Childhood Recollections

Here are a few selections from my parents’ surprise 50^th anniversary scrapbook that I happened to have electronic copies of.  I discovered these as I was cleaning stuff off my old computer (prior to scrapping it).  My parents just celebrated their 57^th wedding anniversary a few days ago.  How time flies!  Names (and in some cases, places) have been changed for the sake of privacy.

Trees (Ari) 

This little ditty on “Trees” was written for the occasion of my parents’ 50th wedding anniversary.

My earliest, dim recollection of existence as a child is of sitting outside on the soft green grass, in the shade of a sycamore tree. I’ve always loved trees, perhaps because in Nebraska we didn’t have a lot of them. On a camping trip to Colorado once, I remember being awed by the dark cathedral-like forest of tall scented pines and the quaking aspens…but the most memorable trees to me were the ones in our own yard.

My parents like to watch the squirrels and the birds in their bird feeder hanging outside their picture window. This is an activity they hardly had time for when we were growing up. My mother no doubt watched anxiously out the window as we children were climbing the trees ourselves, building our tree house perhaps, or leaping onto our monkey swing from a nearby tree limb.

When each of us children was born, Dad planted a tree. “My” tree was a Seckel pear—a prolific but messy fruit tree in the front yard that always provided a feast for the bees and the occasional human who wanted to compete for one of its small, sweet pears. Today it is nearly the last of those original fruit trees still alive. Its gnarled, ashen-gray limbs remind me of a wrinkled, feeble old person one step from the grave. Each year we think it will surely die, but so far it just keeps on producing a bounty of pears.

As children, we had an abundance of fruit trees, in addition to grapes, currents, gooseberries, strawberries and raspberries. I have fond memories of stuffing myself on our sweet sour cherries—it was quite equal to the fun we had climbing up onto Fred Jones’ garage roof and gorging on the overhanging mulberries. Once, my brother Allen and I were sitting in our tree house spitting cherry pits down on the passing cars that were rounding our corner…one driver stopped his car, looked around, gesticulated angrily, but failed to look UP! Now you see, a tree house was just the thing for a kid to have—especially if you were lucky enough to have not one, but FOUR huge sycamore trees to climb as we did. All of the sycamores are gone but one, now—and the monkey swing that used to be attached to it has been missing for 25 years or so.

Perhaps we all remember the simple childish pleasure of jumping in a pile of autumn leaves, feeling the crunch under our feet as we waded knee-deep through them…and smelling the pungent odor of burning leaves on a cool fall day.

At one time, Dad was working some part time jobs to help make ends meet, and one of those jobs was yard maintenance for an old retired Architect (Mr. Strasburg?). On occasion, Dad would take me along to help pull weeds, dig dandelions, etc. In the very back corner of Mr. Strasburg’s back yard stood a giant oak, and I remember helping Dad dig out one of the pesky little seedlings that had sprouted below it, to replant in our own back yard. That little oak sapling is now a beautiful shade tree. Mr. Strasberg’s stately old tree is likely still standing, unlike the row of Lombardy poplars that used to line the back of our own yard, or the willow tree, or the plum, peach or apricot trees. Even our huge apple tree is gone now, the tree that gave us so many bushels of apples, that shaded Heather’s little playhouse and our sand box, that provided our first tree-climb-on-a-cool-Fall-day-to-reach-a-crisp-sweet-juicy-apple-and-take-a-bite-out-of-it experience.

It seems to me the most productive fruit trees are not very tall or stately looking--pretty humble, really. But they have their own beauty… which reminds me of the time my dad was working at another of his part-time jobs at Marvin’s orchard. On one particular spring day our parents decided to pile us all in the car to go see the orchard in full bloom—of course I expected to be bored. But one couldn’t help but be affected by the gorgeous, ethereal forest of delicate white blooms that surrounded us in every direction, and the wonderful apple-blossom scent that filled the air. This was a sensory experience I would never forget.

I have a lot of trees on my property now in Illinois, but no fruit trees. I miss them. Perhaps I will plant some fruit trees myself sometime, perhaps a whole orchard. Then I’ll invite everyone to come see and smell the blooms in springtime…

There’s nothing quite like the serenity and peacefulness of a forest. My German grandfather had a forest near his home, with countless forest paths. On a few occasions, I would go for a hike with one or two others. Early in the morning or after a rain, the sun would filter in and reflect through the mist and off the shimmering leaves overhead; dark ferns, blueberry bushes and soft, damp leaves would surround the forest path. It was a spiritual experience, a quiet, glistening symphony of light and color.

My parents loved beautiful music; they sought to impart this love to each of their children as well. Often on a Sunday afternoon they would take us to hear the college orchestra, and later, my sister and I would play in it ourselves. My folks made some unlikely friends with some of the college professors and others, based on their common love of music. The various instruments in the orchestra, carefully handcrafted from European maple, spruce, birch and ebony, were capable of producing a beautiful new symphony of sound, quite apart from the symphony of their native forests. These were trees I had otherwise never seen, whose life was taken and whose life-giving trunks were cut up for a higher human purpose, carefully formed into the sounding board on instruments such as my viola perhaps, or our sturdy old piano.

We had no grandparents close by, but our surrogate grandparents lived just a block away from us, on a couple of acres or so on the edge of town. Fred Jones was the practical type; outspoken and enthusiastic, and always busy with his hands and working in his big garden, nearly till the day he died. I loved to see the new seedlings growing in his little greenhouse in March—it was a reminder of the rebirth of spring, of warmer days to come. In addition to gardening, Fred had an old building he converted into his “shop”—a place you could go for lively conversation on a cold Winter day, immersed in the scent of fresh sawdust mixed with wood smoke from his Franklin stove. Aunt Naomi (as we called her) had a personality that was quite different from Fred’s. To most people, she was a quiet, shy, diminutive figure who preferred to stay in the house. But to those who knew her better, she was the intellectual, the philosopher, the bold, intrepid adventurer who would accompany her literary and historical characters when they circumnavigated the globe in tall, wooden ships. In another time and place, she might have become an adventurer herself, a discoverer of new worlds, but we children were simply content to help share in her literary adventures and her oatmeal cookies. So, you ask, what does this recollection have to do with the subject of trees? I like to think that both Aunt Naomi’s printed pages and Fred’s various garden tools, buildings and other possessions—and perhaps, we might even say, most of the tools and edifices of both our human survival and our culture—we owe to the gift of trees.

Take an open field, plant some trees and grass, and after 15 years or so, you have a park! My favorite park was Harmon Park. A year ago my parents happened to give me a wall clock that had a picture on the front, of a stone tower next to a shaded pool. This was a photograph from the “rock garden” in Harmon Park. The many stone footpaths winding around underneath grand old trees, with little bridges over man-made streams, little pools and waterfalls—these all evoked a sort of medieval sense of mystery and beckoned us to explore! Last year when I visited the park with my parents, it seemed that everything was smaller and less impressive than I remembered as a child. But the pavilion was still there among the trees, where I had my high school graduation; a band was playing nearby, the fountain and flower gardens were still there, and a path to the rock garden still beckoned to us. We passed a particular, small garden planting, and my mother suddenly paused and revealed a secret. “When I first came over here from Germany, I was so homesick that when I saw some familiar peppermint growing in this little garden, I just had to have some of it, so I stole a tiny sprig when no one was looking and planted it in my backyard garden.” (She has a peppermint patch even to this day.)

It may seem odd that trees would even factor into my childhood memories. And yet, in a sense, we can find analogies, parallels and subtle echoes of our own humanity in the trees. A tree or a forest provides protection from the cold winter winds and food and habitat for the animals and us in the summer, but it also quietly reminds us of life and death, of succeeding generations, of growth and decay, of vigorous youth and tottering old age, of beauty and humility, of greatness and of the impermanence of life on this earth.

