DIGGING UP DEMONS DEMOCRATS NEED

You know who Donald Trump rode to the White House on.


So where are the Democrats when it comes to vilification?


It's not like there aren't any good candidates out there.


John Oliver gave us the CEO of Alpha Coal, who nearly broke down sobbing, talking about the prospect of laying off coal miners in response to a question about a photo on his wall of a coal miner's. But, as Oliver pointed out, he had asked the bankruptcy court to cut the health insurance for 1200 miners while his board voted him and themselves 12 million dollar bonuses.

The coal industry is just too sweet a gift for Democrats, if they were only smart enough to use the gift they've been given.

And big pharma--who could have dreamed up an icon like Martin Shkreli if they'd tried?  Raises the price a drug upon which lives depend by 1000%, "Because I could. There's nothing illegal about it."

Or Robert Murray of Murray Energy who is the latest incarnation of those old tobacco industry executives who testified before Congress that smoking is good for your health and nobody should believe those scientists who said it caused lung cancer because they were all in the pockets of the liberal establishment and were like pinko Commies. Mr. Murray says we shouldn't believe the scientists who say burning fossil fuels (like the coal he just happens to own) contributes to climate change but we should trust his "four thousand scientists" who say just the opposite.  And all he cares about is his coal miners, well, except for that mining disaster which the government said was his fault but he claims was just a natural disaster an earthquake only he knows occurred.

The problem with the CEO's and the board members and the billionaires is most of them avoid fame like the plague. They are happy enough to just be super rich.

The Koch brothers occasionally make public appearances when they are being honored at Lincoln Center for giving money to the opera or ballet. But they keep a low profile and other than books like "Dark Money" they are not much examined, and who reads books anyway?

The shame is that no CEO went to jail for the 2008 financial collapse which, as anyone who saw "The Big Short" movie knows, had many fathers, but some at least were working at the agencies which sold stock and bond AAA ratings to the very companies whose stocks they were rating. 

These Wall Street, Wichita, Kansas,  Bentonville, Arkansas mogols pull the strings which control the lives of coal miners, factory workers, servers all over the country but they are never the bad guys. The bad guys are the imaginary Mexican rapists storming across our Southern Border. 

We need somebody to give us new villains.

Bernie Sanders took a few steps in the direction of stirring up embers of resentment. If only a few younger whippersnappers could follow his lead.

Robert Murray, Coal Miners' Dotard

Another stimulating PBS News Hour in which a right wing fanatic was able to bend truth to his own purposes with nary a peep of objection from Judy Woodruff or John Yang. 

Robert Murray, of Murray Energy, claimed:
1/ Global warming is a hoax meant to enrich liberal elites
2/ CO2 is not a pollutant, as President Obama claimed
3/ The Earth has actually cooled, not warmed over the past 19 years
4/ The Antarctic ice shelf is at an all time high, proving global warming is a hoax
5/ 4,000 scientists say so.

Consulting Professor Google, which apparently neither  Ms. Woodruff nor Mr. Yang had time to do, it turns out:

1/ The Antarctic ice shelf is at a high level, but that is beside the point--the Arctic is where the action is--and it is melting in prodigious fashion. The Antarctic is an ocean of ice but the Arctic is where the polar melting is occurring, where the polar bears are drowning and where the evidence of global warming is most evident.
Apparently, Mr. Murray does not understand the Antarctic is the South Pole with those cute, stoic penguins and the North Pole is polar bears, Santa Claus and melting glaciers.

2/ The Earth has not cooled over the past 19 years, but there have been measurements at various places in Greenland which have shown cooling;  none of those measurements, which were misunderstood by the Daily Mail which picked up the chant, mean the earth is cooling. Some parts of Greenland are still cold.
3/ CO2 is a greenhouse gas not a "pollutant" in the sense of lead or mercury. Mr. Obama never characterized CO2 as a pollutant--it is after all the gas we all exhale. Mr. Obama did not say we are all polluting the atmosphere every time we breathe, much as Mr. Murray would like us to believe. This is the "distraction" technique and Donald Trump is better at it.
4/ The Alt Right can round up 4,000 graduates of Liberty College to say the Earth was made in 7 days just a few thousand years ago. Scientists one and all.
5/ Yes, as coal goes the way of the dodo, windmills and solar will likely make a lot of people money who are not coal mine owners, but the coal miners might get better jobs in clean energy than the coal miners every gave them.

Really, if ever there was a naked example of that old observation:  It is difficult to bring a man to understanding if his salary depends on not understanding, than Robert Murray, I'd like to hear about it.

But nobody said anything about this on the News Hour. They had bigger stories, like the Harvey Weinstein affair.

