The Mommy track

May 17th, 2012

This photoshopped parody of a Newsweek cover is simply hilarious. Everyone knows that Obama’s sudden “conversion” to support of single sex marriage is pure fund raising pander. It might cost him some votes but black churches are unlikely to turn on him and the others who would be offended won’t be voting for him anyway.

The one beneficial effect is to instantly end the questions raised about evangelical support of the Morman candidate. Obama has consolidated Romney’s base for him in one statement.

Why Obamacare is much worse than many think and why it must be stopped.

May 14th, 2012

The Supreme Court will rule on he constitutionality of Obamacare this year. The arguments and the issue which got the most publicity was the individual mandate. I don’t actually care much about this although it may well violate the Constitution. There are far worse things in the legislation and they should be emphatically rejected by the Supreme Court. The worst of the issues is discussed in detail here. This is a really frightening piece of legislation and I cannot imagine that the Court will let it stand. Of course, given the absence of argument, the Court will have to find this itself.

Perhaps nothing in the Obamacare legislation embodies the top-down, command-and-control nature of Progressive healthcare more than the Independent Payment Advisory Board (IPAB), a 15-member panel of “experts” to be appointed by the President. There are three particular features of the IPAB that illustrate this fact: The IPAB will control all healthcare spending, public and private. The IPAB has been awarded near-dictatorial power. And the IPAB is designed to be a nearly immutable entity.

How is this accomplished ?

Specifically, Section 10320 (in the Managers’ Amendments portion of the legislation) grants the IPAB, beginning in 2015, the authority to limit all healthcare expenditures, that is, all healthcare expenditures, and not just expenditures by Medicare or government-run programs.

To emphasize this expanded authority, Section 10320 changes the name of the “Independent Medicare Advisory Board” to the “Independent Payment Advisory Board.” It directs the IPAB, at least every two years, to “submit to Congress and the President recommendations to slow the growth in national health expenditures” for private healthcare programs. Furthermore, it designates that these “recommendations” may be implemented by the Secretary of HHS or other Federal agencies “administratively” (that is, without any action by Congress).

Thus the federal government can control, under penalty of criminal prosecution of doctors, private health care spending ! This goes well beyond Medicare and Medicaid. It will prevent, unless stopped, people from spending their own money on health care.

That is not the worst of it. The IPAB cannot be changed or repealed by Congress. This is unprecedented in US law. Even the ill-advised Prohibition Amendment, promoted as another moral obligation by progressives after World War I, could be repealed by another constitutional amendment.

A quick reading of Section 3403 might leave one with the impression that the IPAB is a sort of Mr. Rogers of healthcare – a mild-mannered, friendly, always-helpful, but ultimately undemanding agent for good. This is the impression imparted by the first few paragraphs of the Section, which paint the new entity as an “advisory” board, whose main task is to develop “proposals” and “advisory reports,” which “proposals” and “advisory reports” would solely consist of various “recommendations,” that ought to be “considered” for the purpose of cost reduction.

Nothing could be further from the truth. This language is simply another example of supplying a new law, which is far more radical than the authors would like people to know, with a soothingly misleading introductory paragraph. The IPAB is actually designed to be as all-powerful as it’s possible to be.

Read the rest of this entry »

Derbyshire redux.

May 2nd, 2012

I recently expressed my opinion about the shameful treatment of John Derbyshire by National Review, his former employer, which dropped him as a writer because of a piece he wrote in another online magazine. One of his statements which seemed to be the most objectionable to NRO was “(9) A small cohort of blacks—in my experience, around five percent—is ferociously hostile to whites and will go to great lengths to inconvenience or harm us. A much larger cohort of blacks—around half—will go along passively if the five percent take leadership in some event. They will do this out of racial solidarity, the natural willingness of most human beings to be led, and a vague feeling that whites have it coming.

(10) Thus, while always attentive to the particular qualities of individuals, on the many occasions where you have nothing to guide you but knowledge of those mean differences, use statistical common sense:

(10a) Avoid concentrations of blacks not all known to you personally.

