Testosterone and Its Discontents

That angry, raging warrior, Pete Hegseth is concerned about the testosterone levels of his armed forces.

The implication is that he does not want any low testosterone soldiers around, and, further, that we would be better served by high testosterone level soldiers, sailors and airmen.

The questions here are:

1/ Do higher testosterone levels result in better performance?

2/ What should the goal levels be?

3/ What would you do if you found a soldier who has testosterone levels lower than you think ideal?

Part of the problem here goes beyond science, endocrinology and performance to an issue of language. "He's a low testosterone sort of guy," has become a trope of sorts for a man who lacks aggression, assertiveness, focus, sexual drive--a pale man, who is quiet, docile, who may respond but not initiate.

Those features may, in fact, accrue to men with low testosterone and, in fact, may ameliorate with testosterone therapy, but leaping to the conclusion that those characteristics are simply hallmarks of low levels is wrong. Plenty of men with normal testosterone levels are all of that and giving them more testosterone does not change them.

Ben John, Testosterone Works!

I would be the last to deny testosterone cannot improve athletic (and by extension, military) performance. The studies which exist, and there are precious few, suggest high levels of testosterone achieved with injections, which raise levels from a  normal of a total testosterone of 250-900 ng/dl (depending on the lab and the assay) to over 1200, will reliably increase muscle mass, strength and recovery. Free testosterone levels by mass spec/liquid chromatography are better assays, and they will increase from 50-200 to 200-800 with injections.

Looking at Sammy Sosa, Mark McGuire and Ben Johnson, I thought, "Uh-oh" seeing Sosa's facial acne, Johnson's huge biceps and McGuire's big trapezius muscles.

One of the most common referrals I got in practice was a man who looked like the Incredible Hulk sitting in my exam room who told me he was seeing me for his "low T."

What he had done, of course, was to stop his injections for  month and then he got his blood drawn, and his T levels were vanishingly low, because his testicles had shut down while he took injected testosterone. Then he gets his blood test and it's low. Why would he do this? Because he wanted me to prescribe a legal source of testosterone rather than his having to depend on a gym rat compounded version which was expensive and made in somebody's dusty basement.

What Hegseth Sees in the Mirror

The other side of the coin are elite female athletes. For the most part, in the few surveys which are available, elite female athletes have normal total and free testosterone levels for females--15-50 ng/dl. I don't know Caitlin Clark's levels, but whatever they are, she has enough to perform.

The fact is, there are at least 1,500 male track stars across the US who run faster 800 meter races than the world's record for any female runner who has ever run, and there are thousands more male runners across Europe, Africa and Asia who beat the world record for women.  Elite male athletes simply are stronger, quicker and faster than elite female athletes. Chris Evert, a sensational woman female tennis player, laughed when she was asked how she would fare playing against Jimmy Connors or any of the great men of her time. "I would not win a game, much less a set." When pressed, she said the power of the serves and volleys among the men was simply overwhelming.

So, I'll take it from her testimony and what little data we have, that testosterone makes a big difference in athletic performance. But there are other factors: male puberty, with it's effects on muscle, bone, brain, tendon is a potent factor. 

How Trump Sees Himself

But here we are talking about huge differences in testosterone levels when we talk about male v female. How much difference differences of 100 ng/dl among a male cohort would make is totally unknown. 

Male wrestlers lose weight, train relentlessly and often sleep poorly all of which likely lower their testosterone levels, and yet they are beasts on the mat. Once you get above a certain threshold of testosterone, it's not clear smaller differences matter much: Does a seven foot basketball player really have much advantage over a player who is two inches shorter?

The issue of whether female soldiers are in the same position as Chris Evert is lurking behind Mr. Hegseth's focus on testosterone levels. I would bet on a male warrior in a knife fight, all else being equal (training, size, nutrition), but as we have seen in Ukraine, most war is not fought with knives in the 21st century. Most women soldiers have guns and famously the best snipers of World War II were women.

