The Imaginary University

 

Should you be fortunate enough to be admitted to the three year Phantom University,* and insane enough to matriculate, your course work will vary according to your major, which you may construct for yourself, or simply follow as outlined by the various academic departments, but  whether an engineering, pre med or philosophy major, you will be required to complete satisfactorily the three year course, "Introduction to Nothing In Particular," and the reading list is long, although entertaining. 

Phantom University

Woe be to any student who arrives in class having not read the book for discussion, because AI and Cliffs notes or Wikipedia will not save you. You will be called upon in class to comment on a particular remark, passage and you won't have time to Google it. Attendance is mandatory. Class participation is mandatory, may be excruciating, but that is the point. Education at Phantom University requires engagement, or "l'engagement" as the French would say, which means exactly the same thing but sounds so much cooler in French.

Humanities Quad

So here's the list, to be picked up, hopefully second hand, at the bookstore, or on Kindle, or signed out from your library online. How you come by the texts is of no concerned to Professor Phantom--did I mention Professor Phantom, the President of the University, teaches this course without teaching assistants?-- the only concern is that you have actually read the piece under discussion.

Library

Semester 1, Year 1: 6 weeks  (Female in a Man's World)

1. The Prime of Miss Jean Brodie, Muriel Spark.

(Extra credit: See the Maggie Smith movie, compare and contrast)

2. Play It As It Lays, Joan Didion

3. Memoirs of an Ex- Prom Queen, Alix Kates Shulman (Extra Credit: Living My Life, Emma Goldman)

4. Final Payments, Mary Gordon 

5. The New York Ride, Anne Bernays

6. The Last Picture Show, Larry McMurty

(Required: See the Movie directed by Peter Bogdanovitch)

Semester 2, year 1,  6 weeks (Origin Story)

7. The Adventures of Huckleberry Finn, Mark Twain

8. Silence At Appomattox, Bruce Catton

9. Animal Farm, George Orwell

10. The Guarded Gate, Daniel Okrent

11. Goodbye to Berlin, Christopher Isherwood

Extra Credit: Movie, "Cabaret"

12. Before the Deluge, Otto Friedrich

Semester 1, year 2, 6 weeks: (Quiet Desperation)

13. Looking for Mr. Goodbar, Judith Rosner

14. Little Big Man, Thomas Berger

(Alternate: The Movie--Dustin Hoffman)

15. The Pawnbroker, Edward Lewis Wallant

(Alternate: The Movie--Rod Steiger)

16. Miss Lonelyhearts & The Day of the Locust, Nathaniel West

17. The Bell Jar, Sylvia Plath

18. Slouching Toward Bethlehem, Joan Didion

Semester 2, year 2, 6 weeks (The Grand Sweep and those Swept Up)

19., 20. A People's History of the United States, Howard Zinn

21.West with the Night, Beryl Markham

22,23., Dark Continent, Mark Mazower

24. War Is A Force That Gives Us Meaning, Christopher Hedges

Semester 1, year 3, 6 weeks (Class, Society &  Self)

25. My War Gone By, I Miss It So, Anthony Lloyd

26, 27. Battle Cry of Freedom, James McPherson

28. White Trash, Nancy Isenberg

29. Lady Chatterly's Lover, D.H. Lawrence

Required movie: Laure de Clermont-Tonnerre director

30. The Wire, Season 1

Semester 2, Year 3 (Alienation by Fire)

31. The Wire Season 3

32. The Wire Season 4

33. The Paranoid Style in American Politics, Richard Hofstadter

34. If I Die In A Combat Zone, Tim O'Brien

35. The Stranger, Albert Camus

36. Parachute Infantry, David Kenyon Webb

* Phantom University offers BA, MD and JD degrees. The undergraduate program is 3 years, as are the graduate programs, following the British model, which seems to produce better educated individuals in 3/4 of the time it takes American universities. 

The campus is located above the 41st parallel, as the Phantom, its founder, believes no university located below this latitude can provide enough adversity to be a real university: To wit, the universities at Santa Barbara, New Orleans, anywhere in Florida are just too amenable to homo sapiens to foster any sort of honing of survival instincts. It's a variant of "I walked 5 miles through the snow to school." 

The buildings and architecture are neo-Hogwarts and the faculty is aged, sometimes decrepit and hand selected by the Phantom on the basis of actual, true, brain certified scholarship. 