(10b) Stay out of heavily black neighborhoods.

Two weeks ago, an incident in Virginia validated a couple of Derbyshire’s bits of advice to his kids (the premise of the piece).

There’s outrage in Norfolk, Va., today after a white couple was attacked by dozens of black teenagers, and the local newspaper did not report on the incident for two weeks, despite the victims being reporters for the paper.

Even today, the Virginian-Pilot did not cover the crime as news, but rather as an opinion piece by columnist Michelle Washington.

“Wave after wave of young men surged forward to take turns punching and kicking their victim,” Washington wrote, describing the onslaught that began when Dave Forster and Marjon Rostami stopped at a traffic light while driving home from a show on a Saturday night. A crowd of at least 100 black young people was on the sidewalk at the time.”

Tonight, Bill O’Reilly played tape made at the scene. There were several young black men who had not participated in the attack. What they said was “If you go into a neighborhood you don’t know (and are white), you had better be careful.”

Apparently the young man driving the car got out of the car after a rock was thrown at it. He said, “That was a big mistake.” He and the young woman in the car were attacked by about 20 to 40 men from the crowd on the sidewalk. One of the young black men interviewed on O’Reilly’s program mentioned the Trayvon Martin case.

How does this differ from what Derbyshire warned about ?

Another issue is the delay in reporting the attack by the local paper.

It happened four blocks from where they work, here at the Virginian-Pilot.”

The Virginia Pilot did not mention the attack on its own employees for two weeks. Why ?

Could this be related ?

That is the Pilot’s publisher and he was just confirmed as Obama’s new Deputy HUD Secretary.

The U.S. Senate on Thursday approved the appointment of Maurice Jones, publisher of The Virginian-Pilot, to be deputy secretary of the U.S. Department of Housing and Urban Development.

No, it couldn’t be related.

Hairy surgery story

May 2nd, 2012

I’ve sort of lost my enthusiasm for Gerald and Sara after having the copyright farmer creep around here. A commenter said he would like to hear a hairy surgery story so here goes.

About 20 years ago, I got a call from the emergency room at San Clemente Hospital. They had just admitted a man who had had an aortic aneurysm repaired at Kaiser about six weeks before. He was now passing blood per rectum and was shocky and pale. This is a diagnosis you can make on the telephone. It is also an extreme emergency. A leaking native aneurysm is bad enough. I’ve seen patients survive for hours in that case, including a couple who refused surgery until it was almost too late. When the patient has had aortic aneurysm, or aortic bypass surgery, this story means that the suture line at the junction between the graft and the neck of the aorta above the graft has eroded into the small intestine, the duodenum usually, adjacent to the graft junction. The aortic flow is being blocked from the gut only by a clot. When that clot goes, the patient will exsanguinate into the gut, a matter of a couple of minutes.

I called the OR at the hospital and asked everybody to come in as fast as they could. It was about 9 o’clock at night as I recall and, fortunately, the elective surgery for the day had all been completed. That was a small hospital with two big operating rooms, whereas the trauma center that my partner and I ran had 14. There was no time to think about transferring him.

When I arrived, everybody, including the anesthesiologist on call, was there. There had been some problems with anesthesia in the past but that night we had a good sturdy gas passer. Faint heart has no place in a case like this.

An internist friend happened to be there and he liked to assist in surgery, unlike most internists. He was fun to have around, even in a big hairy case, so I asked him if he could stay. It was going to be an all-nighter, but he was enthusiastic. Fortunately, I had used self-retaining retractors for years and these are almost an assistant surgeon in themselves. The types I used fastened to the table and had multiple blades, including some that were malleable, so they could be positioned and left in place. They never got tired.

The anesthetist put the patient lightly to sleep and we got the blood bank to get some type-specific blood on hand, there was no time for cross match but it would be done as we went along. I made the incision about 30 minutes after he hit the ER door.

