This Demon Only Comes Out By Prayer and Prozac

Matthew Loftus is a family doctor who lives with his wife Maggie and his daughter Naomi in Baltimore , where they are blessed to be a part of New Song Community Church. He aspires to finish his novel and to teach medicine overseas. You may follow him on Twitter @matthew_loftus if you’d like.

“It’s a chemical imbalance.”

You may have heard or said those words before in reference to mental illness. I have done both myself a number of times in my practice as a primary care doctor. One good example of opening the conversation about them can be found here from Ed Stetzer; one of Stetzer’s explicit goals is to decrease shame and stigma against mental illness by locating the pathology of mental illness in neurobiology and then asserting the need for medication to rectify the dysfunctional biology. As Christians across the world grapple with the modern understanding of mental illness, it is helpful to not only understand what these imbalances are and how medication might address them, but also to challenge a point of view that reduces mental illness to a mere malfunction of biology.

The impetus behind the use of the words “chemical imbalance” is good. After all, confining mental illness solely to the untouchable realm of feelings and thoughts is not only ignorant of biology, but also of orthodox anthropology. Furthermore, such a harsh dichotomy happens to be extraordinarily ineffective in the lives of most sufferers of mental illness. You may or may not have heard of an excellent book that sought to make clear the theological importance of our physical bodies; affirming that deficiencies or excesses of certain chemicals in our brains play a role in mental illness is an important step in the process of rightly treating our bodies as part of the created order. In turn, the judicious use of other chemicals to rein in the torment and harm caused by mental illness is as much a part of using our God-given power to exercise dominion over the earth as is carefully using pesticides on our crops so that more people can eat.

However, saying “you’ve got a chemical imbalance” does not go far enough and, paradoxically, can often take us too far in the wrong direction.

Assigning mental illness solely to such imbalances is inadequate firstly because it underappreciates the complexity of neurobiology. For example, we know very well that people with depression have lower serotonin levels (most potently demonstrated in studying the brains of those who have committed suicide.) Selective serotonin reuptake inhibitors (SSRIs) such as Prozac or Zoloft raise serotonin levels in the brain. However, while many of the measurable effects of SSRIs on neurons can be seen within hours of first taking the drug, the effects of these medications are rarely appreciated until at least 4 to 6 weeks, making it far from clear that raising one’s low serotonin levels is their sole useful effect. Furthermore, the fact that any of these medicines has roughly a 30-40% chance of working in isolation on the first try is evidence that any “imbalances” we discuss are less like our car’s windshield wiper fluid and more like our food’s soil. When dealing with even more complex illnesses like bipolar disorder (which responds to a wide range of medications that are also effective for epilepsy) or schizophrenia (which involves a greater variety of neurochemical pathways), it is clear that the language of “chemical imbalance” is simply a starting point.

Secondly, while it is obvious that there are many aspects of brain biochemistry that we cannot consciously control, there are many others that we can. The choices we make shape our physical bodies– including our brain structure and genes. This is most apparent in the cycle of addiction, wherein an addict’s brain is often demonstrably altered to have a minimal response to normal pleasurable stimuli and to require greater and greater doses of the drug of choice to not feel agonizing withdrawal. However, as we learn more about the bodies that God has given us, we see that chronic stress and traumatic events (often caused by the sin of others) can shape the brains of children with immature decision-making ability in ways that last for a lifetime. Thus, there is a reciprocal relationship between our environment, our bodies, and our feelings. Both our moods and our decision-making abilities are shaped by constant internal decisions and external stimuli.

The most potent example of this principle is the case of a sexually abused child who overeats not only to soothe the excess quantities of stress hormones that may or may not be predisposing them to depression later in life, but also to appear less attractive to their abuser. Even without immediately jumping to the conclusion insisting that the government must do something (as part 3 of the article linked above does), it is clear that we must jettison any simplistic understanding of the complex interaction between brain and body as a matter of individuals choosing to either sinfully wallow in mental illness or righteously embrace freedom in Christ. Similarly, we must also not succumb to a materialistic view that defines people stuck in mental illness solely as victims of circumstance.

