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People living through the Dark Ages don’t necessarily notice it.  It’s not like a film noir version of the Plague or something.  All the people things that people do, go on unabated.  They marry, they have children, they grow food and play.  Dark Ages are different than famines and plagues – the society and its technology curdles and rots, slowly, without much interest from the populace.

Concrete

I’m particularly bothered that the recipe for concrete was lost.  It was well known by the Romans in its various forms, such as hydraulic cement, which can even be poured and set under water.  The artificial harbor of Caesarea was built using hydraulic concrete.  It was a popular building material for setting foundations and creating structural elements in architecture.

Then the recipe was just forgotten.

It was forgotten because nobody had a need for it anymore.  No artificial harbors or great buildings were being made anymore.  Architecture and building technologies were no longer passed down from teacher to student, and after a few generations, or dozen generations, the occasional curious person would wonder about these perfectly-shaped rough stones, clearly different from the natural stones, that were scattered among the buried relics of the old cities.  It was not a valuable stone, like marble had been – the marble was stripped from the old cities to build cisterns and sheds and such.  This stuff was in the ground as anchor material.

Then the recipe was re-invented.

It was never re-discovered, or at least not until the very latest century or two.  It had to be utterly re-invented.  All of the skills had to be reinvented, discovered anew – of pouring forms, of handling and setting, of fragility to freezing – all of that had to come anew.

The Dark Ages of Medicine

The teaching of medicine, in the traditional bedside manner, is almost gone.  It will be gone in a generation.  We have “reinvented” it to be learned before the Great Blue Eye, that it involves multiple-choice testing and memorizing of rules, as though it were a religious rite to be performed in a certain way.  Students learn A Dance – they do not learn how to dance.

Taylorism

Taylorism, often called “industrial progress,” involves the deliberate extinction of crafts and their substitution by manufactured products.  Some things fit marvelously into Taylorism.  It took a skilled blacksmith less than a minute to produce a wood nail; now, nails are pumped out by the hundreds of thousands to all sorts of specifications, and can be purchased in any size and metal in a hardware store.  There is little to be argued for the skill of handmade nail production, although I have seen backyard blacksmiths make them.

To mass produce something, it must be an object – a thing.  Nails can be mass produced, and nobody seems to mourn the loss of handmade nails on the market.  You can still buy them from a blacksmith – go to a Renaissance fair.  But nobody can mass-produce dancing.  Many things that can only be done by skilled craftsman, who learn techniques and details in the presence of a mentor.  Once the mentors die off and the pupils wander, those things are no longer done; and a generation or two later, they are unknown.

Concrete’s a recipe, right?  Yes, and also no.  Yes, it is a recipe.  But the use of it requires pragmatic familiarity with the stuff.  Look to the old USSR, and hear tales of buildings that began falling apart during construction.  One of the great testaments to idiocy, the Ryu-Gyong Hotel in Pyongyang, North Korea, has been topped out at 105 stories.  Designed by Dear Leader, or Revered Leader, or one of the thugs that has run North Korea, it is still the shell of a building that sheds pieces of concrete from lethal heights, and it is bad luck to walk near it – bad luck, but not at all superstition.

Ryugyong_Hotel_-_August_27_2011_Cropped.jpg

RYUGYONG HOTEL

The North Koreans have all they can possibly read about specifications of materials, the coupling together of disparate substances, of tower construction, all that jazz.  But they cannot make a skyscraper that does not kill people.  It stands as an empty shell.  From there, you can see the Dark Ages of Man.  North Korea had the audacity to build a tower of Babel in the heart of darkness that is Pyongyang.  They got what they needed.

The Tower of New Industrial Medicine

I suggest we ask the NK’s if we can rename the hotel the Tower of Retail American Medicine.  Like the tower, it is impressive.  Like the tower, it is empty.  However, the tower has a habit of only killing one person at a time, sporadically.  That’s a big difference between them.  But neither one will be finished, because of the unfortunate lack of money to accomplish the dream.  Scapegoats can be blamed, the appropriate people can be punished for lack of visionary zeal.  Both are empty, poorly wired and lacking plumbing, and the interior design cannot be changed to make it useful.  And both are deteriorating from the inside-out.

The last generation taught by the bedside system of Francis Peabody are retiring now.  The aging over-fifty physicians are eagerly looking at the paddock gate.  And after then?  E-medicine, put forth by all the thinkers and dreamers who have made this mess, who will be left to blame the lack of zeal of the proletariat.  When were the Dark Ages?  Start around 2020 or so.

PS:  I used to be able to link to Peabody’s article of 1927.  Now, JAMA seems to require a subscription in order to get the article.  I do not see “bootleg” reprints available online, once plentifully.  Apparently, the Care of the Patient is classified now, a la HIPAA.  You have no need to know, citizen.


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