Perhaps we can sometimes even picture our own parents a little bit like those old fruit trees, bent with age and wracked by the storms of bygone years, yet continuing to provide quiet shelter and sustenance to any who would venture to sit under the shade of their branches.

--Ari

An Open Home (Heather)

“I teach them love for all mankind,For all God’s creatures, but I find
My love comes lagging far behind.”

This verse of a poem reminds me of the love my parents taught us children – the same love I want my own children to know, but I find “My love comes lagging far behind.”

Our parents had respect for all mankind – the helpless, the old, the unfortunate – and little children. Long ago, after baby-sitting 8 month old Ryan B., I came home and begged Mom to take him full time. Back then I didn’t consider how much Mom would get paid; if a baby in the house would get on people’s nerves; if she would be “tied down” or any other inconvenience a small child could mean. I was happy that she agreed to baby-sit Ryan, which also led to his sister, Anna, later becoming a part of our family. We had the privilege of watching babies grow, develop and respond to loving care. After having my own child it brought back memories of how I loved those little ones at home. Then came Edward – not until years later did I find out what some people’s uncaring, cold attitude toward such a severely handicapped child could be! It made me appreciate a home where we learned respect for all mankind: that even blind, helpless Edward knew the difference between friends and strangers, and he could respond to love and to music.

We learned to respect the old – when we mimicked Great Aunt Gertie and Grandma by walking bow-legged or knock-kneed Mom scolded us! I remember laughing so hard when Aunt Gertie told us stories about when she was young while helping us pit cherries – especially when she said she could hang by her toes from a tree branch, how we laughed! I couldn’t picture her being young. She enjoyed her break from the nursing home and we found out how much fun an old lady could be.

When Dad took us kids to visit Emma Trefzger, it was like a visit to the past sometime in history. Everything in the barn was just where her father had left it, and we were fascinated by the rocking chairs and kerosene lamps so we explored the place while Dad repaired her leaky roof and did odd jobs for her. We discovered that old people can be interesting. Of course, there are many more examples of what our parents did for old people – God has them written down in His book, and it made impressions on my life.

Our parents had respect for all God’s creatures. How many parents would have let me raise messy ducklings in a box in my bedroom? Who else would have let Joni raise a piglet in the basement? Remember the 6 tortoises who came along in the car from the trip to Valentine so they wouldn’t get run over on the road? We had dogs, cats, goats, chickens and fish as well (and didn’t live on a farm), though Mom didn’t appreciate the garter snake we brought home for her garden. And she made me send away all the stray dogs I brought home with me. I’m thankful now for the privilege of learning to care for (and care about) “all God’s creatures” in my childhood.

Sometimes my parent’s good-hearted generosity has been taken advantage of, but it never kept them from trusting and giving to the poor or sharing with children and neighbours. They also have an open home for the homeless servants of God who freely come and go. Matt. 25 “The righteous will answer him, Lord, when did we see you hungry and feed you, or thirsty and give you something to drink? When did we see you a stranger and invite you in, or needing clothes and clothe you? When did we see you sick or in prison and go to visit you?” We know what the King replied: “whatever you did for one of the LEAST of these brothers of mine, you did for me.” Our parents voluntarily took Aunt Edwina into their home when she had Alzheimer’s. That’s what I call an “open home.”
--Heather


I Remember (Joni)

I remember I remember, the house where I was born,
The little window where the sun, came peeping in at morn….

Some of my earliest memories are of sun and heat. I remember only faintly picking vegetables with mom over at old Mrs. Maloof’s.

And I remember the sun and the heat walking with my siblings to the “egg lady’s” house. When we were just about there, we always stopped to rest under the “Chestry Oak”, which, of course, was not an oak at all, but a sycamore.

I think my early memories of winter must have been dad reading. I can remember lying around in the evenings, enjoying the sound of the words and the tone of the voice, without being able to follow the story line at all.

I remember walking home down 8th Avenue, from Kindergarten with mom. I remember very little of kindergarten, and so vividly the walks home.

As the youngest child, I’m afraid I lacked a little in discipline and responsibility. Any of my older siblings would quickly attest to it. But, oh--what carefree days! Summer days stretched on forever, like a long highway curving off into the distance. And bare feet walked the dusty roads of summer. Laurie and I roamed the town like gypsies, and chose whose home to sleep in when night fell, with very little aforethought.

Remember the old brown station wagon? I don’t believe we ever went to meeting without being loaded to the shock absorbers’ capacity. And the youngest ones got the third seat riding backwards. Namely me! Climbing through the back window to the third seat offended my girlish dignity thoroughly; regardless of the fact that none of my friends seemed to mind at all.

With dad being who he was, we took a lot of back roads when we went places. He wanted to “see the country”. This was an aggravation to me when I was a teenager. But I can remember my enjoyment of country roads when I was younger. I remember coming to the top of a hill, and begging to be let out to run. I knew with perfect certainty that I could fly; I could feel it! My toes would only just skim the grass at the side of the road. The car would be left behind in ignominy. Dad would let out whoever wanted out, and we’d find out how hard the earth really was, under our feet.

Here I’ve rattled on about nothing, and if I tell all I want to tell, it’ll become a book. I remember the trips out to Emma Trefzgers; singing hymns at the nursing home; the apple tree with the perfect spot to sit in, in the very top (You could sing higher when you were up there); pitting cherries in the front yard with Grandma and Aunt Gertie; the little current bushes where you could pull off a whole handful of berries at once; the sycamore trees, and the monkey swing. I often got the job of feeding old Sally and Rags, and Mittens. They had a pretty good life, those three. There was Sunday morning meeting at Grants (Turn left on Vitamin E), and bible study at Modines, where we couldn’t swing our bible cases in fear of the beautiful plates on the walls. I remember going hither and yon to Gospel meetings; to hear the workers in our field…

There were the travelogues, the orchestra concerts, the college plays. There was Thanksgiving time with the Jannsons, everyone at Grandma Naomi’s; The poems, and grandpa Fred acting as judge.

I can taste my childhood as well. Sundays with spaetzle and sauerkraut, summertime with creamed lambs quarters over mashed potatoes, Christmastime with magenbrot and anise cookies.

There was music, always music—the piano, violin, viola, flute, accordion, saw and harmonica. When I hear a hymn sung in especially nice harmony, or someone gets a few violins going, I find myself with a little feeling of homesickness. These memories are just some of the music of my childhood.




The Sign Painter (Ari)

When I was a boy, I remember each of us children having a piggy bank to hold our weekly allowance. My first piggybank was a tall tin can with a slot at the top—it made a dull, metallic “clunk” when I dropped a quarter into it, and I would often take it down from the high corner shelf above my bed to weigh it in my hands. For the most part, I’ve long since forgotten what I used those savings for—perhaps the purchase of a toy, some bottle rockets, a chocolate bar, or a 25 cent hamburger from Bikes burger bar?

However, I do remember one notable exception--which brings me to the story of the sign painter. It all started one day when Dad was trying to sell our big brown Buick station wagon. This car had a third rumble seat that would fold up in the back, and it definitely came in handy for carrying a family of seven plus other passengers. Incidentally, by the time our family was finished with a car, it either became a demolition derby contestant, was acquired by someone who restored old “classics” on the cheap, or was sold to some desperate person in even greater need of an inexpensive car than we were. In this case, it was the latter situation.

Now, my dim recollection is very likely to be inaccurate and incomplete, and perhaps my parents could have shed more light on this, but no matter. I do remember that a billboard sign painter came to look at the car, and he, his wife and their four children were in desperate straits. Their car was broken down and abandoned, and they were forced to travel in their remaining pickup truck. Apparently, the sign painter had been traveling with his family across the U.S., stopping in each town to solicit a job painting someone’s billboard. What might have once started out as a romantic adventure had obviously turned into a nightmare—the family was all but destitute and completely out of money, the man was having trouble finding enough work, and the wife and small children were hungry and cramped in their tiny room at the Motel 6.

