Skip to content

An Interview with John Collins and Jennifer Hamilton on the Women in “The Message,” Casting Pearls Project, Abuse, and William Marrion Branham (Part Four)

Interviewer: Scott Douglas Jacobsen

Numbering: Issue 21.A, Idea: Outliers & Outsiders (Part Seventeen)

Place of Publication: Langley, British Columbia, Canada

Title: In-Sight: Independent Interview-Based Journal

Web Domain: http://www.in-sightjournal.com

Individual Publication Date: October 15, 2019

Issue Publication Date: January 1, 2020

Name of Publisher: In-Sight Publishing

Frequency: Three Times Per Year

Words: 2,068

ISSN 2369-6885

Abstract 

John Collins is an Author, and the Webmaster of William Branham Historical Research. Jennifer Hamilton runs Casting Pearls Project. They discuss: the overview of the abuse, the sexual abuse, of those who were or are followers of “The Message”; common sentiments among ex-followers; standard reaction to victims and individuals making claims of sexual abuse within “The Message” community; the activity of law enforcement; the consequences of the sexual assaulters, the rapists, and the sexual sadists abusing men and women, boys and girls, within “The Message” community; and facing justice.

Keywords: abuse, Christianity, John Collins, justice, Seek The Truth, sexual abuse, The Message, webmaster, William Marrion Branham, women.

An Interview with John Collins and Jennifer Hamilton on the Women in “The Message,” Casting Pearls Project, Abuse, and William Marrion Branham: Webmaster, William Branham Historical Research; Lead, Casting Pearls Project (Part Four)[1],[2]

*Please see the footnotes, bibliography, and citation style listing after the interview.*

1. Scott Douglas Jacobsen: Do many ‘Message’ followers of WMB raise issues or concerns about the sexual abuse in the community?  What is the overview in terms of the abuse?

John Collins: For this portion of the interview, I’ve asked my friend and colleague Jennifer Hamilton for input.  Jennifer has experience working with former members of William Branham’s “Message” cult, specifically with females who suffered many forms of abuse while they were part of the cult group.  Jennifer runs the Casting Pearls Project, which is a safe place for women who suffered abuse in the “Message”.

According to Jennifer, victims are pressured into keeping silent about abuse.  As a result, many members of the group are unaware that sexual abuse exists.  Worse, some people that are aware of the abuse have become accustomed to it and view the abuse is “normal”.  Some message followers rarely speak up against sexual abuse within the church because they are conditioned to keep silent.  In many cases, there seems to be an unspoken rule that “if you speak about the problem, then you are the problem”.

When a religious cult becomes destructive, members of the group willingly submit supreme authority to a central figure (or figures) and do so without applying critical thought or raising questions when situations arise worth questioning.  This often leads to sexual, physical, verbal, and emotional abuse by those with unquestioned power or control over their members.

2. Jacobsen: What is the common sentiment among ex-followers?

John: In my experience working with former members of the “Message” and other religious cult groups, it takes time before former members recognize the existence of abuse.  With the conditioning for acceptance of certain types of abuse, some former members are unaware their environment was abusive until adjusting to a non-abusive environment.  This is especially true of second and third-generation cult members who were raised under abuse.  Those raised under parents practicing verbal or physical abuse as means of “correction” have limited or no understanding of positive reinforcement and continue the tradition with their own children.  As awful as it sounds, some former members describe the transition from thinking sexual abuse was “normal” to realizing they were abused.  Years of sexual molestation had become their “normal” life.

Jennifer Hamilton: Because abuse is so normalized within the church, it takes some time of de-programing to understand how toxic their church environment really was.  For other former members, surfacing stories of sexual abuse may come as a shock because of the required silence of victims and families involved.

3. Jacobsen: What is the standard reaction to victims, or individuals making claims to being victims at least, of sexual abuse within the “Message’ community?

Collins: I personally know abuse victims whose “Message” cult pastor became informed of the situation during private consultation and was asked to intervene.  One case in particular, the father was abusive to the mother and children.  The pastor further victimized the mother and children by shaming them further into submission.  In many cases, victims are shamed into silence, no matter how they badly were abused.

Hamilton: Typically, one of three scenarios happen when sexual abuse occurs.  Unfortunately, more often than not, the victim of rape or sexual assault is afraid to speak up and the abuse is never mentioned to anyone in church authority.  The second scenario is that the victim does speak to their pastor or church leader, but the pastor ‘handles’ the situation by either admonishing the abuser privately or dismissing the situation all together.  The third scenario is the less common of the three, but the pastor might bring the offender before the congregation to reprimand them openly. In both instances of speaking out, the victim is almost always shamed and found at some fault.  For sexual abuse towards girls and women, teachings of WMB place blame on the female body for being seductive and therefore a temptation.

Because of victim shaming and lack of appropriate response, there is a psychological sense of no escape for victims.  If they did speak up at one time, they eventually feel trapped into silence.  This creates the vicious cycle of abuse in some cases to continue on for years.

4. Jacobsen: Has law enforcement been active or not?

Collins: I know only of a few situations where law enforcement was involved, and only at the request of victims.  “Message” cult churches are not properly trained in how to properly respond to abuse, and in many cases, make attempts to conceal abuse rather than report it.  In most cases the statute of limitations has expired long before the victim escapes the cult, and correction is outside of the boundaries of the law.

Hamilton: Leaders and members distrust the secular legal and social services system. Very rarely is law enforcement involved.  Therefore, when sexually abused members do speak out, the leader dictates complete control of the situation without reporting it to the local authorities. 1 Corinth 6:1-2 is most often used to justify this: “Does any one of you, when he has a case against his neighbor, dare to go to law before the unrighteous, and not before the saints? Or do you not know that the saints will judge the world? And if the world is judged by you, are you not competent to constitute the smallest laws courts?” Message pastors have no theological or counseling education and erroneously fail to understand that this passage is about settling civil cases, not criminal ones. In a criminal case, such as physical or sexual abuse, the state opposes the perpetrator in court, not the victim.

5. Jacobsen: What have been the consequences of the sexual assaulters, the rapists, and the sexual sadists abusing men and women, boys and girls, within the “Message” community?

Collins: There have been a handful of convictions in cases involving sexual abuse, usually in cases where the pastor or an elder in the church victimized others.  Because of the shaming and silencing of victims by pastors, most cases reported by former members result in little more than a slap on the wrist.  In one case, a pastor’s daughter was abusing male children in the church and was allowed to keep her position.  In other cases, the fathers were not properly reported to authorities, and continued to abuse their daughters.  Unfortunately, most of the situations described to me by former members were past the statute of limitations for the State they lived at the time.

Hamilton: Consequences for rapists and sexual assaulters is rarely appropriate for their actions.  Most are never confronted, and if they are approached by church leadership, they are usually verbally admonished in private. In the cases of the abuser being the pastor or in leadership, the victims are likely labeled liars and disregarded.  Abusers in the Message are more protected than their victims through the forced silence. The Message teaches that if the rapist or assaulter confesses, their sin is “placed under the blood of Jesus”, making them as “blameless” as if the crime literally had never happened. Therefore, anyone who speaks about it is shamed for bringing that sin “back out from under the blood”.  In some very rare instances, law enforcement may be involved with or without the pastor’s consent.

6. Jacobsen: For those who have not faced justice, how can they face it?

Hamilton: Time unfortunately impedes most abusers from facing the justice they deserve.  Victims that are now speaking out about the abuse are sometimes unfortunately past their state’s statute of limitations.  After leaving the cult, there is a processing period for de-programming and realizing that the abuse had been normalized and that justice was not served.  No matter the length of time, victims can contact their local police station or Salvation Army for resources and advocates.

Collins: The only way justice can be served is through education and accountability.  Members of any church – cult or not – must hold elders of the church to an acceptable standard of accountability.  Leaders of church bodies must be trained in how to respond to abuse, when to report abuse, and how to properly warn members of their church when another member has abusive tendencies.  As the proverbial “shepherd of the flock”, they must be held accountable to provide protection for their congregation.

At the same time, members of the church must be educated to recognize signs of abuse and recognize abuse of power.  This becomes problematic for leaders, however, in the case of a destructive cult.  In all cases where members are trained to recognize abuse of power, those same members become former members.

Jacobsen: Thank you for the opportunity and your time, John and Jennifer.

Appendix I: Footnotes

[1] Author; Webmaster, William Branham Historical Research; Lead, Casting Pearls Project.

[2] Individual Publication Date: October 15, 2019: http://www.in-sightjournal.com/collins-four; Full Issue Publication Date: January 1, 2020: https://in-sightjournal.com/insight-issues/.

Appendix II: Citation Style Listing

American Medical Association (AMA): Jacobsen S. An Interview with John Collins and Jennifer Hamilton on the Women in “The Message,” Casting Pearls Project, Abuse, and William Marrion Branham (Part Four) [Online].October 2019; 21(A). Available from: http://www.in-sightjournal.com/collins-four.

American Psychological Association (APA, 6th Edition, 2010): Jacobsen, S.D. (2019, October 15). An Interview with John Collins and Jennifer Hamilton on the Women in “The Message,” Casting Pearls Project, Abuse, and William Marrion Branham (Part Four)Retrieved from http://www.in-sightjournal.com/collins-four.

Brazilian National Standards (ABNT): JACOBSEN, S. An Interview with John Collins and Jennifer Hamilton on the Women in “The Message,” Casting Pearls Project, Abuse, and William Marrion Branham (Part Four). In-Sight: Independent Interview-Based Journal. 21.A, October. 2019. <http://www.in-sightjournal.com/collins-four>.

Chicago/Turabian, Author-Date (16th Edition): Jacobsen, Scott. 2019. “An Interview with John Collins and Jennifer Hamilton on the Women in “The Message,” Casting Pearls Project, Abuse, and William Marrion Branham (Part Four).” In-Sight: Independent Interview-Based Journal. 21.A. http://www.in-sightjournal.com/collins-four.

Chicago/Turabian, Humanities (16th Edition): Jacobsen, Scott “An Interview with John Collins and Jennifer Hamilton on the Women in “The Message,” Casting Pearls Project, Abuse, and William Marrion Branham (Part Four).” In-Sight: Independent Interview-Based Journal. 21.A (October 2019). http://www.in-sightjournal.com/collins-four.

Harvard: Jacobsen, S. 2019, ‘An Interview with John Collins and Jennifer Hamilton on the Women in “The Message,” Casting Pearls Project, Abuse, and William Marrion Branham (Part Four)In-Sight: Independent Interview-Based Journal, vol. 21.A. Available from: <http://www.in-sightjournal.com/collins-four>.

Harvard, Australian: Jacobsen, S. 2019, ‘An Interview with John Collins and Jennifer Hamilton on the Women in “The Message,” Casting Pearls Project, Abuse, and William Marrion Branham (Part Four)In-Sight: Independent Interview-Based Journal, vol. 21.A., http://www.in-sightjournal.com/collins-four.

Modern Language Association (MLA, 7th Edition, 2009): Scott D. Jacobsen. “An Interview with John Collins and Jennifer Hamilton on the Women in “The Message,” Casting Pearls Project, Abuse, and William Marrion Branham (Part Four).” In-Sight: Independent Interview-Based Journal 21.A (2019):October. 2019. Web. <http://www.in-sightjournal.com/collins-four>.

Vancouver/ICMJE: Jacobsen S. An Interview with John Collins and Jennifer Hamilton on the Women in “The Message,” Casting Pearls Project, Abuse, and William Marrion Branham (Part Four) [Internet]. (2019, October 21(A). Available from: http://www.in-sightjournal.com/collins-four.

License and Copyright

License

In-Sight Publishing and In-Sight: Independent Interview-Based Journal by Scott Douglas Jacobsen is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Based on a work at www.in-sightjournal.com.

Copyright

© Scott Douglas Jacobsen, and In-Sight Publishing and In-Sight: Independent Interview-Based Journal 2012-2019. Unauthorized use and/or duplication of this material without express and written permission from this site’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Scott Douglas Jacobsen, and In-Sight Publishing and In-Sight: Independent Interview-Based Journal with appropriate and specific direction to the original content.  All interviewees co-copyright their interview material and may disseminate for their independent purposes.

Advertisements

An Interview with Distinguished University Professor Gordon Guyatt, OC, FRSC on EBM and Too Much Medicine (Part Three)

 

 

 

 

 

 

 

 

 

 

 

 

Interviewer: Scott Douglas Jacobsen

Numbering: Issue 21.A, Idea: Outliers & Outsiders (Part Seventeen)

Place of Publication: Langley, British Columbia, Canada

Title: In-Sight: Independent Interview-Based Journal

Web Domain: http://www.in-sightjournal.com

Individual Publication Date: October 8, 2019

Issue Publication Date: January 1, 2020

Name of Publisher: In-Sight Publishing

Frequency: Three Times Per Year

Words: 2,859

ISSN 2369-6885

Abstract 

Dr. Gordon Guyatt, OC, FRSC is a Distinguished University Professor is the Department of Health Research Methods, Evidence, and Impact at McMaster University. He discusses: Cochrane Collaboration and EBM; Too Much Medicine; and the start of the Too Much Medicine movement.

