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Very good address, pretty much echoing the points from DFW's excellent speech (https://www.fs.blog/2012/04/david-foster-wallace-this-is-wat...):

"That is real freedom. That is being educated, and understanding how to think. The alternative is unconsciousness, the default setting, the rat race, the constant gnawing sense of having had, and lost, some infinite thing."

Granted, I live my 99% of my life in this despicable state that Wallace described so well, but for brief moments, when I can muster up the will choose what to think, it feels great. Actually, let me tell you exactly what it feels like: it's like that moment in Matrix Revolutions where Trinity pushes their ship above the clouds, and for one very brief moment, before returning to the ugliness, fight, and of course, her death, she gets to experience a gorgeous sun-lit scene. And, for giving me that understanding in such simple terms, I will always be grateful to DFW!

I'm hesitant to make this comment because this was a great article and this is somewhat tangential, but I hate to see history whitewashed and simplified so I'm going to make it anyway.

From the article:

> [The idea that all lives are of equal worth] is a radical idea, one ultimately inscribed in our nation’s founding documents: we are all created equal and should be respected as such. I do not think it a mere coincidence that among the fifty-six founding fathers who signed the declaration of our independence was a physician, Dr. Benjamin Rush. He was a committed revolutionary and abolitionist precisely because of his belief in the principle.

Erm, no. It was not really some idealistic principle that motivated his views. From wikipedia:

> Benjamin Rush (1745–1813), a Founding Father of the United States and a physician, proposed that being black was a hereditary skin disease, which he called "negroidism", and that it could be cured. Rush believed non-whites were really white underneath but they were stricken with a non-contagious form of leprosy which darkened their skin color. Rush drew the conclusion that "whites should not tyrannize over [blacks], for their disease should entitle them to a double portion of humanity. However, by the same token, whites should not intermarry with them, for this would tend to infect posterity with the 'disorder'... attempts must be made to cure the disease".

Setting aside the centuries of oppression, the experimentation and the complete dehumanization of people based on their ethnicity that still goes on to this day, I find Rush's hypothesis and the thinking that led to it interesting.

If we take a step back from the disease idea, the leprosy and the idea that it could be cured (and I shudder at the implications of that) then the model had the following properties:

- The darkening of the skin is non contagious

- That it is hereditary

- That aside from this darkening, non-white people are (fundamentally) the same as whites.

It seems so close and yet so far away. I understand it was in the 19th Century that Melanocytes were discovered, but I can't ascertain when or who discovered them. The thing that I find interesting is that surely things like Melanocytic Nevi (moles) were just as prevalent then as today and could have led to a significantly better model with some thought.

Does anybody have any ideas where more information can be found on the history of the scientific ideas surrounding Melanin and pigmentation? A cursory search doesn't bring much up.

>It seems so close and yet so far away.

In what sense is it even wrong? Dark skin is a non-contagious, hereditary trait. The only thing that distinguishes it from a genetic disease is the lack of negative symptoms, which Rush acknowledged.

I would say that the population size of "infected" individuals would also be an arguement for considering it a natural variate instead of a disease. However, we seem to have no problem calling lactose intolerance a disease, even though it applies to 65% of the populations (and, historically speaking, lactose tolorence is the mutation).

> In what sense is it even wrong?

In that it is not hereditary leprosy that causes the differences between whites and non-whites but natural genetic variations. There is no "white" skin underneath. There is no cure, nor should there be any medical reason to seek a "cure."

Disease is a very stigmatizing word that implies defectiveness.

[0] https://en.wikipedia.org/wiki/Scientific_racism#Benjamin_Rus...

So, is your factual complaint that dark skin is not literally a strain of leprosy? Because that seems like a relativly minor disagreement, and certainly would not qualify as being "so far away" from reality.

Further, my interpretation of the quote is that "leprosy" was intended to refer to a specific disease, but rather a syndrome, (which could be caused by multiple diseases presenting simmilar symptoms). Keep in mind that we did not actually identify the leprosy bacteria until 1873 [0], while Rush died in 1813.

>Disease is a very stigmatizing word that implies defectiveness.

This is a reason that we might not want to call it a disease. It does not represent any factual dispute.

>There is no "white" skin underneath.

That depends on how you define "underneath". If you remove the melonin, I believe you will get white skin; so "underneath" seems to me to be a reasonable description. Further, my understanding is that real leprosy does not literally create a new layer of "skin", so "underneath" cannot have the most literal meaning here in the first place.

>There is no cure

https://en.wikipedia.org/wiki/Skin_whitening#Whitening_agent...

As far as medical conditions go, dark skin seems far more curable then many other things that we have cured. For reference, to a first approximation, we have "cured" the condition of being male/female in transfolks. I suspect that that is a far more difficuly problem then changing skin color.

>nor should there be any medical reason to seek a "cure."

This is a value judgement, not a factual judgement.

Facts matter. It is important to distinguish between disagreeing on the facts and disagreeing on the interpretation of the facts.

