Wednesday walkabout

There are a lot of things to ponder this Wednesday, so let’s go for a walkabout. A young sixteen year old from Sweden has twice spoken candidly with members of the US Congress. Two take aways from Greta Thunberg’s comments:

– do something
– listen to the scientists

Yet, while she has been here, the US president’s head of the EPA, a former coal lobbyist, has rolled back an Obama regulation on clean water and overruled California’s ability to have tougher emissions standards for autos sold there. Call me crazy, but this 60 year old man sides with the 16 year old and the climate scientists.

The US president should thank Boris for taking some of the spotlight away from his inane antics. The UK is headed toward a cliff and Boris is saying follow me as he hits the gas. Brexit will be challenging enough, but a no deal Brexit would be a disaster. The British public should listen to the business community who is sharing its concern. An inability to govern this issue has been evident from the outset.

Somebody blew up oil refineries in Saudi Arabia. Iran is the most likely culprit. It is my guess someone is testing the waters with hawk John Bolton gone. Sadly, we are in this mess because of Trump’s decision to back out of a deal all other parties begged him not to, including US military and intelligence leaders. So, Trump’s building a coalition will be harder with our not listening to allies in the first place.

Finally, I am in the middle of Malcolm Gladwell’s latest book, “Talking to Strangers.” The thesis is we are horrible judges of when strangers are lying to us. Meeting the person actually is detrimental to the effort. A comment I just read is belief is not the absence of doubt; it’s the absence of a sufficient number of reasons to doubt. Fascinating read.

Have a great rest of the week.

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Impromptu conversations

Earlier this week, I had a delightful conversation with an 80 year-ish old couple in a doctor’s waiting room. Doing what I often do, I observed
a conversation starter and took the chance to inquire.

The man was wearing a white t-shirt that had the cursive “Dodgers” in blue on the front. Rather than speak across the room, I walked over, got a cup of bad coffee, stopped at their seats and dove in.

“Is that for the Brooklyn Dodgers or the Los Angeles Dodgers?” I asked indicating where the baseball team moved in the late 1950s. He smiled and said the answer I hoped to hear, “Brooklyn.”

In response to my question if they are from Brooklyn, he said “No, Cuba.” Rather than segue into a different subject regarding why they left Cuba, I stayed with baseball. I asked if he was a Jackie Robinson fan and he became animated. He said he actually got to see Robinson play.

We discussed what a treat that was and our collective knowledge of Dodger history. I can remember old baseball history much better than recent history. We meandered down the path of Robinson, beating the dreaded Yankees in 1955, the book “The Boys of Summer,” the pitching prowess of Sandy Koufax, Don Drysdale and Johnny Podres that swept those same Yankees in 1963 and the current team’s prowess.

His wife relished in his enjoyment of the conversation. She had a big smiile, Before I could move onto her, his name was called by the nurse.

It was a delightful conversation. I have shared before how much I like to uncover conversation starters, be it a name like Olivia or Aimee likely after a star or song or some version of double names like Mary Ellen or Betty Sue. Or, I love it when resort areas have someone’s home town on his or her nametag.

My wife said I made that man’s day, but he helped make mine better. I encourage everyone to have impromptu conversations. It brings us closer. Just look for those cues.

Off with his head

Given former White House Communications Director Anthony Scaramucci’s (the Mooch) recent comments that his former boss is “off the rails,” I started to write a post about the Mad Hatter. But, there is a more appropriate caricature of the president in “Alice in Wonderland;” he acts more like the Queen of Hearts.

Any one who dares to criticize the Queen, will lose his or her proverbial head. The Mooch has been criticized for his remarks and advocacy to see the president is NOT reelected. The president said he did not know (the Mooch) that well. Yet, one would ask why he picked him to be his Communications Director, which was such a square peg/ round hole placement that it lasted eleven days.

Eugene Robinson’s latest editorial is called “Trump panicking that reality presidency won’t be renewed.” His opening and closing paragraphs are priceless. Here is the opening:

“Uh-oh. President Trump is in such a state of panic about his dimming reelection prospects that he’s getting his lies mixed up and occasionally blurting out the truth.” Robinson goes on to note Trump said it is hard for Amazon to compete with Samsung when the former has to pay tariffs, forgetting his lies that China paid the tariffs.

When the liar lies so much, he cannot keep track of them. It makes his staff panic as well. And, it has consequences. The Director of National Intelligence Dan Coats had to resign because he told the truth. And, his number two in command had to go as well, as she copied her boss and told the truth.

