Why I Love New England

Saw an eighty-three year old woman in my office today who came in for her hypothyroidism.

She's feeling fine, goes ballroom dancing three nights a week and bowls two nights a week, and the other two nights are "date nights."
She lives off in the New Hampshire woods at the end of a long driveway which she snow blows with a blower which is not self propelled, so it's something of a work out for her.
She met a man in Florida a year or two ago ,but when he came up to shack up with her in New Hampshire he told her he could not take another New Hampshire winter.
She told him she liked snow and maybe she'd call him when she popped down to Florida in the future. She took out her snow blower, cleared her driveway and called him a taxi.
"The truth is," she told me. "I've had better. Of course, at my age, I can't remember them all, but I know I have."
Our front office lady, Cathy, who checks her out never gets her signed out in under half an hour, because she asks this lady about her latest adventure and there is always an adventure.
"I wish I had her life," Cathy says. "If my husband ever leaves me, I'm going to go live with her."

This morning, a patient cancelled, leaving us with a half hour more or less free, which everyone in the office uses to catch up on paper work (really, now, computer work) and we dispatched Cathy across the street to the Dunkin Donuts in the hospital lobby.
Every place in New England has a Dunkin Donuts. They are in hospital lobbies, office buildings, every town square, along the roads, at the docks. If Dunkin Donuts were discovered to have lead in their water New England would have a nervous breakdown. It's part of the fabric of life.


Of course, even a town the size of Salem, New Hampshire has two specialty coffee shops with exotic blends.

Last night, I got down to the local hardware store after closing hour. It opens at 7:30 AM and closes at 6 PM, and I'm off to work before that and home after. But the light was still on so I tried the door which was still open, and poked my head in. The guy who works there was still there.
"Oh," I said. "I know you're closed, but the door was open."
"I'm here, so I guess we're open. What can I do for you."
I had bought a clock there a week earlier and it stopped working and the battery is new.
"I'm sorry, I lost the receipt."
"I know this clock. We sell it. We back it."
He fiddled with the battery, convinced himself the clock was a dud and went in back and got me a new one.
"Bring it back if it stops," he said.
People here enjoy acts of daily living. They talk politics all day long, but they have lives.  And they don't think of politicians as any different, any smarter, any more or less ethical than the guy who sells used cars.


Every town has some version of a breakfast diner.


Real people live here. 

Murder by Any Other Name

Talk about political correctness.
An American border guard  shoots dead an unarmed 13 year old boy who was taunting him, standing on the Mexican side of the border, and Republicans rush to defend the guard who they insist should be immune from prosecution. They take that stand because they want to be seen as defending our borders; they are for always standing with police and the forces of authority, even when the policeman is a cold blooded murderer, captured on video.


Given that political belief, that authority is always to be endorsed, Justices Thomas, Roberts, Alito will likely side with the Right, and they will vote to hold innocent the murderer who happened to wear the badge of United States border control. Because the murderer is on our team, on the American side of the political border.


Kennedy, as always, is a wild card, but will likely side with the conservatives and Ginsberg, Breyer, Sotomayor and Kagan will vote for the dead kid, and  his parents.

The facts of a case are, of course, where you begin in trying to make a decision.
In this case the reality appears to be the 13 year old was playing touch-the-fence with his friends, running up and touching the wall or fence and then running back to the Mexican side and laughing. The Border patrolman, Officer Mesa, shouted to stop that but the boys continued to taunt him. So the policeman shot the boy in the head and then claimed he fired because he felt his life was in danger.


Of course, that's what police always say when they fire their guns, even if the guy they shot is running away as fast as he could.


In this case, there was a video.


The Obama administration refused to extradite the homicidal cop to Mexico, which surprises me.


The Trump administration is saying the murderous cop is a hero in the war on Mexican rapists.


Someone has argued before the Supreme Court the protection for the child ended at the border because the Constitution doesn't apply in Mexico. 

If the German concentration camp guard, who was not violating the German constitution, or any German law, by murdering children at Auschwitz can be tried for crimes against humanity, i.e. for doing something which you do not need to be a lawyer to know is wrong, namely shooting a child in the head, do we really need arguments about where we draw lines in applying the U.S. Constitution?

The Daily Donald

Here it is, hot off the presses, so to speak. President Donald speaks:

1.  "You want good high paying jobs for yourselves and for your loved ones and for the future of your families."

Now, how did he know that? And why hasn't any other President tried to do that?




