Protests v. Violence: Forward to the past

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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.

Some history that might affect us in 2020

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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

 

 

 

Some notes on current political players 4.8.2019

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Both Alexandria Ocasio-Cortez and Ilhan Abdullahi Omar mouthing controversial concepts presumably to get as much publicity for them as possible. Everyone knows there’s no such thing as bad publicity.

But it’s faulty logic and they better stop spouting that nonsense out. They like the sound of their voices and they like to create stirs, none of which will do the Democratic effort any good. It will be harmful when the real players rise to the spotlight, players she won’t be a part of. AOC is a figurehead for the reaction against everything Trump stands for but it’s an overreaction and those that rise to the top for the Democratic nod for 2020 will not buy into any of it.

Mueller. The reality is that (it seems) Mueller’s findings didn’t rise to the level of being criminal. Well, OK. Fair enough. But as numerous pundits have observed, there is a lot of space between criminal and unethical, immoral, amoral, unprincipled, unscrupulous and dishonorable. Things that Trump is famous for. So Mueller said he didn’t did anything criminal but he also said things in the space might be there. Presumably he laid out things that might be there (which I’m sure Barr neglected to point out).

Therefore, the congress and the public have an absolute right to have a look at the pure essence of Mueller. What they (we) got was an “interpretation” by a very loyal Trump flunkie with a history of dissing anything Mueller came up with before he came up with it. I would trust the current Attorney General about as far as I’d trust Charlie Manson. Let’s see it all and let’s explore the space just under “criminal”. If the Republicans like to shout that it’s just politics, that’s fine. Now let’s have a look at all the 400 pages. Particularly the parts about what was in Cohen’s office when they raided it.

No, Trump’s base doesn’t care but it needs to come out anyway. A lot of other people care.  Mueller’s revelations may not make a seismic blast, but they will be noticed. And the more reasonable voters that can be convinced that despite the good economy, Trump is a very, very, very bad person at every level and a totally incompetent leader, the better. Chipping away at his base, the ones that voted for him for reasons they would come to regret, is the best chance of getting rid of him in 2020. Yes, his base has a molten core that applauds all of it and listens only to what comes out the end of his phone. But there are also a lot of voters that voted for him specifically because they thought he could “drain the swamp” as an outsider (very faulty logic indeed) and they hated Hillary more. But since 2016, Trump continues to act out in a fashion that alienates him from more and more potential voters. And Hillary isn’t running anymore.

Remember also that the Republicans have NOTHING resembling a health care plan and they will not be able to construct anything workable by the time primaries roll around. You can definitely take that to the bank and a sniff of the 2018 mid-terms was about health care. You can bet ALL of the primaries for 2020 will be about health care. Republicans moving to kill the ACA, putting over 20 million out of health care and nothing to replace it? Really?

So the combination of Trump acting out, the Republicans continuing to insist of a wall that will be expensive out of proportion to benefit among many other atrocities AND the lack of a health care plan will at least make it a possibility that he will be un-electable. Economists also saying that the bull market won’t last indefinitely. The Democrats have a huge advantage simply by extending Medicare and Medicaid to everyone. Very, very expensive but a game winner since the opposition has nothing.

All the Dems have to do now is come up with a credible candidate that can, unlike all the Republican candidates of 2016, stand up to the withering personal TV blows of Trump. Can Biden do that? Maybe. But Biden has luggage and a lot of it. Plus he’s what they now say is an old white man, no longer much credible in todays world of emerging young women. As an old white man myself, I know exactly how that works.

I think in the end, Biden will fizzle as will Bernie as he did in 2016. What’s going to float to the top is one of those females. Pete Buttigieg is a very smart guy with a lot of interesting things to say. I saw Charlie Rose interview him for a full hour years ago and I was incredibly impressed with him then. Speaks multiple languages, Rhodes Scholar, military history. In another world, he would be a strong candidate but in this world, I doubt a gay candidate can win.

It’s gonna be a female that rises to the top. An anti-Hillary, maybe, and it will be pretty quick. Many of those would-be candidates will disappear very quickly when the money gets tight.

Ha!  Big deal meeting between Sec. Nielsen and Trump April 7 in which virtually every pundit predicted she was out, probably unceremoniously. Terse Twitter thanking her for her service. Unclear whether she was formally fired or allowed to resign.

I remember her for her June explanation of the nastiness involving separation of families at the border and kids in cages. The shit-for-brains press secretary who usually defends shit-for-brains Trump with a perfectly straight face wasn’t having any of that shit and informed the press that Sec. Nielsen was making a special trip by air to explain the shit and she (as press secretary) wasn’t having any part of it. She then walked off the podium as Nielsen took the microphone with a smarmy smile to blame the victims. If they hadn’t shown up at the border, they wouldn’t be separated.

So the experts are saying several things. That Trump is actively searching for yes-men, with emphasis on “men” and the job of homeland security is an impossible one for a human to do. So yes-man will follow yes-man, all with sycophantic bullshit to delay the inevitable. And in the immortal words of sub-human activist Stephen Miller, trump needs “tougher” administrators. Miller is perfect for any trump job. Completely heartless and cruel.

The same pundits, almost without exception exclaimed absolutely no sympathy for her. She tried to be a “yes girl” for Trump but in a job that couldn’t be done by a human. She smiled nervously as he routinely publicly embarrassed her, demanded she do impossible jobs then blamed her when it couldn’t be done. I wonder if she’ll write a letter explaining how she couldn’t meet the requirements of the President and so had to resign.

I’ll give Nielsen the benefit of a small doubt that Trump fired her because she had a molecule of integrity. More likely she was a fawning sycophant that ran to the length of her usefulness to Trump.

4.8.2019

DWC

 

An editorial comment on Trump at 6 months

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DISCLAIMER: What follows is a piece I just wrote for a political blog. It is a personal opinion and nothing else. I’m sending it to you simply because I can (occasionally). I am not using a UPMC server and this is not a comprehensive list of everyone in any Department. Enjoy if you have an interest. Dump if not.


From Mike Allen of AXIOS this morning:

“Trump is at real risk of losing his party. His base voters are remaining steadfast,
but Republican senators are getting increasingly impatient and resistant.
Sen. John McCain’s surprise thumbs-down on health care is likely the beginning
of a wave of defections from establishment Republicans. It’s rarely discussed
publicly, but people in government say that a domestic attack — although unlikely
to be on the scale of 9/11 because of all the countermeasures that have been
added — is a constant possibility. And critics and skeptics worry about ways
Trump could consolidate power in the wake of such an event. We put
Bob Mueller last just because the special counsel gets so much attention.
But make no mistake: The special counsel’s investigation remains the
existential threat to this presidency. Reuters reported that Mueller just added
a 16th lawyer to his team — Greg Andres, who has experience prosecuting
illegal foreign bribery.”

“Also on the WashPost front page … “Senate GOP’s frustrations with Trump
bubbling up,” by Sean Sullivan: “Some are describing the dynamic in cold,
transactional terms, speaking of Trump as more of a supporting actor than
the marquee leader of the Republican Party.”


I say: I’ve always thought that Trump’s “base” will never desert him no matter what he does or how he does it. The point of being tipped into power by relatively dogmatic rednecks is that they obviously believe what he says (in his tweets) other than what the reality is. Several interviews with groups of his “supporters” in Kentucky and Ohio show that they simply don’t believe anything the nightly news reports and they don’t read the Grey Lady or the Washington Post. Trump says his first six months have been absolutely stellar and they hang on his every word.

However, the “base” that tipped him into this unexpected (by everyone else) victory was a relatively small number, and that number is slowly but progressively decreasing. Unclear if the same election was held tomorrow, that tip would occur. There have been defections. The base will always remain but may not be politically active in 2018, and especially 2020. The American voters may still prefer conservative politicians, but that doesn’t necessarily include Trump.