[0] The first bateria identified as the cause of a human disease.

Most importantly, dark skin is adaptive at low latitudes. Which is why calling it a disease is completely wrong, though understandable from 19th century point of view.

It is a hereditary adaptation. That it is malpractice at high latitudes means little. Much like sickle cell trait is adaptive where malaria is endemic.

This is why even Caucasians there, especially ones who lived there for generations, are quite brown. (Say, Arabs.) People who aren't dark skinned enough tend to get sunburnt.

Race baiting comment. Context is key. The article advocates equality and you cherry picked a wikipedia section of a historical and clearly wrong assumption. Look over the wiki and try to find something where Benjamin Rush does not advocate equality, then you can shoot your shot.
I'm really not sure what the point of this article is. Is it saying people are equal? Because they're not.

"All men are create equal" doesn't mean all people are equal. In fact, we know all people aren't created equal either. Rather, it's the law that must see all people as equal for the purpose of justice.

For the purposes of a doctor, I get what he's saying too, but I would argue that the quality of the patient does matter and that discrimination is good.

Consider, an ambulance roles up to a car accident. The drunk driver that caused the accident killed a mother. The drunk and the woman's 12 y/o child both need emergency care. There is another ambulance 20 minutes out. Who should that first ambulance take to the hospital?

If you say the drunk, I don't want to live in your world.

One more thing. The article states "All people deserve respect". I grew up being told respect is earned, so I can't agree with his sentiment. Perhaps all people deserve a chance to earn respect. That's different.

>Perhaps all people deserve a chance to earn respect. That's different.

You’re talking about equality of opportunity. On HN, the word “equality” is pretty much always just an abbreviation for “equality of outcome”.

I'd encourage you to amend "equality of opportunity" to "equality of opportunity under the law". I've seen too many people try to argue that if we want equality of opportunity we still have to actively level opportunity.
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> and that a massive and troubling proportion of all of them are mentally ill or black.

Reword

Beautiful article. I've loved reading the author's writing for over a decade now and this one lives up to his previous writings.

This sentence, in particular, caught my eye:

>Hospitals are one of the very few places left where you encounter the whole span of society.

As a startup founder building consumer tech products in the valley I find that I easily forget how different most people are from me. Hence I sometimes incorrectly assess relevant market size.

It's one reason I like doing to the DMV because, like a hospital, it treats everyone the same and there you can see a near-perfect representation of society that you don't encounter elsewhere. I hope it gives me the awareness and humility to design better products for society.

Before I even finished reading your comment I had the same thought about the DMV! The only other place where I've had a similar feeling of being part of a true cross section of America was when I was called in for jury duty last year.

I often hear people criticize courts, hospitals and the DMV all for being inefficient and unpleasant institutions, but frankly I love them for the way they tend to equalize people. Just being around people from so many different walks of life can be a refreshing change from the socioeconomic bubble I tend to occupy in my daily life. This article served as a reminder to make an effort to seek out that kind of diversity.

> DMV because, like a hospital, it treats everyone the same

From my experience, they are much ruder in if you live in a poor area than a rich suburb. They are way more crowded in poor areas. Same with hospitals, post office ect.

> you can see a near-perfect representation of society

You see people who live near you, aka ppl like you.

Good caveats, thank you. Sigh, takes careful thought to really get out of the bubble we inhabit.
IMO "everyone is equal" is fundamentally about humility.

It's really about recognizing the depth of our own ignorance and bias, and devising systems and habits to minimize its impact.

That doesn't just apply to comparing individuals, but also more abstract stuff. For example, we seldom know all the tradeoffs present in a given set of genes, and genetic diversity is itself a good thing for the species.

But is humility actually good? Or is it just virtue signalling? I think some people construed it as good in opposition to pride, especially excessive, and to arrogance. Probably neither is actually good especially in excess.

Ultimately what matters more is what one does, the actions, not the approach.

There is equality, equal treatment and equal opportunity. None exist in reality since were all different (including genetically) with different backgrounds, and exceptional people can sometimes force the environment to bend to their will.

Equal treatment is the most seductive of those, but in current implementations it just results in wasting potential - and is unnatural way of thinking. People have preferences. Resourceful people have resources to ensure better treatment. It happens all the time. Rich purple can get high level private treatment in terms of medicine. Or education. Or perhaps just housing.

That everyone theoretically can have it does not mean everybody does. And the places open to everyone suffer from the tragedy of the commons and lack of funding.

This is a great article. However, I would like to add that there is a small proportion of the population who are sociopaths and are simply bad.
Yes. It's long been my belief that the actual sociopaths cannot be cured, and they need closed psychiatric care for life.

For everyone else, places like prison just cost money and ruin lives that can totally be turned around much cheaper. But I digress...

I disagree. This kind of thinking keeps opens the door for precisely the type of thinking the article is trying to counter.
No, I said a small* proportion of the population. Which means that if someone is behaving badly, you should assume that is likely for some other reason than sociopathy, and get curious about finding out what it is, which fits the author's message.