Majikthise

'Ordinary' Influenza: A Public Health Failure

This post by ScienceBlogling revere about the horrendous human cost of influenza is getting some serious exposure.  This gives me an excuse to mention something I haven't in a long time:

Stop worrying about avian influenza.  Get serious about 'ordinary' influenza.

Why?  Last year, 'ordinary' influenza killed roughly 36,000 U.S. residents.  That's about equal to breast cancer which kills 40,000 annually.  Before the polio vaccine, the polio virus killed 3,000 people annually, and, even if you adjust for population increases, that number would be roughly 9,000 in today's terms. HIV/AIDS kills about 18,000 U.S. residents annually. That means, in the U.S., for every person who died from AIDS, two people died from influenza. With AIDS and breast cancer, people run, walk, jump, skip, and pogo stick for The Cure. Lots of bleeping ribbons. But influenza is a silent killer.

And most of those deaths could be prevented.

I've described elsewhere how a sane vaccination strategy could lower influenza deaths by eighty percent--that's over 28,000 lives.  And we don't need to piously invoke Hope for a Cure.  We just have to vaccinate more people--and the right ones.  It's that simple.

Could you even imagine the kind of pandimensional shitstorm that would ensue if we could reduce AIDS or breast cancer by eighty percent, and we didn't, simply because we couldn't get it together?

For a long time, I was willing to support the concern about avian influenza because I figured that the steps needed to prepare for avian influenza could be 'repurposed' for ordinary influenza. All of the things we'll need to stop a pandemic are the same things we can use every year to treat the annual influenza outbreak: the ability to rapidly produce hundreds of millions of doses of vaccine, a serious distribution system (actually, having a system would be helpful), and educating people about proper public hygiene.

None of that has happened. We don't produce enough vaccine to adequately vaccinate the U.S. population against the annual epidemic (we would need roughly 200 million doses), and that's a reflection of our 'surge' capability, so good luck if an avian pandemic happens.

But what's truly scandalous is our vaccination strategy--or lack thereof. Let's leave aside the fact that people actually have to pay money to receive a vaccine against a disease that kills 36,000 people annually.

Actually, rattle that last sentence around in your noggin.  For that not to be utterly insane, you have to have Ayn Rand's Atlas Shrugged shoved so far up your ass that it's sticking out of your mouth.

And the people who are vaccinated are the wrong people. Yes, elderly people should receive the influenza vaccine because it reduces their likelihood of death by about thirty percent. The focus on the elderly, however, ignores a basic, albeit Yogi Berra-esque, rule of viral transmission: the best way to avoid getting influenza is to not come in contact with people who have it. In other words, we have to vaccinate those who spread the disease: medical workers, nursing home patients and staff, and children aged 5-18. Studies indicate that vaccinating seventy percent of children aged 5-18 could reduce influenza deaths by up to eighty percent.  In other words, the grandchildren are killing their grandparents.

All that requires is enough vaccine and a system to get it to the people who need to take it (for children, it's called schools).  Since we can't even do this right, even though we know that we will have an ordinary influenza 'epidemic' every year, I don't think we stand a chance against a real pandemic. 

The reason we haven't implemented these simple steps, I think, is because we've been far too focused on avian influenza. Quite simply, people don't really care about avian influenza. They're too focused on trying to get by, not losing their jobs, and, to use El Jefe Maximo's phrase, "putting food on their family." Worrying about something that might happen isn't even on their radar screens in any serious sense*.

We need to stop focusing on a possible pandemic, and start focusing on the annual epidemic. Because right now, we're not prepared for either.

*Of course, if you ask people, they'll state they're worried, but not enough to do anything about it, which is what matters.

Crossposted at Mike the Mad Biologist

Loaded with bear

Calories are a measure of heat. A small calorie is the amount of heat it takes to raise a gram of water from 3.5 degrees centigrade to 4.5 degrees centigrade. A large Calorie (capital C, also called a kilocalorie) is the amount of heat it takes to raise a kilogram of water (2.2 lbs) from 3.5^o C. to 4.5^o C. (OK, technically these are 4^o calories, so don't write me to complain). The "Calories" we read about in nutrition are large calories. The prototypical male weighs 70 kg. So 70 Calories of heat energy released from food is enough to heat him up one degree centigrade. That's enough to be called a "fever." This seems like a lot of heat, especially as most people eat around 2500 Calories a day. Since there is usually a substantial heat difference between us and the environment and we also lose heat by evaporating water (sensible and insensible water loss), we manage to get rid of the excess we need to keep our bodies at 37^o C. (body temperature in centigrade). More on this at the old site here. This post is about the surprisingly large amount of energy in a small amount of sugar. In particular, the energy in one little gummi bear.