If and when Trump goes down, it won’t be because of style but substance. Few if any of his promises to his base have much chance of coming to pass. The incredibly bad health care bill is mercifully dead, hopefully forever. His promises to “drain the swamp” simply diverted the swamp to the White House. Promises to save coal are ludicrous. His disbelief of global warming is harmful. It isn’t up to him to “increase jobs”. It’s up to many factors he has no control over. The “wall” is a joke, especially the Mexicans paying for it. But some very big issues remain. Whether or not his rabid base chooses to see it, the Russian thing has now developed into a very, very big problem for Trump. The obvious Russian thing plus the intentional lying and deception Trump is caught in by Washington Post reporters who have devoted their lives and 18 hour days to ferreting out these lies shortly after he utters them. The intentional deceptions may not be noticed by the rabble, but you can be sure they are by the Republican establishment, few of whom supported Trump initially and most of whom are only paying lip service to him today.

Fewer Republicans are smiling. That John McCain and the two women Senators made a big splash of defying him in the face of personal threats would have never happened six months ago. The new book by respected Arizona Republican Senator Jeff Flake raggedly trashing Trump and the horse he rode in on would never have seen the light of day last December. The Republicans are decidedly as worried so much about being ravaged by Democrats in 2018 or even 2020 as they are their own party ultrastructure collapsing. Since there are no clear Democratic threats showing up, that could happen. If it does, they will lose everything pretty much by default.

The “Great Man” theory suggests that times of crisis creates a “Great Man (or Woman)” to arise and lead the population out of danger. In fact, Contrary to Trump’s tweets, our population is in crisis indeed, and great danger. We’re led by a President who makes decisions capriciously, impulsively, with little or no thought as to long range implications and sometimes according to the last “authority” that advises him. This kind of leader is a serious problem in a world where long range missiles are aimed at us from one side and malicious computer experts on the other. A world where the Middle East can explode at any time and the Chancellor of Germany publicly states that Europe has no confidence in Trump and they’re on their own. A scary place indeed, with a blundering incompetent leader of the free world at the helm.

The burning question at the moment is what, if anything, can be done to minimize the danger of Trump. There continues to be some interest in some quarters to remove him by impeachment, but that’s highly unlikely in a regime controlled by Republicans. If Clinton couldn’t be found guilty in impeachment, Charlie Manson probably wouldn’t either. Besides, if Trump were removed, a smiling, dapper Mike Pence would ascend, a man who really believes ultra conservative Republican nonsense and enthusiastically putting the country under it’s jackboot. Trump is a better deal than Pence if for no other reason than his inherent inefficiency makes it harder for his party to establish it’s black-hearted goal.

I suspect nothing can be done about Trump for the near future and we’re all going to cross our fingers and hope that ineffectualness will breed less danger than a committed charge into guaranteed danger. At Trump’s current rate, little if anything will change and little will get done. In addition, Trump doesn’t see this light yet but Robert Muller is lurking in the background with a bevy of very knowledgeable specialty lawyers and they’re digging like Robert Costa of the Wash Post does, just not reporting any of their findings yet. You can bet they have Trump’s tax forms. When Muller does come to light, and it’s likely to come before 2018, it will be a blinding flash that no one sill be capable of ignoring, not even the “base”. But the base won’t matter then. It will matter to the Republicans, and matter a lot.

I mentioned the “Great (Wo)Man Theory” a while back. Unclear if this will happen before 2020, but we might see signs of it in the Senatorial race of 2018. Will Democrats get a majority of either house, making it virtually impossible for Republicans to get anything meaningful done? Unclear yet. Despite all the pleas for bi-partisan discussions on just about everything, it isn’t happening, and few pundits suggest it ever will. Either side has more to lose than gain by doing so. It will always be a scorched earth battleground, whoever survives the carnage wins (need I mention the Toomey vs McGinty Senate race in Pennsylvania, 2016).

There are some interesting possibilities on the horizon, many of whom have guested on the Charlie Rose show (a really excellent forum). Republican Senator (R. Utah) started out life as a Tea Partier but has become more moderate. He related some good ideas on Charlie Rose a while back. A little too conservative to my taste but I think might be up and coming.

https://en.wikipedia.org/wiki/Mike_Lee_(U.S._politician)

Even Jeff Flake (R. Arizona) has been a round for a long time and has emerged as pretty much a voice of reason.

https://en.wikipedia.org/wiki/Jeff_Flake

On the Democratic side, forget Elizabeth Warren, she blew it all out for Hillary. Al Franken? Maybe, but not terribly well thought of by the power structure. Keep your eye on South Bend Indiana Mayor Pete Buttigieg.

https://en.wikipedia.org/wiki/Pete_Buttigieg

He has impeccable credentials and could arise to be a force for the Democrats?

At any rate, it appears that, like it or not, we’re stuck with trying to limit incompetence for the foreseeable future, not forge ahead constructively. We will be what we are, a large group of “The Apprentice” contestants, overseen by the master who know how to get the best ratings. In the end, much drama and confusion, but ratings likely to drop as the short-span-of-attention audience gets bored, then dropped by the networks. We’ll see in 2018.

Addendum 08/0317

On the NBC News last night, the talking head mentioned that the economy is doing pretty well for the last couple of quarters, even as the White House quagmire continues unabated. I would be pretty happy about this as far as it goes, but be very wary of Wall Street in general and bull markets in particular for at least two good reasons:

  1. None of this has anything to do with Trump other than he’s loosened some regulations that protect consumers. Amazon is booming because no one goes out of their house to a store anymore. That will all come tumbling down when these huge storefronts that employ millions of people come tumbling down. Apple is booming because everyone in the country continues to purchase various stripes of computers with no end in sight and the new iPhone 8 is getting a big push. None of this has anything to do with Trump who if you recall promised to get all the coal mining jobs back. Many other businesses continue to move overseas.

  2. Wall Street variations are, by their nature, fickle, based on smoke, mirror and vapor. Recall that Wall Street goodies also increased after George W. Bush and Obama, larger than what’s happening under Trump. It’s all just based on expectations. Recall the “dot.com” boom a while back thought to never end. Recall the housing boom of 2006 based on lack of regulation, no one watching them. Don’t worry. Business thinks they’re getting a pass on regulations that will allow them to take risk with someone else’s money for a while. But in the end, all risky maneuvers flop and when they do, it’s the public’s money that will be lost. Recall also that not one of those that caused the recession of 2008 are in jail today. Ups always turn to downs, and now that regulations are lax, it’s only a matter of time.

Wall Street is a VERY bad proposition to hang hopes on. The Trump presidency is in VERY deep trouble, and Wall Street is a very fat red herring.

Trump and his future (March 2017)

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There’s pretty good evidence that there is a contingent of Trump
supporters that will NEVER give up on Trump no matter what he does.
Every stupid lie over a Tweet brings them closer to him. However,
after the events of the last two months, including but not limited to
the fact that he has achieved nothing, especially any of his loud
promises, will result in a cumulative deterioration in that group in
time. It’s a long game.

They were not ALL nitwits, some just thought he would be the one to
“shake up the system”, not realizing he was a full-on sociopath capable
of destroying the system. As time progresses, many of those will see the
light and split to other factions, leaving a bare bones contingent of
those that will always find excuses for Trump’s behavior, and an
open-ended ability to blame others for his gaffes.

Trump thought he was invincible because of his radical core of
supporters would push anything home. He thought his deal making ability
was inviolate.He really thought he could arm twist his way to putting
this ridiculous bill into law. He, like Obama, got introduced to the
realities of congress. The honeymoon, if there ever was one, is
definitely over. Nancy Pelosi smirked that the author of the “Art of the
deal” made a rookie mistake. Now, the entire game has changed and will
not go back to the old days two months ago.

This would-be health care bill is as dead as a roadside roadkill skunk
and will never come back. The Donald, skulking back to lick his wounds,
realizes that. So now the game plan is to “allow Obamacare to explode,
following which the Democrats will come begging us to fix it” (a phone
communication to Bob Costa of the Washington Post yesterday afternoon.)
Of course, the reality is that there is no evidence Obamacare is
exploding, or will do so in the near future. It simply needs
adjustments.

Chuck Schumer hit it on the head yesterday. Obamacare is in place and it
can be adjusted so why not everyone get together and do that rather than
trying to craft a replacement that would take years to make everyone
happy. The incentive to do that may hopefully be approaching, but it
will probably only be after congress is thoroughly shaken up in the 2018
elections which I think is coming.