My dad agreed to sell our Buick to them for about $45, or some such paltry sum. The sign painter did secure a deal to paint a sign for a local motel, but he needed a place to paint, so my dad offered our backyard. I was intrigued as he set up his giant easel against our “playhouse” and proceeded to paint a pleasant landscape, although I kept a respectable distance. Later on, a small thundercloud emerged in the very corner of his picture, the only thing that detracted from an otherwise cheerful, welcoming scene. We understood this was because he felt the proprietor who had hired him to paint the sign was cheating him. Looking back on it, I wonder if the man was also frustrated and bitter because he had an inkling that his artistic profession was being quickly swallowed up by the new technology of screen printing, and it was getting harder and harder to find anyone willing to give him a billboard to paint.

At some point, the man’s wife came to our back door, most likely without the knowledge of her husband, who was not there at the time. She apparently spoke to my mom, who was the only one home besides me. My mom told her to wait at the door, then came to my room, sat down with me and told me “this woman’s children are hungry, they have no money to buy food. Would you be interested in donating some amount from your piggybank to help them out? It’s purely up to you.” I suppose my mother may not have had any money on hand herself, or perhaps she didn’t feel right about giving out money without first consulting with my dad, or perhaps she saw this as a lesson to impress on me the value of giving…I don’t know. In any case, when confronted with the picture in my mind of this woman’s poor, starving, whimpering children huddled in a cramped room at the Motel 6, I naturally proceeded to break open my ceramic pig. I put what money I had, maybe 35 or 40 dollars, in a small paper sack, and handed it to the woman at the door. She thanked me heartily, and there was a little choking sound and perhaps some tears as she quickly left. I remember feeling almost a little ashamed that this woman had gotten to the point that she had to lose all her dignity, had to beg for money from a stranger, and had to accept money from a child’s piggy bank, no less. But in any case, I knew that I couldn’t have spent that money for anything else in the world that would have made me feel so good as I felt on the inside. That warm glow of happiness is the focal point of my recollection.

The canvas was soon to be completed before the painter would then proceed to install it on one of the billboards. (Was it on Rte 24? I don’t remember anymore, but I do remember later on that Dad would point it out as we passed it on the highway.)

In the meantime, Dad made a flurry of phone calls to see if he could find this man a temporary job to help him get back on his feet. He finally found a job opening at the municipal waste treatment plant, but the man was apparently still too stubborn to recognize his dire situation, and perhaps aghast at the prospect of lowering himself from the lofty position of an “artist” to a job working in a sewage plant.

I don’t know if the sign painter ever actually paid my Dad for our car or not. I never asked him, and it doesn’t matter anyway. A day or two later, the man and his family left their motel in the middle of the night and moved on.

What ultimately happened to that family, and to what extent my folks’ small token of kindness may have made a difference in their lives, I’ll never know. But I did learn there are always plenty of ways to help others if one is willing to get involved, to help even in small ways. And experiences like this remind us once again “it is more blessed to give than to receive.”


E-mail to siblings:

Here’s a rough draft of a story I wrote for the parents’ 50th. Do you happen to remember anything about the sign painter?



Yes, I remember the sign painter, too. I could add that Mom bought them lots of groceries, etc. and Dad found them an apartment and paid the down payment for them. Don't know how long they lived there without paying a cent, and that's why they up and disappeared... I believe the owner of the apartment turned to Dad to demand payment. But of course, we were children and our parents didn't tell us everything about the money matters. I felt sorry for the mother and children, and they would have been better off getting welfare than always on the road. But I felt angry at the man for taking advantage of my folks good-heartedness. Who knows what ever happened to them.

--Sibling “A”


I'm just sending in my 2 cents, which probably isn't very accurate. Isn't it funny how we can remember different parts of the same story? I never knew that you contributed to the sign painter! I'm afraid I was at a selfish and critical minded stage at that point in time. It was years later before I appreciated what mom and dad had done for those people.

I think dad sold the car for $200.00. But that’s irrelevant. I only remember it that way because I thought it was a lot of money, and I thought dad was being foolish throwing it away. I knew that they weren't going to pay him. It was a long time before I realized that dad, of course, knew that too. Every time I crabbed to him about those people "stealing" his car, he would scratch his head and say, "I sure hope that transmission doesn't go out on them, if they go through the mountains in CO." And he sincerely meant it. I remember the woman too. I was worried she would try to steal something from the house...anything. She told mom a lot of wild stories, that I thought were all balony, but some of those bizarre things were probably true. In my cynical young teenage mind these people were trash. To mom and Dad, those kind of people were "down on their luck", or "life was treating them hard right now". Remember, mom hired the little boys to pull weeds in her garden? They were nice kids.

It was a fascinating experience to watch that man paint. He had palsy, or Parkinson’s, and his hands were already beginning to shake pretty bad. His days as a painter were on the way to being over.

The sign went up on Highway 24 coming in from the west.


--Sibling “B”


E-mail to Dad & Mom:

Dad & Mom--

Here's some behind-the-scenes correspondence regarding the "sign painter" story that I thought you might get a chuckle out of.  Probably only you know the actual, true complete story, but anyway, thought this was sort of interesting.
Cheers,

--Ari

E-mail Response from Dad:

…And all through the years when we have come from the West, I would see it and say, "There's my sign!" I guess I got my money's worth.

--Dad



Now, from your mother:

This is turning into an interesting story. Now I will write a few things that I remember. No, dad did not find them an apartment. But they lived in a motel on Hwy. 24. They left in the night, we wondered if they paid the rent. They lived there 1 or 2 months.

I liked the four little boys. The oldest one kept saying, "If only we were older, we could work very hard to earn money to help Dad and Mom.”

The father told me, "I love my little boys very much. They mean the world to me and I want to be a good Dad". He told me that he had been a concert pianist and played on stages all over the U.S.A. His favorite composer was Tchaikovsky. One day when he saw the piano, he looked longingly at it--and I asked him to play. With his big hands he played Tchaikovsky--all over the piano. How he could play, like in a concert hall. Then sadly he said, "This was my life. I cannot go back."

Now what the wife told me -- For two years she saw or heard nothing of him. The youngest was a baby when he left. He sent no money or support and she knew nothing about him. Then the county helped her out and at the end they were going to take all her children away and she went to court and battled for them. At the most critical moment he came home, with no explanation, broke, no money. He loaded up his family and drove, I don't know all from where. The gas gave out in Kearney, I guess.

He was a good sign painter but that was not enough to support a family. We just hope things went better for them and they raised the family together.

Postscript from Ari:

I had a dim memory of standing in our living room and listening spell-bound to someone playing our piano, but I couldn’t remember who or when exactly it was. Now I remember. His palsy had obviously not yet completely silenced his ability to play.

Medical Science

November 2010

Print | Close

Lies, Damned Lies, and Medical Science

Much of what medical researchers conclude in their studies is misleading, exaggerated, or flat-out wrong. So why are doctors—to a striking extent—still drawing upon misinformation in their everyday practice? Dr. John Ioannidis has spent his career challenging his peers by exposing their bad science.

