Saturday, March 30, 2019

Inflexible Minds

Nearly eight thousand endocrinologists from all over the world met in New Orleans for 5 days and speakers at each session were drawn from well known, highly published researchers and clinicians working on the topics they discussed. 

If you pay your money, you can attend and even as a wee little humble country endocrinologist, you can go up to the microphone and ask your question of the giant on the stage.

My first question was prompted by the comment from the professor who was discussing weight loss diets which included intervals of severely restricted caloric intake, alternating with less severe restrictions. She began by saying that she was from Wisconsin where 65% of the population is obese, so she had no chance to find human beings who were willing to severely calorie restrict for her studies, so she studied mostly rats. 

I rose to point out that she had on her campus a cohort of young men who had engaged in severe calorie restriction from roughly age seven for 6 months of each year until they were 22 and they were spending 4 years on her campus: The wrestlers. 

She blinked like a deer in the headlights and asked the other doctors on the stage what I had said. "The wrestling team," one of them explained. "Oh," she said, clearly having no idea what I was talking about and that was her entire interest in the proposition. 

I have long thought the caloric privation of this group of human beings ought to be studied systematically. There is a theory that diabetics who are intensively controlled with weight reduction and sugar control, if only for a year or two will have a "legacy" effect lasting many years. If this is true, what happens to the young men who have been rigidly controlling their weight and diet? Do they have a legacy effect after they finish their wrestling careers?

No interest in that on the part of the scientists.

Another professor talked about adrenal nodules which have been called "Non functioning" for decades, meaning they do not over produce any of the hormones made by the adrenal gland.  They have been thought to be inert, just sort of like calluses, a lump in the bread dough. But this professor showed a slide demonstrating these nodules make the usual array of adrenal hormones, just none in excess. I asked whether we should not drop the term "non functioning" since they clearly did function, just not excessively. Again, the professor seemed stunned. But we've always called them non functioning adenomas. 

But the best was the testosterone lectures. The professor went through the very common problem of young men who "abused" testosterone, usually "gym rats" who take industrial doses of testosterone they get illicitly at the gym, but when their supplier runs out, they often stop their injections and allow their blood levels to fall to very low levels. It takes a while for the testicles, which have shut down while a tidal wave of exogenous testosterone from the bottle has been washing through, to restart and to fire up endogenous production. During that recovery period, the man can go to his primary care nurse and ask for a testosterone level, which is temporarily low, and then they get referred to the endocrinologist so they can get prescriptions for testosterone to inject.

Of course, this game is easy to recognize: The patient comes in looking like Arnold Schwartzenager, his testes often small and atrophic, complaining of "low T." The professor described a variety of lab studies to confirm all this, and much discussion ensued about who to deal with these drug abusers. 

These men are in some ways like anorexia nervosa patients, who look in the mirror and no matter how thin they are the anorectics see a fat person; the same is true for the testosterone abusers; no matter how muscular and bulky they get, they see themselves as under muscled.  Doctors from other countries described how they treat these patients in clinics alongside psychiatrists. 

Then I visited the talk by the doctor from Mt. Sinai Hospital (NYC) who talked about how he replaces testosterone in his patients who are female to male transgenders and how he relentlessly increases the dose of testosterone, raising their blood levels to "levels we see in androgen abusers" but this is necessary to achieve the goals of facial hair growth,  voice deepening, muscle development.

After the session, I emailed the professor who had spoken about "androgen abusers" and asked whether he would agree that the folks treating transgenders were not also "androgen abusers," both the doctors and the patients. 

He replied that this was using testosterone for "gender affirming" goals and only if the patients were attempting to become overly muscular would he think of this as androgen abuse.

The fact is, political/value thinking has driven the approach to "transgender medicine."  The suicide rate among transgender patients has remained between 25 and 30% for 30 years.

If we embarked on any other sort of therapy for patients which was attended by a 30% mortality rate, would we be permitted to persist? 

The transgender clinic folks say transgenders commit suicide because they are so abused by an intolerant society.

But is it not also possible transgender commit suicide at such astonishing rates because the underlying disorder is itself, a severe psychiatric disease? Are we actually helping these folks by giving them what they ask for? 