What we found was what I expected; a large hematoma around the aortic suture line where the duodenum crosses the aorta. In the days when I was still in training, we saw quite a few of these cases because the anastomosis had been done with silk sutures. Silk lasts for years but not forever and the pulsatile aorta never heals completely to the graft. To make things worse, many of the early grafts were made of Teflon, which just does not heal to tissue at all. The combination of silk sutures and Teflon grafts gave those of us of that generation plenty of experience with “false aneurysms” at the suture line of prior aneurysm repairs and bypasses. In that case, the suture line had come apart but the surrounding tissues were strong enough to prevent complete rupture. I can remember a couple of cases where, when I opened the false aneurysm (having clamped the aorta above), the graft was lying free in the center, not attached to anything.

In this case, the cause of the problem was either a suture line that had not been adequately separated from the duodenum by pulling tissue between them as a barrier, or an infection. No matter the cause, it was infected now as duodenal contents were bathing the graft. Once, in a previous case, a gastroenterologist had endoscoped a patient for mild GI bleeding. Far down in the duodenum, he saw what looked like a piece of celery. He asked if we wanted it biopsied. My partner laughed and said, “No, that’s the graft.” It was stained green and had eroded the duodenum but the suture line was intact. Her aortic surgery had been years before.

Read the rest of this entry »

Gerald and Sara

April 12th, 2012

Two of the most interesting people of the first half of the 20th century were Gerald and Sarah MUrphy. They were rich expatriates but were far more. They were friends with everyone who mattered in the arts in the 1920s.

Gerald liked costumes and was completely unaffected by convention.

Gerald Clery Murphy and Sara Sherman Wiborg were wealthy, expatriate Americans who moved to the French Riviera in the early 20th century and who, with their generous hospitality and flair for parties, created a vibrant social circle, particularly in the 1920s, that included a great number of artists and writers of the Lost Generation. Gerald had a brief but significant career as a painter.

Gerald Clery Murphy (March 25, 1888 – October 17, 1964) born in Boston to the family that owned the Mark Cross Company, sellers of fine leather goods. His father had, in fact, suggested that the fine saddler, Mark Cross, enter the field of leather goods, other than saddlery. The business moved to New York and thrived. His father actually began as a saddle maker but managed to transition to the automobile era by becoming a maker of fine leather goods. The company, partly as a result of Gerald’s later efforts, remains successful 100 years later.

Gerald was an esthete from his childhood forward. He was never comfortable in the boardrooms and clubs for which his father was grooming him. He flunked the entrance exams at Yale three times before matriculating, although he performed respectably there. He joined DKE and the Skull and Bones society. He befriended a young freshman named Cole Porter (Yale class of 1913) and brought him into DKE. Murphy also introduced Porter to his friends, propelling him into writing music for Yale musicals.

His friendship with Cole Porter had a tremendous, not always positive, effect on his life.

Sara Sherman Wiborg (November 7, 1883 – October 10, 1975) was born in Cincinnati, Ohio, into the wealthy Wiborg family. Her father, manufacturing chemist and owner of his own printing ink and varnish company. Such ink product were highly important in the printing world of lithographs and Frank Bestow Wiborg, was a self-made millionaire by the age of 40. Sara’s mother was a member of the noted Sherman family, daughter of Hoyt Sherman, and niece to Civil War General William Tecumseh Sherman. Raised in Cincinnati, her family moved to Germany for several years when she was a teenager, so her father could concentrate on the European expansion of his company. The Wiborg family was easily accepted into the high society community of 20th century Europe. While in Europe, Sara and her sisters Hoytie and Olga sang together at high-class assemblies and were presented to the kaiser. Upon returning to the United States, the Wiborgs spent most of their time in New York City and, later, East Hampton, where they were one of the first wealthy families to build a home, on 600 acres.

The Wiborg fortune was based on the invention by her father of solid inks. These were widely used in printing.

