Author Archives: gonzo66

Sad state of late night TV (and salvation)

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The situation with late night comedian/talk shows has reached an all time low in my estimation. Leno’s stock in trade was stand-up and he was funny but his 11:30 PM schtick was highly scripted and predictable, probably crafted by the same corporate structure that brings us such gems as “The Bachelorette” and “Two Broke Girls”.

Yes, Leno’s and Letterman’s monologs are usually funny until you see the Que cards. Then you see the line of film personalities all only there to hawk their new film or other media masterpiece. Letterman is clearly tired and bored, long past time to quit. I haven’t even bothered to watch the Kimmel clone. Seth Myers wasn’t funny for the 30 or so years Saturday Night Live hasn’t been funny and isn’t funny now. Poor flash in the pan Conan got the short end of the stick and now reposes on a cable site no one watches. Jimmy Fallon isn’t inherently funny. He’s a Saturday Night Live relic and tainted by it. He tries but tries too hard.

Then, a night of temporary insomnia and a thunderbolt out of the blue. The Late, Late show on CBS with Craig Ferguson. It was a bolt of lightning and a stone at my feet engraved: “salvation”.

Cut to the chase, Craig Ferguson is quite possibly the most spontaneously funny human on the planet.  The funniest the fewest humans on the planet have ever seen. Sitting comfortably at the table with Richard Pryer, Robin Williams and Steve Martin, but improved on all the former.

Richard Pryor was and continues to be the platinum standard of stand-up comedy in his prime (1980 or so). He blew audiences away. There was no one one remotely in his league. Then he got bogged down in bad film roles, drugs and faded way too soon. Difficult to know if his white-hot talent could have lasted much longer than it did.

Robin Williams was brilliant for about the same length of time as Pryor then he burned out from the necessity to become more frenetic to hold audience’s limited attention span. Crowing from the rafters and the audience moved on. Now endless “guest appearances”.

Steve Martin was brilliant in that he figured out that the audience was bored with frenetic comedy and was ready for “silly”. His late 70s stand-up was brilliant, “happy feet”, “cat handcuffs”, “Getting small” and “cruel shoes” are simply brilliant.  Then he got bogged down with really bad movies “Father of the bride” (1991) and now occasionally appears on Letterman offering a pale clone of his former brilliant self.

Ferguson is a fresh amalgam of Prior, Williams and Martin. He has no cue cards and no scripts. He paces back and forth aimlessly as spontaneous quips flow freely. Who could have possibly thought up a gay robot skeleton as a co-host and a silly full sized puppet circus horse as a foil. And who could have possibly believed these things “work”.

Ferguson has been effortlessly charming the pants off viewers for something like 7 years now. His signature tossing away of his note cards when a guest sits down is a pointed slam at other late night hosts. The talk stays focused on and is the master of simple conversation rather than pre-digested research.

Craig doesn’t need an audience. He barely needs guests. He is what he is and it works. Ferguson is thoroughly engaging long before before he brings out a guest.  He clearly enjoys himself and it shows. He can speak intelligently about anything. He can occasionally dive into a personal, soul-searching monologue demonstrating he’s a “real” person without becoming maudlin.

It’s difficult to imagine what it must take to deliver a totally spontaneous diatribe that’s simply hilarious and brilliant without so much as a pause. Ferguson is not just the undiscovered king of late light, he’s Richard Prior incarnate, warts and all, peripherally mention multiple marriages, substance abuse and therapy. Somewhere Richard must be smiling.

Why Ferguson is not properly recognized for his contributions to spontaneous, brilliant comedy is something that is beyond logical comprehension.  He’s truly the quirky alternative to the formulaic crop of talk shows with the word “late” in them. That alternative is simply genius. He has no peer in the realm of the simply funny.

Highly recommended by me.

Here are some quips that highlight his talent:

 

 

 

 

Some acerbic notes on the new generation of physicians

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“My impression is that the older ones found work-life integration while the younger ones are focused on work-life balance. There’s not a lot of balance when up at 3 am with a sick patient or 5. And the a common refrain is “I don’t want to work weekends “

Crippen: When I was a medical student on clinical rotations in the early 70s, I was expected to be the first to arrive and the last to leave. I “took” patients and was responsible to the resident for reporting on morning rounds everything going on. I did procedures under guidance and I got chewed out or my ass kicked when I didn’t perform up to expectations. I was expected to have no other obligations during that rotation and it NEVER crossed my mind to complain that I was overworked. Had I done so, that revelation would have been greeted with dropped jaw astonishment and an admonition to get with the program or take my mangy ass elsewhere.

When I was a resident at Bellevue, there were about 100 patients on the general surgery service and ten in the surgical ICU. There were two first year residents on the service and every-other-night call. Do the math. Similarly, there was no excuse for not getting the work load done. One learned to prioritize to get the important stuff done and suck up the hassles on the rest. Complaints of overwork were nonexistent. Not conceived of.

And yes, I did walk to work 20 miles one way on crutches in waist deep snow fighting off alligators and snakes along the entire course.

