Michael Sandel: Meritocracy, Credentials and the Rage that Brought Us Trump and the Proud Boys

On the left, less viciously, we have elite universities that have become engines for the production of inequality. All that woke posturing is the professoriate’s attempt to mask the fact that they work at finishing schools where more students often come from the top 1 percent of earners than from the bottom 60 percent. Their graduates flock to insular neighborhoods in and around New York, D.C., San Francisco and a few other cities, have little contact with the rest of America and make everybody else feel scorned and invisible.

--David Brooks

 Reading Michael Sandel's "The Tyranny of Merit" a glimmer of insight peaked through the fog of the last four years.

Sandel, a "rock star" professor of philosophy at Harvard in the department of government and politics wrestles with the idea of what is a just society and how the idea of a meritocracy and all that goes with that, actually translates into injustice and justifies the vast inequalities we are now seeing in the United States with the top 400 families owning more wealth than the bottom 80% of the country.

How, in other words, can we justify so few owning so much and why should the government, in the interest of the common good, the greatest good for the greatest number not simply seize a sizable part of that wealth and redistribute it to the rest of the population--as it in fact always had done since 1913, when the 16th amendment, creating the income tax was passed?

Sandel exhaustively documents instances in which American politicians, including President Obama and President Clinton exhort the nation to create mechanisms which more than allow, but promulgate opportunity for every citizen to "rise" to the highest level to which their talents and their desires and motivation can bring them.

This sort of talk has been the "liberal" response to conservatives who say that welfare rewards lazy people who do not want to work, who want to freeload off a system which pays them to stay home and watch TV.

Sandel cannot help but explore the different arguments from the different philosophers, going back to Aristotle, and to tease out anything useful if you want to argue with Republicans or your neighbors today can be tedious, but if you've watched his youtube lectures at Harvard, it can be fun.

Basically, he says the idea that any American has pulled himself up by his bootstraps or should have is an exercise in self deception, in the sense that we all function in a very complex and connected system. There are some folks who have no bootstraps to pull and others who were born, if not on third base, at least on second and think they have hit a triple.

In fact that meme is one of the few useful ripostes to the "I did it on my own" braggadocio thing.

The idea that merit should be the guiding light to award glittering prizes gets a thorough scrubbing, beginning with the idea that talent is not a thing which a person actually achieves by trying. Michael Phelps had to work very hard to win his Olympic gold medals in swimming, but he has flippers for hands and feet and he is very tall and his "talent" which was necessary if not sufficient for success was not the result of his trying harder, but from the stuff he got genetically. As far as swimming goes, he got superior genes and exploited that for gain. But he never could have profited from that were it not for a huge commercial enterprise, the Olympics Inc, which provided venues, advertising, TV coverage, opportunities for endorsements, sponsorships. He did nothing to build any of that; he simply was able to exploit what others built for him.

Then there is the idea that people are rewarded for their value to society, that their labors simply have monetary value and should be reward whether or not they are virtuous people; they have something to sell in the environment which rewards it and so they deserve their wealth because they've provided what was valued. Walter White in "Breaking Bad" realizes he gets paid very little for being a good high school science teacher but he can make the world's best methamphetamine and so he does that to sell on the marketplace, which values his product because laws making it illegal make it scarce and valuable. 

Does Walter White "deserve" his wealth? Well, in one sense he does. But because it's been declared illegal, he is undeserving.

Does the hedge fund manager "deserve" his worth?

Terry Rodgers

Doctors, who have been put through a grinder of competition for scarce medical school spots work very hard to get into school and then work hard to get internships, fellowships, to do be trained to be expert surgeons and physicians. Surely, they "deserve" their financial rewards (which are getting more and more diminished.) But, then again, most of them started on second base in the competition to get into medical school in the first place. 

Lawyers who get paid $300,000 a year do work long hours. Do they "deserve" that wealth? They work no harder or longer than electricians, plumbers or HVAC repairmen.

Oh, we are told but the competition to get into top law schools is more difficult than for electrician school. But why should that matter, if 10 years after training is done both electrician and lawyer and doctor work equally hard?

Why should an accountant get paid more than a plumber?

And why should Jeff Bezos, who did not invent the internet and who does not deliver any packages get to keep the money the American financial and economic system keeps creating for him?

The problem with meritocracy is the myths built into it.

Oh, he was a Rhodes scholar. Oh, he got into Harvard Law. She got into Harvard medical school. She won a Nobel prize.  All of them worked very hard and got rewarded, but that does not mean they should be able to keep every cent they make.

Playing by the rules. Well, who made the rules?

Income tax rates during the Eisenhower Republican years were 90%. Our country was not "socialistic."  Did most Americans think our government was "re distributing" wealth?

Why do Americans who have good health care on their union plans not want the same for other Americans? Well, I don't mind if everyone gets as good coverage as me, but I don't want to lose mine.  Why do you think the government is determined to make your coverage worse? Why does the Dane trust his government when the American does not?

Well, look at Denmark--and Norway, Sweden and Finland. Until recently these were all white countries each with its own distinctive language spoken by only about 6 million people each. They are more like large family groups than multiracial, multiethnic America. 

