Guns: Class Warfare and the American Divide

Dan Baum in conversation with Joe Nocera in today's New York Times makes some good points about efforts to diminish gun deaths.

Before Mad Dog gets to that, a disclaimer of sorts: although Mad Dog has never owned a gun, he has gun owners in the family. And Mad Dog does have one bit of relevant personal experience. When Mad Dog was a medical intern at a big city hospital the head nurse on one of the wards he covered at night locked up all the needles and syringes. Nurses would call Mad Dog to see a patient on that ward who needed a blood culture drawn, but there were no needles available. Mad Dog would have to hunt down the ward nurse in the dark and he finally gave up and just ran down a flight of stairs for the unlocked supplies on the ward below and ran back up fully loaded to do his blood culture. When Mad Dog complained to the head nurse she said she locked the needles to prevent drug addicts from getting them. "But the drug addict would have to walk up nine flights of stairs, past all those other wards with open needle cabinets to steal your needles!"  The head nurse was unmoved. "It's the law," she said. "And if other head nurses want to leave their needles vulnerable to theft, that's their business."

So Mad Dog has some experience with ineffective efforts at prevention. And he has felt the anger of the self righteous.

Now needles used by drug addicts are different than guns used by maniacs.  As my resident said at the time, "I hope drug addicts are stealing clean needles. At least they won't be re using old ones and spreading hepatitis." Guns are never used for purposes of administering healthful doses of anything.

On the other hand, Dan Baum makes some good points:  For one thing, if you look at statistics, assault rifles are used only in the most spectacular but rarest events.  We do not worry as much about hand guns, which kill far more Americans every day. The thing is, when assault rifles have killed people, it was white, middle to upper class people and hand guns are the ghetto weapon of choice, killing mostly people in the  zip codes that don't matter--who cares about deaths in the ghetto?  When Nocera says parents ought to ask whether there is a loaded gun in the house before sending their kids for a play date, Baum says, fine but if you are really playing the odds, ask if there is a swimming pool--far more kids drown in swimming pools every year, but that's not as emotionally charged for the rest of us, and swimming pools are owned by rich people; guns are the narcotic of the Joe Sixpack class.

Baum's main point is there are at least 300 million guns out there right now; trying to limit sales is closing the barn door after the horse has left.  As for limiting clip size, he is not as persuasive, but the answer usually is, the average maniac will accumulated lots of clips in his planning for the next shopping mall spree.

In Dodge City, Matt Dillon could disarm any varmint who rode into town and keep his gun at the jail until he left town. You cannot do that in America anymore. The varmints all have stashes of guns all over the place. So the argument from the gun owners is, these laws are ineffective. They are annoying in the same way the theatrics at the airport security gate are annoying--anyone can see through them to a way they could defeat the system. The net catches the wrong fish.

Baum's main argument is the intention of guns laws is to make us safer and limiting assault rifle sales does not do that. He is saying these are feel good gestures to allow politicians to posture and say, "See, we've responded!" In fact the response is half baked and transparently ineffective, affecting the people who are not the problem and leaving the bad actors unaffected. 

His secondary point is the people who love their guns feel insulted and vilified. And he has a point.  A subtext to this argument is rich, urban, upper class people who do not own guns look at rural, less affluent people who cling to their guns as pathetic, relatively powerless people who can only get a sense of self importance by brandishing a gun, by going to a shooting range and making noises and feeling the power of the machine in their hands.  When President Obama gave a speech in Portsmouth, some fool showed up carrying a big gun in the parking lot outside the high school and made all the papers. What he was saying is, "Look here. I have a gun. That means I could kill President Obama, which means I am as powerful and important as he is." 

But not all gun guys are that pathetic. People love guns for, likely, deep psychological reasons--a sense of power, a sense of potency, a sense of self reliance, a sense of I may make only a small fraction of what you make, but I'm a lean, mean killing machine. Some actually simply like the workmanship of guns, and they look at them as works of art. They collect them but do not fire them. Or they like skeet shooting. 

