Sunday, November 27, 2016

Discussions at Thanksgiving Tables in 2016

While folks across the country were gathered around their holiday tables, I suspect that conversations were not focused on the First Thanksgiving when the Pilgrims broke bread with the Wampanoag native Americans over a 3 day feast in 1621.  There was no pumpkin pie or cranberry sauce served then, and it was more likely that venison was on the table than turkey.  Sometimes, myths are more fun than facts.

The First Thanksgiving at Plymouth

I surmise that the many of our Thanksgiving dinners were sites of spirited discussions regarding a recent political earthquake that convulsed this country.  Indeed, over the past 3 weeks, I have departed from this blog’s medical commentary, to offer some thoughts on what occurred and why.

The nation is sorely divided, but I sense that there will be healing, depending upon everyone’s ability and willingness to listen deeply and absorb the views of reasonable folks whose opinions differs from ours.  Reasonable people are rarely all right or all wrong. 

The campaigns were ugly and many of us abandoned the better angels of our nature.  While candidates must be held to account for what they said and did, I expect that the incoming administration will operate within normative restraints.  The republic is like an ocean liner whose course is not easily derailed. 

The American experiment is succeeding.  For over two centuries, we have witnessed a peaceful transfer of power in accordance with the wishes of the governed.  Not a shot was fired. The current president and his administration stepped up to assist the president-elect and his team to effect a smooth transition.  The fact that the president so vehemently opposed the president-elect, and yet pledges to help him now, only reinforces the majesty of our democratic republic. 

Can we all be thankful for this?

Sunday, November 20, 2016

Breaking News! Trump Chooses Conservative Advisors!

Let the whining begin!  Donald Trump, the president-elect, has chosen Mike Pompeo, Michael Flynn and Jeff Sessions to serve as CIA director, National Security Advisor and Attorney General respectively.  Here’s the shocker.  They are all conservative! 

Let me offer some guidance to the demoralized and deflated liberal, I mean ‘progressive’, political left.  When the nation elects a president who resides to the right of the political center (leaving aside that where Trump truly resides is an arguable question), he is going to choose personnel who share his philosophy.  Trump ran hard on immigration, trade, anti-terrorism policy and the Supreme Court.  Now elected, he should be expected to assemble a team that will further the objectives that he campaigned on.  Isn’t this what we expect when a candidate gets elected?

I think that Trump’s appointments mentioned above – all of whom are qualified – cause the left to hyperventilate in an effort to distract their base from their horrendous and systemic electoral defeats they suffered all across the country.   Keep in mind, cabinet positions are not lifetime appointments and all reasonable people agree that a president should be afforded great latitude in choosing his team members.  Americans today can expect very different priorities and philosophies regarding national security, immigration policy, law enforcement and foreign affairs.  This is the natural course of events  when the White House changes hands.

Intel Pros will be allowed to say, Islamic terrorists.

Isn’t this exactly what occurred when President Obama took office in 2008?  Elections matter, as the president himself has often stated.  Were we shocked that his choices for Attorney General of Eric Holder and Loretta Lynch focused on civil rights and were not regarded as champions of the law enforcement community?  Obamacare passed without a single Republican vote.  His Supreme Court choices of Elena Kagan and Sonia Sotomayor were not quite the judicial soul mates of the late Antonin Scalia.   Just today I read that the Obama administration will block new drilling in the Arctic Ocean, an example of several of the president’s actions that have tilted toward environmentalists’ concerns.  Liberal presidents tend to govern liberally.

Trump was criticized, properly in my view, for stating that he would only nominate pro-life individuals to the Supreme Court.  (I’m against judicial litmus tests for specific actions or policies.)  Before you criticize him over this litmus test, remember, that Hillary Clinton commited the same offense when she declared she wanted her nominees to overturn the Supreme Court’s Citizen United decision?  Were you critical of her also?  Trust me, when President Trump offers his nominations for the high court, and he may have more than one opening to fill, we should not be shocked that they will view the judicial world through a conservative lens. 

Instead of carping about a new president’s personnel choices just to offer balm to your political base, why not contemplate the hard lessons that caused your party to be thoroughly trounced and repudiated?  Then, bring your own ideas and vision into the marketplace of ideas and compete for votes.  Then, if your side prevails, you can choose your own team to carry out your mission. 

Sunday, November 13, 2016


Many folks talked about the possibility of an October surprise prior to our recent presidential election.  Rumors swirled of an FBI bombshell, more WikiLeaks or a Russian hack attack.  The predictors were off by a month.  We received instead a November surprise that many view as apocalyptic.  The nation was shocked, as were the candidates, despite Trump’s minions’ confident public exhortations of victory.  How did the press and the punditocracy get it all wrong?   Even days prior to the election, many pollsters were placing Clinton’s chances of victory in the 75-90% range. 

