Ya think?

Two stories came out of Washington, DC this week, sort of.

The first is the trial of 4 conspirators who are said to be the men who planned and paid for the 9/11 attacks, now set for New York City next door to the hole that once was the World Trade Center.

The other was the story President Obama is still thinking about what to do with Afghanistan and won't be rushed.

Driving home I now listen to Sean Hannity, which is usually good for a laugh and I heard someone who sounded particularly vacuous and shrill and she turned out to be Ann Coulter, who predictably enough, thought trying the 9/11 crew was a bad idea. As far as I could figure, she thought it was a bad idea primarily because it was an idea which came out of the Obama administration, so ipso facto,it has to be a bad idea. The other problem seemed to be it was not her idea.

Later, I heard David Brooks on Jim Lehrer's News Hour say it is a bad idea. He actually had some reasons: 1/ It is a bad idea because the accused just might be found innocent and/or set free 2/ It puts New York City at risk from more terrorist crazies (as if NYC is no longer a target for crazies and if we are very very quiet maybe they'll forget all about NYC even being there.) 3/ It portrays the act of the 9/11 attack as being a crime rather than an act of war.

As for the first two points, they are hardly worth refuting on almost any level, but just to make it very clear to the very slow child which has emerged as David Brooks on TV: Yes, a trial is supposed to not be fore ordained, and if we've got the wrong guys maybe it would be a good idea to know about it; on the other hand, the chances of these guys getting set free by a New York jury if there is any doubt they may have been involved, are slim and less than nil.

Putting New York City at new or special risk? The place is the center of the world, the coolest city on earth and for that reason it continues to be in the cross hairs of all those envious loonies from around the world who want to aggrandize themselves by trying to destroy something which is so much more important and greater than themselves.

As for the last problem, the attack on the World Trade Center, from the point of view of the terrorists, was an act of war. Those Palestinians who were dancing in the streets and handing out free candy following the attacks were not celebrating what they saw as a crime but what they saw as a legitimate act of war, on their behalf. Those Nazi big wigs, wearing their uniforms in the docket at Nuremberg called themselves soldiers and thought of their murderous acts as acts of war, against the children at Dachau and against the civilians in London air raids. But part of the humiliation of those miscreants was putting them on trial like common criminals, which is exactly as they ought to be remembered. Just losers who murdered people and were hanged for it.

One of those guys, the fat one, Hermann Goering I think, managed to swallow cyanide to "Cheat the hangman" because hanging is a pretty demeaning and undignified way to die.

So we ought to insist on trying these guys as common criminals. David Brooks is afraid they will stand up in court and speechify and have a forum for their own propaganda, but that can be managed. They can be housed in a glass cage and their microphones turned off if they become too annoying.

No, being put on trial for murder can be quite humiliating and can make you look really bad, and if the thing is staged managed properly, it can be a real great show for a public looking for revenge.

What the conservatives might be worried about, if they were capable of cool headed reflection, is what a huge statement about his own toughness, about his faith in our own system and ultimately about his cool toughness and courage, this trial could be for President Obama.

Yes, we are not afraid of putting these guys on trial. We are not afraid of losing the trial. We are not afraid of terrorist bombings during the trial. We are not afraid of putting these moral monsters to death, possibly by a public hanging at ground zero.


Then there is Afghanistan, the other non news story. The President is taking his time. He has every right to take his time.

The hard part is the decision. How do you look resolute and determined without looking to the Afghan government like a free lunch and without looking to the Afghan people like just another invader?

The answer is: We announce the time has come for us to phase out. The President says, "I said Iraq was the wrong war and Afghanistan was the right war. Well, Afghanistan was the right war, when the Taliban was in power, when Osama Bin Laden had free and open life there. But now, for the moment at least, the Taliban has been sent packing to Pakistan and is not in power. It may come back, but then we can always come back if we see a reinstated Taliban in Afghanistan as a threat.

Our main goal in invading Afghanistan was to protect ourselves and to attack those who attacked us. We now have other ways to protect ourselves. We realize the whole notion of denying Al Qaeda sanctuaries is preposterous because they do not need Afghanistan or Somolia or Indonesia or any special plot of turf or geography for home bases. All they need is an apartment in Germany or in New York or Miami and an internet connection.

So we will continue to fight Al Qaeda with Special OPs and with our own intelligence but we do not need boots on the ground anymore. We do not need to provide either the Taliban or Al Qaeda with convenient targets in the form of our young men and women of the armed services.

These American warriors have served valiantly and effectively but now their leaders need to be as brave as they have been and worthy of being their leaders and it is time to redeploy, to use our armed forces in a more intelligent way than simply consigning them to becoming an occupation force or a police force.

We never intended to stay in Afghanistan for a hundred years.

We can continue to advise any Afghanies who want to listen, but given the realities of that government and that culture, we cannot continue to spend precious American lives trying to impose order and morality on that land.

So tomorrow, we will withdraw our troops to fortified locations and begin to effect an orderly draw down of forces. If we are attacked, we can respond with all the force we deem necessary, but our plan is to leave Afghanistan to the Afghanies.

If we see reason to return to protect ourselves, we will be just over the horizon. "

That's the speech President Obama can give.

As Richard Russell, one of the few people Lyndon Johnson really trusted, once told Johnson, when Johnson asked Russell what he as President should do about Viet Nam, Russell said, "Well, Mr. President, the thing is, we are going to go home eventually."

"Yep, that's true," Johnson said.

"And they know that."

"Yep. They probably do."

"So there's no reason for them to give up. 'Cause they know they're gonna still be there after we're gone."

Johnson, unfortunately, having heard truth spoken to power did not act upon this insight. Hopefully, Obama will be smarter.

An Open and Shut Case

A recent case from Iowa ought to be a good test for the Phantom's unscientific, empirical theory of the Supreme Court.

The case stems from an Iowa murder conviction, and as I understand it, certain "facts" are agreed as matter of stipulation, to wit: A high school senior, a black youth (a promising young man, who was being recruited to play football at Yale,) was arrested and convicted of the murder of a white man on the testimony of another teenager.

The teenager who provided the incriminating testimony got nearly everything wrong when police and prosecutors first interrogated him: the wrong location for the murder he supposedly had witnessed, the wrong weapon (a handgun vs a shotgun) and utimately, even the state of Iowa, or at least the appelate courts agreed the witness was simply not to be believed and there was evidence the prosecutors coached him relentlessly until he had a story which would hold water in court.

The prosecutors, by most if not by all accounts, knew their witness was a phony, but they used his testimony to get a conviction.

Assertions were later made about the reasons the prosecutors were so determined to convict the defendant--the defedant was African American and would be tried by an all white jury; the alternative suspect was well connected in the community. The reasons the prosecutors proceeded with evidence which was clearly a fabrication are not agreed upon, but the falsity of the testimony is not in dispute, nor, as far as I can tell is the awareness on the part of the prosecutors about the falsity.

After 25 years in jail, the defendant managed to get himself exonerated through the appelate process and then sued the prosecutors who knowingly falsely accused him.

The prosecutors have argued not that they were convinced they had the right man but simply that even if they knew the testimony was specious they cannot be held accountable for their actions because as officers of the state, as prosecutors, they are immune from such suits under a law which protects them from personal liability as a result of their work as prosecutors. They argue, and I think I actually have this right, they argue the process of preparing a witness for his false testimony is part of and inseparable from the actual trial and the clear legal precedent is no prosecutor can be sued for what he says during the trial, in court.

So if suborning perjury occurs as part of this process, they are still immune because it was all part and parcel of the trial. That, as far as I can tell, is their actual argument.

They are saying,in effect, it was the jury's duty to determine whether or not to believe the false witness the prosecutors' witness had presented during trial.

You do not need three years in law school to figure out how to rule in this case, you might say.

But, if the Phantom's theory of the Supreme Court is correct, then the four justices who vote for those in power will, in this astonishing case, manage to find a reason to rule in favor of the prosecutors, who, after all, are the guys in power. Justices Scalia, Thomas, Alito and Roberts will all somehow find a way to find for the the authority figures, just as they found a way to find in favor of the high school principal who stomped across the street to destroy the "Bong Hits for Jesus" sign displayed off school property at a parade.

That this young man, who had such a promising future was so wronged by the government's men, that his life and prospects were ruined, that the real culprit was allowed to go free because the prosecutors chose to prosecute the wrong man will matter not at all.

All that will matter is the ex convict is suing the government officials, the little guy is trying to bring down the powerful.

If the justices vote as the Phantom predicts, can there be any doubt having a law degree, having been a judge or a lawyer, having been judged "Qualified" by the American Bar Association is all hogwash.

If they find for the prosecutors, there is no law here, only social agenda. And if social agenda is what drives Supreme Court decisions, why do you need a law degree? Why should we not have a few scientists, police, doctors on the Supreme Court, to balance all the "legal" thinkers.

Stay tuned.

Obama, Fox News, Louis Menand, Anger & George Carlin

Louis Menand, distinguish professor of English at Harvard, advises President Obama to avoid criticizing Fox News directly. "The state may, and should, rebut opinions that if finds obnoxious, but it should not single out speakers for the purpose of intimidating them," he writes in the New Yorker. "At the end of the day, you do not want your opponents to be able to say that they could not be heard."

