by Ali Minai

Following the shock of Brexit in Britain and the cataclysmic election of Donald Trump in the United States, there is much soul-searching, head-scratching and gnashing of teeth in liberal circles. Some see the end of democracy, others predict the collapse of liberalism, or at least of the liberal world order. The more sanguine speak of history's pendulum and some see both promise and peril in new technologies. A sub-genre of political analysis that has blossomed in these troubled times is the critique of cruel, corrupt neoliberalism that has abandoned the working classes in its search for a technocratic utopia powered by unbridled markets. For the most part, all these responses take for granted the existence of a well-defined liberal ethos, and – more importantly – its stability in human affairs. Not surprisingly, liberal thinkers see liberalism as inherently "better" than the alternatives, and approach their analysis from a "How will liberalism succeed?" viewpoint. Conservative critics, in contrast, see liberalism as a deviant human condition that seeks to subvert the "natural" order of things. Understandably, these views are regarded as contradictory. The central aim of this article is to argue that, in fact, accepting both viewpoints as valid may provide a better understanding of liberalism, its promise, its challenges, and its current state.

An early disclaimer is also in order: this article on a very complicated topic is intended as a "view from 36,000 feet", and does not speak to the microdynamics of activism by individuals and organizations. The world is full of good works on all sides of the political spectrum; the focus in this piece is on historical forces and long-term global patterns.

Political analysts often express amazement that, in many important instances, ordinary people support leaders and causes against their own rational interests. But this surprise stems from an idealized and rather inaccurate view of human decision-making as a rational process focused on optimizing economic costs and benefits. In the practical situations of daily life, people usually make choices driven by values, not calculation or analysis. And, as students of human nature have always realized, and as the recent work of behavioral economists has shown systematically, these values are instantiated in a toolbox of heuristics – rules of thumb – that suffice for reasonably good and highly efficient real-time decision-making, but often flout the rules of probability and logic. At different levels, this repertoire of heuristics is termed instinct, intuition, or common sense, and is identified with the "natural" – as opposed to calculated – decision-making. Amos Tversky – one of the pioneers in this field – famously termed these irrational heuristics "natural stupidity" as a tongue-in-cheek contrast with "artificial intelligence", and with the implication that, in fact, much of "real" intelligence arises from this "natural stupidity" rather than the logical rules that underlie theories of classical economics and artificial intelligence.

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Maluma and Takete

No offense to Shakespeare, but I've never quite bought into the philosophy that names are immaterial. Calling a rose by another name might not affect its smell, but it could well impact our association with the flower.

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TV, Bronx News 6/30/17

Gun again.
In this case a pissed-off
former employee
with a not-so-extraordinary
sense of personal privilege
to take life by right,
which in the American zeitgeist
has become popular as
an act of self expression afforded
by liberty through an amendment to law
lucrative to private sector arms interests
who live by death through means of tiny explosions
of sulfur and saltpeter mixed with charcoal
which send chunks of lead by click of triggers
into the boney meat of flesh and blood
to end the only real thing
anyone ever has

Jim Culleny
6/30/17
.

by Holly A. Case

National Library, Sarajevo, 1994

Last November in Vienna, a number of us met to discuss what the outcome of the US election could mean. Because it was too early to tell, much of the conversation focused on parts of the world where leaders who had honed rhetoric and positions like Trump's years earlier had begun to translate them into concrete policies, namely in Russia, Hungary, Turkey, and Poland.

The group included a Bulgarian novelist, two Austrian high school students who had spent a year abroad in the US, a magazine editor, a cultural entrepreneur, and a spattering of graduate students and academics from various disciplines—from medieval studies to political science—and countries (the US, India, Canada, Poland, Hungary, Mexico, Austria, and Bulgaria, to name a few). What those present had in common was middle-class status and a penchant for reading, thinking, and studying, even if some of our lineages were often humbler (more than a few of us were first generation off the farm or factory, and as many had grown up in rural areas). Once all this was established, one of the Bulgarians wondered: "What if this isn't the end of the world. What if it's just the end of our world?"