It does stick with Mad Dog that in the Army, when recruits are sent out to the shooting range they are given a certain number of bullets and they had damn well better return with that exact number of spent casings. Every casing is counted and every bullet accounted for. The Army does not want any recruit using a bullet on his drill instructor. In the real world, the government cannot keep that kind of clamp on its citizens.  When the government tries to clamp down on objects, whether they are books or guns or vials of drugs, it always entails invasion, search, seizure. 

Some years ago, Mad Dog was walking down a New York City street, carrying a long umbrella and a police patrol car screeched to a halt and a policeman jumped out of his car and demanded the umbrella. He twisted and pulled at it to no effect and finally handed it back to the dumbfounded Mad Dog. "Looking for a sword inside," the cop explained, a little sheepishly. "I feel safer now," Mad Dog said, being careful  to smile. Of course, Mad Dog was trying to make the policeman feel better. His heart was in the right place.  But if Mad Dog had been walking in Bedford Styvestant last week and a policeman had thrown him up against a wall and frisked him as part of Stop and Search, Mad Dog would have been outraged. If Mad Dog had been hauled off to the station house and strip searched, he would have been on the phone to his Congressman and if Mad Dog had been thrown into Gitmo, he would have spent every day planning his revenge against a government which could be so evil.

Somehow, the argument has to progress beyond the emotional and the personal to a level which the article by Mr. Nocera and Mr. Baum approached today.

Lunatics with Guns; Experts with Hubris; The Silence of the Lambs

Lunatic Giteau

Experts

President for 6 Months 

In 1881, President James A. Garfield arrived at the railroad station in Washington, D.C., accompanied by a friend, but no retinue of Secret Service Agents clearing a path. Presidents of the United States walked about Washington like normal mortals then. Garfield was in high spirits, on his way to his Williams College reunion. He had been a general in the Union Army, and now he was only a few months into his first term as President. 

Charles Giteau, who wanted to be Ambassador to France, or possibly thought he was King of France, raised a pistol and fired several shots into the President from a few feet behind him, hitting him in the arm and sending one through his back into or near his pancreas. 

Giteau was tackled and quickly removed to jail, where he expected General W.T. Sherman would send a company of troops to protect him and to thank him for his great deed.  Garfield was carried to the White House where a team of surgeons, headed by an imperious and famous physician of the day, proceeded to kill him, by stages, by the probing of his wounds with bacteria ladened fingers and instruments.

Although the idea of antisepsis was well known in America in those days--Lister had presented their ideas to American doctors--the prevailing thinking in American medicine was that pus was a good thing and surgical instruments dropped on the floor were simply picked up and used, and not cleaned between cases. 

In her lovely account of this dreary sequence of events, Candice Millard details the folly of the imperious doctor who ensured Garfield's fate, turning what could have been a serious but non lethal wound into a fatal blow.

There are lessons in history.  We remember things in ways which are useful to us today.  Of course, the obvious parallel between a maniac with a gun and the shootings at Newtown and Aurora is obvious. We have never been able to protect the innocent from the deranged very well, mainly because the nature of derangement is unpredictability. The lethally inclined maniac always has the element of surprise and often has planned to evade defenses. 

For the denouement, the long road to sepsis for President Garfield, there are more lessons. The respect accorded experts was misplaced, should have been questioned and the authoritarian physician, had he been questioned more ruthlessly could have been prevented from doing more harm. 

Alexander Graham Bell tried to quickly fabricate a metal detector to allow the localization of the bullet--there were no X rays then. But the doctors actually thwarted his efforts by refusing to move the President from his metal bed and Bell's metal detector could not distinguish one metal from another.

That Bell was famous was the only reason he was allowed in the President's room.

Fame, exposure, in America, has always been a substitute for real quality. Dr. Oz is listened to and believed because he is on T.V.  David Stockman can get on the front page of the Sunday Review in the New York Times because he was famous once, even though his thoughts are manifestly stupid. Paul Krugman, a few days later, demolished Stockman's recycled version of Andrew Mellon and Herbert Hoover with only faintly dimmed contempt, as well he should have.

In American resumes, "Appeared on Ophra" or "As seen on TV" is proudly displayed as a badge of authority. I have been heard by millions: I must be smart.

