Thursday, December 14, 2006

NNT?

Historically, people with high cholesterol levels were presumed to need drug treatment. But do they? The way drug companies pseudo-scientifically describe the benefits of medications – framed in terms of "relative risks" – powerfully and systematically exaggerates the benefits of those drugs, and inflates their market value. Thus, patients frequently buy and consume medicines that do very little actual good. An alternate way of describing the benefits of drug (or other) therapy could change that.

Take cholesterol-lowering drugs as an example. In 1995, the prestigious New England Journal of Medicine published a study regarding cholesterol-lowering drugs called statins. Researchers reported a 31% reduction in the risk of heart attack among men taking the statin “pravastatin” (sold under the brand name Pravachol). Due in large part to this study, Pravachol now grosses more than $2 billion in annual sales for manufacturer Bristol-Myers.

A 31% reduction in heart attacks does seem impressive, but what does it really mean? In that 1995 study, it meant that taking Pravachol every day for five years reduced the incidence of heart attacks in the study group from 7.5% to 5.3%. By that measure, taking the drug did result in 31% fewer heart attacks in the patient population. However, for any given person, Pravachol reduces the "absolute risk" of heart attack by only 2.2 percentage points (from 7.5% to 5.3%). Consider the numbers ... suppose that 100 people with high cholesterol took statins. Of them, 93 will not have heart attacks anyway. 5 people will have heart attacks despite taking Pravachol. Only the remaining 2 out of the original 100 can avoid a heart attack by taking the daily pills. Since the study determined that 100 people needed to be treated to avoid two heart attacks, the number of people who must receive treatment for a single person to benefit is 50. This is known as the "number needed to treat" (NNT).

Developed by epidemiologists in 1988, the NNT is an objective tool to help patients make informed decisions. The NNT is intuitive, and avoids the confusing distinction between "relative" and "absolute" reduction of risk. To an intelligent, otherwise-healthy person with high cholesterol (that didn't decrease in response to diet and exercise), a doctor could say, "A statin might help you, or it might not. Out of every 50 people who take them, one avoids getting a heart attack. On the other hand, that means 49 out of 50 people don't get much benefit."

Drug companies do not want people thinking that way, and they frame discussions of drugs only in terms of “relative” risk reduction. (For instance, Pravachol’s package insert does not mention NNT. Similarly, Pfizer's literature about Lipitor and Aventis’ press release regarding Actonel both heavily promote “relative” risk reduction while making no reference to NNT). The reason is simple. Big numbers encourage people to purchase drugs. Also, those numbers even encourage medical professionals (who should know better), to aggressively prescribe drugs. In 1991, researchers surveyed faculty and students at Harvard Medical School – a group that should understand health statistics. When presented with identical information (but in two different formats) about a drug, the doctors who received information about the relative risk reduction had a "stronger inclination to treat patients” as opposed to those doctors who received absolute risk reduction (NNT) numbers.

When a therapy is extremely effective – such as surgery for acute appendicitis or insulin for juvenile diabetes, for instance – NNTs are not an important factor. But medical interventions vary in effectiveness (and most are not “home runs”), so NNTs are a highly useful tool in determining if specific therapies may be worthwhile, medically and economically. Some examples: 1) For shoulder pain or stiffness, the NNT for a cortisone shot is 3, which is pretty good. But that still means two out of three patients won't feel any better after the needles. 2) Pediatricians routinely treat childrens’ ear infections with amoxicillin, but the NNT for antibiotics used to shorten the duration of fever is more than 20 … so at least 19 out of 20 parents pour the stuff down their toddlers' throats for no reason. 3) Taking Proscar for four years to treat an enlarged prostate carries an NNT of 18. The drug costs $100 per month per person, so a health insurer will spend $86,400 on drugs to prevent each $28,000 prostate surgery. 4) Taking aspirin to help avoid a heart attack carries an abysmal NNT of 208.

Bear in mind that none of the above figures include the risks of side effects.

