BMJ article on gender dysphoria issues

A few weeks ago, the British Medical Journal carried two educational articles about management of gender dysphoria in the non-specialist setting (one written by a gender dysphoria specialist with input from patients, and one a collection of advice from transgender people). Transgender people can have some significant problems with healthcare both for their gender dysphoria care and for their general care, so, although this only affects a small minority of the population, this is an issue it’s important for me as a GP to be aware of.

I have a separate site where I keep the notes I make on any medical articles or educational modules I read, in order to refer back to them later. This time, however, I thought I might post them here; after all, transgender health care is an important topic to many people here. Here are the points covered by the articles:

  • When someone comes to you expressing problems with gender identity (‘you’, here, meaning GPs, not the general population), offer them referral to gender identity services ASAP. Waiting lists are horrendous, so, if a patient does want to explore the possibility of transitioning, the sooner they get on the waiting list to do so the better. As a GP, I’m very schooled in the approach of “let’s wait a bit and see how this goes with time”, and for a large proportion of the patients I see that is perfectly appropriate, but gender dysphoria is one of the situations where it isn’t. The gender identity services themselves will be the ones who can offer expert assessment and help patients reach an informed decision regarding transitioning. (As one of the patients in the second article pointed out, gender identity treatment has one of the highest satisfaction rates of any branch of medicine. Puts the desistance myth into perspective, doesn’t it?)
  • Take the trouble to find out what name and pronouns your patient wants to use, and use them. That, frankly, is just basic courtesy. However, be aware that, for safety reasons, a patient may need letters to be addressed to their old name for the time being (if they’re living with family members who are against the transition and unsupportive or even threatening over it). Use their new name and pronouns when discussing them with other healthcare personnel; it’s a way of respecting their gender even when they’re not there.
  • Transgender people who haven’t yet accessed proper treatment may be self-medicating with hormones purchased online. Ask about this and advise that it does carry risks and that ideally it should be stopped until the person is seen by the gender identity clinic. Of course, given the waiting lists, there’s a gulf here between ‘ideally’ and ‘bearably’. If a person can’t face stopping medication for the time it’ll take to get seen, advise them to let us know of side effects and to let healthcare practitioners they see know about the medication.*
  • Suggest informal on-line support groups while a patient is waiting to be seen. Tranzwiki.net was the example given.
  • Some surgical treatment can take place locally, such as hysterectomy/oophorectomy; however, do bear in mind that a person who has become visibly male may feel very awkward about attending a gynaecological clinic. One possibility suggested was that a patient in this situation could get a woman to accompany him to the clinic, if possible, so that he wouldn’t stand out as a solitary male in a sea of female patients.
  • Screening can raise unexpected problems. For one thing, gender-based automated systems in the NHS are not set up to deal with patients who’ve changed gender, and so they may not be called automatically for screening they should actually have (aortic aneurysm screening for MTF, cervical screening for FTM who still have a cervix in situ). Remember that the form that goes with the sample will need to clarify what’s going on so that the lab doesn’t simply assume that the cervical smear sample labelled as coming from Mr Fred Jones, M, to be a mistake. For another thing, the screening tools for things like risk of cardiovascular events or fractures include gender as one of the factors used to calculate risk, and the data on transgender people in this context simply doesn’t exist. It’s necessary to do some common-sense estimating and explain the uncertainties to the person in question.
  • On the topic of screening, the article also stated that AMAB women do not need routine mammography as, in the absence of progesterone, their risk of breast cancer is too low for it to be needed.
  • Conversely, an AFAB male who still has breasts should be advised to have mammography if in that age group, but may find it distressing to discuss the matter. The article ‘I am your transgender patient’ suggested that talking about ‘chest’ rather than ‘breasts’ might be easier for some men in this situation.
  • There isn’t any single rule or guideline for how transgender people feel about their gender, their identity, or their gender-specific body parts. They might be very distressed by some, quite comfortable with others. It’ll vary from person to person. This is one of the (many) situations in medical practice where you have to be sensitive to the person’s cues and willing to find out their wishes and to follow their lead.

