tag:blogger.com,1999:blog-87054322791772035092024-03-16T18:32:39.645-07:00Budd's BlogBuddhttp://www.blogger.com/profile/03893224951099943306noreply@blogger.comBlogger498125tag:blogger.com,1999:blog-8705432279177203509.post-14375247745841549842024-03-16T18:31:00.000-07:002024-03-16T18:31:54.376-07:00Israel, Anti-Semitism, And Our Dilemma<p>
</p><p style="margin-bottom: 0in;"><span style="color: #000099;"><span style="font-family: tahoma, sans-serif;">A
friend of mine sent me this disturbing, unbalanced expression of
discontent by Joel Kotkin from The Claremont Institute. </span></span>>
<a href="https://americanmind.org/salvo/golden-land/">https://americanmind.org/salvo/golden-land/</a>.
<span style="color: #000099;"><span style="font-family: tahoma, sans-serif;">Imagine,
unbalanced right-wing distraught expression of alarm from the
Claremont Institute, who'd a thunk it.</span></span></p>
<p style="margin-bottom: 0in;"><span style="color: #000099;"><span style="font-family: tahoma, sans-serif;">Before
the war, last February, in an acclaimed blog post, I set out what I
thought US policy should be toward the increasingly illiberal leaning
Israel. I said basically that much of what had drawn us toward
Israel for decades, before the Likud-Netanyahu-extreme religious
right descent, had disappeared. So we had to start regarding Israel
as an ally of convenience more than an ally of conviction.</span></span></p>
<p style="margin-bottom: 0in;"><span style="color: #000099;">
<span style="font-family: tahoma, sans-serif;"><a href="http://buddshenkin.blogspot.com/2023/02/on-israel-and-american-policy-toward.html">http://buddshenkin.blogspot.com/2023/02/on-israel-and-american-policy-toward.html</a>.</span></span></p>
<p style="margin-bottom: 0in;"><span style="color: #000099;"><span style="font-family: tahoma, sans-serif;">Now,
of course, our dilemma is even more acute. If Israel makes it
difficult to support them, Hamas of course makes support of them
totally impossible – except they are getting it. But I'm getting
ahead of myself. </span></span>
</p>
<p style="margin-bottom: 0in;"><span style="color: #000099;"><span style="font-family: tahoma, sans-serif;">In
reading the Claremont article, which bemoans what he identifies as
rising anti-Semitism and insufficient public opposition to
anti-Semitism, I find some agreement. I, too, am appalled at the
support given to the lefty teachings. I am appalled at the
pro-Hamas virulence, and the lack of arrests and expulsions when they
cross the line. Lefty faculties are appalling.</span></span></p>
<p style="margin-bottom: 0in;"><span style="color: #000099;"><span style="font-family: tahoma, sans-serif;">But,
once again, there is the problem of anti-Israel vs. anti-Semitism.
They are not the same. I think much of what Israel has done,
has been, and continues to be appalling, and it has spawned ever more
Israel isolation in world politics. i find too many Jewish
organizations saying, either you're pro-Israel totally, or you're
anti-Semitic. Israel would have a lot more supporters if their
politics and West Bank actions and declarations of intent to wipe out
all Palestinians were not so dreadful. Netanyahu and colleagues
have squandered the ethical high ground that Jews have occupied
previously. There is a reason so many American Jews, and others
who would be friendly, hesitate in their support of Israel.
Most people feel, I think, that Israel has a right and a necessity to
exist, but not a right to oppress. Not to whitewash the dreck
of Palestinian and other Arab and Iranian organizations, and not to
whitewash the ignorant anti-Semitism of the unwashed left here and
abroad. And certainly not to whitewash all the anti-Semitism
exported from Arab countries. I wish they would all return to
where they came from and see how they like living under Assad and
other friendly murderers.</span></span></p>
<p style="margin-bottom: 0in;"><span style="color: #000099;"><span style="font-family: tahoma, sans-serif;">Likud
and the Israeli right wingnuts have put Jews worldwide in an
impossible position. How do you support liberal values and the
existence and need for safety for Israel, when the state of Israel's
policies are so difficult to support? It's so difficult to say
one hates the government and its policies and that some of its
leaders belong in the Hague, but we need to give all our support to
Israel and let them do and say whatever they want, when so much of
what they want is heinous. We just have to wait out the crisis,
I guess, and hope Netanyahu goes to jail soon, while strongly
resisting and calling out anti-Semitism. Jews need to be
judicious -- strong but reasonable, and not exerting wealth and power
tools on the universities so prominently, which fuels paranoia and
anti-Semitism. Being judicious in these circumstances is really
hard. </span></span>
</p>
<p style="margin-bottom: 0in;"><span style="color: #000099;"><span style="font-family: tahoma, sans-serif;">One
of my friends read the piece and was disturbed. He is dissatisfied,
as Kotkin is, with the Democrats – Progressives support for Hamas
is really appalling and surprisingly widespread, but he is
dissatisfied with the rest of the Democrats as well. He wishes for a
moderate third party messiah. I had to say, friend, ain't gonna
happen, can't happen, all third parties are destructive -- although I
think Kennedy could drain some votes from Trump. I'm hoping
that the security community drops its non-partisan stance and says,
we are partisan for democracy and the continuation of American
leadership of the free world, and therefore, even though we are
predominantly Republican privately, we are dropping our reticence and
urging everyone to vote for Biden, or else we as a country are
doomed. Maybe that would help. The Democratic party,
which is not a stronghold of anti-Semitism at all, and which has good
policies basically in so many areas, although there are certainly
anti- Semites in their Left wing -- is the only hope. And
anyone who thinks that Biden hasn't given enough support to Israel -
at great political cost to himself - is mistaken. He is giving more
than they have a right to expect.</span></span></p>
<p style="margin-bottom: 0in;"><span style="color: #000099;"><span style="font-family: tahoma, sans-serif;">Anyway.
As I used to hear on CBS when it was reputable, That's the way it
is.</span></span></p>
<p style="margin-bottom: 0in;"></p><p style="margin-bottom: 0in;"><span style="color: #000099;"><span style="font-family: tahoma, sans-serif;">Budd
Shenkin</span></span></p>
<p><style type="text/css">P { margin-bottom: 0.08in }A:link { so-language: zxx }</style></p>Buddhttp://www.blogger.com/profile/03893224951099943306noreply@blogger.com0tag:blogger.com,1999:blog-8705432279177203509.post-6732171971243483972024-02-12T09:42:00.000-08:002024-02-12T09:42:27.895-08:00Gerontology: The Profession vs. The Job<p>
</p><p align="CENTER" style="margin-bottom: 0in;"><b>Caring For Older
Patients Is Not American Medicine's Priority</b></p>
<p style="margin-bottom: 0in;"><span style="font-family: Arial, sans-serif;">There is
a prominent paradox in American medicine: we have an ever increasing
elderly population, both in numbers of patients and the age of
patients, but our capacity to treat these patients is not increasing
proportionately. In other words, we are falling short now and if the
trend continues, we will be doing worse and worse as time goes on.
This is a well known problem, and even if it does not seem to provoke
much action, it does provoke words. That's hopeful, in a way,
because words are often a prelude to action, although when we look at
the problem of global warming, we realize that words are often less
effective than the appearance of the crisis in full-blown form.
Humans tend to react to crises rather than plan for them,
unfortunately.</span></p>
<p style="margin-bottom: 0in;"><span style="font-family: Arial, sans-serif;">So
that's where we stand, we are talking about this crisis of an
increasing population of the elderly.</span></p>
<p style="margin-bottom: 0in;"><span style="font-family: Arial, sans-serif;">In
August of last year, two articles on older patients appeared in the
medical literature, one in JAMA and the other in the NEJM, that
illustrate our impasse. What do you do when there is little
progress? The JAMA article is one of frustration. The author
asserts that the field of geriatrics is so intrinsically interesting
and important, yet the number of geriatricians is dropping, and he
can't imagine what more can be done to attract young medical
professionals. The NEJM article doesn't even mention the crisis of
manpower, but it sets out in extensive and thoughtful detail what the
authors think ideal arrangements would be to provide medical care for
elderly dementia patients. </span>
</p>
<p style="margin-bottom: 0in;"><span style="font-family: Arial, sans-serif;">Here's
the <a href="https://jamanetwork.com/journals/jama/fullarticle/2808221">JAMA
article</a>.</span></p>
<h1 align="CENTER" class="western"><span style="font-family: Arial, sans-serif;"><span style="font-size: medium;">The
Paradoxical Decline of Geriatric Medicine as a Profession</span></span></h1>
<p align="CENTER"><span style="font-family: Arial, sans-serif;"><span style="font-size: medium;">Jerry H.
Gurwitz, MD</span></span></p>
<p align="CENTER" style="margin-bottom: 0.2in;"><span style="font-family: Arial, sans-serif;"><span style="font-size: x-small;">From
The Journal of the American Medical Association (JAMA), August 4,
2023 (<a href="https://jamanetwork.com/journals/jama/fullarticle/2808221">https://jamanetwork.com/journals/jama/fullarticle/2808221</a>)</span></span></p>
<p style="margin-bottom: 0in;"><span style="font-family: Arial, sans-serif;">The
author, an academic geriatrician, bemoans the chasm between the need
for geriatricians for an aging population, and the deficient supply
of these specialists, that is withering even further.</span></p>
<p style="margin-bottom: 0in;"><span style="font-family: Arial, sans-serif;">The
situation mystifies him. After all, the work itself is so
interesting! Old people can have so many diseases and conditions
simultaneously, many of them cannot be cured, the surrounding
families trying to help in care can be stretched and exhausted, and
putting together interdisciplinary teams for care can be so
energizing! Well, Jerry, you say it's “interesting,” I'll give
you “challenging.”</span></p>
<p style="margin-bottom: 0in;"><span style="font-family: Arial, sans-serif;">Moreover,
he says, the money for research in geriatrics is increasing rather
than decreasing, even some foundations are pitching in to support the
teaching of geriatrics. </span>
</p>
<p style="margin-bottom: 0in;"><span style="font-family: Arial, sans-serif;">Yes, he
agrees, the money is not great, and in fact, if you take the time to
become a geriatrics specialist after your internal medicine training,
paradoxically, you will earn even less than you would if you just
stayed an internist! But then, pediatrics pays poorly, too, and
pediatrics remains a fairly popular specialty, he says. (He could
have looked further and realized that adolescent medicine, which like
the geriatrics situation, takes extra time to qualify for, then
enables you to make less money than if you had simply started
practicing pediatrics, and adolescent medicine also has trouble
filling all its spots – he didn't look quite far enough for a
correlative situation.) </span>
</p>
<p style="margin-bottom: 0in;"><span style="font-family: Arial, sans-serif;">It must
be the culture, he says, where old people are looked on with some
disgust, agreeing with Louise Aronson and her great book, Eldercare.
And it must be the graduate education councils that don't require
medical students and residents to be exposed to geriatrics.
(Adolescent medicine wages this same fight, by the way.) And it must
be the health care organizations that take the extra money that is
paid for treating the elderly (if you code properly, which they do,
because it means more money,) but they keep the money for their
organizations and their goals and profit, and they don't plow the
money back into the organization by hiring geriatricians and serving
the elderly better. </span>
</p>
<p style="margin-bottom: 0in;"><span style="font-family: Arial, sans-serif;">Jerry
has no answer, no path forward. He is reduced to saying, the
problems with an aging population will only mount, and people –
you'll be sorry you have been making these anti-geriatrician choices!</span></p>
<p style="margin-bottom: 0in;"><span style="font-family: Arial, sans-serif;">Well,
he's right about the need, and he's right about societal prejudice (I
have it myself – I chose to be a pediatrician, partly because I
thought of the dear kids and hopeful families and the futures they
had before them, which old people don't.) And tastes vary – some
people love working with old people and some don't, and it will ever
be so. Like for me – give me the kids, every time.</span></p>
<p style="margin-bottom: 0in;"><span style="font-family: Arial, sans-serif;">But the
main problem that Gurwitz isn't dealing with is the difference
between a profession and a job. There isn't a single reference in
his short paper to what it's like to have the job of being a
geriatrician. Is it a good job? Are geriatric practices well
resourced? Does a geriatrician feel like the captain of a team who
can call on A and B and C to deal with the problems of his or her
patients? Can the geriatrician identify a problem of insufficient
assistance in the home, and assign a member of the team to solve that
problem expeditiously, and then to report back, problem solved? Or
is it always a struggle, always slogging through sand, begging for
this or that agency to come through, looking for financing, etc. Are
home supports easily available, with all the durable medical
equipment at the ready, all the aides? Are there institutions
available that are excellent and welcoming and well-staffed and well
supplied and happy, vibrant places, or are they dingy and sad and
full of dysfunction and is it hard to find a good one?</span></p>
<p style="margin-bottom: 0in;"><span style="font-family: Arial, sans-serif;">How does
the geriatrician experience the day to day? Is the office work easy
and efficient, or is he or she always struggling to keep up with the
documentation required by the electronic medical record that is
designed to optimize billing rather than care? Is the geriatrician
served by a scribe who does all the work of electronic charting, or
does the geriatrician do it him or herself, acting as a data input
clerk? Does the parent organization take pride in the geriatrics
office, even though it is more an economic drain rather than a profit
center? </span>
</p>
<p style="margin-bottom: 0in;"><span style="font-family: Arial, sans-serif;">Does the
geriatrician skate through the day or slog through sand to the point
of exhaustion? </span>
</p>
<p style="margin-bottom: 0in;"><span style="font-family: Arial, sans-serif;">And the
pay, the pay and benefits and vacation time. All the non-procedural
specialties need better pay, the current structure of pay is an
out-of-control outrage. But the job can make up for lower pay, if it
is really well-structured and fulfilling. Is the structure of the
job, the agency available for exertion by the geriatrician, the
resources at hand – do they lead to great job satisfaction? Do
health care groups have a carved out gerontology slots, with
attractive job descriptions and resources at hand? These are things
that students will see as they make their specialty choices. </span>
</p>
<p style="margin-bottom: 0in;"><span style="font-family: Arial, sans-serif;">Is the
substance of the job enough to offset the inferior pay? Is it good
enough to make it attractive to make half as much as your colleagues
to elect to become strutting orthopedists? </span>
</p>
<p style="margin-bottom: 0in;"><span style="font-family: Arial, sans-serif;">There
will always be people who choose to follow their interests and their
ideals into a chosen field, no matter the consequences for their job.
They can accept the indignities because they are obeying a higher
calling, and they are following their passion, their bliss. That's
true of all walks of life. But it makes it a lot easier to do so,
and many more will choose them, if the jobs are really
well-structured, well-operated, and well-conceived.</span></p>
<p style="margin-bottom: 0in;"><span style="font-family: Arial, sans-serif;">So my
advice is, Jerry, is go work on that. You can do it right there
where you are. Construct an ideal operation. Show the world what
you can do to make the life of a geriatrician a dream. You don't
have to match the orthopedist's pay and lifestyle (but you should get
close, say 80% close), but you do have to make the organizations you
are working for pass your increased remuneration down to you and not
just spread it around the group. Make that extra degree worth
something. And make the job one where you skate through the day, not
one where you are continually slogging, which takes resources and
organization. Match the job to the attractiveness of the profession,
and maybe then you will get to serve society with what it needs, more
services for the aged provided by the proper provider with the proper
organization.</span></p>
<p style="margin-bottom: 0in;"><span style="font-family: Arial, sans-serif;">What
Gurwitz has missed, in sum, is the difference between a profession
and a job. While the profession of geriatrician can be terrific, the
job of being one often sucks.</span></p>
<p style="margin-bottom: 0in;"><br />
</p>
<p style="font-weight: normal; margin-bottom: 0in;"><span style="font-family: Arial, sans-serif;">Here's
the <a href="https://www.nejm.org/doi/full/10.1056/NEJMp2301347">NEJM
article</a>:</span></p>
<ol start="2" type="I"><p align="LEFT" style="font-weight: normal; margin-bottom: 0in;"></p><p align="CENTER" style="margin-bottom: 0in;"><span style="font-family: Arial, sans-serif;"><b>Toward
Gerineuropalliative Care For Patients With Dementia</b></span></p><p align="CENTER"><span style="font-family: Arial, sans-serif;"><span style="font-weight: normal;">Krista
L. Harrison, Ph.D.,</span></span><span style="font-family: Arial, sans-serif;"><b>
</b></span>Nicole Boyd, M.D., and Christine S. Ritchie, M.D.,
M.S.P.H.</p><p align="CENTER" style="margin-bottom: 0in;"></p><p align="CENTER" style="margin-bottom: 0in;"><span style="font-family: Arial, sans-serif;"><span style="font-size: x-small;">from
the New England Journal of Medicine (NEJM), August 30, 2023</span></span></p><p align="CENTER" style="margin-bottom: 0in;"><span style="font-family: Arial, sans-serif;"><span style="font-size: x-small;">https://www.nejm.org/doi/full/10.1056/NEJMp2301347</span></span></p></ol>
<p style="margin-bottom: 0in;"><span style="font-family: Arial, sans-serif;">And lo!
Just a little later in the same month comes an article in NEJM, a
more hopeful one, on a similar subject, caring for older patients
with dementia. Where the JAMA article sees an intractable problem in
caring for older people because specialists are not being produced,
this article posits a model of care that, they say, could be adapted
for generalists rather than geriatricians, perhaps because the
geriatricians are just not available. (Again, the same dilemma
arises in adolescent medicine, where specially trained personnel
would render excellent service, but where numbers dictate that they
be mostly researchers, teachers of pediatricians and a referral
specialty.) This service model also highlights the need for
non-fee-for-service payments – nothing new there – and in a
hopeful sign, Medicare has started a model program where capitated
care would be available. Beyond those small nods to practicality,
however, the article is a rather typical academic approach to
matching resources to need in an ideal world. The summary chart in
their article is impressive. What a plan! I only it could be
implemented!</span></p>
<p style="margin-bottom: 0in;"></p><p style="margin-bottom: 0in;"><span style="font-family: Arial, sans-serif;">I would
think that this interesting chart would be helpful in actually
shaping programs in the field, but that remains to be seen. The
problem is, who would try it, and why? Yes, the ideal of helping
people is always there. If a program were to be mounted in academia,
the careers of the progenitors would be enhanced, and staff working
on the project would find their jobs enriched. But when a field with
obvious needs has shown so little progress over time, there's a
reason. Here and there in the country, there would be enthusiasts to
take up the model.</span></p>
<p style="margin-bottom: 0in;"></p><p style="margin-bottom: 0in;"><span style="font-family: Arial, sans-serif;">There
are deeper questions that need to be approached to really understand
this situation. Let's just mention them.</span></p>
<p style="margin-bottom: 0in;"><span style="font-family: Arial, sans-serif;">Is the
country prejudiced against old people? Yes, our culture does not
honor the old very much. Put them out on the ice, <a href="https://granta.com/the-trouble-with-old-men/">some
urge</a>, the gerontocracy takes up slots that should go to younger
people (like the author of that screed, one surmises.) Or probably,
the wealthy can often take care of their oldster problems privately,
so programs that would serve everyone are not their concern.</span></p>
<p style="margin-bottom: 0in;"><span style="font-family: Arial, sans-serif;">Why does
the profession of medicine allow this situation to persist, and not
target their efforts toward the country's problems with primary care
and chronic care? Well, the profession of medicine is not a whole,
it is pieces, and the haves are the procedural specialists, and the
have-nots are the chronic caregivers, the primary caregivers, the
procedure-less specialties. And as always, the well off have more
resources than the less well off, and they use those resources to
reinforce their position of privilege. </span>
</p>
<p style="margin-bottom: 0in;"><span style="font-family: Arial, sans-serif;">Why do
people wait until situations get out of hand to react, why don't they
see the future and plan for it? Well, they're not as smart and as
disciplined as you would wish. You can plan and act thoughtfully in
small groups, but not the larger ones, where entrenched interests are
self-protective, and not naturally inclined to sacrifice their short
term interests for putative long term possibilities. Present perks
are hard to fight. </span>
</p>
<p style="margin-bottom: 0in;"><span style="font-family: Arial, sans-serif;">But,
whatever. In the field of geriatrics, if you want to do good, it's a
good idea to focus on the job rather than the career. Make it a
rewarding job, and they will come. An interesting profession, OK,
yes, but that's speculation. The job that you can see and feel,
that's what will attract new entries.</span></p>
<p style="margin-bottom: 0in;"> <br /></p><p style="margin-bottom: 0in;"><span style="font-family: Arial, sans-serif;">Budd
Shenkin</span></p>
<p><style type="text/css">P { margin-bottom: 0.08in }H1 { margin-bottom: 0.08in }H1.western { font-family: "Times New Roman", serif }H1.cjk { font-family: "SimSun" }H1.ctl { font-family: "Lucida Sans" }A:link { so-language: zxx }</style></p>Buddhttp://www.blogger.com/profile/03893224951099943306noreply@blogger.com0tag:blogger.com,1999:blog-8705432279177203509.post-45696031703600504532024-01-31T21:53:00.000-08:002024-01-31T21:55:09.172-08:00Budd's Blood Pressure - Fascinating!<p>Here's a story about my blood pressure.</p>
<p style="margin-bottom: 0in;">I know, “Fascinating! Let's hear it,
Budd!” Then I'll tell you about my aching left foot – what a
problem that's been!</p>
<p style="margin-bottom: 0in;">Actually, I've wanted to tell this
story since it happened to me last week, and I planned to adumbrate
it with observations of the medical care system. Here's the very
short version:</p>
<p style="margin-bottom: 0in;">For some reason, I really don't
remember why, after more than a year of not checking my BP, I checked
it while I was in Maui, and found it elevated, to 142/84. Not a
deadly level, but concerning, because one, it was rising, and two,
when you get past 140 systolic, the danger of events starts to
increase. And me, well, I always over-react. Can't help it.</p>
<p style="margin-bottom: 0in;">So when I got back in town the next
week I tried to get in touch with my PCP, my friend and long-time
colleague Jim Eichel, who used to work for me and now works for
Stanford. Stanford. A hospital, and thus, a bureaucracy. I
messaged him and got back a message from a physicians assistant who
said my BP wasn't so bad, and what about life-style? Give me a
break. I'm a doctor with 31 years of education and over 30 years of
practice, and I'm going to be talking to a PA whom I don't know?
Next they'll be telling me to check in with an urgent care center,
where I would get an unsupervised PA.</p>
<p style="margin-bottom: 0in;">So I called and asked for an
appointment. Sure, I could do a Zoom call in 3 weeks (you can't
measure a BP in person on a Zoom call, Stanford) or I could see Jim
in a couple of months. My blood pressure is rising (and this phone
call didn't help, obviously) and they're telling me that my PCP isn't
available. Yet they'll claim high quality care. NOT, people! Access
is part of quality care, and personal contact with your own doctor is
a part of quality care. Baiting and switching is not part of quality
care, Stanford.</p>
<p style="margin-bottom: 0in;">So I figured I'd email Jim privately,
which I did, and in a couple of days he got back to me and wondered
if we should start hydralazine, a 4<sup>th</sup> drug for my BP. He
thought maybe yes. I wondered.</p>
<p style="margin-bottom: 0in;">But in the meantime I figured, before
Jim got back to me, let me call my cardiologist. I hadn't seen him
for years, when I had a rhythm abnormality, but what the hell. I
believe in specialist care, and if the US doesn't have enough
primaries and a surfeit of specialists, I'll go with that flow.
Turns out it took me maybe 2-3 days to see my cardiologist – it
would have been sooner if I had been an “active patient.” Since
I was just an old patient, they required a referral. Well, Stanford
would be no help there so I got my doctor step-daughter to send in
the referral – we regularly help each other in getting ourselves
through the system. So, the fact of the matter is that I got to see
my cardiologist before, way before, I could see my PCP. And
actually, not only that, but then I got an echo-cardiogram and a
renal ultrasound the very next business day. Eventually on the
weekend I talked it over with Jim and we were all cool – I got to
tell him what my cardiologist said about him, that he's the best PCP
in the area. I love delivering good news. Jim is such a dear man,
really, such a sincere and dedicated and knowledgable doctor who
doesn't even tell me I'm over-reactor, although he doesn't contradict
me when I confess that I know that I am. Jim's personal humanitarian
instincts and practice are disserved by his Stanford system, seems to
me.</p>
<p style="margin-bottom: 0in;">But that's not really what I wanted to
say in this post, enlightening as it is. When I visited Eric, my
cardiologist, we talked more about the case, and he said he doesn't
really like to add drugs if he can help it. Well, I want to stay in
a good range, not a dangerous range, but I didn't object. So Eric
said, it doesn't look like you need to lose weight. I could lose 10
pounds, I said. OK, do it, he said. But then, as we talked about
the case, I realized that yes, I didn't add salt to my food, but I
really didn't avoid it, either. And I eat a lot of prepared foods,
which I knew were salty. I was just relying on my meds to counteract
it. So I figured it's time for me to really make an effort.</p>
<p style="margin-bottom: 0in;">And that's when I made my discovery. I
started reading labels. Every goddamn thing has so much salt in it!
