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INTRODUCTION TO
BIOSTATISTICAL APPLICATIONS
IN HEALTH RESEARCH WITH
MICROSOFT OFFICE EXCEL®
AND R
INTRODUCTION TO
BIOSTATISTICAL
APPLICATIONS IN
HEALTH RESEARCH
WITH MICROSOFT
OFFICE EXCEL® AND R

Second Edition

ROBERT P. HIRSCH
Foundation for the Advanced Education in the Sciences
Bethesda, MD, USA
This second edition first published 2021
© 2021 John Wiley & Sons, Inc.
Edition History
John Wiley and Sons, Inc. (1e, 2016)
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10 9 8 7 6 5 4 3 2 1
To Libby, for her love and support without which I would be lost.
CONTENTS

PREFACE TO FIRST EDITION xiii

PREFACE TO SECOND EDITION xv

ABOUT THE COMPANION WEBSITE xvii

PART ONE BASIC CONCEPTS 1

1 THINKING ABOUT CHANCE 3
1.1 Properties of Probability / 4
1.2 Combinations of Event / 8
1.2.1 Intersections / 8
1.2.2 Unions / 13
1.3 Bayes’ Theorem / 16
Chapter Summary / 19
Exercises / 20

2 DESCRIBING DISTRIBUTIONS 25
2.1 Types of Data / 26
2.2 Describing Distributions Graphically / 27
vii
viii CONTENTS

2.2.1 Graphing Discrete Data / 27

2.2.2 Graphing Continuous Data / 30
2.3 Describing Distributions Mathematically / 36
2.3.1 Parameter of Location / 37
2.3.2 Parameter of Dispersion / 41
2.4 Taking Chance into Account / 48
2.4.1 Standard Normal Distribution / 49
Chapter Summary / 59
Exercises / 62

3 EXAMINING SAMPLES 65
3.1 Nature of Samples / 66
3.2 Estimation / 67
3.2.1 Point Estimates / 67
3.2.2 The Sampling Distribution / 73
3.2.3 Interval Estimates / 78
3.3 Hypothesis Testing / 82
3.3.1 Relationship Between Interval Estimation and
Hypothesis Testing / 89
Chapter Summary / 91
Exercises / 93

PART TWO UNIVARIABLE ANALYSES 97

4 UNIVARIABLE ANALYSIS OF A CONTINUOUS
DEPENDENT VARIABLE 101
4.1 Student’s t-Distribution / 103
4.2 Interval Estimation / 106
4.3 Hypothesis Testing / 109
Chapter Summary / 113
Exercises / 114

5 UNIVARIABLE ANALYSIS OF AN ORDINAL DEPENDENT

VARIABLE 119
5.1 Nonparametric Methods / 120
5.2 Estimation / 123
5.3 Wilcoxon Signed-Rank Test / 124
 CONTENTS ix

5.4 Statistical Power of Nonparametric Tests / 128

Chapter Summary / 128
Exercises / 129

6 UNIVARIABLE ANALYSIS OF A NOMINAL DEPENDENT

VARIABLE 133
6.1 Distribution of Nominal Data / 134
6.2 Point Estimates / 135
6.2.1 Probabilities / 136
6.2.2 Rates / 138
6.3 Sampling Distributions / 142
6.3.1 Binomial Distribution / 143
6.3.2 Poisson Distribution / 146
6.4 Interval Estimation / 149
6.5 Hypothesis Testing / 151
Chapter Summary / 155
Exercises / 156

PART THREE BIVARIABLE ANALYSES 161

7 BIVARIABLE ANALYSIS OF A CONTINUOUS DEPENDENT
VARIABLE 163
7.1 Continuous Independent Variable / 163
7.1.1 Regression Analysis / 165
7.1.2 Correlation Analysis / 189
7.2 Ordinal Independent Variable / 207
7.3 Nominal Independent Variable / 207
7.3.1 Estimating the Difference between the Groups / 208
7.3.2 Taking Chance into Account / 209
Chapter Summary / 218
Exercises / 221

8 BIVARIABLE ANALYSIS OF AN ORDINAL DEPENDENT

VARIABLE 227
8.1 Ordinal Independent Variable / 228
8.2 Nominal Independent Variable / 236
Chapter Summary / 241
Exercises / 243
x CONTENTS

9 BIVARIABLE ANALYSIS OF A NOMINAL DEPENDENT

VARIABLE 245
9.1 Continuous Independent Variable / 246
9.1.1 Estimation / 247
9.1.2 Hypothesis Testing / 255
9.2 Nominal Independent Variable / 258
9.2.1 Dependent Variable Not Affected by Time: Unpaired
Design / 259
9.2.2 Hypothesis Testing / 266
9.2.3 Dependent Variable Not Affected by Time: Paired
Design / 277
9.2.4 Dependent Variable Affected by Time / 283
Chapter Summary / 286
Exercises / 288

PART FOUR MULTIVARIABLE ANALYSES 293

10 MULTIVARIABLE ANALYSIS OF A CONTINUOUS
DEPENDENT VARIABLE 295
10.1 Continuous Independent Variables / 296
10.1.1 Multiple Regression Analysis / 297
10.1.2 Multiple Correlation Analysis / 317
10.2 Nominal Independent Variables / 319
10.2.1 Analysis of Variance / 320
10.2.2 Posterior Testing / 331
10.3 Both Continuous and Nominal Independent Variables / 340
10.3.1 Indicator (Dummy) Variables / 341
10.3.2 Interaction Variables / 343
10.3.3 General Linear Model / 348
Chapter Summary / 355
Exercises / 358