Those two sentences have haunted me ever since. The late East German novelist Christa Wolf, who was a member of the Socialist Unity Party of Germany (the ruling party of East Germany) from 1949 until a few months before the fall of the Berlin Wall, once recalled the first time she watched a Bertolt Brecht play. The year was 1950, and Brecht himself was sitting nearby in the audience. Wolf watched as the leftist playwright "shook with laughter" throughout the performance: "I would not have dared to laugh at all the places where Brecht had to laugh," she admitted. "His disrespect for the ‘bourgeois tragedy' drove us to distraction." It reminded me of my own reaction to Michael Haneke's Funny Games. Not funny.

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by Richard King

The British have always been wary of modern architecture, the British upper crust especially so. From the Prince of Wales and his "monstrous carbuncles" to Sir John Betjeman and his iambic fantasies about "heavy bombs" raining down on Slough, a deep suspicion of architectural modernism would appear to be the default position of the bluebloods and their literary hangers-on. The prejudice is perhaps most wittily expressed in Evelyn Waugh's Decline and Fall, in the figure of architect Otto Silenus. Silenus is talking to a journalist who has come to inspect his "surprising creation of ferro-concrete and aluminium". "The problem of architecture as I see it," he says, "is the problem of all art – the elimination of the human element from the consideration of the form."

Well, it wasn't modernism that did for the "human element" in Grenfell Tower two weeks ago, though it's clear that the attempts to prettify that building for the sake of the surrounding residents – some of the richest people in the world, mark you – had a fundamental part to play. For whatever one thinks of the "brutalist" style of that 24-story tower block, it was built with working people in mind, at the ragged end of Britain's post-war, social-democratic settlement. No, what did for Grenfell's tenants, 80 of whom are now known to have died, was the extent to which, and the manner in which, that settlement was undermined over decades. Their home, or what is left of it, is now a blackened monument to another kind of "decline": the "managed decline" of poor neighbourhoods as a central plank of the ideology we've come to know as neoliberalism.

"How the fuck does that even happen?" asks one fire-fighter on the way to the emergency, his horror caught in smart-phone footage taken in the small hours of 14 June. There's a technical answer to that question, of course, but there's also a political one; and, infuriatingly for those who would treat politics as something above or beyond lived experience (more on them a little later), the two are related in the most mundane ways possible, in ways that are sure to be labelled "criminal" even if they aren't labelled "manslaughter" or "murder" (more on that word later, too). This was not a "tragic accident"; it was the consequence of years of nihilism and neglect.

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by Muhammad Aurangzeb Ahmad

A cultural shift in our understanding of the arbitration of the truth is afoot. The shift is subtle but it has been creeping up in the collective unconscious for the last decade or so. Discourse on alternative facts and fake news has come to prominence since the last US presidential election and Brexit. This phenomenon is however not new but has a long and notorious lineage: Propaganda is as old as human civilization. The Nazi minister of Propaganda Joseph Goebbels is well known for developing a master plan for spreading false information and influencing the German populace. The Soviet Union and the Warsaw Pact nations had their own versions of “truths” where all of history was rewritten through the singular lens of Marxism. The supposed end of history with the Fall of Soviet Union did not end the need for propaganda. People and states still need to spread misinformation as before. There is however one thing that has changed about spreading mass misinformation: In prior times, spreading falsehood on a massive scale almost always required access to state resources. Then the internet happened followed by the rise of social media; this has made the spread of misinformation on a global scale a truly democratic endeavor.