It is also remarkable how wide the range of therapy: Some female to males do not want voice changes but just to "seem more masculine" and so they are given just a little testosterone. Others receive super doses if that's what they want.  Some receive testosterone but continue to have vaginal intercourse, and need contraception so they don't get pregnant.

When discussing placing IUD's in these patients, one of the treating physicians remarked the whole procedure of placing the IUD was very traumatic for the patient, presumably because it was a reminder of their underlying anatomy--in a patient who is having vaginal intercourse!

Much was made of the idea that we all ought to be careful to elicit what "pronoun" the patient prefers to refer to himself/herself with. Females to males often want to be referred to as "him." This should be scrupulously complied with. 

Some "binary" patients (those who identify with both or neither gender) want to be referred to as "they."

My mind is clearly too inflexible to accommodate all this. It all struck me as the inmates in charge of the asylum. And that is just what the transgender clinic folks would object to: We are not superior to these patients and it is patronizing to even question whether we should not give them anything they wish. 

Which means, of course, we have to give the transgender all the testosterone he desires but we refuse this to the male who wants to "abuse" testosterone to get the effect of increased muscle mass. 

Tuesday, March 12, 2019

MAGA, MAGA, All Come Home

Bill Nye recently asked Alexandria Ocasio-Cortez how she planned to deal with those who were afraid of change.

This, in essence, is the question of the current era: Mr. Trump won, if he won on anything, on the idea that we have to go back to a better time: Make America Great Again, was a call to return to the times when father went off to the factory with his lunch pail, while mother stayed home with the kids and they had a car and two weeks summer vacation and everything was just swell in America. 

While we cling to the past we should remember that the Czar, before World War I, called for a convention of nations in order to get everyone to agree to not seek new knowledge, new technology to make guns shoot farther or to develop more powerful weapons, because he realized his government could not spend the money an arms race would require.

He knew, on some level, that any army or navy of the modern age could defeat any army or navy of preceding ages simply because their technology is better. So the mighty wooden British Navy of the 1700 and early 1800's would be utterly destroyed by any Navy, say, the Italian Navy of 1940, without the loss of a a single ship or life by the Italians, simply because of technology.

There is a wonderful scene in "Master and Commander" in which Jack Aubrey, the captain of a British man of war examines a wood model of the ship he has battled and been nearly wrecked by, the double hulled French ship, and he remarks, "What a marvelous modern age we live in!"  He could not even imagine iron ships under steam power. He was so masterful handling his wooden ship, which he had joined as a 13 year old, and had bled into its wood enough that he felt it was a relative, he could not make the mental leap into an age where none of what he knew, the wind, the sails, the management of sailors aloft, using the wind gauge, firing mussel loaded cannon, would be rendered totally irrelevant to winning a battle at sea.

And yet, less than 60 years later the iron clad ships of the American civil war would render wooden ships impotent. 

Small changes, like the rifling of gun barrels, changed the equation on the battle field, and another small change, the machine gun did even more,  but physics would ultimately make these incremental advances seem almost quaint.
It was only 76 years between Custer's last stand and the dropping of the atomic bomb on Hiroshima. All that in the lifetime of a single man.

Those who could not embrace the notion of change were, literally, incinerated.

Now we are asked to hold fast, to in fact, turn around, about face, toward a sweeter, happier nation, an Ozzie and Harriet, a Leave It to Beaver past.
Pre vaccination polio, iron lung ward

But consider that past, a past when "White Supremacy" was the official motto of the Alabama Democratic Party (1966) and before the state of Mississippi had not ratified the 13th amendment abolishing slavery (1995!) and 1923 when the Mississippi supreme court found it legal for that state to expel from all-white schools two children whose great-aunts were rumored to be married to coloreds on the grounds that the law was intended to "prevent race amalgamation" and, the court approvingly noted the law meant to insure "the broad dominant purpose of preserving the purity and integrity of the white race."  Oh, this too, was America, as Louis Menard has noted in his New Yorker article "In the Eye of the Law." 

In Plessy v Fergusson, a case decided in 1896, the Court argued "We consider the underlying fallacy of the plantiff's argument to consist in the assumption that the enforced separation of the two races stamps the colored race with a badge of inferiority. If this be so, it is not by reason of anything found in the act, but solely because the colored race choose to put that construction on it." 

