Wednesday, June 12, 2024

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.

Wednesday, June 5, 2024

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.

Wednesday, May 29, 2024

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.

Wednesday, May 22, 2024

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.

Wednesday, May 15, 2024

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?

Thursday, May 9, 2024

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.

Wednesday, May 1, 2024

Letter Rip


 
I reply to everyone who emails about my columns. I’ve had coffee with detractors. In one case, we became friends and got together often. More commonly, fizzle happens. Email conversations end when, after being called a liar or commie, I ask for examples.

Never addressing my specifics, captious letters to the editor are similar: boilerplate, counterfactually amusing, rarely original: “The Herald is a lefty rag; Schwab is blinded by Trump hate; subscription canceled.” But a recent one posed a reasonable question: Instead of recounting the dangers of reelecting Trump, why not provide reasons to vote FOR President Biden? Fair enough. It must be said, though, that wanting reasons to vote for Joe, as opposed to not voting for Trump, is like being in a burning building and demanding, “Don’t tell me why I have to leave; tell me why it’s safer outside.”

A self-described “moderate independent,” the writer must not yet have started paying attention. I can help.

Claiming to be “independent” or “I don’t watch Fox” or “I do my own research” is usually code for closeted Trumpophilia. The writer accuses me of “extreme hostility to half the country.” She refers to Biden’s “constant lies,” providing as examples, “The border is secure,” “Inflation is under control.” “I’m the president for all Americans,” “That people are better off today than when Trump was in office. That Biden never talked to his son about his business dealings.” Her independent moderation leaves her unbothered by Trump’s lies about electoral fraud, rampant immigrant crime, what liberals want, etc.

I confess hostility toward Trump’s crude hate-mongering, and I despair that millions (not half the country, yet) are fine with it. President Biden did once say the border is secure, and that was embarrassingly wrong. If he’s repeated it “constantly,” I haven’t heard. In fact, he was a driving force behind the Senate’s bipartisan border bill which acknowledged severe problems and provided significant remedies. As Trump demanded, it died in the House; for me-first, America-last reasons.

Never as high here as in other countries, inflation is now a third of what it was. No president will be, in the minds of every single American, “for them.” But President Biden has never said Republicans hate America; nor called them anything comparable to “communists, Marxists, fascists and radical-left thugs that live like vermin within our country;” never called the press “enemy of the people.” Better off? Seen any refrigerated morgue trucks outside hospitals lately? Anyone employed now, after, as did millions, becoming unemployed under Trump? Have any investments?

Accusations abound about our president and his son. Yet, after months of made-for-Fox “investigations,” no evidence has been presented. So, as Marco Rubio once put it, let’s “dispel with this fiction” that the writer is moderate and independent. Hers are textbook Foxotrumpian talking points.

Reasons to reelect Joe Biden depend, of course, on where one stands. If you believe climate change is real, dangerous, and that the US should work to mitigate it, President Biden is your choice. Trump, obviously, isn’t. If you believe that abortion should remain legal, at least within the restrictions of Roe v. Wade, President Biden is your choice. Trump, obviously, isn’t. When it mattered to him, personally, though, he was.

If, living in Washington State, you know that mail-in ballots are convenient and fraud-free, choose President Biden. If you think poll workers should be free of intimidation; if you think equal access to voting is good for democracy, and that extended days including weekends, convenient drop-boxes, and evenly-distributed polling places promote it, choose President Biden. Trump has called for one-day, in-person voting only.

If you consider record-breaking job creation while addressing our infrastructure needs desirable, it’s President Biden’s doing. In Trump’s term, more jobs were lost than created, and “infrastructure week” became a running joke. If you think environmental poisons need regulating, President Biden agrees, and is. Pleasing his pay-pals, Trump did the opposite.

If you consider Social Security, Medicare, Medicaid, and the ACA worth preserving, Joe Biden will. Trump won’t and has said so. If you value public education, science, and expertise, President Biden does, too. Not Trump.

