NEAL CONAN, host:
This is TALK OF THE NATION. I'm Neal Conan in Washington.
For thousands of years, religion posed many unanswerable questions, among them: How does a human brain perceive God? What happens when we pray or chant or speak in tongues? Is the spiritual experience of a Franciscan nun different from a Buddhist monk? If so, how?
Over the past few decades, technology provided the first opportunity to begin to look for answers. Various types of scanners allow us to see what happens in the brain in the midst of meditation or the throes of religious ecstasy, and it's given birth to a new field of study: neurotheology.
Later in the program, Nina Totenberg and Julie Rovner join us to look at the legal and practical implications of this week's ruling by a federal judge in Virginia who struck down a key part of President Obama's health care law.
But first, what happens when you pray or meditate or focus intensely on a problem? How does it change the way you feel? Give us a call, 800-989-8255. Email us, firstname.lastname@example.org. You can also join the conversation on our website. That's at npr.org. Click on TALK OF THE NATION.
Our guest is Dr. Andrew Newberg. His most recent book is "Principles of Neurotheology," and he joins us from a studio in Philadelphia. And it's nice to have you with us today.
Dr. ANDREW NEWBERG (Author, "Principles of Neurotheology"): Thanks for having me on your program.
CONAN: And what questions do you hope to answer?
Dr. NEWBERG: Well, I certainly hope to answer, I think, some of the most profound questions that face humanity: who we are as people; what's the meaning and purpose in our lives; what does it mean when we have a religious or spiritual experience; is there something out there beyond just ourselves; and how do we ultimately make ourselves better as people? I think those are the fundamental questions that all of us need to answer, and I think that this field of neurotheology is poised to be able to help us in that direction.
CONAN: And those are ambitious goals.
Dr. NEWBERG: Of course.
CONAN: You may not get to all of them before your time runs out.
Dr. NEWBERG: Well, I have at least a few weeks' worth of work, I think.
CONAN: We should note that Dr. Newberg is director of research at the Myrna Brind Center - I hope I'm pronouncing that correctly...
Dr. NEWBERG: Yes.
CONAN: ...for - in Integrative Medicine at Thomas Jefferson University Hospital and Medical College. But you also are involved in - in theology, as well.
Dr. NEWBERG: Yes. I teach at the University of Pennsylvania in the Department of Religious Studies, and really try to fully engage some of these questions and try to help students and faculty alike to better understand the meaning of our deepest questions and the meaning of our deepest feelings that we have about who we are in life and how we - what we are supposed to do in our lives and what it means for us to be religious or spiritual.
Ultimately, I think these are questions that everybody asks about their lives, but we now have the ability to address those questions in ways that we never had before, to bring in the scientific perspective, as well as the religious and spiritual. And I think that to me is a very powerful tool to be able to combine kind of the best of what we have in terms of our ability to try to address those questions.
CONAN: How do you apply science and the scientific method to these theological questions?
Dr. NEWBERG: Well, for a lot of the work that I've been doing over the past two decades has been to utilize brain-imaging studies and to evaluate what's happening in people's brains when they are deep in a spiritual practice, like meditation or prayer.
These are techniques that we've never had before, up until the last 15 or 20 years. And what we can do is actually scan the brain when somebody is in meditation, is in prayer, is in a practice like speaking in tongues or some other type of ecstatic state, and actually compare what's going on in their brain at that point to what is happening in their brain when they're just at rest or perhaps when they're doing some other kind of task, maybe a mathematics task or a relaxation task.
And what we are able to find are the changes in the activity in different parts of the brain, how the different parts of the brain turn on or turn off, depending on the kind of practice and depending on the kind of experiences that they have.
So this has really given us a remarkable window into what it means for people to be religious or spiritual or to do these kinds of practices.
CONAN: I've only had an MRI, but I found it hard to remember to breathe in an MRI. I might have found it pretty difficult to enter an ecstatic religious state.
Dr. NEWBERG: Well absolutely. And actually that's been to me part of the fun and part of the challenge of doing this kind of research. A lot of the studies that we actually started out doing used a different kind of technique, something called SPECT imaging. And what this involves is that we start off the study by putting in a small intravenous catheter in somebody's arm so that during their particular practice, we can infuse, without them knowing it, a little bit of a radioactive material.
