The Why of Bernie Sanders

Thomas Edsall, the best New York Times columnist this side of Paul Krugman, ran an article on why Bernie Sanders scares people, and it boils down to the idea that most people in this country are not hurting and they do not want someone who might change things more than simply ejecting Donald Trump from office.

As always, reading the responses to his column is where the real juice arises.

https://www.nytimes.com/2019/04/24/opinion/sanders-2020-trump.html

Yes, Bernie's past is disturbing for many, and for me, but he will be running against Trump. Talk about a past. Yes, the Republican hatchet men will run all day every day ads about that past, but the question is whether than can overcome the man we see before us today.

Dredging up Bernie's writing about how sexual guilt causes breast cancer, how he was evicted from his apartment and then siphoned off electricity using cable extensions, how he fathered his only child out of wedlock, how his "socialism" and "revolution" talk will scare off suburban housewives.

Edsall cites an economist/political guru=, Daron Aemoglu, of MIT who says, "social democracy did not achieve these things by taxing and redistributing a lot. It achieve them by having labor institutions protecting workers, encouraging job creation and encouraging high wages."  But there is no reason to think Sanders would not embrace this.

Another MIT economist notes, this election will not "turn on policy ideas, factual claims or even thinking of any substantive kind. American electoral politics has become purely expressive: how much do I identify with my candidate? How much do I hate yours? The balance of these competing forces seems to determine the winner."

As so many of those who responded to the article noted, and as the MIT economists noted, Bernie Sanders would be considered a moderate in Denmark, Sweden and Norway. That story could be told, if there were enough money to shout it.

The fact is, Hillary Clinton was not defeated because she was a bad candidate. I can say that as "fact" just as assuredly as anyone who denies it is not a fact because there are no facts, only "alternative facts." 

True, she was a poor candidate: she could never answer the most lethal criticism of her, that she was in the pocket of Wall Street. When asked about all those $250,000 speeches at Goldman Sachs, she looked like a deer in the headlights, as if she was never expecting that question. Never had an answer. And it killed her campaign.

Listening to Bernie Sanders on Alec Baldwins podcast this morning, "Here's the Thing," brought back the memory of the first time I ever heard Sanders speak, which was back in 2016, at the New Hampshire state Democratic convention. He was preceded by Hillary, who got the crowd to its feet and she was splendid. I was amazed how good she was before a large crowd. She walked on the stage to a tumultuous arena and looked around and beamed, "My heart is pounding!" she told the audience, as if to say, "I'm floored by this unexpected enthusiasm. I'm not worthy of it. But we can win this thing."

https://www.wnycstudios.org/story/bernie-sanders-thinks-democrats-are-still-way-course

Then came Bernie whose reception was also enthusiastic but he boomed out, "Are you ready for a REVOLUTION?" And the place went crazy. What he said got the crowd more and more frenzied. What he was arguing, obliquely, was that the Democratic party had failed to deliver for the underclass, for the guy who works three jobs and still gets evicted because he has to choose between paying the rent and buying the medications for his kids.

By the time he was finished, his simple, clear, emotion packed, irate message had reduced his audience to raw emotion. People were actually weeping with joy.

At dinner, a week later with my thirty something kids, they all said they could not support Bernie. None of them wanted a revolution. And he could never win anyway.

But, apparently, there were enough people out there who did want a revolution, in Wisconsin, in Michigan, in Pennsylvania, in Ohio.

It was simply a question of which revolution we would choose.

The same is true this time around. Will the Democrats go with Joe Biden, who is simply a return to normalcy, who is the "Restoration" candidate or will they go for a revolution against the revolution of the Right?

Will those suburban housewives stay home if it's a choice between Trump and Bernie?  Will my own kids, who have jobs and lives which they don't want disrupted stay home because at least with Trump they have a great economy?

The question is: How much will outrage matter? 

Politically Correct Transgender Medicine

When I was in medical school, I was captivated by the work being done at my medical school where Julianne Imperato, a fellow in pediatric endocrinology, discovered a cohort of villagers in the Dominican Republic, where there was a lot of "consanguinity" i.e. interbreeding,  in some remote villages. This meant that genetic recessive traits could be expressed and diseases not seen commonly could occur more often.

