Afterthoughts

Dang. I’d been planning to begin this week’s column with a riff on that laughably large ear bandage Trump sported at his coronation, and, having seen his cult fashioning similar ones, to note the similarity to farmers tagging the ears of their sheep. Probably, I’d have puzzled that, next day, he wore a small Band-Aid appropriate to the injury he incurred.

Maybe he realized, despite seeing his flock lower to the occasion, how ridiculous it looked to everyone else. As a former trauma surgeon, I’d never have applied that honker to such a minimally injured ear. Nevertheless, he was very lucky and that’s a good thing. I don’t minimize the seriousness of the close call; just the crazy that came after.

So I’d also have reflected on miracles. If defined as evidence of divine intervention, and if God saved Trump from death, then it’s no less miraculous that He made Mr. Comperatore die. Same for late-discovered survivors of earthquakes that kill hundreds. You can’t see saves as godly and not the killings. So, maybe there are no miracles. Were I reckless enough, I’d have proposed that to think He would choose an amoral man like Trump to lead us is disrespectful of God. Blasphemous, even.

I’m sure I’d have mentioned the similarities between Kim Jong Il’s ceremonial appearances and Trump, when he wasn’t nodding off, smiling beneficently as sycophants like Tucker Carlson and Hulk Hogan (!) praised him, deified him, one after another. Likely, I couldn’t have avoided noting that, halfway through Trump’s endless, rally-repetitive acceptance speech, the faithful were scrolling their phones or walking out.

President Joe Biden’s magnanimous decision to withdraw from contention is the reason I’d have said none of that. MAGA Republicans won’t, but present company and future historians will agree that President Joe Biden is one of the most, if not THE most effective president since FDR.

Assuming the reins of a devastated economy while a mishandled pandemic was requiring refrigerated morgue trucks outside overwhelmed hospitals, as unemployment was soaring and businesses were closing, he turned it all around, creating millions of jobs, lowering Covid-rebound inflation – never as high in the US as in other developed countries – to a third of its maximum.

Record numbers of small businesses have been created. Decaying infrastructure is being rebuilt. And, had Trump not shepherded his sheep into blocking it, President Joe Biden’s negotiated, bipartisan deal would have made significant progress on border issues.

It’s a remarkable, proud legacy, with a terribly sad ending. Compared to Trump’s venality, President Biden’s decency, placing country above self, couldn’t be more obvious.

Concerned he might not be the one to beat Trump, who, notwithstanding MAGA credulity, historians will agree was one of the if not THE worst president ever, President Biden’s decision to withdraw speaks of patriotism and selflessness. I hope he makes a barnburner of a speech at the Democratic convention.

While we await whatever mess Democrats and pundits will make of their nominating process before selecting Kamala Harris, we know for sure their convention won’t be the festival of falsehoods foisted by Trump’s fraudulent fluffers.

After Speaker-of-Sorts Mike Johnson testified that theirs is the party of law and order, and before his party nominated a convicted criminal, adjudicated rapist, defrauder of New York State of millions of dollars, and recidivist scammer, they welcomed, to delirious cheers, a convict caravan: Manafort, Stone, Navarro, J6 insurrectionists. If he weren’t still serving time, Bannon would have been similarly received.

Came then the strategic lies: Crime rates; energy production; EVs; gas prices; rampant “migrant crime,” the fakest of fakes.  And the one Trump hopes to ride to the White House: election fraud. To which he, the oldest presidential nominee ever, has added another, nearly as pernicious: that he knows nothing of Project 2025.

He knows. Praising the world’s worst dictators, to replicate whose regimes the Project aims, he knows. If elected, he’d follow its marching orders toward a government by and for its billionaire advocates, himself as figurehead, secured by permanently diluted elections.

Continuing its election interference, Russia is praising Trump and, now, his V.P. pick. The former Republican Party would have been appalled to see their nominees praised by America’s enemies and lauded at home despite – or because of -- their disqualifications. In the graves of the respectable old guard, rotations must be continuous.

Money and endorsements are flooding in for Kamala Harris, breaking records. Trump might hide from debating her, but he and his surrogates aren’t hiding their awful, desperate misogyny and racism when attacking her, with worse to come. To which I say, bring it!

Something reminiscent of optimism is nibbling at worry for our country. Too soon to say; but Trump is still Trump, an aged, diminished, fourth-grade name-caller, repeater of lies and incomprehensible digressions. If cultists can’t see it, it’s true nevertheless: he’s become even more unfit for office than he was eight years ago. 

It Changes Nothing

 

The assassination attempt and reactions to it are deeply depressing, foretelling a grim future. The most disgusting responses from politicians and media have come from the MAGA-aligned. Rep. Mike Collins, R-GA, for example, said Biden ordered it. (Which, according to the Supreme Court, would be perfectly legal.) J.D. Vance, R-OH, who once called Trump America’s Hitler among other now-inoperative truths, VP pick unimaginable as president, election denier, pro-Russia, anti-abortion and anti-LGBT zealot, Alex Jones proponent, blamed it on left-wing rhetoric.

That’s the inverse of Republican outrage when Democrats accuse rightwing incitement prior to attacks on mosques and synagogues. Remember Trump saying “Second Amendment people” could solve the Hillary Clinton problem? “Stand back and stand by”? Mocking the attack on Paul Pelosi? And Republican ads like these. If words are to blame, which ones?

But the T-shirts are ready. And sneakers. “God protected him,” say MAGAs. By killing a fifty-year-old firefighter, evidently; father of two. President Biden called the man’s wife. Trump didn't.

On social media, both sides are awful. A few liberals can be just as conspiratorial and nasty as most MAGAs.

Before it happened, I'd been recalling a lecture in 2012, in Seattle, by Stephen Hawking, the genius cosmologist, who lived for decades with Amyotrophic Lateral Sclerosis (“Lou Gehrig’s disease”). When we saw him he was whole-body locked, contorted in a motorized wheelchair which he operated with a single finger, the only body part over which he retained control. He spoke by laborious one-finger tapping on a keyboard attached to a speech generator. As the lecture played, he sat motionless on the stage. 

He took questions. We waited at a microphone for a turn, after which he’d tap for several minutes while attendees talked among themselves. Finally we’d hear, “I will answer,” and then his precise, responsive, type-to-speech reply.