An Unexpected Guest

We are beginning to understand how a man who has never held elective office, who by all accounts is a boorish and vulgar narcissist, could vanquish 17 Republican adversaries to gain the nomination and then handily trounce the Clinton political machine on November 8th.   The brash outsider prevailed over the consummate insider.  We are beginning to understand why his unending stream of deeply offensive rhetoric and behavior, which would have doomed an ordinary candidate, seemed only to burnish his street cred and approval ratings.  
The answer is not pretty.

Both parties have been arrogant, hypocritical and corrupt as they ignored or chose not to be attentive to so many of their constituents.  Look at politicians' approval ratings in either party.  I think the electorate reached a tipping point.  Can you believe that Bernie Sanders, a cranky 74-yr-old annoying socialist nearly beat the Clinton machine?  (And he might have prevailed if the Democratic National Committee wasn't conspiring against him and he wasn't the victim of an unfair superdelegate system.)  Weren't you as amazed as I was that young people in their 20's favored crazy Uncle Bernie over Hillary?  What was she missing?  

Same issue with Trump who performed the political equivalent of scaling Mount Everest barefoot.  There was a level of disgust and a hunger for change that both parties missed or didn't care about.   Trump voters despised and distrusted the political establishment so much, that his horrendous personal behavior was irrelevant.  He was change, and that's all that mattered.  This is why, I think, that all of those comments that would have sunk any ordinary candidate didn't adversely affect him.

I hope and pray that good will emerge from this.  Both political parties - and perhaps some new ones - will realign and recalibrate and hopefully reach out to the tens of millions of people who deserve to be represented and valued. 

Yes, I know that many feel that they are in mourning now.  Let's hope that he surprises everyone and surrounds himself with wisdom and that he will govern differently than he campaigned. 

For those who suspect that I am a Trump apologist, try again.  I didn’t vote for him.  But, he is my president now, and he’s yours also.

The Republic will survive.   Yes, he will have to be held to his campaign promises, understanding that in every case, it's a lot easier to campaign than it is to govern.  Remember President Obama’s promise to close GITMO in a year?

Finally, let’s celebrate that we can witness a peaceful transfer of power every four years.  We take this for granted, but we shoudn't.  Wanna trade our system for the Philippines, Saudi Arabia, China or Russia?

Sunday, November 6, 2016

Clinton and Trump Give the Nation Chest Pains

Oftentimes, physicians and patients face bad options.  I wish that the choices that patients faced were all good ones, or at least had one option that was likely to yield a favorable result.   This scenario is further complicated as medicine is an uncertain discipline with moving goal posts and changing facts.  We make decisions and recommendations based on the current state of facts and our medical knowledge and experience.  We may counsel a patient against surgery, only to discover days later in retrospect that an operation would have been the right choice.  An adverse outcome may result from an excellent decision. 

There are many medical circumstances when the options are equally foreboding.   A man may be suffering frequent episodes of angina, chest pain caused by hardening of the coronary arteries.  He is on maximal medical treatment, but the symptom persists.  This is not only limiting his life activities and pleasure, but also significantly increases his risk of a heart attack.  His cardiologist has concluded that only a coronary artery bypass operation can help him.  However, the heart surgeon is greatly concerned that because of other illnesses and conditions that the patient is suffering from, that his surgical risks are substantially increased.  In other words, his condition after surgery might be worse than he is now. 

Surgery or Status Quo?

It may be that my hypothetical cardiac patient is suffering from chest pains as a result of the current state of our electoral politics.  Perhaps, his heart has been stressed from failure to accept that the two presidential candidates of our major political parties are the best that this nation produced.   In a country teaming with talent, we are left with two highly flawed candidates who most of us can’t stand.  I surmise that many Americans have developed chest pains and other ailments as a result of demoralizing and dirty politics that each week sink deeper into a slimy abyss.

I cannot count how many of my octagenarian patients - who have never missed a presidential election - are sitting this one out with disgust. 

With regard to this election, I also feel that I face two unpalatable options. How to choose between strychnine or cyanide.  Which option is better, quicksand or a cliff?    

Remember, when we read The Odyssey years ago and read of Odysseus’s ship navigating between Scylla the 6-headed monster and the deadly whirlpool Charybdis?  Two terrible options.  Many Americans today, in an electoral sense, are on a similar journey.