In some cases, drug companies’ not-entirely-honest messages about public health aren't necessarily a problem. Consider statins again. Although any one individual with high cholesterol has little reason to take them (since 49 out of 50 get no benefit), when millions of at-risk people consume the drugs, even low-effectiveness rates (multiplied by those huge numbers) can still result in quite a few averted heart attacks. Therefore, well-meaning public-health authorities routinely tolerate such exaggerations of relative risks … that is, as long as the touted intervention is fairly painless and readily accessible. But the NNT calculations become important in the case of an expensive drug.

NNT calculations are also revealing about things people do, like breast-feeding. In June 2006, the New York Times ran an article headlined, "Breast-Feed or Else." It declared “breast-fed babies are at lower risk for sudden infant death syndrome and serious chronic diseases later in life." Yet, the article never mentions the NNT to prevent these scary diseases (such as asthma, diabetes, leukemia and lymphoma), and there’s a significant reason for that omission ... the NNTs are astronomically high. Reasonable women might well (and quite rationally) decide that breast-feeding isn't worth the trouble – a conclusion that those who heatedly promote “breast-feeding at any cost” do not want the general public to draw.

In the end, however, the argument that it is acceptable to promote expensive and largely ineffective drugs/interventions for the sake of the greater good just doesn't wash. Nor does the excuse that NNTs are difficult to understand, or that the math is too hard. Patients look to doctors to translate and/or interpret complex (and often-conflicting) information from drug companies, medical journals, and the media ... and NNTs are an excellent tool for doing precisely that. Doctors need to make the use of NNTs a standard part of helping patients adequately understand their choices.

Wednesday, October 25, 2006

The Environment?

Yellowstone Park was the first wilderness to be set aside as a natural preserve anywhere in the world.

The region around the Yellowstone River in Wyoming has long been recognized for its wondrous scenic beauty (even Lewis and Clark praised it). After the Civil War, the Northern Pacific Railroad wanted an attraction to draw tourists west ... so in 1872 (partly due to railroad pressure), President Ulysses Grant set aside two million acres and created Yellowstone National Park.

There was one (then unacknowledged) problem. No one had any experience trying to preserve wilderness. There was no historic precedent or experience. And it was initially assumed to be much easier than it actually proved to be.

When Theodore Roosevelt visited the park in 1903, he saw a landscape teeming with game. There were thousands of elk, buffalo, black bear, deer, mountain lions, grizzly bear, coyotes, wolves, and bighorn sheep. By that time there were rules in place to keep things as they were. Soon thereafter, the US Park Service was formed as a new bureaucracy whose original and sole job was to maintain the park in its original condition.

Yet within ten years, the teeming landscape that Roosevelt had seen was gone forever. The park managers - charged with keeping the park in pristine condition - had taken a series of steps that they thought were in the best interest of preserving the park and its animals. But they were wrong.

The early park managers mistakenly believed that elk were about to become extinct. So they tried to increase the elk herds within the park by eliminating predators. To that end, they shot and poisoned all the wolves in the park. And they prohibited Indians from hunting in the park, though Yellowstone was a traditional hunting ground.

Thus protected, the elk herd population exploded, and ate so much vegetation that the ecology of the area changed. The elk ate the trees that the beavers used for making dams, so the beavers vanished. The park managers soon discovered beavers were vital to the overall water management of the region. When the beavers disappeared, the meadows dried up … the trout and otter vanished; soil erosion increased; and the park ecology changed even further.

By the 1920s, the park rangers began to shoot the elk by the thousands. But the change in plant ecology had already become permanent; the old mix of trees and grasses did not return. Additionally, the park rangers realized that the Indian hunters had exerted a valuable ecological influence on the parklands by keeping down the numbers of elk, moose, and bison. This belated recognition came as part of a more general understanding that native Americans had strongly shaped the "untouched wilderness" that the first white men thought they were seeing when they first arrived in the New World.

The "untouched wilderness" was nothing of the sort. Human beings on the North American continent had exerted a huge influence on the environment for thousands of years … burning plains grasses, modifying forests, thinning specific animal populations, and hunting others to extinction. In retrospect, the rule forbidding Indians from hunting was seen as a mistake.

