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ceremony honors what has taken place. But ritual is a sequence of actions that symbolically walk you through the inner change the new stage of life will require.

Rituals also comfort because they concretize spiritual experiences.

There should be a ritual for that moment, often around age 27 or 28, when the young adult leaves the wandering post-school phase and begins to get a sense for the shape and direction of his or her life

Rituals encourage you to be more intentional about life. People can understand their lives’ meaning only if they step out of their immediate moment and see what came before them and what they will leave behind when they are gone.

over 60 percent of Judaism’s 613 commandments involve physical ritual: lighting candles, ritual baths, etc. These deeds are a kind of language, a way of expressing things that are too deep for words.

naming your limitations, befriending your inner life, realigning your central focus. For example, young adults might create a life map of where they’ve been and hope to go, and present it to their peers

Maybe neighborhoods and towns could come together to make town compacts. They would vow to be a community together and lay out the specific projects

It could be an occasion to tell a new version of the town story; a community is a group of people who share a common story

Most of all, it would be an occasion for people to make promises toward one another — specific ways they are going to use their gifts to solve the common challenge

we’ve shed old rituals without coming up with new ones. We’ve unwittingly robbed ourselves of a social architecture that marks and defines life’s phases

Why do we willingly throw away chances to throw fun parties about important things?

rituals change the way we pay attention as much as — perhaps more than — they express belief.

ritual isn’t about expressing religious commitment at all, but about doing something in a way that marks the moment as different from the everyday and forces you to see it as important. Their point is that performing a ritual focuses your attention on some moment and deems it worthy of respect

rituals work, if by “work” we mean that they change people’s sense of their lives. It turns out that saying that you are grateful makes you feel grateful. Saying that you are thankful makes you feel thankful. To a world so familiar with the general unreliability of language, that may seem strange. But it is true.

In a study in which undergraduates were assigned to write weekly either about things they were grateful or thankful for; hassles; or “events or circumstances that affected you in the past week,” those who wrote about gratitude felt better about their lives as a whole, and were more optimistic about the coming week. There have now been many such studies.

Religion is fundamentally a practice that helps people to look at the world as it is and yet to experience it — to some extent, in some way — as it should be

Much of what people actually do in church — finding fellowship, celebrating birth and marriage, remembering those we have lost, affirming the values we cherish — can be accomplished with a sense of God as metaphor, as story, or even without any mention of God at all.

Quite apart from the “unbalanced power” of the financial sector, and the tendency of a super-sized financial sector to cause increasingly bad global financial crashes, excessive financialization leads to resources being misallocated. “In many of the financial sector’s segments that have grown fastest since deregulation—like investment banks—the transactions are primarily zero-sum.”

However in times of rapid technological transformation like today, the role of the economic priesthood in protecting its own interests can become a massively destabilizing.

Thus we know from the history of the last couple of hundred years that in times of rapid technological transformation, the financial sector tends to become disconnected from the real economy

This has occurred a number of times in the last few hundred years, including the Canal Mania (England—1790s), the Rail Mania (England—1840s), the Gilded Age (US: 1880s—early 1900s) the Roaring Twenties (US—1920s) and the Big Banks of today.

Getting to safety is not made any easier by the fact the modern economic priesthood—the managers of large firms and the banks—has, like their ancient Egyptian forbears, found ways to participate in the casino economy and benefit from “making money out of money”, even as the economy as a whole suffers.  As Upton Sinclair wrote, “It is difficult to get a man to understand something, when his salary depends upon his not understanding it.

Just as the ancient Egyptian economic priesthood clung to power as the economy stagnated, so today the economic priesthood shows no signs of relinquishing their gains or their power. The appetite and expectation of extraordinary returns is still there.

“Corporate chieftains rationally choose financial engineering—debt-financed share buybacks, for example—over capital investment in property, plants and equipment. Financial markets reward shareholder activism. Institutional investors extend their risk parameters to beat their benchmarks… But real economic growth—averaging just a bit above 2 percent for the fifth year in a row—remains sorely lacking.”

As a result, the economy remains in the “Great Stagnation”(Tyler Cowen), also known as “the Secular Stagnation (Larry Summers). It is running on continuing life support from the Federal Reserve. Large enterprises still appear to be profitable. The appearance, though not the reality, of economic well-being has been sufficient to make the stock market soa

Just as no change was possible in ancient Egyptian society so long as the economic priesthood colluded to preserve the status quo, so the excesses and prevarications of the Financial Sector will continue so long as the regulators remain its cheerleaders.

Just listen to the chair of the Securities and Exchange Commission (SEC), Mary Jo White at Stanford University Rock Center for Corporate Governance speaking to directors. In her speech, she makes no secret of her view that the overall corporate arrangements are sound. The job of the SEC, as outlined in the speech, is to find the odd individual who might be doing something wrong. The idea that the large-scale activities of the major banks might be socially corrosive is not even alluded.

Thus in times of transformational technology, there is a huge expansion of investment, driven by the financial sector. Wealthy investors begin to expect outsized returns and so there is over-investment. The resulting bubbles in due course burst

Just as in ancient Egypt, no progress was possible so long as the myths and rituals of the economic priesthood and their offerings to the gods were widely accepted as real indicators of what was going on, so today no progress is possible so long as the myths and rituals of the modern economic priesthood still has a pervasive hold of people’s minds

In the modern economy, the myths and rituals of the economic priesthood are built on the notion that the purpose of a firm is to maximize shareholder value and the notion that if the share price is increasing, things are going well. These ideas are the intellectual underpinnings of the zero-sum activities of the financial sector for “making money out of money”, by whatever means possible

Like the myths and rituals of the priests of ancient Egypt, shareholder value theory is espoused with religious overtones. Shareholder value, which even Jack Welch has called “the dumbest idea in the world,” remains pervasive in business, even though it is responsible for massive offshoring of manufacturing, thereby destroying major segments of the US economy, undermining US capacity to compete in international markets and killing the economic recovery.