11 MULTIVARIABLE ANALYSIS OF AN ORDINAL

DEPENDENT VARIABLE 367
11.1 Nonparametric Anova / 369
11.2 Posterior Testing / 375
Chapter Summary / 380
Exercises / 381
 CONTENTS xi

12 MULTIVARIABLE ANALYSIS OF A NOMINAL DEPENDENT

VARIABLE 385
12.1 Continuous and/or Nominal Independent Variables / 387
12.1.1 Maximum Likelihood Estimation / 387
12.1.2 Logistic Regression Analysis / 389
12.1.3 Cox Regression Analysis / 399
12.2 Nominal Independent Variables / 401
12.2.1 Stratified Analysis / 402
12.2.2 Relationship Between Stratified Analysis and Logistic
Regression / 410
12.2.3 Life Table Analysis / 414
Chapter Summary / 424
Exercises / 427

13 TESTING ASSUMPTIONS 433

13.1 Continuous Dependent Variables / 436
13.1.1 Assuming A Gaussian Distribution / 437
13.1.2 Transforming Dependent Variables / 477
13.1.3 Assuming Equal Variances / 485
13.1.4 Assuming Additive Relationships / 494
13.1.5 Dealing With Outliers / 506
13.2 Nominal Dependent Variables / 507
13.2.1 Assuming a Gaussian Distribution / 507
13.2.2 Assuming Equal Variances / 510
13.2.3 Assuming Additive Relationships / 511
13.3 Independent Variables / 511
Chapter Summary / 513
Exercises / 516

APPENDIX A: FLOWCHARTS 521

APPENDIX B: STATISTICAL TABLES 527
APPENDIX C: STANDARD DISTRIBUTIONS 597
APPENDIX D: EXCEL PRIMER 601
APPENDIX E: R PRIMER 605
APPENDIX F: ANSWERS TO ODD EXERCISES 609

INDEX 611
PREFACE TO FIRST EDITION

Regardless of whether you are a health researcher or someone who wants to

understand the health research literature, Introduction to Biostatistical Applications
in Health Research with Excel will provide you with a basic understanding of the
most commonly used statistical methods in health research. The focus of this text is
on learning statistical concepts and interpreting the results of performing statistical
tests. The text is intended for readers who are not necessarily mathematically
minded. To accomplish this, I provide plain language explanations and graphic
representations of statistical concepts rather than relying on purely mathematical
descriptions that are typical of many statistical texts. Thus, the readers of Intro-
duction to Biostatistical Applications in Health Research with Excel can come to
understand and appreciate statistical logic with a minimum level of mathematical
ability.
This text includes many examples that are patterned after actual analyses of
health research data. These examples use two approaches to illustrate statistical
principles. Some examples, namely those that illustrate simpler statistical methods,
are worked out “by hand” to allow a better understanding of the statistical method.
Many of the examples, however, involve statistical methods that would require more
complicated calculations that are typically performed by a statistical program. My
experience is that little or no understanding of the logic behind these methods is
gained by performing these calculations by hand. Instead, we will be learning how
to use Excel® to perform these analyses and understand the results.
I believe that health researchers and students of health research will find Intro-
duction to Biostatistical Applications in Health Research with Excel to be highly
accessible due to its interpretation rather than calculation-oriented presentation.
xiii
xiv PREFACE TO FIRST EDITION

Also, the overall format of the text is designed so that appropriate statistical methods
for a particular set of data can be easily located. The text is divided into four parts.
The first of these builds the foundation of statistical logic. The remaining chapters
increase in complexity by building on simpler methods. These parts address uni-
variable, bivariable, and multivariable analysis respectively. Within each part, there
are three chapters. These address methods for continuous, ordinal, and nominal
dependent variables. These chapters are oriented to reflect a unique flowchart that
is provided in an appendix and in the text. This flowchart serves as a statistical
roadmap so that if the reader is able to identify the type of data represented by
the dependent variable and independent variable(s) they will be able to select the
correct statistical method to analyze their data. At the beginning of each chapter,
a continuation of the flowchart reinforces the methods discussed in that chapter
and how the statistical methods are selected. I believe that the overall design of
this text allows even the most mathematically challenged readers to really under-
stand statistical methods used in health research by providing a highly verbal and
visual explanation of statistics in a logical progression that builds on itself while
also providing the necessary tools in an easily retrievable form.
My principal reason for writing a text using Excel is to provide the reader with
access to data analysis without having to depend on a statistical programmer. My
reasoning was that Excel is a commonly available program that includes tools
needed to perform most statistical analyses.1 In addition to what is already part
of Excel, I am providing BAHR (Biostatistical Applications in Health Research)
programs for Excel that give the reader the ability to perform all of statistical
analyses, as well as the data sets used in the examples. These can be found at www
.website.com.
I am going to assume that the reader has a basic knowledge of Excel. If you have
never used Excel (or other spreadsheet program), you can read the Excel Primer in
Appendix D. Even if this is your first time using Excel, I think you will learn very
quickly as much as you will need to perform the statistical tests described in this
textbook.
One thing you need to do before you start using Excel for statistical analyses
is to install two add-ins. These are programs that come with Excel, but they are
inactive unless the user activates them. To do this, click on “FILE” on the main
menu bar. Then click on “Options” followed by “Add-ins.” On the next screen, you
will see “Manage”: followed by a selection box. Select “Excel Add-ins” and click
on “Go … ” This will display a menu that lists the available add-ins. Make sure that
there is a check in the boxes for “Solver Add-in and “Analysis Toolpak”2 Now, you
will see a new class in the “DATA” selection from the main menu. That class is
called “Analysis.”3 We will be using it soon.

