Calling a Spade a Spade

 

"Smug, greedy, well fed white people have invented a language to conceal their sins. Israeli murderers are called commandos. Arab commandos are called terrorists...In the age when torture as become 'enhanced interrogation techniques,' when the rich are 'job creators,' when murdered children are called 'collateral damage.'"

--George Carlin

"Now your Northern nigger's a Negro

You see, he's got his dignity

But down here we're too ignorant to realize

The north as set the nigger free.

Yes, he's free to be put in a cage in Harlem in New York City

--Randy Newman, "Rednecks"

One thing which triggers Mad Dog is euphemism.

As George Carlin noted, this "softening" of language allows us to live with the reality of murdered children, ethnic cleansing or racial hatred by calling it something less offensive.

We are such delicate hot house flowers, our society would just disintegrate if the newscaster reporter that some Congressman called someone a "Nigger," or that some Senator called a colleague a "dumb fuck." 

Over fifty years ago, in 1972 Carlin's wonderful exegesis of the "seven deadly words" which could never be said on television, or in any public American setting titillated audiences and his album sold millions because saying these words in public was simply out of the question. As he examined the word "fuck" he pointed out that was a word which referred to the act which begins life, and as a sound it is actually not offensive, beginning with a soft sibilant and ending emphatically. What he was talking about was not really euphemism but crudity. It was crude to refer to sexual intercourse and the scatological "shit" instead of "excrement." There were acceptable substitutes--"fudge" or "frigging"--for "fuck" and "shoot" for shit. But it all came down to words which would be unacceptable in church or at the PTA or in a lecture hall or at a Thanksgiving dinner as painted by Norman Rockwell,  where women and children (the hot house flowers of American society) were present.

Thirty years ago, Mad Dog was struck by a report from the public grade school his kids attended--an eight year old was sent to the principal's office because he had said, "Fuck, no!" to his teacher. The child was Black and he came from the one part of Bethesda, Carver Road, where an enclave of Black folks, present since just after the Civil War, lived. He likely heard his parents and siblings use "fuck" freely, but he had not learned that in polite, formal, White society you cannot say such words.

Of course, now turn on Youtube and watch any comedian from from Carlin to Robin Williams to Bill Burr and you hear a steady stream of "fuck's" used almost as punctuation marks. You may say, well, that's a different setting, and that is true, but it is still a public setting and women (if not children) are present. 

When his adoring MAGA mob cultists talk about Trump, the first thing they always say is, "He talks like us." Meaning, he doesn't lie to us: He says "fuck." 

Avoidance of crudity, of those seven deadly words is a conscious choice, a "lie" really, in that it is a self edited version of presentation where really inflammatory stuff is avoided.

There are a few comedians who can be really funny without ever using an off color word--Rita Rudner is the epitome of that "clean" humor. Her humor is sly, not without reference to sex, but it relies on the listener's own intelligence to see the joke. That takes a kind of intelligence very few possess.

Part of why people laugh at Richard Pryor or Dave Chappelle or Chris Rock is they use profanity freely in a public hall--often immense public spaces--filled with people who've paid to hear them, paid to be titillated. Of course, each of these men would be devastatingly funny without the profanity, but the rhythm and gestalt of their shtick requires the four lettered words.

Nobody would ever think of charging them with public lewdness. People are paying for that lewdness.

There was a famous Supreme Court case where the defendant, appealing his conviction to the Supreme Court, had written the words, "Fuck the Draft" on his  jacket and he was arrested for Disturbing the Peace. 

His attorney chose to use the word, "Fuck" in oral arguments before the Court, believing that by saying that word out loud in the hallowed halls of the Supreme Court of the United States, and demonstrating the walls of the Supreme Court building did not immediately collapse, he might win his  case.

That case was Cohen v California, 1971, and the Court  ruled that "fuck" was not enough to justify a conviction for disturbing the peace. (A wonderful phrase, when you think about it. Could anyone be charged with that today when Mr. Trump and his MAGA mob are all about disruption?)

 Writing for the Court (in a 5-4 decision) Justice John Harlan noted the violation of local norms in the case of displaying the written word, "Fuck," was purely matter of  speech--the words had been written on a jacket, but the man wearing it had not behaved in any way other than wearing that jacket to disturb the peace. Cohen had not done anything to endanger or threaten anyone.  

Harlan went on to say that "one man's vulgarity is another's lyric"  

Four justices disagreed. Their dissenting opinion was written by Harry Blackmun who said wearing that jacket was not speech, but was "an absurd and immature antic." They would have preferred,  presumably, a jacket which said, "F-word, The Draft."

(Intriguingly, this uptight justice, Harry Blackmun wrote the majority opinion allowing for abortion in Roe v Wade.)