Then in the new millennium, Libby Zion came along and the path of least resistance led to the proposition that residents were overworked and too sleepy to function so they had to be given a break. That evolved to a situation where medical students and residents became entitled. No more of this “service” stuff, it has to be all book learning education. Complaints of “I’m overworked” are forwarded to the RRC (Residency something Committee) a body that immediately investigates all such complaints and the burden is on the teaching program that they’re not overburdening the poor babies with a work load that they can’t handle. As a result, that work load gets smaller every year.

This is an honest to God true anecdote told to me by the Chair of one of our clinical departments here. He was teaching a session for medical students on some subject he felt was important and after a while one of the students raised her hand. She told him maybe he had spent enough time on this subject and maybe he should move on. Astonished, he told her he wasn’t finished yet, whereupon she picked up her books and walked out.

Medical Emergency Teams (MET) appear in at least some, not all, data to be doing a good job in interdicting acute deterioration episodes for hospital inpatients. As they evolve, however, the propensity for nurses to call for the MET instead of the responsible resident evolves with it, for a number of complex reasons. Then the responsible resident stands at the back of a crowd of people watching as their patient is taken care of by someone else. The issue as far as the hospital is concerned is that patient safety trumps medical education, and that may be. But in the immortal words of Bill Gates:

“We always overestimate the change that will occur in the next two years and underestimate the change that will occur in the next ten”

And that’s exactly what’s happening with medical education. We’ve entered a realm where the “education” portion has exceeded the “experience” portion. We’re teaching them all the contents of the Textbook of Medicine and then sending them out into a world where the translation of education into experience is required to survive, and it isn’t there. They were standing in the back of the crowd that day, and every day they survive the mix is a day that their minuscule experience base fails them. To be exceeded only by the next wave of graduates.

Similarly, critical care fellows have complained about night and weekends now for the 28 years I have been involved with the UPMC system and they are following the lead of the rest of them. When I was a fellow in 1986, I was on call every third night and every other night when someone one went on vacation or got sick. Now the fellows are on call one night a week and the night calls are progressively being taken over by Certified Nurse Practitioners and Physicians Assistants. The fellows want to think of themselves as executives now, in a teaching and mentoring mode for the night and weekend crews. How they are getting that knowledge base now is with books and simulators.

I hasten to add that there is nothing intrinsically wrong with the CRNP and PA mode of direct patient call after hours. I have some in the NICU and they are REALLY great in every respect. They do EXCELLENT patient care and they know when to call for the executive modulators, which consist of the Resource Intensivists covering the house at night.

The problem with this model is that since every critical care fellow has the same training as most other residents in their specialty, they are at risk for the same dumbing-down (not always). As the syndrome as Med Student/resident Entitlement continues, will the fellows not bear fruit from the poisoned tree? Unclear at this point. We shall see.

There has been a lot of hand wringing about the poor overworked physician trainees that I am not particularly impressed with. I went through all that and not only did I survive, it made me a provider that is never surprised at ANY clinical situation because I’ve seen them all, and there aren’t many physicians that have had a fuller personal life than me (trust me on this).

Hand wringers lament that overwork and overstress creates drop outs, landing in psychiatrists office, going through ten divorces or killing themselves from what amounts to PTSD related disorders. Sorry, I can’t fix those that sink into PTSD. I wish there was a better way to sort those with a tendency for PTSD out before they get into medical school (unlikely as long as grades move all). I went through all that in Vietnam and I just worked it out and went on. I know Viet vets that thrived on it and wish they could go back and do more of it. PTSD is just luck of the draw.

I don’t know what the fix is for PTSD. I think arbitrarily decreasing work loads may solve some of it but invokes the Great Principle of Unintended Consequences (GPUC), we’re seeing it now and we will continue to see it in the future. Well rested physicians aren’t necessarily the ones you want to look up and see during a disaster in the middle of the night. But then at the rate things are going, no one may ever see one after 5 pm anyway.

I am the last of my kind.

Vision over a burger: What’s in a picture?

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Munching on a burger amongst a plethora of remembrances from past ages in of all places a “Steak & Lube”, the enclosed poster stood out. I couldn’t take my eyes off it.
Poster

At first, I thought a photo of obviously James Dean and Marilyn Monroe from some distant past film. But after some research found to be a painting. In fact, the two protagonists never met in life. Both attended the Actors’ Studio in New York but not at the same time. James Dean’s life was cut short before he ascended to the same film stature as Marilyn.

Both were moody, introspective, talented, troubled by the loss of their mothers and the absence of their fathers. Marilyn marked the 1950s standard of mercurial, mortally injured femininity that she nakedly portrayed in film with childish naiveté insuffused with wistful vulnerability. Rated the sixth greatest female star of all time by the American Film Institute. She died in 1962 at age 36 from an overdose of barbiturates.