Can you imagine Rush Limbaugh, Glen Beck, Bill O'Reilly ever claiming they could not be heard? Part of the cant of the loud-mouth right is the paranoid style, it is true, but they never claim they cannot be heard, because that might undermine their self importance. These guys all claim they have audiences of millions, silent masses raptly hanging on their every word, while the forces of darkness are always trying to prevent the truth from getting out, but never succeeding because Rush, Glen and Bill are so bravely unintimadatable.

Menand does cite an interesting number: Half of Fox "News" Channel is over sixty-three years old. "Contact your doctor if you have rage lasting more than four hours," Menand says--his best line.

Menand says Obama's attacks on Fox have left Obama's fans "dispirited."

Just the opposite, of course, is true.

What is dispiriting is watching the playground bully beat up on the fat kid who will not or cannot throw a counter punch.

Menand may speak for a group of Obama well wishers, perhaps people with whom Menand has dinner, a crowd which might be characterized as "effete." That is a loaded word, of course, harkening back to the days when Republicans began chiding Democrats as flaccid girly men who lacked backbone. Democrats are wusses who lack nerve, courage, testosterone, passion, all the things leaders ought to have in abundance.

But I speak for Obama well wishers who become frustrated and distraught by our President's disinclination to throw a punch at those who richly deserve it.

I would like to see more fire from the President for the emotional satisfaction of seeing him score points I cannot score because I am not onstage. It felt good to see Lloyd Benson's withering disdain for Daniel Qualye zinging him with that "Jack Kennedy was a friend of mine. Let me tell you, you're no Jack Kennedy."

This is why men watch football, prize fights--they get vicarious pleasure out of seeing someone tag a deserving target.

On the other hand, there is a question of style.

Until recently, I did not get Dana Carvey's characatur, "The Angry Old Man." I never realized some men get cranky when they get old. I just thought those old geezer were always cranky.

But watching George Carlin over the years, it is amazing to watch him get cranky as he aged. His wonderful, restrained, understated rifts on Muhammad Ali and the government's tactic of saying, "No, no, if you won't kill them, we won't let you beat them up," as he described the government saying if Ali refuses to be drafted to kill people, the government would not let Ali fight in the ring, was a wonderful jab. Contrast that to his latter day observations about the anti abortion crowd, "Did you ever notice the people who are against abortion are people you wouldn't want to f..k in the first place?" which is essentially a non sequetor.

Carlin was still funny in his cranky old man phase, but not as funny as he was in his mellow phase. He sucked you in in his mellow phase. He trusted you to see the essential absurdity in the government's argument, and in so many things about the Church. The Church granting dispensations, allowing you to eat meat on Friday if your group came in first in the scrap metal drive. Then the undoing of eating meat on Friday as a sin--completely reversing a doctrine during his lifetime--so he could remember those unfortunate souls doing eternity in Hell for the sin of eating a hot dog on Friday.

So maybe Obama is trying to be the early Carlin, zinging them better by zinging them softly. If that is what he's trying, I can tell you it isn't working.

At least not for me.

Not that zinging Rush Limbaugh is easy. To do this, you first have to listen to him and that takes a strong stomach. Even when I listen, trying to figure out what it is he is saying, there is not enough substance there to really reposite.

Listening to Limbaugh takes time--he will carry on with a lengthy imagining of Bill and Hillary Clinton having sex and the essence of this is they are both very overweight and the difficulties this would create and what the bed would sound like, groaning under their weight. This, you have to remember is coming from Rush Limbaugh, not exactly a waif himself.

But how do you respond to that "criticism?"

Or, another time, he listed each expense for the transportation of President Clinton on a trip to Chicago. He went on in excrutiating detail about the cost of transporting by airplane the armour limousine, the cost of the gas for the airplane, the salaries of the pilots down to the penny, all in a mock rage, incredulous laughter, with many asides to the effcct, "Can you imagine if the world only knew about this, how quickly they would throw this clown out of office?"

But, of course, lost in this half hour tirade about the waste of money was the underlying point whenever a President chooses to leave the White House, it costs money. So what was Limbaugh saying? The President should never leave the White House? It's too expensive?

And if the President followed this advice can you imagine Mr. Limbaugh's umbrage at the thought of an out of touch President who never deigns to connect with the common man, with the salt of the earth in the heartland?

But I'm dating myself. I am recalling a tirade from the last time I was trapped in a car long enough to listen to an extended Limbaugh rant. And that was the Clinton administration. Since then I've been unable to keep my fingers away from the button which silences Mr. Limbaugh.

This is a problem I will work on. Trying to fashion a response to knuckle draggers.

Stay tuned.

Fox News and President Obama

David Carr, in a New York Times tried to give President Obama a little motherly advice about not responding to provocations from various Fox News sources.

Don't respond to these attacks, Mr. Carr advised Mr. Obama. Your great strength is your ability to exude "a certain cool confidence."

It's like being on a basketball court and your opponents are trash talking and everyone knows these trash talkers "Would not find much space for rent in Mr. Obama's head."

Cute imagery, but wrong.

On the basketball court, you can answer, with your own actions, by scoring and smiling wordlessly, so everyone in the arena can hear it: Take that sucker.

"Mr. Obama has also shown a consistent ability to disarm or at least engage his critics."

Actually, not.

The real history is Mr. Obama did not have to engage or disarm his critics during the campaign. He knew this. He did not respond and he leaned back against the ropes like Muhammad Ali, and let his opponents wail away at him and become arm weary. He did not have to throw a punch because George Bush had already handed him the election before any of the arguments began.

"I got this," Mr. Obama reassured his supporters who urged him to throw some counter punches.

Mr. Obama could real a poll. He could see the economy tanking and he knew it didn't matter how much Sarah Palin taunted him. People were not listening to her or to John McCain. They were looking at their accounts and their mortgage payments.

But those factors which are external to all arguments are no longer working in Mr. Obama's favor.

Now it's his economy and his budget and his financial crisis and his healthcare program.

He cannot win with Rope a Dope any more.

Now he has to show he can fight for what he believes in.

Truth is, Fox News is no more partisan than newspapers in the early years of our Republic, which were the voice of one political party or another. There was a Federalist press which attacked Jefferson relentlessly, portraying him as a rum soaked anarchist. Democratic papers savaged Abraham Lincoln.

The whole notion of a dispassionate, objective news organization with no axe to grind, a neutral reporter of the Truth, is actually fairly new.

I'm no historian, but I suspect the current ideal of a neutral press dates back only to Walter Cronkite, who appeared to report the news from Viet Nam with great neutrality. Of course, CBS news ran nightly videos of American soldiers expressing their disgust at the whole idea of even being in Viet Nam. But it was not CBS News saying those things. It was the soldiers.

The pretense of "objectivity" is, of course, a basic form of dishonesty.

At least if you let your listener know what your bias is, the listener can say to himself, "Okay, I'll hear this point of view and I'll look elsewhere for the other side."

If President Obama fails, it is more likely he'll fail because he could not man up and say, "I think I'm right about this and this is what we are going to do."

As dismal a Presidency as Ronald Reagan's at least had the virtue of leadership--leadership in the wrong direction. But at least you knew where he stood. "The nine scariest words in the world, 'I'm from the government, and I'm here to help.'" That's what Reagan said. He was the anti-government, government can't do anything well President. And under his governing practice, he proved his point.

Mr. Obama was a savvy candidate. He knew all he had to do was say nothing and ride the waves of discontentment to the Presidency.

But now he has govern.

For my money, that means not putting Olympia Snow in charge of your health care plan. That means saying, "The Republicans are in the pocket of the insurance industry. They do not want any change to their cozy, privileged world. We've tried to include them in the process of change but their only desire is to obstruct and prevent change. So much for bipartisanship. We tried that. Now we are going to do what we were elected to do. If we are wrong, then vote us out."

And while he's at it, he ought to say over and over, "The Republicans tried to kill Social Security under President Bush. They called it 'Privatization,' and what they meant was taking your safe money out of the government coffers and giving it to the stock market. And they fought Medicare. Now they are fighting health care. Why? Because they care more about money and keeping money for their friends and for themselves than they care about you. I'm sorry to have to say it, but that's the truth."

And while he's at it, he ought to single out John Boehner and that nut from South Carolina and Rush Limbaugh and Glenn Beck, not necessarily by their names but by quoting them, for special ridicule.

Why should this be left to Jon Stewart?

If he could do that, he could energize his supporters and put those right wingers on the defensive.

Those who oppose health care changes are either ignorant and frightened or simply selfish and satisfied and President Obama ought to be the one saying that. He ought to be throwing the punches, not relying others to do it and playing the nice guy.

We need more than a nice guy right now.

He cannot depend on me to say it.

Nobody reads my blog, anyway.

But he's got an open mike. He has to use it, not just hum along.

Paul Pillar, One Eye in the Land of the Blind

(Edward Hopper)



Watching TV, the various Americans touted as wise men can be seen testifying before Congress, at the Brookings Institution, on Jim Lehrer's New Hour, I feel, momentarily transported back to the city of my birth and longtime home, but things look so different from the land where I have immigrated, New Hampshire.

From up here, where so many are simply trying to figure out how to pay the mortgage, pay their taxes (such as they have taxes in New Hampshire) and send their kids to school or, more often up here, send their kids out into the work world, the whole issue of Afghanistan and Iraq looks different.

There are two perspectives up here: 1/ How does this war effort affect me personally? 2/ If it doesn't affect me personally, what makes sense for the country in these overseas efforts?