Of course, Donald Trump uses the word "fuck" frequently and publicly, as he did at his  New Hampshire rallies--before crowds--and nobody seems to mind.  

In fact, the crowds seem to delight in it, just as if he were a comedian using his jester hat to titillate and illuminate. "He sounds like one of us," which is to say, he talks to us the way we talk to each other at the barbecue. He doesn't pretend to be better than us by using language you'd have to go to some Ivy League college to learn.

So maybe it's not the word per se, but who is using it and under what circumstances. 

Speaking at meetings where only adults are present, like the Hampton Democrats meetings, Mad Dog would never said, "I just heard Trump say that if the United States pulled out of NATO, then Europe would be fucked." That word "fucked" would have to be replaced with, "You know, the 'F-word."

Even writers at the  New York Times do not report that an ICE agent in Minneapolis called someone he arrested "a nigger." They say he "used a racial epithet," or used "the N-word."

And what is the benefit of saying "the N-word" or "the F-word," other than virtue  signaling?

Oh, HE said that, not me. I would never be so crude.  

But that's a lie, and every MAGA mother knows it. Of course, you would and do use the "F-word" word," in private conversations. But in public, you'd pretend that word never passes your lips.

"The N-word" is a little different because it signals an attitude of derision unto hate in the mind of the ICE agent, who considers Black people or Negroes (which is a word Martin Luther King used) to be subhuman. Anyone who says, "nigger" is a hater, by definition. 

Not even Trump says "nigger," (at least in public) because he wants Black votes.

But, apart from "nigger" now, 50 years after the seven deadly words, and Cohen v California, almost anything goes on the American public stage. We are not living in Downton Abbey.

Of course, even today, we are told using words like "fuck" and "Shit" coarsen" our public discourse, sully our culture and grows hair on our palms.

Imagine American culture tolerating words like "fuck"!

HOOTERS MIDDLE SCHOOL BASEBALL TEAM

Mad Dog thinks we are long past all that, with the advent of Mr. Trump and those who sail with him.

And, Mad Dog asks quite unironically: How could we possibly "coarsen" public discourse or American culture any more than it already has been coarsened--in an America where a middle school baseball team goes out after the game to Hooters, as a reward for a hard won victory on the diamond,   the pre pubescent players can oogle the waitresses?

The fact is, most people, like Mr. Trump who use "fuck" use it because they have limited working vocabulary, and they use this word as a sort of verbal exclamation point; for many it is a verbal tick, a sort of easy rhetorical finger in the eye, a simple way to disparage, like that nine year old Black kid from Carver Road. 

They use these words because they have no better words.

For some, it is a way of saying, "There, I've said it. You want a piece of me? Let's step outside and settle this like men."

But, of course, these guys are not actually real men. They are children who have acquired years, but their brains have been arrested in development, mired forever in the dumpster of stunted display and degenerate neurons.

Let Us not Coarsen Our Public Square

There is a wonderful scene in the movie "Roxanne" where Steve Martin, playing Cyrano, accosts a man who has attempted to insult Cyrano's unwieldy nose. Cyrano spews out 20 superior nose insults. If you had any real wit, any smarts at all, you could have done way better, Cyrano is demonstrating. You could have said, for instance, as sexual innuendo, that my nose is so big,  "some of the ladies have asked if you wouldn't mind putting that thing away," or you could have leaned toward the meteorological: "Watch out, she's going to blow!"  

Of course, what he is saying is "you are so low grade you can't even come up with a good insult."

Can We Tolerate Coarse Language?

And that may be what is so dispiriting about Trump and his fellow travelers: they are simply not even bright enough to engage in imaginative deprecation. They can't even taunt with any panache.

One of Mad Dog's favorite take downs was from the Virginia Congressman, John Randolph, who was taunted by another Congressman about his lack of virility.  Randolph had some affliction, possibly pubertal mumps, which left him with  testicular atrophy, and so he was beardless, spoke with a high pitched voice and had only slight musculature.  Randolph responded to the insult, "You pride yourself on an animal faculty, in which the Negro is your equal and the jackass infinitely your superior."

John Randolph

The Barking Dog

 

And here's the nub...

The Problem of RFKJR

 

The PBS Newshour ran a segment last night about the effects of RFK JR's war against "unhealthy" diets as it gets expressed in food stamp programs (Supplemental Nutrition Assistance Program or SNAP) in Texas.

RFK JR does not want food stamps paying for soda pop, sugary cereals or a variety of other foods he deems "unhealthy."

And PBS found a dietician who informed the viewers that sugar gets converted into triglycerides which cause heart disease, which is about as close to the truth as the advertising on the Fruit Loops package claiming Fruit Loops are "heart healthy" providing significant bran content--but that's another story. (PBS NewsHour always believes you need to provide an expert to tell you what to think, or at least to set the table with the prevailing wisdom.) So, there you have it: there is authoritative opinion to support RFKJR's war on sugar. 