If you prefer a president who’ll appoint competent, experienced people to address pressing needs of the American people, rather than sycophants who’ll facilitate a promise to use our government for punishing critics; if that troubles you, even if you think you’re marked safe; if you like democracy, vote for Joe Biden. He hasn’t promised vengeance if he wins, nor a “bloodbath” if he loses. Trump has made it clear that a “day one” dictatorship would be just the beginning

Here are additional reasons, from other writers, including actual conservatives.

Finally, and not insignificant, President Biden is empathetic and decent. Go back far as you want: Trump never has been. And if that's not enough, enter here, the burning building.

Coffee’s on me, Ms. L. I'm in the book.

Wednesday, April 24, 2024

Honest Mike

 


Garnering little attention, The Washington Post obtained a secret Kremlin document. Containing plans to destabilize the West, especially the US, it proposes to do so by “continuing to facilitate the coming to power of isolationist right-wing forces in America” [Ed. note: MAGA?] and “to escalate the situation in the Middle East around Israel, Iran, and Syria to distract the U.S. with the problems of this region.”

The plans entail an “offensive information campaign” and other measures including “the military-political, economic and trade and informational psychological spheres.” As described by the Washington Post, part of the goal is to “leverage the Ukraine war to forge a global order free from what it sees as American dominance.”

This ought not be news. Excepting the Gorbachev/Yeltsin eras, Russia’s place on America’s enemies list has been obvious since the end of WWII. Remember Reagan? Remember Khrushchev’s “We will bury you”? No surprise to people paying attention, which excludes most Fox-watchers, Putin has aggressively picked up the baton. The document proves it.

Here’s the point: cluelessness alone, of which there’s a surfeit within the likes of Marjorie Taylor Greene, doesn’t explain the Putin-love we see among so many Republican politicians and their mouthing media. Even without the aforementioned document, the clarity of Russia’s intentions means their support for Putin against Ukraine can be understood only as willing collaboration with a dangerous adversary. Sedition, by definition. What Putin has on them or what they expect from him remains clouded.

Whatever it is, though, Ms. Greene’s fact-free proclamations about Russia and Ukraine have pushed her higher even than Tucker Carson in the estimation of Russian media. “She believes that Americans should help Putin win,” gushed Russian TV host Evgeny Popov. “... To help him win in Ukraine.” How proud she must be. Considering themselves patriots, Georgia voters chose her to represent them. Will again, no doubt. Making America great.

Then there’s Elise Stefanik (R-NY), full-time groveller for Trump’s VP spot. Having once said, “Vladimir Putin is a war criminal and deranged thug. We must stand with democracies under assault,” she’s now among over half of House Republicans voting against aid to Ukraine. What happened? Trump happened.

Not a single Democrat voted “nay.” Knowing Putin’s intentions, which party, then, is making America great?

Holy Mike Johnson, Speaker of the House, deserves the credit he’s getting for “bravely” risking his job by cooperating with Democrats to get the aid packages passed. Being called “brave” for doing the right thing, however, is reminiscent of a favorite W.C. Fields bit, explaining why his character was called “Honest John.”

Moreover, reporting suggests his change of heart was less about patriotism than being convinced, by a group of Evangelicals with whom he was praying, of the need to save Christians. Here's a link to an impressively deep dive into that dynamic, from an unnecessarily NSFW-titled but well-researched source.

Putting himself first, per usual, as when he demanded killing the bipartisan border security bill, Trump made it clear that he didn’t want the Ukraine and Israel bills to pass before the election. For the same reason: no wins for President Biden. Plus, in the case of Ukraine, whatever it is that binds him to Putin. It’s safe to say Trump couldn’t care less about saving Ukraine’s Christians. For crossing him, what retribution will he exact from His Holiness?

