Thursday, February 25, 2021

Texas And Then Some

Last week, the invisible hand got frostbite. Lost its grip on conservatism’s Second Commandment: “Thou shalt deregulate. Trust thee in corporate kindness.” If what happened in Texas doesn’t out the scam, nothing will.  

Nothing will. Right-wing propaganda amplifiers are turned up to eleven. As burst pipes propagated icicles, Texas’ governor blamed the not-enacted Green New Deal. Foxifieds’ favorite fibber, Tucker Carlson, who just speculated Qanon is a leftwing disinformation myth, dismissed wind turbines as “silly fashion accessories” that don’t work in cold weather. Are his strategically endumbed believers aware that windmill energy is generated year-round in Sweden, Alaska, Antarctica? That colder-than-Texas Iowa gets forty-two-percent of its generated electricity from wind?

While Ted Cruz lied his way to Mexico and back, AOC, the right’s favorite whipping girl for recognizing the seriousness of anthropogenic climate change, raised $5-million for Texas and went there to help. Travelin’ Ted posed with a box of bottled water. Rick Perry, former governor and Trump’s Ukraine-connected Energy Secretary, pronounced, warm, hydrated, and fed, that Texans would rather suffer than subject themselves to federal regulations. Does he think they feel the same about their post-freeze, price-gouged electricity bills

After a previous freeze, ten years earlier, Texas was warned of the need to winterize its entire generating infrastructure. Because it’s Republican deregulatory paradise, attracting businesses that prefer to profit unrestricted, nothing was done. So it all froze, including windmills. Which, you’d think, would entomb another undead Reaganism: Government is the problem. Wrong. BAD government is the problem. Of which we’ve seen plenty in Texas.

By contrast to Trump’s even more massively failed governance, we’re seeing the opposite from President Biden, who, while simultaneously rectifying disorganized and inadequate vaccine distribution, immediately sent FEMA to Texas and made federal funds available (now they accept help); whereas Trump, because its governor declined backside osculation, delayed the same to California while wildfires raged.

Failed governance was even more obvious as we passed 500,000 deaths from Covid-19. Had Trump not denied it, botched and lied about his response, mocked wearing masks and social distancing, and had most red-state governors and Trumpists nationwide not followed him over his cliff of ignorance, maybe half of those lives would have been saved.

For perspective: were that many names recorded on the Vietnam Memorial Wall it’d be almost ninety feet high. If that number of people were in buses, it’d make a caravan one-hundred miles long. And still there are deniers. Still Americans unwilling to make minor sacrifices to protect their neighbors. Because “freedom.” 

Like acne, more rightwing denialism erupted in the capitol this week. A strong contender for most repulsive senator, Wisconsin’s pustulent Ron Johnson infected Senate insurrection hearings by reading into the record a claim the rioters were “fake Trump protestors.” Right. Trying to overturn an election they won.

Similarly, Ta-Ta-Texas Ted used his time with Attorney General nominee Merrick Garland, whose integrity and moderation shine a light on the darkness of Trump’s nominees, to suggest the “Obama-Biden” administration had politicized the DOJ, ignoring Trump’s most politicized ever, as attested by a score of former US Attorneys, Republicans all. 

Another sort of denialism took a hit this week, as the latest mission to Mars ended its six-month, thirty-four-million-mile journey, finding its target perfectly, sending stunning, high-resolution images back immediately, including of the landing itself. Brilliant engineers, mathematicians, physicists, biologists, technicians made incredibly precise calculations and extrapolations from afar, including how to fly a helicopter on Mars, built an amazing machine, programmed complex maneuvers to be managed entirely by onboard computers. Impressive.

Unless you believe -- like Ron Johnson and the insurrection being staged, Ted Cruz and Trump’s DOJ being pure, Trumpists and climate change, the virus, and Russian interference being hoaxes -- that the whole mission was created on a Hollywood soundstage.

Which is the mindset you must have, and millions of today’s Republicans do, to believe there’s a difference between the science that gave us the Mars mission and that which predicted and proves climate change, including freezing conditions in the US resulting from Arctic warming; gave us guidelines for controlling the pandemic; developed and assured the efficacy and safety of the vaccines. Science is science, like it or not.

Yet another mindset, that “cancel culture” is strictly a liberal thing, produced amusing irony this week when CPAC, whose 2021 bumper-sticker slogan is “America, Uncanceled,” canceled a participant for his flagrant anti-Semitism. Americans are free to say offensive things. Others are free to reject them. Some call it canceling. Others call it consequences.