We go too far in the wrong direction in this manner when our appreciation for the power of pharmacology to help guide our brain chemistry into a more ordered pattern becomes a helpless veneration of medicine. I have seen this, too, in my practice– patients who have been trained to believe that their own efforts to calm their nerves or pay attention are useless when compared to the power of Xanax or Adderall. The danger of these medications is that they are powerful enough to abrogate our efforts; as prescriptions for these (and similar) medications continue to dominate the market in a way that disquiets many clinicians, a sense of restraint and discipline is necessary for all parties involved.

Health is a discipline. The bodies that God has given us require care and attention to maintain in a way that fits the pattern he established for our being; while our appetites can sometimes be helpful guides to our needs, they are often magnified or minimized by sin in such a way to lead us astray. Whether we are choosing certain foods, actively exercising, or avoiding other substances, our health requires active management and control.

These individual choices are also clearly shaped by our environment, from the simple unavailability of fresh vegetables in certain neighborhoods to the more complex changes caused by chronic stress described above. Disciplines, while individually practiced, are shaped by the communities that we live in and the values we collectively affirm. Wendell Berry points out that “autonomy” is a false cure for our modern ills, saying, “Healing is impossible in loneliness; it is the opposite of loneliness.” When we do not pay heed to the disciplines– either individual or environmental– that shape our health, the breakdown of our bodies is attended by the breakdown of our minds and spirits.

In regards to mental health, it is often said that “food is the most overused antidepressant and exercise is the most underused antianxiety medication.” A variety of well-designed studies have borne out the efficacy of behavioral interventions for a variety of mental illnesses, demonstrating that our power over mental illness is not limited to pharmacology. That said, anyone who has ever seen a loved one struggle to take medication for mental illness can see that even the act of using pharmacology’s power (and bearing its side effects) is itself a discipline. Even more telling are the studies that show that some of the sickest people who burden emergency rooms with repeated visits see great improvements in their physical and mental health when they are brought into closer personal contact with caring people and housed.

Talk of health as a discipline or health choices as being shaped by culture brings to mind the issue of personal responsibility, which is a useful rallying cry for helping oneself feel less perturbed about the suffering of others, but by definition cannot be embraced as a corporate policy. Personal responsibility is clearly a component of discipline, but it is not the only one. For those who are struggling with mental illness, it is imperative they are approached first as persons with dignity whose ability to make rational decisions and take responsibility has been impaired– whether by themselves, by another, or by the happenstance of neurobiolog. Once this relationship of trust and respect is established, we can walk with them through both the personal and professional interventions necessary to learn or rediscover the skills that attend to personal responsibility.

Similarly, shame can be useful; the things that people with mental illness say and do when swayed by the winds of their depression or mania are often a powerful motivator to change their behavior when they feel ashamed of them. While we want to rightly eradicate the effects of shame that keep people from seeking help and being honest, it is possible to strain out a gnat and swallow a camel if we take the language of “chemical imbalances” too far and put personal responsibility out of reach for those who suffer from mental illness.

In the end, both the people who wish to eradicate shame from mental illness and those who wish to use it as a hammer for every health-related nail they see will find themselves in conflict with a holistic worldview that embraces the continuity between physical existence, knowledge, indiscernably complex emotions, and meaningful spirituality. The bodies that God created us with are prone to the corruption of sin in ways that science can both illuminate, abet, or help to heal– but only if we can appreciate the full complement of healing means that He has given us.

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The Contest Between Evolution and Christianity is a Duel to the Death

Editor’s note: Peter Blair is editor of Fare Forward, one of the best new sites to hit the interwebs in a while.  I’m on record saying that it’s like us at Mere-O, only better.  I’m thrilled to steal him away for the day.  Subscribe to Fare Forward and support the excellent work they are doing.  – MLA

I have a theory that much of the modern evolution battle stems from the fact that of the two possible anti-evolutionary narratives the church could have adopted—the scientific and the moral—the scientific critique eventually and unfortunately triumphed.

I first developed this theory while studying the famous Scopes/Monkey trial as an undergraduate.  The narrative about the trial I had previously absorbed from the culture and Inherit the Wind proved highly tendentious.  People often think of the Scopes trial as one of those classic moments of science/religion conflict, in which the forces of ignorance, cruelty, and superstition squared off against the enlightened, progressive force of science. William Jennings Bryan and his fundamentalist allies sought to squash Scopes’ heroic efforts in the cause of scientific advancement.

Tennessee v. John T. Scopes Trial: Outdoor pro...