But it was just one of an unbroken stream of mistakes that continued to be made by park managers. Grizzlies were first protected, then were killed off. Wolves were first killed off, then were brought back. Initial animal research (involving field study and radio collars) was halted, but then resumed after certain species were declared endangered. A policy of fire prevention was instituted, with no understanding of the regenerative effects of fire. When the policy was finally reversed, growth was so thick that thousands of acres burned hot enough to sterilize the ground, and the forests did not grow back without reseeding. Rainbow trout were introduced in the 1970s, which killed off the native fish species.

And so on ... in a history of ignorant, incompetent, and disastrously-intrusive intervention, followed by attempts to repair the intervention, followed by attempts to repair the damage (as dramatic as any oil spill or toxic dump) that had been caused by the attempted repairs. Notice that, in this case, there was no evil corporation or fossil fuel economy to blame. This disaster was caused by environmentalists, who were charged with protecting that wilderness! They made one dreadful mistake after another, thus proving how little they understood the environment they intended to protect.

An argument has often been posited to preserve wilderness by leaving it alone, trusting to the (fictitious) “balance of nature” to take over. However, passive protection - leaving things alone - doesn't preserve the status quo in a wilderness ... merely setting aside wilderness doesn't freeze it in its present state, any more than locking children in a room will prevent them from growing up. The world is alive and in constantly changing flux. In order to preserve a piece of land in a particular state, that state must be strictly and accurately defined, and then actively (even aggressively) managed. But no one knows how to do that ... because any action changes the environment. And any change will inevitably hurt some plant or animal. For instance, preserving old-growth forest to help the Spotted Owl means Kirtland's Warbler (and other species) will be deprived of the new-growth forest they prefer. There is no free lunch.

And no actions have only positive consequences. For instance, banning CFCs in (misguided) efforts to protect the ozone layer actually harmed Third World people by eliminating cheap refrigerants so that their food spoiled more often and more of them died of food poisoning. The ozone layer is argued (at least, by industrialized countries) to be highly important, but those Third World populations disagree. Worse yet, banning CFCs had no effect on the ozone layer, anyway.

Another instance … banning DDT is arguably the greatest tragedy of the twentieth century. DDT was the best agent against mosquitoes, and (despite the ridiculous rhetoric) there was absolutely nothing anywhere near as good or as safe. People could (and in laboratory experiments DID) directly swallow DDT with no adverse effects. Yet, for political reasons, it was completely banned in the US. Since the ban, two million people each year (mostly children) have died unnecessarily from malaria. All together, the ban has caused more than fifty million needless deaths. Banning DDT killed more people than Hitler. And the environmental movement pushed hard (and effectively) for it to be legislatively outlawed.

That inarguably qualifies environmentalism as the least exact of all sciences.

Monday, August 28, 2006

INHERIT THE WIND


Based on the popular stage play of the same name, the film "Inherit the Wind" is Hollywood’s version of the famous Tennessee “Scopes Monkey Trial” of 1925.

In the film, the characters remain recognizable despite name changes (to prevent possible legal trouble for the playwright). Real life defendant Scopes was renamed Cates, actual defense attorney Clarence Darrow was renamed “Bulldog” Drummond, popular journalist HL Mencken was renamed Hornbeck, and famous prosecutor William Jennings Bryan was renamed Matthew Brady. The film was faithful to the broad outlines of the historical event, but it flagrantly distorted the details.

1) Cates/Scopes is shown in the film being arrested (in the act of teaching evolution) by a grim posse of morally offended citizens.

No effort was ever made to enforce Tennessee's "anti-evolution" legislation, known as the Butler Act. The issue was initially brought to light -- and this was never mentioned in the play or the film -- by an American Civil Liberties Union advertisement for someone to challenge the law. Several citizens of Dayton (renamed Hillsboro in the play), hoping publicity would benefit their town, approached Scopes as a candidate. Scopes was actually a mathematics teacher and had only briefly substituted as a biology teacher. He did not even remember teaching evolution, but he had used the standard textbook (Hunter's Civic Biology), which contained a short section on the subject.