Male Puberty

There has been an online gossip about "steroid rage" among men who have raised their testosterone levels into the stratosphere and then beaten up their wives, friends, policemen, whoever. Maybe that's a real thing. Likely not, but maybe. If it is real, however, the question comes back to General Patton's famous remark to his soldiers: "I do not want you dying for your country. I want you to make that other poor bastard die for his country and we can kill them and win."

Mr. Hegseth seems to have forgotten that rage and a rebel yell do not win wars.

Hegseth and Testosterone

 

Secretary of Defense/War/Superheroes, Pete Hegseth, is going to test his soldiers, sailors and airman for their testosterone levels.

He has not said if these tests were limited to males, or individuals with an XY chromosome complement or whether individuals with XX chromosomes, or women in common parlance will be tested.

The Secretary, answering questions about why he might want to know the testosterone levels of his warriors, said he did not intend to treat soldiers who fall below the median levels with testosterone injections. But he wouldn't be opposed to soldiers increasing their levels with testosterone injections.

Or something to that effect.

He did not make his own testosterone levels available to the press.

He has not released his SAT scores, either.

Nor has he released his biceps measurements in inches.

The thing about testosterone levels  of which Mr. Hegseth seems unaware, is that testosterone levels are not stable, like for example, cholesterol levels or red blood cell counts. Most men have a diurnal variation--highest around seven A.M. and lowest around 4 P.M. Levels vary across days of the week. When endocrinologists are trying to figure out which men have low testosterone levels, they ordinarily draw at least three levels over the course of two to three weeks. In fact, insurance companies require at least two levels before they will pay for testosterone replacement.

Other levels are germane: pituitary levels of the hormones which rise when the testicles fail to keep levels where the pituitary wants them to be, but Mr. Hegseth does not know about these, and he does not want to test them.

So, Secretary Hegseth is no endocrinologist. But that does not mean he doesn't have an opinion.

Oh, How Speciale

 

Thomas Speciale is, by his own account an expert in terrorism and counter intelligence.

Mad Dog just ran across a Youtube of his testimony before Jared Moskowitz, Congressman from Florida, in which Mr. Speciale explained that most of the protestors who stormed the Capitol on January 6 were military veterans or policemen who invaded the Capitol not because President Trump had exhorted them to do just that just minutes before, but because, when they arrived at the Capitol, intending only to peaceably assemble, the Capitol police sprayed them with a gas and then their military and/or police training kicked in, and they reacted, as the government and the military had trained them to react, through no fault of their own,  by forcibly attacking the Capitol police, over turning the barriers, scaling the walls, breaking through windows, running through the halls of Congress, smearing fecal matter on the walls.

 All that because that's just the way they were trained to react by the military and/or the police.

Mad Dog thinks he's seen this movie before but he cannot recall exactly when.

They were simply doing what superheroes do when threatened, reacting as they were trained, because, you know, they are simply lean, green killing machines, macho men, who are really dangerous when aroused or triggered, or sprayed with certain sorts of gas.

So, it wasn't their fault, January 6th. It was the fault of the police who triggered them. 

Mr. Speciale rejected the question about their gallows and noose for hanging Mike Pence as an asinine and irrelevant question because, presumably, the hangman thing did imply a premeditation and planning and purpose which did not fit his, "they were triggered" story.

Looking at this shaved head beefy guy,  with his supporters sitting behind him looking like extras from the movie "Deliverance," we can see who Trump has got ensconced into positions of power, with their hands on the triggers. 

Right out of central casting. 

The self styled special ops intelligence guy projects the muscular aggressive stuff Pete Hegseth wants in all his military officers.

Below is his list of qualifications, as he presents himself:

Thomas A. Speciale II serves as the Senior Advisor for the Director of National Intelligence at the National Counterintelligence and Security Center (NCSC).  He is a career intelligence officer, having served across the U.S. Intelligence Community—

in and out of uniform for over 20 years.