What then, is the effect of this democratization? For all practical purposes, “truth” has become synonymous with what gels with one’s values and what is accessible. When people look for information online, the search engine ranking determines what information that they are exposed to. Most people do not click after the first few pages when going through searching results. The implication here being that to get your version of facts heard you need to have your web pages at the top of the search results. In other words, searching engine optimization becomes part of the propaganda process. Alternatively, you may be one of those people who do not trust Google or Bing because of its supposed liberal bias. In that case Facebook is your friend as you can readily get information from your friends who are likely to have the same biases as you. This is not to suggest that the information bubbles are limited to the conservative segments of the society. Manipulating Wikipedia to suit one’s agenda is also a well-studied phenomenon. But if you are one of those people who think that Wikipedia is too liberal and too mainstream then there is Conservapedia which seeks to provide a ‘corrective’ to the Wikipedia from a conservative perspective. What is common in these examples is the democratization of means of production of information.

The amount of misinformation that could be pumped into the news cycle has traditionally been constrained by the number of people who are dedicated to the cause of spreading the information, their access to technologies to spread information and the biological constraints with respect to the amount of effort that one can spend in day e.g., everyone need to sleep to properly function. The arrival of intelligent bots and other automation tools on social media now allow wannabe propagandists to transcend such limitations. So, what does the future of misinformation look like? We already have systems that can write news stories. In the near future one would be able to give these systems cues regarding what kind of news to generate and lo and behold they could generate tens of thousands of reasonable sounding news stories with varying levels of untruths embedded in them.

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by Megan Golden and Akim Reinhardt

One time he showed up at the lake, having driven two hours straight from the city, climbed up to a massive rock wearing only his green speedo, took a last sip of vodka, and executed a perfect swan dive from thirty feet.

One time he sewed the head back on a girl's favorite doll.

One time he put his fingers into his teeth and whistled. We heard it a quarter-mile away.

One time a blue fish clamped its sharp teeth down on his forefinger. "Get it off me!" he yelled to his brother-in-law sitting in the boat with him. But the brother-in-law froze, so he pulled out a knife with his left hand and cut the fish off himself. His finger tip was dead for many years.

One time he gave us some quarters to buy cigarettes from the machine in the back of the bar. Kool sounded good, but he was disappointed. He didn't smoke menthols, so he gave them away.

One time he said, "Well I'll be damned."

One time he took a red nosed pit bull that had been used for bait away from some teenagers on the street by flashing his wallet, claiming to be an animal inspector, asking if the dog had its shots, and then saying they could hand it over or pay a fifty dollar fine. He kept the dog and named him Amsterdam for the avenue where he found him.

One time when he was driving back up the hill from the train station he passed a hitchhiker. He rolled down the window and explained "I'd give you a ride but I got my daughter in the car."

One time he was lying in bed, reached under his pillow, pulled out a black comb, and vigorously scratched the itch on his chest for half a minute. Then he tucked the comb back under his pillow.

One time he wrote a poem on the inside of a Nilla Wafers box.

One time he accused a boy of being slovenly and lackadaisical.

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by Carl Pierer

At this year's Edinburgh International Film Festival, Donmar Warehouse presented a filmed version of their Julius Caesar. The all-female adaption of Shakespeare's play is set in a prison with the cast including both professional actors and (former) inmates. It has received much critical acclaim, travelling internationally. Now it has been made available to a wider audience through a record on film.

It may seem a formidable challenge to put on screen a theatre production, even more so if much of its force is derived from the setting in a high-security prison. The theatrical audience is always where the camera should be, the director Phyllida Lloyd said. Yet, through the use of Go-Pros, iPhones and drones, intimate perspectives are possible to which the theatre audience does not have access. The film succeeds in not making the screen viewers feel secondary to the live audience.

Julius Caesar is perhaps one of Shakespeare's most macho plays. The daring step to have an all-female cast ensured that more than a few eyebrows were raised; perhaps predictably, the Telegraph's critic was unimpressed[i]. Each actor has two characters on stage, an inmate and a person in the play. The inmates are all supposed to be female, whilst the vast majority of Shakespeare's characters are male. The audience is aware of the fact that all the actors really are female. These three layers work together to create a unique impression. For here the inmates in their prison clothing have been stripped of their sexuality and yet we know that this is an all-female cast, which makes us encounter the actors as well as their characters in their sexual ambiguity. Lloyd claims that this "(…) was a way of immediately de-sexing the women, because, actually, they were neither men nor women. They were humans."[ii] This certainly applies to the prison characters.