As if there could be any other construction put to it.

Not until Antonin Scalia did mental contortions to explain why "A well regulated militia" did not mean the authors of the Second Amendment were saying guns did not not belong to individuals but to organizations intended to defend the state, was there such transparent idiocy from the Court. 

But this was all an effort to keep change at bay.

In 1896, there were 130,334 colored voters registered in Louisiana; by 1904 there were only 1,342. This was not because colored voters had left the state; colored voters were stripped of their right to vote in that America of former greatness. 
That was "Jim Crow." That was the counter revolution to the 2nd American Revolution which freed the slaves and gave all men the right to vote regardless of race.

In 1930, Birmingham, Alabama passed a law making it illegal for a White and a Black person to play dominoes or checkers together. In 1932, Oklahoma outlawed baseball clubs, one Black one White, playing baseball within 2 blocks of one another.  

For a period of 50 years there were something like 10 lynchings of Blacks in the South every week. 

So this is the America we seek when we want to Make America Great Again.

We want to go back to wooden ships, and muskets and a time when hate rule supreme in the 14 states of the former Confederacy and in Western states like Oklahoma, and in the mountain states and the high plains states which now comprise the Red States. 

Read Howard Zinn, Oliver Stone. Read real American history. Watch "Platoon," and "Full Metal Jacket."  There you will find the real MAGA. 

Humankind cannot stand too much reality, T.S. Eliot warned, and we can see that in full bloom in Mr. Trump and his core.  
These are the fearful, the cowering, who are terrified of what the future may bring, who cleave to a past where you got points for being white, where simply being white guaranteed you always had someone below you in America.

 Make America Hate Again. That's the real message. And it's a message of weakness. "Home of the free. Land of the Brave." Not for Trump who sees MS-13 in every immigrant family presenting itself to the Southern border. 

MAGA. 


Saturday, March 9, 2019

Sacred Heart: Audacity Incarnate

It's that time of year again: The warrant articles marathon.
Rather than a town meeting, Hampton, NH has a day when residents show up at Winnacunnet High School and vote on a tome of articles concerning funding for schools, police, fire department and whether or not Mrs. Jones should be allowed to plant petunias on the far side of the sidewalk, which is ground actually owned by the town.

Sequestered in among all the weeds is a nasty little piece of work, warrant number 5 in the SAU category, having to do with schools.

The local Catholic school, Sacred Heart, located behind the Miraculous Medal church, has 39 children who live in Hampton but whose parents enrolled them in the Catholic school.

Now the Catholic school has presented a bill, it hopes the good people of the town will vote to pay for those 39 students x $998=$38,922. The school argues that if those children attended Hampton public schools, it would cost the town $15,000 to educate each of these kids, so the town is actually getting a break and saving money as a result of the efforts of Sacred Heart.

Of course, the immediate objection was this would be a violation of Church/State, a local government sponsoring a religious school

But that is not actually the most outrageous argument here: The basic premise is wrong.  It's accounting flim/flam on the part of the Church.
Paid For Lovely School, Hampton, NH

It would cost the town of Hampton not a single dime more if all 39 of those students attended Marston Elementary, the Hampton Academy or Winnacunnet High. Those kids have already been paid for: the teachers are already in place to teach them; the buildings are already constructed (or, in the case of the Academy, under reconstruction at great cost); the facilities are already supported by Hampton taxpayers and now taxpayers are being asked by Sacred Heart parents to pay for their own private school.
Hampton public school could use 39 more students

If Hampton had a community swimming pool, would the parents of Sacred Heart  ask the town to reimburse them for the private swimming pools they had built in their own backyards, on the grounds that the town no longer had to pay for the use of the community pool by the children of the homeowners with private pools?

And why not ask the town to pay for the country club memberships on the grounds that country club golfers are no longer burdening the public golf course?
Lovely public school

The possibilities are rich and expansive. 

How about the cost of landscaping your home, on the basis the town no longer has to pay for roadside beautification?
Really spiffy school could use more Catholic kids

If this warrant article passes, Mad Dog will seek a lawyer willing to sue the town to prevent this payment. The warrant article may slip by, but the courts should have something to say about this boondoggle, which even in the age of Trump, is just one absurdity too far. 