My friend Mary Lou, whose son does catering, said that he adds salt
to everything because it makes things more tasty. And that's what
all the food companies are doing, the same thing. They are honoring
sales and taste and shortchanging health. Salt just isn't good for
you.</p>
<p style="margin-bottom: 0in;">But, maybe that's an overreaction – I
don't know, I overreact. So I figured, fresh fruits and vegetables,
you can't go wrong with that. I'll just go that route. I try to eat
a lot of them anyway, I'll just step it up. Which I did over the next
few days. And, amazingly, here's what happened. Look at the BP
change! I went low-salt on the 25th, I think.<br /></p><p style="margin-bottom: 0in;"> </p><table cellpadding="0" cellspacing="0" style="border-collapse: collapse;">
<tbody>
<tr>
<td style="background-color: lightgrey; border-color: rgb(148, 148, 148) rgb(48, 48, 48) rgb(148, 148, 148) rgb(148, 148, 148); border-style: solid; border-width: 1px; height: 17px; padding: 0px 2px 2px; width: 93px;" valign="top">
<p align="center" style="margin: 0px; text-align: center;"><span style="color: black; font-family: Helvetica Neue; font-size: x-small; font-variant-ligatures: common-ligatures; font: 10px "Helvetica Neue";"><b>1-17-2024</b></span></p>
</td>
<td style="border-color: rgb(148, 148, 148) rgb(148, 148, 148) rgb(148, 148, 148) rgb(48, 48, 48); border-style: solid; border-width: 1px; height: 17px; padding: 0px 2px 2px; width: 93px;" valign="top">
<p align="center" style="margin: 0px; text-align: center;"><span style="color: black; font-family: Helvetica Neue; font-size: x-small; font-variant-ligatures: common-ligatures; font: 10px "Helvetica Neue";">8:15 AM</span></p>
</td>
<td style="border-color: rgb(148, 148, 148); border-style: solid; border-width: 1px; height: 17px; padding: 0px 2px 2px; width: 93px;" valign="top">
<p align="center" style="margin: 0px; text-align: center;"><span style="color: black; font-family: Helvetica Neue; font-size: x-small; font-variant-ligatures: common-ligatures; font: 10px "Helvetica Neue";"><b>148/84</b></span></p>
</td>
<td style="border-color: rgb(148, 148, 148); border-style: solid; border-width: 1px; height: 17px; padding: 0px 2px 2px; width: 93px;" valign="top">
<p align="center" style="margin: 0px; text-align: center;"><span style="color: black; font-family: Helvetica Neue; font-size: x-small; font-variant-ligatures: common-ligatures; font: 10px "Helvetica Neue";">62</span></p>
</td>
</tr>
<tr>
<td style="background-color: lightgrey; border-color: rgb(148, 148, 148) rgb(48, 48, 48) rgb(148, 148, 148) rgb(148, 148, 148); border-style: solid; border-width: 1px; height: 17px; padding: 0px 2px 2px; width: 93px;" valign="top">
<p align="center" style="margin: 0px; text-align: center;"><span style="color: black; font-family: Helvetica Neue; font-size: x-small; font-variant-ligatures: common-ligatures; font: 10px "Helvetica Neue";"><b>1-18-2024</b></span></p>
</td>
<td style="border-color: rgb(148, 148, 148) rgb(148, 148, 148) rgb(148, 148, 148) rgb(48, 48, 48); border-style: solid; border-width: 1px; height: 17px; padding: 0px 2px 2px; width: 93px;" valign="top">
<p align="center" style="margin: 0px; text-align: center;"><span style="color: black; font-family: Helvetica Neue; font-size: x-small; font-variant-ligatures: common-ligatures; font: 10px "Helvetica Neue";">2:04 PM</span></p>
</td>
<td style="border-color: rgb(148, 148, 148); border-style: solid; border-width: 1px; height: 17px; padding: 0px 2px 2px; width: 93px;" valign="top">
<p align="center" style="margin: 0px; text-align: center;"><span style="color: black; font-family: Helvetica Neue; font-size: x-small; font-variant-ligatures: common-ligatures; font: 10px "Helvetica Neue";"><b>143/82</b></span></p>
</td>
<td style="border-color: rgb(148, 148, 148); border-style: solid; border-width: 1px; height: 17px; padding: 0px 2px 2px; width: 93px;" valign="top">
<p align="center" style="margin: 0px; text-align: center;"><span style="color: black; font-family: Helvetica Neue; font-size: x-small; font-variant-ligatures: common-ligatures; font: 10px "Helvetica Neue";">69</span></p>
</td>
</tr>
<tr>
<td style="background-color: lightgrey; border-color: rgb(148, 148, 148) rgb(48, 48, 48) rgb(148, 148, 148) rgb(148, 148, 148); border-style: solid; border-width: 1px; height: 17px; padding: 0px 2px 2px; width: 93px;" valign="top">
<p align="center" style="margin: 0px; text-align: center;"><span style="color: black; font-family: Helvetica Neue; font-size: x-small; font-variant-ligatures: common-ligatures; font: 10px "Helvetica Neue";"><b>1-19-2024</b></span></p>
</td>
<td style="border-color: rgb(148, 148, 148) rgb(148, 148, 148) rgb(148, 148, 148) rgb(48, 48, 48); border-style: solid; border-width: 1px; height: 17px; padding: 0px 2px 2px; width: 93px;" valign="top">
<p align="center" style="margin: 0px; text-align: center;"><span style="color: black; font-family: Helvetica Neue; font-size: x-small; font-variant-ligatures: common-ligatures; font: 10px "Helvetica Neue";">10:10 AM</span></p>
</td>
<td style="border-color: rgb(148, 148, 148); border-style: solid; border-width: 1px; height: 17px; padding: 0px 2px 2px; width: 93px;" valign="top">
<p align="center" style="margin: 0px; text-align: center;"><span style="color: black; font-family: Helvetica Neue; font-size: x-small; font-variant-ligatures: common-ligatures; font: 10px "Helvetica Neue";"><b>139/82</b></span></p>
</td>
<td style="border-color: rgb(148, 148, 148); border-style: solid; border-width: 1px; height: 17px; padding: 0px 2px 2px; width: 93px;" valign="top">
<p align="center" style="margin: 0px; text-align: center;"><span style="color: black; font-family: Helvetica Neue; font-size: x-small; font-variant-ligatures: common-ligatures; font: 10px "Helvetica Neue";">68</span></p>
</td>
</tr>
<tr>
<td style="background-color: lightgrey; border-color: rgb(148, 148, 148) rgb(48, 48, 48) rgb(148, 148, 148) rgb(148, 148, 148); border-style: solid; border-width: 1px; height: 17px; padding: 0px 2px 2px; width: 93px;" valign="top">
<p align="center" style="margin: 0px; text-align: center;"><span style="color: black; font-family: Helvetica Neue; font-size: x-small; font-variant-ligatures: common-ligatures; font: 10px "Helvetica Neue";"><b>1-21-2024</b></span></p>
</td>
<td style="border-color: rgb(148, 148, 148) rgb(148, 148, 148) rgb(148, 148, 148) rgb(48, 48, 48); border-style: solid; border-width: 1px; height: 17px; padding: 0px 2px 2px; width: 93px;" valign="top">
<p align="center" style="margin: 0px; text-align: center;"><span style="color: black; font-family: Helvetica Neue; font-size: x-small; font-variant-ligatures: common-ligatures; font: 10px "Helvetica Neue";">7:20 AM</span></p>
</td>
<td style="border-color: rgb(148, 148, 148); border-style: solid; border-width: 1px; height: 17px; padding: 0px 2px 2px; width: 93px;" valign="top">
<p align="center" style="margin: 0px; text-align: center;"><span style="color: black; font-family: Helvetica Neue; font-size: x-small; font-variant-ligatures: common-ligatures; font: 10px "Helvetica Neue";"><b>153/89</b></span></p>
</td>
<td style="border-color: rgb(148, 148, 148); border-style: solid; border-width: 1px; height: 17px; padding: 0px 2px 2px; width: 93px;" valign="top">
<p align="center" style="margin: 0px; text-align: center;"><span style="color: black; font-family: Helvetica Neue; font-size: x-small; font-variant-ligatures: common-ligatures; font: 10px "Helvetica Neue";">64</span></p>
</td>
</tr>
<tr>
<td style="background-color: lightgrey; border-color: rgb(148, 148, 148) rgb(48, 48, 48) rgb(148, 148, 148) rgb(148, 148, 148); border-style: solid; border-width: 1px; height: 17px; padding: 0px 2px 2px; width: 93px;" valign="top">
<p align="center" style="margin: 0px; text-align: center;"><span style="color: black; font-family: Helvetica Neue; font-size: x-small; font-variant-ligatures: common-ligatures; font: 10px "Helvetica Neue";"><b>1-21-2024</b></span></p>
</td>
<td style="border-color: rgb(148, 148, 148) rgb(148, 148, 148) rgb(148, 148, 148) rgb(48, 48, 48); border-style: solid; border-width: 1px; height: 17px; padding: 0px 2px 2px; width: 93px;" valign="top">
<p align="center" style="margin: 0px; text-align: center;"><span style="color: black; font-family: Helvetica Neue; font-size: x-small; font-variant-ligatures: common-ligatures; font: 10px "Helvetica Neue";">8:40 AM</span></p>
</td>
<td style="border-color: rgb(148, 148, 148); border-style: solid; border-width: 1px; height: 17px; padding: 0px 2px 2px; width: 93px;" valign="top">
<p align="center" style="margin: 0px; text-align: center;"><span style="color: black; font-family: Helvetica Neue; font-size: x-small; font-variant-ligatures: common-ligatures; font: 10px "Helvetica Neue";"><b>142/83</b></span></p>
</td>
<td style="border-color: rgb(148, 148, 148); border-style: solid; border-width: 1px; height: 17px; padding: 0px 2px 2px; width: 93px;" valign="top">
<p align="center" style="margin: 0px; text-align: center;"><span style="color: black; font-family: Helvetica Neue; font-size: x-small; font-variant-ligatures: common-ligatures; font: 10px "Helvetica Neue";">66</span></p>
</td>
</tr>
<tr>
<td style="background-color: lightgrey; border-color: rgb(148, 148, 148) rgb(48, 48, 48) rgb(148, 148, 148) rgb(148, 148, 148); border-style: solid; border-width: 1px; height: 17px; padding: 0px 2px 2px; width: 93px;" valign="top">
<p align="center" style="margin: 0px; text-align: center;"><span style="color: black; font-family: Helvetica Neue; font-size: x-small; font-variant-ligatures: common-ligatures; font: 10px "Helvetica Neue";"><b>1-22-2024</b></span></p>
</td>
<td style="border-color: rgb(148, 148, 148) rgb(148, 148, 148) rgb(148, 148, 148) rgb(48, 48, 48); border-style: solid; border-width: 1px; height: 17px; padding: 0px 2px 2px; width: 93px;" valign="top">
<p align="center" style="margin: 0px; text-align: center;"><span style="color: black; font-family: Helvetica Neue; font-size: x-small; font-variant-ligatures: common-ligatures; font: 10px "Helvetica Neue";">9:15 AM</span></p>
</td>
<td style="border-color: rgb(148, 148, 148); border-style: solid; border-width: 1px; height: 17px; padding: 0px 2px 2px; width: 93px;" valign="top">
<p align="center" style="margin: 0px; text-align: center;"><span style="color: black; font-family: Helvetica Neue; font-size: x-small; font-variant-ligatures: common-ligatures; font: 10px "Helvetica Neue";"><b>142/87</b></span></p>
</td>
<td style="border-color: rgb(148, 148, 148); border-style: solid; border-width: 1px; height: 17px; padding: 0px 2px 2px; width: 93px;" valign="top">
<p align="center" style="margin: 0px; text-align: center;"><span style="color: black; font-family: Helvetica Neue; font-size: x-small; font-variant-ligatures: common-ligatures; font: 10px "Helvetica Neue";">68</span></p>
</td>
</tr>
<tr>
<td style="background-color: lightgrey; border-color: rgb(148, 148, 148) rgb(48, 48, 48) rgb(148, 148, 148) rgb(148, 148, 148); border-style: solid; border-width: 1px; height: 17px; padding: 0px 2px 2px; width: 93px;" valign="top">
<p align="center" style="margin: 0px; text-align: center;"><span style="color: black; font-family: Helvetica Neue; font-size: x-small; font-variant-ligatures: common-ligatures; font: 10px "Helvetica Neue";"><b>1-23-2024</b></span></p>
</td>
<td style="border-color: rgb(148, 148, 148) rgb(148, 148, 148) rgb(148, 148, 148) rgb(48, 48, 48); border-style: solid; border-width: 1px; height: 17px; padding: 0px 2px 2px; width: 93px;" valign="top">
<p align="center" style="margin: 0px; text-align: center;"><span style="color: black; font-family: Helvetica Neue; font-size: x-small; font-variant-ligatures: common-ligatures; font: 10px "Helvetica Neue";">9:30 AM</span></p>
</td>
<td style="border-color: rgb(148, 148, 148); border-style: solid; border-width: 1px; height: 17px; padding: 0px 2px 2px; width: 93px;" valign="top">
<p align="center" style="margin: 0px; text-align: center;"><span style="color: black; font-family: Helvetica Neue; font-size: x-small; font-variant-ligatures: common-ligatures; font: 10px "Helvetica Neue";"><b>148/84</b></span></p>
</td>
<td style="border-color: rgb(148, 148, 148); border-style: solid; border-width: 1px; height: 17px; padding: 0px 2px 2px; width: 93px;" valign="top">
<p align="center" style="margin: 0px; text-align: center;"><span style="color: black; font-family: Helvetica Neue; font-size: x-small; font-variant-ligatures: common-ligatures; font: 10px "Helvetica Neue";">72</span></p>
</td>
</tr>
<tr>
<td style="background-color: lightgrey; border-color: rgb(148, 148, 148) rgb(48, 48, 48) rgb(148, 148, 148) rgb(148, 148, 148); border-style: solid; border-width: 1px; height: 17px; padding: 0px 2px 2px; width: 93px;" valign="top">
<p align="center" style="margin: 0px; text-align: center;"><span style="color: black; font-family: Helvetica Neue; font-size: x-small; font-variant-ligatures: common-ligatures; font: 10px "Helvetica Neue";"><b>1-25-2024</b></span></p>
</td>
<td style="border-color: rgb(148, 148, 148) rgb(148, 148, 148) rgb(148, 148, 148) rgb(48, 48, 48); border-style: solid; border-width: 1px; height: 17px; padding: 0px 2px 2px; width: 93px;" valign="top">
<p align="center" style="margin: 0px; text-align: center;"><span style="color: black; font-family: Helvetica Neue; font-size: x-small; font-variant-ligatures: common-ligatures; font: 10px "Helvetica Neue";">8:45 AM</span></p>
</td>
<td style="border-color: rgb(148, 148, 148); border-style: solid; border-width: 1px; height: 17px; padding: 0px 2px 2px; width: 93px;" valign="top">
<p align="center" style="margin: 0px; text-align: center;"><span style="color: black; font-family: Helvetica Neue; font-size: x-small; font-variant-ligatures: common-ligatures; font: 10px "Helvetica Neue";"><b>140/72</b></span></p>
</td>
<td style="border-color: rgb(148, 148, 148); border-style: solid; border-width: 1px; height: 17px; padding: 0px 2px 2px; width: 93px;" valign="top">
<p align="center" style="margin: 0px; text-align: center;"><span style="color: black; font-family: Helvetica Neue; font-size: x-small; font-variant-ligatures: common-ligatures; font: 10px "Helvetica Neue";">68</span></p>
</td>
</tr>
<tr>
<td style="background-color: lightgrey; border-color: rgb(148, 148, 148) rgb(48, 48, 48) rgb(148, 148, 148) rgb(148, 148, 148); border-style: solid; border-width: 1px; height: 17px; padding: 0px 2px 2px; width: 93px;" valign="top">
<p align="center" style="margin: 0px; text-align: center;"><span style="color: black; font-family: Helvetica Neue; font-size: x-small; font-variant-ligatures: common-ligatures; font: 10px "Helvetica Neue";"><b>1-26-2024</b></span></p>
</td>
<td style="border-color: rgb(148, 148, 148) rgb(148, 148, 148) rgb(148, 148, 148) rgb(48, 48, 48); border-style: solid; border-width: 1px; height: 17px; padding: 0px 2px 2px; width: 93px;" valign="top">
<p align="center" style="margin: 0px; text-align: center;"><span style="color: black; font-family: Helvetica Neue; font-size: x-small; font-variant-ligatures: common-ligatures; font: 10px "Helvetica Neue";">8:30 AM</span></p>
</td>
<td style="border-color: rgb(148, 148, 148); border-style: solid; border-width: 1px; height: 17px; padding: 0px 2px 2px; width: 93px;" valign="top">
<p align="center" style="margin: 0px; text-align: center;"><span style="color: black; font-family: Helvetica Neue; font-size: x-small; font-variant-ligatures: common-ligatures; font: 10px "Helvetica Neue";"><b>136/83</b></span></p>
</td>
<td style="border-color: rgb(148, 148, 148); border-style: solid; border-width: 1px; height: 17px; padding: 0px 2px 2px; width: 93px;" valign="top">
<p align="center" style="margin: 0px; text-align: center;"><span style="color: black; font-family: Helvetica Neue; font-size: x-small; font-variant-ligatures: common-ligatures; font: 10px "Helvetica Neue";">61</span></p>
</td>
</tr>
<tr>
<td style="background-color: lightgrey; border-color: rgb(148, 148, 148) rgb(48, 48, 48) rgb(148, 148, 148) rgb(148, 148, 148); border-style: solid; border-width: 1px; height: 17px; padding: 0px 2px 2px; width: 93px;" valign="top">
<p align="center" style="margin: 0px; text-align: center;"><span style="color: black; font-family: Helvetica Neue; font-size: x-small; font-variant-ligatures: common-ligatures; font: 10px "Helvetica Neue";"><b>1-26-2024</b></span></p>
</td>
<td style="border-color: rgb(148, 148, 148) rgb(148, 148, 148) rgb(148, 148, 148) rgb(48, 48, 48); border-style: solid; border-width: 1px; height: 17px; padding: 0px 2px 2px; width: 93px;" valign="top">
<p align="center" style="margin: 0px; text-align: center;"><span style="color: black; font-family: Helvetica Neue; font-size: x-small; font-variant-ligatures: common-ligatures; font: 10px "Helvetica Neue";">5:25 PM</span></p>
</td>
<td style="border-color: rgb(148, 148, 148); border-style: solid; border-width: 1px; height: 17px; padding: 0px 2px 2px; width: 93px;" valign="top">
<p align="center" style="margin: 0px; text-align: center;"><span style="color: black; font-family: Helvetica Neue; font-size: x-small; font-variant-ligatures: common-ligatures; font: 10px "Helvetica Neue";"><b>131/79</b></span></p>
</td>
<td style="border-color: rgb(148, 148, 148); border-style: solid; border-width: 1px; height: 17px; padding: 0px 2px 2px; width: 93px;" valign="top">
<p align="center" style="margin: 0px; text-align: center;"><span style="color: black; font-family: Helvetica Neue; font-size: x-small; font-variant-ligatures: common-ligatures; font: 10px "Helvetica Neue";">56</span></p>
</td>
</tr>
<tr>
<td style="background-color: lightgrey; border-color: rgb(148, 148, 148) rgb(48, 48, 48) rgb(148, 148, 148) rgb(148, 148, 148); border-style: solid; border-width: 1px; height: 18px; padding: 0px 2px 2px; width: 93px;" valign="top">
<p align="center" style="margin: 0px; text-align: center;"><span style="color: black; font-family: Helvetica Neue; font-size: x-small; font-variant-ligatures: common-ligatures; font: 10px "Helvetica Neue";"><b>1-27-2024</b></span></p>
</td>
<td style="border-color: rgb(148, 148, 148) rgb(148, 148, 148) rgb(148, 148, 148) rgb(48, 48, 48); border-style: solid; border-width: 1px; height: 18px; padding: 0px 2px 2px; width: 93px;" valign="top">
<p align="center" style="margin: 0px; text-align: center;"><span style="color: black; font-family: Helvetica Neue; font-size: x-small; font-variant-ligatures: common-ligatures; font: 10px "Helvetica Neue";">5:00 PM</span></p>
</td>
<td style="border-color: rgb(148, 148, 148); border-style: solid; border-width: 1px; height: 18px; padding: 0px 2px 2px; width: 93px;" valign="top">
<p align="center" style="margin: 0px; text-align: center;"><span style="color: black; font-family: Helvetica Neue; font-size: x-small; font-variant-ligatures: common-ligatures; font: 10px "Helvetica Neue";"><b>134/86</b></span></p>
</td>
<td style="border-color: rgb(148, 148, 148); border-style: solid; border-width: 1px; height: 18px; padding: 0px 2px 2px; width: 93px;" valign="top">
<p align="center" style="margin: 0px; text-align: center;"><span style="color: black; font-family: Helvetica Neue; font-size: x-small; font-variant-ligatures: common-ligatures; font: 10px "Helvetica Neue";">61</span></p>
</td>
</tr>
<tr>
<td style="background-color: lightgrey; border-color: rgb(148, 148, 148) rgb(48, 48, 48) rgb(148, 148, 148) rgb(148, 148, 148); border-style: solid; border-width: 1px; height: 17px; padding: 0px 2px 2px; width: 93px;" valign="top">
<p align="center" style="margin: 0px; text-align: center;"><span style="color: black; font-family: Helvetica Neue; font-size: x-small; font-variant-ligatures: common-ligatures; font: 10px "Helvetica Neue";"><b>1-27-2024</b></span></p>
</td>
<td style="border-color: rgb(148, 148, 148) rgb(148, 148, 148) rgb(148, 148, 148) rgb(48, 48, 48); border-style: solid; border-width: 1px; height: 17px; padding: 0px 2px 2px; width: 93px;" valign="top">
<p align="center" style="margin: 0px; text-align: center;"><span style="color: black; font-family: Helvetica Neue; font-size: x-small; font-variant-ligatures: common-ligatures; font: 10px "Helvetica Neue";">5:30 PM</span></p>
</td>
<td style="border-color: rgb(148, 148, 148); border-style: solid; border-width: 1px; height: 17px; padding: 0px 2px 2px; width: 93px;" valign="top">
<p align="center" style="margin: 0px; text-align: center;"><span style="color: black; font-family: Helvetica Neue; font-size: x-small; font-variant-ligatures: common-ligatures; font: 10px "Helvetica Neue";"><b>130/84</b></span></p>
</td>
<td style="border-color: rgb(148, 148, 148); border-style: solid; border-width: 1px; height: 17px; padding: 0px 2px 2px; width: 93px;" valign="top">
<p align="center" style="margin: 0px; text-align: center;"><span style="color: black; font-family: Helvetica Neue; font-size: x-small; font-variant-ligatures: common-ligatures; font: 10px "Helvetica Neue";">61</span></p>
</td>
</tr>
<tr>
<td style="background-color: lightgrey; border-color: rgb(148, 148, 148) rgb(48, 48, 48) rgb(148, 148, 148) rgb(148, 148, 148); border-style: solid; border-width: 1px; height: 17px; padding: 0px 2px 2px; width: 93px;" valign="top">
<p align="center" style="margin: 0px; text-align: center;"><span style="color: black; font-family: Helvetica Neue; font-size: x-small; font-variant-ligatures: common-ligatures; font: 10px "Helvetica Neue";"><b>1-29-2024</b></span></p>
</td>
<td style="border-color: rgb(148, 148, 148) rgb(148, 148, 148) rgb(148, 148, 148) rgb(48, 48, 48); border-style: solid; border-width: 1px; height: 17px; padding: 0px 2px 2px; width: 93px;" valign="top">
<p align="center" style="margin: 0px; text-align: center;"><span style="color: black; font-family: Helvetica Neue; font-size: x-small; font-variant-ligatures: common-ligatures; font: 10px "Helvetica Neue";">9:00 AM</span></p>
</td>
<td style="border-color: rgb(148, 148, 148); border-style: solid; border-width: 1px; height: 17px; padding: 0px 2px 2px; width: 93px;" valign="top">
<p align="center" style="margin: 0px; text-align: center;"><span style="color: black; font-family: Helvetica Neue; font-size: x-small; font-variant-ligatures: common-ligatures; font: 10px "Helvetica Neue";"><b>124/70</b></span></p>
</td>
<td style="border-color: rgb(148, 148, 148); border-style: solid; border-width: 1px; height: 17px; padding: 0px 2px 2px; width: 93px;" valign="top">
<p style="font: 12px Helvetica; margin: 0px; min-height: 14px;"><br /></p>
</td>
</tr>
<tr>
<td style="background-color: lightgrey; border-color: rgb(148, 148, 148) rgb(48, 48, 48) rgb(148, 148, 148) rgb(148, 148, 148); border-style: solid; border-width: 1px; height: 17px; padding: 0px 2px 2px; width: 93px;" valign="top">
<p align="center" style="margin: 0px; text-align: center;"><span style="color: black; font-family: Helvetica Neue; font-size: x-small; font-variant-ligatures: common-ligatures; font: 10px "Helvetica Neue";"><b>1-30-2024</b></span></p>
</td>
<td style="border-color: rgb(148, 148, 148) rgb(148, 148, 148) rgb(148, 148, 148) rgb(48, 48, 48); border-style: solid; border-width: 1px; height: 17px; padding: 0px 2px 2px; width: 93px;" valign="top">
<p align="center" style="margin: 0px; text-align: center;"><span style="color: black; font-family: Helvetica Neue; font-size: x-small; font-variant-ligatures: common-ligatures; font: 10px "Helvetica Neue";">7:55 AM</span></p>
</td>
<td style="border-color: rgb(148, 148, 148); border-style: solid; border-width: 1px; height: 17px; padding: 0px 2px 2px; width: 93px;" valign="top">
<p align="center" style="margin: 0px; text-align: center;"><span style="color: black; font-family: Helvetica Neue; font-size: x-small; font-variant-ligatures: common-ligatures; font: 10px "Helvetica Neue";"><b>139/81</b></span></p>
</td>
<td style="border-color: rgb(148, 148, 148); border-style: solid; border-width: 1px; height: 17px; padding: 0px 2px 2px; width: 93px;" valign="top">
<p align="center" style="margin: 0px; text-align: center;"><span style="color: black; font-family: Helvetica Neue; font-size: x-small; font-variant-ligatures: common-ligatures; font: 10px "Helvetica Neue";">64</span></p>
</td>
</tr>
<tr>
<td style="background-color: lightgrey; border-color: rgb(148, 148, 148) rgb(48, 48, 48) rgb(148, 148, 148) rgb(148, 148, 148); border-style: solid; border-width: 1px; height: 17px; padding: 0px 2px 2px; width: 93px;" valign="top">
<p align="center" style="margin: 0px; text-align: center;"><span style="color: black; font-family: Helvetica Neue; font-size: x-small; font-variant-ligatures: common-ligatures; font: 10px "Helvetica Neue";"><b>1-30-2024</b></span></p>
</td>
<td style="border-color: rgb(148, 148, 148) rgb(148, 148, 148) rgb(148, 148, 148) rgb(48, 48, 48); border-style: solid; border-width: 1px; height: 17px; padding: 0px 2px 2px; width: 93px;" valign="top">
<p align="center" style="margin: 0px; text-align: center;"><span style="color: black; font-family: Helvetica Neue; font-size: x-small; font-variant-ligatures: common-ligatures; font: 10px "Helvetica Neue";">7:25 PM</span></p>
</td>
<td style="border-color: rgb(148, 148, 148); border-style: solid; border-width: 1px; height: 17px; padding: 0px 2px 2px; width: 93px;" valign="top">
<p align="center" style="margin: 0px; text-align: center;"><span style="color: black; font-family: Helvetica Neue; font-size: x-small; font-variant-ligatures: common-ligatures; font: 10px "Helvetica Neue";"><b>129/74</b></span></p>
</td>
<td style="border-color: rgb(148, 148, 148); border-style: solid; border-width: 1px; height: 17px; padding: 0px 2px 2px; width: 93px;" valign="top">
<p align="center" style="margin: 0px; text-align: center;"><span style="color: black; font-family: Helvetica Neue; font-size: x-small; font-variant-ligatures: common-ligatures; font: 10px "Helvetica Neue";">72</span></p>
</td>
</tr>
<tr>
<td style="background-color: lightgrey; border-color: rgb(148, 148, 148) rgb(48, 48, 48) rgb(148, 148, 148) rgb(148, 148, 148); border-style: solid; border-width: 1px; height: 17px; padding: 0px 2px 2px; width: 93px;" valign="top">
<p align="center" style="margin: 0px; text-align: center;"><span style="color: black; font-family: Helvetica Neue; font-size: x-small; font-variant-ligatures: common-ligatures; font: 10px "Helvetica Neue";"><b>1-31-2024</b></span></p>
</td>
<td style="border-color: rgb(148, 148, 148) rgb(148, 148, 148) rgb(148, 148, 148) rgb(48, 48, 48); border-style: solid; border-width: 1px; height: 17px; padding: 0px 2px 2px; width: 93px;" valign="top">
<p align="center" style="margin: 0px; text-align: center;"><span style="color: black; font-family: Helvetica Neue; font-size: x-small; font-variant-ligatures: common-ligatures; font: 10px "Helvetica Neue";">5:35 PM</span></p>
</td>
<td style="border-color: rgb(148, 148, 148); border-style: solid; border-width: 1px; height: 17px; padding: 0px 2px 2px; width: 93px;" valign="top">
<p align="center" style="margin: 0px; text-align: center;"><span style="color: black; font-family: Helvetica Neue; font-size: x-small; font-variant-ligatures: common-ligatures; font: 10px "Helvetica Neue";"><b>129/74</b></span></p>
</td>
<td style="border-color: rgb(148, 148, 148); border-style: solid; border-width: 1px; height: 17px; padding: 0px 2px 2px; width: 93px;" valign="top">
<p align="center" style="margin: 0px; text-align: center;"><span style="color: black; font-family: Helvetica Neue; font-size: x-small; font-variant-ligatures: common-ligatures; font: 10px "Helvetica Neue";">58</span></p>
</td>
</tr>
</tbody>
</table>
<p style="margin-bottom: 0in;"> </p><p style="margin-bottom: 0in;">
</p><p style="margin-bottom: 0in;">And not only that – when I went to
work out, I got my maximum heart rate to up 151, which is exactly
what my max ought to be for my age. I figure I was under toxic salt
syndrome (which I just named.) How amazing is that?!</p>
<p style="margin-bottom: 0in;">So then I went to Berkeley Bowl, our
local supermarket that caters to discriminating customers, and I was
able to find many low-salt items – canned tomatoes with zero salt,
canned beans with almost no salt, lots of things. Plus their usual
amazing selection of fresh produce.</p>
<p style="margin-bottom: 0in;">So there it is, that's the post. I'll
have to change my diet, but who knows what other good doing that will
do? You just can't go wrong with fresh fruits and vegetables. Now,
to figure out how to make soups with no salt – Insta-Pot, gifted to
me by Sara a year ago, here I come!</p>
<p style="margin-bottom: 0in;">Sitting down and talking with your
doctor really has no good substitute, in my opinion. But then, I'm
an over-reactor. But over-reactors need care, too.</p>
<p style="margin-bottom: 0in;"><br />
</p>
<p style="margin-bottom: 0in;">Budd Shenkin</p>
<p style="margin-bottom: 0in;"><style type="text/css">P { margin-bottom: 0.08in }</style> <br /></p>
<p><style type="text/css">P { margin-bottom: 0.08in }</style></p>Buddhttp://www.blogger.com/profile/03893224951099943306noreply@blogger.com1tag:blogger.com,1999:blog-8705432279177203509.post-26090224559634116172024-01-14T19:09:00.000-08:002024-01-14T19:09:44.173-08:00Democrat, Republican or Independent? Friendly Debate<p>
</p><p align="LEFT" style="font-weight: normal; margin-bottom: 0in;">I have
some friends who are frustrated with party politics. Here is what
they and I write to each other:</p>
<p align="LEFT" style="font-weight: normal; margin-bottom: 0in;"><br />
</p>
<p align="LEFT" style="font-weight: normal; margin-bottom: 0in;"><u>Friend
One</u></p>
<p align="LEFT"><span style="color: #4472c4;"><span style="font-family: Arial, sans-serif;"><span style="font-size: small;"><span style="font-weight: normal;">It’s
remarkable that 43% of Americans identify as independent, while only
27% identify with R’s and another 27% for D’s – a new low for
D’s. As a card-carrying independent, I applaud the steady
growth of rejection of both these miserable parties whose time has
long gone. The Republicans have lost all semblance of conservative
principle and are held hostage by neanderthal nihilists on the right;
the Dems are awash in identity politics and woke insanity, and still
absurdly believe – despite all evidence to the contrary – that
government can offer effective solutions to all our social ills.
Both parties are craven and amoral, self-absorbed liars who wallow in
a broken system.</span></span></span></span></p>
<p><span style="color: #4472c4;"><span style="font-family: Arial, sans-serif;"><span style="font-size: small;">And
yet, when nearly half of America is ready to reject them and vote
independent, who do we get to vote for? RFK Jr.</span></span></span></p><p><span style="color: #4472c4;"><span style="font-family: Arial, sans-serif;"><span style="font-size: small;"> </span></span></span></p>
<p align="LEFT" style="font-weight: normal; margin-bottom: 0in;"><u>Friend
Two</u></p>
<p align="LEFT" style="font-weight: normal; margin-bottom: 0in;">Thank
you for the realistic view of our parties today. And it ain’t no
party!</p>
<p style="margin-bottom: 0in;">I am still a registered Democrat
although I have identified as an independent for >20 years. I
share your views. I too am waiting for an independent candidate that
I can support.</p>
<p style="margin-bottom: 0in;"><br />
</p>
<p style="margin-bottom: 0in;">But I feel differently, so here is what
I wrote back to them:</p>
<p style="margin-bottom: 0in;"><br />
</p>
<p style="margin-bottom: 0in;"><u>Me</u></p>
<p style="margin-bottom: 0in;"><u><img align="BOTTOM" border="0" height="80" name=":od" src="https://lh3.googleusercontent.com/a/ACg8ocLxcIbPNNriFN7mPK3aQI0ycUKMqD1hIpdwE6sYjHVxBGo=s80-p" width="80" /></u></p>
<p style="margin-bottom: 0in;"><br />
</p>
<p style="margin-bottom: 0in;"><span style="color: #000099;"><span style="font-family: tahoma, sans-serif;">I
don't feel the same way. I'm a Democrat and always have been.</span></span></p>
<div dir="LTR" id=":14e">
<div dir="LTR" id=":14f">
<p style="margin-bottom: 0in;"><span style="color: #000099;"><span style="font-family: tahoma, sans-serif;">It's
useless to talk about the Republican Party. I never liked
them, even when they were a decent party. They have always
been the rich man's party, the country club party, the
penny-pinching party, and in the past the anti-Semitic party, and
they may be still, those of the old party that are left. I
like the old Mort Sahl line, What's a liberal Republican?
They're for change, just not now. And now, those old me-first
Republican stick in the muds, the help yourself don't look to me to
help Republicans, are far too liberal for the party that has
essentially been body-snatched. It's like when SBC bought ATT
and took the name, because SBC had a bad reputation.</span></span></p>
<p style="margin-bottom: 0in;"><span style="color: #000099;"><span style="font-family: tahoma, sans-serif;">The
Democratic Party has a much better heritage, especially since FDR.
FDR - tripling down on his cousin TR - thought that government
should help people, not call balls and strikes. His Four
Freedoms rang true. One or two of you might remember my paeon
to the Four Freedoms --
<a href="https://buddshenkin.blogspot.com/2021/03/finding-unity-four-freedoms-plus-two.html" target="_blank">https://buddshenkin.blogspot.com/2021/03/finding-unity-four-freedoms-plus-two.html</a>.
In the great questions of the day,the Democratic party has
generally been on the right side. They get a bad rap on
defense -- they are not willing to kowtow to the generals, but they
have always been strong. I could go on about the virtues of
their heritage.</span></span></p>
<p style="margin-bottom: 0in;"><span style="color: #000099;"><span style="font-family: tahoma, sans-serif;">Has
the extreme Left bodysnatiched the Dems? No. It's a
varied party, as you have to be in a two party system, and putting
together alliances is always tough. I admire AOC, but not so
much her chosen lefties, some of which are horrible. The
Black caucus is a problem, whose anti-Semitism is beyond
criticism. I find some of them really irritating, and the
identity politics that Rick cites is awful, just awful. But
the bulk of the party has the right attitude and the right tilt.</span></span></p>
<p style="margin-bottom: 0in;"><span style="color: #000099;"><span style="font-family: tahoma, sans-serif;">Have
government programs failed? Not really. The best ones
are those that write checks -- social security, Medicare,
Medicaid. Where would we be without them? What about
nutrition programs for the poor? So many others.
Government can't offer solutions for all social ills, of course
that's true. I don't know who believes that it can. But
it already does so much, and could do so much more if given a
chance. If you look at the social welfare democracies of
Europe, especially Scandinavia, you can see how a government can
lift up a whole country over time. Sweden was known as Poor
Sweden, until the Social Democrats took over about 100 years ago.
Now they are world leaders in a country not blessed with many
natural resources.</span></span></p>
<p style="margin-bottom: 0in;"><span style="color: #000099;"><span style="font-family: tahoma, sans-serif;">Is
bureaucracy a failure? Often, in this country. Can it
be stupid and stultifying and frustrating? In spades.
The trick is to devise programs and policies that avoid large
bureaucracies, or that decentralize enough so that there can be
competition within government. I think, for instance,
that Medicare should split up into smaller units to administer the
program, and compete against each other. That's a question of
design, and there are many others.</span></span></p>
<p style="margin-bottom: 0in;"><span style="color: #000099;"><span style="font-family: tahoma, sans-serif;">In
a two-party system, in many ways it makes more sense to choose the
party instead of the individual candidate. We all love the
great legislators, but when push comes to shove, would you rather
have a pretty good Republican or an average Democrat? It's
the vote that counts. There will always be leaders and
followers in organizations, and the House and the Senate are
organizations. Overall, much as I detest her personally
(can't say why, exactly) and vote against her in every election,
it's better to have Barbara Lee in the House than any Republican
that runs against her, no matter how great, because it's their
votes that count. Want a great Republican thinker (there must
be some) who votes with Marjory Taylor Green on every vote?
What good is that? Unless the Republican you elect is leading
a group to a new Republican party and is willing to vote
independently, a vote for any Republican is a vote for the
body-snatched party, a vote for Trump and his acolytes. </span></span>
</p>
<p style="margin-bottom: 0in;"><span style="color: #000099;"><span style="font-family: tahoma, sans-serif;">Parties
serve a function in our democracy. I find much to criticize
in the Democratic party, and not just on the radical left (which,
given the conservative structure and function of politics in this
country, would be center or center left abroad). I decry
their gerontocracy, their suppression of competitive primary
elections, etc. But without them, we would live in chaos.