The energy in a gummi bear is mainly locked up in table sugar (sucrose). Sucrose is a carbohydrate (a disaccharide, meaning it is made up of two subunits of smaller sugars, glucose and fructose). Each of these is itself a structure made of carbon, hydrogen and oxygen atoms connected in a particular pattern. If you think of the atoms as analogous to bricks and think of a building as made up of these bricks, you will understand two things. One, it takes energy to assemble the bricks into a building. That's the job of the construction trades. The other is that if the building comes tumbling down it releases a lot of energy in the process. Sometimes you have to put in some work to get the building to fall down but when you do it releases more energy than you put into it. That's what's happening with the sucrose in the gummi bear. There is a lot of energy locked up in the structure that gets released when we let it come apart. It comes apart by combining with oxygen and disintegrating.

You can see the remarkable amount of energy in the small amount of sucrose in a single gummi bear by a demonstration. The video below has made the rounds on the internet so you may have seen it before, but there was no explanation for most of the postings. In the demo a gummi bear is dropped into a test tube that has melted potassium chlorate in it. Potassium chlorate is one atom of potassium, one of chlorine and three atoms of oxygen. In other words, it is oxygen rich and is frequently used in highschool chemistry laboratories to generate oxygen gas. One way to do it is just to heat the potassium chlorate, which is a white powder, in a test tube until it melts.

The gummi bear is mainly sucrose (what did you think it was made out of? bear meat?). When it comes in contact with the oxygen in the test tube some of the sucrose disintegrates and this releases heat energy. The released heat causes the potassium chlorate to release more oxygen and a positive feedback loop develops.

Here's the result.

Cross-posted by Revere at Effect Measure

Freethinker Sunday Sermonette: God turns dog into mathematician

Suppose you had a dog and, mirabile dictu, you found he was able to do mathematics? What would you thnk?

Stan Tuten held up a board and scribbled down a basic algebra problem:

If a=2, and b=3, what is axb-1?

Micah, a terrier mix with penetrating eyes like black molasses, glanced at the board.

"Micah?" said Dr. Cindy Tuten, a physician and Stan Tuten's wife. "Do you understand the problem?"

She held one hand high in the air with a bowl of cut tomatoes and cooked chicken (the dog's reward) and the other out for the dog's answer. Micah tapped his paw once.

"Once means 'yes' and twice means 'no' " she said. "So he's telling us he understands the problem. Micah, what is the solution to the problem?"

The dog stared at the food, then tapped Tuten's palm five times.

"Very good, Micah," she said and fed him a treat.

Her husband decided to ask their 4-year-old dog another question, the square root of 25. Micah tapped his paw five times.

To prove this wasn't a fluke, the couple and a friend tossed out more math than teachers during exam time. Micah consistently pawed the correct answers, appearing to solve such problems as square root division, finding the numerators and denominators of fractions, multiplying and dividing, even basic algebra.

"He can calculate problems given in English, Spanish, French and German," Cindy Tuten said. One member of the small audience gathered in the Tuten's living room wondered if maybe she was unknowingly giving the dog signals or secret messages. The visitor, who'd never before seen Micah, threw out a question.

"Nueve menos tres?"

Micah stood still for a moment, and then tapped his paw six times for the correct answer.

"We were speechless," Cindy Tuten said. "We were also skeptical."(Citizen-Times, Asheville, NC)

Yes. The Tuten's are skeptics, all right. Very hardcore:

Deeply connected by their faith and Christian beliefs, the Tutens began to pray.

"How many persons are in the God head?" Cindy Tuten asked.

Micah tapped three times.

"How many God's are there?" The dog tapped once.

Wow. The dog even got these tough questions right. Algebra is one thing. But knowing how many persons are in the God head? I don't even know what the God head is (I'll look it up in wikipedia when I get through posting this. No need to write in).

But back to my original question. What would you think if you had a dog that could do math? This?

It is the belief of this family, that beyond math and games, Micah was put on this Earth to teach people Jesus is coming soon, the Tutens said.

Both professionals, they knew coming forward with this story would be dicey.