The Queen of Hearts president cannot tolerate someone disagreeing with him, especially when that person speaks the truth. Only the president can disagree with himself. After changing his tune, he will say he never said that or it is fake news he said that. He does not seem to care that he is on record saying such.

Sadly, his sycophants (let’s call them by the less flattering synonym “toadies”) are too scared to push back as the Queen will turn his base on them. So, the toadies go silent or offer milquetoast criticism of the latest regal faux pas. They do not want to risk the vindictiveness of the Queen.

Or, the toadies will do worse and actively berate people saying uncomfortable truths. Right now, his toadies are piling on the Mooch for his remarks. Further, the Queen’s attorney fixer Michael Cohen was berated as untruthful to obfuscate his testimony in front of a House committee. But, the irony is they were accusing him of lying to protect Trump, while they were admonishing him to protect Trump.

What should have been heeded from Cohen’s testimony are two clear messages. First, Cohen’s job was to bully and threaten people and entities who knew of Trump’s poor behavior into not releasing it. He said he wrote over 500 letters threatening institutions not to release any of Trump’s history they possessed.

Second, the words he opened with should be heeded. “Donald Trump is a racist, he is a con artist and he is a cheat.” This man knows him better than many. Why did he say that? The reason these words are not heeded is an age old practice in Washington. If you denigrate the critic (i.e., cut off his head), then you need not pay any attention to what he said.

Yet, what Cohen said gibes with comments of others. Attorney Thomas Wells said about his former boss, “Trump lies everyday, even about things of no consequence.” Former economics advisor called his former boss a “prodigious liar.”

This is why each of us must push back when the president is untruthful, bullying or hateful in his actions and remarks. Showing Republican legislators there are consequences for their acquiescence and even toadiness to this person, is the only way to embolden them.

Helping people climb a ladder – a perspective

The following is an edited version of a comment on Hugh Curtler’s (a retired college professor of philosophy) post regarding whether we should help people in need or let them fend for themselves. I provide a link below to his post. I am going to cite the work a charity I used to be a part of that builds off the book “Toxic Charity,” written by a minister who lived with the disenfranchised people he sought to help. His name is Robert Lupton.

Lupton’s thesis is simple: true charity should focus on emergency or short term needs. What he argued for to help others long term and we did (and still do) is help people climb a ladder back to self-sufficiency. That should be the goal. An easy example is he would advocate for food and clothing co-ops rather than giving the food and clothes away. People love a bargain, so let them maintain their dignity while they get discounted help. This dignity thing is crucial – people would rather not have to ask for help.

Note, we cannot push people up the ladder. They must climb it.  A social worker I have advocated with used to say “we walk side by side with our clients.” The folks we helped are homeless working families. We had two keys – they received a subsidy for rent based on their ability to pay, but they had to plan, budget, get financially educated working with a social worker and attending required training programs. Our homeless clients had to be responsible for rent and utilities up to 30% of their income, which is threshold for housing risk. Another key is we measured success. Success to us is being housed on their own without help after two  years.

As a community and country, we need to better identify what we mean by success in our help for people in need. Also, are things like healthcare a right? Is food on the table a right? Is a roof over the head a right? What we need is better measurement of what we spend and how it helps. It actually is cheaper to provide housing to chronic homeless and partially-subsidized housing to those who are more acutely homeless (due to loss of job, reduction in hours,  loss of healthcare, problems with car, predatory lending on a car, etc.) than let them go to the ER or commit petty crimes and be jailed. People should know all homeless are not alike, so the remedies to help need to vary.

My former party likes to argue off the extreme anecdotes – the significant majority of people do not cheat the system, but the perceived thinking of such is much higher in Republican ranks. When I have spoken to church groups, chamber groups, rotary clubs, United Way campaigns, etc., I come across this bias which is firmly believed. Just last month, the US president announced curtailing a rule on food stamps which will put 3 million people at risk, as one man was able to purposefully game the system. Yes, there is a small percentage of folks that do that, but the significant majority do not.

What people like David Brooks, a conservative pundit, tout is a dialogue on what kind of country do we wish to be? Our economy is a fettered capitalist model, with socialist underpinnings to help people in need and keep people out of poverty. What is the right balance? Is it better to pay a much higher minimum wage or have a higher earned income tax credit, e.g. Is it better to have a Medicare for All system, subsidize those in need or have a free market system only? A factor in this decision is many employers now employ a larger part-time or contractual workforce (the gig economy) to forego having to provide benefits. This is especially true in retail and restaurant industries.

