Truth and Accuracy in the Blogosphere: Ad Hominen

 

Recently the Phantom was intrigued by a criticism of the Phantom's favorite blog-- which he considers almost as indispensable as the "Hitchens Resurrected" channel on youtube--a criticism which concerns accuracy and "fact" checking. 

The case arose over Trump's reaction to the statement by six Democratic Congressman--all veterans of the military or intelligence services--to the effect that soldiers must be aware of their obligation to disobey illegal orders, an obligation which emerged from the Nuremberg trials after World War II where the Nazis on trial invoked the defense, "I was only following orders" to defend themselves against charges they had herded Jewish women and children into a building and then burned them alive, or other such ghastly crimes, which, the American and Allies argued violated a basic sense of right and wrong common to all civilized people. 

Shot By National Guard: Kent State

In the context of modern day America, Trump quickly perceived that these Congressmen were warning National Guard soldiers that beating unarmed and defenseless men and women, and throwing them into vans for the crime of speaking Spanish near a construction site might come back to haunt those Guardsmen. 

National Guard Shooting Unarmed Students

Trump said he wanted those Congressmen arrested, tried and they should face execution.

These Guardsmen Were Never Arrested

Mad Dog had found that especially piquant because Trump, who evaded military service owing to his famous heel spurs has later (reportedly) echoed the mafioso's creed that you owe no loyalty to your country, and should serve only one group, your family. This was most famously and precisely depicted in the movie, "The Godfather," in the scene where the brothers are gathered around the dining room table on December 8, 1941, awaiting the arrival of the Godfather himself, and someone mentions that 30,000 men had enlisted in response to the attack on Pearl Harbor the day before. Sonny, the eldest of the brothers smirks, shaking his heads, saying those men, swept up in patriotic fervor to serve and defend their country are "saps." 

https://www.youtube.com/watch?v=435mkg6_eGQ

It is a perfect display of the conflict between the Old World values of clan, tribal and family loyalty colliding with the newer concept of loyalty to a nation state and it is one of the most important scenes across all of the Godfather saga, and provides the cultural subtext for this film series as noir literature, and it echoes through scenes of Michael walking through villages in Sicily emptied by blood feuds among families, which make the Hatfields and McCoys look like playground skirmishes. And it reveals the contempt these men hold for the American military. And it is perfectly reflected in Trump's (reported) derision of American military as being "losers" and "suckers," on a trip to Normandy, where he refused to get out of his limousine and walk in the military cemetery there, and his words (which he claimed were "fake news") were not captured on tape but were reported by the New York Times, the Atlantic and other sources.

(Of course, this report in the Atlantic magazine was a bombshell and Trump denied saying it, but it has had such durability because it fits Trump's cynical "the game is rigged" and all the poor people are being played by the big guys who pull the strings. Trump is Sonny incarnate. Or Michael, for that matter, as Trump was once asked  on camera about a murder ordered by some foreign leader and he said, "Oh? And you don't think American Presidents kill people?" That's a video the Phantom saw with his own eyes. It echoed precisely that scene when Michael says exactly the same thing to his girlfriend, defending his choice to enter the Mafia Corleone family as the Don.)

So, Mad Dog, referring to all this, said that Trump had no love or respect for the military but was only concerned about these Congressmen undermining his own authority, and Mad Dog said Trump viewed the military as saps and fools, rather than the Atlantic's reported, "losers" and "suckers."

The point being, Trump spoke derisively about people who enlist and serve in the military, echoing Sonny's contempt. Mad Dog had conflated one phrase of derision with another, his critic averred. 

Now, you may ask, why did Mad Dog not simply say Trump has spoken derisively or contemptuously about people who serve in the military and let it go at that?

The reason is that it is stronger writing to give an example of what you consider derisive rather than simply allege what was said was actually derisive--present the facts and let the reader see for himself the nature of the remarks and what underlying values they reflect. 

Not using the actual words allows Trump to wriggle off the hook, "I never disparaged the military!" Well, if you called them "losers" you disparaged them. That echoes the Bob Dylan song, "Join the army if you fail." Or if you call them suckers, then you are right back to Sonny Corleone, and all that is contained in quoting the words. 

But if you say Trump referred to patriots rallying to the flag as "fools" and "saps" then Trump's defenders can say, "He never said that!"

Of course, that is a distinction without a difference.

And, never mind the problem of what is a "fact." Without a video/audio tape nobody really knows whether Trump said, "saps and fools" or "losers and suckers." And even with a video/audio, Trump will claim it's all deep fake, fake news and never happened. He sat in that limousine and refused to walk in the cemetery in the rain because it was raining and his comb over would dissolve.