"I believe the Bible is true and it tells us how God used ravens to feed Elijah, a whale to save Jonah and a donkey to speak to Balaam," Stan Tuten said. "Now that I see how God is using Micah, I'm all the more convinced he can use any creature to accomplish his purpose."

Me too. And why would God use a dog for this?

What's the matter? Aren't you dyslexic?

Cross-posted by Revere at Effect Measure

One man's hands

One man's hands, can't tear a prison down,
Two men's hands, can't tear a prison down,
But when two and two and fifty make a million,
We will see, that day come 'round,
We will see that day come 'round. (Pete Seeger)

When Lindsay's dad, Dr. Barry Beyerstein, died suddenly this week at the age of 60 he was exactly the same age as my own father at his sudden death. I still remember my bewilderment and disorientation, although it was 50 years ago. I was 15. There's nothing to say except I hope that great pain killer of grief, "tincture of time," works speedily.

I didn't know Lindsay's dad personally although I knew he was a shining figure in Lindsay's life, that he was important in the struggle to bring some rationality to drug policy and that he was widely admired. Even my casual knowledge was more than enough to understand why he was so admired. It's not surprising his loss is felt keenly in many places. This post is about one of his causes.

According to the International Centre for Prison Studies at King's College London, the U.S. currently has the largest documented prison population in the world, both in absolute and proportional terms. We've got roughly 2.03 million people behind bars, or 701 per 100,000 population. China has the second-largest number of prisoners (1.51 million, for a rate of 117 per 100,000), and Russia has the second-highest rate (606 per 100,000, for a total of 865,000). Russia had the highest rate for years, but has released hundreds of thousands of prisoners since 1998; meanwhile the U.S. prison population has grown by even more. Rounding out the top ten, with rates from 554 to 437, are Belarus, Bermuda (UK), Kazakhstan, the Virgin Islands (U.S.), the Cayman Islands (UK), Turkmenistan, Belize, and Suriname, which you'll have to agree puts America in interesting company. South Africa, a longtime star performer on the list, has dropped to 15th place (402) since the dismantling of apartheid. (Cecil Adams, The Straight Dope)

The great lock-up is fairly recent, starting, as far as I can tell, in the Reagan years. One of the reasons is an irrational and class-based drug policy:

A major reason for the dramatic increase in the U.S. prison population and associated increases in the number of Blacks, Hispanics and women, has been substantial increases in the numbers of persons sentenced to prison for drug crimes.  Back in 1980 the number of prisoners convicted for a drug offense was only 19,000 or about 6 percent of the state prison population which numbered less than 300,000.  By 1998 the numbers had increased by 237,000, or 21 percent of the state prison population.   Furthermore, the average sentence for drug offenses had increased from 13 months in 1985 to 30 months by 1994.  Many of these offenders are simple drug users who have no record of violence and who pose little danger to public safety. (Policy paper, National Policy Committee, American Society of Criminology)

Lindsay has a special interest in the workings of legal drug pushers, Big Pharma, so I thought this clip was appropriate, given the context:

One man's hands. Barry Beyerstein helped that day come 'round. Meanwhile, the fight goes on.

Beast of Barclay's Bank

Many years ago a strange organism appeared outside a branch of Barclays Bank north of London. The first member of the public to encounter it in the wild was an actor from a TV series. We know how old it is from documentary evidence, but if we didn't we could still carbon date it. Carbon dating uses a weakly radioactive isotope of carbon, carbon-14. If we know the proportion of C-14 in the organism when it was born, we could use the known rate of decay of C-14 to determine the organism's age.

The organism in question apparently had a strong survival advantage and has since proliferated to an unimagined degree. It has now colonized every continent and in some areas can be found almost everywhere, especially densely populated urban areas. It is usually known by an acronym, ATM, but its full name (non-Linneaen) is Automated Teller Machine. It has evolved considerably since its first appearance on earth and now carbon dating is no longer possible. Since ATM's are made out of inanimate materials, you may wonder how it was ever possible. To explain that we have to go back to its birth, 40 years ago. The ATM's father was inventor John Shepherd-Barron, now 82 years old. Like Archimedes, his eureka moment occurred in the bath:

"It struck me there must be a way I could get my own money, anywhere in the world or the UK. I hit upon the idea of a chocolate bar dispenser, but replacing chocolate with cash."