More interesting, PBS interviewed a woman who has used SNAP to buy Coca Cola and Pop Tarts and other things of which RFKJR would not approve, and she said that when you're working three jobs and you are throwing your three kids into the back of the car, driving them to day care, you don't have time to cook a three course meal, so you grab whatever you can out of the fridge, and you stick the plastic bottle with soda pop and the Pop Tart or pastry into the hands of your kids and you say, "There's breakfast" and they can eat it in the car, on the way.

There you have it from the mouth of a White, likely Christian, hard-working Texas mother who works three jobs, has three kids and does not have an office in Washington, D.C.

All this, of course, opens that can of worms which is how Americans, all people really, make food choices. And there is the bigger issue of who should make the rules by which this woman and millions like her should live.

As the wonderful documentary, "Food, Inc." showed, the American mother (who ordinarily does the grocery shopping, and who makes most of the food choices for the family) is driven by price, convenience and a strong desire to see her children actually eat the food she puts in front of them, and children, cats, dogs--any mammal really--will reliably eat sugar and they will smile.

The foods in the middle aisles of the grocery story, or on the shelves of convenience stores are A/ less expensive B/ prepackaged  C/ ready to eat D/ larded with salt, fat and sugar, so it tastes good. 

"Food, Inc." followed a mother, a Walmart employee, as she made her way down the aisles of her grocery store, comparing the price of a quart of orange juice to a two liter bottle of orange pop soda, to a six pack of orange pop soda she could hand out to each kid on the way out the door, and you know RFKJR would have a conniption. 

So, what we caught a glimpse of, from the PBS interview with that Texas mother, was the reality of how food choices get made in America. 

There was also a snippet with the owner of a convenience store (with the emphasis on convenience) who said, waving at his food shelves, with the gasoline pumps visible through his front window, and he said, "You think I got the time and space to stock fresh produce or steaks here?"

The only thing in that entire convenience store RFKJR would have found acceptable was the milk, and not even that, because it was pasteurized and homogenized.

But, the really interesting thing in all this is the inconsistency between the libertarian, "I do my own research" of RFKJR, when it comes to vaccines, and his insistence that when it comes to food, diet and groceries, RFKJR is perfectly happy to insist you eat the way he does, not the way you'd prefer to eat. He has done his own research--for you.

This is what happens, of course, when you have government: If government is going to pay for your meal, then you damn well have got to eat the way the government wants you to eat.

It's one thing to be on the outside, screaming about how Big Food is contaminating your precious bodily fluids with their sugar, their salt, their fat and their fluorinated water,  robbing you of your God given right to make your own choices for yourself, but it's quite another thing when you are now in power. Then you want to make those choices for other people.

There's also a more subtle culture war thing going on here. When Paul LePage was governor of Maine, he insisted that welfare queens were using Maine SNAP to buy tobacco, drugs, lottery tickets and all sorts of nasty things, as he tried to close down that program, which he thought was mainly supporting undeserving dark skinned people--there was actually an immigrant Somali community in Maine. So, his attack on SNAP was really a way of saying Maine had an unwholesome group--African immigrants--and he'd be damned if he'd give them a dime to support their habits.

There may be some of that going on with RFKJR's cohort going after SNAP, but many, if not most SNAP recipients are White, and poor and often working two or three jobs, and in the case of RFKJR himself, this is really most likely about his own certainty that he knows what good is, when it comes to food, because, of course, he has done his own research.

And, as is so often the case for people who do their own research, what they find out for their own selves affects a lot of other people as they execute the implications of their own findings, based on their own research: The classic case in point is Aaron Rodgers, the superlative quarterback for the Green Bay Packers, who did his own research and decided he would refuse to get a COVID vaccine, thus putting at risk every other player in his locker room.

The point is, when it comes to public health, there is that sticky word, "public." Almost by definition, any decision you make, or do not make or fail to make will have direct effects on other people, not just yourself. 

If you decide you know the truth, and you act on that, then a chain of events ensues: whether that's measles, COVID, gonorrhea, syphilis, Mad Cow Disease, pertussis, you name it. 

And if you take on the office of the head of the Department of Health and Human Services, then, almost by definition, you are going to impose your beliefs across the entire population of the United States. 

And if you reject the research of others, and opt instead to base your actions on your own research, well God Save America.

RFKJR operates in the mode of Rush Limbaugh here: He begins with a belief, then scours "the literature" for a selective reading to cherry pick anything which supports his original belief. 

He's not always wrong. Children would likely be better off eating from the perimeter of grocery stores, where the produce, the dairy products and the fish and meat are displayed, rather than eating from the middle aisles, filled with processed, boxed foods rich in salt, fat and sugar. 