Sandel insists we should see ourselves, as Americans, as a community. Fact is, when we were at war, in the Second World War, we came close to that. We were all in it together. But not even in the Civil War was that true. Surely, not since. Those who went off and fough, "for their countries" were "suckers" as Mr. Trump reminds us; Sonny Corleone's sentiments exactly.

We justify our disregard for our neighbors in moralistic terms: Well, I work harder. I deserve it more. 

The winners in America have hubris: they are proud and they think they were both chosen and favored; they worked hard to deserve whatever they've got. The losers are humilitated. If they are losers, it's because they deserve to be losers because they are not bright enough or driven enough. 

When England had more clearly defined and rigid classes, the poor or middle class lad who could not rise into the upper classes know his fate was no fault of his own. He was simply stuck in his place of birth. No shame in that.

But with meritocracy, there is always shame enough to burden all classes below the 1%.

With Apologies to Sam, Toby & Will: Joe's Inaugural Address

 Mr. Chief Justice, Madam Speaker, Senators, Congressfolk, My fellow Countrymen:

This is a day, as Roosevelt said, of national consecration. 

We face today a stricken nation. Our distress owes to two phenomena, one natural and one of our own making.

The natural cause is a virus. Not a virus made by man. It arose in no science fiction laboratory in China, but was carried in bats and overflowed into mankind, the fault neither of the bat nor of man.

The second phenomenon was of our own making, or of the invention of disturbed or confused or fearful minds: The evasion of hard, cold reality and cowardly retreat into fantasy, a flight to the land of make believe and conspiracy and darkness.

We have found that we can live in worlds of our own imagination for only so long until reality intrudes and asserts itself. In the past this reality has come in the form of war, military attack or, as in this case, of epidemic disease. Once reality arrives, our need for real action, for science, for cooperation, and for, yes, for government to light the black night of error and mendacity becomes clear.

Our descent into the mad world of dismantling our government left us ill prepared to face reality. The libertarian view that we do not need government, that government is not the solution but the problem always crashes on the hard boulders of public health, public defense or economic disaster. 

My predecessor in this office did not invent the idea that government is necessarily bad, that we should shrink government to a size where we can drown it in a bathtub, but efforts to destroy the departments of government responsible for data collection, (the Department of Commerce,) to destroy the department responsible for science, (the Department of Agriculture,) to destroy the Center for Disease Control, the Food and Drug Administration, the National institutes of Health, the Environmental Protection Agency, the Department of Energy and the Department of Education, all vital to our safety and prosperity as a nation, have made matters much worse than they had to be.

If I read the results of this election clearly, what I am being asked to do is to restore these vital agencies to their full power.

Our distress comes from no failure of ourselves. And our distress did not begin with the pandemic.

Our distress arose because we lost faith in each other, and we lost faith in the fairness of the American way.  Too many people in too many counties came to believe they had been dealt a loser's hand, systematically, and the deck was stacked against them.  What they have come to believe is meritocracy is a fraud. They were constantly reminded if they worked hard, played by the rules, they would be rewarded, but they found themselves on the losing end and they were shamed into believing it was their own fault.

They were sold that canard that the value of their jobs could be measured in dollars. They watched as American companies moved their jobs to nations where workers were valued only as pieces of machinery. The false god of material wealth as the standard of success walked hand in hand with false god of an aristocracy of elite colleges as the defining prize of entry into the upper classes. 

We have learned in this pandemic who really are the "essential workers." Nurses, grocery store workers, sanitation workers, hospital attendants, electricians, HVAC workers, plumbers, mechanics, information technology geeks, construction workers must be in place and thriving before the doctor, lawyer, professor, stock broker or businessman can even begin to work.

We need first to restore science, government and organization to our society, and only then can we get our population vaccinated, our children back to school and our factories and restaurants open. Only then, can we begin to travel, to fly, to reconnect.

Once we have accomplished this, our economy and our long nightmare of isolation and paralysis will recede. 

When that happens, we can take stock. We can look at reality and real facts, not "alternative facts" in the face and we can know, once again that children really did die at Sandy Hook, that a policeman's knee really did kill a defenseless Black man and that the reaction to this, while it ultimately was marred and besmirched by violence, was understandable.

And once the dark curtain of pestilence has been lifted, we must not forget how it was dropped in the first place. We must not forget that every state has, between it's gleaming and energetic metropolises, too much decaying and disintegrating rural space, too long out of sight and out of mind.  We must turn our Rust Belt back into a thriving heartland. 

We must turn our energies and our money toward vitalizing our rural areas as we once decided to embark on rural electrification. We must bring the farmland and the "empty spaces" into the heart of our national life. We can no longer be content to ignore or denigrate "fly over country" or to dismiss the poor Southern states as lost causes, or characterize the Mountain West as white nationalist country. There are millions who live in these places who, though outnumbered, voted for change, voted for progress.