Keywords: Canada, evidence-based medicine, Gordon Guyatt, medicine.

An Interview with Distinguished University Professor Gordon Guyatt, OC, FRSC on EBM and Too Much Medicine: Distinguished Professor, Health Research Methods, Evidence, and Impact, McMaster University; Co-Founder, Evidence-Based Medicine (Part Three)[1],[2],[3],[4]

*Footnotes in & after the interview, & citation style listing after the interview.*

*This interview has been edited for clarity and readability.*

1. Scott Douglas Jacobsen: Before the last calls over the last several months; we have talked about how to do effective speeches, for instance. We have talked about some of the talks that you have given on EBM. Some of the other things we could probably talk about would be the areas in which the Canadian public is known not to have a savvy attitude about science, as close to as desired as possible.

It hasn’t been talked about before, but it is something that they need to know. So, strongly, a bit of apart from this conversation on supplements and Chinese medicine compared to the methodology of EBM, in terms of getting some good information out.

Distinguished Professor Gordan Guyatt: So, in fact, I do not have much to say. That is not an area of my particular investigation now. There is attention being given to getting the information to the doctors and the other health professionals. There is work going on; they’re getting it out to patients,

Is there is much less being done and being studied in terms of how to get an opt out to patients? People are hoping that if you get it out to the health providers; the health providers will effectively communicate it to the patients.

Now, that may or may not be the case.

Jacobsen: [Laughing].

Guyatt: That is the hope. So, what do I do about this? The Cochrane Collaboration, which puts together systematic reviews, as plain language summaries for patients up to date, this electronic textbook now has hired somebody to try and get the material in a way that it can be communicated well to patients. So, you have a few initiatives like this, but nobody is doing an up to date for patients exclusively. Nobody is, I do not think that nobody is taking it seriously.

Having them helping patients to dealing with the incredible profusion of sometimes valuable, sometimes misleading, information on the internet, for instance. So long way, long way to go, in terms of there as well, so, one of my colleagues now has a focus on this. You said earlier on the skeptics about science.

Jacobsen: [Laughing].

Guyatt: So, the skeptics about science: their problem may be that they do not understand that there are ways of getting accurate, reliable, trustworthy inferences, in ways that aren’t useful. Their skepticism may be from not being able to make that distinction, or thinking it is impossible to make that distinction.

So, this colleague of mine by the name of Andy Oxman, he is about my age. So, he is in the latter part of his career. For the last few years, he has been focusing on getting – his goal is people – getting people to be able to assess health claims, to have the wherewithal. He has decided, looking at the world, that the only way to do this is to get them while they’re in school. When they’re out, subsequent to that, it is pretty difficult. Maybe not hopeless, but pretty difficult.

Although his research states, so I’ll show you. I’ll tell you about one of those results that suggests it is not complete.

Jacobsen: [Laughing].

Guyatt: He remarkably asked: where if you wanted to do this, where would you start?

He said, “Let’s start in grade schools in Uganda.” So, he goes; he teaches grade school kids in Uganda on how to assess health claims. He creates material that is appropriate for assessing health claims. Among again, school children.

And the he did a big randomized trial, where they went to their regular schools. They went to the schools where the teachers were provided with the materials to teach children how to assess health claims: big effects, big positive effects on children being assessed and able to assess health claims. Where the other interesting finding, the kids got to take their material home to the parents, show their parents the material, then there was some little extra material that they could give to the parents. Against all odds, the parents’ ability to assess health claims improved as well, having been taught by their children.

Jacobsen: Statistically, scientifically.

Guyatt: Interesting. So, he is now saying, “Now that we have done the easy part with Uganda, let’s take it to the Western world.” Now, we have done the easy part with the great school kids, let’s take it to the kids in high school. That is where he is doing ongoing work at the moment.

Jacobsen: That is interesting.

Guyatt: Yes.

2. Jacobsen: That is interesting. I recall some research, it was around that type of math, and then the age of the person in terms of their future interest in sciences, the STEM fields. So, if someone – it was Algebra, and it was age 12, I think, one is starting to learn some of these slightly more advanced math concepts relative to their age.

If they learn that, and they get the principles down, it is something about early, abstract manipulation of variables. That becomes a strong predictor for interest in Science. So, I’d be curious to know what the end result of all this research is, in terms of knowing; maybe, there is a general curve of possibility and then the decline.

Because you are noting after school, you are getting older, then more established cognitively. So, they’re more fixed in terms of their, unfortunately, sometimes non-critical thinking about what we were talking before alternative epistemologies.

Guyatt: Non-predictable, or sets of rules, they’re very critical but misguided.

Jacobsen: That is a good way to put it. What are some extra topics? We could cover the pressure research out all these new aspects, especially NMAs and, and then alternative medicine, big data, “Chinese medicine for 6,000 years,” outreach in Uganda.

Guyatt: Something else occurs to me. So, there is now a movement called Too Much Medicine.

Jacobsen: You are kidding.

Guyatt: No, no, no, a big movement, Too Much Medicine.

3. Jacobsen: Where did it start?

Guyatt: It started in the Clin-Epi (Clinical Epidemiology) in the EBM Clin-Epi world, or I would say this is the source of it. There is a campaign called Choosing Wisely. That is a related thing. Then it comes from an awareness that we are doing too many tests where are the benefits are questionable and we are giving up treatments where the benefits are questionable.

So, there is now a whole movement to say, “Wait a minute, we have gone too far. We need to scale back.” So, I’ll tell you about three of our relevant BMJ rapid recommendations. So, it used to be that when you hurt your knee, torn meniscus, as they say, the cartilage.

So, before the surgeons would operate, they had to be sure. It was hard to be sure, because the X rays can only show the bones; they cannot show the soft tissues. If you had an operation, it was a big deal. It took weeks to recover from your surgery. So, two things happened there. One was, we had MRI that could show the soft tissue. So, you can say, “Aha, that cartilage looks torn.”

We can fix that, arthroscopic surgery. We do not have to open anymore. We can stick the little thing. We can operate arthroscopically. A gigantic expansion in the surgeries, hundreds of thousands of them all the time, taking tens of millions of dollars. The patients go to the surgeon and they said, “Oh, thank you, doctor, I am better.”

Jacobsen: [Laughing].

Guyatt: They get going, and so a randomized trial. People are doing randomized trials of mock surgery, or placebo surgery.

Jacobsen: [Laughing].

Guyatt: What they do is they, for instance, whether you are getting real surgery or not, they will put up a screen between you and your knee.

Either they will do the real thing, or they will splash around some water to simulate this though, they will give you a little plat. Now, you need a little anesthesia to do this thing. Move your knee around, in the end, the patient does not know whether they got the surgery or not. As it turns out, the first one of these trials shows no benefit from the surgery. Surgeons do not want to hear this. They have all sorts of reasons.

All sorts of reasons not believe it. But then, there is a second trial, showing no difference. The third and the fourth and the fifth, and the surgeons won’t still believe it. So, now, we have about 10 trials.

Jacobsen: Wow.

Guyatt: By 10 of them, we can do a meta-analysis. So, now, we are able to pick up small effects. There is a small transient benefit. So, three months, people with the surgery do a little better, the effect seems to disappear by six months, but it is trivial. Our guideline panel, our rapid recommendations guideline panel, thought so clearly trivial that they were making a strong recommendation against this search.

Worldwide, there are probably, literally, millions of these surgeries happening every year that they are doing and having marginal, trivial benefit. So, this is an example of too much medicine. Then another one, when you break your bone, this putting a particular type of ultrasound is supposed to help heal and, maybe, radiologically it does. We did the biggest trial so far of this ultrasound machine. We failed to show any difference on radiologic healing, but clearly absolutely no difference in terms of function.

We did the meta-analysis and randomized trials, no difference in function, again, millions of dollars being spent on this stuff that isn’t doing anybody any good. I made a strong recommendation against this. Our latest one is shoulder. So, it is the same story as the knee. It used to be that you had to operate the shoulder, big deal. Surgeons were quite hesitant to do this.

We didn’t have the radiologic tools to investigate it. Then we got the MRI to show exactly what’s going on with shoulder. We can now do arthroscopic. So, so this takes off., bunch of randomized trials show a small benefit, then people do two of these blinded placebo surgery trials – no benefit.

Jacobsen: [Laughing].

Guyatt: So, and what we are finding out is surgery has substantial placebo effects. Right? Yes, people do feel better. But it isn’t the surgery. It isn’t. It isn’t that somebody with something biological happened. It is that surgery has big placebo effect. So, anyway, all these shoulders, so the latest it is not out yet being not quite out yet, it will be soon.

But our latest BMJ rapid recommendation is a strong recommendation against doing this surgery. So, our rapid recommendations have three examples, so far, of too much medicine.

4. Jacobsen: When did this movement start with Too much Medicine?

Guyatt: Five years ago.

Jacobsen: Who was the founder?

Guyatt: Oh, there is no one individual. If there is, I do not think there is one individually. There are a lot of people who contributed. I was at this too much medicine conference. So, there is now a regular too much medicine conference. People come together. They share stories of too much medicine. So, here is another, here is a good one that I heard of. So, a drug company starts to think that, “Well, first, there are these stories of how the companies, the first thing they do is they do a campaign to create a disease that was not there before.”

This disease that was not there before, is dry, itchy, uncomfortable eyes. Then they say, “There is an epidemic of this dry, itchy, uncomfortable eyes.” Then they have a drug, “This is what you need for your dry, itchy, uncomfortable eyes.” Again, randomized trials are in our margins, no benefits. But nevertheless, they have been able to create a big industry. Now, the funny part of this, so they were telling the story and it is probably problematic.

So, again, millions of people using this, huge amounts of money spent on this stuff. It is a drug that you use for chemotherapy that they’re putting in people’s eyes, believe it or not. Then thousands of people are doing that. Now, the funniest part is as we are talking about this, my eyes start to feel quite uncomfortable.

Anyway, I was talking to one of my various seniors. He said the same thing. I started on the power of suggestion, “Isn’t it?” So you have these advertising campaigns? “Oh, I feel my eyes like this. It is a little uncomfortable.” It is funny. I mean, I do not know.

Every time I talk about it, I get the same sensation in my eyes, not when I am not talking about what I am talking about it.  So, here is another example, here is another example of too much medicine. So there are lots of these, there are real problems with too much medicine.

Jacobsen: Fair enough. When we talk of the grade, the NMA, the EBM, of either acronyms or initialisms coming into the medical fields, now, when a lot of this almost a medical yawn effect. So, maybe if someone’s reading this, they can come up with a YAWN acronym for this effect of someone yawning, it is contagious. Contagious, but not innocuous.

Guyatt: Good point. It is contagious the way the audience is contagious.

Jacobsen: That is stunning.

Guyatt: There was one, this conference and one story after another of these things.

Jacobsen: That I would like to explore next, if possible.

Guyatt: All right.

5. Jacobsen: Excellent. Thank you much for your time. Appreciate that.

Guyatt: Pleasure. Take care. Bye for now.

Appendix I: Footnotes

[1] Distinguished Professor, Health Research Methods, Evidence, and Impact, McMaster University; Co-Founder, Evidence-Based Medicine

[2] Individual Publication Date: October 8, 2019, at http://www.in-sightjournal.com/guyatt-three; Full Issue Publication Date: January 1, 2020, at https://in-sightjournal.com/insight-issues/.

[3] B.Sc., University of Toronto; M.D., General Internist, McMaster University Medical School; M.Sc., Design, Management, and Evaluation, McMaster University.

[4] Credit: McMaster University.

Appendix II: Citation Style Listing

American Medical Association (AMA): Jacobsen S. An Interview with Distinguished University Professor Gordon Guyatt, OC, FRSC on EBM and Too Much Medicine (Part Three) [Online].October 2019; 21(A). Available from: http://www.in-sightjournal.com/guyatt-three.

American Psychological Association (APA, 6th Edition, 2010): Jacobsen, S.D. (2019, October 8). An Interview with Distinguished University Professor Gordon Guyatt, OC, FRSC on EBM and Too Much Medicine (Part Three)Retrieved from http://www.in-sightjournal.com/guyatt-three.

Brazilian National Standards (ABNT): JACOBSEN, S. An Interview with Distinguished University Professor Gordon Guyatt, OC, FRSC on EBM and Too Much Medicine (Part Three). In-Sight: Independent Interview-Based Journal. 21.A, October. 2019. http://www.in-sightjournal.com/guyatt-three>.

Chicago/Turabian, Author-Date (16th Edition): Jacobsen, Scott. 2019. “An Interview with Distinguished University Professor Gordon Guyatt, OC, FRSC on EBM and Too Much Medicine (Part Three).” In-Sight: Independent Interview-Based Journal. 21.A. http://www.in-sightjournal.com/guyatt-three.