For a more trenchant analysis of the argument for coal, look at John Oliver, below:

https://www.youtube.com/watch?v=aw6RsUhw1Q8&t=235s


Here's Oliver on Mr. Murray:

https://www.youtube.com/watch?v=XwoAu_UiZvs

Reading the Wall Street Journal Editorial Page

Remember Peggy Noonan?  She wrote that famous speech Ronald Reagan gave after the Challenger space shuttle blew, up seconds after leaving the launch pad.

Reagan was, until President Dotard, our most recent "Teflon President."  Almost anything could go wrong under his watch and everyone, beginning with the President, would shrug it off:  Hundreds of American Marines blown up in a compound in Lebanon, having been put there for no discernible reason, apart perhaps from literally showing the flag? Well, nobody plans everything out, not even when you build a house--who finishes the basement? Yeah, well, we didn't plan for a truck bomb. You know. Things happen.
And when warnings from underlings about those O rings were ignored, Reagan went on national TV with the speech Ms. Noonan wrote and he said, among other things, in Peggy's purple prose: 
"We will never forget them, nor the last time we saw them, this morning, as they prepared for their journey and waved goodbye and 'slipped the surly bonds of Earth' to 'touch the face of God."

So she helped everyone rise from the dismal reality to keep their eyes planted firmly on the Heavens and dreams of glory. Or, put another way, she parlayed a steal from John Gilespee Magee into a gig on the WSJ. (For my money, if you want to read a woman who knows a thing or two about slipping the surly bonds of Earth, open up Beryl Markham's "West With The Night." There is a woman who could write.)

Well, that woman who used to be Peggy Noonan has now managed to pin the blame for the mass shooter of Las Vegas on, guess who?  
The Democrats. 
Not just the Democrats but the "elites."  It's the fault of all those people who disagree with her, who she doesn't like. 
Liberals are what gave us mass shooters. Liberals drove them to it. 
And in response to the mass shooters, everyone else is quite justified in accumulating arsenals.
Now, that's even better than a guy who can shoot someone on Fifth Avenue and not lose a vote. Shooting has never been a problem for Republicans, but mass shooter maniacs, they have not yet figured out how to market that. 
"I think a lot of Americans have guns because they're fearful--and for good reason. They fear a coming chaos...They think it's all collapsing--our society, our culture, the baseline competence of our leadership class."

Oh, we've got a leadership class now. Well, what a relief to hear that. 
But wait:

"Americans have so many guns because drug gangs roam the streets, because they have less trust in their neighbors, because they read Cormac McCarthy's "The Road."

Well, now that is reassuring. Those gun toting, gun hoarding NASCAR fans are readers! And they read Cormac McCarthy, no less.

"Because our country's real overlords are in Silicon Valley and appear to be moral Martians who operate on some new postmodern ethical wave-length. And they'll be the ones programming the robots, that'll soon take all the jobs! Maybe the robots will all look like Mark Zuckerberg."

Ah, here we are getting to it. This is sort of a cross between that South Park episode where outer space beings from the future come back through a time warp to take the jobs of all the present day earthlings, because in the future everyone loses his jobs to robots, and the Protocols of the Elders of Zion.  I don't know about Cormac McCarthy novels, but I do watch South Park

And, by the by, did you notice the introduction of the manipulative Jew into the plot line?  The guy who is not guided by good American values but by Martian morals? (And remember Mars is where Barack Obama was born.)  Zuckerberg drinks the blood of Christian children, don't you know? He's into blood sacrifice, but first he circumcises them without anesthesia.

"Our leaders don't even think about technological revolution."

Well, nobody's ever accused Zuckerberg about that before. Peggy's on a roll. 

"They're too busy with transgender rights."

Well, there she's got me on board. Entirely too many Zuckerbergs thinking about transgender rights. And you know once they get to thinking about transgender rights, it just sucks all the air out of the room and their brains go all to mush.

Try not to think too much about this.

Personally, I'm no fan of Chelsea Manning or Bruce Jenner who is now somebody else, a woman on the cover of a magazine.  Unlike homosexuality, transgender people appear, from superficial evidence alone, to harbor a certain level of pathology.

Oh, are we disturbed yet?

But I digress--only to say I'm with Peggy about spending too much time thinking about transgenders, but I'm astonished to learn this leads directly to the guy in Las Vegas who mows down innocents with a bump stock converted automatic rifle.

Where's my gun?

"Those who create our culture feel free to lecture normal Americans."

Culture creator

And here I thought normal Americans created their own culture, for better or for worse. Silly me. It is a relief to hear there are extant, Normal Americans. I've been looking for them and just about given up hope.