2.   "You want a health care system and by the way, we are going to be submitting in a copule of weeks a great healthcare plan that's going to take the place of the disaster known as Obamacare. It will be repealed and replaced. For those people, the people put into rooms where Republicans are talking about the plan, and it wouldn't matter what they say, for those people just so you understand, our plan will be much better helath care at a much lower cost. Okay? Nothing to complain about. Obamacare remember, it is a disaster."


I'll remember that:  Obamacare is Disastercare,: Got it--although, you know, before I couldn't find any insurance and then with Obamacare I had 15 choices and my policy cost half of my previous policy and it covered three times as much. Best health insurance I ever had, but that's just me, personally. I must have been the exception. But this new Trump Care is going to leave me with nothing to complain about. I am really looking forward to that. And it's all coming in a couple of weeks.


I just hope this new healthcare is going to make me twenty years younger and twenty pounds lighter; then I really will have nothing to complain about.


3. "You want low cost American energy also, which means lifting the restrictions on oil, on shell, on natural gas."


Wait, you mean there are restrictions on oil and natural gas now? Restrictions! That can't be good. Nobody likes restrictions!


4. "And clean, very clean coal.  We're going to put the miners back to work. The miners go back to work. "

Lucky guy. He's getting his job back!

CLEAN COAL!
VERY clean coal! What a great idea!  And all this time I thought there was no such thing as clean coal. I'm so glad those coal miners can go back down into the mines again. Are they the same guys would cut the tops of mountains in West Virginia?  They really do need a break.  If Hillary had won, she'd have retrained them all to make windmills and solar panels. What a jerk.




5. "You want us to enforce immigration laws and defend our borders."

Muslims in that horse, as Sweden has discovered!

Absolutely! We all need borders.  Who can disagree with that?


6. "You want lower taxes. Less regulation."


Now you're talking. The President was too smart to pay income tax the last 20 years. He said the government would have just squandered the money. Paying taxes is for little people. I don't like taxes.
Also regulations. Don't like regulations either, like speed limits on roads and limits on how much I can drink before getting behind the wheel and regulations on how much interest the same day loan guys can charge me for my loan, or how big a bank can get before it's too big to fail, and all like that.

I'm so glad we finally got a guy in the White House who listens to me.

Donald Trump: Channels Archie Bunker

Listening to Donald Trump and, most importantly, watching his fans standing behind him, I've drifted away from the odious image I have heard from my friends toward a more benign view of the man. He doesn't strike me as really hideous so much as very simple, and his fans are, well, just really knuckleheads.

When you think of the really nasty, pathologic leaders visited upon the face of the earth, you think of Hitler, whose pathology was so manifest, the shrieking hate spraying out from his lips. That guy, like his admirers, Henry Ford and Charles Lindbergh, among others, were real haters.  They put their hate down in writing and broadcast it unequivocally. 

Trump is not like them.

In fact, I was impressed by his handling of the professional Jew who attempted to ask him a question during his press conference. Trump did not indulge him; he treated him as he would any other reporter who offended him. The man promised a simple, friendly question and instead launched into a prolonged statement about a rise in anti-Semitism which Trump took as an attack on himself because so many have said Trump's intolerance of one religious group, the Muslims, unleashes intolerance against all minority religious groups.

Trump could have used the fact his own daughter converted to Judiasm to marry a Jew as an argument about his own tolerance, but he did not. He instead insisted he is the least anti Semitic person on earth and you have to take him at his word there.


Even his anti Muslim rhetoric lacks the sort of animus we would expect in a real hater. He does not say Muslims are evil or conniving or that they should be expunged from our society.


The trouble is, his is incapable of drawing well crafted distinctions. He says there are bad people out there and some of these are Muslims and some of these Muslims are motivated by what they think is their Muslim faith to want to do us harm.
If you pinned him down, and I haven't seen anyone do this, I suspect he would say the problem is not Islam, nor even the majority of the billions of Muslims on earth but a small radical fringe--those who follow what he calls "radical Islamic extremists" and we ought to be focusing on these.


Those two bozos standing behind Trump's left shoulder at Melbourne do not understand fine distinctions. They just want something to cheer about. They lost interest in what he was saying by minute 50 and one realized he was on national TV and started calling his friends on his cell phone and waving at the camera, behind Trump, making hand signs with his fingers. He did everything but hold up rabbit ears behind Trump's head. He was 20 something, with the mental age of a 10 year old, to look at him.  That's where so many of Trump's fans seem to be.