In those days, medical students did exploratory rotations and a group of these students discovered a group of remote villages where mothers gave their children gender neutral names--the Spanish equivalent of "Pat" or "Chris"--because, as they explained to the students, the mothers were never sure which of the children who looked like girls at birth would "grow a penis at 12." 

Imperato McGinley sent the students back to the villages to draw blood on these "penis at 12" kids and they traced the family trees. (This was before genotyping could be done, back in 1970.) Her report was the first of five alpha reductase deficiency, a phenomenon which caused individuals who had female appearing external genitalia at birth but who "grew a penis" (the clitoris enlarged) at puberty, when the tidal wave of male hormone overwhelmed the blockage caused by an enzyme deficit.

Cornell, in those days, was a hotbed of "pseudohermaphrodism" research with Maria New, who was Imperato's mentor, and a steroid lab which was capable of analyzing which sex hormones were present in the blood of patients.

Now endocrinology, this science of biochemistry and hormones, has run aground on the rocky shoals of "transgender medicine."

The problem is, you cannot question the prevailing doctrine without running into both an emotional and political response and all dispassionate discussion is drowned by a tsunami  party line. If you question any aspect of "transgender medicine" as it is currently practiced, you are assailed as one of those people who denigrate, dismiss and degrade the patients, subject them to more suffering and abuse. 

Personally, I hope all physicians want to avoid making anyone feel badly about their sexual orientation, or gender identity, but, the fact is, "transgender medicine" and transgender clinics are now big business. Careers are being launched on transgender patients and their needs.

Paul McHugh is currently one of the disciples of the devil as his story is told in transgender circles, because he raised the issue of the meaning of suicide in this group. When he left Cornell as head of psychiatry to take the job of head of psych at Johns Hopkins, he was asked to take over the psychiatric part of their transgender program and he was alarmed to discover that 30% of the patients in this program committed suicide. He promptly stopped psychiatry's participation in the program.

And Hopkins was not an anomaly.  The suicide rates at virtually every transgender clinic, near as I can tell, stubbornly persists in this same range, even 30 years later, around 30%.

The transgender medicine folks shrug this off as the result of the hostility from society and from some unsympathetic medical people which weighs heavily on the transgender patients.

But one has to ask: If you were running a program for cardiovacular surgery or for joint replacement or for transplantation, or for any other medical problem, which suffered a 30% suicide (or death) rate, would you not stop this program? Would you not want to investigate and mitigate this startling finding?

The other things you have to ask about the doctors who care for these patients:
1. How can you recommend uterine transplants for male to female transgenders who want to give birth to babies? What is the risk of the mother's immunosuppressive drugs to the babies?
2. When you have a female to male transgender who wants to freeze eggs, how do you justify the risks of extraction and the expense of preservation?
3. When you have a  male to female transgender, how do you justify the expense of freezing sperm? And to whom would this new woman be donating this sperm? If it is to a lesbian mate, does that mean this new woman prefers the same women as she did prior to becoming a woman? 
4. When you have a male to female transgender who has not had castration who is in a relationship with a lesbian what sort of sex do they have?
5. When you have a female to male transgender who has not had surgery and has an intact uterus and ovaries and whose hormonal therapy has not suppressed ovulation and she asks for an IUD, what sort of sex is that individual having?
Presumably, vaginal sex. So this new male now is continuing to have sex as a female but function in some other ways as a male?
If that transgender individual who identifies as male is still having vaginal sex, what does that say about gender identification?
6. For a couple who has a male to female transgender in a relationship with a lesbian, is the risk and expense of IVF warranted?

Most of these questions concern the expense, the load to the system. Some have to do with unknown risks.
But mostly, these whole series of questions  suggests to me that transgender medicine is possibly being driven by something beyond compassion and that is spelled "m-o-n-e-y."
Is this a subspecialty or an industry?
The medical profession is often operating in the realm of making value judgments: 1. We do not abet opioid drug abuse except as a way of trying to change the behavior of the drug abuser.  2. We try to "treat" pedophiles, and prevent them from acting on their urges toward children who we perceive as inappropriate sexual partners. 3. As psychiatrists if we find ourselves treating people who are compulsive rapists or murderers we intervene to try to stop this behavior which we consider harmful to others. 4. When behavior is simply harmful to the patient, as in anorexia nervosa, we try to intervene even when the patient does not see her illness as a problem. We are often judgmental in medicine. But any whiff of "being judgmental" of "shaming" when it comes to dealings with transgenders is verboten. 