Barclays was convinced immediately. Over a pink gin, the then chief executive signed a hurried contract with Mr Shepherd-Barron, who at the time worked for the printing firm De La Rue.

Plastic cards had not been invented, so Mr Shepherd-Barron's machine used cheques that were impregnated with carbon 14, a mildly radioactive substance.

The machine detected it, then matched the cheque against a PIN number. (BBC)

C-14 emits very weak beta particles, so Shepherd-Barron wasn't concerned about the radiation exposure. It wasn't the only thing that wasn't very powerful. The machine only dispensed £10 at a time. Of course £10 went a bit further then. One consequence of the ATM that went beyond the cash availability is very much with us today: the PIN number.

Mr Shepherd-Barron came up with the idea when he realised that he could remember his six-figure army number. But he decided to check that with his wife, Caroline.

"Over the kitchen table, she said she could only remember four figures, so because of her, four figures became the world standard," he laughs.

Of course now we have much longer PINs and my security codes are so complex -- ten digits, upper case and lower case and at least one number and one special character -- the only way I can remember them is to write them on the blackboard in my office.

That's the price of good security, I guess.

Cross-posted at Effect Measure

Time for Plan B

Guest post by Revere

In December 2003 a Food and Drug Administration advisory panel voted 23-4 to urge that Barr Pharmaceuticals Inc.'s Plan B contraceptive (the "morning after pill") be made available without prescription (over the counter). Then came a memo to the FDA from Bush appointee Dr. David Hager, a well known evangelical Christian OB-GYN on the panel. In May 2004 the FDA ruled against its own advisory committee, saying the drug had not been shown safe in young girls. Reuters reports that Senators Clinton and Murray are asking for an investigation as to whether Hager's advice was based on science or his religious beliefs.

The Washington Post reported on Thursday that Hager gave reporters conflicting accounts about who asked for the memo, at one point saying the request was from an FDA staff member and another time saying it came from outside the agency.

"Due to confidentiality, I am not at liberty to say who encouraged that this opinion be written," Hager said in an e-mail to Reuters.

An FDA spokeswoman said Hager sent the letter "as a private citizen" and that the agency does not ask for "minority opinions" from advisory committees. She said she could not release the letter, but that it might become public in response to a Freedom of Information Act request.

Hager is a spokesman for the Christian Medical Association and co-wrote a book that emphasizes the healing power of Jesus and prayer. But it turns out that Hager's co-author, his ex-wife Linda Carruth Davis, is disgusted by his frequent proclamations of devotion to family values. In a lengthy report in The Nation by Ayelish McGarvey, she says he not only committed adultery but frequently engaged in non-consensual anal intercourse during their 32 year marriage and eventually she could not tolerate it.

According to Davis, Hager's public moralizing on sexual matters clashed with his deplorable treatment of her during their marriage. Davis alleges that between 1995 and their divorce in 2002, Hager repeatedly sodomized her without her consent. Several sources on and off the record confirmed that she had told them it was the sexual and emotional abuse within their marriage that eventually forced her out. "I probably wouldn't have objected so much, or felt it was so abusive if he had just wanted normal [vaginal] sex all the time," she explained to me. "But it was the painful, invasive, totally nonconsensual nature of the [anal] sex that was so horrible."

For the record, Davis remains a committed conservative and is still deeply religous Her story has been corroborated by a number of friends and acquaintances in whom she confided during her marriage.

She at least, had a Plan B. That is more than Hager, the Bush Adminstration and the lapdogs at the FDA are affording women in this country.

[Cross-posted at Effect Measure]

Sunday Sermonette: The Father and the Son (Axis of Evil)

Guest post by Revere

Every preacher knows a little humor is a good thing, especially before you scare the shit out of everyone.

The Son: The British are American citizens:

"As young Americans, you have an important responsibility, which is to become good citizens."

George W. Bush, in a June, 2001, letter to British students at Oakhill College in Lancashire, England: but giving the benefit where doubt is due, we ask, had they been Americans, wouldn't they already be citizens? Quoted from Randy Cassingham, "This is True," 24 June 2001, via Positive Atheism's Big Scary List of George W. Bush Quotations

The Father: Atheists aren't:

The following exchange took place at the Chicago airport between Robert I. Sherman of American Atheist Press and George Herbert Walker Bush, on August 27 1987. Sherman is a fully accredited reporter, and was present by invitation as a member of the press corps. The Republican presidential nominee was there to announce federal disaster relief for Illinois. The discussion turned to the presidential primary:

RS: "What will you do to win the votes of Americans who are atheists?"
GB: "I guess I'm pretty weak in the atheist community. Faith in God is important to me."
RS: "Surely you recognize the equal citizenship and patriotism of Americans who are atheists?"
GB: "No, I don't know that atheists should be considered as citizens, nor should they be considered patriots. This is one nation under God."
RS: "Do you support as a sound constitutional principle the separation of state and church?"
GB: "Yes, I support the separation of church and state. I'm just not very high on atheists."