"They sail on, oblivious to the legitimate anxieties of their countrymen who live near the edge."

Well, now I understand. With the coming apocalypse, we will all need guns and a home ammo depot and a bomb shelter, from which we can blast away at our neighbors--good guns make good neighbors--when the legions of transgender armies unleash their awful attack on our homes like those Orks in "Lord of the Rings" or the White Walkers in "Game of Thrones." 

Peggy is nothing else, if not literary. Did you catch the whiff of F. Scott Fitzgerald there? I'm sure it was intentional: "So we beat on, boats against the current, borne back ceaselessly into the past." And that is where Peggy lives--in some imagined past that never was.

Do you think Peggy Noonan has dinner with Rupert Murdoch every week?
If we invited them and the Dotard and maybe Mike Pence and Rush Limbaugh to Hampton for a cocktail party--or a beer fest--do you think it would be a good time?

Really, how about a bash at Smutty Nose?  I'm buying.

Do Drug Rehab Programs Work?

Our journal club, where we read the month's New England Journal of Medicine among a group of doctors from various specialties, now starts every article by examining not the names of the authors, or an examination of the universities from which they generated their studies, but a look at who sponsored the study--many if not most "investigators" are now funded by drug companies to assess the efficacy of the drug the company is trying to market. So if the drug is made by Merck, then Merck sponsors a group at Harvard to run a study to see if it works. 

As Upton Sinclair said, "It is hard to bring a man to understanding if his salary depends on not understanding."

One Squirrely Slide--coming from the NIH!

I now feel the same way when I read papers on the question of whether or not our approach, or our various approaches, to treating drug addiction are effective.

Even the web site of the National Institute of Health's National Institute of Drug Abuse reads like something between a marketing plan and  a legal brief more than an dispassionate examination of data.

Money spent on drug rehab programs, the site tells us, is far less than it would cost to incarcerate drug addicts.  We are also shown a bar graph which shows that during the time an addict is in the program, he stops  using drugs, but he relapses almost as soon as he quits.  The NIDA tells us, this is acceptable, if you think of drug abuse like hypertension; it never disappears. You have to continue treatment for life.

But the problem is: What is your goal?
If your goal is to get the drug fiend, as addicts call themselves, to stop using drugs forever, then what the NIDA is saying is, forget that. It's like alcoholism: You will always crave that fix.

click on image

But if your goal is to reduce the illnesses associated with drug abuse: HIV/AIDS, hepatitis and subacute bacterial endocarditis, then treatment programs, most particularly clean needles, do that effectively.

click on image

Whether drug rehab programs reduce drug overdose deaths is tough to say. 
If you are running a program, and one of your clients overdoses and dies, do you say, well, we failed? Let's record that as a failure, and make your statistics look like you are a worthless organization running a failing program, or do you say, well, that guy dropped out of our program a week ago--his death is not on us.

The question is: What do we do? Just give up? 

I would say we should do what Portugal did: Legalize drugs and treat addicts as a public health problem.

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Of course, that's not easy in a for profit, commercial health care system like ours.
You really need a government health care program for that, because drug addicts are going to make every bottom line in every ledger look bad, from ER visits, to hospitalizations to deaths.

Getting Real About Guns

If I had my way, there would be no privately held guns in the United States.
But, if I had my way we would have no drug addiction and I would be twenty pounds lighter when I wake up tomorrow morning. Oh, and I'd have a full head of hair and be twenty years younger.

Sadly, none of the above will ever happen.


Now about guns:  My father in law was a lifetime member of the NRA. He got his first rifle age 12 and hunted in the fields around his home in Utah. He kept several locked lockers full of guns in his basement. He kept notebooks on each gun, with targets shot with holes by each and careful notes about the gun's characteristics: At 150 feet this gun pulls to the left 1 inch, etc. 


He was appalled by the idea a gun is any good at defending you in your house because the home invader has a weapon more powerful than any gun: surprise. He thought the most likely outcome of a bedside gun was some family member would someday be shot with it. Guns at home were kept locked.


He raised his three sons and his daughter (my wife) to be good shots. In fact, he was pleased that for a few years, his daughter was rated higher than any of his sons at the skeet shooting range and she was listed in some rifle magazine as some sort of hot shot.

But he spent his life in the military, where, he noted no solider was every allowed back from the shooting range without the same number of spent cartridges as he was issued before he went shooting targets. The military tightly controlled bullets lest one of the recruits had it in for his drill instructor, as in "Full Metal Jacket."