Shakespeare said, "Speech is logic," which meant, if you say something, especially if you dress it up with elocution and a good suit, people will believe it; it is persuasive if only because you have said it. 

The great failing of American education is not enough children are taught to doubt, to question to separate what is being said from the aura of the person who says it.  When a local politician says that building a motorway, two lanes from Hampton to Portsmouth, will reduce idling time on Route One and thereby reduce air pollution better than creating a bicycle path in that same space,  and the Portsmouth Herald publishes that without comment, speech is logic.  Discourse on the seacoast is brought down to the lowest common denominator, to below that.

Our local papers, and even some national papers routinely fail to ask the obvious follow up question, to challenge authority, to seek a rebuttal. 

David Brooks writes today that American universities should teach people how to disagree pleasantly.  Mad Dog disagrees. Where people disagree politely, in the South, things do not change. The most outrageous things can be said and people say, "Well, I understand where you are coming from and you make some good points, although I cannot agree with your conclusion," when what they should said is: That is a mean, nasty and misguided sentiment and is not worthy of discussion and you should think twice before you say such things in public. To say Blacks should not be allowed to swim in swimming pools with Whites is not an opinion to be entertained over tea and biscuits with pleasant smiles.

Stringer Bell, who is running a meeting according to Robert's Rules of Order,  explodes and cuts off an impertinent questioner with the explosion, "This nigga's too ignorant to have the floor. I will punk your ass, say such things!"

A little more Stringer Bell and a lot less David Brooks would do New Hampshire a great service now and then.

Leaders

Best& Banting

Edison

Yersin

Sherman

 Mad Dog traveled 500 miles away from home to go to college,  at a time and in a century before cell phones and the internet. Long distance phone calls were expensive and if you wanted to communicate with mother, you wrote a letter.  Like many of his classmates, who came from all over the country, he discovered he was lonely and homesick, but he was surprised to find he was stronger than most of his classmates in one way: He was comfortable and not afraid to be alone.  

Some days, walking from the library to a late afternoon class, he realized he had not spoken to another human being for days.  He looked forward to class because he would  have contact with other people, but he did not need that interaction the way so many of his classmates did.  He could study alone, be alone, and he noticed his dorm mates could not tolerate isolation; they studied together, just to be in the same room; they walked to the cafeteria together; they had parties together and went out on double dates. They seemed afraid to be alone with themselves.

As Mad Dog progressed through training in later years, he found he could be alone on a ward and function without calling for help. He could apply himself to a problem and rely on his own internal resources to solve it.  He found himself, in a way, in a position of leadership because of this capacity--nurses looked to him, waiting for orders. And he felt comfortable giving those orders, not because he was superior, but because he had been prepared by others and then he was capable of sailing the ship without the help of others.

In the world of medicine, real leaders are self directed,  "inner directed" some academics call it.  Frederick Banting, the Canadian surgeon who pushed ahead, alone, convinced the pancreas contained some critical element, the thing which turned out to be insulin, was such a leader.  Alexander Yersin, pushed ahead to identify the causative bacillus of the black plaque, after being spurned by governmental authorities (Brits who had invested their hopes in a famous Japanese microbiologist,  who botched the job).  Thomas Edison worked for long stretches alone. Like Banting, he had capable and dedicated colleagues, but the cardinal feature of Banting, Yersin and Edison is they pushed ahead alone, undeterred by the opinions of others.

In American politics, the loner is not likely to be chosen as a leader. Lincoln, who some have called the loneliest of men, achieved his greatness by working with other men, by manipulating them, by persuading them but not by isolating himself, except at the times he needed to think through a problem; then he would isolate himself. 

Mad Dog wonders whether some of the intractable problems we face in government today arise because we have elected the wrong sort of men to lead us; we have  failed to appreciate the importance in leaders of the capacity to be self directed.  We have men like John Boehner and Mitch McConnell who raise their sails to catch the wind, whichever way it is blowing, rather than setting their own course, and steaming toward the star of their own choosing. They are men of compromise and complexity, but they are afraid to be alone with their own thoughts and decisions.  Mad Dog wonders whether or not it is this character flaw in our leaders which has hurt us as a nation.