Trump's problem is, he hasn't the foggiest idea of how to do what he wants to do. He wants to stop attacks by radical Islamists on America.  His first attempt, to simply exclude Muslims from entering the United States, is an approach which got the brain dead throngs cheering. But, of course, this simple minded solution won't work any better than declaring the United States a bomb free zone, putting up signs outside every elementary school and airport. No bombs allowed.


What he has said is it is possible to be too magnanimous and to allow "the wrong people" or "bad people" across our borders as we attempt to help the huddled masses. He is correct that the flood of Middle Eastern men into Germany was followed by Middle Eastern Men groping women in German cities, and this was not a random sort of malfeasance, but was born of a culture in which women unaccompanied by protecting male relatives are considered whores and fair game.

Trump points to the one Mexican who rapes an American woman and says this one event justifies excluding all Mexicans from American soil. He did not say this man was also a Catholic. So are we excluding all Catholic Mexicans?  Because,  you know how they are.  And, of course, that sort of thinking is what devolves into bigotry. One guilty person is identified as a member of a feared group and thus all members of the group are tarred with the same brush.
Trump is not a Hitler spewing hate; he's more like the frightened grandmother, who fears people not from her own group. She is not so much a hater, as an individual possessed by fear.


Wouldn't we all love to have a machine which could identify radical Islamists intent on blowing up Americans? We could have everyone coming in from an international flight step through the machine, as we do for the scanners now, and when the terrorist steps in, the machine would detect the malevolent thoughts emanating from his brain and the doors would snap shut and we would extract him in a can and send him off to some place, not in the United States, hopefully not Gitmo. Somewhere safely away from us. Maybe Somalia.


Would we not like a similar machine for the Mexican border, which would detect rapists and people intent on overstaying their visas?


The problem with human beings is they are deceptive. Say what you will about those 19 terrorists on 9/11--they were cunning.   And effective.


But the problem is our Presidents tend to be not cunning. And they are not effective. 


 George W was simply not very bright. His response to 9/11 was to send in the troops, and it didn't much matter to him if they did any good.   He simply wanted a good show for the folks back home. And he provided part of the theatrics by flying his own plane onto the aircraft carrier where they hung up that "Mission Accomplished" banner.


Trump will eventually face the same problem: Either he'll replace Obamacare with something better or he will not. Either he'll bring back coal mining jobs and factory jobs or he will not. Either he'll prevent the next terrorist attack or not. Either he'll stop the flow of illegal immigrants across our southern border or he will not.


Right now, it's all wishful thinking. Those miners are going to mine CLEAN COAL. Oh, now why didn't we think of that before? All that dirty coal polluting our skies and air. Why didn't we just go for the clean stuff?


Right now, it doesn't look as if Trump actually has engineered solutions to any of these problems. He's got his staff writing memos about rounding up immigrants.  Meanwhile, cities are declaring themselves sanctuary cities. Sounds like a plan.

Ronald Reagan managed to fool most of the people all the time--and they named an airport after him and still revere him today, even though he was a dismal failure as a President, tripling the national debt by cutting taxes and increasing spending, putting 280 marines in  a building in Lebanon and they were blown to smithereens by a truck bomber, over seeing the Challenger explosion.  He couldn't get the government to do much of anything right, but he could sure play the part of the guy who would drain the Washington swamp.

Trump does not have script writers Reagan had. But he does not burn with the black venom of a Hitler. He is the worried, panicky old woman from Queens, who sees the world as a threatening and dangerous place and who sees no point in drawing distinctions between those who mean us harm and those who are simply different.

Trump and Staying Relevant

In one way, it is easy to understand Donald Trump. 
For all his money and private airplanes, he is 70 years old and at that point in life many men, and women, begin to feel irrelevant, unimportant, cast aside.

People are listening now 

Bill Clinton once remarked that one of the best things about leaving the Presidency, was that he could say whatever he really thought. As long as he was in the White House, people hung on his every word, even trivial off handed remarks and they made much more out of what he said than he ever meant. He had to think about each word for who it might offend. 

Trouble was, once he was free, out of the spotlight, nobody cared what he said any more. 

Most of the males in the House and the Senate, love to be the center of attention, love to hear themselves talk.  These are men who are not musicians or stand up comics; they are simply ordinary, often very average men, too often not even average, too often really stupid men, (e.g. Louie Gohmert, Jim Jordan)  who simply want to be important, but have not very compelling reason to be viewed as important, apart from their elected office.