If we restricted gun ownership and home possession, we would likely cut down on deaths among children shooting themselves or others at home and we might cut down on suicides by gun, although it's an open question whether we'd cut down on suicides by other means.

We may not prevent mass shootings by lunatics.  The reasons for this are obvious: A guy who plans out his mass shooting by booking a room plus an adjoining suite, rigging up hallway surveillance cameras, fits out his guns with bump stocks,  is not likely to have much trouble collecting guns of mass destruction.  As anyone who has read "The Friends of Eddie Coyle" knows, the trade in illegal guns is not much more inhibited by law than the sales of illegal drugs.


Beyond the sportsman and gun aficionado who was my father in law, I've met plenty of men who love talking about their guns in New Hampshire. Most of these guys are small or very obese or simply physically unimpressive men for whom a gun is their ticket to instant respectability: I may look like a loser, like a nobody, but put a gun in my hand or on my hip and you've got to respect me, because I might just kill you.

Big gun is the surrogate for big penis. 


Those are the guys you have to pry their gun from their cold, dead fingers, because they need that gun so.


For some of these guys, its a thin line from an inferiority complex and fragile ego to a shooting rampage, but they may go their whole lives without crossing it.
They are the guys who worry us, however. Ordinarily, they get through the day, but all it might take is that one very bad, no good, terrible day, when their car is rear ended, their boss fires them for being late to work and they go home to find their wife in bed with the mailman.

We do not need bump stocks and we do not need legislators packing heat in the State House to show what tough guys they are and we do not need guys at political rallies carrying assault rifles. All that can be legislated away, just as soon as we assure our gun loving fellow citizens, they can keep their security blankets.

What Would Victory Look Like in the War on Drugs?

Kima: "You motherf***kers kill me. Fighting the drug war one brutality case at a time."
Carver:"Girl, you can't even call this a war."
Kima:   "Why not?"
Carver: "Wars end"

Exchange between Detective Kima Greggs and Police Sgt. Carver, "The Wire."


Sgt. Carver

Det. Greggs

As   Sgt. Carver observes, the "Drug War" is an endless endeavor.  You do not settle things decisively with one battle, which is, of course, why like the "war on cancer" and the "war on terror," it's not really a war at all but a metaphor of a struggle, a conflict which we would like to win but never will.
So it is with drug addiction.

Alcoholics say, "I'm an alcoholic. I've been sober 30 years," to emphasize that demon is always with them, no matter how long they've kept it at bay.

When the National Institute of Drug Abuse (an institute within the National Institute of Health) defines "success" in treating drug addicted patients it says its goal is returning patients to function, to a viable place in society.  The NIDA does not talk about eliminating drug overdose deaths as a measurable outcome, or curing patients of addiction. They talk about managing this disease over time, as you would any chronic disease, like hypertension or diabetes.

No cures; Relapses as soon as the patient leaves the program

When critics say drug rehabilitation programs "don't work" or fail, the NIDA says, well, that depends on what you mean by failure. No the rehab programs don't cure addiction, but they help people manage it.

Van Gogh, Wheat Fields with Cyprus

The reason America has turned its attention to the "opioid crisis" is that we are seeing more deaths and more deaths among white middle and upper class children. This is really an epiphenomenon.  Heroin addiction has always been out there and often among the affluent as well, but dead bodies have a certain insistence; you cannot cover up a death the way you can an admission to the hospital for drug detoxification. Fentanyl, a lethally potent opioid has caused the surge in deaths. That's what's new. The addiction problem is nothing new.

EMT's interviewed on NPR, who are on the front lines, complain they are called back six times to administer Narcan to the same addict who has overdoses yet again. Why are we doing this, they ask? What have we accomplished?

What irritates me is the unexamined assumptions I hear politicians and other pundits use:

1/ If we only cared more about these addicts, we would not see widespread addiction.
2/ If we only cared more about these addicts, we would not see all these overdose deaths.
3/ Caring more is expressed as spending more money on:
a/ Drug rehabilitation programs in and out of the hospital
b/ Hiring more people to be "drug rehabilitation certified" experts and advocates.
c/ Funding more programs in schools to "educate" kids not to use drugs or be attracted by the drug culture. Of course programs like "DARE" proved to be an utter failure and when it was examined for results it was such an abject bust, they discontinued it even in affluent counties which could afford it. The drug pundits say that's because it was only for grade school and middle and was not continued into high school. No, actually, that's because kids in an counter culture, bad boy mode are not going to be scolded into acquiescence by adults. 
d/ Putting Narcan rescue containers in ambulances, schools, airports, subways, you name it.
e/ Fund needle exchange programs so addicts can get clean needles



It is entirely understandable how  frantic parents become when they learn their kids are stealing opioids from them or from others and using them.
To say we are taking the wrong approach to managing drug addiction in this country is not to say we should do nothing, just give up on the addicted.