James dean marked the 1950s standard of troubled masculinity under tenuous constraint not seen in film again until Steve McQueen. Like McQueen, Dean indulged in serious motorsports racing, (but not motorcycles, like McQueen) ultimately running out of road in 1955 at age 24. He became the first actor to have had two posthumous acting nominations (East of Eden-1955)(Giant-1956). The American Film Institute ranked him the 18th best male movie star after starring in only three films.

This poster embodies the imagination of artist Paul Gassenheimer who conjectured how these unique personalities might have reacted had they come in contact with each other in another life. In cool charcoal tone, he conjectures James with committed but controlled intensity. Two fingers insouciantly draped over the front brake lever (as all veteran riders do). He is the ascendant of Marlon Brando (The wild one-1953) and the pre-incarnation of Steve McQueen (Bullitt-1968) His journey is his spirit.

His incarnation of Marilyn, however, is awesomely intuitive. She is colorized for contrast, dressed in a man’s jacket but wears high heels on the pegs to insure certainty of her femininity. She wraps her arms around her pilot not for stability but for certainty. Eyes closed, her head on his shoulder, she feels the wind and vibration but interprets the experience as trusting invulnerability, possibly for the first time in her turbulent life. Her face accurately reflects her cocoon. Her journey is her deliverance. It matters not where or when, only that it never ends.

The existence of an afterlife has been debated for centuries. If there is such a thing, and if those entering it have any volition as to their participation in it, I think Marilyn and James are there exactly as they appear in Gassenheimer’s preternatural vision. Oblivious to all but their ride into eternity.

 

 

Film Review: Jersey Boys (2014)

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“Jersey Boys” is the motion picture version of the Tony winning play starring three of the four members of the Broadway version.  This film got a mediocre review in USA today from critic Claudia Puig, AGE TWENTY-FIVE who lives in Walla Walla, Washington. Culturally about as far from New Jersey as it’s possible to get.  Claudia wasn’t a gleam in her daddy’s eye when all this took place at the turn of the 60’s decade. Her daddy was probably kicking the sides of his playpen during all of it too so it’s quite possible she’s out of her range.

I think critics who have never been there for a social phenomenon should leave it alone. George F. Will “reviewed” the death of Jim Morrison for Time in 1971. Essentially, he said he had no idea what the fuss was about, and clearly he didn’t because he was alive then but isolated from any of the culture. He was like a Bornean headhunter reviewing a Boeing 747.

I was there for all of it in 1962 and I play in a musical group that came together by the same Brownian motion as Frankie Valli and the 4 Seasons. I listened to them live playing all their songs as they became symbolic of a generation. I can render you a very insightful picture of the temper of those times and the desultory factors that make a successful musical group. So can Clint Eastwood.

Eastwood’s genius is portraying details and the meticulously nuanced flow of events.  Singing the songs in their own voice, each of the Four Seasons tell various aspects of the story, sometimes stepping out of context to speak to the audience. Unlike what “Ray”(2004) and “Walk the Line” (2005) did for Ray Charles and Johnny Cash, Jersey Boys isn’t so much about the personalities but the ingredients that combine in a random and illogical manner to create magic.  The birth of a “sound” greater than the sum of its parts.

Eastwood takes his time meticulously building the story, ignoring the usual Hollywood imagery and formula as he did in “Flags of our fathers” and “Letters from Iwo Jima” (both 2006).  At first the audience needs to be dragged into the unfolding story that starts out more like an old cops & robbers film, but as the story proceeds, they witness emerging genius. Some critics complain the film is too long. I say it takes exactly two hours and fourteen minutes to build the nuances of the story.

John Lloyd Young gives an outstanding performance as Frankie Valli, not just with vocals but also with bringing to life the youthful ambiance of the early years, the inevitable descent into excess, and the emotionally battered period that followed. The rest of the cast deliver solid performances, especially Vincent Piazza as Tommy and as always, Chris Walken as their Godfather.

Best part:  The aging group appears in New York City in 1990 to be inducted into the Rock & Roll Hall of Fame. A quietly beautiful scene.

Not so great part:  Californian Eastwood directs in just a little too laid back fashion, missing some opportunities to allow the characters to leap out of the screen.

Most if not all of the critics that give this film so-so review don’t understand the culture and especially don’t understand what Eastwood is trying to do here. Yes, if judged by Hollywood Spectacular Epic benchmarks the film fails. This film was clearly not written by Joe Eszterhas (Showgirls: (1995).

Accordingly, I strenuously disagree with some of the mediocre reviews of this film by critics who analyze it using benchmarks that don’t work. Yes, this is a bit of a long film but the length is needed and necessary to build characters the audience believes in and can absorb. This film builds a story line full of carefully constructed nuances that work as builds toward enchantment. If accepted for what it is, this film is a masterpiece.

I give it four and a half of five falsettos. Must See.

 

 

 

Film review: Edge of Tomorrow (2014)

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I’ve always thought Tom Cruise was underrated as an actor. He should have gotten an Oscar for Risky Business (1983). He consistently turns in a wide range of performance art.