Wednesday, February 27, 2019

Horses on Hampton Beach: The Straight Poop

Last night my wife was out to dinner and for once I had control of the TV. Ordinarily, by long established rights and privileges, she watches TV after the News Hour. 


She hates the PBS News Hour: It's booorinnng! I refuse to watch commercial news, so the compromise is I get that hour and she has the rest of the night. The TV adjoins the kitchen so she can cook, wash dishes, run the garbage disposal, do anything she can to drown out the News Hour and after that, I leave the room, go down to the basement or up to my room and she watches Blackish, Scandal, some show with Jane Fonda and Lily Tomlin and we have peace in the house.

But last night, I got to watch my own choice and I chose Channel 22, the Hampton town channel which has the town selectmen or whatever they are called,  discussing important plans, projects and issues. I watched fascinated as a woman, Jennifer Hale, from the Dept of Public Works , described the progress of road construction, the replacement of street lights along Rte 1 with LED lighting. She was just so competent; she knew all the details about building roads, allowing for settling, drainage ditches and she must be some kind of engineer. I was mesmerized.

Just about the time things really heated up, my wife returned and immediately started storming around, demanding I relinquish the channel clicker, but just at that moment they got into the question of horse poop on Hampton Beach.

"I'm starting to get a flashback," my wife wailed. "It's PTSD!"

She used to cover town council meetings like this in her first job as a cub reporter for the Springfield Daily News. Sewer installations were her specialty. She is to this day very proud of the fact that H. Mead Alcorn, a big Republican mucky muck, had her bodily ejected from some meeting for asking "impertinent" questions. She was hero for the day back at the newsroom, but she hated that job.

Anyway, it turns out that "the equestrian community" loves riding their horses along Hampton Beach in the off season and there are sometimes as many as 12 horses down there trotting around. The horses, of course, leave behind lots of poop, and some locals have complained to the town selectmen. "After all," one of the selectmen noted, "I get after people who don't clean up after their dogs, and these horses leave a lot bigger poops behind than any dog."

There ensued a spirited, if completely uninformed discussion of the difference between dog and horse poop. One selectman asserted the dog diet is such that it poses a risk to human health but horses eat mostly grass and hay and so their poop is innocuous.

Consulting Professor Google, I could not find substantial evidence to the contrary. It seems, depending on the diet, dog poop may contain parasites or some sort of undesirable bacteria, especially if they have been fed raw meat.

Horses do not eat raw meat.

What nobody said what the risk to human health for either dog or horse poop may not be known but the aesthetics of poop on the beach, beyond seagull poop, is hardly in dispute. On the other hand, during the winter, the only people on the beach are walking animals. Well, maybe not the only people, but the vast majority.

It turns out the Hampton Main Beach and North Beach are state parks and come under state law and there is no state law against horses on the beach, although there has been a law against dogs on the beach, possibly recently amended to allow them after certain hours in the summer, on leash.

The question was referred back to the Hampton state representatives, two of whom were in attendance (SenatorTom Sherman, and Representative Pat Bushwick.) Presumably, they will bring the concerns of local beach walkers back to Concord and we will have some answers about horse poop, horses and the role of the equestrian community, in Hampton.

This morning, my wife noted, the headline about the meeting, written by some cub reporter, was "Hampton Selectmen Meeting Mired in Horse Manure."


Tuesday, February 26, 2019

Downfall: Then and Now

Horror movies have a strange fascination: part of the joy is walking out of the theater, into the light of day, safe. 
Of course, some, like "Jaws" stay with you because you look out at the surface of the ocean and now you see it differently; you know what monster and danger could well be, is certainly, under that calm surface.

A woman won a $10 million dollar lawsuit against the hospital and doctors which had removed a benign tumor (a meningioma) from inside her skull, claiming the surgery had destroyed her clairvoyant powers.  She had made her living as a psychic. Of course, the argument went, if she had such powers to see the future, she would have foreseen the loss of her powers and not submitted to surgery. But, then again, she would not have got that $10 million, more than she could ever have earned as a psychic in her entire lifetime. So, maybe...

