Cutting Through The Crap

Tuesday, February 21, 2017

Monday, February 20, 2017

Good Choice for NSA



Sounds like this General McMaster guy is an excellent choice. So why the fk did Trump go first with an obvious nutjob like Flynn?

There's a certain amount of irony in Trump's leaning on generals, given his previous claims that he knows more than them. But what the heck. If McMaster is as smart and level-headed as is being said, it can only be to the good.

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Thursday, February 16, 2017

How It Begins? It's Begun!


My upcoming newspaper column:
One of my favorite surgery teachers used to say, regarding therapeutic decision-making, “Keep your eye on the donut, not the hole.” Good advice. By design or not, Donald Trump has gotten us to concentrate on the holes in his leadership instead of the baker’s dozen donuts of danger. It could cost us our country. 
We sometimes laugh but usually recoil at his mercurial tweets, his inaugural apparitions, his blaming a judge for any future terrorist attacks. We find it inexplicable that he repeats his lies about millions of illegal votes, about skyrocketing crime rates, and a judiciary “gone rogue.” And then out of the fryer comes this crisp confection, and it becomes clear: Trump’s senior policy adviser, Stephen Miller, says on a Sunday show, referring to judicial stays on that mal-executed executive order: “… [T]he whole world will soon see, as we begin to take further actions, that the powers of the president to protect our country are very substantial and will not be questioned.” 
Will NOT be questioned! “Ze hull vorlt vill zoon zee … zat ze powvers uff ze prezeedint … vil NUT be KVESHtunt!” (He also claimed Trump is 100% correct, always. Trump immediately tweeted love for the performance.) 
Many Americans saw this coming, for it’s the despots’ playbook which far predates Trump: instill existential fear, intimidate and suppress opponents, distract attention, produce a flood of lies repeated until believed, convince citizens that only their new leader can save them. Promote distrust of the media and of experts, denounce as traitors all who resist, accuse judges of corruption. Thus are seeds of autocracy sewn, efficiently, deliberately, and, in the case of Trump’s supporters, with ease. Unless his devotees stop believing the lies -- which, so far, appears unlikely -- Trump will continue to tell them. 
With his perseverative claim of voter fraud, Trump modernized the script. Willingly, believers believe, so when the next wave of voter suppression rolls around, disguised, per usual, as innocent ID requirements, those supporters won’t blink an eye. But, in the blink of someone else’s eyes, voters of the opposition, at whom those laws are specifically and admittedly aimed, will find themselves robbed of the franchise. And then, the means for his removal gone, resistance rendered futile, truth twisted on its head, enabled by self-serving acquiescence, Trump, like those before him, could be empowered without limits. 
As Trump and his collaborators attack “mainstream” media, they cynically promote Fox “news” as the true source of information. If Trump hasn’t yet banned other news sources, he’s refusing to take their questions, while making Fox the Pravda (which, amusingly, means “truth”) of our age. Based on vituperation I receive, Trumpists are fully on board. After the restraining order on the “travel ban” was upheld, Fox did what Fox does, trumpeting a lie that the Ninth Circuit is the court most frequently reversed by the Supreme Court. That’s not only false on the facts; it reveals fundamental misunderstanding (or deliberate deception) about the tiny percentage of appeals the Supreme Court accepts, and how they’re chosen. Civics lessons? Not on Fox “news.” Following the pattern, I’ve heard from Trumpophiles who swallowed the lie. (Fun fact: a court with nearly the lowest reversal rate is the one of which Merrick Garland is Chief Judge.) 
Wonder why Trump and his new attorney general are lying about soaring crime rates? Why the plans to militarize police, the talk of vague, easily abused and physically dangerous rules against protesters? Why, indeed. It’s the embryonic police state right-wingers hallucinated under Obama, now actually gestating under Trump. Russian collaborators and Nazi-sympathizers in the White House? Hey, look over there: refugees! 
Is this paranoid hyperbole on my part? Against the evidence, I’d prefer to think so. Then again, Trump just offered to ruin the career of a State Senator whose ideas he dislikes. And, concerned more about who leaked than about the disturbing revelations of Team Trump’s Russia connections, Congressional Republicans, whose investigations of Hillary Clinton broke records for time and money spent, show little interest in investigating. How bad must it get before enough Trumpicists open their eyes? Those of us who value democracy can only keep trying to help them see, I guess.
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Wednesday, February 15, 2017

