Wednesday, January 31, 2024

Borderline Crazy

Immigration! The border! Solutions have eluded presidents and congresses of both parties for decades. If producing effective policy is confounding, though, one aspect is self-evident: Republicans do NOT want resolution. They want only to rail and derail. Lacking positive accomplishments on which to run, stuck defending a convicted sex-offender facing 91 felony indictments and likely huge penalties for fraudulent business practices, they have nothing but lying about Biden’s border policies; declaiming lack of action while making sure none happens.

Don’t take my word for it. After President Biden facilitated a bipartisan agreement in the Senate, Trump, who hopes to ride immigration into November, has been pressing Congressional Republicans to block it. Said election-denying Texas Rep. Troy Nehls about any border deal, “I'm not willing to help Joe Biden's approval rating... I'm not going to do it.” He speaks for them all. Milder, though, than Speaker-From-God Mike Johnson, who holds photo-ops at the border while accusing President Biden of treason, and, later, promising that the Senate agreement is DOA.

Could anything be more cynical? From House Republicans? Sure: newly-hatched articles of impeachment against DHS Secretary Mayorkas for “doing nothing” about immigration after they’ve blocked all of Biden’s and Democrats’ efforts to address it. How Trumpified are Republicans? The Oklahoma GOP censured their Senator Lankford for participating in that bipartisan border agreement. This is a party interested only in retrogressive performance.

Nor should you take my word for their lack of accomplishments. Here’s Republican Rep. Andy Biggs, on superMAGA Newsmax: "We have nothing to go out there and campaign on. It's embarrassing.” “Right,” agreed anchor Chris Salcedo. “... the Republican Party in the Congress of the majority has zero accomplishments."

When there’s nothing to say, say anything. Hurt America for points on the scoreboard, be it immigration or Trump hoping for economic calamity.

Here are some facts about our president’s “wide-open” border: He got Mexico to agree to spend $1.5 billion in border technology, which Trump failed to do. Under President Biden, more illegal migrants have been removed from the US than any administration in history: almost 2.5 million Title 42 expulsions, which is 35 times as many as people put into “Remain in Mexico” by Trump. Under Title 42, Trump released a higher portion of border-crossers into the US than President Biden. And, under Biden, more potential terrorists and dangerous drugs have been interdicted than Trump could dream of or lie about. “Open border”? Hardly.

Like budget priorities and legislation, immigration policies disclose who we are. By far, the majority of people seeking entry are escaping crushing poverty and political abuse. And most of those are arriving from the “Northern Triangle” countries of Central America. Recall that President Barack Obama put in place initiatives and funding to improve conditions in those countries, lessening the need for their citizens to flee. Recall, also, that in his perverse desire to undo all of Obama’s accomplishments (still false-promising something better and cheaper than the ACA), Trump ended those initiatives, almost while his smaller-than-Obama’s inauguration crowd was still dispersing. For him and most legislative Republicans, it’s about making things worse. And more inhumane.

Sending National Guard troops and confused truckers to the border, insurrectionist Governors like Texas’ Abbott and others, with Trump’s encouragement, are angling to cancel the Constitution. In particular, the Supremacy Clause. Four of the scary six SCOTUS sitters saluted it. This bodes ill. As does a convicted criminal who wants another shot at the presidency calling for a potentially lethal confrontation between Americans. As on January 6, he’d delight in the results.

Other than MAGA Trumpublicans, who fear everyone who doesn’t look, speak, and pray like themselves, who are the rest of us? Progressives and real conservatives have always recognized that immigration is essential to our country. It’s not only about Christ-like love and caring for the poor and the strangers (remember Jesus, MAGAs?)

Welcoming immigration is about self-preservation; it’s about advancing our future. How many to absorb and how to screen them remain unanswered questions, and no solution will be perfect. But as long as MAGA Republicans continue to demagogue it, we’ll have none at all.

In 2021, President Biden proposed billions for enhanced border security, including more agents and more officials to adjudicate applications for entry. Nowhere, is where it went with Republicans. The current bipartisan Senate agreement reportedly includes those items, plus the ability of a president to “shut down” the border when it’s overwhelmed, which Biden has said he’d do.