Musicians can walk onto a stage after 50 years, in their 70's and still hold a crowd enraptured. But these men can still bring it. They have skills and talent, and can keep a beat and tickle those keys and strings, and, in fact, they may be even better at 70 in some ways than they were at 20.

George Carlin, until he died, could still thrill an audience, simply by talking. But he had substantial gifts.  

The Mitch McConnells, Orin Hatch's, you name one, are really no talent guys who gather a crowd of reporters eagerly thrusting microphones into their faces, are followed down hallways and down escalators by young women with recording devices, because they can still do one thing--make news.

When I was in my 20's, I looked at the 50 or 60 something men who were in charge of the hospital where I was a grunt in the trenches, and I could see they were, as often as not, empty suits.  There were simple decisions they could make which would have improved the efficiency and safety of the way care was delivered in the hospital  but they came forth with worn out drivel and they felt smart saying it.

Any intern could see that putting a 26 year old kid a day after his graduation from medical school on a ward with 40 sick as stink patients getting septic  with acute leukemia or drowning in their own secretions from metastatic ovarian carcinoma was not good planning. Then take that kid and keep him in the hospital from 7  AM Friday morning until Monday at  7PM, on call, responsible for all those lives, and you have done something close to criminal. 

February, New Hampshire 

What the Chief of Medicine, Dean of the Medical School, CEO of the hospital would say about this were two things they called justifications, which we all knew were simply lame excuses:
1. The best way for the new intern to be transformed from a student with a MD into a real doctor is to put him out there to make decisions and to see the effects of those decisions and to follow a patient through his crisis until resolution.
2. The intern always had back up. 


 Of course, that back up was a resident with a year's experience and he could help, but he was often covering other interns as well, so it often took too long for help to arrive, and not all residents were inclined to get out of bed. And not every intern could always recognize when a patient was getting into trouble before it was too late.

Eventually, these  justifications got blown out of the water, when a twenty year old girl died at the New York Hospital only hours after her admission and she happened to be the daughter of an writer for the New York Times and he was inclined to sue and sue and sue. Her case, became a cause celebre. It was not clear, actually, in her case, the intern had actually made any mistakes, but once the light got shown on how the hospital worked, on which doctors actually were physically present, the gig was up.

When the system got exposed in court, and in the newspapers, uncomfortable questions got asked and the jury of ordinary citizens were not persuaded that leaving a new graduate all alone at night with a telephone was not a great idea or was justified by the intern's need to learn medicine on that particular crucible. 

Lo and behold a new system  was put into place with changing shifts with fresh troops coming on at night,  and not just interns but experienced doctors, called "hospitalists" who feel comfortable taking care of dangerously sick patients.  This is the system interns in the bad old days had asked for, only to be rebuffed by the old guys who were in charge. The old guys were the only relevant guys. 

The interns back then knew the real reason coverage at teaching hospitals was designed the way it was: interns were cheap compared to fully trained experienced hospital doctors, and night shift teams meant hiring more interns to cover those shifts.  The real reason for the bad old system was money. We all knew it. The old relevant guys knew it and they probably knew the interns knew it, but the relevant old guys had the only opinion that counted.

New Hampshire 

In the case of hospitals, it took the courts shining light on a festering wound--sunlight was the best disinfectant. But it took years before a big enough case shook things up, reached into the bureaucracy and shook people up enough to foster change. 

Is he still relevant? 

With our current gang in Washington, the sunlight may not shine quickly enough for the people who get deported, or for the people who lose their health insurance, or the older citizens who find their Social Security checks are now tied to the stock market and, oh, guess what, that bubble just burst, as stock prices are wont to do. 

We shall see, but for now. All we can do is watch and wait and see how long it takes to expose the relevant old men for the self interested  fools they really are.

Could be Worse: Trump Tristesse--Get a Life

People, get a grip.

We do not have a war halfway across the world with 50,000 American kids slogging through jungles or deserts for no apparent reason, other than to get shot.

Our wars are now fought by people who weighed their choices and thought the pay was good enough to sign up.

We do not have a king with porphyria who is mad as a hatter and talking to toads. We have a bloviator who is mildly demented, but we've had at least one demented President in living memory and he now has an airport named after him.

We have not put American citizens into "detention camps" because they are Japanese or Muslims (yet.) We do have ICE agents storm trooper-ing into homes in search of illegal immigrants, which is bad enough, but not quite wholesale racism in action.

There is little any of us can do, individually. So, I recommend a descent into bleakness.  Watch really depressing Ingmar Bergmann movies, watch apocalyptic movies, The Seventh Seal, Apocalypse Now, Full Metal Jacket. Read Howard Zinn, A People's History of America. You want despair; it's all there.