He's Better Than God


Well, okay. Now I'm on board.
"... We are going to stop crime in this country. We are going to do everything within our power to stop long-simmering racism and every other thing that's going on," Trump said...
And not just EVERY thing. Every OTHER thing. I mean, this is an agenda for all of us. If anyone can do it, it's a business guy and a couple of Nazis.

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Blinded By The Right


Nope, nothing to see. And neither the Senate Intelligence (!) Committee nor the House government oversight committee will investigate.

WASHINGTON — Phone records and intercepted calls show that members of Donald J. Trump’s 2016 presidential campaign and other Trump associates had repeated contacts with senior Russian intelligence officials in the year before the election, according to four current and former American officials.
American law enforcement and intelligence agencies intercepted the communications around the same time that they were discovering evidence that Russia was trying to disrupt the presidential election by hacking into the Democratic National Committee, three of the officials said. The intelligence agencies then sought to learn whether the Trump campaign was colluding with the Russians on the hacking or other efforts to influence the election...
This is way beyond worrisome. It's fking insane. Who are these guys? For whom are they working? And what about those piss-tapes?

Guess they're all tuckered out after all that Benghazi 'vestigatin'.

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Tuesday, February 14, 2017

Truth Will Out, Unless They Suppress It



In other words, he didn't give a shit until the truth became public:

WASHINGTON — President Trump was informed weeks ago that his national security adviser, Michael T. Flynn, had not told the truth about his interactions with Russia’s ambassador and asked for Mr. Flynn’s resignation after concluding he could not be trusted, the White House said on Tuesday...
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Thursday, February 9, 2017

