Tuesday, August 19, 2014

Obama's Foreign Policy Makes Medical Sense

In medicine, sometimes we have to wait. “Tincture of time” is a traditional strategy. You have to let the body react, you have to see what is going to happen, you have to resist the temptation to treat right away, because it might not be necessary, and because treatment later on might work better. Yes, it's most often best to catch an ailment early, but when you do, the judgement of the clinician is sometimes just to wait. And when the time comes to act, sometimes the best intervention is not dramatic, but just a well-aimed lance, perhaps; boom boom and it's done.

And sometimes you just don't know what you're dealing with. When I was a senior medical student I made rounds with infectious disease specialist Sam Katz. He would be called in for a case of infection on the wards of Children's Hospital in Boston. Often it wasn't clear what the infection was. So he would say, take the child off all antibiotics and reculture in three days. The housestaff (residents) would protest – this kid's sick! I know, Sam would say, but we need to know what we're dealing with. Take him off all antibiotics (it would take time for the antibiotics to clear from the system so we could get a good culture) and we'll see if we can find the bug after three days. Have some confidence here that the kid is not going to expire – if he gets a lot worse, we can restart early.

Which is a roundabout way of saying that I am one of the apparently few defenders of Obama's foreign policy. Everybody's dumping on the guy with I told you so's. As though it's obvious that an earlier intervention would have prevented the ISIS Syria-Iraqi insurgents from coming this far this fast, and as though it's obvious that this is far too dangerous a place for us to be. Hillary opened her big mouth to distance herself from a sensible policy once again – she claims to have learned the lesson of Iraq, but I doubt it.

Myself, I think Obama, in his very understated way, did the subtly courageous thing to do, he let the infection come to a boil that could be lanced. While doing it, he effectively got rid of the noxious Maliki side infection. Don't want us? Fine, we're out of here. Let's see what will happen. Let's be confident we can handle it in the future. Let's not let ourselves be wagged by the noxious tail.

Now the body has reconstituted itself, we have started to mobilize our forces with a better constituent body to wage the counter-war, and we'll supply some medicine while that tail won't be wagging us any time soon. We also found another functional organ to support in the north, the Kurds. They want us, they have a state that is working (Erbil has a Jaguar dealership), their army will fight. Obama has been quite right to say that they have to want it at least as much as we do – we'll just have to see if the Iraqis do or don't.

Meanwhile, for the situation just a little north of there, Obama refuses to speak out dramatically against the posing-against-the-sky-as-background Putin. Patiently and privately, he says, you don't want to do this. He counters every bishop move with a pawn blocker, and moves his pieces behind the lines of attack to more powerful positions. He has a sense of proportion.

I have been quite critical of Obama in the past, and maybe I'm just the kind of guy who looks for an opportunity to take the other side. Nonetheless, let's see what happens. My sense is that his caution and his subtle risk taking will prove in the end to be admirable and effective.

Budd Shenkin

Friday, August 1, 2014

An Electoral Strategy

Yes, there are huge questions facing our country. War or peace, renewal of the cold war? Immigration? Economics? All important. But we know enough to understand that elections don't often hinge on important questions; they hinge on feelings, emotions, and immediate concerns. As in, abortion, gay marriage, giveaways to the lazy poor.

Thus comes my proposal for a cogent electoral strategy. Hear me out.

Last week, my security was breached. My bank was contacted for a transfer of funds to a third party. All my financial institutions were contacted in a similar manner. Later, all my email contacts were spammed for information, and false invoices were mailed to them (and to me.) And yesterday my bank was presented with a check with my wife's forged signature that was cashed at a Southern California credit union (my corporate account was defrauded via a credit union too, some years ago. What is it with credit unions?) The fraudsters have not received any money from me that I know about, and I have taken the laborious but necessary steps of changing my bank account number, changing all passwords and User ID numbers, cleaning up my computer, etc. A pain, and emotionally disorienting, but so far, so good.

I am not alone. Everyone I have talked to has told me I am only one in a long line. Many of my friends who have been spammed have recounted their own family's misadventures. Anyone who has visited Target knows the feeling. The amount of resources expended by institutions on this sort of fraud must be enormous. I wonder what the total population impact and total cost is. It's got to be huge.

At the same time, it is excruciatingly difficult to identify the miscreants in these frauds, and difficult even to report them. I can't find a way to tell Google that someone created a new email address called budshenkin@gmail.com – one “d,” such an insult and abomination! There is no fraud unit ready to jump into action. The bank said originally that their major function would be to deny payment on the fraudulent check, and leave it at that. They said I could do something personally if I cared to. I demanded to see a senior officer who said he would contact the FBI. I doubt that this will lead anywhere; after all, I haven't even lost money. My wife's identity was stolen last year. Amazingly they caught the people involved trying to charge on her account in a Sacramento store – and the Sacramento police let them go! WTF?? In essence, there is precious little enforcement.

Now let's look somewhere else in the public policy sphere. We know that the prisons are overflowing, and needlessly so. The failed War on Drugs is a major source of all the incarceration; everyone knows that. Why the War on Drugs has not been able to be shut down and replaced is a mystery of the usual public policy and bureaucratic stagnation. (In my own field of pediatrics, the self-maintenance of the bureaucracy around lead poisoning – an affliction that sank to very low levels decades ago as soon as gasoline was made unleaded – has been absolutely astonishing. The public health bureaucracy employs thousands. But I digress.) But there is clearly movement as marijuana is being legalized, despite the entrenched interests who benefit from maintenance of its illegality.

So, let's put this all together. My proposal is this: Let's take the money from the War on Drugs and devote it to the War on Credit Care and Online Fraud. And let's do a Prisoner Exchange – let the marijuana offenders out of the clink, and refill it with the Fraudsters. That should keep the Prison Guard Union happy. I'd call it The Great Pivot, “Out of drugs and into fraud!”

Sounds like good public policy to me. If someone were to run on this platform, can there be any doubt it would be an overwhelming winner? Any doubt at all?

I thought not.

Budd Shenkin