If there were more parties than two, we would soon be subject to
the same woes of other countries like Israel, where a small swing
faction gets to have its way.</span></span></p>
<p style="margin-bottom: 0in;"><span style="color: #000099;"><span style="font-family: tahoma, sans-serif;">And
that's the way it is.</span></span></p>
<p style="margin-bottom: 0in;"><span style="color: #000099;"><span style="font-family: tahoma, sans-serif;">Budd</span></span></p>
</div>
</div>
<p style="margin-bottom: 0in;"><br />
</p>
<p align="LEFT" style="font-weight: normal; margin-bottom: 0in;"><u>Friend
One</u></p>
<p align="LEFT" style="margin-bottom: 0in;"><br />
</p>
<div dir="LTR" id=":uf">
<div dir="LTR" id=":pm">
<p><span style="font-family: Arial, sans-serif;"><span style="font-size: small;"><span lang="en-US">As
always, it’s a delight to read your thoughts, Budd. Much of what
you say is persuasive, and all of it is so forcefully and
mellifluously presented!</span></span></span></p>
<p><span style="font-family: Arial, sans-serif;"><span style="font-size: small;"><span lang="en-US">Just
a few points in reply, please.</span></span></span></p>
<p><span style="font-family: Arial, sans-serif;"><span style="font-size: small;"><span lang="en-US">First,
it’s telling to me that, when you talk about the Democratic
party, you’re somewhat forced to look way into history,
rightfully extolling the pedigree that FDR (and TR before him) laid
down. I share your deep admiration for both of them, but that’s
almost a century ago. It has limited relevance, in my view, to
those who populate the party today. Yes, the Dems have long been
the party of compassion, but I see woke culture – which permeates
not only politics, but almost every aspect of modern life – to be
the antithesis of respect, tolerance, inclusion and the celebration
of diversity (in all its aspects). Today’s Democratic Party is
awash in identity politics, and you acknowledge all the baggage
that comes with it: racism/anti-racism, antisemitism, character
assassination, mob rule, the dumbing down of academic standards,
the polarization of our society. I know you see all that’s
wrong with this party today – you say so – so I won’t go on
and on. </span></span></span>
</p>
<p><span style="font-family: Arial, sans-serif;"><span style="font-size: small;"><span lang="en-US">Ironically,
the best argument for the Democratic Party right now, in my view,
is the job Joe Biden has done as President. He gets little credit
for it, and the overwhelming view – of all Americans – is that
he should not run again. But his presidency has been remarkably
strong, in both domestic and foreign policy. </span></span></span>
</p>
<p><span style="font-family: Arial, sans-serif;"><span style="font-size: small;"><span lang="en-US">The
real question is, where are the visionary, talented Democrats who
are leading the party to a better future, post-Biden? I submit that
they are nowhere: not my pal Cory Booker, who has about as much
support within the party as my dog, Ollie; not Gretchen Whitmer,
who ought to be their candidate for President, but no one in the
party had the balls to try to make that happen. Not Pete Buttigieg,
who has disappeared altogether within the Biden Administration. And
certainly not Kamala Harris, the heir apparent who is rightfully
loathed and disrespected by everyone in the United States, in both
parties.</span></span></span></p>
<p><span style="font-family: Arial, sans-serif;"><span style="font-size: small;"><span lang="en-US">So
I don’t hold the brief for the Democrats that you do. (Being an
independent in Maryland is pretty comfortable: we have plenty of
good Republicans to vote for on occasion, like former Senator Mac
Mathias, former Governor Larry Hogan, former Congresswoman Connie
Morella, along with many great Democrats like current Governor Wes
Moore, both our US Senators and Rep. Jamie Raskin.) </span></span></span></p>
<p><span style="font-family: Arial, sans-serif;"><span style="font-size: small;"><span lang="en-US">In
general, we agree completely about the Republican Party. No
discussion needed there.</span></span></span></p>
</div>
</div>
<p align="LEFT" style="font-weight: normal; margin-bottom: 0in;"><br />
</p>
<p align="LEFT" style="font-weight: normal; margin-bottom: 0in;"><u>Me</u></p>
<p align="LEFT" style="margin-bottom: 0in;"><span style="text-decoration: none;"><img align="BOTTOM" border="0" height="80" name="graphics1" src="https://lh3.googleusercontent.com/a/ACg8ocLxcIbPNNriFN7mPK3aQI0ycUKMqD1hIpdwE6sYjHVxBGo=s80-p" width="80" /></span></p>
<div dir="LTR" id=":1cc">
<div dir="LTR" id=":1cd">
<p style="margin-bottom: 0in;"><span style="color: #000099;"><span style="font-family: tahoma, sans-serif;">Thanks,
as always, for the compliment!! Warms my heart and my
figurative pen.</span></span></p>
<p style="margin-bottom: 0in;"><span style="color: #000099;"><span style="font-family: tahoma, sans-serif;">The
greatest sin of the Democratic party is not to provide for the
future. The best companies identify, recruit, nurture, and
promote talent, and meld all the talent into teams that produce and
provide for the future. The Democratic party hardly does this
at all. There's lots of work we don't see -- candidate
recruitment, for instance. But the talent that's there gets
crushed under committee chairs who stay forever -- in contrast to
the Republicans, by the way, who term out chairs. And they
don't sunset. And they don't have ways to bring governors
into national spotlight, as they could by having commissions to
approach problems, for instance, composed of governors, cabinet
officials, leading legislators. It's a severe organizational
problem.</span></span></p>
<p style="margin-bottom: 0in;"><span style="color: #000099;"><span style="font-family: tahoma, sans-serif;">Our
era has been conservative, ever since 1980. Even the Clinton
presidency championed neoliberalism, conferring further impetus to
inequality. The lack of caring for the middle, working, and
lower classes has been a hallmark of these YOYO years, even with
Clinton. Instead of real programs and tax policies to help
those classes, we have devolved into minority care, with Hillary
nearly running out of breath as she listed the minority groups her
administration would help. It's a mark of progress that Biden
talks more about helping ordinary people in general. One idea
he took up, but which the Republicans have let lapse, was Rosa
DeLauro's child tax allowance, which lifted about half the children
in poverty out of it. He also has been trying to revivify
anti-trust, as Bork and the Chicago School and the Republicans have
allowed concentration of business entities to run rampant, even
giving them the rights of citizens in elections, as we know.</span></span></p>
<p style="margin-bottom: 0in;"><span style="color: #000099;"><span style="font-family: tahoma, sans-serif;">So,
given that conservative environment, we can't point to big wins as
in the previous era. In fact, just look at tax policy, and we
can point to big losses. But I have confidence, perhaps
misplaced, that eras change, and given enough time in power, the
Democrats would regain their senses and concentrate on lifting all
boats. After all, it's their legacy, and enough believe in it
that I think it would reassert itself, given the right
environment. And as in the late 1930's, a major obstacle
would be a recalcitrant SCOTUS, that will have to be neutered
somehow, someway.</span></span></p>
<p style="margin-bottom: 0in;"><span style="color: #000099;"><span style="font-family: tahoma, sans-serif;">And
I would be remiss if I didn't mention that it is even possible,
given some longevity of Democratic governance, that Modern Monetary
Theory will be given a good test! And that we will find
governmental policies to help us transition to a new society where
increased productivity is translated into increased leisure and
security for all. And where climate becomes a #1 priority.</span></span></p>
<p style="margin-bottom: 0in;"><span style="color: #000099;"><span style="font-family: tahoma, sans-serif;">Dreams
are the salvation of life.</span></span></p>
<p style="margin-bottom: 0in;"><span style="color: #000099;"><span style="font-family: tahoma, sans-serif;">Budd</span></span></p><p style="margin-bottom: 0in;"><span style="color: #000099;"><span style="font-family: tahoma, sans-serif;"> </span></span></p><p style="margin-bottom: 0in;"><span style="color: #000099;"><span style="font-family: tahoma, sans-serif;">Talking with friends is one of the great pleasures of life.</span></span></p><p style="margin-bottom: 0in;"><span style="color: #000099;"><span style="font-family: tahoma, sans-serif;"> </span></span></p><p style="margin-bottom: 0in;"><span style="color: #000099;"><span style="font-family: tahoma, sans-serif;">Budd Shenkin <br /></span></span></p>
</div>
</div>
<p align="LEFT" style="font-weight: normal; margin-bottom: 0in;"><br />
</p>
<p><style type="text/css">P { margin-bottom: 0.08in }A:link { so-language: zxx }</style></p>Buddhttp://www.blogger.com/profile/03893224951099943306noreply@blogger.com0tag:blogger.com,1999:blog-8705432279177203509.post-52921341088753982422024-01-06T16:37:00.000-08:002024-01-11T10:45:53.979-08:00Is It Reasonable To Focus On Biden's Age?<p>Is President Biden too old to be running for a second term? You might think so – 81 is a big number, with 85 looming 4 years later. On the other hand, you might be wrong.<br /><br />As a physician, I’m used to looking at risk factors. Being old is just a risk factor, just as being heavy is a risk for diabetes, or getting sunburned frequently is a risk for melanoma. You’re at risk, but you may have it and you may not. So we see the risk and we test for it. <br /><br />What is the risk for being old? There is a dreadful stereotype of an “old man,” someone who dodders with a frail body, weak memory, depleted energy, compromised reasoning ability, someone who lives in the past and is liable to collapse at any time. Let’s call that Type 1 — it exists, but it is not inevitable, just because you’re old.<br /><br />There is also a Type 2 old man, an “old fox.” He might be a seasoned leader who resists the impulses of the moment, whose patient judgement weighs alternatives and possible consequences, whose experience enables him to make government work, who knows the people and the terrain of the country and the world, whose years have earned him wisdom. Think “greatness of spirit” rather than “old and broken.” Think secure and clever and wise. As Ronald Reagan put it in 1984, “I think it was Seneca but it might have been Cicero who said, if it were not for the elders correcting the mistakes of the young, we would have no state.” Especially nowadays, in the age of modern medicine, it is increasingly likely that a man of 80 might be this Type 2.<br /><br />So, just as we observe Biden, is he Type 1 or Type 2?<br /><br />His stiff walking posture probably betrays some spinal arthritis, which does not interfere with doing the job. But his health seems excellent otherwise, and there are no reports and no evidence of mental decline. In fact, his presidency has been the most productive since LBJ, his schedule is more rigorous than George W. Bush’s was, and he travels extensively and meets all over the world. It’s true that he stumbles over words, but that is nothing new for someone with a history of stuttering.<br /><br />In short, the evidence we have points to Biden as being Type 2, someone who has grown with age, rather than shrunk.<br /><br />It’s true, however, that illness can come quickly to an older person. It is also true, however, that bad things can happen suddenly to younger persons as well — think JFK. After the Kennedy assassination, Congress passed the 25th Amendment, providing a procedure for replacing an ailing President, whether they recognize it themselves, or whether it is the decision of the Vice President and a majority of the Cabinet. Beyond that, staff and advisors function as teammates, supporting and supplementing when health problems arise. The procedures to take when a President is ailing are there, even though it can be admittedly difficult to administer them.<br /><br />In addition, we should also think about this - is it reasonable to center our concern on Biden's age, above other considerations? Yes, there are risks to age, but think of all the other risks that we have with presidential candidates. Think of everything that can go wrong when you hire someone. There is alcoholism, depression, anxiety, sleep deprivation, delusions, sociopathy, corruption, chronic anger. Indeed, a candidate might be quite literally crazy. There is lack of good intelligence, bad work habits, laziness, dishonesty, lying, ties to foreign powers, prejudice. What about the ability to think through problems, to build a team? What about breadth of knowledge, a tendency to make a country more peaceful rather than more contentious, knowledge of government operations, executive experience and ability?</p><p></p><p>Age is but one factor among many, and to focus on that one factor and to ignore the other risks seems unreasonable. Biden seems to have evaded the bad consequences of aging and has garnered the positives. Like a well worn shoe, Biden is a known quantity who has proven reliable and effective, even surprisingly so. We should judge the man by his abilities and his character and his
history and the fact that he is Type 2 older person who has gained
wisdom, not one who has withered.<br /><br />The odds are, Biden will still be driving his Corvette wearing his aviators when the next President is sworn in, in 2028.</p><p> </p><p>Budd Shenkin</p><p> </p><p><i>Note - a form of this post appeared as an op ed in the San Jose Mercury News on January 11, 2024 -- I thank David Levine for his editorial help, as always.<br /></i></p><p><i>https://www.mercurynews.com/2024/01/11/opinion-is-it-reasonable-to-be-concerned-about-president-bidens-age/</i> <br /></p><p> <br /></p>Buddhttp://www.blogger.com/profile/03893224951099943306noreply@blogger.com0tag:blogger.com,1999:blog-8705432279177203509.post-88342054088459581992023-12-22T21:27:00.000-08:002023-12-22T21:27:43.810-08:00Integrity vs. Despair<p>
</p><p style="margin-bottom: 0in;">I've been pretty unconscious about it.
Since I've passed 80, unimaginably and contrary to all expectations –
mine, anyway – and since my wife has passed on – unexpectedly,
despite her long illness, I never expected her to die on me – since
I've passed 80 and I'm living alone, although I have friends and
family I retire to our house where I am alone with my computer and my
television and my refrigerator and several bathrooms, I now proceed
through each day with some idea of where I'm going, what tasks to
accomplish every day, because I do insist on accomplishing something
everyday of either urgent or long-term implications, even if it's
just putting some stuff in order that I've been wanting to do, and I
don't plan a lot of the rest of what I do. It just kind of happens,
in a way, although it all seems purposeful.</p>
<p style="margin-bottom: 0in;">So it seems I'm seeking my past and in
a way stitching it together, not respecting time very much at all.
I'm reaching back to the different parts of my past, the people in my
past, and some of my past activities. My past activities seem to be
centered on my pursuit of learning and my school days. I take
French, study it each day, read French books and love it, I lie in my
bed and read and underline and I study French on my computer and I
write little notes like this, and I write a chapter of my French
novel each week – up to chapter 286 this week. I love my
characters in the novel. Who would have thought that that's what I
would do?</p>
<p style="margin-bottom: 0in;">And now I take advantage of my own and
my contemporaries' longevity and the abolition of long-distance
charges, reminding me how much of a curse AT&T was, years of high
charges and stagnation. It's actually amazing. My past is studded
with friends who still exist and who will still talk to me or write
to me. My oldest friend is my brother Bobby whom I have known since
I was 2 years 8 months old, although I don't remember when we met;
according to me, he was just always there, a little bit smaller than
me. Then there's Bob Levin, from kindergarten, John Raezer from
nursery school originally, and then he was my high school friend
where he was a God and then roommates in college and friends ever
since. My high school friends, a bunch of them, Lynn Sherr whom I
love to introduce as my friend for the last 65 years, Jonny Fish who
lives nearby and Jon Gross from fifth through 8<sup>th</sup> grade
and then high school, and my med school friends, lots of them now,
and Tom Uridel and Jim Perrin from the Public Health Service, and so
many more contemporary friends from practice from the neighborhood
from book club from our new friends in Maui and so much more.
</p>
<p style="margin-bottom: 0in;">It's like jewels on a belt of time that
you can lie out flat and see the periods, and rub whichever jewel you
want, or roll it up and then the different times are right beside
each other.</p>
<p style="margin-bottom: 0in;">They say that you take stock of
yourself at my age.
</p>
<p lang="en-US" style="margin-bottom: 0in;"><span style="color: #2b00fe; font-size: x-small;"><i>Integrity
vs. Despair – <span lang="en">According to Erikson, the last
psychosocial stage is </span><span lang="en"><b>Integrity vs.</b></span><span lang="en">
</span><span lang="en"><b>Despair</b></span><span lang="en">. This
stage includes, “a retrospective accounting of one's life to date;
how much one embraces life as having been well lived, as opposed to
regretting missed opportunities,” (Erikson, 1982, p. 112).</span></i></span></p>
<p style="margin-bottom: 0in;">So you do, or at least so I do, but
it's not as serious as all that, and it's not mournful – well,
maybe a little – it's more grateful than that. It would be even
better if I could revisit the women in my life – I wonder what
happened to those women friends in Sweden, when I was so desirable
but so confused, but also very fulfilled. I'd love to see them
again. I really should go back there and visit Annika, although I'm
lacking an invitation.</p>
<p style="margin-bottom: 0in;">But what I wanted to mention was the
conversation that I had a few days a with John Wesley, a friend from
Leverett House in college and from med school. I called him out of
the blue – why not? I have his number in my contact list and, as I
said, calls are free these days, amazingly, and we have the
equivalent of Dick Tracy's wristwatch radio, called a cell phone. I
talked to one of my college roommates, Arthur Freeman, last week, he
just up and called me, on Raezer's urging. We talked for an hour and
45 minutes, picking up where we left off, although it's been about 60
years. We had to catch up.</p>
<p style="margin-bottom: 0in;">But in talking to Wesley, he reminisced
about being a resident in surgery at the Mass General and his fellow
resident was John Erdman, another friend from college and med school
both, who committed suicide as a young doctor. There are various
theories, I guess, and I don't know the facts, really. I did hear he
plugged himself into an IV and infused something fatal as he lay on a
gurney. But the story John told, with a humorous lilt in his voice,
strangely, was how their chief resident demeaned John in front of all
the assembled residents for not knowing some basic data, the
hematocrit, of one of his patients. He said something about “Sweet
baby Jesus” having a task for everyone and if everyone doesn't do
it then it doesn't get done. A public putdown. John thought it was
charming and funny, somehow. But I can imagine the emotion Erdman
must have had, and the fact that he later did himself in, and I can't
help but connect them, and I can't help but think of the inhumanity
of the hospital setting for trainees, just when the tension is so
great and the relief and support so needed. I remember the small
provocations I experienced. I think of what my med school friend
Larry Kadish just related last week in our Humanistic Medicine
Initiative discussion, when he was serving a medicine rotation as a
resident and a new patient was admitted from the ER and turned up on
the ward dead. Here's the way Larry put it:</p>
<p style="margin-bottom: 0in;"><span style="color: #000099;"><i>Although I had
a surgical internship, every surgeon in our program had 2 months of
medical rotation. My rotation in medicine started July 1st. My
first patient had an MI and was sent to the medical floor from the
ER. I examined him as soon as he arrived, but he was dead.
After informing the family, I called the second year resident to
inform him. He said I was lucky to have a Q-C. I should
go to bed. A Q-C was a quick cool. So much for humanistic
values.</i></span></p>
<p style="font-style: normal; margin-bottom: 0in;"><span style="color: black;">I
guess that qualifies as taking stock of myself, or ourselves. I
figure that our HMI, seeking to help students appreciate and solidify
humanistic medical values and activities, is part of reassessment,
taking account, and then doing what parents do when they lose a
child, try to prevent others from suffering our fate if it can be
avoided. Look back and repair, if not for yourself (time's arrow
takes care of that), then for others. In our case, help the current
students to at least understand the pressures they will be under to
lose their humanity as they become professionals. </span>
</p>
<p style="font-style: normal; margin-bottom: 0in;"><span style="color: black;">But
it's not all grim, unless I dwell on my failures and embarrassments,
which are so many. But I do have my strengths, which might be
overrated, but it's pretty amazing how time has continued, and how I
can make a claim to a successful life, even in terms of helping
others, which I suspect of conventionality. But there it is.</span></p>
<p style="font-style: normal; margin-bottom: 0in;"><span style="color: black;">I
guess it's no sin to be conventional.</span></p>
<p style="font-style: normal; margin-bottom: 0in;"><span style="color: black;">Budd
Shenkin</span></p>
<p><style type="text/css">P { margin-bottom: 0.08in }</style></p>Buddhttp://www.blogger.com/profile/03893224951099943306noreply@blogger.com0tag:blogger.com,1999:blog-8705432279177203509.post-16834526690820448532023-12-01T10:20:00.000-08:002023-12-01T10:20:01.928-08:00Newsom Could Sharpen His Defense Of Biden's Age<p>
</p><p style="margin-bottom: 0in;">I caught the last part of last night's
Newsom-Desantis10-rounder, a worthy undercard for what's perhaps to
come. I don't like these face-offs much, dispute for dispute's sake,
don't stick to the question, no premium on clarity, and Hannity is a
disgrace – tilted questions that weren't even disguised. But given
the form, Newsom is formidable, and Desantis was persistent in his
execrable opportunistic right-wing lying points.</p>
<p style="margin-bottom: 0in;">But as strong and prepared as Newsom
was, he could have done better on the Biden-age thing. Hannity and
Desantis both harped on the “obvious truth” that Biden isn't what
he used to be. Newsom replied that he has been a terrific President,
getting so many things right. Which is true, but it isn't quite
direct enough, to my mind. It doesn't spell it out. I spell it out
in my <a href="http://buddshenkin.blogspot.com/2023/09/bidens-age-gift-or-burden.html">post</a>
here, but here's a shorter reply that Newsom could have adopted, and
that other Dems should adopt as the campaign progresses.</p>
<p style="margin-bottom: 0in;">The best answer to that is this: right!
Of course he isn't! We all change, for the good and for the bad,
all the time, as long as we're alive.
</p>
<p style="margin-bottom: 0in;">But it's a balance. You get better at
some things and worse at some things. As you get older, your
numerical calculation skills decline – it's hard to divide and
multiply in your head. But, you also get smarter with experience,
you gain in wisdom, you've seen a lot more. When you're young you
might have more energy – although Biden is still tremendously full
of energy, just look at this schedule, what he's done around the
world as well as at home! But when you're young, you don't know as
much, you haven't been around the track as much, you are more
impulsive, less patient, you have gained less wisdom.</p>
<p style="margin-bottom: 0in;">Reagan was right in his debate with
Mondale – he vowed not to make an issue of how untried and
inexperienced Mondale was.</p>
<p style="margin-bottom: 0in;">Who knows more about government and
getting things done than Biden? Desantis? GMAFB. Who knows more
world leaders over more years – an indispensable advantage in
foreign affairs – than Biden? For that matter, who knows people
all over the country, and understands them?</p>
<p style="margin-bottom: 0in;">Yes, Biden's walk has become stiff;
there is some arthritis, no doubt. He sometimes has trouble with
words – but that's not new, and in the end, it doesn't matter.
He's still sharp as a tack, he's still solid in his values, he knows
how to be patient and go one step at a time, but he also knows how to
act at the right moment, to be decisive, to be sharp and on point and
seize the day. He still knows how to relate to people in and outside
of the governing process, and that is indispensible.</p>
<p style="margin-bottom: 0in;">On balance, he's better than he's ever
been, and we're so lucky to have him.</p>
<p style="margin-bottom: 0in;"><br />
</p>
<p style="margin-bottom: 0in;">Budd Shenkin</p>
<p><style type="text/css">P { margin-bottom: 0.08in }A:link { so-language: zxx }</style></p>Buddhttp://www.blogger.com/profile/03893224951099943306noreply@blogger.com0tag:blogger.com,1999:blog-8705432279177203509.post-33758177610901642462023-11-30T23:42:00.000-08:002023-12-01T09:09:15.921-08:00Muddling Through<p>
</p><p style="margin-bottom: 0in;"><br />
</p>
<p style="margin-bottom: 0in;"><span style="color: #2b00fe;">Dear Reader:</span></p>
<p style="margin-bottom: 0in;"><span style="color: #2b00fe;"><br /></span>
</p>
<p style="margin-bottom: 0in;"><span style="color: #2b00fe;">Note use of the singular – you might
be the only one. This post hides in plain sight. Potentially
public, it will be very private, because if I don't tell anyone about
it, here it will sit, you could say lonely, but that's not actually
how I see it. I'd just say, unobserved and tranquil, like a book in
a dusty library, with the pages uncut. Since I'm studying French,
sometimes words come up that you would say in French, “tranquil”
being one. Sometimes a word will pop up in Swedish, that language I
learned so long ago but which stays in my mind, lurking, like a
pleasant kind of shingles, welcomed outbreaks.</span></p>
<p style="margin-bottom: 0in;"><span style="color: #2b00fe;"><br /></span>
</p>
<p style="margin-bottom: 0in;"><span style="color: #2b00fe;">It's the end of the month, and I vowed
I wouldn't let November creep away without a post. I've got so many
planned, and a couple almost ready to go. Good ones, I think. I'll
put out notice of them once I post, maybe next week. I plan some of
my posts and work on them, and some I just wake up and write. What
the mind does in bed, reposing (another French word, note), I don't
know, but there's a clarity and a creativity, you just see it as it
comes and then help it along. It's so funny that “work” would be
defined as something we do awake, sitting or standing, alert, doing
something. But the non-work of lying there is some of the best work
we do.</span></p>
<p style="margin-bottom: 0in;"><span style="color: #2b00fe;"><br /></span>
</p>
<p style="margin-bottom: 0in;"><span style="color: #2b00fe;">I didn't know that when Ann died it
would be so profound for me. Of course I should have known, but I
didn't. Let's just say I'm not a planner, which makes my trip East
in early October, a week in Boston and New York City, so amazing,
because I had to plan everything, including the times that would be
unplanned, and it all worked out perfectly, 100%. Each thing fell
into place, even the train when I found myself sitting next to a
companionable lady, whose name turned out to be Andrea Forbes,
returning home after a sojourn (French word) with old Wellesley
classmates, Tower Court, Class of 1981, and we talked for 3 hours.
Even that turned out fine. I don't plan, it's hard to foresee things
in detail, but you just kind of have to trust the future and your
ability to cope. I get that distinction, by the way, from my time at
the Graduate School of Public Policy at UC Berkeley, now the Goldman
School, with initials unchanged, GSPP, when planning was juxtaposed
to “muddling through,” as <a href="https://texaspolitics.utexas.edu/archive/html/bur/features/0303_02/muddling.html">Lindblom</a>
put it. I'm a muddling-througher, so this whole period that they
call grieving is such a surprise to me. I thought grieving was full
of sadness, but that hasn't been my experience, it's more just
readjustment. I think I haven't let myself think about it much,
although now that I'm getting further away from it, I do let myself,
and mostly I'm sad about the missed opportunities we had to be happy.
We had lots of great times, it's true – if I think about them, I
get sad. The good times make me sadder than the bad times, as you
would expect, but not as I would expect because I don't expect
anything because I'm not a planner. Still. I wish we had relaxed
enough to love each other the way we did, we were devoted to each
other, but there was conflict, and there was Ann's illness during the
80's and 90's until she got better with about 20 years left to live.
The final illness, which took years of decline but when we were
really, paradoxically, sometimes the happiest, well, that was a
crescendo or decrescendo, or both, I don't know, but then for some
stupid reason, I didn't know that when her death finally came, that
it would be such a period for me. Period, as in comma and period,
not epoch and period. I discovered that part of the marriage vows should be, "I now make you the most important person in my life."<br /></span></p>
<p style="margin-bottom: 0in;"><span style="color: #2b00fe;"><br /></span>
</p>
<p style="margin-bottom: 0in;"><span style="color: #2b00fe;">So, of course I knew it would be a big
difference, I just had no idea how different it would be. It's not
all bad, not at all. It took some getting used to, but I'm fine
alone. That is, living alone, not being alone. I'm not in some
woods with a clearing and a log cabin and no one around. I can talk
to everyone; we have phones, and “long distance” is a thing of
the past. I look to my past, and I have friends from virtually every
period of my life. Bob Levin dates back to kindergarten, and now we
live 2,500 miles away from the Henry C. Lea Elementary School, but we
live about 3 miles apart. Bob says, we didn't like each other then,
and I answer, well, I liked you. My high school classmates (a bunch
of them! Including Lynn, who I saw in New York in my perfect trip in
October), my college roommate, my med school classmates, two friend
from the Public Health Service, Dean from my practice days (a closer and closer friend, Dean) and my
basketball email friends, Rich my medical director from Bayside
Medical Group days, Stu from Alta Bates, friends from GSPP,
neighbors, friends from the gym, my sister-in-law Nancy, my kids, my
brother and sisters, book group friends, friends from Maui and the
Makena Surf. And I left people out. New friends who I walk with
Saturday mornings at 6:45 AM, and then we have breakfast. And still,
I have lots of time alone, and look forward to Tuesday and Thursday
afternoons when Antonia and Jose come to take care of the house and
garden, as they have for over 25 years, we're our own little family,
they loved Ann so.</span></p>
<p style="margin-bottom: 0in;"><span style="color: #2b00fe;"><br /></span>
</p>
<p style="margin-bottom: 0in;"><span style="color: #2b00fe;">So, I didn't know what I'd do with my
freedom. Would I “date?” No, doesn't seem to be in the cards,
although I have a new friend I lunch with. I do notice that when I
relate to women, it's with an immediate intimacy that takes them
aback. They all respond, often with surprise, but with welcome. I
was a pediatrician for 30 years, don't forget. They're not used to
someone as emotionally intimate as I am. But, you know, I've had a
lot of relationships in my life – when I was younger I was liked –
and now I'm 82. So the intimacy isn't going to be sexual, as far as
I can see. It's kind of a truncated intimacy, but there it is,
insistent. I do like women. I really like the new women I've met,
doing the HMS project, at a dinner party, etc. But I don't date.
You never know what happens, you just kind of muddle through.</span></p>
<p style="margin-bottom: 0in;"><span style="color: #2b00fe;"><br /></span>
</p>
<p style="margin-bottom: 0in;"><span style="color: #2b00fe;">So what I'm doing with my freedom is
working a lot. I write my blog, and people read it sometimes. I
think I write pretty good. People think I'm smart – Bob Levin and
I have discovered that we have differing ideals – he always wanted
to be seen as “cool,” and I always wanted to be seen as “smart.”
Also a good athlete. Bob thinks if I had stayed at Friends' Central
I could have been all-league in basketball and a four letter man. I
never thought of that. As much as you can achieve your goals, it
seems that we have, Bob and I. I think he's cool (and I love his
books, especially I Will Keep You Alive,) and he thinks I'm smart,
and I think others view us that way, too.</span></p>
<p style="margin-bottom: 0in;"><span style="color: #2b00fe;"><br /></span>
</p>
<p style="margin-bottom: 0in;"><span style="color: #2b00fe;">So, I work. Completely unforeseeable,
since Ann died of Alzheimer's and it was a long process, I discovered
a lot in the process and I realized that I knew nothing about it,
despite being a highly-educated and experienced doctor. So, I've
thought that med students should be better exposed than I was to the
“humanistic” side of medicine. Our Harvard Medical School class
of 1967 had a Zoom meeting last January on Alzheimer's and I
discovered a real community of classmates who were animated about the
caring side of medicine, so we started a project, we found great
student collaborators and faculty collaborators, and we're actually
being successful in getting to projects to help students develop in
Humanistic Medicine. I tell my collaborators, always be pessimistic,
these things never work out, so if there are surprises, let them be
pleasant ones. So far, that's what we're having, pleasant surprises.
It helps when you give money or have the possibility of same, let's
be clear, but I'm trying to offer ourselves and our experience, and
that seems to be holding sway so far. We'll see.</span></p>
<p style="margin-bottom: 0in;"><span style="color: #2b00fe;"><br /></span>
</p>
<p style="margin-bottom: 0in;"><span style="color: #2b00fe;">I'm working on my French, which I
started before Ann died, and I've stepped it up. My reading is a lot
improved and I've read about 30 books, I guess, all fiction, and I've
been swept away by literature, French literature. I fell in love
with Annie Ernaux. Read <a href="https://www.amazon.com/Years-Annie-Ernaux-ebook/dp/B07465HWS3/ref=sr_1_1?crid=34OPTLXRCBLC7&keywords=ernaux+the+years&qid=1701416010&sprefix=ernaux+the+years,aps,258&sr=8-1">The
Years</a> first. One of her books is about the death of her mother.
I read A Very Easy Death (which I took to be an ironic title) by Simone de
Beauvoir. Writers and the death of their mothers seems to be a
genre. Annie and Simone both turned those intimate deaths into
literature. I had thought about taking notes as Ann declined and
died – I did that when I had my macroadenoma of the pituitary and
it's a great <a href="http://buddshenkin.blogspot.com/2011/08/welcome-to-neurosurgeryland.html">post</a>
– but I decided I wasn't going to do that. It would have been a
service for others, but I declined. Nope, it was just going to be me
and Ann, no prostitution. Not that Annie and Simone prostituted
their mothers' deaths by writing about them, pas du tout, but it
wasn't what I was going to do. But I loved both Annie's and Simone's
books. I want to write a post about them, especially Simone's, but
I'm pretty busy. I can't tell you how much I loved them. I'm so
happy I can read the in French (with the English on my Kindle for
reference.)</span></p>
<p style="margin-bottom: 0in;"><span style="color: #2b00fe;"><br /></span>
</p>
<p style="margin-bottom: 0in;"><span style="color: #2b00fe;">I'm also writing a post about the
problem with primary care medicine in the US, which they say is
dying. It will be a good post; it's close to done. Posts can be
done without all the crap you have to do for a formal article; what a
pleasure. Of course, in my case, hardly anyone reads them, but c'est
la vie.</span></p>
<p style="margin-bottom: 0in;"><span style="color: #2b00fe;"><br /></span>
</p>
<p style="margin-bottom: 0in;"><span style="color: #2b00fe;">I've got to get all the pictures I've
taken, and the pictures we have of our ancestors with little notes on
who they were – I don't know but my sister Kathy might – I wish
there were someone to just set me up doing it. It's the setup that's
hard; after you know what the mechanics are, you can just find the
time to do it. It's getting started that's hard. And now my damn
desktop has lost it's internet connection, and the urgent will take
precedence over the important.</span></p>
<p style="margin-bottom: 0in;"><span style="color: #2b00fe;"><br /></span>
</p>
<p style="margin-bottom: 0in;"><span style="color: #2b00fe;">I can't tell you how rewarding this
project with HMS has been. I found this student who wants to be a
leader and has all the potential to be, and I think I can help her.
All my classmates are enthusiastic, and I think I can help them find
fulfillment. I was telling Eana, the HMS student leader, that it's
true, that when you give to others so often you are doing more for
yourself than you are for them, even though you'd have to look way
inside to find that out. But then, does that mean that when you are
doing for others, you are committing a selfish act? Everything is so
confounding in life. “Confounding” is a great French word.</span></p>
<p style="margin-bottom: 0in;"><span style="color: #2b00fe;"><br /></span>
</p>
<p style="margin-bottom: 0in;"><span style="color: #2b00fe;">In the spring of 2022 there was a class
reunion at HMS and I found I couldn't go. I couldn't even write the
class note on where I was or what I was doing. I didn't say “I'm
not ready,” I didn't think of it that way, it wasn't that I thought
I was sad, I just wasn't ready, and of course there was COVID, and I
didn't think “ready,” really, I just thought I would be unhappy
going, without Ann, even though she made things harder because of
things she didn't want to do, and I couldn't be gone from her for too
long, etc. But we had found a restaurant on Beacon Hill for
breakfast, we walked there a couple of mornings though the Public
Garden from the Four Seasons, and somehow going to the reunion and
not walking over there with her wasn't something I wanted to do. So
I didn't go. They had a good time there, and it was after that that
my classmates started the Zoom meetings.</span></p>
<p style="margin-bottom: 0in;"><span style="color: #2b00fe;"><br /></span>
</p>
<p style="margin-bottom: 0in;"><span style="color: #2b00fe;">But then this last June there was a
French students' trip to a chateau just north of Toulouse with my
French teacher, and I did that, and then my sister Emily came over
from London and we spent four days or so together and had a great
time going down to Carcassonne, and then to Lagrasse and Perpignon
and Barcelona and then we flew out, and I said, yes, I can do it, it
was a perfect trip. Somewhere in there, near to a year and a half
after Ann died, maybe a year and a quarter, I got up one morning and
felt better. I hadn't felt sad, or maybe I wouldn't let myself, I
thought about it I guess, but then I refused to think about it, as I
said, but then I discovered that I looked forward to the day more,
and then I discovered I could travel, even if I didn't have a
built-in companion to travel with, and now I'm on Maui and I'm typing
away and I have too many projects to finish, but somehow maybe I
will, maybe I'll muddle through.</span></p>
<p style="margin-bottom: 0in;"><span style="color: #2b00fe;"><br /></span>
</p>
<p style="margin-bottom: 0in;"><span style="color: #2b00fe;">Budd Shenkin</span></p>
<p><style type="text/css">P { margin-bottom: 0.08in }A:link { so-language: zxx }</style></p>Buddhttp://www.blogger.com/profile/03893224951099943306noreply@blogger.com0tag:blogger.com,1999:blog-8705432279177203509.post-65359703679951723762023-10-29T22:26:00.001-07:002023-10-30T08:07:58.589-07:00My Father Was Left To Cope On His Own<p>
</p><p style="margin-bottom: 0in;"><span face="Arial, sans-serif">My
father was a neurosurgeon, which I always thought was a defining
characteristic. He was dominant. He was also loving and supportive,
at least to me, and he treated my mother basically as an equal, or
nearly so. They had a traditional marriage, and Dad said of her, she
always supported me. When she died at 72 of breast cancer, they had
already moved to a senior living facility, the Quadrangle near
Haverford College on the Main Line in Philadelphia, because my father
got nervous, worried that if my Mom died first, he would find it very
difficult to live on his own. Impossible, really. When I suggested
once that he make lunch for himself, he growled at me. “I've never
made my own lunch and I'm not going to start now.” Or maybe he was
nervous that his house in center city Philadelphia would lose value –
Dad could never hold onto assets.</span></p>
<p style="margin-bottom: 0in;"><span face="Arial, sans-serif">He lost
my Mom and I didn't understand what would happen, and I didn't worry
about it. As my Dad would say, caring goes down and it doesn't come
back up. I did care about him, but I didn't take care of him much.