[Cross-posted at Effect Measure; revised title]

Smarter than you?

Guest post by Revere

Blog carnivals are difficult because you have to find some of your own posts good enough to submit. But here's an easy one, the "Smarter than I" carnival, being hosted on Monday by Coturnix. Most all of us read a lot of great stuff we think others should see. Share it. Help build some community. And do a good turn (or a co-turn) by alerting others to "great stuff". Here's the idea and the way to submit:

Go around your favourite blogs, pick your favourite posts, and send the links to me [Coturnix] by Monday, May 16th at 9am EST. Put "Smarter Than I" in the title of your e-mail. Let me know why you think that particular blogger is smarter than you, and in particular why is the chosen post such a great example of the blogger's brilliance.

You can send your entries either to smarterthani AT hotmail DOT com or directly to me at Coturnix1 AT aol DOT com.

The draft, redux

Guest post by Revere

I'm glad Charles opened up the  question of the draft. My views are not the same as his, although I share his sentiments. I should be upfront about my biases here. I was a Vietnam era draft resister and helped form a draft resistance organization for doctors and medical students. I am also a conscientious objector (1 - O draft status). I was subject to the "doctors draft." The doctors draft extended to age 35 (normal cutoff was age 26) and was virtually automatic: they took doctors with one leg, never mind flat feet. The intermediate possibility of a 1 - A - O draft status (non-combatant, like medics) clearly doesn't apply to doctors, almost all of whom were already non-combatants and indeed engaged in saving lives, not taking them.

I'd like to raise two points here, one of them the rationale for why a doctor would refuse to serve; the second, and related to it, why we should resist re-instating the draft strenuously, despite some of Charles's legitimate qualms regarding the class-based inequity of a volunteer military.

First, the argument for why I resisted and why I encouraged other doctors to resist. I won't go into a long theoretical argument but use the analogy we used in our literature aimed at doctors and medical students. Suppose you are approached by a gang of bank robbers. "We are going to rob a bank," they tell you, "and this is pretty dangerous work. We'd like you to ride in the getaway car with your medical equipment in the event one of us gets hurt." Any doctor with an ounce of conscience would refuse this request. On the other hand, suppose you are walking past the bank when robbers suddenly burst from its doors and one falls at your feet in a hail of bullets. You would immediately come to their medical aid if you were to heed your responsibilities as a doctor. A crude analogy, perhaps, but indicative of our view that to sign on to the enterprise was to be complicit in its objectives, regardless of your function.

This also relates to the second point, made by several commenters. A fair process to bring about an unjust outcome does not legitimate the process. More importantly, and implicit in some of the comments, is the role that conscription plays and has played historically. Mass conscription is relatively new, having been instituted in the modern sense around the French Revolution. Jonathan Schell's wonderful book, Unconquerable World discusses this in the context of Clausewitz's view on war:

In trying to understand the changes that have overtaken war in modern times, it's useful to begin with the eighteenth-century Prussian general and philosopher of war Carl von Clausewitz, who was born in 1780 and died in 1831. He lived and fought and wrote during one of the most important turning points in the history of war. For most of the eighteenth century, war had been largely the business of kings and aristocrats and whatever commoners they could hire or force into their service. Battles usually involved tens of thousands, not hundreds of thousands, of men on each side. The ends of war were often modest, and military strategy often consisted as much of maneuvers as of combat.