About half of the people I meet every day consider the military efforts from the point of view of employment. It affects them because the military is often one of the most viable options for employment for their kids, after high school. They mix that in with a little talk of "Patriotism" but the parents are looking at potentially losing their kids forever and so they get past the patriotism stuff pretty quickly. One attraction of the military is it's a reasonably secure job without much prospect of getting laid off and it does remove the worry about supporting your kid financially. When you've got five or more kids and you are making a living at the Portsmouth boatyard, that can be a pretty attractive prospect.

If your kids are not likely to need that option, then you tend to think in more general, almost academic terms, with the intellectual remove of the academic. Not that this means you think originally. Many of my fellow townsmen fall back into patterns of thought acquired during their youth--America should not "Cut and Run." America should "honor its obligations," or countries like Iran will disrespect us and make more trouble for us down the line.

That "Disrespect" argument is actually pretty interesting. It's a motivating force for all sorts of crazy actions you see in inner city culture. You can read about it in the novels of the inner city by George Pelecanos (Washington, DC) or you can see it in The Wire (Baltimore.) Presumably these writers base their depictions on what they actually knew about the culture of the inner city, where a fourteen year old boy is shot to death because he "Disrespected" someone with a gun, for the grave offense of making a disparaging comment about the shooter's sneakers.

How much more sophisticated, restrained and smart are those who argue the USA cannot withdraw from Afghanistan because Iran or Somali or Yemen or North Korea will see that and conclude we are too cowardly to defend ourselves? We got to shoot that Afghanie because if we countenance disrespect, we open ourselves to loss of fear from our enemies.

Watching Paul Pillar, the Georgetown professor, former CIA analyst, answer this argument, calmly, is quite amazing. He says, actually, that's not what happens in the world beyond our shores: If we withdraw from Afghanistan that doesn't guarantee a chain reaction of testing attacks from our enemies. Just as Russia's antagonists in countries it had under its thumb did not immediately rise up and attack Russia when it withdrew from Afghanistan, we are unlikely to face any emboldened enemies. Others watching a big power withdraw simply conclude Afghanistan didn't mean enough to America for America to bother with it.

Our enemies are at least that sophisticated.

We got out Somalia and the entire continent of Africa did not rise up to test us.

We got out of Viet Nam and all the dominoes of South East Asia did not fall.

As for allowing safe havens, Pillar calmly pointed out the 9/11 attackers did not have safe havens in Afghanistan or Somalia or Yemen. Their save havens were in apartments in Germany and hotel rooms in Florida and Portland, Maine.

Pillar notes quietly Al Qaeda does not need geography, it does not need a land base or an aircraft carrier. All it needs is the internet. It needs a credit card, a cell phone or maybe a boat or a ton of fertilizer, or a stolen nuclear bomb. But safe havens, forts, flags, factories to stitch together uniforms, not so much.

But nobody in those Congressional hearings seemed to hear Professor. He didn't have any punchy or memorable lines to quote. His lines were all understatement and unemotional reason. Sitting next to him in the hearing room were much more colorful advocates of bringing the fight to Al Qaeda, of "Fighting them over there so we don't have to fight them in the streets over here," of not falling into the weak kneed posture of submissiveness, of "Cut and Run" policies.

Even at the Brookings Institution, where he sat on panel with a Congresswoman and a couple of Brookings Institution gurus who also worked for some high power sounding institutes of policy analysis or centers for strategic studies or something equally grand sounding, Pillar was politely given time to say his piece and ignored.

He was ignored in Washington, but I heard him up here in New Hampshire.

Trouble is, I'm not sure how many other people in New Hampshire, or elsewhere across our continental sized nation, were tuned in.

All The Answers

The Supreme Court currently dominated by Justice Antonin Scalia and his like minded enthusiasts, Thomas, Roberts and Alito have given the phrase "Strict Constructionists" new meaning.

For me, this idea has an old meaning going back to an old black man I used to see sitting in a park. He held in his hand a very worn, leather bound Bible, and he would page through it, stopping at various passages and tell passers by that "All the answers," were contained in this book.

"All the answers to what?"
"All the answers."
"You mean all the answers to life's big mysteries? Who are we? Where do we come from? Why are we here? Where are we going?"
"Those and everything else."
"You mean, like: Should we legalize prostitution? Should we legalize marijuana? Is homosexuality a sin? Is divorce okay? Should we cut down the forests? Should we drill for oil or build more nuclear reactors? Should we allow corporations to promote candidates? Should we allow a teenager to hold up a sign, Bong Hits for Jesus?"
"All the questions, all the answers, right here," he would say, shaking his head at the enormity of it. Right here in this book. If only we are smart enough to read it. Read it properly...and understand."
"What about answers like how to make a vaccine against AIDS?"
"All the answers," he'd say. "All the answers, right here."

Now one thing you can say about absolutists: They are consistent. They do not get caught up in the contradictions which arise when presented with specific cases.

So his utter faith, his belief in that book held a certain charm and reassurance. There is one God, and he speaks through one book and all we have to do is look to that one source and--here's the rub--interpret it and we'll know the Truth.

Having learned in school about evolution, and having absorbed the idea a "Plan" a divine "intention" may take a rather free flowing form, I had my doubts the Bible could point the way to a vaccine against AIDS. Even if it was written by men under the guidance of God, I doubted it covered every problem.

As dreary as many of my courses in science had been, they had at least inculcated a dim awareness there are more questions than answers and each new instance requires a temporary answer which works for while until it is found inadequate and set aside for a new answer to take its place. The immutability of an "answer," loses its impact the more you study nature.

So we learn about microbes. Then we learn about antibiotics which kill microbes. But then we learn microbes have DNA which can mutate and make them invulnerable to those antibiotics until you can design a new antibiotic to kill them in a new way their DNA hasn't adapted to, yet.

The Bible, as far as I know, does not really guide you much there.
But then again, I cannot call myself much of a student of the Bible.
Maybe I'm just ignorant.

All this is a way to say, I cannot really buy the idea of a sacred text which contains all the answers, especially as new problems arise, as DNA mutates and presents new problems.

So it is with me and our Constitution as a sacred text.

Again, I admit I'm ignorant. I really should have learned more about the framers, about Jefferson and Madison and Washington and Franklin and Adams and all those guys and what they knew and what they were thinking.

But I do know, they lived in the eighteenth century, before the human voice could be amplified, before television could bring a politician's image to millions, before the Internet, before automatic weapons and telescopic lenses could transform a single citizen into a killing machine who can kill a President or wipe out a classroom, before corporations could drill for oil, despoil vast prairies, before airplanes could fly from Africa bringing passengers infected with Ebola virus to our shores, before terrorists could steal an atomic weapon and blow up whole cities, before terrorists could steal airplanes and attack cities, before cities, actually, in the modern sense of a New York City, before skyscrapers, before tunnels and suspension bridges.

Having read just a little about Jefferson and his contemporaries, I do have the sense he had insight into his own limitations. I may be wrong, but I think the men who wrote then amended the Constitution had some sense of humility about what they were doing. Maybe I'm wrong, but they seemed to be a little humble about sailing uncharted seas, about creating a form of government which had not been tried in any vast way (except by a few Greek Villagers and some Roman senators in some nascent form) and they were somewhat tentative.

If Jefferson said he thought a little revolution every now and then was necessary for Democracy, I don't think he was thinking about rolling out a guillotine, but about changing course, with an election, maybe even with a Supreme Court ruling, although I gather he would be rather startled by the power and reach of our current Supreme Court.

The writers of the Constitution were men of their times, and in their times slavery was a fact of life and they included slaves in the head count of the population and even mentioned a formula for how to apportion representatives to Congress to account for the number of slaves living in their territory. But, if I understand what these men were like, they did not look into the future thinking they could predict all the problems their creation would encounter, so they built in a lot of flexibility so the government they created could morph and change to face future problems--could accommodate a little revolution now and then.

If they were geniuses, it was in their recognition they did not have all the answers for all times and for all problems. All they were doing was positing a way future problem might be discussed and resolved without resort to civil wars. Smart men, seems to me, would have not attempted to write a document with all the answers. They would have said, you guys solve your own problems which arise in your own times. Don't look to us for all the answers.

They were, in other words, fathers who refused to have all the answers, who refused to play the role of God, who said to their progeny: You're on your own now. Don't look to me or to my writings to solve all your problems for you.

Of course, as Lincoln discovered, the Constitution and the government those men devised did not work to solve every problem.

When you got down to the problem of whether or not a man could be considered property, you got the Dred Scott case, which found in the sacred text an answer that if "Other persons" who counted 2/3 of a white male person had been mentioned, then slavery was enshrined in the Constitution and was all right with the founding fathers.

Until a war changed what the founding fathers said, and a couple of amendments to the Constitution got added. There's a not so little revolution, of the sort Jefferson would probably preferred to avoid.

So when you have Antonin Scalia saying all the answers are in the Constitution, and the Supreme Court cannot do anything but hew to the ideas of those eighteenth century authors, he is missing the very point of the authors, who, I am imagining now, if they were as smart as I suspect they were, knew they did not have all the answers and would be only too glad to believe their government was flexible enough to allow the Supreme Court to write a Brown vs the Board of Education and to begin the process of ending the life of the mutant child of slavery, Jim Crow.