I figured it was up to him to take care of himself, and that he
would. I didn't worry about him. I didn't think about what it would
be like for him to have an apartment where he lived alone. Of my
kids, it would probably be the youngest, Peter, who would be most
conscious of his father's plight. The others are more like me. I
wasn't in Peter's class when it came to caring.</span></p>
<p style="margin-bottom: 0in;"><span face="Arial, sans-serif">So in
maybe less than a month after my Mom died, my Dad had hooked up with
an old friend, Reva, the divorced wife of a doctor friend, Richard,
an orthopedist. I had met their son years ago, a boy whose son's
lips were always blue from Tetralogy of Fallot. He had died in early
adulthood of failed heart surgery. I had never experienced
compassion for this blue-lipped boy, just as I hadn't experienced
compassion for the boy in my high school class who was frequently
absent from school because of kidney disease, who died in
adolescence. Actually, truthfully, I thought I was lucky not to have
known either of these boys well, because then I didn't have to
confront their death and my feelings about the death of a friend.</span></p>
<p style="margin-bottom: 0in;"><span face="Arial, sans-serif">My Dad
called me, as I'm sure he did to my brother and sister, to tell me
about Reva and I said fine, that's good, kind of amazed at his speed,
and he queried me about if it was too soon, meaning was it
disrespectful of my Mom, and I said no, and he was relieved.</span></p>
<p style="margin-bottom: 0in;"><span face="Arial, sans-serif">Richard,
Reva's ex-husband, had actually operated successfully on my deformed
right foot when I was in tenth grade. My father and Reva got along
well, he was proud of her artistic prowess and she painted quite a
nice portrait of him. He was also proud that she knew enough about
art to buy the right pictures and make money on them. She was a real
expert. They stayed together for maybe 10 years until she died. Her
gynecologist missed a diagnosis of cancer when she had some bleeding,
finding out the true diagnosis late, but I don't know if it would
have made a difference. I didn't worry about my Dad's being alone,
again, and I can't tell you why. I was busy, I had my own work and
my own family. I was attentive, I called, but he was back to taking
care of himself. </span>
</p>
<p style="margin-bottom: 0in;"><span face="Arial, sans-serif">Even
though he had a very nice relationship with Reva, it seemed like it
was my Mom who he missed. My Dad would be hot sometime, there was a
little shunt his mind would take and he would be hot, his emotions
would take him away. So I remember once when he was in a mood,
feeling lonely I guess, and he said about my Mom, “She had no right
to die! She had no right!” Of course he knew that that was
ridiculous, but that's the only way he could express himself.</span></p>
<p style="margin-bottom: 0in;"><span face="Arial, sans-serif">She had
no right to die and leave him alone. He didn't worry about sounding
ridiculous with me, he said what was on his mind. If something goes
wrong, find out who is guilty and throw the blame their way.
Everyone has to have a way to handle setbacks, and this was his.
Took me a while to get my own way to react, I naturally followed the
family tradition, but I found that my kids tend to laugh at something
that happens to them, and I've kind of picked it up.</span></p>
<p style="margin-bottom: 0in;"><span face="Arial, sans-serif">But then
with both my Mom and Reva dead, there he was alone in his apartment.
I didn't think that much about it, although I was attentive, and he
didn't want me to worry about him, either. He just wanted me to stay
in touch and to visit when I could. He had his friends around the
Quadrangle, and they seemed to take care of each other. Meals were
in the dining room, and Dad had his regular tablemates. A nice man
named Steve, and his wife, and then a woman named Anne who attached
herself to him. That's what happens in these places. You trade
independence for company and security. Anne adopted him as hers,
told everyone that he was the love of her life, she was kind of
weird, a lawyer who had practiced in Texas, I think, but her family
was local, and I have pictures of Dad with Anne and her family for
holidays at her daughter's house, where he looked jolly, which I
found strange. He adapted well to being adopted, I thought. He was
her man-friend, or something. Dad tried to tell us her good points,
her achievements about being the first woman to be counsel of a
company or something, the way he had praised Reva's art prowess, but
my brother hated her, and I tolerated her and was polite if not very
warm and of course, Dad needed her and was lucky to have someone.</span></p>
<p style="margin-bottom: 0in;"><span face="Arial, sans-serif">As I
look back on it, I thought he had lost all his neurosurgical power –
well, that's not true. He had his prestige, he had his past, he had
the dignity of his achievements and his former stature, some of which
still applied. But do you really need that when you approach 90 and
you're in a big institution where you've been for close to 15 years
and you've seen them come and go, and when you walk to your meals
down long hallways, or drive your cart as time went on instead of
walking and where some busybody complains that you drive too fast,
and you drive past the little shelf off to one side where the latest
deaths are announced in little white cards and the day and time of
the upcoming service, and when you go up to the nursing home part of
the Quadrangle and you see the debris of wheelchairs with slumped
occupants and maybe a TV on and you see that you never want to be
like that – do you really need your past stature? You're in the
long corridors of the Quadrangle, driving toward the end, and you're
lucky if you have someone to keep visiting you in those last days
when you need constant attention and when you can no longer hardly
get up to go to the bathroom and you can't wipe yourself and who
cares about stature then? That's when you pull yourself together and
tell the doctor you want to stop taking the pills that keep you
alive, you just want to keep taking the pills that make you
comfortable, and I'm not sure what you think about, but Steve and his
wife and Anne visited in the days, and when one of your four children
is there every weekend, and then your California son comes in Friday
night on your last weekend and it's like you've been waiting for him,
and he brings you a little video player and he puts in a CD of your
favorite movie, The Producers, and your oxygen level must be low by
this point but you see the movie and you recognize it and you point
to it and you look around to see if the others are seeing it, too,
and you make sure they do, but then you relax back down on your pillow
and everyone goes home for the night and Buddy and Bobby and Susan go
out to dinner and Bobby says I've never seen him this bad, and he's
right because they discover him in bed dead about 6 AM or so, as
though he had been waiting for me to come.</span></p>
<p style="margin-bottom: 0in;"><span face="Arial, sans-serif">And I
wonder if he thought of my Mom, or if he thought of anything really,
that night before he died. He was dead when I sat in his room after
Bobby had called me to tell me he was dead, and everyone else cleared
out and I sat and I cried so hard, and I called him Daddy, and I knew
I loved him so much, and I think he knew it, too, but one way or the
other, I was there in time, and I brought him a present that he loved
in time, and one of the last words he had said, I'm not sure when,
was “92,” which was how long he lasted, to 92, and who'd a thunk
it, he seemed to say, his last achievement, lasting that long. An
achiever to the end. And as far as I know, he never had to make that
goddamn sandwich for lunch on his own, his contract called for three
meals a day and he was having three meals a day, or at least two, and
he was being taken care of in that infirmary until the very end full
service because he had been an original resident and that's what his
contract called for, back when they were offering good terms to
attract people to get things started, and Dad made sure that he was
going to get one of those good contracts for being an original
resident, and God help them if they tried to charge him. And some
old friends, or at least acquaintances from his former life would
themselves move to the Quadrangle and see that he was already
established there, and he took care of himself, more or less, until
close to the end. Or rather close to his end, not the end, because
the world goes on and nobody is irreplaceable, they say, although I
don't believe that. My Mom was irreplaceable for my Dad, although he
did replace her, but not really, because he had had her when they
were young, and when their kids were born, and when they traveled
together, and when they were amazed and delighted at their successes
and the life they had built so far above where they had been born,
and they would remember that together, and only they could do that,
no replacements allowed for that.</span></p>
<p style="margin-bottom: 0in;"><span face="Arial, sans-serif">And no
replacement allowed for my Dad, either. No one ever loves you like
your parents, I think, but maybe that's overgeneralizing. Some
marriages are really so strong, and good on them.</span></p>
<p style="margin-bottom: 0in;"><span face="Arial, sans-serif">In
retrospect, I regret that I never thanked my parents enough, for all
they did for me. I did tell them I loved them, which was good, but I
didn't thank them. I didn't thank my wife enough either. I should
have thanked them more. But at least I told them I loved them, and
for all of them, I was a good boy. I did get to take care of my
wife, to walk the walk, but not my parents. But my Dad took care of
my Mom until she died, she didn't need me. And for someone who
couldn't make himself a sandwich, Dad did pretty well for himself. </span>
</p>
<p style="margin-bottom: 0in;"><span face="Arial, sans-serif">I did
what I could, I was attentive, and I told them I loved them. Thank
God I did that.</span></p>
<p><style type="text/css">P { margin-bottom: 0.08in }</style> <br /></p>Buddhttp://www.blogger.com/profile/03893224951099943306noreply@blogger.com0tag:blogger.com,1999:blog-8705432279177203509.post-30802893127240790742023-10-01T09:54:00.005-07:002023-10-01T09:54:34.687-07:00The Terror of Medicine<p></p><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEifKmjZYnVGqEnBcW2R6-L07a3sM1F0xS2JSYAp50NuKXT7Hchew1i0Q6qVST9Y-Z7cB84ACpBoHVIuuWRbLdI-CbPnq_T4JOqT00Yeoy8YGkFjE_KlVmBS5udNlIlmRh9wtVj3UXRmhrANHbVXoGJDIDDgXrIdlU59XG0pXm46BQkvOMVM-_iEjjNWX4c3/s4032/CD26C58B-4385-4051-AEAB-6B7EBC82AC8A.jpeg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="4032" data-original-width="3024" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEifKmjZYnVGqEnBcW2R6-L07a3sM1F0xS2JSYAp50NuKXT7Hchew1i0Q6qVST9Y-Z7cB84ACpBoHVIuuWRbLdI-CbPnq_T4JOqT00Yeoy8YGkFjE_KlVmBS5udNlIlmRh9wtVj3UXRmhrANHbVXoGJDIDDgXrIdlU59XG0pXm46BQkvOMVM-_iEjjNWX4c3/s320/CD26C58B-4385-4051-AEAB-6B7EBC82AC8A.jpeg" width="240" /></a></div><br />
<p></p><p style="margin-bottom: 0in;"></p><div class="separator" style="clear: both; text-align: center;"><br /><div class="separator" style="clear: both; text-align: center;"></div><br /></div><br /><br />
<p></p><p style="margin-bottom: 0in;">I think it was starting this new book –
new to me, anyway, used edition, 1984 – L'Amant (The Lover) by
Marguerite Duras, that got me started thinking about this thing I
have successfully repressed for a long time. That, and our Class of
1967 Harvard Medical School project on Humanistic Medicine. I'm only
a few pages into it, but it's a book of images and interiors, a
French high school girl in colonial Saigon, with two brothers, a
father who is going to die, and a mother who it seems won't last much
longer, a mother who is distracted and ineffably sad as she tries to
cope. At the same time I'm hearing from my med school classmates
about their own coping with the medical care system as we age and our
medical needs increase, how some of us are well served and others
aren't. And how everyone is coping with the choice to move to a
facility for older people or keep on going as we are.</p>
<p style="margin-bottom: 0in;">But all of a sudden, as I was reading
L'Amant in the bed that my late wife and I shared for years – I
slept there last night for the first time in a long time, I've been
staying in the attractive front bedroom in the house were I slept
when Ann had to sleep alone in our bedroom and be attended our health
aides – all of a sudden, the image came to me of my patient Ms.
Ratto, I forget her first name, but Ratto is a common name in Oakland
and Alameda, there's Ratto's Delicatessen around 8<sup>th</sup> and
Washington in downtown Oakland, and there's Ray Ratto, the local
sportswriter turned TV, radio, and podcast analyst and raconteur,
known for sardonic humor, whose family became my patients when we
opened our Alameda office and he and his wife showed up for a
prenatal visit and when I heard he was a sportswriter for The
Examiner, I told him I was thrilled to meet him, and he told me I'd
get over it. Anyway, this Ms. Ratto, a fair-skinned
red-haired-to-auburn, very sweet mother of two, was my patient, and
they claimed not to be at all related to any of the other Ratto's
that I was familiar with. Right. Somewhere along the line, somebody
didn't want to be known to be related to somebody else, I guessed.</p>
<p style="margin-bottom: 0in;">So I had the image of her face in my
mind, in our Alameda office, an old-fashioned office that took the
whole second floor of a two story building that could have been an
old house, that we rented from the dentist who occupied the first
floor. She was distracted, too, like the mother of the narrator of
L'Amante.</p>
<p style="margin-bottom: 0in;">What do you do when you are dying of
breast cancer and you have two little kids? Thank goodness you have
a good husband. But, she looked at me full in the face – I still
have tears when I recount this – she was still apparently healthy
to look at her, hadn't yet lost her looks or her energy, it looked
like, but she said to me, straight-on – what is going to happen to
my kids?</p>
<p style="margin-bottom: 0in;">Oh, how I wanted to help her. I wanted
to take her in my arms and hug her and cradle her and tell her
something and do something and make things all right. I could have
tried. I could have said that her husband was a good guy and he'll
find someone to be a good mother to them, which was probably true. I
could have at least said I would be a good and loving pediatrician
for them. I could have cried with her, making things worse, no
doubt. I wanted to do something. I should have been able to do
something, shouldn't I have? I was their pediatrician, and I cared
for her and them, and they cared for me, too. It was everything that
a medical relationship should be.</p>
<p style="margin-bottom: 0in;">But I was helpless. I could have told
her how much I wanted to do for her, but I had no idea, and I still
don't, of what I could do. What do you do when there is nothing to
be done?</p>
<p style="margin-bottom: 0in;">I don't recall seeing her again. I
must have seen the kids, I don't know, I just don't know. All I know
is that it was searing. What do you do when there is nothing to be
done? I could have asked her what she was doing, what could she
conceive of doing that would give them the best chance ever. True
belief in religion used to help with this, the Lord will provide, and
sometimes I tell myself that now, knowing that I don't believe in
God, but it's a great heuristic, an as-if.</p>
<p style="margin-bottom: 0in;">I bet there are people around, in the
medical schools and in practice, both, who know a lot more about what
I could have done, what the medical system or the social care system
could have done. It was probably up to the family, her husband, the
grandparents, the aunts and uncles, everyone, to pitch in. I didn't
know. But that's not what she was about. We had a relationship, she
and me, patient and doctor. She could bear her soul to me. I could
listen and accept her projection of what she wanted me to be, as her
pediatrician. The way a pastor must feel when parishioners turn to
him or her, what do you want me to be. She just wanted to tell me
her deepest thought, wish, fear, terror. What will happen to my
kids?</p>
<p style="margin-bottom: 0in;">If I had known what I was doing, I
would have found the time to sit with her, and listen, and reassure.
Share her feeling. Then I would have been a good doctor. Avuncular,
paternal, something. Helpful. Maybe I did</p>
<p style="margin-bottom: 0in;">But I didn't know. I don't know, maybe
I did do something good. Maybe I actually reassured her, although I
don't remember that. Really, I was in the shock of being confronted
by life in all its terrors. Talk about not being prepared. The fact
that tears come to my eyes now tells me that I wasn't prepared for
that. Maybe I had heard a rumor about her condition, maybe from
another patient – so many of them knew each other in Alameda,
although apparently not the various Ratto's – or maybe from one of
my staff members. The best medical offices have staff and
professionals who share a mission, and help each other to cope and do
good. But whatever it was, I was still in shock. Face to face.
Terror.</p>
<p style="margin-bottom: 0in;">I'm just into the first few pages of
this book. I don't know what happens to this girl. I don't know how
autobiographical it is. I have intentionally not read to much about
it, I want to confront it face to face. I just read my sixth Annie
Ernaux book, Se Perdre (Getting Lost), and the shock of vivid and
consuming autofiction (I doubt there's much fiction in it, really,
maybe some compression of facts, and as in all non-fiction, the
choosing of facts to fit a narrative) is still reverberating.
</p>
<p style="margin-bottom: 0in;">Life, literature, reading and writing,
medicine, helping people, being helpless, the unrelenting pace of
events that won't stop, time stops for no one, the earth is 4.5
billion years old and our universe is apparently 13.7 billion years
old, but this is what we have, the here and now, the present, the
awful unrelenting present from which we try to extract happiness,
love, support, the illusion of eternity here in the present.</p>
<p style="margin-bottom: 0in;">But at least, I hope that our
Humanistic Medicine Initiative from our HMS Class of 1967 helps some
of the present students and trainees, the age of our grandchildren
perhaps, at least what little we can do will help some of them to
cope and help with their mission of being physicians, and helping
people with the burden of life.</p>
<p style="margin-bottom: 0in;"><br />
</p>
<p style="margin-bottom: 0in;">Budd Shenkin</p>
<p><style type="text/css">P { margin-bottom: 0.08in }</style></p>Buddhttp://www.blogger.com/profile/03893224951099943306noreply@blogger.com0tag:blogger.com,1999:blog-8705432279177203509.post-57871267216939004182023-09-30T23:18:00.003-07:002023-09-30T23:41:29.434-07:00Doctors, Patients, and Hitters<p>
</p><p style="margin-bottom: 0in;"><span style="color: #000099;"><span face="tahoma, sans-serif">As
I think you all know, I believe that there are very few situations in
life, if any, that don't lend themselves to elucidation by referring
to sports.</span></span></p>
<p style="margin-bottom: 0in;"><span style="color: #000099;"><span face="tahoma, sans-serif">Take
my current project, where a group of my classmates of the Class of
1967 at Harvard Medical School have started a Humanistic Medicine
Initiative, to try to help the current students and trainees develop
their knowledge and skill in the caring side of medicine (“caring,”
as opposed to the “scientific” side.) Part of this is, how do we
help them learn to communicate effectively with patients? I heard
that the Kaiser system, which tries to attack every problem
systematically, has been teaching a standardized system of
communication to its new clinicians. For instance, how long do you
wait before you jump into a patient's recitation of his or her story?
The usual wait is somewhere under 10 seconds, I think, and Kaiser
wants to up that to 40 seconds. Then they have standard ways to
start, words to use. Will they succeed in this standardized
approach? Maybe so, because maybe the level of current communication
is so low there is no where to go but up.</span></span></p>
<p style="margin-bottom: 0in;"><span style="color: #000099;"><span face="tahoma, sans-serif">Somewhat
akin to that is the recent finding that patients like the empathy of
AI better than they like the empathy of real doctors really
communicating on their own.</span></span></p>
<p style="margin-bottom: 0in;"><span style="color: #000099;"><span face="tahoma, sans-serif">I
ran across a more intriguing and sophisticated effort than those, or
at least one aiming at a higher level result, in a JAMA article that
I put away to save, but which I now (typically) cannot find. I think
this was about how to deliver bad news or regret, and how to do it
with empathy. As it happens, the author of the article was a
resident in medicine doing the learning, and his father was a
specialist in medical communications. So the author was going to
show his father how he had learned to do it. Piece of cake, he
thought – I've been watching my father do this my whole life! I
know this gig!</span></span></p>
<p style="margin-bottom: 0in;"><span style="color: #000099;"><span face="tahoma, sans-serif">So
he does it, he follows all the rules he has learned from watching his
father, all the examples he has seen. Then he turns to his father
and says, well, how did I do? He naturally expects an A.</span></span></p>
<p style="margin-bottom: 0in;"><span style="color: #000099;"><span face="tahoma, sans-serif">Terrible,
says the father.</span></span></p>
<p style="margin-bottom: 0in;"><span style="color: #000099;"><span face="tahoma, sans-serif">What?
Why? I did everything that you do!</span></span></p>
<p style="margin-bottom: 0in;"><span style="color: #000099;"><span face="tahoma, sans-serif">That's
the problem, says the father, you did me. Now you have to learn to
do you.</span></span></p>
<p style="margin-bottom: 0in;"><span style="color: #000099;"><span face="tahoma, sans-serif">Crushed,
the son has learned that it's not so easy, because we are humans, we
are all different, and we all have our own way.</span></span></p>
<p style="margin-bottom: 0in;"><span style="color: #000099;"><span face="tahoma, sans-serif">I
don't remember how the article went on from there – I'll know when
I finally find it – but the point was clear, and it makes intuitive
sense. Well done, well written.</span></span></p>
<p style="margin-bottom: 0in;"><span style="color: #000099;"><span face="tahoma, sans-serif">So,
as I said, there is always a sports analogy to be found. There will
always be a way to illuminate the point through sports. I searched
my mind, and what came to mind was hitting. There are many great
hitters, and they share some characteristics in their swings, but
they are all so different! You can watch a swing with the hitter
being otherwise unidentifiable – no number or name on the back, no
face to recognize -- and some of them you can get immediately right
on the nose, and some you can make a good guess at, and there can be
such a wild variety of swings, but some you can classify as good,
some as bad, so can tell that some of them come from the same hitting
coach (does the name <a href=" https://en.wikipedia.org/wiki/Charley_Lau)" target="_blank">Charley Lau</a> ring a bell) and so resemble each other – but I guarantee you, every
single one is different. </span></span>
</p>
<p style="margin-bottom: 0in;"><span style="color: #000099;"><span face="tahoma, sans-serif">And
it's such a stereotypic task! It's amazing that there is such a
variety of approaches! The best hitters share some characteristics -- there are the basics -- and many bad hitters share the same weaknesses, but none are quite the same. And some will work for some people, and
others will work for others, they can learn from each other, there are
certain basics, but each one must fit the individuality of the batter.</span></span></p>
<p style="margin-bottom: 0in;"><span style="color: #000099;"><span face="tahoma, sans-serif">And,
I would add, some work best with some pitchers, and some work best
with others. It's a combination. Some patients need one thing, some
patients need another, and there are some hitters who can hit some
pitchers, and others can hit others, etc., pairs of pitchers and
batters that work and some that don't.</span></span></p>
<p style="margin-bottom: 0in;"><span style="color: #000099;"><span face="tahoma, sans-serif">And
then, think of how many different ways there are of shooting a
basketball!</span></span></p>
<p style="margin-bottom: 0in;"><span style="color: #000099;"><span face="tahoma, sans-serif">I
won't go on, because either I've made my point or I haven't, you
accept it now or you don't. Just like some people like what I write
and others don't.</span></span></p>
<p style="margin-bottom: 0in;"><span style="color: #000099;"><span face="tahoma, sans-serif">But
to me, I made my point. Which is that sports is not just pointless
games, but in fact, they encapsulate life, one way or another.</span></span></p>
<p style="margin-bottom: 0in;"><span style="color: #000099;"><span face="tahoma, sans-serif">Which
is a point to rebut my father, long gone now, but still I work to
both please and rebut him – Dad, sports are not just a worthless
waste of time! Sports are life itself!</span></span></p>
<p style="margin-bottom: 0in;"><br />
</p>
<p style="margin-bottom: 0in;"><span style="color: #000099;"><span face="tahoma, sans-serif">Budd
Shenkin</span></span></p>
<p><style type="text/css">P { margin-bottom: 0.08in }</style> <br /></p>Buddhttp://www.blogger.com/profile/03893224951099943306noreply@blogger.com0tag:blogger.com,1999:blog-8705432279177203509.post-49320495266653099142023-09-24T11:32:00.000-07:002023-09-24T11:32:52.248-07:00Biden's Age -- Gift Or Burden?<p>
</p><p align="LEFT" style="font-weight: normal; margin-bottom: 0in;"><br />
</p>
<p align="LEFT" style="font-weight: normal; margin-bottom: 0in;"><span style="font-family: Arial, sans-serif;">It
is a well known but still amazing fact that our President is now 80
years old, and that he is running for a second term and would be 86
at the end of that term. Alarm bells have sounded, many smell
disaster ahead. After all, they say, they know what “old men”
are like.</span></p>
<p align="LEFT" style="font-weight: normal; margin-bottom: 0in;"><span style="font-family: Arial, sans-serif;">But do they, really? They
refer to the stereotype of an “old man” who dodders with frail
body, weak memory, decreased reasoning power, depleted energy,
inflexible ideas, no capacity to appreciate the new or the young, and
liable to be injured or simply collapse at any time. Or, worse, the
old man might decline progressively and not leave office, allowing
aides to prop him up and take over, or to let the country drift as he
himself drifts away, as happened with Woodrow Wilson. Imagine if he
should be replaced by a distrusted Vice-President. It's a nightmare
scenario.</span></p>
<p align="LEFT" style="font-weight: normal; margin-bottom: 0in;"><span style="font-family: Arial, sans-serif;">But
think for a moment – does this nightmare scenario ring true with
Biden, or is it simply an ageist trope? Here's an alternative:
replace the term “old man” with “seasoned leader.” Modern
medicine has increased healthy life spans; some say that 80 really
can be the new 65. Seasoned leaders resist the impulses of the
moment; their hard-won judgement allows them the patience to weigh
alternatives and possible consequences, to appreciate ebb and flow,
to know which moment to seize, to judge well. Their years have
earned them wisdom.</span></p>
<p align="LEFT" style="font-weight: normal; margin-bottom: 0in;"><span style="font-family: Arial, sans-serif;">The
seasoned leader knows people at home and abroad, who to trust and
rely on, and who to be wary of. They know how their chosen field
works, because they have been at it a long time. With their
perspective, they can actually be more forward looking than younger
leaders, and more conscious of their potential legacy. Despite
accusations to the contrary, older people tend to relate well to the
young. Think of the warm and close ties of doting grandparents as
they advocate and indulge their grandchildren, making sure the
younger generation has good education and a healthy planet and are
fair to one another. In fact, one has to think – wouldn't a
grandparent sometimes make a better, more selfless President than a
young, ambitious parent? Think “greatness of spirit,” not “old
and broken.” Think secure and wise.</span></p>
<p align="LEFT" style="font-weight: normal; margin-bottom: 0in;"><span style="font-family: Arial, sans-serif;">As
Ronald Reagan put it in 1984, “I will not make age an issue in this
campaign. I'm not going to exploit, for political purposes, my
opponent's youth and inexperience.... I think it was Seneca but it
might have been Cicero who said, if it were not for the elders
correcting the mistakes of the young, we would have no state.”</span></p>
<p align="LEFT" style="font-weight: normal; margin-bottom: 0in;"><span style="font-family: Arial, sans-serif;">Perhaps
it is not President Biden who is stuck in the past, but the critics
who cling to out of date stereotypes.</span></p><p align="LEFT" style="font-weight: normal; margin-bottom: 0in;"><span style="font-family: Arial, sans-serif;"> </span></p>
<p align="CENTER" style="margin-bottom: 0in;"><span style="font-family: Arial, sans-serif;"><b>II.</b></span></p>
<p align="LEFT" style="font-weight: normal; margin-bottom: 0in;"><span style="font-family: Arial, sans-serif;">But,
to be fair, bad things do sometimes happen to older people. Woodrow
Wilson had a devastating stroke at age 63 (old then,) and his wife
and aides hid it from the country, while taking the presidential
reins in their own hands. Dwight Eisenhower had a serious heart
attack at age 65 (old then) from which he recovered in a weakened
state. Ronald Reagan may have slipped into Alzheimer's in his 70's
(old then) in his second term. Older people are at higher risk for
serious illness, although the risk to the young is not insignificant.
Think Kennedy. The risks might rise with age, but they are always
there.</span></p>
<p align="LEFT" style="font-weight: normal; margin-bottom: 0in;"><span style="font-family: Arial, sans-serif;">Since
disabilities can occur to anyone at any time, it is important to be
able to detect problems early, and to have back up capacities.
Recognizing part of the problem after the Kennedy assassination, the
25<sup>th</sup> Amendment was ratified in 1967, providing a procedure
for replacing an ailing President, whether he or she recognize it
themselves, or whether it is the decision of the Vice President and a
majority of the Cabinet. But beyond that, we have no formal
institutional guard rails. Informally, staff and close friends and
advisors function as teammates, supporting and supplementing. But
for early detection and remediation, more is clearly needed for all
Presidents, not just older ones.</span></p>
<p align="LEFT" style="font-weight: normal; margin-bottom: 0in;"><br />
</p>
<p align="CENTER" style="margin-bottom: 0in;"><span style="font-family: Arial, sans-serif;"><b>III.</b></span></p>
<p align="LEFT" style="font-weight: normal; margin-bottom: 0in;"><span style="font-family: Arial, sans-serif;">Nikki
Haley and others have suggested that a presidential candidate 75
years or older should be tested for mental capability to function in
the office. Screening for capability to fill one of the world's most
important offices might not be a bad idea. We in medicine know that
some patients are more at risk of certain conditions than other
patients, and we screen for those conditions to ensure early
detection and treatment. We know that the concept of “average”
can be deceptive – just because you have a higher risk of having a
condition doesn't mean you have it. An 80 year old might be
healthier than a 60 year old; a 60 year old may demonstrate more
mature judgement than an 80 year old. In medicine we don't confuse
risk with actuality, we know we have to evaluate the individual. </span>
</p>
<p align="LEFT" style="font-weight: normal; margin-bottom: 0in;"><span style="font-family: Arial, sans-serif;">But
here's the problem with Haley's suggestion – it's far too narrow.
What conditions could compromise a candidate's performance as
President? Surely it's not simply dementia. Other common
debilitating conditions are: alcoholism, depression, anxiety, sleep
deprivation, delusions, sociopathy, sexual deprivation or perversion,
chronic anger. Indeed, a candidate might be quite literally crazy.</span></p>
<p align="LEFT" style="margin-bottom: 0in;"><span style="font-family: Arial, sans-serif;"><span style="font-weight: normal;">What
about other conditions that could compromise performance? </span>
What about general intelligence? What about work habits? What about
honesty? What about ties to foreign powers? What about temperament?
What about prejudice? What about the ability to think through
problems? What about the ability to build a team, a breadth of
knowledge, a tendency to make a country more peaceful rather than
more contentious? What about knowledge of government operations?
What about executive experience?</span></p>
<p align="LEFT" style="margin-bottom: 0in;"><span style="font-family: Arial, sans-serif;">These
are all serious questions, and most of them are not age-related.
That indicates that focusing on Biden's age is really a question of
ageism. Yes, being older brings on the risks and characteristics of
age, which can cut both ways. But to focus on just “being older”
is unreasonable.</span></p>
<p align="LEFT" style="margin-bottom: 0in;"><br />
</p>
<p align="CENTER" style="margin-bottom: 0in;"><span style="font-family: Arial, sans-serif;"><b>IV.</b></span></p>
<p align="LEFT" style="font-weight: normal; margin-bottom: 0in;"><span style="font-family: Arial, sans-serif;">So
what is to be done? A general health examination including the
mental status of candidates would be a good idea, with the results
released to the public. Just as the American Bar Association judges
Federal judicial candidates as “qualified” or “not qualified,”
the American Medical Association could be asked to issue a medical
judgement on Presidential candidates. The extent of the medical
characterization of the candidate's health would have to be
determined. Do we want professionals to issue a judgement on alcohol
use, anger management, sleep habits, fitness, paranoia? Or should we
leave the status quo alone, with issues known to insiders leaking
here and there in the press? Maybe we should leave it at blood test
results, the clock drawing test, and short term memory assessment. </span>
</p>
<p align="LEFT" style="font-weight: normal; margin-bottom: 0in;"><span style="font-family: Arial, sans-serif;">In
the end, the political system must find its way to judge. In the old
days of strong parties and leadership by insiders, the guard rails of
protection of the republic were left in those quiet insider hands.
Nowadays, when primaries have taken the place of smoky back rooms,
more public information is necessary. But beyond that, we cannot now
say. We will find our way to how much information is needed as we
move step by step. </span>
</p>
<p align="LEFT" style="font-weight: normal; margin-bottom: 0in;"><span style="font-family: Arial, sans-serif;">But
for the present, it's best to understand that judging on age pure and
simple is foolish. The characteristics associated with age are
distributed on a Gaussian curve, and only individual
characterizations matter. Claiming that a candidate is “too old”
or “too young” or “too fat” or “too female” or “too
anything” is not clear thinking. Over 80 and doing a good job vs.
under 80 and corrupt and paranoid, you're going to rule out the over
80 as “too old?” Older age and well-tested vs. younger and
untested Senator or Governor, choosing the younger on basis solely of
age? Does that make any sense? This 81year old, exactly one year
older than Joe Biden, says “Hell, no!”</span></p>
<p align="LEFT" style="font-weight: normal; margin-bottom: 0in;"><br />
</p>
<p align="LEFT" style="font-weight: normal; margin-bottom: 0in;"><span style="font-family: Arial, sans-serif;">Budd
Shenkin</span></p>
<p align="LEFT" style="font-weight: normal; margin-bottom: 0in;"><br />
</p>
<p align="LEFT" style="font-weight: normal; margin-bottom: 0in;"><span style="font-family: Arial, sans-serif;">Thanks
once again to David Levine for suggestions, including especially the
final sentence!</span></p>
<p align="LEFT" style="font-weight: normal; margin-bottom: 0in;"><br />
</p>
<p align="LEFT" style="font-weight: normal; margin-bottom: 0in;"><span style="font-family: Arial, sans-serif;">PS
– striking recent references: </span>
</p>
<p align="LEFT" style="font-weight: normal; margin-bottom: 0in;"><span style="font-family: Arial, sans-serif;">1. Tom
Friedman cites Biden's “wisdom:” </span>
</p>
<p align="LEFT" style="font-weight: normal; margin-bottom: 0in;"><span style="font-family: Arial, sans-serif;">https://www.nytimes.com/2023/09/23/opinion/biden-netanyahu-meeting.html</span></p>
<p align="LEFT" style="font-weight: normal; margin-bottom: 0in;"><span style="font-family: Arial, sans-serif;">2. Retired
Three Star General James Dubik, quoted in Atlantic article on Mark
Milley, decries Donald Trump's “cognitive unfitness and moral
derangement.” Besides documenting the manifest unfitness of Trump,
the article describes the ways in which the executive team and the
military were able to erect guardrails through much of Trump's term
in office, illustrating how supplementary influence of the
organization around the President can be corrective: </span></p><p align="LEFT" style="font-weight: normal; margin-bottom: 0in;"><span style="font-family: Arial, sans-serif;">https://www.theatlantic.com/magazine/archive/2023/11/general-mark-milley-trump-coup/675375/</span></p>
<p><style type="text/css">P { margin-bottom: 0.08in }</style></p><p><style type="text/css">P { margin-bottom: 0.08in }</style></p>Buddhttp://www.blogger.com/profile/03893224951099943306noreply@blogger.com0tag:blogger.com,1999:blog-8705432279177203509.post-8252622914575460212023-08-27T14:11:00.009-07:002023-08-27T14:11:43.503-07:00Two Weeks After The Lahaina Fire - A Day On Maui<p>
</p><span style="color: #000099;"><span style="font-family: tahoma, sans-serif;">Met
old friend for coffee in Kihei, near son Peter's gym in the Azeka
Mall. Her husband died last month, age 59. He was a realtor who sold
us our first condo here on Maui. (For the sake of confidentiality,
I'm going to leave out names, not that there's anything super-secret,
just being a little discreet.) After we bought the condo he became
our friend, especially Ann's. He told us that he looked on us as his
preferred parents, since his home life back in Europe had always been
a mess. He lived here in Maui for about 25 years, I guess. We saw
less of him when Ann got sick, and then COVID, but then after Ann
died I had coffee with him at that same coffee house. Then on July
27 he was riding his bike with two friends down from Haleakala and
there was a line up of cars coming up in the opposite lane and and a
jeep tried to pass then all. His two friends riding ahead of him
bailed out but he was third in line and probably didn't see him
coming, so he was killed. It was pretty horrible.</span></span>
<p style="margin-bottom: 0in;"><span style="color: #000099;"><span style="font-family: tahoma, sans-serif;">His
wife, 64, is putting pieces back together. We had our coffee and
talked. Having dead spouses gives us something in common. We do
what people who have lost spouses do, I guess – we reviewed our
lives chronologically, the mistakes of our first marriages, the
second ones a lot better, both better choices and more informed and
patient efforts. She said, eventually as we talked, as though
realizing it for the first time, the only time tears appeared, He was
the love of my life. Not saying, and now he's gone. Maybe she also
felt that at least she had had that, and has that. She said that the
last three months might have been the happiest time of his life. He
thought that he had done well enough, that he had enough, that he
didn't need to do better or have more. </span></span>
</p>
<p style="margin-bottom: 0in;"><span style="color: #000099;"><span style="font-family: tahoma, sans-serif;">At
our last coffee, he had told me about his new responsibilities as
husband and father of two young adult girls. He seemed surprised a
little at his new responsibilities, as husband and father, and
surprised at how well he was meeting them. He was modest about it,
just kind of confided in me. Now, his wife – I so hesitate to say
his widow, but that's what she is, so abruptly, and although they
never officially married, that's what they were to each other,
spouses – confirmed that in spades. He had reached out to the
younger daughter, whom she as the mother couldn't reach, and he found
her responsive. He had told me that he worked so hard on her that it
was hard for him to do his real estate work. Now that he is gone
from their lives, the daughter tells her mother that if she want to
drink, she doesn't, because she remembers him, and is being faithful
to his memory – he wouldn't want her to. The mother and two
daughters agree, it was the wrong father who died; if the original
one had, they would have said, well, no surprise. And implied, no
great loss. How unexpected how everything turned out, the new good
father and the wrong death.</span></span></p>
<p style="margin-bottom: 0in;"><span style="color: #000099;"><span style="font-family: tahoma, sans-serif;">When
she had gotten divorced, in her 50's with two teenagers, she had
thought, well, the odds of finding someone else were slim, but she
and he knew each other within the real estate industry and they
gravitated to each other. He had been careless – no insurance,
little savings, no will, no retirement. She fixed that. He grew up.