But there’s other news, too. Trump, in court, unused to being held accountable for his life of transgressions, muttering, glaring, dozing, and, according to several accounts, making life unpleasant for the macrosmatic seated within his olfactory aura. The gagged and the gagging.

And the gaslighting. Daily, Trump emerges from court to bemoan being required to sit there while his crimes are exposed; freely speeching that gag orders violate his right to free speech. Nope. He’s an indicted criminal, out on bail. Within that category of American illegals, free speech has always had limitations. The lifelong escaper of consequences is finally facing some.

Certain that MAGAs will neither understand nor accept that particular truth, gassiest of all gaslighters, grandfather of the Republican devolution into nastiness as policy, Newt Gingrich analogized Trump’s plight: “This is literally like some of the civil rights workers in Mississippi in the 1960s.” (“Literally” is Newt’s favorite word.)

That’s only the most ridiculously phrased and unhistorical claim made by Foxian talkers. All of them share Newt’s rejection of the rule of American law, making Trump the victim, rather than those he’s victimized, which, whether they know it or not, includes his ardent, rally-going devotees. Jesse Waters gave us next-level mind-blow. Very much worth a view.

The trial and the pro-Ukraine votes show what can happen when reactionary, enemy-adoring Trumpists are (temporarily, anyway) outnumbered in Congress. For the good of all Americans, and of the world, November is when we can – must! -- make it permanent.

Wednesday, April 17, 2024

Who Thinks You're Stupid?

 


Playing the system like a kazoo, abetted by a judge feeling a bit too grateful for her lifetime appointment to a plumb job by him, Trump has successfully delayed the most clear-cut case against him. While calling the timing of all similarly delayed cases “election interference.”

It’s the stolen secrets, kept at Mar-a-Lago and elsewhere, illegally, subpoena-ignored and lied-about. The illegality is so undeniable that his only escape is the ridiculous claim that a “president” has absolute immunity to break whatever laws he chooses, whenever and wherever he wants. Or becoming “president” again, and having the prosecutions terminated. Like his Attorney General Barr did for him previously.

Obligingly, SCOTUS is putting off ruling for as long as it can. Presumably, even the Sanctified Six know they’d have to rule against him unless they’re willing to destroy what remains of their credibility. So, for now, we’re stuck revisiting Trump’s Stormy Daniels election interference scheme.

It’s the least interesting of the cases against him and, regarding implications for national security and the taxpayers he’s scammed, the least important. So, while he dozes off during the proceedings (who’s “Sleepy” again?), let’s talk about other things. But not before noting this trial is the opposite of what MAGA Republicans are calling an unfair, two-tiered justice system. In court, Trump is being treated exactly like all indicted criminal defendants.

Now, those other things.

Constantly, viciously, and death-threat invokingly, having attacked all other judges overseeing his prosecutions, Trump whined, a three-fer, that Biden, Garland, and Smith are calling the aforementioned grateful Judge Cannon “terrible names, wrongfully threatening her with impeachment, and disrespecting her.” Neither Biden nor Garland has said a word about her, much less threatening impeachment. And Jack Smith has mostly pled with her to move things along, and appealed, successfully, to higher courts when necessary. Accusing others of what they do and others don’t, expecting their voters to buy it, is typical MAGA Republican strategy.

That, and performative uselessness. Holy Mike Johnson, R-LA, Speaker-of-Lies of the House, scarpered to Mar-a-Lago, where its so-far owner and he announced plans to criminalize voting by non-citizens. It’s already illegal. Fox “news,” when carrying the announcement, hilariously ran a sidebar showing the existing law. Even Steve Bannon, as Trumpophilic as it gets, found it meaningless

Because illegal voting isn’t a thing. The right-leaning Heritage Foundation found fewer than 100 votes by non-citizens between 2002 and 2022, looking at a BILLION ballots. And the left-leaning Brennan Center found 30 among 23 million votes from 2016. Which confirms what’s really behind the vote-suppression laws rising like swamp gas from red state legislatures: Lies. Rigging to win.