There are people, who for whatever reasons, want to think of the world as an orderly creation, the idea of a single force or God, which becomes disorderly and needs to be brought back into conformity with a single will. And what could be more orderly than a single source?

Well, actually, two sources, the Constitution and the Bible.

Just look there and you do not have to think any further.

Of course, you may not get a polio vaccine, a heart lung machine for heart surgery, airplanes, atomic bombs, computers, cell phones, automatic teller machines. But,you'll have order.

I look at those four justices who believe in strict construction and I cannot help but wonder when they will start wearing powdered wigs.

I do miss those stripes Chief Justice Renquist sewed on his sleeves to show he was the grand master. Those black robes are pretty impressive get ups. But they are so unadorned. The priests I see on TV all have doo dads on their robes--crosses, little symbols of big mysteries, stripes of course, and colors, wow the colors. The Supreme Court justices could use a little of the pizazz of the television preachers. Maybe some shoulder boards with stars on their shoulders. They might take a look at the dazzle on the coats of the generals who really have a sense of color and the possibilities of adornment.

Heaven forbid justices of the Supreme Court should become "Activist" judges, making up new laws the Congress never passed. Of course, what makes you an activist is actually when you make up a new law which offends the sensibility of Justice Scalia. It's okay to make up a law which says a teenager cannot hold up a sign across the street from a school parade which offends the principal and the justices who don't know what it means but they know they don't like the word "Bong." That's just being a strict constructionist.

The guys who wrote the Constitution were clearly against Bong Hits for Jesus.

It's all right there,in the Constitution, along with all the rest of the answers.

The Sunshine Makers

As Afghanistan swirls into a whirlpool, it all looks so familiar: American soldiers, strangers in a strange land, a war with no borders and no geographic objectives, no capital to capture, no uniformed army to defeat, no more mission other than to "pacify" a whole civilization, to wins hearts and minds of people whose language, culture, hopes and fears are foreign.

The big difference is supposed to be that this time the people we are attacking are supposed to have been the source of the 9/11 attack, and, we are told, will be again. We've got to get them before they strike us again, is the line. And if we leave them alone, they'll have "sanctuaries," as if they do not already have sanctuaries.

It all reminds me of a very strange and haunting cartoon which every male of my generation remembers distinctly, "The Sunshine Makers," about a group of tiny elf like men who skulked around singing, "We're happy when we're sad." One of these black clad gnomes fires off an arrow at the white clad happy guys, who bombard these black guys into happiness.

It was an unsettling notion, even to a seven year old, the idea one group could bombard another into happiness, could by warfare convert them to love, could win their hearts and minds by bottled sunshine. Even as a child, the idea somewhere, deep down was disquieting. I had the feeling, "Get Real." I knew I didn't know much about the world, but I knew that cartoon felt not just bogus but dangerous.

There is an old saw about medical interns: The most dangerous intern is not the intern who does not know--it's the intern who does not know he does not know.

What I don't know about Afghanistan is titanic. I cannot even picture the place. It is a country of millions, I read, but the only images I've seen of it are dusty little villages with mud for streets. I've read about the poppy farmers and the drug trade which feeds the Taliban and Al Qaeda. I've read about their "elections." And I've read about Richard Holbrooke riding around the place, trying to apply the lessons he learned in Viet Nam.

But Mr. Holbrooke does not appear to have learned the big lesson of Viet Nam.

It may be we have to fight Al Qaeda, but sending in uniformed American troops looks to me like a show for the folks back home watching on their T.V.'s.

It is a continuation of the Bush era idea of strutting onto main street with guns slung low and looking for someone to shoot it out with.

Trouble is, Al Qaeda is too smart to strut down main street.

How do I know this? I can only guess. What would I do, if I were in the position of Al Qaeda or the Taliban? Would I expose myself? Or would I hid under a rock until I had a clear shot, maybe with a roadside improvised explosive device.

That I am woefully ignorant of Afghanistan does not necessarily mean I am wrong.
Richard Holbrooke can base his conclusions on experience talking to Americans and Afghanies on the ground. But that does not mean he is correct in thinking we can "win" a war of pacification there.

I am so ignorant, in fact, I have to rely on a fictional account of how an indigenous underclass deals with a more powerful ruling armed force--as in The Wire, which was fictional only in form, not in understanding.

The fact is, no occupation force, whether it is made of soldiers or police can pacify a local population unless the people living in the territory have very good reason to want to help.

What would I do?

I think I'd get all the uniformed soldiers out of the country. Then I'd send in the guys who can collect information, who can blend in, who can listen in, if we have enough of those guys. And when Osama, and the Taliban peep their heads up, maybe then we'll have a shot at them. It's the difference between listening on the wire, understanding what the mopes are thinking and planning and being very patient, not breaking down doors until you have the top guys. Whenever I see stacks of cocaine or heroin in front of top brass displaying the haul, which they always say has a "Street Value," of a billion dollars, I think of The Wire and know we are being sold and manipulated. It's not the stuff you pick up on the street that means anything. It's the people you don't see behind it who mean something.

Another analogy is medical: what you see on the skin is what catches your eye, but if you don't dig down to the real source of the problem, you are just amusing yourself and deceiving the patient into thinking you have cured him when all you've done is strut.

Of course, if the President did remove the troops, the frat boy Republicans would howl about how he's caved in and when there's another attack, it'll be all his fault and he'll lose the election.

So it's not likely we'll see the soldiers coming home any time soon.

But that's democracy. Your President can only be as good as the people who elect him will allow.

As Tommy Carcetti once said, "Tomorrow, I'll wake up in Baltimore and the election will be over. And I'll still be white."

Which is to say, you can't change deeply rooted biases of the electorate, even with reasoned arguments.

When Republicans Say Democrat

(Chop Suey--Edward Hopper)




One thing I liked about Howard Cosell, the sports announcer, was his statement when Cassius Clay changed his name to Muhammad Ali. He said, simply enough, a man ought to be entitled to be called by the name he wishes to be called by.

Sounds simple and self evident, but there was a ton of psychology afoot in America of the 1960's and 1970's and white people, especially establishment types in the media, did not want to call Muhammad Ali by that name which evoked violent Black Muslims who, it was said, wanted to form a separate black nation led by Malcom X or that other Black guy who led the Nation of Islam. The name was an act of rebellion, a sort of hot cinder in the eye of white America.

First Ali beats Sonny Liston, costing a lot of smart white guys who bet against him a lot of money. That was bad enough. Now he wants to change his name, after we had all taken the trouble to learn Cassius Clay. Celebrities are not allow to re-brand like that.

But Cosell persisted and eventually other white people discovered they could love Muhammad Ali as much as Cassius Clay and Western Civilization did not fall to Islam or the Mongol Hordes, and some of us forgot he was ever named Cassius Clay.

Personally, I sort of liked Cassius because I dimly remembered some line from Julius Caesar to the effect, "Yon Cassius has a lean and hungry look," which was meant to imply, I gathered, the old Caesar was a little worried about the upcoming younger guy who might want to depose the old lion and take over the pride.

But I started calling him Ali because Cosell persuaded me that was the decent thing to do.

Now we have Democrats, who refer to their party as the Democratic Party. And they use the adjective, Democratic.

But the Republicans seem to think it sounds degrading to refer to the "Democrat" party or a "Democrat" bill going through Congress.

It reminds me of how George Wallace, the Governor of Alabama, who Martin Luther King famously described as the governor who had hate dripping from his lips, Governor Wallace used to pronounce the word "Negro," (which was then polite enough useage) as "Nigra," which sounded to most Northerners a lot like "Nigger." It was the Southerner's little frat boy ploy to be able to go on national TV and called African Americans (as we now say) "Niggers," without anybody being about to do anything about it because they would reply, all wide eyed in mock innocence, "You just don't understand my accent. You'all are just intolerant of us Southerners and the way we sound."

So now you've got smirking John Boehner and all the Republicans and certainly all the Rush Limbaugh's saying, "Well, the Democrat party is completely wrong about that," or more commonly, "Well, isn't that just like the Democrat party to want to cut and run."

The Democrats have other fights to fight and say nothing about this. But the Republicans all have this smirky little smile of victory whenever they refer to that dorky Democrat party, getting a little kick every time they taunt with a little political epithet. See we can call you Wop or Mick or Democrat and take you down and you can't do anything about it.

What a bunch of frat boys.

And they have all got together at some frat council and agreed to hew to that line; if you don't know the party of the man being interviewed you know as soon as you hear, "Democrat Party." That's their audible frat pin.

All those smug boys on the porch in their tassled loafers, no socks, drinking beer or bourbon out of plastic cups and shouting about interesting things like how much they planned to drink or what sort of cars they own and feeling very good about themselves because they are in the club.

There you have the perfect image of the Republican Party today.

What are Sue Collins and Olympia Snow doing with that crowd?

Who Knew?

One thing you got to say for Obama, he did not start his Presidency by going right after the toughest, most important issue around--gays in the military.

He had to slap aside his own version of the Cuban missile crisis which was thrown at him by the fates just to test him, and then he went after something which should have been a no brainer, something everyone could gather round the campfire and sing Kumbaya: healthcare.

He could have diddled around with Afghanistan, that graveyard of empires. Aside from the families of those fighting there, and aside from the effects on the economy of spending all those billions a month on those military exercises, most of us here in the Land of the Free, Home of the Brave are not much affected by what goes on over there.