By David H. Freedman

Image credit: Robyn Twomey/Redux
In 2001, rumors were circulating in Greek hospitals that surgery residents, eager to rack up scalpel time, were falsely diagnosing hapless Albanian immigrants with appendicitis. At the University of Ioannina medical school’s teaching hospital, a newly minted doctor named Athina Tatsioni was discussing the rumors with colleagues when a professor who had overheard asked her if she’d like to try to prove whether they were true—he seemed to be almost daring her. She accepted the challenge and, with the professor’s and other colleagues’ help, eventually produced a formal study showing that, for whatever reason, the appendices removed from patients with Albanian names in six Greek hospitals were more than three times as likely to be perfectly healthy as those removed from patients with Greek names. “It was hard to find a journal willing to publish it, but we did,” recalls Tatsioni. “I also discovered that I really liked research.” Good thing, because the study had actually been a sort of audition. The professor, it turned out, had been putting together a team of exceptionally brash and curious young clinicians and Ph.D.s to join him in tackling an unusual and controversial agenda.
Last spring, I sat in on one of the team’s weekly meetings on the medical school’s campus, which is plunked crazily across a series of sharp hills. The building in which we met, like most at the school, had the look of a barracks and was festooned with political graffiti. But the group convened in a spacious conference room that would have been at home at a Silicon Valley start-up. Sprawled around a large table were Tatsioni and eight other youngish Greek researchers and physicians who, in contrast to the pasty younger staff frequently seen in U.S. hospitals, looked like the casually glamorous cast of a television medical drama. The professor, a dapper and soft-spoken man named John Ioannidis, loosely presided.
One of the researchers, a biostatistician named Georgia Salanti, fired up a laptop and projector and started to take the group through a study she and a few colleagues were completing that asked this question: were drug companies manipulating published research to make their drugs look good? Salanti ticked off data that seemed to indicate they were, but the other team members almost immediately started interrupting. One noted that Salanti’s study didn’t address the fact that drug-company research wasn’t measuring critically important “hard” outcomes for patients, such as survival versus death, and instead tended to measure “softer” outcomes, such as self-reported symptoms (“my chest doesn’t hurt as much today”). Another pointed out that Salanti’s study ignored the fact that when drug-company data seemed to show patients’ health improving, the data often failed to show that the drug was responsible, or that the improvement was more than marginal.
Salanti remained poised, as if the grilling were par for the course, and gamely acknowledged that the suggestions were all good—but a single study can’t prove everything, she said. Just as I was getting the sense that the data in drug studies were endlessly malleable, Ioannidis, who had mostly been listening, delivered what felt like a coup de grâce: wasn’t it possible, he asked, that drug companies were carefully selecting the topics of their studies—for example, comparing their new drugs against those already known to be inferior to others on the market—so that they were ahead of the game even before the data juggling began? “Maybe sometimes it’s the questions that are biased, not the answers,” he said, flashing a friendly smile. Everyone nodded. Though the results of drug studies often make newspaper headlines, you have to wonder whether they prove anything at all. Indeed, given the breadth of the potential problems raised at the meeting, can any medical-research studies be trusted?
That question has been central to Ioannidis’s career. He’s what’s known as a meta-researcher, and he’s become one of the world’s foremost experts on the credibility of medical research. He and his team have shown, again and again, and in many different ways, that much of what biomedical researchers conclude in published studies—conclusions that doctors keep in mind when they prescribe antibiotics or blood-pressure medication, or when they advise us to consume more fiber or less meat, or when they recommend surgery for heart disease or back pain—is misleading, exaggerated, and often flat-out wrong. He charges that as much as 90 percent of the published medical information that doctors rely on is flawed. His work has been widely accepted by the medical community; it has been published in the field’s top journals, where it is heavily cited; and he is a big draw at conferences. Given this exposure, and the fact that his work broadly targets everyone else’s work in medicine, as well as everything that physicians do and all the health advice we get, Ioannidis may be one of the most influential scientists alive. Yet for all his influence, he worries that the field of medical research is so pervasively flawed, and so riddled with conflicts of interest, that it might be chronically resistant to change—or even to publicly admitting that there’s a problem.
The city of Ioannina is a big college town a short drive from the ruins of a 20,000-seat amphitheater and a Zeusian sanctuary built at the site of the Dodona oracle. The oracle was said to have issued pronouncements to priests through the rustling of a sacred oak tree. Today, a different oak tree at the site provides visitors with a chance to try their own hands at extracting a prophecy. “I take all the researchers who visit me here, and almost every single one of them asks the tree the same question,” Ioannidis tells me, as we contemplate the tree the day after the team’s meeting. “‘Will my research grant be approved?’” He chuckles, but Ioannidis (pronounced yo-NEE-dees) tends to laugh not so much in mirth as to soften the sting of his attack. And sure enough, he goes on to suggest that an obsession with winning funding has gone a long way toward weakening the reliability of medical research.
He first stumbled on the sorts of problems plaguing the field, he explains, as a young physician-researcher in the early 1990s at Harvard. At the time, he was interested in diagnosing rare diseases, for which a lack of case data can leave doctors with little to go on other than intuition and rules of thumb. But he noticed that doctors seemed to proceed in much the same manner even when it came to cancer, heart disease, and other common ailments. Where were the hard data that would back up their treatment decisions? There was plenty of published research, but much of it was remarkably unscientific, based largely on observations of a small number of cases. A new “evidence-based medicine” movement was just starting to gather force, and Ioannidis decided to throw himself into it, working first with prominent researchers at Tufts University and then taking positions at Johns Hopkins University and the National Institutes of Health. He was unusually well armed: he had been a math prodigy of near-celebrity status in high school in Greece, and had followed his parents, who were both physician-researchers, into medicine. Now he’d have a chance to combine math and medicine by applying rigorous statistical analysis to what seemed a surprisingly sloppy field. “I assumed that everything we physicians did was basically right, but now I was going to help verify it,” he says. “All we’d have to do was systematically review the evidence, trust what it told us, and then everything would be perfect.”
It didn’t turn out that way. In poring over medical journals, he was struck by how many findings of all types were refuted by later findings. Of course, medical-science “never minds” are hardly secret. And they sometimes make headlines, as when in recent years large studies or growing consensuses of researchers concluded that mammograms, colonoscopies, and PSA tests are far less useful cancer-detection tools than we had been told; or when widely prescribed antidepressants such as Prozac, Zoloft, and Paxil were revealed to be no more effective than a placebo for most cases of depression; or when we learned that staying out of the sun entirely can actually increase cancer risks; or when we were told that the advice to drink lots of water during intense exercise was potentially fatal; or when, last April, we were informed that taking fish oil, exercising, and doing puzzles doesn’t really help fend off Alzheimer’s disease, as long claimed. Peer-reviewed studies have come to opposite conclusions on whether using cell phones can cause brain cancer, whether sleeping more than eight hours a night is healthful or dangerous, whether taking aspirin every day is more likely to save your life or cut it short, and whether routine angioplasty works better than pills to unclog heart arteries.
But beyond the headlines, Ioannidis was shocked at the range and reach of the reversals he was seeing in everyday medical research. “Randomized controlled trials,” which compare how one group responds to a treatment against how an identical group fares without the treatment, had long been considered nearly unshakable evidence, but they, too, ended up being wrong some of the time. “I realized even our gold-standard research had a lot of problems,” he says. Baffled, he started looking for the specific ways in which studies were going wrong. And before long he discovered that the range of errors being committed was astonishing: from what questions researchers posed, to how they set up the studies, to which patients they recruited for the studies, to which measurements they took, to how they analyzed the data, to how they presented their results, to how particular studies came to be published in medical journals.
This array suggested a bigger, underlying dysfunction, and Ioannidis thought he knew what it was. “The studies were biased,” he says. “Sometimes they were overtly biased. Sometimes it was difficult to see the bias, but it was there.” Researchers headed into their studies wanting certain results—and, lo and behold, they were getting them. We think of the scientific process as being objective, rigorous, and even ruthless in separating out what is true from what we merely wish to be true, but in fact it’s easy to manipulate results, even unintentionally or unconsciously. “At every step in the process, there is room to distort results, a way to make a stronger claim or to select what is going to be concluded,” says Ioannidis. “There is an intellectual conflict of interest that pressures researchers to find whatever it is that is most likely to get them funded.”
Perhaps only a minority of researchers were succumbing to this bias, but their distorted findings were having an outsize effect on published research. To get funding and tenured positions, and often merely to stay afloat, researchers have to get their work published in well-regarded journals, where rejection rates can climb above 90 percent. Not surprisingly, the studies that tend to make the grade are those with eye-catching findings. But while coming up with eye-catching theories is relatively easy, getting reality to bear them out is another matter. The great majority collapse under the weight of contradictory data when studied rigorously. Imagine, though, that five different research teams test an interesting theory that’s making the rounds, and four of the groups correctly prove the idea false, while the one less cautious group incorrectly “proves” it true through some combination of error, fluke, and clever selection of data. Guess whose findings your doctor ends up reading about in the journal, and you end up hearing about on the evening news? Researchers can sometimes win attention by refuting a prominent finding, which can help to at least raise doubts about results, but in general it is far more rewarding to add a new insight or exciting-sounding twist to existing research than to retest its basic premises—after all, simply re-proving someone else’s results is unlikely to get you published, and attempting to undermine the work of respected colleagues can have ugly professional repercussions.