Look at Terry Rodgers paintings on line. Here's one good example.

Having Fun Yet?

Look at these strung out people, and in comparison, you'll feel cheerful and fulfilled. 

We have to know what bottom is and we haven't hit that yet. 

Treason Lite: Scoundrel Time Comes of Age in Congress

When Mitch McConnell said his only job once President Obama was elected was to insure the President failed, he was saying he did not believe in the concept of the loyal opposition. This idea underlies every democracy. Your first duty is not to your party, but to your country. Without that, you cannot have government or union. You have only tacit secession.

His words washed over the airwaves and the nation and somehow never seemed to matter much. People shrugged. Well, not all people, but enough.


Now we have the same McConnell attempting to silence Elizabeth Warren for violating Senate decorum for reading a letter from the widow of Martin Luther King which impugns Senator Jeff Sessions as a man who thwarts racial progress. This is the plantation owner acting to silence the slave who attempts to object to his own bondage--the slave has lacked civility and decorum.


Republican Senators have been saying such stuff lately.  Senator Cruz claims the American health care system is the best in the world and he does a very un Republican thing by actually attempting to cite evidence: The United States healthcare system does more Cesaeran sections than any of the government run systems in Europe.  This, of course, is like claiming the American Army is superior and won a battle because it had more casualties than its enemy. Oh, we must be better soldiers, look how many more of us died on the battlefield!  C-sections, of course, should benefit the patients, the mothers and babies born, but all too often, they benefit the obstetrician who wants to get home for dinner or it benefits the hospital which makes more money on C-sections than on vaginal births. In the medical world, among the cognoscenti, high C-section rates are indicators of poor medical care, not good medical care, it's a high casualty rate, not a sign of victory.

The other evidence cited by Senator Cruz about American medical superiority is we order more MRI's per capita than the Europeans, which is like saying we have better food than the Europeans if we are willing to pay $100 at  MacDonald's for big  Big Macs and we consume more Big Macs than anyone else in the world. The fact we over pay for MRI's does not make our system better. The fact we over pay for MRI's ($4,000 in the US vs $75 in Belgium) does mean we have given doctors and hospitals and radiologists huge incentives to order these tests.  MRI's are a case study in how the profit motive drives decisions in American medicine. You remember the Republican argument for the importance of the profit motive in medicine, for keeping government out of medicine and making doctors behave more like waiters, eager to please, eager to provide fast, polite service--they will try harder to please when they own the practice.  Pretty thought, perhaps, but dead wrong.

If you look at Mr. McConnell's state you see huge, pervasive enthusiasm for Ky-nect, the Kentucky Obamacare program. Overwhelming majorities, over 80% say they love it. For the first time in generations, in memory, people don't have to endure the teeth rotting in their mouths, the heart attack at home rather than care in the hospital, the untreated lung disease.  Love it. But oh, how these same voters hate Obamacare. Somehow, Mr. McConnell's fools never got the message that Ky-nect by any other name is still Obamacare.  Fact is, in Kentucky, they just could not abide the idea this wonderful thing was provided them by that Black President, who their beloved Senator vowed to oppose, against whom their Senator vowed to lead the insurrection.

Reading about William Tecumseh Sherman, I was struck by his conviction that government can be a force of great benefit, and that without good government, the union cannot survive.  The whole idea of a republic, Sherman could see, depended on union. Without union, the states would fly apart and start warring with each other as the nation states of Europe had done.  Union, however requires either a willingness to cooperate or a strong hand to coerce cooperation.

Now the Republicans are in charge and Mr. McConnell says he hopes the Democrats will afford the same support for President Trump's Supreme Court nominee as the Republicans had done for Mr. Obama's Supreme court appointments.  He pointed to the two justices Obama had appointed who were confirmed but he somehow forgot all about the third appointment Obama sent forward, who the Republicans refused to even consider.

If truth is the first casualty of war, then what have we had with Mr. McConnell and the Republicans in control of Congress these past 6 years?

What One Person Can Do to Resist and Change History

Did Lee Harvey Oswald change history by himself?  Did the guy who shot Martin Luther King change history?
The graveyards are filled with indispensable men, DeGaulle noted.