Chicago/Turabian, Humanities (16th Edition): Jacobsen, Scott “An Interview with Distinguished University Professor Gordon Guyatt, OC, FRSC on EBM and Too Much Medicine (Part Three).” In-Sight: Independent Interview-Based Journal. 21.A (October 2019). http://www.in-sightjournal.com/guyatt-three.

Harvard: Jacobsen, S. 2019, ‘An Interview with Distinguished University Professor Gordon Guyatt, OC, FRSC on EBM and Too Much Medicine (Part Three)In-Sight: Independent Interview-Based Journal, vol. 21.A. Available from: <http://www.in-sightjournal.com/guyatt-three>.

Harvard, Australian: Jacobsen, S. 2019, ‘An Interview with Distinguished University Professor Gordon Guyatt, OC, FRSC on EBM and Too Much Medicine (Part Three)In-Sight: Independent Interview-Based Journal, vol. 21.A., http://www.in-sightjournal.com/guyatt-three.

Modern Language Association (MLA, 7th Edition, 2009): Scott D. Jacobsen. “An Interview with Distinguished University Professor Gordon Guyatt, OC, FRSC on EBM and Too Much Medicine (Part Three).” In-Sight: Independent Interview-Based Journal 21.A (2019):October. 2019. Web. <http://www.in-sightjournal.com/guyatt-three>.

Vancouver/ICMJE: Jacobsen S. An Interview with Distinguished University Professor Gordon Guyatt, OC, FRSC on EBM and Too Much Medicine (Part Three) [Internet]. (2019, October 21(A). Available from: http://www.in-sightjournal.com/guyatt-three.

License and Copyright

License

In-Sight Publishing and In-Sight: Independent Interview-Based Journal by Scott Douglas Jacobsen is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Based on a work at www.in-sightjournal.com.

Copyright

© Scott Douglas Jacobsen, and In-Sight Publishing and In-Sight: Independent Interview-Based Journal 2012-2019. Unauthorized use and/or duplication of this material without express and written permission from this site’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Scott Douglas Jacobsen, and In-Sight Publishing and In-Sight: Independent Interview-Based Journal with appropriate and specific direction to the original content.  All interviewees co-copyright their interview material and may disseminate for their independent purposes.

An Interview with Distinguished University Professor Gordon Guyatt, OC, FRSC on Chinese Traditional Medicine and Evidence-Based Medicine (Part Two)

 

 

 

 

 

 

 

 

 

 

 

 

Interviewer: Scott Douglas Jacobsen

Numbering: Issue 21.A, Idea: Outliers & Outsiders (Part Seventeen)

Place of Publication: Langley, British Columbia, Canada

Title: In-Sight: Independent Interview-Based Journal

Web Domain: http://www.in-sightjournal.com

Individual Publication Date: October 1, 2019

Issue Publication Date: January 1, 2020

Name of Publisher: In-Sight Publishing

Frequency: Three Times Per Year

Words: 2,439

ISSN 2369-6885

Abstract 

Dr. Gordon Guyatt, OC, FRSC is a Distinguished University Professor is the Department of Health Research Methods, Evidence, and Impact at McMaster University. He discusses: chinese medicine and evidence-based medicine; modern science and modern medicine; prognostic models; and PJ Devereaux.

Keywords: Canada, Chinese, Chinese medicine, evidence-based medicine, Gordon Guyatt, medicine.

An Interview with Distinguished University Professor Gordon Guyatt, OC, FRSC on Chinese Traditional Medicine and Evidence-Based Medicine: Distinguished Professor, Health Research Methods, Evidence, and Impact, McMaster University; Co-Founder, Evidence-Based Medicine (Part Two)[1],[2],[3],[4]

*Footnotes in & after the interview, & citation style listing after the interview.*

*This interview has been edited for clarity and readability.*

1. Scott Douglas Jacobsen: Now with regards to other methodologies, as you are methodologist, as others are statisticians. I remember taking a directed studies course in the epistemology of psychology, the foundations of psychology.

It was one-on-one with a professor of psychology, he was the chair of the department.  He said, “We sneak in epistemology classes into psychology. We call them statistics and methodology.”

So, in a way, both the statisticians and methodologists in medicine, it makes you a medical technologist. In that sense, what other more speculative epistemologies in medicine are coming down the pipeline for evidence-based medicine, if any.

Distinguished Professor Gordon Guyatt: When I talk epistemology to people, it is all the threats to evidence-based medicine by alternative epistemologies.

Jacobsen: [Laughing].

It the most interesting in that regard, which is a big way the world is changing. It is the prominence of China.

I joke to people that in my research outfit here. There is a Chinese invasion going on. I know, it would take me a minute to try and figure out how many Chinese and Korean students and faculty members, and postdoctoral fellows.

One of the things is, some of them come from traditional Chinese medicine backgrounds. So, there is now this split within Chinese medicine. Even so, there is Western medicine and traditional Chinese medicine, and they have different epistemologies. Even within the traditional Chinese medicine, there are some people gravitating toward the EBM epistemology, and epistemology the way I understand it,

It is the science of how we know things. How do we know that something’s true? How do we know that is not true? So, evidence-based medicine has a particular epistemology, so traditional Western sides had an epistemology that was focused on basic science and biological action now.

EBM has an epistemology that is much more focused on experiments of human beings looking at patient important outcomes, randomized trials, and observational studies. So, that’s ok, little physiology is fine, but that only gets you so far.

How do you know things? You need to test them out in human beings in the real world. So, that is the EBM epistemology for when you go to traditional Chinese medicine. They know it, because it is being done for 6,000 years. 6,000 years of experience cannot be wrong. So, that is a different way of knowing.

Some of my Chinese colleagues are trying to rationalize these two ways of knowing. I may be wrong. I may be pessimistic, but I am telling them, “You’ve got two different epistemologies here, which will never come together. They represent different ways, different ideas of how things in the world work.”

So, that is my most dramatic epistemological issue that is around at the moment.

2. Jacobsen: Historically, we can look at the Western tradition going through its developments and even regression. There was a long period of regression. Where now someone’s frothing at the mouth on the ground, we go, “That person is having an epileptic seizure.”

Go back sufficient number of centuries, and people hadn’t known the answer in their own epistemology, the answers they came to were, “They’re possessed by the devil, or a demon.”

So I mean, that is a massive regression. But things have changed, become more concrete and EBM-based. So, outside of NMAs (Network Meta-Analyses), and the alternatives coming from of East Asia and general, China in particular, are there any others?

Guyatt: So, there is something called, there is a push toward, real world data and big data. You have these huge databases. You can then use machine learning. People think that you can figure out what treatments work out in the real world by looking at this real world data.

We do not think so. So, we point to the problems with this real data. Patients may do better if exposed to one treatment versus the other. But it may not have anything to do with the treatment.

It may be because the people who took the particular treatment, you are destined to do better, they took, and the one example that I… so I’ll give you two. I’ll give you one primitive example, then one that people thought, something works or didn’t. So, the primitive example is, let’s look at hospitalization as an intervention? Does hospitalization make people better?

Well, as it turns out, people die an awful lot in the hospital much more than they die out in the community. Therefore, clearly, hospitals are harmful. So, that is a vivid illustration that because people do badly in this environment, and not so badly in this environment, it may have nothing to do with the environment.

It might be the nature of the people who got into that environment. So, obviously, we know, “No, people do not die in hospitals because hospitals kill you. It is because the people who go to hospitals are sick.”

So, that when everybody sees that it is a mistake to think that hospitals kill people. It is not too difficult. But there was another one, dramatic one of antioxidant vitamins. Vitamin C, antioxidant vitamins, have what we call observational studies, you look at a big population who take antioxidant vitamins.

A big population does not take antioxidant vitamins. You look at what happens. These antioxidant vitamins, if you looked at the report, were supposed to do good things for you. It turned out that when they did the observational studies.

People with the antioxidant vitamins had less cancer and less cardiovascular disease than people who didn’t take antioxidant vitamins. Message, we should all take antioxidant vitamins. It will reduce cancer and cardiovascular disease. Fortunately, they decided to do the randomized trials.

The randomized trials showed no difference between people who took and did not take the antioxidant vitamins in, either cancer and cardiovascular disease, and in some instances, a possible suggestion of harm.

So, it was true that people in the real world who took antioxidant vitamins had less cancer and cardiovascular disease than people who did not. It had nothing to do with the antioxidant vitamins.

Jacobsen: [Laughing].

Guyatt: What it has to do with is the nature of the people who took antioxidant vitamins were different than the people who didn’t take antioxidant vitamins, we needed randomized trials to store data. Now, there is a push with this big data of real world data, which will tell us about treatments.

People do not seem to have learned the lesson of the antioxidant vitamins example. Yes, they may do better when they’re exposed or not exposed or more primitively to lessen the hospitalization.

They’re ready to attribute it to the treatment, but it may not be the treatment at all. Sometimes, it is. Sometimes, it isn’t. We would argue that you need randomized trials to be definitive to know whether it is or it isn’t. If we believe those observational studies, we would all be taking antioxidant vitamins, too, and no one would be benefiting.

So that is an interesting epistemological debate now. Can this big data that tell us what’s true? Or we need randomized trials?

3. Jacobsen: What were some of the more overblown claims?

Guyatt: That they can tell you what works and what does not work? That is the fundamental overblown.

Jacobsen: What are some secondary ones?

Guyatt: The other things that it is useful for is, for instance, development of prognostic models. So, it is often important to say, “Is this person at high risk or low risk of something?” The big data potentially can, by having huge amounts of data, they can come up with great prognostic blocks.

So, that is something. The only problematic part is the claim that it can tell us what works and what does not work.

4. Jacobsen: Are there any other areas in professional life that you want to explore?

Guyatt: I can do something more. As I say, I am methodologist, but I work with people who do, fortunately, frontline research. That is practical. I can tell you about one of my colleagues by the name of PJ Devereaux.

10 or 15 years, probably 15 years ago, now, maybe more, PJ, started to focus on non-cardiac surgery. So, people go into surgery. They’re not going for their heart. They’re going for all sorts of other regions.

So, the first big discovery that PJ made was lots of people are having heart attacks. Nobody is noticing. The reason they do not notice is you come out of undergoing this non-cardiac surgery, which has the metaphor of running a marathon.

Most of the people who go to non-cardiac surgery have not been training for six months to run a marathon.

Jacobsen: [Laughing].

Guyatt: A matter fact, they may not have been getting out there. Getting out of their seats in front of the television set much, so, now, you put them to a marathon and – lo and behold, perhaps no big surprise – a fair number are having heart attacks that nobody was noticing. Why not?

Because they come out of the operating room, they’re sedated. They’re out of it. If they were awake, they’d be saying, “Doc, I am having this terrible chest pain,” but they can tell you they do not know. They’re asleep or sedated.

What PJ said, “Hey, wait a minute, let’s take everybody or at least these high risk people coming, and let’s do electrocardiograms. Let’s do enzymes, which tells us what’s going on too hard.” He found out that 80% of the people having heart attacks were missed.

If you did the regular clinical day, you were missing 80% of people that had heart attacks. So, that was interesting; that was important. But the issue still remained, we know what to do with you. If you come into the emergency department with a heart attack, we have a hundred thousand people studied in randomized trials.

We know what to do with that. Should we be doing the same thing with people who are having these heart attacks coming out of surgery?

Jacobsen: [Laughing].

Guyatt: Maybe, but maybe they’re different. So, now we have to find out. We have to find out what we should do about that. Now, he is done the first big important study showing that if you give these people anticoagulants, blood thinners sometimes we called them, they do better.

The implications of that, I do not think we need to stay informed that the most important things we do for people coming to the emergency room with heart attacks, is give them aspirin and drugs to lower their lipids, the fats in the blood those things. We should be doing those things.

It is clear from the results of PJ’s works that we should be doing that to these people who have these otherwise unrecognized heart attacks after they’re not a cardiac surgeon, so PJ with his work is revolutionizing the perioperative medicine.

Of all the people I work with in terms of doing the biggest impact work with immediate impact in terms of medical care and improving outcomes, PJ’s doing the best stuff.

Appendix I: Footnotes

[1] Distinguished Professor, Health Research Methods, Evidence, and Impact, McMaster University; Co-Founder, Evidence-Based Medicine

[2] Individual Publication Date: October 1, 2019, at http://www.in-sightjournal.com/guyatt-one; Full Issue Publication Date: January 1, 2020, at https://in-sightjournal.com/insight-issues/.

[3] B.Sc., University of Toronto; M.D., General Internist, McMaster University Medical School; M.Sc., Design, Management, and Evaluation, McMaster University.

[4] Credit: McMaster University.

Appendix II: Citation Style Listing

American Medical Association (AMA): Jacobsen S. An Interview with Distinguished University Professor Gordon Guyatt, OC, FRSC on Chinese Traditional Medicine and Evidence-Based Medicine (Part Two) [Online].October 2019; 21(A). Available from: http://www.in-sightjournal.com/guyatt-two.