Passage of such meaningful changes will happen only if Democrats regain control of the House and retain the Senate and White House. As if there aren’t other, equally important reasons to make sure that happens, like preserving democracy, education, healthcare, the environment, and, if Trump and governors like Abbott have their way, the Constitution itself.

Wednesday, January 24, 2024


Of the many thousand operations I did in my surgical career, most were life-improving rather than life-saving. To me, life-saving implies immediate or imminent risk of death. Gunshot wounds, stabbings, gastrointestinal bleeding or perforations, punctured lungs. Cracking a chest in the ER for a stab wound to the heart. Stuff like that. Potentially life-saving but less dramatic is removing a malignancy that, untreated or treated later, would likely have killed the person.

Most patients on whom I operated eventually returned to the care of their primary physicians or an oncologist. Much as I loved long-term relationships with any of my patients, it was uncommon. Beyond a few months, I usually had no idea how they fared. It’s among the few things I regretted about my chosen life. Last week, things changed, if only in one instance.

After vacating the premises while my wife hosted her book group, when I returned she said, urgently, “You have to listen to this phone message.” Uh oh, I thought. My weekly political commentary engenders a range of voice mails, most of them hypo-appreciative. “Hello, Dr. Schwab,” it began. “This is (Jeff Jones, let’s say), in Salem, Oregon, and this call is long overdue.” I’d started my surgical practice there, moving to Everett forty-two years ago, largely to be closer to my wife’s parents and eight siblings, all of whom live nearby.

“You may not remember me,” he went on, “But you saved my life from a ruptured spleen due to metastatic melanoma, in 1981.” Oh, I remembered him. Nearly every detail. It was remarkable then; astounding to hear from him now. Melanoma is the deadliest skin cancer. But it’s also the most unpredictable.

The emergency room called on New Year’s Eve night, 1980. A man had arrived with severe abdominal pain, in shock. They’d done a CT scan before calling me, showing a ruptured spleen. My goal for celebrating a new year’s arrival has always been to sleep through it, but this was a good reason not to.

Having received adequate intravenous fluids, his vital signs were satisfactory when I got there, so we had time to stabilize him further; in his case, that meant transfusing about five pints of blood. By the time we took him to surgery, first case of 1981, he was pink, calm, and stable. I don’t recall whether his history of melanoma was mentioned preoperatively. If so, I’m not sure I’d have connected it. For one thing, it had been treated several years earlier.

I grew up in Portland. Our next-door neighbor, a friend, was, coincidently, the surgeon who’d provided Jeff’s original cancer care. The treatment rendered was, at the time, experimental. The presenting melanoma was on his arm, and, after standard wide surgical excision and removing the lymph nodes under his arm, he was given chemotherapy agents infused directly into the artery supplying the malignancy’s former location. There were no untoward consequences. Years passed.

After opening Mr. Jones’ belly, I cleaned out the expected large amount of blood. What I hadn’t expected were several golf-ball-size masses within his leaking spleen: melanoma, which had to have spread there before his initial treatment. Given their size, they were possibly his only metastases, culled from his bloodstream by his spleen doing its job; any others likely would have been equally large and easily detected.

Nevertheless, after removing the spleen I spent time looking for suspicious areas, taking a couple of biopsies, and washing out his abdominal cavity, copiously, with sterile water, which will osmotically explode free-floating tumor cells. After such a rupture, odds are they’d have been there. Recurrence was more likely than not.

When I checked him later that day – and, given commonly-heard fears, I hesitate to say this without emphasizing its particularity – he shocked me again. “I felt everything when you cut into me,” he said, accurately recounting the first minutes of conversation I’d had with the team. Assuming the anesthesiologist would be similarly dismayed, I later told him of it. “Right,” he said. “It was a ruptured spleen, so I only gave him paralyzing agents at first, so he didn’t crash on induction.” Unbelievable. He was totally stable, had been for hours. Alert, not in shock. As if it just happened, Jeff recalls the pain to this day. Inexcusable.

His recovery was smooth. After a couple of office visits I didn’t see him again, but I’d recalled his exceptional case many times. Hearing from him decades later, in his 80s, was indescribably wonderful. I called him back, of course. We talked for a long time, about life, mostly. His children, grandchildren, and great-grandchildren. I sent him a copy of my book.