Here’s the relevance: inability to speak or doing so with imperfect fluency or rhetorical lapses doesn’t necessarily mean impaired cognition. Professor Hawking wrote “A Brief History of Time” with that single finger. In the case of President Biden, age has made worse his struggles with public speaking. Much is made of his misstatements and confusion of names; dire conclusions drawn from members of both parties. Trump’s surfeit of similar stumbles pass on the right without mention. As did the gusher of lies he hosed forth at that fateful “debate.” 

President Biden recently met with NATO leaders. Later, they reported how in command of details he is. We don’t know how his public persona comports with his private presidential abilities; but, considering his ongoing record of historic accomplishments, there’s no certainty that he’s lost it. If, in his public appearances he misspeaks frequently, he doesn’t drift off into confounding confabulations about electric boats and sharks and windmills, or praise fictional cannibals, or inject his acolytes, like bleach, with fear and hate.

Less and less do I know what to wish for regarding President Biden staying in or dropping out. Like anyone who considers our form of government worth preserving and climate change real, though, I’ll vote without hesitation for him, or, if Ds choose another, that person.

While pliable politicians like J.D. Vance blame President Biden and truth-telling liberals for the assassination attempt, this needs to be said from now till November: Calling out the terrifying trifecta of Trump, Project 2025, and their Constitution-rewriting Supreme Court is not hate speech; neither is it sub-rosa advocacy for violence. It’s pleading to voters’ best selves; a warning, confirmed by his and their own words, of theocratic authoritarianism. It’s democracy. Attempting to shut it down by describing it otherwise is Project Trump.

Because I know all I need to about black holes, watching last week’s interview with Secretary of State Antony Blinken was more relevant than seeing Stephen Hawking. Speaking with historian Heather Cox Richardson, he made clear why inclusive foreign policy is vital to US interests; why international partnerships, including NATO, are essential. For anyone concerned about the future and the US role in it, it’s worth watching. Part one. Part two.

Though we don’t know who Trump would choose for his Secretary of State, it’s certain to be the opposite of Antony Blinken. Trump and the Project He’s Never Heard Of have made clear their intention to weaken or abandon NATO. Their “America First” policies will do the same to other cooperative relationships, leaving America isolated and, as Blinken so convincingly explains, vulnerable and weaker. Given Trump’s professed love of our enemies’ dictators, perhaps deliberately.

So, no: Whatever the motive, the attempt on his life mustn’t quiet the voices speaking out against the consequences of another Trump “presidency.” Quite the opposite: since it’ll redouble the uncritical, besotted enthusiasm of his idolizers, it should spur even more commitment amongst the open-eyed to vote against him.

Maybe, though, it’ll inspire Republicans finally to agree on banning military-style weapons. 

Trump 2025

Trump, who lies, denies knowledge of Project 2025, the conservative plan to Make America Bleak. “I know nothing about Project 2025,” he avowed. “I have no idea who is behind it. I disagree with some of the things they're saying and some of the things they're saying are absolutely ridiculous and abysmal...”

If he stops speaking only to his mouthpiece media, he should be asked to specify with which abysmal parts he disagrees. And how he can disagree but "know nothing." But “journalists” are too busy ignoring the issues and calling for President Biden to withdraw, when, given his status as a convicted criminal, liar, star of the Epstein tapes, and day-one dictator, it’s Trump who should.

He can’t be unaware; attempting to distance himself from it proves the point. Several members of his inner circle are behind the Project. He and his policies are mentioned in it numerous times. Incurious, unwilling to work hard, he’ll do whatever they tell him. Because it’s over 900 pages, dense, and irreducible to cartoons, we’ll accept that he hasn’t read it.

I have. Some is anodyne proposals for streamlining government agencies. But even those are littered with Trumpic references to “Marxism,” and “wokeism.” Enormous defense spending is called for: more ships, nukes, planes, drones, missiles. No mention of paying for it. Fire transgender troops; reinstate, with back pay, those discharged for refusing vaccinations. “Eliminate Marxist indoctrination and divisive critical race theory programs...” Religious indoctrination, though: Yankee-Doodle-dandy.

“Require completion of the Armed Services Vocational Aptitude Battery Department of Defense —the military entrance examination—by all students in schools that receive federal funding.” It’s reminiscent of the Soviet Union’s “Young Pioneer” schoolchildren, whom I saw during language study there.

Student loans would be privatized; forgiveness would be disallowed. The Department of Education would be dispersed and eliminated. All departments would be filled with political appointees answering directly to “the next conservative president.” To deploy the agenda quickly, Senate approval for high-level appointees would be delayed by naming “acting” leaders.

Particularly the State Department, where “large swaths of [its] workforce are left-wing... The next Administration ... should both accept the resignations of all political ambassadors and quickly reassess all career ambassadors... No one in a leadership position on the morning of January 20 should hold that position at the end of the day.” Sweep away experience. Uncritical fealty to the president is the prime directive.

NPR and PBS would be defunded, because incurious MAGAs don’t tune in. “... [E]ducation is publicly funded but education decisions are made by families.” Monies should go directly to states, with tax dollars spent on private and charter schools, “Empowering families to choose among a diverse set of education options...” Goodbye fact- and history-based public education.

At all levels, “gender” will refer only to that assigned at birth. References to “sexual orientation and gender identity,” along with equity rules, should be expunged. “The next Administration,” it says, should note “how radical gender ideology is having a devastating effect on school-aged children today—especially young girls.” How, they don’t say. Documentation, they don’t provide. “Ideology.”

As to children of low-income families, “Over a 10-year period, federal spending should be phased out and states should assume decision-making control over how to provide a quality education to [them].” Also, eliminate Head Start. Good luck, poor kids in poor red states.

The next president should “stop the war on oil and natural gas,” which isn’t a war. As with the majority of their proposals, many of which are akin to “clean air is nice,” specifics are lacking. Per its main spokesperson, that’s deliberate. Hide the darkest details before the election.

Many related regulations are to be abolished. Gone, too, are energy efficiency standards. Electric grid improvements are defunded. Climate- and energy-related initiatives are called “partisan” and “political.” Enabling red state efforts to disenfranchise Democratic constituencies, the FEC’s power would be diluted. Likewise, the EPA’s. The CDC is “the most incompetent and arrogant agency in the federal government,” it says, and the FBI is a “bloated, arrogant, increasingly lawless organization.” Also, it must stop fighting the spread of disinformation and lies. Arrogant! That there’s some ironical irony.

P2025 would gut labor protections overseen by the DOL, other than, because “God ordained the Sabbath as a day of rest,” requiring time-and-a-half pay for working on that day. (Which one?) Christianity would be prioritized everywhere. Accreditation requirements for religious colleges would be removed. “Abortion is not healthcare.” No Medicaid funds for Planned Parenthood. Ban abortifacient drugs.

