Archive for March, 2008

Hillary, Bosnia and Iraq

Monday, March 31st, 2008

Christopher Hitchens has some strong feelings about Hillary’s laughable Tuzla story. He doesn’t think it is funny, however, and says why. What is forgotten in the Democrat’s rush to abandon Iraq is how we get into these things in the first place. Saddam invaded Kuwait, imitating the Japanese who united the USA in 1941 by attacking Pearl Harbor. Had they nibbled away at Malaya and the Dutch East Indies, which is what they really wanted, they might very well have gotten away with it as we focused on Europe. What is different today is the influence of television.

We went into Somalia because CNN was showing thousands of starving Somalis and got out when Clinton’s attempt at nation-building caused casualties.  Why did we go into the Balkans ? CNN was showing the massacre of Bosnian civilians by Serbs. We had no strategic interest in Somalia or Bosnia. In fact, the first Bush administration made the decision to stay out of the war, a decision criticized by Bill Clinton during the 1992 campaign. After he was elected, he dipped a toe in the water a couple of times and finally decided to bomb Serbia from high altitude to avoid casualties. The Serbs eventually got out but the example set by Clinton probably encouraged Saddam in his ambitions toward Kuwait.

What would happen if Obama were to be elected and a precipitous withdrawal from Iraq resulted ?

Zbigniew Brzezinski thinks he knows:

Contrary to Republican claims that our departure will mean calamity, a sensibly conducted disengagement will actually make Iraq more stable over the long term. The impasse in Shiite-Sunni relations is in large part the sour byproduct of the destructive U.S. occupation, which breeds Iraqi dependency even as it shatters Iraqi society. In this context, so highly reminiscent of the British colonial era, the longer we stay in Iraq, the less incentive various contending groups will have to compromise and the more reason simply to sit back. A serious dialogue with the Iraqi leaders about the forthcoming U.S. disengagement would shake them out of their stupor.

So, a pain-free withdrawal happens. Fine. What if he is wrong and genocide results ?

Kevin Drum is not concerned:

there’s no point in denying that U.S. withdrawal might lead to increased bloodshed in the short term. It most likely will. But it’s highly unlikely to lead to a catastrophic regional meltdown of the kind that the chaos hawks peddle on cable TV. What’s more, Brzezinski is also right that the risk of increased violence is inescapable at this point and, in fact, probably grows the longer we stay in Iraq. The events in Basra over the past week ought to make that clear.

What neither of them address is what happens when the TV networks show massive genocide of Sunnis followed by a Sunni intervention by the Saudis to avoid an Iranian takeover ?

They don’t say.

Obama in a clumsy interview says he would have a “strike force” ready to do whatever…. That sounds like “Blackhawk Down” all over again. If I were an Army ranger who had been yanked out of Iraq just as we were on the verge of winning, what do you think my attitude would be about being ordered back ?

Especially by a wimp like Obama ?

Will Zinni endorse Obama ?

Thursday, March 27th, 2008

This op-ed in USA Today sounds like the vague, feel-good foreign policy pronouncements of Obama. Zinni has been an opponent of Bush and his policy in Iraq since the invasion. Here he was on 60 Minutes in 2004 denouncing Bush’s policy. Since McPeak’s meltdown, Obama needs a new retired general advisor and Zinni seems the best bet. Of course, Zinni was the Centcom commander prior to 9/11 so that isn’t the greatest endorsement I could think of, but what do I know ?

The second era of bacteriology

Wednesday, March 26th, 2008

The history of medicine, as distinct from surgery, took giant steps in the 19th century when bacteria were identified and then linked to human illness. Surgery had been able to treat battle wounds for centuries although bacteriology would also lead to major advances there. For the medical doctor, however, there was little that could be accomplished for the sick prior to Louis Pasteur. Medicine in that era was concerned with diagnosis and prognosis, a significant benefit if accurate, which it sometimes was. Treatment was more harmful than effective.

William Withering had introduced the first effective medicine in 1785.

Paracelsus had discovered that mercury would inhibit syphilis in the 14th century but that was the only previous effective use of medicine. It was said, in an era when syphilis was endemic, that “A night with Venus leads to a lifetime with Mercury” as the treatment required continuous use to be effective. There would be no other treatment for syphilis until the 20th century.

Edward Jenner discovered the ability of cowpox infection to prevent the far more dangerous infection of smallpox. These few pioneers were bright supernovae in a dark universe of ignorance. Infectious diseases were the most common cause of death prior to this century.

Louis Pasteur

Louis Pasteur was a chemist who first recognized that living organisms were responsible for such phenomena as fermentation of wine and souring of milk. His research resulted in an age of bacteriology for the next 50 years.