But we can believe Trump was saying anyone who joins up is a small person being manipulated by propaganda from the elitist, rich and powerful, because that's been his pitch from the get go. It really is of a piece with the old Communist jibe that a bayonet is a weapon with a worker on either end, meaning, of course, German workers who were conned into joining their army wound up fighting Russian workers who were conned into joining the Russian army, but they were both actually on the same side, that of exploited working class fools, who allowed themselves to be manipulated by rich capitalists who are fighting over profits.

In this case, fools, saps, suckers and even losers are pretty much identical, with only minor differences in connotations for the word "losers," but not really: They all refer to people who were conned, misled, not bright enough to see their own interests on each side of the bayonet. 

So the critic who upbraided Mad Dog for inaccurately saying Trump uttered the words "losers" and "suckers" rather than "fools" and "saps" was insisting on a distinction without a difference, was missing the forest for the trees, was blind to the abstract point of derision and focusing instead on what was not true about that statement rather than what clearly was true.

This is a sort of argument called "ad hominem."

And one thing you can say for AI and Google, it allows for simple, direct and clear explication, so here it is:

The technique of "seizing on an irrelevant inaccuracy to undermine an argument" is known as the ad hominem fallacy, or a personal attack that distracts from the actual point being made. While not exclusive to any one political group, it is a common tactic used to redirect an argument by attacking the person rather than their position, often to evoke an emotional response rather than addressing the logic of their argument. 

How it works

• Focus on the person: Instead of engaging with the substance of an argument, the attacker focuses on a perceived flaw, inaccuracy, or character trait of the person making the argument.
• Create a diversion: This is done to shift the focus away from the original topic and create a distraction.
• Ignore the facts: The inaccuracy may be true or false, but the key is that it is irrelevant to the validity of the original argument itself.
• Appeal to emotion: The tactic often relies on emotions and prejudices to make the opposition's case seem invalid, even if the underlying reasoning is flawed. 

Example

• Original argument: A person presents data on climate change and proposes a specific policy.
• Ad hominem response: "That person is a liberal elite who has never lived in the real world, so their opinion on climate change is worthless," or "They once got a statistic wrong in a different speech five years ago, so everything they say now must be a lie."
• The technique: This response avoids a factual debate about the climate data or the proposed policy and instead uses a character or past error to dismiss the entire argument. 

A Ray Bradbury World: Hanging On by Our Book Covers

 

Ray Bradbury created a world in "Fahrenheit 451" where the hope of the world devolved down to people wandering in the woods reciting great works of literature. All the books these curators of man's greatest thoughts were reciting had been burned. Bradbury, of course, like all science fiction writers of his era, had not imagined books existing on the internet, as zeros and ones, downloadable from the air. 

But his point remains: Books and the ideas and records they embody remain among the last best hopes of man.

Of course, one of the most insoluble problems relating to books is not that there are none left, all having been burned, but that there are so many that really important books are not burned but simply smothered among the 500,00 to 1 million books published each year in the US alone. 

Which is why the NY Times Book Review is so important. And The New Yorker and other publications which point the way to those needles in the haystack worth the time.

After 17 years of this blog, the Phantom has decided to add his opinions to the pile.

Forthwith:

1. "Motherland" by Julia Ioffe

    Ioffe pulls off a neat trick by opening with both a personal history of her family, told unsentimentally, and a volley of numbers and statistics that far from numbing the reader, propel the reader into a dystopia of a dysfunctional society. "A 1908 study found that 25% of forty-five year old Russian peasant women had ten or more pregnancies one-fourth of which ended in miscarriages." And "A not atypical example of a fifty-five year old woman who had been married for thirty-five years  and had been pregnant twenty-four times. Two children had lived."

Women went off to work in the factories leaving their infants in the care of toddlers already at home. The death rate among children in Russia at this time is unknowable.

The life of the Russian woman, whether peasant or aristocrat, was that of a prisoner of first Tsarist ownership by males, then Communist dictates. 

Prostitution and venereal disease were widespread, beyond endemic to epidemic. 

The Russian women who pushed for change and got it are astonishing, and Ioffe is up to the task.

2. "Embracing Defeat"  by John Dower

What was it like to be a Japanese civilian living in Japan when the war ended? 

What were these people like? What did they believe in? Well, whatever they believed in, collectively and individually, for many those beliefs collapsed as American soldiers arrived to begin the occupation.