The surface here is barely skimmed. There’s plenty more. The best summary of Project 2025 comes from its prime mover, Heritage Foundation president Kevin Roberts, who’d previously said its purpose is to institutionalize Trumpism. "We are in the process of the second American Revolution, which will remain bloodless if the left allows it to be.”

Trump’s America: Submit or bleed. Voting against it is incalculably important, no matter the Democrats’ nominee.

Debatable

 

Nothing can be said about last week’s presidential debate (debacle, more like) that hasn’t already been. So I will.

Trump lied with every word, avoided questions, made weird faces and no sense. Had President Biden performed as in years past, that would have been fatal for Trump. But he didn’t and it wasn’t. I wish the “moderators” had called out Trump’s lies and diversions; more, I wish President Biden had. But they didn’t and he didn’t.

I wish President Biden had announced, a year ago, that he wouldn’t run again. He didn’t and, so far, he is. I wish Trump had been asked about Project 2025 and said how he’d implement it. He wasn’t, so he didn’t. Because it’s the blueprint for enshrining the clear threat to democracy about which Democrats have been warning since Trump promised, “I am your retribution,” not asking was journalistic dereliction. By dismantling government, protective regulations, public education, separation of church and state, minority protections and making voting harder for them, and curtailing social programs, it’s an authoritarian manifesto that serves only the wealthy.

I wish I knew who has the best chance against Trumpism’s multifaceted threats. Whether the Democrats’ nominee will be President Biden or someone else, I’ll vote for that person without reservation. So should everyone who values democracy and competent, Constitutional governance, who’d rather not live in a far-right theocracy, who thinks science and quality public education are vital to our future. Who prefers safe water, food and consumer goods, breathable air, and a livable climate.

The deba-whatever-it-was didn’t change the stakes. Instead, it confirmed that Trump should never again be within wrecking distance of the Oval Office. No matter President Joe Biden’s acuity, we know he would continue to surround himself with the kinds of experts who helped him end the pandemic, create millions of jobs, begin rebuilding infrastructure, and lots more. And we know he’d respect the law.

Based on what he’s promised, openly, and on Projectile 2025, Trump would do the opposite. First time around he chose incompetents who ended up indicted. The few competents he let slip through ended up leaving and now warn against voting for him. This time he’d replace qualified government employees with people whose only qualification is willingness to help punish the people and entities he resents.

No matter his opponent, assuring Trump’s defeat is a patriotic duty. Don’t believe me? Listen to former MAGA, current conservative Joe Walsh’s NSFW declamation. Nothing is as important. Nothing. Dead people have won elections. We could do worse.

But Trump isn’t the only threat. SCOTUS’ decision about government agencies’ regulatory authority can be summarized in Chief Justice Roberts’ own words: “... [A]gencies have no special competence in resolving statutory ambiguities. Courts do.” Unless Congress spells out every regulation and future need in precise, specific detail, he ruled, experts in government agencies can’t be allowed to define them. Only judges can. They’ll decide which chemicals are dangerous, what medications you can take, whether pollution is bad or climate change is real. Time was, conservatives eschewed that kind of judicial legislating.

Another SCOTUS judgment enshrines government corruption. A bribe, they said, is an illegal gift given before the giftee takes action. The same transaction, completed after gifters get what they want, is a permitted gratuity; a tip. “I’ll do what you want. Just don’t hand me the cash until after.” By no coincidence, Trump has promised to end taxing tips. In the presidential immunity ruling, Alito and Thomas expressed their gratitude.

With no basis in the Constitution, the Roberts Court invented rules saying anything a president does is above the law if defined as an “official act.” Compare and contrast: in my surgical practice, if I made a correct diagnosis, chose the appropriate operation, and carried it out properly, if the patient had complications it’s not, to me, anyway, malpractice. If, however, I chose the wrong operation and did it carelessly, causing harm, it is, no matter how “official.”

If Trump were to accept a “gratuity” in exchange for a pardon, or one from Putin for outing embedded agents, is he “officially” immune from prosecution? Trying to overturn a legitimate, fraud-free election? Stealing critical documents and lying about it? Yes, say John Roberts and his accomplices, arrogating to themselves the power to distinguish official from non-official acts. “Total immunity,” brayed Donald the First, regally.

Could Biden have SCOTUS’ Slaughterous Six arrested now? Guess so. But they understood that’s not who he is, so, casting their gaze upon a man who’s promised dictatorial abuse of power, they told him, “Go forth and subtract.”

The only, and likely the last chance to thwart this double-team attack on democracy is to vote for every Democratic candidate everywhere, sweep both houses of Congress, and then, enlarge the Court with four honest and ethical people.

Paraphrasing Pogo, we have met the remedy and it is us.

He Is Risible

 

Obsessively pondering the mystery of Trump supporters overlooking his abject amorality and monumental mendacity while claiming to be Christian has, finally, ignited an epiphany: They ignore Jesus’ lessons for life but still need to believe they believe. In Trump, they’ve found a way.

Among the thousands of deities available for selection, the most popular is Jesus. With good reason, His promise of life eternal and absolution of sins into which we were born because of Adam and Eve and a snake, have put Christianity on top. Aside from the occasional pogrom, holocaust, crusade, inquisition, suppression of science, and burning of witches, it’s served humanity well.

Now, however, a great discomfort – unspoken and unrecognized by them, but real -- has arisen within the so-called Christians who’ve thrown in with Trump. Jesus, they’ve realized, was a liberal. Liberalism, God forbid, is the political embodiment of His teachings, the Sermon on the Mount put into practice. Feed the hungry, clothe the naked, welcome the stranger, love thy neighbor (which, since He never preached otherwise, includes LGBTQ people.) But the Foxotrumpified have been convinced to hate liberals. What are they to do?

Donald Trump, lifelong breaker of each of the Ten Commandments, is Jesus’ antithesis. In lifestyle and policy, some would say the anti-Christ. So, how can MAGA Christians reconcile their professed love of both? Therein is the epiphany: by claiming that Jesus sent Trump to save us, that Trump is Jesus’ chosen one, making the two all but indistinguishable, ignoring His teachings and revering Trump becomes a manifestation of faith.

In their equilateral genuflection, not living according to Jesus’ teachings is living according to His teachings. Gone is the uncomfortable dissonance: if Jesus chose Trump, it’s all okay. It’s like vegans idolizing Jeffrey Dahmer, but if it works it works.

