Saturday, December 31, 2016

2526. Frankenstein in the Promised Land

By Kamran Nayeri, August 1, 2014

Between 8 July and 27 August, Israeli forces killed more than 2,100 Palestinians in the Gaza Strip. According to the United Nations the vast majority of Palestinian deaths were civilian, 504 of them children.  17,200 homes were destroyed as well as 244 schools, and 475,000 were forced to live in an emergency shelter or with relatives. The Gaza Strip is only 4,505 square kilometers but is home to 1.8 million Palestinians.  In contrast, only 66 Israeli soldiers and seven civilians were killed by Hamas forces.  In a just world, Israeli actions in Gaza Strip would have been condemned and prosecuted as war crimes. Not action against Israel has ever been taken. If fact the U.S. government resupplied Israeli air force during the Gaza campaign. 

Editor's note: In his parting speech, U.S. Secretary of State, John Kerry, publicly acknowledged that the Israeli government has shown no interest in pursuing a peaceful end to the bloody conflict with Palestinians and has consistently undermined all efforts for a "two-state solution."  A few days earlier, the Obama administration refused to veto a Security Council resolution that condemned newly planned housings in East Jerusalem.  Kerry and President Obama were roundly condemned by the Israeli government as well as the leaders of both parties in the U.S. 

The so-called "two-state solution" is nothing more than creating a Bantustan-type entity in parts of West Bank and Gaza Strip to forestall a majority Palestinian Jewish State which would be a reality if Israel annexes the rest of Palestine.  The Zionist movement and with it the United States imperialist elite are divided on how to maintain the Jewish State without openly creating an apartheid state where a large section of the population is disenfranchised. This crisis of Zionism, as well as imperialism, will intensify in the coming years--alas, it will also bring about much more misery for the Palestinian people.  Israel may be the last significant holdout of the nineteenth-century racist colonial-settler movement. But its end will come as its internal contradictions intensify and as the march of humanity forward continues. 


The following essay was written at the end of the Israeli murderous assault on the Palestinians in the Gaza Strip from July 8 to August 27, 2014.  It takes up a correspondence from a Zionist reader of OPITW that objected to the reporting of the Israeli war crimes.  The Jewish people who suffered discrimination throughout history and in the German fascist Holocaust bear the singular moral responsibility to denounce Zionism as a racist colonial-settler ideology that has murdered, wonder, jailed, tortured, humiliated and expropriated and displaced millions of Palestinians in and from their own homeland in order to build the Jewish State. Only when a significant section of the Jewish population in Israel and the world join the Palestinian struggle for self-determination can there be a possibility for a democratic secular Palestine where they can live alongside Palestinians and others as equals in peace and rejoin the march of humanity to live in harmony within itself and with the rest of nature. 
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A reader of Our Place in the World (OPITW)—an older New York Jewish woman who lives in Costa Rica (let’s called her Judy)—has asked me to remove her from the OPITW weekly letters list because she disagrees with Jeff Mackler’s “Stop the Israeli Invasion of Gaza!” (post 1492).  

Those on the OPITW  “friends” list receive more or less weekly updates with a brief note and hyperlinks to the most recent posts. Judy got on the list mostly because of her expressed interest in the Cuban revolution.   


In her email, Judy complains that Mackler’s article is skewed in its treatment of what she saw as the conflict between Israel and Hamas which she calls “a longstanding terrorist organization.”  She also claims that Mackler’s article did not even mention “the horrific period of the Holocaust.” She ends by decrying that “The world only wants the Jewish people to be weak once again.” 

Of course, Judy could have expressed her concerns as a comment to Mackler’s article on OPITW, thereby encouraging discussion.  Disagreements are no reason to cut off relations in normal circumstance.  So, let's deal with her concerns here.  

First, Hamas is a relatively recent political formation among the Palestinians and the terrorist designation of it is the work of the Israeli and the American governments.  As we know after the collapse of the Soviet Union, the imperialist fear mongering campaign has shifted, especially after 9/11 terrorist attacks, from “Communism” to “terrorism.” As I will discuss below, in this conflict it is the Israeli regime that is the real terrorist. 

Second: how about the Holocaust? Jeff Mackler’s article, in fact, does mention the Holocaust but understandably its focus is on the current crimes of the Israeli regime against the Palestinian population in the Gaza Strip.  

Third, the outrage at Israeli criminal assault on defenseless Palestinians in the Gaza Strip has ignited a wave of protests across the world, including among a minority of Jews in Israel and in the United States.  The aim of these protests is not to make the “Jewish people weak once again” but to stop the Israeli government’s murderous war against the people of Gaza Strip and Palestinians in general.  This is crystal clear as the protest include a number of Jewish peace organizations, including in Israel and the United States. In Israel, the protest have been crushed by rightwing and neofascist physical attacks. 

Another Jewish woman who receives my weekly letters and learned about Judy’s views as I related them to those on that list wrote to me expressing her sympathies with the Palestinians. She wrote in part: 
“I've lived with this stuff all my life, from the time my parents sent me to my room, during the 1967 war, when I was 8, for questioning why they and an uncle were discussing the news and supporting violence against Arabs.
“I've found Israel to be one of those issues where liberals tend to go off the deep end and endorse the most hideous things, revealing that they are not ‘progressive' at all.   
“Last week I wrote on Facebook that it is beyond disgraceful to see fellow Jews, descendants of survivors of pogroms, waging pogroms in Gaza.”

Zionism and the Israeli Apartheid
Why would two Jewish women arrive at such different understanding of the reality of Israel state’s policies?  The answer is Zionism.  

Judy is blinded to the sufferings of the Palestinian people. The key to understating the crisis in the Middle East is to understand Zionism. That is why Jeff Mackler’s article is so valuable as it places the atrocities of the Israeli government in the Gaza Strip in its historical context. And that is why it has outraged Judy. 

The Zionist movement emerged in late nineteenth century as part of the general European colonialist movement.  It represented a major split in the Jewish community that endures to this day—one between the Jewish revolutionary socialists who combined the fight against anti-Semitism with the struggle for socialism and those who wanted to escape European anti-Semitism by establishing a Jewish State somewhere else as part and parcel of the world capitalist order.  

Despite the prevalent Zionist propaganda that tries to justify the occupation of Palestine on the basis of the Jewish mythology of The Chosen People returning to The Promised Land, the Zionist movement considered a number of other locations for colonization.  For example, in 1903 at the sixth Zionist Congress Theodor Herzl, the “Father of Modern Zionism,” proposed Uganda as the site for the Jewish State.  However, in the aftermath of the First World War and division of the Middle East and North Africa between the English and French imperialism, Palestine became the target of the Zionist movement. This was codified in the Balfour Declaration that was first proposed in a letter from the British Foreign Secretary Arthur James Balfour to the British Zionist financier Baron Walter Rothschild dated November 2, 1917 and later incorporated into the Sèvres peace treaty with the Ottoman Empire and the Mandate for Palestine.