I think, as do a lot of other experts (not necessarily me in that group)
that this isn’t just a forgettable loss that happens every day in
congress. This is an unqualified Richter 10 disaster that actively
undermines Trump’s ability to lead. Virtually everything he’s done in
the last two months has failed and the number of flat out lies that roll
off his tweet machine continues to astound and continues to undermine
his credibility, if he ever had any. The combination of having
everything he signed tied up in legal quagmire, quietly asking the
taxpayers to fund the impeccably silly and ill-advised wall the Mexicans
gleefully refused to even talk about now combined with his inability to
get ANY health care law passed. Never mind that NONE of it fulfilled
his loud previous promises that everyone would be covered cheaply.

He’s now skulking, contemplating his next move (probably) in his
multi-million dollar estate in Florida wasting millions of dollars of
taxpayer money, disrupting the local economy with hundreds of guards and
restrictions while the rest of his family wastes other millions needing
to be guarded when they take a walk down fifth avenue to window shop.

Well, folks, there are some likely scenarios. I think next up on the
ledger is Trump and his conservative friends fucking up the economy by
cutting out everything and anything that might actually benefit people,
but saving a lot of money to be spent elsewhere. Now that he’s found out
congress is a little tougher than he previously thought, and congress
has figured out they don’t have to be bullied, this will be a very
interesting game, indeed. It’s not out of the question that Cruz et al
will try to sink the government again, but this time Trump is in a
different position than he was a year ago, a position of being
responsible for the ship’s safety.

I think also that Trump’s silly tweets and wild, unsupported accusations
will continue and he will double down on all of them, slowly but
progressively eroding his credibility and also eroding his “base”. At
some point, the Republican majority, becoming more terrified at losing
their majority in 2018 will start doing some interesting things we don’t
really know the nature of yet. I think it’s highly unlikely Paul Ryan
will ever trust Trump again and vice versa, so Trump’s relationship with
congress will be non-existent.

First time, I’m wondering if this continues, will there be an attempt to
evict Trump from office in 2018 simply on the basis of his inability to
lead, much less his ability to fuck up the world. And BTW, we haven’t
seen any world crisis yet this month for Trump to fuck up. We don’t yet
know how bad or how dangerous it could be.

Pence, conservative wog that he is, comes off infinitely more
“presidential”, and might attract a lot of Trump’s more realistic
followers. I’m wondering if this could happen.

Trump as POTUS: an editorial comment

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unknownWe should have all seen this coming. The favorability ratings of the entire Washington bureaucracy had been in the cellar for years and decreasing. Partisan political activities consisted of bitter hatred of each other’s side and resolve to insure nothing the other wanted ever came to fruit. Ted Cruz worked as hard as he could to completely sink the government and go down with the ship. All progress in Washington stopped dead in its tracks with no potential for moving it.

What we didn’t know was the sheer size of Trump’s support. Michael Moore predicted Trump from the beginning and he never wavered. We should have noticed that Trump won most of the primaries by big votes against all odds. We also should have noticed that none of his support ever wavered for a second despite ALL his antics. None of it mattered. I should have known watching all those Trump signs while riding out in central Pennsylvania. My friend the ICU Nurse laughed and told me he cared nothing about any of that- Trump was chosen to “shake Washington up”.

So to the surprise of all of us, especially the pollsters, all of whom were wrong, we are now witnessing a full blown REVOLUTION in which the population of the USA has spoken loudly. It’s classic democracy at work. The populace is NOT happy with what’s happening in Washington and they have chosen the individual furthest from the archetypical Washington politician, Hillary Clinton, a candidate with so much baggage it would fill a train.

It’s difficult to comprehend anyone less likely to be elected President by an intelligent, perceptive voter. She was projected to win not for her plan but because everyone with an opinion in the media thought she was the lesser evil. But the “real” voters weren’t talking on the media. The “real” voters that knew Hillary would perpetuate the exact situation in Washington they loathed and they didn’t believe a word that came out of her mouth. The pre-election activities were all a waste of time and money. Trump was a self-fulfilling prophecy.

So here we are. The public has served notice that they expect the entire fabric of the Washington bureaucracy to be torn to shreds and a new order emerging, more efficient and favorable to the common man. So that’s where it is as I sit here on 11/11/16. It is a done deal so no use crying over spilt milk. It is what is, so we must now consider where this is likely to go.

Donald Trump will quickly develop some new best friends, conservative politicians, all of whom distanced themselves from him during the campaign. Don’t worry; they’re all back and planning to re-forge the country into an ultraconservative dark age. They now own both houses so there will be virtually no effective opposition to any of it.

No more Obamacare, with nothing of any consequences to replace it, leaving 22 million out in the cold. Repeal the Iran deal, leaving them to continue making a bomb as rapidly as they can. Repealing the climate accord because they choose to disbelieve 99% of the experts. Cutting taxes preferentially for the super-rich, choosing to believe that “trickle down” works (didn’t work for Reagan in 1980). Unlimited weapons of any kind on demand from anyone. Destroying Planned Parenthood and quickly repealing Roe v. Wade, following which an enormous cottage industry of abortion will develop, an underground economy impossible to stamp out. They will of course blame the victims. Getting an ultraconservative judge onto the SCOTUS, rubber-stamping all their plans. Never mind the impeccably ridiculous Mexican wall and goon squads to seek and destroy illegals.

That is EXACTLY what Trump’s new best friends have in mind and they’re all in the process of planning it.

However, there are jokers in this deck. All of Trump’s new best friends might consider that Trump really isn’t a conservative Republican at all. Never has been. He was once a Democrat. He chose to run as a Republican because it was the most expedient path He has frequently opined on policy that is not conservative at all. And it also must be remembered that Trump has an extensive history of only listening to Trump. He’s found out what works and it isn’t free advice, especially from folks he doesn’t trust. So there is no guarantee at all that Trump will blandly follow through with all the plans of his new best friends. He might just have the “right thing” in mind, and the right thing might be more “right” than we currently imagine.

Recall that in 2008, Obama ran on a very solid “change Washington” platform. When he actually arrived, he tried to gather all the Republicans together to talk out their differences and form some kind of body that worked for the best benefit. They all ignored him and vowed to insure nothing he wanted to do happened. The majority speaker opined that their job was to insure he was a one term President and this is exactly how they acted. It’s also very interesting that despite his best efforts, Obama was chewed to pieces by the bulletproof Washington establishment, not even making a dent in it. Washington changed him as it did everyone that came before him.

So there is also no guarantee that Trump will get all he wants in a system that’s preternaturally designed to NOT be changed by anyone. He is more likely to become meshed in the gears to find out that “deals” don’t work the same as in his previous career. He will have to learn an entirely different and unfamiliar “art of the deal”, especially with China and Russia.

So, I think that just like the previous predictions of the election, there is no more likelihood of predicting what Trump will do, or what he’s able to do once in office. All the claims of what he wants to do are now enmeshed in gears he really knows nothing about and when extensively evaluated, may simply not be realistic for Trump to actually accomplish. It will be VERY interesting to see how Trump explains repealing the ACA, even if he’s technically able to do so, to 22 million of those affected, many Trump supporters.

Once into the realities of the world sociopolitical situation, “bombing the Hell” out of ISIS never had any possibility of working. There are probably realities of the Middle East, Iran, Turkey, Syria and Russia that he had no idea about when he made some of his ridiculous vows. He will find out that the realities of foreign policy are extremely dangerous and he will have to tread as lightly as Obama did, with open-ended criticism from all sides.

It should also be obvious that none of the above works for his committed base that want’s it all fixed in a few months, for ISIS and Iran to go away, more money in their pockets, better jobs and unlimited milk & honey. His base in W. Virginia and Kentucky want coal to become the energy of the land. Working class white men want to make more money and promotions. It’s VERY unclear whether Trump will even have a shot at any of that in a Washington that doesn’t run as his previous career did. Making promises is cheap. Delivering them in THAT Washington is a separate issue and he, like the rest will probably learn to obfuscate those promises with great facility.