She even had him go to the doctor – he had a check up in May, all
OK. That will help in the lawsuit, lots of years left. They had
been together ten years. Just ten years. How do you know it's the
best ten years of your life when you are living it?</span></span></p>
<p style="margin-bottom: 0in;"><span style="color: #000099;"><span style="font-family: tahoma, sans-serif;">She
is directing her anger at the bureaucracy that delayed telling her
that he was dead even though everyone else seemed to know, but the
police had cautioned them not to tell her, to let them do it, but
they were slow, so slow that she got a condolence call before they
actually told her at about 4:30. The accident had been at about
11:15 or 11:30. Write it off as inefficiency, everyone was trying to
do their best. But still.</span></span></p>
<p style="margin-bottom: 0in;"><span style="color: #000099;"><span style="font-family: tahoma, sans-serif;">She
will have to sell their house. She's close with her step-father, who
has been kind of lost himself, but she buoys him up. He's out here
in Maui now; maybe they'll find a house for the two of them. She
thinks that that's it for her and men – no more now. But I think –
you never know. She has friends – I told her I have some friends,
too, some guys, but she said that's nice, but men aren't like women
when it comes to friends, and of course she's right. I told her it
really took me nearly a year and a half to feel recovered, even
though I didn't realize I wasn't all there until I actually felt
better. I don't think there's anything you have to do, except keep
in good shape and busy; then one day all of a sudden you start
feeling better, body and soul both. You have to settle with yourself
that it's not disloyal to feel OK. “Time heals” must be right.
There's a lot going on as time is healing, of course, but I've chosen
not to pay too much attention, just let it happen. I trust my
unconscious, it doesn't need my help.</span></span></p>
<p style="margin-bottom: 0in;"><span style="color: #000099;"><span style="font-family: tahoma, sans-serif;">She
has beautiful blue eyes; she knows she's good looking. I told her to
get in touch if she every wants to do something together. Not
romance, but it's good to have friends. She said let me know when
you're in town. Neither of us wants anything more than friends,
although I did tell her I miss being in love (sometimes, anyway.)
Maybe it's strange for a man to say that, but I've spent a lot of
time with women – I was a pediatrician, after all – and I like
girls and women, so I feel at home with them and I can say stuff like
that.</span></span></p>
<p style="margin-bottom: 0in;"><span style="color: #000099;"><span style="font-family: tahoma, sans-serif;">Then
we hugged tight and left the coffee shop and in the parking lot an
older lady with gray hair and a lively voice was driving by and
stopped and asked me the way to Foodland. I'm the kind of person
that people stop and ask, I guess. Older but not doddering,
respectable, in gym shorts and looking sharp, for a change. I
directed her and she said, answering the unasked question of what a
lady like that was doing asking for directions to Foodland, I'm from
Lahaina. She nodded toward the back seat and there was a large
canvas with a painting of the Capitol Building in DC. She said
to me, "Biden's here today. Maybe if I meet him he can
take this and sell it and I can get some money. It's what I
grabbed. I probably should have grabbed the Hawaii paintings."
I think I said something like, well, who knew, or something like
that. I wanted to do something appropriate to help a refugee,
grab her and hug her, to be very dramatic, or say what can I do, but
she probably wondered what she was doing talking to a perfect
stranger like that, and drove off with what I think was a wistful
smile.</span></span></p>
<p style="margin-bottom: 0in;"><span style="color: #000099;"><span style="font-family: tahoma, sans-serif;">It
was a nice day. I dropped by the always nice Kihei DMV office
(strange for a DMV office, but true, intimate, friendly, efficient)
to reregister the car but there was a note taped to the glass door
that the office was closed because of lack of personnel. No
dates given, but I think it was just put up there today. I
always liked this little office, and I wonder if it will reopen.</span></span></p>
<p style="margin-bottom: 0in;"><span style="color: #000099;"><span style="font-family: tahoma, sans-serif;">I
drove home, ate a little, saw Peter who then went to work, and took a
nap.</span></span></p>
<p style="margin-bottom: 0in;"><span style="color: #000099;"><span style="font-family: tahoma, sans-serif;">Life
is a pretty strange experience, all in all.</span></span></p>
<p style="margin-bottom: 0in;"><br />
</p>
<p style="margin-bottom: 0in;"><span style="color: #000099;"><span style="font-family: tahoma, sans-serif;">Budd
Shenkin</span></span></p>
<p style="margin-bottom: 0in;"><br />
</p>
<p style="margin-bottom: 0in;"><br />
</p>
<p><style type="text/css">P { margin-bottom: 0.08in }</style></p>Buddhttp://www.blogger.com/profile/03893224951099943306noreply@blogger.com1tag:blogger.com,1999:blog-8705432279177203509.post-8806558416128350492023-08-13T08:03:00.005-07:002023-08-13T08:13:22.107-07:00Lahaina A Total Tragedy, Don't Let South Maui Be Collateral Damage<p> </p><div aria-haspopup="true" aria-label="Show details" class="ajy" data-tooltip="Show details" id=":pl" role="button" tabindex="0"><img alt="" class="ajz" src="https://mail.google.com/mail/u/1/images/cleardot.gif" /></div><div id=":p7"><div class="qQVYZb"></div><div class="utdU2e"></div><div class="lQs8Hd"></div><div class="btm"></div></div><div class="aHl"></div><div id=":pk" tabindex="-1"></div><p>Dear Governor Green,<br /><br />Greetings
Governor, my name is Peter Shenkin and I am a 39 year old Kihei
resident, an attorney, and business owner on Maui in the town of Kihei. I
am the owner of Maui Powerhouse Gym in Kihei, with 41 employees and
3,000 local resident full-time members. <br /><br />Sir, I am writing to
your office this evening because I am concerned by the unintended
consequences of omissions to your messaging during statements and
appearances on social media and national television. I think you have
done a wonderful job exhibiting leadership during the current crisis
showing patience, kindness, and sensitivity. I hate to offer
constructive strategic criticism at this time and would not do so if I
believed that it could wait. Sir, with all due respect, I believe that
you are erring strategically by not directly addressing future visitors
to Maui and alleviating their confusion over travel to South Maui over
the next quarter.<br /><br />My recommendation, Governor Green, is that you
please openly and clearly encourage visitors to the island to continue
their trip to South Maui starting in September. Encourage the visitors
to show their support for the island by visiting Maui and remaining in
South and Central Maui during their stay. Your messaging would assist in
mitigating cancelled reservations for the Fall and Winter by reminding
people that South Maui is open for business and that traveling here is
OK and encouraged, and also morally allowable.<br /><br />My fear, sir, is
that your current messaging is not setting a clearly acceptable timeline
for when visitors may return to Maui without moral consternation. As
you are well aware, the resident population of South Maui is entirely
dependent on tourism revenue for their livelihoods. You and I are both
also acutely aware that the incoming wave of cancellations will
devastate the local economy. Measures should be taken to minimize those
damages and their effects. The most conspicuous means of mitigation
would, I believe, be direct and vocal messaging on national media
through your office and the Mayor's office. For political cover you
could cite Mayor Bissen who has acknowledged several times that "Maui is
open for business, you can go to South Maui, do not go to West Maui."
For even more cover, you should nudge Mayor Bissen to start protecting
his South Maui electorate and their jobs on National TV. <br /><br />The
zeitgeist on the mainland is currently: "if you visit Maui you are a
terrible person," "DO NOT VISIT MAUI IN 2023", and other similar
slogans. These populist messages intend to be protective of the victims
and the island residents, which is admirable, but they could potentially
be deeply harmful to small businesses in Kihei, like mine. If these
messages are successful, I sincerely fear a return to doing business
similar to June - September 2020 when there was zero visitor revenue at
all that will last into early 2024. Doing business in that type of
environment would be tremendously challenging for a successful business
like mine but could be existentially difficult for the food trucks,
restaurants, snorkel tours, surf schools, and other small businesses
that are not as sophisticated or well-girded. I truly fear for their
existence if this shutdown lasts for too long, sir. <br /><br />You may not
be aware sir that commercial rent in Kihei is comparable to midtown
Manhattan prices. Kihei businesses cannot afford a fourth quarter with a
thirty to forty percent reduction in revenue without a bailout. It
would be a shame to see this happen when the preventative measures cost
nothing to taxpayers and easily accomplished through words alone.<br /><br />Governor
Green, we are all hurting very deeply right now. We need you to protect
the future of South Maui by being mindful and protective of our fragile
local economy going forward and ensuring its viability. <br /><br />Reach out anytime. Thank you for your time. </p><p>Sincerely Yours, </p><p>Peter Shenkin, Esq.</p>Buddhttp://www.blogger.com/profile/03893224951099943306noreply@blogger.com0tag:blogger.com,1999:blog-8705432279177203509.post-91815433149449361372023-07-31T21:56:00.004-07:002023-08-01T07:49:16.884-07:00Oppie<p>
</p><p style="margin-bottom: 0in;">I was interested to go to see
Oppenheimer, but then I was reluctant to make it my first movie visit
in maybe five years. Then when my friend Benj wondered if I might
review it for him for his on line periodical First of the Month, I
was willing to fight the obstacles. The full houses that put off my
seeing it for a week; the new technology of being ticketed on-line
which led to double booking for my seat J-19 and kept me expectantly
waiting for the rightful owner of the empty seat J-16, where I had
perched, to appear and claim the seat. When we got to 2:30 I thought
I was home free until I realized all the mindless previews only ended
at 2:55, but I managed to stay where I was unimpeded. And then the
new technology for paying for parking which involved loading an app
and getting a movie employee to enable the scanning machine to get my
voucher recognized. Good thing I had time, nowhere to go, it was
summer and so still light outside. Yet, I had to wonder yet again,
is advancing technology worth it? How appropriate.</p>
<p style="margin-bottom: 0in;"><br />
</p>
<p style="margin-bottom: 0in;">(Not to mention that for a half-hour
lead in and a three-hour film, I got so uncomfortable later on that I
had to leave momentarily to visit the bathroom, about when Kitty
faces the inquisition committee that ultimately nixed renewing
Oppie's security clearance, so I won't be commenting on that, except that "inquisition" is the right word in these very religious rites. We get
so comfortable with streaming, bathroom and refrigerator nearby,
pause button at the ready.)</p>
<p style="margin-bottom: 0in;"><br />
</p>
<p style="margin-bottom: 0in;">But forget all that. Benj had
suggested I review Oppenheimer because of my unquestionable
credentials – security, science, movies, and taste for men who love
women. That was too much of an inducement to ignore. And then,
despite Nolan's once again, as in Dunkirk, overusing loud, insistent
music that sometimes drowns out dialogue, this is a brilliant, even
genius movie. He's making a familiar story into myth, in the best
way possible, in the new technological advance over literature, the
movies. A technology that was itself questioned by lovers of books, although now that books and movies comfortably co-exist, the bleats of objection are muted.)<br /></p>
<p style="margin-bottom: 0in;"><br />
</p>
<p style="margin-bottom: 0in;">It could only be told by interweaving
the later time plot line of (1) trying to renew Oppie's clearance
followed by Strauss's failure to be confirmed by the Senate for a
post in Eisenhower's cabinet, and moving back and forth to (2)
Oppie's personal history and the well-known Manhattan project
trajectory. A straight chronological time line would have been
deadly; the script is just brilliant at heading to two climaxes
simultaneously. (And, after all, we're dealing with physics here,
and the imponderablity of time running only one way and the
undecipherability of quantum physics, so moving time around is
altogether appropriate.) The use of black and white for the post war
plot line, and full color for the sunnier times of war and fighting
fascists, is once again brilliant. The McCarthy era deserves nothing
more than black and white, truth and myth over reality let's not uplift emotions for those guys.
One reviewer regretted that the full depth of Oppenheimer's genius
for languages and art went unplumbed, but to my mind, just alluding
to it was startling and revealing, and the unstated depths were just
the back story you can get if you read the books. The man was a
genius, folks, and that's what geniuses do. But it doesn't mean
they're good at relationships or politics, let's get that straight.
Here in the movie, the allusions were perfect, and that's what is
great about movies, the small items, hardly even noticed, that you
have to take real time to allude to in books.</p>
<p style="margin-bottom: 0in;"><br />
</p>
<p style="margin-bottom: 0in;">And then the mixing of the
personalities, the human stories, and the science. The picture of
individuals with all their weaknesses and evil – their humanness –
unlocking the locked boxes of the gods, the knowledge, the Furies.
That's really what it is.</p>
<p style="margin-bottom: 0in;"><br />
</p>
<p style="margin-bottom: 0in;">The scientists are, well, scientists.
They are like the people who think that explaining the facts will
make Red states get vaccinated. Oppie argues with facts to make his
case for his personal survival and resurrection and conquering his
foes, no strategy but that, “if I only explain to them.” His
wife says, fight! She smells out Strauss for the jackal he is, and
what a performance by Robert Downey Jr. It might be his best
performance ever, and it's brilliantly written as the truth only
gradually becomes apparent – it had me distrusting what I knew
about his being awful when I experienced the time as a young
teenager, was I wrong? Downey plays it perfectly, as finally the
truth of his petty perfidy and consummate skills as a bureaucratic
infighter come out, in black and white as it should be.</p>
<p style="margin-bottom: 0in;"><br />
</p>
<p style="margin-bottom: 0in;">Nolan makes the whole story mythic, how
the power was unleashed by people who all saw only slivers of the
picture. Scientists as technicians who think they know more than
that, political and military figures who know more than the
scientists about uses but have less vision of what is possible,
perhaps, or perhaps more vision of what is realistic in international
relations. It could be this way, we could trust each other and find
a common path to peace, says Oppie. I didn't see it in the movie,
maybe I missed it, but Einstein said to him, don't you see, they need
you, you don't need them, walk away. But then, that's Einstein, with
his weaknesses for the reality of everyday life and love that we saw in the series where he can't
handle women. Einstein dives back into his private life of
contemplating sitting on light beams and feeding ducks, but Oppie
can't do that, he's involved, which isn't to say he knows how to play
the game. Einstein thinks he's foolish for that, I think Oppie has the
impulse to be more socially responsible than Einstein. But people
are different.</p>
<p style="margin-bottom: 0in;"><br />
</p>
<p style="margin-bottom: 0in;">And then there are the sex scenes –
brief but enjoyable, prolonged look at female nudity without shame or
desire – the burden that wife Kitty has to bear with this husband
whose capacity for showing affection might be limited but whose
libido is not, and she's had her own troubles, of course. I think
people tend to treat the foibles of the scientists with less
compassion than they should; if it were a straight love story, we
would, but here it's just backdrop to the main issue of the unlocking
of the secrets of the gods by mortals, so compassion for foibles is
in short supply. People just open the damn locked box because they
are people.</p>
<p style="margin-bottom: 0in;"><br />
</p>
<p style="margin-bottom: 0in;">The picture we get of a scientific
genius becoming an organizational genius who bumbles through his
private life (although he's shown as very brave politically in resisting social pressure to join the Party,) of the times when smart scientists thought life could
be organized scientifically as socialism because it was reasonable,
of the politicians who don't realize that it's not a new weapon it's
a new world – all this makes you think, how can Armageddon not
happen, one way or the other? An unanswered question, likely for all
time, until it's decided unfavorably, and then we know. (See my
review of the final book of Dan Ellsberg – a review that Ellsberg
himself liked a lot – here
<a href="http://buddshenkin.blogspot.com/2018/02/ellsbergs-doomsday-machine.html">http://buddshenkin.blogspot.com/2018/02/ellsbergs-doomsday-machine.html</a>).</p>
<p style="margin-bottom: 0in;"><br />
</p>
<p style="margin-bottom: 0in;">It's not disrespectful to make these
events into a story, into myth. The spectacular use of special
effects, prospects of dead and disfigured people in blanched-out
flashes as projections of Oppie's vision of crazy guilt or seer's
vision of reality as seen by gods, is appropriate and not overdone,
as it could well have been. The quieting in the soundtrack of
screaming crowds and explosions you half-expect to see, the
counterpoint to the insistent music (that, again, I didn't like any
better here than in Dunkirk), that's fine, too. Not too flashy for
flashy's sake, more masterful, I'd say.</p>
<p style="margin-bottom: 0in;"><br />
</p>
<p style="margin-bottom: 0in;">So, finally, a brilliant movie that I
was set to dislike. Maybe one of the great ones. Just goes to show you – don't predict, let
them play the game. <br /></p>
<p style="margin-bottom: 0in;"><br />
</p>
<p style="margin-bottom: 0in;">Budd Shenkin
</p>
<p><style type="text/css">P { margin-bottom: 0.08in }A:link { so-language: zxx }</style></p>Buddhttp://www.blogger.com/profile/03893224951099943306noreply@blogger.com0tag:blogger.com,1999:blog-8705432279177203509.post-63679218073970886602023-07-17T09:23:00.003-07:002023-07-17T09:27:31.831-07:00A Baby And A Rolls-Royce<p>
</p><p align="LEFT" style="font-weight: normal; margin-bottom: 0in;">I
needed a job. I had run out of fellowships, I had run out of local
academic positions that didn't pay anything anyway, I had a new wife,
two kids, two step-kids, and I needed a job. I didn't really know
how to practice pediatrics, the way a new lawyer doesn't really know
how to practice law when he or she starts, but it was something I
could do at the beginning well enough not to kill anyone, and I would
learn. So I started being a pediatrician.</p>
<p align="LEFT" style="font-weight: normal; margin-bottom: 0in;">My two
new colleagues in Oakland needed someone to be on-call with them.
Nights and weekends needed to be covered, and their third on-call
pediatrician was leaving independent practice to join a newly forming
group that Peralta Hospital had been persuaded to back, even building
a new office building for the group right there on Oakland's
so-called Pill Hill, where three hospitals were within a block of
each other. In time, of course, the three hospitals would merge into
one, then be bought by regional powerhouse Sutter Healthcare, and the
new group would fail, and I would move with my new small pediatric
group into one of the offices in the new building – but that was
ten years in the future. For now, one of my new associates, John,
needed someone to occupy the other suite in the small, one story
office building that he owned, and he and Bruce, with an office around the
corner, needed that third on-call slot filled. They needed me, I
needed a job, so we had to strike a deal. Luckily I had some money
so I could ease into practice slowly and not worry about loans. My
independent means also gave me some class in their eyes, and of
course, I always had my swagger, the Big Shot, as my father would
say. But really, I had never thought about being in solo practice,
and I had no idea what awaited me.</p>
<p align="LEFT" style="font-weight: normal; margin-bottom: 0in;">Part of
our deal was reduced rent for six months or so, and they would
introduce me to their referring doctors so I could start picking up
patients. John and Bruce didn't want me to siphon off their private
patients, so they made sure to introduce me to the OB's with a lot of
Medi-Cal patients, along with some privates. They took me over to
the hospital to the doctors' lunch area in the cafeteria and
introduced me around. And that's how I met Jim Cadwallader.</p>
<p align="LEFT" style="font-weight: normal; margin-bottom: 0in;">Jim and
his OB associate Ned Nuddleman weren't partners, but they worked
together, assisting each other for C-Sections and splitting call.
Bruce and John had enough Medi-Cal patients and could spare those
patients that Jim and Ned would refer to them. That was the pattern
as you got more successful, let the Medi-cal go and load up on
privates if you could. Later on, as I got successful on my own, I
changed that pattern and kept my Medi-cal patients, and instead hired
associates to help with an enlarging practice, but that's another
story.</p>
<p align="LEFT" style="font-weight: normal; margin-bottom: 0in;">If
Jim's unusual last name seems familiar, you might recognize it from a
little throwaway line in The Philadelphia Story, uttered by Cary
Grant, in his ultimately winning way. (What an actor, Cary Grant!)
His character was top of the heap on the Philadelphia Main Line, old
established rich, and he mentions “the Cadwalladers” as others of
his ilk. You have to listen hard to hear it, but it's there. The
Philadelphia Cadwalladers, poshest of the posh. And right here, on
Pill Hill in Oakland, was a verified Cadwallader. Although I soon
found out that this Cadwallader – a little above average in
height, an attractive round face with dark hair and rather clear
light skin, with many a smile but also some lingering insecurity –
was definitely not top of the heap at Merritt, and was not from
Philadelphia, but from Nebraska. Was he related to the Philadelphia
Cadwalladers? Not that we knew, but it's not that common and name,
and who knows? Every family has its black sheep, the ones who find
their way to, say, Nebraska, whose offspring might get medical
degrees and find themselves serving Medi-Cal patients in Oakland,
California, don't they? I thought they must.
</p>
<p align="LEFT" style="font-weight: normal; margin-bottom: 0in;">And Jim
definitely qualified as an eccentric sort. He looked good, he
dressed well, we hit it off at once – he told me later, “didn't
you just feel it?” – and he liked to laugh. But he wasn't
married, and he was insecure, that's something you certainly could
feel. He tended to look anxiously left and right. Someone who
seemed to need a friend. And sure enough, we did become friends,
often waiting together with Nuddleman during the night for an OR to
open up so that he and Ned could do their C-section and I could catch
the baby. We weren't fast and close friends, but he did invite us to
parties given by his considerably older girl friend Ethyl, who lived
in a huge house in Burlingame, which Ethyl had owned since her rich
husband had died some years before. They were an interesting pair,
they kind of adopted Ann and me, then newly-married and both much
younger than Ethyl, as we sought to establish some kind of social
life, as I was establishing a new professional life.
</p>
<p align="LEFT" style="font-weight: normal; margin-bottom: 0in;">As I
look back on it now, it was hairy. I really didn't know what I was
doing, just winging it day by day, having a job, although I did think
that I had to learn to do this job before I could make it a thriving
business with a group of doctors, I hardly even thought of these
future doctors as employees, too bold a thought, but it was there.
And Ann and I were making our way together, both having divorced our
spouses to be together, hoping it would work, because we had bet a
lot and hurt other people to live our dream.</p>
<p align="LEFT" style="font-weight: normal; margin-bottom: 0in;">So
anyway, Jim and I became friends and he referred patients to me and I
did a better and better job with them. But in practice, you never
know what will happen, and sure enough, a couple of years into it,
one bright morning in the office I got a call from him. He sounded
excited and challenged. He had gotten a call from someone, probably
his patient, who had a daughter who lived at home and who was a
college student at Cal. What had happened was, that morning her
daughter had gone into the bathroom and had a baby. Jim's patient
and her husband didn't even know that their live at home daughter was
pregnant, so it was more than a surprise. They didn't know what to
do, so they called Jim. He said that he was going to get the new
mother into the office and examine her to make sure she was all
right, and would I examine the baby? Sure I would.</p>
<p align="LEFT" style="font-weight: normal; margin-bottom: 0in;">So,
next thing I knew, just maybe a half hour later, Jim was driving into
our parking lot with the new mother, the new grandfather, and the new
baby. Oh, yes, I forgot to say, one of Jim's eccentricities was that
he liked to drive nice cars. His car was a Rolls-Royce. So he rolls
into our parking lot in his Rolls and they all pile into my little
office. What a scene! The baby's grandfather was Chinese with a
rather thick accent, clearly an immigrant. The new mother was an
attractive young college student, and as I examined that baby girl, I
discovered that she was a normal newborn, a healthy and beautiful
newborn. What should we do? I said to Jim, well, the baby's normal,
they could go home. Nope, said Jim. Born at home, non-sterile
conditions, let's admit them both to the hospital and watch for a
while, which we did. Back up to Merritt, our home base, into our OB
ward and the nursery, and we were all comfortable.</p>
<p align="LEFT" style="font-weight: normal; margin-bottom: 0in;">But
then Jim said, what should we do with the baby? We didn't know what
their plans were, and as it had all come as a sudden surprise, we
figured that they didn't have any plans. So, here's the amazing
thing. Just a couple of months previously, one of our hospital
colleagues, Revels was his name, an internist with a specialty in
pulmonology, had approached me. Revels was an operator, always with
an angle and always well and even nattily dressed, a light skinned
black man with origins in Mississippi and a civil rights family
background, with a beautiful and classy Chinese-American wife.
Revels had asked me a question that I had never been asked before and
would never be asked again. He asked me if I sometimes came across
babies who needed to be adopted. He and his wife could not have
babies and they had decided to adopt. I had told him that I would
look out for him, but that's it's not something that usually comes up
for me.</p>
<p align="LEFT" style="font-weight: normal; margin-bottom: 0in;">So,
when Jim asked me what do we do with the baby, I naturally thought of
Revels and his wife. What a set up! An asian baby for a half-asian
couple, a college student mother so the baby would probably be
intelligent, and no waiting time on a list of prospective adoptive
couples. The hand of God, I would think if I believed in God. We
approached the family, Jim and I, and they seemed receptive to the
adoption idea, so I put in the word for Revels. Revels was beside
himself at the find, told me of course I would be his pediatrician of
choice (strange that he would say that, I thought, but I figured that
I was not top of the heap in pediatrics at Merritt – yet – and it
was a concession to me on his part) and the deal was made. Adoption
is not a final decision in California until six months had passed,
and such was Revels anxiety that he was after me repeatedly during
that six months period, was the mother wavering? Of course I wasn't
seeing the mother, but I still reassured Revels, I can understand
your anxiety, but I think it's going through. Which indeed it did,
and Jim and I counted ourselves heroes in this excellent adventure.
</p>
<p align="LEFT" style="font-weight: normal; margin-bottom: 0in;">I never
got a chance to check on the Chinese family, wondering what happened
to them. From our point of view, Jim and me and Revels, it had gone
great. I don't know about the mother. When mothers give babies up
for adoption there are always little or bigger scars, second thoughts
for a long time, no matter how much they know it's the right thing to
do. I never saw her again, so I don't know.</p>
<p align="LEFT" style="font-weight: normal; margin-bottom: 0in;">Then
there's the father of the new mother, the grandfather. What a day he
had! He was a tender man with a heavy Chinese accent, clearly an
immigrant who seemed to have made a wonderful transition to America
with an achieving daughter, despite this misadventure. After all the
commotion that had ended with both mother and baby at Merritt
Hospital for a few days for observation, we drove away in Jim's Rolls
with me in the passenger seat and the new grandfather in the back
seat. He looked around and summed it up for us. “What a day!”
he said. “First my daughter has a baby and I didn't even know she
was pregnant, and then I get to ride in a Rolls-Royce!” Jim and I
looked at each other and kind of chuckled.</p>
<p align="LEFT" style="font-weight: normal; margin-bottom: 0in;">You
just don't know what you're going to find, when you go into practice
in the community, you just never know. You make friends, you meet
all kinds of people, you share in life's adventures. I did get to
see what happened to the baby. She grew up to be a lovely and
accomplished young woman whose parents doted on her. When she got
into the school years, Revels and his wife switched her away to my
colleague Bruce for pediatric care. Bruce had higher prestige around
the hospital, but that's the way it goes. Revels was an operator.</p>
<p align="LEFT" style="font-weight: normal; margin-bottom: 0in;"><br />
</p>
<p align="LEFT" style="font-weight: normal; margin-bottom: 0in;">Budd
Shenkin</p>
<p><style type="text/css">P { margin-bottom: 0.08in }</style> <br /></p>Buddhttp://www.blogger.com/profile/03893224951099943306noreply@blogger.com1tag:blogger.com,1999:blog-8705432279177203509.post-88336147491976883352023-06-09T22:05:00.002-07:002023-06-20T07:38:27.353-07:00Catcher in the Rye and Streetcar Named Desire<p>
</p><p align="CENTER" style="margin-bottom: 0in;"><span face="Arial, sans-serif"><i><b>To
Love Without Knowing</b></i></span></p>
<p style="margin-bottom: 0in;"><br />
</p>
<p style="margin-bottom: 0in;"><span face="Arial, sans-serif"><span style="font-size: small;">I
always find it kind of amazing to find out how little I know.</span></span></p>
<p style="margin-bottom: 0in;"><span face="Arial, sans-serif"><span style="font-size: small;">I
can go through life loving something, being attracted to something,
recommending something to others, and then I realize that I really
didn't understand it in the first place. I am saved only by the fact
that others have been in the same state. We might have liked
something, been attracted to something, been able to talk about it,
but then something happens and I realize that we reallydidn't
understand it, not really. In fact, the more I think about it, the
more I think we like (or dislike) much more than we understand.</span></span></p>
<p style="margin-bottom: 0in;"><span face="Arial, sans-serif"><span style="font-size: small;">I'm
thinking about books and movies, two pastimes, sometimes obsessions,
and sometimes loves. When something grabs me, – that's the word,
when something grabs me, I just grab it back. Eventually we let go
of each other, but even then, the memory stays. Even if it was a
youthful attraction – the Hardy Boys, say – and you realize you
were an immature appreciator of a work aimed at the immature, still,
the good feeling remains. Or even before that, A. A. Milne and
Christopher Robin and Pooh. And then in my mid-teen years, when I
felt so good about having become a good reader, and I reveled in
being able to just go through books, I briefly read science fiction.
Lester Del Ray – what a name! He had to have been born to write
science fiction, Lester Del Ray. It was a brief infatuation, but the
good feelings remain, and some of the memories – exploring around
the place of your birth to discover you lived in a sphere in space
that had been expelled from Earth. Can't forget that one.</span></span></p>
<p style="margin-bottom: 0in;"><span face="Arial, sans-serif"><span style="font-size: small;">But
some books are loves that haunt, and stay, and you love, but maybe
you don't really understand. Like that old trusty book now become a
standard, so standard that current young people can say to my
surprise, “I hated that book they made us read!” They made you
read that book, the one my mother gave me, recommended to me, only
five or six years after it was written, that was even somewhat
subversive – my mother liked somewhat subversive books. Or at
least intelligent books, which some people suspect of being
subversive just because of that quality. Catcher in the Rye. I read
it when it didn't have the disadvantage of having been recommended
and assigned, so it had the air of discovery. It's not secret now,
but when I first read it, I think I was the only one of my friends
who did. My mother was responsible for so much of my discoveries of
books. I myself discovered Word Power Made Easy, which I still love,
but that's such a minor discovery compared to all the books my mother
gave me to read.</span></span></p>
<p style="margin-bottom: 0in;"><span face="Arial, sans-serif"><span style="font-size: small;">Holden
was haunting, who couldn't root for him, identify with him? I sided
with his denouncing phonies even though when I read the book I had
not yet met a real preppie. That came several years later, when I
was a freshman at Harvard, and I guess I saw then what he was talking
about. The accents, the attitudes, even the nice ones, John Erdman
who was a nice boy my age but came from Hotchkiss Academy and
affected a tweed jacket and, wait for it, a pipe. Eighteen years old
in a tweed jacket and with a pipe. Ivan Light tried the same shit, a
pipe. And John was taking advanced French literature as a freshman,
he said with his deprecating and experienced voice, and he was only
eighteen, and I was envious. He was nice, actually, he just had
these affectations, which maybe affected him more than others. They
said he was depressive, afterwards they said that, anyway, after we
went to medical school together and he became a heart surgeon – why
did you do that, John? – and I guess he was good enough to go to
the Mass General but long after I had left Boston, while he was still
in training, he was ready to fly on his own and he opened up a chest
to do an operation but, for some reason that was only described to me
as fear, he didn't follow through with doing the operation and he
just closed the chest back up, without doing anything, and hooked
himself up to an IV and lay down, I imagine on a gurney, and killed
himself. He was a nice person, he was smart, although affected, but
nice, somewhat less than average size, pursed lips it seemed, formal,
preppie. I wouldn't have known he was Jewish if someone hadn't told
me. I don't know if he had pimples, probably not, but I tend to
think of him as having had pimples because that's the way Holden
Caulfield described The Makeout King, I think it was, although John
was nothing like The Makeout King. Phonies, Holden hated that.