We do not face a financial crisis from a corrupt banking system; we do not face a Great Depression with origins in a  degenerate economic order and colonialism. Our challenge, in fact, has already been met by the most innovative and successful scientific triumph since the polio vaccine. 

We can and we will charge ahead, distribute the vaccine, maintaining our masks and our distance for only as long as is necessary and then we can emerge from the dark into that sunny plain of honesty, of mutual respect and of, finally, unity, so that we can once again speak of the "United" States of America with real belief and not irony. 

We can be that country which has time and again come together, as people from different places, rural and city, wealthy and poor, North and South, East and West, coastal and inland, realize we are all Americans, so much more like each other than different from each other and we can know in the words of that old song, 

"We'll walk in the rays of a beautiful sun,

We'll put it together and we'll get it undone,

We'll walk in the rays of a beautiful sun,

When the world is much brighter."

Thank you and God bless the UNITED States of America. 

Into the Deaf World: Confessions of an Ignoramus

 Yesterday, I did a Sykpe session with a lip reading deaf person and it triggered memories of a decades old awakening.

When my children were 9 months and 2 years, my wife suffered multiple fractures in an auto wreck and was confined to a wheelchair for four months, undergoing multiple surgeries and rehab. Unable to chase after a very mobile toddler and a pin ball 9 month old, who careened about the house in his unsafe-at-any-speed roller ball device, we realized we'd need to hire a nanny to care for the children for a few months. 

Indoor demolition machine 

I got a call at the office and my wife sounded odd. "I've found our nanny," she said.

"What's wrong?"

She hesitated, choosing her words carefully. "You won't like her."

"Why?"

"But she's the best by far. She ignored me, and got right down on the floor and started playing with both kids and they loved her. All the others talked to me and ignored the kids or looked slightly horrified by them--not that I can blame them. Reid nearly crippled one with his roller derby thing."

"So what's wrong?"

"She's from Galludet."

Galludet is the college for deaf people in Washington, D.C.

"What!?!"

"She not completely deaf. She can talk to you and read lips and she still hears a lot, but she's going to be completely deaf in the next few years."

"No way!" I protested. "Suppose one of the kids falls down the stairs and she's in the next room and can't hear that."

"She can hear that much. She's my choice."

My wife knew I was pretty intolerant of deaf people. I didn't like seeing them gesticulating (signing) at restaurants. Don't know why that bothered me but it did. I had  always been impatient with disabilities, less with blind people for some reason, more with deaf people. Dealing with deaf people in the office always slowed me down and impatience has always been a problem for me. I found deaf people particularly annoying, especially older people who didn't wearing hearing aides but really, just seeing deaf people signing irritated me for reasons I could not explain.

But the boss prevailed and within days Estella moved in. 

She arrived with a TTY machine which allowed us to get the equivalent of text messages on a home phone, so we could answer phone calls from Estella's friends at Galludet. (This was before cell phones, just at the dawn of the internet age. We had computers but cell phones were still a few years away.) And, given Estella's active love life, and boyfriends, the TTY machine became the focus of no few romantic dramas.

In fact, we got to know dozens of Estella's deaf or going deaf friends. We learned that deaf co-eds have all sorts of romantic intrigues and deaf boys are no more a match for girls than their hearing males. I found myself covering for Estella when she slipped out for  clandestine assignations with a new boyfriends. She occasionally asked for an opinion about a new boyfriend--why she thought I would be a good judge, I have no idea, but she seemed interested in my opinion.  I did like her engineer boyfriend a little better than her political science major, for some reason. I liked all her girlfriends, who were irreverent and lots of fun. But mostly, I just saw them coming and going from our house, as I got home late most days. 

My wife's instinct proved correct. Estella was a godsend. She carried the 9 month old on her hip everywhere and she was quick and agile enough to cope with the 2 year old who had started walking at 8 months, and could now race up and down the three levels of our house with lynx like quickness. 

She drove our car and took the kids to Galludet football games, where they were a big hit with her 20 something friends and she made life possible for us, allowing me to stay at the office and keep our financial heads above water.

We met lots of Estella's deaf friends, and they were a winning group. Two of her friends, very pretty young ladies, would eventually bicycle cross country with her. They were all funny, full of energy and life and they made our home, encumbered by a hospital bed and home rehab devices, more of a playground than an old age home. 

They told us about things we never considered, like the difficulty dealing with repairmen over the phone if you're deaf, difficulties dealing with police and government agencies and we realized just how difficult life for the deaf could be, and how easy solutions could be, if only the hearing world would make minimal effort.

But most of all, we learned how fiercely proud of their deaf world these people were, how they asked nothing more than to be allowed to participate and contribute and thrive, which surely they would. 

After 4 months, my wife regained her mobility and was able to take our now 13 month old tyke to the grocery store, plop him into a shopping cart, in the seat facing her, as she worked her way up and down the aisles. He was pre verbal, having a few words, but mostly he just pointed to things and grunted. 

Waving his arms around, especially when he was rolled in front of stuff he particularly desired, like the cereal section with Honey Nut Cheerios and Fruit Loops (which Estella had introduced him to, and which we would otherwise have never allowed in the house) this enfant terrible was busy gesticulating when a woman approached and started in with the fingers and mouthing we had seen Estella do so often with her friends.