His problem is he can make the rules, but that doesn't mean people will obey them. He can cut off SNAP benefits, but that may not change what people eat.

But mostly, as is true of nearly all convictions about food, you may not be able to define what makes food good, but you know it when you see it. Or at least, you believe you do.

Real Food and MAHA

 

The trouble with "nutrition science" is there isn't any such thing.

Real Food for Real Americans

This is one of those things which depends on discoveries and advances now centuries old, and then gets frozen in place.

Food Pyramid 1950
Cereal/Bread 11 x daily

Modern nutrition science began with scurvy, a truly horrific disease which afflicted sailors during the age of sail and wooden ships in the 18th and 19th centuries. Isolate cohorts of human beings in a self contained bubble, and you have a very nifty laboratory for experiment, as so many things available to human beings living in a community on dry land, with access to food, sunlight, fresh air, heat and sanitation have to be consciously provided on board.

RFK/MAHA: No fake food
What is "Nutrient Dense"?

So, when men sailing on ships were deprived of vitamin C--the whole concept of vitamins being then unknown--they developed dreadful mouth ulcers; old wounds and fractures re opened; fatal hemorrhaging; loss of teeth and swollen gums.  Then a simple observation: in ships where men had access to limes, scurvey simply did not happen. There was something in those limes. Eventually, that something was discovered to be vitamin C.

                       Would this Nurse Lie to You?

A whole belief system ensued: if there was one vitamin which could do all this, there might be/must be others, and if you were going to launch a man into space, where resupply of limes and other nutrients would be impossible, perhaps we could micro manage and simply provide a diet with all the necessary "nutrients" and vitamins and that would be compact and light weight enough to fit on a space ship and enough to maintain health. 

All we needed to do was to break down the components of foods, biochemically, to understand what we needed to send a long with the astronauts.

And thus: Tang!

But life is not usually that easy, and it turned out neither was feeding man based on a chemistry lab.

A typical American meal, whatever that may have been since the 18th century, has always contained thousands of different molecules beyond vitamins, and it was the great hubris of 20th century scientists to imagine we knew what they all were and how they interacted. 

And then there were insights from diseases: The lining of arteries got clogged with cholesterol rich plaques and thus eating cholesterol is BAD! Because  how could that cholesterol have got into those arteries beyond eating it? Turned out, it came from somewhere else entirely.

Norman Rockwell Repast

Meanwhile, American children growing up in the 1950's were shown food pyramids in all their schools, posters devised with the help of the American Dairy Council, which, unsurprisingly, showed diary products as the most healthy and necessary features, and along the way other commercial interests (Wonder Bread)  got their say and products were placed before the American public for fun and profit, but not based on science.

He thinks he knows. 

Mad Dog once spent all afternoon in a medical library searching through journals of nutrition and he was alarmed to discover that he could not find a single article anywhere in the "medical literature" he could call "science."

Science requires hypothesis, testing (experiment), challenge, confirmation. 

Beyond hypothesis, nutrition science in medical journals had little to none of any of this. Double blind experiments were, of course, impossible. The subjects and the researchers ordinarily knew what it was they were eating, although in a few studies something like chocolate or a vitamin was encapsulated in a pill and given to the subjects, but if you are eating a banana or an apple, you and the researcher know it. 

And then there was the problem of controls. You eat one thing and another person in a control group does not eat that. But just try enforcing that. We did one study at Yale which involved keeping subjects on the fifth floor Metabolic Research Ward and feeding them nothing but white turkey (thought to be pure protein, but of course it was much more)  and water. These subjects were carefully instructed in what the project entailed and were paid to live and eat on that ward. 

The problem was, the hospital cafeteria was also on the fifth floor, just around the corner and down the hall. Subjects were stealing off undercover, down the hall and buying the cafeteria's truly scrumptious oatmeal cookies, and when the results were in, the researchers could not find any effect of a strictly turkey (all protein?) diet, because, in fact, the subjects had not been eating a strictly turkey diet but they were  eating an oatmeal, sugar, salt, fat and turkey diet.

There have been occasional studies from Israeli kibbutz's which have enough control of what is eaten to approximate a ship at sea, but these are few and far between.

For the most part, dietary recommendations reflect the beliefs, the nutrition faith and ideas about what is a healthy diet which borders on religious beliefs of the person making the recommendations. Mad Dog is not talking about religious proscriptions against pork but he is saying the beliefs about what constitutes healthy food are just beliefs, as dearly held as religious beliefs, but with no actual science on which to base these beliefs.

It's sort of like the scouting reports from baseball scouts: if a player "looks good in jeans" i.e., if he looks well built, looks like a great athlete, he'll be able to hit the ball out of the park reliably. But that's just bias, not science.