That's what I guess I thought the book was about, even though Holden
wound up in a mental hospital at the end of the book, which I didn't
understand, and his closest friend was probably his little sister
Phoebe. That's an unusual name these days, but when you meet a
Phoebe, or you hear of one, do you think of Holden's sister? I do,
even when I don't consciously do it. It's a name I pay attention to.</span></span></p>
<p style="margin-bottom: 0in;"><span face="Arial, sans-serif"><span style="font-size: small;">But
what I was saying before I got diverted, or at least I think I got
diverted, was that you can love something and be influenced by it, or
seduced by it for reasons you might not be able to describe, or even
haunted by it, and not understand it, or maybe understand it and not
know that you do, because you can't express it, or maybe it's an
unconscious understanding, a non-verbal understanding of a purely
verbal medium, books. So when Catcher in the Rye was fifty years old
Louis Menand wrote in the New Yorker <a href="https://www.newyorker.com/magazine/2001/10/01/holden-at-fifty">Holden
at Fifty</a>. The book is so famous you can just use the first name
of the protagonist. Louis Menand is so very smart, he's one of those
writers that if you see his name, just read it. </span></span>
</p>
<p style="margin-bottom: 0in;"><span face="Arial, sans-serif"><span style="font-size: small;">So
I read the review and I realized, for all my love of the book, for
the attention I had paid to it, even writing a tiresome paper about
it in David Riesman's class at Harvard, I realized that I didn't
understand the first thing about it. Because the first thing about
it is his brother Allie died, and Holden just couldn't come to terms
with it. “Come to terms.” That's quite an expression, isn't it?
“Get over it.” “Wrap his arms around it.” Instead, he goes
nuts. He tries to work it out with Phoebe, but he goes nuts,
although he does emerge eventually. And where are the parents?
Parents – they never get over a death of a child, do they? Or not
nowadays, maybe. More kids died than survived originally, some
societies didn't even name kids until they were two years old.
Lincoln lost Willie, his favorite, right in the middle of the Civil
War, and he was depressive to begin with, they say. And I couldn't
even realize that, as Menand says, that's what it's all about. I
just don't understand literature, I think. Although I did, for
reasons that I never really understood, name my firstborn child
Alexander, to be called Allie. Allie – why choose that? I always
said that I named him after Holden Caulfield's older brother who
died, and the Yankee righthander Allie Reynolds, although that must
have just popped into my mind, because if anyone knows me, they know
I'm a born and bred and nurtured Yankee hater, from Philadelphia. So
Reynolds was just an afterthought. I think maybe I did understand
more than I knew, because choosing that name is like repairing
Holden's sanity. But what did I know?</span></span></p>
<p style="margin-bottom: 0in;"><br />
</p>
<p style="margin-bottom: 0in;"><span face="Arial, sans-serif"><span style="font-size: small;">I've
also always loved my favorite playwright's best movie, Tennessee
Williams's Streetcar Named Desire, which I watched the other night.
I'm pretty sure I never really understood it, maybe don't understand
it now. I'm pretty sure I've watched it more than I've read Catcher
in the Rye. Movies are short, but so concentrated. It doesn't take
long to describe an atmosphere, it just appears. You choose black
and white sometimes even when color is available. Eddie Muller on
TCM quotes someone who says, color is more realistic, but black and
white is more truthful, or something like that. Black and white is
so intense, especially when there are lots of shadows and streaks of
sunlight, like a Tintoretto. Somehow black and white concentrates
the feelings, I think. </span></span>
</p>
<p style="margin-bottom: 0in;"><span face="Arial, sans-serif"><span style="font-size: small;">I've
always felt Streetcar was one of the very great movies, a true movie,
even though it deals with so much invention and pretension. I think
if you're not in a class and you don't have to think about it and
talk about it, maybe you don't come to terms with it. So I guess I
didn't. I liked Marlon Brando, I could sense all the tension, I
heard people remark on his brutality, and everyone yells “Stella”
when you start to talk about it. Why is that? It's so startling, is
that it, striking? Or is it embarrassing, it's so stark. And you
think about Blanche, played by Vivian Leigh, and her feeble
pretensions and her sordid past about which she lies. And you think
about Mitch, played by Karl Malden, his frustrations living with his
mother, seeing a chance to break through his limits with Blanche, and
then finding out about her lies. Finding out because Stanley
(Brando) makes it his business to find out that she had turned to
whoring, that she had seduced the wrong young man and had gotten
thrown out of her town. I had to tell him, Stanley tells Stella, he
was with me in the war! What was he going to do, sit on it? But why
did he inquire, because he hated her, or because her seductiveness
caused him so much confusion?</span></span></p>
<p style="margin-bottom: 0in;"><span face="Arial, sans-serif"><span style="font-size: small;">The
quietest of the group, the one with the least screen time, the least
demonstrative, is Stella herself, played by Kim Hunter. When I saw
it this time, her dilemma is what hit me hardest for the first time.
What would anyone do in her situation? You love your husband, you
are having a baby for the first time, a huge event, and your older
sister comes to visit, as a last resort in saving her life. Sisters
can't turn each other away. Stella is caught in a vise. She can't
deny her sister, she can't deny her husband, and she's having a baby.
You see your household falling apart, but what can you do?</span></span></p>
<p style="margin-bottom: 0in;"><span face="Arial, sans-serif"><span style="font-size: small;">Stanley
has been called a brute, but he's not. What is he going to do? He
loves his wife, he needs his wife, and he can't stand her sister's
invasion, he can't stand her, and she's there for months with no
signs of leaving. He could let Mitch take her, but that would be
craven – poor Mitch, how can he let that happen? His wife's crazy,
lyhing seducetive sister. And Mitch is caught, too – why does the
truth have to raise it's ugly head? If it didn't, he could solve his
own problem, no woman and home with Mama. Can you imagine what would
happen to Mitch with his friends if he ignored Blanche's lies? </span></span>
</p>
<p style="margin-bottom: 0in;"><span face="Arial, sans-serif"><span style="font-size: small;">And
what is Blanche to do? She wound up at her last resort. She has run
out of options. Her dilemma is that she can't do anything, she has
to rely on others, and she must hope that they will be kind. </span></span>
</p>
<p style="margin-bottom: 0in;"><span face="Arial, sans-serif"><span style="font-size: small;">In
Streetcar, everyone has impossible choices.</span></span></p>
<p style="margin-bottom: 0in;"><span face="Arial, sans-serif"><span style="font-size: small;">Sometimes
the only solution is to bulldoze things through, and Stanley is the
bulldozer. Don't ignore the truth, don't wait for “things to work
themselves out,” don't wait for others to act, it takes a bull.
But to be the solver, he will also be the heavy. To solve these
problems, someone must suffer. Or maybe everyone will suffer,
because that's what happens with dilemmas, especially with quadruple
dilemmas. But then, everyone hates you for it. Mitch is left with
his problem, Blanche has to go with all her pretensions. Stella has
failed her sister and hates her husband for it. And Stanley is left
hoping that he will be forgiven and his marriage will be restored.
Because the central truth of the movie is the love between Stanley
and Stella. It's why it's so appropriate that everyone remembers
“Stella!” What is it about those cries, repeated throughout the
movie? Brando's cries are a mixture of insistence and plea, with his
aggression, yes, but with his insistent need. Mitch knows they love
each other desperately – everyone knows. She says she'll never be
with Stanley again, but whenever she says it, even at the end, you
know it's not true, it can't be. </span></span>
</p>
<p style="margin-bottom: 0in;"><span face="Arial, sans-serif"><span style="font-size: small;">So
in the end, faced with all the dilemmas, the brutal insistence of
love puts itself forward. But you get the feeling, and this is
Tennessee's genius, you can't imagine anyone doing anything else.
It's all as insistent as a Greek play, the insistence of fate and
destiny which lies in ourselves and where we come from and, if you'd
like to believe it, the insistence of what the gods will. Are there
some of us the gods will to be crazy? Insoluble dilemmas, not brain
chemistry, were posited to be the core of schizophrenia, said R. D.
Laing, back in the 1970's. Seems right for Blanche.</span></span></p>
<p style="margin-bottom: 0in;"><span face="Arial, sans-serif"><span style="font-size: small;">How
much control do we have? Any? We all struggle through and do the
best we can. People help us along the way. The kindness of
strangers, the kindness of those we know and love, the best we can
do.</span></span></p>
<p><span face="Arial, sans-serif"><span style="font-size: small;">The
gods are cruel. Our dilemmas are often hopeless.</span></span> <br /></p><p style="margin-bottom: 0in;"><span face="Arial, sans-serif"><span style="font-size: small;">But,
on the other hand, they are also kind. For instance, how come we
have been granted to right to love something, or someone, and we
don't even know what it is or who it is we are loving? Why do I love
Catcher in the Rye and Streetcar? I really can't tell you. But I
really do love them. </span></span>
</p>
<p style="margin-bottom: 0in;"><br />
</p>
<p style="margin-bottom: 0in;"><span face="Arial, sans-serif"><span style="font-size: small;">Budd
Shenkin</span></span></p>
<p style="margin-bottom: 0in;"><br />
</p>
<p style="margin-bottom: 0in;"><br />
</p>
<p><style type="text/css">P { margin-bottom: 0.08in }A:link { so-language: zxx }</style></p>Buddhttp://www.blogger.com/profile/03893224951099943306noreply@blogger.com0tag:blogger.com,1999:blog-8705432279177203509.post-78041472647845890942023-05-29T09:25:00.004-07:002023-05-29T09:25:58.214-07:00Medical Education Is A Patchy Thing<p>
</p><p style="margin-bottom: 0in;">I've been asked a lot, first, why do
you want to be a doctor, and then, why did you want to become a
doctor. I've always been too concrete to say, “destiny,” which
is a more positive word than “fate.” Nowadays, now that my
doctoring is through – or is it? – I tend to think it was
destiny, what with my father being a neurosurgeon, and with my
temperament harboring kindness and with my being smart. But back
then, when I was a medical student, it might have felt more like
fate, although I never regretted it. Even when I felt I might not
belong to the Harvard Medical School milieu, even when I was a
malprepared and maladapted second year student appearing on the wards
of the Beth Israel Hospital with a formal and unwelcoming Benjamin
Banks as my first attending, even when the house staff were the
insiders who hazed me and I was the outsider, I never thought that I
didn't belong. I might not have known how to play their game yet,
but it was I who belonged, because my father was a great and devoted
doctor and I was a chosen and respected son, and if I perceived the
BI crew as formidable and ingrown and somewhat bleak, it wasn't me
who didn't fit in medicine, I figured, because one thing that I had
been given by my family was self-respect, and that was never leaving
me.</p>
<p style="margin-bottom: 0in;"><br />
</p>
<p style="margin-bottom: 0in;">But that isn't to say I was ready,
because I wasn't. I didn't picture myself saving anyone, or serving
anyone, although being nice and essentially beneficent by nature, my
brother and my sisters thought I was and family friends thought I was
and I guess they mentally matched me up with their daughters, they
all probably projected my being nice onto my role as a prospective
doctor. But I was coddled, there is no better word for it, I guess.
Not that I wasn't held to rigorous standards, I was, and I had
internalized that, but it was all academics, although it was also
sports. But classroom study was my thing, I excelled, my father said
I could pass an exam in any subject, even if I hadn't studied it, as
long as it was a multiple-choice test. Classrooms – let me at
them. Tests – not a problem. Laboratories – well, not so much
the hands on stuff, to tell you the truth, I was a theory guy, a
words guy. Except for sports, there I was rock'em sock'em. But
classroom studies, chess, my turf. My medical destiny? Maybe public
health, my father drummed into me – they had a good deal going, he
thought, practice was so high-tension, such a grind. Public health –
all that time off, the academic postings in foreign lands, that was
the greener grass to my father, and I accepted it <i>faute de mieux</i>.</p>
<p style="margin-bottom: 0in;"><br />
</p>
<p style="margin-bottom: 0in;">And then, all of a sudden, there I was
on the wards, real doctors and real patients and long hours. The
patients were welcoming. In those days the BI had open wards, a big
room with probably eight or ten beds arrayed around the periphery.
When the sun came up we were there to take the daily blood tests,
syringes, needles, tourniquets, test tubes in hand. One really nice
black guy on the left as you came in had giant veins, and he knew he
was the med student's gift. I came in and he said, “Hey, doc!”
and beckoned me over and offered up his antecubital fossa – that
is, the reverse side of the elbow – where giant veins stuck out
like giant worms. He offered his veins as a return gift for all the
care he was getting in these pre-Medicaid pre-Medicare days. Me -
“doc.” Jesus, what a new world.</p>
<p style="margin-bottom: 0in;"><br />
</p>
<p style="margin-bottom: 0in;">And then on the far wall was Mr.
Marcuse, a spare and very thin little man who lived not far from the
Mass General, but had wound up here at the BI. When he had appeared
at Mass Eye and Ear, his chief complaint had been wax in the ears.
Assigned to a medical student, a full history and physical had
uncovered stomach pains in the review of systems. The doctors worked
him up and determined he needed an operation for cancer of the
stomach or intestines, or something, so they had operated and there
had been post-op adhesions – fibrous bands had strangled his small
intestines after the operation, probably performed by house staff, I
guess – and he had lost pretty much all of his intestines and
couldn't absorb anything and was wasting away on this ward of the BI,
because he had sought help for excessive wax in the ears. No one
said much about him, there was silent indications of a cautionary
tale, but caution for what? Was the patient at fault for seeking
care, the med student for doing a complete history, the decision to
operate for what turned out to be non-cancer, the operation itself?
Or a system that used human beings of the lower socioeconomic order
to train doctors? No one said, but there was Mr. Marcuse stoically –
or, rather, with anger suppressed – wasting away in his bed on the
far wall, ready to give his history to one and all.</p>
<p style="margin-bottom: 0in;"><br />
</p>
<p style="margin-bottom: 0in;">Looking back on it, maybe that was the
shocking introduction. Or maybe it was the formal rounds where I was
expected to know how to present a case, never have been taught to do
so, just having seen an example or two, I guess, and only at the end
adding to my succinct history, after Dr. Banks, with his little gray
mustache and suit and tie bent over the patient with stethoscope in
hand and in ears, only at the end did I add, Oh, and he is a
diabetic. The look of disdain and offense and disgust that I was
shot by Dr. Banks as he straightened himself up and snapped at me for
only adding a crucial piece of “the case” as an afterthought.
The look of glee from Lee Younger, one of my residents with a cruel
streak, as he contemplated my dismemberment. I wasn't in
Philadelphia anymore, I wasn't in a classroom anymore, I was no one
in particular's son in the eyes of Dr. Benjamin Banks and Lee
Younger, I was just an ill-prepared second year student at the med
school that had just decided that waiting for the third year to send
the students onto the wards was a waste of time, let's just send them
in second year, ready or not here they come, and Dr. Benjamin Banks
had probably been one of those in opposition and here was the proof
of the pudding, ill-prepared me, fresh meat. Maybe thin-skinned me,
entitled me, reluctant me, not ready for prime time me. I guess.</p>
<p style="margin-bottom: 0in;"><br />
</p>
<p style="margin-bottom: 0in;">Weeks later in the rotation we made
rounds on the semi-private rooms at the BI. Little groups of
housestaff, short white coats, “Boys In White” was the title of a
sociological study of medical school, senior residents and junior
residents and interns and students on what seemed like a traveling
team huddled together going from room to room, like a platoon. We
visited patients, reviewed their tests and studies and vital signs
and reviewed the chart notes and performed for one another. We were
there most of the day while the attending physicians came and went.
One lady was in her late 40's, I guess, petite and dark haired and
wiry and very yellow and very concerned about something as she
approached us to find out when something was going to happen or
something, but almost frantic. The head of our team, maybe it was
Bruce Chabner who went on to excel at the NIH, dealt with her
formally but not unkindly, she scurried back to her bed, somewhat
unsatisfied, and we moved on. That afternoon I guess we were going
to go back to see her but we heard that she had died. She had been
so alive. No one said anything.</p>
<p style="margin-bottom: 0in;"><br />
</p>
<p style="margin-bottom: 0in;">I was sent by a chortling Lee Younger
to evacuate manually the bowels of Mrs. Naruscewicz, who suffered
from some apparently terminal illness, was bed-ridden, who couldn't
speak English, and who objected to this necessary but invasive
assault on her body with groans and grunts. I said, there there, I
have to do this, and she resisted but I was finally successful. It
was quite unpleasant, which pleased Younger no end.</p>
<p style="margin-bottom: 0in;"><br />
</p>
<p style="margin-bottom: 0in;">Of all the Harvard hospitals I had
chosen BI for my internal medicine because I had heard they were the
most humanistic in their approach, a hospital with a heart. Maybe
so. But it must have been there that I was introduced to the gallows
humor of house staff, a psychological defense against the trials of
dealing with people with serious diseases. Most memorable were the
series of signs of the dying patient – the O Sign when the mouth of
the patient formed that perfectly round letter, the Q Sign when the
tongue protruded out of the edge of the mouth, and the Fly Sign when
an actual fly buzzed round and round the patient's face awaiting
death. I guess we laughed when we first heard it. It was there that
I heard the expressed intellectual fascination with the
pathophysiology of the patient, the distancing from the individual in
anguish and distress, those feelings that went unremarked, or frowned
upon as unseemly and uncontrolled. This was the foreign territory of
clinical medicine I hadn't experienced at home, where my father
suffered along with his patients, usually nonverbally. He never made
fun of a patient, he never discussed a patient's physiology with
relish, although he did manage to publish over 130 papers, even
though he was not in a university hospital. He most relished the two
bottles of wine he received each year from a patient who never
forgot, and he would have relished the short speech of a person I
didn't know, who came to his memorial service at The Quadrangle, his
last home, when this man stood up at the front and told the story of
how my Dad had made a diagnosis of his own dad that no one else could
make, and operated on him, and gave him decades more of life. No one
talked about things like that at the BI.</p>
<p style="margin-bottom: 0in;"><br />
</p>
<p style="margin-bottom: 0in;">But of course my Dad had his own
defenses. His telephone number was BA6-5050, which he said was
appropriate, since when you came to him, that was about your odds,
50-50.</p>
<p style="margin-bottom: 0in;"><br />
</p>
<p style="margin-bottom: 0in;">I also did my obstetrics rotation at
the BI. I “delivered,” that is, I sat at the foot of the
delivery table when a Catholic mother pushed out her eighth baby. I
guess someone congratulated me at my first delivery. I don't even
remember clamping the cord, but I certainly remember the
other-worldly feeling of a newly formed baby, a little human being,
coming out of another human being and landing in my lap. No one said
much.</p>
<p style="margin-bottom: 0in;"><br />
</p>
<p style="margin-bottom: 0in;">Finally, I did my pediatrics rotation
at Children's Hospital. Since it was my last rotation I got the most
out of it, I had been acculturated, I knew about coming in early, I
knew how to present a case, I sat quietly and cooperatively with the
neonatology team helping them do a double volume exchange transfusion
of babies with Rh factor incompatibility, erythroblastosis fetalis,
all that. One day I was taken into the neurology ward. All the
little kids were on the floor playing with toys, little toy cars to
pedal around, in their hospital clothes. And they all had football
helmets on their heads. I wondered what that was all about, and
either I figured it out or someone told me it was because on
neurology, kids had seizures, and their heads had to be protected as
they fell. It was shocking to me, these poor kids, the parents. But
no one said anything.</p>
<p style="margin-bottom: 0in;"><br />
</p>
<p style="margin-bottom: 0in;">There was one very nice attending
there, an active, extroverted somewhat pudgy, bouncy, and kindly man,
and I posed a question for him. Why are the internists such stuffed
shirts, and pediatricians are so nice? He said, it's very hard to be
a stuffed shirt when your patient is peeing on your leg. Question
asked and answered. I went into pediatrics.</p>
<p style="margin-bottom: 0in;"><br />
</p>
<p style="margin-bottom: 0in;">We were taught and questioned and
quizzed and tested and coached and examined and rated on all our
scientific and clinical knowledge and skills and performance. Our
emotional reaction to all that we were exposed to and experienced
remained, throughout my training as a medical student and later as
house staff and as clinician treating thousands of patients through
decades, as patients experienced severe illnesses and deaths, as well
as wonderful cures, unexamined and unexplored, private territory to
work out on our own.</p>
<p style="margin-bottom: 0in;"><br />
</p>
<p style="margin-bottom: 0in;">Budd Shenkin</p>
<p><style type="text/css">P { margin-bottom: 0.08in }</style></p>Buddhttp://www.blogger.com/profile/03893224951099943306noreply@blogger.com1tag:blogger.com,1999:blog-8705432279177203509.post-53867225395384954992023-05-27T11:11:00.000-07:002023-05-27T11:11:21.705-07:00Medical Student Medical Event Debriefing Service - A Proposal<p>
</p><p align="CENTER" style="margin-bottom: 0in;"><b>Medical Student Medical
Event Debriefing Service </b>
</p>
<p align="CENTER" style="margin-bottom: 0in;"><b>MSMEDS</b></p>
<p align="LEFT" style="font-weight: normal; margin-bottom: 0in;"><br />
</p>
<p align="LEFT" style="font-weight: normal; margin-bottom: 0in;">Inevitably,
in the course of medical school training, medical events will occur
which are striking. Sometimes they are destabilizing – being
present at a death, seeing a patient happy one minute and dead the
next, seeing a patient raving crazy, seeing a patient and family
receiving a dire diagnosis, seeing the controlled chaos around a code
blue, tending to a severely ill patient day after day with no end in
sight, seeing children suffer and families coming apart. Sometimes,
happily, there are uplifting events – an amazing life-saving,
life-changing event, a great diagnosis and treatment, an operation
that seems magical, a recovery to health, seeing the devotion of a
spouse, a birth. Whether positive or negative, seeing the human
condition unfold before you, where you are a participant, where the
context is medical, is a deeply emotional experience.</p>
<p align="LEFT" style="font-weight: normal; margin-bottom: 0in;"><br />
</p>
<p align="LEFT" style="font-weight: normal; margin-bottom: 0in;">How do
medical students deal with these experiences? Variably. All
students are different, the circumstances in which they find
themselves with each event are different, the input they get from
those around them are different. Usually, most of what happens to
students is internal, often solitary. They absorb it. Sometimes
there is the counsel of a wise and experienced clinician, someone who
handles it in their own way, who can give advice, someone who can
offer concern and solace. Occasionally, such a person can elicit the
students feelings and reactions in a way that not only consoles, but
deepens their appreciation. But in most medical schools, I think,
this is usually a matter of chance, of who is available when, of who
has time and inclination, of who is equipped.</p>
<p align="LEFT" style="font-weight: normal; margin-bottom: 0in;"><br />
</p>
<p align="LEFT" style="font-weight: normal; margin-bottom: 0in;">Sometimes,
unfortunately, the surrounding atmosphere is not so positive, and
reactions are psychological defenses. The gallows humor that
develops in medical trainees has been well documented, as senior
students and house staff ironically make light of a dying patient.
Iconic sarcasm on medical lingo is typified by evocation of the
progression from the O sign to the Q sign, and to the Fly sign. The
O sign is when the dying patient's mouth forms a circle; the Q sign
occurs when the tongue protrudes in the corner of the mouth, and
finally the Fly sign is when a fly hovers circling the patient and
awaits his or her death. House staff observes the process of dying
by asking, how far along is he, and reference made to O, Q, and Fly.
Sometimes there is just a flip comment, “That's the way it goes, on
to the next.” House staff laugh as they assign the student to
evacuating the bowels manually of a terminal patient. Often there is
intellectualization as in, “What a fascinoma! Wasn't that an
amazing EKG?” It's not so different from soldiers, or police, as
they gird themselves against the rigors of their profession and life
itself. Defenses against the stark realities of life, disease, and
death abound.</p>
<p align="LEFT" style="font-weight: normal; margin-bottom: 0in;"><br />
</p>
<p align="LEFT" style="font-weight: normal; margin-bottom: 0in;">You
would think that medicine, with its history of beneficence, would
have evolved ways of passing on wisdom in the face of these events,
and in many ways it certainly has. But in many ways it hasn't. When
airline pilots have traumatic events, accidents or near-misses,
guidelines call for them to be grounded and counseled for a period of
time. When that happens to a surgeon, he or she is expected to
proceed to the next case as though nothing had happened, schedule
comes first, tough it out. And students and trainees, when faced
with these events, are often left to fend on their own. Scientific
knowledge is presented and judged and tested constantly, but
humanistic knowledge almost never.</p>
<p align="LEFT" style="font-weight: normal; margin-bottom: 0in;"><br />
</p>
<p align="LEFT" style="font-weight: normal; margin-bottom: 0in;">If
students are to be taught humanistic medicine, it would make sense to
recognize the impact of these events, and to view them all as
opportunities to deepen the humanity of the student, whatever the
student's ultimate career objective. Students could profit
enormously by discussing the events, and most importantly their
reactions and their feelings and their reflections on the events,
with someone wise and understanding and experienced. Doctors have a
lot to give in their roles as physicians, but what they can give is
predicated on what they have absorbed.</p>
<p align="LEFT" style="font-weight: normal; margin-bottom: 0in;"><br />
</p>
<p align="LEFT" style="font-weight: normal; margin-bottom: 0in;">While
departments and divisions throughout the university will have
resources to provide this reflective counseling, and while there is
something to be gained by having a variety of approaches that
different disciplines might offer, some centralization would have
advantages. A separate service would ensure that effort would not be
diluted and derided by those who view humanization as somehow
namby-pamby. A centralized service would allow faculty to best learn
from each other, and to identify strengths. A centralized service
could arrange for constant availability for processing events. A
centralized service would bring more attention to the effort to all
the students, perhaps even by conferences, classes, and publications.
A centralized service would enable tracking of the student body to
take place, papers to be written about the experience, statistics to
be kept, and progress made in an organized fashion. If it's
important, put it in one place, and staff it with those who are
wedded to the task.</p>
<p align="LEFT" style="font-weight: normal; margin-bottom: 0in;"><br />
</p>
<p align="LEFT" style="font-weight: normal; margin-bottom: 0in;">We
propose, then that a MSMEDS be established. There are many ways
that one can imagine that this service would be organized and
operated. Wherever it is centered, the department of psychiatry
should be involved. Senior clinicians noted for their humanity
should be involved. Departments notoriously resistant to such
considerations – one can think of orthopedics and urology, perhaps
– should be involved. Students should be empowered to participate
in the shaping of the efforts.