Seeing the future from the present; seeing the present from the past. All possible.

Watching the 2004 movie "Downfall," the unease grows and grows because what you are seeing becomes more and more familiar, more current as things progress.

The power comes from the familiarity. 
Hitler, is so kind in the opening scenes, as he selects from a line up of seven starstruck twenty year old women a willowy lass from Munich, who he selects, perhaps, because she is from Munich which seems to resonate in some happy place in memory for him. 
She is pretty and she is terribly nervous as he brings her into his office and begins dictating a speech which she is supposed to type as he is speaking. Of course, she should be taking shorthand and then transcribing it; shorthand was developed because even the fastest typist cannot keep pace with the spoken voice. She falls behind and slumps, defeated, at her typewriter, but Hitler says, "We all make mistakes. I make so many. Let's just try again."

She is forgiven, hired, dazzled, instantly loyal to be selected from among the seven women. We see she has been given an impossible task, failed but he likes her enough to say, well, we'll work it out.

Hitler loves in the abstract: he loves the looks of the children brought before him, if they have the right looks. He loves the freshness of the women who work in his bunkers. 

Surrounding him are a rogues' gallery of unappetizing scoundrels, but also some ostensibly decent folks--Albert Speer is reticent, but stolid, standing by Hitler as Hitler lovingly touches the room size, white model of the thousand year Berlin, the best capital in the world, the best city ever to be built on earth. It is a wall against mortality and the mongrel hordes. 

Little by little, you see it, the slipping away from reality, the delusions of grandeur, as Hitler cannot see what everyone around him can see--that city will never be built and, in fact, Berlin, far from being the grandest, most spectacular city on earth, the anchor for a thousand year Reich, is collapsing around them.

The relentless optimist, Hitler orders armies which exist only on paper, on his map, against the overwhelming hordes closing in around Berlin. He clutches a red and a blue pencil he uses to draw on his maps, showing where he thinks his armies are and then should be to crush the Russians encircling him.
The power of positive thinking starts to crumble, but he cannot see it. If he says it, it will happen. 
The triumph of the Will!

He dismisses his top generals, one by one, as effete products of the academy where they only learned to hold a drink or to eat with fine silverware, and when any one of these generals fails to cleave to his plan to never take a step backward, he turns on him as a betrayer. 

The generals keep pointing to where Berlin is--so close to the Russian border, and advise him to withdraw West, where it would make more sense to regroup and where they would have a smaller border to defend. He will have none of it. 

Slowly, it dawns on them, one by one: He has become detached from reality. 

He loves the children, who he will send to their deaths

The men in the bunker talk about a way out: try to cut a deal with Eisenhower and the Americans; surely the Americans must fear the Reds as much as the Germans, and they will join in an attack to repulse the Russians.

So, even the generals are consumed by wishful thinking, but at least their wishful thinking has some basis in reality: Patton, in fact, talked about exactly that, sweeping across Germany and defeating the Russians. 

There are the true believers, the ancestral counterparts to Rush, Sean and Ann.  The wife of Goebbels brings her six beautiful children ages 5 to 12 with her into the bunker. Speer urges her to save her children, if not herself. They can be spirited away, but she says if Hitler dies and if National Socialism dies, she does not want her darling children growing up in the nasty world which would replace the golden blond Germany they had built. So she pushes a cyanide capsule into each of her children's mouths and has them bite down to crush it and release its poison, one by one.

She wants no dark hordes crossing the border to mix with her pure Aryan children. Maybe if the invaders were from Norway... but these are Slavs!

Hitler rejects measures to save the million civilians from the on rushing Red Army. If the German people are not worthy, they don't deserve to survive; besides the best are already dead. 

Why does he fight on? "He has nothing to lose," one of the officers observes. 
He is already dead, the walking dead, why should he care about taking steps to save others?

The eternal optimism in the face of all contrary evidence; the centrality of this man in his own thinking, and up to a very late point, in the mind of so many others, is so current, it's jarring. 

The ideal world Hitler constructed, gleaming, white, grandiose, all of which is threatened by outside dark hordes, and undermined by betrayal from disloyal enemies from within, it's all there in what we see on Twitter every morning. Hitler's detractors are enemies, not just of Hitler, but enemies of "the people." 