 

*This, of course, raises the question of whether GPs in that situation should prescribe hormones themselves rather than leave the patient with the risks of buying hormones on-line. This wasn’t covered by the article. WPATH guidelines do touch on the possibility of ‘bridging’ prescriptions, but it’s a complicated issue that carries the risk of major medicolegal problems for the GP if they prescribe outside their area of expertise, and there are very good reasons why GPs would typically be unwilling to do this. This is beyond the scope of this particular article, which is why I haven’t gone into it further here.

The Don’t-Have-To-Do List

I made it. As I wrote in my last post, the school holidays (six weeks) and my chunk of booked annual leave (one week) both start today. Time, finally, to catch up on the vast amount of things in my life I’ve been letting slide.

Books on organising would probably advise me to write out a To-Do List at this point, but they can get stuffed, since the mere thought of putting everything I have to do into a visible list sends me into AAAAAARRRRRGGGGGHHHHHH NOOOOOOOO mode. Things will just get done when they get done; that’s all. What I did find myself writing out this morning, however, was a Don’t-Have-To-Do List – a list of the things from which I get a reprieve.

Here is the list of things that, over the next nine days (in many cases longer, but minimum of nine days), I will not have to do.

  • Think of lessons for my homeschooled son to do
  • Listen to him complaining about having to do those lessons
  • Wrestle and negotiate with my daughter about her homework
  • Make any packed lunches for anybody
  • Be anywhere by a specific time
  • Rush round in a frenzy as I face the stress of knowing that I’m not going to manage getting to the place I’m supposed to be at a specific time
  • Worry about whether my son’s taxi transport to his tuition centre will turn up on time
  • Figure out what to do about anyone’s medical problems
  • Figure out what to do about anyone’s blood results
  • Write referral letters for anyone

Even knowing how much I do still have to do, it’s truly amazing how much mental space and energy it frees up knowing that I have a break from doing all of that stuff.

Anyone else enjoying a Don’t-Have-To-Do List?

Light at the end of the tunnel

Tomorrow is the last day of the current school year, and hoo boy, you can bet your socks I’ll be glad to see it end. It’s not the end of homeschooling for me, unfortunately, as my son’s school situation is as yet unresolved; we’re hoping to get him back into school at some point in the next school year, but everything’s up in the air at the moment and the one thing that is definite is that it won’t be sorted out by the time September rolls round. But at least I’ll get a few weeks off from the soul-draining pressure of having to come up with vaguely adequate lessons and get my son to do them. It’ll be good to be done with this year for my daughter as well; she did not get on well with her teacher this year at all, and I’ve had to do what I could to deal with the struggles and fallout from that. I will wave this one goodbye with great joy.

As a bonus, I’ve actually got the week off work next week as well. Sheer chance – I had some annual leave to use up, asked my practice manager which days would be least inconvenient to have me missing, and ended up with this week – but it’s exactly what I need right now.

So, I’ll have some time to catch up on the other aspects of my life, and I’m hoping to use at least some of that to get some blogging done. I realise I don’t have a brilliant track record on that count lately, and that I have a heck of a lot of other stuff to catch up on, but at least I can try.

Off now to juggle getting dinner cooked, the laundry done, and logging into work remotely so that I can catch up on as much stuff as possible before my week off. Hope you’re all enjoying some form of relaxing summer and that those of you who are struggling with life can see the light at the end of whatever your personal tunnel right now is.

Why I’m not a believer – what about prayers and personal experience?

This is the fourth in a short series of posts I’m writing about the subject of why, after investigating reasons for theism, I ultimately became a non-believer.

For background: These investigations were in my childhood/teenage years. I grew up in a non-religious household, but was intensely interested in the whole subject from an early age. I regarded the whole question of whether or not there was a God, and, if so, what religion he wanted us to follow, as being an extremely important one; so I put a lot of time into reading and thinking seriously about the subject. These are, as best as I can remember after a thirty-year gap, my reactions at the time to the arguments I found in my reading.