Mr. Speciale cut his teeth working strategic military planning and counter terrorism 

at the Defense Intelligence Agency. He previously worked at the Office of the 

Director of National Intelligence (ODNI) in various capacities, including at the 

National Counterterrorism Center and National Intelligence Management Council.

Most recently, Mr. Speciale served at the Pentagon, where he supported our 

warfighters and the Intelligence Community at the Irregular Warfare Technical 

Support Directorate under the Assistant Secretary of Defense for Special Operations/Low-Intensity Conflict.

This is the type of looney tune champion who surfaces from under the rocks when guys like Trump and Hegseth get into office. He did not just serve; he "cut his teeth." And he supports not just ordinary soldiers but "warfighters," as a special ops guy, which, you know, from the movies, are like Navy Seals or real tough guys.

The Youtube is worth watching just to see how cunningly Mr. Moskovitz is able to taunt Mr. Speciale into launching his Jeremiad. But, it is ultimately no fun because Mr. Speciale is simply not smart enough to know how deeply he has dug his own grave.

It's a sort of "A Few Good Men" moment, when Colonel Jessup erupts, "You can't handle the truth!" But in the movie the colonel understands his eruption is in a courtroom and he will be judged guilty. Mr. Speciale isn't even that special.

Mad Dog and The Odyssey

 

This week's New Yorker carries an article by a critic, David Denby, which I started reading thinking it was a review of the new IMAX movie "The Odyssey," and although he begins with the movie, he quickly admits he hasn't seen it yet, and what the article is about is the whole "return home" story genre.

But my mind wandered off to The Iliad and the  Odyssey quickly and away from trying to place it in a canon of literature.

For me, the story is personal.

On my eleventh Christmas, I opened a long flat present last, knowing it was a book. I had got the presents I was hoping for--a new baseball mitt, other important eleven year old boy stuff, and here was a book. 

It was a big book, seventeen by fourteen inches, the Giant Golden book series, this one by Alan and Alice Provensen, illustrators. It was called "The Iliad and the Odyssey."  The illustration on the cover and those throughout the book struck me as strange and off putting. I was accustomed to illustrations from Marvel comics and Mad Magazine, but these were ethereal, different.

"What is this?" I asked my parents.

"Read it," my mother said, smiling.

"But what is it?"

"Read it and find out."

She seemed secretly amused, and that annoyed me, and she was atypically closed mouthed about this whole thing, so naturally, I set the book aside, but in the late afternoon of a quiet, boring Christmas day, I finally opened it up.

I had read Golden Book Bible Stories and Aesop's fables, and other stuff which seemed a little like this book, but there were no morals at the end of a page in this one.

There were gods and warriors which should have been enough for an eleven year old boy, but the art was so strange and the language so flat and neutral, as it described the rage which propelled the Iliad. 

And these people were killing each other, and it wasn't clear to me exactly where Helen stood in her own mind. She was some Greek's wife but she seemed pretty passive, standing behind and peering through the wall at Troy as the battles raged. 

My mother called me down for dinner that night, but by then I was completely hooked and did not answer. She came to the door and I looked up momentarily, and she closed the door behind her, but I could hear her tell my father I wouldn't be down for dinner.  

"He's reading," she told him.

I lugged that book with me to college in Providence, R.I.,  to medical school in New York City, to a farm in southern Rhode Island, to New Haven and back again to Washington, D.C. when I finally moved back "home."

I had been gone 16 years, got as far as 500 miles up the east coast, but in all the moves and packing and boxes, I made sure that book did not get lost.

I had fought some monsters and had some adventures in my travels, but nothing as magical as the Odyssey.

When I had sons of my own, I read it to them. When they were four and six, we had a bedtime routine: The older boy lay in his upper bunk and the younger one sat in my lap on a reading chair. As I read each page, I'd hold up the book so the older boy in his perch could see the illustrations.  

They absolutely loved that book. 

It had warriors and fighting, and gods doing magic in the Iliad, and in the Odyssey there were monsters and narrow escapes, the ultimate sci fi super hero stuff.