Tennessee v. John T. Scopes Trial: Outdoor proceedings on July 20, 1925, showing William Jennings Bryan and Clarence Darrow. [2 of 4 photos] (Photo credit: Smithsonian Institution)

Yet the facts are much more complicated, even bizarre. The trial was deliberately staged in order to test the constitutionality of the Butler Act, which forbid the teaching of evolution. Scopes was unsure whether he had even ever taught evolution in class, but he was willing to claim he did to give the planned trial a defendant.

Even more interesting, however, was Bryan’s role in the proceedings. The Scopes trial pitted Bryan against the famous defense attorney Clarence Darrow, and Darrow’s questioning of Bryan about evolution and Biblical literalism during the trial has been immortalized as a glorious moment of triumph for science. It’s widely held that Darrow made Bryan’s fundamentalist position look silly and absurd.

But what’s been left out of our historical memory is the fact that Bryan’s primarily opposition to evolution was moral, not scientific. In Bryan’s time, the scientific theory of evolution was mixed up with all sorts of social Darwinist ideologies that favored eugenics and sterilization, advocated racism, and held that the poor deserved to be poor and should not be helped out of their poverty. The textbook Scopes was accused of teaching from itself advocated for the removal of  “feeble-mindedness” from the population through eugenics.

Bryan was a politician who spent his life campaigning for the poor, the weak, the disenfranchised, for the “common man.”* He was horrified by the ideological and moral uses to which evolution was being put in his time. He was disgusted, in general, by the way the scientific technology refused to be constrained by proper moral boundaries.  He wrote up some closing remarks for the Scopes trial, but he was never allowed to deliver them. They contain this remarkable passage: Continue reading

Modernity and Medieval Science

Like Matt Milliner, I’m impressed by David Schaengold’s post over at the League of Ordinary Gentlemen, wherein he relates observation decks, science, and the joy of observation:

Being happy merely to see and to understand, as scientists are, is the feeling responsible for observation decks, whose most intellectually incurious and aesthetically stolid visitors thrill with joy as they marvel at the works of Man and discover how familiar neighborhoods tessellate. Though surmise about the psychology of ages past is hazardous, I’ll venture to guess that the civilization of the modern West has privileged and encouraged joy in the way the universe works more than any civilization in history.

Schaengold’s point is well made, which is why I find his criticism of medieval science unfortunate and unnecessary:

Nothing like the scientific method was found in antiquity, and what glimmers of it appeared in the Middle Ages were feeble. The systematic use of the method, institutionalized in journals and laboratories, is characteristically modern, but the psychology of the scientists who employ it represents a Christian ideal.

There are, of course, some differences between the moderns and the medievals with respect to science.  But Schaengold’s dismissal of the medieval understanding of the scientific method as “pretty feeble” is an injustice to the work that went on during that period  Most famously, the work of Robert Grosseteste and Roger Bacon were using experiments to do remarkable work in optics (motivated as they might have been by the medieval emphasis on the notion that God is light), and in the case of Bacon advocating for something that very closely resembles the contemporary “scientific method.”

In fact, while the relationship between the medievals and the moderns with respect to science was contentious in the 20th century, the bulk of scholarly opinion seems to have moved toward thinking that the scientific revolution wasn’t a revolution at all, but rather a modification of what they inherited from the medievals.

Consider the judgment of David Lindberg, a leading historians of medieval science, on the matter:  “The underlying source of revolutionary novelty in the sixteenth and seventeenth centuries…was metaphysical and cosmological, not methodological.”  Lindberg’s work even challenges Schaengold’s claim that “nothing like a scientific method was found in antiquity,” at least if we’re discussing the actual practices of experimentation and not its rhetoric.  In fact, his entire chapter really is worth reading.

One way of telling the story of science in the late-modern period, then, is that these metaphysical changes eventually dislocate science from its proper position in our understanding of the world and (ironically) begin to impinge upon the scientific method itself by calling into question the rational basis of the universe.  But that moves toward the source problem of (as Schaengold aptly puts it) the alienation of man from himself in the late modern world.

All that aside, Schaengold’s basic point about the joy of observation is well made, and clearly a point of contact between the later modern scientists and their medieval forerunners.  While I doubt Schaengold’s point that our modern period empahsizes that joy more than any period before, I for one am glad that Schaengold has found it, and even more glad that he is intent on spreading it.