Speaking of gas, Trump made one of his usual “It wouldn’t have happened if I were president” statements after Iran sent hundreds of drones and missiles into Israel. (Nearly all were shot down, helped, in part, by the US military and others – thanks, Biden.) Trump is hoping voters have forgotten that when Iran injured 110 American soldiers by firing missiles into a base in Iraq while he was in office, he did nothing. Except lie about it.

Back on the trail after collecting (he says) fifty million bucks from billionaires he promised more tax cuts, he discussed the Battle of Gettysburg, sounding like a grade-school student faking a book report. It’s disturbingly bizarre. Among the fawning faithful, nary a wtf expression. Watch it here.

Earlier, on his way to milk a few more billionaires, he’d faked a “spontaneous” photo-op, “surprising” just-regular folks at a Chick-fil-A. Fox “news” was ready with their usual Trumpophansy

Cataloging the week’s fakery would be incomplete without mentioning the agenda cooked up by House Republicans. Serious legislation to save us from Joe Biden. Because, you know, he’s approaching your driveway right now, with a truckload of illegal immigrants, ready to haul away your appliances. Guns, too, probably, though unmentioned in the current proposals.

No satire, this is their proposed legislation: Hands Off Our Home Appliances Act; Liberty in Laundry Act; Clothes Dryer Reliability Act; Refrigerator Freedom Act; Affordable Air Conditioning Act; and the Stop Unaffordable Dishwasher Standards Act. Jared Moskowitz, D-FLA, responded appropriately For once, shaming the shameless worked.

There’s a common thread here: It’s not commie, America-hating, Marxist “thugs,” as Trump likes to call liberals, saying MAGA Republicans are stupid. The call is coming from inside the house. From Trump and Moses Mike; from Fox “news;” from Lara Trump’s RNC robocalls amplifying lies about “massive fraud” in the last election.

Nor do they merely assume stupidity. To win elections, they count on it. Adopting Joseph Goebbels’ propaganda methods, they’ve learned that repeating lies for long enough turns them true in the manufactured minds of their voters. Unless outvoted, they won’t stop, because polls show they’re not wrong.

Wednesday, April 10, 2024

Signs, Signs, Everywhere Signs

 


Even a blind squirrel, it’s said, can find an acorn once in a while. Thus it is that Marjorie Taylor Greene, strong contender for Congress’s dumbest and most obnoxious member, yet privy to God’s thinking, came up with a worthy pronouncement. “God is sending America strong signs to tell us to repent,” said she. “Earthquakes and eclipses and many more things to come. I pray that our country listens.”

Though total eclipses of the sun have been predictable for centuries, before dismissing her connecting the timing with a minor East Coast earthquake, not unlike recognizing the evil behind Joe Biden forcing Easter onto International Transgender Day of Visibility, let’s admit she’s onto something. The epicenter of the quake was, for practical purposes, Trump’s Bedminster golf-cemetery tax write-off.

God attends to the entire universe, a gazillion miles across, so we can excuse His missing by a mile or so. Failing to mention for what, our little Margie is right that America needs to repent. And the “what” is daylight clear. Bedminster? Not subtle. What God is saying, as MAGAgonizers proclaim Trump’s divine chosen-ness, is, “No. He’s not. Stop it.”

A disturbingly large umbra of America needs to repent for its commandment-breaking idolatry of Trump, whose latest ungodliness, after lying that Biden wants to “quadruple your taxes,” suborned criminality from his idolators, whining, “How many more corrupt judges do I have to endure before someone steps in?” Steps in. No wonder God is repulsed.

Differing from Ms. Greene, Rudy Giuliani hears from God that He quakes California and New York because they’re “communist states.” It’s certain that America’s Used-to-Mayor couldn’t define communism, which describes no US state. Fascism, though: Texas, Florida... Weirdly, neither he nor MTG had anything to say about catastrophic hurricanes in those states. Slippery things, empyreal omens.