We know of attempts to change history by killing a single leader--the plotters who put a bomb in an attaché case next to Hitler thought they could change history with one act. The bomb exploded and killed everyone in the room but Hitler, whose pants were shredded but he was otherwise unharmed.  This was taken by Hitler and those who loved him as a sign of divine intervention: God saved Hitler because Hitler was doing God's work.  Gott Mitt Uns.  Later, this was turned around as divine intervention in the other direction: Hitler was so incompetent as a military leader, had he been killed that day more competent generals would have assumed control and likely won the war and none of those concentration camps would ever have seen the light of day.

The same can be said of President Trump, who, if he were to die tomorrow, would leave behind more pernicious men (Pence, Price, McConnell, Paul Ryan) who can really do some harm. The best thing about Mr. Trump may be he is so incompetent he gums up the works.

None of this helps me. Dietrich Bonheoffer remarked it is not enough to bandage wounds; one must thrust a rod into the spokes of the wheel of tyranny.

It is said the Arab Spring began with the self immolation of a man in Libya. The same has been said of a Buddhist monk who set himself on fire in Vietnam.  A flaming example which captures the world's attention with a single gesture changing the arc of history. Not likely.

The best we can hope for is we might band together and take action which changes our government. That means getting cooperation from a lot of other people. People we may not even like much. People who we think are fools, but who agree with us about  just one thing.

A doctor sits in his office, treating one patient at a time. He has little or no impact on the public health.  But a Fleming notices a fungus in his laboratory petrie dishes and out of that comes penicillin and the masses are saved. There is a huge multiplier effect on the wisdom and insight of one man. That happens in medicine and other areas of science with some frequency. I'm not sure there is any equivalent in politics. Martin Luther King gave one inspiring speech, and he organized events which helped bring about change, but apart from the speech, it was other people who made his work matter.

 

I suppose this is a good thing. If one man could actually change history, there would be a succession of one man efforts to change history. And most of these changes would likely be things we did not want.

Tecumseh Sherman: The Man Who Would Not be President

William Tecumseh Sherman famously said he would not run for President.  When pressed by the Republican Party to run he answered he would not accept the nomination, and if nominated he would not run and if elected, he would not serve. He did not play that coy game ambitious American men had played since the time of Hamilton and Burr, and even before them, when men pretended  to be not interested. What he was saying was he really was not interested.

Sherman had done something more important. He had helped Grant win the Civil War. Governing as President was not as important a job as the one he had already done.

Sherman's father, who died when Sherman was a boy, named him after an Indian chief--the William was added later when Sherman applied to West Point--Tecumseh was an Indian who had united diverse Indian tribes and brought their federation together to negotiate with the looming white man's government.  People asked Sherman's father why he had named his son after an Indian. In that time Indians were still actively in conflict with White society.   Sherman's father said he respected the accomplishment of Tecumseh.

When Peter Mansfield won the Nobel Prize for physics because of his work which led to MRI imaging, which revolutionized diagnosis in medicine, his mentor told him he had already done something more important than winning the Nobel prize--he had done the work, made the discovery.


When Bill Russell's daughter asked him if he felt badly, hearing the crowd boo him toward the end of his career, he said, "No. I never actually heard the boos, because I had never heard the cheers."  Bill Russell knew what was important.


Donald Trump is the opposite side of that coin. He doesn't know the value of the work. He is only interested in hearing the cheers. And the cheers are empty. He is hoisted on shoulders because he has paid for those shoulders.

In "The Lonely Crowd"  David Riesman explores two types of personality--the "inner directed" man vs the "outer directed" man. The inner directed man cares about his own values, his own goals. He is the ultimate engineer, for whom the work is what's important, not the glory. What others think is of little importance to the inner directed man--only important in so far as how it may help him accomplish his task. The "outer directed man" derives his pleasure and satisfaction from the response he gets from others.


Most of our Congressmen and government officials are outer directed people. Ted Cruz is the epitome of the outer directed person, as is Trump.
This may be one reason our government has descended into such profound dysfunction.  While career civil servants may be concerned about getting things to work, about FEMA getting relief to hurricane victims, about the Food and Drug administration identifying harmful drugs, about the Environmental Protection Agency discovering the lead in Flint's water, about the Nuclear Regulatory Agency and the Department of Energy making sure our nuclear plants do not melt down, the people running them do not care much about any of this. It's not about us. It's about them.

American Health Care: We're the Greatest!