Dower shows a photograph of five children who look to be about six or seven years old, playing "Prostitute Pick Up" where the boy, with his arm around a girl presents her to three other girls with a "Want to meet my sister?" which was one of the new English phrases Japanese children learned first along with, "Got Chocolate?" which they used on American GI's passing by in their Jeeps. "Jeep" was another word they all knew. There was a whole generation of Japanese girls who began their 15th year in the arms of American soldiers.

The devastation before the dropping of the atomic bombs is not well known today in the US, but Curtis LeMay, who directed the Army Air Force bombing strategy, was to incinerate cities with napalm rather than trying to target factories and armament plants, which were integrated into residential areas and small and dispersed.  On a single night of fire bombing in and around Tokyo, 100,000 people were incinerated.

The Japanese had been indoctrinated to believe the Americans would rape and murder their way through Japan but they were flabbergasted by the American occupation troops.

3. "Dark Continent" by Mark Mazower

Mazower's basic argument is that fascism did not overwhelm democracy, but democracy crumbled, like the dinosaurs, and out of the rubble, the fascists inherited the German earth, with a different concept: Borders were not important; borders were creations of corrupt Versailles treaty government officials. All that mattered was the kinship of race and the German race, whether living in Poland, Austria, Czechoslovakia, Estonia, Latvia or Ukraine, had to be united and had to flourish for the sake of mankind and civilization. Worked for them. Until it didn't.

4. "Vaccinated" by Paul Offit

This is an ode to Maurice Hilleman, who, as Dr. Offit demonstrates, was the driving force behind many if not most of the vaccines we used right up until COVID when the mRNA technology allowed for a leap forward. Along the way, Offit convincingly asserts vaccines have saved more lives than antibiotics, anti cancer agents combined. Offit knows how to write, and if he does not have quite the verve of Ioffe, he surely knows how to hook a reader and keep the hook set deeply.

CODA:

https://www.youtube.com/shorts/MXkwvc0TYeg

When the Cynical Becomes the Norm

There are two scenes from very different theaters which the Phantom cannot forget: The first is from "Gone With the Wind," where Rhett Butler (Clark Gable) looks over his shoulder as he accompanies Scarlet O'Hara and Melanie Wilkes along a road leaving burning Atlanta, and he sees old men and young boys trudging along in the opposite direction, going to fight the Yankees, to defend their homes and city. Butler has been disdainful of the arrogant rebel "Cause," of all those fools who shouted they would beat the Yankees in ten days, that one Southern gentleman on horseback could whip ten Yankees.  Butler had pointed out there were only three munitions factories in the entire Confederacy at the beginning of the war, and that the Union navy would blockade the ports, and Union trains would transport the federal host to overwhelm the Confederates. The whole idea of a righteous war was ridiculous, Butler argued, and he would have no part in that fight.

But looking at the bedraggled, all but defeated stream of what was left of Southern manhood, marching off to fight against all odds, Butler acknowledges that for the first time in his life he felt ashamed, and he turns to join them, leaving Scarlet to manage Melanie and her newborn baby and the wagon along the escape route out of burning Atlanta. Butler has to do the thing which is honorable, for once, even though it will cost him, and is clearly not the profitable thing to do.

Omar

The Second scene is from "The Wire," where Bunk, the workaday detective in his sweat stained suit, confronts Omar, who makes a lot of money at gun point, robbing other players "in the game," living by his own rules and turning a good profit at it. Omar has engaged in a shoot out in broad daylight , leaving two dead behind on a Baltimore street. Bunk tells Omar that when Bunk arrived on the scene afterwards, children, who had witnessed the shootout, were re-enacting the scene, each one wanting to play Omar, who they idolized as a great street hero.

"Oh, how far we've done fallen," Bunk tells Omar. He means how far the Black folk of Baltimore, where they both grew up, have fallen. What a bankrupt, degenerate, decadent world they have created.  Later, Omar decides to aid Bunk in an investigation, arranging for the return to the Baltimore Police Department a police gun, and that costs Omar considerably, and he is told, "Conscience do cost." The police gun was important to the chiefs of the BPD, as it was a symbol--a police gun should never be captured. Omar shakes his head, just as Rhett Butler did, angry with himself for doing the foolish, right thing.

In each case, the right thing, the righteous thing was ridiculous, the empty ideal of a power structure which was sanctimonious, beyond misguided to delusional. But still...there was something noble about fighting for a lost cause, stupid as it might be.

There is another story, likely apocryphal, about Lenny Moore, the wonderful football player, who won a scholarship to Penn State, and one day in class a professor asked him a question and Moore just stared at him. "Uh, Mr. Moore," the professor said, "I asked you a question."