And he had accomplished so much! "I have conquered Europe! By myself. Not the generals. Me." 

From the 21st century, one sees a plan. If there is a God, who intervenes in the affairs of men, then you must see Him, in that extraordinary bomb blast from a briefcase set down under a table, at Hitler's feet, which leveled the building and killed every other person in that room, but left Hitler unharmed, with shredded trousers. 
Even Lincoln looked for an other worldly explanation for why the Civil War had been as devastating as it had: perhaps God wanted every drop of blood drawn from the slave under lash to be paid for by a drop drawn by the sword. Had the war ended early, with an easy Union victory, the people of the South would not have been ready to accept defeat. 

Had Hitler conceded defeat soon after D Day, come to an arrangement with America, England and France,  then negotiated peace with Russia, his Reich might have continued for another 40 years, and nobody outside Germany and Poland would ever have known about the concentration camps or the reality of life inside Germany. 

Cities in ruins, the leveling to rubble of all those old German buildings and institutions had to happen to start anew. 

Hitler tells Speer the war is a blessing in disguise: To have cleared Berlin for construction of his new gleaming, white walled city would have taken 20 years. The Russian artillery and bombs  were accomplishing the demolition for them in weeks.

The power of positive thinking and where it can lead. 




Saturday, February 9, 2019

A New Liberal Deal

One thing you can say about Fox News and Trump and Sean Hannity, and Ann Coulter--they are cartoons, but they are so obvious and in a sense, honest, about their vitriol. 
Oh, they do their own dances, trying to portray themselves as the ones under attack, after they've unleashed some diatribe about those Central American caravans being the second coming of Attila the Hun, but they are water off the duck's back.
Dr. Frederick Banting, discover of insulin, painted this 

What drives Mad Dog mad, what gets under his skin and gets him frothing at the mouth,  in fact, is the inanity on the left.

To wit:

1/ Knee jerk calls for the resignation of the Lt. Governor of Virginia because two women have come forward with "credible accusations" of sexual assault/rape against him.
2/ And everything which is not overtly or subtly "racist" is "racist." That word has been so over used it has ceased to have any meaning at all. 
When Trumpsky says we need more blond Norwegian immigrants but (brown) Central Americans are an "infestation," that needs no further characterization.
But Heaven forbid you fail to call for the resignation of any Southerner who has appeared in blackface 30 years ago--this can only be because YOU are racist for being willing to tolerate this miscreant. 
Did you know that the governor of Virginia went to VMI? Did you know Robert E. Lee is buried at VMI, NEXT TO HIS HORSE! And you are worried about blackface in Virginia? The man is buried next to his horse. 
Seems to me we have far more to worry about, psychologically speaking, about Virginians. 
Actual racism

3/ And then there is the constant refrain about needing to stand up and defend the LGBT-Q community. 
First of all, if Q is fore "queer" then what is the "G" for? I am out of it, but I thought that was "gay." And in fact, when you get right down to it, is "L" not for lesbian which is simply gay female? Do lesbians need their own distinct letter?  
But let that pass. 

Then there is the mixing of "transgender or trans-sexual" with the homosexual as if this is simply the same thing. 
Nobody should be attacked or demeaned because of his/her sexual orientation, preferences, gender identity. That much we can agree on, but being corrected because of the use of the wrong pronoun or being told to refer to someone as cis or trans? How does that play on Main Street? And do we not care if we alienate the masses over this because it's RIGHT? Pick your fights people.
A Very Koch Brothers Childhood

I beg to differ. 
One simple distinction is lesbians, gays, bisexuals need no prescriptions, no medical intervention whatsoever to be gay, lesbian, bisexual, whereas transgenders ask for hormones, and sometimes not all that frequently, surgery. But there are many other differences, which, if you read widely enough, homosexuals have begun to note and comment upon.
Might be sexist, but you are not a victim