So, the bottom line of this conversation is that we really know little or nothing about how The Donald will function in the same environment that gutted Obama and others. I’ve mentioned before that like it or now, Trump is OUR President now and continuing to grouse about this or that is meaningless now. It’s time to support the President by simply being reactive to what’s going on. A lot of Republicans are NOT extremely conservative and will not necessarily rubber-stamp every program that emerges from Trump’s new best friends, or even Trump.

There is a lot of sound & fury but in the end these things have a way of settling down. The majority of the public has never supported the Sarah Palin brand of conservative politics. It’s unlikely that they will now. They want “real change”, a political body that serves them. Conservative Republicans don’t serve, they break things and the majority of the public will not allow that.

What Hillary said is correct now. Trump IS the President and he needs a chance to lead. It’s not unreasonable to give him our support while he explores that chance. Who knows, he may actually “do the right thing” to the best of his ability and surprise us all. If he can’t or doesn’t, then another voting cycle will come around in 2018 and 2020. We can then do what Trump supporters did in 2016; assertively change the order of things.

So I say lets all just watch for a while and see how things go. It doesn’t have to be a disaster. When the dust settles, it might be OK and Washington might actually become more responsive to the greater good. There’s at least as good a chance of that as the collapse of society. Society is pretty resilient. I would be inclined to see the glass as half full rather than half empty.

We’ll all see in time.

 

 

 

 

 

 

Some politically volatile comments (personal opinion FWIW)

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crippenWhat follows is some conversation from the Website:  Med-Events:, a site I moderate for opinions and comments about current events. Sometimes it gets pretty volatile and there isn’t much held back as Events is a closed site. I cannot reproduce any of the opinions other than mine because I don’t have permissions. So I have put forth my opinions regarding certain current events of a volatile nature for whatever interest anyone may have, maybe none. It’s all mine and I opine from the perspective of having been there for some of it and having personally known some of those involved. I was, however, never a member of the Weather Underground and I never participated in any such violence.

It’s fairly long and involuted and I rarely copy-edit anything for spelling or grammar.

 

Crippen on “Protests”, Media” and “Black Lives Matter”. (Med-Events discussions in January-February, 1016.)

LE HAVRE, FRANCE - MAY 21: Anti-G8 activists protest during a demonstration on May 21, 2011 in Le Havre, France. The demonstrators were protesting against the G8 summit, to be held May 26 and 27 in the north-western French city of Deauville. (Photo by Franck Prevel/Getty Images)

LE HAVRE, FRANCE – MAY 21: Anti-G8 activists protest during a demonstration on May 21, 2011 in Le Havre, France. The demonstrators were protesting against the G8 summit, to be held May 26 and 27 in the north-western French city of Deauville. (Photo by Franck Prevel/Getty Images)

Demonstrations, Protests and the Media

Crippen: I’ve seen a lot of demonstrations in my lifetime and participated in a few when I was a younger dog. Here’s how it works. A group gets worked up over some atrocity, real or imagined, and they all congregate to show the public how pissed off they are and to assure their anger makes the 6 pm, 11 pm news and CNN. However, no one watching these news sources cares. Most don’t look up from their issue of People magazine. Whatever it is they’re demonstrating about, it doesn’t touch them and it doesn’t matter to them. It’s somewhere else, and it affects black people. OK, fair enough. Anyone for Chinese? The news services work it up for a while and they to get bored with it and move on to whatever the Royals are doing or how many ISIS sites were blown up.

Then the protesters figure out no one cares and they’re wasting their time. They march and then everything goes back to normal. So they then understand they need to make more of a splash to get the attention of those dulled by most news stories anyway. So the U of Missouri football team refuse to play, and some of the students go on hunger strikes and they loudly call for the resignation of higher-ups in the system. The dumbass higher-ups offer blanket apologies for atrocities they don’t even know about, roll over like weasels, exposing theirs softest parts at the whims of a pissed off MINORITY and skulk off to cheers of equally clueless cheering sections.

This hits the 6 pm, the 11 pm and Anderson Cooper briefly, the viewers look up from their Us magazine, tut-tut and then move on to the Real Housewives of Atlanta. The protesters loudly shout “we won!” and then repair to formulate more demands, many having nothing to do with the original atrocities at their school, real or imagined. Then all goes back to normal again for a while.

Then the protesters understand it’s time to kick the sleeping bear again. This time they obstruct traffic and entrance into major businesses on the busiest shopping day of the year. “LOOK AT US, WE’RE TRYING TO SHOW YOU WE’RE BEING DISCRIMINATED AGAINST”. That’ll show ’em. The public then definitely notices them. The “notice” the protesters get is the exact opposite of what they want. The public is inconvenienced and they don’t give a shit about the principle, they want the road cleared and the businesses non-obstructed.

Finally, the protesters understand that the only way to get noticed and stay noticed is by bombs and bullets. Just like the Weather Underground in 1970. The public will be dragged into an understanding of the problem whether they want to or not. That’s where this is headed.

 

436247168_640David Gilbert and the Weather Underground

Crippen: While in the air and hanging around airports over the last week I read an interesting book on the revolution in this country from the 60s and 70s, a subject I am very interested in as I was there for a lot of it. In my collection, I have almost every book written about this era, most from those involved, including a signed (to me) copy of “Fugitive Days” by Bill Ayres and an original first edition copy of “Prairie Fire: A political statement of the Weather Underground” (1974), run off by mimeograph to avoid detection by the ever vigilant Federales.

Regardless of whether you agree with him on anything, Bill Ayres writes a lot about American culture and most of it is an interesting read:

http://billayers.org

If anyone’s interested, the book is: “Love & Struggle: My life in the SDS” by David Gilbert, a stalwart of the Weather Underground in the early 70s, currently imprisoned at the Auburn Correctional facility in New York for his (non-violent) part in the infamous Brinks robbery in 1981 during the waning years of the WU. David and his wife Kathy Boudin were caught up in a plot to finance future radical activity by robbing a Brinks truck that went completely wrong and people were killed by members of the Black Liberation Army (BLA), a faction that both Gilbert and Boudin stupidly underestimated. Boudin was released in 2003 after 22 years. Gilbert is my age, has spent most of his adult life in prison and will die there as he isn’t eligible for parole until the year 2056. Bill Ayres and Bernardine Dohrn legally adopted Gilbert & Boudin’s son while they were incarcerated. He is a civil rights lawyer today.

http://www.amazon.com/gp/product/B008CID47S/ref=dp-kindle-redirect?ie=UTF8&btkr=1

UnknownThere are several things learned from reading accounts of the “Days of Rage”, specifically the Students for Democratic Society (SDS) and it evolution to the “Weather Underground” (WU) by people that were intimately involved.