"My name is Lenny Moore," he replied. "I don't answer no questions. I just carry the ball."

Of course, what Moore was saying is that he was at Penn State as an employee of the athletic department, and he was being paid to play football. He might be required to attend class, but that was just a ruse, a lie to make the big hoo-ha's in the college administration feel righteous, as they talked about "student athletes." Student athletes, of course did not have to be paid. Moore would get his financial reward in the pros, and Penn State was a farm team for the pros. 

Another story:  the Phantom was driving to work listening to NPR when a story about a medical student came across. This student was first in his class at the Mount Sinai Medical School in New York City and the Dean of the medical school called him into his office. "I see you've applied to a residency program in Florida, at a community hospital. You could match for Mass General, Columbia, or Stanford, any of the best programs in the country, and you are applying for a community hospital which has nothing to recommend it beyond the fact it's accredited? Why?"

"If I did my residency at those big name programs, I'd spend three years doing their scut work and then another two working for their professors on their research papers. For what? I am going to Florida, where I'm going to learn to do colonoscopies, and every day by three o'clock, I'll be on my boat, living the life, making more money than any of those professors."

The Phantom nearly drove off the road.

Years earlier, the Phantom walked into the office of the Chief of Medicine at Cornell, with an application for the dermatology program at NYU. The Phantom had done a 6 week elective at NYU because the Cornell New York Hospital had no dermatology department and the NYU program was known to be the best in the city, and the Phantom loved it. All the little surgeries, learning how to make "Augenblick" diagnoses (in the blink of an eye.) The NYU department had an in patient service for people with the most severe conditions, like bullous pemphigus, not that there was anything much you could do for them, but still. The staff was warm and welcoming and Derm was fun.

"You've spent four years learning how to treat the very sickest patients," the Chief said. The Chief was a hematologist and he had patients with leukemia on his service. "You've learned how to rescue a septic leuk in the middle of the night. You've been on the cardiac team. One night, when you were alone, you rescued a seventy year old man who went into florid pulmonary edema, who was bubbling froth from his mouth, and you did that with just a nurse and a vacuum bottle, all by yourself. And now you want to go into dermatology?" 

He made that word sound almost obscene.

"There's a reason The New York Hospital-Cornell Medical Center does not have a department of dermatology," the Chief said. "It's not really medicine. It's dentistry with stethoscopes and you don't even really need the stethoscope." 

The Phantom slunk out of the office, the application to the derm program balled up in his hand.

But, twenty years later the Phantom looks at the salary schedules for the various specialties: Dermatologists come in around $500,000 annually, but rheumatology, neurology, endocrinology, all those honorable specialties where the sick patients go, about half that.

The most competitive specialties are now Dermatology, Ophthalmology, Anesthesiology and Radiology. And radiologists, except for the invasive radiologists, never even lay a hand on a patients; often they never even see the patients. But those specialties are called "the ROAD" (the first letters of their names) to happiness.

The fact is, the four years of medical school is likely a sham as well. The Brits send their doctors to medical school right out of high school. And most of what has been done only by doctors is now done by nurse practitioners and physicians assistants. They do not do internships or residencies; they learn on the job as apprentices. 

Big healthcare systems like Hospital Corporation of America hire nurse "endocrinologists" who have never done an endocrine fellowship or even a medical residency, much less gone to medical school.  What they are saying is you don't need to know the molecular biology of diabetes to prescribe insulin.  The whole long trudge to board certification for a variety of specialties was just a guild's efforts at throwing up a gauntlet to restrict supply of providers. 

When the money managers take over, there is no sentiment about saving lives; it's all cost/benefit and if you miss a diagnosis here and there, or render the wrong care, and there's a lawsuit, well, that's just the price of doing business.

And now "student athletes" are recognized as what they have truly always been--employees of the colleges, and they are paid accordingly and may even soon be allowed to unionize. 

Our American system is a commercial system, operating on capitalistic for profit principles, even at the nominally "non profit" academic hospitals. If a hospital is making profit in the emergency room, the radiology department but losing money supporting community practices in neurology, rheumatology, diabetes, it will and by the rules of the American game, it should cut the loss leaders and focus on the profit centers. The executives in their thousands are not bad people; they are doing the jobs they were hired to do: make a profit for the corporation. 

They are not hired by the community, but by the corporation. Until the community, i.e. the government decides to get in the business of healthcare, the business of healthcare will be to maximize profit for some profit center, whether that's Partners or Hospital Corporation of America or United Healthcare Insurance Company.