Robert P. Hirsch

1 This is true for most Mac users as well as PC users.

2 For Mac users, the only add-in available is “Solver Add-in.” You can perform the same procedures (and

a lot more) by downloading the free version of StatPlus, which can be found on the internet.
3 For StatPlus, the commands appear in the top menu bar.
PREFACE TO SECOND EDITION

There are a several changes in the second edition. The most obvious is the addi-
tion of a thirteenth chapter. This chapter discusses the assumptions that underlie
the statistical methods described in Chapters 4–12. In this chapter, you will learn
how to identify the assumptions for a particular statistical test and how to evaluate
whether the assumptions are satisfied. Further, you will learn what can be done if
the assumption is not satisfied.
To further aid in identifying assumptions, Appendix C has been changed. In
this appendix, all of the flowcharts are presented. The versions of the flowcharts
in Appendix C have added indicators of the assumptions made by each test.
Another change in the second edition is the inclusion of examples in using R to
perform the statistical analyses described in Chapters 4–12. R is a free collection of
statistical programs, which is gaining in popularity in introductory statistics texts.
For the most part, R is an alternative to Excel for analysis, but Excel remains supe-
rior for data management. Data sets generated in Excel can be imported into R for
analysis there. Appendix E gives a primer for R. There, you will learn how to access
R and get it running on your computer as well as some of the basic uses of R.
Provided with this textbook on the companion website is a new version of BAHR
programs for Excel. In this new version are new programs for nonparametric anal-
yses, Student–Newman–Keuls tests, and stratified analyses. With these new pro-
grams, it is less necessary to perform calculations by hand and, instead, let the
computer perform them for us. The methods for perfuming tests by hand are still
included in the text for those who find that helps them understand the statistical
logic.
xv
xvi PREFACE TO SECOND EDITION

At the end of each chapter a chapter summary and exercises from the first edition
of the workbook have been added. The answers to the odd exercises appear in
Appendix F.

Robert P. Hirsch
Maryland, 2020
ABOUT THE COMPANION WEBSITE

This book is accompanied by a student companion website and an instructor com-

panion website:
www.wiley.com/go/hirsch/healthresearch2e
The student companion website includes

• Workbook
• Datasets
• Excel add-in
• Instructions for installing the add-in

The instructor companion website includes the Solutions Manual.

xvii
PART ONE

BASIC CONCEPTS

Statisticians are used to dealing with uncertainty. Even so, there is one fact of which
even statisticians are certain: the fact that we, as health researchers and practition-
ers, are always interested in applying the results of a study to persons, places, and/or
times that were not included in the study. Our purpose is to interpret a study’s obser-
vations as they relate to some larger group. In statistical terms, the larger group is
called the population and the smaller group is called the sample. As we interpret
health research data from a particular sample, it is always with the intention of using
the sample’s observations to draw some conclusion about the population from which
that sample was taken.
Since we are always in the position of using a sample to understand the popu-
lation, it is important that we take samples so that each one is representative of the
population. Unfortunately, we do not know how to do that. To appreciate the prob-
lem, let us think about a population that we understand completely. For instance,
suppose we were to think about a deck of 52 cards. In this “population” there are
two characteristics of its members: suit and rank. These characteristics are dis-
tributed uniformly among the members of the population so that there are 13 cards
in each of 4 suits and each suit has 13 ranks from deuce to ace. Now, thinking of
that well-defined population, which five cards would you use to communicate the
structure of the population?

Introduction to Biostatistical Applications in Health Research with Microsoft Office Excel® and R,
Second Edition. Robert P. Hirsch.
© 2021 John Wiley & Sons, Inc. Published 2021 by John Wiley & Sons, Inc.
Companion website: www.wiley.com/go/hirsch/healthresearch2e
2 BASIC CONCEPTS

If you feel frustrated with this question, it is because there is no completely cor-
rect answer. Any set of five cards fails to communicate precisely the structure of
the deck.
If we are unable to select a representative sample from such a well-defined pop-
ulation, imagine selecting a representative sample from a population that is really
of interest to health researchers. It just cannot be done!
Even though we do not know how to make each sample representative of the
population, we do know how to make a collection of samples representative of the
population. We can do that with the deck of 52 cards by shuffling the deck and
dealing several “samples” of 5 cards. In other words, we could let chance determine
which members of the population are going to be included in each sample. Any
particular hand of five cards might be distinctly unrepresentative of the deck, but if
we continued to deal hands of five cards, in the long run those hands would represent
the deck. We do the same thing when we take samples from populations as part of
research. We let chance determine which members of the population end up in the
sample.
It is this principle of random sampling that makes it necessary to understand the
role of chance when we are interested in interpreting the results of health research.
The primary purpose of statistics is to consider how chance influences that inter-
pretation. To be interpreters of health research data, we need to recognize that the
samples we examine might, just by chance, be substantially different from the rest
of the population. To do this, we need to be comfortable in interpreting the results
of statistical analyses. It is the purpose of this text to help you develop that level of
comfort.
To understand statistics, we need to understand how chance influences observa-
tions in a sample and how the role of chance can be taken into account. Thus, we
begin this text by examining the characteristics of chance and how we can use the
sample’s observations to draw conclusions about the population. First, in Chapter
1, we will look at chance itself to understand how it works. Next, in Chapter 2,
we will examine the characteristics of a population to discover how its data can be
described. Finally, in Chapter 3, we will concentrate on the sample to see how the
sample’s observations can be used to describe the population. Once we understand
these basic principles, we will be ready to take a look at statistical procedures that
are commonly used in health research.
CHAPTER 1