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by Samir Chopra

Once upon a time in America’s not-too-distant past, immigrants of the first and second generations were reckoned a safe vote for the Republican Party’s brand of conservatism. It was not just immigrants with log-sized chips on their shoulders from communist countries—Russia, Hungary, Poland, Cuba, for instance—who were willing and enthusiastic consumers of American conservatism; immigrants of all stripes often showed marked allegiance to important conservative causes and claims. This history should still feature in explanations of why immigrants have not always been successful in building multi-racial alliances with African-Americans, and thus, why American anti-racism politics remains handicapped by a lack of solidarity between its demographic components. It will show how the Republican Party found a rhetorical appeal to divide anti-Republican coalitions of minorities by attacking them at one of their most vulnerable points—the divide between the ‘immigrant’ and the ‘resident,’—by appealing to a sense of immigrant virtue, one cast as a conservative ideal.

The immigrant’s imagination, tinged with a hint of the romantic, bears some explanatory responsibility for his political predilections. The romantic imagination sees man pitted alone against the awesome, stifling forces of nature and society; the immigrant considers himself confronted by the formidable foes of unfamiliar languages and cultures, class relations, and sometimes political forces that colonized his former home. Modern revisionary descriptions of conservative intellectuals as a species of romantic reactionaries suggest immigrants—who tell stories of transformative journeys of arrival and accomplishment—and conservatives are united by a species of self-conception in which they are outsiders who subvert and master a dominant system that has inflicted a heavy and painful loss upon them. Like the conservative, the immigrant suggests the ladder be ‘pulled up’ now that he has been hauled aboard—in his mind by an effort whose credit is solely his. The immigrant sympathizes with an unsympathetic conservative vision of others ‘like him’ because, like the conservative, he sees himself as an outsider who has ‘made it’ despite suffering a terrible loss.

I should know, for I was one such ‘loser.’

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by Michael Liss

The Founders are having a collective posthumous fit—and it's not because of Donald Trump.

Yes, it's true, Trump is not ever going to be one of the guys on Mount Rushmore—unless he buys the place and converts it to a luxury spa and personal shrine. He's just not a Rushmore type. We want our Presidents brave, eloquent, decisive, visionary, caring, gracious. That's not Trump. They need to have the intellectual ability and knowledge to integrate multiple sources of information to facilitate making complex decisions in rapid real time. Still no. Plus the emotional pliancy to cope with wrenching moral choices as a surrogate for the nation, taking upon themselves the responsibility for life or death choices and providing absolution for the rest of us. Yet another no. And a thick skin that enables them to do all these things with equanimity as a polarized electorate and a media hungry for scoops and gotcha tear at them. Definitely, absolutely, not our Donald.

At the risk of offending roughly a third of the electorate, let me make an obvious point: Whatever his talents in business or otherwise, as a President, Trump is a disaster, utterly unfit to hold the office. To offend the other two-thirds, I am going to suggest something radical: Unless he literally blows up the world (admittedly, not completely impossible) it doesn't matter. The Trump Presidency is a temporary problem—a big one, likely to be remembered for emotional vandalism, a hard-right agenda, and some crushing disappointments for his loyal base—but a temporary one. His Presidency will end. We will have another election, pick someone new, rebalance ourselves domestically, and reintroduce ourselves to the world as the rich, powerful, and reliable partner we were before. And to be truthful, the world isn't going to have that much of a choice, because we are still the Indispensable Nation—and because we really can be the good guys when we try.