  1. The SDS were by and large white children of privilege, reared in families of means, many of them Jewish as were both David Gilbert and Kathy Boudin. Kathy’s father was an ultra-left wing lawyer, counsel to numerous left-wing organizations. Her great-uncle was Louis B. Boudin, a Marxist theorist. Gilbert was an Explorer Scout. In essence, they were all what we would have described then as “Communists” in the purist sense with a Marxist economics inflection. They interpreted many of Marx’s principles of the value of work belonging to workers and not to those who dilute it unfairly.
  1. The SDS started life in the late 60s with the fundamental goal of addressing the inequities of the poor and disadvantaged in a world that entitles white males. Their primary interest was exposing the inequities of minorities including dramatic deficits in education, nutrition, housing, jobs and opportunity for black folk. They developed an accumulating interest in the Black Panther Party (BPP), established in 1966 and mirrored most of their political/social activities. The BPP’s core practice was its armed street patrols to monitor police officers behavior and challenge police brutality in the vicinity of Oakland, California. In 1969, with assistance from the SDS, the Panthers evolved to community social programs including Free Breakfast for Children Programs, and community health clinics.
  1. The complaints brought by either the Panthers or the Weathermen in the late 60s were absolutely righteous. There were, indeed, egregious and terrible offenses against those unlucky to have been poor and especially black. They were herded into ghettos. There was intense job and education discrimination and mostly they were systematically abused by police, who considered them vermin. The WU also “discovered” sexism in society and went to great lengths to resolve in in their own organization, creating great strife amongst the mostly while male factions steeped in sexism from birth.
  1. In their early iterations, neither the panthers or the WU had any particular interest in violence as it pertained to murder. That said, the Panthers were happy to flaunt their right to openly carry weapons, frequently waving them under the noses of police, daring them to respond. This was not a particularly wise action in the late 60s. From 1967-1969, there were at least eight gun battles in which three police officers and five Panthers died. Otherwise, both the Panthers and the Weathermen were committed to social change by publicly exposing social inequities and by participating in non-violent demonstrations. However, the police and FBI overreacted to most of it. J. Edgar Hoover called the panthers “the greatest threat to the internal security of the country” and he supervised an extensive program (COINTELPRO) of surveillance, infiltration, perjury, police harassment, and many other tactics designed to undermine them, quickly extending to the SDS, who reacted by forming the much more aggressive Weather Underground in 1969. The program was also accused of using assassination against Black Panther members, including the death of Fred Hampton and Mark Clark in December, 1969 in Chicago, a seminal event in radicalizing the SDS.
  1. After the deaths of Hampton and Clark, the Weathermen realized that the police could run roughshod over protesters. They also realized that general public had little interest in addressing the problems associated with the poor and disadvantaged, especially of black folk minorities. The Vietnam war was also beginning to rage, an altercation considered by the WU to be blatant imperialism. Simply pointing it out was as ineffective for the BPP and WU as it was for Dr. King much earlier. Both groups then radicalized into factions that would not only point out these societal deficits but do so more forcefully by “getting the attention” of an otherwise apathetic public. This would be accomplished by blowing up buildings associated with Nationalist imperialism and discrimination, of course to be vividly described on National television for a much wider audience than newspapers.
  1. The WU aligned themselves with virtually any other organization dedicated to the aggressive (violent) redesign of American government/politics, end the imperialist war in Vietnam and as an afterthought, to end sexism. It was at this juncture that they made at least two fatal mistakes that would go on to destroy them. They embraced collections of steely-eyed killers whose mission was simply to kill cops in retribution for the ills they had suffered and they thought that simply blowing up buildings would not harm innocent bystanders.
  1. The “Brinks Job” in 1981 that sent Dave Gilbert and Kathy Boudin to prison for much of their adult lives was a terrible miscalculation. Both should have known better, but again, this must be viewed in the persona of the time. While Gilbert and Boudin waited in a U-Haul truck in a nearby parking lot, armed BLA members found themselves accidentally confronting the Brinks guards and a shootout ensued, killing several at the scene. The BLA members transferred $1.6 million in cash transfer into the waiting U-Haul, quickly apprehended by a police roadblock. Gilbert and Boudin surrendered but when the officers tried to search the back of the vehicle Black Liberation A members emerged shooting with automatic weapons, killing more at the site.
  1.   Most of the Weather Underground intimates have never recognized or repudiated their mistakes of the 60s and 70s. In Gilbert’s book, he repeatedly articulates that they were on a mission from God and their quest was righteous, glossing over several realities. In fact, they probably ever had a chance. None of their passionate ideals were of any particular interest to most of the general public. Few in majority America cared much about the plight of the poor and disadvantaged. It is VERY unclear whether “protest demonstrations” actually did much to change anything until those changes evolved naturally over their own good time, particularly anti-war demonstrations. All these protests went on for years but change generally didn’t occur within the time frame of the demonstrations. The Vietnam war didn’t end until 1975 and conditions for black folk, including a lot of them shot by police continue to this day. And again, blowing up buildings to publicize social inequity didn’t work very well, sufficing mainly to build CNN up to it’s worldwide penetrance. A few accidental innocents killed because of being in the wrong place at the wrong time undermined any utility of these actions.
  1. One of the things gleaned from David’s rather eloquent memoirs is the fact that to the truly radicalized, there is absolutely NO concession to any opposition and there will always be an perpetual, open-ended search for discrimination and social inequity. This concept has come to fruit now following the shooting or beating of unarmed (but sometimes aggressive) young black males by police. The reaction to it has been now to “find” discrimination on places normally though to be fairly benign. Discrimination is now defined in institutions where there “aren’t enough” minorities. How many minority administrators are “enough”? (More). In a mid-western university, several top administrators bullied into resigning because their minds weren’t quite right. How right should their minds be? (more than they are). How many minorities should be offered acting jobs in Hollywood? (More). Anything is now “racist” if a “J’accuse” finger is pointed at them by a loud voice popping up on the Internet. When that happens, the accused party is guilty until they can prove themselves otherwise.
  1. We are now liable for a repeat of the events of 1970 because we haven’t learned that little of it worked in 1970. Much heat was generated but little useful work. We now have a stage set for another Black Liberation Army and the events that followed it.

 

-4-panthers-on-parade-at-free-huey-rally-in-defermery-park-oakland-july-28-1968.-photo-courtesy-of-stephen-shames._wide-c2a3c0470820d318da280cf6614412a295d6bbda-s900-c85Black Panthers and “Terrorism”

Crippen: The Black Panthers, Weather Underground and Timothy McVey were clearly terrorists. Anyone who uses violence to terrorize or instill fear into a community to try to effect change is a terrorist.

 

Well, since I knew people involved with the Weather Underground in the early 70s and I have really studies both the Panthers and their successors the Black Liberation Army (BLA) I may not be an expert but I’m more knowledgeable than many.

There are subtle and maybe not so subtle differences between all three of these factions but I would not call any of the “terrorists” in the same sense as radical fundamentalist Islamics.

The Arabs use wanton killings of masses as a tool to spread fear in a population, and it works pretty well. They do so because they want to kill off as many infidels as possible and run the rest of us off the cliff if possible. It’s a global hatred thing of an entire civilization and there isn’t any focus. There isn’t any specific issue. It’s all Americans, or all non-islamics for that matter. Their destruction isn’t focal. It’s anywhere, anytime.

However, the Weathermen of the early 70s were focused specifically on the Vietnam war. They focused damage (not so much death, most deaths were accidental) on public icons and buildings related to the war and it was specifically for publicity value, to advertise their opposition of the war. All of their bombings were warned before the fact.

The Panthers rarely did any specific damage. Their focus was to point out the discrepancy between black america and white America as it applied to jobs, education and opportunity. They created alternative schools and food sources. They liked to wave guns in front of cops and dare them to do anything about it but didn’t they kill anyone that I recall. However, the cops did kill some high profile Panthers.

The BLA was the tactical arm of the Panthers’ social philosophy. They were the reaction to cops killing Bobby Hutton and Fred Hampton. They killed isolated police officers in cold blood minding their own business cruising in cars or walking beats. They were all busted and many of them re-located to Cuba or Africa, where some remain.

Tim McVeigh bombed an isolated building as revenge against the federal government for its handling of the Waco Siege. It was a one-time event by one pissed off individual to simply get quits with the government. Not meant to spread “terror”.

No none of these factions are technically “terrorists” was we understand the term in 2015.

 

13.pngDinesh D’Souza vs. Bill Ayres debate, 2/10/16.

Crippen: This debate was just amazing. Fantastic. Everyone should have seen it. The really great thing was the fact that the University of Michigan had the foresight to put this on in this world of enforced political correctness. To present different viewpoints in an educational forum, not screaming at each other as frequently happens on Bill Maher. The audience was clearly biased to conservativeness but they were well behaved and didn’t boo either debater. The debaters were very polite and respectful of each other in their comments. They both stuck to the issues and not attacking each other…much.

To my observation, D’Souza came off dark, foreboding and very, very angry. He rarely smiled. Frowned frequently and regularly grimaced at Ayres making some point he didn’t like. He was dressed in a formal suit & tie and appeared nervous, beads of perspiration on his face. Dinesh is a self-proclaimed “child of the 80s” (The “me” generation as I recall).

D’Souza was right about the generation gap between them. Ayres is straight up 60s hippie, free & easy, t-shirt, earrings, comfortable even in this hostile environment, laughed and smiled a lot. Jeans, backpack on his back. He has nothing to be angry about, really. He’s been there and done it all, but he makes good points cheerfully and with no particular malice.

