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.