Cruises last film, Oblivion (2013) flopped at the box office, but he’s back in a new sci-fi effort, Edge of Tomorrow, a melding of “Groundhog Day (1993) and “Saving Private Ryan” (1998) with a dash of “Aliens” (1986).  Most such derived creations are sold to HBO two weeks after opening, but “Edge” is surprisingly good.

Cruise plays a reluctant soldier who, after being killed in combat, awakens the day before the battle and must relive, over and over the events leading to his death. Each path to his death is variable and he can choose paths.  Cruise’s curse is to die again and again affording him a limitless capacity to learn on the job, each return to battle another chance to probe the enemy’s vulnerabilities. The premise is similar to Groundhog Day but very ingenious and creative.

The film contains plenty of obligatory computer generated graphic bang, boom and destruction, which normally assault the senses, but the characters effectively, stand out. Edge of Tomorrow with a budget of over $175 million is said to be one of the biggest box-office risks for mid-2014. I saw it in an IMAX theater yesterday Saturday for an afternoon showing and there were ten people in the theater. It might do better in foreign venues as many of Cruises films do.

Best part: Southern fried top sergeant Bill Paxton smirking: “May I help you. Sir?”

Least best part: An attempt to superimpose a love story onto Cruse and Emily Blunt’s relationship which stands out like a sore thumb during a “lets do anything possible to kill the enemy” scene.

It’s a good film, consistently interesting and novel. I give it three and a half Tom Cruise toothy grins.

 

 

 

 

Some comments on the Veterans Hospital situation in May, 2014

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I have a book somewhere in my library written in the late 70s that details how Vietnam vets got the same treatment as those complaining now at a New York Va. The problem was identical. That facility, however, had a huge number of injured and sick vets referred them from all over the area. They simply rationed so that no population of vets got more than others. They all got the same and there wasn’t enough for anyone.

I prefer not to think that these people are intentionally stiffing vets, although the woman head of the Phoenix VA is now showing signs that she did all this to “look efficient” to her bosses so she could climb the career ladder faster. I think they figured out ways to ration care and hide it from the media (for a while).

I “think” the problem is an overwhelming mass of returning vets with a ton of medical problems and a limited amount of resource to deal with them. There are more doctors than Carters has Liver Pills all over Iraq and certainly Afghanistan. None of these doctors can do much definitive care there but they can “patch up” and send them back to the USA alive but with disastrous issues they would have ordinarily died from. Then they require a ton of expensive care that isn’t available in the system.

This is especially true for neurosurgical injury. If a soldier got a serious neurosurgical injury in Vietnam they died. In fact, if s soldier got an injury that a paramedic couldn’t fix at the scene he still had a pretty good chance of dying. Now they get patched up by doctors at up-front field facilities and sent back to the USA for a lifetime of expensive care and many remain non-functional, requiring some form of welfare support. All this is incredibly expensive and the funds were never available.

Most of the Vietnam vets were sent back with relatively inexpensive health care issues and there was enough resources in the VA system to cover them. When I was a resident in both Indianapolis and New York City, I trained at the VA hospitals in both those cities and I was never impressed that their resources were stretched. I thought patients there got pretty good care and very good training of doctors. Now they’re coming back requiring a LOT of chronic care for injuries that should have killed them and the system is dramatically overloaded.  So what do you do when you have resources for 100 soldiers a week and you have 1000 pushing at the gate to get in?

The answer in a perfect world is you prioritize in some way so those requiring the more acute care get it first and the rest stand in line till their number comes up. But watch the “Wounded Warrior” commercials on TV. They’re all acute and they all need more expensive technical care, ICUs, neuro care, extensive rehab for blown off limbs.

In this country, allowing one group to cut in line on the basis of anything will get vociferous complaints of favoritism and discrimination. So I have little doubt that the VA simply found ways to thin out the demand for services by backing them all up into a barrel and turning the spigot open to allow a defined number of them into the system that could deal as effectively as possible. The rest just backed up waiting their turn. There are lots of ways to do that. What they did in Phoenix is one. Then the media got hold of it and the resulting feeding frenzy didn’t point out the fundamental problem of too many injured soldiers trying to get too few resources. It pointed out incompetence and stupidity which is much better copy.

So how to fix the fundamental problem.

As long as we’re resuscitating otherwise mortal injury in Afghanistan, we will continue to deal with them inadequately in the overheated VA system. Now that the toothpaste is out of the tube in the media, it won’t go away. We have several choices.

1.  Pour a ton of money into the VA system creating a “separate but equal” care system for acute injury and rehab.

2.  Close the VA system for acute injury and spread these patients out through the nearly overheated public health care system and pay for that care via a separate reimbursement provision that the military has in place anyway for veterans who for some reason cannot access a veterans facility.

I “think” that #2 is the logical way to deal with these patients most effectively. The VA system clearly cannot deal with them at all, much less effectively. It would cost a lot more to bring the VA system up to speed than to adjust the “private” system. At any rate, we better do something soon because there are a lot of soldiers out there who deserve better.

I pitch a concept for a cable TV show!

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Sitting here day after day, it came to me that maybe I had plenty of time to think up a pitch for a TV show, cable of course so the actors could say “fuck” and show their tits. I really always thought I could do that someday.