Jimmy Carter is always held up as an example of the man who failed because he failed to involved other people; he was too much of a loner. But he had more flaws than that and but for a sandstorm in a desert, he might have been remembered far differently.

Apart from Mr. Obama, Mad Dog despairs of our leadership. There are some good men  and women, smart people  in Congress--Dick Durban, Chris van Hollen, Diane Feinstein--but they are swamped by the other variety. One has to fear for our fate, in the hands of the lemmings who lead us now. Start with the Republican majority in the House, add the Republicans in the Senate, not the least among them Kelly Ayotte, and look around and it's pretty bleak. 

Lincoln

Representative Democracy in New Hampshire

Heavy traffic? Build a bigger road!

Not New Hampshire. Yet.

Crescent Trail, Washington, DC. Notice what is not here.

Something about obtuseness is just mesmerizing. You keep thinking: If only I could explain this concept adequately to this person, he could see the light.  I just need to find the right words, the right images.

But, in fact, that's not the way it is. The willfully blind cannot see because they do not want to see.  

If you know about roads for automobiles and you like these things, then you do not like alternatives to these things. 

Now, consider converting an old railroad bed to a paved bicycle path, which will run through several towns, all the way from Hampton to Portsmouth. What will your mind conjure up? 

Let's take a fling:  How can we make this into something we already know?  A road!  A motor way, an autobahn.  Roads are good! Build a road and commerce will flourish. Build a road and you will reduce crowding on the road which runs parallel to it, because, you know, there are only a finite number of cars, and so this number will now be distributed over a larger asphalt surface and the concentration of cars will fall.   It doesn't matter that study after study shows trying to relieve traffic congestion by building more roads is only a way to create more traffic congestion,  on the new roads. If you build it, they will come. More cars arrive to  fill whatever asphalt surface you provide.

If you have never seen a successful rails to trails, all you can think of when you think of a bicycle path is a yellow line painted on the margin of a highway. 

Such is the frustration of thinking people like Chris Muns, who want to try something which would be new for New Hampshire, although it has been done successfully in many other states across the nation:  A paved bicycle path in a heavily populated, highly developed part of the state.  

There is an unpaved bicycle path from Newmarket to Manchester, but this is far from any significant locus of development and population.  What Muns is talking about would run right through the heart of Hampton, North Hampton, Rye and on into Portsmouth and it might transform life in these towns by providing an area where people might actually--imagine this--Walk!   

Walk without cars whizzing within ten inches of you.  Hampton has a few sidewalks, but for the most part these towns have little or no provision for foot travel. Walking a dog along the road,  crossing a street,  these are not what life in the Seacoast is built for. In these parts, you need a car to fetch a quart of milk. Even the sidewalk along Route 27 into Hampton offers no respite--you can walk along it, but you can barely speak with a companion,  the roar of cars and motorcycles is so deafening. 

The predicament of the New Hampshire pedestrian is like that of the kitten living in a house where they don't much like cats. 

But we could change all that, if only we can get  people like Fred Rice could to  throw open a window to their  minds and see the possibilities of a corridor safe from motorized vehicles, protected from the smell of gasoline and the roar of the engines. 

  But that brings us back to the problem: How do you get a man to see, who likes living in the darkness?

Fred Rice: Hampton Nightmare

Today's Portsmouth Herald ran a story about the purchase of land carrying the abandoned rail road track between Hampton and Portsmouth.

Mad Dog has previously blogged about the potential for this track to be converted, in a Rails to Trails fashion, into a bicycle path open to hikers, bicyclists, joggers, roller bladers, children and their parents, all free of the dangers of automobiles.  This is a dream which has been turned into reality all around the country.

Interviewed for this story was Fred Rice, a Republican Representative from Hampton, to the New Hampshire House of Delegates, who was quoted as saying this pathway ought to be converted into another roadway for cars.  His rationale was: 1. If this were turned into a road, commercial development would inevitably occur along its path.  2. Building a 2  lane road to Portsmouth would  reduce traffic along route one, reduce idling engine time and thus improve air quality. 