In the late 1990s, Ioannidis set up a base at the University of Ioannina. He pulled together his team, which remains largely intact today, and started chipping away at the problem in a series of papers that pointed out specific ways certain studies were getting misleading results. Other meta-researchers were also starting to spotlight disturbingly high rates of error in the medical literature. But Ioannidis wanted to get the big picture across, and to do so with solid data, clear reasoning, and good statistical analysis. The project dragged on, until finally he retreated to the tiny island of Sikinos in the Aegean Sea, where he drew inspiration from the relatively primitive surroundings and the intellectual traditions they recalled. “A pervasive theme of ancient Greek literature is that you need to pursue the truth, no matter what the truth might be,” he says. In 2005, he unleashed two papers that challenged the foundations of medical research.
He chose to publish one paper, fittingly, in the online journal PLoS Medicine, which is committed to running any methodologically sound article without regard to how “interesting” the results may be. In the paper, Ioannidis laid out a detailed mathematical proof that, assuming modest levels of researcher bias, typically imperfect research techniques, and the well-known tendency to focus on exciting rather than highly plausible theories, researchers will come up with wrong findings most of the time. Simply put, if you’re attracted to ideas that have a good chance of being wrong, and if you’re motivated to prove them right, and if you have a little wiggle room in how you assemble the evidence, you’ll probably succeed in proving wrong theories right. His model predicted, in different fields of medical research, rates of wrongness roughly corresponding to the observed rates at which findings were later convincingly refuted: 80 percent of non-randomized studies (by far the most common type) turn out to be wrong, as do 25 percent of supposedly gold-standard randomized trials, and as much as 10 percent of the platinum-standard large randomized trials. The article spelled out his belief that researchers were frequently manipulating data analyses, chasing career-advancing findings rather than good science, and even using the peer-review process—in which journals ask researchers to help decide which studies to publish—to suppress opposing views. “You can question some of the details of John’s calculations, but it’s hard to argue that the essential ideas aren’t absolutely correct,” says Doug Altman, an Oxford University researcher who directs the Centre for Statistics in Medicine.
Still, Ioannidis anticipated that the community might shrug off his findings: sure, a lot of dubious research makes it into journals, but we researchers and physicians know to ignore it and focus on the good stuff, so what’s the big deal? The other paper headed off that claim. He zoomed in on 49 of the most highly regarded research findings in medicine over the previous 13 years, as judged by the science community’s two standard measures: the papers had appeared in the journals most widely cited in research articles, and the 49 articles themselves were the most widely cited articles in these journals. These were articles that helped lead to the widespread popularity of treatments such as the use of hormone-replacement therapy for menopausal women, vitamin E to reduce the risk of heart disease, coronary stents to ward off heart attacks, and daily low-dose aspirin to control blood pressure and prevent heart attacks and strokes. Ioannidis was putting his contentions to the test not against run-of-the-mill research, or even merely well-accepted research, but against the absolute tip of the research pyramid. Of the 49 articles, 45 claimed to have uncovered effective interventions. Thirty-four of these claims had been retested, and 14 of these, or 41 percent, had been convincingly shown to be wrong or significantly exaggerated. If between a third and a half of the most acclaimed research in medicine was proving untrustworthy, the scope and impact of the problem were undeniable. That article was published in the Journal of the American Medical Association.
Driving me back to campus in his smallish SUV—after insisting, as he apparently does with all his visitors, on showing me a nearby lake and the six monasteries situated on an islet within it—Ioannidis apologized profusely for running a yellow light, explaining with a laugh that he didn’t trust the truck behind him to stop. Considering his willingness, even eagerness, to slap the face of the medical-research community, Ioannidis comes off as thoughtful, upbeat, and deeply civil. He’s a careful listener, and his frequent grin and semi-apologetic chuckle can make the sharp prodding of his arguments seem almost good-natured. He is as quick, if not quicker, to question his own motives and competence as anyone else’s. A neat and compact 45-year-old with a trim mustache, he presents as a sort of dashing nerd—Giancarlo Giannini with a bit of Mr. Bean.
The humility and graciousness seem to serve him well in getting across a message that is not easy to digest or, for that matter, believe: that even highly regarded researchers at prestigious institutions sometimes churn out attention-grabbing findings rather than findings likely to be right. But Ioannidis points out that obviously questionable findings cram the pages of top medical journals, not to mention the morning headlines. Consider, he says, the endless stream of results from nutritional studies in which researchers follow thousands of people for some number of years, tracking what they eat and what supplements they take, and how their health changes over the course of the study. “Then the researchers start asking, ‘What did vitamin E do? What did vitamin C or D or A do? What changed with calorie intake, or protein or fat intake? What happened to cholesterol levels? Who got what type of cancer?’” he says. “They run everything through the mill, one at a time, and they start finding associations, and eventually conclude that vitamin X lowers the risk of cancer Y, or this food helps with the risk of that disease.” In a single week this fall, Google’s news page offered these headlines: “More Omega-3 Fats Didn’t Aid Heart Patients”; “Fruits, Vegetables Cut Cancer Risk for Smokers”; “Soy May Ease Sleep Problems in Older Women”; and dozens of similar stories.
When a five-year study of 10,000 people finds that those who take more vitamin X are less likely to get cancer Y, you’d think you have pretty good reason to take more vitamin X, and physicians routinely pass these recommendations on to patients. But these studies often sharply conflict with one another. Studies have gone back and forth on the cancer-preventing powers of vitamins A, D, and E; on the heart-health benefits of eating fat and carbs; and even on the question of whether being overweight is more likely to extend or shorten your life. How should we choose among these dueling, high-profile nutritional findings? Ioannidis suggests a simple approach: ignore them all.
For starters, he explains, the odds are that in any large database of many nutritional and health factors, there will be a few apparent connections that are in fact merely flukes, not real health effects—it’s a bit like combing through long, random strings of letters and claiming there’s an important message in any words that happen to turn up. But even if a study managed to highlight a genuine health connection to some nutrient, you’re unlikely to benefit much from taking more of it, because we consume thousands of nutrients that act together as a sort of network, and changing intake of just one of them is bound to cause ripples throughout the network that are far too complex for these studies to detect, and that may be as likely to harm you as help you. Even if changing that one factor does bring on the claimed improvement, there’s still a good chance that it won’t do you much good in the long run, because these studies rarely go on long enough to track the decades-long course of disease and ultimately death. Instead, they track easily measurable health “markers” such as cholesterol levels, blood pressure, and blood-sugar levels, and meta-experts have shown that changes in these markers often don’t correlate as well with long-term health as we have been led to believe.
On the relatively rare occasions when a study does go on long enough to track mortality, the findings frequently upend those of the shorter studies. (For example, though the vast majority of studies of overweight individuals link excess weight to ill health, the longest of them haven’t convincingly shown that overweight people are likely to die sooner, and a few of them have seemingly demonstrated that moderately overweight people are likely to live longer.) And these problems are aside from ubiquitous measurement errors (for example, people habitually misreport their diets in studies), routine misanalysis (researchers rely on complex software capable of juggling results in ways they don’t always understand), and the less common, but serious, problem of outright fraud (which has been revealed, in confidential surveys, to be much more widespread than scientists like to acknowledge).
If a study somehow avoids every one of these problems and finds a real connection to long-term changes in health, you’re still not guaranteed to benefit, because studies report average results that typically represent a vast range of individual outcomes. Should you be among the lucky minority that stands to benefit, don’t expect a noticeable improvement in your health, because studies usually detect only modest effects that merely tend to whittle your chances of succumbing to a particular disease from small to somewhat smaller. “The odds that anything useful will survive from any of these studies are poor,” says Ioannidis—dismissing in a breath a good chunk of the research into which we sink about $100 billion a year in the United States alone.
And so it goes for all medical studies, he says. Indeed, nutritional studies aren’t the worst. Drug studies have the added corruptive force of financial conflict of interest. The exciting links between genes and various diseases and traits that are relentlessly hyped in the press for heralding miraculous around-the-corner treatments for everything from colon cancer to schizophrenia have in the past proved so vulnerable to error and distortion, Ioannidis has found, that in some cases you’d have done about as well by throwing darts at a chart of the genome. (These studies seem to have improved somewhat in recent years, but whether they will hold up or be useful in treatment are still open questions.) Vioxx, Zelnorm, and Baycol were among the widely prescribed drugs found to be safe and effective in large randomized controlled trials before the drugs were yanked from the market as unsafe or not so effective, or both.
“Often the claims made by studies are so extravagant that you can immediately cross them out without needing to know much about the specific problems with the studies,” Ioannidis says. But of course it’s that very extravagance of claim (one large randomized controlled trial even proved that secret prayer by unknown parties can save the lives of heart-surgery patients, while another proved that secret prayer can harm them) that helps gets these findings into journals and then into our treatments and lifestyles, especially when the claim builds on impressive-sounding evidence. “Even when the evidence shows that a particular research idea is wrong, if you have thousands of scientists who have invested their careers in it, they’ll continue to publish papers on it,” he says. “It’s like an epidemic, in the sense that they’re infected with these wrong ideas, and they’re spreading it to other researchers through journals.”