I don’t know whether anyone’s been following this mini-series of posts (probably not, given how long it’s taken me to write it), but anyone who has read through the post series to date may well be wondering why there was even a question in my mind at this point about becoming a non-believer. So far, I’ve written three posts about different arguments for the existence of a god that I came across in my reading, and the overarching theme of all three seems to have been me looking blankly at the argument wondering why on earth this was meant to be even remotely convincing. Why did it take me so long to get to the point of officially declaring myself an atheist, or at least an agnostic?
Well, part of it was the difficulty of proving a negative; I couldn’t prove God didn’t exist, and hadn’t yet realised that that wasn’t in itself an automatic reason for having to take the possibility of his existence seriously without positive evidence for same. And a lot of it was an ‘Emperor’s New Clothes’ effect; so many people seemed so convinced that God existed that I didn’t feel able to dismiss the possibility just like that. Surely, if I kept reading and looking, I would find a more convincing argument one way or the other? Around the next corner? In the next book on the shelf on the religious section in one of the local libraries? But on top of that, there was still one category of evidence that… well, that still wasn’t conclusive, but that did seem to have more to it than the various ineffective arguments I was reading. This was the fact that so many people reported personal experiences of psychologically encountering God, often in compelling and life-changing ways.
As I said, I didn’t find this conclusive. There seemed to be other plausible explanations; after all, if someone really believed God was speaking to them or that God loved them, surely that could lead to the kinds of experiences of bliss and comfort and changed lives that I was reading about. Still, could this be enough to account for the experiences I was reading about? (This wasn’t a rhetorical question; I genuinely wanted to know the answer.)
I tried praying myself, since it seemed the obvious thing to try; if God did exist, this would give him the best chance to let me know directly. Not frenzied wordy prayers, just time in which I did my best to focus my mind on God and open myself to whatever He might be trying to tell me. And, when I did, I certainly noticed something – an inner sense of mental quiet, an awareness of my obligations. I figured that could indeed be God taking the first steps to commune with me. The trouble was, it also seemed the kind of effect that might plausibly be caused by me calming my mind and thinking I was communing with the divine. So which was it? And did the fact that I was even thinking that mean that I was overanalysing it and talking myself out of a genuine relationship with God like the dwarves in C.S. Lewis’s The Last Battle? Or did it just mean that I was exercising appropriate caution? After all, surely there was a risk that if I was too ready to believe I might talk myself into believing I was communing with God when I wasn’t, in much the same way as I’d managed to convince myself at the age of twelve that our house was probably haunted because I thought I could feel a presence there when I thought about it.
I simply didn’t know. This was such an important subject; surely it was incumbent on me to work out what the answer was! But I only found myself getting more confused. One thing was for sure; it all seemed a lot less clear-cut than the authors I was reading on the subject seemed to think.

And so my teenage years went on…

Why I’m not a believer – the ‘But without God we wouldn’t have any morals!’ argument

This is the third in a short series of posts I’m writing about the subject of why, after investigating reasons for theism, I ultimately became a non-believer.

For background: These investigations were in my childhood/teenage years. I grew up in a non-religious household, but was intensely interested in the whole subject from an early age. I regarded the whole question of whether or not there was a God, and, if so, what religion he wanted us to follow, as being an extremely important one; so I put a lot of time into reading and thinking seriously about the subject. These are, as best as I can remember after a thirty-year gap, my reactions at the time to the arguments I found in my reading.

This one is probably self-explanatory, but can be briefly summarised thus: ‘Without God to tell us what to do, we’d all be scratching our heads trying to figure out what right and wrong are, since there is obviously no way anybody could work this out for him/herself without some sort of Supreme Arbiter defining it for us. And you obviously don’t want that to be the case, do you? So better believe in God.’ *

I have to say that this argument, when I read it as a teenager, did send me to particular levels of facepalming “Are they serious?!” In the first place, as you’ve probably noticed, this argument is subject to exactly the same flaws as the ‘But your life is meaningless without God!’ argument that I discussed in my last post; it falls apart logically (to be technical, it has the form of logic flaw known as an argument/appeal from consequences), and it isn’t even factually correct, since, despite not being a believer, I found myself perfectly well able to make the sort of basic distinctions between right and wrong that the authors using this argument were insisting I couldn’t possibly make. But this argument also has an extra flaw over and above the ‘But your life is meaningless without God!’ argument; namely, that the very fact that someone is using it indicates that they don’t actually believe it.