The audience was hostile under the surface but the rules were followed pretty much. No booing, no speeches by the audience instead of questions. When one female started making an extended speech they cut her short and she really didn’t have much of a question.

I think best interaction was when some female started espousing the classic conservative line: “I work hard for my money, why should I have to give any of it up. It’s mine to do with as I please”. Ayres shut her down hard (I think), letting her know that the reason she has any money at all is because of all the infrastructure paid by taxes. She wanted to use all that then keep the proceeds, letting someone else support the infrastructures that allowed her to accumulate wealth.

There was another good one. Another female rose to very a smarmy remark that she was offended at Ayres’ “Black Lives Matter” T-Shirt. Very smugly and self righteously opined that “all lives matter”. Ayres nailed her with the reply that “all lives” were not getting shot dead, unarmed, in the street for bad attitudes.

Dinesh actually did make a few valid points though (only a few, the rest of his diatribe was sophomoric mythology). I was a little more impressed with him than I thought I’d be. I thought Bill Ayres shut him down pretty regularly, exposing his faulty logic. The moderator said something about his film: “Obama 2016” being the highest grossing this and the most award winning that. Of course that’s all bullshit Conservative propaganda. That film was laughable garbage, none of it was true at the time and none of it came true later. Every reviewer, those that bothered, trashed it (except of course conservative Republicans). So in the end, Dinesh is STILL the guy that produced and directed that smelly piece of shit and he believes it to this day.

The moderator also pronounced that Dinesh was one of the true great conservative intellectual voices of our generation. That may very well be true, but if it is, I’m not too impressed with that voice. Most of his points made were unsupportable theory and open-ended criticism of any opponents without specifically refuting facts.

They mentioned something at the end about having another “debate” about each others legal woes. Ayres brightened up about that. He’s been defending most of that for years, pretty eloquently. I’d like to see that show.

 

blacklivesmatter-2015“Black Matters Matter” and history

Crippen: I think they go out of their way to portray almost any kind of trouble that blacks get into to reaffirm the ongoing suspicion that blacks are always in some kind of trouble. News services have no interest in news. They have an interest in as many viewers as possible watching their advertisers. They’re interested in taping into the drooling cretins that watch “Kardashians”, “Real Housewives”, “Batchelor” and “Broke Girls” (with it’s ridiculous laugh track).

Dr. King never asked that blacks get an exalted position in American culture. He only asked for an even break and it never happened, then or now despite “laws” superficially assuring it. They know that as black culture progressively recedes from mainstream it’s progressively disliked by the mainstream. It’s a alternate universe, a matriarchal culture with continued job and educational discrimination, too many kids hanging around streets with nothing to do, a drug culture and a crime culture. Mainstream America loves to watch the details on the tube. Scary pictures of suspects. Black on black crime occurring in areas receding from mainstream residential areas. It affirms what mainstream America has always suspected; that they’re dangerous and need to be isolated.

Ayres had a “Black Lives Matter” shirt because he fervently believes that. I give him that. In the 60s, blacks were reliably and brutally mistreated by society in general and cops in particular. The Weather Underground started it’s life on a parallel course with civil rights and only became violent when it became apparent that nothing was changing any of it. Bill Ayres continues to be stuck in the 60s because he’s seen it all and there’s a lot to see.

Black lives DO matter and there is a VERY strong suggestion in the media that they are being shot simply for bad attitudes. I don’t know if “most” cop shootings of unarmed citizens are black. I VERY strongly suspect they are and I’d be interested to see any convincing data to show otherwise.

I do know that there have been a considerable number of blacks shot by cops on film that at least appear that they’re shot for little other than bad attitudes. Cops shooting them for criteria they would NOT shoot a Fox Chapel housewife with a bad attitude for in my neighborhood. All lives do matter too, but the attitude of the female on the Ayres-D’Souza program was that because “all lives matter”, black lives don’t matter so much.

 

screen_shot_2014-08-13_at_8.38.17_pmDeadly Force and young black males

Crippen: Re: justification for “deadly Force”. The reality is that multiple legal challenges from the past, including the SCOTUS have confirmed that it’s the police shooter that determines at the time what a “threat” is, not the TV news the next day. If the officer believes there is a threat to his life or the life of some other innocent he’s pledged to “protect and serve”, his decision is VERY “bulletproof” from complaints after the fact (as we’ve seen from current events).

The problem, I think, is that the decision to shoot young black men armed only with bad attitudes breaks a lower threshold than for solid citizen suburban whites. In Ferguson, it’s difficult to know exactly what happened because of all the highly biased observers on the street, each with a very strong incentives to blame cops for everything and anything. Some observers claimed Brown was on his knees, tearfully begging for his life, whereupon the cop callously shot him in cold blood. Does anyone really believe that? I don’t. It makes zero sense that in an inflammatory situation a young police officer with a family and a career would do that in front of a pissed off audience of witnesses.

90205-fullMore likely, Brown, passionately pissed off at the situation, decided to get into the face of a cop that was hassling him and others, probably threatening all of them with the authority of a uniform. The experiences of young black males on the street with cops is “uniformly” bad. The experiences of cops dealing with pissed off young black males very quick to exert their “constitutional rights” to “protest” by taunting a cop in his face are equally bad.

This sets the stage for both groups that hate each other on sight. But the young black males STILL have not learned that they can NEVER win an altercation with police on the street. They still like to get in their faces, especially in a situation where the cop is outnumbered. But the reality is that if the cop feels threatened, the law is on his side if he chooses to protect himself and he gets to determine if he’s threatened.

It’s highly that Brown, a big kid, pissed off to the max, decided to approach the cop in a threatening manner, not to kill him but to taunt him with his nose inches from his face. The cop interpreted this as threatening and, his threshold for deadly force already lowered for blacks on the street, protected himself before he could find out if the threat to him was dangerous. If it had been a Fox Chapel housewife (blond, great legs, driving a Lexus SUV, got out of a car (stopped for speeding to her hair appointment) and got screaming in the face of a cop on Fox Chapel Road, it’s HIGHLY UNLIKELY she would be shot. And yes, I consider those situations similar.

There is an extensive history of young black males getting in the face of cops. It was the whole point of the Black Panthers in the 60s. They made an art form of it, frequently waving guns in front of the cops nose daring them to do anything about it. The knew (or thought they knew) that the cops would back off rather than make a big stink with the Panthers who were like the “Mighty Ducks”. You screw with one, you screw with the whole flock. And they got away with it for a long time, but as they did, they built up a frustration level in the police force. A frustration level that eventually led to breaking through and the police manufacturing confrontations where the Panthers’ frustrations broke the threshold to actually shoot back, whereupon they were bested by superior tactics and firepower.

FBI Director J. Edgar Hoover called the party “the greatest threat to the internal security of the country”, initiating surveillance and harassment program (COINTELPRO), tactics specifically designed to undermine Panther leadership, incriminate party members, discredit and criminalize the Party and drain the organization of resources. The program was also accused of creating and manipulating scenarios where police could assassinate Panthers after setting them up to appear to be “threatening” officers. Shootouts with police began in which Panthers usually got the worst of it.

On October 28, 1967, Oakland California police officer John Frey was killed in an altercation with Panther Huey Newton during a traffic stop. Newton and a backup officer also suffered gunshot wounds. On April 7, 1968, Panther Bobby Hutton was killed in a shootout with the Oakland police, and Panther Eldridge Cleaver was wounded . Two police officers were also shot. Panthers later admitted that Cleaver had led the police into a deliberate ambush, provoking the shoot-out. On January 17, 1969, Panthers Bunchy Carter John Huggins were killed in a shootout on the UCLA campus. Another shootout on March 17 led to two more Panthers dead.

fredhamptondeadBut the big one, the one that led to the violent focus of the Weather Underground was the killing of Fred Hampton and Mark Clark on December 4, 1969 in a shootout orchestrated by the Chicago police and FBI. A federal investigation reported that only one shot was fired by the Panthers and police fired at least 80 shots. Hampton was shot twice in the head at point blank range. He was 21 years old and unarmed at the time of his death. Coroner reports show that Hampton was drugged with barbiturate said to have been administered by that night by FBI Panther infiltrator William O’Neal. Cook County State’s Attorney Edward Hanrahan, and eight Chicago police officers were indicted by a federal grand jury over the raid, but the charges were later dismissed. In 1979 civil action, Hampton’s family won $1.85 million from the city of Chicago in a wrongful death settlement.