Back and forth with our 13 month old, she laughed and signed and carried on for several minutes before turning to my wife, much amused by whatever my son had to say.

She started signing to my wife, who realized she was signing, having seen enough of that from Estella and her friends, but she had to simply smile and say, "I'm sorry. I don't sign."

"You don't sign?" the woman expostulated. "And you with a deaf, signing  child?"

She gave my wife a withering look of distain and horror, and stomped off to find a child abuse official somewhere in Giant Food store.

I got a furious phone call at the office.

"Did you know Reid signs?"

"Signs? What sort of signs?"

"You know, sign language. What Estella does!"

"But he doesn't talk."

"Well, he may not talk, but he sure as hell signs up a storm. Had a very lively conversation with some woman at Giant today, who looked at me like some sort of child abuser today when she realized I did not sign. And me with a deaf, signing child I could not possibly communicate with because I'm too lazy to learn to sign. I'm am sure I will be getting a visit from the Montgomery County child welfare department any day now."

"Wait! He converses?"

"Apparently. Who knew? He only grunts at me, but with this lady, he has prolonged conversation."

"Oh," Estella said, when my wife got home and stormed into her room. "Well, yes. He's a bit chatty," she said. "He's got a pretty big vocabulary for a little kid."

"What does he talk about?"

"Oh, food mostly. But he's also a pretty big football fan."

"What!?!"

"You knew I took him to the football games."

"Yes, but..."

Estella left us by the next Spring, when she went off with her two friends to ride bicycles cross country.  Within a year our son was communicating verbally and having not seen Estella after she returned to Galludet and gone back to campus, he lost his signing.

But, difficult as that time was, with a mother learning to walk again and kids demanding various things and a business needing constant attention, Estella's time with us was undeniably enriching, as we got an insider's view of the deaf world and we were, none of us in our house, ever the same since.

Prophesy in a Small Package: The Fifth Risk

 

Michael Lewis's "The Fifth Risk" has three salient virtues:

1. Brevity: 219 pages

2. Originality: It's really a book about why we need government

3. Perspicacity: Published in 2018 and focused mostly on the failure of Donald Trump's pirate band to engage in transition, it is the story of what happens when smart warnings go unheeded. Lewis asks an under secretary of Agriculture what his greatest fear is looking ahead-- in the form of "What do you worry about what Trump might do to the department of Agriculture?" and he answered with a single word: Wildfires.

Having spent most of a chapter describing the myriad responsibilities of the Department of Agriculture, which, as Lewis says, is really the department of science, having talked about its roll in keeping geese away from airports, its food programs for rural poor, its meat and food inspection functions--remember Mad Cow Disease--its role in preventing cruelty to animals, its forest management service, that word "Wildfires" seems to come out of the blue. And yet, spoken in 2017, this obscure bureaucrat, Robert Bonnie, knew what Trump and his band were afraid to know, as the vast wildfires of 2020 proved.

Re-reading this book now, two years later, it is a beacon in the dark.

Democrats are forever apologizing for "big government" but Lewis lays out in sufficient detail how indispensable government, even big, federal government is in the life and well being of the nation. 

He begins with the Department of Energy, which like most of the departments in the federal government is misnamed, having outgrown its original missions, and  now midway through re-reading the book and Mad Dog has worked his way back up to the Agriculture Department.

Energy was the obvious place to begin, if only for comic effect. Trump appointed Rick Perry to head it, presumably because during debates Perry had said he would eliminate three departments: Education, Commerce and...he could not recall the third, but later added "Energy."  So he seemed the ideal man for the job to head (i.e. to destroy) the Department of Energy.

Unlike other Trump appointees who were sent to their posts to destroy the organizations they headed, Perry actually slowly learned a little about what the department does. (As opposed, for example, to Wilbur Mills who begrudgingly agreed to be briefed about his new digs at the Commerce Department only to learn that is really the department of statistics, and he erupted: "I thought this was about business! All you talk about is numbers!) 

DOE, it turns out is responsible for the safety of all those nuclear missiles in their silos, which have a tendency to age, deteriorate and leak. It also funds research into energy related things like solar panels, fracking and electric cars. "Every Tesla you see on the road came form a facility financed by the DOE." Of course, whatever you think of fracking, it was the pivotal technology which made American energy dependent and freed us from reliance on those miscreant Saudis.

One fourth of the budget of DOE, many billions, is tied up in trying to keep nuclear waste from seeping into the Colorado river from the site of production of our nuclear arsenal in eastern Washington, Hanford, where the plutonium was made, buried and then sought out ground water like a viper hungering for vital organs. 

Oh, and before we leave the DOE, there is that little matter of the electric grid and the incident, mostly unreported, where "a well informed sniper" with a high powered rifle shot up exactly the right transformers  and cut the cables to the substation to prevent it from communicating. This substation, in San Jose, fed Apple and Google. Imagine what well informed snipers could do if they organized to take out grids on the East Coast.