At a recent Endocrine Society meeting, one of the expert panelists mentioned that for female to male transgender patients he often uses testosterone doses in excess of what we would typically describe as androgen abuse in male patients, "gym rats" who simply want to have bigger and bigger muscles. For those male patients trying to build huge physiques, these doses of testosterone are seen as abuse. For the transgender patient the same doses are not "abuse" but  simply qualifies as allowing patients to achieve the gender identity they seek.

The big question here is: What have we wrought?
Secondarily, has the medical profession exerted the control over practice it should have done and if the medical profession as not exerted salutatory control, then who will?

The Problem of Ilhan Omar

The obvious problem for the Democrats of the Representative from Minneapolis is she offers Donald Trump and his co-conspirators the perfect boogey man: A Muslim who characterizes Israel as an apartheid state (alienating some American stalwart Jews who still support Israel out of an atavistic affection for the nation of Leon Uris) and she extends her remarks to attack American Jews whose money (Benjamins=$100 bills) support Israel and she questions their loyalty, because, after all, how can you support two countries and be loyal to either?

Part of the problem is she is not very bright and she is ignorant.
Part of the problem is she has not mastered English and is unaware of the resonance of certain phrases.

Bret Stephens, in a very convincing article, suggests she knows exactly what she is doing in her references to the moneyed Jews who conspire against America in the interests of "world Jewry," which must be based in Israel.

She is from a part of the world where people who regard Jews as a powerful enemy, who embrace an image of Jews as money obsessed, virulently self interested, do not even see that as Antisemitism. Now she finds herself in America where the resonances are different. 

(There is also something a little suspect in her own presentation of her life story: She portrays Arlington, Virginia as a place where she suffered taunting as a Muslim, and this may be true, but that place is one of the most diverse spots in the nation, perhaps second only to Queens, N.Y.. If there is any place to be an immigrant, that has got to be it. It is Ellis Island on the Potomac.
The Wilson Center describes it thusly:
Arlington, in other words, is at the forefront of demographic processes which are changing the face of American communities as well as the United States in its entirety.  Arlington is doing so with relatively little rancor as well as with improving economic opportunities and advancements, achieving low crime rates and far-reaching transportation opportunities. Arlington, in other words, reveals how an “inclusive, safe, resilient and sustainable” city looks.

So Omar's description of her having overcome the bullying of life in a parochial Southern city may be overwrought.)

But I digress: The fact is, Omar has criticized Israeli Jews, American Jews, not because they are Jewish but because of what she says they have done in terms of buying Congress and turning Congress into an "Israel occupied territory."

But the fact is, she has also attacked Saudi Arabia for its depredations in Yemen and she has attacked Egypt, Syria and other Arab nations, saying they are every bit as vile as Iran. So she's sort of an equal opportunity agitator.

Why do I say she is not very bright? Because that description Trump seized upon, while it may emanate from a simple deficit in English vocabulary and training, it was also an invitation to misinterpretation. Part of intelligent speaking is clarity and bullet proofing. "Something happened on September eleventh," did in fact stand as a dismissive remark, "Oh, the L train was late on September eleventh."  No, there are some events you cannot describe without clearly stating where you stand on the issue. No Japanese ambassador to the United States would ever say, "Oh, something happened on December 7, 1941."

And tying misdeeds of Jews to money is a pretty ripe trope. For whatever reasons, every anti Semite always suggests Jews are powerful because they are rich and control the flow of money. If she did not understand that, maybe she is just ignorant, which is bad, but if she did know that then she's worse.

The dual loyalty thing is trickier. This really is a problem. Of course, the laws have changed so Americans can now hold dual citizenship. When I was growing up you had to give up every other citizenship once you became an American citizen. Few people seem to worry about the woman who has Norwegian and American citizenship or even British and American passports. But those countries rarely have policies which bring them into conflict with America.