It's a choice the American public has consistently made, even if it doesn't know it's made that choice. When Bernie Sanders rails about profit poisoning health care, about the need for Medicare for all, citizens think to themselves, "That'll cost me more," and they vote against him. 

The financial realities are now being faced. Doctors incurring debt to go to medical school cannot afford to be seduced by the myth they are doing something heroic, no matter what you see on "ER" or "The Pitt," or "General Hospital." 

There is no glory. There is just commerce, transactions and deals. 

There are no backward glances for Rhett Butler, no welling up of shame for Omar. 

It's all the art of the deal.

Olgunquit's Titanic

 

First, let it be known the Phantom is a musical illiterate.

His only musical distinction was being America's worst piano student for the years 2017-2022, when he finally gave up trying to master rhythm, pitch, style and remembering the different scales. 

Having said all that, the Phantom has been an ardent fan of Broadway musicals since he first heard "My Fair Lady" and "Oklahoma" and "South Pacific," age 7, when his parents acquired a turntable, speakers and 33 rpm phonograph records and he could sing along with every song in those masterpieces (off pitch).

So those are the bone fides for the Phantom, as it were.

Add to that the Phantom is dazzled by the quality and richness of the Ogunquit Playhouse, where he has seen 17 years of musicals including "Miss Saigon," and "Avenue Q" and "Young Frankenstein" and "Guys and Dolls" just to name those which leap to mind. 

He has never seen anything on Broadway done any better than what he's seen at Ogunquit, which is no surprise because the Ogunquit is simply Broadway north, the summertime retreat for Broadway dancers, singers and actors. They come up to the coast of Maine for the summer and the locals watch bewitched. 

"Titanic" at the Ogunquit is a terrific idea: The allegorical nature of this stunning ship, the largest moving man made object on the planet at the time, to be compared in its engineering prowess with the pyramids, is pitched from the outset of this production.

And this story has not been told enough, even given the 1997 movie with its Celine Dione theme song and the 1996 TV miniseries and the 1958 movie, "A Night to Remember."

What Ogunquit does differently, to its great credit, is to focus on the "what went wrongs" of the story, and this is a rich lode:

1. The bulkheads which could have prevented flooding from one compartment to the next were not built high enough because the engineers were told to not obscure the view of the first class passengers.

2. The steel used for the ship was not of highest grade and was of a grade which got brittle in cold water and had it been of higher grade, may not have ruptured at all with the glancing blow from the iceberg.

3. There were only enough lifeboats for half of the passengers.

4. There were no lifeboat drills done (so as not to alarm the passengers) so 450 seats on the lifeboats were left empty.

5. The lookouts were not issued binoculars, which were locked up.

6. The captain plotted a northerly course, in an attempt to cross the Atlantic in six days, rather than a more southerly course, where icebergs were not present.

7. The Titanic received multiple warnings by wireless morse code about icebergs, but the captain ignored them.

8. There was no such thing as radar in 1912. 

9. The ship was pushed to its maximum speed, 23 knots, on its maiden voyage, violating the basic safety custom of treating the voyage as a "shakedown exercise" to reveal problems. 

10. Bruce Ismay, the owner of the White Star Line, was allowed on the bridge and is depicted as goading the captain to increase his speed and take the shortest but most dangerous route to New York, so commercial concerns may well have led to bad seamanship and bad engineering. 

Ismay is beyond Judas Iscariot, as depicted here--pushing for the most dangerous choices, then blaming the captain for following his instructions and then taking a place in the lifeboats meant for women and children, while third class women and children remained locked belowdecks.

All this is conveyed admirably by Ogunquit's Titanic.

But, the problem is, this is not "Jesus Christ Superstar."

The reason this comparison comes to mind is bars from JCSS sound through in the climactic scene where Ismay storms at the Captain blaming him for the disaster.

The fact is, "Jesus Christ Superstar" also had a grand and significant story to tell, but it was able to do it with fantastic music, great melodies and electric songs. There is not a single hum-able song in "Titanic." 

In fact, the songs carry the story in  JCSS, in operatic function--"I Don't Know How to Love Him," and "This Jesus Must Die" and "What's the Buzz" and "Everything's Alright," and "Pilates Dream" and "Herod's Song."

Each one of these can be hummed and enjoyed simply as music, as great songs, but in the aggregate, they comprise a great musical.

There is nothing like this in "Titanic."

Andrew Lloyd Weber and Tim Rice did not do "Titanic."

Why, I do not know.