Finally, on the passing of Rush Limbaugh, we defer to the more pleasantly quotable Clarence Darrow.

Thursday, February 18, 2021

Fight The Fight

“Lean to the left, lean to the right, stand up sit down, fight fight fight.” According to Trump’s impeachment trial lawyers, we who’ve
chanted it are as guilty as Trump.  

Coherent arguments weren’t required. Though Trump’s guilt was as obvious as shattered glass, they knew acquittal was assured. So they lied, whataboutized, Trumpified. Their audience was Trumpists and Trump, figuring, one assumes, that if they didn’t do it his way they’d be joining the fraternity of stiffed contractors. No-lose for them, it was much-lost for the country. 

We needn’t recount the evidence or praise the persuasive House managers, as compared to Trump’s overmatched team. Everyone understands that without Trump’s months-long crescendo of incendiary election lies, the insurrection wouldn’t have happened. It’s worth noting, however, that most Republicans who voted to acquit had joined Trump in perpetuating the big lie that led to the murderous violence. To affirm his guilt would be to admit their own. In a courtroom, those senators would have been preemptively rejected as jurors.

Likewise, if courtroom jurors colluded with defense lawyers, as did Graham, Cruz, and Lee, they’d be held in contempt. Which is exactly what they displayed: intentional, smug indifference, as they and others sat, desk-footed, reading magazines, dumb-phoning, ho-humming their oaths and the Constitution. They’d welded their minds shut five years earlier, when they locked in with a dishonest, amoral “businessman” nominee.

Several Congressional Republicans who gave Trump a pass for provoking a bloody insurrection with countless lies, had voted to impeach and/or convict President Clinton for a harmless one. Protecting the future of democracy and, for that matter, their own party, required finding seventeen honest Republicans. Like finding rock candy in a window-well. (Tried, failed, age seven.)

57 – 43 is a historically bipartisan vote for conviction. Senators who did so represent seventy-six-million more Americans than those who let him off. So we ask: do Trump’s treacherous lies about fraud, attempting to discredit fair elections forever, really exemplify what’s left of conservatism in his party? Do his tweets and inaction during the depravity, failing his duty, inflaming the rioters, tossing Pence to his mob like paper towels in Puerto Rico, abandoning everyone in the capitol but the insurrectionists, constitute the Republican presidential ideal? Guess so. Seventy-five-percent still want him, a sedition-provoking sociopath, as their leader. 

Are there no future Republican stars as admirable as the Democratic House managers? Will Trump’s successor be the fisting Josh Hawley? Ted Cruz or Lindsey Graham? Marjorie Tantric Greene? Matt Gaetz? Evidently. Cowed by Trump’s deluded, angry cultists, Republicans must, for a very long time, provide only such mendacious embarrassments as those.

One after another, state parties are censuring members who voted against Trump. (Cancel culture!) Said a Pennsylvania GOP chairman, of Senator Toomey, “We did not send him there to do the right thing...” Integrity and conservatism: officially ostracized. We who long for two honorable parties find it dispiriting. 

After voting for absolution, McConnell excoriated Trump with words that could have been the prosecutors’, calling his behavior leading to and during the riot unprecedented dereliction of presidential duty, for which he’s fully culpable. Avouching every prosecutorial argument, he then justified voting “not guilty” with the refuted, outvoted claim that it’s unconstitutional to impeach a non-sitting president; not mentioning it was he who prevented a timely trial. We sometime-hypocrites tip our hats, shirts, pants, socks and shoes to the greatest of all time.

As real conservatives repudiate the party, Republicans are increasingly defined by their worst, like those who still believe, or claim, the election was stolen; who say the Capitol riot was “staged,” a hoax, antifa. Rand Paul, who just called senators who wear masks “science deniers.” Thus we understand unwavering support for Trump: asininity. And oleaginous, Grahamic cowardice. 

What else can it be? His biggest accomplishment was maintaining the Obama recovery for three-fourths of a quadrennial. His response to Covid-19 was, using his favorite word, a disgrace. Denial, lies, multi-level mismanagement. Silencing scientists, mocking the measures needed to slow the spread. Finally, giving up. He got manhandled by China, Russia, and North Korea; increased the risk of a nuclear Iran; made the US pitied, and the only country in the world not taking climate change seriously. Any Republican would produce tax cuts and deregulation. (And deficits.) Even after his hand-crafted insurrection, though, Trumpidolatry remains. 