Trump Hates America


My upcoming newspaper column:
Not that I’m the sort to be repetitive, but let me ask everyone who voted for Trump, “What will it take to make you wish you hadn’t? Anything you could imagine in the future? Nuking California?” (Okay, bad example. We know the answer.) 
Mere months ago most of those now defending Trump were complaining about Barack Obama’s “authoritarianism,” his executive orders, his vacations. OMG, he played golf! Insisting Obama hated America, they claimed he’d gone on an “apology tour,” was trashing the Constitution. Now, as those apocryphal Obama abuses have become real Trumpic ones? Silence. It’s one thing to approve the man’s policies, even though, so far, they’re bringing harm to everyone but polluters and the very wealthy. It’s quite another to overlook or excuse his wild claims, outright lies, and undisguised, premeditated attacks on the foundations of the republic. Like his latest: our independent judiciary. 
After a Federal judge, right here in Washington, issued a temporary restraining order on his immigration ban, Trump did what Trump does: Besmirch. Threaten. Blame. Sean Spicer claimed the judge had “gone rogue.” Counterfactually, Trump tweeted “people [are] pouring in. Bad” and that future attacks at home must be blamed on this “so-called” judge. Manifestly, neither Donald Trump nor his most avid supporters have much use for our Constitution, especially when it requires following laws or respecting processes they don’t like. But this is as fundamental as it gets, the very heart of Constitutional law. Judicial review. Coequal branches of government. When a couple of Obama’s executive orders were limited by the courts, their glee was unchecked and unbalanced. What changed? 
Observe Judge Robart, and decide for yourself if he seems to have gone rogue. Then, if you have the stomach, read comments accompanying the referenced video to see whether Trumpists understand how our American legal system works. 
Without judicial checks on unlawful orders and unconstitutional legislation, the path to tyranny is downhill and unimpeded. Our founders knew that. Throughout our history, Americans have known and understood. But history stops with Donald Trump, his Svengali, Steve Bannon, and, it seems, Trump’s most vocal supporters. The danger is obvious. 
Not being a legal scholar, I won’t opine on the constitutionality of Trump’s hasty and scattershot executive order. I do, however, understand the indispensible role of an independent and co-equal judiciary in our system of government. It shouldn’t be as hard as it seems to be for Trumpophiles likewise to understand. Nor should it require an act of courage or the ability to withstand hateful attacks for a judge to issue a restraining order. 
But, okay: let’s give Trump unchecked power. Then what of his passing off Putin’s murderous acts, claiming the US is no better? Interviewed by Bill O’Reilly, he did just that. While Russia praises his silence, he’s said nothing about Russia’s renewed killings in Ukraine. Given the unknown depth of his Russian indebtedness, and the lack of interest of Congress’ former Benghazi-chasers to apply similar (or any) scrutiny, you’d think anyone who loves our country would be worried. I do, and I am. 
And here's another Trump attack on America: his declaration that “negative polls are fake news.” News he doesn’t like: fake. The voices of the people to whom he promised to return our government: fake, if they speak against him. On vacation, playing golf after two grueling weeks of signing orders he barely read, he alleged the media aren’t reporting terrorist attacks, because “they have their reasons.” The White House later produced a predictably dishonest (and misspelled) list. In the O’Reilly interview he re-hallucinated millions of illegal votes for Hillary Clinton.  Asked for confirmatory data, his response was, “Forget about all that.” And he’s still lying about crime and murder rates. 
Pretty much covers all things America, doesn’t it? Trump distains the judiciary, the press, the opinions of citizens, the integrity of voting, and reality. He’d have us believe (because HE does) he’s the sole knower and dispenser of truth, and plenty of his followers are obliging, taking us downhill, picking up speed. This isn’t America-hating: if taken root, it’s America-destroying. We know his most devout apologists don’t care. Are none on that side starting to worry? If so, what will it take for them to speak up? 
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Wednesday, February 8, 2017

The Ass In The Morass



Assad. Putin. Trump. This is the guy Putin, Trump's BFF, is helping to retain power. The guy who calls Trump his "natural ally." Who committed mass murder of what appears to be largely peaceful opponents.

 Syrian President Bashar al-Assad’s government secretly executed between 5,000 and 13,000 people in just one prison as part of its campaign to eliminate opposition to his rule, a new report by the watchdog group Amnesty International has found.
The killings took place over a four-year period between 2011 and 2015 in the notorious Sednaya facility outside Damascus, and the bodies were later disposed of in mass graves, according to the report released Monday by Amnesty... 
... The majority of those executed at Sednaya were political prisoners, including many of the ordinary people who joined in the peaceful protests against Assad, the report says. ... [F]or the most part they were “doctors, engineers, protesters,” one former prison official is quoted as saying. “They were somehow understood to be linked to the revolution. Sednaya is the place to finish the revolutionaries. It’s the end for them.”...

The situation in Syria is awful in all ways. And complex. Which, if any, of the rebels are good guys? Are all enemies of ISIS our friends? Are enemies of ISIS's enemies friend or foe, and how can we tell? Whether the US could have done more or should have done less under President Obama, I have no idea. But it's not hard to understand why he was reluctant to intervene bigly at this point.

Comes now Trump, to whom thoughts arrive in 140 characters, and who thinks there's a way for the US single-handedly to end ISIS militarily. (Whatever happened to his oft-claimed, pre-election, secret plan?)

... Trump’s response to the Syrian Civil War has been nothing short of flippant. He has repeatedly voiced support for Russian president Vladimir Putin’s military intervention. He has suggested that the United States work with the tyrant Bashar al-Assad against ISIS. And even a charitable observer would conclude that he has shown little interest in the country’s refugee crisis, which to him is less a matter of burning humanitarian need and more an opportunity to demonstrate American strength... 
Hard to believe anything Trump decides to do can make things better. But, you know, give him a chance. 