For example, the Dean of Students, and head of the Department of What Matters is a graduate of the University of New Hampshire at Keene State and is the most thorough going scholar the Phantom has yet met--she never fails to read the footnotes, the references and the references within the references. She asks embarrassing questions whenever possible, and is simply the smartest person in the room on every occasion, and she has been in the room with Larry Summers, Bernie Sanders and Scott Brown. She denies knowing Jeffrey Epstein but cannot recall if she has ever met him.

Admission requirements are so exacting and discriminatory that no student has yet qualified for admission, but the Phantom remains hopeful. 

SAT's and ACT's are optional, but won't impress anyone. Starring roles in feature length films will be considered as part of the admission portfolio, but applicants are warned that the film criticism department has been known to make Pauline Kael look like a shill for People Magazine, and they will review your performance. 

Applicants who are certified in plumbing, HVAC, electrician services may be granted full scholarships on a work/study basis. (The buildings are old.) Auto mechanics, same deal.

Military veterans will be considered on a case by case basis, or on a war by war basis, whichever applies. 

Athletes are welcomed, but the university competes in no leagues and has no stadium.  

Swimming, baseball, wrestling, crew, tennis, rugby, football, golf are supported, in that order, but there are no coaches. 

State of the art gymnasium, weight rooms, swimming pool and fields are supported just as soon as we find rich patrons to write the checks.

Theatre arts, film making and film criticism are highly valued and may be your ticket into the school, just as soon as we get Spielberg, Geffen or Tom Hanks to write the checks. 

Music is a high priority, but the university has refused to support faculty until it can offer enough salary to make it worth their while. So far, Josh Redmond, Herbie Hancock and Susan Tedeschi have not been approached because we could never pay them what they would be worth.

Painting, sculpting and such like are allowed, but not supported. Rooms may not be heated, although northern light is provided.

 

A university infirmary is available just as soon as Elizabeth Warren gets the bill through Congress, with prevention of sexually transmitted diseases a priority. We know the demographic we are dealing with here. Also contraception.

The university does not embrace "diversity" although it's happy when it happens in our classes, but we are not talking about race here, to which we are indifferent, but class. "Inclusion" is a given. If you are admitted, you are in, or included or whatever you want to call it. "Equity" is discouraged, as people who decide to read all the assigned stuff will be treated way better than people who fail to engage the assignments, who will be expelled for non participation. 

Geographic distribution is not a priority. Race is not considered. If we find ourselves with a class of 400 Asians or Blacks or Blonde Caucasians, we will be happy if we think these are the best individuals we can find. 

 

 

Interviews on campus are required. Transportation to campus will be paid for by the university, just as soon as we can get Delta airlines to buy in. 

All rooms on campus are singles. 

Grades are recorded for each student for each course, but not shared with the student. 

Faculty are not required to write letters of recommendation for students, but if you are any good, they typically don't mind.

Students must vacate the campus the day after graduation and are never allowed back on campus and cannot contribute to the university thereafter.

The university will certify students have graduated but otherwise wants nothing to do with you once you are gone from campus.

The Sociopath On The Train

 

From Professor Google:

Sociopath: consistent disregard for the rights and feelings of others, lack of conscience, and manipulative behavior. Key traits include deceitfulness, aggression, impulsivity and an inability to distinguish right from wrong, often without remorse for their actions.

Distinction from "psychopath" may be artificial, although psychopaths said to more often be successful, owing to a consistent quality of deceptiveness which plays to other people's good will.

Apparently, the term "sociopath" has fallen out of favor but the Phantom saw one on a train ride out of New York just now, on a trip south and all his bells were ringing inside his skull: "SOCIOPATH!" And it was a little thrilling, however disturbing to observe.

So here's the story: The Phantom was riding in the business class of the Amtrak from Boston toward Washington, DC. He had spent the extra money because he wanted to ride next to his wife and she wanted to face forward so to be sure of assigned seats, you have to pay for business class, otherwise you're in coach, which is cheaper, but you may not be able to find two seats together, especially during the mayhem of train travel in the Northeast corridor three days before Thanksgiving. 

In New York, a thirty-something, maybe mid twenty something man takes the seat across the aisle from us, and he immediately spreads out over his aisle seat and the window seat, bringing the trays for both down and loading them up with three computers, not to mention at least one, maybe a second monster Apple phone.  He's also got some sort of technical journal spread out on the tray. 