American Psychological Association (APA, 6th Edition, 2010): Jacobsen, S.D. (2019, October 1). An Interview with Distinguished University Professor Gordon Guyatt, OC, FRSC on Chinese Traditional Medicine and Evidence-Based Medicine (Part Two)Retrieved from http://www.in-sightjournal.com/guyatt-two.

Brazilian National Standards (ABNT): JACOBSEN, S. An Interview with Distinguished University Professor Gordon Guyatt, OC, FRSC on Chinese Traditional Medicine and Evidence-Based Medicine (Part Two). In-Sight: Independent Interview-Based Journal. 21.A, October. 2019. <http://www.in-sightjournal.com/guyatt-two>.

Chicago/Turabian, Author-Date (16th Edition): Jacobsen, Scott. 2019. “An Interview with Distinguished University Professor Gordon Guyatt, OC, FRSC on Chinese Traditional Medicine and Evidence-Based Medicine (Part Two).” In-Sight: Independent Interview-Based Journal. 21.A. http://www.in-sightjournal.com/guyatt-two.

Chicago/Turabian, Humanities (16th Edition): Jacobsen, Scott “An Interview with Distinguished University Professor Gordon Guyatt, OC, FRSC on Chinese Traditional Medicine and Evidence-Based Medicine (Part Two).” In-Sight: Independent Interview-Based Journal. 21.A (October 2019). http://www.in-sightjournal.com/guyatt-two.

Harvard: Jacobsen, S. 2019, ‘An Interview with Distinguished University Professor Gordon Guyatt, OC, FRSC on Chinese Traditional Medicine and Evidence-Based Medicine (Part Two)In-Sight: Independent Interview-Based Journal, vol. 21.A. Available from: <http://www.in-sightjournal.com/guyatt-two>.

Harvard, Australian: Jacobsen, S. 2019, ‘An Interview with Distinguished University Professor Gordon Guyatt, OC, FRSC on Chinese Traditional Medicine and Evidence-Based Medicine (Part Two)In-Sight: Independent Interview-Based Journal, vol. 21.A., http://www.in-sightjournal.com/guyatt-two.

Modern Language Association (MLA, 7th Edition, 2009): Scott D. Jacobsen. “An Interview with Distinguished University Professor Gordon Guyatt, OC, FRSC on Chinese Traditional Medicine and Evidence-Based Medicine (Part Two).” In-Sight: Independent Interview-Based Journal 21.A (2019):October. 2019. Web. <http://www.in-sightjournal.com/guyatt-two>.

Vancouver/ICMJE: Jacobsen S. An Interview with Distinguished University Professor Gordon Guyatt, OC, FRSC on Chinese Traditional Medicine and Evidence-Based Medicine (Part Two) [Internet]. (2019, October 21(A). Available from: http://www.in-sightjournal.com/guyatt-two.

License and Copyright

License

In-Sight Publishing and In-Sight: Independent Interview-Based Journal by Scott Douglas Jacobsen is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Based on a work at www.in-sightjournal.com.

Copyright

© Scott Douglas Jacobsen, and In-Sight Publishing and In-Sight: Independent Interview-Based Journal 2012-2019. Unauthorized use and/or duplication of this material without express and written permission from this site’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Scott Douglas Jacobsen, and In-Sight Publishing and In-Sight: Independent Interview-Based Journal with appropriate and specific direction to the original content.  All interviewees co-copyright their interview material and may disseminate for their independent purposes.

 

An Interview with Dr. Sarah Lubik on Qualifying and Disqualifying Business Ideas, Advice to Students, and Concluding Thoughts (Part Six)

Interviewer: Scott Douglas Jacobsen

Numbering: Issue 21.A, Idea: Outliers & Outsiders (Part Seventeen)

Place of Publication: Langley, British Columbia, Canada

Title: In-Sight: Independent Interview-Based Journal

Web Domain: http://www.in-sightjournal.com

Individual Publication Date: September 22, 2019

Issue Publication Date: January 1, 2020

Name of Publisher: In-Sight Publishing

Frequency: Three Times Per Year

Words: 1,844

ISSN 2369-6885

Abstract 

Dr. Sarah Lubik is the Director of Entrepreneurship, SFU Co-Champion, Technology Entrepreneurships Lecturer, Entrepreneurship & Innovation Concentration Coordinator, Innovation and Entrepreneurship. She discusses: qualifying or disqualifying a business idea; advice to impart to students; and final feelings and thoughts.

Keywords: Canada, Hariri, Industry, Kurzweil, Sarah Lubik, technology.

An Interview with Dr. Sarah Lubik on Qualifying and Disqualifying Business Ideas, Advice to Students, and Concluding Thoughts: Director of Entrepreneurship, SFU Co-Champion, Technology Entrepreneurships Lecturer, Entrepreneurship & InnovationConcentration Coordinator, Innovation and Entrepreneurship (Part Six)[1],[2]

*Please see the footnotes, bibliography, and citation style listing after the interview.*

1. Scott Douglas Jacobsen: These are more or less obscure to someone that doesn’t have their ear to the ground as you do with your position. I want to also go back to the undergraduate students.

When you’re working with them, they come with an idea. What’s the process that you’re running through your mind to qualify or disqualify a particular idea, whether it be a product or a business idea?

They’re pitching to you either for a course project or for some extracurricular thing that they’re trying out. They want to run it by you.

Lubik: I try to keep an open mind about every idea because one of the things that you learn when you spend that time around entrepreneurs is that you haven’t heard of everything yet. So, because it doesn’t make sense to me in my frame of reference doesn’t mean that it’s not a good idea. That’s how I teach and how we teach here.

So, what I’m looking for, have they done their homework? Have they gone out to talk to experts? Have they asked all of the questions that I’ll ask them? So, rather than me making a decision, my job is to help them reach a decision whether they should stop and pivot, stop entirely, go full force, or go but there is a good chance that you can hit a wall.

So, my job is less of a stage gate and more of a guide to that process. The things I would ask is, “Who have you talked to?”, “Why do this?”, “Have you thought of this?”, “What about other markets?”, “What about other people?”, “If you changed something in the health field, have you tried to make life better for doctors? Did you make life harder for nurses?”, “Have you spoken to people who are experts?”

So, I spent a lot of time saying, “Why do you think that?” Withy expertise is in advanced materials and advanced technologies; I can tell you how those work. I can give you an opinion based on my experience that I think ‘that’ will work’, ‘I haven’t seen that work’, and ‘this is why this is setting off a yellow or red light for me.’”

But if it’s a case of ‘I want to find a way to use food that might otherwise be thrown away to keep it out of the landfill and also to do some good with it, whether it’s how to feed other people or whether it’s turn it into a certain product.’

My answer is going to be: “Talk through the logic with me, then I will point you at someone who is in that industry.” Because it’s important for us; not as entrepreneurs, but as coaches, to realize where the limitations of our knowledge are and rather than be the be-all and end-all of entrepreneurship to say, “Why?”

I can guide you through the process, to tackle the challenges and gather all of this information. I will put you in touch with everyone that I know who can validate your assumptions. That can help you validate whether you are on the right path.

But I can still be surprised.  I watched some students presenting and gave them some feedback

I thought, “I probably wouldn’t be going with that target market. They said, “We’re not in the class yet we sold 12.” I was like, “Fair enough, yes, I was wrong. I’m not the target market for this.”

That means my next job is to put them in touch with someone who might know more about that industry.

2. Jacobsen: So, we touched briefly now on what will be considered a reference frame for considering business ideas from students and not taking into account necessarily qualifying or disqualifying something based on the current reference frame, but taking into account would this potentially sell and keeping in mind that I might be wrong. 

What advice, in general, do you try to impart to students either through an example of yourself or through simply telling them a narrative, “This was a successful business. They did X, Y, and Z,” or saying, “This principal will get you pretty far in the innovation and entrepreneurship fields?”

Lubik: It’s a good question. So, in the classes that I teach, part of delivering the content is all about being like a business coach and saying, “Here’s a different framework that you can employ and here’s how it works.”

But one of the things that I try to do, and this comes back to always questioning whether you’re right or not, is I immediately say, “Here’s the place that I found that this doesn’t necessarily work and here’s how I’ve modified the models for myself.” What I’m hoping will happen when I do that, they realize that absolutely nothing should be taken as gospel and never questioned, even the models that we use to explore these things.

For example, there’s the business model canvas, which is like a map of the different parts of your business. It’s taken as a standard tool no matter where you go and where you’re doing entrepreneurship, where the business model canvas is incomplete in my opinion is that it doesn’t asks for your vision for your company.

I ask my students to immediately draw another box, which is, “Tell me, rather than I’m going to make a thing because it’s cool, what problem are you trying to solve? What does the world gain if you’re successful? What is the vision that’s going to drive you?”

So, that’s probably one of the most important things I can impart. Figure out why you’re doing what you’re doing, what drives you and figure out that you can question pretty much everything, and that you should because nothing is perfect and no one is infallible.

3. Jacobsen: Last question. Based on what we’ve discussed today, do you have any thoughts or feelings in conclusion?

Lubik: Yes, one of the most important places that we can invest in is to create a more competitive society as well as a more compassionate society. We should look at the big picture, to create more people with those entrepreneurial skills that have tolerance for ambiguity and a desire to use them to make things better.

Most of the world is made up of people who don’t think like you, problems are only getting more complex, and we need to have the humility to understand that most of those big problems take time to sort out and take A wide range of expertise working together.

I think that’s one of the reasons why as the world changes we need an education that can let us keep up- be it a university education or any type of education –

That to understand how to question yourself, to keep an open mind, to search out people who don’t think like you, to understand what we’ve done in the past, understand how ideas fit together, to understand how you might use cutting-edge knowledge and cutting-edge technology, and also if you can use the resources of the university – whether it’s their networks or their internal resources – to help you to make a difference in the world, whether it’s as an organization or an entrepreneur or social innovator.

The reason entrepreneurship is all about teamwork and impact at SFU is that we all need this mindset and we all need each other if we are going to tackle future opportunities and take on serious challenges.

4. Jacobsen: Thank you for your time, Dr. Lubik.

Lubik: Thank you for the enjoyable conversation.

Appendix I: Footnotes

[1] Director of Entrepreneurship, SFU Co-Champion, Technology Entrepreneurships Lecturer, Entrepreneurship & Innovation Concentration Coordinator, Innovation and Entrepreneurship, Beedie School of Business, Simon Fraser University.

[2] Individual Publication Date: September 22, 2019: http://www.in-sightjournal.com/lubik-six; Full Issue Publication Date: January 1, 2020: https://in-sightjournal.com/insight-issues/.

Appendix II: Citation Style Listing

American Medical Association (AMA): Jacobsen S. An Interview with Dr. Sarah Lubik on Qualifying and Disqualifying Business Ideas, Advice to Students, and Concluding Thoughts (Part Six) [Online].September 2019; 21(A). Available from: http://www.in-sightjournal.com/lubik-six.

American Psychological Association (APA, 6th Edition, 2010): Jacobsen, S.D. (2019, September 22). An Interview with Dr. Sarah Lubik on Qualifying and Disqualifying Business Ideas, Advice to Students, and Concluding Thoughts (Part Six)Retrieved from http://www.in-sightjournal.com/lubik-six.

Brazilian National Standards (ABNT): JACOBSEN, S. An Interview with Dr. Sarah Lubik on Qualifying and Disqualifying Business Ideas, Advice to Students, and Concluding Thoughts (Part Six). In-Sight: Independent Interview-Based Journal. 21.A, September. 2019. <http://www.in-sightjournal.com/lubik-six>.

Chicago/Turabian, Author-Date (16th Edition): Jacobsen, Scott. 2019. “An Interview with Dr. Sarah Lubik on Qualifying and Disqualifying Business Ideas, Advice to Students, and Concluding Thoughts (Part Six).” In-Sight: Independent Interview-Based Journal. 21.A. http://www.in-sightjournal.com/lubik-six.

Chicago/Turabian, Humanities (16th Edition): Jacobsen, Scott “An Interview with Dr. Sarah Lubik on Qualifying and Disqualifying Business Ideas, Advice to Students, and Concluding Thoughts (Part Six).” In-Sight: Independent Interview-Based Journal. 21.A (September 2019). http://www.in-sightjournal.com/lubik-six.

Harvard: Jacobsen, S. 2019, ‘An Interview with Dr. Sarah Lubik on Qualifying and Disqualifying Business Ideas, Advice to Students, and Concluding Thoughts (Part Six)In-Sight: Independent Interview-Based Journal, vol. 21.A. Available from: <http://www.in-sightjournal.com/lubik-six>.

Harvard, Australian: Jacobsen, S. 2019, ‘An Interview with Dr. Sarah Lubik on Qualifying and Disqualifying Business Ideas, Advice to Students, and Concluding Thoughts (Part Six)In-Sight: Independent Interview-Based Journal, vol. 21.A., http://www.in-sightjournal.com/lubik-six.

Modern Language Association (MLA, 7th Edition, 2009): Scott D. Jacobsen. “An Interview with Dr. Sarah Lubik on Qualifying and Disqualifying Business Ideas, Advice to Students, and Concluding Thoughts (Part Six).” In-Sight: Independent Interview-Based Journal 21.A (2019):September. 2019. Web. <http://www.in-sightjournal.com/lubik-six>.