Trump makes it easy to see. Avoiding churches except for photo-ops and AI-generated fakes, and though the last one he’d ever join would be a megachurch where he’d be a tiny presence in a huge crowd, he’s taken megachurch ministers’ methods as his own. Other than the fact that those ministers preach in complete sentences and stay on topic, Trump rallies are profane duplicates of megachurches.

Humans need worship. If the word of Jesus is problematic for the MAGA-selfish, they meld Him with Trump who, like megachurch millionaires, gives them what they need. America is a hellhole, he tells them, promising salvation. “God bless the USA” plays as the congregants sing along, tearfully. I alone can save you, he intones, often speaking in tongues. Follow me or die. Send me your money, buy my merch, and be rewarded. I’ll rid you of the vermin/demons who’d do you harm, cleanse the land of your enemies, salve your fears, and make you great.

If you notice that I spend your money on private planes and lavish homes, that I sock away most for my own purposes, reneging on promises to use it charitably, you won’t care. Unless you’re a faithless infidel.

The analogy fits even better with faith healers, whose debunked fakery compares perfectly to Trump’s regularly disproved lies. Rigged healing brings the crowds and the money, and they keep on coming, eager to believe. It’s the same with Trump’s comforting lies, even as they get increasingly bizarre: people are pitching tents in airports, he claims, waiting four days for their flights. Who cares if it’s lies or delusions of a disassembling mind? It’s Trump! Throw away the crutches and send him money!

The J6 Committee destroyed all its records, he repeats. They didn’t: it’s all available online. Crime is rising, he preaches: under Biden, it’s falling. The election was stolen: no evidence says so; in fact, it proves the opposite. But, like faith-healing, his lies trick the mind, powerful enough to convince the willingly deceived.

Trump’s dishonesty has become so egregious that honest media are finally reporting without both-siding it. By contrast, Trumpophilic media have taken to cutting away from rally coverage as he descends into incoherence, lest their viewers become heretics. To the loyalists, it wouldn’t matter. So strong is their faith that they believe what Eric Trump gaslightingly calls his daddy’s “unvarnished honesty.”MAGA is a misnomer. It’s MEGA.

Like the remarkable number of Trump’s inner circle convicted of crimes, along with Trump himself, so it is that we keep hearing of pastors – especially youth pastors – abusing those in their charge. In the latest example, Trump’s one-time “spiritual adviser” (what sort of people need one, and what do they do?) resigned from leading his megachurch after admitting to sexual abuse of a thirteen-year-old girl.

So now we understand the Trump/Jesus thing. What we may never unravel is why Trumpists, loving his plans to ruin the lives of the people they hate, can’t see that theirs will suffer the same. 

Let's Go Big

Until last week, I was agnostic about enlarging the US Supreme Court, even after they’d handed down several outrageous decisions. I can’t, for example, understand how so-called “originalists” were able to derive from our Constitution that corporations are people and money is speech; decisions that have given “dark money” enormous political power, most of it to Republican benefactors.

Nor could I agree, as Justice Roberts glibly implied when gutting the Voting Rights Act, that racism no longer exists in America. And, of course, ignoring precedent to overturn Roe v. Wade.

Those decisions were based on personal opinion, not interpretations of the law. Judicial activism, in other words. Legislating from the bench. Something conservatives once decried. Nevertheless, though those decisions baselessly furthered a far-right political agenda, and though they strayed far from the law’s letter, the idea of growing the Court to thirteen Justices still felt questionable.

No longer. Now, we have two justices, Alito and Thomas, injecting their black-robed political prejudices to achieve premeditated ends, not even pretending to care how they’re received. Relishing, no doubt, law-abiding liberals’ outrage. The public’s trust in SCOTUS is at an all-time low? Who cares? Chief Justice Roberts, some say. If so, he hides it well. And why should he? Like the rest, he’s untouchable. In fact, in theory, public opinion ought not matter at all in judicial decisions. Assuming they were based in law, that is; an arcane concept that, because of Mitch McConnell’s hypocrisy and the Federalist Society’s unaccountable power, withered years ago.

The 6-3 decision on bump stocks did it for me. Written by Clarence Thomas and agreed to by all the Court’s “conservatives,” it was cynical parsing of words to achieve a desired outcome, ignoring the clear intent of 1934 legislation outlawing machine guns. Their decision negated a rare, helpful action that happened under Trump: declaring that rifles so equipped fall under that legislation, after a shooter in Las Vegas, using bump-stock-outfitted AR-15s, killed 58 people and wounded 500 almost instantly.

The 1934 law prohibited citizens from owning machine guns, which it defined as weapons that can fire “automatically more than one shot, without manual reloading, by a single function of the trigger.” A semi-automatic rifle, like the AR15, requires pulling the trigger for each shot. But when the standard stock (the part that’s held to the shoulder) is replaced by a bump stock, it can fire over 500 rounds per minute, with a single, continuous pull of the trigger.

So, how did Thomas exclude such weapons from the unambiguous 1934 definition? “Single function,” is how. His published opinion contained several diagrams showing how internal trigger mechanisms move during firing. Therefore, they opined, not a single function. Because, though the trigger remains stable during its rapid, deadly firing, inside it doesn’t. That’s a Plastic-Man-level stretch.

Also not single: the non-trigger hand has to push the front of the stock forward; two things are happening. Oh, c’mon: the trigger is pulled, once, by the finger and held in place. That’s as single as Melania probably wishes she were. It’s like saying you violated a “don’t move” order because your heart was beating.

Bringing up those other motions suggests the “originalist” majority, ignoring the unmistakable original intent of the law, had to want killing machines back in the hands of citizens. Why? For the next January Sixth? Remember when John Roberts says the Court’s job is to “call balls and strikes,” not make law? Good times. Soon, we’ll be told that left hands are people and mass murder is speech.

With typical condescension, Alito wrote, in concurrence, that Congress can simply rewrite the ban. Right. Republicans just quashed an attempt to do exactly that. He knew that as surely as he knows flags. Such tendentious reasoning is what convinced me of the necessity to enlarge the Court with honest people. Which could happen only if Democrats control Congress and the White House after November 5.

Originally, there were six justices. Since then the number has gone up and down. Briefly, there were ten. And five, and seven. It’s been nine since 1869, despite the number of judicial districts they oversee, along with the US population, having increased exponentially since then. Adding justices makes mathematical as well as common, non-ideological sense. Given the extra-legal intransigence of Alito and Thomas, plus their refusal to recuse from cases in which they have conflicts of interest, including wives’ activities and expensive gifts from people having business before them, the political need is clear, too.