And so, when we look at RFKJR's criticisms of "processed foods," we can well imagine he may be on to something. Just look at the ingredients on the label--which, it must be admitted, list the things we know are in those cookies, or that frozen lasagna but not the stuff which is in there we don't know about. But the stuff listed looks bad enough.

The director of a biochemistry lab at the National Institutes of Health once told Mad Dog about the coffee maker in his lab which was made whole by whoever got in first in the morning. There were 10 people in the lab and they consumed 40 cups by 10 AM. 

Then, one day, a summer intern, a college sophomore, did what kids that age might be expected to do, which is to say, he got up to mischief, and he brought over a cup of fresh coffee to the NMR (nuclear magnetic resonance) machine, a very expensive, sophisticated instrument which shows a graph of the different molecules in any sample, and he sucked up coffee into the machine using the little plastic sampling tube and forty different molecules printed out from the coffee, only twelve of which were known compounds or molecules.

After that, the coffee pot remained full all morning and the lab director eventually felt compelled to remove it because nobody in the lab was drinking coffee anymore.

"But did the NMR did not show anything bad," I asked. "I mean, no poisons or known bad actors?"

"No," the lab director said. "But what bothered everybody was all the things in coffee nobody knew anything about. It freaked everyone out."

"But if you did that for an entire meal on your tray, there would likely be thousands of molecules nobody recognizes."

"Might well be," the lab director said, "But the difference is nobody knows about all those mystery molecules. We haven't actually seen them print out on the NMR. And after that coffee NMR, nobody wanted to sample any other foods. Ignorance is bliss."

Mad Dog makes no recommendations about diet to anyone.

Personally, he does not eat barnyard animals or meat because he doesn't like the idea of killing animals or raising them in industrial settings. He eats salmon, which are suicidal fish and would just wind up belly up upstream after they've released their eggs and sperm and provide a feast for some lucky bears. So salmon, are okay to eat. And things without faces, like shrimp and lobsters. No guilt there, although, truth be told, Mad Dog buys his lobsters cooked--he does not have the heart to throw a living lobster into a pot of boiling water and listen to that hissing sound.

Having held a living fish in his hands, wriggling, trying to escape, desperately wanting to live, Mad Dog has wilted at the idea of becoming a full pescatarian, not with any sense of moral superiority--far from it--he realizes he is not morally superior to meat eaters--he's just a wimp when it comes to killing things that want to live.

But what is good for you? What is a "healthy diet"? 

Mad Dog has only the vaguest idea. Something uncontaminated by bacteria and parasites. Things not in the middle aisles of the grocery stores in boxes. Those things have been through some assembly line.

Better maybe to just take things off the tree or the vine or to pull it out of the ground and cook it. Add nothing but the spices from your pantry--and who knows what's in those, but a chance Mad Dog is willing to take.

Beyond that, Mad Dog believes, nobody really knows.

Selling the Harvard Name

 

A friend of mine married a Japanese man and moved to Tokyo where she gave birth to twin girls. I hadn't seen her in a decade, but she dropped in to see me with  her daughters, on a trip the US; they were on a college tour. 

Her in-laws, she told me, wanted her kids to go to Tokyo University, but they were willing to consider two American colleges for their grand daughters. 

"So, you're on your way to Harvard?" I asked. 

She was a Harvard alumna.

"Oh, no!" she laughed. "The only two American colleges they would even consider allowing their grand daughters to attend are M.I.T. or Wellesley."

"What's wrong with Harvard?" I asked.

"Too soft. Too many kids who were selected to play football or ice hockey. Simply not academically pure enough. They want their girls to use their college as a springboard for their careers."

"But, Mark Zuckerberg and Bill Gates went to Harvard."

"Exactly," she said. "And both of them looked around, concluded Harvard had nothing to offer them and they were gone after a year."

Growing up in Washington, D.C., in a place where and at a time when "credentials" were paramount, I looked to the "best schools" to punch my ticket at age 18, but I never considered Harvard, even after all the glamour which attached to that college during the Kennedy/Camelot years.

 The fact is, judging huge New England institutions from 500 miles away was done pretty superficially. But we did have a local touchstone: we could see the kids who went to Harvard from our own high schools. 

There was one person, Caroline Pope, who was in my classes, and when I read her papers I realized she was in another league altogether from me. The vocabulary, the insight, the mastery of her work, whether it was about James Joyce or Jane Austen or the significance of the Renaissance or the Bloomsbury set--she was simply of a different quality. She went to Harvard (Radcliffe, in those days) and she belonged at the best university in the country.

But all the other kids who shipped off to Harvard

 who I knew were unexceptional, at least their talents were no greater than my own; they simply studied all the time. They were colorless, uninspiringly, asexual, boring and in some cases, not very smart.