But healthcare, now there's something which effects every last man, woman and child, one way or another, eventually, right here in the homeland.

You got to hand it to him, he chose wisely.

And every one has an opinion about healthcare here.

We all know, for example, that whatever it is we are doing here, it has got to be the best. This is America. We are always the best at everything, except maybe at soccer, but that's a game for guys with no deltoids and no biceps.

And we also know that next to all the Mexicans streaming across our Southern border looking for jobs, the next biggest illegal immigration problem we have is all those Canadians flooding across the Northern border looking for hip replacements, and they are coming here for brain tumor surgeries which they have to get on a ten year waiting list to have in Canada.

Because, outside of the US of A: HEALTHCARE IS RATIONED.

You want it, you cannot get it. At least, you can not get it instantly,which is very unAmerican. It's unAmerican because here in America you always can get whatever you want instantly. Just look at our supermarkets open 24 hours and our refrigerators which are just packed with instant gratification.

Americans have always had health care instantly and supersized. At least that's what we tell ourselves.

And, oh, did I forget to mention how all the best medical research and all the big innovations are done right here in the US of A, because we got competition here, driving innovation and unleashing the powerful horses of mental acuity--except for a few things like CT scans which the English somehow stumbled upon, and adjuvant chemotherapy for breast cancer (Italy) and about two dozen other major advances which we would have come up with sooner if it hadn't been for the FDA and all those government agencies which hold back the flood of energy coming from our medical schools and universities.

See, we are so much better than the rest of the world because the rest of the world all has socialized medicine. The rest of the world is just too dumb to fend for themselves, so they walk like sheep into the maw of these big socialized bureaucracies where they get inefficient care. Except maybe for England, Italy, Germany, Spain, Canada and mabye even Cuba where polls show the local citizens are quite happy with their care.


You know, I can't understand the English. They say they wouldn't have our healthcare system to save their lives--which is exactly what health care systems should be all about. They say we've got the world's best system for 10% of our population and one of the worst for the other 90%.

But, hey, when did we ever worry about losers here in America?

What we got here in America is efficiency and sometimes progress requires some tough choices.

Just consider this: There are roughly 400,000 physicians delivering health care in this country. There are roughly (and this is a hard number to pin down because the insurance industry is a little embarrassed by it) 15 million people working for health insurance companies, efficiently denying insurance to sick people, people with pre existing conditions, old people who just might get sick and reduce profits, people who don't work for big companies, people who have been sick, visited doctors in the past (showing they are inclined to use the system and cost companies money) and people who just don't look healthy.

Now, if you figure the average salary of all these people is $50,000, going from all the clerks who process the forms to the CEO's of the insurance companies and the members of their boards of directors, you get roughly $250,000,000 as the cost of the insurance company employees.

If none of those insurance people showed up for work tomorrow, not a single patient would go without care, nobody would die or get sicker.

But if any of the 400,000 doctors failed to show up for work, bad things would happen.

So have we got efficiency here in the USA or what?

And now Obama wants to wreck all that. He's gonna ruin everything.

Doctors and Do Littles

Of all the fear purveyors, the Death Panel Jerimiads, the Betsy McCoughey types trying to attract a spotlight to themselves, one of the most reliable lines is, "Do you want some government bureaucrat telling your doctor what he can do for you?"

Fact is, doctors have been told what they can and cannot do by insurance companies for decades.

Sometimes the intrusion is easy to see--as when an insurance company clerk, staring at her computer screen in Oklahoma, tells your doctor in Connecticut he cannot order an MRI or a lab test because she cannot find the reason he wants to order it on her screen. That's been going on for years.

More recently, as 88% of all doctors have moved out of solo practice and as they have become employees, they have come under scrutiny of the company. The company has to employee auditors to be sure the doctors keep records in sufficient detail to justify whatever level of visit he charges for.

The explosion of rules governing the doctor's medical record means he must spend more time satisfying the bean counters than he actually spends listening to and responding to the patient.

Usually, the doctor tries to go through the checklist before and after he steps into the room with the patient. The patient then complains, "He only spent 10 minutes with me."

Yes, that's because he spent 20 minutes going through the checklist which would make the airline pilot's pre take off checklist look like a snap. He has to verify he has acquired enough "points" for an old problem which hasn't worsened, an old problem which has worsened, a new problem which needs no work up, an new problem which requires an evaluation, that he has documented he has reviewed records from other doctors, or his own, that he has adjusted or not adjusted medications, that the problem he is addressing is life threatening or not, that there are chronic problems with implications for the patient's longevity and...well, you get the picture.

The very structure of the doctor's notes, which in medical school and in all his training reflected a logical approach to the patient's problems are now designed not by a medical school faculty or even by practicing physicians but by the auditors who review his charts who must be able to quickly assign "points" for his visit with the patient.

The rule is, "If you did'nt write it, you didn't do it."

And Heaven save the poor doctor who has billed for one level of visit without enough points: He has committed "Fraud and Abuse."

The auditor calls him on the phone and says, "Doctor, how do you look in orange?"

Meaning, of course, he is risking jail time for the grievious offense of failure to document enough points.

If the devil ever has been in the details, it is in the details of every doctor's visit.

Surgeons, consultants are less subject to this burden, although they do not escape it. But it is the primary care physicians who bear the heaviest burden. Is it any wonder so few doctors stick with primary care?

What really drives doctors wild is the relentless intrusion of non physicians into areas which the doctors know they know more than the bean counters.

A very punchy line from the 1960's is "The practice of medicine is simply too important to be left in the hands of doctors."

Everyone liked that one a lot.

Now we have reached the point where "The practice of medicine and it's costs are too important to allow the doctor to intrude."

Now, a certain amount of whining from doctors about paperwork and the loss of their perch on top of the pyramid of delivery of medical care has been with us for decades. The difference is, the doctors who complain about being thwarted by non physicians, those complainers are actually correct.

One test of whether or not to believe doctors in this country who complain about watching good medical care thwarted by non physicians is what we see in other countries. T.R. Reid, in his wonderful book comparing American healthcare in the USA with other countries, elucidates how different the practice of medicine is in Germany, France, Spain, England and Canada. And the big news is, despite all we have been told here in the States, other people in other countries are very satisfied with their systems. And the doctors who do much better for their patients in those systems do not feel as if their decisions and their training have been undone by "the system."

So we have arrived at a bad place in American medicine.

President Obama may be wrong about some things. But one thing he is dead on right about is the unsustainability of the current American medical system. You may be one of the 70% of Americans who is satisfied with your insurance plan and with your doctor.

Believe me, you are living in a fool's paradise.

You won't be satisfied for long.

Just remember when those voices in the wilderness were warning about the housing bubble and about unsecured mortgages.

Sometimes you have to know when to listen to the warnings.

Toughness and Gas Taxes

(Louisiana Heron--James Audubon)


Thomas Friedman, in a New York Times article made an interesting connection between the concept of personal toughness and public policy.

In this country there is a lot of talk about toughness. Flaccid, overweight, over compensating commentators rant about the soft headed, weak kneed liberals who are intent of wousifying this country with plans for healthcare, programs for the needy (who needs to pander to those undeserving welfare queens in the land of the free and the home of the brave?) and worst of all, those liberals now want us to cut and run from the fights in Afghanistan and Iraq.

The thunder from the right from the tough brave guys who have never faced a bullet fired in anger (Rush Limbauh, Dick Cheney, you fill in the blanks) is that we are going to get attacked again unless we are tough enough to deny those terrorists their safe havens in Iraq and Afghanistan.

Never mind, as one undaunted professor from Georgetown recently pointed out, the terrorists don't need safe havens in Afghanistan or Iraq as long as there is a Somolia or a Pakistan or an Indonesia, or for that matter a nice apartment in Germany or Queens, New York.


Real American patriots are all about buying those $1 decals at the gas stations which say, "Support Our Troops." But those same patriots get blood in their eyes and drive their Humvees to Washington to protest even the whiff of news we might consider higher taxes on anything, especially taxes on gasoline.

Of course, terrorists have no greater nightmare than an American tax on gas, which would raise the price of gas more or less permanently, decrease dependency on Middle East oil and provide real national security for the US of A.

One thing about those terrorist types--their minds are a little more subtle than Rush Limbaugh's. They think about clever ways to attack a stronger enemy with the greatest effectiveness and economy: So they use our own airplanes to bring down the most visible symbols of American power, real American power, which is to say, economic power. They are vile and they are maddening, but they are not stupid. They are cunning.

None of our responses have been cunning, unless you count electing a guy whose middle name is Hussein to the presidency. That apparently rattled them a little.

They'd be much more rattled if we passed a dollar a gallon gas tax.

That would show some actual resolve on the part of people who have been insulated fromt the fight, who have until now made no sacrifices for their country, who have sung America the Beautiful with tears in their eyes, but not sent their kids off to die, who have pasted the decals on their cars, but still cheat on their taxes, who have shouted out at town hall meetings, but whose idea of a united States of America has nothing to do with unity with other Americans, if those Americans might require some financial help from the government.


Of course, those decal patriots would argue the only people our government helps out financially are the bankers and Wall Street CEO's. Just don't touch my Medicare or Social Security, you big government tax and spend liberal socialists.