The man is wearing a trim Navy blue hoodie with "New York Energy" emblazoned on it. Googling that, Phantom discovers these were very trendy after the NYC Marathon and were very hard to find or purchase. It's a sort of Kate Spade bag for men, or maybe a pair of Jimmy Choo shoes. He has a large diamond ear stud. He wears Diesel jeans or some sort of very pricey jeans and what are likely pricey sneakers, although the Phantom is insufficiently informed about sneakers. Jimmy Choo sneakers, maybe. He looks like young, conspicuous but very trendy money.

When the conductor makes his way down the aisle this man shows him his phone  and the conductor says, "Oh, this is a coach ticket," you'll have move. The next six cars are all coach. 

"Oh," the man says. "So sorry." The man is Asian and he sounds like he doesn't speak very much English, which might explain how he did not notice or was unable to read all the "Business Class" signs above his seat, suspended from the ceilings of the car, and on the doors at each end. 

The conductor continues on down the aisle but the man makes no move to leave. The Phantom's wife says, "He's not going to move." 

"Well, when whoever has bought that seat arrives, he'll have to move," the Phantom reassures her while she stares knives in his direction.

Sure enough, the man continues to work his computers and remains in place. 

Then he gets on the phone and, speaking very unaccented English he engages in several phone calls, the last one, makes him agitated.

"I don't care if your supervisor is busy. If you want to retain my company's business you'll fucking get your supervisor on the fucking phone! And I mean, like right now."

He continues to harangue whatever poor soul has the misfortune to be on the other end of the line.

His English, however profane, is very good. Like a native.

Around Philadelphia, a somewhat overweight, abused looking man arrives toting a suitcase, over the shoulder computer case and he looks at the seat numbers and finally concludes the Asian guy is sitting in the aisle seat but occupying with computer stuff the window seat this man has paid for. 

"You'll have move that stuff and let me in," the man says.

The Asian guy looks up from the phone and reverts to "I can barely speak English" saying, "Oh, so sorry. Just wait a moment. I'm on the phone." 

The train begins to leave the station and the man says, "No, I cannot wait until you've finished your phone call. I need to get to my seat so move your stuff and get up and let me by."

The Phantom's wife is enjoying this immensely--all  she needs is  a bag of popcorn.

The Asian guy collects his things and moves two seats down the aisle to an empty aisle seat. 

The conductor comes by to collect the tickets from the passengers who got on at Philadelphia and the Asian guy having no yellow paper slip over his head as a ticketed passenger who has been logged in by the conductor would have, and the conductor asks for his ticket and once again gets the phone ticket and tells the Asian guy he has to move to the coach car. It's the same conductor who had told him to move before but the conductor never returned to make sure he had moved. 

"Oh, so sorry," the Asian guy says. This time the conductor looks back at him as he continues collecting tickets from other passengers and the Asian guy gets up with all his stuff and walks back toward the coach car. But he ducks into the bathroom at the far end of the business class car, just before the coach car.

"You know," the Phantom tells the conductor. "You hear about 'If you see something, say something?' Well that guy never did leave business class when you told him to an hour ago."

"Yeah," the conductor says. "There's always one."

"And right now," the phantom says, "He's hiding in the bathroom."

"Yeah," the conductor says. "I'll hang around this time."

Another conductor comes by, a woman conductor and the two knock on the bathroom door and the Asian guy emerges and walks into the coach car.

The conductor looks at the Phantom. "There's always one," he says. "A sociopath. Rules don't apply to him."

"Happy Thanksgiving," the Phantom's wife tells the conductor.  "Mine already is."

Truth and Accuracy in the Blogosphere: Ad Hominen

 

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

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

Shot By National Guard: Kent State

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

National Guard Shooting Unarmed Students

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

These Guardsmen Were Never Arrested

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

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

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

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

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

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

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

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

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

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

Of course, that is a distinction without a difference.

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

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

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

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

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

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

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

How it works

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

Example

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

A Ray Bradbury World: Hanging On by Our Book Covers

 

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

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

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

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

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

Forthwith:

1. "Motherland" by Julia Ioffe

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

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

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

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

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

2. "Embracing Defeat"  by John Dower

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

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

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

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

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

3. "Dark Continent" by Mark Mazower

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

4. "Vaccinated" by Paul Offit

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

CODA:

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

When the Cynical Becomes the Norm

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

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

Omar

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

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

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

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

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

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

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

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

The Phantom nearly drove off the road.

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

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

He made that word sound almost obscene.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

It's all the art of the deal.