Finding him guiltless, those non-conservative senators and their no-longer-conservative party announced, in effect, “Trump is the best we’ve got. The Republican party commits to the uninformed, conspiracy-believing, anti-democracy, white-supremacist, insurrectionist mob we spent decades creating. Come, join us.”

Thursday, February 11, 2021

Gallbladder: The Donald Trump Of Viscera

Though the outcome of Trump’s impeachment trial isn’t in doubt, it’s still going on, making now the obvious time to talk about your gallbladder, the Donald Trump of internal organs. Mostly unnecessary, it makes millions of people sick, and when it does, most are delighted by its removal and better off without it. Also, it has its own fake news.

Having separated a few thousand gallbladders from their owners in my surgical career, I claim more authority on the subject than, say, Trump on election fraud, Covid-19, or climate change. But this is bile of a different sort. 

Tucked underneath your liver, just below the midpoint of the bottom of your right-front ribcage, the gallbladder is a slightly pear-shaped sac. Unlike your other, generally earth-toned viscera, when healthy it’s a startlingly beautiful robin’s-egg blue. Empty, it’s about the size of my thumb, which is likely bigger than yours. Full, it can be more like that pear. 

Its purpose is storing bile, a liquid made in the liver to the tune of around a quart per day, passing into the gut via a tube called, appropriately enough, the bile duct. Most drips steadily into your intestine, where it facilitates fat absorption. Via a branch off the bile duct, a few tablespoons detour to your gallbladder, where it waits to be squirted into your intestine in response to eating, particularly a fatty meal. 

Before civilization and supermarkets, gallbladders were essential. Back then, humans and other bile-producing fauna might starve for a while between meals, so a bilious bolus when gorging on a kill made sense (during fasting, your gallbladder gets very full). Nowadays, since we eat regularly and frequently, food exits the stomach comparatively constantly, rendering bile storage mostly inutile. Remember: the gallbladder doesn’t make bile. With or without it, that daily quart gets to your gut; just a matter of pacing.

A complicated solution of salts and other stuff, bile makes fats soluble in water. Like detergent. Evolution, or whatever alternative you believe in, is imperfect. For reasons including heredity, diet, hormones, and gravidity, ingredients can become insoluble, forming crystals. Which, concentrated in the gallbladder, can grow into what we call gallstones. Looking like kaleidoscopic, multi-faceted agates, some are quite beautiful. I’ve seen them made into jewelry. Others are ugly, clay-like, or both. There can be hundreds of them. Or few, or single, large enough to fill the entire gallbladder.

Unlike Trump, gallstones aren’t always an affliction. Many – possibly most -- gallstone-bearers are asymptomatic, some never knowing they have them; so the discovery doesn’t always demand surgery (cholecystectomy, commonly an outpatient laparoscopic procedure). Except for the presence of certain risk factors, it’s typically done if stones are causing problems, which they can do in several ways.

Most often it’s pain, occurring if a stone blocks the outlet of the gallbladder when it decides to squeeze out some bile. That can be extremely painful, felt below the right ribs and straight into the back. Or shoulder. Or lots of places. Called biliary colic, it usually goes away in a few minutes or an hour or two, as the cramped gallbladder muscles relax. The pain pattern is not always “textbook,” leading to potential misdiagnosis. Which explains, I think, most of the people dissatisfied with treatment.

More easily diagnosed and more serious is a stone lodged tight, in which case the pain persists, the gallbladder become inflamed, sometimes infected (cholecystitis). Worse still is a stone (has to be fairly small) passing out of the gallbladder into the bile duct. If it passes out into the gut, the problem resolves. If not, obstructive jaundice, pancreatitis, or severe liver and blood infection can result (cholangitis).

As explained, with some exceptions people get along fine without a gallbladder; therefore, treatment is almost always surgical removal. Pills can dissolve certain kinds of stones, but it can take months and there’s a high recurrence rate; true of any treatment that eliminates stones, or claims to, without removing the gallbladder. Which brings us to the foreshadowed fake news: gallbladder and liver “flushes,” “detox” cleanses. All-consuming, alt-med bogosity.

If you drink olive oil along with some sort of acidic juice, curdled lumps of oil may appear in your stool. The internet and some naturopaths will assure you those turd-curds are gallstones and you’re cured. Convinced, people have brought me theirs in Dixie cups. Nope and nope. There’s a belly-full of reasons why; pathophysiology, anatomy, and biochemistry among them. Demonstrably false (have them tested, get another ultrasound), it’s nevertheless believed like Q among the credulous.