As Lewis noted, people are pretty good at responding to a crisis that has already happened, like Pearl Harbor. Never going to let that happen again! But imagining what could happen--suppose somebody flew airplanes into a world center of finance in Manhattan--that we don't want to think about. Why upset yourself with scary ideas?

Why, indeed. Of course, imagining scary things is exactly what prompted Einstein to write that famous letter to Franklin Roosevelt, who read it and started the Manhattan project. Einstein had learned of the German work on nuclear fission and he imagined a risk. Fortunately, FDR was not inclined to seek the comfort of ignorance.

Most people are at least dimly aware the internet and GPS are government inventions.

But if you were elected to "drain the swamp" which translates: Kill government or shrink it down to a size you can drown it in a bathtub, then you do not want to know what that would cost you, or how it would put you and those you love--assuming you love anyone other than yourself--at risk.

Lewis observes: 

"Here is where the Trump administration's willful ignorance plays a role. If your ambition is to maximize short term gain without  regard to the long-term cost, you are better off not knowing the cost. If you want to preserve your personal immunity to the hard problems, it's better never to really understand those problems. There is an upside to ignorance, and a downside to knowledge. Knowledge makes life messier. It makes it a bit more difficult for a person who wishes to shrink the world to a worldview."

So when Trump sent his men to the various departments, none of them were sent to learn anything about the work of those departments, they were sent to hunt. They demanded lists of employees who had attending conferences on climate control or solar panels. They were seeking out those nasty knowledge seekers in the various departments just as Joe McCarthy, one of Trump's heroes, had sought out "Reds" in the State Department in the Red Scare of the 1950's. 

The core Trump value, which is really the core value of his voters, is the desire to remain ignorant, to stop the search for new knowledge, to simply repeat a mantra, "Freedom!" or "Make America Great!"

In this, Trump and his acolytes are nothing new; they are in fact a regression to the Middle Ages, where knowledge was considered the great threat. People who believe they cannot learn new things cling to their guns and their religion, as Mr. Obama so keenly observed. It's not really socialism or elitism which strikes fear into the heart of the Proud Boys, it's the scary idea of new knowledge. 

Joe Biden is not the smartest man who has ever won the Presidency, but he is brave enough to look at the potential for the new and not be terrified but to be excited. He wants a "moon shot" to "cure cancer." As if there is just one disease, cancer. But his idea is that progress is not to be feared but to be pursued and applauded. 

Look at those defeated coal miners, whose wives say, "We don't want re-training. My husband is 50 years old. All he knows is digging coal. He can't learn anything new now." 

At least they were honest. 

And, in one sense, Trump is honest in that same way: I'm just as stupid as you are, and as ignorant and I don't need to know anything new. I'm rich and I fly around on my own private jet and that's fine with me."

Transgender Politics and the End of the Republic

If ever Jim Jordan, the Freedom Caucus, Rush Limbaugh and the folks at Breitbart could conspire to dream up the perfect spider wasp to insinuate itself into the internal organs of the Democratic Party and left wingers everywhere, then transgender nation provides it.

There are certain cases which, once swallowed by a defender of the faith, can cause an internal meltdown: One classic case of a poison pill is the Mad Cow paradigm for libertarians. 

  Ask a true libertarian, who sees no justifiable role for government, who wants to shrink the government down so small you can drown it in a bath tub, about the proper role of government in the case of a farmer who has a herd suffering from Mad Cow Disease and he dissolves before your eyes:

Leftie: So you say we do not need a Department of Agriculture, a Food and Drug Administration or a Center for Disease Control?

Libertarian: Absolutely!

Leftie: So when farmer Brown wants to sell his herd of cattle suffering from Mad Cow Disease to meat packing plants making hamburgers,  you would say the government has no business depriving him of his property and livelihood through the heavy hand of government?

Libertarian: Well, the market can regulate that.

Leftie: Mad Cow Disease is a prion disease, and if you cook the infected meat you do not destroy it. It enters your body and ensconces itself in your brain and spinal cord, silently, but 10-20 years later, you die as a writhing mass of drooling demented protoplasm.  No market force can remedy that because it all happens long after dollars have changed hands and statutes of limitations expired.

Receptor disorder: XY chromosomes

Now you are faced with one flayed open Libertarian.

Something like that happens when a right winger confronts the Leftie on transgender medicine, but this time it's the Leftie who melts down, because his own fundamental, absolutist principles tether him to positions which rapidly become absurd.

The Leftie is committed to certain principles, just as fervently as the Libertarian was committed to his principles:

1. Demeaning and disparaging people because of their sexual preferences of sense of self is cruel and wrong.

2. Tolerance of a wide variety of belief and self actualization is paramount to a free society.

3. History has shown how damaging and unfair the treatment of homosexuals was throughout the 20th century, with efforts made to "deprogram" homosexuals.

We accept these truths to be self evident.

But what do you do with the person who wants to say Susan is going to town and winds up saying, "Susan says they are going to town." ?

We have a crisis of the pronoun, you see, because Susan is gender fluid, does not consider herself either a she or a he, but something in between. 