One of them, Martha, showed up to our study group to discuss the assignment, "Discuss the use of 'Roads' in Dickens' 'Tale of Two Cities," and she stunned us, her classmates, by unsheathing a long list of the pages where the word 'road' appeared in that 400 page novel. This was long before  you could do 'word search' on a computer, decades before home computers. She had simply gone through the book, page by page, and she tabulated the word 'road,' thoughtlessly, ruthlessly, studiously, to no point at all.

Another guy was the manager of the basketball team, and he kept meticulous records of how many shots each player had taken, how many had scored, and a lot of other statistics in days well before "metrics" were a thing in sport.  I don't think he ever went out on a date in high school. At a class reunion, twenty years later he approached woman who had been a pretty, cheerful, nubile adolescent and he told her he had always longed to talk to her in high  school, but he never had the nerve. She looked at him, still a blue eyed beauty, and said, "Well, then, you've come a long way. We're talking now."

So, apart from Caroline Pope, all the other kids who my high school sent off to Harvard were worker ants, reliable lieutenants for whom executing orders was their purpose in life, but they were just taking up space, living in the best spaces, comfortably, company men and women.

So, no, I never had any interest in Harvard.

Even in medical school, when we were applying for internships, I never considered any of the big Harvard Medical School programs--MGH, The Brigham, Beth Israel--because they did not offer housing for their housestaff, and because  their clinical training was inadequate: an intern admitting patients at night was one of three other interns being covered by a single resident, which struck Cornell medical students as a sort of high wire walk between the twin  towers of the World Trade Center. 

 Decades later, I was struck by the fact that if I sent a patient from Haverhill, MA, down to MGH for consultation or admission I never got a call from anyone down there asking for information (which I always sent in advance anyway) and never heard a word from the doctors about the patient, or what the staff at MGH thought about her. 

That would have been an unforgivable sin at the New York Hospital, and certainly at Johns Hopkins. "A failure to communicate," was no joke at these places, but it was endemic to Harvard hospitals.

The Harvard hospitals have plenty of business, being the central magnet for patients from all over New England. They do not need "the business." But, if you are a university, you are supposed to be driven by values which go beyond business. You are supposed to be doing things right because it's the right thing to do. 

At Harvard, it's now all about the money.  Maybe it has been all about the money for years.

Now, of course, I get daily offers from Harvard, trying to sell me for $3,400, an online certificate or in some cases, an online "degree" embossed with the Harvard logo for having purchased a little piece of Harvard for my office wall. These Harvard paraphernalia are marketed on Linked In and through a lot of online agents who have my emails on their lists of nice names.

It's like those "Best Doctors" plaques marketed to doctors to display in their offices; for only $500 you can tell your patients that somebody "voted" you best doctor in your community. 

Many businesses try to protect their brand name which they consider a key part of their companies' value. They don't want their brand, their logo associated with the wrong people, the wrong things. Reputation, "brand name," is difficult to measure. It's not something you can put in a bag, but it's considered so important, they employee a boatload of lawyers to protect.

Harvard, apparently, has not grasped that concept.

Jeffrey Epstein craved that validation from Harvard. Neither Yale nor Princeton would do. 

Perhaps he needed to get a little farther away from New York City, because someone closer to his origins would have known a little too much about him. 

And, according the New York Times, Harvard professors and officials were only too glad to sell the Harvard name without asking too many questions, as long as the money was good. Mr. Epstein donated $200,000 to Harvard and in return he got to be a "visiting fellow" in the Harvard math department.

And, of course, Epstein quickly appreciated how Harvard faculty (like those of other universities) were keen to spin off the discoveries they made at their universities into private companies for personal profit. In the information age, information and knowledge is where the dollars are. You might have a base salary, a lab and an office at the university, but anything you discover there, you can take outside the university walls and turn into personal profit.

Up here in New Hampshire now, we are just close enough to Harvard to know enough stories, enough people to be less starry eyed about Harvard. The institution is not some Disney castle, but more a work a day place where some people are truly remarkable and worth a trip, but many others are just grubby and repulsive.

Henry Kissinger, who needed the Harvard name to buff his personal image, was a loathsome character, who, even more than Larry Summers or Alan Dershowitz, did the world a ton of harm, parlaying a basso profundo voice and his Harvard creds into a guru status, enough to design and execute the immolation of innocent villagers on the far side of the world, because, you know, they were, in the end, just little people.

Large universities are cities behind walls and, as in every city, there are admirable people, some brilliant, talented people, but there are also the despicable creepy crawlies and then there is the lonely crowd of tourists, there for four years who then move on.

 

Donald Trump, evil genius that he is, has discovered you really can overthrow the empire, and you don't have to do it by a thousand cuts, of which the Jeffry Epstein story is just one: You can cut off government funding, on which Harvard has become dependent. It is as if Harvard, which was once an apex predator, has regressed to a suckling pig, unable to sustain itself without the government teat. 