But the lyricist and the book writer for Titanic are not Andrew Lloyd Weber or Tim Rice, and not in their class.

And the Phantom says this with regret, because he really wanted to love this production and the stagecraft is, as always at the Ogunquit, superlative, starting with the stage filled with the sunken ship underwater.

This, hopefully, will not be the last attempt at a rock opera for the Titanic. 

Hopefully, the next folks to attempt it--?Elton John and Hans Zimmer and Tim Rice?--will do better.

It's a story so rich in hubris, pathos, class struggle, human frailty that one botched attempt should not, forgive the pun, sink it. 

Intelligence

Ever since Alfred Binet tried to identify children who might be expected to struggle in school going forward, with an "intelligence test," testing has replaced intuition and description and thought as a measure of intelligence.

Intelligence testing has been used, at least at its earlier incarnations, for the purpose of crowd control. It was meant to stream large numbers of individuals into different pens, so they could be managed. If you were going to have trouble learning to read, to do sums, then you got moved into one pen; if you were already there or likely to move quickly, you got shunted to another. 

During World War I, the army wanted to know who had the "right stuff," the intelligence to become officers, to lead soldiers out of the trenches, charge across a field under withering fire and reach the enemy and later to organize the feeding and care of soldiers in a company. So the army used "intelligence tests" which reflected what Robert Yerkes, a Harvard professor of psychology, thought qualified as intelligence. It doesn't take a high IQ to see the problem with the tests as soon as you look at the questions:

1. Seven up is played with: a. rackets b. cards c. pins d. dice

2. The Merino is a kind of: a. horse b. sheep c. goat d. cow

3. The most prominent industry of Minneapolis is: a. flour b. packing c. automobiles d. brewing

4. Garnets are usually: a. yellow b. blue c. green d. red

5. Soap is made by: a. B.T. Babbit b. Smith &Wesson c. W.L. Douglas d. Swift & Co.

6. A house is better than a tent because: a. It costs more b. It is more comfortable c. It is made of wood

7. If the grocer should give you too much money in making change, what is the right thing to do?: a. Buy some candy off him with it b. Give it to the first poor man you meet c. Tell him of his mistake

So, what Yerkes was looking for was people with his own virtues, people who knew the sorts of things a Harvard gentleman should know. He was disturbed to discover that immigrants from southern and eastern Europe getting off the boats at Ellis Island failed these tests miserably and were clearly the scum of the earth, or as Mr. Trump might say, "They are not sending us their best people."

When I was growing up in the 1950's, we took "intelligence tests" with number 2 pencils filling in the blanks on single sheets of papers which were scored by machines, not computers but which aligned up our marks with holes on grids. I cannot recall the questions, but I know the results were considered so important and determinative we were never told our own scores.  Kristie Hansen, a gorgeous blue eyed blonde, however, knew her score: 154, but she never told me how she was able to ascertain this. Maybe her parents found out. 

When I was entering my senior year in high school and struggling in some of my classes, my parents went to the guidance counselor and were relieved to discover my "verbal IQ" score was 160--"Almost genius!" my mother trilled--even though my math score was "much lower." The counselor remarked she had never seen  a wider gap between these two types of intelligence, but that made sense to me as I had no interest in arithmetic or math--although for some reason I loved geometry, and algebra, once I repeated the course, seemed to make a lot of sense. Never could learn calculus--never was interested enough. Trigonometry struck me as worse than useless.

I concluded from this that whatever tests I had attacked with my number 2 pencil knew something about me which was true--although not the "genius" part, which I knew, for sure, was not true.

Years later, a study appeared in the New England Journal of Medicine which purported to show that fetuses incubating in women who were hypothyroid during pregnancy wound up with lower IQ scores if the mother failed to receive thyroid hormone during pregnancy. There followed other studies. But the first study was peculiar in that it was done by screening 25,000 frozen sera (blood samples) and finding 64 mothers who were hypothyroid sometime during their pregnancies. Their kids were tested at 7-9 years of age and scored about 4 points lower than 125 children in a control group. Fifteen percent of the "affected" kids had IQs lower than 85 compared to only 5% in the control group.

Later studies confirmed this in 3 year olds.

The reason they were looking at thyroid in pregnancy is it has long been held that cretinism (a form of mental retardation accompanying other physical findings) happens in hypothyroid children but when children got tested just after birth and treated with thyroid hormone, cretinism vanished from the American scene. You had 6 weeks to start treatment, and if you did the brains were fine--but kids who went a year or two got cretinism. Note, we are talking about the levels of thyroid hormone in mothers in one study and in children in the other. We also have to conclude that the timing of thyroid hormone in the brain is critical, as children treated within six weeks of birth are just fine. So there are obviously critical timing issues with respect to brain development.