Subsequently, the Zionist movement organized settlements of European Jews in the historical Palestine to lay the basis for a Jewish State.  Like in all European colonies, the process of land grab was pursued by any means necessary, including through the use of force and terrorist Zionist groups such as such as the Irgun, the Lehi, the Haganah and the Palmach.  In fact, Menachem Begin, a leader of the terrorist group Irgun, later became Israel’s Prime Minster (He was succeeded by another terrorist, Ariel Sharon). 

The Nazi persecution of Jews and the Holocaust caused the mass migration of European Jews.  However, key destination countries such as the United States limited Jewish immigration and encouraged their settlement in Palestine, a policy supported by the Zionist leaders.  By the end of the World War II, the United Stated had emerged as the undisputed imperialist power. As part of the consolidation of its empire, the United States moved to establish Israel as its outpost in the Middle East.   The recently formed United Nations very much under the sway of the Allies, especially the United States, drew the partition plan for Palestine voted for by the General Assembly on November 29, 1947.  On May 14, 1948, David Ben-Gurion, the head of the Jewish Agency, proclaimed the establishment of the State of Israel. U.S. President Harry S. Truman recognized the new nation on the same day.

Thus, Israel was established as the Jewish State in violation of the right to self-determination of the Palestinian people.  However, as Mackler points out Israel is no ordinary nation-state.  It has never defined its borders because the Zionist movement has always claimed the Greater Israel, shifting geographical designation, as its “homeland” that often extends well beyond the historic Palestine.  The history of the Jewish State has seen a relentless push to expand its territory and force Palestinians to flee their land. It has also been marked by war with its Arab neighbors (for a history see, Middle East Research and Information Project—MERIP).  

Israel has degraded the Palestinian people by dividing them into variously oppressed groups. About 20% of the population of Israel are “Arabs” (that is Palestinians). They have lived as second-class citizens.  Then there are Palestinians who live in the West Bank who were under the Jordanian administration from 1948 to 1967 and after the Six Day War have lived under Israeli occupation.  The Gaza Strip was mostly administered by Egypt (1959-1967) and then under the Israeli occupation from 1967 to 2005. In 2005, Israel unilaterally withdrew from Gaza Strip but placed it under a tight blockade that has remained in place, with Egyptian help, until today. In fact, one of the demands of Hamas and the people of Gaza Strip is the lifting of the Israeli and Egyptian blockade. Then there are Palestinian refugees who live in camps mostly in Jordan and Lebanon. Finally, millions of other Palestinians are scattered all over the world in hope of returning to their homeland. 

Frankenstein in the Promised Land 
Thus, the Zionist movement and its imperialist backers have created a Frankenstein in the Promised Land: a nineteenth-century European-inspired colonial-settler state founded on the basis of the ongoing ethnic cleansing of its native Palestinian population that is inherently racist and at war with its Arab and other neighbors.  As such, Israel has been the reliable key imperialist outpost, a garrison state, in the Middle East and North Africa. It is the only nuclear state in the Middle East with an estimated 300 nuclear devices. Although the Israeli government never denies having nuclear weapons it is shielded from international scrutiny by the United States that has supported it constantly with $3 billion dollars of military aid every year even as it curtails social programs for the American working people due to claimed budgetary constraint.  Although created by a U.S. inspired U.N. resolution, Israel has never abided by the decisions of the United Nations for its repeated violation of international norms, always shielded by the U.S. veto power in the Security Council.  Israel is a bulwark of international reaction; it was a staunch supporter of the South African Apartheid regime but has opposed every anti-imperialist and revolutionary movement in the Middle East and around the world.  It supported the United States in its Indochina war, opposed the Nicaraguan revolution of 1979, and is the only country in the United Nations General Assembly that consistently votes in support of the U.S. embargo of the Cuban revolution.  Thus, the Jewish people who fled anti-Semitism in Europe and Nazi Holocaust, especially those who came to Palestine with socialistic aspirations, have been betrayed by their Zionist leaders, and, in many cases have been transformed into racist oppressors that serve the interest of imperialism and oppose the Arab revolution.

As long as this Frankenstein exists in the heart of the Middle East there will never be peace.  There will never be a stable two-state solution to “the Palestinian problem” because of the very racist and expansionist nature of the Zionist regime as the failure of the Oslo Peace Accord has demonstrated.  The only possible solution to the 66-year-old crisis is the replacement of Israel (the Jewish State) with a democratic secular state with its historic name, Palestine, where Palestinians and Jews live as citizens with equal rights and opportunities.  Contrary to Judy's view (as quoted above), the Jewish people can be strong only when they learn to live alongside their Palestinian brothers and sisters as equals not as their oppressors.  That is the only road to peace in the Middle East.  (Of course, there are other monsters in the Middle East but that need separate discussion and analysis; see my three part article "From Nasser to Mubarak: The Rise and Fall of Arab Nationalism, Part 1Part 2Part 3). 

However, it is important to note that the demand for a democratic secular Palestine that was first raised by the Palestinian Liberation Organization in 1969 cannot meet the current requirements of the regional and global crisis that are also environmental and ecological (see my "Economics, Socialism and Ecology: A Critical Outline, Part 1 and Part 2).  The 1969 perspective of a national liberation movement did not concern itself with the ecological crisis of the Middle East.  Rapid population growth, pollution, degradation of land, rivers, natural habitats combined with the national, regional and world capitalist crises require urgent action that will transcend the artificial borders of countries created based on inter-imperialist negotiations in the aftermath of World War I and World War II.    The civil war in Syria, the rise of the Islamic State of Iraq and Syria (ISIS), the rise and fall of the Egyptian revolutionary movement, the sectarian and tribal wars in Iraq, Syria, Libya, and the conflict between Israel and Palestinians and Israel and its Arab neighbors are accentuated or in part originated by such environmental and economic crises.  

The most forward-looking Palestinian, Arab, Jewish and other peoples of the Middle East and North Africa would realize the need for a common effort to address ecological and social justice issues in tandem and across the bioregion.  A United Ecological Socialist Middle East and North Africa is the only truly viable perspective for the peoples of the region.  That, and not the nationalistic and religiously inspired formations, is the only perspective that can emancipate the peoples of the Middle East and North Africa and join similar struggles elsewhere towards an ecological socialist world. 

Friday, December 30, 2016

2525. E.O.Wilson: The Sixth Extinction: Life and Death in the Biosphere

By E. O. Wilson, Half-Earth: Our Planet's Fight for Life, May 2016


Editor's note: The following text is from E. O. Wilson's Half-Earth: Our Planet's Fight for Lifechapter 7: "Why Extinction Is Accelerating?"  Only a few sentences from the first paragraph were omitted to shorten the text as much as possible. Title and subtitles are mine. I urge the reader to read the entire book. 