Israel, with its rightward move to Netanyahu, with its ongoing push into lands claimed by Palestinians has, in fact, looked like the bully, even though the Israelis are vastly outnumbered by their mostly hostile neighbors. And Israel has a fundamental, structural problem, as far as I can understand it: Either it is a Jewish state and that means that it cannot allow the majority of people living within its borders (Arabs) to have full political power or it is not, in which case, the Knesset could become a truly representative legislature and vote the Jews out of power. Israelis I have known are as horrified by Orthodox Jews as they are by Palestinians, but they do not go so far as to say Israel should not be a Jewish state. These secular Jews nevertheless cannot accept Israel as an open democracy in which the possibility exists, someday, if demographics go that way, Israel will be just another Arab state in the Middle East. 

And what does it mean to be a "Jewish state"?  I'm not sure. But I assume it means Jews have privileges not granted to others, namely Palestinians, who live as their neighbors. In that sense, Israel is some flavor of theocracy. But you can say the same of England, with its official Church of England or Italy with its Catholic Church. 

Now, I say all this knowing I do not really know what I'm talking about. I do not know enough about Israel and its laws, demography and politics. But neither do most of my fellow Americans. We know we like Israel because they are the only democracy in the Middle East, and they are basically Europeans--at least they look and sound like Europeans even if they resent that perception. We know Israel has actual free elections and we know Israel does not require women to be accompanied by a male in public, holds no public beheadings, allows women to drive, vote, serve in the legislature. Israels, in short, don't offend us with their religious based beliefs. 

No matter how you slice it, Omar has been a gift wrapped present to Trump running in the Rust belt and she poisons the Democratic party, which was oh so weak kneed to jettison Al Franken for horsing around, but when Omar rattles the anti Semitic cage, well, the Dems have to be very understanding.

Fact is, there are way more white, male Rust belt voters than Muslim voters.
That's simple democracy.

New Hampshire Apple Orchard Scam

When you think about "the system is rigged" you get angry, but that whole thing is just a vague idea until somebody does some digging.

Listening to Michael Lewis's podcast "Breaking the Rules" he details the sleazy way companies have ruined the lives of teachers, cops and firemen by acting as their "student loan managers" and managing to deny the former students the Congressionally enacted program which allows their student loans to be zeroed out after 10 years of faithful payments. When this happens, the companies managing their accounts lose customers and so they do everything in their power to keep the former students on the hook.

That's a pretty obvious scam.

But lately I was reminded of another sort of less personal but still sketchy scam involving apple orchards.

The richest man I personally know, a guy I knew from high school when I didn't know how rich his family was, now lives in New Hampshire and he invited me up to his apple picking fete one autumn. He lives on a ten acre compound bordered by a creek which feeds into a river and he's devoted maybe half an acre to apple trees and he invites friends up to pick the apples, drink apple cider and he cooks hamburgers on his Weber. 

"This is a great party," I said. "Much better than just a dinner party."
"Well," he said, "Of course there's a financial angle to it."
"Oh, did I miss the admission tickets?"

No, he explained, if he keeps a certain number of apple trees, or a certain acreage in apples, he gets a tax break on his property taxes, which are then cut because his land is in "agricultural use." 

I hadn't thought about it again until I took my bike ride yesterday and coming down Old Stage  Road in Hampton Falls I noticed the big McMansions on Avery Ridge Road had apple trees. Riding up the road, it was remarkable nearly every single manse was flanked by apple trees. At the summit of the ridge I looked over toward that huge chateau with the windmill and the Buddha statues out front, and apple trees lined up from the ridge on down.  All these rich folks with their huge chateaus were apparently apple fanciers.

And I thought, these guys are gaming the system.
Now, I haven't seen the tax returns of any of the folks who own these McMansions on Avery Ridge Road, but I do find it curious they all seem to have apple orchards.

Trump and the Anesthesia of Amnesia: Give Us Lloyd George

A bayonet is a weapon with a worker at either end
--Lenin

No Vietamese ever called me nigger
--Muhammad Ali

A fully equipped duke costs as much to keep up as two Dreadnoughts
--David Lloyd George

The past is not dead. It's not even past.
--William Faulkner

Something about Donald Trump has turned me into a reader of history.
Maybe it's his complete indifference to history, to history as it existed a month ago or a few minutes ago, as in "I know nothing about Wikileaks."