It’s more proof that democracy is truly, no exaggeration, seriously, absolutely on the ballot this year. As are the countless lives that will be lost by handing definitional machine guns back to mass murderers. I’m not suggesting the SCOTUS majority approve of mass murderers. But right-wing militias in support of MAGA Trumpism and Christian Nationalism? No comment.

Oldtime Doc

 

Let’s take a break from worrying that, aided by the most corrupt and hyper-partisan Supreme Court in history and a non-stop disinformation campaign from all parts of the rightwingosphere, The World's Greatest Democracy™ might elect a convicted felon and lifelong liar who pledges to end it and to purge experts and opponents, Stalin-like. Hunter Biden’s rigged trial must wait for another time, too.

So here’s an essay I wrote for a now-defunct writers’ website. The first offering I submitted (not this one) got thirty-thousand views, so they kept asking for more. Which explains why they failed.

When I applied to medical school I imagined myself one day making house calls, good ol' Doc Schwab, paid in chickens and pies, smiles, tears, and blackberry jam. There I'd be, delivering babies in bedrooms, patchin' up Farmer Jones's leg on the sofa, shaking out thermometers and feeling foreheads.

I became a surgeon.

Early in my practice, when I had time on my hands, and to some degree throughout my career, I made house calls, the old-time doc I’d imagined. As I got busier I had to triage my time: people with a simple problem for whom a trip to my office was especially difficult, living not too far away. But as a youngster there were occasions when I went quite out of the way, and spent a lot of time.

For example: "The Phone Call." A woman awaits the news of a breast biopsy I’d done; I call her and note the stoppage of breath at the other end of the conversation. To say she should come in for the results is to let her know but provide no support. To give the news over the phone feels cold and impersonal. So I'd split the difference by breaking the news as gently as I could, and inviting her in for an immediate consultation.

Sometimes, early on, I reversed the equation and said, "How about if I come over and we can talk about it?" One time, in my pre-gray, abundant-hair days, after I'd spent at least an hour at their home, my patient and her husband gushed their appreciation for the visit and my care to that point, but announced they'd be going to Seattle for treatment. Probably thought I looked too young. Gray hair: a welcome advantage for ripening doctors.

Most of the time, my house calls were to a post-op patient, usually older, having a hard time getting around: check a wound, a little debridement, change a bandage, remove or unclog a drain. I'd load up with a few tools, some tape and gauze and ointments stuffed into my classic doctor bag, a name-embossed med-school graduation gift from my grandmother. Walking to the door, I’d imagine what the neighbors thought, figuring they'd be jealous: Miss Jones has a heck of a doctor there.

Always the visit was appreciated; frequently met with amazement. Sometimes it was my own, finding out how my patients lived, in a trailer, in an unkempt crumbling home, in a fancy joint with all the options. And I'd learn how they were able, or not, to carry out the post-op instructions I'd given them. Which led to a much more practical and pragmatic approach to what I'd tell people about after-care at home.

Once, I got a call from a feisty old lady for whom I'd recently done a mastectomy: she was worried about her wound, or a drain, or something. To her obvious delight I'd said, "Well, I'm almost done here, how 'bout I swing by your place and have a look?" She answered the door buck naked from the waist up, her unoperated side of the voluminous variety; responding to my surprise she said, "Hell, I figured you'd want to see it anyway, so why get dressed?" Her home was right on a main street. No screeching tires, far as I recall.

Making house calls always made me feel good, and the benefits were invariably mutual. In my medical school, each first-year student was matched with a family in which the wife was pregnant. We followed her through pregnancy and delivery, which I did with supervision, and were involved in the care of the baby. At least one home visit was a requirement, and we’d meet in groups afterward to discuss how it went. The real import was in learning how patients' conditions are part of an entire life and not just the little slice of it in which we see them.

All doctors -- especially surgeons, who typically send people home significantly altered, if only temporarily, hopefully -- would learn from seeing patients in their homes. It is, of course, completely impractical and nearly impossible nowadays, time and compensation (and liability) being among the reasons why it rarely happens.

Not to mention the possibility of seeing an old lady nearly naked at her front door.

Right Verdict, Wrong Case

Second in line to the presidency per the Constitution he and his constituents reject, House Speaker Mike Johnson called last week’s election interference verdict “a shameful day in American history ... a purely political exercise, not a legal one." Godly Mr. Johnson doesn’t seem stupid, so peddling those disingenuous assertions is MAGA-typical political hackery. Unless he was referring, retroactively, to the impeachment of DHS Secretary Mayorkas.

Every elected Republican said the same; most parroting Trump’s exact language. They may as well be ventriloquist dummies with Trump’s hand up their access. Several Republican senators performatively pledged never again to cooperate with Democrats’ legislation. (As with the infrastructure act, they will, of course, take credit for whatever passes without them.) Acting to benefit the American people, or MAGAphilic vengeance: they made their choice.

Such orchestrated unanimity reveals their not-so-hidden agenda. Having successfully destroyed their voters’ confidence in elections, all that remained was doing the same to our Constitution. On the hypo-informed, hyper-Foxified, angry in the streets, it’s working.

Unanimously finding him guilty on all counts, the jury, one of whom said his main source of news is Trump’s Truth Social, considered the evidence, including handwritten notes detailing the precise plans to falsify records. To argue his defense, Trump had lawyers none of us could afford and any witnesses they chose to call. He lost. In America, a jury of citizens empaneled by both sides decides what’s true. That’s anathema to MAGA Republicans, for whom truth is execration.

Praising and excusing Trump, lifelongingly dishonest and now a convicted felon, today’s Republican Party -- dba "the party of law" -- has given itself over to authoritarianism. What if they win? Ask yourself: what legislation do Republicans propose and who benefits? Tax cuts for the wealthy. Ignoring climate change. Deregulating pollutants. Weakening public education. Banning honest history lessons. And books. Even vaccines. Removing protection of minorities. Ending the Affordable Care Act, squeezing Social Security, Medicare, and Medicaid; banning abortion and birth control while leaving the government-required born on their own.

When Republicans propose funding needed legislation it’s at the expense of programs that help the vulnerable: SNAP, the aforementioned healthcare programs, early childhood education, childcare for working moms... Since Ronald Reagan, Republicans have been enriching the rich and ignoring the not.