We will get through the Trump Presidency. I say this because I have faith in our system. The Founders anticipated a Trump problem and built into the Constitution a variety of checks and balances that would either keep him from office (through the Electoral College), remove him (if he merits impeachment), or legally constrain him and limit the institutional damage he could cause if elected. And if all else fails, he still has to face the electorate in 2020. Sooner or later, he's going to have to take his Twitter account and his golf clubs and go home.

So, why are the Founders spinning in their graves? Because of the one man who, under the radar, is doing a lot more damage to Madison's delicate mechanism than Donald Trump. That would be the Senior Senator from Kentucky, Mitch McConnell. He's the guy with the can of gasoline and the box of matches burning down Independence Hall.

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by Dave Maier

Here’s a joke I remember from my childhood. A man takes a taxi. The fare comes to $9.63, so the passenger gives the driver nine dollars, two quarters, a dime, and three pennies. The driver looks at the money dubiously; whereupon the passenger asks “Isn’t that correct?” The driver’s answer: “It’s correct, but it ain’t right.” Here the driver is distinguishing correctness from moral rightness in particular. That’s not quite the distinction I want to talk about today, so let’s instead use a word which wouldn’t make the joke quite so funny: appropriateness.

Our context is that of the nature of truth. Pragmatists are often accused of reducing truth to appropriateness or utility. (William James invited such attacks with his supposedly pragmatic slogan that “truth is what works.”) Yet it certainly seems possible to say something true which is not appropriate or useful. There are many types of case, but for now as an example of “inappropriateness” try tactlessness: “Why yes, that dress does indeed make your butt look big.” While clearly effective against James’s slogan, this is not the refutation of pragmatism that it appears. We must look more closely at what determines what it is appropriate to say, and why.

* * *

After 9/11, President George W. Bush emphasized that the Iraq and Afghanistan wars were not wars against Islam generally by claiming that, as he put it, “Christians and Muslims worship the same God.” He got immediate pushback on this from some Christian leaders (Richard Land is the one who sticks in my mind, but there were others), who disputed this claim. More recently, a professor at a Christian school got into hot water when, as a way to show solidarity with Muslims, she made that same claim. In each case, the objectors quite plausibly pointed out that the Christian deity and the Muslim deity have many conflicting characteristics – for example, that the former is triune and the latter not – so how could they possibly be the same entity?

This presents itself as a disagreement about the correctness of a manner of speaking, or a matter of fact, one which is difficult even to word properly so as not to beg the question: is the entity (are the entities) which Christians call “God” and (Arabic-speaking) Muslims call “Allah” the same entity or different entities? Bush says they are the same and Land disagrees; so it seems that one of them must be wrong, depending on how the world actually is. Let’s examine the arguments and see if we still think this when we’re done.

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by Sarah Firisen

Recently, I dropped my iPhone on the sidewalk. I have a case with a bumper on it, but even so, I guess it hit the sidewalk in just the wrong way and, the next thing I knew, I had a $130 trip to the Apple store in my immediate future. Now clearly, like many thing iPhone, Apple could quite easily make a shatterproof screen. We have shatterproof windshields after all. They could also make water resistant phones (as other companies do), but then think of all that lovely lost income from phones dropped in the toilet or tangled up in bedding and put through the washing machine – yeah, I’ve done that as well. The trip to the Apple store was quick and pretty painless, they’re a well oiled machine with a steady incoming stream of people with pretty similar issues to mine. It would be interesting to stand there for a few hours and try to count how many people come in with either cracked screens or water logged phones, I bet it’s high.

The “things” we can’t live without; for most of us, our phones are pretty high on that list. And so of course Apple, as happens in a capitalist society, exploits this need, some might say addiction. And of course, our phones are not the only screens we’re addicted to: TVs, laptops, tablets, Fitbits, Apple Watches, and more.