If instead society decides that the financial sector should concentrate on its socially important function of financing the real economy and providing financial security for an ever wider circle of citizens and enterprises, we could enjoy an era of growth and lasting prosperity.

Making friends can be hard—but there may be more opportunities than we think. Doing these interviews has taught me that connection can come from anywhere, at any time, if both parties are open to it.

“You have to look for friendship in places you would never expect it.”

Paying attention goes a long way when forging these unexpected friendships—noticing when you click with someone, being open to chance encounters.

as much as we may feel like our social networks are set and settled, it’s never too late to meet someone who will be important to you for the rest of your life. I spoke with more than one group who was surprised and grateful to have found one another in middle age, a period when work and family responsibilities tend to peak and keeping up with friends is not always easy.

I’m inspired by the people I’ve spoken with who imagined something different for themselves: the friends who bought a house together, who went to therapy together, who have raised their children together, who committed to an “arranged friendship,” whose friendship has fueled their fight for justice.

they won’t grow without intention. This is the hardest part of friendship. It takes energy and thought, and our mental and physical resources are often spread thin. In other words, friendships take work. But I have never liked framing our friendships as labor. Showing up for our friends takes effort, yes, but it shouldn’t be drudgery. It should be a joy.

One thing that seems to make keeping up with friends easier is ritual. I personally find that the effort of coordinating hangs (or even phone calls) is the biggest barrier to seeing my friends. It’s much easier when something is baked into my schedule, and all I have to do is show up.

Some have organized a book club, a monthly hike, or a regular dinner party. Others have committed to a group chat that runs all day every day, or a Dungeons & Dragons campaign that’s lasted for 30 years. In addition to keeping groups close, these traditions can fuel a friendship and give it a shared culture.

Imagination

Society has a place for friendships, and it’s on the sidelines. They’re supposed to play a supporting role to work, family, and romance. It takes imagination not to default to this norm, and to design your life so that friendship plays the role you really want it to.

Attention only gets you so far without action. When opportunity arises, you have to put yourself out there, and that requires courage, vulnerability, and a willingness to let things be awkward.

The man who gave his friend a kidney and the woman who gave birth to her best friend’s quadruplets remind me that there are friends who choose to love each other radically every day. Their love does not stand on the sidelines.

The beauty and the challenge of friendship is its diversity. A friendship can be whatever you want it to. Each one is a canvas whose only limit is our imagination.

Grace

All of the forces I’ve mentioned so far—accumulation, attention, intention, ritual, and imagination—are ideals. They’re impossible to fully live up to. Life often gets in the way.

I do love the concept of grace, of a gift so profound that it could never be earned or deserved. And so when I cite grace here as the final and most important force in friendships, I mean it in two ways. One is the forgiveness that we offer each other when we fall short. The other is the space that creates for connections—and reconnections—that feel nothing short of miraculous.

Many of the people I spoke with—who, in many cases, love each other so much that they nominated themselves to be interviewed about their friendship—told me that they don’t see each other that often, or that they don’t talk as much as they would like. I’ve come to believe that friendship doesn’t always have to be about presence; it can also be about love that can weather absence.

Sometimes, people have assumed that I must be a really great friend, given how much time I’ve spent thinking about this. And I’m not. I try to be, but I tend to retreat too much into myself and my romantic relationship and don’t prioritize my friends as much as I’d like to.

But absence doesn’t have to last forever. “The Friendship Files” includes many stories of second chances and rekindlings.

Accumulation

Attention

Intention

Ritual

Why is fact-checking so popular? The traditional American view of democracy has a ready answer: The people know that, to be responsible voters, they must know the facts.

There’s a complex myth of democracy packed into that little story. There’s a basic premise: Democracy can work because we humans are rational animals. We are built to be fact-checkers; we all have the capacity to separate true facts from lies. And once we have true facts, we know how to analyze them logically to come to reasonable conclusions. If that weren’t true, democracy would be a foolish experiment, indeed.

But, the myth goes on to say, a capacity is useless unless it is developed through training. That’s why democracy demands universal access to education

Only educated people can be responsible citizens because only the educated have actualized their potential for fact-checking and rational thinking.

When the final book is written on this campaign, one-sided deception will still have played a central role. As it stands, the very notions of fact and truth are employed in American politics as much to distort as to reveal. And until the voting public demands something else, not just from the politicians they oppose but also from the ones they support, there is little reason to suspect that will change.

they must have honesty from their leaders and transparency from their government.

Hence, the need for fact-checkers at every step on the campaign trail. It’s only logical.Except that there’s no evidence all the fact-checking has any measurable impact on the voters’ choices.

ideas hardly mattered any more than facts in the outcome of the first debate. Romney won on style points alone.

The “theater state” is a performance art. Every candidate is judged, above all, on their performance. Good theatrical performers know how to create satisfying illusory images of truth. It’s one of their highest skills. Mitt Romney proved that in the first debate.

The myth of democracy says that citizens must educated enough to know which policies are best for their community. But good citizens must also bring their rationality into the polling booth.

The fact-checkers, too, are seasoned performers skilled in the art of creating satisfying illusory images of truth.