So the creative juices flowed and here it is:

“Who you calling’ a racist, Bubba??”

A disgustingly rich 80 year old industrial magnate (and of course, a lawyer) living in Bel-Air, LA, accumulates the obligatory 30 year old dumb-as-a-box-of-rocks female with a great body as an “assistant”.  She accumulates four expensive automobiles, a high end condo and an expense account for her labors. Unclear exactly what her duties in this relationship are, but she tends to manage some of his easier to understand archives. Of course there is an estranged 60 year old wife (was 30 with a great body when she originally married our hero).

As it happens, the slightly dim 30 y/o with the great body didn’t enter into this relationship with open ended affection for our hero like Anna Nicole Smith. She thinks there might be something in it for her in the way of becoming some variety of a TV reality star. So she tapes a private conversation between her and our hero in which our hero opines he’s never really liked black guys much even though he’s made a fortune on and for them playing for his sports franchise. She then sends the CD to the local news agency and it hits all the big venues the next day.

Since thought-crimes involving persons-of-color has become a crime rivaling most felonies and the mere accusation has ended careers, the result is swift and predictable. Every person of color that can get near a TV camera and all their friends/colleagues appear shaking their heads sadly to decry the stunning level of racism in this county. Then quickly thereafter howl for heads to roll.

The sanctioning body for the sports team owned by our hero quickly announces that our hero has performed original sin for which there can never be any perdition and sadly pronounces him to become a non-person in the true Orwellian sense. He must sell the team and proceed to the 5th Circle of Hell for eternity, never to emerge again.

Of course, the slightly dim girlfriend is discovered by the media, hoards of which descend on her condo, setting up cameras between the Ferrari and the Bentley. She appears with her face partially hidden and like the Pied Piper, leads them around town until the right one arrives offering her an interview with oh-so concerned, exceptionally socially relevant Barbara Walters who drools at the prospect of this big one to end her career on.

The interview is classic Walters versus a not-quite-with-the-program female with just the right amount of thighs showing to the camera. Barbara is appropriately concerned and relevant trying to get maple syrup out of a stone but in the end the sad girl didn’t understand the concept of how to work Barbara so nothing came of it but a lot of blank looks and non sequiturs. End her 15 minutes.

Next episode, another tape appears leaked to the media, a telephone conversation between our hero and an obvious person of color in which our hero confirms mild to moderate dementia, winding in and out of lucidity. He doesn’t understand the problem as some of his best friends are black guys and he’s certainly made all of them a bundle of money. They should be thanking him and who cares what he thinks about anything in the privacy of his bedroom when pillow talking to his close assistant who hangs on his every word.

He mentions that he got a call from Donald Trump who opined that maybe our hero had accumulated a “girlfriend from Hell” (Donald would know- Marla Maples-1986). Then, quite convincingly informing the listener that no power on earth can force a private citizen sell private property involuntarily in this country and they can all “go fuck themselves”.

But, next episode, of course, there are more females involved. There always are. Within a week, the best friend of the dim girlfriend ends up on Nancy Grace interpreting what she thinks her girlfriend’s motives are (with about the same amount of thigh showing to the camera). An “estranged” but not quite divorced wife gives an interview to the local media in which she assures them she is half-owner of the sports team, she has no intention of selling anything to anyone and they can all go fuck themselves. Thousands of college seniors around the country stopped their career plans and entered law school knowing this issue would be going strong when thy graduated and far beyond assuring job security for years.

Every person of color within sight of a TV camera continues to howl for our hero’s head on a platter, loudly predicting the return of slavery and collapse of civilization. The dim girlfriend retains a lawyer and seeks a book deal. The girlfriend of the girlfriend smiles to the camera and suggests there might be more if the price is right. Oprah discreetly suggests to someone she might be in the market for a sports team full of black guys to support her new TV network. Lawsuits are filed from every faction involved including many not involved but want to get in on the fun.

Last scene of last episode of first year cuts to our hero on an opulent sofa, arm around his estranged wife, both sipping Chateau-Lafite-Rothschild and laughing fitfully at a widescreen TV tuned to “Entertainment Tonight”.

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Teaser for Season 2 of: “Who you callin’ a racist!”

CNN uncovers yet another tape leaked to the media by an as yet un-named source. Our hero claims sexual desire that prompted him to utter remarks decreed by CNN consultants to be racist. He sez a man trying to get laid will say just about anything, much of it contrived for the moment. Unclear how this relates to the charges against him but CNN plays it every 20 minutes all day accompanied by multiple expert commentaries.

CNN consultant Shabazz McMurphy (BS- Black Studies, PhD- “The Black Experience” Howard University) opines that we have arrived at the era where we can no longer tolerate racist crimes of ANY variety, including now the emergence of “thought crimes”.  It’s no longer permissible to tolerate anyone successfully passing for non-racist simply because they keep their mouth shut about their real motives. Our hero demonstrates there are a lot of them out there.