But ask those tough guy American patriots to make anything approaching the first step their fathers and grandfathers made during the Big War--when there was gas rationing and sugar rationing and lots of sons and even some daughters actually dying overseas, and our present day patriots pound their corn fed chests and hitch up their blue jeans over their beer fed bellies and bellow, "Government is the problem not the solution."

Thomas Friedman says a gas tax would separate the courageous from the cowards, the committed from the phonies.

As they say on the mean streets of Baltimore, where they know something about toughness, "True that."

Expert witness

A report by David Grann appearing in the September 7 New Yorker about the trial and execution of Todd Willingham reminds us of how thoroughly appalling our judicial system is, especially when faced with testimony about technical/scientific matters, and beyond that, how intransigent judges and all levels of appeal up to governors and the Supreme Court are once a verdict hes been passed.

The unwillingness to rescind the verdict of the hallowed, uncomprehending jury on the grounds "We have faith in the jury system," is utterly baffling and must make anyone wonder why a sane man would trust his fate to a trial in any of these United States, but most especially in Texas, where being accused of a capital offense appears to be the equivalent of conviction; you might as well write your will if you find yourself in jail in Texas.

Briefly, what Mr. Grann meticulously presents is the case of Mr. WIllingham who was convicted of setting fire to his own house, and the fire killed his children. The evaluation of the arson investigators Douglas Fogg and Manuel Vasquez sounded reasonable and well founded and thorough as Grann lays it out at the beginning of the article. I found myself thinking, yes, the accused is guilty.a I know next to nothing about arson or the science of investigation of arson, and given what "facts" I was, the case seemed clear enough.

But then the "facts" got challenged, or rather the science or lack of it underlying
the interpretation of the data emerged, once an arson expert who actually knew what he was doing, who questioned assumptions very clearly annihilated the prosecution's case, and in doing so, proved beyond any reasonable doubt.

Various groups concerned to correct wrongful convictions got involved. Appeals were made to the governor and to the Supreme Court of the United States but all appeals were rejected and the accused was duly executed.

During the course of this fiasco a forensic pathologist who routinely testifies to the guilt and homicidal streak in every defendant, Dr. James Grigson, proclaimed the accused was a homicidal maniac.

What is so astonishing about this case is not so much that junk science convicted an innocent man--any physician who has ever been drawn into that circus called a malpractice trial knows science ends at the courtroom door--but the most amazing thing is the unwillingness of the courts and the executive branch to admit an error.

The really galling aspect of all this is how determined the judges and prosecutors and governors are in their refusal to admit mistakes. The happy exception to all this is the governor of Illinois who put a hold on executions once he had reviewed enough cases where DNA exonerated clearly innocent men accused of rape, men who were on death row. He said what any citizen should have believed: If we make mistakes this often, if we make mistakes even rarely, we should not be burying our mistakes.

The most convincing argument against the death penalty is not that killers do not deserve to die. The most compelling argument is our judicial system is too often wrong about who gets accused and we ought to be humble about our own judgements.

Scientiss, doctors are accustomed to living with doubt. Diagnoses are made, hypotheses are proferred but everyone in the discussion knows the most convincing theory can and often does prove wrong. So the scientist does not tie up his ego too closely to his judgment. He is more concerned with the process--did I think this thing through well enough? He is not mortified when his theory is disproved.

This is not the ethos of the judge.

Antonin Scalia said in an opinion there has not been a "single case--not one--in which it is clear that a person was executed for a crime he did not commit."

How different is Justice Scalia from James Grigson, for whom every one accused in the docket is guilty?





T

Charity Ward

Recently, at a journal club one of the most erudite hematologists I know, a man who can explain the intricacies of DNA repair mechanisms, departed from his usual sphere of molecular biology to comment on a journal article about the suggestion for a "Public Option."

He told a story about his father, a radiologist in Maine, who had opposed the proposed Medicare legislation in 1965. His father had said government cannot do anything right, cannot be trusted. But, his son asked him forty years ago, what then to do about all those elders who were living on pensions and unable to pay for surgery or for hospitalizations?

"We always take care of those folks," his father said. "We write it all off. They come to the hospital, pay what they can, if anything, and if they can't, well we just take care of the patient and don't worry about the money. We won't starve."

That sounds pretty magnanimous, doesn't it?

But when you examine that idea, especially if you use that to guide public policy or consider it an expression of ethical behavior, it becomes very disturbing.

From the point of view of the doctor, it works pretty well. He may not get paid, but this approach leaves him with a good feeling about himself. It reinforces his sense of saintliness, of practicing medicine as it ought to be practiced, as a calling.

But one must ask, beyond the doctors, who will pay the nurses, the ER clerk, the guy who cleans the patient's room, and who will pay for the equipment? The doctor's fee is only the beginning, from the patient's point of view.

From the point of view of the patient, how does he feel? Does he feel grateful for the free care? Or does he feel humiliated?


The impulse toward charity, toward acting in a Christ like way to give to those in need conjures up all sorts of warm and fuzzy feelings, but what does this approach say about America?

When you listen to this doctor, what you are hearing sounds eerily familiar: "We take care of our people." Heard another way, you might hear the master of the plantation: "Our people are like children, and we take care of them." See where I'm going with this? When the master of the plantation gives out benefits to his slaves, he feels good about himself. And the slaves on the plantation are supposed to be grateful for his largesse. But of course, the master is better off under this system because if he doesn't feel like it, he doesn't have to do a thing. Nobody is taxing him, forcing him to pay for someone else's care. His obligation to his slaves is totally discretionary.

But the problem is the slaves should never have been put in the position of needing a hand out to begin with.

The whole structure of a dependent group of people, who depend for their lives on the beneficence of a powerful set of masters is pretty obnoxious.

My high school history teacher, Mrs. Von Doenhoff, used to declaim, in
moments of exasperation when her students had claimed she had violated their rights, "You have only one right on this earth and that's the right to starve and die."

This is as bald a statement of "American values" as you get.

Or at least, this is one strain of American values--the living off the grid set of values.

My home is in the Live Free or Die state. But how many people in this country have actually considered what that might mean? If you live off the grid, you are free. But if your appendix blows up in the middle of the night on your self sufficient off-the-grid farm, with its windmill generating electricity, and its fields of food growing around it, you still need the help of others at that dark hour. Someone has to haul you into a hospital and some surgeon, who has been trained in a medical school and in academic teaching hospitals (all creatures of a large government and large bureaucracies), someone has to help you or you will forfeit your life for the principle that you live off the grid and don't need the rest of the world.

Now, I do not accept uncritically the notion, "Healthcare is a right not a privilege." Do you have the right to make me get out of bed in the middle of the night? Someone has to pay me to do that.

On the other hand, Governor Mario Cumo once used the image of the wagon train going across the Great Plains and when someone fell of the wagon, the others stuck out a hand to pull him back on again. Or you might like the image of a boat, as in we are all in the same boat. You get the idea.

The fact is, that image of all of us sharing a fate, of looking out for your fellow American, that is not something which even half of this country embraces. We do not like each other that much.

So President Obama is correct when he says the reason this debate over health care has gotten so hot is because it emanates from the one of the most basic disagreements we have in this country, which is how much the government ought to be doing and how much ought to be left to the individual.

Democracy ordinarily means compromise. Medicare actually began as a very limited program in which the government paid for only doctor's services in hospital. No lab tests, no out patient care, no X rays. When it was apparent America had not gone communist with socialized medicine after a few years, more things were added. In fact, those doctors who decried it, soon discovered they were making more money than ever because now more of their services were actually paid for. Now you cannot get doctors to think about life without Medicare, which may be one reason 70% of American physicians say they prefer the "Public option."

Oh, South Carolina

Okay, I know it's dicey to try to fit an isolated incident into some preconceived grievance, but really, consider this: some miscreant expostulates during the President's address to a joint session of Congress, and this this miscreant turns out to be from South Carolina: Is anyone surprised?

South Carolina has tradition in this arena. In 1856, a South Carolina Congressman, Preston Brooks, walked into the Senate chamber and expressed his indignation to remarks made by an anti slavery Senator by reigning blows with a wooden cudgel upon the skull of this Senator, the unfortunate Charles Sumner. Sumner's legs became entangled in his Senate desk which was bolted to the floor, and rising to defend himself against the surprise attack, he wrenched the desk free from its moorings while the South Carolina Congressman continued to deliver blows to the skull. The Congressman from South Carolina managed to blind the object of his displeasure, but only in one eye, and it took three years for his victim to recover from the hail of blows.

I suppose one could call this maneuver, the South Carolina blind side.

In South Carolina, such attacks are apparently regarded as a sign of courage and resolve and moral superiority; Brooks received scores of canes from admirers throughout South Carolina, who urged him to use these cudgels on other opponents of slavery. The Congressman became a hero to that locus of paranoia and resentment which had as its umbilicus the Palmetto state.

Was it merely a coincidence the first shots of the Civil War were fired in a South Carolina harbor?

I think not.

Where else would disagreement degenerate so predictably?

The Congressman either suffers from Tourette's syndrome or he is from South Carolina.

Has to be one or the other.

And I realize I am being quite unfair to sufferers of Tourette's.

The Congressman is either an imbecile or he is simply from South Carolina. But then, this may be a distinction without a difference.

Do we know anything about this man? Do we need to know more?

Does he listen faithfully to Rush Limbaugh and Imus? Of course he does. He has not had an original thought his entire life. He simply listens and smiles idiotically when something Rush says appeals to the few functioning neurons he manages to synapse.