Above all, they create the illusion that American democracy is alive and well because the public is apparently being informed of the facts and the veracity of each candidate is apparently being carefully evaluated and widely reported. Fact-checking, then, is the ritual enactment of our myth of democracy. As long as the myth keeps getting acted out, we can trust that it is alive and well.

these ideas are not about looking within and finding oneself. They are about overcoming the self. They are, in a sense, anti-self-help.

Today, we are often told that our goal should be to look within and find ourselves, and, once we do, to strive to be sincere and authentic to that true self, always loving ourselves and embracing ourselves for who we are. All of this sounds great and is a key part of what we think of as a properly “modern” way to live.

But what if we’re, on the contrary, messy selves that tend to fall into ruts and patterns of behavior? If so, the last thing we would want to be doing is embracing ourselves for who we are — embracing, in other words, a set of patterns we’ve fallen into. The goal should rather be to break these patterns and ruts, to train ourselves to interact better with those around us.

Certainly some strains of Chinese political theory will take this vision of the self — that we tend to fall into patterns of behavior — to argue for a more paternalistic state that will, to use a more recent term, “nudge” us into better patterns.

many of the texts we discuss in the book go the other way, and argue that the goal should be to break us from being such passive creatures — calling on us to do things that break us out of these patterns and allow us to train ourselves to start altering our behavior for the better.

You argue that Chinese philosophy views rituals as tools that can liberate us from these ruts.

Rituals force us for a brief moment to become a different person and to interact with those around us in a different way. They work because they break us from the patterns that we fall into and that otherwise dominate our behavior.

In the early Han dynasty, for example, we have examples of rituals that called for role reversals. The father would be called upon to play the son, and the son would play the father. Each is forced to see the world from the other’s perspective, with the son learning what it’s like to be in a position of authority and the father remembering what it was like to be the more subservient one

We tend to think that we live in a globalized world, but in a lot of ways we really don’t. The truth is that for a long time only a very limited number of ideas have dominated the world, while ideas that arose elsewhere were seen as “traditional” and not worth learning from.

imagine future generations that grow up reading Du Fu along with Shakespeare, and Confucius along with Plato. Imagine that type of world, where great ideas — wherever they arose — are thought about and wrestled with.

There’s a very strong debate going on in China about values — a sense that everything has become about wealth and power, and a questioning about whether this should be rethought. And among the ideas that are being brought into the debate are these earlier notions about the self and about how one can lead a good life. So, while the government is appropriating some of these ideas in particular ways, the broader public is debating them, and certainly with very different interpretations.

Wu wei is integral to romance, religion, politics and commerce. It’s why some leaders have charisma and why business executives insist on a drunken dinner before sealing a deal.

the quest for wu wei has been going on ever since humans began living in groups larger than hunter-gathering clans. Unable to rely on the bonds of kinship, the first urban settlements survived by developing shared values, typically through religion, that enabled people to trust one another’s virtue and to cooperate for the common good.

But there was always the danger that someone was faking it and would make a perfectly rational decision to put his own interest first if he had a chance to shirk his duty.

To be trusted, it wasn’t enough just to be a sensible, law-abiding citizen, and it wasn’t even enough to dutifully strive to be virtuous. You had to demonstrate that your virtue was so intrinsic that it came to you effortlessly.

the discovery in 1993 of bamboo strips in a tomb in the village of Guodian in central China. The texts on the bamboo, composed more than three centuries before Christ, emphasize that following rules and fulfilling obligations are not enough to maintain social order.

These texts tell aspiring politicians that they must have an instinctive sense of their duties to their superiors: “If you try to be filial, this not true filiality; if you try to be obedient, this is not true obedience. You cannot try, but you also cannot not try.”

is that authentic wu wei? Not according to the rival school of Taoists that arose around the same time as Confucianism, in the fifth century B.C. It was guided by the Tao Te Ching, “The Classic of the Way and Virtue,” which took a direct shot at Confucius: “The worst kind of Virtue never stops striving for Virtue, and so never achieves Virtue.”

Through willpower and the rigorous adherence to rules, traditions and rituals, the Confucian “gentleman” was supposed to learn proper behavior so thoroughly that it would eventually become second nature to him.

Taoists did not strive. Instead of following the rigid training and rituals required by Confucius, they sought to liberate the natural virtue within. They went with the flow. They disdained traditional music in favor of a funkier new style with a beat. They emphasized personal meditation instead of formal scholarship.

Variations of this debate would take place among Zen Buddhist, Hindu and Christian philosophers, and continue today among psychologists and neuroscientists arguing how much of morality and behavior is guided by rational choices or by unconscious feelings.

“Psychological science suggests that the ancient Chinese philosophers were genuinely on to something,” says Jonathan Schooler, a psychologist at the University of California, Santa Barbara. “Particularly when one has developed proficiency in an area, it is often better to simply go with the flow. Paralysis through analysis and overthinking are very real pitfalls that the art of wu wei was designed to avoid.”

Before signing a big deal, businesspeople often insist on getting to know potential partners at a boozy meal because alcohol makes it difficult to fake feelings.

Some people, like politicians and salespeople, can get pretty good at faking spontaneity, but we’re constantly looking for ways to expose them.

However wu wei is attained, there’s no debate about the charismatic effect it creates. It conveys an authenticity that makes you attractive, whether you’re addressing a crowd or talking to one person.

what’s the best strategy for wu wei — trying or not trying? Dr. Slingerland recommends a combination. Conscious effort is necessary to learn a skill, and the Confucian emphasis on following rituals is in accord with psychological research showing we have a limited amount of willpower. Training yourself to follow rules automatically can be liberating, because it conserves cognitive energy for other tasks.