An Evolutionary Defense of Dogma and Religion

Criticizing organized religion is easy to do. In fact, it is a favored pastime for many evangelical and post-evangelical Christians who can only see institutionalized religion as “dead.” George Valliant is providing such critics some scientific firepower to go along with their theological arsenal in his new book, Spiritual Evolution: A Scientific Defense of Faith.

In his book (which I have not read), Dr. Valliant “lays out a brilliant defense not of organized religion but of man’s inherent spirituality. Our spirituality, he shows, resides in our uniquely human brain design and in our innate capacity for emotions like love, hope, joy, forgiveness, and compassion, which are selected for by evolution and located in a different part of the brain than dogmatic religious belief. Evolution has made us spiritual creatures over time, he argues, and we are destined to become even more so. Spiritual Evolution makes the scientific case for spirituality as a positive force in human evolution, and he predicts for our species an even more loving future.”

Dr. Valliant clearly thinks that the emotions are the only valuable aspect to religion, which he made very clear in his On Point interview today. Such emotions reside in the limbic system, which is the more primitive section of the brain. The dogma and institutionalized religion stem from the neocortex, which is the purported rational section of the human brain and which evolved later.

Dr. Valliant wants to defend faith. But he wants faith without dogma, spirituality without religion. Thoughts, apparently, are only appropriate for scientists. I presume, after all, it was with the neocortex that Dr. Valliant made his (important and interesting!) discoveries. And I presume he made his discoveries within the context and systems of the scientific establishment (which has been brought to you, once again, by the neocortex–a neocortex he has declared disruptive and harmful in matters of faith).

In short, it seems Dr. Valliant has a priori ruled out dogma and religion as sources of positive good, and has built his science around that presupposition. Yet such a move seems counterintuitive given the process of evolution, wherein humans ostensibly reach higher and higher planes. On issues of faith and religion, Dr. Valliant would have us reject the higher evolution of the neocortex in favor of the limbic, a reversal of the evolutionary process. If anything, the evolution has pushed us toward dogma and religion; as with all of society, as we attain higher levels (if such a thing is possible), deeper evils will be possible (think the nuclear bomb), a principal as true of organized religion as it is of technology.
Dr. Valliant’s error is not because he is too firmly committed to the principles of evolution. It is because he is not committed enough.

Evolution does not apply to evolutionists

In a recent comment, the formidable Mr. Falk said, “The noteworthy thing about the universe is that everything appears to be explainable by immutable laws. As Einstein said, ‘the miracle is that there are no miracles’”

Everything indeed appears to be explainable by immutable laws… Except for people. Psychology, that blessed pseudo-science, and sociology, its ugly step-sister, sometimes have very interesting and even surprisingly explanatory hypotheses, but nothing as of yet near the level of “immutable laws.” Nor is there much hope of finding them via experimental research.
The “laws of human thought and behavior” insofar as they are put forth, are anything but empirical (much though they would like to be!) Insofar as they exist in any universal and agreed-upon form, are they not more intuitive, observational, introspective, and well… psychological?(I know, I know, you’ll say “Neuroscience is still young and developing.” Well, in the meantime, then, we have a lot of certain knowledge about science, and a lot of certain ignorance about scientists…. Unless of course we begrudingly step outside the monarchical realm of ‘immutable laws’ and start talking about relationships, persons, goals, virtues, values, happiness, and the deep demanding desire for knowledge. These are no less real than quarks and supernovas, but are much more mysterious.)

This is a glaring gap in the knowledge acquired by empirical scientific methods. Evolutionists have lots to say about lower life forms. Do they have anything authoritative to say about evolutionists?