Lacking enough space here, I offer an ancient post on my surgery blog, where there’s more explication. And, found by searching “gallbladder” on the blog, more still. 

Thursday, February 4, 2021

Gored By A Whirlwind

Having chosen, for decades, to sow disinformation to the easily gulled, creating preferential feelings for falsehoods among the flock, the Republican Party is now reaping the horns of a Gordian whirlwind. A course correction by the Republican Party isn’t as simple as saying, “Make it so.” They are, in other words, hoist on their own Picard.

Of such a cynical and condescendingly dishonest attitude toward their voters, Trump and Qanon were the inevitable result. And now they’re damned if they dump, damned if they don’t. For those of us who’ve been warning about what was coming, this ought to be a time of overflowing schadenfreude. 

It’s not. America’s ability to confront challenges has always depended on having opposing parties operating in good faith to find workable middle ground. Until the Republican Party began on its scorched-earth Gingrichian path decades ago, that was generally the case. Now, though, the support of Qanon and people with similar conspiratorial fantasies has become so integral to maintaining today’s Republican Party’s base that they’re stuck with them. Despite the desire of a few within the party and many true conservatives who are leaving it, there seems no way back to assiduous participation. It’s still the party of Trump and his cult of the deceived.

The dilemma’s horns on which they’re Pamploned is no better demonstrated than by the schizophrenic squirming of House Minority Leader Kevin McCarthy (R-Both-Ways). First, he led his members in rejecting the results of the Electoral College, even after the insurrection threatened their lives and democracy. Briefly brave, he then declared that Trump bore responsibility for inciting his mob. After which, he decamped to Mar-a-Loco for abject genuflection, earning from Trump the same feculent grin we saw when he played poor Mitt into thinking he had a shot at Secretary of State.   

Back in D.C., McCarthy held a late-night congregation of House Republicans, during which Liz Cheney (R-WY), in hot dihydrogen monoxide from the rank for voting to impeach Trump for his dereliction, escaped from a secret-ballot vote to remove her as leader of the Republican caucus. Marjorie Taylor Greene (Q-GA), on the other hand, loved for her enthusiastic support of killing Nancy Pelosi and other baby-biting Democrats, for 9/11- and school-massacre-denialism, almost eclipsed by belief in Jewish-controlled space lasers causing forest fires, received a standing-ovational tap on the wrist. And a “great” call from Trump. (Still promising, in public, never to apologize, she did, evidently, behind closed doors.) 

The party that had previously stripped committee memberships from Steve King (R-cantaloupes) for less insane and threatening words, refused to do the same to Ms. Greene for far worse. Different times, different constituency.

Dependent as they are on the Greene wing of their supporters, can the Republican Party return to rationality? If some, including M. Mitch McConnell, would like to see it – he called her out forcefully – it’s not looking good. Why? Because the media that rake it in by peddling conspiratorial thinking, stoking fact-free anger and victimhood, are responding to insurrection by making it worse.

Said Republican pollster/sloganeer Frank Lunz: “Fox has succeeded for years in straddling the line between a quality news organization and the opinion side. But Trump won’t let that happen anymore, and neither will his supporters. They want their ‘news’ to affirm them rather than inform them.”

Affirm, rather than inform. Nutshell. 

Desperate to stop the flow of viewers to even more affirming sources like OAN and Newsmax (now attacking each other), Fox is ridding itself of its “news” wing, making more space for the vitriol. It’s what gets Trumpist eyeballs. Thus Mr. McCarthy’s pilgrimage to see Florida man. Thus, letters to the editor in this paper, regurgitating what they’ve swallowed, crook, lying, and clinker: Democrats are the hypocrites (cf. Garland/Barrett); they spent their time “harassing” Trump rather than legislating (cf. hundreds of bills spiked by the aforementioned Muscovite); Democrats want illegals to vote (cf. reality); the election was stolen (cf. DOJ review); we won’t stop the insurrection till BLM stops demonstrating (cf. planet earth).

Affirmed, not informed. Fox’s move proves it’ll only increase. What else explains Trumpist/Covid-deniers blocking access to vaccination sites, forcing their way, unmasked, into grocery stores, claiming they’re protecting “freedoms”? Like the capitol-defiling, police-beating murderers, these are people willing, based on lies, to harm themselves and others. Constitutionally.

Having lost the presidency and senate, Republicans are seeking a more truthful, less obstructionist agenda. Kidding. In state after state, they’re turning to legislation making it harder for Democrats to vote and easier for the delusional. That’s where we’re heading. Where it ends is too awful to think about.

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