Monthly Archives: September 2025

The Water of Kiyomizu-dera

by in Culture, History, Japan | 18 Comments

“What water is there for us to clean ourselves?“
– Friedrich Nietzsche, The Parable of the Madman (1882).

Among the first destinations of many visitors to the Japanese city of Kyoto is the UNESCO World Heritage site of Kiyomizu-dera. The mountainside location is a Buddhist temple complex founded in 780 AD, during Japan’s “Heian” period. The temple was originally associated with the Hossō school of Buddhism. This is a unique and interesting branch of Buddhism which originated in Nara in 654 AD, and that drew ideas from the Yogachara approach to Mahayana Buddhism.

Kiyomizu-dera’s original construction was commissioned by the Shogun, Sakanoue no Tamuramaro. But in 805 AD, the site was officially designated as an imperial temple. The current temple complex structures date to 1633, when the Shogun, Tokugawa Iemitsu, ordered that they should be rebuilt. Between 2008 and 2020, several of the buildings within the temple complex were also heavily renovated.

The temple’s full name, Otowa-san Kiyomizu-dera (音羽山 清水寺), literally “Otowa Mountain Pure Water Temple”, is drawn from the mountainside waterfall, the Otowa-no-taki, around which the temple complex was constructed. The waterfall feeds into the “Three Sacred Streams”, three small streams of water emanating from overhead outlets in a shrine below the falls. Visitors would traditionally stand in the shrine, beneath the small jets of water. Then they would reach out with a shrine cup to catch some of the falling water to drink for blessings.

The water shrine is visible from the “Kiyomizu no Butai”, or the “Stage”, an open deck behind the Hondō or the temple complex main hall. Views from the 13-meter (45-foot) high Stage, as well as views of the structure itself are among the most photographed and well recognized images of Kiyomizu-dera.

Perhaps just to illustrate that viral messaging and stupidity aren’t anything new, an idea somehow circulated during Japan’s Edo period that if one leapt from the Stage and managed to survive, that his wish would be granted. Afterward, 234 people apparently jumped, with a surprising 199 recorded to have survived. However, I haven’t been able to find any record of wishes being granted. And the Kyoto government officially banned any further Stage-diving in 1872.

While I don’t have much of a fear of heights, Kiyomizu-dera does mark one particularly terrifying experience. Beneath the Zuigu-do Hall, a large structure to the northwest of the Hondō and the Stage, is a less well known location called the “Tainai Meguri”, or the “Journey to the Womb”. It’s essentially a long, winding, pitch-black passage beneath the Zuigu-do Hall, symbolic of finding one’s way through darkness, and subsequent rebirth.

Did I mention that I’m extremely claustrophobic?

After a small fee of 100 yen, removing your shoes, and assuring that there will be absolutely no flashlights, photography, or peeking whatsoever, individuals are led to the bottom of a flight of stone steps. And from there, it’s a one-way journey into the absolute darkness of the womb of the female Bodhisattva, Daizuigu. The only guidance is a chain of wooden beads that can be felt along in one’s left hand. For most people, this probably wouldn’t have been such a big deal. Regardless, I was fortunate to have had someone who could push me along from behind (contractions?) while I clenched my sweating palms and tried to keep from passing out in the darkness.

With regard to its more reverent status as a religious site, Kiyomizu-dera remains an important location for Buddhist pilgrimages, with each area of the complex dedicated to a different Buddhist deity. Perhaps most importantly, however, the temple is known as a “Kan’non Reijo”. The term “Kannon” refers to the Buddhist deity of mercy and compassion. And a “Reijo” is a holy or reverent location. The particular Kannon revered at Kiyomizu-dera is known as the “Henge Kan’non” (変化観音), or the “Transformational Kannon”. It’s depicted in a form that dates to around the 9th century.

Henge Kan’non can be identified by their 11 heads, visible on the Kiyomizu-dera representation in its crown. The three front faces represent the Kannon’s compassion. Three faces to the left watch over us, while three faces to the right encourage our own determination. A face on the back is said to “laugh-off evil”. And the face on the top, known as “Butsomen”, represents truth.