So, you have professors who criticize or question Mr. Trump or Mr. Vance or Kristi Noem? Then all those labs in your medical school devoted to fighting cancer, stroke and heart disease will just have to close down because they depend on government funding.

Control the gold--Make the Rules

And Harvard is not alone in that. At Yale Medical School, when I was there, it was the rare faculty member who derived his salary from Yale University--everyone else had to find a grant from the federal government for his salary.

What the Jeffrey Epstein/Donald Trump era has  revealed is that Harvard, and other big institutions of higher learning, have gone after those bright and shiny things, but they discover they are attached to hooks and they got reeled in.

The Liar, The Witchdoctor and the Warroom

 

"Humankind cannot bear very much reality."

T.S. Eliot

"You have to understand, we are just at the beginning of this thing. What we tell you this week is  based on the best available information we have right now. But six weeks from now, with new information, we may be saying something entirely different. That's science. That's the way it works."

--Dr. Rich Conit, podcast "This Week in Virology" 2020, speaking of the COVID pandemic.

                             Banting & Best & dog

I was going to title this blog post, "Of Snake Oil, Hulk Hogan and Brain Worm," but the chance to echo C.S. Lewis prevailed. 

Listening to Pete Hegseth unwittingly quoting "Pulp Fiction," and presenting it as Ezekiel 25:17, using scripture to establish his war cred, I thought, what could be more illuminating?

Seeking authority often entails claiming to possess the Truth, to have true knowledge. There are several ways to come by knowledge:

1. You can do the hard work of science: observation, record keeping, tabulation and publication so others can try to disprove or corroborate what you say is true. But this is a tedious, laborious and demanding process.

2. You can refer to a written text, something like the Bible. How often have we heard someone, caressing the Good Book, worn by use, saying, "All the answers are right here, right here in this book."  The advantage of quoting the Bible is there is a nifty sounding verse, "Ezekiel: 25:17" which nobody will have time to look up, until the advent of  Google, and even after that, there often isn't time, so you can sound erudite with pretty little effort.

3. You can just pretend, play a role, as actors do. This is the path chosen by Bobby Kennedy, Jr., as he refers to some article from the medical literature, as if he has actually read and understood the whole thing, and then he can conclude that more people were harmed by the polio vaccine than were ever saved by it, or that 75% of people given a vaccine were harmed by it.

The thing about science is, unlike "reading the law," you cannot really do it on your own. This is why doctors have "journal clubs" where they read articles from The New England Journal of Medicine, and various specialists will give you the background of why an article was written, how the research was done and what the problems really are with the conclusions. RFKJR does not go to these journal clubs. He just scans articles for sentences which might be construed to support the firmly held convictions he brings to the article and he goes from there. He is "doing his own research," which means, he really isn't reading for understanding; he is scanning for cherry-picked sound bites.

Virtually no scientists doing important and reliable research do their own research; they all operate in a community and they are rivals, teammates and in constant communication.

 

Anti-vaxers have been particularly animated by RFKJR, but resistance to the whole idea of vaccination has a long history.  The forerunner of vaccines, was inoculation, where a small dose of a virus (or material from a small pox pustule) was injected, and a mild case of smallpox ensued, but it wasn't always mild. The idea of giving a healthy person a disease to prevent a worse disease was a hard sell in the eighteenth century, and Cotton Mather, a cleric and Dr. Zabdiel Bolyston, a Boston physician, met agitated resistance: A bomb was thrown into Mather's home, because he advocated for smallpox inoculation.

Fear the Smallpox

It came down to the question: Which are you more afraid of: the disease or the medicine?

Small Pox 

When I was a medical resident, I saw what influenza could do. Sometime around midnight, we admitted a 21 year old woman to our intensive care unit at New York Hospital--she was a dusky blue color, in and out of lucidity, and her blood oxygen level was incompatible with life. She died in three hours, despite our efforts. I presented her story to every conference, every doctor I could, trying to figure out what I could have done to save her, but failed to do. Most of the older doctors, who had seen the last influenza epidemic decades before, simply shook their heads and said, "That's what influenza can do." 

When I saw her lungs, at autopsy, I understood why we had failed to raise her blood oxygen level: they had turned into the consistency of the liver you'd buy at a butcher's--normal lungs are spongey, full of spaces for air to be captured. She could not move any air through her lungs to her bloodstream. 

Years later, now in private practice in the real world outside the hospital, I urged all my patients to get their annual influenza vaccine. One of them, a fifty-two year old woman, developed Guillain-Barre syndrome following her vaccine and she had to be hospitalize for the polio like syndrome. She fell out of her wheel chair in the hospital and broke a hip. When she finally got home, I stopped by to see her, expecting to incur her wrath or the rebuke from her husband, but they were forgiving and pleasant. 