Magic Leap, the most incredibly secretive and highly anticipated startup in the VR/AR (virtual reality/augmented reality) space seems, at least from its demo videos, to be working on a product that could, in principle, do away with all these screens. There will certainly be a headset of some sort to begin with, but it’s not hard to imagine a scenario where we’re all wearing contacts lenses instead. Then you can not only have a screen that you can’t smash or drop in the toilet, you could have many of them, at once. Every screen, devices beyond screens, could, at least in theory, be replaced overnight. If I was a company producing laptops, or TV screens, I might be a getting a little nervous. And while I realize that there is a whole social dimension, and probably legal and moral ones, around whether we want a world where people can be looking at virtual screens (unbeknownst to those around them) at any point, we sort of almost live in that world now. 15 years ago our current levels of smartphone usage was unthinkable, but it turns out that these technologies have a way of worming themselves into our daily lives and suddenly the unimaginable becomes the impossible to live without.

I recently ran a workshop on emerging technology and virtual/augmented reality was one (or two) of the technologies we looked at.

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by Claire Chambers

In discussions of postcolonial and diasporic literature, questions of faith and religious identity have until recently tended to be subsumed under such categories as ethnicity, nationality, hybridity, and race. Rae Isles, a character who lectures on Middle Eastern politics in Leila Aboulela's The Translator, accordingly asserts: 'Even Fanon, who I have always admired, had no insight into the religious feelings of the North Africans he wrote about'. In his 1959 essay 'Algeria Unveiled', Frantz Fanon anticipated by almost three decades Gayatri Chakravorty Spivak's famous idea of 'white men saving brown women from brown men'. Against the Algerian backdrop, white saviour discourse allowed French colonizers to dismiss Islam as 'a repressive, dehumanizing religion for women'. By contrast, Fanon explored the haïk or veil's subversive aspects of secrecy and concealment. He also debated such issues as modest Muslim dress functioning as a type of uniform, the 'absent presence' of the covered person, and the colonial gaze. Yet, as Rae indicates, Fanon does little to shed light on any of the reasons, other than nationalist resistance, that lead Maghrebi women to wear the haïk. When Islam or religion is mentioned in Fanon's essay, it is construed as the false bestowal by 'Islam specialists' or other colonizers of an irrational belief system on those peoples they keep subjugated. Fanon was not Muslim and nor indeed was he religious in any orthodox sense. Through her character Rae, Aboulela suggests that the theorist underestimates the power of religion in his adopted home of Algeria and in Africa more broadly.

Of postcolonial theory's foundational thinkers, Edward W. Said provides by far the most substantial contribution on Muslims and religion more broadly. Said's engagement with Islam is still timely and urgent. This is because although the flashpoints and key players have altered since the publication of his groundbreaking book Covering Islam in 1981, unfortunately little has changed in relation to negative representations of Muslims. Writing in his 1997 introduction to the second edition of Covering Islam, Said asserts: 'the term 'Islam' as it is used today seems to mean one simple thing but in fact is part fiction, part ideological label, part minimal designation of a religion called Islam'. This comment has been inspiring for my own work, and that of the field of 'Muslim writing' more broadly. In my first book British Muslim Fictions, I took up Said's identification of Islam as 'part fiction', discussing the extent to which the terms 'British Muslim' or 'Muslim fiction' are illusory. Following Covering Islam's lead, I also argued that many mainstream writers' and journalists' depictions of Islam and of Muslims might themselves be viewed as types of fiction. Similarly, in their virtuosic cultural studies book Framing Muslims, Peter Morey and Amina Yaqin note the importance of Said's contribution to the field, observing that his research enables readers to ponder 'the limited and limiting conceptual framework surrounding Islam' in much depressingly circular current debate.

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by Bill Benzon

Back on June 14 Kenan Malik published an op-ed, In Defense of Cultural Appropriation, in The New York Times. I liked it; it was a good piece. But, said I to myself, he’s going to catch hell for it. And he did.