The Kannon is usually described as having “1,000 arms”. But around the 8th century, common physical depictions included 42 arms, with each hand having a specific meaning, either through a particular hand position, or by holding an object. The Kiyomizu-dera Kannon includes two arms with hands in prayer, and two arms holding a smaller statue above its head, both somewhat unusual in Japanese depictions of Kannon. I don’t have any photos, as the Kiyomizu-dera Kannon is considered a “hibitsu”, or “hidden Buddha”; so any photography would have been extraordinarily disrespectful. But the link below is to their site for pilgrimages, and it has some images.
https://www.kiyomizudera.or.jp/en/pray/

Kiyomizu-dera is a popular and well-known tourist destination, so there are many sources of information available to visitors. But one thing I’ve never seen noted anywhere is that there’s actually a small Shinto shrine located at the very center of this Buddhist temple complex. It’s dedicated to the goddess, Benzaiten, a water deity associated with dragons, fortune, creativity, and love. Located on a small island in the middle of a pond, it’s accessible via two walkway bridges.
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Leaving the temple complex on foot, the most direct route toward the Gion District where one might hope to see some of the city’s traditional Geisha and Maiko, is to the northwest through the Nio-mon Gate and down the narrow, and touristy, Matsubara-dori. This is actually a really nice walk along a route past the old shops and food vendors, and into the surrounding neighborhood… if it’s not too crowded. Lately, however, the masses of tourists along this narrow road have been overwhelming.
But there is a lesser known and considerably more peaceful alternative to the southwest, if you don’t mind the company…
down the route through the massive and ancient Otani Cemetery. 

The Pain Scale of Acetaminophen

by in Death, Hmmm..., Numbers, Risk, Science | 21 Comments


“When pain is over, the remembrance of it often becomes a pleasure.”
– Jane Austen

Acetaminophen (aka: “APAP”, “paracetamol” or “Tylenol”) has been in the news lately, for reasons I won’t even bother to address. However, I find this all rather amusing. The drug is actually something I avoid for several reasons that have absolutely nothing to do with the current kerffuffle.

Acetaminophen is a non-opioid, non-steroidal “analgesic” (pain-reliever) and “antipyretic” (fever-reducer”) that is widely available as an over-the-counter drug sold under various brand names, including Tylenol and Panadol. It’s commonly used as an alternative to acetylsalicylic acid (aspirin) or ibuprofen in cases where these latter medications cause stomach or gastrointestinal discomfort. It’s generally not considered an especially controversial drug. However, I avoid acetaminophen entirely for a couple of reasons that I think are worth mentioning.

Acetaminophen isn’t a “patent drug”, so it’s too inexpensive to be profitably researched by the pharmaceuticals industry. So there haven’t been many controlled studies regarding its efficacy or long-term side-effects. Most information regarding its effectiveness and safety is consequently either anecdotal, observational, or from documented cases of overdose.

These show a consistent pattern relating acetaminophen use with increases in mortality, strokes and heart-attacks, kidney damage, and gastrointestinal bleeding. However, causal relationships here aren’t clear. That’s to say that while acetaminophen may have caused the noted problems, it could also be that whatever caused the health problems merely encouraged the use of the acetaminophen. It is known, however, that acetaminophen does cause an increase in blood pressure and heart rate.

Acetaminophen is, however, well known to be “hepatotoxic”, or harmful to the human liver. In fact, by the time of my brief stint as a pre-med in the 1990s, unintentional acetaminophen overdoses accounted for nearly 25% of all emergency-room (ER) visits, a large percentage of which resulted in hospitalizations.

The drug can cause “hepatocellular necrosis”, or the death of liver cells. In fact, acetaminophen toxicity had become the single most common cause of acute liver failure in the United States as of 2003. And as of 2005, acetaminophen accounted for the single largest number of drug overdoses in the United States, the United Kingdom, Australia, and New Zealand. And as of 2004, acetaminophen overdose resulted in more calls to poison control centers in the U.S. than overdose of any other drug or medication.

More recently, acetaminophen overdoses have become associated with recreational drug use, and especially opioids. These drugs are often “cut”, or combined with with acetaminophen, with the drug’s toxic effects on the liver amplified by concurrent alcohol consumption.

Acetaminophen toxicity presently accounts for around 500 deaths, 100,000 calls to Poison Control Centers, 50,000 emergency room visits, and 10,000 hospitalizations per year in the US alone. As an over-the-counter and prescription drug (when mixed with prescription opioids), acetaminophen toxicity far surpasses all other prescription drugs as a cause for acute liver failure in both the United States and Europe. And despite this well known risk, it still isn’t significantly regulated.