"It's a risk of the vaccine," she said. "I knew that."

"I don't think I ever mentioned it to you," I told her. "But, if I had, I would have still urged you to get the vaccine. Guillain-Barre just so rare. You were just the lucky one."

"I know. Of course, I'll never get another flu vaccine."

The risk of something comes down to numbers, to record keeping, to a lot of meticulous, boring, hard work and people who fear and vilify vaccines don't want to do all that. They just want to know, without doing the work.

Science is often a slog. 

Before anyone knew about insulin, children with type 1 diabetes were treated with a diet by Elliot Joslin in Boston. He reasoned that because these children were known to have very high blood sugars if you denied them any sugar--or anything in their diet which could be transformed into sugar--you could control their blood sugar. Some children seemed to live a little longer, but they looked like living skeletons and they died anyway.

Then, one summer in Toronto, an irascible former Army surgeon, Frederick Banting, and a PhD student, Charles Best, spent the summer of 1921 chasing down a phantom agent in dog pancreases, dissecting out the pancreases, tying off the pancreatic ducts in their dog victims/patients and inducing diabetes in them, showing the pancreas was the source of something which prevented diabetes, and then they more or less isolated that something, which they called "insulin."  It was tedious, frustrating, demanding work, done in a steaming laboratory of a hot Toronto summer, but when they finally had enough data and had gone through enough dogs, they presented their findings to a conference of doctors in New Haven, and Elliott Joslin listened, asked questions and then beamed. You have made my diet a relic. Now we have a new understanding and a new approach which will finally work. 

Before and After Insulin 1922

That's science.

RFKJR never worked that hard at anything. He's never done anything like Banting and Best beyond dissecting out a racoon penis from a road kill raccoon, and calling that science.

For centuries, the Bubonic Plague had ravaged Europe, laying waste to whole populations, sometimes cutting down half of all living human beings, and there were lots of "doctors" and priests who wandered around wearing beaks and carrying whips, the RFKJR's of their day.

Then, Alexandre Yersin, who had trained in Louis Pasteur's laboratory, who knew the techniques for growing bacteria in the laboratory, and he headed off to Hong Kong from his clinic in Vietnam and he managed to capture, identify and raise antisera to the bacterial agent, Yersinia pestis, and when Plague made its way to Vietnam he saved the villagers surrounding his clinic. That was a lot of dangerous, demanding hard work, but he did it.

Alexandre Yersin

 

RFKJR has never done anything like that.

The thing about science is it has to happen in the real world, not in fantasyland. In fact, a lot of science is simply an effort to understand what is real, and what is not.

It requires creative thought, innovation, but it usually also requires building upon what has been done before you, and using that to understand new stuff.

Ask any middle school kid at Hampton Academy who Banting and Best were or who Alexander Yersin was, or how type 1 diabetes got tamed, or how the plague got controlled and you will get nothing but blank looks. They can tell you who George Washington was, or Robert E. Lee reliably enough, but have they ever heard of Jonas Salk and the polio vaccine story or about small pox vaccines or how observations about milk maids with cowpox led to the small pox vaccination? 

We just don't teach that stuff to Americans.

The New York Times reports that over 3 dozen American physicians and nurses are running for Congress, mostly running against RFKJR. Of course, 40 years ago that could never have happened, because 40 years ago most doctors were in private practice and they could not afford closing their businesses to run for Congress. Now 90% of physicians work for corporations, they are hired employees paid by large corporate entities to be "providers."  A pediatrician leaving a job with Partners paying $90,000 a year is not a wrenching financial decision.

There have been physicians in Congress, of course, but most were more like Dr. Bill Frist, whose father started the for profit Hospital Corporation of America in Nashville, and when Dr. Frist left the Senate, he did not return to doing transplant surgery; he started a corporation to provide health care. Dr. Frist was frustrated in the U.S. Senate because, unlike in the operating room, he could not just  give orders. He found himself having to deal with 99 other Senators who often disagreed with him.

None of those health care providers, if they do win their seats in Congress, will be able to do what RFKJR has done to American health care as a cabinet Secretary. RFKJR has single handedly destroyed the CDC, the FDA, and a host of other lesser known agencies which once did good works for America, and never mind what he's done to the National Institutes of Health or to the thousands of universities where research funded by the NIH was doing good work until RFKJR acted fast and broke things, to the delight of the MAGAmob. 

So we have RFKJR, who more Americans can name, recognize and even quote than there are Americans who can identify Banting and Best, Yersin, Jenner, Salk or any of dozens of scientists and doctors who have made far more difference in their lives, the way they live their lives every day than any general or President ever has.