After all, apologists surely use only arguments that they at least think have a chance of being effective? The ‘But your life is meaningless without God!’ argument, despite its flaws, at least has a chance of convincing someone; a person who does feel their life is meaningless is going to want it to be meaningful, so that argument has a potential audience. But a person who doesn’t care about morals… doesn’t care that they don’t care about morals. If we unbelievers genuinely were all indifferent to right and wrong, then we wouldn’t care when someone pointed that deficiency out to us. It would be as meaningless to us as the fact that we don’t keep to kosher dietary laws. The very fact that apologists use the no-morals-without-God argument as an attempt to convert non-believers shows that – at least on some level – they know perfectly well that morals matter to non-believers.

I was quite intrigued by the twisting of logic that must be required to use an argument that could only be used if you didn’t believe it was true. Surely there has to be a name for that particular logic flaw? Maybe not; I can’t think of any other examples of it that I’ve heard. If anyone knows what that logic flaw would be called, do please tell me!

*Note that CS Lewis, in Mere Christianity, used a different type of pro-theism moral argument which effectively contradicts this one; the argument that precisely because we all have innate knowledge of right and wrong, we can conclude that God must exist, on the basis that the only way such innate knowledge could exist within us would be if a deity had caused us all to be born with this type of instinctive knowledge. While I don’t agree with that form of the argument either, I do find it rather better than this form. However, I’m writing this as the story of what arguments I looked at when originally deciding whether I should believe in God or not, and this particular argument was one I didn’t run across until some years later; therefore, in the interest of vaguely chronological accuracy, I’ll leave it to a later post.

Why I’m not a believer – the ‘But your life is meaningless without God!’ argument

This is the second in a short series of posts I’m writing about the subject of why, after investigating reasons for theism, I ultimately became a non-believer.

For background: These investigations were in my childhood/teenage years. I grew up in a non-religious household, but was intensely interested in the whole subject from an early age. I regarded the whole question of whether or not there was a God, and, if so, what religion he wanted us to follow, as being an extremely important one; so I put a lot of time into reading and thinking seriously about the subject. These are, as best as I can remember after a thirty-year gap, my reactions at the time to the arguments I found in my reading.

The ‘But your life is meaningless without God!’ argument almost got left out of this list, as it was such a poor argument I’d actually forgotten about it; however, I was reading John Blanchard’s ‘Does God Believe In Atheists?’, which spends a lot of time on it, and I thought ‘Oh, yes… now I come to think of it, I do recall coming across this when I was researching the whole God subject’. So here it is.

This argument consists of telling the reader or hearer, in impassioned terms, about… well, obviously, about how meaningless lives are without God, with the implication that we should therefore believe in God. Or, to put it another way, ‘We should believe in God because we really want [our version of] Him to exist’.

This is what is technically known as an argument from consequences (or, if you want to get fancy about it, an argumentum ad consequentiam) – the claim that a particular viewpoint is true because the consequences of it being false would be bad. (Or, conversely, that a particular viewpoint is false because the consequences of it being true would be bad.) It’s the logic flaw that’s the downfall of the cancer sufferer who ignored that lump or worrying symptom for too long because they didn’t want it to turn out to be cancerous, the gamblers who convinced themselves that that long shot just had to pay off because they so much wanted it to.

It can work if used as an appeal to emotion, but it’s an argument too flawed to stand up in the light of day. Which is why you will probably never see anyone spell it out quite as blatantly as I did a couple of paragraphs above – if anyone attempting this argument ever did explicitly state ‘And because it feels so awful not to believe in God, God must therefore exist’ then the crashing failure of logic would (hopefully) be far too obvious to take seriously.

(Ironically, if this type of argument actually had worked well in converting me, it would have backfired on any Christian apologist who tried it, since I always found the idea behind Christianity quite horrifying. The idea of God existing – a wise, kind, all-knowing being in charge of the universe and steering its ultimate destiny – sounded lovely to me, and I always hoped my studies would lead me to theism as a conclusion. But the idea that this being had set things up so that people would burn in hell forever simply for having the wrong beliefs? It appalled me. If I hadn’t recognised the fallacy behind this sort of believe-what-you-want-to-believe argument, I’d have rejected Christianity in a heartbeat without further thought, simply because I so much didn’t want it to be true.*)

A more important problem I had with this argument as a teenager, however, was that the premise was so obviously false. Plain and simple, my life did have meaning without God. Plenty of meaning. I loved being alive, I loved enjoying life’s pleasures, I loved looking forward to everything life had to bring. Sure, I liked the idea of a God existing (as long as it was a nice one, not the horrible variety of god that I was hearing about from Christian sources), but I was in no way dependent on God’s existence for finding meaning in my life.