With the success of the French Revolution and the rise a decade later of Napoleon Bonaparte, a new force--the energy of an entire population fired with patriotic zeal--was poured onto the battlefield. [p. 14]

[snip]

When Clausewitz surveyed the history of war, he found his own period all but unique. Rarely, if ever, he believed, had war come so close to realizing its ideal form. The underlying reason was the French Revolution, which began in 1789, when Clausewitz was a boy. In 1793, when France sent immense conscripted armies into the field, he wrote, "a force appeared that beggared all imagination. Suddenly, war again became the business of the people--a people of thirty million, all of whom considered themselves to be citizens. . . Nothing now impeded the vigor with which war could be waged." [p. 19]

Conscription is thus intimately bound up with what Schell calls "the modern war system." What a re-instated draft would do is greatly increase the ability of the US to wage war, where and when its leaders chose. Yes, there would be an inevitable reaction, especially if the war were protracted and unpopular. But they need not be. Consider Panama and Grenada, both examples of naked aggression. A draft could allow actions like this to be undertaken simultaneously in many places, an ability which is a strategic goal of the Rumsfeld Doctrine.

The moral issue related to the inequality of burden sharing that Charles broaches is important. But it doesn't seem different in kind to me than similar inequalities of burdens and benefits that run throughout our society. Correcting them in this sphere would, I fear, have serious unintended consequences.

The Way We Will Be

Guest post by Revere

Mahablog had an extremely interesting post on Saturday (May 7). It was just days past the anniversary of the killings at Kent State and she was reviewing Philip Caputo's book on the events there. Like almost everyone politically active in those years I remember Kent State vividly--the sense that they were actually killing us. Here are some of Maha's observations:

Reading this has brought back a lot of memories of The Way We Were. As angry as people  are now, I remember the Vietnam War era as a lot worse. But was there really more anger than there is now, or just more shouting?

People are expressing their anger on the Web now instead of in the streets, which  is probably a change for the better. But the other differences are worrying.

Maha is completely on target about the anger. It was palpable, corrosive, and despite rosy reminiscences, not much fun. Those were extremely dark days. She goes on to contrast news coverage then with news coverage now and the comparison is unflattering to today. My view is a bit different. In those days I was obsessed with the war. I watched 90 minutes of news each dinner hour, two networks and the local PBS station. I read every NYT article. The war was ever present in the media and pretty much "in your face." But there were only a few news outlets and they hewed, pretty much to the government line. Yes, the news conferences were more free-wheeling, but there was little critique or commentary afterwards, at least not until much later. The carnage and destruction that were shown only lasted for 10 minutes on the network news and that was it. The rest of the 24 hours was silent about the war.

Today there are the cable noise networks. They are delivering a lot of information along with a lot of crapola. History will tell us what that means. But it isn't obvious we are worse off than we were then. The war in Iraq is quite present and people are more informed now than they were then. More of them agree with us that it is a very bad mistake than agreed with us then (I doubt we ever got close to a majority at any time in those days). We had no efficient way to communicate then. We used mimeograph machines and typewriters. There was nothing like The Daily Show or Bill Moyers or dailyKos or Juan Cole or many other things we have today.

We had other ways to bond and produce solidarity, and mass demonstrations were among them. They were frightening, exhilarating, sometimes dangerous--but essential. Mahablog says they were often counterproductive. Maybe. But they played a role that was extremely important.

But here's the important difference. Maha is clearly right that today the split is not generational as it was then. The draft had something to do with that, but not everything. There was a cultural discontinuity that occurred in the 1960s that excluded the older generation. Today our children are not so very different than we are. That's not where the split is now. The people who are different are the religious right. On November 3 half the country woke up to find the other half of the country not only strangers, in some deep and unsettling way, but also threatening. Threatening to cultural moorings.Whether this is a true state of affairs is debatable. But I think the feeling was widespread. And it was reciprocal.

Thus there is an interesting reversal of roles. We are now the excluded ones, as our parents were in the 60s. Many of the things we took for granted are gone. Concerning the role of government, for example, everything seems upside down. Essential functions are being "privatized" and without any resistance. At this point it wouldn't surprise me if someone were to suggest we privatize the judiciary (citing the use of hired mediators as proof of principle). But unlike the parents of the 60s generation, since our split is not generational, we won't just die out. The split will reproduce itself in our children and the other side's children. That is where the battleground will be. Focus on the Family, with its preoccupation with religious (i.e., ideological) education, values imparted in the home and public education signals where the struggle will take place. That's the meaning of the gay marriage debate, evolution, religion in the schools. It is a struggle about reproducing ideologies in the next generation.

The real political issues of this generation relate to social structures, policies and language that reproduce ideologie--through religion, education, tribalisms of various kinds (especially nationalism) and gender roles.

The big question is not The Way We Were, but The Way We Will Be.