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Tuesday, February 7, 2017

Trump The Destroyer


Donald Trump's career as a businessman is characterized by bankruptcies from which he's managed to escape profitably while ruining the people below him. And it's been one of seeking vengeance on those who've crossed him. Many, including me, have pointed it out, and have wondered how that will translate now that he has the power of the US government to seek and destroy. Not that it was ever a mystery; but now we know:
WASHINGTON — There's a Texas state senator with a new target on his back, courtesy of President Donald Trump and the Rockwall County sheriff. 
At a meeting Tuesday with sheriffs from around the country, Sheriff Harold Eavenson complained about a state senator who wanted to make it harder for law enforcement to get control of assets forfeited by drug traffickers.  
"Do you want to give his name? We'll destroy his career," Trump offered...
That senator's effort, by the way, was to require conviction before assets are taken. Because "civil forfeiture" has been abused across the land by many a police agency, and people are finally catching on. Not Trump, of course, because it's a little complicated.

Meanwhile, does anyone really think he was kidding about destroying the guy?

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The Dickhead Is Wearing Me Down


If my ones of readers have noticed I'm mainly posting my weekly newspaper column lately, it's because so much news and opinion, all of it more salient than mine, is out there. Also, it seems almost foolish to concentrate on one outrage among the daily flood of so many. Which, I guess, is the desired result of the outrages. Mea sucka.

Which is not to say I'm planning to stop the column, nor am I ending the blog. (A sigh of relief, loud enough to be heard for inches, is raised.) But firing off a statement about something as it happens, while possibly de-stressing for me, has started to feel a little self-indulgent. Why read me, for example, when Charles P. Pierce is out there? At best, I feel I'm only paraphrasing or repurposing what smarter and more connected people than I have written.

That said, I liked posting the title picture.

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Thursday, February 2, 2017

The Man And The Man-Child


My latest newspaper column, to appear Saturday:
Trump voters got one thing right: he’s running the government like a business. Regrettably, it’s Trump University, Trump Airlines, casinos, and the rest of his inept undertakings. 
Or maybe not. It’s unclear that Trump is the one in charge. After all, he brags he doesn’t read and doesn’t need briefings. As protests against his Muslim ban unfolded, he was holding a private screening of (not kidding) “Finding Dory.” The appellation “man-child,” it turns out, might be understated. 
No, this presidency seems to be the work of chief adviser Steve Bannon, proud white nationalist, and, reportedly, a self-described Leninist who wants to “destroy the state” and “bring everything crashing down.” Imagine his delectation at ensnaring Donald “You-Do-It-I’m-Watching-Cartoons” Trump. Court orders? Ignore them. Acting Attorney General willing to take a stand against unconstitutional regulations? Fire her in the nastiest way possible. If irony hadn’t died in November, I’d mention that in 2015 Trump’s nominee for A.G. asked that same woman if she’d refuse an illegal order, because, he said, that’s what an Attorney General must do. On what basis shall we believe Mr. Sessions, a full-throated cheerleader and high-level political adviser to Trump, would do so? 
As practice for what’s coming, though, let’s ignore legality. Let’s talk about the wisdom of a ban on Muslims entering this country. We needn’t address the incompetence of implementation because that’s obvious. Let’s just point out that, absent cooperation with Muslim people and Muslim countries, we have no ability to “wipe ISIS off the face of the Earth,” as Trump promised. Everyone prefers preventing terrorists from entering. But it seems desirable not to create more or lessen the likelihood of finding them in the process, and there’s a substantive argument that that’s exactly what’s happening. 
Trump insists his order is about protecting America. Having lied so much, is this another? Why did his ban exempt every country from which participants in the 9/11 attacks came? Is it because those countries are also ones in which he does business? At best, this is cynicism. At worst, it’s scattershot and ill-considered endangerment of our country, the fruits of unchallenged conflicts of interest. There have been, let’s recall, no acts of terrorism committed here by refugees from the banned countries. As security experts have predicted, ISIS and al-Qaeda are already recruiting by touting the actions as proof America is at war with Islam. 
Some suspect the chaos created since the inauguration is intentional distraction from the arrival and entrenchment of autocracy. If Trump’s not clever enough for such multilayered planning, Bannon surely is. It seems he’s taking charge, eliminating dissent, and leaving no paper trail. He wants us to live in fear. He’s called press “the enemy” and said they should “shut up.” (In another epitaph to irony, Trump calls them “fake news.”) There are plans afoot to criminalize demonstrations, to make internet access harder, and further to limit voting rights; there are increasingly ominous warnings to anyone who questions White House actions. Do no conservatives find this alarming? 
If these efforts succeed, the carnage to democracy will be absolute. Constitution-supporting, checks-and-balances-understanding conservatives, only a few of whom seem to exist anymore, need to step up. Removed from every Republican Congressperson, there’s a pile of backbones that’d fill the lobby of money-losing and illegally leased Trump Hotel in D.C. Having just steamrolled approval of Trump appointees despite their lies in hearings, such ethically challenged hypocrites will be of no help. 
We must hope for more patriotic and brave Republican voters to see the light. Trumpists never will. A friend says he’s happy seeing the “whole thing” burn down. Missing the indispensability our founders invested in a free and adversarial press, he considers them useless liars, just as Bannon would have it. A man I recently met for coffee after he criticized a column said his vote wasn’t for Trump but against Hillary. Having chosen Trump’s incompetence and mendacity over personal dislike, his view is unlikely to change. Finally, confirming everything I’ve ever said about Trump’s most thoroughly Foxified supporters, here, in its entirety, is an email I received in response to my column about Trump’s pathological lying: 
“Another sicko opinion from a d**khead.” 
Not very promising, is it, America-wise?
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Friday, January 27, 2017