So all of these arguments about how meaningless life was without God got a rather blank look from me. I was sorry for the people who felt that way, who obviously needed very much to hold on to their beliefs and who seemed to struggle inexplicably with enjoying life for its own sake; but their attempts to persuade me that I felt the same way simply fell flat.

 

*Obviously, I ended up rejecting Christianity anyway. But I did so only after spending a lot of time, over many years, reading and thinking about the various arguments and holding myself to strict standards in terms of whether I felt any particular argument actually disproved the belief system or not. It was not just a case of ‘I don’t want to believe it so I’ll assume it’s not true.’ (All of which will make for another post series which I do hope eventually to get round to writing.)

Why I’m not a believer – the ‘So how could X have happened without God?’ arguments

This is the first in a short series of posts I’m writing about the subject of why, after investigating reasons for theism, I ultimately became a non-believer.

For background: These investigations were in my childhood/teenage years. I grew up in a non-religious household, but was intensely interested in the whole subject from an early age. I regarded the whole question of whether or not there was a God, and, if so, what religion he wanted us to follow, as being an extremely important one; so I put a lot of time into reading and thinking seriously about the subject. These are, as best as I can remember after a thirty-year gap, my reactions at the time.

The ‘So how could X have happened without God?’ arguments, as I now think of them, are the main ones I remember coming across in this period of reading and examining different arguments for theism. Looking back from a perspective of somewhat greater knowledge of the debate field, I think I was getting my kalam cosmologicals lumped in with my design arguments (for the uninitiated, the kalam cosmological argument is a philosophical argument around the supposed necessity of a First Cause for the universe to exist at all, and the design argument is the argument that various specific aspects of the universe couldn’t possibly have reached their current form without a creator). But the basic formula always seemed to be to be similar; how could [the universe, the origin of life, some specific complex aspect of life-forms] have possibly happened without God to bring it about?

I didn’t, of course, know. I just didn’t see how that could logically lead to a certainty that ‘God did it’ must be the only possible answer.

I was perplexed. Scientists were continually working to find out new knowledge, and, as a result of this, we now knew the answers to a lot of questions about the universe that baffled humans in the past. So surely the most logical assumption to make about any question about the universe to which we didn’t know the answer was that that sentence should probably end in ‘…yet’? Why should we leap straight to assuming that this question, unlike the many that baffled humanity similarly in the past, will be insoluble? And, as long as the possibility exists of us someday finding a natural process that could explain this problem, surely we can’t logically use its existence as an argument for the existence of God?

Of course, there was a logical difficulty with that approach as well; it also couldn’t be used to prove the non-existence of God. After all, let’s suppose that the answer to one of those ‘How could X have happened without God?’ conundrums actually was ‘It couldn’t; this time, God really did do it’. How could we exclude that possibility, given that ‘We don’t yet know what natural process caused X’, and ‘X happened because of God’ were effectively indistinguishable for any as-yet-unanswered question for as long as it remained unanswered?

I thought it over, and pictured a scenario: Scientists the world over throw up their collective hands, declaring “We’re stumped. We have absolutely no idea how this could have happened through natural causes. We don’t even have any theories left as to how to investigate this. We’re clear out of ideas.” The years go by, scientists continue to rack their brains, and yet no-one can come up with a thing. At that point, it seemed to me, theists really would have a good case – not watertight, but very good indeed – for saying “It must have been God.” And, if that happened, I would take that seriously as an argument.

Until and unless that happened, though, I couldn’t see how the argument held water. I couldn’t see any way that ‘How could X have happened without God?’ questions could be used to establish the existence or otherwise of a god.

Why I am not a religious believer

When I first started atheist-blogging, on a blog prior to this one, I figured the obvious place to start would be with the story of how and why I became an atheist. So I wrote a series of posts about the story; about growing up in a non-practicing family of mixed religious heritage, about considering different religions, and about eventually becoming first an agnostic and ultimately an atheist. Looking back, there’s a rather important aspect of the story I didn’t cover; the details of why I ended up as a non-believer rather than a believer. The short answer to that, of course, is that I didn’t find any of the supposed evidence to be convincing; but it would be worth blogging about the question of why I didn’t.