So they don't feel it at all. It doesn't distract them at all, and they can be in whatever state, whatever posture, whatever, if they're moving around, whatever they need to do, they can do it in as kind of conducive way to possible for them to replicate the kind of practices that they do in their usual spiritual place, in their church or synagogue or mosque, for example.
So what's really nice about this particular technique is that it doesn't interfere with their particular practice, and it doesn't distract them, but what's also nice about it is that when we do infuse this small amount of radioactive material, it gets up in the brain, and it gets locked into the brain so that when we actually do put them into the scanner, the picture that we get tells us what was happening at the time that they were doing their practice.
So, for example, if I was to inject you right now and then bring you up to Philadelphia and put you into the scanner, it would - a couple hours later, it would tell me what your brain was doing right now, while we were on the radio.
CONAN: So it's like a snapshot in time.
Dr. NEWBERG: Exactly. It's a snapshot in time, and it's a very sensitive way and a very elegant way for capturing a particular brain state. And by doing this, we have been able to compare lots of different kinds of practices.
Now, you mentioned the MRI scanner. We have experimented with that, and, you know, it is difficult for people to do these kinds of practices. But sometimes if you get the real experts at it, the people who have been doing it for many, many years, they are able to overcome the barriers of having to lie down and the noise and all the things that you experienced in the scanner. And we can still get some good data.
CONAN: Yet, does this not suggest that you're going after a very select group, those who are masters of entering this state?
Dr. NEWBERG: Well, absolutely. And to some degree, that is how we started, for the most reason is that we wanted people who we felt would be able to achieve the kind of states and do the practices appropriately the way they've always done it. And to that extent, it was important for us to take people who were very experienced.
In fact, most of the people that we've studied have had at least 15 or 20 years of experience in their particular tradition and doing that particular practice.
But more recently, we actually have started to work with individuals who have never done these practices before. And what we're looking at there is to scan their brain today, what they're like in just kind of the raw, how-do-they-present-to-us state, send them on a path towards doing a particular practice for several months or even years and then see what happens in their brain at some point later.
So we're actually seeing whether or not there are changes that occur not just while the person is doing the practice, but does this practice cause a change in the long term, over many, many weeks, months or even years. And it does look like there are many changes that go on.
CONAN: So can you make your brain, you'll excuse the expression, stronger or shape your brain as you might shape your abdomen by doing sit-ups every morning?
Dr. NEWBERG: Well, absolutely. One of the studies that we've just recently published in the Journal of Alzheimer's Disease actually took older individuals who are having memory problems, and we had them do a particular kind of meditation. It was called Kirtan Kriya. And it's kind of a mantra-based practice where you repeat certain phrases, and you have to move your fingers a little bit.
What we did was we took them and scanned them day one to see what they looked like. We actually taught them how to do the meditation day one and scanned them while they were doing the meditation. Then we sent them home for eight weeks to do the practice 12 minutes a day and scanned them again when they came back, about eight weeks later.
And we found some very significant and profound changes in their brain just at rest, particularly in the areas of the brain that help us to focus our mind and to focus our attention.
And in fact, many of the people related to us just subjectively that they felt that they were thinking clearer and that they were able to remember things better. And we had the scans to show us that we actually had changes in their brain in those areas that support those kinds of functions, and we also tested their memory and showed that they had improvements of about 10 or 15 percent in several different memory tasks.
And this is only after eight weeks at 12 minutes a day. So you can imagine what happens in people who are deeply religious and spiritual who are doing these practices for maybe hours a day for years and years and years.
CONAN: We're talking with Dr. Andrew Newberg. His new book is "Principles of Neurotheology," and we'd like to hear from you, how praying or chanting or meditation changes you, what you feel differently, 800-989-8255. Email us, email@example.com. Richard's(ph) on the line calling from Sioux City in Iowa.
RICHARD (Caller): Hello, good afternoon, thank you for taking the call.
RICHARD: It's a great topic. I'm a meditator. I meditate quite a bit and have used - both followed Buddhism or used Buddhism for a lot of years. And meditation's been wonderful for me.
I took a mindfulness-based stress-reduction class quite a few years ago, working on my graduate work. And I know for me, what it does is, it's not just the moment, but it's the peacefulness and the perception of the world changes for me.
So just like each sentence that we speak has a beginning and an end and a space between the sentences, our thoughts have that space. And when I meditate, my job is to simply expand the space between thoughts. And that's the old Zen of nothingness, if you will.
