. As the months slip past and the years pile up one upon another on the shelf, I fear I have also become a creature of things. A collector of more than just Time.

And yet I have always harboured a suspicion that new is not necessarily better, nor is more always preferable to less. I would probably make a rather poor salesman, with the menace of the sharp needle of conscience only millimetres away -although I have to confess to feeling the thrill of buying a new and different watch each time the 5 year battery runs out. I justify it by assuming I’m assuring that someone will have a job -and anyway, I’m keeping the economy afloat… Aren’t I?

Dichotomies like these make it difficult to choose sides, though, don’t they? Sometimes it helps to step back far enough to see both sides of the street, and an essay by the author Nick Thorpe in Aeon put things in a rather intriguing perspective for me: https://aeon.co/essays/we-should-love-material-things-more-than-we-do-now-not-less

‘We’ve got used to the transitory nature of our possessions, the way things are routinely swept aside and replaced,’ he writes. ‘It’s one of the challenges facing the UK Department of Energy and Climate Change, whose chief scientific adviser, Professor David MacKay, in January bemoaned ‘the way in which economic activity and growth currently is coupled to buying lots of stuff and then throwing it away’… According to data aggregated by the Global Footprint Network, it takes the biosphere a year to produce what humanity habitually consumes in roughly eight months.’

One could try to avoid consumer goods altogether of course, and yet things do wear out. Things do break. And some things become sufficiently outmoded that they no longer function in the rapidly evolving technosphere. So I suppose we have to persevere ‘with what the British psychologist Michael Eysenck calls the ‘hedonic treadmill’, holding out the unlikely hope that the spike of satisfaction from our next purchase will somehow prove less transitory than the last.’ But as Thorpe observes, ‘If Western consumer culture sometimes resembles a bulimic binge in which we taste and then spew back things that never quite nourish us, the ascetic, anorexic alternative of rejecting materialism altogether will leave us equally starved.’

The answer, as Goldilocks knew all along, lies in compromise. It’s not that we value things too much, but rather that we don’t value them enough. ‘The challenge is to cherish our possessions enough to care about where they came from, who made them, what will happen to them in the future.’

We seem to be innate categorizers, more addicted to the hierarchies of price than cognizant of intrinsic value. And yet, with only a slight shift in perspective, wouldn’t it be valuable to ‘retain the pulse of their making’ as the British ceramicist Edmund de Waal put it? Much as a gift wears a different aura, and adds a different value to the object than is merely contained in its function, consideration of its history and its craft may well do the same.

In the modern world we are too far from the source to marvel at the genius of its production. I am reminded of one of the novels of Mark Twain –A Connecticut Yankee in King Arthur’s Court– in which an American engineer from Connecticut sustains a head injury and awakens in the medieval English court of the mythical King Arthur. It hadn’t developed the processes and gadgets we take for granted nowadays, so it fell to the engineer to develop them from scratch.

I tried to imagine making a working bicycle and the need to fashion it from whatever raw materials were at hand. And had I succeeded -which would have been well beyond my skill- I certainly would have viewed it in a different light than nowadays. The same had I built a clock, or fashioned reading glasses, or even devised a flashlight… My midden would not have required weekly removal.

Still, it’s not just keeping everything you’ve ever bought -that would be hoarding- but in valuing the item enough to repair it and continue using it: Repair, Reuse, then Recycle. Thorpe writes about a growing trend (at least in his part of the UK) of repair shops, and about an absolutely delightfully named social enterprise ‘‘Remade in Edinburgh’ [which] is one of a growing network of community repair shops dedicated to teaching ordinary people to mend and reuse household goods.’

Of course, the ability to avail oneself of this sort of thing is dependent on the initial quality of the item, as well as the opportunity to avoid the planned obsolescence of a technology wrapped in its own hubris. It also requires role models that we can all admire and emulate -people -and things- of proven worth.