Wait A Minute! You're Saying...


This conclusion isn't original with me, but it bears spreading around: Trump claims that Democrats, or Hillary, or some dastardly force successfully orchestrated the illegal voting of millions of people; managed to get poll watchers, Secretaries of State, election officials in countless counties to allow those votes to happen. And they limited their efforts, complicated as they must have been, to states Hillary was already sure to win. 

Three to five million votes; and yet they didn't think to finagle the 70,000 total votes needed in three states that went for Trump to have swung the election to Hillary.

Makes sense.

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Thursday, January 26, 2017

Liar In Chief


Here's my next newspaper column, to be published Saturday:
In the age of Trump, having only a weekly column makes it challenging to prioritize. By the time this is published, who knows how many more significant issues will have come up? On the other hand, what’s more important than truth? So, displacing about a dozen other topics for now, let’s talk about Sean Spicer, Trump’s official press mouthpiece, and his remarkable appearance one day after inauguration. 
In case anyone is unaware, he devoted his first news conference to upbraiding the press for, he claimed, lying about the size of the crowd at the inauguration. Photos taken at the same time, from the same angle, make it clear that the crowd for Trump was enormously less enormous than for President Obama eight years earlier, as do Metro ridership data; but Sean Spicer was having none of it. It was the largest crowd ever, for any inauguration. Period. Yes, he said “Period.” And left without taking questions. 
Is this weightier than issuing gag orders on scientists across all government agencies? Does it deserve more attention than his impossible claim he’ll end crime and remove radical Islamic terrorism from the face of the earth? Offending the CIA by using their Memorial Wall as a backdrop for vainglorious self-promotion and having brought stooges there to cheer and clap? Well, if we have a president who’s untethered from reality, yes. If blatant lies are to be modus operandi from this administration, it deserves unwavering attention, because this level of shameless mendacity is unprecedented. 
Although many Trumpites seem okay with being lied to, I believe among them are decent people, thoughtful ones, who prefer truthfulness and reality-testing in a president. People whose patriotism and bravery run deeper than partisanship. Very soon, we’ll all depend on that. 
If Sean Spicer believes what he claimed, he’s delusional. If not, if he’s just following orders, we must wonder what demand, if any, he’d consider beyond justifying. Are Trump’s people already afraid to tell him the truth? More pertinent, though, is why Trump ordered him to say what he did. During the campaign we learned to expect lies. But this? Crowd size? When there’s photographic evidence? What does it mean that our president is compelled to such obvious fabrication? There aren’t many explanations, and they’re all alarming. 
If Trump sees only what he wants to see, ignoring irrefutable evidence to the contrary, we’re in grave, non-partisan danger. (He’s repeating his discredited claim that millions voted illegally for Hillary; even confabulated about rain and sun during his inauguration. This is disturbingly abnormal.) If he lies intentionally, thinking so little of the people to whom he promised to return the government, we should be both frightened and insulted. Which is the greater threat: a president who’s pathologically unmoored from reality, or one capable of lying whenever he speaks? That’s the no-winners situation we face. 