And her best friend, Pat,  is a person who though born a boy, has discovered he is actually not a he, but a she in a male body and so is now taking high doses of estrogen and considering having his penis and testicles removed surgically. 

Pat's is living with Suzanne, who is a lesbian. They are lovers. They want to have a baby but there are problems.  The insurance company refuses to pay for in vitro fertilization at $10,000 a pop a cost which the insurance company will pass on to the American public.

So what to do? 

When this case was presented to the psychiatrist, Paul McHugh, he asked: Well, what kind of sex are Pat and Suzanne having? If Pat's penis goes into Suzanne's vagina, is she really a lesbian and is he really now a she? If this is not happening, what is? When they make love, does Pat get an erection? Does he ejaculate?  If so, why is in vitro necessary?

Paul McHugh, MD

Paul McHugh is a psychiatrist, who left Cornell to head the Johns Hopkins department, but when he arrived he was asked to help with the Hopkins Transgender Medicine Clinic, which included Urology, Endocrinology, Surgery and Psychiatry. McHugh did his homework and was shocked to see the suicide rate among patients in the clinic approached 40%. (This turns out to be not an anomaly, as even today most Transgender Clinics report similar numbers.)

This disturbing suicide rate among patients was then and continues to be written off by the directors of these clinics as being attributable not to any failure of the clinics but to the severe antipathy faced by these patients as they are berated and hated by American society at large.

But McHugh asked a different question: What if these patients are committing suicide because of a failure of the clinic to meet their needs, or worse, because of the therapies the clinic offered?

Until he had the answers to these questions, he withdrew Psychiatry from the Clinic, which caused an explosion of recrimination both within Hopkins--medical students and professors alike refused to talk to him--but when word got out, a host of attacks launched on social media. McHugh was imposing his 20th century Catholic beliefs on needy transgender patients, denying they had a disease, and he was as bad as those doctors who wanted to force homosexuals into "deprogramming" clinics in the 20th century. 

Semenya: Androgen receptor dysfunction

Of course, McHugh was saying nothing of the kind.  Homosexuals did not seek therapy from clinics or doctors. They did not need hormonal therapy to achieve their goals of leading a happy, normal life. They did not have 40% suicide rates, even though they faced horrific discrimination, had been excluded from church, jobs, social clubs.

"Gender dysphoria"  is a different thing altogether, McHugh postulated. If gender dysphoria can be defined as a sense by an individual that the role he or she had been assigned, and in fact the anatomy he or she possesses is different from what they feel inside and in fact is simply wrong.

McHugh wondered whether the real model for transgenders who want to go from male to female or from female to male is in fact not homosexuality at all, but anorexia nervosa.

The patient with anorexia nervosa, typically a young female, who is five feet seven inches tall and weighs 90 pounds, looks in a mirror at her body and says, "I am SO fat!"

That, McHugh calls "a wrong idea." And that wrong idea takes control of the patient's life and ultimately ruins or ends it. Few people would argue the patient should be accommodated, should be helped to lose weight and to maintain such a low weight or be assisted in continuing to driving it downward. 

But when a 13 year old girl tells her parents or the doctors at the transgender clinic she feels like a boy trapped in a girl's body, that cannot be a wrong idea and anyone suggesting otherwise is like those old doctors who tried to convince homosexuals they had to be deprogrammed and changed to conform to society's demands.

5 A reductase: Girls at birth, boys at 12

Complicating all this is the well studied arena of disorders of sexual differentiation, which by the mid 1970's had been explored biochemically and genetically and which continues to be studied today.

What has happened, of course, is doctors who never understood the disorders of sexual differentiation science have conflated these disorders with "gender dysphoria" as if the gender dysphoric patient is simply another variety of patients afflicted with a disorder of sexual differentiation.

But there is a substantial difference: In the case of biochemical disorders of sexual differentiation, the hormonal and neurological mechanisms have been discovered and defined and can sometimes be treated, but none of that has been possible (yet) for gender dysphoria. What makes it even more complicated is that way back in the 1970's some patients with some types of biochemically induced disorders of sexual differentiation did complain of the same phenomenon: Some said they never felt like a girl, even though they had been identified as a girl at birth, and raised as a girl. They were, in fact, in many important ways, boys in girls' bodies, just as the gender dysphoric patients say today. And when science finally caught up with these individuals, it was discovered that girl was XY (as opposed to the normal XX female chromosomal complement). There were even some villages in the Dominican Republic, where there was lots of consanguinity (intermarriage) where the children were given gender neutral names--the Spanish equivalent of Pat, Chris or Robin)--because at age 12 some of the village "girls" grew penises and developed into strapping boys. (The five alpha reductase deficiency.) These were boys who really were trapped in girls' bodies and in fact, transformed themselves (transitioned) at puberty.

Penis at 12 patient

But these folks are a far cry from today's Transgender Clinic populations, where the vast majority of patients feeling trapped in a body of the wrong sex, have no identifiable biochemical abnormality, no genetic abnormality; from the point of view of male and female hormone levels, of chromosomes, of genes (the SHY gene) these girls saying they want to be boys or boys saying they want to be girls, by all tests known to man, have no identifiable "reason" to feel this way.