4/ And then there is the #METOO "movement," which, as far as I'm concerned has "liberals" abrogating all notions of fairness, due process in the name of "believe the woman," as if no woman has ever accused a man of sexual transgression and not been completely correct, as if memory is infallible and no woman has ever suffered from any sort of psychopathology. 
I get the fact there are sexual predators. Bill Cosby was likely one. Al Franken, not so much. An idiot, tasteless, awkward, gauche in the extreme, but not in the Cosby, drug 'em and have intercourse with their unconscious bodies category.
It makes Mad Dog crazy that his fellow liberals have driven him into the arms of Betsy DeVos, a really disgusting prospect, but she has justly attacked the star chambers cum "student committees" on college campuses which have expelled boys who were never allowed to confront their accusers or even, in some cases, to learn the particulars of the offense which prompted their punishment. 
Good Lord, do we really need to discuss this in detail? There are plenty of details available on line about campus "trials" which would make Kafka and Arthur Koestler blanch. 
If you think someone has been a sexual predator or a rapist: BRING HIM TO TRIAL. Defenders of #METOO have argued the legal system is stacked against the accuser, victimizes the victim. 
But the American legal system does this deliberately, for a reason. The idea is that to unjustly convict someone of a crime is worse than allowing a guilty man to walk free. 
Is there not the possibility that by simply granting a woman her "justice" by virtue of her accusation, we have made it too easy for women who may not have been violated in quite the way they now remember it to exact punishment on the men they accuse? I'm not saying this is the case even in the majority of cases, but is this not even a possibility?
And if the legal system is broken, then let us fix it. But to simply say, oh, let's forget the legal system and all its fairness and safeguards, let's just get vengeance, then where are we? 
Marketing vs Science

5/ Endless nurturing, sympathy and expressions of grief for "survivors" and "victims." Oh, I'm so sorry for your loss. Oh, that must have been so awful, come let me give you a hug. Liberals do this. 
 Trumpsky gets a little dewy when he is speaking about a white woman raped by a brown man, but for the most part, he does not get deeply into sympathy. There was enough of that at the State of the Union with teary eyed white female victims having their moment in the gallery, but for the most part, hurt females are gathered up by liberal women. 
 Really, Mad Dog could just howl at the moon for all this faux empathy. The left is drowning in victimhood and empathy and oh-how-damaged-you-must be. Please.
Let's find some liberals who push past all that, who are not survivors or victims, who do not want to wallow in safe spaces, who can shrug off moronic sexist, racist remarks and go for the jugular. 

Where is a virtuous Democrat? 
Give me a combat veteran, so he doesn't have to prove how tough he is. Make him a man, but we could take a woman if she's an Ann Richards type woman who can say stuff like, "Poor George, he was born with a silver foot in his mouth." Or, when told she has to remove the nativity scene from the state capitol grounds, says, "That's too bad. This has been on the only time we've ever seen 3 wise men gathered together in Austin."
It Can Happen Here

And make him a real liberal, who goes after anyone who trespasses in ways that matter--like when our own Democrats vote for a bill which guts Dodd Frank protections against too big to fail banks after receiving significant contributions from the banking industry. Make him able to sling a zinger as in, "You know, with all the divisions we have in this country I thought, maybe I'm naive, but I thought we could all agree: There IS NO SUCH THING AS A VERY FINE NAZI." 

Let him push for clean energy because it's likely to help our economy. Let him observe how even after a fire, rebuilding tends to build new wealth and more. Let him say there will be more jobs for all levels of worker building windmills and solar panels than were ever employed in coal mining.  Let him say: Look, I don't know enough science to be sure about climate change, but the evidence looks good enough to make me want to go for the Green New Deal. If we are wrong, the jobs it creates will still be a benefit. It just won't benefit the Koch brothers.
Keep in mind the real problem

Let him say science is a work in progress but we can, after a certain amount of experience, say we believe as a working hypothesis that the heart pumps blood to the brain and that vaccinations cause a lot more good than harm.  And that if you want to be a member of the herd, you have to be vaccinated, no philosophical exceptions allowed.
And let him give a three minute explanation of how he thinks abortion is different from infanticide. And let him risk confusing his audience, the national media and risk the wrath of Planned Parenthood and NOW by saying that the distinction between abortion and infanticide is all about line drawing and he might be willing to draw the line earlier than 21 weeks, as science and discussion guide us, with exceptions for exceptional and rare cases. 

And let him not worry about hurting feelings more than he cares about doing the right thing. 

Where is that Democrat?