I’m therefore going to write a short series of posts on the arguments I encountered while researching the question of whether or not God existed, my reaction to them, and why I ultimately found each of them unconvincing. I weighed up the evidence as well and fairly as I could, and I’ll try to do the same in recounting it (although bear in mind that I’m relating things that mostly occurred thirty or more years ago). I’ll link each of them back to this post to give me a single place to refer back to if the general question ‘So, why are you an atheist?’ ever comes up.

(Note that – as indicated by the title – this is the story of why I’m an atheist in the sense of why I’m not a believer. The story of why I’m now an atheist rather than an agnostic is a simpler and quicker one which can be found at the fourth of the above links. Which I’ll repeat here, in case you don’t want to bother counting them.)

(Quick edit – This series will cover general arguments for the existence of God. I also spent a lot of time researching the more specific issue of whether I should believe in Christianity, but, while that’s obviously a linked subject, it’s still a separate one which I hope to cover in a separate series of posts at some point in the future. Therefore, any arguments regarding the Christian faith specifically won’t be covered in this series.)

Links to posts:

‘So how could X have happened without God?’

‘But your life is meaningless without God!’

‘But without God we wouldn’t have any morals!’

‘What about praying and personal experiences?’

What I’ve been reading – The Maze Runner trilogy

(Content note – This post contains spoilers for the books. Also mention of post-apocalyptic scenarios, though I don’t go into that bit very much. Also, at the end, a bit about fantasy high-tech medical stuff described in more graphic terms than you might want to hear.)

Caveat: I read the first book and the first part of the second book, but then skim-flipped from there through to the end of the third, as by then they’d moved into the ‘post-apocalyptic wasteland populated by crazed, doomed survivors’ part of the setting, which is something that just doesn’t float my boat. It is therefore possible that I might have missed an explanation that made at least somewhat more sense out of the plot. If so, do let me know, and my apologies.

Anyway, this is going to be a summary of my thoughts on the trilogy as a whole. If you want a really good chapter-by-chapter deconstruction of the first book, do check out Whitley Birks’ excellent review (plus her other reviews while you’re there; it’s a superb blog with all kinds of interesting points about what well-known authors got horribly wrong through lazy research/not doing the writing).

Here’s the overriding impression with which this trilogy left me: the author had a lot of good ideas but then had no idea how to write a coherent plot that would properly account for them all.

I mean, you can picture James Dashner thinking “Hey, wouldn’t it be cool to write about a large group of children trapped in a meadow in the middle of a maze, with no idea what was going on! Or for them to have some sort of trial that involved making their way a hundred miles across a post-apocalyptic wasteland within a time limit! Or to have a dilemma about whether it’s OK to do terrible things to children if it’s the only chance of saving the world! Or a government agency with the acronym WICKED and the slogan ‘WICKED is good’ and amnesiac people remembering this slogan but having no idea what it means! Doesn’t that sound great?”

And, yes… it was. For a while. Right up until the point where we got what was supposed to be the Big Reveal explanation for each of those. At which point I would be looking at it and thinking “What?! That doesn’t make any sense! What about…??”

Main plot points that evoked the “What?! That doesn’t make any sense!” explanation from me:

The reason WICKED are experimenting on the children is to find a cure for a deadly plague (known as the Flare) which is ravaging the rest of the human race; most of the children are naturally immune (some of them are apparently there as control subjects) so WICKED desperately need to study the children and find out what accounts for their immunity, in hopes of finding a cure for everyone else. So far, so good. The trouble is, they’re doing it by studying the way their brains function (by putting them through various stressful situations and monitoring their responses). Which makes no sense whatsoever. If you want to know what makes someone immune to an illness, surely you start by studying their immune system? Tissue biopsies of the brain would probably also be useful, but the only time we see WICKED trying to do that, it’s when they want to dissect Thomas’s entire brain (and only Thomas’s – they don’t seem to feel any requirement to compare biopsies from a variety of the children).