Republicans could also use a little repenting for their curious capitulation to America’s enemy, Vladimir Putin. Defending her opposition to helping Ukraine, MTG said, as counterfactually as humanly possible, “This is a war on Christianity. The Ukrainian government is attacking Christians...Russia is not doing that. They are not attacking Christianity. As a matter of fact, they seem to be protecting it.” Just. Wow.

It’s that kind of traitorous untruth that has led a high-ranking Republican Representative to admit it’s “absolutely true” that members are repeating Russian propaganda on the floor of Congress; and another to say it has “infected a good chunk” of his party’s base, blaming it on rightwing media. “Trumpofoxification” is the word he’s looking for.

Holy Moses Mike Johnson, Speaker of lies of the House, should repent for his unending, Trumpophilic lies, like referring to “Biden's unprecedented assault on American oil production,” when the truth is the opposite. For better or worse, US production of oil (and all forms of energy) is at an all-time high. It’s only by lying that Trumpublicans have a chance of winning. If Trump is the fakest Christian, Mike is the real deal. He should be ashamed of such Biblical mendacity.

For further repentance, Americans on both sides need to renounce the scam that is RFK, Jr’s campaign. Unbagging the cat, his New York campaign manager removed any doubt that his goal is to put Trump back in office. Explicitly. A vote for him is one for Trump. The truth is out there; no longer can it be self-righteously rationalized away.

In a speech full of lies, Trump, whose blasphemy RFKers would return to office, tried to have it every which way on abortion. “Leave it to the states,” he obfuscated, which is exactly what SCOTUS did in ending Roe. After the ridiculous claim that “all legal scholars” wanted Roe overturned, he lipped the libelous lie that Democrats “are the radical ones on this position because they support abortion up to and even beyond the ninth month.” Where’s an earthquake when you need one?

Finally, since we led with it, solar eclipses are magical. Our family’s first, of three, was in eastern Washington, in 1979. After all the media hype, I expected disappointment. I was totality wrong. It began with watching the moon’s shadow race, west to east, up the Columbia Gorge; amazing in itself. Then the drop of temperature, and cheers, as that unworldly ring of light appeared, centered in darkness, making one feel somehow connected to the Universe, yet also the tiniest, tiniest part of it. I’ll be one hundred for the next one.


Wednesday, April 3, 2024

No Foolin'

 


April Fools’ Day passed with few of the usual prank postings. Or maybe I missed them. These days, who can tell? For example:

Members of the “Freedom (for me but not for you)” Caucus want to rename DC’s Dulles International Airport “Donald J. Trump International Airport.” If that doesn’t fly, how about Folsom Prison?

“Some folks probably like to eat bugs with Bill Gates, but not me,” said Tennessee state Republican Bud Hulsey. He was talking about meat, lab-grown from animal cell cultures, which has environmental benefits, is safe, and tastes normal. It doesn’t yet exist for consumers, but red-state legislatures are already criminalizing its distribution and consumption, with stick-to-the-libs rationality. And, no doubt, with cash from big meat. 

Two presidential candidates shared their Easter greetings. Stable genius, God-chosen, not-fake Christian, who avoided church as usual, Trump posted in all caps: “HAPPY EASTER TO ALL, INCLUDING CROOKED AND CORRUPT PROSECUTORS AND JUDGES THAT ARE DOING EVERYTHING POSSIBLE TO... PUT ME IN PRISON, INCLUDING THOSE MANY PEOPLE THAT I COMPLETELY AND TOTALLY DESPISE... AMERICA, A NOW FAILING NATION... “DERANGED” JACK SMITH WHO IS EVIL AND “SICK” ... CROOKED JOE ... THUGS ... HAPPY EASTER EVERYONE.” Full rant here.