Of course, it is possible we simply are not smart enough yet, do not have the biochemical tests yet to understand why they feel that way. But until we do, these people are said to have a "psychiatric" disorder. Or, no, we cannot say "disorder." These people should not be called "abnormal," be "accused" of having a disease. We should be more open minded (a liberal absolute), more accepting of differences, and by all means, Heaven forbid, we should not be judgmental!

In some of those 1970's patients who were raised as girls but feeling like boys, until their underlying biochemical problem was identified, the question was raised: How did this boy know? He never wanted to play with dolls or do girlie things. He always chased around playing war with the boys, although his testosterone levels were normal female. What happened? The tentative explanation was that during the "first puberty" which happens during fetal life, a time when male hormone in the male fetus surges, just enough male hormone was made in these boys who were identified as girls, to condition parts of the brain where male and female behavior are programmed. This is different, apparently, from parts of the brain where sexual preference is programmed. But all of this remains an unproven hypothesis.

At Mad Dog's last trek through the international Endocrine Society meetings he went to two sessions which alarmed him greatly, as a sequence.

#1 Abuse of Anabolic Hormones:  This was a session given by a professor from the University of Michigan, who we will call Dr. Apologist. He present the case of a patient who is very familiar to any practicing endocrinologist. 

This patient is a twenty something man referred for "hypo T." That is, low blood testosterone levels. He arrives at the office, often in form covering clothes but in the exam room, with his shirt off, you see two things: Massive musculature with trapezius, pectoralis, bicep and deltoids which would put Arnold Schwartzeneger to shame. There is also a hint of excess breast tissue ("man boobs".) Looking at his biochemical testing: the tell tale biochemical profile of someone who have been injecting industrial doses of testosterone for months to years but then stopped about 6 weeks before having his bloods drawn.  The patient is clearly getting testosterone from some source, likely among his gym rat friends but now he wants a more reliable, less expensive source from the doctor. 

Endocrinologists from the Netherlands in the audience noted that this is such a common group of patients they have actually established "Androgen Abuse Clinics" there, where patients are treated as if they have any other sort of drug addiction problem, sign contracts to gradually taper off in a classic "detox" mode. These patients look in the mirror at their Incredible Hulk bodies and see a 98 pound weakling.

#2 Transgender Medicine: From that session, Mad Dog walked into the session with a panel of the heads of Transgender Medicine Clinics at university hospitals from Boston to New York to San Francisco.

A case of a female to male transgender was presented. This patient had been given doses of testosterone to help grow lip hair and also to suppress menstruation, which continued despite the male hormones and served as a reminder to the patient of her own persistent internal organs. The doses are what knocked the socks off Mad Dog.

A normal dose of testosterone is 200 mg every two weeks. This patient was getting 300 mg three times a week, thats 3600 mg a month compared to 400 mg--nine times the recommended, "safe" dose. None of those "androgen abuse" patients had anything on that transgender clinic patient. 

Mad Dog texted Dr. Apologist from the prior session to ask how this could be sanctioned by the Endocrine Society and Dr. Apologist texted back that this was not androgen abuse because it was "gender affirming" therapy.

Notice, when the man uses 1/9 of that dose to maintain his bulk, he is treated as a substance abuser, a man very like the patient with anorexia nervosa, who has the wrong idea about his body, but if the Transgender Clinic doctor prescribes that dose, he is "gender affirming."

Which brings us back to why Transgender Clinics will spell the end of the Republic.

Once Jim Jordan gets ahold of this craziness, those who want to embrace Gay, Queer, Transgender rights will cling to their desire to be warm and accommodating, to not make people who suffer gender dysphoria suffer any more than they already do, and they will cling to that main mast as the ship of state sinks beneath the waves.

The very conflation of LGBT/Q is a harbinger of demise for liberal politicians.

Saying that Lesbian & gay & bisexual folks deserve to be treated as anyone else should be emphatically embraced by liberal politicians. This is about "sexual preference." These folks need no clinics and request no change in the English language surrounding pronouns.

Not sure, exactly the difference between "queer" and L and G is, but not a major thing.

It's grouping "T" --transgenders--with that group which spells doom. It's like adding an "A" for anorexia nervosa folks into that. Yes, of course, patients, people with a "problem" should be treated with respect and sympathy and empathy, but let's not confuse folks with distinctions the average American has no patience for. Educate the public, fine. But let's not sink the Democratic battleship with that torpedo.

The more middle America who know nothing about the biology of sexual differentiation, the difference between genetic sex and gender identity, the difference between being homosexual and wanting to change your sex, the more middle America is confronted with locker rooms, bathrooms, being told they are obtuse because they cannot wrap their heads around calling a person who looks like a girl "they" and stumbling over pronouns, the sooner those politicians who look weak and incapable of standing up to all this craziness will be shown the door. And those politicians are AOC, who is otherwise laudable, but fatally flawed on this issue and then more moderate Democrats and we'll have another four years of Donald Trump or someone like him.