Now they’re scheming to make it permanent: Elect Felonious Trump, who’ll facilitate his flock of favorite fellow felons in weaponizing the DOJ, FBI, IRS, and Congress itself against dissent and dissenters, embedding forever their pipe-dream plutocracy. It’s why they’ll never abandon him. Conservatism is dead to them. Lust for unrestrained power killed it.

Voters, then, must decide whether they’re more worried about Democrats forcing their kids to switch genders, and about immigration, bipartisan plans to address which Trump sabotaged; or about losing the benefits of Constitutional governance that have made America great. That’s the choice. It’s not hyperbole. It’s the inescapable inference from the obvious.

When godly Mike Johnson lies without shame about the Trump trial; when Lara Trump, head of the RNC, smirks, “What will happen to the jurors” and when a Newsmax host orders people to “search them out,” there can be no doubt about what’s afoot. 

No matter how much one believes Joe Biden is both senile and the mastermind behind prosecuting Trump’s crimes, this isn’t difficult. One party produces legislation that makes lives better and the future healthier; the other caters to wealthy, white, Christians (only those who reject the teachings of Jesus) and promises totalitarian rule. Trump, who’s never taken responsibility for his failures, who’s used the American legal system he decries to enrich himself and intimidate others, bombasted his way through this case, hurling conspiracies and truthless accusations while raising tons of money.

With no evidence, a convicted felon has convinced millions of people that American jurisprudence is corrupt; that this trial, the election, the sexual assault verdict, the Georgia charges, the documents case are all “rigged.” How? We await details.

Immediately after the verdict, a host of the self-described “most patriotic channel” in Russia, said, “They wronged our Donald Trump!” “OUR.” Dictators love dictators. Trumpublicans are okay with it. 

Far more damaging to the US and even more clearcut, the stolen documents case would have gone first, if not for Trump’s accessory judge, Aileen Cannon. Notwithstanding his lies, the Presidential Records Act gave him no right to the documents. He refused requests to return them, hid them, ignored a legally binding subpoena, lied about returning them all. Reportedly, he showed them to people unauthorized to see them.

It ought to take a jury five minutes to convict; and, because it borders on treason, it could well lead to incarceration, which the current conviction won’t. That’s why Trump, convicted felon, is desperate to finagle his way back into office by whatever means. From there, as he had A.G. Bill Barr do last time, he’d fire all the prosecutors charging him. And skate.

In Memoriam

Four days ago, on Memorial Day, we heard from two presidential candidates. In separate statements, they addressed the significance of the day.

First, President Joe Biden, at Arlington Cemetery:

“Freedom has never been guaranteed – every generation has to earn it, fight for it, defend it in battle between autocracy and democracy, between the greed of a few and the rights of many. It matters, our democracy is more than just a system of government. It’s the very soul of America. 

 “We gather at this sacred place, at this solemn moment, to remember, to honor the sacrifice of the hundreds of thousands of women and men who have given their lives to this nation. Each one a link in the chain of honor stretching back to our founding days, each one bound by common commitment; not to a place, not to a person, not to a president, but to an idea unlike any idea in human history: the idea of the United States of America. Today, we bear witness to the price they paid...”

Then Trump, on “Truth Spectral”:

“Happy Memorial Day to All, including the Human Scum that is working so hard to destroy our Once Great Country, & to the Radical Left, Trump Hating Federal Judge in New York that presided over, get this, TWO separate trials, that awarded a woman, who I never met before (a quick handshake at a celebrity event, 25 years ago, doesn't count!), 91 MILLION DOLLARS for 'DEFAMATION. ... 

"... The Rape charge was dropped by a jury! Or Arthur Engoron, the N.Y. State Wacko Judge who fined me almost 500 Million Dollars (UNDER APPEAL) for DOING NOTHING WRONG, used a Statute that has never been used before, gave me NO JURY, Mar-a-Lago at $18,000,000 - Now for Merchan!"

Can you spot the differences? Subtle, right? Who’d be the better leader? Who’d have the best interests of our country in mind? Toss of a coin, really.

It still galls me, recalling when Trump, draft-dodger, said “I’ve always wanted a Purple Heart,” after a sadly Foxified veteran handed him his. Seriously, who “wants” a Purple Heart? Maybe he expected those fake bone spurs would have earned him one.

Well, as it happens, I have a Purple Heart, not gifted; presented to me by my hospital commander in Vietnam, for injuries received in a rocket attack. Were I to give my Purple Heart to someone, it wouldn’t be Trump. Nor anyone who thanked me for my service and voted for him, the least respectful of veterans of any president, ever, who calls them “suckers” and “losers.” Familiar with the psychological term “projection”? It comes to mind when a person like that refers to “human scum.” Especially on Memorial Day.

My feelings about Memorial Day and Veterans’ Day are mixed. I honor and respect all those who served, those who made it back home, and, especially, those who didn’t. Those who volunteered and those who, like me, were drafted. All deserve respect and, even more, proper care at home. But, other than the Revolutionary and Civil Wars, was our democracy ever truly at stake?

In active combat zones, troops on the front lines aren’t fighting for democracy, the Constitution, or even America. They may not even know why they’re there. In the line of fire, they’re fighting for their lives and those of their team. Too much do we equate patriotism with fighting wars.

In the larger view, the daily, ongoing defenders of our democracy are teachers. Which is not to ignore the indispensable role in society of all workers. But, specifically, democracy? There can be none without an electorate having at least a rudimentary ability to tell truth from lies, fact from fiction. We’re seeing that in real-time.

And parents, of course, though not the ones demanding banning of books and an end to teaching history. Nor the subset of home-schoolers determined to protect their kids from the horrors of empathy, open-mindedness, and separation of church and state.

And journalists. Except ones employed by Rupert Murdoch or his ilk.

It’s not by happenstance that attacks on public education, science, expertise, and legitimate news are intensifying as today’s Republican Party gives itself over to a demagogic liar, one whose disdain for democracy and lust for authoritarianism is undeniable. Trump’s reelection (he’s never won the popular vote) would culminate decades of effort to confuse, misinform, and deceive enough Americans into allowing the intentional end of the democracy our soldiers have fought for – or believed they were fighting for – since the founding.

If Memorial Day is for remembrance, it’s never been more so. We need to remember those things that, until now, actually made America great. The Constitution and acceptance of it. Truth, as in there was no election fraud. Peaceful transfer of power. Country over party. Remember those ideals, because if Trump gets to implement Project 2025, this year will be the last we see them.