General surgery was hard work, physically and mentally. Eventually, it burned me out. But, because Mr. Jones thought to call, I’ll assume there are others out there, too, living lives they otherwise might not have had. Thanks, Jeff, for staying alive and letting me know.

Thursday, January 18, 2024

I'm Not Deranged. You Are.

“TDS.” In its Jon Stewart/Trevor Noah heydays, the acronym meant “The Daily Show,” and I liked it. Now, though, consistent with the way Fulton County (Ga.) Inmate No. P01135809 has melted the minds of millions, it’s come to stand for “Trump Derangement Syndrome,” a term liberally (!) applied to these columns and to all Americans who find the former “president” abhorrent. Because he’s a threat to democracy; a liar; an instigator of violence. A promiser of vengeance and retribution against those who’ve rejected his claims of electoral fraud; a man of lifelong immorality, scams, business failures, and cozying to mobsters foreign and domestic. Who just claimed the endorsement of a former Gambino crime family Mafia hitman as a badge of honor.

TDS. As I responded recently to a less-than liker of my writing, it’s like saying people who found Jeffrey Dahmer bothersome were suffering from DDS. (No offense to dentists.) Nevertheless, Trump Derangement Syndrome is real, a condition of pandemic proportions. And, like an endemic virus, despite our best efforts, it defies attempts to eradicate it.

Criticizing Trump, rejecting his venality and mendaciousness, trying to awaken people to his unfitness, is no more of a “syndrome” than calling for help when your house is on fire. It’s observational. It’s recognizing imminent danger and sounding warnings. Supporting Trump, on the other hand, defending or denying his inadequacies and incompetence, or, worse, sharing his hate for the Constitution and most of the people protected by it, constitutes a confounding depth of definitional derangement. Believing his laughably conspicuous lies about elections, Joe Biden, birth certificates, the economy, the Presidential Records Act, etc., ought to have its own diagnostic code. It’s neither normal nor healthy for the body politic. And it’s evidently incurable. In this case, an effective vaccine would require Billgatesian, brain-altering microchips.

Example: my online conversation with a lady who insisted Trump had lowered the US budget deficit when, in fact, his unnecessary tax cuts for the wealthy exploded it. Inflation was lower under Trump, she said, correctly, but was unable to process that it was due to the economic impacts of the pandemic, made even worse by his mishandling of it. She blamed Biden for the subsequent rise in inflation even though it coincided with economic recovery and was and remains higher everywhere else in the Western world. Our lower rates of inflation may be attributed, at least in part, to Biden’s Inflation Reduction Act, of which she’d not heard.

Many Republican politicians who once forcefully criticized Trump, describing what a disaster his “presidency” was or would be, have shed their evanescent flicker of integrity and kissed the ring. Lindsey Graham, Marco Rubio, Doug Burgum, among others, all endorsing him, derangedly. True, many people who worked directly with him in or near the White House are warning of the danger Trump represents; they’re enduring his and his supporters’ wrath and death threats because of it. But those temporary, timid truth-tellers tumbled when tested by Trump. Fear of those afflicted by the real TDS sent their honesty to the exits like the latest of Trump’s lawyers.

When asked why they support Trump, MAGAcal thinkers point to “the direction” this country is headed. Asked for specifics, it’s always the border. Wide open, so the undocumented will vote Democratic, they say, deluded and deranged. Some mention the economy, but are unable to elucidate, which is unsurprising, given its red-hotness and unprecedented job creation. Having no accomplishments on which to run, it’s understandable that “the border” is the MAGA rallying cry.

To the surprise of no one, Trump won Iowa. To the disappointment of no one, Vivek Ramaswamy dropped out. So did decent-guy but unnoticed Asa Hutchinson. 81% of Iowa voters agree with Trump that immigrants are “poisoning the blood” of America. 68% believe the 2020 election was “stolen.” This is who they and virtually all Trump voters are: TDS sufferers, worshippers at the feet of a xenophobic, demagogic liar, welcomers of dictatorship coming to America. People very much at home on derange.