Vancouver/ICMJE: Jacobsen S. An Interview with Dr. Sarah Lubik on Qualifying and Disqualifying Business Ideas, Advice to Students, and Concluding Thoughts (Part Six) [Internet]. (2019, September 21(A). Available from: http://www.in-sightjournal.com/lubik-six.

License and Copyright

License

In-Sight Publishing and In-Sight: Independent Interview-Based Journal by Scott Douglas Jacobsen is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Based on a work at www.in-sightjournal.com.

Copyright

© Scott Douglas Jacobsen, and In-Sight Publishing and In-Sight: Independent Interview-Based Journal 2012-2019. Unauthorized use and/or duplication of this material without express and written permission from this site’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Scott Douglas Jacobsen, and In-Sight Publishing and In-Sight: Independent Interview-Based Journal with appropriate and specific direction to the original content.  All interviewees co-copyright their interview material and may disseminate for their independent purposes.

An Interview with Dr. Iona Italia on Universal Basic Income, Strongmanism, Human Rights, and Fearlessness (Part Five)

Interviewer: Scott Douglas Jacobsen

Numbering: Issue 21.A, Idea: Outliers & Outsiders (Part Seventeen)

Place of Publication: Langley, British Columbia, Canada

Title: In-Sight: Independent Interview-Based Journal

Web Domain: http://www.in-sightjournal.com

Individual Publication Date: September 15, 2019

Issue Publication Date: January 1, 2020

Name of Publisher: In-Sight Publishing

Frequency: Three Times Per Year

Words: 1,940

ISSN 2369-6885

Abstract 

Dr. Iona Italia is an Author and Translator, and a Sub-Editor for Areo Magazine, and Host of Two for Tea. She discusses: incentivization of the arts and humanities; responding to those who do not see the value in the arts and the humanities; varieties of strongmanism; the whys of the current situation and how to get out of it; and final feelings or thoughts in conclusion.

Keywords: Areo Magazine, human rights, Iona Italia, Two for Tea, UBI, strongmen.

An Interview with Dr. Iona Italia on Universal Basic Income, Strongmanism, Human Rights, and Fearlessness: Host, Two for Tea & Sub-Editor, Areo Magazine (Part Five)[1],[2]

*Please see the footnotes, bibliography, and citation style listing after the interview.*

1. Scott Douglas Jacobsen: If we’re looking to incentivize, in some manner, civic culture, arts and humanities culture, how do we do it? There is the obvious answer of it is coming out of the intrinsic need to express oneself, explore the world of ideas, of the history of the world. However, what else?

Dr. Iona Italia: I suggest UBI. I think that is currently the best, most practical suggestion. Of course, like any system, some people will “abuse” it. I do not think it is abuse. Some people will choose to live on the low income that UBI provides. I think it is $1,000 a month they are suggesting for the US, which is a small income for the US. That is about what I currently live off, but I live in Argentina.

I think most people will either go and get a job that earns much more than that or they will take the UBI and they will use it as that safety net to be able to put energy into things like Areo Magazine, into podcasts, into writing, into art. Those are all things that we cannot seem to monetize easily but which do enrich our lives. It will also enable people to do things like care for their elderly parents, disabled partners, et cetera, and it will cut down on bureaucracy, enormously.

It will not punish people for going back to work, for example, because if you go to work and earn your salary, you will still receive your $1,000 in UBI, so you will not be tempted to stay on welfare because otherwise you will be penalized financially for going to work. So, I am a big fan. I think that would be one good start.

2. Jacobsen: What would be a proper response to individuals who completely see no value, or little value in the arts and humanities and productions for or coming out of civic culture?

Italia: If people see no value in something, it is rather hard to persuade them. All you can say is, “You live in civil society and other people value this.” You can, I think, though, see a good example of what happens when education is entirely technical with the kinds of things that are coming out of India and the movement on the Indian far-right, which is very much driven by young men from technical colleges, who have degrees, who have PhDs but they have absolutely zero humanities education at all.

They know how to do programming or to build a bridge, but they have no background in literature or history. They’ve become absolute fodder for this worrying, troubling strong rise of a violent terrorist, ethnonationalist, far-right movement in India. That’s one cautionary tale, there.

3. Jacobsen: Also, we’re seeing this in many forms when we’re seeing it a form of strongmanism, and then men who identify with the form of strongmanism. 

We can see this in a secular garb with Xi Jinping in mainland China with the elimination of terms limits. We can see the imposition of that through re-education camps, or at least, a million.

We can see this with Orbán in Hungary, saying the state stance is there are only male and female, which is a traditional fundamentalist Abrahamic religious stance. We can see this with, I think, Theresa May, in a bit. I think she’s one that comes up. We can also see this with Bolsonaro.

Italia: Bolsonaro.

Jacobsen: Who was at the top of the polls? Lula. Who is in prison? Lula. What happens when Bolsonaro gets into office? Immediately within a week, LGBTI+ rights and indigenous land rights are the first things to be targeted, in certain ways.

Italia: And of course, throughout the Muslim world you, you have strongmen in most of those countries. We’re already talking about the movement in India and “Modi the strongman”. You have Putin.

Jacobsen: Duterte.

Italia: Yes. You have people from the left, as well, who are doing this, left-wing authoritarians like Maduro. You already mentioned China.

Jacobsen: The typical story is men in most positions of power and influence and most of the men making those important decisions. We’re seeing a rise in the aggressive form of that, where it is you were noting it as “ethnonationalism,” sometimes connected to religious fundamentalist revivalism, or something like this.

Italia: Yes, in some African countries also.

4. Jacobsen: Two questions, whys and hows there, we have got a few minutes left. One, why? Two, how do we get out of it?

Italia: [Laughing] What an easy couple of questions! Why? I do not know. I officially studied English literature, but I did, of course, study lots of history because of my specialist period interest. One thing I can tell you is that history is highly contingent. You have one accidental event happening.

I am often asked to decide, for example, on Twitter, people often ask me, which is the greater threat, the far right or ultra-woke Social Justice excesses. I find the far right a bit scarier, but which is the greater threat? I have no idea because I do not have a crystal ball. It is impossible to predict the future. It is hard to know, even, how historical things happened. We can trace how but we cannot trace the why.

Perfect storms happen all the time. This thing happened. It led to this. That led to that. There are many, many feedback loops and snowball effects. I do not have a good answer to the “why”. “How”. I do not have a good answer to the “how” except that I think that we must keep returning—and it sounds so corny, I know—but we must keep returning to universal little humanism.

I used to think the liberal part of that was the most important part, but now I tend to think that the universal part may be the most important. I am currently reading Nick Christakis’s book, Blueprint, which is very much about this. We must abandon identity politics of all stripes, and we must return to a strong focus on the things that unite us.

5. Jacobsen: Does a return to human rights, or maybe a re-emphasis on human rights, provide such a framework? We see this in specific documents, for instance, on women’s rights with the Beijing Declaration from 1995. We can also see this 71 years ago with the foundation of the Universal Declaration of Human Rights, December 10, 1948. Would these suffice as bases?

Italia: No. Legislation never suffices on its own without cultural change, as well, but, as I said before, both cultural changes can drive legislation, also, legislation can drive cultural change. On its own, no, but it is a start.

Jacobsen: Any final feelings or thoughts, in conclusion, based on the conversation today?

Italia: I guess my final thought is that I think that one big problem is that there is too much fear around speech. Even when people’s free speech rights are guaranteed, people are, of course, and always will be, in certain situations, careful about what they say, and this can be a good thing.

But when you are discussing bigger philosophical or political or social issues, it is important to be fearless, to explore ideas by talking through them, i.e. to work out what you think about the issue over the course of discussion rather than coming with a fixed agenda, with your conclusions already in place, and then presenting that as if you were…This is the difference between real political discussion and high school debating, the type that Ben Shapiro does. You stand up and you’re going to win your point.

Not for reasons of ego, but also that means that you must even contemplate some ideas that are either politically incorrect, or that are evil-adjacent, let’s say, but are not actually evil. Sometimes the right answer is close to a wrong answer. That is the way that things are.

We need more fearlessness in what we’re willing to talk about and how we’re willing to talk about it. Only then will we come to the good solutions and will we be able to debunk the bad ones.

6. Jacobsen: Thank you much, and best of wishes with your chocolate chai and your keto diet.

Italia: Thanks. Bye-bye.

Jacobsen: Bye.

Appendix I: Footnotes

[1] Host, Two for Tea; Sub-Editor, Areo Magazine.

[2] Individual Publication Date: September 15, 2019: http://www.in-sightjournal.com/italia-five; Full Issue Publication Date: January 1, 2020: https://in-sightjournal.com/insight-issues/.

Appendix II: Citation Style Listing

American Medical Association (AMA): Jacobsen S. An Interview with Dr. Iona Italia on Universal Basic Income, Strongmanism, Human Rights, and Fearlessness (Part Five) [Online].September 2019; 21(A). Available from: http://www.in-sightjournal.com/italia-five.

American Psychological Association (APA, 6th Edition, 2010): Jacobsen, S.D. (2019, September 15). An Interview with Dr. Iona Italia on Universal Basic Income, Strongmanism, Human Rights, and Fearlessness (Part Five)Retrieved from http://www.in-sightjournal.com/italia-five.

Brazilian National Standards (ABNT): JACOBSEN, S. An Interview with Dr. Iona Italia on Universal Basic Income, Strongmanism, Human Rights, and Fearlessness (Part Five). In-Sight: Independent Interview-Based Journal. 21.A, September. 2019. <http://www.in-sightjournal.com/italia-five>.

Chicago/Turabian, Author-Date (16th Edition): Jacobsen, Scott. 2019. “An Interview with Dr. Iona Italia on Universal Basic Income, Strongmanism, Human Rights, and Fearlessness (Part Five).” In-Sight: Independent Interview-Based Journal. 21.A. http://www.in-sightjournal.com/italia-five.

Chicago/Turabian, Humanities (16th Edition): Jacobsen, Scott “An Interview with Dr. Iona Italia on Universal Basic Income, Strongmanism, Human Rights, and Fearlessness (Part Five).” In-Sight: Independent Interview-Based Journal. 21.A (September 2019). http://www.in-sightjournal.com/italia-five.

Harvard: Jacobsen, S. 2019, ‘An Interview with Dr. Iona Italia on Universal Basic Income, Strongmanism, Human Rights, and Fearlessness (Part Five)In-Sight: Independent Interview-Based Journal, vol. 21.A. Available from: <http://www.in-sightjournal.com/italia-five>.

Harvard, Australian: Jacobsen, S. 2019, ‘An Interview with Dr. Iona Italia on Universal Basic Income, Strongmanism, Human Rights, and Fearlessness (Part Five)In-Sight: Independent Interview-Based Journal, vol. 21.A., http://www.in-sightjournal.com/italia-five.

Modern Language Association (MLA, 7th Edition, 2009): Scott D. Jacobsen. “An Interview with Dr. Iona Italia on Universal Basic Income, Strongmanism, Human Rights, and Fearlessness (Part Five).” In-Sight: Independent Interview-Based Journal 21.A (2019):September. 2019. Web. <http://www.in-sightjournal.com/italia-five>.

Vancouver/ICMJE: Jacobsen S. An Interview with Dr. Iona Italia on Universal Basic Income, Strongmanism, Human Rights, and Fearlessness (Part Five) [Internet]. (2019, September 21(A). Available from: http://www.in-sightjournal.com/italia-five.

License and Copyright

License

In-Sight Publishing and In-Sight: Independent Interview-Based Journal by Scott Douglas Jacobsen is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Based on a work at www.in-sightjournal.com.

Copyright

© Scott Douglas Jacobsen, and In-Sight Publishing and In-Sight: Independent Interview-Based Journal 2012-2019. Unauthorized use and/or duplication of this material without express and written permission from this site’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Scott Douglas Jacobsen, and In-Sight Publishing and In-Sight: Independent Interview-Based Journal with appropriate and specific direction to the original content.  All interviewees co-copyright their interview material and may disseminate for their independent purposes.

An Interview with Distinguished University Professor Gordon Guyatt, OC, FRSC on GOBSAT, Guidelines, Living Documents, and Network Meta-Analysis (Part One)

 

 

 

 

 

 

 

 

 

 

 

 

Interviewer: Scott Douglas Jacobsen

Numbering: Issue 21.A, Idea: Outliers & Outsiders (Part Seventeen)

Place of Publication: Langley, British Columbia, Canada

Title: In-Sight: Independent Interview-Based Journal

Web Domain: http://www.in-sightjournal.com

Individual Publication Date: September 8, 2019

Issue Publication Date: January 1, 2020

Name of Publisher: In-Sight Publishing

Frequency: Three Times Per Year

Words: 3,181

ISSN 2369-6885

Abstract 

Dr. Gordon Guyatt, OC, FRSC is a Distinguished University Professor is the Department of Health Research Methods, Evidence, and Impact at McMaster University. He discusses: professional research in the fall of 2018; hopes of a reduction in the timelines of publication of guidelines; reducing communication time and update time; message to skeptics of medicine in the mainstream; other professional areas to explore; early hypothesized applications of network meta-analysis or NMA; limits to pairings of NMAs; 2010s as the decade of NMAs; and the integration of NMAs into guideline methodologies.