Mad Dog kids you not: Mr. Rice actually allowed himself to be quoted saying these things.

As if adding a 2 lane road would reduce the volume of traffic on Route 1, which is actually not all that dense to begin with but certainly, at the times traffic is heavier, would be unlikely to be much relieved by a road with only an entrance at Hampton and an exit at Portsmouth. As if reducing idling time on Route1 would have any measurable effect on air pollution in the Seacoast. As if air pollution on the New Hampshire Seacoast is a problem at all. 

Of course, politicians and city planner stopped claiming that building more roads reduces traffic congestion sometime in the mid 1980's after experience and studies demonstrated that building more roads simply adds more roads which then become filled and congested.  

As for building a road to encourage more commerce, this will certainly come as encouraging news to all those merchants along Route One, who are struggling to keep their doors open even as we speak.  If you build it, they will come. Except along Route One between Hampton and Portsmouth. Oh, well, if you build another, maybe the word will get out.

To argue that adding a roadway on which to burn more fossil fuel, as opposed to a bicycle path,  which encourages people to abandon vehicles which burn fossil fuel,  is something most people would have trouble saying with a straight face, even most Republicans, but then again, most people are not Fred Rice.

Mad Dog seems to remember, correct the record if Mad Dog is wrong, an exchange at a meeting some years ago when Mr. Rice argued for reducing taxes on cigarettes.  His argument ran something like this: Reduce the cigarette tax and you will reduce the cost of a pack of cigarettes and consumers will buy more cigarettes and although you make less per pack, you sell more packs, so overall, you increase revenues. 

Mad Dog rose unsteadily to his feet at this meeting, unsure of whether or not he had heard Mr. Rice correctly, or was being set up for some bizarre combination punch, and Mad Dog said, "Excuse me, but I thought the idea of a cigarette tax was only secondarily to produce revenue, but primarily to raise the price of cigarettes to encourage people to smoke less, not more. Cigarette smoking is, after all, I thought, something we wish to discourage."

"Well, " Mr. Rice replied. "Cigarettes are legal."

Which left Mad Dog rather speechless. So, as long as it's legal, we, as a state government should encourage increases in the volume of cigarette consumption. In fact, Mr. Rice had another argument: We would lure Massachusetts citizens across the state line to buy their cigarettes in New Hampshire.

"So, you want to export our cancer to Massachusetts?" Mad Dog asked.

This was lost on Mr. Rice. 

This scene was so surreal, Mad Dog has, ever since, questioned whether or not it actually happened.  But reading Mr. Rice's comments today in the Herald, Mad Dog is inclined to believe it actually did occur.

Mr. Rice, a duly elected Representative from Hampton, New Hampshire, is quoted as saying the best way to reduce air pollution along the seacoast is to build another road for gas fueled vehicles to use.

Really, you cannot make this stuff up.

Mad Dog thinks this is a Sasha Baron Cohen stunt. There is no Fred Rice. This is Sasha Cohen disguised as a New Hampshire House of Representatives Republican.

But then again, in the same House, a Representative testified that birth control pills cause prostate cancer and that abortions cause breast cancer.

She did not aver abortions cause breast cancer because some woman in the parking lot told her, but because multiple pregnancies are associated with a lower rate of breast cancer and, ipso facto, that means if you avoid multiple pregnancies, you will acquire breast cancer.  

She and Mr. Rice must be drinking from the same bottle.

Spring Comes to New Hampshire

It is 55 degrees Fahrenheit along the Seacoast today, between Hampton and Portsmouth. Dogs are chasing balls in to the surf.  Snow on the south side of the street has melted away from the lawns, and snow on the north side is getting thinner. It feels very warm to people who have got through another New Hampshire winter. People are out in T shirts and shorts.  Sprouts are pushing up through garden peat moss and dogs are nose to the ground, as the heat from the soil brings up  smells to the surface.