Goodness, Evil, and Darwinian Science

Noah Millman, in commenting upon the Derbyshire dust-up, writes:

I continue to believe that both sides of the Darwin vs. Christianity battle are missing the most telling point. We should all agree that religious dogma has no bearing on the truth or falsity of a scientific theory. Heliocentrism is true; geocentrism is false. There is an enormous weight of evidence behind the theory of evolution by natural selection. There is going to be more and more evidence behind new theories about the workings of the human mind, and the interactions of the human genome and human personality. All religion can do is react to these discoveries and, as part of that reaction, caution us about drawing unwarranted conclusions (political, moral, what-have-you) from the evidence. But I don’t think that’s the end of the story, because I think science does have implications for the persuasiveness of specific religious doctrines, simply as a psychological matter. And I think evolution through natural selection is extremely uncongenial to the central Christian story about the nature of sin and evil in the world. Why? Because the Christian story has the entry of strife into the world come about as the result of human sin, whereas the core idea behind evolution by natural selection is that our existence – and the consciousness and ability to sin that comes with it – is a product of strife. Put bluntly: natural selection is not the mechanism that the Christian deity would use to create man in His image. Or, if it is, I’d like to see the explanation. I think that natural selection poses similar but less-acute problems for Judaism and Islam; it poses the fewest problems, I suspect, for Hinduism. Again: I’m not speaking of science refuting religion. I’m speaking of scientific results making certain core religious claims less persuasive.

Millman captures the philosophical tension between Darwinism and Christianity well.

But it is not a tension that is limited to the explanation for evil.  If natural selection erodes the Christian concept of ‘sin,’ then it does so only by virtue of its own inability to explain goodness, the concept upon which the Christian notion of sin depends.  On the one hand, the Christian teaching of the imago dei is that human nature is fundamentally good.  On the other hand, the Darwinian narrative implies that human nature is born in strife and grows out of strife.  At best, its goodness and the goodness it creates is ancillary to its nature, rather than inherent to it like Christianity teaches.
There are, of course, attempts by evolutionary ethicists to ground ethics in the evolutionary process, just as there are attempts to Christians to incorporate the notion of the fall into evolutionary theory.  I am, in fact, not arguing against those attempts.

My aim is simply to point out that in addition to being an astute observation of the effects of Darwinian science on Christian theology, Millman’s point implicates Darwinian ethics.  I think Chesterton got it exactly right when he said the doctrine of sin is the only doctrine of Christianity that can be empirically proved.  The existence of sin makes the burden for evolutionary ethics tht much heavier and the plausibility of Darwinian science’s presuppositions much less persuasive.

Fasting For Joy

There’s hidden sweetness in the stomach’s emptiness.

Crystal Clarity

We are lutes, no more, no less.

If the soundboxes stuffed full of anything, no music.
If the brain and belly are burning clean with fasting,

every moment a new song comes out of the fire.

                                                                      Rumi


The benefits of fasting are empirical. They must be verified by each individual person, like scientists double- and triple-check the results of fellow scientists. Do not take anyone’s word for you. “I too am a painter.”

They also fundamentally incommunicable, like the content of a dream, or the taste of a strawberry, or a vision of the Grand Canyon. Each of these phenomena may be described in prose, or simulated in poetry, but they cannot be fully re-presented to one who has not taken the time to imagine, taste, see for themselves.


Fasting brings joy, and a burning clarity. There, I have stated it. My friend had a dream she walked with her husband John who was actually Jesus, along the beach. He asked her, “Why do you love being near the ocean so much?” She said, “I don’t know.” There. Strawberries taste like mangoes, but sweeter. There. The Grand Canyon is beautiful, and big. There.

The Possibility of Dogmatism

Over on Mere-O Abridged (the sidebar), where I highlight interesting articles by attempting a pithy line about them, I highlighted a review of the recently released research indicating that homosexuals can, in fact, change their behavior.

The main thrust of the research calls into question this rather dogmatic position by the American Psychological Association:

Can Therapy Change Sexual Orientation?

No. Even though most homosexuals live successful, happy lives, some homosexual or bisexual people may seek to change their sexual orientation through therapy, sometimes pressured by the influence of family members or religious groups to try and do so. The reality is that homosexuality is not an illness. It does not require treatment and is not changeable.

What’s more, the APA expresses its concern that therapy may harm those homosexuals who do seek treatment.

In a response, my brother highlighted the shortcomings of the study’s sample group, shortcomings about which the authors seem quite candid.  He concludes:

So people who really, really, really want to change can change–somewhat.

Maybe.

To borrow the phrase, sexuality is indeed “meaningful and complicated.” Dogmatism about its biological nature, its ethical import, and its psychological malleability isn’t warranted on any side. Fundamentally, though, the moral question comes first. Even if we could, through patience and therapy, make gays turn straight–or straights turn gay–it wouldn’t make it right.