Keywords: Canada, evidence-based medicine, Gordon Guyatt, medicine, network meta-analysis, NMA.

An Interview with Distinguished University Professor Gordon Guyatt, OC, FRSC on GOBSAT, Guidelines, Living Documents, and Network Meta-Analysis: Distinguished Professor, Health Research Methods, Evidence, and Impact, McMaster University; Co-Founder, Evidence-Based Medicine (Part One)[1],[2],[3],[4]

*Footnotes in & after the interview, & citation style listing after the interview.*

*This interview has been edited for clarity and readability.*

1. Scott Douglas Jacobsen: With regards to professional research for the fall of 2018, what are some of the new projects arising? What are the new questions being asked?

Gordon Guyatt: I will tell you some, what I would consider highlights. So, clinicians nowadays are relying heavily on guidelines. So, there is a medical electronic textbook called up to date that provides recommendations.

That is probably the number one resource in the world, certainly in North America, and provides recommendations. There are specialty societies in heart and lung and kidney and everything else. Young and older clinicians are paying great attention to these guidelines.

Over the last 20 years, there have been standards developed for trustworthy guidelines. There was an older model of guidelines, which was affectionately referred to as “GOBSAT”.

Jacobsen: [Laughing]

Guyatt: GOBSAT means good old boys sitting around a table.

Jacobsen: [Laughing] That is right.

Guyatt: That is how guidelines used to be developed but now we have a science of producing guidelines. I have been fortunate to be involved in the development of some of those standards. So, you have these up to date standards. It produces recommendations quickly. I do consult for them, trying to make them more evidence-based.

So, they do a pretty good job, but the nature of what they do, they do not adhere fully to the standards of trustworthy guidelines. Pretty good. Then some, not far from all, but some of the specialty societies adhere to the standards of trustworthy guidelines.

But they put together a team and it is a big production and it takes them a year to get there to get their guideline together, and then they’re so exhausted that they have to wait another two years before they start the process again.

So, the guidelines, many of them become quickly out of date. So, the question is, “Can one have trustworthy guidelines that are also updated when there is new evidence that is quickly updated?” So, there is also a science of pulling together the literature.

We call it systematic reviews. Again, I have been privileged too, as that science has developed over, starting a little farther ago, maybe 30 years ago. We know how to do that. I have been involved.

So, it was a systematic review out there. A new piece of evidence, we can update it quickly. So, it is good to know. Then a colleague who trained with me from Norway, who was interested in the whole guideline endeavour. He said, “Somebody’s got to do it, so that we follow the trustworthy guidelines standards. We update quickly, you and your team show we can update our systematic reviews quickly.”

We do have a process for producing this the trustworthy guidelines quickly. I said, “Pierre, you are right, but who’s gonna listen to us? We are not up to date. We are not the American Thoracic Society or the American Heart Association, who is going to listen to us?”

So Pierre said, “What if one of the top journals put out our new recommendations and published it as their endorsed recommendations?” He persuaded the BMJ to buy into the idea. So, for the last couple of years, we have been producing what we call BMJ rapid recommendations. So, a new study is published, we think it’s practicing changing information. We get our systematic review done in a matter of several weeks.

We put our guideline panel together and target within 90 days of the publication then we have our updated recommendation. Ideally, it would come in that time frame, as we think we have done our part. BMJ [Laughing] has been a little slow.

But producing these BMJ rapid recommendations, it is exciting. We have provided the ability once before to say that success will be when and with a particular activity, we become redundant. It felt good at the time, 20 years later, when we start to become redundant; it does not feel quite so good.

So, I shouldn’t be worn. But hopefully, these BMJ rapid recommendations someday will be redundant, when they went out of date then they can bump up their standards of maybe making theirs more trustworthy, and or the sub-specialty societies realize that they shouldn’t be putting out these guidelines every two years.

They should be making them living guidelines and updating. But until they do that, and we become redundant, it is fun leading the field and providing a model that this can be done, and how it should be done.

2. Jacobsen: With some software, people do open source. So, you have these, as you phrase it “living documents,” but software. So, people have continually updated and improved, basically, algorithms to perform a specific task, which is an idea built into that.

By analogy is interesting, if you were to smooth out some of the rough edges of process, and, into 2020 say, what will be your hope in terms of not only reduction of the 90 days, but also in terms of big journals, like BMJ, in terms of their process of publication?

Guyatt: They could. It is tough for them. But I could tell them ways that they could do it. It requires resources. Even the top journals have limited resources and require a level of commitment and devoted staff, which is resource-intensive, it couldn’t be done.

It would be better if it didn’t need to be the journals. So, the specialty societies have their ‘why we gave up on them’ is they have their bureaucracy. As they pass through their board before it gets out, they need a way of streamline.

Because they should all have teams our BMJ rapid recommendation team ready to update continuously. It started, the journal publication process slows things down. They have their bureaucracy. They need to streamline that to get their living guidelines out quickly.

So, that is what we would hope would happen in the future. That is still the model we want to provide that will help them do that.

3. Jacobsen: Can there be a way in which to use something like an open-source platform to reduce, for instance, communication time and update time?

Guyatt: We have something called the system of developing these recommendations. It has been around for 15 years or so. We call it GRADE. So, it is a way of looking at the quality of the evidence and the strength of recommendations. It is this graded approach that is a crucial part of trustworthy guidelines. Pierre and his colleagues in Norway have come up with a nonprofit company that they call MAGIC, for “making great the irresistible choice.”

Jacobsen: [Laughing].

Guyatt: It includes the MAGIC app, which is an electronic platform.

And we think this platform is there. As soon as we finished, we have it on the platform. It can be disseminated. It is out there. As a link anybody can go to, but before we can put it out, we would likely have to get the pass to go through the BMJ peer review process.

Jacobsen: Yes.

Guyatt: We could do it for specialty societies and put it out in the same way. But it has to go through their process. So, we have got to the electronic communication part of it. We have got that. It is that the bureaucracy is saying, “Yes, you can disseminate it now.”

4. Jacobsen: This brings to mind something like a mild peripheral question. When people are excessively skeptical about the scientific process, especially in medicine, often, I get the sense that they do not understand how difficult getting good-quality evidence and robust guidelines of research out are in the end analysis. What will be your short message to them?

Guyatt: These are people who are skeptical about the whole medical scientific endeavour?

Jacobsen: Yes.

Guyatt: The fraud is extremely unusual – unusual, but it happens. Overwhelmingly, scientists are interested in making the world a better place. Where they need to be cautious is financial conflicts of interest, researchers being attached to their own research; everybody thinks that their study is the greatest.

That is the problem. So, there are dangers. But there is such a thing as high-quality science, which, as you say, is challenging to produce, challenging to summarize. But there are trustworthy sources of evidence. They have to get some help in recognizing them.

5. Jacobsen: Is there anything else that in the professional areas we want to explore?

Guyatt: Trouble is, I am not sure what; I am what’s called a methodologist. So what turns me on is not the latest discovery of this, that, and the other thing, which might be the general audience thing, but advancing the methods.

So, at the expense of not necessarily being the most interesting finding, we came up with systematic reviews, which take all the best evidence and have a scientific standard for putting together all the best evidence.

Now, we know how to do that and with a set of rigorously. But then we summarize it, we can get each outcome for death, heart attack, stroke. We have a summary that says, “Here is our best estimate of the effect of the treatment on mortality, sorry it does not affect mortality, on stroke it reduces stroke by a small amount. Sorry, it affected myocardial infarction. Oh, there is a big effect in reducing myocardial infarction,” so hard at times.

So, we have got the system and it is called meta-analysis. Meta-analysis is the statistical approach, where you put all the evidence together, and you come up with the best estimate of effect.

But you could compare two treatments. But now often we have six treatments, or sometimes 12 alternatives. So, for instance, there are probably 20 drugs out there. When you are depressed, there are 20 drugs out there.

You’ve got rheumatoid arthritis, we have these new biologic agents, there are 10 of these biologic agents. Which one is the best? Or what are the best?

What are the collections of ones that do better than others?

We didn’t have a way of doing this. In the last decade, the statisticians have come up with something called network meta-analysis, where you can simultaneously compare all these treatments.

This is new science. We are figuring out how to do it well, how to interpret the results. The results are coming out in these huge tables that are completely uninterpretable to anybody. How do we take that? How do we take that and summarize it in a way that is true to the data and is still useful to the condition?

This is all an adventure to get these networks. This network meta-analysis optimized, and to find ways of having an output that is true to the data and still makes sense so the conditions in our health are helpful to the conditions and to the patients. Our group was involved in that process. That is exciting for us.

6. Jacobsen: What are some of the early applications hypothesized with regards to network meta-analysis?

Guyatt: So here’s one of the things. It is an initially misguided approach. We thought that this will tell you the best treatment; seldom is there a best treatment, so it needs to be reframed as, “Here are the three that you might want to consider for these reasons. You probably do not want to even think about these other three.” So, your patient may fit best with one of these three, which have their merits.

So, we are able to say, “Here, of these dozen things out here, here’s the two or three that you might want to take that you are that are thought to be best for your patients.” So, there is an explosion of these network meta-analysis, providing that advice.

So, without this approach, it was much, much more difficult when you have a dozen things out there. You have this paired comparison with A versus B, and then another C versus D. But the drug companies all compared to placebo, they do not have too many comparisons of these things. When they do you have A to B, B to C, but he hasn’t been compared to D, and so on.

Jacobsen: Right.

Guyatt: So, how do you make sense of this? The network meta-analysis allows one to make sense of it.

7. Jacobsen: Is there a limit to the pairings in the network meta-analysis?

Guyatt: No. There is no limit to network meta-analysis.

Jacobsen: That is exciting.

Guyatt: The limits are when you have a net we have meta-analysis with a dozen treatments or 15 treatments, the output is this…

Jacobsen: …[Laughing]…

Guyatt: …gigantic, take A versus B, C, D, E, F, G, H, I, J, K, and CB vs. blah, blah, blah. Anyways, these giant tables reach outcomes that are extremely difficult to make any sense out of. Also the limitation, the arithmetic, the statistic goal, work and handling of any numbers comparisons.

It is more difficult to make sense with the more comparisons there are; the more difficult it is to make sense of the network that emerges. Our work is in making some things about the statistics and how to do that best, but also interpreting and making sense of the whole thing, and interpreting in a way that makes sense to clinicians.

8. Jacobsen: With regards to evidence-based medicine, could the 2010s be considered the network meta-analysis decade?

Guyatt: Yes, yes, yes, yes. There are other things. There are other things that I hope will be part of the next decade. But yes, definitely, meta-analysis itself, the first was a huge advance. This network meta-analysis definitely takes things forward.

Jacobsen: So if these updates to these rapid-fire guidelines happen, and if we do them in 90 days, we send them off to the journal; and they have their own margin of error.

Guyatt: 90 days is supposed to take into account the journal processing.

Jacobsen: [Laughing].

Guyatt: We had one or two that have made the 90 days, but not quite. We are supposed to do ours in 60 days. They give them 30.

Jacobsen: So then 60-120 days. The 60-120 days’ rapid-fire updates. So, basically getting, somewhere between six and three of these per year, given that timeline.

Guyatt: But we are working on some of them simultaneously.

Jacobsen: [Laughing] So, even more.

Guyatt: But, our capacities are limited, 6 to 9 per year.

9. Jacobsen: That is cool. So, you are doing this in the 2010s, with a network meta-analysis, and you are having these guidelines updated nine to 12 per year. How integrated is network meta-analysis into this guideline methodology in terms of producing them?

Guyatt: Good question, makes it more challenging. We have had two. We have done definitely closer to the 6 per year. So, we have done a dozen or so of them, which have involved network meta-analysis.

So, but again, we are getting better at doing the NMAs quickly. I must admit, the NMAs, the Network Meta-Analysis, that we have done has already involved a few treatments. We can try to do one quickly with a dozen treatments.

We’ll get there. But we need more experience before we can take that on. But we have done them with relatively small networks, and we have done NMAs in the updating process.

Appendix I: Footnotes

[1] Distinguished Professor, Health Research Methods, Evidence, and Impact, McMaster University; Co-Founder, Evidence-Based Medicine

[2] Individual Publication Date: September 8, 2019, at http://www.in-sightjournal.com/guyatt-one; Full Issue Publication Date: January 1, 2020, at https://in-sightjournal.com/insight-issues/.

[3] B.Sc., University of Toronto; M.D., General Internist, McMaster University Medical School; M.Sc., Design, Management, and Evaluation, McMaster University.

[4] Credit: McMaster University.