At the end of the day, Gandhi said it best – a community’s greatness is measured in how it takes care of its less fortunate. With so great a disparity in the haves/ have nots in our country, I can tell you we are out of whack as our middle class has declined and far more of them fell into a paycheck-to-paycheck existence. Ironically, even in the age of Trump promises, we have many people who do not realize they are voting against their economic interests. Doing away with the ACA and not expanding Medicaid are very harmful to rural areas, e.g.

So, I agree with Gandhi, Lupton, and Brooks that we need to help people, but decide what is the best way. We should measure things and adjust them when they get out of whack. It is hard to fix what you do not measure. The group I was involved with would alter its model, if the numbers showed less success than hoped. What I do know is over 80% of the people we helped are still housed on their own after two years of leaving the program. In other words, they live without a subsidy.

Finally, what we need most is for politicians to check their tribal egos at the door when they enter the room. Having been a member of both parties, each party has some good ideas, but both have some bad ones, too. I do not care what a person’s party preference is or if he or she is more conservative or liberal than me  (I am fiscally conservative and socially progressive), we need to use facts and data to make informed choices. And, continue to measure the results making modifications, if needed.

Dilemma

Medical errors are a problem – here are some thoughts on how to reduce them

Earlier this week, a US health news piece entitled “In a review of 337,000 patient cases, this was the no 1 most common preventative medical error” by Meera Jagannathan was made available on msn.com. This article echoes the findings of two pieces I have referenced previously, the first, a book called “Internal Bleeding: the truth behind American medicine’s terrible epidemic of medical mistakes,” written in 2004 by two internists Dr. Robert Wachter and Dr. Kaveh Shojania. The second was the Leapfrog Study which looked at deaths caused by medical errors toward the turn of the century. A link to the recent article is below.

The article reveals the results of four medical studies that analyzed medical death rates from 2000 – 2008. Of the just over 251,000 medical deaths, 9.5% of the deaths could be attributed to medical error. In other words, 1 out of 10 deaths could have been avoided as they resulted from a medical error.

The article focuses on nine things that should be done to reduce medical mistakes. I will just list them, but please click on the article link below.

  1. Make sure you fully understand the procedure and why it is necessary.
  2. Brief the doctors on your allergies, health conditions and medicines.
  3. Don’t assume every provider has access to your records.
  4. Bring a friend or family member if the patient is not good with asking questions about what is happening.
  5. Keep close track of your medicines and results.
  6. Make sure the doctors and nurses wash their hands.
  7. Research wisely.
  8. Don’t be afraid to speak.
  9.  Ask providers what they are doing to prevent  mistakes.

The Leapfrog study noted three things to reduce deaths due to medical errors.

  1. Have complex surgeries performed in centers of excellence where they have done multiple hundreds or thousands of the procedure.
  2. While dated, poor handwriting of prescriptions or instructions caused mistakes. Most hospitals now have electronic orders, but be sure you understand what is being asked or prescribed.
  3. Make sure there are doctors on site and not just residents in intensive care units.

I wrote earlier about the book “Internal Bleeding,” so I provided a link below. Reviewing that summary and comparing to the above, here are a few more thoughts from that post as well as a few others thrown in.

  • write a summary of your and your family medical history
  • write down what your symptoms are – people see the white coat and forget.
  • if you are not sick or injured, the hospital is the last place you should be; some hospitals incent ER doctors to admit patients; ask questions about this.
  • know your environment; if you have bladder or some other cancer it may be environmental not familial. Bladder cancer is a bellweather environmental caused cancer.
  • ask for other pain medications beside opioids; they should be only used for severe pain and for short durations.
  • introduce yourself to all providers; make sure they know who you are.
  • Complete the prescription regimen and don’t stop when you are feeling better.

Medical professionals do not want medical errors either. So, help them help you. And, if you have trouble advocating for yourself, take a trusted person with you.

https://www.msn.com/en-us/health/health-news/in-a-review-of-337000-patient-cases-this-was-the-no-1-most-common-preventable-medical-error/ar-AAEGPVF?ocid=spartandhp

https://musingsofanoldfart.wordpress.com/2012/07/28/internal-bleeding-be-your-own-health-care-advocate/

The Mueller Report – my synopsis

I have read the Mueller Report. Several things are clear from this official document of an important investigation.