To add insult to injury, acetaminophen is also recognized as a relatively ineffective pharmaceutical for pain relief. Among the few serious scientific studies done on the drug, most have involved its efficacy as an overall pain-reliever, including as a means to reduce opioid use in cases of severe pain. Among these…

  • In a 2020, randomized, double-blind controlled trial published in a peer-reviewed journal, IV acetaminophen when compared to a placebo, the drug entirely failed to show any beneficial effect.
  • In a 2021 Australian study of the effects of acetaminophen in a randomized, placebo-controlled trial, the authors concluded: “For most conditions, evidence regarding the effectiveness of paracetamol (acetaminophen) is insufficient for drawing firm conclusions. …there is strong evidence that paracetamol is not effective for reducing acute low back pain.”
  • A 2017 Cochrane Review study of pain relief in children and adolescents, researchers examined the reported efficacy of acetaminophen in treating chronic, non cancer-related pain in children and adolescents between infancy and 17 years old. The researchers concluded that results were too statistically insignificant to conclusively draw any conclusion one way or another. 
  • Another Cochrane review in 2016 citing a study of over 1,700 subjects concluded that acetaminophen was ineffective in treating lower back pain.
  • In 2016, Dr. Andrew Moore, then Director of Pain Research at Oxford, who had by then written 200 systematic reviews, posted a blog entry titled, “Paracetamol: widely used and largely ineffective“. Dr. Moore also refuted the idea that acetaminophen is safe.
  • In 2017, Dr. Jonathan (Josh) Bloom, Director of Chemical and Pharmaceutical Science at The American Council on Science and Health, one of the least hyperbolic resources for legitimate US health information available, suggested that Tylenol could be, “By Far The Most Dangerous Drug Ever Made?” And in 2023, Dr. Bloom went on to conclude, “…acetaminophen fails to provide adequate pain relief for any condition. Yet, hospitals will dispense the pills like candy and/or an expensive and useless IV form of the drug.”

Subjectively, my own experiences with acetaminophen, including some instances when dosages were sufficient to cause liver pain, haven’t encouraged its use. I don’t even keep any in the house, as I’ve found it ineffective for even minor headaches or muscle pain. I also tolerate aspirin, which seems to work well for muscle and joint pain. And I’ve found ibuprofen to be as effective as a non-narcotic gets for anything else.

To be fair, I could find research concluding that acetaminophen is about 10% more effective than a placebo in relieving headaches, and that it can probably help with cold symptoms. I also came across something suggesting that it can augment ibuprofen after a wisdom tooth extraction. And it has been shown to help reduce fevers in children.

Still, I’ve grown rather attached to my liver… or at least what’s left of it. So current distractions notwithstanding, I have to question whether any of these benefits might outweigh acetaminophen’s already well known risk.

Getting an Enshittification

by in Boundary Behavior, Culture, Hmmm..., Identity, Politics | 17 Comments

“I don’t have a short temper;
I just have a quick reaction to bullshit.”
– Elizabeth Taylor.

 

Maybe I just have a tolerance problem. But it seems to me that an expectation of crap has simply become the norm… crap products, crap service, crap management, and the crap expectations that result. Society blames the people we see holding the crap. But with the possible exception of what gets pumped over the local mountain pass, shit generally rolls downhill.

The term, “enshittification” comes from the writings of Cory Doctorow, a science-fiction writer, journalist, and co-editor of the science/technology/futurism group-blog, “Boing Boing”. Also termed “crapification” or “platform decay”, it refers to ways in which high-quality consumer services almost invariably become shittier over time.

Expanding on the idea in Wired Magazine, Doctorow used TicTok, Amazon, and Facebook as examples. Each company initially attracted customers by offering free access to high-quality platforms. And then, they proceeded to trash their own products in order to bring in advertising revenue or to increase corporate profits. The process, however, is symptomatic of something far more pervasive than just online services, extending well into the domains of physical products and actual human services.

The ability of producers to enshittify the very commodities they ply is only possible as a result of some form of entrapment. In cases where better options are available, most consumers will eventually move to those better products. But when there’s a required investment in a particular platform, it can be prohibitively costly to make the switch.