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Very few people wish to see species disappear, except those occasional pests that attack our bodies and sources of food….Other than still-unknot pathogens among bacteria, microscopic fungi, and viruses, the number of species worthy of extinction, or at least of harmless storage in liquid nitrogen, is probably (my guess( fewer than a thousand…

The millions of other species are beneficial to human welfare, whether directly or indirectly. There are unfortunately almost countless ways humans are hastening their extinction, what ever might be their present or future beneficial roles.  The human impact is largely due to the excess of the many quotidian activities we preform just to get on with our personal lives.  Those activities have made us the most destructive species in the history of life.

The extinction rate
How fast are we driving species to extinction? For years paleontologists and biodiversity experts have believed that before the coming of humanity about two hundred years ago, the rate of origin of new species per extinction of existing species was roughly one species per million species per year. As a consequence of human activity, it is believed that he current rate of extinction overall is between one hundred and one thousand times higher than it was originally, and all due to human activity.

In 2015 an international team of researchers finished a careful analysis of the prehuman rates and came up with a diversification rate ten times lower in general (groups of closely related species). The data, when translated to species extinctions, suggests species extinction rates at the present time are closer to one thousand times higher than that before the spread of humanity. The estimate is further consistent with an independent study that detected a similar downward shift in the rate of species formation in pre-humans, as well s in their closet relatives among the great apes.  

Every expansion of human activity reduces the population size of more and more species, raising their vulnerability and the rate of extinction accordingly.  A 2008 mathematical model by a team of botanists predicated that between 37 and 50 percent of rare tree species in the Brazilian Amazon rain forest, “rare” defined as having populations of fewer than ten thousand individuals, will suffer early extinction, caused by contemporary road building, logging, mining, and conversion of land to agriculture. The lower figure, 37 percent applies to areas  developed in part but protected by careful management. 

It is difficult to make comparisons of origin and extinction rates across different kinds of plants and animals in different parts of the world. But all the available evidence points to the same two conclusions. First, the Sixth Extinction is under way; and second, human activity is its driving force.

Does conservation work? 
This grim assessment leads to a second question: How well is conservation working? How much have the efforts of global conservation movements achieved in slowing and halting the devastation of Earth’s biodiversity? Having served on the boards of Conservation International. The Nature Conservancy, and the World Wildlife Fund00U.S., and as advisor to many local conservation organizations, I can testify to the zeal and inspiration, backed by private and public funding, and to the years of sweat and blood in the field, that have gone into conservation efforts around the world during the past half century. How much has this heroic effort accomplished? 

In 2010 a survey conducted by close to two hundred experts on vertebrate land animals (mammals, birds, reptiles, amphibians) analyzed the status of all the 25,780 know species. One-fifth were confirmed as threatened with extinction, and of these a fifth had been stabilized as a result of conservation efforts.  An independent study in 2006 had already concluded that extinction of bird species in particular had been cut by about 50 percent as a result of conservation efforts during the past century.  Thirty-one bird species worldwide still live because of efforts on their behalf. In short, global conservation thus far, when averaged out for land-dwelling vertebrates, has lowered extinction rates of species by approximately 20 percent. 

Next, what is the impact of government regulation, in particular the U.S. Endangered Species Act of 1973? A review made in 2005 found that a quarter of the 1,370 American plant and animal species classified earlier as threatened achieved new population growth, while 40 percent declined, with 13 of the listed species improved enough to be taken off the endangered list. The most important statistic is that while 22 spaces had slipped into extinction, 227 had been saved that would likely have otherwise disappeared.  Among the more familiar protected species that have climbed back to health are the yellow shouldered blackbird, green sea turtle, and bighorn sheep. 

These successes have show that conservation works, but at the level of effort being applied at the present, it falls far short of what is needed to save the natural world. The conservation movement has slowed the species extinction rate but failed to bring it anywhere close to the prehuman level.  At the same time the birth rate of species is dropping rapidly. Like and accident patient in emergency care continuing to hemorrhage and with no new supply of blood available, stabilization is out of reach and further decline and death are inevitable.  We might be inclined to say to the surgeons and conservationists alike, “Congratulations. You have extended a life, but not by much.”  

Of course, not all wild species are threatened by the assault on biodiversity.  A few are compatible with a humanized environment.  What fraction of the present survivors will last to the end of this century? If present conditions persists, perhaps half.  More likely, fewer than one-fourth. 

That is my guess. But the fact is that due to habitat loss alone, the rate of extinction is rising in most parts of the world.  The preeminent sites of biodiversity loss are the tropical forests and coral reefs.  The most vulnerable habitats of all, with the highest extinction rates per unit area, are rivers, streams, and lakes in both tropical and temperate regions.

An established principle in conversation biology for all habitats is that a reduction in art results in   a fraction of the species disappearing in time by roughly the fourth root of the area.  If 90 percent of a forest is cut, for example, about half of the species will soon disappear that would have been otherwise persisted. And the beginning most of the species may survive for a while, but roughly half will have populations too small to persist for more than a few generations. 

Barro Colorado Island in Panama has proved a valuable natural laboratory to study the effect of area on extinction. Covered by rain forest, it was created by the formation of Gatun Lake in 1913 during the construction of the Panama Canal. An ornithologist, John Terborgh, predicated that after fifty years the island would lose seventeen bird species.  The actual number was thirteen, representing 12 percent of the one hundred eight breeding species originally present.  On the other side of the world, a 0.9-square-kilometer patch of rain forest, the Bogor Botanical Garden of Indonesia, was also isolated, not by water but by clearing of all the forest around it.  In the first fifty years it lost twenty of its sixty-two breeding bird species, approximately the number expected.

Causes of extinction
Conservation scientists often use the acronym HIPPO for a quick recall of the most ruinous of our activities, in order of importance:

Habitat destruction. This includes that caused by climate change.

Invasive species.  This include plants and animals that crowd out native species and attack crops and native vegetation, as well as microbes causing disease in humans and other species. 

Pollution. The effluents from human activity are killers of life, especially in rivers and other freshwater ecosystems, the most vulnerable of Earth’s habitats. 

Population growth.  Although it is still widely unpopular to say so, we must really slow down. Reproduction is obviously necessary, but it is a bad idea, as Pope Francis I has pointed out, to continue multiplying like rabbits.  Demographic projections suggest that the human population will rise to about eleven billion or slightly more before the end of the century, thereafter peak, and begin to subside. Unfortunately for sustainability of the biosphere, per-capita consumption is also destined to rise, and perhaps even more steeply than human numbers. Unless the right technology is brought to bear that greatly improve efficiency and productivity per unit area, there will be a continued increase in humanity’s ecological footprint, defined as the area of Earth’s surface each person on average needs.  The footprint is not just local art, but space scattered across land and sea, in pieces for habitation, food, transportation, governance, and all other services down to and including recreation.

Overhunting.  Fishing and hunting can be pressed until the target species is driven to extinction or on the way, making the last surviving populations subject to final erasure by disease, competition, changes in weather, and other stresses survived by larger ad more far-ranging populations of the same species. 

Single causes in the decline and extinction of species can be identified readily in a few cases. One example is the dietary preferences of the brown tree snake, which is especially skilled in preying on bird nestlings.  Another has been identified in the decline of the monarch butterfly in the Midwest, which famously overwinters in masses of millions on pine trees in Mexican state of Michoaćan.  By 2014, there was an 81 percent decline of the butterflies in the United States Midwest populations, attributed to a 58 percent decline in milkweeds, the exclusive food plant of the monarch caterpillars. The milkweeds have fallen off in turn because of the increased use of glyphosate weed killer in corn (maize) and soybean fields.  The crops have flourished after being genetically modified to resist the weed killer, while the wild milkweed plants have not been so protected.  With their food supply unintentionally reduced the migrating monarch butterflies of both the United States and Mexico have declined steeply. 

In most extinctions, however, the causes are multiple, linked to one another in some way, all ultimately the result of human activity.  In one well-analyzed example of multiple causes, the Allegheny wood rat has vanished or grown endangered through a third of its range.  It is considered to have suffered from the extinction of the American Chestnut and hence the loss of its seeds, on which the species partly depend. Also important have been the logging and fragmentation of forests where the wood rats live, plus further reduction of this habitat by the voracity of the invasive European gypsy moth.  The coup de gras is the roundworm infection from raccoons, which are animals better suited than the wood rats to live around humans.

Those unimpressed by the fall of a rodent may turn a more caring eye to the songbirds that migrate each yea between their winter grounds in the New World tropics and breeding range in the eastern United States.  From data compiled by the federally sponsored North American Breeding Bird Survey along withe Audubon  Society Christmas Bird Count, it is clear that populations of more than two dozen species are in a steep descent.  Those affected include the wood thrush, Kentucky warbler, eastern kingbird, and bobolink. One, Bachman’s warbler, whose wintering ground was in Cuba, has gone extinct.  I have a place in my heart for this little bird.  During field trips to the floodplain forests of the U.S. Gulf Coast, which brought me close to canebrakes where the warbler once nested, I’ve often looked and listened for a Backman’s as best I could (admittedly not very skillfully), but to no avail.

It sometimes seems as though the reminder of American native plants and animals are under deliberate assault by everything humanity can throw at them.  Leading the list is our deadly arsenal are the destruction o both wintering and breeding habitats, heavy use of pesticides, shortage of natural insect and plant food, and artificial light pollution causing errors in migratory navigation.  Climate change and acidification pose newly recognized yet game-changing risks—shifts in all aspects of the rhythms of the environment away from those necessary for wildlife survival and reproduction.  

Facts about biodiversity
There exist several facts about global biodiversity to keep in mind while trying to save it.  The first is that the human caused agents of extinction are synergistic.  As  any one of the agents intensifies, it causes others to intensify also, and the sum of the changes is an acceleration of extinction.  Clearing a forest for agriculture reduces habitat, diminishes carbon capture, and introduces pollutions that are carried downstream to degrade otherwise pure aquatic habitats en route. With the disappearance of any native predator or herbivore species, the reminder of the ecosystem is altered, sometimes catastrophically.  The same is true of the addition of an invasive species. 

Another overarching principle of biodiversity is the greater richness of tropical environments over temperate environments, in both number of species and vulnerability.   While the variety of aphids, lichens, and conifers increases poleward, a vastly larger number of other kinds of organisms increase in the opposite direction.  For example, you can expect to find about fifty species of ants in a square kilometer of New England temperate forest (if you care to look) but up to ten times that number in a comparable area of rain forest in Ecuador or Borneo.

A third principle of biodiversity worth noting is in the relation between its richness and the geographical range of the species comprising it. A large fraction of the species of plants and animals of the temperate NorthAmerican are distributed across most of the content, but very few species range the same way across tropical South America. 

When these last two principles are linked, both entailing the numbers of resident species, we find as expected that on average tropical species are more vulnerable than temperate species.  They occupy smaller ranges and thereby manage to sustain smaller populations. Furthermore, existing as they do among a greater array of competing species, they tend to be more specialized in where they live, in what they eat, and by the predators that hunt and eat them.  

As a general rule to follow in conservation practice is therefore that, while clear-cutting a squat kilometer of old-growth coniferous forest in Canada, Finland, or Siberia will do a lot of environmental damage, cutting the same area of old-growth rain forest in Brazil or Indonesia will do far more damage.  

Finally, there is the immense disparity between the 62,839 known species of vertebrates (mammals, birds, reptiles, amphibians, fishes, the total number in 2010) and 1.3 million known invertebrate species (also 2010). Almost all the information on quantitative trends in biodiversity are based on the vertebrates, the big animals with which we have intimate familiarity. There are well-studied groups within the invertebrates, notably mollusks and butterflies, but even these organisms are less well known than the mammals, birds, and reptiles.The great majority of invertebrate species, notably hyper diverse insects and marine organisms, remain to be discovered and made known to science. Nevertheless, of those groups well enough studies to make  estimate of their conservation status down to species, such as freshwater crabs, crayfish, dragonflies, and corals, the percentages of vulnerable and endangered species are comparable to those of vertebrates.

Avoiding misconceptions about the Sixth Extinction 
In thinking about life and death in the biosphere, it is important to avoid two misconceptions. The first is the a rare declining species is probably senescent.  You might think that its time has come so let it go. The contrary, its young are just as vital as the young of the most aggressive expanding species with which they compete.  If its population is shrinking in size from vulnerable to endangered to critically endangered (the scale of descent used in the Red List of the International Union of Conservation of Nature)*, the reason is neither age nor destiny of the species. Instead, the reason is the predicament in which the Darwinian process of natural selection has placed it.  The environment is changing, and the genes assembled by earlier natural selection are by happenstance not able to adapt quickly enough.  The species is a victim of bad luck, rather like a farmer who invests at the start of a ten-year drought.  Put some young individuals into an environment where the genes are better adapted, and the species will flourish. 

Humanity, keep in mind, is the principal architect of such maladaptive environments. Conservation biology is the scientific discipline by which better environment are identified and protected or restored for species imperiled within them. 

Biologists recognize that across the 3.8 billion-year history of life over 99 percent of all species are extinct. This being the case, what, we are often asked, is so bad about extinction?  The answer, of course, is that many of the species over eons didn’t die at all, they turned into two or more daughter species. Species are like amoebae; they multiply by splitting, not by making embryos.  The most successful are the progenitors of the most species through time, just as the most successful humans are those whose lineages expand the most and persist the longest. The birth and death rates of humans are close to a global balance, with birth having the edge for the last sixty-five thousands years or so. Most important, we, like all other species, are product of a highly successful and potentially important line that goes back all the way to the birth of humanity and beyond that for billions of years, to the time when life began.  The same is true of the creatures still around us. They are champions, each and all. Thus far.  


* The Red List scale for individual species is the following in descending order: Least Concern (LC), Near Threatened (NT), Endangered (N), Critically Endangered (CR), Extinct in the Wild (EW), Extinct (E). 

Thursday, December 29, 2016

2523. Rosa Luxemburg: "My Innermost Personality Belongs More to My Tomtits than to the Comrades"

By Rosa Luxemburg, Marxists.org, May 2, 1917
Rosa Luxemburg

Editor's note: This following text is taken from a letter written from to Sophie Liebknecht (1884-1964), a Russian-born German socialist and feminist. She was the second wife of German revolutionary socialist leader Karl Liebknecht. The letter was first published in Letters from Prison: by Rosa Luxemberg: with a portrait and a facsimile, Young International at Schönberg in Berlin, 1921–1923.  KN

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... Do you remember how, in April last year, I called you up on the telephone at ten in the morning to come at once to the Botanical Gardens and listen to the nightingale which was giving a regular concert there? We hid ourselves in a thick shrubbery, and sat on the stones beside a trickling streamlet. When the nightingale had ceased singing, there suddenly came a plaintive, monotonous cry that sounded something like “Gligligligligliglick!” I said I thought it must be some kind of marsh bird, and Karl agreed; but we never learned exactly what bird it was. Just fancy, I heard the same call suddenly here from somewhere close at hand a few days ago in the early morning, and I burned with impatience to find out what the bird was. I could not rest until I had done so. It is not a marsh bird after all.

It is a wryneck, a grey bird, larger than a sparrow. It gets its name because of the way in which, when danger threatens, it tries to intimidate its enemies by quaint gestures and writhings of the neck. It lives only on ants, collecting them with its sticky tongue, just like an ant-eater. The Spaniards call it hormiguero, – the ant-bird. Mörike[10] has written some amusing verses on the wryneck, and Hugo Wolf[11] has set them to music. Now that I’ve found out what bird it is that gave the plaintive cry, I am so pleased as if some one had given me a present. You might write to Karl about it, he will like to know.

You ask what I am reading. Natural science for the most part; I am studying the distribution of plants and animals.

Yesterday I was reading about the reasons for the disappearance of song birds in Germany. The spread of scientific forestry, horticulture, and agriculture, have cut them off from their nesting places and their food supply. More and more, with modern methods, we are doing away with hollow trees, waste lands, brushwood, fallen leaves. I felt sore at heart. I was not thinking so much about the loss of pleasure for human beings, but I was so much distressed at the idea of the stealthy and inexorable destruction of these defenceless little creatures, that the tears came into my eyes. I was reminded of a book I read in Zurich, in which Professor Sieber describes the dying-out of the Redskins in North America. Just like the birds, they have been gradually driven from their hunting grounds by civilised men.

I suppose I must be out of sorts to feel everything so deeply. Sometimes, however, it seems to me that I am not really a human being at all but like a bird or a beast in human form. I feel so much more at home even in a scrap of garden like the one here, and still more in the meadows when the grass is humming with bees than – at one of our party congresses. I can say that to you, for you will not promptly suspect me of treason to socialism! You know that I really hope to die at my post, in a street fight or in prison.

But my innermost personality belongs more to my tomtits than to the comrades. This is not because, like so many spiritually bankrupt politicians, I seek refuge and find repose in nature. Far from it, in nature at every turn I see so much cruelty that I suffer greatly.

Take the following episode, which I shall never forget. Last spring I was returning from a country walk when, in the quiet, empty road, I noticed a small dark patch on the ground. Leaning forward I witnessed a voiceless tragedy. A large beetle was lying on its back and waving its legs helplessly, while a crowd of little ants were swarming round it and eating it alive! I was horror stricken, so I took my pocket handkerchief and began to flick the little brutes away. They were so hold and stubborn that it took me some time, and when at length I had freed the poor wretch of a beetle and had carried it to a safe distance on the grass, two of its legs had already been gnawed off ... I fled from the scene feeling that in the end I had conferred a very doubtful boon.

The evening twilight lasts so long now. I love this hour of the gloaming. In the South End I had plenty of blackbirds, but here there are none to be seen or heard. I was feeding a pair all through the winter, but they have vanished.

In the South End I used to stroll through the streets at this hour. It always fascinates me when, during the last violet gleam of daylight, the ruddy gas lamps suddenly flash out, still looking so strange in the half light as if they were almost ashamed of themselves.Then one sees indistinctly a figure moving swiftly through the street, perhaps a servant maid hastening to fetch something from the baker or the grocer before the shops close. The bootmaker’s children, who are friends of mine, used to go on playing in the streets after dark, until a loud call summoned them in. And there was always a belated blackbird which could not settle down, but like a naughty child would go on wailing, or would wake with a start and fly noisily from tree to tree.

For my part, I would continue standing in the middle of the street numbering the stars as they came out, reluctant to go home, unwilling to leave the mild air, and the twilight in which day and night were so gently caressing one another.

Sonyusha, I will write again soon. Make your mind easy, everything will turn out all right, for Karl too. Good-bye till the next letter.

With love
Your Rosa

Footnotes
[10] German poet, born 1804, died 1875.
[11] Austrian composer, born 1860, died 1903. Celebrated as a writer of songs. 

Wednesday, December 28, 2016

2522. Bariatric Surgery for Extreme Obesity: What Can Be Leaned about Human Body

By Gina Kolata, The New York Times, December 27, 2016
Jessica Shapiro, second from left, talking to Keith Oleszkowicz at their doctor’s office the month before their surgeries, Credit Michael F. McElroy for The New York Times. 

Editor's Note:  This article is an excellent example of medical journalism for its case study design.  If anyone is interested in bariatric surgery this article should be among her/his required readings.  But I post it here for an additional contribution it makes--to document through case study of two patients how a gastrointestinal surgery can change the body's make up on the most fundamental levels resulting in a change in who the patients are and how their behavior change.  In the late 1980s and early 1990s, in my political economy seminars for first year and second year medical students at the State University of New York-Health Science Center at Brooklyn (SUNY-HSCB), I often spent a two-hour seminar session on the discussion of conceptions of health and various theories of illness.   My hope was to encourage the students to consider the multidimensional determinant of them.  A central conclusion was that the body is an integral bio-social organism and not a sum total of it anatomical parts. The more we learn about the human body and its functions the more that discussion seems important to have not only for medical students and professionals but also for the rest of us.  This is the part of what follows that I urge the reader to focus on.  There are many more recent example.  In the previous post we learn from new research that the brain changes as the result of pregnancy.   KN


*     *     *

It was Oct. 11, 2015, and a middle-aged man and a young woman, both severely obese, were struggling with the same lump-in-the-throat feeling. The next day they were going to have an irreversible operation. Were they on the threshold of a new beginning or a terrible mistake?
They were strangers, scheduled for back-to-back bariatric surgery at the University of Michigan with the same doctor. He would cut away most of their stomachs and reroute their small intestines. They were almost certain to lose much of their excess weight. But despite the drastic surgery, their doctor told them it was unlikely that they would ever be thin.

Nearly 200,000 Americans have bariatric surgery each year. Yet far more — an estimated 24 million — are heavy enough to qualify for the operation, and many of them are struggling with whether to have such a radical treatment, the only one that leads to profound and lasting weight loss for virtually everyone who has it.


Most people believe that the operation simply forces people to eat less by making their stomachs smaller, but scientists have discovered that it actually causes profound changes in patients’ physiology, altering the activity of thousands of genes in the human body as well as the complex hormonal signaling from the gut to the brain.


Over the last year, I followed Keith Oleszkowicz and Jessica Shapiro — a computer programmer and a college student — from their surgeries through the transformations that followed. The operation, increasingly common as obesity threatens the health of millions of Americans, changes not just the bodies of those who have it, but also their lives: how they see themselves and how they relate to their romantic partners, co-workers and families.

As the pounds fell away in a society that harshly judges fat people, Keith and Jessica, two ordinary Americans, would go through an extraordinary experience, one that brought both joys and disappointments.


Jessica, 22, lived with her mother and grandmother in Ann Arbor, Mich., and worked at Panera Bread preparing food. At 5-foot-3 and 295 pounds, she had a difficult life. She needed a seatbelt extender on airplanes. She was unable to cross her legs. She had acid reflux and mild sleep apnea, which meant she woke up at night about seven times an hour.

A doctor told her something that shook her: “You are only 22, but your body is much older than you are.”

Even worse were the constant struggles of being fat in today’s society. She never had a date and no man ever seemed interested in her. Total strangers lectured her on how to eat. And she suffered unexpected humiliations, like when she went to an amusement park with friends and the ride attendant pulled her aside and asked her to try pulling the safety bar over her stomach. It didn’t fit, and he turned her away.


“Every day of my life, I’m just aware of how overweight I am,” she told me as she sipped a cup of water at a Starbucks near her home.


She tried programs like Weight Watchers, but her urge to eat, as powerful as the urge to breathe when holding your breath, defeated her. It is a drive, obesity researchers say, that people who have never felt it find hard to fathom.

“It’s like a physical need,” Jessica said. “It’s not just a longing or just a passing urge.” It is, she said, “like a kind of hunger that like kind of claws at you from the inside out.”

The surgery, she said, “is a last resort for me.”


Keith’s circumstances were a bit different. He was 40, married with a teenage son, and worked as a programmer at a big automaker. His wife, Christa, had had the operation two years before, after pondering it for nine years. She lost 143 pounds and felt that her life had been transformed.


Keith’s older brother had had the surgery, too, 16 years earlier, at a time when many doctors were splitting patients open instead of doing the surgery laparoscopically as they do today. The complication rate was much higher at that time, and the death rate at one year after surgery was 4.6 percent, verging on unacceptable.


“We were not in a good place then,” Dr. Amir Ghaferi, a bariatric surgeon at the University of Michigan, told me. The one-year mortality rate today is 0.1 percent, safer than gallbladder surgery or a joint replacement.

Keith, at 5-foot-9 and 377 pounds, was not as fat as his brother had been, but he was having physical and medical problems. He somewhat hesitantly listed some of them: His joints hurt; moving around was an effort; he could not bend down to tie his shoes; he had sleep apnea and had to use a continuous positive airway pressure machine to push air into his lungs when he slept; he had high blood pressure.

He had lost 10, 20, 30, even 40 pounds at a time over the years with various diets, but he was plagued with insatiable urges to eat. The weight always came back.

“I’ve tried everything I can,” Keith said.


But, he stressed, it is not as hard for a guy to be fat as it is for a woman. And he’s right. Researchers have found that there is more prejudice against fat women than against fat men. Still, Keith suffered many indignities.


As a child, he was teased and became so ashamed of his body that he could not bring himself to undress for gym class. So he wore his shorts and T-shirt under his school clothes and spent the rest of the day with those sweaty clothes underneath. He even had his own amusement park moment, at the same place, Cedar Point in Ohio, where Jessica had been embarrassed.


Yet he had a hard time committing to the surgery. It was such a big step, and once it was done, there was no going back.

In the end, it was Keith’s son who tipped the balance. “I don’t want you to die, Dad,” he told him one day when the two were playing video games. He looked up at Keith, saying, “Dad, we need to do something.”


The Operation
By the day of their surgeries, Oct. 12, 2015, Jessica and Keith had spent months preparing.
They had had medical and psychological tests. They went to counseling and mandatory sessions explaining what was going to happen, and what to expect and how to eat afterward.

They learned that the gastric bypass operation both had chosen (it and a procedure called the gastric sleeve are the two main options) leaves patients unable to absorb some vitamins and minerals. They would need to take supplements daily for the rest of their lives. And because the rearranged digestive tracts can dump sugar into the bloodstream too quickly, they would have to be careful about sugar intake or risk “dumping syndrome,” which can cause vomiting, sweating and shakiness.

For two weeks before the surgery, Jessica and Keith followed a high-protein liquid diet to shrink their livers. People with obesity often have large, fatty livers that can get in the way during the operation.
The day before, Jessica stood at her kitchen counter preparing a mango protein shake with mango flavored Crystal Light and protein powder. It smelled foul. She forced herself to swallow it.
“I am excited,” she said.


At 6:30 the next morning, a nurse and a surgical resident wheeled Jessica into an operating room on a special wide gurney. They slid her onto an operating table that was set as low as it could go because bariatric patients’ abdomens rise high, as if they were domes.


The surgeon, Dr. Oliver Varban, started by inflating Jessica’s abdomen with carbon dioxide to give him more room to work. Then he made seven small holes in her skin and inserted his equipment, including a cylindrical tube containing a tiny light to illuminate her abdominal cavity, lenses, mirrors and a tiny camera to project the scene on a computer monitor above Jessica’s head. The screen showed gleaming golden bubbles of fat that were surprisingly beautiful.


Dr. Varban used what looked like a miniature table tennis paddle to push Jessica’s liver aside and give him a clear view of her stomach. Her intestines were obscured by fat, so he used a special surgical grasper to gently push the fat aside.

It might seem reasonable for Dr. Varban to simply remove some of the fat from Jessica’s abdomen, but doing that, he said, would result in a bloody, hemorrhaging mess. He explained that there is a mile of blood vessels in every pound of fat.


Dr. Varban cut off most of Jessica’s pink and healthy stomach, leaving a pouch the size of an egg. He stapled and sealed the pouch with a device that looked like a saw-toothed pair of shears, leaving a shiny metallic edge of staples. Then he grabbed the top of her small intestine and attached it to the stomach pouch.

A couple of hours later, he was done and it was Keith’s turn. The operation was the same, but Keith’s fat looked different, more yellow than golden, and lumpy. And there was much more of it — his organs were buried in it. Men tend to have thicker abdominal fat, Dr. Varban said, and it is slipperier, harder to grasp with the laparoscopic instruments.

Jessica and Keith spent two nights in the hospital and then were discharged, with instructions to follow a liquid diet for a couple of weeks and then gradually add solid foods.

Jessica was surprised by the pain. When she was home, recuperating, she started to have second thoughts about the surgery. One day, she sat down and cried.


“I had like this awful buyer’s remorse,” she said. “I was like, ‘What did I do to my body?’ This is not reversible, there is no going back.”

Improving the Technique
For years, surgeons thought weight-loss operations worked because they made the stomach so small that it hardly held any food. And with the bypass operation, they made it even harder for food to be digested. Of course patients lost weight.

But some things just did not add up.


A simple surgical treatment, the gastric band, which constricts the stomach, was widely used when it was first approved in 2011 but fell out of favor because its effects on weight were variable and almost always smaller than those of the other operations. It still is used (New Jersey’s governor, Chris Christie, had one), but it now accounts for just 5.7 percent of weight-loss surgeries.


At a recent meeting of Michigan bariatric surgeons, one doctor asked for a show of hands. Who in the room would refuse to do a gastric band procedure even if a patient asked for it? Just about every hand in the room went up.


“The most common operation with the band now is an operation to remove it,” Dr. Varban said.

Even leaving aside the gastric band issue, the idea that the bypass and sleeve surgeries were a mechanical fix, by limiting the amount of food a patient could eat, did not seem right.


Wiring people’s jaws shut would keep them from eating, noted Randy Seeley, who holds a doctorate in psychology and is a professor of surgery at the University of Michigan. But, he asked rhetorically, “If I wired your jaw shut, would you be more hungry or less hungry?”

In contrast, patients who had bypass and sleeve operations reported that they were not particularly hungry afterward, and that their incessant urges to eat vanished. Even more surprising, their taste for food often changed.


Dr. Lee Kaplan, an obesity researcher at Massachusetts General Hospital, recalled a patient who asked him: “Are you sure they didn’t operate on my brain? Food does not call out to me anymore.”

Another, who used to seek fatty and sugary foods, said, “I crave salads now.”

Dr. Justin Dimick, a bariatric surgeon at the University of Michigan, said a woman who lost 200 pounds told him that before the operation, a Reese’s peanut butter cup gave her such a rush that it was, she said, “like an orgasm of pleasure in my brain.” Now, she said: “It’s just peanut butter and chocolate. What’s the big deal?”


Experimental data support these reports. Both patients and rodents who had surgery are actually more sensitive to the taste of sweets: Receptors on their tongues detect smaller amounts of sucrose.

The data, the patients’ stories, made no sense if all surgery did was make it harder to eat, Dr. Kaplan said. Both the bypass and sleeve operations, he added, “drive the body to want to eat less.”

But why?

Some, including Dr. Seeley and Dr. Kaplan, looked for answers by studying the surgeries in fat rats and mice.
“What you find very quickly is that rats and mice lose weight just the way you see in humans,” Dr. Seeley said. “It’s remarkable.” Surgery changed the weight the animals’ bodies settled into. And, as with patients, their tastes in food changed.

For example, Dr. Seeley gave some rodents the exact bariatric surgery operation that humans get while he gave others, which served as controls, sham surgery: Researchers opened the animals’ abdomens and then sewed them shut. The bariatric surgery animals lost most of their excess weight and then stabilized at a lower weight.


Then the researchers put all the rodents on a diet. All lost weight.

Three weeks later, the animals were given as much food as they wanted. Those that had had the sham operation ate until they were back to their original weights. Those that had had the real bariatric surgery ate until they reached their post-surgery weight.


“Surgeons often talk about bariatric surgery as a tool. You have to follow all these instructions,” Dr. Seeley said. It only works, they tell patients, if they follow a diet and exercise program.

“My message is that the rats don’t appear to do it that way. They don’t know it’s a tool. They just naturally change lots of things in the way they relate to food.”

Three Months Later
After plummeting soon after the operation, Jessica’s weight began to fall more slowly. By January she had lost 65 pounds.


It showed. She moved more briskly and met me wearing a black elastic belt over a loose top. “I have a waist!” she exclaimed.

Her predicted final weight is 180 pounds, based on a statewide database of nearly 70,000 bariatric operations by 80 surgeons in Michigan. Doctors use it to calculate what a person Jessica’s age and starting weight can expect to weigh a year after the operation, when nearly all the weight loss will have occurred.

But her goal is to weigh 130 or 140, and she plans to diet to get there if the surgery does not do it for her.

Almost all patients have such vows, her surgeon, Dr. Varban, says. But they rarely succeed in losing more weight and keeping it off. The surgery resets their weight at a lower level, but it is just as hard to lose more than that as it was to lose weight before the surgery.


Still, Jessica did not crave food like she used to; some days she actually forgot to eat, she said. She was not counting calories or consciously trying to diet, but the weight came off. She still got hungry but was quickly satiated.

Yet surprisingly little had changed in her life. She had returned to community college after taking a semester off and her typical day was “the same as before,” she said. “I go to school or do homework. On days I don’t have school, I sleep or stay up late and watch shows or read into the night, from midnight until 5 a.m.”

She knew she was thinner, but she said: “I feel like the change isn’t dramatic enough. I look at myself and still see fat.”

Keith had lost 80 pounds by the time I visited in January. His sleep apnea was gone; he didn’t even snore anymore. His blood pressure dropped to normal before he left the hospital and stayed normal; before surgery he had been taking two drugs to control it.

He dropped 10 pants sizes — from 58 to 48. Even his shoe size shrank. His legs and knees did not hurt anymore.


And his eating habits were transformed.


“I used to crave pizza like crazy,” he said. He doesn’t like it anymore. It’s too heavy, too greasy.

Same with White Castle hamburgers, which he used to lust after. One day, on his way home from work, he bought a bag. Somehow, they didn’t smell appetizing. He took a bite. He did not like the taste.
“I don’t have to worry about White Castle hamburgers anymore,” Keith said.
But he, too, still thinks of himself as fat.