Our hero was thought to be a normal, regular guy, good businessman accumulating a fortune through hard work and got several awards for his acumen and a 30 y. big-titted babe on the side as an appropriate reward for his position. Then his thought crimes broke through the surface and now he fries in the 5th circle of Hell. None of the rest of that history matters. We must now aggressively seek out and destroy secret thought criminals. Thought crime is the one single process that threatens to unravel all the advances in racial progress over the last 100 years.

Starting with each and every person in the public eye, we must seek out everything they’ve ever said or written anywhere for any taint of racism and expose it. We must find and review anything they may have said on any TV screen and have a qualified PhD psychologist (Howard University maintains a list) evaluate for any hint of thought crime that may not have broken the surface yet.  There are literally million of law firm associates around the country building their careers on just such quests. We must think about what they’re thinking and we must assume they will try to hide their true thoughts so this quest must be extensive and aggressive. We must also obtain via the Freedom of Information Act, the full database of all NSA archives to find any evidence of racism.

Another CNN consultant, LaToya Smith ((BS- Black Studies, PhD- “Occult Racism”) also opined that our Hero’s wife needs to be looked at very carefully because living with our hero possibly means she shares many if not all of his biases, otherwise she probably would have married someone else. She needs to be questioned closely under vital sign monitoring for any potential thought crimes she’s foxy enough to keep to her mouth shut (under the circumstances).  Any hint of thought crime must then be dragged out of her by any means necessary so she can join her husband and all the other accumulating masses in the 5th Circle.

A public service announcement appears that evening brought by the American Bar Association urging college seniors undecided about their careers to immediately apply for admission to Schools of Law. The new series “Who you callin’ a racist” has insured full employment for lawyers for the foreseeable future if not into the next century.

Each of the next 14 episodes will be the interrogation of selected news figures including Anderson Cooper, Brian Williams, Barbara Walters, Matt Lauer and selected others.

 

 

 

A few notes on State of Pennsylvania health care politics

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This missive is an abstract of two letters to a friend asking me to sign a petition urging current Pennsylvania Governor to “do the right thing” and expand Medicaid benefits in our State. Sadly, I think the fate of that issue is not amenable to public or provider opinion, for the reasons outlined below.

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In order for this petition to have any impact, two variables must be expressed positively.

  1. Tom Corbett must care about the welfare of those that will lack meaningful health care if Medicaid expansion doesn’t occur. There is little evidence that he does. Mr. Corbett is a Republican, which means by political inclination he has little interest in the financial woes of those impacted by Medicaid and has continued to support other Republicans efforts to cut even more of their resources.
  1. Tom Corbett must be amenable to changing his lifelong political inclination on the basis of rational pleas from providers. This would be a lot like pleading with God to cure your brain tumor. If the tumor spontaneously regresses, it’s the work of God. If it doesn’t, it’s still the work of God but we just don’t understand the celestial logic.

Mr. Corbett is also very likely to be elected out of office soon, to be replaced by an increasingly popular Democratic candidate. You can be sure that Mr. Corbett will do everything in his power to hobble or incapacitate that person who will follow him. Not only is Mr. Corbett insulated from rational persuasion, you can be sure that this decision has already been made and the only issue left is how to present it to the public to minimize the political damage to Mr. Corbett and blame subsequent problems on his successor.

As a Republican Governor, Mr. Corbett’s only interest in Medicaid is cutting it, and since his money connection is the same as all of them, extreme right wing factions, he’s very unlikely to do anything not in the best interest of his political future.

So, unfortunately, we will have to live with the Medicaid issue, or hope an incoming Democratic Governor can cobble together something from the ashes.

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Sure. Be happy to sign the petition, but you must keep in mind that this is a political issue not amenable to coercion from special interests (health care providers) for  lot of reasons.  This decision and many others like it were made long ago. The only residual is how to assure political opponents get the blame for unpopularity with those affected after they’re implemented.

Again, Corbett is a more or less as it suits him “conservative” Republican which means among other thing (1) he’s committed to insure the rich get richer on the backs of the disadvantaged and (2) he lays awake every night praying and dreaming of how to get rid of the Affordable Care Act of 2008 (see #1).  So, Corbett has already decided that the only way he will approve any help for the poor is if he can make them pay more or work for their pittance. Yes….sickly single mothers of three and chronically ill old people up every morning to report to a WPA-like assignment.  Why not whips and chains.

The only public coercion that would move Corbett is if he figured some of it might hurt him politically. Unlikely for at least two reasons:

  1. Corbett is a lead pipe cinch to be dumped in 2016 and replaced by a popular Democrat (Wolf), so the opinions of those affected by his decisions always quickly transfer their ire to the most proximal victim, not the one that made the decisions (Obama in 2010).
  1. Paradoxically, although Republicans are quick to defend richer citizens (doctors), they (we) have managed to get bad enough press that it puts us into a different category- need to cut expenses to show fiscal responsibility. So as the media portray us as greedy abusers of Medicare (millions made ramming patients through “clinics” illegally, we become ripe targets to cut fat from a system with little fat to be cut elsewhere. Besides, Doctors complain a lot but they don’t strike so they’re paper tigers and can be effectively ignored, unlike Teamsters.