Appendix II: Citation Style Listing

American Medical Association (AMA): Jacobsen S. An Interview with Distinguished University Professor Gordon Guyatt, OC, FRSC on GOBSAT, Guidelines, Living Documents, and Network Meta-Analysis (Part One) [Online].September 2019; 21(A). Available from: http://www.in-sightjournal.com/guyatt-one.

American Psychological Association (APA, 6th Edition, 2010): Jacobsen, S.D. (2019, September 8). An Interview with Distinguished University Professor Gordon Guyatt, OC, FRSC on GOBSAT, Guidelines, Living Documents, and Network Meta-Analysis (Part One)Retrieved from http://www.in-sightjournal.com/guyatt-one.

Brazilian National Standards (ABNT): JACOBSEN, S. An Interview with Distinguished University Professor Gordon Guyatt, OC, FRSC on GOBSAT, Guidelines, Living Documents, and Network Meta-Analysis (Part One). In-Sight: Independent Interview-Based Journal. 21.A, September. 2019. <http://www.in-sightjournal.com/guyatt-one>.

Chicago/Turabian, Author-Date (16th Edition): Jacobsen, Scott. 2019. “An Interview with Distinguished University Professor Gordon Guyatt, OC, FRSC on GOBSAT, Guidelines, Living Documents, and Network Meta-Analysis (Part One).” In-Sight: Independent Interview-Based Journal. 21.A. http://www.in-sightjournal.com/guyatt-one.

Chicago/Turabian, Humanities (16th Edition): Jacobsen, Scott “An Interview with Distinguished University Professor Gordon Guyatt, OC, FRSC on GOBSAT, Guidelines, Living Documents, and Network Meta-Analysis (Part One).” In-Sight: Independent Interview-Based Journal. 21.A (September 2019). http://www.in-sightjournal.com/guyatt-one.

Harvard: Jacobsen, S. 2019, ‘An Interview with Distinguished University Professor Gordon Guyatt, OC, FRSC on GOBSAT, Guidelines, Living Documents, and Network Meta-Analysis (Part One)In-Sight: Independent Interview-Based Journal, vol. 21.A. Available from: <http://www.in-sightjournal.com/guyatt-one>.

Harvard, Australian: Jacobsen, S. 2019, ‘An Interview with Distinguished University Professor Gordon Guyatt, OC, FRSC on GOBSAT, Guidelines, Living Documents, and Network Meta-Analysis (Part One)In-Sight: Independent Interview-Based Journal, vol. 21.A., http://www.in-sightjournal.com/guyatt-one.

Modern Language Association (MLA, 7th Edition, 2009): Scott D. Jacobsen. “An Interview with Distinguished University Professor Gordon Guyatt, OC, FRSC on GOBSAT, Guidelines, Living Documents, and Network Meta-Analysis (Part One).” In-Sight: Independent Interview-Based Journal 21.A (2019):September. 2019. Web. <http://www.in-sightjournal.com/guyatt-one>.

Vancouver/ICMJE: Jacobsen S. An Interview with Distinguished University Professor Gordon Guyatt, OC, FRSC on GOBSAT, Guidelines, Living Documents, and Network Meta-Analysis (Part One) [Internet]. (2019, September 21(A). Available from: http://www.in-sightjournal.com/guyatt-one.

License and Copyright

License

In-Sight Publishing and In-Sight: Independent Interview-Based Journal by Scott Douglas Jacobsen is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Based on a work at www.in-sightjournal.com.

Copyright

© Scott Douglas Jacobsen, and In-Sight Publishing and In-Sight: Independent Interview-Based Journal 2012-2019. Unauthorized use and/or duplication of this material without express and written permission from this site’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Scott Douglas Jacobsen, and In-Sight Publishing and In-Sight: Independent Interview-Based Journal with appropriate and specific direction to the original content.  All interviewees co-copyright their interview material and may disseminate for their independent purposes.

The Cynical Smile Of A Solitary Head

Author(s): Ismail Hamaamin Hamalaw

Numbering: Issue 1.B, Idea: The Kurds (Part One)

Place of Publication: Langley, British Columbia, Canada

Title: Indigenous Middle East

Web Domain: http://www.in-sightjournal.com

Individual Publication Date: September 8, 2019

Issue Publication Date: TBD

Name of Publisher: In-Sight Publishing

Frequency: Three Times Per Year

Words: 3,926

Keywords: Baldin, Ahmed, head, Ismail Hamaamin Hamalaw.

The Cynical Smile Of A Solitary Head[1],[2],[3]

*Please see the footnotes, bibliography, and citation style listing after the interview.*

*Originally published in Culture Project.*

On the artwork of Baldin Ahmed,

“The spirit moves the matter…”

Peter Sloterdijk*

An essay by Ismail Hamalaw

A solitary head sits atop a chair, face smiling, eyes observing the space ahead of it, dividing it into two spheres–historical and artistic. I found the sculpture difficult to decipher initially, its right cheek resting against the metal of the chair, face fixed in a gentle smile that seemed to communicate tranquility at the crowded main street, as if nothing had happened, no one had been harmed, no tragedy had occurred. It even seemed romantic, the quietly smiling head of the Ahmadi Dalak monument, a creation by renowned Kurdish artist Baldin Ahmed.

The sculpture was erected on (29.10.2019) and is located in Sulaymaniyah, on the west side of the sizable hill not far from the city’s main street. Above it, on top of the hill, sits the hotel Share Jwan, or “beautiful city”.

Ismail Hamaamin Hamalaw

Sulaymaniyah: birthplace of Ahmad Dalak

Ahmadi Dalak (Ahmad Mahmoud Ahmad) is the eldest son of Mahmoud Dalak, the first barber of the city. Ahmad was born in the neighbourhood of Kani Askan, in the city of Sulaymaniyah, in 1928.

The city, which served as inspiration for the sculpture, was founded in the late eighteenth century. It was caught politically between the Ottoman Empire and Safavid Dynasty. The Ottoman Empire controlled the city until the end of World War I, at which point the British took over. Most of the soldiers in the British forces were poor men from India, who arrived accompanied by “civilised” officers, whose presence would only establish political chaos. The bombardment of Sulaymaniyah in 1924 by the British RAF was the introductory gift to the Kurdish city that would set the stage for things to come.

The bloodbath of 1930 in Sulaymaniyah was another, similarly gentle answer to the peaceful demonstration of the city’s inhabitants, who had called for an end to the colonial domination and occupation of the city. (Andrew Green, 2014([i])

The tragedy began with the bombardment of the city simply because the Kurdish people disagreed with the new geopolitical map suggested by British officer (Gertrude Bell) and war generals, which forced Arabs and Kurds, Assyrians, Yazidis, Shiites, Sunnis, Christian, Jews, and other ethnic groups to live forcibly together under the umbrella of King Faisal, whom the British had brought from Saudi Arabia. The British army squashed the resistance of the 1920s, which arose in protest of the British colony in southern Iraq. They also killed and bombed the Kurdish people in their own homes. Even Winston Churchill suggested the use of chemical weapons to put an end to the Kurdish struggle in the North, which would force them to abide by the new British map and abandon any hopes of an independent Kurdistan.

From that time, within the newly created state of Iraq, there raged a battle between the central government and the inhabitants. (Raed Asad Ahmed, 2014)[ii]

The military coup in Baghdad, on 14 July 1958, resulted in overthrowing the Hashemite monarchy, which had been established by King Faisal I in 1921 under the auspices of the British. Afterwards, there was the coup of 1963, followed by the 1967 coup in which the Baath party took power.

It is against this historical backdrop that the story behind the sculpture “Ahmadi Dalak” took place. (Moments in U.S. Diplomatic History)[iii]

In this bloody period of Iraqi history, during the struggle for liberation and independence, especially post-World War II, Ahmadi Dalak appeared on the political stage as a leftist, active in the Iraqi communist party.

His family name, Dalak, means “barber” in Kurdish. His father was the first one in Sulaymaniyah to establish a shop especially for the purpose. Prior to that, barbers carried their equipment in a small bag, and they brought their work with them to customers’ homes, to street corners, to door fronts, working wherever they could. Ahmad Dalak’s father brought a special chair and large mirror from Baghdad. He rented a shop in the 1930s, which became the first barbershop in Sulaymaniyah. In honour of this, the family received the name of Dalak.

Ahmadi Dalak would help his father in the shop. Throughout his childhood, he came into contact with many special customers, including politicians, writers, and poets such as Abdulla Goran and Fayaq Bekas. The conversations he overheard, on politics, poetry, dreams of an independent Kurdistan, of modern life, democracy, and the need to resist against British colonial rule, would all have a significant influence on the young Ahmadi Dalak.

The political body and the invisibility of the real body

Ahmadi Dalak in prison in 1950’s.

Dalak became a member of the Iraqi communist party, actively participating in demonstrations against the colonial power of the central government in the 1950s. In 1952, a demonstration took place in Baghdad, during which police shot a young Kurdish demonstrator from Sulaymaniyah. On the day of the funeral parade in Sulaymaniyah, Ahmadi Dalak gave a speech that would make him a target of the Iraqi intelligent service. This forced him to go underground, moving from city to city in Iraq and changing his name and identity many times.

During the era of military coups, he was the most wanted man on the list of the brutal intelligence service. He led a secret life, resorting to clandestine action. The secret police managed, nevertheless, to capture him many times. They placed him in prison and tortured him repeatedly. He was in prison during the monarchy and even during the coup of 1963. His last imprisonment was in 1969, when the Baath Party was in power.

That year, his execution was ordered. Nazim Guzar, his executioner, ordered that his body be slowly emerged in a bath of acid. It was this defining moment that served as inspiration for Baldin Ahmad’s sculpture of the disembodied head.

The artistic moment of Baldin Ahmad

Baldin Ahamad & the statue of Ahamadi Dalak.

The passage from historical to artistic moment occurred at this point, with the disembodied head, as artist Baldin Ahmad recalled forty years later.
Baldin Ahamad & the statue of Ahamadi Dalak.

The pleasant, handsome face of the revolutionary man whose smile perished through brutal, Soviet-style torture and who fought for liberation, not only for a Kurdish nation but for the working classes of the world, is immortalised through this sculpture.

To understand the historical encounter between executioner Nazim Guzar and revolutionarily prisoner Ahmadi Dalak, it is necessary to examine the macabre moment that the artist would capture, the moment in which Ahmadi Dalak’s body separated from his head, the last part to remain above the acid bath.

Ahmadi Dalak’s execution was the result of millions of dollars spent by Saddam Hussein to finance apprenticeship programmes in the “Soviet Union” to train the secret police in torture.

Guzar was one of the officers whom Saddam Husain had authorised to kill, torture, mutilate, melt, and crush anyone who dared to whisper against him and his Ba’ath party (Shawkat xaznadar,2005 )[iv].

If we look back at the history of Ba’ath Party, from when it first came to power in 1967, Saddam Hussein’s first urgent decision as vice president was to bestow the rank of general on Nazim Guzar, despite the latter not receiving formal training at any military or police academy.

Nazim Guzar became the director general of the secret police in Iraq. According to former Baath member Hadi Alawai who was also journalist at the time, in 1969, Saddam was convinced that Nazim Guzar could achieve the best results in bringing political prisoners, especially members of the Communist Party, to confess and give up the names of their comrades who were clandestinely active against Baath regime. (Hadi Alawai,1990)[v]

Guzar’s brutality, ruthlessness, and bloodthirsty character was enough for him to attain this position as general director of the Iraqi Secret Police. His brutality was exactly what Saddam Hussein needed at the time, but it was also the nature of Saddam Hussain to kill anyone who tried to achieve more than what he had ordered them to do.

According to the Baath government official story, Nazim Guzar had tried to assassinate Iraqi’s president general Ahmed Hassan al-Bakr on 30 Jun 1973, when he returned from an official visit to Bulgaria. He was captured after trying to escape to Iran. In an ironic twist, Saddam employed the same method to execute Nazim Guzar which the latter had used against prisoners in his time of glory. There is a rumor that Nazim Guzar was raped repeatedly before his execution. In only this brief history, the cruelty of the Baath party is abundantly evident.

The historical moment

In order to understand the sculpture, it is necessary to examine the historical context that led to the fatal encounter between Nazim Guzar and Ahmadi Dalak.

In 1967, there was a split within the Iraqi Communist Party. The group that left called themselves the “Central Command”. They tried to established connections with partisan cells in the south of Iraq, especially in the Marsh areas of Nasiriyah.

Ahmadi Dalak was one of these leaders who engaged in partisan actions against the Iraqi secret police in the Marsh areas. In a short time, however, the Ba’ath regime managed to capture all the leaders of Central Command and put them in Baghdad’s secret police prison. The members of the Central Command were tortured, and many of them gave up the names of their comrades, or were killed under torture. Nazim Guzar spearheaded the confession processes.