He likes the compromise approach of Mencius, a Chinese philosopher in the fourth century B.C. who combined the Confucian and Taoist approaches: Try, but not too hard.

“But in many domains actual success requires the ability to transcend our training and relax completely into what we are doing, or simply forget ourselves as agents.”

The sprouts were Mencius’ conception of wu wei: Something natural that requires gentle cultivation. You plant the seeds and water the sprouts, but at some point you need to let nature take its course. Just let the sprouts be themselves.

Our brains are statistical organs that are built simply to predict what will happen next

This makes sense because, in prehistoric times, faulty predictions could lead to some very unpleasant surprises — like a tiger eating you or sinking in quicksand.

So-called prediction errors (like finding salmon instead of turkey on your plate on Thanksgiving) send us into a tizzy because our brains interpret them as a potential threat.

Keep doing what you’ve been doing, because you did it before, and you didn’t die.

all essentially subconscious efforts to make your world more predictable, orderly and safe.

Routines and rituals also conserve precious brainpower

It turns out our brains are incredibly greedy when it comes to energy consumption, sucking up 20 percent of calories while accounting for only 2 percent of overall body weight.

Our brains are literally overburdened with all the uncertainty caused by the pandemic.

Not only is there the seeming capriciousness of the virus, but we no longer have the routines that served as the familiar scaffolding of our lives

“It’s counterintuitive because we think of meaning in life as coming from these grandiose experiences

grandiose

grandiose

Of course, you can always take routines and rituals too far, such as the extremely controlled and repetitive behaviors indicative of addiction, obsessive-compulsive disorder and various eating disorders.

it’s mundane routines that give us structure to help us pare things down and better navigate the world, which helps us make sense of things and feel that life has meaning.”

In the coronavirus era, people may resort to obsessive cleaning, hoarding toilet paper, stockpiling food or neurotically wearing masks when driving alone in their cars. On the other end of the spectrum are those who stubbornly adhere to their old routines because stopping feels more threatening than the virus.

You’re much better off establishing a new routine within the limited environment that we find ourselves in

Luckily, there is a vast repertoire of habits you can adopt and routines you can establish to structure your days no matter what crises are unfolding around you

The point is to find what works for you. It just needs to be regular and help you achieve your goals, whether intellectually, emotionally, socially or professionally. The best habits not only provide structure and order but also give you a sense of pleasure, accomplishment or confidence upon completion.

It could be as simple as making your bed as soon as you get up in the morning or committing to working the same hours in the same spot.

Pandemic-proof routines might include weekly phone or video calls with friends, Taco Tuesdays with the family, hiking with your spouse on weekends, regularly filling a bird feeder, set times for prayer or meditation, front yard happy hours with the neighbors or listening to an audiobook every night before bed.

The truth is that you cannot control what happens in life. But you can create a routine that gives your life a predictable rhythm and secure mooring.

This frees your brain to develop perspective so you’re better able to take life’s surprises in stride.

I attended a Thanksgiving dinner several years ago where the hostess, without warning family and friends, broke with tradition and served salmon instead of turkey, roasted potatoes instead of mashed, raspberry coulis instead of cranberry sauce and … you get the idea.

Too many people are still longing for their old routines. Get some new ones instead.

It wasn’t that the meal itself was bad. In fact, the meal was outstanding. The problem was that it wasn’t the meal everyone was expecting.

When there are discrepancies between expectations and reality, all kinds of distress signals go off in the brain.

It doesn’t matter if it’s a holiday ritual or more mundane habit like how you tie your shoes; if you can’t do it the way you normally do it, you’re biologically engineered to get upset.

This in part explains people’s grief and longing for the routines that were the background melodies of their lives before the pandemic

"I've been known as the player that doesn't want anybody to come to their events," she told The Inquirer. "It's not a superstitious thing, it's just something that works for me. In order for me to be at my best -- and if I'm at my best, that essentially helps the team -- I just want to go over there and do my thing."

Co-captain Alex Morgan likes to go against the grain, so it's no surprise that she's made 13 her lucky number. In a video for Team USA, Morgan said she found the superstitions toward the number strange and decided to make it her own.

Rapinoe told POPSUGAR that her diet is something she makes sure is consistent. According to the publication, she said there are certain things she absolutely must eat in order to get ready for a game, and her special diet is something she just can't deviate from.

The Rapinoe diet:Breakfast: She has a cup of coffee and a breakfast sandwich consisting of two eggs, sauteed onions and spinach on an English muffin.Lunch: Avocado toast with a chicken thigh and a side of fruit.Dinner: Two chicken thighs, sweet potatoes and asparagusPregame snack: Energy bar or a handful of almonds.

Every player has their own ritual for preparing for game day: For some it may be relaxing and focusing on the game -- for Christen Press, it's yoga and shopping.

Press said she likes to start her day by meditating, having a good breakfast, doing some yoga and she prefers to wrap it all up with some shopping at the mall.

Press said she also likes to make "a really big purchase" on game day "maybe like a fancy pair of shoes or a purse I would not normally splurge on." She says if she plays well, scores, or it's a good game, she gets to keep it.

“The net is designed to be an interruption system, a machine geared to dividing attention,” Nicholas Carr explains in his book “The Shallows: What the Internet Is Doing to Our Brains.” “We willingly accept the loss of concentration and focus, the division of our attention and the fragmentation of our thoughts, in return for the wealth of compelling or at least diverting information we receive.”