We may yet get another snowfall, but even the old New Hampshire natives say we have turned the corner.  We all feel as though we have made it past exam week and those of us walking around upright have passed some pretty tough courses. We feel we have earned this Spring.

It's not that people in the South do not welcome Spring, but they do not have the same sense of accomplishment we feel up here, just for making it through another winter.  Those of us of a certain age know we may not have many more winters or spring times to enjoy.  Each new turn of season somehow seems more precious now.  

Dry roots stirring in spring rain, as Eliot said.

We look at the children and teen agers kicking up their heels, new colts testing their muscles and sinews,  and we are envious.  Testosterone is rising with the sap. Renewal and new life is coming to a white and gray country, and green up here is twice as bright and savored twice as much for the contrast.

There are lovely places all over the country this time of year. True, it's not all joy--manatees are dying in Fort Meyers with a red tide.  But Washington, DC has azaleas budding and cherry blossoms coming. North Carolina has grass and magnolias. But up here in the frozen north land we have Spring stretching its arms after a long winter sleep and there's no place Mad Dog would rather be.

The Politics of Antibiotics and Drug Resistant Bugs

David Kessler, former head of the Food and Drug Administration, has written an important article in today's New York Times, which will likely be ignored.

The central concept which underlies what he is saying is when it comes to lethal bacteria, you do not want to wound the tiger, you need to kill it. So, if you want to treat a human being,  or any mammal, with an antibiotic to kill a particular bacteria, you had better use a lethal dose of antibiotic or you will surely see the emergence of resistant bacteria.  
(There is often some confusion, caused by the language we use here. When we treat a patient with an antibiotic, the drug is aimed not at the patient's tissues but at the bacteria living in the patient's tissues or  in his blood. We cannot ask the bacteria to open up their mouths and swallow the pill, so we give it to the human being, who swallows the pill, which enters his blood stream and the antibiotic circulates in the blood, hopefully to bathe the bacteria in the antibiotic and kill them. It is the bacteria not the patient, not the human being, who become resistant to the antibiotic. The human being is simply the host for those bacteria.)

Those bugs who were not killed by a low dose and which have genes which allow them  to survive a low dose attack, can  then pass on genes which provide resistance to even higher doses of antibiotics to their progeny. The antibiotics have "selected" the strongest bugs: It's a variation of the "anything which does not kill you will make you stronger" meme,  but on a microbiological  level. 

Resistance to antibiotics occurs when these drugs are used too often,  or  in inadequate doses. We try to encourage doctors to treat human patients with antibiotics only when they are reasonably sure they are treating a bacterial infection, and then to engage in overwhelming force, a sort of shock and awe attack. But 80% of all antibiotics sold in this country are not used for people--they go to cows and other livestock, in small doses, for two reasons:  1. Most cows are no longer allowed to wander grassy fields but are penned up in feed lots, standing in manure. They get infected and the antibiotics allow them to survive life in this literal cesspool.                   2. Somehow, livestock fed antibiotics seem to grow faster. 

Exactly how many cows get antibiotics is not known,  because antibiotic sales data is a closely guarded secret and all attempts at making it public by law have been thwarted by agribusiness and the pharmaceutical industry.  When Diane Feinstein and Kirsten Gillabrand tried to introduce legislation to report data the FDA already collects,  their efforts were rebuffed by a powerful agribusiness/pharmaceutical lobby.  

Henry Waxman (D-California) and Louise Slaughter (D-NY) have introduced a bill to require food producers to disclose how often they feed antibiotics to animals and this, too, is being fought by pharmaceutical companies and agribusiness.

Predictably, maybe not this year, maybe not next, but some year in the not too distant future, this will all come back to bite us. We'll have antibiotic resistant super bugs which will make Methicillin Resistant Staph, E. coli and resistant gonorrhea look like warm up acts. And this will happen because a few people were determined to protect their profits, public health be damned. 

Here we have the intersection of government, business and science and the first two are ignoring what the third has to say,  at the peril of everyone.

This has happened before, with global warming, with healthcare insurance, but in terms of what  will actually become most cataclysmic, the drug resistant bacteria will surely get humankind before the effects of global warming or the lack of health insurance do.