</p>
<p align="LEFT" style="font-weight: normal; margin-bottom: 0in;"><br />
</p>
<p align="LEFT" style="font-weight: normal; margin-bottom: 0in;">To
support this important service, funding should be assured, and yearly
reports should be made available on the efforts of MSMEDS. If it's
important, give it money, give it personnel, and write about it.</p>
<p align="LEFT" style="font-weight: normal; margin-bottom: 0in;"><br />
</p>
<p align="LEFT" style="font-weight: normal; margin-bottom: 0in;">Budd
Shenkin</p>
<p><style type="text/css">P { margin-bottom: 0.08in }</style></p>Buddhttp://www.blogger.com/profile/03893224951099943306noreply@blogger.com1tag:blogger.com,1999:blog-8705432279177203509.post-76040787439211098932023-04-30T20:42:00.001-07:002023-05-01T08:53:03.693-07:00"Quando?" "Jamais!" Chapter 262 of my French novel<p><span style="color: #38761d;"> I thought someone might be interested in this little story, which is a chapter of the book I am writing in French, as I study French with my teacher, Claude Convers, a native of Switzerland. Here’s our process: Claude gives all her students the same title for whatever they are going to write for their lesson the next week, and it's up to us to work it into our writing. Early on, I decided that I had always wanted to write a novel, so I would write another chapter each week, as our writing assignment, and that I would make the assigned word the title of that chapter. I’m now up to chapter 262, although I skipped some numbers, so the total number isn't quite that high. But still, it seems to have gotten significant.<br /><br />This week’s title was "Jamais." In this chapter, the three characters who are professors of sociology are at a southern France city (without a name so far, despite the fact that other locations do have names, and this is the central area where action takes place) where they will be meeting with most of the other characters to discuss what to do about this allegation that they are all just characters in a novel. Originally, the two women, Laura and Juliette, colleagues in the department and friends, had attended an annual party given by Morton, the older head of their department. Morton was a notorious bore, and Laura discovered Morton and Juliette in rapt conversation during the party, and she was appalled that Juliette was the trapped victim. But it turned out that this was the beginning of a passionate affair that led to their living together and being now engaged. Laura, for her part, is single and notorious for being seductive and attracting all sorts of men, but not sticking with them. There is a brief mention of Hortense, an older woman who was active in the May 1968 student revolt, who has her own history with men, which I won't bother you with.<br /><br />Note that my translation is kind of awkward - as a translator, I don't give myself much freedom to be colloquial.</span><br /><br /><br /> <b> 262 Jamais</b><br /><br />In France, they say that the best strolls end in a cafe, especially when there is a threat of showers. And in this season, in this town, there is a threat of showers almost every day, even with a clear sky. As a result, the city’s cafes are prosperous, as are the boot stores and umbrella stores. It was because of these two things, shelter from the storm, and to continue the conversation with a glass of wine, that the three colleagues from the Department of Sociology at the University of Lille found themselves at a table at the Café de la Chanteuse (the Café of the Singer.)<br /><br />“Who is this singer that the cafe is named for?” <br /><br />Morton set the question to the waitress, a small young brunette with blue green eyes. “She’s a beauty,” Morton told himself. “What a body!”<br /><br />“Oh, Monsieur, there is a special story here in our town.” The voice of this small woman sounded like honey.<br /><br />“Well, mademoiselle, we’re not from around here, so we’d like to hear the story. Do you have the time? I know the place is full, before the shower comes.”<br /><br />“I doubt a storm, Monsieur,” said the waitress. They say there is a threat of showers and everybody thinks is a good time for a glass of wine. I think if there were too much sun they would say it’s a good time to have a drink to protect us from a sunburn. It’s a good business, this cafe, don’t you think?”<br /><br />“Is there a story?” said Laura.<br /><br />“Oh, yes, the story,” said the waitress. She sat herself down on the fourth chair at the table, very much at ease. “Once upon a time, there was a small lady, no taller than I am, and she could sing like Edith Piaf. Two real sparrows, those two. And she and her boyfriend wrote songs, about the seasons, about the sea, and especially about love, of course, since they were young and French. Anyway, at that time there was a very popular song, Quando Quando Quando. You know, that means When When When in French. And this one summer there were a load of Italian women here in town — there were courses in French for Italians, and many young Italian women needed to learn French for their work, I suppose. After class, the Italian ladies usually here to have a drink and to eat something — too much pizza, actually, too much pizza, disgusting pizza, our town is well known for having pizza like a rubber tire. But anyway, the cafe had its little band, and they were fed up with the requests to play Quando Quando Quando. All the city residents, especially my mother, who was a waitress here just as I am today, all the French detested that terrible song.<br /><br />“But what could you do? The young customers request the song from their country, they pay for their drinks and their disgusting cardboard pizzas, and they wanted their song.”<br /><br />“Yes, what could you do?” said Juliette. The customer is always right, no?<br /><br />“Here in France? You speak French perfectly, Madame, is it possible that you could really be an American? That’s an American myth, I think. Here in France, the waiter are kings, certainly!<br /><br />“Did the musicians refuse to play it?” asked Morton.<br /><br />“More amusing than that, Monsieur. Remember, the singer and her boyfriend were song writers. So, they could find a creative solution. In place of Quando Quando Quando, they wrote another song. They declared that it was a love song, and indeed the words referred to love but the title was a clever answer to the students. The song was called Jamais Jamais Jamais (Never Never Never). You understand that? When When When? Never Never Never!”<br /><br />“I remember that song,” said Laura. “I loved it! When am I going to get married? Never Never Never! A very romantic song.”<br /><br />“Why is it romantic, Laura?” said Morton. It says I’m never going to get married. It’s anti-romantic, isn’t it?”<br /><br />“Not at all, Morton, the song and the singer doth protest too much! I will never be in love again, they say. That’s something Hortense would say. This is after an affair that had to end badly. It was too painful at the end, to say see you later, or goodbye. That doesn’t work, it’s never worth the pain. Never again! At least, never again for now.”<br /><br />“Madam is right,” said the waitress. It was very romantic. The song and the singer were like Edith Piaf. After the first performance, every one requested Jamais Jamais Jamais instead of Quando Quando Quando, even the Italian students, in fact the students more than anyone. They planned to go back to Italy with their new discovery. The cafe became famous. So, they were going to rename the cafe Jamais Jamais Jamais.”<br /><br />“But that didn’t happen that way?” said Laura. “What happened?”<br /><br />“Unfortunately, the singer and her boyfriend separated.”<br /><br />“Did success spoil their relationship?”<br /><br />“No, I don’t think so. I think that at bottom they were first of all partners, and that their love relationship was secondary. They were together, so why not be a couple, I suppose. Anyway, the boyfriend left the relationship, the singer stayed, and it seemed that it would be unlucky to name the cafe after a relationship that ended. So, they gave it the name of the singer, Café de la Chanteuse.”<br /><br />“And your mother was a waitress here then?” The young waitress nodded her head. “And she stayed here after the guy left?”<br /><br />“Well, in fact, she left at the same time as he did.”<br /><br />“She did?”<br /><br />“Yes. In fact, the two of them became my parents. But now that the singer is long gone, I took the old place of my mother.”<br /><br />“Oh, yes. And what do you do? Are you a student?”<br /><br /><br />“Nope, I’m a waitress. And I’m waiting for my prince someday.”<br /><br />“Yes?”<br /><br />“Yes. That’s my family history, that’s what we do.”<br /><br />And at that, Laura exclaimed, “Me too! Someday!”<br /><br />And with that, the two women, one a little tall and a little bit redheaded and a little older, and the other a little short and a little brown haired and a little younger, kissed each other and looked at each other warmly, and them they turned around and scrutinized the crowd to find their prince.<br /><br />Meanwhile, distractedly. Morton was whistling the melody of Jamais Jamais Jamais, and over the loudspeaker came the sound of Miles’ Davis’s trumpet, One Day My Prince Will Come. A small shower started.<br /><br />—————————————————————————————————————————-<br /><br /><span style="color: #2b00fe;">Et en français, la version originale:<br /><br /><b> 262 Jamais </b>(corrections by Claude Convers)<br /><br />En France, on dit que les meilleures promenades se terminent dans un café, surtout lorsqu’il y a une menace d’averse. Et en cette saison, dans cette ville, il y a presque tous les jours une menace d’averse, même lorsque le ciel est clair. En conséquence, les cafés de la ville sont prospères, comme aussi les magasins de parapluies et de bottes. C’était donc à cause de ces deux choses, l’abri d’une averse, et pour continuer la conversation avec un verre, que les trois camarades du Département de Sociologie à l’Université de Lille se trouvèrent à table au Café De La Chanteuse.<br /><br />— Qui est cette chanteuse après qui ce café est nommé ? Morton posa la question à la serveuse, une petite jeune femme avec des cheveux brun foncé et des yeux bleus-verts. C’était une beauté, observa-t-il à lui-même. Quelle silhouette !<br /><br />— Ohhh, monsieur, il y a une histoire particulière de notre ville. La voix de cette petite femme résonnait comme du miel.<br /><br />— Ah, bon, mademoiselle, nous ne sommes pas d’ici, alors on aimerait bien [] entendre l’histoire. Vous avez le temps ? Je sais qu’il y a du monde ici, avant [] l’averse.<br /><br />— Je doute d’une averse, Monsieur ! dit la serveuse. On dit qu’il y a une menace d’averse et tout le monde pense que c’est un bon moment pour prendre un verre. Je pense que s’il y avait trop de soleil on dirait que c’est un bon moment pour prendre un verre pour se protéger d’un coup de soleil. C’est une bonne entreprise, ce café, n’est-ce pas ?<br /><br />— Il y a une histoire ? dit Laura.<br /><br />— Ah, oui, l’histoire, dit la serveuse. Elle s’assit sur la quatrième chaise, à table, très à l’aise. Une fois, il y avait une petite dame/femme, pas plus grande que moi, assez petite, et elle pouvait chanter comme Edith Piaf. Des vrais moineaux, les deux. Et elle et son copain écrivaient beaucoup de chansons, sur les saisons, sur la mer, et surtout sur l’amour, bien sûr. Ils étaient jeunes et ils étaient français. En tout cas, à l’époque, il y avait une chanson italienne très populaire, [] Quando Quando Quando ! Vous savez, ça veut dire Quand Quand Quand en français. Et [] cet été il y avait beaucoup d’italiennes, ici dans la ville — il y avait des cours de français ici pour les italiennes, beaucoup de jeunes femmes italiennes [] avaient besoin d’apprendre le français pour le travail, j’imagine. Après les cours, d’habitude les italiennes venaient ici pour prendre des verres et manger - trop de pizza, en fait, trop de pizza, de pizza dégoutante, notre ville est bien connue pour la pizza qui ressemble à du pneu. Mais, en tout cas, le café avait son petit groupe qui jouait ici, et ils en avaient marre des demandes pour cette chanson, Quando Quando Quando. Tous les habitants, surtout ma mère, qui était serveuse ici comme moi aujourd’hui, tous les français détestaient cette chanson épouvantable.<br /><br />— Mais quoi faire ? Les jeunes clientes demandaient la chanson de leur pays, elles payaient leurs verres et leurs pizzas en carton dégoutantes, et elles voulaient leur chanson.<br /><br />— Qu’est-ce qu’on [] fait ? dit Juliette. Le client a toujours raison, n’est-ce pas ?<br /><br />— Ici en France ? Vous parlez le français parfaitement, madame, mais est-ce [] possible que vous puissiez être, en réalité, américaine ? C’est un mythe américain, je pense. Ici en France, les serveurs sont les rois, certainement !<br /><br />— Les musiciens ont refusé de la jouer ? dit Morton.<br /><br />— Plus drôle que ça, Monsieur. Rappelez-vous que la chanteuse et son petit ami étaient [] chansonniers. Donc, ils pouvaient trouver une solution créative. Au lieu de Quando Quando Quando, ils ont écrit une autre chanson. Ils ont affirmé que c’était une chanson d’amour, et en effet les mots parlaient d’amour, mais le titre était une réponse maline aux étudiantes. La chanson s’appelait, Jamais Jamais Jamais. Vous comprenez ça ? Quando Quando Quando ? Jamais Jamais Jamais !<br /><br />— Je me souviens de cette chanson ! dit Laura. Je l’aimais beaucoup ! Quand est-ce que je vais me marier ? Jamais Jamais Jamais ! Une chanson très romantique.<br /><br />— Pourquoi c’est romantique, Laura ? dit Morton. Il dit, je ne me marierai jamais, c’est antiromantique, n’est-ce pas ?<br /><br />— Pas du tout, Morton, la chanson et la chanteuse protestent trop ! Je ne serai jamais plus [] amoureuse, elles disent. C’est quelque chose qu’Hortense dirait. C’est après une aventure qui a dû mal se terminer. C’était trop pénible à la fin, de dire au revoir, ou plutôt adieu. Ça n’a pas marché. Ça n’en vaut jamais la peine. Jamais plus ! Au moins, jamais plus pour le moment.<br /><br />— Madame a raison, dit la serveuse. C’était très romantique. La chanson et la chanteuse ressemblaient à Edith Piaf. Après la première présentation, tout le monde demandait, Jamais Jamais Jamais au lieu de Quando Quando Quando, même les étudiantes italiennes, en fait, surtout ces étudiantes. Elles avaient l’intention de rentrer en Italie avec leur nouvelle découverte. Le café est devenu très connu. Alors, on a eu l’intention de renommer le café, Jamais Jamais Jamais.<br /><br />— Mais ça ne s’est pas passé comme ça ? dit Laura. Qu’est-ce qui s’est passé ?<br /><br />— Malheureusement, la chanteuse et son copain se sont séparés.<br /><br />— Le succès a gâché leur relation ?<br /><br />— Non, je ne [] pense pas. Je pense qu’ils étaient au fond, en premier, des collègues, et que leur relation amoureuse était en effet secondaire. Ils étaient ensemble, pourquoi ne pas être un couple, j’imagine. Quand même, le copain a quitté la relation, la chanteuse est restée, et il semblait que ce serait de la malchance de nommer le café après une relation finie. Alors, ils ont donné le nom à la chanteuse, Café de la Chanteuse.<br /><br />— Et votre mère était serveuse ici à l’époque ? La serveuse hocha la tête. Est-ce qu’elle est restée ici après que l’homme soit parti ?<br /><br />— Non, en fait, elle est partie au même temps que l’homme.<br /><br />— Oui ?<br /><br />— Oui. En fait, les deux sont mes parents. Mais maintenant la chanteuse est partie depuis longtemps, et j’ai pris l’ancienne place de ma mère.<br /><br />— Oui. Et que faites-vous ? Vous êtes étudiante ?<br /><br />— Non, je suis serveuse. Et j’attends mon prince d’un jour à l’autre.<br /><br />— Oui ?<br /><br />— Oui. C’est l’histoire de ma famille, c’est ce que nous faisons.<br /><br />Et avec ça, Laura s’exclama — Moi aussi ! D’un jour à l’autre !<br /><br />Et avec ça, les deux femmes, une un peu grande et un peu rousse et un peu plus âgée, l’autre un peu petite et un peu brune et un peu moins âgée, s’embrassèrent et se regardèrent chaleureusement, et puis elles se retournèrent et scrutèrent la foule pour trouver leur prince.<br /><br />Entre-temps, distraitement, Morton sifflait la mélodie de Jamais Jamais Jamais, et par les haut-parleurs arrivait le son de la trompette de Miles Davis, Un Jour Mon Prince Viendra. Une petite averse commença. </span></p>Buddhttp://www.blogger.com/profile/03893224951099943306noreply@blogger.com0tag:blogger.com,1999:blog-8705432279177203509.post-60870109157311120162023-04-23T08:36:00.001-07:002023-04-23T11:09:54.013-07:00Humanistic Medicine Defined, and Why We Need To Teach It<p>
</p><p align="CENTER" lang="en-US" style="margin-bottom: 0in;"><b>Humanistic
Medicine, and Why We Need To Support Teaching It</b></p>
<p style="margin-bottom: 0in;"><br />
</p>
<p align="CENTER" style="margin-bottom: 0in;"><b><span lang="en-US">I</span></b></p>
<p style="margin-bottom: 0in;"><span lang="en-US">This is the age of
amazing medical advances – I personally have had </span><span style="color: navy;"><span lang="zxx"><u><a href="http://buddshenkin.blogspot.com/2011/08/welcome-to-neurosurgeryland.html"><span lang="en-US">my
own share of medical gifts</span></a></u></span></span><span lang="en-US">
of life and limb that former generations could only dream of, and the
odds are that you, the reader, have had your own. The touch of
modern medicine is everywhere. But in this age of scientific
advance, there are unforeseen consequences. Just as the scientific
doctor has advanced, so has the role of traditional healer, the practitioner
of humanistic medicine, been partially eclipsed.</span></p>
<p lang="en-US" style="margin-bottom: 0in;">That is a shame. Because
as much as we welcome the newly empowered doctor as scientist with
miracle cures in the pocket, we still need the doctor as humanist, a
tradition that goes back for millennia in human history. Scientific
and humanistic medicine are both necessary; one does not go without
the other.</p>
<p style="margin-bottom: 0in;"><span lang="en-US">Let's be more
specific about what Humanistic Medicine is. “</span>Humanistic
medicine” encompasses a lot. It can mean interviewing patients to
find out where they're at, how best to reach them, how to be
empathetic. It can be befriending patients, even while being a
professional. It can refer to adopting the proper stance according
to the problem, as indicated by the classic article on the
doctor-patient relationship by <span style="color: navy;"><span style="font-family: Times New Roman, serif;"><u><a href="https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/560914"><span style="color: navy;">Szasz
and Hollender</span></a></u></span></span><span lang="en-US">, a
relationship that can go from (a) active-passivity, to (b)
guidance-co-operation, and to (c) mutual participation. It is part
of the art of medicine to determine which situations and which
patients require (a), (b), or (c).</span></p>
<p style="margin-bottom: 0in;"><span lang="en-US">It can mean becoming
wise, as old time doctors were reputed to be, rabbi-like. It can be
becoming attuned to the cycles of life, from birth to death, knowing
when and how to intervene and when to let nature take its course, to
acquiesce. It can be giving advice that is not strictly medical. It
can be being able to call upon literature, philosophy, art and other
forms of wisdom to help patients and give them perspective.</span></p>
<p style="margin-bottom: 0in;"><span lang="en-US">It can mean being
part of a team that works with patients when curing is not an option.
It can be helping patients navigate so they can do things they
really want to do, when it becomes very hard. It can be giving
patients and families bad news in a sensitive manner, different for
each practitioner and each family. It can be caring for the
bedridden, turning and cleaning, cheering up, relating, simply being
there. It can be tending sensitively to the dying patient, and the
families of the sick and dying patient, in all their variety.</span></p>
<p style="margin-bottom: 0in;"><span lang="en-US">Humanistic Medicine
is that part of medicine, the softer side.</span></p>
<p style="margin-bottom: 0in;"><br />
</p>
<p align="CENTER" style="margin-bottom: 0in;"><span lang="en-US"><b>II</b></span></p>
<p style="margin-bottom: 0in;">If you look at the medical miracles of
modern life, it's understandable that an unintended consequence of
its rise would be to put the traditional role of caring in the shade.
The new possibilities of curing are so exciting <span lang="en-US">as
well as demanding. There is so much more science to master. It can
be overwhelming in its difficulty and obvious importance. The time
for learning to care can be crowded out.</span></p>
<p style="margin-bottom: 0in;"><span lang="en-US">In addition, it's
not clear that medical schools and large research institutions were
ever very good at teaching the softer side of medicine, the feeling
side, the relational side, the empathetic side, the long term
supportive side. The role of the scientist has taken over the
medical turf, and the humanistic doctors are not the top recruits for
medical schools, which think of themselves as research institutions.
Curing has crowded out caring. </span>
</p>
<p style="margin-bottom: 0in;"><span lang="en-US">And that is a shame,
because caring for and caring about the patient, and relating
intimately to the patient and the family, and caring for the
chronically ill, is as important as it ever was. Even when doctors
could do very little to cure patients, they still rendered important
services by being there. They always coordinated care for patients
with ongoing illnesses, and for patients who were dying.</span></p>
<p style="margin-bottom: 0in;"><span lang="en-US">Caring for people,
moreover, is not only important for patients, but for the doctors as
well. It's hard to be a doctor. It's hard work to tend to patients,
it's hard to prepare and learn so much and to keep learning all your
life, it's hard just physically to work all that time including
nights, and nowadays, of course, it's hard to cope with the
corporations that run medicine. It's a very hard job.</span></p>
<p style="margin-bottom: 0in;"><span lang="en-US">But more than in
most jobs, medicine can have so much meaning. You are doing so much,
you have all the expectations on you, and when you meet them, when
you actually do your job and help people in this most important
aspect of people's lives, their health – talk about satisfaction in
your work, few things match medicine, at least when things go right.
So for all the difficulty of the job, there is a lot of upside.</span></p>
<p style="margin-bottom: 0in;"><span lang="en-US">Humanistic medicine
is not a frill. Most doctors who have been in practice know how
fulfilling it is to both patient and doctor when the softer
requirements of medical care are fulfilled. And most doctors who
have been practicing for a while realize how hard it has been to
achieve that status of the wise and sensitive and caring physician.
When you have been at it a while, you realize how important it is
that humanistic medicine be taught and emphasized, perhaps more consciously
than ever.</span></p>
<p style="margin-bottom: 0in;"><br />
</p>
<p align="CENTER" style="margin-bottom: 0in;"><span lang="en-US"><b>III</b></span></p>
<p style="margin-bottom: 0in;"><span lang="en-US">And, on a personal
note, this all came home to me in spades over the last few years as
my wife was afflicted with Alzheimer's. I had tried as best I could
in a long career in primary care pediatrics to be that practitioner
of humanistic medicine that I've advocated here. It was a long slog,
I had a lot to learn, although I tend naturally towards being
empathetic, which was a help. In pediatrics, I did have some bad
diagnoses to deliver, and I did better at that as time went on. I
tended to people's personal lives. I tended to try to put things in
perspective. I wasn't a “Just the facts, ma'am” practitioner.
But still, it wasn't easy.</span></p>
<p style="margin-bottom: 0in;"><span lang="en-US">And then I sat with
my wife as our neurologist delivered the diagnosis, "I'm afraid it's
Alzheimer's," a direct and caring face to face encounter, a heartfelt
“I'm sorry.” She didn't at all shy away from the direct,
personal connection while giving bad news. I was able to tell her,
our neurologist, that we liked her very much as a doctor and ask her
if she could schedule us for periodic visits a few times a year even
if there was little she could do, because she was our doctor. She
said yes, and told me later she had learned something from me and
that she was scheduling her patients more frequently, just to give
them care, if not prescriptions.</span></p>
<p style="margin-bottom: 0in;"><span lang="en-US">I cared for my wife
as she needed more and more care, as I had to drive her everywhere,
to the hairdresser, to take her shopping for clothes she would never
wear and books she would never read, help her in showers, I had to help her in the bathroom, I had
to prepare meals on an ever more restricted menu of things she would
eat. I had to get care for her, thank God I found our Angelicare
agency with professional caregivers, wonderful giving people, based
in nearby Vallejo, all from the Philippines, eventually 24/7 care
when Ann couldn't get out of bed and they had to keep her clean,
which wasn't easy, but they did it so well in a way that I never
could have. She never had a bedsore. The nurses came from hospice,
as did the aide who washed her body and her hair twice a week as she
was in the hospice-supplied hospital bed. We had to give her more
and more medicines to control her neurological symptoms, especially
when the seizures came. What I didn't see in pediatrics was
professionals who take over when they know their patient is going to
die, prepared to see that happen and move on to the next dying
patient.</span></p>
<p style="margin-bottom: 0in;"><span lang="en-US">And then the final
days, the kids assembled, sitting with her when she couldn't eat or
drink anymore, I sat by her side and held her arm as she took her
last breaths and gradually her heart stopped. </span>
</p>
<p style="margin-bottom: 0in;"><span lang="en-US">I realized that
although primary care pediatrics had prepared me for some of all
this, a lot actually, my training had left out a lot. I had never
sat with a patient for a long time to see what it was like – I
mean, it would take 12 hours of sitting there to really absorb it,
and more than that, longitudinally. In med school and in residency I
had never learned to give a dreadful diagnosis properly, and as a
result I had botched some of those instances in practice. I had
never sat with someone as they died – my only direct death
encounters were after the fact, although one time at the Mass General
ER a patient had coded in the radiology suite and the staff doc had
taken me with him and as the patient wasn't responsive he opened the
chest and massaged the heart manually and urged me to do the same,
which I did. But that wasn't caring for a patient and then being
there for the death, the way the movies of old-time doctors show that
that's what used to happen.</span></p>
<p style="margin-bottom: 0in;"><span lang="en-US">So, it occurred to
me that our training left out a bunch of stuff on the humanistic
side. And that's why I'm writing this.</span></p>
<p style="margin-bottom: 0in;"><span lang="en-US"> </span></p><p style="margin-bottom: 0in;"><span lang="en-US">Budd Shenkin</span></p>
<p style="margin-bottom: 0in;"><br />
</p>
<p><style type="text/css">P { margin-bottom: 0.08in }A:link { so-language: zxx }</style> <br /></p>Buddhttp://www.blogger.com/profile/03893224951099943306noreply@blogger.com0tag:blogger.com,1999:blog-8705432279177203509.post-62471293235321376002023-03-04T18:21:00.001-08:002023-03-04T18:21:32.300-08:00My Day In Maui<p> </p><div class="gmail_default" style="color: #000099; font-family: tahoma,sans-serif;"><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjWo0cRto1AMhy_MBJbnM9jYf9mCw38hrovudm2z65_lwFcuRoNq-QbhVeRtvMzAvMz4dT5YOrvq_TAvWOngwI4r02aEycTGx6I3DVC0BWqCPizghyTk-C51hp3aSW9l_8hCqiELmSunTsfpvZnjyqOh7P-SfYLhJGCP6QNv0nvJsi0ghDojHosccjNJg/s4032/5EB6C1CD-899D-4717-9590-6D9F4B5AFE58.jpeg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="4032" data-original-width="3024" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjWo0cRto1AMhy_MBJbnM9jYf9mCw38hrovudm2z65_lwFcuRoNq-QbhVeRtvMzAvMz4dT5YOrvq_TAvWOngwI4r02aEycTGx6I3DVC0BWqCPizghyTk-C51hp3aSW9l_8hCqiELmSunTsfpvZnjyqOh7P-SfYLhJGCP6QNv0nvJsi0ghDojHosccjNJg/s320/5EB6C1CD-899D-4717-9590-6D9F4B5AFE58.jpeg" width="240" /></a></div><br /></div><div class="gmail_default" style="color: #000099; font-family: tahoma,sans-serif;"> </div><div class="gmail_default" style="color: #000099; font-family: tahoma,sans-serif;">I'm
here in Maui, and on viewing a recipe from the NYT, I realized that,
for some reason I cannot fathom, we did not have a Dutch oven. My wife
Ann was implacably well supplied with everything. I set her up in our
spare bedroom with a built in wrap around desk and shelves, and in going
through them last year, I discovered pens and paper and folders etc.
for roughly the next decade or two. But no Dutch oven.</div><div class="gmail_default" style="color: #000099; font-family: tahoma,sans-serif;"><br /></div><div class="gmail_default" style="color: #000099; font-family: tahoma,sans-serif;">So
I went onto Wirecutter to find the best Dutch oven for a good price,
found one, ordered it from Amazon, and it was here in two days. Then I
was ready to make the NYT eggplant chili recipe. I found the
ingredients, had to replace one or two -- couldn't find canned fennel so
I used pinto beans instead -- and cooked it up yesterday. No salt -- I
never add salt to recipes, it's unhealthy, maybe too much pepper, made
the jalapeño to be added for each portion rather than in the mix. And
guess what -- it's great! What a triumph of man over ability!</div><div class="gmail_default" style="color: #000099; font-family: tahoma,sans-serif;"><br /></div><div class="gmail_default" style="color: #000099; font-family: tahoma,sans-serif;">But then, the point. Who did that make me feel like? Was it Julia Child, Tony Bourdain? Hardly.</div><div class="gmail_default" style="color: #000099; font-family: tahoma,sans-serif;"><br /></div><div class="gmail_default" style="color: #000099; font-family: tahoma,sans-serif;">It made me feel like Steve Kerr.</div><div class="gmail_default" style="color: #000099; font-family: tahoma,sans-serif;"><br /></div><div class="gmail_default" style="color: #000099; font-family: tahoma,sans-serif;">I
often say that great managers and general managers are like landscape
artists, who discover how each person, like a plant, fits in; which one
needs light and water, which ones shade and sand, and which ones enhance
the growth and beauty of the others. But yesterday, I thought maybe
they are also well thought of as great chefs, although in this case the
creativity was only in recreating someone else's.<br /></div><div class="gmail_default" style="color: #000099; font-family: tahoma,sans-serif;"><br /></div><div class="gmail_default" style="color: #000099; font-family: tahoma,sans-serif;">So,
with that little snippet, we move on, perhaps to other pastures,
perhaps to bramble bushes, but like the now un-PC Br'er Rabbit -- I had
to go off-Amazon to get a DVD of Song of the South -- wherever we wind
up, let it be a place of familiarity and ease.</div><div class="gmail_default" style="color: #000099; font-family: tahoma,sans-serif;"><br /></div><div class="gmail_default" style="color: #000099; font-family: tahoma,sans-serif;"> <div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhLfkubx-4GOXr1Ap24QpdJVOlDhUASoHZ5USQUrMDSpc4PykBj8BsQyOTOZPSo70muPr_U-0qT9hgMz4zkk_iEdlp6fmBjRcGHBxVWsFV4kEm_37VtSxXTHECpqyt1bzhkJvCno68XeweGfEWE0pYG1YPEEX9CL4BQUxXskDjTC4DFKNo4ZhZOOc8YWw/s4032/FF2EFB5E-A690-42BF-A585-F6A4CC3F6E06.jpeg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="4032" data-original-width="3024" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhLfkubx-4GOXr1Ap24QpdJVOlDhUASoHZ5USQUrMDSpc4PykBj8BsQyOTOZPSo70muPr_U-0qT9hgMz4zkk_iEdlp6fmBjRcGHBxVWsFV4kEm_37VtSxXTHECpqyt1bzhkJvCno68XeweGfEWE0pYG1YPEEX9CL4BQUxXskDjTC4DFKNo4ZhZOOc8YWw/s320/FF2EFB5E-A690-42BF-A585-F6A4CC3F6E06.jpeg" width="240" /></a></div><br /></div><div class="gmail_default" style="color: #000099; font-family: tahoma,sans-serif;"> </div><div class="gmail_default" style="color: #000099; font-family: tahoma,sans-serif;">But,
oh, like Columbo, just one more thing. After making the chili, I drove
to Wailuku to have lunch at Cafe Saigon with two Maui friends, Ryan and
Jess. Ryan used to be my pool guy, now has moved up a bit in the
company, but we used to see each other regularly and talk. We became
friends; I was able to encourage him in his give-up-smoking and
live-better project. An interesting, intelligent, introspective and
very sweet guy, it turns out. Then, what happened to him? Far away in
his native North Carolina, his friend of 20 years, Jess, traversing her
own briar patch of a life, was in therapy, and discovered that what she
wanted to do was to marry Ryan. So she came to Maui and put it to him
and said, we are going to get married. Which they then did, and they
are so happy, and she is so proud of herself, and he feels like he was
given a gift. They are going back to NC next week, after 3 years since
she's been there, to get stuff settled, see her lawyer, sell her car,
etc. And, what did Jess want to know, what was eating at her? She
wanted me to narrate the further adventures of Hortense, one of my
characters in my French novel, the grandmother-age who still has the
hots for guys and doesn't hide it. Somehow, Hortense tickles Jess, and
she thinks she has some older friends at her gym up-country here in Maui
who might fit the description of Hortense, I think.</div><div class="gmail_default" style="color: #000099; font-family: tahoma,sans-serif;"><br /></div><div class="gmail_default" style="color: #000099; font-family: tahoma,sans-serif;">And
I was able to tell Ryan and Jess a little bit about my friend Big Bob's odyssey,
his quest for and success in wooing Adele, and how I thought it was
probably the greatest achievement of his life. They nodded
appreciatively, and recognized themselves in the story.</div><div class="gmail_default" style="color: #000099; font-family: tahoma,sans-serif;"><br /></div><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjPn6fehaD9JX4WB9mUPNn_OoNK6220sHUZovSawk2n_RINwbSrt826u77m-pZksPdeaN2jG8Z1k3rit504fyBoWOZl3mmcaO_8BpYIJogtRksFb-sezeemMucZcHhHN488-uqTXM80TP9vaCCisXb8HfzHp8g-ycgRtfJufux0Icl4vwZTDD7rE_BsOw/s4032/52477BD3-A3F2-4120-9BE9-1356A07B28DF.jpeg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="4032" data-original-width="3024" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjPn6fehaD9JX4WB9mUPNn_OoNK6220sHUZovSawk2n_RINwbSrt826u77m-pZksPdeaN2jG8Z1k3rit504fyBoWOZl3mmcaO_8BpYIJogtRksFb-sezeemMucZcHhHN488-uqTXM80TP9vaCCisXb8HfzHp8g-ycgRtfJufux0Icl4vwZTDD7rE_BsOw/s320/52477BD3-A3F2-4120-9BE9-1356A07B28DF.jpeg" width="240" /></a></div><div class="gmail_default" style="color: #000099; font-family: tahoma,sans-serif;"><br /></div><p><span style="color: #0b5394;">Anyway,
onward and upward? This is my son Peter's cat here in Maui, a
feral cat whom he has befriended and made family, and who comes in and
eats and rolls around several times a night. I finished the day off petting him. His name is Meatloaf.</span></p><p><span style="color: #0b5394;"><br /></span></p><p><span style="color: #0b5394;">Budd Shenkin<br /></span></p>Buddhttp://www.blogger.com/profile/03893224951099943306noreply@blogger.com0tag:blogger.com,1999:blog-8705432279177203509.post-91028287917116902932023-02-15T20:20:00.012-08:002023-02-15T20:20:57.552-08:00On Israel, And American Policy Toward Israel<p align="CENTER" style="margin-bottom: 0in;"><b>I</b></p>
<p style="margin-bottom: 0in;"><br />
</p>
<p style="margin-bottom: 0in; text-indent: 0.49in;">Events clarify
your positions, values, interests, opinions, points of view, and so
on. Events.</p>
<p style="margin-bottom: 0in; text-indent: 0.49in;">Before <span style="color: black;"><span style="font-family: Times New Roman, serif;"><span style="font-size: small;"><span lang="en-US">getting</span></span></span></span>
to Israel, the subject of this post, let me first cite a preliminary
example of how events provide clarity. What could be more clarifying
than the Russian invasion of Ukraine? Russia was quiescent for
years after the USSR breakup<span style="font-size: xx-small;"></span>.
But then, the invasions of Georgia and Crimea should have been
clarifying. Three US administrations<span style="font-size: xx-small;"></span>
ignored them, essentially, out of what? Hope that it was not true,
disbelief that Russia was changing, or perhaps better said,
reverting? But with the Ukraine invasion, the picture became
unavoidably clear <span style="color: black;"><span style="font-family: Times New Roman, serif;"><span style="font-size: small;"><span lang="en-US">–</span></span></span></span>
Russian aggression was back. And then, a year later, events have
clarified another truth <span style="color: black;"><span style="font-family: Times New Roman, serif;"><span style="font-size: small;"><span lang="en-US">–</span></span></span></span>
Russia's conventional military strength is nothing like what was
advertised. As these truths have become clear, in response, the US
and NATO have changed their policies accordingly. Events clarify.
</p>
<p style="margin-bottom: 0in; text-indent: 0.49in;">I think you can
say the same thing about Israel, events have been clarifying, even if
there has been a delay in recognizing the clarification. When I was
a boy in the 1950's<span style="font-size: xx-small;"></span>,
the Israel myth was potent. A long-sought haven in a world that had
experienced the Holocaust, which was just the latest and worst
manifestation of anti-Semitism in a world long distinguished by its
omnipresent existence in word and deed. The restrictions from
employment and residence, the national expulsions, the pogroms,
Dreyfus, the reluctance of the West to help the victims escape during
WW II, the profound injustices against a people. And then, at last,
a homeland.</p>
<p style="margin-bottom: 0in; text-indent: 0.49in;">And not just a
homeland, a country of liberal Western values carried by Ashkenazi
Jews, the only democracy in the Middle East, the industriousness of a
people turning desert into farmlands, many educated and English
speakers, underdogs, the original people of the book. The <i>sturm
und drang</i> of its birth was tossed aside. The terrorism of the
fight for existence, the pushing out of Arabs who had lived there,
explained by the willingness of the more liberal Jews to live
together with them, and explained by the war made by the Arab
countries to destroy Israel, their expulsion of Jews who had lived in
Arab countries for centuries, the confiscation of their property and
goods. All in the throes of birth, we were told, and we accepted it.</p>
<p style="margin-bottom: 0in; text-indent: 0.49in;">And for decades,
Israel held fast. Israelis were democratic, they were welcoming,
they had a hell of an army and intelligence service, they became
prosperous, they were smart. They held their own against outrageous
anti-Israeli acts of savagery, like the Munich Olympics and Entebbe.
After all, they were modern Jews, Jews at their best.</p>
<p style="margin-bottom: 0in; text-indent: 0.49in;">But then, as
Israel matured, it changed. The swing to Likud was at first thought
to be the quirk of an election or two, and attempts at peace with the
Palestinians were hopeful and often sincere. But the turn to the
Right turned out to be permanent, reinforced by the demographics of
Russian immigration and increasing Sephardic/Ashkenazi ratio,and the
increasing orthodox/secular ratio. Moreover, what immigration doesn't
fully provide the religious right, a propensity to large families
does. The religious parties and their rabbis show little hesitation
in trying to bend all of society to their theological beliefs and
practices. The favoritism shown to the ultra religious in policy, at
first thought to be simply an artifact of a multiparty parliamentary
system where the ultra religious were willing to go to either side
simply because of favors granted, now appears to have become a deeply
ingrained and accelerating fact of Israeli life. The question of
“who is a Jew,” which originally seemed obviously inclusive, with
implications of for whom Israel would be a haven of last resort, is
at risk of being further narrowed with religious constraints. Israel
can no longer be said to be a secular nation. The attitudes of many
Israelis toward Arab land and rights, and the connivance of official
decisions, are far from the original version. This swing to the
theological and the right has proved enduring. The Labor Party is
dead, and the Left looks to be a permanent minority.
</p>
<p style="margin-bottom: 0in; text-indent: 0.49in;">These are the
events. This is not a phase, this is not a test, this is a
longstanding trend that is still increasing in its power. In fact,
it's clear that the events are accelerating. Abolition of judicial
independence (now under serious consideration in the Knesset) is a
well-known landmark on the way to illiberal democracy. Truculent and
aggressive policies toward Arabs, both citizens and residents of the
West Bank and Gaza, are increasing, not decreasing. Only the
willfully blind think that all this is temporary. It's true that
Arab aggressive extremism and incompetence and corruption in
governing have contributed to making peace impossible, but still, by
now, the Israeli policies have a momentum of their own.</p>
<p style="margin-bottom: 0in;"><br />
</p>
<p align="CENTER" style="margin-bottom: 0in;"><b>II</b></p>
<p style="margin-bottom: 0in; text-indent: 0.49in;">Assimilated
American Jews like me, reflexively supportive of a Jewish homeland,
supportive of the important national right to defend yourself, proud
of Jewish accomplishments, are put onto the horns of a dilemma by the
clarifying events in Israel. How far do you go in defending a
country that is becoming less like a Western social democracy, whose
government seems on the brink of becoming more similar to Hungary or
Turkey, rather than resembling the US?</p>
<p style="margin-bottom: 0in; text-indent: 0.49in;">Being assimilated
and secular, I turn to thinking of American national interest. After
all, the US is in a dilemma similar to my own. Do you adjust your
views in light of clarifying events in Israel? Well, you have to.
And as you readjust, you go back to the roots of the basis of your
support to date. Why has the US supported Israel so fervently?</p>
<p style="margin-bottom: 0in; text-indent: 0.49in;">Our support is
clearly not the result of the so-called Israel Lobby spotlighted by
the misbegotten, unsupported, and discredited accusations of
“realists” Mearsheimer and Walt<span style="font-size: xx-small;"></span>
20 years ago. No, there have been firm, self-interested reasons for
the US to support Israel.</p>
<p style="margin-bottom: 0in;"> As a matter of <b>values</b>, Israel
is a home to Jews, who need and deserve a home, who have been
discriminated and targeted for eons, and were able to achieve a home
less than 75 years ago<span style="font-size: xx-small;"></span>.
The US itself bears its share of the guilt of neglect of European
Jews as they were slaughtered and neither protected while they were
in Europe nor welcomed here.</p>
<p style="margin-bottom: 0in;"> As a matter of <b>principle</b>, both
for morality and for the practical reason of establishing order in
the world, the United States supports the sanctity of borders and the
preservation of identity of countries.</p>
<p style="margin-bottom: 0in;"> As a matter of <b>geopolitics</b>,
having Israel as an ally in the Middle East is of immense help to the
United States for exerting influence in that region.</p>
<p style="margin-bottom: 0in;"> As a matter of <b>national interest</b>,
it is in the interest of the United States to support countries and
movements that share the democratic form of government, and the
general Western set of values. This has both a moral basis, of
wanting all people to have human and political rights, and a
self-interested basis, since the more agreement on values we have in
the world, the safer are our own values.</p>
<p style="margin-bottom: 0in;"> As a matter of <b>internal national
politics</b>, Jewish Americans and others who wish Jews and Israel
well for various reasons, including Christian religious adherents,
have formed for many decades a strong source of support for American
support of Israel. It is important, valid, and practical for
governments to represent the sentiments of significant parts of their
population.</p>
<p style="margin-bottom: 0in; text-indent: 0.49in;">So, the question
becomes, should the significant changes in Israel make a difference
to our preferred policy?