It’s worth noting, with bridled optimism, that nearly half of Iowa Republicans who voted (only about eight percent of the registered did) chose not-Trump. Nevertheless, there’s no doubt that, unlike previous winners of Iowa caucuses who weren’t -- Cruz, Huckabee, Santorum, Dole, and others -- Trump will be the nominee of the party that once produced people of honor. And elected them. Though it’s been sounding since Trump first dragged it down that Trump Tower escalator, the death knell of that long-ago party was completed in Iowa. Only non-MAGA Republicans can resurrect it. They could do it, just this once, by voting for Biden.

Wednesday, January 10, 2024

God's Will

It’s widely accepted -- common knowledge, really -- that Trump has been chosen by God to save America. I’m not personally privy to the Patriarch’s proclivities, but I trust those Evangelical preachers who’ve assured us they’re in constant contact and know first-hand.

Preachers don’t lie. They’re not hypocrites. They’re deadly serious men and women of God and are to be believed, and not just because they want a “president” who’ll let them keep their tax breaks. Indeed, it’s been a couple thousand years since He sent anyone to save us; He must be walking to the mound, signaling to the bullpen.

To some, it’s surprising that He chose Trump, who has broken every one of the Ten Commandments, multiple times. But those were handed down a long time ago. Things change. Rules change. Maybe, tired of waiting for America to save itself via His original Choice, He looked for the person most opposite to His Son. Give that a try. It wouldn’t be the first time original hires were passed over. You know what they say about insanity.

Saving America is not a job for a humble man, and Trump is far from humble. On “Truth Social” he posted a video in the style of Paul Harvey’s (I’m that old) “God made a farmer” speech, making a solid case for the heavenly choosing of Trump. We’ll forgive the video’s few misstatements, like saying Trump loves America, attends church every Sunday, works tirelessly day and night, never resting. After all, Trump, the chosen-by, makes worse misstatements several times a day; who, then, are we to question the methods found acceptable by God, Himself? (Some readers may choose not to visit Truth Social, lest they get on some list or other, so I offer no link to the wondrous video. It’s easily found there by the willing. It’s quite something. Trump loves it.)

At the risk of spending eternity or more in Hell, I do have questions, though. Reasonable ones, based on the Bible. God knows us before we’re born, it tells us; has a plan for us all. When, therefore, did God conceive (not in the virgin-birth way, naturally) of Trump as the modern-day Messiah? Was it a pre-conception? Now, this is just me, and I’m sure God will absolve those who choose to read further; but if Trump was being groomed, as it were, for neo-saviorhood, you’d think the groomer would send him on a righteous path of preparation for such great responsibility, right?

Mysterious are the ways of God; mysteriouser still are videos made to speak for Him. But doubts can be raised about His methods, so raise them I will. Of what purpose, for example, was creating Trump to be a bone-spur faking draft dodger? The same goes for serial infidelity within three marriages: how do those episodes prepare one for saviorhood? What of his dozens of business failures? Sowing falsehoods like bread upon the waters? Refusing to pay contractors and suing them when they sought relief? Did God decide, for His second go-around, to imbue saviority with selfishness and a cold heart? Did He send the pandemic as training for crisis management? If so, how did Trump’s failure to handle it hone his future skills? Were the estimated 500,000 American deaths due to incompetence part of God’s intended learning experience? It wouldn’t have been the first time He wiped out humans to teach a lesson.

Of course, there’s that “free will” thing, a conundrum that’s challenged philosophers and religious scholars for eons. Perhaps God didn’t micromanage Trump’s pre-“presidential” behaviors at all. Maybe, busy elsewhere with the billions and billions of other galaxies He supervises, He began checking for potential saviors only recently. Circled back this way, checked it out, and said, “Oh my Me! For a tiny, meaningless speck, things there are looking Me-awful. Perhaps I should undo the whole thing? It wouldn’t make a ripple in time. Looks like an experiment gone wrong.”

But God has a sense of humor, it’s said. Why else, after all, would He have hung testicles out there in a wrinkly sac, all ridiculous and vulnerable? So, He could have thought, those people have been expecting My Son to return, but let’s shake things up. Looking for candidates, maybe He checked out those pre-gathered Jeffrey Epstein listees: “That one looks promising,” He might have said. “Oh, but he’s term-limited. How ‘bout that one? Kept his underwear on. Nah, Jewish. Never get elected. Hey, now: that guy. Only spends a minute with each girl. Not a time-waster. He’ll do fine.”