Which brings us to Kellyanne Conway. While many of Trump’s appointees are some combination of inexperience, incompetence, and ethical deficiency, Ms. Conway is a brilliant choice. Never have we seen a more facile propagandist or producer of disinformation, not even on Fox “news.” Asked why Trump sent Spicer out there to lie, her glib response was chilling: he was presenting “alternative facts.” We’ve just learned the motto for the new administration: Alternative Facts. 
Accepting the health risks, I check in on right-wing websites. They defended it all, claiming the pictures weren’t from comparable times (they were), blaming the press, seeing conspiracy, exactly as Trump would have them do. But even Chris Wallace, one of Fox “news’” two sometimes fair and occasionally balanced reporters, creating a Sophie’s choice for Trumpists, stated he was there and saw the empty space.  Is Trump plumbing the depths of gullibility of his voters, prepping them for even bigger lies, testing what he can get away with? Is that a less disturbing explanation than literal insanity? Joseph Goebbels vs. George III? 
How much duplicity can Trump’s supporters rationalize? It’s in their hands, especially those in Congress, to take a stand if he becomes even more unhinged. If they don’t, they will have failed themselves and their county. And, having the temperament, history, and, now, the means to punish “enemies,” what will Trump do if they do?
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Monday, January 23, 2017

The Brave And The Bullshit




The brave ones are the women marching, faces uncovered, banners held high. Peaceful, enthusiastic, determined, saying "Look at me, look at us, here we are. Listen." Telling their employers, employees, patients, clients, families, everyone, they're willing to, want to, be seen. Have something important and valuable to say.

The cowardly and stupid ones are dressed in black, faces covered, lighting fires, running up to windows and smashing them and going off to hide in the crowd, like kids who put burning bags of dog shit on a porch, ring the doorbell, and run away.

I don't know who they are, what they think they're accomplishing, what message they're sending. For that matter I don't know whose side they're on, if any. But I hate them for making it easier for Trumpists to ignore the meaning of the rallies, to pretend that what they did is the message, not the voices of the marchers in protest. Perhaps that was, in fact, exactly their intention. Happily, they stayed away from the Women's March. Afraid their mothers would see them, maybe.

But they're there, somewhere. Burning garbage cans, looting, breaking windows, hiding. Wherever there are good people, committed, brave people (braver, still, in these times), so are there these self-described but delusional anarchists, who are, at best, nothing more than idiots, pretending to be something they most decidedly are not, afraid to take an actual stand, and be seen.

In this era of fake news as subterfuge and distraction, following false stories of "liberal" protesters being paid to disrupt, who can say these destructive assholes aren't, in fact, organized by Trump supporters, to discredit the waves of protest around the country? I find it entirely possible, with worse to come. On the other hand, such people as these have always been around, as they were here in Seattle during the WTO protests which turned into riots. Deliberate or not, on the "right" side or not, the only thing they achieve is damage.

Whoever they were in D.C. during the inauguration, they're the equivalent of a Trump tweet: superficial, simple, nasty, accomplishing nothing positive.

