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.
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.
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.
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.
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.
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.
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