This is why since 1997, there has been no permanent fix of Medicare reimbursement policies, instead trying to find a way to tie cuts to the desired demise of the ACA of 2008.  And by the way, all of it is said to be financed by cuts to providers.  By rejecting joint/federal Medicaid expansion under the ACA, Corbett becomes the 11th Republican governor to stiff poor recipients of these funds in a hope of somehow dismantling the ACA.

 

Corbett would cheerfully toss two-bits at a homeless guy and snarl: “get a job”.  His path to do similarly to Medicaid recipients is pretty clear as well. He’s happy to humbly accept petitions for anything and might even actually have one of his flunkies read and summarize them before they’re trashed. Like Nixon’s response to 200,000 Vietnam vets demonstrating under his window on April 24, 1971 (I was there).

 

On this day in 1970

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filo_kent_state_pulitzerOn this date, May 4, 1070, four unarmed students were shot dead by National Guardsmen using live ammunition at (then) Kent State College, Kent, Ohio.  Some of the students killed were protesting against then President Nixon’s hostile excursion from Vietnam into Cambodia. Other students who were curious bystanders and had nothing to do with the protest.

Richard Nixon was elected President of the United States in 1968, possibly on his promise to end the Vietnam War quickly. However, the war continued unabated and reports of atrocities (the My Lai Massacre in November, 1969) prompted increasing protest movements, especially among students.

At Kent State College, about 500 students protested publically on May 1, 1970. That evening, skirmishes occurred at several local bars involving property damage and frustrated Kent students, resulting in the local police force responding. Beer bottles were thrown at the police, prompting the Mayor to declare a “State of Emergency”.

Rumors abounded that there were committed terrorists on the Kent campus and lives were at risk as well as property, prompting Ohio Governor to call out a contingent of the Ohio National Guard.  By May 3, the protest had escalated to over a thousand persons, not all students, throwing rocks and bottles at police and Guardsmen. Then Governor Rhodes vocally called protesters: “revolutionaries set on destroying higher education in Ohio”.

On Monday, May 4, college officials tried to ban further protest gathering, a gesture that was ignored.  2,000 people gathered on the university’s Commons chanting and singing protest songs.  Soldiers from the Ohio National Guard Armored Division then attempted to disperse the students by intimidation. The protesters responded by throwing rocks. The soldiers then dispersed tear gas into the increasingly angry crowd, continuing to throw rocks and gas canisters back at the Guardsmen.

Guardsmen then “fixed bayonets”, and advanced on the crowd which split up into several groups as they retreated. Now, let me at this point step out of context and tell you what “fix bayonets” means. In a combat scenario, it means you’re out of ammunition and facing a relentlessly advancing, numerically superior enemy and you’re reduced to eye-to-eye fighting to the end, probably your end. One of the most terribly frightening things a human can face. In this situation, it means the Guardsmen intended to use bayonets at close range against unarmed students.

The Guardsmen pursued the protesters but became confused as to the landscape and ultimately became more or less sequestered in a tight area allowing some of the students to surround them continuing to throw rocks and gas canisters.

At 12:24 pm, according to witnesses, Guardsmen open fired with military issue .45 pistols an M1 Garand rifles at random students. In 13 seconds, a total of 67 rounds were fired. Four students were killed nine others seriously wounded.

Immediately after the shootings, a full-on riot nearly erupted that might well have incited well-armed Guardsmen to take more lives. Faculty members at the scene plead with all involved to stand down before that eventuality occurred. After about 20 minutes, the students left the Commons followed by the Guardsmen.

Photos of the dead at Kent State found their way into the International media and amplified the frustration against the war in general and Nixon in particular. Kent State photojournalism student John Filo captured a photo of a fourteen-year old runaway, Mary Ann Vecchio, screaming over the body of a dead student that won a Pulitzer Prize.  On viewing the photo of the dead student in a newspaper, musician Neil Young purportedly wrote “(Four dead in) Ohio” on a café napkin in one sitting, performing it with Crosby, Stills, Nash &Young several weeks later.

A week after the Kent State shootings, 100,000 protesters in Washington, D.C demonstrated against the war and the killing of unarmed students. Nixon’s life was thought to be threatened and he was quickly moved to Camp David. The Urban Institute conducted a national survey concluding that the Kent State shooting was the precipitating factor for over 4 million students protesting in 900 American colleges and universities. President Nixon’s reaction to all of it was perceived as “callous and insensitive”.

A Gallup Poll taken after the shootings showed that 58 percent of respondents blamed the students, 11 percent blamed the National Guard and 31 percent expressed no opinion.

We were a country at war with itself. It was arguably the first and last time in history that a major youth uprising against a political regime occurred with such singularly and coordinated organization.

The Vietnam War did not end until five years later.

 

 

 

 

 

International MotoGP race at the Circuit of the Americas, Austin, Texas, April 11 – 13, 2014.