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Sunday, January 22, 2017

Scream, Or Your Head Will Explode



Swear to God: if anyone can watch the video of Kellyanne Conway, this planet's most gifted and unrepentant bullshitter, in this link and not scream or throw something or, at least, feel disgust, horror, and fear for the future, they don't deserve to live. Or vote, anyway.

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Friday, January 20, 2017

I Felt It, Too.

Stab Wounds



My latest newspaper column, to be published Saturday. Since it has to be sent in before the inauguration, I didn't want to rant about something that might be contradicted by events yet unknown.

Here’s another heavily modified piece from my surgery blog. Entering the Trump era, I need time to let it sink in.
When I picked up my laundry I’d have a little small talk with the proprietor. She always called me "Doctor.” This time, though, she was notably distant, which I didn't understand till I got home and hung up my jacket. On the inside she'd pinned an envelope, into which she'd put a photo taken months before, forgotten in one of my pockets. 
What it showed was a young female torso bearing sixteen stab wounds and the handle of an 8-inch butcher's knife in-stuck to the hilt, a couple of inches below her left breast, ticking, when the picture was taken, with every heartbeat. She’d tried to make herself the second person she killed that day. A cop had accompanied us to the OR. 
Worried that I could cause a catastrophe if I did it blindly, I hadn't removed the knife in the emergency room; the officer needed to maintain "chain of custody." I opened her belly first: with stab wounds to the lower chest, it’s likely there are injuries within the abdomen. Indeed, the knife had skewered her stomach, barely missed her colon, stopping with its sharp edge whispering to her spleen. Holding the spleen out of the way, I withdrew the knife, handed it off to the cop, cool as Steve McQueen: calmly cutting the lady open in front of the officer, handing him the weapon like I did it every day. He tagged it and bagged it, like he did it every day. 
As I attended to the abdominal injuries, the anesthesiologist announced blood pressure zeroing out, cardiogram widening into a functionless sine wave. In the ER, I’d treated her punctured lung with a drainage tube. Now I guessed she’d nicked her heart as well. With no time for tidy entry, I made a fast and ugly, trauma-center-trained, trap-door opening through her ribs. Expecting a blood-filled pericardium, the sac around the heart, I opened that, too, carefully, despite the urgency, to avoid paralyzing the nerve to her diaphragm, which runs along its surface. 
A cut lung can allow air into the pulmonary veins, through which it returns to the left ventricle of the heart, wherefrom it gets pumped out to the body. Departing first from the aorta are the coronary arteries; an air bubble there acts no differently from a blood clot, potentially causing a heart attack. The next exits lead right to the brain. 
While requesting (or screaming, I don’t recall) that the anesthesiologist tilt the table head down so bubbles would rise away from our patient’s head, I clamped the aorta downstream from the vessels going there, called for drugs to raise her blood pressure as high as safely possible, and to run 100% oxygen (in addition to protecting tissues, it speeds up absorption of air). Raising blood pressure might force the bubbles through her heart before doing permanent damage. Clamping the aorta raises blood pressure as well. It's a dangerous combination of maneuvers, but as they say about desperate times... 
Indeed, bubbles were moving through her coronary arteries, lined up like ticket-holders to the Stygian boatman, as frightening a thing as I’ve seen, operating. But, as hoped, they marched on through, and I began, incrementally, to release the clamp; now she was able to maintain her pressure, as she hadn't before. Without obvious signs of brain injury, she awoke later in the ICU, her cardiogram returning rapidly to normal. Sixteen stab wounds, a near-fatal cardiac emergency: not a single after-effect. 
Being young, before experience ground such misconceptions away like centuries of sea on stone, I figured, having rummaged around in her entrails and having held her heart in my hand, squeezing it alive, I of all people should be able to get through to this lady, humbly receiving her gratitude while clearing the demons in her mind. Well, of course, no. Neither could the psych consultant. 
I’d taken that graphic and ill-forgotten picture thinking I might use it in a lecture or an academic paper on penetrating chest injuries, but never did. I kept taking my laundry to the same place, never mentioned the envelope, and our conversations soon found their way back to normal.   
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Thursday, January 12, 2017