When my younger son read the Iliad in his freshman high school English class, the teacher, who thought he was something of a dolt, a dumb jock admitted to the private school because of his athletic ability, got a shock when she asked the class about Zeus's wife, Hera. 

"He's frightened of her," my younger son told her. "He might be king of the gods, but he's afraid of his wife."

The teacher was so stunned she mentioned it twice during our parent/teacher conference. 

"He reads with more insight than anyone in that class," she marveled. 
"It's a boy's book," I told her. "Among other things. Boys don't have to be explained what is going on during that war. How are the girls in the class liking it?"

"Odd you should mention that," she said. "They read it. But they do better with 'Pride and Prejudice.'"

When my older son went off to college, he took a freshman course called "Anger," and the first book they read was the Iliad.

"Good grief," I told him. "We thought Columbia was hidebound and ossified because they insisted every freshmen read 'the classics' beginning with the Iliad and here you are at freewheeling NYU, and you're reading the same damn thing. And this is a course about anger."

"Well," my son explained patiently, "There isn't very much in the Iliad but anger."

I still have the book. It's now nearly 70 years old and it's getting rebound this summer. 

I tried reading it to my seven year old grand daughter. 

She was polite, but not really taken. She's more into "Moana" and "Frozen." 

To her credit, she did like "Banshees of Inisherin," until her mother walked in during the finger cutting scene and rescued her from her incorrigible grandfather. 

Maybe she'll circle back and pick up the Iliad and the Odyssey later. 

But I do think it's a boy's book, politically incorrect as that statement might be.

I'll definitely go see the movie, but, for my money, I'll be very surprised if anything on screen can ever match the Provensen's and their Giant Golden Book.

Rape/Defamation Judgment Stands: Trump Vows Mexico Will Pay

 

The Supreme Court of the United States, or at least what passes for the SCOTUS nowadays,  after the rape of that institution by Mitch McConnell and the Sycophant Senate, has let stand the verdict against Donald Trump in favor of the woman he raped and then defamed by claiming: 

A/ She lied about it 

B/ She is a skanky ho, and not his type.

C/ He thought he was raping his ex-wife, Marla Maples, an innocent mistake.

This $5 million judgment is, of course, chump change to the President who makes that daily from his crypto currency scams, or simply by announcing he's going to nuke Iran or Palestine before lunch, sending the stock market tumbling at which point he (or Jared or Ivanka) buy low all the stocks Wall Streeters have shed in a panic, and then in the afternoon Trump announces, "Only Kidding" and the stocks soar and he sells at a huge profit.

But, Trump is still indignant at the offense from his disloyal super vetted bought-and-paid-for Court and he announces Mexico will pay for the judgment.

Or maybe, unnamed "private donors" (wink, wink, Musk, Musk, Bezos, Zuckerberg.)

The Court, locally known as the Roger B. Taney Redux All Star Band, has declined to null and void the verdict from the lower courts, figuring, apparently, "No harm, no foul," which is a sort of default stance this Court has preferred.

Chief Justice Taney

Meanwhile, Stephen Miller has announced that White House Police have put out a All Points Bulletin for the arrest of Davey Hearn, the American Olympian, for the destruction of government property, which Mr. Trump noticed when he went looking for the East Wing of the White House and discovered it had disappeared and there is only a hole in the ground where it once stood.

Davey Hearn: Caught in the Act

As the Fourth of July approaches, Democrats across the state of New Hampshire went full on "Fahrenheit 451" and held readings of the anti-American, revolutionary and seditionist track by Frederick Douglass, "What To The Slave Is the Fourth of July?"  Like those pathetic, heroic and ineffectual ghostly partisans of Ray Bradbury's novel, who wander around the woods reciting from memory the texts of burned books, the Democrats had readers stand up and read from Douglass's speech of 1852.