Where was his little hand held poster of Obama with the Hitler mustache? Other Republicans throughout the chamber were armed and ready with little placards to wave at the President that night, although none saw fit to interrupt him with a shout out.

Here in New Hampshire, during the run up to the voting last November, a local Democrat was educating me about New Hampshire Republicans. I was new to the state and standing on corner with her and she was holding up an Obama for President poster. She told me, "Well, New Hampshire Republicans are Republicans, but they are not assholes." Coming from this very primlady in her Talbot's jacket and her pressed blue jeans and her L.L. Bean field shoes, I was a little taken aback. Such language from this lady who had Junior League written all over her.

Just then, a car drove by us, and a man leaned out of the window and I could see he was angry because the neck veins under under his tattoo were bulging. He screamed, "Nigger lovers."

I looked to her for an explanation.

"I'm not sure he's a Republican," she said. "I'm not sure he's even from New Hampshire."

Maybe a tourist, from South Carolina.

The mystery is not that people like this exist--we saw them at all the town hall meetings this summer. They crawl out from under their rocks now in then, into the sunlight to spew.

The mystery is why the President clings to the notion you can engage in civil discourse with people...like that. By which I mean, the Republican party.

They waved their little placards at the President during his speech. They are so smug and self satisfied.

They believe in being born on third base and thinking they've worked hard and deserve all the good things and all the advantages they have.

We cannot be rid of the Republicans. We have to tolerate them, even if we ignore them.

But let's just saw off the entire state of South Carolina with its statehouse flying the stars and bars, that symbol of "Southern heritage" and "history," a proud history of defending slavery and then tobacco and whatever other slime ball institution like states rights, segregation, lynching uppity black people--let's just saw off the entire state, which is, thank our lucky stars, on the eastern seaboard, and we can hope it will drift out to sea.

There are several states we would not miss at all. South Carolina has to be a leader of the pack. Mississippi and Alamba are not far beind. But South Carolina has always had a special place in the black little hearts of the really demented.

What would we miss about South Carolina, if it simply got its 150 year old wish to separate from the Union? It has no institutions of higher learning, although it has some football teams attached to things they call colleges. There may be a few golf courses. There is a fort off shore which has historical significance. But can you name anything you'd really miss?

The place is an abscess which ought to be incised and drained and excised if possible. All the hate and poison of the country has flowed right there.

Let's be done with that wretched state. It may pollute the Atlantic, but eventually the ocean will claim it and we'll be a much healthier country.

Questions I'd like to Ask

James Audubon


Here's a few Questions I'd like to have answered by particular people

AFGHANISTAN/HEARTS AND MINDS/ THE MISSION/ 911/ SLEEPING SOUNDLY

For President Obama or possibly Linda Winslow, (executive producer or The News Hour): Why do you believe in rabbis to answer questions where "expert" opinion is clearly not expert?

Picture this panel of experts, which, I've read has actually been assembled.

A dinner is thrown at the White House for the President and historians sit around the table as the wise men, the rabbis, and they are asked to expound on the differences between Vietnam and Afghanistan: It snows more in Afghanistan. Afghanies do not speak Vietnamese.

Now I never got a chance to take a single history course in college, but I have listened to the Lyndon Johnson tapes, and I heard LBJ sound very insightful when he was discussing a farm bill, and he sounded pretty resolute about the Civil Rights bill.

And contrary to public perception, he wasn't crassly strong arming the Congressmen and Senators he wanted to vote for his bills; he was any but strong armed.
But when he talked about Vietnam, he was clueless. He would fall back into the posture of, "I'm just a good o' boy. Can't understand the whole thing, but I rely on the bright boys who went to all those big named schools to tell me what to do and they say we got to draw the line in the sand right there in Vietnam--or the whole world will fall to this nefarious, plotting, conniving, mysterious threat to Western civilization thing called communism."

Now President Obama is saying we've got to fight in Afghanistan because those nefarious, plotting, conniving terrorists are all going to gather there and plot and train and connive if we don't find them there and kill them.

So here's the question I never hear the President answer: If we do succeed in driving the terrorists out of Afghanistan, what makes you think they will just give up and stop conniving? Why would they not simply move to Somolia or some other place where there is little or no government?

What is with this concept of a training ground for terrorists?

Oh, we got to clean up those training camps and wipe out all those terrorists. As if you can pull up crabgrass around the tree and flower beds in the front yard and never have to worry about the flower beds in the backyard?

Another way of putting it: What exactly is the mission? How do you know when you've won and can bring home the boys and girls back home?

Richard Holbrooke, seasoned diplomat that he is, had a ready answer for the question of how we define victory in Afghanistan: "We'll know it when we see it."

Oh, that's cute. That means he's clueless, too. Another rabbi without answers.
As I said, I'm no historian, but I had reached the age of reason by the time of the Cuban missile crisis, or at least I'd reached an age at which I could form my own unfounded conclusions and I remember thinking Kennedy's big problem was he was always trying to show he was tougher on Communism than Richard Nixon.

And it was difficult to out tough Nixon when Nixon was accusing people of being pink right down to their underpants.

I really like President Obama. But is he going to try to out tough the Darth Vader of the Bush administration about terrorism?

At least he's abandoned this "War" talk. As if we have a war here. Wars have beginnings and endings. They occur between identifiable enemies, who usually have an identifiable home base. Or, like Ghengis Khan and the Mongol hordes, at least there's an army to defeat. But the wars on crime, cancer, drugs, pornography and terrorism, who's going to come to Appomatox and offer to hand over his sword?

I am unschooled, I admit, when it comes to history, but I did have the good fortune to get in some courses in Anthropology in college and I know from that you are not going to win the hearts and minds of Afghanies with American soldiers who speak no Afgh anie, who look like space invaders and who are, when you come right down to it, infidels.

You might win some hearts and minds with Michael Jackson, Madonna, the Neville Brothers, but not with soldiers.

I'm no history professor, but I was in college during Vietnam and I remember that stuff. It's not history to me. I remember what I saw. And I know what my brother told me when he got back about winning hearts and minds--that sort of thing is just not going to happen.

You cannot win hearts and minds with an army of anthropologists, although you might learn a lot more than you will with the current army.

Anthropologists are, if they are very good, and if they are lucky, and most of all, if they are given enough time, capable of telling you what the Afghanies are thinking, what their values are, how they are willing to live inside and outside those values, but anthropologists do not change a people's mind.

So where was I? Oh, yes, Afghanistan. Here's the question: What is the best outcome you can wish for with those 70,000 American troops?

That's a question for the President. It's a friendly question, really. I'm open minded. Maybe I just don't have enough information. All I know so far is what I read in The New Yorker and what I've heard from a few friends who have recently returned from Afaghanistan.

The Taliban is composed of people we Americans find easy to hate. The Taliban does not place a high value on tolerance. They tend to demonstrate their displeasure by chopping off heads, often in front of helpless children. They are a hard bunch to develop much sympathy for.

Then the follow up question is: Okay, we've captured Osama Bin Laden. We've routed the Taliban, we've got all those farmers in every valley and every mountainside growing wheat and soy and corn and pansies instead of poppy. And we clear out.

Do we think we have prevented the next 911 attack?
Is that the goal?

Do we really believe there are no sleeper crazies in the USA, in Brazil, Argentinia, Bolivia, Somolia, Indonesia, Mali, Palestine, Lebanon, Syria, Iran, North Korea?

So now we are safe again and we can keep our shoes on at the airports?

HEALTHCARE:

President Obama has the right instincts here.
His first instinct was, okay we'll do what the Brits did forty years ago: We'll set up a public system which will cover anyone and we'll allow a private system to run alongside it, where you can get your high priced doctors, your high tread count sheets on the bed in the hospital, but at least everyone will be covered, and we'll get the burden of health insurance off the backs of American industry and we'll likely save money for the US economy in the long run because now all those uninsured are not burdening hospitals and emergency rooms.

But why--here's the question--why do you then back off at the first sign of resistance?

Did you not expect the Republicans to fire a shot? Why do you charge in on the stallion but then retreat when the first shot is fired?

Did you not expect to see Betsy McCoughey with her notebooks with the thousand pages of the bill all highlighted, making some really outlandish, inane and scary pronouncements about how this means pulling the plug on grandma?
(That's what Betsy did with Clinton's healthcare and it make her famous, got her on TV and got her appointed Lt Governor of New York. She claimed to be the only person in America who had actually read the entire Clinton health care proposal, so we was virtually the only authority around.)
And now she sees her big chance for a second act.

Did you have no plan for people like her?

One thing her performance on Jon Stewart did elucidate: The bill she was reading from was horrifyingly detailed. It mandated (on page 432, no less) what the doctor has to discuss with the patient and the family about end of life planning, how it has to be documented. So now the end of life industry has a page in the bill. As far as I know, none of the other industrialized nations with health care systems get into micromanagment to this extreme. Only in America.
Now, suppose every group who has employees making a salary to advocate for vaccinations (a different group for or against each vaccine: Mump) gets a paragraph inserted into the primary care doctor's boilerplate note, where does that leave the doctor? He's got to hire a nurse or a front office person to be sure all thoses paragraphs are signed, dated and so forth and you then have the meet with the auditors who will base your compensation on how pretty your records look.
Do we have better medical care now?

Here's another question for the President: How are we going to pay for the 50 million who are uninsured and the 100 million who are underinsured?