Showering Us With Lies


My latest newspaper column, scheduled for Saturday:
Only hardcore Trumpophiles deny Donald Trump lies, regularly, about matters large and small. Recently he claimed album sales of the young singer scheduled for his inauguration have soared since the announcement. The opposite is true. Simultaneously he announced that inaugural after-parties are such a hot ticket that you can’t find a single fancy gown in all of D.C. Calls from reporters showed the claim to be false, by the thousands. Simple observation confirms he WAS mocking that disabled reporter. Like all pathological liars, he doesn’t care, and won’t stop. 
The record of Trump’s pronouncements proves truth is not his default setting. About Jackie Evancho and ball gowns, who cares? About mocking the disabled, financial ties to Russia and cahoots with Vladimir Putin, we all should. 
In publishing the alleged report on alleged travesties in Russia, Buzzfeed gifted Mr. Trump. So much is salacious, all of it, the public version at least, unsubstantiated, that he could dismiss it and its implications as “fake news.” (Might the barrage of fake news distributed pre-election by Trumpites, including Russia, have been designed not only to tilt the outcome but as future cover for discrediting actual news?) Until proven otherwise, the “report” reminds me of those fake Obama birth certificates touted by rightwing media: unconvincing. That this specific document stinks, though, doesn’t prove there’s no dead rat nearby. But it gave our next president a platform for, yet again, trying to pre-discredit the press and the intelligence community over future revelations. 
In college, having studied the Russian language for several years, I traveled in the Soviet Union at the height of the Cold War. From sad personal experience (involving a Soviet citizen, not me) I can confirm that our rooms were bugged. Surely they still are, especially for high-profile visitors like the vulgar, narcissistic, flattery-craving owner of the Miss Universe pageant, a perfect target for gathering compromising data. I don’t much care if the Donald arranged for the defiling of the bed used by the Obamas, per se; I do care if he said or did anything while there that could be used to blackmail him, and so should we all. I do care if he has financial entanglements with and is indebted to powerful forces in Russia, and so should we all. Given his well-established penchant for lying (and his refusal to release tax returns), the last thing we should do is to take his denials at face value. 
If it was effective strategy before the election constantly to flood the public with so many lies that it became meaningless to track them all down, for a sitting president it’s kind of a drawback. Or would be, if his voters hadn’t been taught not to care, and if his party’s representatives in Congress weren’t so euphoric over having an ill-informed, incurious occupier of the White House, likely to sign whatever he’s sent, that they’re already looking the other way on a number of outrages. 
Eight years ago, as the minority leader, Mitch McConnell sent to the majority leader a list of quite reasonable vetting requirements before holding hearings on President Obama’s nominees. Now, to the surprise of exactly zero sentient beings, he says such scrutiny is not only unnecessary; the very act of suggesting them is childish. Democrats, he said, need to “grow up.” Tax returns? Vetting by the Government Ethics Office? Conflicts of interest? That was then! 
Kellyanne Conway, Trump’s mouthpiece, an undeniable genius at obfuscating the outrageous, recently chided the media for focusing on what Trump says. “You always want to go by what's come out of his mouth rather than look at what's in his heart," were her exact, bizarre, and anatomically impossible words. I’ve listened to countless hearts stethoscopically, held a few, beating, in my hands. But I don’t know how to discover what’s in non-patients’ hearts other than by what they say. Daily, we’ve learned that Donald Trump’s heart accommodates a plentitude of lies. How can we know when he’s being truthful, about Russia, bribes, or anything else; and isn’t it imperative, despite his threats, to keep trying? 
Media professionals have to resist Trump’s intimidations; his supporters must become willing to consider the obvious. Sustaining our democracy depends on it. 
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