In the case of intravenous use, you get a whole separate set of diseases: heart valve infections, hepatitis C and HIV.  This could be addressed by a functioning health care system which included things like needle exchanges.



But this public health program has never been accepted as a public health problem. Big shots want to jail users and dealers alike.



Portugal has found a solution with measurable results. After legalizing the use and possession of drugs, HIV, hepatitis C and endocarditis rates, once the highest in Europe plummeted to the lowest by far. But that meant drug fiends, as they call themselves, were not jailed or scolded but simply treated in a national health care system.

But in our for profit, commercial health care system, what insurance company wants to take on the expense of drug addiction? Who will pay for these fiends?


There are some ugly truths out there. The fact is, most middle to upper class folk cannot even bring themselves to watch "The Wire" where these problems are most clearly delineated, much less to actually act to make our government develop humane and sensible and cost effective policies.

Doing the Opioid Crisis Rag

Heard a talk from a former New Hampshire House of Representatives Rep, a physician, about the opioid crisis and about all those deaths from Fentanyl in New Hampshire which earned us a shout out from President Swamp Boy about New Hampshire being a "drug infested den."

He showed a slide which showed that New Hampshire, second in the nation in drug deaths, is 49th in spending on drug rehab programs, the suggestion being that if we only weren't so cheap, and valued the lives of these people who are using opioids, we could save them. 

He did not have a slide which showed the expenditures of the other states on the X axis and drug deaths on the Y axis: In other words he did not know if the states which spent the most money on drug rehab programs had fewer deaths, and if this correlation exists is this because there are fewer drug deaths in richer states because when people are rich and have a lot to live for, they don't take drugs?

Of course, there are lots of stories of affluent white kids dying of drug overdoses, but the reasons for that are not well examined, as far as I can see.

A little defensive, are we?

The National Institutes of Health has a National Drug Abuse Institute and on this site they attempt to answer a Frequently Asked Question: Do drug rehab programs actually work?  Intelligently, the authors say, well it depends on what you mean by a program "working." They feature a graph showing that during the actual treatment program, those enrolled in drug rehab programs have fewer drug overdoses, but afterwards a sizable number return to drug use, in about the same proportions as people who are hospitalized for asthma continue to need treatment for asthma and people hospitalized for type 1 diabetes need ongoing treatment.
Oh, that's reassuring. 
Really, what they are saying is like alcoholism, heroin addiction is for life and you need constant attention.

This answer stinks strongly of self interest, the bias of a group of practitioners whose salaries depend on the notion that what they are offering is effective.

Of course, every time the deaths of young people are presented to politicians, they run for cover and talk about the government programs, the spending they are directing at the problem.  This is a shield for the politicians, but as far as I can see, there is precious little evidence these programs or expenditures actually prevent drug deaths in the medium to long run. 
It reminds me of the point in the diabetes lecture when the guy says, well, of course, you have to refer your patients to a registered dietitian and everyone in the audience is thinking--oh, good, now I can wash my hands of that obligation. But, of course, the nutritionists have nothing effective to offer: Well, count your carbs and eat what is pictured on this poster and you will notice absolutely no benefit at all. 

It may be dated, and it is focused on the inner city drug culture, but "The Wire" presents a detailed discussion and depiction, which if people actually watched the 5 seasons, would convince most of them what we are doing and calling "drug rehab" is insanity.

There was an old cynical jibe at the cancer hospitals: More people make a living off cancer than actually die of it.  When I listened to the programs mentioned tonight, involving certification of Drug Rehabilitation Coaches and in patient facilities and outpatient clinics, that came to mind. Lots of people cashing in on the efforts to treat drug addiction and drug deaths are benefiting. The patients, not so much.

Portugal has taken an radically different approach to drug deaths and drug disability: It decriminalized drug use and drug possession and treats addicts as patients.
They still prosecute drug dealers, oddly enough. Not sure how they do this.
But deaths from drug use related HIV, subacute bacterial endocarditis and hep C diagnoses have plummeted in Portugal. 
Until we actually want to face the uncomfortable truths in America about what drug use means, and how we should regard drug abusers, we likely will spend money foolishly, and we'll pat ourselves and our politicians on the back and ignore the real problems and their solutions and the deaths and associated diseases will continue.

Until liberal politicians take a hard look at reality, engage in tough minded analysis of what we call "drug rescue programs" they will continue to look like opportunists who always have an easy answer, and no credibility.