THINKING ABOUT CHANCE

1.1 Properties of Probability 4

1.2 Combinations of Event 8
1.2.1 Intersections 8
1.2.2 Unions 13
1.3 Bayes’ Theorem 16
Chapter Summary 19
Exercises 20

In the introduction to this first part of the text, we learned that chance is used to select
samples from the population that are, in the long run, representative of the popu-
lation from which they came (Figure 1.1). Before we can appreciate how chance
influences the composition of those samples, however, we need to understand some
things about chance itself. In this chapter, we will look at the basic properties of
chance and see how the chances of individual events can be combined to address
health issues.

Introduction to Biostatistical Applications in Health Research with Microsoft Office Excel® and R,
Second Edition. Robert P. Hirsch.
© 2021 John Wiley & Sons, Inc. Published 2021 by John Wiley & Sons, Inc.
Companion website: www.wiley.com/go/hirsch/healthresearch2e

3
4 THINKING ABOUT CHANCE

Population
Chance

Sample

Figure 1.1 Chance determines which data values in the population end up in the sample.

1.1 PROPERTIES OF PROBABILITY

To begin with, we should point out that there are two terms that can be used inter-
changeably: chance and probability. In everyday language, probability (or chance)
tells us how many times something happens relative to the number of times it could
happen. For example, we might think of the probability that a patient presenting
with a sore throat has streptococcal pharyngitis. If we can expect 1 patient to actu-
ally have streptococcal pharyngitis out of every 10 patients seen with a sore throat,
then the probability of having streptococcal pharyngitis is 0.10. Or equivalently,
there is a 10% chance that a person selected at random from among persons with
sore throats would have strep throat.
In statistical terminology, the number of times something happens is called its
frequency and that “something” is called an event. The opportunities for an event to
occur are called observations.1 When using the concept of probability, we need to
understand that there are two possible results for each observation: either the event
occurs or the event does not occur. In the previous example, the event was strepto-
coccal pharyngitis and the patients seen with a sore throat were the observations.
Everyday language is often cumbersome when discussing issues in statistics.
An alternative approach is to examine events and observations graphically. We do
this by constructing a Venn diagram. In a Venn diagram, we use a rectangle to
symbolize all of the observations and a circle to symbolize those observations in
which the event occurs. Figure 1.2 is a Venn diagram we could use to think about
the probability that a patient with a sore throat has streptococcal pharyngitis.
There are some aspects of observations and events that are evident in a Venn
diagram. For instance, we can see that the entire rectangle outside of the circle cor-
responds to observations in which the event does not occur. When an event does not
occur, we say that the complement of the event occurs. In this case, the event is
having strep throat and its complement is not having strep throat.
The way a Venn diagram tells us about the magnitude of the probability is by the
area of the circle representing the event relative to the area of the entire rectangle. A
way we can compare these areas is by creating a Venn equation. A Venn equation

1 Statisticiansalso refer to the opportunity for an event to occur as a trial. Since the term trial refers
to a clinical experiment in health research, we will exclusively use the term observation to refer to the
opportunity for an event to occur.
 PROPERTIES OF PROBABILITY 5

Figure 1.2 An example of a Venn diagram. The rectangular area represents all observations.
The circular area represents the observations in which the event occurs. The area within the
rectangle but outside of the circle represents those observations in which the event did not
occur.

Patients
with strep
throat

Probability of strep throat =

All patients
with
sore throat

Figure 1.3 A Venn equation illustrating the probability a patient with sore throat has strep-
tococcal pharyngitis.

uses the parts of a Venn diagram in a mathematical equation that shows how the
probability of an event is calculated. For the probability that a patient with sore
throat has streptococcal pharyngitis, the Venn equation would look like Figure 1.3.
A Venn equation helps us see another property of probabilities that probabili-
ties have a distinct range of possible values. Since an event cannot exist without an
observation, the circle can only be as big as the rectangle. In other words, the numer-
ator must be a subset of the denominator. The result of this property is to make the
largest possible value for a probability equal to 1 (or 100%). The value of 1 occurs
when every observation in the denominator is also an event in the numerator. When
6 THINKING ABOUT CHANCE

the probability of an observation being an event has a value of 1, it is certain that

the event will occur.
The numerator of a probability contains the number of events. The largest value
possible is equal to the number of observations. The smallest value possible is 0. If
the numerator of a probability is equal to 0, this implies that none of the observations
are events and, therefore, the probability is equal to 0 as well. A probability of 0
indicates that it is impossible for an event to occur. A probability can be no smaller
than 0 and no larger than 1.2
When we want to calculate a probability, it is easier to use some mathemati-
cal shorthand. To symbolize a probability, we use a lowercase p followed by a set
of parentheses. Within those parentheses, we identify the event addressed by the
probability. Then, the equation looks like this:

number of events
p(event) = (1.1)
number of observations

Next, let us take a look at an example that illustrates calculation of a probability

and its interpretation.

◼ EXAMPLE 1.1
Suppose we did throat cultures for 100 patients who complained of a sore throat
and 10 of those cultures were positive for streptococcus. What is the probability a
person picked at random would have a positive strep culture?
In this question, a positive strep test is the event and someone with sore throat
is an observation. To calculate the probability of a person having a positive strep
culture, we can use Equation (1.1).

number of events 10
p(event) = = = 0.1
number of observations 100

Thus, there is a probability of 0.1 (or a 10% chance) that a person selected from the
group of patients with a sore throat would be positive for streptococcus. ◼

A part of the shorthand we use to show how probabilities are calculated concerns
the complement of an event (i.e., an observation in which the event does not occur).
Rather than inserting the description of the complement of the event within the
parentheses, we more often put a bar over the description of the event. So,p(event)
stands for the probability of the complement of the event occurring (i.e., the prob-
ability of the event not occurring). For the complement of having strep throat, we
could use p(strep). There are two properties of a collection of events that an event
and its complement always demonstrate. The first is mutual exclusion. A collection
of events is said to be mutually exclusive if it is impossible for two or more events

2 This range of possible values between 0 and 1 means that a probability is also a proportion.
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room was packed, the bar was overflowing, and there was a line of
men waiting in the street. Some girls dance simply by walking. She
was one of them. She had what is called 'poetry of motion', but I think
it was her legs, really, that most men came to see. I will let you judge
for yourself. Incidentally, the piano which you will hear accompanying
her was played by me."
King Tutankhamen leaned forward, slid aside a small panel just
beneath the edge of the proscenium, and depressed several
luminescent buttons. Instantly the lights went out, and the velvet
curtains parted. A stereo-screen leaped into bright life, and a moment
later, Mary Legs, nee Annabelle Leigh, appeared upon it. So flawless
was the illusion that it was as though she had stepped upon the
stage.
Perfume reminiscent of the vineyards of Azure infiltrated the room.
Drake found breathing difficult.
She was wearing a standard stripper's outfit that could be removed
piece by piece. Hardly had she "appeared" upon the stage when the
first piece fluttered forth and disappeared. Three more followed in
swift succession. A fifth went just as she stepped, seemingly, out
upon the ramp.
"She was always that way," the King whispered. "I told her that she
should be coy, that she should tease, but she paid no attention. It was
as though she couldn't get her clothes off fast enough."
Drake barely heard him.

Mary Legs was moving down the ramp now, and now another
garment drifted forth and winked out of sight. He saw her breasts.
Chords sounded in the background. A progression of ninths and
elevenths. Her face was glowing; her eyes were slightly turned up.
Glazed.
Drake watched the final garment disappear into the mists of time. She
was down to sandals and cache-sexe now. Her slow walk down the
ramp continued.
There was poetry in the play of light upon her flesh, there was poetry
in her every motion. The flabby pectorals of beauty queens, she knew
not. Here was firmness; depth. Her hair burned with the yellow fires of
fall. An arpeggio like the tinkling of glass chimes leaped up and
formed a brief invisible halo over her head. At the base of the ramp
she went through a series of contemptuous bumps and grinds, then
returned casually the way she had come. Now there was a subtle
difference in her walk. Sweat broke out on Drake's face. His breath
burned in his throat. Eyes turned up, she saw no one, then or now;
knew no one, knew nothing but the moment. Her body writhed
obscenely. Notes fell around her like cool rain. Suddenly Drake
realized that she had not been flaunting her sex to the audience, but
to the worlds.
She began a second series of bumps and grinds. While it lacked
finesse, it was obscene beyond belief, and yet, in another sense, it
was somehow not obscene at all. There was something tantalizingly
familiar about it, so tantalizingly familiar that he could have sworn that
he had seen her dance before. And yet he knew perfectly well that he
had not.
His mind ceased functioning, and he sat there helplessly, a prisoner
of the moment. Presently she began a series of movements, a dance
of sorts that had in it the essence of every orgy known to mankind,
and yet simultaneously possessed a quality that had nothing
whatsoever to do with orgies, a quality that was somehow
transcendent ... and austere. She paused transiently just above him,
and her legs were graceful pillars supporting the splendid temple of
her body and her head was the rising sun, then she stepped back into
the screen, the lights went on, and the curtain closed.

I am a wall, and my breasts like the towers thereof:

Then was I in his eyes as one that found peace.

It was some time before either man spoke. Then Drake said, "I'd like
to buy it."
"The realitape? Why—so you can destroy it?"
"No. How much do you want?"
"You must understand," said the King, "that it is very precious to me,
that—"
"I know," Drake said. "How much?"
"Six hundred Rockefellows."
The amount came perilously close to the figure to which Drake's
capital had dwindled. Nevertheless, he did not haggle, but counted
the hundred-credit notes out. The King removed the realitape from
the proscenium projector, and the exchange was made. "You are
getting a bargain, Mr. Drake," the King said. "For a collector's item
like that, I could get twice six hundred Rockefellows."
"When did she leave here?" Drake asked.
"About a year after she arrived. A big year. I went to her room after
one of her dances and found her gone. Her clothes, everything.... For
all her willingness to exhibit herself, she was never really one of us.
She would never permit any of us to get close to her in any sense of
the word. There was something tragic about her. She said once that
she could not bear children, but I do not think that this had very much
to do with her unhappiness. She was unhappy, you know, although
she was very careful never to let on." The King raised his eyes, and
Drake was dumfounded to see tears in them. "You have told me that
after she left Worldwellost she became a saint. Somehow this does
not surprise me. There is an exceedingly thin line between good and
evil. Most of us manage to walk this line with a greater or lesser
degree of equilibrium, but I think Mary Legs could not walk it at all:
with her, I think it had to be one side or the other. Evil, she found
intolerable after a while, and she ran away, crossing the line to good.
But good, she eventually found intolerable too, and she ran away
again. She told you that she wished to be put down on Iago Iago to
witness a resurrection. This, I do not believe. Real or not, the
resurrection was an excuse for her. I believe that she was searching
for a way of life that would combine the two extremes of good and evil
and that she hoped to find it among the primitive Polysirians. And I
think that she also hoped to find a man who would understand her
and accept her for what she was. Do you think I may be right,
Nathaniel Drake?"
"I don't know," Drake said. Abruptly he stood up. "I'll be on my way
now."
King Tutankhamen touched his arm. "The question which I am about
to ask is an exceedingly delicate one, Nathaniel Drake. I hope you
will not take offense?"
Drake sighed wearily. "Ask it then, and get it over with."
"By any chance, are you of Dutch descent?"
"No," Drake said, and left.

Three of the six months which Pastelsilks, Inc. had given Drake to
sell his cargo had now passed, and his cargo was undiminished by so
much as a single bolt of blue. His capital, on the other hand, was
virtually exhausted. Even Der Fliegende Holländer had never had it
so bad.
Drake had not expected to be able to sell any of the pastelsilk on
Worldwellost, nor, he realized in retrospect, had he expected to be
able to sell any of it on Azure. It was imperative, however, that he sell
it somewhere and sell it soon, for, unredeemed or not, he still
intended to go on living, and in order to go on living he needed a
means by which to make his daily bread, and while a ghost-ship left
much to be desired, it was better than no ship at all. He had known all
along that there was one place in the Sirian Satrapy where the people
were naive enough to barter worthwhile goods for "bolts of blue and
pastel nothingness", and that place was Iago Iago. However, he had
deferred going there for two reasons. The first reason had been his
eagerness to discredit Saint Annabelle Leigh, and the second had
been his fear that fencing the goods he procured on Iago Iago might
get him into trouble with the authorities and lead to the loss of his
pilot's license. But for all his seeming success in blackening the face
of the woman he wanted to hate, he had failed so completely to
evoke the desired emotion that he knew by now that the cause was
hopeless; and in view of the fact that his pilot's license would be
worthless if he lost his ship, the second objection was no longer valid.
It had been in the books all along for him to go to Iago Iago.
He lifted up from Heavenly and found the stars again, and the stars
were good. Madame Gin, he left behind. After turning over the ship to
the automatic pilot, he got out the realitape he had purchased from
King Tutankhamen and fitted it into the girlie realitape projector.
Presidently Mary Legs stepped out of the past. He propped the
stereo-snapshot Penelope had given him against the base of the
chart lamp, then he turned on the intercom. "I have chosen to speak
to you this day of the Potomac Peregrination, of the walking of His
ghost upon the land," said Saint Annabelle Leigh. Mary Legs cast her
final garment into the mists of time and walked lewdly down the ramp.
Perfume reminiscent of the vineyards of Azure permeated the room.
Cancelling out the background music, Drake discovered that her
dance blended with the words Saint Annabelle Leigh was uttering.
No, not Saint Annabelle's words exactly, but the rhythm and the
resonance of her voice. What the one was trying to express, the other
was trying to express also. Look at me, they "said" in unison. I am
lonely and afraid, and full of love. Yes, yes! cried the girl on the hill.
Full of love, full of love, full of love!... And in the cabin, vineyards
blossomed, flowers bloomed; there rose a blue-bright sun, and in its
radiance the boy and the girl walked, the boy Nathaniel and the girl
Annabelle Leigh, and the wind blew and the grass sang and the trees
put their heads together in rustling consultations ... and all the while,
the hull-beams creaked and the grav generator murmured, and the
spectral Fly by Night sped on its way to Iago Iago.
It was fitting that a ghost should fall in love with a ghost.