Yes, I know, it's a little confusing.  Senator Cruz, Secretary Price, President Trump, and a host of others say America has the greatest medical care in the world. Doctors from all over the world want to come here to train in medicine (except, of course, those nasty Trojan horses who are actually coming here to blow up our buildings and mass murder our people. But these dangerous doctors are really no problem because they always try to catch a plane from Iran, Iraq, Yemen, Somalia or Afghanistan, so we can screen them out.)  Anyway, our medical health care system is just so Fantastic, let me tell you.

We know this because all the Canadians want to leave their worthless socialized National Health system behind and flood across the northern border so they can get their hips replaced at the Cleveland Clinic.  We are working on that--maybe a wall, or maybe just something like a sobriety test at the border crossings, but only for hip health--everyone who looks the least suspicious, or who has a cane or a crutch has to do twenty-five deep squats to show their hips and knees are working. Of course, not many Americans can do more than 10 deep squats, but that's because they are overweight, and anyway they carry American passports; it's the Canadians we need to screen.

This, ordinarily, might not make sense--if our healthcare system is such as disaster, after all, we've got Obamacare, why then are we so much better than the Canadians?
I guess what Mr. Cruz would say is even at our worst, we are still better than the Canadians. 

And nobody can match us for the number of MRI's we do per capita, not even the Brits, who are so snooty about their National Health system.  You know their MRI's couldn't be as good, because their MRI's cost only $75, where ours cost $4,000, so what kind of off brand, no account MRI's can the Brits have?

They are just a failing health care system over there. Who ever heard of medical students going to Britain to train from other countries, like India, Pakistan, or America? 

Well, actually, they do. I went to England for a rotation as an American medical student, where I met lots of other medical students from America and all over the world. 

Sir Peter Mansfield, creator of the MRI

And, the thing is, it was the Brits who did all the basic physics which led to the MRI and they made the first MRI.  Bloke named Peter Mansfield did it. University of Nottingham. Oxford and Cambridge, eat your hearts out. Sir Peter did it.
Actually, he wasn't even the first Brit to revolutionize diagnosis in the 20th century--the CT was developed in Britain under that failing National Health system they got there. Such a disaster. Really, I assure you, our American way is so much better, just so much better. The difference is huge. We make the best health care dollars in America. Trust me.

And we do so many more C-sections here, it's just no contest. Not even close. Of course, our maternity mortality and our infant mortality are both way worse than in the U.K., but those are pretty lame measures of public health and the success of a health care system, compared to the profit margins. The profit margin, that's the real measure of the health of a health care system. 
What you really want to track is how many doctors across the world want to come here. And we've got every other system beat cold on that. 
And you ask the doctors why they want to come here and they'll tell you we've got the best system in the world, hands down. Well, some of the Muslim doctors will tell you they want to come here to kill infidels, I mean, they all want to kill us, even the doctors,  but setting aside the Muslims, they all love us around the world, those other doctors.
Indian doctors come here whenever we let them. They make ten times what doctors in India make when they come here. Same for all the other countries. Our doctors are on the gravy train--all those MRI's and C-Sections and you name it. Medicine here in America is such a cash cow. It's HUGE.

Did I tell you Obamacare is a disaster?

The Judges Are Just So Political: Well, duh!

Tonight, Judy Woodruff interviewed two law school professors about Donald Trump's remarks about the so-called judge who ruled against his Muslim ban and the three judge panel, who, he said, "are just so political."

The liberal judge/law professor, from Colorado  was shocked, just shocked, dismayed, and fearful about the blow to the Constitution, to the separation of powers, to American democracy. She was outraged to hear the President describe judges as political, to say they may harbor bias.  You cannot say that about judges. Judges may be wrong, but they are never biased. 

The conservative judge/law professor, from Utah, shrugged off the President's remarks saying he was speaking plainly and directly and personal attacks on the judges was nothing new in American history.

Much as I hate to agree with anything emanating from the mouth of that elected simpleton in the White House, I had to agree with Mr. Trump about judges being political creatures. 

Judges may be smarter than a bad high school student, but as anyone who has read The Phantom Speaks or Hampton Mad Dog Democrat knows, there is overwhelming evidence Supreme Court Justices are among the most political actors if not the most political actors in government.

The only evidence you need consider is this: If I can present a single paragraph describing a case before the Supreme Court and from that description I can predict with 95% accuracy how each of the Justices will vote on that case, simply by asking: What is the liberal view and what is the conservative view on this case, is that not the ultimate test about the political bias of each justice? 

If Justices were simply calling balls and strikes, you could not know how they would rule. But if the Justices are, in fact, creating a new strike zone with each case, then you can predict just by knowing who their favorite team is.