It was essential for the Ba’ath party that the leaders of the Central Command give up the names of their comrades and confess publicly that they had made a mistake in opposing the government. Saddam Hussain promised the leaders that he would spare their lives, offering to secure their financial futures too, in addition to giving them positions within the government. Aziz Al Hajh, Secretary General of the Central Command, confessed publicly, and Saddam rewarded him and sent him to Paris as Iraqi ambassador in (UNESCO) until his retirement. (Aziz Al Hajh, Interview)[vi]

It is clear that Ahmadi Dalak had the chance not only to keep his life, but to exploit that generous opportunity that Saddam had offered. He ultimately refused, insisting that the Ba’ath party and its government–especially Saddam Hussein–were leading the country to war and destruction. He posed a challenge to the bloodthirsty Nazim Guzar, refusing to name any of his comrades. Nazim Guzar ordered that he have one of his eyes removed, leaving him to bleed in his dirty cell for many days. After that, they put him on a chair to be displayed to his comrades in the prison. This act of terrorizing other prisoners was method for which Nazim Guzar became famous. It led many to confess, not just to save their own lives but at the very least to ensure a quick death, free of brutal torture.

Aziz Al Hajh was one of the prisoners who saw Ahmadi Dalak. After witnessing this, he confessed publicly on an Iraqi TV channel. Which eye was removed remained a mystery; not even Dalak’s family was given any information. They did not receive his corpse for the simple reason that there was nothing left to hand over, except the acid water in Baghdad’s secret police headquarters’ torture chamber, which was used to melt many a prisoner before Dalak.

The solitary head and the “anatomic” chair

At the intersection of history and art, artist Baldin Ahmed captured the last moments of Ahmedi Dalak, the moment of the prisoner’s last sentences, of his cynical smile on the confession chair in the torture room.

It was the fact that Ahmadi Dalak was smiling all the time, never displaying any weakness or regret, that made Nazim Guzar lose his mind and torture him even further.

At last Ahmadi Dalak agreed to confess, but on one condition: that all the higher officers should be present in the room. According to many accounts, Saddam was convinced that Ahmadi Dalak was not the sort of man to back down easily. It was for this reason he didn’t appear in the acid room, which was the last stage of the tragic theatre.

The day came. In addition to Nazim Guzar, there were many officers present at the scene, who would later go on to recount this story after witnessing it. They put Ahmadi Dalak on the small, dirty, bloodstained chair. He was in a profoundly lamentable condition. There was a cold silence in the acid bath room at the time of confession. The officers for waited the moment of victory, when at last Dalak would confess. A cynical smile appeared on his face and he spoke his last words: “As a communist, I fought all my life for equity and liberation. Even if I were to be born again, I would relish being born as a communist to continue the fight for liberation. Gentleman, this is my first and last confession”.

According to the many witnesses, Dalak did not lose his temper, his cynical smile, his confidence, even when he was on the horrible, small chair, his eye, his face, his nose, his entire body covered with blood from continual torture.

At that moment, the chair and the body fused together, melted together, historically and biologically, for two reasons. Firstly, the small chair offered him the last historical stage, the last battlefield against dictatorship, the last chance to valiantly defy the chauvinism of the Baath party in their proud terror castle, personified in Nazim Guzar and his master Saddam Husain. Secondly, the chair was the last object, to touch his body, his biological roots. More precisely, the small chair is proof that the body was here with the entirety of its flesh and blood. The chair was the last place to hold Dalak after his torture and confession.

The chair was a witness–everyone who related his story mentioned how Nazim Guzar avenged his defeat, ordering his men to take Ahmadi Dalak and dive him in the acid bath, gradually, from his feet to his head.

Two things remained from Ahmadi Dalak. One was the chair, which was covered with his blood. The other, was the solitary head without a body. These two objects engendered the moment of the sculpture called “Ahmadi Dalak”.

Talking to death

Anatomic chair sketch by Baldin Ahamd.

Our artist Baldin Ahmad described the chair. It was no mundane chair; it was covered with Dalak’s blood, with his DNA. Baldin Ahmad recalls that the family did not receive the body simply because nothing from his body remained after the acid bath.

Baldin remembered his early years and how his brother “Ahmadi Dalak”  had gifted him a pen; he recalled the smile that would come to his face when they spoke about different matters in life. After his execution, the entire family lived under horrible shock because there was no grave to go to; there were only shadows, sounds, whispers, stories about him and Nazim Guzar in which Ahmadi Dalak turned into a dead shadow who would visit and speak with Baldin.

This artwork is based on one such a conversation from beyond death, the conversation that Ahmadi Dalak was not able to finish with his brother, the sort of conversation the living sustain with their loved ones who have travelled to the world of the dead. Baldin was greatly impressed with Pier Paolo Pasolini, Italian film director, novelist, writer, and intellectual (1922 – 1975) who worked on this subject. Pasolini’s death itself was an unsolved mystery, a conversation left unfinished.

In one of our many conversations, Baldin Ahmed said: “When I lived in Italy, I was–and still am– impressed with Pier Paolo Pasolini. I followed most of his works. His ideas on death had a profound influence on me: He believed that everyone, at some point in their lives, has the power to hear the dead who have left them. For this reason, I endeavored in my sculpture not to personify any kind of heroism, though Ahmadi Dalak is a universal, revolutionary hero who fought against chauvinism and fascism. I wished, instead to convey this vital energy of life, which emanated from his death. I didn’t want to push any kind of heroism on the surface, no, I wanted to represent his optimistic energy, his warm conversations about the best future for a human being, his exuberant dedication to equality. I wanted to bring to life his conversation from death, which gave me hope and helped me through my darkest moments.”

The hero in empty space

Reliving the historical moment means recalling the hero after his journey in the ocean of the unwritten history. Peter Sloterdijk in his book Weltfremdheit – Unworldlinessrefers to this kind of hero “who is the man who goes ashore from the ocean of despair. In him begins the adventure of civilization as the colonization of the Ego – mainland” (Sloterdjik, 2003)[vii]

Our hero vanished in the chaos of accumulated historical events–wars, mass murders, revolutions, social conflicts–after his death in 1969. After forty years, however, the hero returned to the mainland, not with his entire body, but with his last, remaining part after the acid bath, his head, which rests on what Baldin refers to as the “anatomic” chair–the part that Dalak’s body melted into and which preserved his DNA, the print of his life and existence.

Peter Sloterdijk refers to “the birth of hero”  in the momentum of self-discovery, “Selbstfindung” through   Suddenness “Plötzlichkeit”.  This momentum is “being” or “being’s reflection”–“Sein – Being”–which is the birth’s momentum of the hero in their “I – being / Ichsein”.

Anatomic chair sketch by Baldin Ahamd.

Precisely, to understand this in relation to the two moments, historical and artistic, we imagine two sorts of births in two different times. One is the birth of the hero in their authentic historical ground. The second is the birth of the cynical smile on the face of our sculpture.

Of course, the first Suddenness “ Plötzlichkeit” by Ahmadi Dalak was the tragic moment one of his eyes was removed and shown to other prisoners. This was the birth of a hero who “discovered himself” and stood tough against all the tortures and humiliation. He decided, nonetheless, to stay in his chosen path, which would ultimately lead to his death but also to his birth as a hero.

The second symbolic birth was that of his cynical smile, which our artist Baldin Ahmad immortalised some forty years after. The hero interacts with the empty space of his torture and turns it into a stage. “The hero picks up the trail that leads him to the site of the pristine malefaction. He thus returns to the scene his exposure, his bellicose alienation.” (Sloterdjik, 2003)[viii]

Dalak himself created the stage; he was the “stage maker” in the empty space in which he led his killers to sit opposite him and to turn the myth of Nazim Guzar into a historical jock. Through the creation of the cynical smile on Dalak’s face, we perceive the historical moment in which the hero interacts with the empty space of fascism and turns the dead element, the empty space, into a living element.

In order to explain the empty space and dead elements, we may consult Peter Brook’s book ‘The Empty Space” in which he refers to the stage as not only something physical within a theatre, but something that exists everywhere in life. He said: “I can take any empty space and call it a bare stage. A man walks across this empty space whilst someone else is watching him, and this is all that is needed for an act of theatre to be engaged” (Peter Brook, 1968)[ix]

He also imagined that “There is a deadly element everywhere; in the cultural set-up, in our inherited artistic values, in the economic framework, in the actor’s life, in the critic’s function. As we examine these we will see that, deceptively, the opposite seems also true, for within the Deadly Theatre there are often tantalizing, abortive or even momentarily satisfying flickers of real life” (Peter Brook, 1968)[x]

Our hero walked through the empty space and lived with the deadly element that was embodied in Nazim Guzar– the killer, the torturer, the executor, the most frightening man in the history of Iraq. But our hero Ahmadi Dalak did not let the deadly element of fascism fade his vitality, his true optimism, his ironic smile. He turned the empty space of torture chambers, He turned the empty space of the torture room, the empty space of deadly theatre to the living theatre, to the historical moment of self-discovery of his being a hero who sits on the anatomic chair and smiles so cynically at his executors.

References

*Sloterdijk Peter, 2009:p.195 Du mußt dein Leben ändern, Shurkamp. German

[i] Green, Andrew, 2014, Bombs over Iraq, then and now, accessed website 20.12.18.

http://gwallter.com/history/bombs-over-iraq-then-and-now.html

[ii]Asad, Raed Ahmed 2/11/2014, Churchill, the Kurds and poison gas, accessed website 23.12.18.

http://www.rudaw.net/english/opinion/02112014

[iii]The Iraqi Revolution — of 1958, Moments in U.S. Diplomatic History, access website 23.12.18.

https://adst.org/2014/07/the-iraqi-revolution-of-1958/

[iv]. Alhiwar al Mutamden, Shawkat xaznadar, Sadaam Hussian and Name Guzar and the painful memory – Online magazine -22.11.2018 http://www.m.ahewar.org/s.asp?aid=72137&r=0.

[v]. Hadi Alawai, ,1990 page 47 -48., Iraq as a state of secret organization, Arabic, London

[vi]. Al Iraqia IMN TV – Pr ‘step’ program – Interview with Aziz Al Hajh – part 1- 3

قناةالعراقيةالدوليةIMN– Published on 27 Jun 2018 https://www.youtube.com/watch?v=VX7L89SQ5iE

https://www.youtube.com/watch?v=1iUnE6xywUQ

[vii]. Sloterdijk Peter 2003 Page 24. Weltfremdheit, Shurkamp Verlg German,

[viii]. Sloterdijk Peter, 2003 Page 21, Weltfremdheit, Shurkamp Verlg German,

[ix]. Peter Brook, 1968, page7.The empty space, Touchstone

[x]. Peter Brook, 1968, page10.The empty space, Touchstone

Appendix I: Footnotes

[1] Manager, Culture Project.

[2] Individual Publication Date: September 8, 2019: http://www.in-sightjournal.com/head

Appendix II: Citation Style Listing

American Medical Association (AMA): Jacobsen S. The Cynical Smile Of A Solitary Head [Online].September 2019; 1(B). Available from: www.in-sightjournal.com/head.

American Psychological Association (APA, 6th Edition, 2010): Jacobsen, S.D. (2019, September 8). The Cynical Smile Of A Solitary HeadRetrieved from www.in-sightjournal.com/head.

Brazilian National Standards (ABNT): JACOBSEN, S. The Cynical Smile Of A Solitary Head. 1.B, September. 2019. <www.in-sightjournal.com/head>.

Chicago/Turabian, Author-Date (16th Edition): Jacobsen, Scott. 2019. “The Cynical Smile Of A Solitary Head.” Indigenous Middle East. 1.B. www.in-sightjournal.com/head.

Chicago/Turabian, Humanities (16th Edition): Jacobsen, Scott “The Cynical Smile Of A Solitary Head.” Indigenous Middle East. 1.B (September 2019). www.in-sightjournal.com/head.

Harvard: Jacobsen, S. 2019, ‘The Cynical Smile Of A Solitary HeadIndigenous Middle East, vol. 1.B. Available from: <www.in-sightjournal.com/head>.

Harvard, Australian: Jacobsen, S. 2019, ‘The Cynical Smile Of A Solitary HeadIndigenous Middle East, vol. 1.B., www.in-sightjournal.com/head.

Modern Language Association (MLA, 7th Edition, 2009): Scott D. Jacobsen. “The Cynical Smile Of A Solitary Head.” Indigenous Middle East 1.A (2019):September. 2019. Web. <www.in-sightjournal.com/head>.

Vancouver/ICMJE: Jacobsen S. The Cynical Smile Of A Solitary Head [Internet]. (2019, September; 1(B). Available from: www.in-sightjournal.com/head.

License and Copyright

License

In-Sight Publishing and Indigenous Middle East by Scott Douglas Jacobsen is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Based on a work at www.in-sightjournal.com.

Copyright

© Scott Douglas Jacobsen, In-Sight Publishing, and Indigenous Middle East 2012-2019. Unauthorized use and/or duplication of this material without express and written permission from this site’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Scott Douglas Jacobsen, and In-Sight Publishing and In-Sight: Independent Interview-Based Journal with appropriate and specific direction to the original content.  All interviewees co-copyright their interview material and may disseminate for their independent purposes.

%d bloggers like this: