A forgotten CODEs gig at an SCCM meeting resurrected


Hello again, the 50th Anniversary of the Society for Critical Care Medicine (SCCM) is coming up and they were wondering if the CODES were available to play for the meeting again as we did several years ago. Not likely as we haven’t played together for a couple of years but it was a good run as our first gig was in 2006.

So I suggested maybe I edit a song from our last SCCM gig, which was several years ago. I rummaged through the high-resolution videos of that gig, selected a song that featured all of us playing and cut it back to a minute and a half. Don’t know if they’ll play this in their repertoire of ZOOM selections but I gave it to them. Maybe they’ll play it. Maybe not, but here it is for whatever interest anyone has.

The song is “Twilight Zone” originally done by a Dutch group Golden Earring (1982). It’s a great song and part of our set list for years. I chopped it after the meat & potatoes just before the extended lead break for brevity. You’ll get the idea. Listen for Gary’s scrape of the low E string from top to bottom. EEEEEOOOOOWWWWW. Not very loud. You have to listen for it.

Enjoy if you have an interest. As always, turn up the volume.

Percussion: Mike DeGeorgia, MD, FCNS
Chair, Neurology and Neurocritical care
Case-Western University, Cleveland

Rhythm guitar and backup vocals: David Crippen, MD, FCCM
Professor Emeritus (ret)
Department of Critical Care, Neurovascular ICU
UPMC, Pittsburgh

Lead Singer and base guitar: Stephan Mayer, MD, FCNS
Director of Neurocritical Care and Emergency Neurology Services, Westchester Medical Center, Valhalla, New York

Lead guitar and vocals: Gary Bernardini, MD, PhD, FCNS
Chair, Neurology and Neurocritical care
Cornell Medical Center, New York City

A passing: Eddie Van Halen (1955-2020)


The death of Eddie Van Halen is a big enough deal as to require some comment by me.

Van Halen’s efforts in 1978 produced a seemingly odd instrumental named “Eruption” that radically changed the entire spectrum of guitar music. It introduced the concept of “tapping”, that is- tapping with the finger on the string 12 frets away from its insertion. This can be moved around the fret board and produces a very unusual tone compared to simply plucking a string.

Eddie was not the first to produce sounds from tapping strings.  Steve Hackett of Genesis did it in 1975. Canned Heat guitarist Harvey Mandel was doing it in as early as 1968 at the Whisky in LA.  But no one did it like Eddie Van, who originally only did it in clubs and as a warm up exercise. But when it surfaced on Van Halen’s first album in 1978, the 1.4 minute instrumental explosion changed everything from the ground up.

Every player, including me, had to learn it but few could really do it justice. I could do about ten seconds of it before every finger cramped. Otherwise, “tapping” became the order of the day and every guitar shop had at least two or three acolytes trying it out on instruments sporting fast fret boards and lots of amplifier distortion effects. It’s said that Eddie plugged in an electronic gadget to increase the voltage to his Marshall amp, blowing them up pretty routinely.

The fact, however, is that most players couldn’t play it and even if they could, the amount of technical ability didn’t translate into listenability. You really can’t take it for too long before your ears start to ring. That said, Eddie did a lot more for guitar music than Eruption. His creativity and imagination was unparalleled. I learned to play some of his slower songs and very much enjoyed them. In their prime (late 70s and 80s), Van Halen with Diamond Dave Roth was a great band.

So one of the guitar magazine guys once asked Eddie how he came to be such a facile player. The story is interesting. When in high school, Eddie discovered that his life was guitar and nothing else mattered. He routinely skipped school, got up early in the morning, sat on the edge of his bed and practiced. Continuously, then had a sandwich for lunch and practiced again all afternoon, then supper after which his brother went out to socialize and Eddie say on the edge to practice until bedtime- every day for days on end.

So my response to that is that if I had that kind of passion for playing, I could probably play like Eddie too but I had a day job and I didn’t live for music. I had other passions that I lived for. Music was a side issue.  And BTW, if you read very erudite criticism of Eddie’s playing, they are all the same. It sounds “practiced”, practiced music lacks soul and soul is what the ear likes to hear.

If you dial into watch Neil Young play “The needle and the damage done”, he doesn’t have much of a singing voice and his guitar chords are rudimentary but trust me, you can’t take your eye off him.  Similarly, BB King always on the same area of the fret board and he rarely looks to see where he’s playing. He doesn’t have to. His fingers know where to go intuitively.

Sadly, the musical heros of my youth are sinking quickly. Some from old age. Some from suicide as they are unable to make the transition from the 60s and 70s to the new world. Eddie and the Band “Van Halen” were absolute masters of their trade in the 80s and now, having flashed across the sky in a blinding burst, have descended into history.

Rest in Peace Eddie Van. A life well lived.

Protests v. Violence: Forward to the past


Last night, 5/30/2020, my daughter the cop was called out emergently with a bunch more cops, to join the National Guard in protecting the city (Pittsburgh) from roving bands of vicious destructors. Cars overturned and set on fire. Store window glass destroyed and stores looted. Four cops hospitalized, dozens of others treated at various sites. Traffic backed up for miles. All seemingly to raise the public’s consciousness about what amounts to 100 years of racial inequality and abuse. The first Amendment allows for peaceful demonstrations to complain about various kinds of abuse and one rarely hears much complaint about it. City dignitaries and various professional sports figures (here) frequently join such demonstrations.

Some history:  Back in the 60s Dr. King’s strategy was strictly non-violent demonstration to point out inequities in how the races were treated. There were good reasons for this. If protesters fought back in kind when physically abused by police, it might be construed that the protesters were assaulting the police, giving them a legal reason to beat them to a pulp in self-defense. These were the days before pocket size video that everyone now carries. In the 60s, creative photography made it difficult to prove one way or the other who was assaulting who.

This strategy lasted from the 50s into the late 60s when it was finally figured out that non-violent demonstrations were ineffective, if for no other reason than few cared and they were not carried to large audiences via what was then rudimentary TV. About the time Dr. King was assassinated, it was becoming clear to would-be protesters that getting routinely beat up wasn’t very effective in proffering their points. About this time, younger black leaders, Rap Brown, Malcolm X, Eldridge Cleaver, JoAnne Byron, the, The Black Liberation Army, (BLA), Black Panthers and many others began various “push-back” strategies of getting their agenda more noticed by becoming more noticed. BLA goons assassinated white police officers walking beats.

So, somewhere in this time period, protesters figured out they get a lot more attention if they started inconveniencing those who really don’t care much about their activities, aided by the visual media (CNN) whose advertisers love anything that draws viewers to their plethora of commercials. So drawing viewer’s attention to social inequities moved from visual to violent.

It should also be noted that none of this is anything new. The white population in virtually any city traditionally had a heap of contempt for former slaves who had been legally liberated but remained their previous underdog social status. White lawmakers, administrators and politicians greatly feared that if blacks gained any amount of political power (voting), this would diminish the dominion of those ensconced in power. Various very creative schemes were created to insure “minorities” stayed minor.

For want of a better term, “Whites” as a group have never liked the black population very much and that dates all the way back to Reconstruction. They are legally mandated to legally treat them as equals but that changes nothing about their emotional feelings about them. It must also be remembered that blacks are no longer “minorities” anywhere. They’re majorities or near majority in virtually any major city except in the deepest Western States. In many cities with ingrained racial problems, the local TV stations gleefully portray them on-screen after they’re picked up for various law-breaking, subjectively suggesting that most of the ills of the city are caused by roving bands of grimacing black criminals festooned with facial metal, tattoos and bulky hair braids. Aliens. Aliens caught doing damage.

So here we are.  One would think that police officers would have enough sense to do whatever it takes to stop killing those black guys, especially the ones obviously unarmed. They’ve been doing it now pretty reliably since Fred Hampton in 1968. Killing them over and over, sometimes for the thinnest excuse, nowadays each episode filmed from multiple vantages by ubiquitous cell phone video cameras. Whenever a cop appears almost anywhere, fifty cameras appear starting with Rodney King in 1991. You would think they’d learn that every time it happens it gets videoed in high resolution, followed by multi-city riots.

Why does this keep happening?

I think it keeps happening because the experience of many police officers with black citizens is pathologic and not much is being done to rectify it. A relatively few bad interactions goes a long way. After a cop gets shot at a few times, and forced to follow would-be armed criminals up dark, dangerous alleys, they start considering them not much more than vermin and stomping them out isn’t much different than eliminating cornered rats. Videos of many of these murders don’t show much emotion on the faces of cops killing other humans.

Similarly, anyone that’s viewed the killing of Mr. Floyd will not be reminded by protests. They’re quite aware of the atrocity and it’s as unclear how to solve it as it was in 1968. Mass peaceful protests usually fall on bored motorists that avoid the traffic jams shown up on WAZE. However, once protesters start burning cars and businesses, beating up cops and doing as much damage as possible, everything changes. CNN, MSNBC, Fox News and all the local stations stop everything and photograph as much as the violence as they can- close up from helicopters. Already Beleaguered downtown business owners (from COVID shutdown) pleading with looters carrying out flat screen TVs. Protesters throwing Molotov Cocktails through broken glass windows to start damaging fires in their own community.

At this point, no one remembers the original point of the “protest”. Now it’s become a Netflix special action series, cops against the bad guys. If TV viewers glued to the tube didn’t care much about the root cause of the protest anyway, they now loathe them and the entire thrust of the protest vanishes as the police and National Guard prevail because they’re more of them and they’re better armed.

So, in essence, the events of the 60s that evolved to the violent 70s is coming around again.

Editorial comment by me 5/14/2020


What I’m seeing here in Pittsburgh is similar to what’s happening elsewhere in the mid-west, lots of people believing that rituals will save them from doom and gloom. That wiping down things with alcohol, wearing essentially ineffective surgical masks and bandanas that demonstrate they’re “doing something” and playing out the opera as dictated by experts who have never seen anything like this before and are all guessing.

Sunday, on Fareed Zakaria’s show, expressed the idea that the virus most probably did start from a wet market in China where a large number of previously “wild” animals were herded together (as food stuffs) in proximity to lots of humans, some probably sick or with immune deficiency for whatever reason. It’s easy for any virus to follow these pathways from sick animals to sick humans. And as more and more of the natural habitat of these animals is destroyed to build Hiltons and parking lots or simply to slash and burn, the pathway from animal to human becomes smoother. I think that’s a very viable theory and what it means as a practical matter is that this virus made a very smooth transition to the globe and for all those reasons we can expect more of the same.

In Pittsburgh, we are now in the “Yellow Zone” of social activity, which means “some” businesses are now open in a limited sense, with nods to social distancing and crowd control, lots of wiping things down and some kind of mask for all. But Americans always find creative ways around anything that inconveniences them. Two businesses that are STILL shut down in the Yellow Zone are gyms and hair salons. I have no idea why, but I have an appointment at a local Gym tomorrow to start building my functional ability back again. I also have an appointment next week for a haircut after two months. If I look around, I can find a place to go out to eat. So, I would hazard a guess that all over the country, most of these admonitions for the viral infestation are simply ignored or things like surgical masks are being touted as “real” prevention. What that means is that the virus will persist for a LONG time and lots of things will become the “new normal”.

What will be the new Normal? Last night on the news, they explored the probability that we will become a “Virtual” nation. That means computer visualization of meetings, education and everything else formerly requiring face-to-face discourse. It’s already happening. Schools and universities have already served notice that they are most assuredly transitioning to computer classes, students participating by laptops from home. Harvard School of Medicine has served notice that they are rapidly gearing up for visualized classes from home. The dehumanizing effect of this kind of faux social interaction is truly scary.

Everyone accesses their daily items and desires from Amazon, Craig’s List and eBay, with more added every month.  It’s simply more convenient and those on-line businesses have EVERYTHING for sale, cheaper than the increased cost of the necessary middle-man in structural stores. Brick & Mortar businesses are closing right and left. The last one yesterday was GNC food supplements, a huge office building and shops all over the country. They’re going to go the way of Radio Shack, with thousands of jobs going with them.

The concerts that normally fill stadiums have all been cancelled with no hint of when, if ever, they will return. That means the Kenny Chesney concert scheduled for next week is out and all the football games that normally number over 50,000+ rabid fans that come from all over the country to see the Steelers in Heinz Field are cancelled till further notice. Similar actions for hockey and baseball. What they didn’t mention is what’s happening right now. All those 50,000 rabid fans eat food, drink beer and park their cars in Pittsburgh, bringing in a ton of money and literally supporting industries. All gone, and with it those industries and jobs.

The major grocery in Pittsburgh is the Giant Eagle and going for food is a very interesting trip. The entrance to the store is about 30 or so yards along the side of the store from the entrance and the only way out is the designated exit. No entry without a mask of some variety. 6 feet spacing on the sidewalk and store personnel walking around to enforce social distancing. Large chunks of foodstuffs missing off the shelves due to panic buying, including water bottles. Prices of everything are up at least 30% so far. As there is more and more unemployment and providers of meat slow down production, this will continue and get worse. As demand from kids school meals vanishes, Farmers are dumping milk into their fields as the cows need milking whether the product is sold or not. The income from milk is now less than the cost of producing it. This has the potential to destroy farming.

The CEO of Boeing Aircraft was interviewed yesterday and he opined that at least one, possibly two airlines were poised to enter Chapter 11 due to decreased number of passengers and increasing cost of fuel and airport costs. Delta is burning through fifty million dollars a day. There are several photos of passenger planes lined up, filling the entire runway at Pittsburgh International. The planes that are still flying are doing so with only a few passengers. They won’t do that for long at the current cost of fuel. So, not only are people not traveling anymore, the potential for carriers is progressively crashing. I was thinking I might want to go one more interesting place before I died. Delta told me to forget it unless I was prepared to pay an astronomical price for a seat 6 feet from the next guy.

The Washington Post detailed American workers filing 3 million new unemployment claims last week, bringing the eight-week total of coronavirus-induced layoffs to 36.5 million. This number will progressively increase as more and more businesses go under. The money men in government are sending out trillions of dollars here and there. No one knows where it’s coming from or exactly where it goes. The effective long range planning by central government officials can best be described as loose cannons rolling around the deck firing the odd shot here and there. The unemployed will start protesting their plight in larger and larger numbers resulting in ????  This is said to return when “things get better”.  I think there is some evidence that once many of these industries die, the cost of resurrecting them would be prohibitive and they’ll stay dead. Society will then learn to live without them and that will be a very interesting life, indeed.

I’ve made it to nearly 77 years of age and I now count myself as exceptionally lucky to have lived in an era where I could do pretty much anything I wanted, go where I wanted and work in a career that worked very well for helping sick persons. I’m very glad I won’t have to live in the world being created right now as I sit here. I feel very sorry for those much younger than me that will have to figure out how to survive in it.


“The Edge… There is no honest way to explain it because

the only people who really know where it is are the ones

who have gone over it.”


―Hunter S. Thompson, “Hell’s Angels: A Strange and Terrible Saga”


A Passing. Little Richard (1932-2020)


“Little Richard” (1932-2020) was far more than a founding father of Rock and Roll, he was literally the “architect of Rock”. Richard Penniman was born in Macon, Georgia in the same era as the Allman Brothers, Otis Redding and James Brown. His daddy sold bootleg whisky around the area. His flamboyant style of piano playing began in the mid-50s as a blend of gospel spirituals, country and what was then Rhythm and Blues originating in the Mississippi Delta area. He was an influence for everyone from Elton John to the Beatles. Rolling Stone said Elvis popularized Rock and Roll, Chuck berry was the storyteller and Little Richard was the archetype.

Richard’s band consisted of multiple instruments, many electrified, raised the energy level of Rock several levels. Jimi Hendrix played guitar in one of Richard’s bands at age 18. James Brown is said to have sang backup briefly at a young age. Richard’s pumping piano was usually accompanied by frenetic songs with a barely hidden sexual orientation (sometimes clouded by gibberish to white audiences but understood by blacks present). The Beatles masterfully sang several of Richards songs in the same style. Several of Richard’s songs (Long Tall Sally, Tutti Frutti) sans the energy and spirit were notoriously covered for white audiences by Pat Boone.

If uniting black and white audiences was a point of pride for Little Richard, it was a cause of concern for others, especially in the South. Shaped by then social issues, Little Richard’s style music followed certain inevitable paths throughout the South, The tributaries that feed the “Chitlin Circuit”, an entertainment venue safe for black musicians started in Louisiana, became manifest in Mississippi through Alabama and Georgia. The path swung up through the Eastern Seaboard as far New York City, including the famous “Cotton Club” and the Apollo Theater in Harlem. Paul McCartney said that the first song he ever sang in public was “Long Tall Sally,” which he later recorded with the Beatles. Bob Dylan wrote in his high school yearbook that his ambition was “to join Little Richard.”

A large number of notable performers have trod the Chitlin Circuit over the years including Count Basie, Ray Charles, Duke Ellington, Ella Fitzgerald, The Jackson 5, Aretha Franklin, Jimi Hendrix (with Little Richard), Billie Holiday, John Lee Hooker, Lena Horne, Gladys Knight & the Pips, Wilson Pickett, Otis Redding, Smokey Robinson, Ike & Tina Turner, The Temptations, Muddy Waters. It was considered a monster breeding ground for talent. Richard was one of the first ten inductees into the Rock and Roll Hall of Fame in 1986. He appeared in several period films and most of his life is too plentiful and colorful to detail here.

It’s said that talent is born, grows up, streaks across the sky, then ultimately expires. What’s left is how long and how bright. Some talent like Nick Drake and Pete Ham flash brightly but briefly. Others like Little Richard, Elvis, Chuck Berry and Jerry Lee persist in the sky leaving a trail of devotees that carry on the glow.





There is a very complete biography by Charles White, Foreword by Paul McCartney:








Some history that might affect us in 2020


Some history that might affect us in 2020

David Crippen

The great famine in Ireland, 1845 -1849.  During the worst of it, 1847, one million Irish died and another one million were put on ships bound for America. A microorganism, the “potato blight” was actually found first in Philadelphia and New York City. Winds spread the spores to the rest of America and it crossed the Atlantic into most of Europe but settled most in Ireland because of its dependency of a single susceptible variety of potato, the “Irish Lumper” The blight also affected Germany, leading to the deaths of 700,000.

In 1846, three-quarters of the Irish harvest was lost to blight. By December, a third of a million destitute people were forced on the dole or straining meager public works. Since over three million Irish people were totally dependent on potatoes for food, hunger and famine were inevitable. By February 1847, there were huge snowdrifts and the poor had no warm clothes to work outdoors in cold and wet weather. When the father of a family became sick or died after working on the public works, the women or children in the family tried to take over the work but it was very hard and involved carrying heavy loads or digging. This type of work was not useful in helping the people who were starving.

English landowners quickly figured out it was cheaper to purchase tickets to the new world for their Irish tenants than support them through a blight no one knew the potential length of. New York, three times the size of Boston, was better able to absorb its incoming Irish. Throughout the Famine years, 75 percent of the Irish coming to America landed in New York. In 1847, about 52,000 Irish arrived in the city with a total population of 372,000. The Irish were not the only big group of immigrants arriving. A substantial German population totaling over 53,000 also arrived in 1847.

Unlike many other nationalities arriving in America, the Irish chose to huddle in the cities partly because they were the poorest of all the immigrants arriving and partly out of a desire to recreate the close-knit communities they had back in Ireland. The Irish loved each other’s company, but the daily pressures of living in America at the bottom rung of society also brought out the worst in them. Back home, the Irish were known for their honesty, law-abiding manners, and chastity. In America, old social norms disintegrated and many of the Irish, both men and women, behaved wildly. In the hopeless slums of New York, prostitution flourished and drunkenness occurred even among children.

So many Irish drifted into the five points of New York City, a repository of the poorest, most disadvantaged and exploited of all the immigrants, including the Irish and the Blacks. Since virtually all Irish were Catholic, the burgeoning supply of them fostered fear of the Papacy, which became fear and hatred of the Irish.

The original Five Point in New York City are no longer there as they were in the mid-1800s. They existed off Centre Street to the west, Bowery to the east, Canal to the north, and Park Row to the south. The Civic Center and Chinatown also bound this area now. The Martin Scorsese film“Gangs of New York (2002) , accurately depicted a long running catholic/protestant feud erupted into violence fueled by Irish immigrants rebelling against low wages and social repression and an influx of freed slaves with similar repression. This mix of low wages, lack of jobs, racism and social repression generated frustration and anger finally brought to a head by the onset of conscription into the Union Army (in New York) in at the time of “Draft Week”(Mid July, 1863).

The actual riot boiled over July 13-16, 1963.  Working class discontent and smoldering anger were a function of white working-class men, mostly of Irish descent, who feared free black people competing for work and resented that wealthier men, who could afford to pay a $300 fee to hire a substitute, sparing them from the draft. Initially focused on frustration and anger at the draft, the protests evolved into a race riot. The death toll was thought to be around 120 individuals. Herbert Asbury, the author of the 1928 book “Gangs of New York” upon which the 2002 filmwas based, puts the figure much higher, at 2,000 killed and 8,000 wounded.

The military swinging up from the residual of Gettysburg did not reach the city to create martial law until late in the second day of rioting, by which time the mobs had ransacked or destroyed numerous public buildings, two Protestant churches, the homes of various abolitionists or sympathizers, many black homes.  The “Colored Orphan Asylum”  at 44th Street and Fifth Avenue was burned to the ground. Eleven black men were hanged over five days.  The area’s demographics changed as a result of the riot. Many black residents left Manhattan permanently with many moving to Brooklyn. By 1865, the black population had fallen below 11,000 for the first time since 1820.

Reading through the narrative of the New York City situation in the mid-1800s, reveals several things that stand out. A populous stranded by low or nonexistent wages into squalor and miserable living areas full of crime and death. A populace unable to get reasonable paying jobs. Rampant disease and no real protection from it. Psychologists suggest that these conditions have the facility to alter the normal adaptive human brain to a “Mob Mentality”. Humans tend to imitate each other’s behavior in certain situations.  Crowds can easily become uncontrolled and frenzied once a critical mass of numbers is reached, exerting a hypnotic impact resulting in otherwise unreasonable and emotionally charged behavior the individuals would ordinarily indulge in. When angry and frustrated individuals congeal into a large group, they “deindividualize”, absorbing the power and authority of the anonymous mob, then they become capable of striking out violently at issues not original to their complaint. The violence becomes the remedy for their complaint, which usually broadens quickly.

A study of riots in the 60s and 70s show that original complaints of poor, crowded living conditions, few jobs, police hassle of a poor black population and no viable hope of any improvement eventually boiled over into massive riots that did millions of dollars of property damage, and death, most of it doing more damage to the original complaints of the rioting population. Seemingly minor issues sparked many of these riots. The Watts riot started when a Los Angeles police officer tried to arrest a Watts resident for drunk driving. The Watts riot lasted for six days, resulting in 34 deaths, 1,032 injuries and 4,000 arrests, involving 34,000 people and ending in the destruction of 1,000 buildings, totaling $40 million in damages. Rioting to make a social point vanishes when rioters destroy and loot business establishments they would ordinarily protect.

But all that was then. This is now but we have some of the same pressures building and we should be aware of them because we’ve been there before. What we have now for the first time in 100 years is a massive social and physical disaster that threatens to bring back some of the factors that created mob violence in the past.

  1. Coronavirus has the capability to relentlessly incapacitate virtually human on the planet. It’s like the “Terminator” (1984) Listen, and understand! That Terminatoris out there! It can’t be bargained with. It can’t be reasoned with. It doesn’t feel pity, or remorse, or fear. And it absolutely will not stop…”. We canmore or less “flatten the curve” of its longevity and potential to kill humans, but not obliterate it. It moves and shakes in its own schedule.


2.  In “flattening the curve”, we perpetrate on ourselves a style of living that doesn’t work well for our longstanding social order. “Social Distancing”, voluntary or involuntary quarantining, involuntary closing of all but (seemingly) necessary businesses, creating virtual ghost towns.


  1. Large masses of citizens forced to be out of work with no consistent end in sight, none of their usual funds to pay for rent, transportation, food. Promises of Federal money to offset this, none seen as of yet. Panic within the population that their homes, cars and especially their jobs are at risk.


  1. Previously healthy persons not predicted to succumb to this strain of flue, unexpectedly dying, sometimes very quickly. The realization that first line defenders of the population, doctors, nurses and other medical providers seen to be wrapped up like modern day mummies, many lined up to (legitimately complain bitterly about their lot on Cable News Network (CNN).


  1. Federal Administrators promising to insure all the needed materials to buttress the viral Pandemic, face masks, gowns, gloves, goggles/face shields, ICU equipment, mechanical ventilators. These promises are inconsistent and the identified individuals in charge, mostly politicians have not come through as yet, leaving the population with the impression there is no protection from the virus.


The point of this long diatribe is to point out how some of the above factors have led to violent riots in the past.


  1. A seemingly inalterable scourge will continue seemingly unabated, picking out innocents to infect everywhere and anywhere. Open-ended fear and anxiety that death looms unpredictably.


  1. Loss of normal social interaction (distancing and quarantining) creating lonliness, antisocial ideation, open ended anger at a threat that cannot be seen or felt. Looking for something to rage at.


  1. Loss of the extremely important social interactions inherent in meaningful performance of work that generates a paycheck that an individual can maintain social visibility by paying his bills. No convincing evidence this situation will resolve before the job is lost.


My point is that if all this comes to a substantial head, a critical mass of angry, frustrated citizens ready to find something to rail at, riots are possible. History shows that some of the factors that created riots like the Draft Day riot of 1863 can be superimposed over some of the factors involved in the Pandemic of 2020. A hated but otherwise indistinct metaphysical object (the Draft), uncomfortable living conditions, loss of jobs, social breakdown, inconsistent political assistance (Boss Tweed) and fear of unpredictable death from the environment. That we haven’t seen any yet, only means the requisite critical mass has not been reached, but it could happen if some of these factors don’t start resolving fairly quickly.

A critical mass can be a very dangerous thing. Camp of the Saints (Jean Raspall- 1975)  a dystopian fiction novel depiction the destruction of western civilization by the mass migration of the “third world” (the poor and disadvantaged) to France and the West, like locusts in the western United States. The critical mass of humanity was reached to enable them to move as one force, absorbing everything in their way.

Copyright DWC, 2020




Film Review “1917” (2020)


“1917” is an unusual film, somewhat like “Dunkirk” (2017), a vision of war through the eyes of individuals. Two men have to trek across a dangerous terrain in order to save the lives of 1,600 others, and time is a factor. It’s said to be the opposite of “Saving Private Ryan (1998), one soldier on a mission to save 1600 rather that a group trying to save one. There are two really interesting sides to this film.

1. The filming. The cinematography by Roger Deakins (nominated for an Academy Award) is simply phenomenal. This is the same guy that thrilled audiences with “Sicario”, “Skyfall”, “No Country for Old Men” and “Blade Runner 2049”. Seemingly filmed with one camera in real time with no apparent cutting, making the film apparently seamless. One long shot. The color and set is magnificent, I would imagine as accurate as how it actually appeared in 1917. Director Sam Mendes takes the audience along for the ride through the carnage rather than just as observers, and it’s a sad, deadly journey that seems to go on with no end.

2. The film depicts the death and brutality of the First World War (WW I) in very graphic terms, sparing little. The enormity of WW I is not fully appreciated today if for no other reason than the participants who would remember it are all dead and the incredible senselessness of the whole affair (which was thought by Great Britain would be over in a few weeks). In the previous 40 years before 1914, Great Britain had been involved in the minor leagues of conflict. In 40 war skirmishes Britain lost less than 40,000 men. However, in the Somme Offensive in France (1916), 58,000 Allied soldiers were dead in one day’s fighting, the bloodiest single day of face-to-face (non-atomic) ground warfare in the history of the English speaking world. For perspective, in the Franco-Prussian War of 1870-71, France suffered an estimated 270,000 battlefield casualties. France surpassed that number in the first three weeks of WW I. In a two-year span, the life expectancy of a French male dropped to 27 years of age.

Roughly ten million soldiers and 6 million civilians died in WW I, mostly as a result of incredibly absurd battle tactics designed to kill huge masses but resulting in extended stalemates. All this for what amounted to an extended royal family feud acting out old grievances. The sheer incompetence of strategy and tactics was exceeded only by their callousness toward those dying for them. The two survivors, Britain and France would be so shattered as to never fully recover.

Warning- not for children, very vivid slaughter and devastation scenes.

Some interesting asides- Over 5,200 feet of trenches were dug for the film (just under one mile). The verse that Schofield recites to the French baby is part of the poem “The Jumblies” by Edward Lear. In the scene where a soldier bleeds to death, his face gets paler and paler until it’s paper-white. This is a medical reality that many films overlook when someone bleeds out.

I give this film 4 of 5 Lee-Enfield .303 bolt-action rifles. Recommended by me. (Best Picture nomination for 2020)

David Crippen, MD, FCCM
Critical Care Medicine (ret)

A treatise on aging and dementia


I read with great interest Mike Darwin’s essay on aging and potential dementia. I decided to add some to that, including a perspective of my own experience- how it applies to me as I age. (76 years of age this month).

The issue of dementia has become more prevalent for a very interesting reason. In my research for my 60s music appreciation class at Pitt I ran across a very interesting statistic. Because of the huge birth rate during and following WW II, all those kids landed in the same place at the same time.  Do the math.  Born 1945, in 1965 half the population of the USA was under 21 years old. This formed the platform for the 60s cultural and musical era that never would have happened otherwise. Then all the 21 year-olds continued along the line until now ~2015, add 50 years and they’re all in their early 70s.  50% of the 2015 population is over 65 years of age.

That age group is responsible for at least two discrete population dynamics: a much larger population getting sick and a much larger population living longer and suffering from various degrees of dementia.  In the early 1960s, the average life expectancy in the United States was 70.2 years. In 2013, the average life expectancy was 78.8 years. However, the quality of life of aging Americans has not increased commensurately. In the 1960s, the incidence of dementia among people approaching death was less than 1%. Currently, the incidence of dementia in Americans is between 5% and 7% for adults’ age 60 or older. Starting at age 65, the risk of developing some form of dementia doubles every 5 years. By age 85 years, between 25% and 50% of people will exhibit signs of Alzheimer’s disease or some degree of nonspecific dementia.

The issue of subtle, age-related deterioration of brain function is difficult to sort out. The “heart too good to die” concept as espoused by Peter Safar does not apply to the brain. The heart is usually amenable to restart by traditional resuscitation. The brain has proven to be dramatically less so. The brain is a rather frail organ, rapidly damaged during hemodynamic or metabolic disasters and difficult to resuscitate.

Cerebral atrophy occurs naturally in aging and is accelerated between the ages of 70 and 90. But the process actually begins sub-clinically in gray matter of the cerebral cortex at a much earlier age. It’s unclear whether “normal” cerebral atrophy during aging affects each brain the same way or how each cognitive area is affected. Cognitive abilities such as verbal fluency increase until the mid-50s but start to deteriorate in the sixth decade, after which most of the neo-cortex continues to degenerate until death. Many people in their fifth and sixth decades experience “word searching” and a transient inability to recall previously known names. This variety of cognitive deterioration is associated with hippocampal inadequacy.

Interestingly, aging people have a propensity to trade cognitive decline for enhanced judgment. As processing speed slows in late life, logic, reasoning, and spatial abilities remain generally well preserved. Older individuals’ life experience, their long accumulation of knowledge, and their maturity and wisdom offset some of the losses during processing decline. For instance, an adult tells a child to play in their safe yard and not in traffic. The child has the knowledge and enhanced ability to play with great vigor but lacks the wisdom to refrain from dangerous behavior.  This, of course, proceeds into the teen years.

Now, I’m 76 years of age and much like Linda Ronstadt, I can feel the onset of something wrong before it actually happens. Poor Linda. In her time, one of the most beautiful voices in the universe. In the movie of her life she said one day she instantly knew something was wrong because she could feel the prodrome no one else could hear. She went on to get Parkinson’s so severe she was too frail to travel to Cleveland to get her award at the Rock & Roll Museum.

If I could name one deficit that started about age 65 and continues to encroach on my life much like Darwin’s slope of deterioration, it would be the extremely irritating and debilitating issue of “word-searching”. It’s reached the point where holding a conversation with friends is punctuated by instant inability to remember the formal name of persons, places or things. “Yeah, I went to the ……….(blank) concert and it was great! I knew what I wanted to say. It was safely ensconced in my memory bank, but I couldn’t recall it in the time available. I meant to say “I went to the Electric Light Orchestra with Jeff Lynn concert…..”, but when asked to recall it instantly, I just look blank and offered “I’m blocking”. I watch “Jeopardy” on TV and I actually know the names of many of the questions but I can’t produce them in time to hit the button before any of the contestants.

My general physical condition began to deteriorate at about age 70 and unrelentingly progresses yearly, as does my word-searching. When writing something, I frequently use Google to pull up the name I’m trying to remember. I’m a victim of a phenomenon of the 1940s (baby boom) that silently followed me for two generations until we’re all the majority of the population now, collectively consuming huge amounts of medical care to keep us alive longer, but our quality of life has not necessarily followed increased with our viability. Not what we anticipated in the 60s.

So I’ll leave you with the masterful philosophy-of-life according to Pete Townshend of “The Who” (currently age 75):

“People try to put us d-down

Just because we get around

Things they do look awful c-c-cold

I hope I die before I get old”


                          The Who, “My Generation,” 1965








Film Review: Ford v. Ferrari (2019)

Well, this film “Ford v. Ferrari” is a very surprising hit that I
never expected. It never crossed my mind that the subject matter would
be of the slightest interest to most of the movie-going population. But
it was the number one grossing film following its weekend debut and
Rotten Tomatoes gave it a very healthy 92% with an audience approval
rating of 98%. So I guess it rates a review by me.
Now, I must tell you before you start that there is no way to review
this film without recalling how the history proceeds, avoiding
recounting the drama that’s most of the film. My version concentrates
on history and that might be a bit lengthy. So find a quiet time when
you’re not doing much else to absorb this review. I think you’ll
find it interesting even if you don’t know a Ferrari from a fuzz-ball.
The film recounts a lot of history between Henry Ford II of Detroit and
Enzo Ferrari in Modena, Italy. Ford’s acolytes, including Lee Iacocca
were looking to expand the brand and got interested in buying Ferrari as
a sports car portion of their brand. Enzo Ferrari had been racing with
Alfa Romero in the 1920s, eventually to start his own car construction
company around 1933, named after him and flying the iconic black
prancing horse, borrowed from an Italian WW I fighter planes’ nose
cone. Enzo Ferrari’s strong personality and controversial management
style became notorious. He poured all of his passion (and money) into
racing, very successfully, especially in the 60s. Only a few Americans
had ever driven for Ferrari, Phil Hill, the only American Ferrari driver
to win the Formula 1 championship in 1961. Mario Andretti was born in
However, Ferrari’s business went bankrupt, as the income from his road
cars could not sustain the flood of money into racing for virtually
every category. A 12 cylinder Ferrari 275 would sell for about US$6000
in 1965. They’re worth millions if you can find one now. Henry Ford
figured he could pick up Ferrari for pennies on the dollar and so sent
Iacocca to Italy to make a lowball offer. The old man then went to Fiat,
showed them the Ford offer and negotiated a much better deal including
Ferrari’s continuance in their racing efforts. Ferrari then went out
of his way to insult the entire Ford team, especially Henry II and
Americans in general.
This prompted a furious Henry to get even and he figured the best plan
was to outrun Ferrari in one of the most famous races in the world, the
24 hours of Le Mans, where Ferrari had been dominant for years and
Americans had never put forth much effort. Carroll Shelby, a very
successful American car builder (Cobra cars) became involved and along
with mechanic/driver Ken Miles, designed and constructed a GT racing car
to compete with the very Successful Ferrari 330P at Le Mans in the
In 1964, Ferrari won Le Mans first, second and third (one of the drivers
Lorenzo Bandini, I’ll discuss later). However, a Shelby Cobra was in
the game, winning 4th place, arriving at the flag before two other
Ferraris. In 1965, the Ferrari contenders all blew head gaskets and
didn’t finish. Porsche took most of the places. In 1966, however and
where most of the film takes place, the American Shelby GT cars took
1,2,3 all arriving at the flag together. The Ferraris blew engines
trying to keep up with the Fords. This was the highlight of the Ford
effort. In 1969, the Ford GT took 1,3,5 but in 1970, Porsche wiped the
field. The American effort essentially fizzled at this point due to the
incredible amounts of money spent that, like Ferrari, threatened to
bankrupt Ford.
Le Mans is the most famous race in the world. It’s the third leg of
the “Triple Crown” (Indianapolis 500, Le Mans and the Monaco Formula
1 Grand Prix). Unlike Formula 1, it’s an endurance race on a mix of
closed public roads and dedicated sections of racing track, in which
racing teams must balance the demands of speed with the cars’ ability to
run for 24 hours without mechanical failure. Of the 60 cars that
qualified for the 2018 race, 41 cars lasted the full duration. There are
many varieties of non-GP cars actually racing at the same time,
including, interestingly, the Austin Healy “Bugeye” Sprite (42
horsepower). The course is 8.5 miles long and in 24 hours, the cars will
traverse over 3100 miles. The infamous Mulsanne Straight was 3.7 miles
in length and in the old days, before it was shortened in the 90s. The
only speed limit for the GT cars was how many RPM they could reach
without the engine blowing up. 240 MPH was not unusual.
In the original race, drivers stood opposite their cars on the opposite
side of the track. When the flag dropped, the drivers ran to their cars,
jumped in, started them up and proceeded onto the track in a big crowd.
Any of you have Porsches; you’ll notice that the key/ignition is on
the left side of the steering wheel (most are on the right). This is
because Porsche figured out a driver could jump in the car and turn the
ignition with the left hand while simultaneously shifting into gear with
the right, conserving a second or two on the start. All Porsches still
have left hand ignition.
In the film and in real life, there was a very angry and pitched
competition between the Fords and Ferraris. In the film, there are a few
cuts of the Ferrari drivers seated in their cars as they fought for
place in the race. The Ferrari drivers appeared very elegant, with
barely a smirk as they passed the Fords. (Who are these posers??). I
suspect these Ferrari drivers are remembrances of Lorenzo Bandini who
Won Le Mans in 1963 and was driving a Ferrari in 1964 when Ford arrived.
He was a very smooth, unflappable driver. Of note, Bandini helped
director John Frankenheimer with his movie ”Grand Prix” (1966) by
recommending an interesting location, the Harbor Chicanes at Monaco, for
a crash scene. This spot would be the site of Bandini’s death in the
Formula 1 race one year later.
The film is very well done, the actors are suburb and the racing scenes
are really exciting, well photographed. There is a real plot to the
film, unlike Steve McQueen’s version in 1971. Those not particularly
interested in the cars would enjoy the progress of the plot. One of the
interesting characterizations was a thought expressed by Carroll Shelby
(Matt Damon), and I paraphrase here, it would be sad if a person never
found meaning in their lives and it was very admirable if a person found
a calling that satisfied them. But some find an overwhelming passion
that saturates everything they do and those persons “must” satisfy
this passion. There is no other option. It saturates their life
Such a person was driver/mechanic Ken Miles (Christian Bale) who
“became” part of the car they were building, understanding the
smallest minutia of the car, driving and improving every part of it for
hours and days at a time. Ken was directly responsible for the success
of the car and was one of the winning driver team at Le Mans in 1966. He
was killed testing a car at Riverside in August of 1966. The steel roll
cage in the Mk IV mandated as a direct result of Miles’s death probably
saved the life of Mario Andretti, who crashed during the 1967 24 Hours
of Le Mans but escaped injury because of the added structural
An interesting aside: Keep your eye on the two (consecutive)
wristwatches Matt Damon is wearing. In the early part of the movie,
it’s a white face with two black sub-dials. Later in the movie, it’s
a white face with three black sub-dials. There was some discussion
about this and the preponderance of opinion seems to be that these
timepieces are the Heuer 3647 Carrera white/two black dials (value now
about $3500). Heuer Carrera panda three dial chronograph ($5500) Heuer
didn’t become TAG Heuer untill 1985 (see photos).
So if you’re still with me, I definitely agree with Rotten Tomatoes,
this is an interesting film on every level. They’ve played fast and
loose with real history, but it isn’t really noticeable and most of
the history is accurate. I’ve tried to augment the drama with
historical context.
I give it easily four 7000 RPMs out of five.
Here’s what it looks like to go 220 miles per hour in a Mazda GT (Yes,
Mazda- they did well in these races). It’s fascinating. Probably
1989, pre-shortening of the Mulsanne. Wait a bit till he enters the
Mulsanne to get the proper feel for it. You’ll know when he’s there.

Review: “The Joker” (2019)


UnknownReview:  “The Joker” (2019)

The DC Comics “Batman” trilogy The Dark Knight” told the full story of the Batman. The first of the trilogy was “Batman Begins” (2005) with an all-star cast including Christian Bale. Later, “The Dark Knight” (2008), starred the late Heath Ledger (Posthumous Academy Award) and “The Dark Knight Rises (2012)” finished off the trilogy, The Joker first appeared in the debut issue of the comic book “Batman” April 25, 1940 and has been a consistent villain, played by various actors including Jack Nicholson and Jared Leto.

“The Joker” (2019) is very different film than you might have expected. This film delves into an intense character study of Arthur, an authentically “mentally Ill” man without any recourse or even remedy. Arthur has been abused in various ways since a small child. He has “never experienced a happy moment in his entire life”. He absorbs brutality as an adult from bullies all around him with no conception of recourse. It’s just a usual part of his life. He attends weekly interviews with some variety of public health nurse who tells Arthur he needs to try harder with no real vision of what may make a difference in his life. She gives him prescriptions for several different drugs and he goes about his life as if on rails.

Then a well meaning friend gives Arthur a gift that he really doesn’t understand at first, but which comes into a clear meaning later during one of the familiar bullying episodes that postmark his life. From then on, mental illness exacerbated by abuse takes on a different vibe. The chronic misery and anguish of brain dysfunction begins to see an outlet never conceived of before, an outlet that taps some previous skill sets previously concealed by shambolic brain wiring.

The previously simple man evolves to a very simple but dangerous man indeed. A nemesis of Batman for 80 years of DC Comics. The performance by Joaquin Phoenix is exceptional. A florid, Pagliacci-like sad clown turned mad-on-a-mission clown. If it’s possible to transmit the emotions of anxiety, depression, pathos and confused life-paths from a screen to humankind in an audience, beware. This film accomplishes that intent extremely accurately via the direction of Todd Phillips (Borat- 2006, War Dogs- 2018), Produced by Bradley Cooper et al and cinematography by Lawrence Sher.  “The Joker” is a vivid connection for Arthur to his expanding universe, brutally shared with the audience.

This examination of the character and life course of the hopeless mentally ill with no real recourse to anything better is truly remarkable as the viewer experiences an evolution to one of the possible, maybe inevitable outcomes that society facilitates.

Interesting aside:  Watch for “White Room” by Cream near the film finale.

I give this film 5 of 5 whiteface makeups.  Requires attention and focus.  Some violence. Adults only. Must see.