Members of the Chicago Weathermen (including Bill Ayres) were on the scene and viewed Hampton’s body. They were galvanized and instantly radicalized by Hampton’s death. From that point on, they made the strategic decision to begin retribution for the way blacks were treated and the indifferent attitude of White America. Plus of course the continuing mess in Vietnam.

Hampton’s death was also the focal point for the creating of the infamous Black Liberation Army (BLA) around 1970, a group radically different than the Panthers. The Black Panther Party’s original goals were to provide alternate community social programs for the perpetually disadvantaged black community. Breakfasts for kids, alternate health care and education. It was the side actions of their contempt for the police (and pretty much white America) that got them into trouble. The BLA cared nothing about these things. The BLA existed to make the police (and white America) “pay” for their crimes against black america.

Black_Liberation_Army_(emblem)The BLA was mostly composed of former Panthers and their stated credo was “armed struggle”, taking up arms for the liberation and self-determination of black people in the United States.” The BLA carried out a series of bombings, murders, robberies and prison breaks (including my friend and patient Tim Leary in 1971). Expatriate Eldridge Cleaver publicly criticized the BLA as being revolutionary instead of reformist. According to a Justice Department report, the BLA is suspected of involvement in over 70 incidents of violence between and the murders of 13 police officers1970 and 1976. The Weathermen strongly sympathized with the radical Black Panthers. The police killing of Panther Fred Hampton prompted the Weatherman to issue a declaration of war upon the United States government.

Part of the WU manifesto goes: “The most important task for us toward making the revolution, and the work our collectives should engage in, is the creation of a mass revolutionary movement, without which a clandestine revolutionary party will be impossible. A revolutionary mass movement is different from the traditional revisionist mass base of “sympathizers”. Rather it is akin to the Red Guard in China, based on the full participation and involvement of masses of people in the practice of making revolution; a movement with a full willingness to participate in the violent and illegal struggle”.

Now, why do I ply you with this long, dry history? I think because it’s history repeating itself. Police with a low threshold for shooting young black males approaching them in “threatening” poses, legally justified and blessed by Grand Juries”. A gathering of seriously pissed off blacks now with the “Black Lives Matter” logo in he media, greeted by indifference of a large chunk of white America.This sets the stage for blacks figuring out that “Black Lives Mater” isn’t taken seriously (as vividly demonstrated in the Ayres/D’Souza debate Wednesday evening).

The next logical step is for those galvanized blacks to start getting more aggressive in showing white American their displeasure, including getting in the faces of cops as a demonstration that they DO matter. Then cops will continue shooting them and Grand Juries will continue exonerating them. Then the stage is further set for another Black Liberation Activity, just like 1970 when business owners sat guard in front of their storefronts, shotguns propped on their toes.

History shows that this could easily happen and might already be happening. I’m worried that it could, and how it might impact the 2016 election.

Some comments on where critical care medicine is headed in the next ten years

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Recall several months ago I wrote some editorial opinions on where IIF thought critical care was headed, some of them not too kind. I foresaw a critical care world full of Physicians Assistants (PA) and Nurse Practitioners (CRNP) doing patient care and critical care physicians as their handlers in executive roles. The actual experience and training of the critical care fellows to do that more and more attenuated as they eschew night call and direct patient care the PAs and CRNPs are more than happy to provide.

I see it already in the surgical specialties. I saw the guy that fixed my ruptured Achilles Tendon once, the day of surgery. Everything thereafter was handled by his PA. No way to contact him even if I wanted to. I saw the guy that fixed my femur fracture once, the day of surgery. The followup visit three weeks later was handled by his PA.

I was told a while back by the head of our Department who happens to be a long time personal friend that my weakness was that I wasn’t into teaching the fellows the algorithms and protocols that are ruling critical care, and that direct patient care is becoming overrated as it really won’t be done by physicians much anymore. It will be “directed”. the critical care physicians job will be to know every possible parcel of literature and to be involved in some form of research, because that’s where the institutional prestige (and probably money) is.

My response to that was that the directorial critical care physician will be more of a figurehead as he or she gets less and less hands-on experience, especially at night when all disasters happen. That’s, of course, not to say that these people won’t do an outstanding job. It is to say that either you’re a physician and trained as such or you’re not. That distinction is becoming more and more blurred.

So, as I go down the road, predictably this Paradigm is bearing very visible fruit in my case. First time ever, my “faculty reviews” broke the bottom end of 4 (5 being the highest possible). 3.8 for this partial year (this year has been tough for me). That means bottom end of “Very Good” because of a number of “satisfactory” marks given me (3.0).

Now, you have to understand that this is a lot like “Officer Efficiency Reports” in the Army. If a guy gets a completely fair report, his career is over. The only acceptable report is hugely inflated, and mostly bullshit. Pretty much the same here. The report detailing the statistics for all clinical attending here glows for anything over 4.25 and anything under 4.0 is mentioned only as an anchor dragging the Department down.

So, if you examine my strength and weakness numbers, you see that my highest numbers are involved with the issues of (quotes) “Faculty should promote patient care that is compassionate, appropriate, and effective for the treatment of health problems and the promotion of health”. “Faculty should promote knowledge of established and evolving biomedical, clinical, epidemiological, and social behavioral sciences, as well as the application of this knowledge to patient care”. Faculty should demonstrates respect, compassion, integrity, and altruism in the maintenance of professional relationships with patients, families, and colleagues. Meets all professional responsibilities with regard to patient care. Highest score: Faculty explains the ethical, economic, and legal aspects of Critical Care Medicine as well as the psychosocial and emotional effects of critical illness on patients and family”. Creates an appropriately relaxed, cordial, positive, and stimulating learning environment. Briefly reviews expectations of the fellow at the beginning of the rotation or at the start of time on service.

Lowest scores: “Faculty should promote the ability of trainees to investigate and evaluate their care of patients, to appraise and assimilate scientific evidence.” These scores were low enough to bring my average down below 4, first time ever. A fairly dramatic change from years past.

I’ve cherry picked here as much of this is much more complex but I give you the skinny. What’s happening is that the CCM Fellows are being told what is important. What is important is less hands on direct medical care and more ability to honcho others to do it based on current literature cites and research data. If they don’t feel they are getting what’s important, they downgrade those they don’t think are giving it to them.

So, I think it is happening and it’s happening fast. My fear is we are graduating more intelligent, intuitive doctors that have less and less experience in dealing with direct patient care and more experience bringing forth the latest cite on any subject. Direct patient care will more and more be done by non-physicians. . Unclear where it ends and what the sudden, unexpected aftermath will be. Maybe it will work out fine. If so, the curricula of medical college will begin to approximate that of PhD programs.

Comment:  Much of what has happened is a result of supply, demand and market forces here in the south. Few intensivists, fewer who will choose to be up all night, and relatively plentiful NP/PA who value training and practice in critical care.

This has been a steady process of deterioration here for the past few years and fighting it is impossible since prospective fellows can choose to enter a “Pulmonary, Allergy and Critical Care” fellowship that has NO night call and get jobs identical to those coming out of multi-disciplinary fellowships that demand night call as a learning experience. We actually started seeing a deterioration in qualifications in our applicants until we cut back on night call. I think currently they have to do one night a week and at the rate we are adding PAs/CRNPs, most of that is just hanging out watching other people work.

Comment:  Our challenge becomes finding an effective and efficient strategy to train up those physicians who are willing to work hard to an ever higher standard. My bias–and this is a personal, not corporate bias–is that we need to get to progressively more realistic simulations that expose trainees to more problems and issues in 4 hours than we ever encountered in a fortnight.

I think the pool of those would-be physician trainees is dwindling and dwindling fast. In fact, physician trainees willing to deal with the hassles of direct patient care is dwindling. Why should they. Nuclear medicine and radiology specialists are well paid and they all go home at five. Physical Medicine and Rehabilitation. Rheumatology. Sleep medicine. Hematology. Physician trainees are choosing specialties that come with a built in barrier to being bothered after hours.