I objected to the study of 3 year olds at a Boston conference, questioning whether you can even know about lifelong intelligence from a test in a 3 year old. What tests are used? Are these 3 year olds even capable of  using those number 2 pencils? 

A pediatrician caught up with me in the hallway afterward and insisted you can tell who is intelligent by testing at age 3. She was most indignant I had questioned the meaning of IQ at age 3, and even more angry about my dismissal of IQ testing techniques. 

I asked her if anyone had tested those 3 year olds when they were 18. Of course not.

So, IQ testing is freighted with a lot of baggage and emotionally held beliefs. 

I later wrote Alan Kaufman, a Yale psychologist who has written extensively, and is a sort of IQ guru, about all this and he laughed about a difference of 4 IQ points, which he said could not be meaningful with current tests, like trying to determine if one elephant weighs 4 ounces more than another. 

The SAT exam has been used as an IQ test--it was supposed to be the great leveler, so kids from rural Iowa could be discovered as diamonds in the rough, bright kids without the advantages of kids in New York or prep schools would have, but who had just as great "native intelligence." 

It is reasonably clear that, even as the SAT has changed its questions over time, it tests one band of intelligence, which is one reason the ACT was developed, to show another sort of intelligence.

But I would like to submit, if I were devising tests for college admission, another sort of test: The New Yorker cartoon caption test. Look at these two samples:

Here we have three submission for captions for this cartoon which are so far beyond my capacity it is profoundly humbling. 

The picture, of course, evokes Humpty Dumpty sitting on a wall, about to fall, but each of these contestants has seen  new and different possibilities:

1. Rather than worrying about Humpty falling and splattering the woman below, looking up his rear end is offended by the exposure.

2. The topicality of the price of eggs, having played such a prominent role in the last election is on the mind of the second contestant.

3. My favorite: In this caption we see Humpty not as teetering on the wall, in danger from his own precarious position but a willful Humpty, desperately trying to heave himself over the wall to safety.

I would grant admission to any of these three contestants to my college. They each display a sort of intelligence unmeasurable using number two pencils on test sheets.

Or take this cartoon: 

Here we have someone who looked at this array and noticed one road cone reaching out to another comfortingly, and the circle of chairs resembling an alcohol anonymous group session and the remark is totally appropriate to a sympathetic, therapeutic effort but at the same time to what traffic cones are all about: you go around them.

Brilliant.

Our colleges do, somehow, manage to attract brilliant minds, although they do not always retain them--Mark Zuckerberg and Bill Gates quickly concluded Harvard had nothing to offer them. 

But, if you believe as I do that societies really do need to collect and nurture brilliant minds, you might agree we need better ways of identifying them.

England, with Oxford and Cambridge, has managed to punch above its weight for nearly a century. CT scans, MRI's, the critical, early work on nuclear fission all came from England, not America. 

But, even more clearly, wouldn't it be wonderful to have on campus people with the sorts of minds which can win a New Yorker cartoon contest?

Capitalism, For Profit Medicine and Souless Careers

 

Mike Wirth, the CEO of Chevron Oil, got a two page profile in the Sunday New York Times business section.

They asked him what guiding advice he had got from his father, who worked in the porcelain division for Coors beer company, where they made the ashtrays with Coors logos to be distributed to bars and restaraunts. And Mike Wirth said, "It was more of an example...My dad had a habit of walking through the shop floor. He knew who won the high school football game on Friday night. Everybody there felt they knew him. That was an important lession for me. Treating everybody with respect and decency was the key to his success, not being a Ph.D."

Alexandre Yersin, Discoverer of the Plague bacillus 

This was just after he'd been asked about cutting 20% of his workforce, "What is it like, as a chief executive, to lay off so many people?" 

"In a commodity business, costs always matter. We have to stay competitive and the most difficult thing we do is downsize our work force."

Oil is always boom and bust, and maybe people working on the rigs and in the oil companies expect to be laid off work and don't take it personally, but it certainly affects them personally, and one wonders whether it would matter at all to them that Mike Wirth might know whether their kid's football time won or lost on Friday night or whether they fel he knew them when he fired them.

It's just the nature of the business, of many businesses, that it's impersonal at some level. It's just profit and loss, overhead and income.