Dr. NEWBERG: Right, right.
CONAN: It's - I'm sorry, I didn't mean to cut you off, Richard.
RICHARD: Oh no, that's all. I was just going to say it carries over. What's great is the post-meditative process because when conflicts do arise, as they're naturally going to in our lives, I find that I'm just not triggered anymore. I mean, the things that might have set me off five years ago, six months ago, don't anymore. And I think more calmly through and find a more middle ground, if you will. And so it's been a wonderful experience.
Dr. NEWBERG: Oh, that's great.
RICHARD: And I pass it on to a lot of people.
CONAN: And Dr. - go ahead, I'm sorry.
Dr. NEWBERG: I was going to say, the brain-scan studies that we've done really support that kind of response that people have had. On one hand, one of the things that we see are changes not only in the parts of the brain that help us to focus our attention but the parts of our brain that help us with our emotional responses, to help to lower our levels of anxiety and depression and make us feel better.
And as the caller just mentioned, part of what we're seeing is not only an effect that occurs while you're doing the practice but an effect that lasts and actually has a change - causes a change in these areas of the brain even while you are at rest, when you're not meditating.
So it speaks to the idea that as you do this practice, you not only change what's happening in your brain and in the way you look at the world while you're doing it, but it actually has a long-term effect.
And one of the other areas of the brain that seems to be very involved in these practices is a very interesting structure called the thalamus, a very central structure in the brain that really helps us with our perceptions of reality and how we think about reality. So again, it's no surprise that these practices really change people and change the ways they look at themselves and change the ways they look at the world.
RICHARD: I find that - you know, I find that's true, I mean, because you are looking for that space between your thoughts, you begin to recognize the thoughts in a more mindful manner when they do arise, and then for me personally, your perception of yourself, that tape loop that we play about how we feel, how we see someone, how we see ourselves, how we see the world, we're altering that tape loop. And we're learning to shut it off, actually, I mean, because our parents, our educators have always looked for ways to make the neuronal connections, but nobody ever showed us the off switch or the pause switch, and this is the pause switch. This is the switch that shuts it all down for a while and gives you peace.
CONAN: Richard, thanks very much for the call, good luck.
RICHARD: Thank you, such a great show.
Dr. NEWBERG: Thank you.
CONAN: We're talking about neurotheology with Dr. Andrew Newberg. Stay with us. I'm Neal Conan. It's the TALK OF THE NATION from NPR News.
(Soundbite of music)
CONAN: This is TALK OF THE NATION from NPR News. I'm Neal Conan in Washington.
We're talking about how religious and spiritual experiences affect our brains. Technology lets us see that the brains of people who regularly pray or meditate for many hours look different.
Dr. Andrew Newberg explains this relatively new field and the questions he hopes to answer in a new book, "Principles of Neurotheology." It's not exactly a page-turner. It's a textbook. But you can find out more about this collision of science and religion in an excerpt at our website. That's at npr.org. Click on TALK OF THE NATION.
What happens when you pray or meditate or focus intensely on a problem? How does that change the way you feel? 800-989-8255. Email us, firstname.lastname@example.org. You can also join the conversation on our website. That's at npr.org. Click on TALK OF THE NATION.
This email from Joshua(ph) in Columbus: My question is about the current talk on neurotheology. Has Dr. Newberg consulted individuals such as Sam Harris? Sam is a prominent neuroscientist and outspoken atheist and suggests that our religious experiences can all be explained through the sciences of brain chemistry and activity.
Does he worry about the implications of such studies, i.e., if they suggest that there is something non-physical about our religious experience? And how do you separate your own religious biases from your experiments?
Dr. NEWBERG: Some great questions. Well, I think one of the main points that I tried to bring up in "Principles of Neurotheology" is the idea that for neurotheology to really work as a field, it needs to be very respectful and open to both perspectives, to both the scientific side that encompasses the neuro- part and the religious and spiritual side that comprises the theology part.
For those individuals who want to go down the path of arguing that all of our religious and spiritual experiences are nothing more than biological phenomena, some of this data does support that kind of a conclusion. But the data also does not specifically eliminate the notion that there is a religious or spiritual or divine presence in the world that we somehow connect into.