They’re also, apparently, taking a bizarrely long time to do this. The children get taken away from their parents at an early age and kept by WICKED for years until they’re old enough to take part in the Maze trials, which then go on for two more years. Since the time from infection by the Flare virus to destruction of your functioning brain doesn’t, from what I could see, seem to be that long – how exactly is it that the virus hasn’t wiped out everyone non-immune during those years and left the whole question of a cure moot?

WICKED are also quite extraordinarily profligate with money. The Maze walls, we are told, are hundreds of feet high and move into different positions every night. (Wait, what?! How do you even make a wall that high stable enough to be moved?? Now I’m all ‘Ye canna change the laws of physics, laws of physics, Cap’n!’ and that wasn’t even the plot hole I was about to discuss.) We also learn that the Maze is eight times the size of the central area (the Glade) which is in itself the size of eight football fields, so that is one bloody big maze. All made out of moveable walls hundreds of feet high. And the children live there for two years, with the walls being moved every night and supplies being sent in weekly. In fact, we learn in the second book that there are two such groups of children, not just one. So… how much did all this cost?? The cost of first building and then maintaining two such mazes would be… so colossally expensive that we need a new term for ‘colossally expensive’. I mean, which planet do you sell to whom in order to finance something like that? And this is all meant to be taking place in a post-apocalyptic world when even basic services are likely to be going belly-up. (We are told at one point in the third book that WICKED have managed to corner available funding and resources due to being the only ones holding out the promise of a cure, but… funding and resources available for cornering at that point are still not going to be that great.)

So, are we seriously meant to believe that at absolutely no point in the design of the Mazes did anyone in charge point out “Hey, I realise walls hundreds of feet high sound exciting, but surely we can get the same effect at a fraction of the price by making the walls something like eight or ten feet high”? Or that at no point during the two years that all this was going on and that both groups of children were making zero progress on cracking the code or figuring out how to escape did anyone say”‘Guys, this experiment isn’t getting us anywhere and you can’t justify claiming these levels of funds any longer. Find something to hurry it up”? I’m sorry, I just do not buy the idea that any government agency anywhere in the history of government agencies who were, are, or will be can get away with being that blithely unconcerned about funding availability for that long.

Nearly done (not because that’s an exhaustive list, just because it’s a list of the things that bugged me the most) but I do have to mention the Retractor that we learned about in ‘The Death Cure’. This is, supposedly, a hi-tech device that removes implants from the children’s brains by sending wires in via their ear canals. Because apparently Dashner either doesn’t know or doesn’t care that ears aren’t just holes stretching straight through to the brain. You send a wire in through someone’s ear, the first thing it’s going to meet is the eardrum, which seals the outer canal off completely from the middle ear. Go through that, and you’re getting into some complex and delicate anatomy – the tiny bones of the middle ear, and the inner-ear organs that process sounds and monitor your balance. I’m a GP, not an ENT surgeon, but trying to pull an implant out via that lot strikes me as a really bad idea.

Also, since they are apparently going for this appallingly bad via-the-ear plan, why do the Retractors go on the children’s faces to perform this procedure? Wouldn’t it make far more sense for them to go on one side of the head? I mean, if it’s on the face, the wire it sends out has to curve sideways and downwards to find the ear and then upwards and forwards again to negotiate the ear canal… I think Dashner was, once again, going for the ‘this is such a cool scary image’ approach over actual practicalities.

OK, I’m done. What did everyone else think of the books? Did I miss anything important? Do let me know.

Happy blogging anniversary!

Yes, indeed – ’tis one year exactly since the day when I received the great news that I had been granted the high honour of a FreeThoughtBlogs blog. Since then, I’ve been privileged to get to know some great people and, of course, to actually post on here on those admittedly infrequent occasions when I get time to do so.

I know I haven’t posted nearly as often as I’d like to, but I’m still thrilled to be here; getting this blog really was one of the best things that happened to me in 2016, and that would be the case even if it hadn’t been a basically sucky year overall. So, happy blogging anniversary to me and to the many other bloggers who started at the same time as I did.

(Aaaaaaand… I am marking the day appropriately by, once again, being almost late for dinner, which is more of a problem this time since I’m the one making it. So, apologies for the brevity of this, but I must go.)