Robert Koch

Robert Koch was a German physician who learned to grow bacteria in cultures that could be purified and subcultured. He established the principles of infection by a specific organism. Pasteur grew bacteria in liquid medium that did not lend itself to purifying cultures. Koch began the use of solid medium and his assistant invented the Petri dish. Koch also discovered the organism that causes cholera, which cannot be grown in artificial culture. It lives only in the human intestine and is transmitted in water supplies contaminated by fecal material.

John Snow

John Snow the founder of epidemiology (along with Florence Nightingale), had identified the connection of cholera to water supplies in 1859 but he could not go further because bacteria had not yet been discovered.

The microscope, especially after improvements by Joseph Jackson Lister allowed these men to see the bacteria in wounds, diseased organs and rotting flesh. Lister’s son would add the first great step in treating these diseases.

Joseph Lister

Joseph Lister, the son, was an orthopedic surgeon who learned to prevent infection by applying carbolic acid to compound fracture wounds after the fracture had been reduced. Lister was still somewhat vague about the organisms he was treating because they were still poorly visualized. In fact, that lack of proof caused great resistance to his innovation.

Hans Christian Gram

In 1884, Hans Christian Gram discovered that some bacteria would stain blue with crystal violet and that this characteristic was related to other features of the organism. A powerful new tool was available to bacteriologists called Gram staining.

The era of the bacteriologist reached its pinnacle when Koch described the tuberculosis organism in 1882 , proving that “consumption” was an infection, and then Pasteur was able to prevent rabies with a vaccine. Unfortunately, Koch’s career ended with a bit of farce as he announced a cure for tuberculosis that was, in fact, no such thing. He fled with a girlfriend to Egypt proving there is nothing new under the sun. His other innovations survived.


Vaccines would dominate medicine until the discovery of antibiotics, first by Domagk, , when he discovered the sulfa drugs in 1937. A German physician, he was not permitted by Hitler to accept the Nobel Prize and was awarded the Prize after the war.

Alexander Fleming

Even before Domagk’s discovery, in 1928, Alexander Fleming had discovered penicillin but did not follow up his discovery after a few tentative attempts at treatment.

Howard Florey

Ten years later, Howard Florey, an Australia physician at Oxford, resumed study of penicillin with the result that infectious diseases caused by bacteria would recede into a secondary role in medicine. Other antibiotics were discovered and new ones continue to be synthesized. Cancer, and other degenerative diseases, became the most common causes of death.

The New Era

Carl Woese

In 1977, a microbiologist named Carl Woese proposed a new kingdom of biology. It was called Archaea and he met considerable resistance at first. They are also called Extremeophiles as they were often found in extreme environments such as steam vents on the ocean floor, or in national park geysers, with temperatures at far above boiling. Bacteria and most other forms of life could not exist there because proteins denature at temperatures well below those found in these environments. However, it was soon found that these organisms are widely distributed and some are quite common, such as Methanococcus, which makes swamp gas by metabolizing rotting vegetation and producing methane gas. Some varieties are even found in the gut of cows.

The genomes of over 50 varieties have now been sequenced and similarities with higher life forms have been found, placing them between the bacteria and higher forms. They may well represent the first life forms and there is a possibility that similar organisms may be found on other planets. Since some of these organisms are capable of synthesizing carbon chains, like those in oil, the secret of the energy crisis may be found here. Some of them are capable of scrubbing CO2 from the exhaust of coal burning power plants. Some are capable of making methane (natural gas) from coal without burning at all. This may even be possible without digging up the coal. For example, it is now known that Archaea organisms are still making methane in abandoned coal mines. This creates danger for anyone entering these old mines but may provide a source of natural gas from residual coal that was left behind. In the future, it may be possible to inject coal deposits with the culture of Archaea and collect the gas without ever digging a mine or stripping surface layers above the coal.

The possibility of processing nuclear waste should not be ignored. The organism survives in a high radiation environment and other Archaea are capable of generating electricity in fuel cells

The future is with biotechnology and the limits are not yet visible. We are entering the second Age of Bacteriology

Good news from Basra

Wednesday, March 26th, 2008

UPDATE #2 In spite of Kevin Drum and the NY Times certainty that Maliki has lost this battle,  others have a different opinion. Why is the Left so eager for defeat ?

UPDATE: Here is more on the situation in Iraq with the Iraqi Army and Sadr. Lots of mixed messages and reluctant optimism from a press that does not want us to win.

You would not know it from this New York Times story but the fighting in Basra this week is good news. The Shiite majority Iraqi government is cracking down on Shiite militias that have taken over Basra, with Iranian assistance and are hampering operations of Iraq’s massive port facilities.