And going back to our brain scans, when we see a change in the brain when someone experiences being in God's presence, what we can say is that this is the change that we see when they experience being in God's presence.
One could try to conclude, one way or the other, that maybe it's just the biology, or maybe God's really in the room, but the scan itself doesn't really show that.
And part of what I've tried to explain and extrapolate a little bit more is how careful we have to be with our conclusions because as the emailer suggested, these are not simple answers, and these are not simple problems for us to resolve, and I think we have to be careful about concluding too fast one way or the other, either for the pro-religious or for the anti-religious, what the nature of these experiences are and how they affect us and what the true nature of the reality is, which in my mind is one of the most fundamental questions and also one of the things that I always try to bring up whenever we look at the topic of neurotheology because it has some very important things to say about our views of reality and how we perceive that reality and make sense of it.
CONAN: Have you scanned the brains of mathematicians who are accustomed to studying, you know, just thinking in-depth about complex problems? Do their brains look different than people who are speaking in tongues?
Dr. NEWBERG: Well, I personally have not. However, when people have studied mathematicians and other individuals who deeply engage in certain practices, they do show some similarities. But they also show some very fundamental differences.
And when we look at people who engage in religious and spiritual practices, what our research points out is that there are many more areas of the brain that start to become active, because it's not just a cognitive process. It's not just a thinking about God, but there are the emotions, the behaviors. There's the ways in which it actually changes your thoughts and feelings about the world, that all seem to add together, that make it in some ways, I guess, a deeper or richer experience for that individual.
Now again, that's not true across the board, but that's one of the things that we tend to find is the distinction that when people are religious or spiritual, they engage many different parts of their brain, more so than what other people will engage when they're just doing other kinds of practices or having other kinds of experiences.
So we do see - and I think the other thing that we've studied is we actually have studied some people who are atheists, and we do see differences in the brains of an atheist than we do an individual who is religious.
In fact, one of our cute little studies that we did was we had a few atheists come in and actually had them try to contemplate God and asked them to focus on God. And we got a very different kind of response in their brain, obviously, than a religious person.
In fact, their brain didn't really turn on very much when they focused on God, most likely because it was kind of a form of cognitive dissonance. They really couldn't grasp the concept very well because they didn't believe in it, whereas the religious person really turns their brain on and really gets very active inside their head when they engage the concept of God.
CONAN: Sherry's(ph) on the line, calling from Newport in Arkansas.
SHERRY (Caller): Yes, hello?
CONAN: Hi, you're on the air, Sherry. Go ahead, please.
SHERRY: Yes, I was just going to tell you all that I have - do my own meditation. I can kind of stare at a corner and concentrate on breathing, which I think it may be a form of yoga. And it seems to calm me.
It worked when I was a teacher. I taught for 30 years. And it works now. I work with animals. I work with older people. And sometimes it just gets, you know, rough, and I can use that meditation, whether I'm thinking about anything religious or not. Just what I try to do is empty thoughts and just concentrate on breathing. And that really helps me. It helps me organize myself back into being able to work again.
Dr. NEWBERG: That's great.
CONAN: We had a caller earlier, Sherry, who said it sort of changed the way he perceived his place in the world. Would you agree with that?
SHERRY: Yes, I would.
CONAN: And that's...
SHERRY: I feel like I raise myself back up again, you know, if I - I'm not saying depression because it's not depression, but it's - I just feel better, I guess, is what I can say. I feel better, and I can go right on back to doing what I wanted to in the first place.
CONAN: We had this similar tweet from "querqshoppe": If I've been doing it often, I feel great. If not, I always feel a little hopeless and desperate. So - but that part about perception of your place in the world, yes, Dr. Newberg, you found that blood flow increased to the frontal cortex, the place where we're, of course, focusing on problems. But it also decreased to other areas of the brain.
Dr. NEWBERG: Absolutely, and you're absolutely right that one of the most interesting findings that we've had is a decrease of activity in an area of the brain called the parietal lobe, which is located in the back part of the brain. And that's part of our brain that takes our sensory information and helps us to create our sense of self and how we relate that self to the world.
So what we're seeing is a very profound decrease of activity in that area, which we have thought is associated with the kinds of experiences that the different listeners are relating to us, the sense of connecting to oneself, connecting to the world, kind of letting or sometimes feeling that the world goes away, or yourself goes away.