Reading Margaret McMillan's wonderful book about the causes of World War I almost began to grasp the idea of history. History is one long argument, of course, but what Ms. McMillan shows is history is a river with many currents and they all flow in and out together to take us somewhere. 

And, as obvious as it may seem to say, we are all here because we came from somewhere, and, as Faulkner noted, in that sense, the past lives in all of us today.
McMillan is unusual in her willingness to step out of her historian's role and to parenthetically point out how what happened then devolved to where we are now today, even in the case of a small town on the Nile which was poor then and is still poor but became the focus of conflict between England and France and then got swept up into the conflicts which persist in Sudan and that part of Africa today.

The World War, and I am beginning to think of WWI and WW II as simply one long fight, with a pause between the rounds, happened because of struggles between the haves and the have nots in European countries. In this sense, Lenin and the communists were correct, the "nations" of Europe were divided by boundaries and borders but the wars they fought were really fought by hapless workers who constituted a single interest group, the dispossessed, duped into fighting the boys in the other uniforms by calls for "patriotism." 
So Lenin's remark about the bayonet is true.  The German farm boy  with the bayonet had no antipathy toward the Russian peasant or the Frenchman or the British butler with the bayonet but each of them had been indoctrinated with the idea of "patriotism" and "God, King and country."

As for the kings, well, they were never in danger and war was nothing more than horse racing with respect to their own personal fortunes. Even the Kaiser, in the end simply decamped to the Netherlands and continued to live in luxury.

In Eric Maria Remarque's "All Quiet on the Western Front" this theme of the German soldier in the trenches having no animosity toward his enemy across no man's land comes up again and again and the Germans say what they should do is to put the Kaiser and the King of France in a field, in their underpants, with cudgels and let them fight it out and then everyone could go home. 

This is really what they were saying at Woodstock, during the summer of peace and love. Make love not war. We've got no skin in this game. 

In fact, reading between McMillan's lines, you can clearly see the importance to the ruling classes that the idea of patriotism and country be promulgated, because without a foreign enemy to loathe, the working classes would look for more local targets for their seething resentment and hate. 
Mr. Trump has played this hand over and over. 
"You will all be winners. You'll be winning so much you'll get bored of winning."

One of the most fascinating characters to emerge in this history is the Welchman, David Lloyd George, who grew up speaking Welch in a part of the United Kingdom which, I am led to believe is something like West Virginia is to the United States, disparaged, poor, uneducated and disregarded. 

Of course, other currents which flowed toward the great War were rooted in animosities which percolated among common folk: Ethnic hatreds in Bosnia, the Balkans, between Slavs and Germans drove nations toward conflict. Hate trumped love in those parts of Europe. It was not all peace and love among the have nots.

Part of the run up the the War, one of the currents, was an arms race to build the greatest navy. Britain, or its leaders, which included the king but also the parliament, believed it could be invaded unless its navy was indisputably superior to all others. It needed not "air superiority" as we now say, but naval superiority. When Germany began challenging that with a program of building ships, England felt threatened, and the British inclination toward Germany and against its historical enemy, France, shifted. So individuals in the British government steered her into conflict with Germany.

Lloyd George did not disagree, at least in the beginning, about the need to win the arms race but he was determined the economic consequences be born by the upper classes as well as by the poor. He  campaigned for a "death duty" on inherited estates, and for property taxes, disproportionately falling on the land owning class and he went on to institute the first national health care system, social security and other benefits for the less wealthy part of the population. Immigrants living more than 10 years in the country we eligible for all benefits. 

Lloyd George (who was Margaret McMillan's great grandfather--and she describes him as "a radical) was on the wrong side of history in some instances: He was a major actor in the 1918 treaty which insured the continuation of the war 20 years later and he insisted on Irish conscription which led to the infamous Easter rebellion and ultimately the "Troubles." But he was someone who had come from a downtrodden place and never forgot his roots, the struggles of the people on both sides of the bayonet. 

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. 

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.