Though scientists and science journalists are constantly talking up the value of the peer-review process, researchers admit among themselves that biased, erroneous, and even blatantly fraudulent studies easily slip through it. Nature, the grande dame of science journals, stated in a 2006 editorial, “Scientists understand that peer review per se provides only a minimal assurance of quality, and that the public conception of peer review as a stamp of authentication is far from the truth.” What’s more, the peer-review process often pressures researchers to shy away from striking out in genuinely new directions, and instead to build on the findings of their colleagues (that is, their potential reviewers) in ways that only seem like breakthroughs—as with the exciting-sounding gene linkages (autism genes identified!) and nutritional findings (olive oil lowers blood pressure!) that are really just dubious and conflicting variations on a theme.
Most journal editors don’t even claim to protect against the problems that plague these studies. University and government research overseers rarely step in to directly enforce research quality, and when they do, the science community goes ballistic over the outside interference. The ultimate protection against research error and bias is supposed to come from the way scientists constantly retest each other’s results—except they don’t. Only the most prominent findings are likely to be put to the test, because there’s likely to be publication payoff in firming up the proof, or contradicting it.
But even for medicine’s most influential studies, the evidence sometimes remains surprisingly narrow. Of those 45 super-cited studies that Ioannidis focused on, 11 had never been retested. Perhaps worse, Ioannidis found that even when a research error is outed, it typically persists for years or even decades. He looked at three prominent health studies from the 1980s and 1990s that were each later soundly refuted, and discovered that researchers continued to cite the original results as correct more often than as flawed—in one case for at least 12 years after the results were discredited.
Doctors may notice that their patients don’t seem to fare as well with certain treatments as the literature would lead them to expect, but the field is appropriately conditioned to subjugate such anecdotal evidence to study findings. Yet much, perhaps even most, of what doctors do has never been formally put to the test in credible studies, given that the need to do so became obvious to the field only in the 1990s, leaving it playing catch-up with a century or more of non-evidence-based medicine, and contributing to Ioannidis’s shockingly high estimate of the degree to which medical knowledge is flawed. That we’re not routinely made seriously ill by this shortfall, he argues, is due largely to the fact that most medical interventions and advice don’t address life-and-death situations, but rather aim to leave us marginally healthier or less unhealthy, so we usually neither gain nor risk all that much.
Medical research is not especially plagued with wrongness. Other meta-research experts have confirmed that similar issues distort research in all fields of science, from physics to economics (where the highly regarded economists J. Bradford DeLong and Kevin Lang once showed how a remarkably consistent paucity of strong evidence in published economics studies made it unlikely that any of them were right). And needless to say, things only get worse when it comes to the pop expertise that endlessly spews at us from diet, relationship, investment, and parenting gurus and pundits. But we expect more of scientists, and especially of medical scientists, given that we believe we are staking our lives on their results. The public hardly recognizes how bad a bet this is. The medical community itself might still be largely oblivious to the scope of the problem, if Ioannidis hadn’t forced a confrontation when he published his studies in 2005.
Ioannidis initially thought the community might come out fighting. Instead, it seemed relieved, as if it had been guiltily waiting for someone to blow the whistle, and eager to hear more. David Gorski, a surgeon and researcher at Detroit’s Barbara Ann Karmanos Cancer Institute, noted in his prominent medical blog that when he presented Ioannidis’s paper on highly cited research at a professional meeting, “not a single one of my surgical colleagues was the least bit surprised or disturbed by its findings.” Ioannidis offers a theory for the relatively calm reception. “I think that people didn’t feel I was only trying to provoke them, because I showed that it was a community problem, instead of pointing fingers at individual examples of bad research,” he says. In a sense, he gave scientists an opportunity to cluck about the wrongness without having to acknowledge that they themselves succumb to it—it was something everyone else did.
To say that Ioannidis’s work has been embraced would be an understatement. His PLoS Medicine paper is the most downloaded in the journal’s history, and it’s not even Ioannidis’s most-cited work—that would be a paper he published in Nature Genetics on the problems with gene-link studies. Other researchers are eager to work with him: he has published papers with 1,328 different co-authors at 538 institutions in 43 countries, he says. Last year he received, by his estimate, invitations to speak at 1,000 conferences and institutions around the world, and he was accepting an average of about five invitations a month until a case last year of excessive-travel-induced vertigo led him to cut back. Even so, in the weeks before I visited him he had addressed an AIDS conference in San Francisco, the European Society for Clinical Investigation, Harvard’s School of Public Health, and the medical schools at Stanford and Tufts.
The irony of his having achieved this sort of success by accusing the medical-research community of chasing after success is not lost on him, and he notes that it ought to raise the question of whether he himself might be pumping up his findings. “If I did a study and the results showed that in fact there wasn’t really much bias in research, would I be willing to publish it?” he asks. “That would create a real psychological conflict for me.” But his bigger worry, he says, is that while his fellow researchers seem to be getting the message, he hasn’t necessarily forced anyone to do a better job. He fears he won’t in the end have done much to improve anyone’s health. “There may not be fierce objections to what I’m saying,” he explains. “But it’s difficult to change the way that everyday doctors, patients, and healthy people think and behave.”
As helter-skelter as the University of Ioannina Medical School campus looks, the hospital abutting it looks reassuringly stolid. Athina Tatsioni has offered to take me on a tour of the facility, but we make it only as far as the entrance when she is greeted—accosted, really—by a worried-looking older woman. Tatsioni, normally a bit reserved, is warm and animated with the woman, and the two have a brief but intense conversation before embracing and saying goodbye. Tatsioni explains to me that the woman and her husband were patients of hers years ago; now the husband has been admitted to the hospital with abdominal pains, and Tatsioni has promised she’ll stop by his room later to say hello. Recalling the appendicitis story, I prod a bit, and she confesses she plans to do her own exam. She needs to be circumspect, though, so she won’t appear to be second-guessing the other doctors.
Tatsioni doesn’t so much fear that someone will carve out the man’s healthy appendix. Rather, she’s concerned that, like many patients, he’ll end up with prescriptions for multiple drugs that will do little to help him, and may well harm him. “Usually what happens is that the doctor will ask for a suite of biochemical tests—liver fat, pancreas function, and so on,” she tells me. “The tests could turn up something, but they’re probably irrelevant. Just having a good talk with the patient and getting a close history is much more likely to tell me what’s wrong.” Of course, the doctors have all been trained to order these tests, she notes, and doing so is a lot quicker than a long bedside chat. They’re also trained to ply the patient with whatever drugs might help whack any errant test numbers back into line. What they’re not trained to do is to go back and look at the research papers that helped make these drugs the standard of care. “When you look the papers up, you often find the drugs didn’t even work better than a placebo. And no one tested how they worked in combination with the other drugs,” she says. “Just taking the patient off everything can improve their health right away.” But not only is checking out the research another time-consuming task, patients often don’t even like it when they’re taken off their drugs, she explains; they find their prescriptions reassuring.
Later, Ioannidis tells me he makes a point of having several clinicians on his team. “Researchers and physicians often don’t understand each other; they speak different languages,” he says. Knowing that some of his researchers are spending more than half their time seeing patients makes him feel the team is better positioned to bridge that gap; their experience informs the team’s research with firsthand knowledge, and helps the team shape its papers in a way more likely to hit home with physicians. It’s not that he envisions doctors making all their decisions based solely on solid evidence—there’s simply too much complexity in patient treatment to pin down every situation with a great study. “Doctors need to rely on instinct and judgment to make choices,” he says. “But these choices should be as informed as possible by the evidence. And if the evidence isn’t good, doctors should know that, too. And so should patients.”
In fact, the question of whether the problems with medical research should be broadcast to the public is a sticky one in the meta-research community. Already feeling that they’re fighting to keep patients from turning to alternative medical treatments such as homeopathy, or misdiagnosing themselves on the Internet, or simply neglecting medical treatment altogether, many researchers and physicians aren’t eager to provide even more reason to be skeptical of what doctors do—not to mention how public disenchantment with medicine could affect research funding. Ioannidis dismisses these concerns. “If we don’t tell the public about these problems, then we’re no better than nonscientists who falsely claim they can heal,” he says. “If the drugs don’t work and we’re not sure how to treat something, why should we claim differently? Some fear that there may be less funding because we stop claiming we can prove we have miraculous treatments. But if we can’t really provide those miracles, how long will we be able to fool the public anyway? The scientific enterprise is probably the most fantastic achievement in human history, but that doesn’t mean we have a right to overstate what we’re accomplishing.”
We could solve much of the wrongness problem, Ioannidis says, if the world simply stopped expecting scientists to be right. That’s because being wrong in science is fine, and even necessary—as long as scientists recognize that they blew it, report their mistake openly instead of disguising it as a success, and then move on to the next thing, until they come up with the very occasional genuine breakthrough. But as long as careers remain contingent on producing a stream of research that’s dressed up to seem more right than it is, scientists will keep delivering exactly that.
“Science is a noble endeavor, but it’s also a low-yield endeavor,” he says. “I’m not sure that more than a very small percentage of medical research is ever likely to lead to major improvements in clinical outcomes and quality of life. We should be very comfortable with that fact.”
This article available online at:
http://www.theatlantic.com/magazine/archive/2010/11/lies-damned-lies-and-medical-science/8269/