Keith knew he should exercise, although he never liked it. On a bright winter Saturday, I went with him to the gym. He stepped onto a treadmill and started to walk, going two miles at a pace of three miles an hour, sweating at the end, breathing a bit hard. Before surgery, walking on a treadmill for one mile at a pace of two miles an hour was a huge effort. We followed the treadmill with a one-mile walk on the gym’s indoor track.

Keith did not change into workout clothes at the gym, remaining in jeans (that were now loose) and a polo shirt. When I asked him why, as we drove away, he told me it must be a remnant of his school days when he did not change for gym class. Being fat stays with him.
“I have a fat brain,” he said.

Eight Months Later
One day in June, Jessica walked into the Ann Arbor Panera Bread where she had worked before her surgery, 90 pounds thinner than her peak weight of 295 pounds. She had cut her hair short and wore a glittery black scarf as a headband.


She ordered a turkey and cheese sandwich, a kids’ yogurt and a bottle of water. She ate slowly, as though hunger were an afterthought.


As the pounds dropped, she had become a bit more daring.


She even ventured onto OkCupid, an online matchmaking site, posting a couple of selfies. She got 30 likes and a few messages. But after six hours, she deleted her account.

“It was weird and it wasn’t me,” she said. She worried when one guy wrote, “Hey, want to have fun?” Another guy, she said, “seemed all right but then he started asking about sex and things.”

Still, she said, the experience “was definitely a confidence booster.”


When I visited Keith the same weekend, he had lost 93 pounds and was down to 277. But his weight loss had stalled, and he worried because his goal was to weigh 210. He wondered if he would even reach his projected weight of 230.


But he, too, had noticed some big changes. He mulched his front yard in a day. Before surgery, he said, it would have taken a couple of weeks. His back did not ache; his knees were not sore.
Keith’s weight loss, Christa said, “has definitely changed our relationship, in a good way.” He used to slouch on the sofa when he was off from work, too tired to accompany Christa on errands. Now, she said, “if I need to go to the store, Keith says, ‘Want me to come with you?’”

On that sunny June Saturday, I accompanied Keith, Christa and their son on a trip to Zingerman’s, a famous Ann Arbor deli. Keith’s jeans, size 44, had fit when he bought them a month earlier, but they were already loose. Christa and I watched as he tried samples of soft cheeses, seeking one with just the right tang. The other customers paid no attention, a big change from the presurgery days when people could not help staring at the fat man.

Resetting the ‘Set Point’
For obesity experts, bariatric surgery is at best a compromise. What they really want is a medical treatment with the same effect — lowering the body’s set point, the weight it naturally settles into — without drastically altering the person’s digestive tract.

Ten years ago, it seemed as if it could be simple.

“We had the idea that probably surgery did several distinct things that you could figure out,” Dr. Kaplan said. “If there were 10 different mechanisms, we could find 10 drugs that could hit them.”
If only.

It has become clear that bariatric surgery changes the entire setting of a complex, interlocking system. There is no one place to tweak it. To show what is involved, Dr. Kaplan reports that surgery immediately alters the activity of more than 5,000 of the 22,000 genes in the human body.


“You have to think of it as a whole network of activity,” Dr. Kaplan said. It’s a network that responds to the environment as well as to genes, he added. Today’s environment probably pushed that network into a state that increased the set point for many people: Their brains insist on a certain amount of body fat and resist diets meant to bring them to a lower weight and keep them there.


“Surgery moves the network back,” Dr. Kaplan said.

But surgery only alters the intestinal tract. That tells you, Dr. Kaplan says, that there are whole classes of signals coming from the gut and going to the brain and that they interact to control hunger, satiety, how quickly calories are burned and how much fat is on the body.

One major hormonal change is in bile acids. There are more than 100 varieties of these hormones, which help regulate metabolism and digest foods. They send out broad signals, like television signals, to any cells in the body with the capability to respond. And the relative proportions of the different bile acids change immediately with surgery.


That simplistic notion — that there may be just a few key places to intervene in the tangled web of controls that sets a person’s weight — seems just that: simplistic.
But some nodes of the network may be more important than others. They may be the drivers.

“What we need to do is find these mechanisms,” Dr. Kaplan said.


One Year Later
This fall, Michigan surgeons gathered about 100 bariatric surgery patients into small focus groups roughly a year after their operations and asked about their new lives, expecting mostly enthusiastic reports. Yet responses were muted.

“From an outsider’s perspective — as someone who hasn’t had the operation — it is confusing,” Dr. Ghaferi said. “Why on earth wouldn’t you be ecstatic?”


There was a lot of talk about changed relationships. Some patients had divorced or separated from a spouse. Some said that a partner did not like the way they looked, or that their partner was still obese and jealous, or that the partner complained, “You’re not the person I married.”


Some believed that people would judge them for having had the surgery, so they kept the operation a secret.

Some did not like the way they looked. It was not enough weight loss, or they were not aware — although it had been part of their presurgery education sessions — that they would end up with big flaps of loose skin that could be gotten rid of only with extensive and expensive plastic surgery.
On the other side of the equation, patients raved about newfound energy and stamina, and the way joint and back pain disappeared. They loved tossing away medications for diabetes or high blood pressure.

Jessica and Keith, too, had mixed reactions.


A year after his surgery, Keith weighed 284 pounds, down from his starting weight of 377, but not at his projected weight of 230. It is increasingly unlikely that he will get there.


But he looked and felt transformed.

“Some people I haven’t seen in years don’t recognize me,” Keith said.

“And I do have more energy,” he added. “It is a huge difference.”

Yet he is still fat, and still feels big. “I expected all my weight to be gone,” Keith confessed over lunch at a sushi restaurant near his work. “I wanted to be 230. I was hoping.”


And he misses his former lust for food. “I just liked eating before. I liked to eat.”

Jessica lost 112 pounds, just about exactly what was predicted.


“I expected myself to grieve a lot more for my loss of my old relationship with food, and I didn’t,” she said.

She began classes at Eastern Michigan University in the fall but dropped out in October, explaining that she did not like the courses and had a lot of anxiety. While she waits to apply to another college, she is working at coffee shop near her home. She still lives at home.

Before her operation, she could blame her stalled life on her obesity. Now, she says, “I don’t have an excuse anymore.”

“I’m smaller,” she said. “But it’s been gradual enough that I still feel like I’m the biggest person in the room wherever I go.”

On the other hand, her acid reflux is gone and she had the confidence to buy a bike.

She wants to lose another 40 pounds. Her plan is to start with that awful liquid diet she was on for two weeks before her surgery. In the meantime, she has not bought new clothes, holding off until she loses more weight. She says she will consider having plastic surgery to remove loose skin after she loses more pounds.


Yet, Jessica says, although she has mixed feelings about the results of the surgery and although she is disappointed that her life has not changed as much as she hoped, she does not regret having the operation.

And she had some triumphs.

She went back to the amusement park where she had been so humiliated when she was turned away from a ride, too big for the safety bar to go over her.

Now she fit.