Sarah and her sisters spent years in Europe prior to World War I and were the first family, certainly the first American family, to tour Europe by car. In spite of numerous breakdowns, they managed to travel across France and part of Spain in 1914.

In East Hampton Sara Wiborg and Gerald Murphy met when they were both adolescents. Gerald was five years younger than Sara, and for many years they were more familiar companions than romantically attached; they became engaged in 1915, when Sara was 32 years old. Sara’s parents did not approve of their daughter marrying someone “in trade,” and Gerald’s parents were not much happier with the prospect, seemingly because his father found it difficult to approve anything that Gerald did.

After marrying they lived at 50 West 11th Street in New York City, where they had three children. In 1921 they moved to Paris to escape the strictures of New York and their families’ mutual dissatisfaction with their marriage. In Paris Gerald took up painting, and they began to make the acquaintances for which they became famous.

Eventually they moved to the French Riviera, where they became the center of a large circle of artists and writers of later fame, especially Zelda and F. Scott Fitzgerald, Ernest Hemingway, John Dos Passos, Fernand Léger, Jean Cocteau, Pablo Picasso, Archibald MacLeish, John O’Hara, Cole Porter, Dorothy Parker and Robert Benchley.

The French Riviera was a favorite winter vacation spot for the English who determined what was fashionable at the time. In 1923, the Murphys convinced the proprietors of the Hotel du Cap to stay open for the summer so that they might entertain their friends, sparking a new era for the French Riviera as a summer haven. They purchased a villa and refurbished it, calling it the “Villa Americain.”

When the Murphys arrived on the Riviera, lying on the beach merely to enjoy the sun was not a common activity. Occasionally, someone would go swimming, but the joys of being at the beach just for sun were still unknown at the time. The Murphys, with their long forays and picnics at La Garoupe, introduced sunbathing on the beach as a fashionable activity.

They were accompanied by friends, including Pablo Picasso who seems to have had an unrequited passion for Sara. He painted her as a nude, although it is doubtful he ever saw her so. She was well known for wearing her large string of pearls, even at the beach.

His paintings include one, named “Pipes of Pan”, which includes a painted over image thought to be Sara.

A contemporary portrait of Sara suggests her beauty.

There are her pearls.

This will be continued.

The Derbyshire affair.

April 11th, 2012

John Derbyshire is a rather curmudgeonly writer whose books I love and who formerly wrote pieces for the National Review. He is a freelancer and writes for other publications. This got him into a firestorm of criticism over Easter weekend and resulted in his services being dismissed by National Review. I was outraged by the way this was done. The article in question, is undoubtedly controversial and, in a couple of places unnecessarily so. I have posted part of it at ChicagoBoyz. The issue revolves around a set of “rules he proposed for his teenage children (Eurasian, by the way. His wife is Chinese)

(1) Among your fellow citizens are forty million who identify as black, and whom I shall refer to as black. The cumbersome (and MLK-noncompliant) term “African-American” seems to be in decline, thank goodness. “Colored” and “Negro” are archaisms. What you must call “the ‘N’ word” is used freely among blacks but is taboo to nonblacks.

(2) American blacks are descended from West African populations, with some white and aboriginal-American admixture. The overall average of non-African admixture is 20-25 percent. The admixture distribution is nonlinear, though: “It seems that around 10 percent of the African American population is more than half European in ancestry.” (Same link.)

(3) Your own ancestry is mixed north-European and northeast-Asian, but blacks will take you to be white.

Derbyshire’s wife is Chinese and his kids are mixed race Chinese-Caucasion

(4) The default principle in everyday personal encounters is, that as a fellow citizen, with the same rights and obligations as yourself, any individual black is entitled to the same courtesies you would extend to a nonblack citizen. That is basic good manners and good citizenship. In some unusual circumstances, however—e.g., paragraph (10h) below—this default principle should be overridden by considerations of personal safety.