Scopes was surprised during the trial by how knowledgeable the student witnesses were, and he speculated that the students must have gained their knowledge of evolution somewhere else and mistakenly associated it with his class. Scopes himself knew very little about evolution, so the defense attorneys kept him off the stand, where his lack of knowledge (and his uncertainty as to whether he had actually taught the subject at all) might prove embarrassing.

2) Cates/Scopes is depicted in the film as being imprisoned, and hung in effigy.

In reality, Scopes was free after his indictment. He traveled to New York to meet the ACLU Executive Board. Then he returned to Dayton, where he remained friendly with the townspeople. He even greeted the visitors streaming into town.

3) In the film, Brady/Bryan demands a harsher penalty for Cates/Scopes.

Violation of the Butler Act carried no prison sentence, and Bryan actually argued against even a monetary penalty. When the judge did eventually levy a $100 fine, Bryan actually offered to pay that himself.

4) In the film, Drummond/Darrow comes into town late in the evening with little notice. Brady/Bryan is adored and applauded, but Drummond/Darrow is shunned by the townspeople, and is even called “Devil” by a screaming little girl.

Scopes attended a dinner given by the Dayton Progressive Club in honor of Bryan's arrival. Bryan (famous for remembering people) recognized Scopes as one of the graduates he had addressed at a high school commencement six years earlier. Bryan's kindness and sincerity were acknowledged even by his enemies, and he spoke amiably to Scopes, insisting they could be friends despite their disagreement.

Darrow was greeted on his arrival in Dayton by a crowd equally as large and friendly as the one that had greeted Bryan. Darrow was honored at a Progressive Club dinner just as Bryan was. Being a folksy, small-town type himself, Darrow gained the good graces of the locals, and many of the spectators at the trial showed support for the defense.

5) In the film, Drummond/Darrow defends Cates/Scopes alone.

Darrow assembled a defense team that included Arthur Hays of the ACLU, international lawyer Dudley Malone (who had served as Bryan's Undersecretary of State in the Wilson Administration), and constitutional expert John Neal. Scopes later wrote that he couldn't have done better if he'd had all the money in the world.

6) In the film, Cates/Scopes loses his teaching job.

Scopes’ job was still open to him even after the verdict. However, he was offered a scholarship for graduate school, and studied geology at the University of Chicago. He later had an active career as a geologist.

7) The film’s plot elements included the lonely stand of the brave individualist against the small-minded bigotry of the townspeople, and Cates’/Scope’s fear as he waited in his prison cell, with the threat of ruin hanging over his head.

That was pure fabrication. Scopes was not living in fear. For example, during one lunchtime recess, Scopes went swimming with two of the young assistant prosecutors (one of whom was Bryan's son). They were late getting back to the courtroom, and the reprimand Scopes received from defense attorney Hays was the roughest treatment he received during the entire trial.

8) The play gives Drummond/Darrow a worthy adversary, but it belittles Bryan. The film actually distorts and ridicules its Brady/Bryan figure.

The trial transcript reveals that during the trial, Bryan was exuberant, funny, discerning, and focused. Many reporters shared the prejudices of HL Mencken, who ridiculed Bryan in print. One reporter never even attended the trial sessions, remarking, "I don't have to know what's going on; I know what my paper wants me to write." During the famous cross-examination by Darrow, only six reporters were present; the others were taking a long lunch, thinking that the most important portions of the trial had passed (Scopes later helped the absentee reporters file their stories). The number of reporters dwindled during the trial, and even Mencken did not stay through the whole eight days.

9) The film depicted Brady/Bryan as a biblical fundamentalist unfamiliar with the theory of evolution.

Bryan (who was a member of the American Academy for the Advancement of Science) was quite familiar with Darwin, and actually understood the evolution doctrine better than his adversaries. Bryan was not a biblical literalist. He volunteered to Darrow (it was not wormed out of him, as the play suggests) that the "days" in the biblical account of creation were not twenty-four hour days. He did not insist that the "sun stood still" in Joshua 10:13, but explained that the Bible was using archaic language. Still, he did not yield on his belief in miracles and the primacy of divine power. His supporters were disappointed over Bryan's testimony (the play makes much of the crowd's turning on him) but it was not because he looked stupid as a defender of crude fundamentalism … it was because he was NOT a defender of crude fundamentalism.