They Don't Hide It

 

Trump and MAGA Republicans aren’t hiding who they are. The only mystery is how anyone finds it appealing. There follow examples that smack more gobs than normal people have at their disposal. If “normal” hadn’t, in the post-Gingrichian and current Trumpian eras, become so far below normal.

In Louisiana, Republican legislators have voted to end mandatory lunch breaks for child workers, because of course. This follows a trend within several red states to weaken other laws protecting children. (Republican child-protection ends at birth.) It makes sense: when Trump, as promised, deports millions of immigrants, shortages of workers will become so severe that, absent allowing (or forcing) children to work all day will be the only thing keeping the economy going. Forced birth might be part of the plan, too. 

Taking no back seat to Cajuns, North Carolina legislators are proposing to make wearing masks illegal. It’s on brand: being considerate to yourself and others is woke nonsense. Shopping at Walmart, packing ARs: that’s their kind of considerate. They might have to mandate diapers, though, for their breakless children. 

Who they are in Florida is Governor and VP won’ta-be Ron DeSantis banning mention of climate change in state documents. Florida: at risk for and already suffering from its effects more than most states. If no one mentions it, it’ll go away from there, like American history. Or would, if it weren’t just a wokes hokes. 

Elise Stefanik, R-NY, who once and rightly excoriated Trump as the horrible human he’s always been, unglued herself when reminded of that as she jockeys for veepnesshood. And let’s not forget totally glued MTG, pushing Trump's latest lie. 

Unironically and presumably unaware of how toolishly ridiculous they looked, decked out in matching cultish Trump costumery – identical dark blue suits and red ties – a cluster of confederates complicitly condemned the criminal court where Trump is called to account for crimes for which he was indicted by a grand jury that considered the evidence and voted to charge him.

Then there was Squeaker of the House, Mike Johnson, second in line to assume the presidency if God so chooses. Killing irony like MAGAs claim Democrats do newborns, he accused President Biden, who isn’t, of doing what Trump has ofttimes promised: using the DOJ (and FBI and IRS) as his personal vendetta apparatus.

That someone in that position lies so freely, defending such a manifestly dangerous person, ought to worry everyone: calling corrupt the system of justice that, imperfect though it may be, is being followed to the Constitutional letter. Besides which, the current trial is in a state court for state-defined felonies. Biden’s DOJ has nothing to do with it. Nor is he involved with pursuing Trump’s federal crimes. Foxotrumpic dishonest repetitions notwithstanding.

To repeat: adhering to the Constitution, crimes were asserted; evidence was presented to a grand jury; an indictment was issued; after myriad delays by Trump, the absence of which could have had it over with well before now, allowing him to lie his way through rallies at will, a trial began; prosecution and defense made their arguments; a jury will decide innocence or guilt. Those Trump-suited clowns’ repetition of “if they can do it to him they can do it to you” applies only if you commit crimes like his. In which case, you’d deserve it. That’s how it works. There’s nothing unfair about it.

If there’s judicial corruption, it’s the Supreme Court agreeing to review the lower court ruling which laid out exactly why Trump’s immunity claim is meritless. SCOTUS could have let it stand but chose to take it and delay ruling on it, leaving all pending Trump trials to fester till after the election. And Trump’s grateful Judge Cannon, foot-dragging ruling on the stolen documents case, to similar effect. The documents case is the most indisputable and second-most serious crime of them all. 

There’s nothing more SCOrrupt than Justices Thomas and Alito refusing to recuse from J6-related cases, when the former’s wife is so involved, and when Alito has flown his sympathies like an inverted flag. Thanks to their lifetime appointments, they don’t have to care; lucky for them, they don’t. Alito, it should also be said, is the most undisguisedly partisan Justice in modern times. 

Is anyone surprised that Trump, having announced his intent to testify at the current trial, won’t? It’s reminiscent of his taking the Fifth hundreds of times, after previously stating that only guilty people do so. Or, having warned that if Joe Biden became president we’d see a crash of stock markets like “no one has ever seen,” after record highs are surpassed weekly, that he’s now saying it’s because Wall Street thinks he’ll win. For three years?

Repeated lies, conspiracies, intentional division, false promises, and phony predictions are who Trump is. Predictably, he’s mouthing the same warning of economic disaster if Joe is reelected. And yet, millions of people still believe whatever he says. It’s not normal.

He's A Goner

It’s over. No thinking person will vote for Trump now. The catastrophe is out of the bagman. How?

At a gathering of oil executives at Mar-a-Lago last weekend, dropping any pretense of caring for anyone but himself, Trump promised that for a billion dollars in donations he’d give them anything they want. Pollute at will, unregulated. Drill everywhere. End support for windmills, solar power, electric vehicles. “You’ll get it on the first day,” Trump said, waving his corruption like a bloody flag. 

So much for “He loves America” and “He cares about us.” A billion. Trump’s price to sicken your children and contaminate the planet they’ll inherit. From the day his daddy handed him millions, it’s been about the bucks. Morality? Not even an afterthought. This episode makes it undeniable. Listen to his media buttosculators finally giving it the coverage it deserves, atoning for their servile, perfidious fealty.

Even before this oily solicitation, Geoff Duncan, former Lieutenant Governor of Georgia, announced he’d be voting for President Biden. “Unlike Trump,” he said, “I’ve belonged to the GOP my entire life. This November I am voting for a decent person I disagree with on policy over a criminal defendant with no moral compass.”

Then there was Charlie Spies, the Republican Party’s top lawyer, who resigned after Trump trashed him for acknowledging the 2020 election wasn’t stolen. The list of prominent not-for-Trump Republicans, which includes Trump cabinet members and current and former office-holders, is long. As Trump might say, “People are saying they’ve never seen anything like it.” 

Okay, not everyone. Not Trumpists who show up at his rallies, definitely not a cult, wearing diapers. Not those who didn’t think “wtf” when he praised “the late, great Hannibal Lecter.” Not Holy Mike Johnson, R-LA, Specious of the House, who spoke during a break in Trump’s election interference trial, to which he’d hied along with a bunch of Republicans hoping to become Trump’s VP, announcing plans to “rein in the abuses” of Special Counsel Jack Smith. Because stealing government documents to the having of which Trump had no right, hiding them, lying about them, reportedly sharing them, ignoring subpoenas about them, aren’t crimes about which a government of laws should care.

Mouthing words Trump evidently wrote for him, genuflecting to an adulterous dallier with porn stars, Mike, who, according to Mike, God likened to Moses, who told us his philosophy can be found in the Bible, most of whose commandments Trump has violated, disgraced himself and the office he holds.