(5) As with any population of such a size, there is great variation among blacks in every human trait (except, obviously, the trait of identifying oneself as black). They come fat, thin, tall, short, dumb, smart, introverted, extroverted, honest, crooked, athletic, sedentary, fastidious, sloppy, amiable, and obnoxious. There are black geniuses and black morons. There are black saints and black psychopaths. In a population of forty million, you will find almost any human type. Only at the far, far extremes of certain traits are there absences. There are, for example, no black Fields Medal winners. While this is civilizationally consequential, it will not likely ever be important to you personally. Most people live and die without ever meeting (or wishing to meet) a Fields Medal winner.

So far, despite the outrage, this seems pretty benign to me. (Probably evidence of my own racism)

Here comes trouble:

(7) Of most importance to your personal safety are the very different means for antisocial behavior, which you will see reflected in, for instance, school disciplinary measures, political corruption, and criminal convictions.

He is writing about means but few readers made that distinction and many may have no idea what a “mean “is.

Here comes the really controversial part:

(8) These differences are magnified by the hostility many blacks feel toward whites. Thus, while black-on-black behavior is more antisocial in the average than is white-on-white behavior, average black-on-white behavior is a degree more antisocial yet.

(9) A small cohort of blacks—in my experience, around five percent—is ferociously hostile to whites and will go to great lengths to inconvenience or harm us. A much larger cohort of blacks—around half—will go along passively if the five percent take leadership in some event. They will do this out of racial solidarity, the natural willingness of most human beings to be led, and a vague feeling that whites have it coming.

(10) Thus, while always attentive to the particular qualities of individuals, on the many occasions where you have nothing to guide you but knowledge of those mean differences, use statistical common sense:

(10a) Avoid concentrations of blacks not all known to you personally.

(10b) Stay out of heavily black neighborhoods.

Read the rest of this entry »

Obama, Constitutional Scholar.

April 4th, 2012

In Barak Obama’s resume was a statement that he taught constitutional law as an “adjunct professor” at U of Chicago Law School. I have never considered this to be a major achievement since adjunct professors are not paid and the subject he taught was more related to his other interests. Constitutional law was not one of them.

At the school, Mr. Obama taught three courses, ascending to senior lecturer, a title otherwise carried only by a few federal judges. His most traditional course was in the due process and equal protection areas of constitutional law. His voting rights class traced the evolution of election law, from the disenfranchisement of blacks to contemporary debates over districting and campaign finance. Mr. Obama was so interested in the subject that he helped Richard Pildes, a professor at New York University, develop a leading casebook in the field.

His most original course, a historical and political seminar as much as a legal one, was on racism and law. Mr. Obama improvised his own textbook, including classic cases like Brown v. Board of Education, and essays by Frederick Douglass, W. E. B. Dubois, the Rev. Dr. Martin Luther King Jr. and Malcolm X, as well as conservative thinkers like Robert H. Bork.

Mr. Obama was especially eager for his charges to understand the horrors of the past, students say. He assigned a 1919 catalog of lynching victims, including some who were first raped or stripped of their ears and fingers, others who were pregnant or lynched with their children, and some whose charred bodies were sold off, bone fragment by bone fragment, to gawkers…

Should we be surprised at his knowledge, or lack of it, on the basics of constitutional law ? Even his attempt to correct his clueless comments about judicial review are incoherent

The original comment was, Apparently unaware of the most basic principles of constitutional law, going back to Marbury v. Madison in 1803, he said:

“I’m confident that the Supreme Court will not take what would be an unprecedented, extraordinary step of overturning a law that was passed by a strong majority of a democratically elected Congress.”

And I — I’d just remind conservative commentators that for years what we’ve heard is the biggest problem on the bench was judicial activism or a lack of judicial restraint; that, uhhh, an uninelected, uhhh, group of — of people would somehow overturn, uhhh, a duly constituted and — and passed, uh, law. Uh, well, uh, uh, is a good example. Uhh, and I’m pretty confident that this, — this court will recognize that, uh, and not take that step.