10) In the film, Brady/Bryan and his beliefs were crushed.

Untrue. Scopes himself remarked that Bryan (the Great Commoner) remained amazingly exuberant and buoyant during the trial.

And while the anti-evolutionary cause may have suffered embarrassment, the guilty verdict was overturned a year later (only on a technicality). Several state laws similar to the Butler Act were finally declared unconstitutional in 1968.

11) In the film, the judge prevented Brady/Bryan from delivering his lengthy closing statement.

It is true that Bryan was unable to deliver the closing statement, but NOT because the judge cut short the trial. Rather, after the questioning of Bryan (which was stricken from the record the following day), Darrow accepted a guilty verdict in order to move to appeal. This removed the need for closing statements. Darrow later admitted that the defense had purposely deprived Bryan of his closing statement, out of fear of his legendary oratorical powers.

12) In the film, Brady/Bryan had a mortal stroke in the courtroom.

Again, untrue. Bryan died five days after the trial. His death may have been hastened due to exhaustion and stress, but he also suffered from diabetes, which he did not carefully control. He passed away peacefully during an afternoon nap and after a heavy meal. The film’s irreverent line spoken by the cynical Hornbeck at Brady's death … ("He died of a busted belly") was actually Darrow's private remark upon hearing that Bryan had died.

13) Even in small things, the film and play diminish Bryan. Drummond/Darrow derides the honorary title of "Colonel" that Hillsboro bestows upon Brady/Bryan, protesting, "I am not familiar with Mr. Brady's military record." The play's Brady is mothered by a wife who cradles him, and calls him "Baby".

In fact, Bryan had indeed been a colonel in the U.S. Army during the Spanish-American War (though he never saw combat). Bryan's wife was actually a semi-invalid of whom he was protective and solicitous.

14) Both the play and the movie vastly oversimplify religion's relation to evolution. The play insists that there is no contradiction between Christianity and Darwinism.

The defense, both actual and fictional, wanted to isolate “ignorant biblical literalism” as the only kind of religion that disputes evolution. They have been joined in this view by many mainstream religious leaders in the past seventy-five years.

Ultimately, the theme of Inherit the Wind is not the truth/error in the theory of evolution, but the "right to think," and even the "right to be wrong."

TERRORISM

Just over forty years ago, history’s first and only attack by Middle Eastern Islamic fundamentalists against Russian nationals occurred with surprisingly little fanfare. There was no media coverage of the incident. The Russian government did not call international attention to the issue, nor did it seek assistance from other countries or from the UN.

The Russian government simply responded, in its own best interest. After taking enough time to develop a thorough understanding of their Islamic adversary, Russian officials quietly authorized quick, decisive, and forceful action. Not military action, however … rather, an action that has effectively and consistently guaranteed the physical safety of Russia (its land and its population), against fundamentalist terrorism, for more than four decades.

Although Russia has suffered instances of internal civil strife, involving its own Islamic population within some of its satellite states, no terrorist attacks by foreign Islamic fundamentalists -- no Middle Eastern “jihads” -- have occurred on Russian soil or against Russian nationals in over forty years. Clearly understand that point … Russia’s responsive action directly, effectively, and appropriately addressed the specific issue of religion-based terrorism. Undeniably, that action worked.

Russia’s response to the initial attack was carried out by its primary intelligence organization. The KGB, a professional unit vaguely equivalent to America’s CIA, sent teams to several Islamic strongholds around the Middle East. Shortly thereafter, the (occasionally dead) bodies of Islamic leaders began to appear in local garbage dumps. The bodies had been carefully and precisely mutilated. The mutilations were skillfully performed in a ritual manner -- including branding, castration, and hog fat, among other things -- that shattered the most basic tenet of Islamic fundamentalism’s erroneous “jihad” faith.

Where Westerners generally dread open warfare, Islamic fundamentalists actually desire militaristic action. Wholesale violence -- with its consequent destruction of property, disruption of families, loss of life, shattering of social structures, and dissolution of governments -- is considered horrible by civilized minds. But warfare is Islamic fundamentalism’s concept of an easy and highly desirable gateway to heaven.