Much as we tend to look up to sports heroes, say, or famous scientists, perhaps we need look no further than ourselves, and our biology’s long evolutionary history of successful strategies to reuse what we already have. Sometimes there is no need to develop new genes, or even new organs, to increase our success: existing equipment can be repurposed. Exaptation is the word that the palaeontologist and evolutionary biologist Stephen Jay Gould and his colleague Elisabeth Vrba proposed in 1982 to describe a new function for which an organ, say, was not originally intended. An example might be that of feathers on dinosaurs -in that instance, they may have been helpful for warmth, but were obviously not originally intended for flight as in their later descendants, birds. Or another example, drawn from my own specialty (Obstetrics), but drawn to my attention in an essay in Livescience by Wynne Parry: ‘All vertebrates have sutures between the bones of their skulls to allow for growth, but in young mammals these sutures have acquired an additional use easing birth by allowing the skull to compress as it passes through the birth canal.’

Inventions are seldom wasted in nature; why should we think our own artifacts need be an exception? There are so many obvious precedents that should encourage it -maybe would encourage it- if they were more widely known.

Okay, I’ll admit it’s quite a stretch, and perhaps unduly naïve to think that it would have much of an effect on the average person. But sometimes I think it’s important for us to believe that we have permission to rethink our obsession with novelty, and to realize that we are here today largely because of repurposing. Reusing. And then, ultimately, being ourselves recycled so we can all begin anew…

The best laid schemes o’ Mice an’ Men Gang aft agley

Two steps forward and one step back –isn’t that  always the way with progress? Reward coupled with unintended consequences? The Industrial Revolution with worker exploitation? Nuclear power with the Bomb. Nothing, it seems, comes without a price. Even religion, the great leveller, once established brooks no rivals. Life itself, is a succession of survivors outcompeting the other contenders.

But simply to focus on the successes is to miss the important lessons to be learned from the failures. In biology the difference between winning and losing might hinge on a single change in a single gene, or more instructively, on an adaptation of an existing organ for another, more useful function in a different environment –an exaptation. Arms and hands for wings, in the case of bats, or for fins, in the cases of aquatic mammals like whales and dolphins.

In the early days after the discovery of X-rays, their ability to see through things was thought to be miraculous, and many possible uses were suggested. It was not until much later, after countless reports of cancers, burns, hair loss and worse, that the dangers of its careless use were acknowledged. Then, Phoenix-like, from the ashes of its many unwanted side-effects, grew carefully investigated treatments like irradiation for tumours, CT scans for internal visualizations, or fluoroscopy for placement of medical kit like stents, anti-embolism balloons, etc.

Unfortunately, even nowadays, the sundry complications of progress are often inadequately predicted in advance, probably because most things are multifaceted and changing one parameter has a knock-on effect on the others. Clearing forests for agriculture changes the animals that can survive in the changed ecosystem; monoculture to maximize demand for a particular variety of crop, say, increases the likelihood that the plants –previously diverse- may not be able to withstand the onslaught of a disease or infestation that would otherwise have only affected a small portion of their number. Evolution would normally have winnowed out the susceptibles, leaving only the resistant plants to reproduce. But all of this is Grade 9 biology, isn’t it?

What led me to think about this was an article in the Smithsonian Magazine discussing the effects of making friction matches on the women and children involved in their manufacture: https://www.smithsonianmag.com/smart-news/friction-matches-were-boon-those-lighting-firesnot-so-much-matchmakers-180967318/ – 6ZQ6WshMH2Ghpoys.03

‘Like many other poorly paid and tedious factory jobs in the nineteenth and twentieth centuries, match makers were predominantly women and children, writes Killgrove [in an article for Mental Floss]. “Half the employees in this industry were kids who hadn’t even reached their teens. While working long hours indoors in a cramped, dark factory put these children at risk of contracting tuberculosis and getting rickets, matchstick making held a specific risk: phossy jaw.” This gruesome and debilitating condition was caused by inhaling white phosphorus fumes during those long hours at the factory. “Approximately 11 percent of those exposed to phosphorus fumes developed ‘phossy jaw’ about five years after initial exposure, on average”. The condition causes the bone in the jaw to die and teeth to decay, resulting in extreme suffering and sometimes the loss of the jaw. Although phossy jaw was far from the only side-effect of prolonged white phosphorus exposure, it became a visible symbol of the suffering caused by industrial chemicals in match plants.’
So much so, that by 1892, newspapers were investigating the problem. ‘“Historical records often compare sufferers of phossy jaw to people with leprosy because of their obvious physical disfigurement and the condition’s social stigma,” Killgrove writes. Eventually match makers stopped using white phosphorus in matches, and it was outlawed in the United States in 1910.’