– the Russians had an orchestrated influence on the US presidential election actively using social media and hacking and releasing information obtained from Democrat campaign files;

– the highly researched effort officially documents the US president has a very hard time with the truth and the legality of certain actions and his aides know that;

– the US president repeatedly attempted to obstruct justice (see example below);

– while not crystal clear from a legal standpoint that he coordinated with Russia, the US president had a relationship with Russia he (and Michael Cohen) lied about and there were changing stories, deleted texts/ emails/ messages, and an incredible naiveté not recognizing that interfacing with Russians during the campaign was improper; and

– the US president was and is obsessed with the investigation, but with the results thus far and still pending, this is definitely not a hoax or a witch hunt.

One of the paragraphs I found telling relates to the president continually trying to get White House Counsel Don McGahn to change his story that the president ordered him to fire Mueller. McGahn would not fire Mueller or change his story as reported in The New York Times. The quote is as follows:

“Substantial evidence indicates that in repeatedly urging McGahn to dispute that he was ordered to have the Special Counsel terminated, the President acted for the purpose of influencing McGahn’s account in order to deflect or prevent further scrutiny of the President’s conduct towards the investigation.”

While there are other examples, this summary of intent is clear indication the US president tried to obstruct justice.

While the Mueller report noted there was no clear evidence the US president coordinated with Russia, Mueller notes with the missing information including an interview of the president, they may have come to a different conclusion. To me, overt coordination was not necessary as there were so many links between Russian influencers and campaign officials and with their active social media/ hacking, the Russians accomplished their goal with unwitting participants.

So, I concur with the Republicans for the Rule of Law, now former Republican Congressman Justin Amash and more than 1,000 plus former federal prosecutors that there are grounds for impeachment. But, I think the Republican Party should be in lock-step with the Democrats. To me, the Republican leaders must recognize publicly what many discuss in private per several highly researched books.

 

A little bit of this and that

Too many issues and events are percolating in my head. Rather than do a deep dive on any of them, here is a little bit of this and that.

Not unexpectedly, Trump sycophants in Congress are rationalizing their support of Donald Trump over E. Jean Carroll’s accusation of Trump raping her over twenty years ago. They “believe the president” rather than the accuser, with some saying they heard Carroll has a “credibility problem.” Let me state the obvious. If you have not noticed, Donald Trump has a huge credibility problem. 

Before 2017, we had a recurring immigration problem where efforts to solve it have died in one house or the other. The current president used fear to make the problem a winning issue blowing it out of proportion. We now have a huge immigration problem at the border on Trump’s watch due to diminished funding of Central American countries, demonization of immigrants from south of the border, threats to build a wall, and not providing sufficient judicial support to process migrants seeking asylum.

Treating children like animals is not who we are. This is not how we make America great. Yet, one thing that I harken back to is about sixteen months ago, this president had a bipartisan agreement with Senators Graham and Durbin for $25 billion for a wall and making DACA a law. There were other measures therein. That was in the morning. Before Graham and Durbin got to the White House in the afternoon, hardliner politicians got in Trump’s ear saying he should be even more unwelcoming. That was the day of the “sh*thole countries” comment.

Speaking of that credibility problem, our allies are not too keen to support the US on Iran. The other six countries in the Iran Nuclear deal said Iran was in compliance and encouraged the US not to pull out. Our intelligence staff agreed, but the president’s gut knows better. Coupling this with his bullying and untruthfulness along with the WMD fiction that George W. Bush and Dick Cheney pushed on the world, makes the US and this president untrustworthy.

Finally, Peter Wehner, a former member of three Republican White Houses, and a Christian, has written a new book called “The Death of Politics.” Last night on PBS Newshour, he said divisiveness started before Trump, but he clearly has made it worse, even reveling in the divisive seeds he sows. He also noted how his fellow Christians are too silent on Trump’s routine bad behavior. He is critical of those who rationalize his many indiscretions, and says Christians need to speak “truth to power.”

I did not want to write a solely Trump concerning post, but our tribal behavior is having reasonable people rationalize abhorrent actions and words from the White House incumbent. I can argue policy decisions all day on Trump’s decisions, but how he conducts himself, how he treats allies, colleagues, Congress, media, et al, is well beneath what she expect from a leader. His lack of a moral compass is disturbing. And, getting back to Ms. Carroll, his defense is “she is not his type.” Well sir, apparently you are not hers. She likely prefers her men not to force themselves on her like you have done with others.