Copyright © 2012 by The Atlantic Monthly Group. All Rights Reserved.

Arizona and Illegal Immigration

Arizona is often portrayed has having a lot of racists etc. due to their frustration with all the illegal immigrants from Mexico.  This is an assessment of the illegal immigrant situation in Arizona, by someone who lives there:

Mexico is a country of the few very rich and the very poor masses.  If we hope to create change within Mexico, keeping the citizens there can become a catalyst for change, rather than of allowing them to come here to become second class citizens.  Those Mexican immigrants who have come here legally, are the most vocal about keeping illegal border crossers out.  Tensions are already created here in Arizona because of the constant drug and human trafficking which has led to high car insurance policy costs (due to uninsured motorists), high law enforcement costs, and high costs of education.  You only need to see the challenges/costs to our schools with students who come from rural parts of Mexico, where they have had no literacy, and whom we are supposed to help become literate--despite them often being only willing to speak Spanish and hang out with their Spanish speaking families.  Arizona citizens become especially bull headed when the federal government will not acknowledge the extent of problems that the state has faced and continues to face, and then acts like a bully.

Our Arizona life boat was doing well when construction was booming and illegal immigrants from Mexico were supporting this industry.  Then when the housing bubble popped, the life boat began to hit rough water, and jobs were gone for many of the immigrants. Resentment began to build again against those who were here and causing problems, and against those who were continuing to flood into Arizona.

Many illegal immigrants had already flooded into Arizona, with moms giving birth in our hospital emergency rooms so that their babies would be United States citizens.  As these children began school and as immigrant families began to make some money, they would sent it back home to help their relatives begin the trip to America.  By the time the housing bubble burst, more and more illegal immigrants had already put down roots.  After the economy took a downturn, Arizona citizens began to feel resentful of illegal immigrants that were taking resources and continuing to come to Arizona.  Laws then were passed or current laws enforced, to make it easier to send illegal immigrants back across the border.    Big public relations trouble began when some of the illegal immigrants were sent back that had already become rooted in Arizona, and no longer had ties in Mexico.  One can only imagine the pain, fear and anger that was then shared with their family and friends upon finding that they were going to be sent back to Mexico.

I have one personal experience to share.  As a teacher of students with visual impairments, I began serving a cute little girl in preschool, who was blind and quite smart.  Her family was from Mexico and her father had a permit to work here in a factory.  Then one day, this little girl did not return to school.  I was told that her father was picked up at work one day and sent back to Mexico for not checking in at the immigration office when required.  Dad thought that his lawyer was supposed to tell him when he needed to talk to the immigration people, but he never did.  The company this dad worked for, tried to advocate for him, but to no avail.  Since the mother was expecting her second child, she had to return to Mexico to be with her husband.  This was a fine family, and I still feel bad for this little girl, as I know that there are little or no services for the blind in Mexico.

 What to do about Illegal Immigration

"The significant problems we face can not be solved at the same level of thinking we were at when we created them." - Albert Einstein

I believe that there will be no easy or comprehensive fix for illegal immigration, just as we have never found easy or comprehensive fixes for many of our other social problems.   I believe that our federal government can be very helpful in assisting in containing our borders and dealing with costs of prisoner incarceration.  Beyond these issues, I feel that the individual States should be given the freedom to create their own solutions to illegal immigration. 

One lesson that is sometimes ignored is that solutions no longer seem to work when created either as large comprehensive packages, or when hidden in other bills.  It seems that the American people have an interest in how their money is being spent, and in how issues, including illegal immigration, are addressed.  This means that the process used to address illegal immigration is just as important as the steps needed to alleviate the problem.  This process needs to be transparent and straightforward!

I have some ideas that could help with the illegal immigration issue: 

   1.  Key to this issue is to determine at what point the border is leaking slowly enough to begin the next step.  I believe that we now may be close.  Between making it harder to get here and more difficult to find work here, I believe illegal immigration has slowed down at least in Arizona.  For immigrants who have been here for some time, it may be time for step 2.

   2.  States may need to create a system where there is a review board that will create rubrics based on things like: 

Length of time spent in the state

Crimes committed

Community support

English Language learned

Employment

This board could then either recommend:

a.      Citizenship and quickly provide the individual with the needed paperwork.

b.    A path to citizenship with an agency set up to track, much like probation.  If steps are not followed within the specified timeline, review can recommend changes or immediate deportation.

c.      Immediate deportation.