</p>
<p style="margin-bottom: 0in; text-indent: 0.49in;">The idea of “Jews
should have a homeland” is still a good one, given the historical
targeting of Jews, all of this obvious to Westerners. There are many
other minorities who lack a homeland – the Kurds, the Rohingas,
many others, but they are less visible to Westerners, and none of
them have actually achieved the modern establishment of a homeland,
so for them it is still a hope to be pursued, while for Jews, a
homeland would be a takeaway. There's a difference between defending
what is and hoping for what isn't. Don't go backwards.</p>
<p style="margin-bottom: 0in; text-indent: 0.49in;">But, this homeland
argument is tarnished by the question, would all Jews be welcomed in
this increasingly theological country? Would Jews now in the Diaspora
really want to repair to a state that so constricts their freedom to
believe and to act? Imagine – would the Iranian-Americans now
living in Los Angeles really want to support Iran on the basis that
they need a place to decamp to if things got hot for them in the US?
It's not a fair argument, Israel is not Iran yet, but that comparison
might help to clarify Israel's claim to support as a homeland. Not
to mention that, with increasing orthodox power, even conservative
and reform Jews could well be excluded from the right of return in
the future. Home is where they have to take you in, but sometimes
they won't recognize you as part of the family, and sometimes you
really can't stomach the prospect yourself.
</p>
<p style="margin-bottom: 0in; text-indent: 0.49in;">A more powerful
argument for continued US support for Israel are the more prosaic
geopolitical issues. Especially with Ukraine as the target of
unbridled old-fashioned predation by a stronger power with
duplicitous arguments, and as we remember what happened when Kuwait
was overrun, we are strongly reminded of the value of recognition of
borders for world peace<span style="font-size: xx-small;"></span>.
It is in the interest of international collective security that
countries be supported. Israel has a right to exist, not only
because it is a refuge for a people, but because it already exists.
Israel also has every right to protect itself, and to receive aid
from allies to protect itself<span style="font-size: xx-small;"></span>.
(The issue of the occupied territories leaps up at this point, and
forms another reason for the US to be wary of undue support of an
Israel that makes claims on international support to protect its own
borders, yet violates the principle on various practical and Biblical
grounds, all fairly bogus.)</p>
<p style="margin-bottom: 0in; text-indent: 0.49in;">Traditional
geopolitics also attracts the US to ally itself with Israel. We need
allies in the world everywhere, and the Middle East is a crucial
area. We have always looked for allies abroad, allying even with
states we view with various degrees of distaste. Famously, FDR said
about Somoza in Nicaragua, he might be a son of a bitch, but he's our
son of a bitch<span style="font-size: xx-small;"></span>.
Even in the Middle East itself, few regimes could be more
distasteful than that of Saudi Arabia, but here we are. And, what
are we going to do about increasingly extreme and recalcitrant Iran,
which seeks not only to destroy Israel, but allies itself with Russia
and will establish drone production in Russia for their offensive
military use? Having a firm ally in the area is a value that speaks
for itself.</p>
<p style="margin-bottom: 0in; text-indent: 0.49in;">We were used to
supporting Israel as “the only democracy in the Middle East,” the
only country there that shares a European-American sensibility. As
we see Israel become illiberal in both governance and society, this
reason for supporting Israel is increasingly severely attenuated.</p>
<p style="margin-bottom: 0in; text-indent: 0.49in;">Finally, is
American sentiment within the country still attuned to supporting
Israel? Yes, it seems so, although with the alliance between
Netanyahu and the Republican, Trumpist right, liberal and Democratic
sentiment has attenuated. Jews at large still support Israel,
although many (probably most) would like to see a shift back to the
middle in Israel. The BDS-supporting Left is a vocal minority that
really hardly counts at present, given the predominant sentiment
nationally.</p>
<p style="margin-bottom: 0in; text-indent: 0.49in;">So, as an American
and as a very secularized Jew, what do I conclude? I conclude that
holding one’s nose as one deals with an ally or votes for a
candidate is an ordinary course of action. We make choices among
possibilities, not among wishes. I have a sentimental attachment to
Israel, although clearly not so strong as many of my more reverent
American Jewish friends. But even as my personal ties to Israel
attenuate, as an American, I see plenty of reasons to continue to
ally with Israel. We will have only limited ability to affect their
internal actions, much as with other countries. We can admonish, we
can encourage, but our leverage will remain limited. Israel might
make some policy alterations as we reduce aid to them considerably,
and as we cease protecting them so consistently in the UN Security
Council, or they might not. But the US will have to take these and
other actions as it distances itself from Israel, according to the
distancing that Israel is in the process of establishing with us<span style="font-size: xx-small;"></span>.</p>
<p style="margin-bottom: 0in; text-indent: 0.49in;">Finally, there is
another consideration, which is the widespread existence of
anti-Semitism. Internationally and domestically, it's always there,
either under the surface as a threat, or even more visible as it is
now. Like it or not, Israel and Jews are tied together, and if we
encourage anti-Israeli sentiment, we are also pushing the door a
little bit open to anti-Semitism. We have to be very measured in our
stances, no matter how despicable we find the particular Jews who are
becoming predominant in Israel. We can't treat Israel as we would
like to treat Hungary or Turkey, as foreign powers with little
history of being a target of worldwide hate and repression. We have
to be prudent.</p>
<p style="margin-bottom: 0in;"><br />
</p>
<p style="margin-bottom: 0in; text-indent: 0.49in;">So, in the end, we
have to let events clarify our thinking. Israel is becoming more
theocratic, significantly less liberal and on the brink of becoming
an illiberal state, but remains strategically important to the US,
and there are vestiges of morality that still accrue to Israel. We
need increasingly to hold Israel at a distance, take steps to
discourage Israeli alliances with the extreme right wingers in the
US, and<span style="font-size: xx-small;"></span>
indicate to Israel that we will help them as a last resort, but the
more their values and interests differ from ours, the more removed
they will be from our inner circle of friends.</p>
<p style="margin-bottom: 0in; text-indent: 0.49in;">It's an
unsatisfying conclusion, but at least it might be based on some
clarity.</p>
<p style="margin-bottom: 0in; text-indent: 0.49in;"><br />
</p>
<p style="margin-bottom: 0in;">Budd Shenkin</p>
<p style="margin-bottom: 0in;"><br />
</p>
<p style="margin-bottom: 0in;"><i>I am once again indebted to David
Levine for excellent suggestions and editing.</i></p>
<p><style type="text/css">P { margin-bottom: 0.08in }</style> <br /></p>Buddhttp://www.blogger.com/profile/03893224951099943306noreply@blogger.com0tag:blogger.com,1999:blog-8705432279177203509.post-57172682742235614622023-02-10T21:14:00.000-08:002023-02-10T21:14:06.771-08:00Memories of High School - My Friend Arlene<p>
</p><p align="CENTER" style="margin-bottom: 0in;"><b>Memories – High
School – Arlene Davis and the New, Handsome Young Teacher</b></p>
<p style="margin-bottom: 0in;">I was sitting next to Arlene Davis.
Arlene was kind of frizzy haired, as I remember, maybe off-blond,
with facial zits she had to use makeup to cover. I felt bad for her
about that. She wasn't unattractive, just not so attractive as she
wanted to be, I think. She also wanted to be sophisticated, but I
think she was just trying to fake it. She wanted to be mature. She
wore blouses that an older woman could wear. Of course in those
times a lot of girls wanted older guys. With good reason. People
like me were eager for something we couldn't name easily, naive, we
couldn't keep up with the girls. That's the way it's supposed to be.</p>
<p style="margin-bottom: 0in;">Anyway, I can't remember what class it
was; maybe something that wasn't a regular class. We were sitting
side by side. We really weren't friends, as far as I knew, but I was
friendly, a friendly sort was I, I guess you could say. I think I've
always been friendly, that's me, pretty much. Anyway, Arlene was
looking up at the teacher as he stood talking in the front of the
class. He was a young guy, a new teacher I think. Fresh-faced, kind
of on the short side, probably with a tie, could even be a bow tie,
white shirt, and as he talked, he was the opposite of jaded. He was
eager to be accepted, I think he was perky. Very clean shaven, and
perky. Trying to make eye contact with the class, trying to charm
them.</p>
<p style="margin-bottom: 0in;">Me, I thought he was a little dorky,
not cool, but engaging, that was a plus. But when I looked over at
Arlene, she looked enraptured. Ardent, that would describe her.
Ardent Arlene. I was surprised. She looked at me and she said, “I
want him.”</p>
<p style="margin-bottom: 0in;">That was surprising. But I'm a nice,
friendly somewhat naive guy, so I said, “You want him? How do you
want him?” I was sincere. I really didn't know. A girl wants the
teacher? (Don't forget, these were the days way, way before Porn Hub.)</p>
<p style="margin-bottom: 0in;">So she answered my question. She said,
“In every way.”</p>
<p style="margin-bottom: 0in;">I had stumbled on the fact of female
desire. Which I wasn't ready to believe, despite the obvious, even
protuberant fact right beside me. I was just amazed. I also didn't
think that this new teacher guy deserved that kind of ardent
attention from Arlene. I mean, he was actually a little wimpy. OK,
kind of good looking, maybe, but definitely not cool, and definitely
not sexy.
</p>
<p style="margin-bottom: 0in;">So that's it, just one of those scenes
from the past that gets lodged in the brain. Arlene Davis and
feminine desire, directed in a surprising direction. And my
inability to confront the obvious, that girls want sex, too.
Sometimes ardently.</p>
<p style="margin-bottom: 0in;">Years later, when I was a pediatrician
doing an adolescent yearly physical with a maybe 14 year old boy, and
we were talking about his sexual desire, and I told him that the
girls wanted it as much as he did. “They do???” he said, amazed.
I guess he could take it from me, I was always truthful with him. I
finished the visit and told him I would see him next year. He looked
so disappointed. “So long?” he said.</p>
<p style="margin-bottom: 0in;">I should have told him about Arlene.</p>
<p style="margin-bottom: 0in;">Budd Shenkin</p>
<p><style type="text/css">P { margin-bottom: 0.08in }</style> <br /></p>Buddhttp://www.blogger.com/profile/03893224951099943306noreply@blogger.com0tag:blogger.com,1999:blog-8705432279177203509.post-55793979005162099772023-01-21T19:04:00.002-08:002023-02-12T16:25:08.753-08:00For A While, I Felt Like King Of The World<p>
</p>
<p align="CENTER" style="margin-bottom: 0in;"><b>King of the World</b></p>
<p style="margin-bottom: 0in;"><br />
</p>
<p style="margin-bottom: 0in;">The time that I might have been
happiest was in fourth grade. I was in a public elementary school in
West Philadelphia, where my mother had grown up, and we lived just
two blocks from the Henry C. Lea Elementary School at 47<sup>th</sup>
and Spruce. I forget who Henry C. Lea was, but I'm afraid to go back
and google it, for fear that he will turn out to have been racist.
But it didn't make any difference to me what he had been, or what the
school was named. I know for sure that my mother had gone to the
more felicitously named West Philly High, which was just around the
corner, I think. My brother and sisters had all been born by then,
and the six of us lived in a three story semi-detached house in a
neighborhood that was influenced by the University of Pennsylvania,
down at 34<sup>th</sup> and Spruce, where there was the University, a
museum of anthropology called the University Museum, with large cases
and smooth and polished concrete floors that we could slide on if we
ran and had only our socks on, and where there was a big, round
stadium, Franklin Field, where they had football games, which I saw
when I was young once or twice, and where every spring they held the
Penn Relays, a hugely important track and field event, which I had
never gone to, but which I knew about because I read the Philadelphia
Bulletin, our evening newspaper.</p>
<p style="margin-bottom: 0in;">By fourth grade, I felt like being a
senior, and so I felt like a king. Our school assemblies were from
kindergarten to fourth grade; when you got to fifth grade, which I
never did because that was when we switched to private school, you
were thrown in with the sixth, seventh, and eighth graders – no
junior high or middle schools then, just the upper section of
elementary school – and you were at the bottom again. But in
fourth grade, you were at the top. You had been there for five
years, you knew the ropes, you knew the games in the big concrete
school yard, games like flipping cards and our version of handball
against the big, concrete wall that separated the school from the
next-door osteopathic college, which I learned from my neurosurgeon
father and homemaker mother to hold in some contempt, although I
didn't quite know why. We also played running bases, catch, and
maybe some touch football. We saw the older kids hanging around,
like the Tjerian brothers, Johnny and Pat, Johnny looking like a thug
in sixth grade. A mixed crowd, and we held our own.</p>
<p style="margin-bottom: 0in;">There were three of us in our grade who
were tight, the three musketeers, we called ourselves. Me; Arnold
Bernstein, my best friend; and Irving Gerowitz, who told us one day
that his family had changed their name to Gerwood, and he gave some
sort of explanation that didn't include saying that the new name
sounded less Jewish. We also included a fourth, lesser member, a
smaller kid named Bruce Leanness, who was fast. I Just found out
from my friend Bob that he was also Jewish, and his father was the
soccer coach at Temple and is regarded as the Dean of American
Collegiate Soccer Coaches. It was all a mixed but white
neighborhood, and there were a bunch of neighborhood kids, like
Frankie Collissey who lived across the street, who went to Catholic
school, at St. Francis de Sales. Frankie told us that we learned for
this life but they learned for the afterlife, as though you could
believe that shit, but he apparently did. But at Lea School, we
musketeers viewed ourselves as cream of the crop, the best athletes,
I was probably the smartest in the class, and Arnold was great at
math. His father drove a taxicab, and sometimes I would visit him
and his little brother Stevie and his mother Faye at their apartment
over on Chestnut Street around 48<sup>th</sup> Street. I was
startled to see that it was small and they all lived there, and their
father was asleep because he drove a cab at night.</p>
<p style="margin-bottom: 0in;">By fourth grade, we had weathered the
preliminaries. Fat and jolly and warm Mrs. Huggins for kindergarten.
The more popular teacher (among the mothers, anyway) was Mrs. Tufts,
who was thin and taller and gray haired, but I liked my teacher best,
Mrs. Huggins. I don't think she actually hugged us, but I didn't
miss the implication. Then the more angular Mrs. Anderson in
probably second grade, who once went around the class and asked a
question and someone was standing up and gave the right answer, but
Mrs. Anderson challenged him or her, I think it was a girl, and she
backed down, and then Mrs. Anderson admonished her, “Stick to your
guns!” Wow! How I learned from that!</p>
<p style="margin-bottom: 0in;">Later on in fourth grade it was Mrs.
Ousey, whom we of course called Mrs. Lousy when she couldn't hear us
– we were so clever – and my mother warned me not to say it,
because sometime I might forget and say it when she could hear. When
there was a parent teacher conference and my mom and dad met with her
and she gushed about how smart I was, saying “Definitely college
material!” my parents took it as a sign that they couldn't keep me
there, if this was a low-bar school where it wasn't assumed that most
everyone would go to college. The next year all four of us kids
started going to Friends' Central school about 30 or 40 minutes away,
out on City Line, along with some neighborhood friends, including Bob
Levin, one class behind me, who is now my oldest friend, except for
my brother and sisters. Bob remembers that “we didn't like each
other,” but I reply to him, “Well, I liked you.”</p>
<p style="margin-bottom: 0in;">Needless to say, at Henry C. Lea
Elementary School, we were prepubescent. Now they talk about
“hormones kicking in,” so prepubescent kids expect that, but I
was blissfully and completely unaware of all that. Girls were there,
and I liked some of them, even though they couldn't play sports. I
was aware that the other kids were different, and I didn't quite know
what to make of it. It just registered. John Lewis was thin and
light haired and gentle, but mostly, he distinguished himself by
being uncoordinated. He ran like a girl, you could say, and maybe we
did say that. Couldn't throw. He wasn't manly, the way Arnold and
Irving and I were, and Bruce. We were all about sports and
manliness, although we were nice and kind and not mean. John was
smart enough, but he didn't fit with us. He hung out more with the
girls, like Patty, a fat girl who sat upright at her desk with her
hands folded in front of her and her lips turned in a little – you
know how you do that? Is there a word for that? It's not pursed, I
think, pursed is like ready to kiss. But this is when you kind of
suck your lips in so they don't show. Anyway, that's what Patty did.
And there was Lenore Cooperstein who was smart and who was a little
reserved and stern, and nice enough and once we went to a birthday
party at her house and Arnold and I tortured her by pulling up her
dress and laughing as she got mad at us. I told my mother and she
told one of her friends and laughed at it, in a way that understood
that this was what boys did. As the oldest kid in the family,
everything I did was new for her.</p>
<p style="margin-bottom: 0in;">But mostly, when it comes to the other
kids in the class beyond the musketeers, there was Connie. Connie,
with her blondish hair cut so that it came down around her face and
stopped at her jaw line, whose hair was straight, who I thought was
the prettiest girl anyone could possibly imagine. If there could be
something called a girlfriend in those days, she was my girlfriend,
although I can't recall a single thing we did together except stand
up and look at each other straight on and smile. Except for one
time. That time, we were all at our desks, and we had all been given
Dixie Cups – ice cream in a cup, half chocolate and half vanilla,
with a little wooden spoon. Ice cream! What could be better than
ice cream! But, amazingly, Connie didn't want hers. Why didn't she?
Who can imagine why, but she didn't. So she went up to the teacher,
it might have been Mrs. Anderson, and said that she didn't want hers,
so Mrs. Anderson announced to the class that Connie didn't want hers,
and who did? Me!! Me!! It seemed like the whole class was raising
their hands toward the front, straining with effort, shouting Me!!
Me!! So Connie surveyed the class, and with the sweetest smile
anyone has ever had, she walked down the aisle to the middle of the
class where I was seated and she reached out and gave me the Dixie
Cup. I said, Thanks a lot!!! We looked at each other and smiled. I
still remember that smile. She kept her smile and went back to her
seat and I ate the best Dixie Cup ice cream I have ever had.
Truthfully, I can taste it now. Connie had some complicated last
name, I think it was Greek, that I couldn't seem to remember. My
God, she was beautiful.</p>
<p style="margin-bottom: 0in;">But then, of course, we switched to
private school. No more king, no more musketeers, no more class
representative to the student council, no more assemblies where we
were the oldest and most experienced. Out to Friends Central on City
Line, which was beautiful and, to me, bucolic, with a big hill behind
the school property, where they constructed Lankenau Hospital a few
years later and we saw it go up, with orange steel girders on the
green hill. There were some big trees on the Friends' Central
property, some playing fields with grass, where we had mandatory
sports after school, with uniforms and shoulder pads and spikes for
football, and an old gym and a new gym, named after the Linton
family, who owned a chain of modest restaurants (called “Linton's,”
amazingly enough) that competed more or less with Horn and Hardart's,
and whose kids were students there – David in my class, long and
lanky and fair and introverted, fast when he got going with thin
fists clenched, and soccer fields, and a big wide slide for the lower
school kids to use at recess, and some parents who picked their kids
up with woodie station wagons, and who my mother later assured me,
were anti-Semitic. Some were, I'm sure, and the in-group in my class
must have been somewhat, but overall, the biggest difference was that
I was no longer king, and we didn't have the musketeers. I was still
smart and athletic, but it was different. One time Dave Kirk, our
football coach and our history or social studies teacher, took me
aside, probably in 7<sup>th</sup> or 8<sup>th</sup> grade, and asked
me, I forget the words, why was I uptight? I had everything, he
said, I was smart and a good athlete, he probably said something
about an outgoing personality and pretty good looks, so why did I
have a chip on my shoulder? I wonder that to this day. I think that
was the same class where he gently and amusedly told me while we were
taking a test to stop giving answers to the girls. It must have been
eighth grade. Some people come to a new situation and rise to the
top, but I just didn't. I was among the smart kids, as always, Jon
Gross thought he was smarter but I don't think he was, and I was
definitely smarter than Barry Sharpless, who went on to win two Nobel
Prizes at Scripps for chemistry, and no one was a better athlete. I
played shortstop and was probably the best hitter. But Bob Hall was
a good runner and well coordinated, and Bob Long was a good pitcher,
so who knows. I had some friends, but no one like Arnold had been.</p>
<p style="margin-bottom: 0in;">One time I excelled and was recognized
for it, and was surprised. I did well in our public speaking class,
and our teacher, Mr. Burgess, a very tall and thin man with
close-cropped hair saw some talent, and stooped down in a crouch to
ask me if I wanted to be in the high school senior play. I
immediately said yes, and he was surprised I answered immediately,
and was very pleased and stood up. My mother said that Mr. Burgess
was wonderful, and I believe that to be true. The play was Our Town,
and my part was Wally Webb, little brother of female lead Emily Webb,
and my mother delivered me for many weekends out to rehearsal. I was
part of the play, and treated like everybody's little brother, and
Mr. Burgess taught us to say, “Break a leg!” I had one memorable
line, delivered at the breakfast table when our mother told me to
stop reading at the table, and I protested, “Aw, Ma, by 10 o'clock
I have to know all about Canada!” That line was duly waited for
and savored by every member of my family, all five having packed
themselves in the car to see my one line, sitting proudly in the
audience. I was in other plays later on, receiving impassioned
applause as I exited the stage after declaiming the fate of my
patient if he failed to follow my instructions in The Imaginary
Invalid. If I had continued with that stage life, I truly believe I
could have been a contender. But never a champ. And probably not
really a contender. But what an experience it was, the stage.</p>
<p style="margin-bottom: 0in;">I kept up with Arnold for a while, he
would come to visit us for a week at our Long Beach Island, New
Jersey beach house, but then it got too competitive and my father got
angry at him for competing too hard with his son and he didn't come
any more. A few years later my mother took my brother and me to
Frank's Delicatessen on Spruce Street for lunch and Arnold was at a
neighboring table with three or four friends and his brother Stevie
was flitting around the edges, spied us, and excitedly told Arnold,
look who's there, and Arnold sushed him away and didn't look up and
we didn't acknowledge each other and that was that. Kind of a bad
end, after all those years of close friendship. I still regret it.</p>
<p style="margin-bottom: 0in;">So, I had friends in my class at
Friends' Central and in other classes (including Brian De Palma who
was a year ahead of me,) but no one like Connie, of course. Puberty
had arrived, much to my confusion, since I was completely unprepared
and no one was about to help me. My parents watched. My mother gave
me two books to read, in one of which they misprinted “vagina” as
“regina.” I asked my mother about it but she was mostly
embarrassed. There were no sex-ed classes in those days. I had kind
of a girl friend a year behind us, Carol Carr might have been her
name, and my very blond classmate Steve Jess told me excitedly at
some event or other, “She really has them!” Which meant breasts.
Which was very confusing for me, since I hadn't much noticed. Was
that desirable? Who wanted them? Steve was all excited about them,
but I was mainly confused. I could see kissing, but that was about
it. The only books I read were about sports and history. Then in
7<sup>th</sup> grade we had an infusion of new kids and one of them
was Sally Couthy, who I think was southern, and who wore a flower in
her hair, and who wore what I guess I would call flowered exuberant
dresses, or sometimes tight ones, and who for some unknown reason
took a liking to me. She was very exciting, but I was mostly scared,
although I knew she was beautiful and, although I didn't know the
word, sexy. We were at a party with girls and someone turned out the
lights and there was squealing and I hid under a table, literally.
It was a very confusing time.</p>
<p style="margin-bottom: 0in;">It was a good thing that my father was
a neurosurgeon, because those private school tuitions for four kids
weren't easy, I'm sure. It speaks a lot to their values that my
parents sprang for those tuitions, because they were careful about
money, but spending it on the kids' education was top of the list.
But finally, something must have snapped, because they had me apply
to go to Central High in Philadelphia for 9<sup>th</sup> grade, where
my father had gone and which was a top quality high school but where
I didn't want to go, and then instead of going there, we moved to
Wynnewood on the Main Line, named for Sir Thomas Wynn, physician to
William Penn, and first speaker of the first Pennsylvania Assembly,
or so spake the historical signpost. It was a little split level
house in a development that was Jewish, just a few blocks down
Montgomery Avenue from Ardmore Junior High and Lower Merion High
School, which stood side by side. The schools were top quality, and
I think the house cost maybe $35,000. There were four small
bedrooms, and mine, at the end of the short hall, was tiny, enough
room for a bed and they had Mr. Lopez, a carpenter, make built in
shelves and drawers for clothes and a formica surface that would
served as both top of the bureau and a desk, with fluorescent bulbs
underneath the shelves that made for perfect lighting while I
studied. My parents apologized for the small size, but I loved being
down the hall and who needed space? I put up National Geographic
maps on the wall on the theory if they were there I would gradually
absorb all that geographic knowledge without working on it. My
theory didn't work, but my sibs remember that “You loved maps.”</p>
<p style="margin-bottom: 0in;">The year at Ardmore Junior High as a
new kid was the way new schools are for kids, and they school had a
tough time interpreting the report card from Friends' Central, that
had O for outstanding for the academics but NI for needs improvement
for behavior, so Ardmore averaged out the grades and put me not in
9R, the top section, or 9H, number two, but in 9S, third section
down. Since I was a little bit ahead of the class in Latin and in
math, coming from private school, and since there was no competition
to speak of, academics was not a challenge for the year, and in fact
the rumor got around that the new kid was smart – He reads Latin
like it's English! And I made the football, the basketball, and the
baseball teams, although I wasn't at the top the way I had been
before. But some of the kids were bigger and more developed than I
was.</p>
<p style="margin-bottom: 0in;">And I had some balls. I insisted in
speaking up in the football team meeting, making sure everyone knew I
had been quarterback at Friends' Central, and I was a fierce tackler
at linebacker that the coaches had to double team sometimes, but I
didn't play much. Everyone and his brother went out for the
basketball team, and Mr. Abrams, the coach, divided us into guards,
forwards, and centers. I looked at the horde going to the guard side
and decided, how will I ever be seen there? So despite my average
height I went with the tall guys at forward. Mr. Abrams kind of
gulped, but let it go. We worked out, ran the floor, and I got off a
great shot in full flight as I flipped it in off the board from about
15 feet on the right side. When Mr. Abrams had seen enough and
culled the lot, he said, OK, Shenkin, you can go with the guards now,
and I was on the team.</p><p style="margin-bottom: 0in;">It wasn't bad with my being with the
average students for a year. I made friends, although not close
ones, and I got to see what it was like. It was a mixed group. I
remember Steve McCoy walking down the halls humming the first wave
of rock and role music – maybe Tutti-Fruity. There were the
Italian kids who made sure that they were the only ones who got to
say Fungoo, because that was “their native language.” It was
probably later on that one afternoon we were playing basketball just
across the street from Ardmore Jr. High's black iron metal stake
fence., at the house of the somewhat feckless Alan Greenough. It
wasn't too late in the afternoon, but his father came out and said it
was time for everyone to go home, and he would drive them. He asked
me if I wanted a ride and I said I didn't need one, I'd walk, and
then the car with all my friends in it passed me and they all waved.
Later on, I found out that Greenough's father had just driven around
the block and taken them all back to the house, and the object had
been to get rid of the Jew. I felt pretty good when the company he
was president of, the Pennsylvania Railroad, went bankrupt. To tell
you the truth, it didn't bother me much. I knew I was better at
everything than Greenough.</p>
<p style="margin-bottom: 0in;">Lower Merion High was a fusion of
Ardmore Junior High and Bala Cynwyd Junior High. There were a lot
more Jewish kids from Bala Cynwyd, but by this time I was an Ardmore
kid, where in the end, people had really been so nice to me, and
where I had started to acquire lifelong friends – John Raezer, Bob
“DiGi” DiGiovanni, Bill Birkhead, and even a guy named Charlie
Newsom from Narberth, home of one of the premier Philadelphia
basketball outdoor courts where Guy Rodgers and other pros were known
to play, who told me not to give in to comments about my being
Jewish, and took me to a Catholic club dance of some sort.
</p>
<p style="margin-bottom: 0in;">In English class I was with Loretta
Siegel, who had fully developed breasts to the admiration of many but
still to the ambivalence of me. Loretta would come over at the
beginning of class and shake my hand, warmly, with feeling, and she
would look into my eyes and say, Budd, don't ever change. It was the
9<sup>th</sup> or 10<sup>th</sup> grade equivalent of getting laid,
but to me, it was pretty confusing. What was that all about? I
wondered. My widowed paternal grandmother, Nana, got ahold of that
information and grabbed it – she's Bernie Siegel's daughter, the
great Philadelphia lawyer, Bernie Siegel! Like later on in college
when I mentioned that one of the guys next door was Sam Saltonstall,
a nice, quiet kid who mostly wanted to play the trumpet, and was
probably burdened by the famous name. Nana said, stay close to him!
Saltonstall!
</p>
<p style="margin-bottom: 0in;">But I digress. Lower Merion was,
looking back on it, an oasis. Our group had a regular weekend poker
games, now legendary, where we played the usual games, and famously,
introduced by a visitor one time, one Bubble Liedman, Itsy-Bitsy With
A Tiddle. Lynn Sherr, my close friend, wrote about it in her
reminiscences, how the smartest kids were the best athletes and the
most popular, all at once, she said. I don't know if that was true,
but I couldn't have been happier and we are still good friends, so
many of us, including Jon Gross, who had been my classmate at
Friends' Central and had moved over to public school, like me. And
we had the best high school class I every had, Special English, with
Mrs. Hay, where we sat in a circle, maybe 18 or 20 of us, and read
and discussed great literature in four areas, tragedy, freedom and
responsibility, and two others – we struggle to remember them –
and where Mrs. Hay cautioned us to be very careful using clich<span style="color: black;"><span style="font-family: Times New Roman, serif;"><span style="font-size: small;"><span style="text-decoration: none;">é</span></span></span></span>s,
and where we wrote papers and we all read each others. There is a
special part of heaven for Mrs. Hay.</p>
<p style="margin-bottom: 0in;">We still have reunions for LM, and we
still go. I don't know if we will anymore. After our 60<sup>th</sup>,
they said we probably won't have anymore, but I said, hey, at our
age, we shouldn't stick to every five years, time's awasting, we
should move it up. So we did, DiGi taking the lead, and we had
another one last year, but I couldn't go because my wife Ann was so
sick. I was missed, they said, and I believe them.
</p>
<p style="margin-bottom: 0in;">At the reunions there were people we
knew but weren't real close to, but that was great in itself. One of
the great things about reunions is that they are an antidote to
awkward unacknowledged goodbyes. But for the ones who don't come, the
unacknowledgement remains. I did miss seeing some classmates. There
was a bunch of kids who were kind of goof offs, or how could I
explain it? Who weren't in our group, and I guess whose parents
were lower middle class. We had our working class kids, from
Manayunk, and our black kids from Ardmore, who still sting from the
racism they encountered and which we didn't know what to do with in
those pre Civil Rights times, and these other kids, like David Kirby
and Hughie O'Neill, the motorcycle kids, had their own group. Maybe
they'd go to college, they had parties and there was drinking, I
heard. Not that we didn't drink, we did. There were no drugs in
those days, that I knew about. These classmates don't come to the
reunions. Others do, and I'm thrilled to see them. I introduced my
wife Ann to a couple of them, telling Ann that Carol Arzio was the
prettiest girl in the class, and Ann said, I can see why, and Vicky
Casciatto, who now lives in Marin, and I said that everyone was
jealous of her boyfriend and we all daydreamed about her, and she
turned away a little, and blushed a little, and it seemed she was
just super-pleased. Our friend, our really close friend Ricky
Shryock doesn't come. His father ran a local hifi store, but his
parents were divorced, and he ran from one to the other in his
Kharmann Ghia, and he would stop by our house unannounced and would
put a sandwich in our refrigerator and my mother would say, Ricky,
you don't have to do that, I'll feed you, and he would go down to the
basement with my brother Bobby and they would play cards and Rick
would basically clean him out, and later on Rick had the distinction
of marrying and divorcing one sister and then marrying the other
sister, and the last job I heard he had was selling Snap-On Tools,
but we all loved Ricky and he was such a great athlete, boy could he
hit a baseball and he went to Lafayette College and I don't know if
he graduated, but I think he hit .450 or so, but Rick had such
character, he constructed a little golf course in his father's back
yard where his Dad lived with Pat, his new wife, which Rick would
play alone, and Rick moved back and forth between his mom in Narberth
and his dad and Pat in Gladwyn, as I said. Ricky doesn't come to the
reunions, although we all loved him so much.</p>
<p style="margin-bottom: 0in;">Speaking of divorce, at the last
reunion I went to I sat with Lynn and Angela Schrode a long time, and
found out that Angela's days with us at LM were tortured, because her
parents had a bitter divorce and she had to travel very far to come
to school, and she was miserable, and I didn't know about it but Lynn
did, because she explained it was Schrode and Sherr, so seating made
them friends, and Angela became a professor of French literature at
Sarah Lawrence, and just sitting and talking made that night just
wonderful, we could hardly stop. I hadn't known, I think, that her
mother had married Claude Rains, who Angela said was a difficult man.</p>
<p style="margin-bottom: 0in;">And Hughie's girlfriend doesn't come.
She was an extroverted girl, with a nice full chest, with kind of
short, straight dark hair, who I thought was just so unobtainable and
we ran in very different circles, she certainly seemed, as we say,
much more advanced socially, and we didn't have any classes together,
but I kind of looked at her, and sometimes, is it my imagination, or
did she sometimes look at me? Maybe once or twice, maybe. Probably
not. We never spoke. I sure wish she had come to some of our
reunions. I'd like to see her again. Maybe she did, but I don't
think so.</p>
<p style="margin-bottom: 0in;">Her name was Connie Petropolis, I
think.</p>
<p style="margin-bottom: 0in;"><br />
</p>
<p style="margin-bottom: 0in;">Budd Shenkin</p>
<style type="text/css">P { margin-bottom: 0.08in }</style><p><style type="text/css">P { margin-bottom: 0.08in }</style></p>Buddhttp://www.blogger.com/profile/03893224951099943306noreply@blogger.com1