The administration got the CEO of the Cleveland Clinic to appear on the News Hour and give the answer to that one: Well, see, what we are going to do is to get doctors to work with their patients to lose weight and to stop smoking and then everyone will be healthy and we'll not have to pay for their healthcare.

Question for the Cleveland Clinic CEO: Are you serious? Better question: Who put you up to this?


The other answer has come from Atul Gwandi and Peter Orszag, and that is there is lots of waste and overcharging in the system. We'll cut out that fat. They looked at an outlier group of doctors in some town in Texas where the doctors looked at patients as "profit centers" instead of looking at them as patients and they decided this is what all the doctors all over the country are doing--except some at the Mayo and Cleveland clinics.


Here's another problem.
Doctors, in some ways are like auto mechanics. Customer arrives, says there's a squeaking screech every time she hits the brakes. Customer doesn't know what the mechanic knows. He can take some time to figure out the problem. If it's just brake pads, he's got an hour's work, and not much of a charge. Or, he can find it's not just the brake pads she needs but axles,wheel bearings. Now we're talking boat payments for the mechanic.
The incentives are not hard to see. Some mechanics, maybe most, resist the incentives and simply fix the brake pads when that's all that's needed.

We can devise a system, and in fact Medicare has moved in the direction of devising a systems where the doctor is in the same position as the mechanic: He only gets paid a lot if he finds something serious. Before Medicare changed its rules, doctors got paid by the time they spent. They got paid the same, in the end, if the patient turned out to have something simple and non life threatening. But recent rules virtually eliminate the hourly salary effect and install rules which pay hansomely only for the bad stuff. Micromanagment run amuck.
It doesn't have to be this way. Government can do things right, but someone has to be watching.

What is the solution?

Personally, I'd be happy to see doctors on salaries. Then they really do what's in the interest of the patient. They are then "Disinterested" in the sense they've got no stake in a life threatening diagnosis, in doing invasive expensive tests.

But then you've got the arguments about whether you pay the heart surgeon more than the family practitioner.

And here's the question for President Obama: Who are you looking to for the answers?
Are you looking only in the easy places? Someone writes an article for the New Yorker so you listen to him. Someone is the CEO of the Cleveland Clinic, so you visit him? Or are you listening to the answers these visible people propose and asking yourself: Does this really make sense?

President Obama is a smart man. I hope he'll wind up listening to his own inner voice. Amid all those voices clamoring for his attention, hopefully, he'll finally find his own voice.

American Tough Guys

>"He had a lot of frustration with what an insurgency is--that we are fighting a bunch of cowards who won't fight us man to man, who hide amongst women and children, who don't wear uniforms."
American soldier describing his sergeant in the 101st Airborne in Afghanistan, from Raffi Khatchadourian, the New Yorker July 6&13, 2009.

>"They wouldn't fight us like men. They wouldn't wear uniforms. They'd shoot at us from the fields and run away.They should have stood and fought, like men."
Former German soldier explaining why it was necessary to shoot villagers who lived near the scene of an attack against German troops, The Sorrow and The Pity.

>"In 2005, he forced nearly seven hundred prisoners, wearing nothing but pink underwear and flip flips, to shuffle four blocks through the Arizona heat, pink handcuffed together, to a new jail...The men were strip-searched both before and after the march...Arpaio also told reporters, 'I put them on the street so everybody could see them.' He marched another nine hundred this April."
William Finnegan, The New Yorker July 20, 2009.

>"This is not us. This is not America," President George W. Bush, in a televised speech about Abu Garib prison photographs showing naked, blindfolded prisoners forced to form human pyramids.



So what is a tough guy? Who is Us? Are these guys, Sheriff Arpaio in Arizona, the officers of the 101st Airborne, the jailers at Abu Garib not Americans?

I think they are very American. They are American Tough Guys. Our home grown phony Tough Guys.

To my mind, a real tough guy is the little kid who faces an apparently physically superior opponent and goes right at him, as if being smaller, weaker in body meant nothing. It's the old, "It's not the size of the dog in the fight; it's the size of the fight in the dog," thing.

David might have been considered a tough guy, conquering his fear of the giant. From the giant's perspective, however, David should have been forced to fight with a sword and from Goliath's point of view, David's use of technology which allowed him to strike from a distance and to run if he missed, might make David a coward who should have stood and fought like a man.

One question: Is it possible to be "brave" in the asymmetric warfare of the American army vs the Afghani insurgents? Is the sheriff of Maricopa County, Arizona a tough guy only as long as he is surrounded by armed deputies?

From where do American males get their notions of bravery and toughness?

There's a great Second City line, "You ain't gonna become a great basketball player working moves against your father in the driveway. You got to play inner city on the playgrounds with no referees."

At some level, white American males like Sheriff Joe Arpaio, and like Colonel Michael Dane Steele and his murderous sergeant Eric Geressy,of the 101st Airborne in Afghanistan, all know they have been playing in the driveway their whole lives, protected and supported by the Man. And they know, deep down, they are wusses.

Overcompensating wusses.

In my white suburban high school, members of the wrestling team could look across from their locker room into the locker room of the basketball team. After practice, the wrestlers were always pretty beat up, dehydrated, mauled really; it was all they could do to pull on their clothes over the battered shoulders and necks and hips. They look across the hall to the basketball players in their dressing room, trying to get all inner city in-your-face with each other, doing the male displays of pseudo ferocity.

And the wrestlers would shake their heads and look at each other from under their brows and smile. "Tough guys," someone would say, and everyone would laugh. The wrestlers knew what tough meant.

Tough meant stepping out on the mat with nobody but yourself on your team. Tough meant when the whistle blew you had to step toward your opponent, never take a step back, and there was nobody to pass the ball to, no heavy artillery or helicopters to call in to help.

Anyone who has watched The Wire from start to finish knows what tough is. Those inner city Baltimore kids on The Wire are tough guys, heaven help them, and not because they really want to be. They have to be. They are as tough as any one in Mogadishu. And they are not imagined characters, they are not fiction. Nobody could make those kids up. Those are kids who David Simon and Ed Burns know. They have no parents, no homes beyond what they can scrounge in a vacant building, no support beyond the drug organizations for which they work as hoppers on the corners, which treat them as dispensable pawns. Those kids exist on the corners of every American inner city. They are tougher than Col. Steele and certainly they are tougher than Sheriff Joe Arpaio.

So who is tough?

Let's examine the American tough guy, Colonel Steele. (Great name for a tough guy.)

"We give the enemy the maximum opportunity to give his life for his country."

Cute, huh?

How about, "The guy that is going to win on the far end is the one who gets violent the fastest." Steele exhorts his guys to "whip somebody's ass." His soldiers are going to go after the enemy and, "Kick their feet out from under them...bring them back and put them in a room...give them an open-mouth kiss and tell '''em we love 'em...If you mess with me, I will eat you. You're the hunter. You're the predator. You're looking for prey."
(Khatchadourian, New Yorker)

Steele walked on to the University of Georgia and made the team as an unrecruited offensive lineman. That's how tough he was. Of course, that is only one step away from playing in the driveway with your father.

It's not exactly surviving on the corner in Baltimore.

So he gets to Mogadishu and he tries to be all tough with a helicopter and all the firepower of the United States Army and he gets his ass handed to him and loses eighteen soldiers. Those corner boys in Mogadishu didn't have to make tough talk and hang a sign above their office door, "Carnivore." They were looking across into Steele's locker room and laughing at him.

Of course it's frustrating when the other guys don't get dressed up for game day in their uniforms and they see your guns and your airships and they decide they can hurt you by being smarter than you.

It's no surprise there are people like Sheriff Joe in Maricopa, Arizona. He's real tough, as long as he's got the attack dogs on his side.

When he builds his tent prison he says, "I put them next to the dump, the dog pound, the waste disposal plant." He creates chain gangs. He gets himself a tank, paints the howitzer muzzle with flames and paints "Sheriff Arpaio's War on Drugs," on the sides. He has his jailers overpower prisoners, fourteen to one (real brave guys these jailers) has them strap the prisoner in a restraint chair and Taser them with stun guns. Got to be tough to do that.

That men like Sheriff Joe exist, is no surprise. He runs his own little Abu Garib right out in the Arizona desert.

But what is really interesting is President Bush's remark that this sort of sadism is not what America is like, at its core. Americans are not like this. This is not us.

Or is it? Sheriff Joe has been elected to five four year terms in Maricopa County.

For twenty years he's been parading prisoners and everyone in Maricopa County knows what he is doing. The good people of Maricopa County cannot even claim, as the Germans claimed when the concentration camps were opened, "We were unaware of this evil."

There's a great scene in Band of Brothers (the HBO adaptation of the true story of Easy Company) where the 101st Airborne liberates a concentration camp just outside a picturesque German village and the soldiers of the 101st airborne in 1945 are sputtering with rage and they storm into the village and confront the villagers who claim they had no idea.

"No idea? That camp is less than half a mile from here: On a hot day, when the wind shifts, you had to smell it from here."

I'm not sure any of the soldiers from the 101st Airborne which liberated those camps would recognize much more than the screaming eagle patch about the current 101st Airborne.

On the other hand, there were soldiers of the 101st who refused to shoot Afghani men who were simply digging in fields, farming, when the soldiers arrived.

Ordered to shoot, the soldiers refused.

Now that was tough.