Addiction is the relentless pull to a substance or an activity that becomes so compulsive it ultimately interferes with everyday life

Denial is any addict’s first defense. No obstacle to recovery is greater than the infinite capacity to rationalize our compulsive behaviors

According to one recent survey, the average white-collar worker spends about six hours a day on email.

The brain’s craving for novelty, constant stimulation and immediate gratification creates something called a “compulsion loop.” Like lab rats and drug addicts, we need more and more to get the same effect.

Endless access to new information also easily overloads our working memory. When we reach cognitive overload, our ability to transfer learning to long-term memory significantly deteriorates.

By that definition, nearly everyone I know is addicted in some measure to the Internet. It has arguably replaced work itself as our most socially sanctioned addictio

t we humans have a very limited reservoir of will and discipline. We’re far more likely to succeed by trying to change one behavior at a time, ideally at the same time each day, so that it becomes a habit, requiring less and less energy to sustain.

Now it was time to detox. I interpreted the traditional second step — belief that a higher power could help restore my sanity — in a more secular way. The higher power became my 30-year-old daughter, who disconnected my phone and laptop from both my email and the Web.

During those first few days, I did suffer withdrawal pangs, most of all the hunger to call up Google and search for an answer to some question that arose. But with each passing day offline, I felt more relaxed, less anxious, more able to focus and less hungry for the next shot of instant but short-lived stimulation. What happened to my brain is exactly what I hoped would happen: It began to quiet down.

I had brought more than a dozen books of varying difficulty and length on my vacation. I started with short nonfiction, and then moved to longer nonfiction as I began to feel calmer and my focus got stronger. I eventually worked my way up to “The Emperor of All Maladies

I am back at work now, and of course I am back online. The Internet isn’t going away, and it will continue to consume a lot of my attention. My aim now is to find the best possible balance between time online and time off

I also make it my business now to take on more fully absorbing activities as part of my days. Above all, I’ve kept up reading books, not just because I love them, but also as a continuing attention-building practice.

I’ve retained my longtime ritual of deciding the night before on the most important thing I can accomplish the next morning. That’s my first work activity most days, for 60 to 90 minutes without interruption. Afterward, I take a 10- to 15-minute break to quiet my mind and renew my energy.

If I have other work during the day that requires sustained focus, I go completely offline for designated periods, repeating my morning ritual. In the evening, when I go up to my bedroom, I nearly always leave my digital devices downstairs.

The living, breathing source of the data and images we juggle, meanwhile, is in the bed and left wondering: Where is everyone? What are they doing? Hello! It’s my body, you know

Our $3.4 trillion health care system is responsible for more than a quarter of a million deaths per year because of medical error, the rough equivalent of, say, a jumbo jet’s crashing every day.

I can get cash and account details all over America and beyond. Yet I can’t reliably get a patient record from across town, let alone from a hospital in the same state, even if both places use the same brand of E.H.R

the leading E.H.R.s were never built with any understanding of the rituals of care or the user experience of physicians or nurses. A clinician will make roughly 4,000 keyboard clicks during a busy 10-hour emergency-room shift

In the process, our daily progress notes have become bloated cut-and-paste monsters that are inaccurate and hard to wade through. A half-page, handwritten progress note of the paper era might in a few lines tell you what a physician really thought

so much of the E.H.R., but particularly the physical exam it encodes, is a marvel of fiction, because we humans don’t want to leave a check box empty or leave gaps in a template.

For a study, my colleagues and I at Stanford solicited anecdotes from physicians nationwide about patients for whom an oversight in the exam (a “miss”) had resulted in real consequences, like diagnostic delay, radiation exposure, therapeutic or surgical misadventure, even death. They were the sorts of things that would leave no trace in the E.H.R. because the recorded exam always seems complete — and yet the omission would be glaring and memorable to other physicians involved in the subsequent care. We got more than 200 such anecdotes.

The reason for these errors? Most of them resulted from exams that simply weren’t done as claimed. “Food poisoning” was diagnosed because the strangulated hernia in the groin was overlooked, or patients were sent to the catheterization lab for chest pain because no one saw the shingles rash on the left chest.

I worry that such mistakes come because we’ve gotten trapped in the bunker of machine medicine. It is a preventable kind of failure

How we salivated at the idea of searchable records, of being able to graph fever trends, or white blood counts, or share records at a keystroke with another institution — “interoperability”

The seriously ill patient has entered another kingdom, an alternate universe, a place and a process that is frightening, infantilizing; that patient’s greatest need is both scientific state-of-the-art knowledge and genuine caring from another human being. Caring is expressed in listening, in the time-honored ritual of the skilled bedside exam — reading the body — in touching and looking at where it hurts and ultimately in localizing the disease for patients not on a screen, not on an image, not on a biopsy report, but on their bodies.

What if the computer gave the nurse the big picture of who he was both medically and as a person?

a professor at M.I.T. whose current interest in biomedical engineering is “bedside informatics,” marvels at the fact that in an I.C.U., a blizzard of monitors from disparate manufacturers display EKG, heart rate, respiratory rate, oxygen saturation, blood pressure, temperature and more, and yet none of this is pulled together, summarized and synthesized anywhere for the clinical staff to use

What these monitors do exceedingly well is sound alarms, an average of one alarm every eight minutes, or more than 180 per patient per day. What is our most common response to an alarm? We look for the button to silence the nuisance because, unlike those in a Boeing cockpit, say, our alarms are rarely diagnosing genuine danger.