Because of a ridiculous misinterpretation of the Q’Ranic term “jihad,” fundamentalist Islamic adherents devoutly believe that a “warrior’s death” (including martyred or suicidal death) earns specific rewards such as honor, entry into heaven, and a harem of virgins. Their expectation of reward is heightened for efforts against a particularly hated non-Islamic, infidel enemy such as the US. Conversely, a non-warrior’s death is considered dishonorable, and earns punishment.

Most Western Hemisphere citizens have difficulty understanding such a violent and hate-driven mindset, and they generally dismiss it or deny its existence as “illogical” or blandly “just not possible.” Few Westerners (outside Russia’s “think tanks”) adequately grasp the sincerity and strength with which such vehement beliefs are held by Islamic believers. But that mindset is truly the core of Islamic fundamentalists’ everyday existence.

Russian intelligence analysts realized that such a depth of belief could be both a laudable strength and a distinct weakness. Those analysts were also realists, who were aware of a simple but powerful and universally applicable law of human nature. When the cost of an action becomes higher than the participant is willing to pay, that action will not be taken.

The analysts, rather brilliantly, determined the exact type and extent of “cost” that their Islamic adversaries genuinely considered “too great.” That specific excessive cost was not “David-vs-Goliath” warfare (which the Islamic radicals really consider a prized opportunity for martyrdom). Rather, it was the loss of heavenly reward. The KGB coldly and efficiently applied that knowledge, with immediate and permanent results.

Although they respect and/or fear very little else, Middle Eastern cultures do respect strength of will. Russia’s chilling resolve and ruthlessness are unquestioned, and to Islamic fundamentalist minds, the Russian message struck home with horrific clarity: “We will send you directly to hell.” Since that explicit demonstration, Islamic radicals have been well behaved toward the Russians. Although the KGB’s actions are coldly distasteful (or outright repugnant) to most Americans, the Russians obtained four decades of peace and security in exchange for a quick, if ethically questionable, investment of about a half-dozen murders and the disruption of about two dozen other lives.

Now contrast that Russian efficiency to America’s gunslinger approach. At a cost of billions of dollars, years of lost productivity, 45,000 dead Iraqis, 2,800 dead Americans, political and societal upheaval in both countries, and strained relations with other world powers … the US has thus far accomplished exactly nothing in the way of realizable behavior modification of Middle Eastern Islamic radicals (that is, actual deterrence of terrorism attempts and martyrdom efforts).

About four decades ago, the US entered the VietNam Conflict, despite being ill-prepared to do so. America, laboring under an abysmal ignorance of its opponent, engaged the North VietNamese military, who were experts in guerilla warfare. American forces initially attempted to conduct that jungle war with the same outlook (using the same equipment, tactics, communications, logistics, personnel training, and weaponry) with which the Allies had fought Germany on French farmland, a quarter century earlier. America’s earliest VietNam Conflict results were, not surprisingly, militarily and socially disastrous.

However, American political leaders (civilians) have forgotten history, thus dooming the US to repeat it. The current administration suffers from a 1,500 member hierarchical monstrosity of a White House staff (in comparison, President Kennedy had a staff of 60!). That huge and inept bureaucracy has been completely unable to timely provide the necessary input -- accurate and honest information -- that any Commander-in-Chief requires in order to make intelligent decisions. Thus, America has entered another eerily VietNam-like conflict. The similarity includes suffering an identical and inexcusable ignorance of its new opponent. And worst of all, the fighting is manifestly … and unforgivably … on the enemy’s terms.