Three days later he posted a series of replies on Twitter, starting with this:

One of the more endearing traits of cultural appropriation warriors is their belief that only they have read and thought about the issue. 1/

— Kenan Malik (@kenanmalik) June 16, 2017

He then posed a series of tasks and questions for the “cultural appropriation warriors”. I’ve decided to post some replies as a means of teasing out some of the implications of those prompts. I’ve put Malik’s statements in boldface while my elaborations are in ordinary text.

1 Define a culture (‘Western culture’, ‘black culture’, etc)

One might try to define Western culture as a geopolitical entity that has its origins in ancient Greece (philosophy, math) and Israel (religion), continues in Europe and then spreads to the Americas starting with European exploration, conquest, and colonization at the end of the 15th Century. That, for example, is more or less the scope of a two-semester art history course I took during my freshman year of college some decades ago. But in what sense is that all ONE culture?

Imagine yourself transported back to the ancient world – Sparta, Jerusalem, Rome, wherever. Would you be able to function? Chances are you can’t speak the language, and whatever culture is, language is surely a big part of it. But assume that whatever magical power took you there also gave you command of the local language, would you be comfortable with the customs, the food, clothing, housing, social structure? What if, in the magic of transport, you ended up a slave? Is slavery essential to Western culture or merely contingent?

I began to have my doubts about “Western culture” when I learned that those Greek sculptures and temples in pristine white marble had not, in fact, been white. They’d been painted in shades of blue, red, green, yellow, and so forth. They’d have been rather gaudy, even, you know, “Oriental”. Whoops! Not so “Western” after all.

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by Jalees Rehman

How many hours of sleep does the average person require? The American Academy of Sleep Medicine and the Sleep Research Society recently convened an expert panel which reviewed over 5,000 scientific articles and determined that sleeping less than 7 hours in adults (ages 18-60) was associated with worsening health, such as increased obesity and diabetes, higher blood pressure as well as an increased risk of stroke and heart disease. In addition to increasing the risk for illnesses, inadequate sleep is also linked to impaired general functioning, as evidenced by suppressed immune function, deficits in attention and memory, and a higher rate of errors and accidents. Since at least one third of adults report that they sleep less than 7 hours a day (as assessed by the Centers for Disease Control and Prevention in a survey of 444,306 adults), one can legitimately refer to insufficient sleep as a major public health issue. Even though insufficient sleep and other sleep disorders have reached epidemic-like proportions affecting hundreds of millions of adults world-wide, they are not adequately diagnosed and treated when compared to medical risk factors and conditions. For example, in most industrialized countries, primary care physicians perform annual blood pressure and cholesterol level checks, but do not routinely monitor the sleep duration and quality of their patients.

One reason for this may be the complexity of assessing sleep. Checking the blood cholesterol level is quite straightforward and provides a reasonably objective value which is either below or above the recommended cholesterol thresholds. However, when it comes to sleep, matters become more complicated. The above-mentioned expert panel acknowledged that there can be significant differences in the sleep requirements of individuals. Those who suffer from illnesses or have incurred "sleep debt" may require up to 9 hours of sleep, and then there are also significant environmental and genetic factors which can help determine the sleep needs of an individual. The average healthy person may need at least seven hours of sleep but there probably groups of individuals who can function well with merely 6 hours while others may need 9 hours of sleep. Then there is also the issue of the sleep quality. Sleeping for seven hours between 10 pm and 5 am has a higher quality of sleep than sleeping between 6 am and 1 pm because the latter will be associated with many more spontaneous awakenings and interruptions as well as less slow-wave sleep (a form of "deep sleep" characterized by classical slow wave patterns on a brain EEG recording during sleep). Unlike the objective cholesterol blood test, a true assessment of sleep would require an extensive sleep questionnaire asking details about sleep history and perhaps even recording sleep with activity monitors or EEGs.

Another reason for why insufficient sleep is not treated like other risk factors such as cholesterol and blood pressure is that there aren't any easy fixes for poor sleep and the science of how poor sleep leads to cognitive deficits, diabetes and heart disease is still very much a topic of investigation.

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