Iago Iago
Iago Iago is like a massive ball of yarn left lying in the hall of the
universe by some capricious cosmic cat. It is emerald in hue, and
when it is viewed from a great distance its atmosphere lends it a soft
and fuzzy effect. This effect diminishes as the distance decreases,
finally ceases to be a factor, and the planet emerges as a bright
green Christmas-tree ornament hanging upon the star-bedight spruce
of space.
The Polysirians were expecting Nathaniel Drake. They had been
expecting him for many months. "I will arise and come back to you,"
he had said. "I will appear in your sky, and come down to you, and
you will know then that His ghost did truly walk, and that it did not
walk in vain." Nathaniel Drake did not know that they were expecting
him, however, nor did he know that he had said these words.
He brought the Fly by Night down in a grassy meadow, parked it on
extended anti-grav jacks, and drifted down to the ground. He heard
the shouts then, and saw the Polysirians running toward him out of a
nearby forest. He would have re-boarded his ship and closed the lock
behind him, but the tenor of their shouts told him that he had nothing
to fear, and he remained standing in the meadow, tall and gaunt and
ghostly, waiting for them to come up.
They halted a dozen yards away and formed a colorful semicircle.
They wore flowers in their hair, and their sarongs and lap-laps were
made of pastelsilk. The pastelsilk was decades-old. Had another
trader come down out of the heavens in times past and defiled this
virgin ground?
Presently the semicircle parted, and an old woman stepped into the
foregound. Drake saw instantly that she was not a Polysirian. Her
Church of the Emancipation uniform stood out in jarring contrast to
the colorful attire of the natives, but it was not one of the mass-
produced uniforms worn by her compeers in the civilized sections of
the satrapy. It had been spun and cut and sewn by hand, and in its
very simplicity had attained a dignity that its civilized cousins could
never know. Somehow he got the impression that she was wearing it
for the first time.
She began walking toward him through the meadow grass. There
was something tantalizingly familiar about the way she moved;
something nostalgic. The brim of her kepi kept her eyes in shadow,
and he could not see into them. Her cheeks were sere and thin, yet
strangely lovely. She stopped before him and looked up into his face
with eyes into which he still could not see. "The people of Iago Iago
welcome you back, Nathaniel Drake," she said.
The heavens seemed to shimmer; the terrain took on an unreal cast.
The semicircle knelt and bowed its be-flowered heads. "I don't
understand," he said.
"Come with me."

He walked beside her over the meadow, the ranks of the people
parting, and the people falling in behind; over the meadow and
through the park-like forest and down the street of an idyllic village
and up a gentle hill that swelled like a virgin's breast into the sky. The
people began to sing, and the tune was a thrilling one, and the words
were fine and noble.
On top of the hill lay a lonely grave. The old woman halted before it,
and Drake halted beside her. Out of the corner of his eye he saw a
tear flash down her withered cheek. At the head of the grave there
was a large stone marker. The marker was intended for two graves,
and had been placed in such a way that when the second grave was
dug the stone face would be centered behind both.
"Mine eyes have seen the glory of the coming of the Lord;" the
Polysirians sang. "He is trampling out the vintage where the grapes of
wrath are stored; HE hath loosed the fearful lightning of his terrible
swift sword, His truth is marching on."
Nathaniel Drake looked at the marker's stone face. One half of it was
blank. On the other half—the half that overlooked the grave—the
following letters had been inscribed:
SAINT NATHANIEL DRAKE
Drake knew the answer then, and knew what he must do—
What, in a sense, he had done already....
He turned to the old woman standing beside him. "When did I first
come here?" he asked.
"Fifty-two years ago."
"And how old was I when I died?"
"You were eighty-three."
"Why did I become a saint?"
"You never told me, Nathaniel Drake."
Gently, he touched her cheek. She raised her eyes then, and this
time he saw into them—saw the years and the love and the laughter,
the sorrow and the pain. "Were we happy together?" he asked.
"Yes, my darling—thanks to you."
He bent and kissed her upon the forehead. "Good by, Mary Legs," he
said, and turned and walked down the hill.
"Glory, glory hallelujah," the Polysirians sang, as his ship rose up into
the sky. "Glory, glory, hallelujah. Glory, glory, hallelujah, his truth is
marching on."

To what may a warp seepage be likened?

It may be likened to a leak in the roof of a twentieth-century dwelling.
The roofs of twentieth-century dwellings were supported by rafters,
and whenever a leak occurred, the water ran along these rafters and
seeped through the ceiling in unexpected places. While the "rafters"
of man-made spacewarps are of a far more complex nature than the
rafters of such simple dwellings, the basic analogy still holds true: the
spatio-temporal elements that escape from spacewarps such as the
Suez Canal never emerge in the immediate vicinity of the rift.
Even in Nathaniel Drake's day, the Suez Canal techs knew this, but
what they did not know was that such seepages do not pose a threat
to the continuum, but only to whoever or whatever comes into contact
with their foci. Neither did the Suez Canal techs—or anyone else, for
that matter—know that the effect of these foci varies in ratio to the
directness of the contact, and that in the case of partial contact, the
effect upon a human being or an object is seemingly similar to the
hypothetical preliminary effect of a Lambda-Xi bombardment. Hence
it is not surprising that no one, including Drake himself, had tumbled
to the true cause of his "ghosthood": i.e., that he and the major part of
his ship, in coming into partial contact with a focus, had been partially
transmitted into the past. Simultaneously, the rest of the ship—and
Annabelle Leigh—had come into direct contact with the focus and
had been totally transmitted into the past.
Here then was the situation when Drake left Iago Iago:
Part of himself and part of his ship and all of Saint Annabelle Leigh
were suspended in a past moment whose temporal location he knew
to be somewhere in the year 3614 but whose location, although he
knew it to be within displacement-drive range of Iago Iago, he could
only guess at, while the preponderance of himself and the
preponderance of his ship hurtled toward the region of space that
was responsible for his "ghosthood" and whose co-ordinates he had
jotted down in the Fly by Night's log over three months ago. In the
light of the knowledge with which his visit to Iago Iago had endowed
him, he quite naturally assumed that once he and the ship made
direct contact with the force that had partially transmitted them, the
rest of the transmission would automatically take place—as in a
sense it already had. But what Drake did not know, and had no way
of knowing, was that spatio-temporal inconsistencies must be
balanced before they can be eliminated, and that before total
transmission could be effected, his three months-plus sojourn in the
future had to be compensated for by a corresponding sojourn in the
past, the length of said sojourn to be in inverse ratio to the spatio-
temporal distance he would be catapulted. Consequently he was
shocked when, following the Fly by Night's coincidence with the
focus, he emerged, not in the spatio-temporal moment he was
prepared for, but in the war-torn skies of a planet of another era and
another system.
At the instant of emergence, every warning light on the ship began
blinking an angry red, and the scintillometric siren began wailing like
an enfant terrible. Drake's conditioned reflexes superseded his shock
to the extent that he had the anti-fission field activated before the
automatic pilot had finished processing the incoming sensoria.
Although he did not know it at the time, the shield that the ship threw
out cleansed nearly an entire hemisphere of radioactivity and
engulfed half an ocean and a whole continent. All of which brings up
another aspect of time that was undreamed of in Drake's day:
Expansion.