The 5th Circuit Court of Appeals responded

Overturning a law of course would not be unprecedented — since the Supreme Court since 1803 has asserted the power to strike down laws it interprets as unconstitutional. The three-judge appellate court appears to be asking the administration to admit that basic premise — despite the president’s remarks that implied the contrary. The panel ordered the Justice Department to submit a three-page, single-spaced letter by noon Thursday addressing whether the Executive Branch believes courts have such power, the lawyer said.

Marbury vs Madison is one of the oldest and most basic cases that would be studied by a law student interested in Constitutional Law. The fact that our president does not know this ranks with his comments on speaking “Austrian” in Austria and his estimation of the number of US states.

Is he really this dim ? Did Harvard turn out this affirmative action dullard and inflict him on the country ?

Extreme Sailing

March 24th, 2012

This should be a welcome change from the political news.

That looks like great fun except that I would want my hot shower.

Those guys are going about 30 knots. Day after day.

The Race Card

March 24th, 2012

There was a shooting in Florida this week that has now accumulated all the “usual suspects” for a racial extravaganza. The bare details are that a Florida neighborhood had had a high number of burglaries in the previous year. The neighbors had instituted a “neighborhood watch.” The watch member on duty saw a black tennager in a “hoodie” sweatshirt acting in a way that was suspicious in his opinion. He called 911. The 911 call was recorded but the record may not be clear. A new eyewitness has said that the shooting victim was attacking the shooter and was on top of him as the shooter called for help.

The usual suspects have all appeared, including Barack Obama, who seems to insert himself into every racial incident. Of course, Al Sharpton (MSNBC commentator) is heavily involved. Hopefully, the body count will not reach previous levels in Sharpton’s activities. Sharpton did manage to convince some suckers to pay his debts in the Tawana Brawley hoax I guess that means he can go back to New York for his MSNBC gig.

This may be the substitute for the failed contraception ploy the Democrats attempted. Maybe there really was a crime committed by an excited neighborhood watch member. If so, the magnitude would be voluntary manslaughter, hardly a reason for the attempted lynching now going on in Florida and Washington. It is ironic that the group, which suffered 100 years ago from lynching, now seems to promote it. I think the Republicans would do well to stay away from this case with the exception of the usual sympathy for the victim. It is getting ugly and the facts are far from established.

Dick Boggs

March 15th, 2012

When I was a medical school junior, we had a rotation on the Neurology service at LA County Hospital. One of my classmates was planning a career in neurology but the reason it was so popular with the students like me who were interested in surgery was that we got to do tracheostomies. A number of patients with severe neurological lesions would require respirators or had trouble with airway secretions requiring a tracheostomy. This was our one chance to do surgery, even a minor procedure as things go. It was good practice and I later did a lot of tracheostomies, some quite difficult and rushed.

Our resident was a very interesting guy named Dick Boggs. He was tall and looked a lot like Orson Welles did when he was young and making “The Third Man.”Boggs was quiet and aloof but let us do trachs and work up any patient we wanted to. I had some very interesting cases. One was a woman who showed all the signs of alcoholic neuropathy, which is very similar to diabetic neuropathey. It was a popular rotation for juniors. Boggs was popular among the residents and was elected the president of the Interns and Residents Association, which under his leadership took on some of the characteristics of a union.

At the time, intern and resident pay was very low and, aside from a new dormitory that was built for single house staff, we were on our own. I was married with one child, born in March 1965, so I was really on my own. My wife quit her job as a teacher in January 1965 and I was working after hours doing histories and physicals at private hospitals for $7 per hour. Fortunately, my tuition was covered by scholarship but living expenses were tight. We lived on $200/month contributed by our parents, $100 from my father and the same from Irene’s parents. Half of that went for the rent of our two bedroom house in Eagle Rock, near Pasadena. I’m spending some time on details to emphasize what Boggs accomplished for us all.

Read the rest of this entry »