In Basra, American and British jets roared through the skies, providing air support for the Iraqi military. A British Army spokesman for southern Iraq, Maj. Tom Holloway, said that while Western forces had not entered Basra, the operation already involved nearly 30,000 Iraqi troops and police forces, with more arriving. “They are clearing the city block by block,” Major Holloway said.

This is what skeptics have been saying the al Maliki government would never do. They are doing it and, of course, the skeptics are not reporting the crucial facts. This is the next “milestone” in the march to Iraqi self-government.

The Times reporter contacted Mahdi Army leaders who say:  “They are trying to finish us,” the commander said. “They want power for the Iraqi government and Sciri.”

OF COURSE they want power for the Iraqi government !   It looks as though Sadr has figured out that he had better keep the truce since the Iraqi Army is holding together. He would be smashed if he chose to fight and he knows it. This is the end game.


Tuesday, March 25th, 2008

The term treason has been applied to Senator John Kerry’s action’s in 1971 and 1972 when he was meeting with the enemy North Vietnamese party to the Paris Peace Talks while still a reserve Navy officer. However, we don’t have to go back that far in our history to find just as blatant an example of treason. A member of the US Congress has been in contact with FARC guerrillas in Columbia, an ally and a democracy approaching victory in its drug-funded civil war.

A military strike three weeks ago killed Raúl Reyes, No. 2 in command of the FARC, Colombia’s most notorious terrorist group. The Reyes hard drive reveals an ardent effort to do business directly with the FARC by Congressman James McGovern (D., Mass.), a leading opponent of the free-trade deal. Mr. McGovern has been working with an American go-between, who has been offering the rebels help in undermining Colombia’s elected and popular government.

This is clearly treason. Will it be punished ?

For a little background on FARC, here is a piece on their attempts to upset the 2005 elections. They failed but a Democrat from Massachusetts is trying to help them now.

Here is what he is helping: Farc has sought, unsuccessfully, to overthrow the state for more than 40 years, but its permanence is in part due to the bountiful resources it enjoys from its control over part of the cocaine trade.

Great !

Maybe it just goes with Massachusetts.

Could this be our boy ?

AP News Alert
Mar 26 05:40 PM US/Eastern

WASHINGTON _ Federal prosecutors say Saddam Hussein’s intelligence (AP) – agency secretly financed a trip to Iraq for three U.S. lawmakers during the run-up to the U.S.-led invasion.


Steven Pinker

Tuesday, March 25th, 2008

Steven Pinker is a linguist and cognitive psychologist and, oddly enough for a colleague of Noam Chomskey, something of a conservative. His book, The Blank Slate, describes how most behavior is genetic in origin. This, of course, is anathema to the left which follows the behavioral theories of Stephen Jay Gould.

Pinker here gives a marvelous lecture on the history of violence and why it has been declining since The Enlightenment. Rousseau was wrong and those who believe in the myth of The Noble Savage should view this talk.

More concerns about government health care

Monday, March 24th, 2008

I have previously written that I think we will eventually have some sort of government program that provides minimum care for everyone. Several recent articles emphasize some of my concerns about government programs. One , from the National Health Service, discusses a shortage of maternity care. In the US, this sort of thing would be a felony. Another, mentions the government’s deplorable practice of cutting doctor fees when fewer and fewer doctors are willing to care for the poor because the fees are so low now. When I was in practice, I saw MediCal patients, just as many of my colleagues did, but we would not allow our names on the MediCal panel of providers. We would see patients as a favor for other doctors or if they were relatives of other patients. Of course, as director of a Trauma Center, I saw many MediCal patients but we did not advertise our availability.

Then, of course, there are the stories like this. That may sound apocryphal but I have seen similar things many times.

Then there are a few brave souls who speak up and suffer the consequences. In a private system, lawsuits would result but a government system has no such vulnerability.

Anyway, these are cautions for those whose enthusiasm gets beyond the reality of dealing with the government.

To set the record straight

Saturday, March 22nd, 2008

I just read a book that provides the background of the Swiftboat Vets campaign against Kerry in 2004. It is called To Set the Record Straight. It is a little odd that Amazon shows only a paperback edition at a price of $25. The authors have a website also called To Set the Record Straight. The website also lists the book and I bought two copies at a slightly higher price for hard cover. It is a very good read and I highly recommend it.

My review should be up on Amazon soon and I won’t repeat it. The other reviews are interesting. Several are from vets who provide additional documentation and a couple are from disgruntled Kerry supporters still fighting the war of 2004.