By some estimates, more than 50 percent of physicians in the United States have at least one symptom of burnout, defined as a syndrome of emotional exhaustion, cynicism and decreased efficacy at work

It is on the increase, up by 9 percent from 2011 to 2014 in one national study. This is clearly not an individual problem but a systemic one, a 4,000-key-clicks-a-day problem.

The E.H.R. is only part of the issue: Other factors include rapid patient turnover, decreased autonomy, merging hospital systems, an aging population, the increasing medical complexity of patients. Even if the E.H.R. is not the sole cause of what ails us, believe me, it has become the symbol of burnou

burnout is one of the largest predictors of physician attrition from the work force. The total cost of recruiting a physician can be nearly $90,000, but the lost revenue per physician who leaves is between $500,000 and $1 million, even more in high-paying specialties.

I hold out hope that artificial intelligence and machine-learning algorithms will transform our experience, particularly if natural-language processing and video technology allow us to capture what is actually said and done in the exam room.

as with any lab test, what A.I. will provide is at best a recommendation that a physician using clinical judgment must decide how to apply.

True clinical judgment is more than addressing the avalanche of blood work, imaging and lab tests; it is about using human skills to understand where the patient is in the trajectory of a life and the disease, what the nature of the patient’s family and social circumstances is and how much they want done.

Much of that is a result of poorly coordinated care, poor communication, patients falling through the cracks, knowledge not being transferred and so on, but some part of it is surely from failing to listen to the story and diminishing skill in reading the body as a text.

As he was nearing death, Avedis Donabedian, a guru of health care metrics, was asked by an interviewer about the commercialization of health care. “The secret of quality,” he replied, “is love.”/•/

Shigir Idol

Dug out of a peat bog by gold miners in 1890, the relic, or what’s left of it, is carved from a great slab of freshly cut larch.

Scattered among the geometric patterns (zigzags, chevrons, herringbones) are eight human faces, each with slashes for eyes that peer not so benignly from the front and back planes.

“Whether it screams or shouts or sings, it projects authority, possibly malevolent authority. It’s not immediately a friend of yours, much less an ancient friend of yours.”

In archaeology, portable prehistoric sculpture is called “mobiliary art.”

The statue’s age was a matter of conjecture until 1997, when it was carbon-dated by Russian scientists to about 9,500 years old, an age that struck most scholars as fanciful.

The statue was more than twice as old as the Egyptian pyramids and Stonehenge, as well as, by many millenniums, the first known work of ritual art.

A new study that Dr. Terberger wrote with some of the same colleagues in Quaternary International, further skews our understanding of prehistory by pushing back the original date of the Shigir Idol by another 900 years, placing it in the context of the early art in Eurasia.

“During the period of rapid cooling from about 10,700 B.C. to 9,600 B.C. that we call the Younger Dryas, no beavers should have been around in the Transurals,” he said.)

Written with an eye toward disentangling Western science from colonialism, Dr. Terberger’s latest paper challenges the ethnocentric notion that pretty much everything, including symbolic expression and philosophical perceptions of the world, came to Europe by way of the sedentary farming communities in the Fertile Crescent 8,000 years ago.

“It’s similar to the ‘Neanderthals did not make art’ fable, which was entirely based on absence of evidence,

Likewise, the overwhelming scientific consensus used to hold that modern humans were superior in key ways, including their ability to innovate, communicate and adapt to different environments.

Nonsense, all of it.”

makes it clear that arguments about the wealth of mobiliary art in, say, the Upper Paleolithic of Germany or France by comparison to southern Europe, are largely nonsensical and an artifact of tundra (where there are no trees and you use ivory, which is archaeologically visible) versus open forest environments

The Shigir Idol, named for the bog near Kirovgrad in which it was found, is presumed to have rested on a rock base for perhaps two or three decades before toppling into a long-gone paleo-lake, where the peat’s antimicrobial properties protected it like a time capsule.

“It was not a scientific construction,”

“The rings tell us that trees were growing very slowly, as the temperature was still quite cold,”

Dr. Terberger respectfully disagrees.

“The landscape changed, and the art — figurative designs and naturalistic animals painted in caves and carved in rock — did, too, perhaps as a way to help people come to grips with the challenging environments they encountered.”

And what do the engravings mean? Svetlana Savchenko, the artifact’s curator and an author on the study, speculates that the eight faces may well contain encrypted information about ancestor spirits, the boundary between earth and sky, or a creation myth.

The temple’s stones were carved around 11,000 years ago, which makes them 1,500 years younger than the Shigir Idol.

One could wonder how many similar pieces have been lost over time due to poor preservation conditions.”

The similarity of the geometric motifs to others across Europe in that era, he added, “is evidence of long-distance contacts and a shared sign language over vast areas. The sheer size of the idol also seems to indicate it was meant as a marker in the landscape that was supposed to be seen by other hunter-gatherer groups — perhaps marking the border of a territory, a warning or welcoming sign.”

“What do you think is the hardest thing to find in the Stone Age archaeology of the Urals?”A pause: Sites?“No,” he said, sighing softly. “Funding.”

Yet the almost sing-songy declaration “I’m so OCD!” seems to be everywhere.

People with a common type of OCD can even have paralyzing anxiety over their own sexual orientation.

Since absolute certainty is rarely possible, almost no reassurance clears the yes, but hurdle, and that keeps the anxiety wheels spinning.

It’s common for people with OCD to believe that if they check the stove just once more, or Google just one more symptom of a disease they’re convinced they’ve got, then their mind will be clear.

“The brain is conditioned to alert us to anything that threatens our survival, but this system is malfunctioning in OCD,” says psychologist Steven Phillipson, clinical director of the Center for Cognitive-Behavioral Psychotherapy in New York City. “That can result in a tsunami of emotional distress that keeps your attention absolutely focused.”