It also could be that God has given up on America and, rather than pestilence and famine, He’s sending Trump.

Wednesday, January 3, 2024

Section Three

(Image source:

If the concept of constitutionally disqualifying Trump from running for president is complex, multi-layered, and controversial, one aspect isn’t. The wording of Section Three of the Fourteenth Amendment is unambiguous:

“No person shall be a Senator or Representative in Congress, or elector of President and Vice-President,” says Section Three, “or hold any office, civil or military, under the United States, or under any State, who, having previously taken an oath, as a member of Congress, or as an officer of the United States, or as a member of any State legislature, or as an executive or judicial officer of any State, to support the Constitution of the United States, shall have engaged in insurrection or rebellion against the same, or given aid or comfort to the enemies thereof. But Congress may by a vote of two-thirds of each House, remove such disability.”

It couldn’t be more clear: if, after taking an oath, you participated in insurrection or rebellion against the US or any state, or aided or encouraged people who did, you are barred from federal or state office. Period. It’s the Constitution. It’s the law. It can’t be selectively enforced, can’t be ignored for any reason, including applying it to a former or current candidate. Political impact isn’t a consideration. In a constitutional republic, the law is to be enforced, undisirregardlessly. Must be.

None of which is to pretend the particulars are clear-cut. Whereas some claims from the right are specious at best – questioning whether a president is an officer of the United States, for example – others deserve consideration. There’s plenty of thoughtful discussion out there, and even non-lawyers should be able to sort through it.

The fundamental question may be who defines an insurrection; it’s at the heart of a related question: is Section Three self-actualizing or does it require some sort of enabling legislation from Congress? Must Congress define the word and state by what standards it’s applied, and by whom? Courts? Secretaries of state? These are fair questions. Coincidentally, they provide a way for the Supreme Court to escape adjudicating Trump’s eligibility to become “president” again. Or, in his case, a dictator as promised.

Looking for a place to hide, the SCOTUS Six may rule that, absent enabling legislation, Section Three is unenforceable. Credible legal scholars, both liberal and conservative, have concluded otherwise, some going so far as to predict an unlikely 9-0 decision that disqualifies Trump. (8-0 if Clarence Thomas, whose wife actively attempted to overturn the election, recuses, in an uncharacteristic display of integrity.) 

Unlike the compelling erudition of the preceding link, a lower-court Colorado judge, before she was overruled by its supreme court, stated that Trump engaged in insurrection but, bizarrely, that presidents aren’t “officers” of the US, as described in Section Three. That, to say the least, is hard to defend, given that the Constitution specifically prescribes the presidential oath, beginning thus: “I do solemnly swear (or affirm) that I will faithfully execute the Office of President of the United States...” (My emphasis.) It’s an office, by Constitutional definition. People in office are officers. And Trump took the oath.

Less compelling than the enabling argument is the political one: it’s dangerous; it’ll inflame Trump voters, cause an uprising. Same with “let the voters decide,” which they have, twice rejecting Trump by majority vote. Here’s his lawyer, Christina Bobb, on topic: “The president is elected by the entire nation and it should be the entire nation who determines who they want for president, whether they are guilty of insurrection or not.” Right. Except for, you know, what the law says. About insurrection.

Maybe it shouldn’t be judges who define or decide who participated. (Note that Section Three includes “rebellion.” If January 6 wasn’t that, what is?) On the other hand, we remember Justice Potter Stewart’s response when asked for a definition of obscenity: “I know it when I see it.” In trying then and now, many times, many ways, to overturn a Constitutionally valid election and, therefore, the Constitution itself, Trump is disqualified, by law. Call it insurrection. Call it rebellion. We know it when we see it. Or make it really easy: “Aid or comfort.” His continuing election lies, called out even by his own people, are at the heart of it. That’s a slam, as they say, dunk. 

Would there be violence? Is Fox “news” like a bear in the woods except in our brains? Probably. But unless you believe in selective application of the law, based on status or politics, meaning you don’t believe in law at all, what choice is there? The NRA doesn’t believe the Second Amendment has exceptions. Per the Third, no one’s being forced to quarter troops. Trump pleaded the Fifth hundreds of times. If the Fourteenth is different, how exactly? It’s not politics. It’s the law.

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