Craig Venter

Thursday, March 20th, 2008

Bradley Fikes and I spent the afternoon at UCSD to hear Craig Venter speak. I was not disappointed. I wrote the first review on Amazon of his autobiography and he knew this today, commenting that it was the most credited as “helpful.” His accomplishments go well beyond medicine although that seems to be the part that fascinates reporters.

He discussed the sequencing of the genome but the most important part is the environmental potential of his work. For example, the methanobacteria are now properly known as Methanococci as they are now known to be a member of Archaea, a new kingdom of life. If you really want to know about Archaea,
this is the source
, although a PDF version can be downloaded and printed. These organisms can exist at the extremes of nature, such as steam vents on the ocean floor.

Some of them are capable of regenerating oil or natural gas from CO2. Some can metabolize coal in underground deposits and release methane gas. Some can metabolize sulfuric acid and release metallic sulfur and water. Some bacteria can generate nanowires and potentially function as a battery with electricity generation from animal waste.

Some of them will take up uranium and some may even be able to metabolize radioactive elements. Some may function as a bacterial fuel cell. Some of these fuel cells involve bacteria with nanowires. These systems are getting close to practical use.

The great advantage of all of these systems is that energy inputs are far less than the inorganic equivalent, such as burning or conversion to ethanol of plant substrate. The bacterial systems can convert the substrate directly to methane or a higher carbon molecule by enzyme action that takes place at ambient temperature.

Methane has one carbon. Ethane has two and octane, the ideal form of gasoline, has eight. These systems may be the way to refine tar sands or high sulfur crude oil that is not yet economical to use as fuel. Some of them will make fuel from waste. Some may even reduce nuclear waste to safe deposits that do not require isolation.

Right now, Venter is working on ways to analyze the genome of organisms with exotic properties and transfer the gene to more common or faster growing organisms. His company is called Synthetic Genomics. and is in southern California. He has other companies in the east but this application is more important, I think, than the medical applications right now. He calls it “digitizing life” and says that creating a synthetic chromosome is not difficult. The problem is “rebooting it.” He is about to announce an artificial bacterium and I thought the announcement might come today. It will be soon.

We’ll see what the next steps are.

The problem with single payer

Thursday, March 20th, 2008

This is another in my series of posts on health care reform. Eventually, I’ll get to my thoughts on what reform should look like. So far, I have mostly written about the history of health care and the basic problems that must be addressed. Here, I want to discuss a weakness of the single payer concept.

Kevin Drum, a leftist blogger with excellent reporting skills, states one of the problems clearly. A single payer system will be dominated by administrators whose focus will on “the greatest good for the greatest number.” This will inevitably determine an emphasis on public health and general “good health” measures like stopping smoking, obesity and changing behavior. Those are important issues but should not be part of a health plan. Most “preventive health” activities cannot be shown to be effective, often because they are politically driven. Exceptions are mammography and immunization but, even here, political considerations, such as the mythical link to autism, influence these factors.

…patterns of health service utilization in developed countries suggest that the marginal dollar of health care spending — money used to purchase high tech equipment or specialist services — is less progressively spent than the average dollar.

“Less progressively spent.” What does that mean ?

Maybe this: “Finally, a review of the literature across the OECD suggests that the progressivity of financing of the health insurance system has limited implications for overall income inequality, particularly over time.”

There is where the politics comes in and it is clearly socialist.

But I’d certainly agree that a publicly financed system ought to be careful about making any of it part of a basic healthcare package until it’s well proven in the field. As progressives, our goal shouldn’t be to provide gold-plated care to every person in the country, nor should it be to restrict the ability of the rich to get better service if they want to pay for it. Our goal should be to provide decent care to everyone, with the market free to operate on top of that.

Here, I agree with Kevin completely. A public funded health care system should provide a basic program that makes available the standard care that everyone living in the country should have access to. The problem is that many single payer activists, who might have considerable influence in an Obama administration for example, are adamantly opposed to allowing a market system to exist in conjunction with a publicly funded single payer system.

Kevin’s post comes from this analysis of another report on health care systems in other countries. It is available only for a fee.

Here is a comparison (actually a summary of a study available only for a fee) of Canadian and US health care.

The conclusion is interesting.

The authors conclude that while it is commonly supposed that a single-payer, publicly-funded system would deliver better health out-comes and distribute health resources more fairly than a multi-payer system with a large private component, their study does not provide support for this view. They suggest that further comparisons of the U.S. and Canadian health care systems would be useful, for example to explore whether the higher expenditures in the U.S. yield benefits that are worth their cost.

I believe that the Canadian system has a fatal flaw in that it banned all private care. That is the major issue that we must consider when examining the prospects for a US national health plan. Here, Kevin Drum and I may be close.

More to come.