Social or intellectual investment can be as simple as human connections or an established audience. But an investment can also be physical. Commodities from refrigerators to automobiles may now compel subscriptions for the ability to adjust the temperature, use the heated seats, or to fully charge batteries. Devices like cameras or printers may even be rendered inoperable without first connecting them to Internet services that collect data or that require regular purchases. The “cloud” has become synonymous with enshittification.

Entrapment also occurs when institutions simply swallow-up or ruin competitors and grow to dominate entire market segments, as with Amazon, Apple, Microsoft, and Google. But even worse are cases where government bureaucracies actually encourage such monopolies, as with construction contractors, public services, for-profit utilities, or Internet providers. Recently, however, I’ve been witness to a kind of government promoted enshittifaction that I find frankly more than a little disturbing.

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My first ever online blog post was about two decades back on a now defunct site called “Gather”. It was about the ludicrous bureaucratic machinations involved in attempting to donate a piece of technology to a local public school classroom. What I encountered was a bureaucracy in its most inefficient and counterproductive manifestation, utterly devoid of human purpose. And ultimately, my attempts at working to the benefit of others proved futile.

Now, I find myself participating in what will certainly be my final year as an adjunct (cheap labor) for the local college, supposedly supporting new teachers. But mostly I’ve been getting paid to sit through a series of what are essentially sales-pitches for extremely costly systems intended to repair the mess left by decades of public education enshitification.

I’m no expert on the topic… which is apparently just as well. But I guess the “Whole Language” approach to teaching reading became a big thing among public education establishment some time after I left college in the mid-nineties. It’s based in an idea that kids will simply learn how to read by osmosis. So instead of teaching students how to use the tools of sounding-out unfamiliar words, they are instead supposed to just read past the offending collections of meaningless letters and derive a meaning from the rest of what they can’t read.

Yes, the idea is just as stupid as it sounds; and it’s evidently okay to say that openly now. Not quite so okay, however, is to mention that competent teachers knew this all along, and were quietly supplementing official materials with their own phonics programs. At the local elementary, there is even a teacher whose unofficial specialty has been to help fill the phonics gaps left by official curriculum.

Regardless, as more experienced teachers have retired, or simply given up and quit, fewer students have been the recipients of that kind of functional expertise. The result has been, of course, predictable. So parents with the resource to do so have responded by either enrolling their children in private schools with better programs, or by turning to homeschooling. And this flight of more capable students has occurred at a time when public schools are also having to deal with the end result of COVID policies and swelling immigrant and disabled populations. Think: Declining test scores!
The desperation is palpable.

This has spurred the middle-managers and bureaucrats in charge of making decisions for the people who do the actual work to come up with a program to address the record numbers of US, middle-school aged kids who read like 3rd-graders… if at all. This new approach is known as, “The Science of Reading”. And since it’s “scientific”, I understand that it’s also “research-based”.

Education science “research”, however, apparently isn’t constrained by sciency things like double-blinded studies, repeatable data, peer review, or even actual “science”. To make the point, last week I was shown a picture of a “brain scan” that looked suspiciously like a clip-art with arrows pointing to words such as “cognitive activating region” and “zone of phonemic awareness”. Regardless, it was enough to justify an “all new” program that emphasizes… phonics!

The only problem now is that years of neglect at the level of those who do the actual work has left most public schools without enough qualified teachers. And the best solution the current bureaucracy can come up with is to move education onto the cloud. I am, however, assured that these high-tech, cloud-based programs will stimulate students’ cognitive activating regions and zones of phonemic awareness by including engaging cognitive tasks… or what used to be called, “games”.

I’d like to be able to say that I’m making this shit up. But the reality is that US public education has become a bureaucratic monopoly that mostly responds to lobbyists from the very companies that produce the proprietary tests of what now qualifies as “learning”. It no longer serves even itself, its current enshittification being addressed by new programs that will simply bury everything under a fresh layer of virtual bullshit.

This grieves me tremendously. As a first-generation immigrant to this country, my own public education provided a gift of self-determination that I can never repay. Even if I may not have appreciated it at the time, I had many excellent public school teachers, competent and knowledgeable people who actually cared, and who kept me motivated. But somewhere along the way, public education became a system more invested in billion-dollar publishing and tech monopolies, and overpaid bureaucrats who justify themselves by blaming the very teachers who tried their best to keep it from failing. And now I fear it’s too late.

US public education cannibalized itself in order to feed its own bureaucracies. And what’s left is the natural result.