Devout Catholic President Biden, who attends church weekly, who MAGAs believe hates Christians, said, “Jill and I send our warmest wishes to Christians around the world celebrating Easter Sunday. Easter reminds us of the power of hope and the promise of Christ’s Resurrection...”

Then, the man who compares himself to Jesus, MAGA-certified presidential material, Trump, indicted felon, out on bail, posted a picture of President Biden hog-tied, unconscious, in the back of a pickup truck. MAGA Republicans, Christians all, loved it.

He even lies when exploiting the death of Ruby Garcia.

Another non-joke: The Alliance for Hippocratic Medicine, doctors pushing a ban on the abortion drug mifepristone, didn’t exist two years ago. Their claims about the drug are false, and they’re arguing against being forced to provide care they consider against their religion; something that’s never happened. Moreover, if they’re really “Hippocratic,” they’ve sworn allegiance to Apollo and a few other Greek gods, plus their teachers, to whose children they’ve promised to teach medicine for free. 

Alabama football coach Senator Tommy Tuberville says Democrats are part of a “Satanic cult.” A quality guy, one in a hundred, chosen by MAGA Republicans over highly-qualified incumbent Doug Jones. Remember the coach’s blockade of military officer promotions, protesting a program to pay abortion-related expenses for military members? Only 12 people have availed themselves, costing a total of $40,000. For travel and lodging, but NOT abortions themselves. Nice work, Tommy.

ETTD: Lawyer John Eastman has been permanently disbarred for his role in Trump’s fake elector plot. Mike Lindell’s business was evicted for non-payment of rent. Rudy Giuliani declared bankruptcy.

Trump, out on bail to play golf, bragged that, as usual, he won trophies at his own golf course, which he does by cheating. Openly. Flagrantly. Well-known and documented among golfers. Is this consistent with presidential character? 

What about posting pictures of a judge’s family, knowing the death threats it’ll incur? Presidential?

Investigator extraordinaire, James Comer, giving up on finding impeachment-worthy crimes by President Biden, claims Attorney General Merrick Garland is colluding with the “deep state” and the press to hide evidence. 

In the Georgia election fraud case, a Trump lawyer told a judge, that “... examination of a false statement—even if made deliberately to mislead—can promote a form of thought that ultimately helps realize the truth.” Right: Liars lie to help us find truth. Makes sense. Especially for a life-long liar.

RFK, Jr’s announced running mate believes IVF is “one of the biggest lies that’s being told about women’s health today.” She has no political experience; nothing to suggest she’d make a good president. She does, however, have tons of money, with a few millions of which she bankrolled his bizarre Superbowl ad.

The guy who bankrolled Trump’s bond-posting, seems kinda sleazy. And not because he’s Mr. Hankey. (South Park reference) 

When a bridge over the Mississippi collapsed during the GWB admin, Congress unanimously approved funds to rebuild. Trumpublicans are outraged that Biden promised the same for Baltimore. The men who died were immigrants. Likewise, 120,000 workers in the Baltimore area, about 40% of the total workforce. Without immigrants, or, as MAGAs call them, “animals,” our economy would collapse.

Also not a joke was the reaction by Republican leaders and their media and preacher mouthpieces to Easter at the White House. Whatever you think about “Trans Day of Visibility,” it’s been March 31 for fifteen years. Easter Sunday varies wildly. That the two coincided this time was Biden deliberately desecrating the holy day. Lying like that is who they are.

Same with their claims about banning religious-themed White House Easter eggs, a rule in place for 45 years. These are awful people.

No joke.

Wednesday, March 27, 2024

Names And Places


As right-wingers blame collapsing bridges on President Biden, “wokeism,” and “open borders;” as Hannity says Trump should be allowed death-threat-inducing fulminations against a judge’s daughter and others; and as ever-grifting Trump is selling sixty-dollar (plus shipping and handling) “The only endorsed by Trump” Bibles, let’s change the subject to surgical ruminations before I tear out the last of my hair. So, here’s some fluff, modified from my surgery blog

It was always with wonderment that I considered the pioneers of medicine, surgery, and anatomy. To conceive of a time when every thought was a new one, when discoveries abounded for those with imagination, boldness, and curiosity, is to be thrilled, jealous, and.... bemused. What could it have been like, opening the body and its mysteries to the world, naming something new on the way out?