And interestingly, even though they sounds like they might be disturbing kinds of experiences for people, they ultimately are very powerful experiences for people. They are very calming, very relaxing, also very alerting and very exciting, as well, which is kind of interesting because they have kind of these mixes of emotional responses, depending on what people are doing or how they're getting into that particular state.
But it really speaks very significantly to the notion that their sense of who they are and how they relate to the world is being changed by these practices in very compelling and powerful ways.
CONAN: You can see images that Dr. Newberg has been describing to us, the brain scan of someone who's meditating, compared with someone who's not. You can see a clear difference. Just go to npr.org/blogofthenation.
And let's see if we can get another caller on the line. This is Nate(ph), and Nate's with us from Kensington in California.
NATE (Caller): Hi, guys, how are you doing?
CONAN: Very well, thanks.
Dr. NEWBERG: Good, thanks.
NATE: I studied some evolutionary psychology down at UCSD with a guy named Don MacLeod, and I was wondering if your guest could sort of weigh in on something that I had wondered about. And this is - this may sound sort of atheistic, but I was wondering if maybe a lot of our so-called God module and our tendency towards religion and feeling calmed and soothed by those types of experiences, praying, meditating and so forth, might have been an adaptive measure that we sort of selected for, if you will, because of our ability to conceptualize our own mortality. And I'll take the response off the air, thanks.
Dr. NEWBERG: Well, yeah, absolutely. You know, a lot of people have tried to make that argument in various forms. People have looked at how religions can help give us a sense of control over our environment, help create a sense of morals, help to create a cohesive society.
And all of those may be true, and all of those may contribute to how religion helps us as individuals - not just as individuals but as a species, that really has a deep impact and in part helps us to understand why religion and spirituality has been with us for so long. It doesn't go away very easily because it seems so rooted in who we are biologically, socially, culturally and perhaps evolutionarily, as well.
And to pick up on one thing that the caller just said, I don't think that that means that there's purely an atheistic or non-spiritual interpretation of that.
You know, there are many individuals who are religious believers who would say, well, sure it makes sense that it's in our biology. This is how we connect with God. This is how it began to be a part of who we were as human beings. So you can take different perspectives depending on your own beliefs that you have about religious or non-religious ideas about the world, but still try to understand how and why these experiences and these practices and this biology of who we are all has come together to enable us as human beings to be - to look to religious and spiritual ideas and concepts and experiences as being very, very important and very meaningful.
CONAN: The caller also mentioned a phrase that I was wondering: God capsule?
Dr. NEWBERG: Oh, God module. Yes.
CONAN: Yes, yes. Excuse me.
Dr. NEWBERG: Yes. That - now, that's also another thing that, over time, several people who have looked at this relationship between the brain and religion have tried to make an argument that religion is really housed in one little area of the brain.
I think what most of - at least my research - shows is that if there is a God part of ourselves, it's really all of us. It's the whole brain. Many different parts of the brain turn on or turn off during different kinds of religious or spiritual practices or states. We see, as we've mentioned, the frontal lobes and the thalamus and the parietal lobes, all these different areas of the brain, the emotional areas of the brain, all doing different things, depending on the practice. So it seems to me that there are many different elements of who we are that ultimately enable us to experience and/or express our religious and spiritual feelings.
In fact, one very interesting study that we've been running is an online survey of spiritual experiences. And we find so much diversity in how people describe what is religious and spiritual to them - into their own lives. Some people will describe God. Some people will call it a force, a feeling of love, a feeling of energy. And what we don't know is whether those are the same experiences interpreted differently, or whether they're fundamentally different kinds of experiences. Ultimately, the people all describe them as being spiritual. So it's very - raises some very interesting questions for us to tackle as the years - in the future of this field of neurotheology.
CONAN: And perhaps denominational questions, too. Does a Catholic relate to the experience the same as a Protestant to a Jew, a Muslim or a Sikh or a Buddhist?
Dr. NEWBERG: Absolutely. And, again, this is something that really has just - we've just scratched the surface. We've done over 100 different scans of people of a variety of different traditions, but there are so many different traditions within traditions. There are many different kinds of practices and different kinds of experiences.
It would be wonderful to try to really tease out - in fact, a term that I've tried to consider is the idea of a religionome, almost like the human genome, but trying to understand all the different aspects of what it means to be religious or spiritual, both from a doctrinal, theological perspective, as well as a biological one. And there's a lot for us to learn yet. And that, to me, is exciting, because it gives me a lot of things to look forward to.