Memo to Joe: White House Office of Pithy Phrases

 

Mad Dog delighted in Joe Biden's remark "With Obama, Osama Bin Laden is dead and General Motors is Alive."

Rare among Democrats Joe has the capacity and willingness to zing the Republicans in memorable, delightful phrases.

Republicans have long been the masters of the pungent  phrase: Death Tax, Tax and Spend Democrats, all those things meant to hook and energize their willing masses yearning to breath fire.

But Joe will have new demands on his time and he needs a steady stream of pith made available, for which Mad Dog recommends he enlist Aaron Sorkin, David Simon and anyone else he can enlist to percolate up some phrases the White House can put out there and Congressional Democrats can pick up as a daily mantra.

He also needs a few cards in his vest for special targets:

Mad Dog has long wanted to see Jim Jordan skewered, as he strides the halls of Congress in his shirtsleeves, chest out for thumping, just to drive home the point he was a college wrestling champion and is still a big, virile Republican who could take you out behind the bar and beat you into submission.

One of Mad Dog's favorites, stolen from John Randolph, would be used the next time Jordan suggests some Democrat is a wimp and a weenie who doesn't have the balls to send the tanks made in his district into some new war, or Democrats are too chicken and wimpy to just allow COVID to burn its way through the nation:

"Mr. Jordan prides himself on a muscular animal faculty in which the orangutan is his equal and the jackass infinitely his superior."

And all like that.

Democrats need a daily stream of deflationary barbs to puncture the Republican blimp of virility.

Golly Toto, I Don't Think We're in New Hampshire Anymore

 "All politics is local."

--Tip O'Neill, former Speaker of the House

Before the internet, Mr. O'Neill's quip likely was more accurate, but one thing our connected information age has done is to nationalize politics. Just go on Twitter and see comments from Michigan, Texas, California, Oregon and you cannot distinguish them from people writing from New Hampshire.

Hampton Falls, NH

Which is not to say, we do not have local issues or that announcing you want to cut the corn ethanol in gasoline program will go unnoticed in Iowa, but if Donald Trump has taught us anything it's that the creepy crawlies are distributed from sea to shining sea, from the Great Lakes to the Gulf. 

There is some commonality which connects the junkyard owner in Wisconsin to the Hispanic who lives along the border in Texas to the guy down the street from Mad Dog in Hampton, who still flies his Trump flag, and who drove around for months with Trump flags flying from his Ford F 250.

Beautiful Downtown Hampton

Analyzing what connects these folks, across state lines, geography and even social class should be the first priority of political thinkers, but Mad Dog sees no signs the public intellectuals who might do this analysis have the tools or modes of thought to do it.

Jill Lepore might have a chance, but she is more historian than analyst. 

Certainly  Nate Silver is just guessing.

David Brooks might eventually figure it out, but Mad Dog is not holding his breath.

If Trump appealed to only the white male who barely got out of high school, worked a succession of uninspiring jobs--delivering auto parts, stocking shelves, changing oil at Jiffy Lube or tires at Town Fair Tire, or maybe, if he was a little more successful, working in a garage or in the trades, then one could go to work understanding the phenomenon. Losers in the meritocracy, who felt humiliated in school, who ran with the wrong crowd in high school and were never going to be seen by their peers as anything but ordinary at best and losers at worst. And along comes Trump.

But that doesn't explain the rich folks in Bonita Springs, Florida or up at Frye Island in Maine who love Trump.

And now we know it's not just some subterranean 40%. It's 50% or very nearly.

Obadiah Youngblood, Salt Marshes North Hampton

The only real comfort is history: Read Howard Zinn, or "Bury My Heart at Wounded Knee," or "A Bright and Shining Lie" or even "Gone with the Wind," and you will see that Trump part of America--resentful, feeling cheated, violent, every bit the same crowd who worked themselves into a frenzy over Adolf, right here in the USA. This hate, this intractability matches anything seen in Northern Ireland ("Say Nothing") or Palestine. 

Now, we are faced,  unexpectedly, with a Republican governor, Executive Committee, state House of Representatives and Senate, and we have no real explanation for this, in a state which sent a woman to the US House and another to the US Senate and a gay man to the House. 

What happened in New Hampshire?

Mad Dog has some idea, mainly what he wants to believe, that the powers that be in the New Hampshire Democratic party have failed to recruit the best candidates. But that's too simple. The best candidate or at least one of the very best for state House, Katherine Harake, a woman of poise, intellect and enormous promise did not make the House.

And the Pig Shall Lie Down with the Lamb

Then again, New Hampshire sent Maggie Hassan to the US Senate and to the governorship when it could have chosen Jackie Cilley.

And when it had the  choice between Terence O'Rourke, a sharp witted former federal prosecutor, a bronze star captain in the Airborne, and a man so mild mannered he tends to disappear into the woodwork, Chris Pappas, they chose Pappas. 

This may just be what makes politics an art, not a science. But it does not augur well for our future.