When it takes some effort -- maybe a microscope or some really careful dissection -- to discover something, it seems reasonable that your name gets attached. Islets of Langerhans. Ampulla of Vater. Sphincter of Oddi. Valves of Heister. Crypts of Morgani (he got "columns," too, like me.)

But where's the cutoff? I don't get why Gabriele Falloppio got to name something as obvious as an oviduct. That's not discovering. That's noticing. We don't have the Colon of Powell or the Heart of Palm. (I don't know who March was, or why he got to name the Eyes.) The white line of Toldt is sort of macro-observational and a name seems an extravagance. On the other hand, if he was the guy who figured out that it was a dotted line on which a surgeon cuts to mobilize the colon for resection -- a move that thrilled me the first time I did it and still does, for its anatomic simplicity, for its sweet entry into secret space, for the way it translates embryology into practicality -- then he deserves the kudos.

"Foramen" (for-A-men) and its pleasant plural, "foramina" are among those cool words we learn in med school. It means "opening." A hole, is what it is. Many anatomic openings are deserving of the name: foramen ovale (oh-VAL-ee) sounds good and does good; keeps a fetus alive. Lots of bony holes, especially ones through which nerves or vessels pass, are called foramina -- the obturator foramen, optical foramen, foramen magnum... But Jean-Jacques Winslow (shouldn't that be "Winsleau?") discovered he could stick his finger through a hole behind the portal vein, and stuck his name on it, too. Borderline.

I don't want to get into the Zen of what constitutes a hole, but his "discovery" is only about some things that are near each other. Inlet, maybe. We've got islets, why not inlets? Then it starts to sound nautical, which makes me think not of Winslow, but of Winslow Homer. That's it: it's the "Oddity of Homer."

Consider Morrison and his pouch. And Douglas’s. They're just places, areas. To me, it's not earthshaking. On the other hand, Broca claimed his area of the brain with some effort. I'm ambivalent about the Space of Retzius. As an anatomical concept, "space" doesn't have a lot of panache. On the other hand, the surgical dissection of it, developing it into a tissue plane, is cool: another of many places that spread themselves open for and yield to the surgeon, when their secrets are out.

Clearly the Greek and the Latin have fought for dominance of nomenclature. It's a puzzle to me that they made a truce of sorts in the kidney. We speak "nephric" and we talk "renal" interchangeably. Even to the point of naming things twice: that little yellow top-hat to the kidney, the ad-renal or the epi-nephron, as of juice it makes, two names for the same thing: adrenaline, epinephrine. What gives? Like the robin’s egg blue of the gallbladder, the bold yellow of the adrenal is a startling splash of exuberant color among the otherwise earthy tones of the belly. Sure, there's lemony lipid all over in there. But as organs go, the color of the adrenal is a surprise.

Those solid surgical soldiers of old deservedly got operations named after them; and instruments, and procedures. Because there's no end to invention, it still happens, and will. (Cotton Schwab?) Lots of the living have their names (and lucrative patents) on devices; techniques and new operations keep unfolding.

Then there’s having a position named after oneself: Trendelenberg, Fowler (and its kin, Semi-) managed to do it. If I had a position named after me, I'd rather...

Nearly unique, though, among namings, is to be remembered for a maneuver. Like Theodor Kocher, name-bearer of many things: clamps, incisions, and this, a way to make the duodenum handy and hold the pancreas in your hand. An elegant snip and slide. The Kocher Maneuver. Inspiring. Deserving a whole column in itself. I’ve written about it, here.


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