Seems nuts to say this in the season of Republican debates, but I steer clear of political commentary. That doesn’t mean I’m not opinionated. It’s not about politics. I was always quick to launch my opinions and their passionate defense which too often, on reflection,  I might have been wrong.  Besides I’ve found that type of personality to be seriously off-putting.  I prefer to control myself and listen.

I was just in a political squabble each of us touting books -His was the new book attributed to Ted Cruz,  where it occurred to me we were at cross purposes at deciding what to read. I love books but almost never read one like that, campaign-political, likely to be written by others.To the extent I read newspapers  or listen to media, it is often political. But politics for me is secondary. I care less about being consistent with a particular political persuasion than deciding political issues on the basis best knowledge. Non-polemic endeavors, especially science, and even good fiction, secondarily inform politics and it isn’t the other way around. Politics should be in service of the truth opinion fashioned on the basis of fact.

The worst sin is to bend the truth to one’s political purposes. Distorting truth is always a sin, even the so-called white lie. But to distort the truth for political purpose is a hallmark of the worst regimes we have seen in the twentieth century, Stalin, HIlter, Mao.

It was obvious the kind of stuff my political friend likes to read and what I like to read are totally different. First of all I read more, but also I read different. He likes to think he is broad-minded because he reads or “monitors” as he likes to put it, political tracts with totally the opposite view that he likes. He is not broad-minded as he seeks only to denigrate the thoughts of the other side. He says he knows their failed arguments and the virtues of his own all the better.  I notice nothing I say, even proving internal contradiction of his own arguments, moves him in any way, and I’ve tried to avoid talking at all about this, whenever possible changing the topic to something jocular or apolitical. But he isn’t interested in anything else.

I should explain. Here’s an example of internal inconsistency. He is a libertarian conservative. Government should not take away any of our personal liberties even if dangerous or fatal such as to own guns, he feels. So he thinks some freedoms more important than the shedding of innocent blood. Fine.  But then he turns around and says he’d compel a teen to carry a baby to term and give birth to a baby, conceived in rape or incest. What better time for the government to stay out and let the matter be decided by the lady, her doctor and family in private? To me forcing a woman to carry this baby is raping (forcing, compelling)  her twice. This reprehensible forceful behavior fails the yuk test.  Here I am the libertarian, not him. Now he will read the propaganda on both sides as this issue is important to him so he is the broad-minded one. He hangs in the clouds, above all the arguments.  He has chosen what is correct for all eternity and will never budge. For myself, I try to steer away from propaganda altogether, not always successfully. But I’d be more interested on a good story about this young woman, real or fictional, well written that skirts the politics. I’d rather read science or even religion, not polemics. He reads political tracts and few books. I read books and hardly any politics.

It struck me he has a fundamentally different aim in his reading than I do. I didn’t realize this until recently. I am sure of it. He seeks to read something on his side that fortifies his position. He likes to read something on the other side so he can pat himself on the back. So he is always trying to reassure himself in his reading. This is a reasonable goal in consuming content.

I can say forthrightly that I never read for those reasons. I read to learn. I like something that will put me in a place I have never been before like National Geographic make me sense something I have not up until now and most of all I like what will change me like an epiphany.  Nothing pleases me more than expanding horizons. I have an idea in my head about who is the greatest person. I think it’s one with the widest vision. Some say it’s someone who has done something spectacular and I can see that argument too. But what a person can do if fairly narrow and finite. Your vision tries to be infinite.

I have a lot to learn.  I want to see like I have not before. What’s best is counterintuitive. Something that on first inspection proves me wrong will give me reason to read. Right now I am reading Nudge which so far seems a polemic against Adam Smith’s point of view.  I’ve been brought up to believe about how in a free economy the individual makes wise choices. But we see time and again people make poor choices opposed to their own self-interest. Richard Thaler latches on to this very phenomenon, the non-wise individual to build a whole psychology of choice and then plans to tell us how gentle manipulation he calls architecture of choice may be used for the betterment of lots of humans.

Thaler talks about two parts of the brain. As a neurologist I happen to have an interest in his anatomical point of view, and I can see he has anatomy and physiology a bit wrong maybe striving to be simplistic. That would be his neat splitting of the reptilian and the more advanced cortical brain. Actually much of what he describes in type I psychology is cortical.  I like that stuff as I can add it to my own points of view and use it, to move beyond Adam Smith’s original paradigm into a new conception. This is useful information for me, like Einstein building on Newton.

I just finished Alice Dreger’s Galileo’s Middle Finger. I thought it would be about Galileo and the history of science. It really wasn’t about that.  It was one of those books that I read that was about a personal struggle that tries to apply widely held principles to her own parochial arguments and they weren’t convincing. I had no idea the whole book practically would be about Intersex,  something maybe I don’t know enough about. I was surprised to see that a model of male to female transsexuals  that I’d subscribed to seems to be substantially correct though I don’t claim great knowledge on this fascinating topic.  I liked how she described being influenced by evidence in preference to emotion, though the text was highly charged,  and came to defend some people I admire, EO Wilson giant of Sociobiology and Napoleon Chagnon.  It is annoying when someone boasts they have the genes of a god like Galileo as she does. She lacks Galileo’s most important characteristic. Galileo was an empiricist, a master of experiment and convinced by objective reality available to everyone. Dredger is a theoretician, expert on the history of science, not an experimentalist. Doesn’t she know that?  But she is not a clinician either and was out of her depth, I thought, attacking physicians who sought to help their patients with the best technology they had at the time.

I hardly thought this was accidental that she failed to explain some theoretical things, she definitely should have, basic physiology behind of one of the conditions she writes on, congenital adrenal hyperplasia. When feedback mechanisms are fully explicated and understood, that  bolsters her opponent’s arguments.  The therapy prescribed is a highly reasonable approach that is likely to improve the entire life of the patient.  By the way it is wrong to call  a therapy that lacks FDA approval, “experimental.”

I have witnessed medicine over the course of my career evolve from a paternalistic model, in which certain information thought by the doctor to increase suffering (such as emphasizing someone’s imminent death) was kept from him or her over to the other extreme, anethic of brutal honesty and truth. The patient and family are between all this given all the facts, but burdened by decisions often better and  efficiently borne by an informed clinician. Medical practice is embedded in societal norms which change over time. I see patient advocacy as having little impact on this process. Medicine has evolved with society, generally but not always for the better.

Now that we have over 8 drugs to treat MS some clinicians weigh patients down with wagon loads of advertisements which are far from not objective and tell patients to make a choice. There is an intelligent choice for these patients which should to be made by the doctor, who might in the end give them some choice between one or maybe two drugs.  Anyway since I did not initially know what Dreger’s book was about and stuck through it anyway, I got what I wanted, which was the unexpected.

Due to the fact that me and the fellow I was arguing with, read for totally different reasons, I compiled a little list which purports to give motivations for reading. It can’t possibly be comprehensive. You will certainly think of other motivations. But here is something to start.

Motivations to read.

1. To confirm your opinions, pat yourself on the back

2. Learn something new. Sense new things. Change yourself.

3 Go to where you’ve never gone before or conversely relive experience

3. Entertainment.

4. Something to pass the time

5. Show you’re smart. For ammunition in future discussions.

6. Read narrowly to gain expertise in a field

7. Mental Exercise, devotional as in Bible

8. Book club. Though individual, a social endeavor.

9. Ritual reading. Book as social instrument.

10. Therapeutic Reading

11. You are forced to read by a teacher, boss, judge.

Why do you read?