On Meet The Press, Senator Tim Scott, R-SC, refused, six times, to say he’d accept election results if Trump loses. He’s another angling for the VP nod, which will go to the grovelliest of grovellers. He’ll need some up-grovelling, as Senator J.D. Vance, R-OH, Trump critic till he wasn’t, is throwing himself, hard, into the grovel pit.

Who else? Johnny McEntee, Trump’s former valet, now adviser to his democracy-destroying Project 2025, personifying the excreta inflowing if Trump is “elected” again, seen here gloating about his heartless cruelty, like Trumpism itself, toward the vulnerable. 

Senator Katie Britt (R-MS), spinner of that creepy “rebuttal” to President Biden’s State of the Union speech, proposing a national data bank for collecting data on and tracking pregnant women; intended, she smiles, to provide help at all stages of pregnancy, including funding for crisis pregnancy centers. Not, however, any that mentions abortion. Not creepy at all. Nothing to fear, ladies. To make it happen, vote for Trump. 

Among voters, creepy abounds. Seventeen percent blame Joe Biden for the end of Roe v. Wade. Not a huge number, but when reality insists on zero, it bespeaks brain worms. As does the fact that a higher percentage claim Trump would handle the economy better than President Biden. To which the proper response is: “Foxconn.” (“Fox” + “con.” No irony there.)

Remember? The Taiwanese company that suckered Wisconsin’s then-governor, Republican Scott Walker, into gargantuan tax breaks; touted by Trump as validation of his “America First” policy? That invested a fraction of the intended amount, created far fewer jobs than promised, then bailed? Under President Joe Biden, the abandoned buildings will be occupied by Microsoft, who’ll invest $3.5 billion for an AI training hub, creating hundreds of permanent local jobs and thousands of job-ready graduates.

Providing infrastructure funds his leadership created, Biden’s administration has dispersed $450 billion for 56,000 projects in 4,500 communities. It’s fixing 165,000 miles of roads, 9,400 bridges, 450 ports, and 300 airports. 1,400 drinking water and wastewater projects. 8,000 low- and zero-emissions buses. Cleaning up 95 neglected Superfund sites. 12,000 miles of high-speed internet infrastructure. At Biden’s direction, America is benefitting in even more ways than those. 

So, who deserves reelection? A democracy-degrading, billion-begging, pollution-promiser, or a results-producing maker of America greater?

A Clinic Clinic

Herewith, a local example of a wider issue:

When I joined The Everett Clinic forty-two years ago, we were thirty-some physicians. The main campus consisted of what’s now called the Founders’ Building and a couple of parking lots. The building was industrial and off-putting, guiding patients to the various locations by way of colored stripes on the floor. TEC had just opened its first satellite office, in Marysville, and had negotiated an exclusive contract with a now-defunct health insurance provider.

The clinic’s manager, a legend among medical executives nationwide, had seen the future: to survive, we had to grow, build more satellites, and hire lots more primary care docs. Now there are around 600 care providers, and over 15 satellite locations.

Back then, because of that insurance contract and the Marysville opening, relations between non-clinic and clinic docs were prickly. Outside the clinic, my arrival wasn't greeted warmly. Those were unpleasant, tricky times.

Non-clinic docs eventually formed a “clinic without walls,” The Western Washington Medical Group,” which soon bedded down with the Sisters of Providence. That made it awkward for those of us who admitted patients there, an underwriter of the competition.

Happily, over time, it became apparent that there was room for both kinds of practices. No one put anyone out of business, nor had they intended to. Everyone gets along fine, now, mostly.

Once a month, we all met in the basement to conduct business. Early on, Clinic partners voted on all expenditures over ten thousand dollars (if memory serves). Then it became a hundred thousand. Eventually, a million. Subcontracting all lab and imaging services at the time, it was a tough sell even to approve purchasing blood testing equipment. Then X-ray machines. Scanners. The cost of building the adjacent Gunderson Building and multi-level parking garage blew minds.

Creating our outpatient surgical center, in the planning of which I partook heavily, caused apoplexy among non-surgeons, who saw it as a huge risk. It wasn’t. Patients loved it and still do. As insisted upon by some of us, its commitment to comfort for patients and families, by way of commodious and welcoming, non-industrial surroundings, changed the culture of the clinic at large. No more cold and bland warehousing.

The Clinic made news when, at another attempt by a large insurer to cut reimbursement, we refused to accept. Sent notices to affected patients, of which there were many thousands, that we’d arrange alternative coverage. Because we’d become large enough, and because our reputation for excellence was fact-based, faced with losing so many customers the insurer backed off. Nationwide, it was the first incident of its kind. That was then.

Offers to sell to investors weren’t rare. Believing we could survive as a doctor-owned, self-managed group as long as we provided excellent care and were large enough to hold the line, we always said no. Why sell out and lose control?

Why, indeed? When DaVita, which had recently paid millions in fines for Medicare fraud, made an offer, it wasn’t refused. Of the reasons given, the million-dollar windfall (so I’ve heard) to every partner might have played a role. By then, I was retired, not part of the decision, on which I’d have voted no. 

Although many retirees got in on the (alleged) spoils, those who’d bailed more than fifteen years prior, which included not only me (though I’d returned, at their request, for several more years as a contractor) but some who’d worked there much longer than I and had contributed immeasurably to the success of the clinic. It hurt. But that’s a story for another time.

It wasn’t long before DaVita sold the Clinic. For profit, one assumes, with no say from its members because they no longer had any. Optum is the new owner, and that’s now the official moniker. In name, at least, The Everett Clinic is no more.

In conversations, many docs regret selling out; particularly those there in the before times. Especially primary care docs. Under pressure for efficiency (profit) above all, there’s frustration, leading to turnover. And that’s the point: unless we get to universal coverage, the profit-first consolidation of American healthcare into a few giant corporations will likely make things worse. America’s largest health insurer, United Health Care owns Optum, which raises interesting questions. In any case, the ability of physicians to practice outside the corporate world is coming to an end. 

In my opinion, the more dedicated physicians are to excellence, the less happy they’ll be. I considered medicine a calling, an overarching commitment, not a business. Constantly squeezed to cut costs, limit care, and increase profits, will prospective docs still see it that way? Treat it as just a job? Not the optimum outcome.

2024 is the hundredth anniversary of its founding. My wife and I remain Everett Clinic patients. I’ll still call it that. The doctors we see and the care they provide are superlative. 

Four have recently left or are leaving soon.