For the person with OCD, he explains, the brain is signaling what feels like a life and death risk, and it’s hard to put a price on survival.

“Performing the ritual just convinces it that the danger is real and that only perpetuates the cycle.”

“It’s the moment when a panic marries a concept,”

If you can live with the uncertainty those dangers can cause—even if they make you uncomfortable—you likely don’t have OCD, or at least not a very serious case of it. If the anxiety is so great it consumes your thoughts and disrupts your day, you may have a problem.

Medications, including certain antidepressants, are often a big part of the solution, but psychotherapy—especially cognitive behavioral therapy (CBT)—can be just as effective.

progress up the ladder of perceived danger

"If you're Latino, you'll get less pain medication than a white patient. If you're an elderly woman, you'll receive fewer life-saving interventions than an elderly man. If you're a man being evaluated for a job as a lab manager, you will be given more mentorship, judged as more capable, and offered a higher starting salary than if you were a woman. If you are an obese child, your teacher is more likely to assume you're less intelligent than if you were slim."

"Damn," I thought. "I just racially profiled a black man -- and I'm black!"

The experience didn't just humble me, it scared me. If I -- someone who is black and has read about race and bias for years -- could act like this, what was possible for others who never thought much about these issues?

Perhaps there's another way. Our language and behavior should evolve. We shouldn't talk about racism, for example, as an either/or proposition: Use a slur and you're the Grand Imperial Wizard of the KKK; if you've never used one you're free of intolerance.

Here's a little secret that I think many minorities can identify with. Sure, we get angry when people get caught saying or doing the wrong thing. But we get angrier when others claim they could never be like those people.

One of my best friends is a fellow bigot -- a white minister I've known for years. He freely admits he still struggles with the racism he absorbed growing up in the segregated South.

We should never retreat from calling out the unapologetic cruelty that we see flashed across social media.

The great problem of our shared social existence is not wanting things, it’s wanting things because they are someone else’s.

Desire for what the other person has brings about a situation in which individuals in a community grow more similar to one another over time in a process of competition-cum-emulation. Such dual-natured social encounters, more precisely, are typical of people who are socially more or less equal

In relation to a movie star who does not even know some average schlub exists, that schlub can experience only emulation (this is what Girard calls “external mediation”), but in relation to a fellow schlub down the street (a “neighbor” in the Girardian-Biblical sense), emulation is a much more intimate affair (“internal mediation”, Girard calls it)

This is the moment of what Girard calls “mimetic crisis”, which is resolved by the selection of a scapegoat, whose casting-out from the community has the salvific effect of unifying the opposed but undifferentiated doubles

In a community in which the mimetic mechanism has led to widespread non-differentiation, or in other words to a high degree of conformity, it can however happen that scapegoating approaches something like the horror scenario in Shirley Jackson’s 1948 tale, “The Lottery”

As a modest theory of the anthropology of punishment, these observations have some promise.

he is a practically-minded person’s idea of what a theorist is like. Girard himself appears to share in this idea: a theorist for him is someone who comes up with a simple, elegant account of how everything works, and spends a whole career driving that account home.

Girard is not your typical French intellectual. He is a would-be French civil-servant archivist gone rogue, via Bloomington, Baltimore, Buffalo, and finally at Stanford, where his individual brand of New World self-reinvention would be well-received by some in the Silicon Valley subculture of, let us say, hyper-Whitmanian intellectual invention and reinvention.

Most ritual, in fact, strikes me as characterized by imitation without internal mediation or scapegoating.

I do not see anything more powerfully explanatory of this phenomenon in the work of Girard than in, say, Roland Barthes’s analysis of haute-couture in his ingenious 1967 System of Fashion, or for that matter Thorstein Veblen on conspicuous consumption, or indeed any number of other authors who have noticed that indubitable truth of human existence: that we copy each other

whatever has money behind it will inevitably have intelligent-looking people at least pretending to take it seriously, and with the foundation of the Imitatio Project by the Thiel Foundation (executive director Jimmy Kaltreider, a principal at Thiel Capital), the study and promotion of Girardian mimetic theory is by now a solid edifice in the intellectual landscape of California.

with Girard what frustrates me even more is that he does not seem to detect the non-mimetic varieties of desire

Perhaps even more worrisome for Girard’s mimetic theory is that it appears to leave out all those instances in which imitation serves as a force for social cohesion and cannot plausibly be said to involve any process of “internal mediation” leading to a culmination in scapegoating

the idea that anything Girard has to say might be particularly well-suited to adaptation as a “business philosophy” is entirely without merit.

dancing may be given ritual meaning — a social significance encoded by human bodies doing the same thing simultaneously, and therefore in some sense becoming identical, but without any underlying desire at all to annihilate one another. It is this significance that the Australian poet Les Murray sees as constituting the essence of both poetry and religion: both are performed, as he puts it, “in loving repetition”.

There are different kinds of theorist, of course, and there is plenty of room for all of us. It is however somewhat a shame that the everything-explainers, the hammerers for whom all is nail, should be the ones so consistently to capture the popular imagination

Part of Girard’s appeal in the Silicon Valley setting lies not only in his totalizing urge, but also in his embrace of a certain interpretation of Catholicism that stresses the naturalness of hierarchy, all the way up to the archangels, rather than the radical egalitarianism of other tendencies within this faith

Girard explains that the positive reception in France of his On Things Hidden Since the Foundation of the World had to do with the widespread misreading of it as a work of anti-Christian theory. “If they had known that there is no hostility in me towards the Church, they would have dismissed me. I appeared as the heretic, the revolted person that one has to be in order to reassure the media

Peter Thiel, for his part, certainly does not seem to feel oppressed by western phallocracy either — in fact he appears intent on coming out somewhere at the top of the phallocratic order, and in any case has explicitly stated that the aspirations of liberal democracy towards freedom and equality for all should rightly be seen as a thing of the past. In his demotic glosses on Girard, the venture capitalist also seems happy to promote the Girardian version of Catholicism as a clerical institution ideally suited to the newly emerging techno-feudalist order.