I am happy to acknowledge the tendentious and limited nature of the study.  But Jim seems to confuse things when he says that “Dogmatism about…[sexuality's] ethical import…isn’t warranted.”  In making the claim in this context, it seems Jim thinks that dogmatism about ethics is derived from the conclusions of the social scientists.*  While this may be a plausible position to hold, it puts Jim in some unexpected (and perhaps undesirable?) company:  that of natural law theorists.  Using inconclusive scientific results to justify agnosticism about the moral status of what is being observed is another form of deriving the “ought” from the “is.”

Jim and I probably admit different categories into the “is” that we consider to be reality (in this case, at least), but in our ethical reasoning we may share more common ground than we have yet realized.
*I feel quite free to make this claim because I know Jim will correct me if I’m wrong!

A Unified Knowledge: Science and Theology

When modern science approaches the world, it asks two questions of it: what is the nature and arrangement of the matter under consideration, and how did that arrangement come to be? If one is a methodological naturalist, then the only valid answers to the second question are physical.

In Aristotelian terms, modern science is interested in two causes: the material (what is it made of?) and the efficient (how was it made?). The formal cause–what is it?–and the final cause–what is its purpose?–have no bearing on scientific inquiry.

In the epilogue to his extraordinary The Discarded Image, C.S. Lewis points out, “But nature gives most of her evidence in answer to the questions we ask her. Here, as in the courts, the character of the evidence depends on the shape of the examination, and a good cross-examiner can do wonders. He will not elicit falsehoods from an honest witness. But, in relation to the total truth in the witness’s mind, the structure of the examination is like a stencil. It determines how much of that total truth will appear and what pattern it will suggest.”

In other words, asking some questions of nature and not others will inevitably lead to an incomplete–and in that respect, inaccurate–model.
What this means, however, is that the notion that we can understand the material composition of a thing abstracted from its form or purpose is questionable. We will certainly learn a lot about the material composition–we may even be able to manipulate that object in interesting and “productive” ways. But we will not understand that which we are manipulating. The formal and final causes–the “what is it” and “what is it for”–relate to the material and efficient causes. To see them as isolated divides reality from itself, giving us a stunted impression of both the material and efficient causes on the one hand, and the formal and final causes on the other. (This may be the difference between modern and medieval science: the medievals wanted understanding, leaving the control to the magicians, whereas moderns more often allow the desire for control to motivate their scientific endeavors).*

For this reason, the relationship between science and theology must be maintained. Each impinges upon the other–if we wish to understand the physical reality of creation, then we must understand it as creation. If we wish to understand the mind of God, we must study the text(s) He has written. Ultimately, reality is unified and so our approach to reality must be as well. We ignore form and purpose to our own peril.**

* This is a really tendentious thought that has, I think, Leon Kass’s book on technology lurking in the background..

**I have two pieces in my mind as I write this, but I am unsure of how to relate them: 1) Joe Carter’s post on Romans 1, and 2) Avery Cardinal Dulles recent piece in First Things. I commend them both to you.

You know what you get with an assumption, don’t you?

“In a nonmetaphysical age there is probably more metaphysics, in the common sense (ie a priori assumptions) than in any other, because there is more complete unconsciousness that we are resting on our own ideas, while we please ourselves with the conviction that we are resting on facts.”

Benjamin Jowett*JP Moreland (of recent Kingdom Triangle fame) wisely pointed out in his book “Christianity and the Nature of Science,” that our modern scientific worldview has achieved such wide-ranging acceptance and agreement that it has begun to masquerade as a Given, as “Fact.” Though pure Scientism (the belief that only propositions empirically verifiable may be judged to be true or false) has failed for an obvious lack of internal coherency (At which lab was that belief itself empirically proven to be true?), its modern idealogical brother, what Moreland calls Scientific Naturalism, has somehow escaped the same level of critical examination and so enjoys an unjustified imperial authority in the minds and hearts not only of specialists (scientists, philosophers, psychologists, news media, the writers at the Discovery Channel) but of the average American layperson as well.

The modern scientific endeavors that flow out of Scientific Naturalism are mostly good. The scientific methods (as Moreland argues is a more proper name for them) work. They produce new information, new technologies, new airplanes, bigger, better, and faster than the ones before. They produce discoveries and insights into a limited scope of the knowable universe. But this success is partial.

Continue reading