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38A new track constructed specifically to lure the Formula 1 for the World Championship of Drivers circus back to the USA. The track is immaculate, beautiful and specifically constructed for fans to see and absorb as much as possible from any vantage. Very fan-pleasing.

My medical credentials allowed me pretty much full access, but not necessarily into the “seats” where I could sit, have food and drink. That was “extra” but I managed to finesse my way in, at least on Friday where there weren’t too many people.

My buddy Billy Fanstone of Brazil and I wandered around the track all day and each site was as good as the next, although we nor anyone else can never get too close to the actual track. Double levels of fence.

The track is huge, biggest track I’ve ever seen. Something like 3.5 miles from one of the six parking lots to the main gate.  And of course, extremely expensive to get tickets US$1000.00 or so for the three-day race weekend including parking and a seat.

The Formula 1 circus directors liked this track and so the Formula 1 motorcycle series was a natural to add to its itinerary.  There are paramedics on the track but not doctors. The safety director is my old friend from CART Lon Bromley and we had a nice reunion. Long time CART medical director Dr. Steve Olvey is the Medical Director and there are several other doctors around under his direction.

This is the big leagues of two wheel racing, three separate series- Formula 3 (250 cc engines), Formula 2 (600 cc engines) and finally the big boys at 1000 cc, 220 mph on the straights.

It’s difficult to accurately describe the phenomenon of a flat-out motorcycle on the front straight. It’s so incredibly fast it’s difficult to understand how a human can retain control. The rider tucked in behind the diminutive windscreen…..then sitting upright to catch wind (slowing down), followed by clutching the side of the bike like a spider as it tilts to an impossible angle in a corner at speed.  And most of these riders are kids. It’s just ridiculous.

We wandered though the pits watching engineers and techs correlating virtually everything the engines do on a computer. On the actual track, each machine has a shack full of computer monitors that follow every stroke of the piston and turn of the wheel. Each rider has a tiny air conditioned apartment” for sleeping and resting during the day. They hang their tracksuits out to sun.

Then though the paddocks where T-Shirts and other memorabilia are hawked with a blood lust for money that would embarrass the Whore of Babylon. Of course I couldn’t resist picking up a couple of t-shirts, even at blatantly rip-off prices.

The state of motor racing in the new millennium continues to amaze me. When I was there in the 60s, we drove our MG-A’s, Triumph TR-3’s and Porsche 356’s to the track, taped the headlights, fitted a tubular roll bar behind the front seat, raced all day, uninstalled it all, then drove home. The few people that showed up had a good time and went home with full wallets.

Now it’s a big business indeed. Every square centimeter of space on a race bike is filled with an advertisement. Riders and drivers are forced into indentured servitude from their sponsors, the females, of course, encouraged to exhibit as much sexuality as they can pull off without looking “too” much like Playboy centerfolds. The money gleaned from everything and anything associated with racing is parceled out by intricate contracts.

Interestingly, the “fans” have little or no access to the really top riders.  I had a medical pass which allowed me to go anywhere I wanted and I never got anywhere near Dani Pedrosa, Casey Stoner, Nicky Hayden or Valentino Rossi. Their pits were carefully sequestered and closed to everyone and anyone not directly related to them. I got some shots of Rossi coming and going out of his pit.  If they do address “fans”, it’s briefly and very meticulously orchestrated with lots of sponsor visibility.

The MotoGP speeds are difficult to process. Any accident at these speeds would be reliably fatal. Each rider on swinging around the final turn before the main grandstand goes out of their way to lift he front tire for a while just to show their control at over 100mph. Their control of the machine if phenomenal.

All this forces the question of whether MotoGP is a “Sport” or an exhibition. In order for it to be truly a sport, the skill of the rider must exceed the inherent performance of the machine. Of course, the more money put into the machine, the faster it goes. A skillful rider can theoretically overcome limitations in the machine’s performance by simply taking more chances than the next guy.  This potential stoked by the sponsors’ demands to go faster presents a very dangerous situation indeed and transcends skill.

I think that nine time world champion Valentino Rossi is technically the fastest rider that ever lived, but is in the process of lugging a really uncompetitive machine. So, it’s unclear at this point how many chances he’s really willing to take before he cuts his losses and changes teams. .

Unclear also how any of this applies to open-wheel motorcar racing where driver’s ability is less than the car’s performance in a situation where passing is difficult or impossible. In Formula 1, the first cars on the grid usually finish first. Not so much in MotoGP as there is more room to pass.

This race was won by Spaniard Marc Marquez, who started from the poll, let the entire race and set the track record. The Honda team came in first and second, making them pretty much unbeatable so far. He looks like he’s ten years old and started shaving yesterday. Rossi finished 8th, complaining of tire issues.

The actual race is typically colorful and exciting. The fans can see much of the action from good vantage points. I think you have to see it live at least once to fully appreciate the unique ambiance. Then the best seat in the house is always in front of a nice, big high resolution TV screen. I was happy to have had the opportunity to experience this adventure.