For some reason it reminded me of a scene which played out decades ago in my office in Chevy Chase.  I had just added up the dollars and cents and decided not to renew the recently increased lease on my office and to work for a for profit hospital system, where I would not have to worry about rising rents, increased costs of malpractice insurance--all I'd have to do is see patients and somebody else had to deal with insurance company reimbursements and photo copy machines which broke down.

So, I'm sitting there at my desk and a lean and active man arrives in a tailored suit. He was, I guessed, a first generation guy, Middle Eastern origin, and he was a product of the George Washington University medical school, a newly minted urologist and he was looking over the office, which had lots of natural light and was a lovely place to see patients and he asked me if I was going to get a bigger space and why I was leaving the suite. I told him I was leaving private practice, sick of having to worry about money.

And he said something, without malice, but with a sort of knowing smile, "Just can't compete, huh?"

Which caught me off guard.

I'd never thought of medical practice as a competition.

It's true, when I opened my practice there were 12 other endocrinologists within the four block area of Friendship Heights, Chevy Chase, and by the time I left we were down to three. And as the other endocrinologists retired or moved on, or relocated, my own practice got noticeably busier. 

August Maake

But I'd not thought of myself, perhaps naively, as being in competition with those other guys.

The only competition I'd ever thought about was a sort of bragging rights dependent on where people had gone to school, which did not matter at all to other doctors or to patients. Anyone with an "MD" on the wall was the same as any other MD to most of my patients and to the other doctors referring patients to me.

The snob appeal of having gone to a famous, Ivy League, medical school had no traction in DC. The three local medical schools, George Washington, Georgetown and Howard were not schools anyone at my "prestigious" medical school would have been please to "match to" for residency training programs. The closest "prestige" school was Johns Hopkins.  But that whole sort of academic competition had long since cease to matter and seemed to be a sort of fool's game, a relic of a gilded age, where people looked down their noses at others because of notions of "the right family" or, fortune, birth or social connections.

It was a sort of fantasy of personal quality pasted on something that was really impersonal, like knowing about high school football games.

Money Is What You Want

Famously, Fitzgerald told Hemingway, "The rich really are different,"  and Hemingway replied, "Yes: they have more money."

But Fitzgerald was thinking of the ruthless people, among them his long desired unattainable paramour, Ginevra King, who would never marry him because he was not competitive in the commercial sense, i.e., he did not have enough money. Her world was about money, and he was not competitive in that world, at least when she knew him. 

And here was this young doctor, just starting out, and he saw medical practice as a business venture, a competition with other urologists. He would take out loans or use family money to hire a staff to bill insurance companies, to make appointments and to then phone patients to be sure they would show up and if not, to plug other patients in those empty slots, and he would have other staff to pursue delinquent accounts and he would invest in equipment so he could do cystoscopies in his office and keep more of the money from those procedures, and he would join clubs to meet new people to refer him patients. He would invest in computers to streamline his billing and collections. He might hire a scribe to follow him around so he would not have to waste time writing medical records and he could see more patients every day. He would hire assistants to place patients in rooms and to do blood pressures and vital signs so he could see and BILL more patients every day. Like a profitable restaurant, if he could "turn over the tables" faster, he could generate more profit.

As for my experience, working for the big hospital corporation: It was wonderful. They just asked me to see the patients scheduled, they gave me an hour to 45 minutes for new patients and half an hour for follow ups, until electronic medical records arrived which allowed me to see patients faster, so ultimately I went from 16 to 22 patients a day, but none of that seemed rushed.

But then, after about 5 years, their business people looked at the numbers and they realized that the real profit in their system lay at the hospital. The practices they supported which saw patients who were not hospitalized, the daily in office type of non urgent care at best broke even, but clearly the pulmonary, endocrine, primary care, rheumatology, neurology, practices were not money makers. Even the procedure heavy practices like oncology, hematology, cardiology and gastroenterology were only really profitable if their procedures were moved into the hospital and the doctors moved to doing just the most profitable procedures and not dawdling on the time consuming practice of patient care which required history and prescription renewals and patient examination.

So the organization closed down all those practices and kept the hospital functioning, which was just fine for profits. The hospital got all the patients it needed from the emergency department, and they ultimately opened emergency walk-in departments in surrounding towns, which were profitable.

As for all those patients who needed their diabetes or congestive heart failure or arthritis or cancer taken care of, but did not require immediate hospitalization,  well that was just not profitable and it would be somebody else's problem. 

It's not that the CEO's of the organization were bad people; they were simply doing their jobs--to maximize profit for their share holders. The CEO's did not live in town. They actually lived thousands of miles away. They might have known the scores of their local high school football games.

And they could compete with anyone.