CONAN: We're talking with Dr. Andrew Newberg, his new book, "Principles of Neurotheology." You're listening to TALK OF THE NATION from NPR News.
And let's go next to Carla, Carla with us from Honaunau - is that right? - in Hawaii.
CARLA (Caller): Yes, that's it.
CONAN: Go ahead.
Dr. NEWBERG: Oh, wow.
CARLA: Hello, there.
Dr. NEWBERG: Hi.
CARLA: I've been very just fascinated with this whole conversation. I've been an obsessive-compulsive painter for the past 30 years, as well as a meditator. And what's solved the religious-science debate for me was studying a little quantum physics and having some pretty phenomenal experiences and realizing that if I just defined God or the universe -whatever you want to call it, as having infinite possibilities - then when you define God that way, then the whole universe becomes that way and the world becomes that way. And then there could be multiple realities, multiple universes. Each one of us could be making our own, for all we know.
And I do experience this. When I'm painting, I have to go into a meditative state, and I feel as if there's something else that's painting for me that's the better painter. Because when I'm in - try to do it in a logical, linear way, which one of your callers mentioned was - he was talking about space between the thoughts.
CARLA: Well, for me, what happened was I had a kind of a spiritual experience. I was trying to paint with my right brain, and that means that you paint negative space. And I realized that the negative space was the space around the thought, okay? So I was looking at the figure I was trying to draw, and that was the thought. And the space around the thought, I thought, oh, my God. It's not - you're not the blissful spaces between the thoughts. You're the blissful space between - not between the thoughts, but around the thought. So that means you're everything but the thought, you know?
Dr. NEWBERG: Hmm.
CONAN: It's interesting you should talk about that. There's an email we also have from Steven in Prescott, Arizona: I'm a musician. It's been my experience that spiritual practice and creative performance have a lot in common.
Dr. NEWBERG: Absolutely.
CONAN: Have you considered studying artists, as well?
Dr. NEWBERG: Yeah, absolutely. We - actually, some of our current studies have not so much looked at artists, per se, but the effect of music on the brain. And absolutely, what to me is also a very important element of religious and spiritual feelings for people is that they can manifest in so many different ways. And there's artistic creativity. There can be being out in nature, practices like meditation, formal practices like the ceremonial rituals in churches and synagogues. They're all different ways in which we can engage in these kinds of experiences.
And there - I don't think that there's a right or a wrong way. Each person ultimately has to kind of find what works best for them and how they best understand it. And that, I think, also leads into what the caller had just mentioned about how do we define things.
And this is something that I also take up in the book, "Principles of Neurotheology," because so oftentimes, we hear people who are nonreligious say something about, well, God can't exist or there can't be a soul, or we'll have disagreements within religious individuals. And part of the problem is, is that sometimes we're not even saying - we're not even talking about the same thing. We're talking about God, but somebody may mean one thing and somebody may mean something entirely different. So that's part of the question, too, that we have to look at, is how are we really thinking about these questions? How are we really grasping them, understanding them? What does it mean for us when we talk about something that's spiritual or religious?
In fact, one of the studies that we've done is ask people to draw a picture of God, and something that all the listeners could think about doing is just go home, and what would you draw if I said draw a picture of God? And what would it look like? Because everybody draws something a little different. But that's how we try to visualize what that spiritual realm is, for the people who are spiritual. So there's some real interesting things that we could start to look at and try to better understand about who we are as people, as human beings, and how that spiritual urge affects us.
CONAN: Dr. Andrew Newberg describes some of the studies that he's done and some of his findings in "Principles of Neurotheology." He also explains some of the limitations of this new field of study, the inability of the instruments at hand to see precisely into the brain with sufficient resolution and, well, the simple lack of brain scans altogether. But in any case, a new and dawning field. Dr. Newberg, thanks very much for being with us today.
Dr. NEWBERG: Well, thank you so much for having me on your program.
CONAN: Dr. Andrew Newberg joined us from Audio Post in Philadelphia.
When we come back, it's going to be Nina Totenberg and Julie Rovner help us to answer how the ruling of a federal judge on the health care law will change the legal and practical debate.
Stay with us. This is NPR News.