Neanderthal man stood knee-high to a twentieth-century

grasshopper, and the woolly mammoth that he hunted was no longer
than a twentieth-century cicada. The universe expands on a temporal
as well as a spatial basis, and this expansion is cumulative. Over a
period of half a century, the results are negligible, but when millennia
are involved, the results are staggering. Look not to fossils to dispute
this seeming paradox, for fossils are an integral part of the planets
they are interred upon; and do not point with polemic fingers to such
seemingly insuperable obstacles as mass, gravity, and bone tissue,
for the cosmos is run on a co-operative basis, and all things both
great and small co-operate. Nor are there any discrepancies in the
normal order of events. A six-foot man of a past generation is the
equivalent of a six-foot man of a future generation: it is only when you
lift them from their respective eras and place them side by side that
the difference in relative size becomes manifest. Thus, in the eyes of
the inhabitants of the planet he was about to descend upon,
Nathaniel Drake would be a figure of heroic proportions, while his
ship would loom in the heavens like a small moon—
Or a small planet....
Beneath him lay the ruins of a once-magnificent structure. Not far
away from the ruins, a pale river ran, and across the river, a city
burned brightly in the night. Nathaniel Drake knew where he was then
—and when. Looking down upon the ruins, he had an inkling of his
destiny.
What I do now, he thought, has already been done, and I cannot
change it one iota. Therefore, what I do I am destined to do, and I am
here to fulfill my destiny.
He still wore his anti-grav belt. He parked the Fly by Night on
extended jacks, and drifted down to the ground.
Here, cherry trees grew, and the cherry trees were in blossom.
Towering above the pink explosions, Nathaniel Drake knew his heroic
proportions.
He approached the ruins he had seen from above. The noble
columns lay broken; the stately roof had fallen in. The walls,
blasphemed not long ago by the hate-steeped scrawls of
segregationists, were rivened. Was that a marble hand protruding
over there?
A hand. A marble arm. A shattered white-marble leg. Drake knew his
destiny then, and began to dig.
No one saw him, for men had become moles, and cowered in dark
places. Above him in the sky, missiles struck the anti-fission shield
and winked out like gutted glowworms. Interceptors blazed up, then
blazed back down again, and died. The flames of the burning capital
painted the Potomac blood-red.
He continued to dig.
A fallen column lay across the broken marble body. He rolled the
column aside. The noble head lay broken on the floor. He picked it up
with gentle hands and carried it out and laid it on the spring-damp
ground. Piece by piece, he carried the broken statue out, and when
he was sure that not a single fragment remained among the ruins, he
brought his ship down and loaded the pieces into the hold. Lifting, he
set forth for the sea.

Some distance inland from the shores of Chesapeake Bay, he left the
ship and drifted down to the bank of the river and began walking
along the river to the sea. Above him, the automatic pilot held the
ship on the course.
He felt like a giant, Nathaniel Drake did, walking down the Potomac to
the sea, and in this long-ago age a giant he was. But all the while he
walked, he knew that compared to the giant he was impersonating,
he was a pygmy two feet tall.
... and if you cannot believe in the walking of His ghost upon the land
and in His ascension to the stars, then you are as one dead, without
hope, without love, without pity, without kindness, without humanity,
without humility, without sorrow, without pain, without happiness, and
without life ...
"Amen," said Nathaniel Drake.
He came to a village untouched by the destruction around it, and saw
people crawling out of underground shelters. Looking down upon
them, he proclaimed "Lo, I have arisen. Lo, I walk again! Look at Me,
ye peoples of the earth—I have come to emancipate you from your
shackling fears, and I have summoned the Planet of Peace from out
of the immensities of space and time to transport My ghost to the
stars. Lo, I force peace upon you, ye peoples of the earth, and I
command you to remember always this terrible day when you drove
Kindness from your doorsteps and threw wide your portals to
Perdition."
On the shore of Chesapeake Bay he halted, and when the automatic
pilot brought the ship down, he removed the fragments of the statue
from the hold and laid them gently on the beach.... And the Planet of
Peace absorbed His ghost and bore it from the face of the earth.
A moment later, complete transmission occurred.

The cabin was a lonely place. He left it quickly and hurried down the
companionway to the starboard storeroom. The bulkheads no longer
shimmered, and the deck was solid beneath his feet. His
translucence was no more. He opened the storeroom lock and
stepped across the threshold. Mary Legs, nee Annabelle Leigh, was
huddled on the floor. She looked up when she heard his step, and in
her eyes was the dumb and hopeless misery of an animal that is
cornered and does not know what to do.
He raised her gently to her feet. "Next stop, Iago Iago," he said.
THE END
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