Civilization is the steady accumulation of successes over failures. Trials and errors –mistakes which perhaps seem to have been largely anticipatable in retrospect- summate to useable compromises. It’s how a child learns; it’s how evolution learns.

But the point of this essay is not so much to highlight the exploitation of workers in the past as to suggest that there can be sociological as well as biological evolution. After all, the etymological root of the word is the Latin evolvere –to unfold.

Occupational Safety and Health -as a distinct discipline, at least- is a relatively recent development stemming from labour movements and their concern about worker safety in the wake of the Industrial Revolution. As Wikipedia explains it: ‘The Industrial Revolution was the transition to new manufacturing processes in the period from about 1760 to sometime between 1820 and 1840. This transition included going from hand production methods to machines, new chemical manufacturing and iron production processes, the increasing use of steam power, the development of machine tools and the rise of the factory system.’

Although this provided jobs and undoubtedly improved many aspects of living standards, the driving force was production, and in its early stages, had little regard for worker safety or health. Enter the labour movements in the early 19th century, along with great resistance to their demands. In many instances they were seen as antithetical to progress –antithetical to Capitalism, for that matter. And yet, in the fullness of time, the benefits of a healthy workforce to economic success evolved from an initial, grudging pretense of acceptance in some countries to a legal framework of protection in others.

There is certainly a long way to go along this path to be sure, and exploitation still seems a default that is all too easy to overlook. Especially since it is the poor and vulnerable who are usually the victims –people with little voice of their own, and even less power to resist.

But are things actually changing? Does knowledge of exploitation make a difference? We know slavery is still practiced; we know that refugees are still being brutalized and abused in places like Libya; women are still being kidnapped and sold into prostitution despite the best intentions of agencies like the World Health Organization.

So, do the gains experienced in some areas, offset the tragedies in others? We cannot appreciate the broad sweep of History in the few years we are allotted, and evolution –even social evolution- can be deceptive and disheartening. But remember the words of Khalil Gibran:

You are good when you walk to your goal firmly and with bold steps.
Yet you are not evil when you go thither limping.
Even those who limp go not backward.

I have to hope he saw something that I missed along the way…

Pleasing Her: sexual evolution?

I came across an interesting article in the magazine Science a while back. I am always intrigued when a paper tries to place an issue in its ontological context, although I have to confess that the title had something to do with catching my eye. It was a scientific theory from seemingly reputable sources about the evolutionary significance of the female orgasm. http://www.sciencemag.org/news/2016/08/new-theory-suggests-female-orgasms-are-evolutionary-leftover  The article to which it refers is more detailed and helpful, but somewhat difficult to read; to get a more comprehensive description of the process however, I will include it here for reference: http://onlinelibrary.wiley.com/doi/10.1002/jez.b.22690/full

Orgasm is a topic that seldom surfaced through all the years of my gynaecologic practice; it was something that many women felt too embarrassed to mention –especially to a male doctor. It was also a subject that I felt ill-prepared to tackle –apart from standard psychological advice of dubious merit, the only benefit seemed to be that of a sympathetic, nonjudgmental hearing. Little was known about either the function or the physiology of orgasm, so advice about its production was more anecdotal than beneficial; it was therefore usually the purview of sexual dysfunction clinics rather than that of the general gynaecologist.

The only thing that seemed on a firm basis with regards to orgasm was that it was essential in males for sperm transfer. Clitoral stimulation is usually required for the production of female orgasm, and since the penis and clitoris share a homologous origin perhaps it was simply a fortuitous consequence of this –a secondary adaptation (exaptation) for the purposes of bonding, or the like.