Over the years, both Phantom and Mad Dog has provided case after case examples of how predictable the Justices are: Those appointed by Republican Presidents vote Republican on cases and the Democrats do the same. Only Anthony Kennedy is a wild care, but for the most part, he votes Republican.

Mr. Trump is, apparently, just discovering this and he is appalled. Just so appalled. It would be just so nice if the judges would only listen to the bad high school student and rule the way Mr. Trump thinks they should. And just as soon as he can appoint one or two more Justices, they will. 

Class Reunion

It may surprise you to learn I went to high school with Donald, Bill, Bernie and Hillary.  Little known fact.

But for those of us in that class, the election results of 2016 came as no surprise whatsoever.
The writing was on the wall, even then.
Back then, Hillary was voted "most likely to succeed" and Bill was in the marching band and the debate club.

 I liked Bill because he was always willing to talk about things, "principles" he called them. He was very earnest, sort of boy preacher trying out his spiel on his friends. He was a fat boy,  didn't have much of a shot with the girls, but you couldn't help but like the guy.

Bernie was more interesting. He was captain of the track team and the cross country team. Kind of a bean pole, but he has more nerve and fire, and tended to disagree. You put Bernie and Bill in the same room and Bill always started preaching and Bernie would listen with this knowing smile, like he'd heard all this before, and then he'd ask a few questions, and back Bill into a corner and pretty well shred whatever Bill said. 

So, Bill,  you think if we raise expectations of the colored in the South and are then, inevitably, unable to meet those expectations--you know, like desegregated schools, voting rights-- then we've made matters worse? So, then where are we? Just do nothing?
That sort of thing.
The Donald was sort of invisible. Well, not invisible, actually. All the parties were at his house Saturday night. He had a really big house. They had a boat in the basement, like a cabin cruiser. It was not really a basement, because you could walk in from the back yard, so it was mostly above ground, but anyway, all the girls would be there. They had something called a "Pot Luck" which was sort of like a sorority, and they would all go over to Donald's house, and around 8 or 9 PM guys like me would drift in. And Donald would sort of stand in front of the bar with a big mug in his hand with a family crest or some such thing on it and he'd mostly just smile, surveying the scene. He wasn't a guy who seemed to have any ideas, actually.
He wasn't really good at much of anything. 

Sort of a second stringer--tried soccer, football, baseball. Not much of a threat. An easy out.

He tried wrestling one year, which is where I knew him from. 

In wrestling you had to either know what you were doing, or you had to be very tough and he was certainly not that. 
Before I'd step out on the mat, my heart was pounding at, like 130 beats a minute. All my teammates were watching. My coach was watching. Maybe even the stray cheerleader who had been assigned to cover the wrestling matches was watching. There was the possibility of humiliation. 
But not so much for the Donald. Didn't seem to matter to him he wound up on his back most of the time. Actually, now that I think of it, with the perspective of years, I bet it did matter to him. 
When we read "The Short Happy Life of Francis MacComber" junior year, I thought immediately of Donald.  I looked over toward him in class, but he just looked down at his book.  You may not know the story. Hemingway writes about  this guy, Francis Macomber,  who is out on safari in Africa, with his wife and the white hunter/guide. MacComber is all dressed up in his expensive safari clothes, and he's got the best gun (and the best words) and he walks into the bush, but then he's faced with an actual, living, roaring lion and he drops his gun and runs and the guide has to shoot it. But all the hired natives carry Francis back to camp on their shoulders as if he's the big hero in that scene, because, after all, he may not be a brave hunter, but he is paying all the salaries.
That's sort of Donald's story, you know? He never really has to stand his ground and fire the shot that brings down the lion. Someone else has to do that, but it's Donald who gets hoisted up on the shoulders. 

For guys like me, it was our manhood on the line, on the mat. We wanted to be heroes.  We wanted to stand our ground and win.

Donald  seemed to know there was no way he could be a hero. Just not tough enough. Never had to fight, never learned how. 
So,  why should he suffer and struggle to be a hero when his parents could just buy him the costume?

He was fat and happy. Not as fat, physically, as Bill. Fat in the spiritual sense.
He never had to try very hard, never had his back to the wall. 

Bernie pushed himself. Bill did too. Hell, even Hillary did. 

But the Donald was just sort of the slow, fat kid. He seemed to figure he didn't have to do much. It would all come to him eventually. They'd carry him on their shoulders no matter what. 

And, given the money, it did sort of play out that way. So, as I said, the results November 8, came as no surprise to anyone from our high school.