The American public has yet to understand the religious and ecstatic zeal with which Islamic radicals welcome militaristic conflict, or why the fundamentalists commit increasingly severe acts of worldwide terrorism. But if Americans received sufficient education about Islamic fundamentalism, and were subsequently given the opportunity to specifically choose between 1) the dubiously effective “conventional force” loss of thousands of American lives, or 2) use of the type of force that Islamic radicals actually understand and respond to … the results might be intriguing.
MAYAN CALENDAR

The Mayan calendar carries a 3,000 year old prophesy of doom. Like every religion and every ancient civilization, it predicts the end of humanity. Specifically, the calendar predicts the human race will cease to exist on the “Day of the Dead,” which we call the winter solstice (the 21st day of December), in the year 2012. This doomsday prophecy could be easily dismissed -- by “rational” people -- simply as the superstitious nonsense of jungle-dwelling savages who hadn’t even invented the wheel. Yet, the Maya possessed advanced knowledge of architecture, astronomy, and mathematics (they invented the zero, for instance) that rivals modern scientific knowledge. By analogy, the Maya were like a child who could master Beethoven’s Moonlight Sonata, but could not bang out “Chopsticks.”

Simplistically, a calendar is a tool designed to determine (as accurately as possible) the Earth’s annual orbit around the sun. Our modern Western ("Gregorian") calendar was introduced in Europe in 1582. It calculates the Earth’s solar orbit as 365.2500 days, which incorporates a very small error of .0003 days per year. Quite impressive for 16th-century scientists! The Maya received their calendar from their predecessors, the Olmec – a mysterious people whose origins trace back well over 4,000 years. The Olmec, entirely without precision instruments, calculated the solar year to be 365.2495 days, which incorporates an even smaller error of .0002 days per year. The 3,000-year-old Mayan calendar is actually 1/10,000 of a day MORE accurate than the calendar currently in use.

The creator of the doomsday calendar was an Olmec teacher known to the Maya as Kukulcan. He was a tall, white-haired and white-bearded Caucasian, who was also known to the Aztecs … and known to the Egyptians and Incas as well. Kukulcan left four informational “codices” when he -- as a VERY old man -- disappeared sometime after 1,100 AD. Several hundred years later (1519), Spain invaded the Yucatan Peninsula. Since Conquistador Hernando Cortez was a bearded white man, both Maya and Aztec civilizations laid down their weapons and rather peacefully allowed themselves to be conquered, thinking that their Caucasian Messiah had returned. Catholic priests took possession of the codices, and were so frightened by what they read that they burned the entire set.

The Mayan calendar’s origins are centered on the Popol Vuh, the Book of Creation. According to this “Bible of the Mesoamerican Indians,” the universe is divided into an Overworld (heaven), a Middleworld (earth) and an Underworld (hell, which they called Xibalba), accessed by the dark central snake-like rift -- the elongated band of interstellar clouds -- of the Milky Way galaxy. The Maya called this rift Xibalba Be (the Black Road), and its portal/gateway was represented in both Olmec and Mayan art as the mouth of an enormous serpent. Xibalba was ruled by the god of death, Hurakan. The English word “hurricane” is derived from that name, since the deity existed inside a maelstrom. The Aztecs had the same legend, but their name for the white teacher was Quetzalcoatl, and their underworld deity was named Tezcatilpoca.

The Mayan calendar is divided into five Great Cycles, the first of which began about 25,800 years ago, which coincides with the Popol Vuh’s date of creation. This is not an arbitrary or coincidental time period. It is the time required for Earth to complete one cycle of precession, the slow “wobble” of our planet on its axis. The first sunrise of each new Mayan year occurs on the December (winter) solstice. The prophesied date of doom is the winter solstice in the year 2012 – exactly one 25,788-year precessional cycle from the date of creation (the very first day of the Mayan calendar).

Using a sophisticated computer program that forecasts the cosmos, I calculated the night sky as it will appear in 2012. Beginning at the autumnal equinox, an extremely rare astronomical alignment will start to occur between the galactic and solar planes. The Milky Way will appear to sit (level) on the Earth’s horizon, and the sun will slowly approach alignment with the Milky Way’s center point. On the day of the winter solstice (a day considered evil by every ancient culture), for the first time in more than 25 millennia, the sun will rise directly over the Galactic Equator, at the exact center of the galaxy. Over 3,000 years ago, the Mayan calendar accurately predicted this previously-unknown celestial event.

The calendar says on that day, the Mayan Underworld of Xibalba will open …