So we are building a full compliment of clinical intellectuals who know everything there is to know about subjects that fully insulate them from after hour disasters. Who’s there in the middle of the night when the dying happens. Emergency Physicians, but they are normally not credentialed for in-house care. Hospitalists? Jury out. It will be PAs and CRNPS because it seems they are more affordable. The legacy of affordability has yet to be confirmed but I see the hazy vision as it forms.

Comment:  One view is that the technology to achieve this is “too expensive”. Another view is that whoever pulls it off could create a national sim center that operates around the clock for primary and recurrent training.

This is another factor I’m seeing come to fruit here. My medical students all look at their watches mid-morning during or after rounds and decry they are late to the “sim-center” where presumably they spend the rest of their day. I am on record that if the day ever comes and it might, that students get most if not all their time dealing with clinical emergencies via simulators, we are all in deep, deep trouble indeed. The worst possible place to end up would be a hospital where providers translate virtual reality to real reality.

I landed in a hospital in the middle of the night with a femur cracked from stem to stern, a hematocrit dropped to 26 and hypotensive. Even as a long term attending physician at this institution I took pot luck when it came to a provider that knew how to deal with this issue. When Dr. X cruised into my room, had a look at me and the films and told me he’d take care of this I could have kissed him. By the time I got to the operating room it was something like 4 am and he’d been operating all day. The conversation in pre-op went like this : “Him (Putting his initials on the skin of my leg): “you up for this?”. Me: “better question- YOU up for this?” Him: “(stretching)…..You bet. Lets get this done”. Four hour procedure started at 0400 hrs, masterfully done.

Young guy seven years out of his fellowship in trauma and orthopedics. Literally putting my life and my future ability to ambulate in the hands of someone I don’t know. Trusting him with my life and livelihood? How long do you think we’re going to have these spirited guys willing to beat themselves to death for the benefit of people they never saw before. I genuinely fear we are not headed for more of them.

Comment:  I do not think there’s much point in bemoaning the new division of labor. We need to consider how to concentrate training and broaden experience at the same time. At risk of sounding like a “broken record ” (for the younger list members, please Google this archaic expression), aviation figured out the importance of high-fidelity simulators a while ago.

Dealing with the infinite clinical nightmares all conspiring at the same time is NOT like high resolution avionic training. I genuinely fear for sick people in ten years. Hospitals may or may not have the ability to care for them. I am not optimistic, Tim. Making the best of an inherently bad situation for the worst possible of reasons (diminishing funds) isn’t the same as streamlining provision logically and intuitively.

Here’s what I see happening to critical care in the next ten years.

  1. Insurers will become more and more tight with funds as they discover the multitude of patients transferred to ICUs simply to die after a massive wallet biopsy to chronicle their impending demise. But politically, it’s impossible to “say no” to it so they will find other ways co cut funds for “critical care” that can’t be traced back to bean counters. As a result, the time and energy needed to prove admissions are deserving of “critical care” will become progressively ponderous and difficult. Critical Care physicians will become experts in reimbursement policy and will spend most of their time doing it.
  1. Most if not all of the clinical catering will be accomplished by mid-level providers, PAs and CRNPs, and they will all do a great job because if for no other reason most of the day-to-day patient care isn’t all that intuitive. Busy work looking after numbers, cultures, vitals and so on. Acute decompensation in the middle of the night will be addressed mainly to keep the patient alive until morning when higher levels of expertise will come to bear.
  1. I have always said that the day will come when I can tap into a huge global multi-million patient data base, punch in my patient’s particulars and show the family what the real mortality will be and when it will occur no matter what treatment is afforded. I think that day is close. Similarly, that same data base could be used to create algorithms and protocols showing the best possible outcome according to how those millions in the data base did with any treatment scheme.
  1. Accordingly, morning rounds will consist of input from executive levels of critical care physicians who will select the proper clinical protocol for the patient to be on. Protocols based on “evidence based medicine” (consensus of journal articles on the subject), and there will be one for every possible disorder. Respiratory, cardiac, gastrointestinal, neuro and do on. Of course there will be a trailer at the end of each suggesting that they may be modified by “clinical judgment”, but since the critical care attending has long since lost any experience in clinical judgment, that won’t matter. Variations of response to protocols will be met by more protocols, and if the patient dies, it will be because he had no ability to respond to good, standardized care.

As medicine becomes more complex and the information base has increased beyond the ability of individuals to contain it, we go more to the tender mercies of collective clinical judgement (from the literature). Individual clinical judgment is not amenable to control or standardization which is a situation that can’t be condoned.

When I walk into a patients room, the entire ambiance of illness and infirmity flows into my own personal database. I see and feel things that only someone who has spent 35 years at the bedside sees & feels and I intuitively know a lot of things that I don’t need to test against a computer database of the literature to see if it’s valid for THAT patient.

However, I might be wrong because I also have human frailties. And if I am wrong, then my wrongness will be measured by the database of “evidence based” literature which will always be right, especially since it didn’t need to be consulted for THAT patient.

So, current thought is that in the end, everything will be measured by “evidence based” data. The BEST chance for success is to plug everything into a protocol that reflects “evidence”. Although sometimes brilliant, individual care plans suffer from poor quality assurance. Sometimes they can be lousy and there isn’t sufficient ability to separate the two.

So, the whole point of a protocol is that’s it’s uniformly followed to the letter. Deviations result in uncertainty which cannot be condoned. It’s like letters from the Internal Revenue Service. A half page informing you that money is owed and you have been identified as the person owing it, then five pages of what they’re going to do if you don’t pay up.

Protocols are not for thinking processes of whether they should be followed. Protocols are to be followed or those refusing will die the death of 1000 meetings to explain why to stern faced administrators.

Are protocols a good thing that will improve patient care. Unknown. Will be eventually seen. My personal brand of clinical intuition is clearly dead and if I last the next couple of years before forced retirement, I’ll be lucky.

I am the last of my kind.

  1. There will be no place for medical education as we understand it in this scheme. There will be no point in medical students dealing with these patients because they are cut out of the protocol loop. Medical students will spend 90% of their time on simulators watching the numbers fly by and the robot twitch. Any direct patient care performed by resident staff or medical students will be for routine hospital care. Anything resembling an emergency for a hospital patient will be dealt with by mobile emergency response teams who will arrive at the bedside to usurp the continuity of the previous trainees who will observe the goings-on from the back of the pack.

That this will occur (and is occurring now) is a lead pipe cinch guarantee unless……………..

The big joker in this deck is now political. (FL now suspends previous prohibition against political diatribe temporarily because it is integral to this discussion).

As the cost of health care continues to escalate and the reimbursers continue to find novel and bulletproof ways to cut funding for it, the “real” predictions of how this will all go are just that. The scenario I presented above is what’s happening right now and what will progress all other factors remaining equal, but other factors will not remain equal. Everything is now changed as of the mid-term elections where we now have a radically different power structure and a VERY unclear picture of what the Presidential situation will be in 2016.

The Affordable Health Care Act of 2008 was created to do several important things including to make health care portable and affordable by spreading the cost over all those involved. This became a political football and as of today survived those who would destroy it. However, the barbarians previously at the gate are now in charge and so it is now very unclear whether the AHCA will survive. If it doesn’t, and it may not, then we will drop back to our previous system of “private” insurance for those not eligible for Government health insurance. That insurance has been in the process of escalating the cost of indemnification yearly to as much as 50% a year and will continue to do so as long as demand exceeds supply until it collapses under it’s own weight. When it does, there is nothing else in sight for non-Medicare and Medicaid patients other than “self pay” which guarantees instant lifetime financial insolvency for a routine illness requiring hospitalization or surgery.

I also believe then that if the AHCA fails, the next step is European style National Health Service, which is the ultimate affordable system. It gets X amount of $$ and that’s it. Use it wisely. If and when that occurs, my previous predictions above are dashed on the rocks and we will be sailing through completely uncharted waters.

 

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”.

———————————————————————

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.