  3.  The United Nations needs to work with the government of Mexico to encourage a gradual transition to a more democratic system of government.  We may also want to do more to help with education within Mexico, and to step up our efforts to assist Mexican law enforcement to help fight their drug cartels. 
  
  Update 2018 - In America, Canadians and people from other countries who come here on green cards to work or through DACA can expect to always have a cloud hanging over them.  They never know if their green card will be renewed or not or if they will be sent back to the country that they came from.  Often they go through college and graduate and then can only work of they have a sponsor or or can get their green card renewed again.  If this doesn't happen, they have to go back to a country where they often no longer know anyone and sometimes not even the language, or where they can expect renewed poverty and violence.  When the legal immigration process often takes ten years, Americans expect these children to live in anxiety for years.  What a great country... 

Some Predictions for "the Next Few Years"

Don't make too much of these predictions.  They might be wrong.  I didn't do any serious research.

1.  The solar revolution has finally begun in earnest.  Over the next 10 years, it will grow by leaps and bounds, taking over coal, natural gas and eventually petroleum (and even shale gas and oil) as the leader in energy.  It will represent a booming industry that we can scarcely imagine even today.  I'm not not really going out on a limb here, I'm only making some inferences from articles like this and this and this etc.  I'm more optimistic than BP, though.  I figure that if the cost of solar really achieves grid parity by 2015 as predicted in the first article, then Katie bar the door.  Wind energy will also continue to grow.  The U.S. has the potential to harness 14.5 million gigawatts of wind energy each year, although currently it produces only 43,461 gigawatts.  Wind and solar energy grew by 30-40% in 2010, and world wind and solar grew by 35% in 2011.  Chinese companies have quickly become the low-cost supplier and is crushing all competition, and as a result, 2011 has been brutal to U.S. solar and wind power producers.  Thanks to Chinese pricing, solar is already cheaper than diesel, and has already gone mainstream in India, where some large companies are "jettisoning diesel in favor of solar panels".

2.  In the next 10 years, we will see some bubbles that will pop:
     a)  The U.S. dollar will implode sometime after Europe gets their house in order, and our political power and prestige in the world will take a huge hit.  I don't know whether this will happen in one day or over a period of  years.  It might follow an earlier implosion of derivatives worldwide.
     b)  The soaring cost of higher education (especially state-funded public institutions) will peak and implode as more people opt for less expensive Internet classes.  A crisis will ensue as professors lose their jobs or opt for working in internet-based teaching companies.  This crisis will be further exacerbated by the lack of jobs for college-educated people.
     c)  The price of farmland will eventually peak as a result of speculation and high commodity prices, and then when prices drop, farmers will be going belly up all over the place...except those farmers who are getting payments for wind generators...they will be buying up their bankrupt neighbors.
     d)  Health care practitioner salaries, malpractice costs, unnecessary procedure costs, drug costs, insurance and government oversight costs, technology costs and unhealthy diet costs will continue to skyrocket.  A larger and larger percentage of people will lose their company health care benefits.  Medicare will collapse, and we'll then either leave the poor and destitute to die, or we will adopt socialized medicine, similar to the European countries.  In the meantime, there will be lots of political turmoil.
     e) China will attempt to buy up our best technology companies, in the same way they are currently buying Japanese companies.  This will create a political furor, but we may not be able to keep it from happening any more than Japan is able to keep it from happening right now.

3.  Facebook's stock will droop once it goes public.  Apple will also become less popular as Google Android sales rise and Microsoft & Nokia also make a comeback.  Cd's and even DVDs will fade out of use.   Land line phones will disappear.  Kmart, Sears and Radio Shack will close their doors.

4.  Cyber warfare will preempt our ability to consciously declare (or not declare) war.  It will be continuous and have no end.  It will no longer just affect the army, but it will affect us, the citizens.  We won't necessarily even know who to strike back at.  Drones and miniature robots of all sorts will render the conventional part of armies, air forces and navies much less useful, and they will also have more of an affect on the citizenry and will also be harder for countries to respond to.  Miniature drones will also be used more by law enforcement as well as by criminals.

5.  a)  Putin will finish installing himself as dictator, or else he will be kicked out amid burgeoning protests.  He wants to fix Russia's problems, but he has totally gutted every aspect of Russia's democracy in order to gain the power that he thinks he needs.  Russia is at his mercy.  We'll have to hope he's a "nice" dictator.
b)  China might attempt to influence a coup in which Kim Jong Un of North Korea will be replaced by one of his brothers--but probably not.  (Actually, there is so little available information on North Korea that I would be foolish to make any prediction.)
c)  Iran, already a brutal, corrupt police state, a giant mullah-sanctioned house of prostitution, and an opium den in which an astonishing 5% of the adult population is addicted, has the same problems of unemployment and lack of opportunity faced by the young in other Muslim countries that have revolted.  It's schizophrenic religious/democratic government has been co-opted by an alliance between the hard-line, dictatorial president Ahmadinejad and his clerical allies.  I predict that another attempt at a democratic revolt by the young may occur within the next few years.  It's also possible that a death of one or more of the geriatric ruling clerics will result in another power struggle.  Incidentally, I believe the whole nuclear standoff is at least partly Ahmadinejad's scheme to rally the country around him and allow him to crush dissent.  In any case, Russia and China will make sure the sanctions on Iran have limited effectiveness--and in doing so, may actually be doing the world a favor.  Pressing Ahmadinejad in a corner and having him start a war would not be helpful.
d)  The U.S.'s relationship with Mexico will become more problematic, as the illegal immigrant dilemma is allowed to develop into a real crisis and strong emotions give way to possible riots and ethnic strife.
e)  China will lead the world in new environmental technologies, electric cars, and many other technologies and will export products to the U.S. using these homegrown Chinese technologies.  Prior to this, U.S. businesses will be starved out of China once the (illegal) transfer of existing technology is complete, via China's increased government subsidies for copycat products made by Chinese companies.
f)  Iran is on a race against time, and only a strike by Israel will stop their efforts to build nuclear-tipped missiles--and Iran has vowed to fight back.  Egypt and Saudi Arabia are quietly building their own nuclear program as a response to this threat.  However, if there is a truly serious, near-term armagedden-type threat, it will likely come directly or indirectly from either Russia or Pakistan, which are both in political turmoil and have lots of serious nuclear weapons.
g)  It would be easy to be pessimistic with respect to the financial markets, but I'm going to predict a good year in 2012.  My reasoning will be that corporations (and even some countries) are sitting on piles of money waiting to be invested; not to mention all the inflationary government stimulus.  Now that IS a bit like sticking my neck out!

Alternative and Possibly Wild Predictions for the Next Few Years

Made 4-2012

 1.  Solar and wind energy will slowly add to our electric grid, and within about 50 years, will supply about 20 percent of the electricity used in North America.

2.  Over the next ten years, we will see approximately 20 percent inflation, with a return to higher interest rates.

3.  One of the first signs that the health of our economy is improving will be a sudden uptick in stock prices.

4.  The national media will never publicly admit that there is enough oil in the Canadian oil sands to provide North America with enough oil at current consumption rates to last for the next 100 years, and the new oil fields in North Dakota have at least twice that amount.

5.  No matter which direction health care moves, it will become more expensive and the weakest in our society will suffer the most in the next ten years.

6.  Our federal government will continue rapid growth over the next ten years as needs increase for various forms of litigation.

7.  Much of our future warfare will include both ways to get directly at specific leaders, and to get information to the masses.

8.  The North Korea political and economic situation will change little over the next ten years.

9.  Within the next five years, Israel and the United States will carry out a joint mission to bomb Iran’s mountain bunker and will take out a few jets and many missiles.

10.  Within the next ten years, real estate prices will skyrocket when current inventories dry up.

11.  After the next ten years, less than six percent of our cars will be battery powered.

12.  In the next ten years, there will be competition for information data bases on individuals habits, preferences, genetics, and finances, followed by copy write and litigation issues.