Blame the much-documented rise of the “hookup culture” among young people, characterized by spontaneous, commitment-free (and often, alcohol-fueled) romantic flings. Many students today have never been on a traditional date,

Hookups may be fine for college students, but what about after, when they start to build an adult life? The problem is that “young people today don’t know how to get out of hookup culture,”

In interviews with students, many graduating seniors did not know the first thing about the basic mechanics of a traditional date. “They’re wondering, ‘If you like someone, how would you walk up to them? What would you say? What words would you use?’ ”

Traditional courtship — picking up the telephone and asking someone on a date — required courage, strategic planning and a considerable investment of ego (by telephone, rejection stings). Not so with texting, e-mail, Twitter or other forms of “asynchronous communication,” as techies call it. In the context of dating, it removes much of the need for charm; it’s more like dropping a line in the water and hoping for a nibble.

Online dating services, which have gained mainstream acceptance, reinforce the hyper-casual approach by greatly expanding the number of potential dates. Faced with a never-ending stream of singles to choose from, many feel a sense of “FOMO” (fear of missing out), so they opt for a speed-dating approach — cycle through lots of suitors quickly.

“I’ve seen men put more effort into finding a movie to watch on Netflix Instant than composing a coherent message to ask a woman out,” said Anna Goldfarb, 34, an author and blogger in Moorestown, N.J. A typical, annoying query is the last-minute: “Is anything fun going on tonight?” More annoying still are the men who simply ping, “Hey” or “ ’sup.”

The mass-mailer approach necessitates “cost-cutting, going to bars, meeting for coffee the first time,” he added, “because you only want to invest in a mate you’re going to get more out of.”

in  a world where “courtship” is quickly being redefined, women must recognize a flirtatious exchange of tweets, or a lingering glance at a company softball game, as legitimate opportunities for romance, too.

THERE’S another reason Web-enabled singles are rendering traditional dates obsolete. If the purpose of the first date was to learn about someone’s background, education, politics and cultural tastes, Google and Facebook have taken care of that.

Dodgy economic prospects facing millennials also help torpedo the old, formal dating rituals. Faced with a lingering recession, a stagnant job market, and mountains of student debt, many young people — particularly victims of the “mancession” — simply cannot afford to invest a fancy dinner or show in someone they may or may not click with.

“Maybe there’s still a sense of a man taking care of a woman, but our ideology is aligning with the reality of our finances,” Ms. Rosin said. As a man, you might “convince yourself that dating is passé, a relic of a paternalistic era, because you can’t afford to take a woman to a restaurant.”

“A lot of men in their 20s are reluctant to take the girl to the French restaurant, or buy them jewelry, because those steps tend to lead to ‘eventually, we’re going to get married,’ ” Mr. Edness, 27, said. In a tight economy, where everyone is grinding away to build a career, most men cannot fathom supporting a family until at least 30 or 35, he said.

Even in an era of ingrained ambivalence about gender roles, however, some women keep the old dating traditions alive by refusing to accept anything less. Cheryl Yeoh, a tech entrepreneur in San Francisco, said that she has been on many formal dates of late — plays, fancy restaurants. One suitor even presented her with red roses. For her, the old traditions are alive simply because she refuses to put up with anything less. She generally refuses to go on any date that is not set up a week in advance, involving a degree of forethought. “If he really wants you,” Ms. Yeoh, 29, said, “he has to put in some effort.”

The history of Europe since the 18th century has been the story of successive attempts to find alternatives to God as an object of worship, among them the nation state, race and the Communist Manifesto. After this cost humanity two world wars, a Cold War and a hundred million lives, we have turned to more pacific forms of idolatry, among them the market, the liberal democratic state and the consumer society,

This is what a society built on materialism, individualism and moral relativism looks like. It maximises personal freedom but at a cost.

This freedom, energising and exciting as it is, is also profoundly disintegrative, making it very difficult for individuals to find any stable communal support, very difficult for any community to count on the responsible participation of its individual members. It opens solitary men and women to the impact of a lowest common denominator, commercial culture.’

In one respect the new atheists are right. The threat to western freedom in the 21st century is not from fascism or communism but from a religious fundamentalism combining hatred of the other, the pursuit of power and contempt for human rights.

But the idea that this can be defeated by individualism and relativism is naive almost beyond belief. Humanity has been here before.

The barbarians win. They always do.

The new barbarians are the fundamentalists who seek to impose a single truth on a plural world. Though many of them claim to be religious, they are actually devotees of the will to power. Defeating them will take the strongest possible defence of freedom, and strong societies are always moral societies

That does not mean that they need be religious. It is just that, in the words of historian Will Durant, ‘There is no significant example in history, before our time, of a society successfully maintaining moral life without the aid of religion.’

I have not yet found a secular ethic capable of sustaining in the long run a society of strong communities and families on the one hand, altruism, virtue, self-restraint, honour, obligation and trust on the other

A century after a civilisation loses its soul it loses its freedom also. That should concern all of us, believers and non-believers alike.