Better than Lincoln

"At at time like this, scorching irony, not convincing argument is needed. O! had I the ability and could I reach the nations' ear, I would, today, pour out a fiery stream of biting ridicule, blasting reproach, withering scarcasm and stern rebuke. For it is not light that is needed, but fire, not the gentle shower, but thunder. "

Greening the Swamp: Reflections in a Green Haze

 

Every day, it gets better and better. 

The man who promised to drain the swamp just created a big swamp in front of the memorial to the President who he is challenging for the "best President" title.

Turns out, the creator of the reflecting pool painted the bottom silver because, you know, it's supposed to be a mirror and white or light gray or silver reflects sunshine back out of the water and keeps it cooler.

But when you paint the bottom dark, (American flag) blue, that absorbs sun rays and heats the pool, so now you've got warm water more or less stagnant, and the perfect place to grow algae.

The resulting stagnant stuff kills ducks who plop down to float around in it. Geese fly over and poop in it, and goose poop is green. And, all in all, the man who came to drain the swamp quite literally created a new swamp of his own.

Donald Joffrey Trump has claimed this is all the result of vandalism, which is demonstrably true, as he has vandalized the site in broad daylight.

One of the best related gags is they arrested Davey Hearn, an American Olympian, a guy who knows water, as a canoeist. The charge was "destruction of government property."

Donald is outraged that anyone other than himself should try to destroy government property. Next thing you know, Davey Hearn will be over at the East Wing of the White House desecrating the crater over there.

Reflections in Algae Green

 

Of all the Trump follies, my favorite is gelling as fast as the soup green algae of the Reflecting Pool. 

Even the name is ironic, as it reflects just what Trump is.

Trump decides to show the world what a force of creativity and restoration he is, and he tries to recapitulate his one success--the skating rink in Central Park--by demolishing a part of a house which does not belong to him, by hanging banners on federal buildings, by proposing an outlandish Arc De Triumph at the entrance to the National Cemetery for actual real soldiers as opposed to heel spur soldiers who never actually served but sort of did by going to military school. 

But his piece de resistance, was going to be the Reflecting Pool, which he promised would be American flag blue, and although he did not promise Mexico would pay for it, he did arrange for a no bid contract with a swimming pool guy he knew, but within days of completion, the vinyl bottom split apart and floated in pieces up to the slimy surface and the water turned green with algae, just the way all the experts said it would.

But Mr. Trump does not believe in experts any more than his Secretary of Health believes in vaccines.

It was just so predictable.

And it was not Trump's fault.

Trump insists vandals vandalized his treasure, although none of the security cameras detected any vandals. But as any fan of the Jeffrey Epstein saga will know, surveillance cameras do not always catch every malfeasance. 

Well, there was one vandal, Davey Hearn, who stopped by on a bicycle ride along the mall, where he saw a floating piece of blue debris and tried to fish it out and was arrested for destruction of government property. And if anyone should know about the destruction of government property it should be Donald J. Trump, who has destroyed an entire wing of the White House, which, last I heard, was actual government property, even if Mr. Trump believes it belongs to him. 

For Mr. Trump, if you've occupied a house from VRBO, you own it and can do anything you want to it.

Davey Hearn, it turns out, is an American Olympic canoe guy, and he has a history with the Park Police, so he's lucky they didn't send him immediately to Alligator Alcatraz or deport him.

But, I digress. Even without Davey, the story is just so great.

The water is most determinedly green, not blue, and the Green Party is usually an environmentally committed party in most countries, and Mr. Trump says global climate change is a hoax, so he knows hoaxes.

King Canute ordered the sea to stop its tides.

The ocean did not pay him any mind.

King Donald ordered the algae to stop blooming. It stayed green.

Mr. Trump is not unreasonable; he would have done a deal for a blue bloom. The art of the deal.

But the algae has been no more willing to accommodate Mr. Trump than the Iranians have been about the Strait of Hormuz. 

Mr. Trump has trouble with water. Just ask Atlantic City.

And we all know, it's not easy being green.