But to place female orgasm on a more secure footing, the authors have looked at reproduction in other animals. ‘The essential condition for the success of internal fertilization is the timely maturation and release of the oocytes from the ovary into the female reproductive tract, that is, ovulation, for the egg to be accessible to sperm. These events need to be coordinated with the availability of males and favourable environmental conditions for raising the young.’ And for such, there are roughly three factors that might influence induction of ovulation in mammals: environmental –cues that suggest it would be a favourable time for successful rearing of offspring such as weather, food sources, etc.; copulation induction –only produce valuable eggs when they’re needed –i.e. when a mate is available; and spontaneous ovulation –no matter the availability of mate or suitable environment. Humans, it would seem, utilize the latter option –spontaneous ovulation.

In copulation-induced ovulation, a surge of two hormones in the female are required –prolactin, and to a lesser extent oxytocin. Interestingly, these are also produced during human female orgasm, although with spontaneous ovulation in humans, they are not specifically required. As the authors suggest: ‘The orgasm in women does not obviously contribute to the reproductive success, and surprisingly unreliably accompanies heterosexual intercourse. Two types of explanations have been proposed: one insisting on extant adaptive roles in reproduction, another explaining female orgasm as a byproduct of selection on male orgasm, which is crucial for sperm transfer.’ In other words, ‘Human female orgasm is associated with an endocrine surge similar to the copulatory surges in species with induced ovulation. We suggest that the homolog of human orgasm is the reflex that, ancestrally, induced ovulation. This reflex became superfluous with the evolution of spontaneous ovulation, potentially freeing female orgasm for other roles.’

There is another aspect of the study that fascinated me –something that had not registered despite my years as a gynaecologist: ‘With the evolution of spontaneous ovulation, clitoral stimulation lost its role in ensuring fertilization simultaneously with the removal of clitoris from the copulatory canal, likely causing a variable association between copulation and orgasms for the female.’

Think about it. Why would the homologue of something important for ovulation in some species, and so important for orgasm in ours have moved away from the action? The clitoris is now located quite a distance from the vagina and is only inadvertently stimulated with human heterosexual intercourse. I think the Science article expressed it well: ‘Humans and other primates don’t need intercourse to trigger ovulation—they evolved to a point where it happens on its own—but the hormonal changes accompanying intercourse persist and fuel the orgasms that make sex more enjoyable, the biologists hypothesize. And because those hormonal surges no longer confer a biological advantage, orgasms during intercourse may be lost in some women. This explanation “takes away a lot of stigma” of underwhelming sexual relations, says one of the authors, Mihaela Pavlićev, of Cincinnati Children’s Hospital in Ohio.’

And also: ‘Pavlićev and Wagner’s theory helps explain why female orgasms during intercourse are relatively rare. “It is new to use [this] innovative, Darwinian approach to understand one of the mysteries of human sexuality—why the male orgasm is warranted, easy-to-reach, and strictly related to reproduction and the female counterpart [is] absolutely not,” says Emmanuele Jannini, an endocrinologist at University of Rome Tor Vergata. The nonnecessity of orgasms for reproduction may also explain why women’s reproductive tracts vary a lot more than men’s—there are fewer constraints, he adds.’

I have to admit that this was all terra incognita to me. And a clarification and reassurance for those few women who confided concerns about their difficulties or even inability to achieve orgasm with heterosexual intercourse seemed impossible if it was supposed to be part of the process. Surely they weren’t all psychologically liable… So-called foreplay was clearly important –if only to stimulate both the clitoris as well as interest in the procedure- but was there something wrong with them if he couldn’t be persuaded?

Satisfactory sexual experience is clearly important and helps to provide the glue that bonds a relationship. But does the changed anatomy tell us anything? Might we be permitted a secular Darwinian postulate that pleasure may, after all, be divorced from the procreative imperative? A sort of anatomical excuse? Much can be done to wrap this in a more attractive package -the counselling of both partners as well as suggestions on technique- but at least from an evolutionary perspective that seeks to propagate our species, we’re doing just fine. Maybe too fine, in fact…