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The Vaccine

The Mona Lisa getting her COVID 19 shot

To be or not to be…? To be or not to be vaccinated, that is the question?  I am shocked by the number of people I consider intelligent human beings that are not going to get the vaccine. The number of people that are not going to get vaccinated will prevent the nation from attaining herd immunity! That is more than selfish! I have been a physician for over half a century, and I am convinced this vaccine is as safe as it can be. Having been in the military and traveling worldwide, I have been vaccinated for pretty much everything and am still alive. I was not affected by Mercury or Formaldehyde poisoning, and had just a little fever with some of them. I am sure that no government agency is tracking me either (unless, of course, I wear my aluminum foil helmet that transmits the signal to the secret location of the trackers –just kidding). The benefits outweigh the risks by a wide margin.  You are more likely to be killed by lightning (lifetime risk 1 in 15,000), or a drive to the corner grocery store (lifetime risk 1 in 100).  The most dangerous vaccine, Johnson and Johnson, has killed 1 in 3,500,000. Yet you are still at risk for getting the virus that has a mortality of 1% to 10% depending on where you live, how old you are, and what other co-morbidities you have. The overall mortality from COVID-19 in the US is currently 1.8%, which included one of my best friends while he was waiting his turn to be vaccinated. The anti-vaccers are opposed to any vaccine based on sparse or false evidence of the dangers of the vaccine.  The vaccine-hesitant are just not sure. There are two vaccine averse demographics that have very little in common except that they do not trust the government, the white Republican males, and the African Americans.  The latter bring up Tuskegee. The white male Republicans have a relentless distrust of government.

I do believe that anyone who does not want to be vaccinated should not be forced to be vaccinated. What should be injected into your body should remain your right to decide.  But at the same time, I believe that you have no right to subject others to the risk of getting infected by your virus. If you are not vaccinated, you have a higher risk of getting the virus and passing it on to others that have or have not been vaccinated.  I am not opposed to Vaccine Passports to prove that you have had the vaccine.  Those should not be government-mandated.  Various governmental agencies, including Dr. Fauci, have claimed that there will be no government-issued passport.  By the same token, I will not fly in an airplane full of unvaccinated people. I want all my fellow passengers to be as unlikely to infect others and me as possible.  Nor do I want to sit next to unvaccinated people in a restaurant, a theater, or a sporting event. These services have the responsibility to tell me if they do or do not require vaccination. Although it is still possible to be vaccinated and be a carrier, being vaccinated makes that very unlikely (kind of like Twilight Zone). I believe that private businesses have a right to demand that consumers of their products be unlikely to pass on their viruses.  By the same token, each business must decide whether to demand customers be vaccinated or not frequent their premises. But they have an obligation to let me know what they do. Businesses reserve the right to refuse service to anyone—no shirt, no service, or in this case, no passport, no pizza. I, the consumer, then can choose to frequent or avoid that business. The only way to implement this is to show your Vaccination Passport, which is far less intrusive than the scarlet letter “A” tattoo on the forehead (in this case, “V”). I do believe in rights, but I also have a right to be as safe as possible.

Typhoid was a major killer in the 1900s.  Public Health tracked down the source, Mary Mallon, a.k.a. “Typhoid Mary,” who spread the typhoid bacillus.  She had been imprisoned once before because she caused several deaths from Typhoid, and they warned her to stop being a cook, a waitress, a spreader of the disease, but she did not.  She went “underground,” moved, and changed her name. Finally, the only choice was to imprison her again.  She died in 1938, having been confined for a total of 26 years. The people that refuse to get vaccinated but still want to fly in airplanes, that want to go to restaurants, movies, and sporting events are like Typhoid Mary. Showing proof of vaccination is much less of an imposition than quarantine or imprisonment. But if it comes to that, there really are no other choices. And it should be ironclad so that you cannot get a forged passport on the “Black Market.” If you do, Typhoid Mary’s fate should be your fate because, like Mary, you show no regard for your fellow human, nor do you respect what the best current knowledge is. We are social beings and therefore have an obligation to do what is in the best interest of our fellow humans and not injure or infect them.  

Freedom is a constitutional right given to all of us, but it does not permit abandonment of your constitutional responsibility not to harm others.

Is Photo ID Now Also Racist?

Thirty-six out of fifty-two states require voter ID.  You need an ID to board a plane, to enter the country, to cash checks, to get a driver’s license, to open a bank account, to apply for food stamps, to apply for Medicare, Medicaid, or Social Security, to apply for a job, to apply for a mortgage, to buy a house, to buy a car, to buy a gun, to get married, to adopt a pet, to get a hunting or fishing license, to donate blood, and many more.  Georgia just passed a law that requires voter ID, and it generated a major tantrum.  It is called racist, and the claim is that it is responding to the lie of voter fraud. Therefore it is fixing something that is not broken, etc. 

The majority wants fair elections, which requires knowing who is voting. An election must be spotless. If it is under suspicion, justified or not, it damages democracy and makes for a lot of unhappy people. Mayor Daily of Chicago was notoriously rumored to participate in voter fraud.  The favorite saying attributed to him was, “Vote early and vote often.” I lived in Chicago for several years. That issue was not disputed. It was taken as the truth that his operatives would round up all the street bums, and line them up at the poles early when they opened. In the afternoon, they would all get a new suit, get shaved and a haircut, and go back for the second round of voting.  

People that are not citizens, people that are dead, people that are not of legal age, people that have already voted, and people that are felons should not vote.  If it is racist requiring an ID to vote, then it is also racist to require an ID to board a plane, cash a check, get a fishing license, or adopt a dog, and then that makes the majority of States racist.

Multiple organizations have protested, led by Major League Baseball (MLB), which is boycotting Georgia by moving the All-Star Game to Colorado, said to cost Georgia $100,000,000.  Other companies have joined the protest: Delta, Twitter, Coca-Cola, UPS, Home Depot, Aflac, Apple, and more under pressure from the Woke Left. Even Stacy Abrams, minority leader of the Georgia House, walked back her demand for protest.  She did not think it would cost her state $100,000,000. In her words, “Leaving us will not help us.  Stay and fight!” But it is too late!  MLB cannot change now, and all the other protesting companies have gone public.

New polling shows that a large majority (75% of all voters, 69% of black voters, 60% of Democrats, and 89% of Republicans) supports photo ID laws.  It appears that a minority is opposed to photo ID, composed primarily of the radical left.  Voter ID is said to be a remnant of Jim Crow, according to Biden, equating voter ID with lynching, burning crosses, and the KKK, all of which was, by the way, primarily fueled by Democrats if you know history. Senator Robert C. Byrd, a good friend of Joe Biden and former Grand Wizard of the KKK was a staunch Democrat, and lest we forget, he filibustered against the 1964 Civil Rights Act. He died in office in 2010 and was eulogized by none other than Joe Biden. Statues of Columbus must come down for his treatment of the native population that supposedly happened. That was 500 years ago. But Joe’s racist behavior of 11 years ago will go unnoticed. Is that an example of hypocrisy or just stupidity?

Voter ID affects all races equally.  The black population should take the left’s position on voter ID as a major insult.  The patronizing left insinuates that African Americans are not able to get ID on their own.  They should not have to show ID because they are not capable of getting photo ID.  That, my friends, demonstrates how racist they really are!

All these companies that are protesting did not think this through. First of all, Atlanta’s African Americans are 51% of the population. Denver’s black population is 9.8%. Who exactly are the business geniuses of  Major League Baseball going to hurt with this boycott most? They should have asked me, and it does not take an Einstein to run the numbers. 74,000,000 voted for Trump, and Biden garnered 80,000,000. For those of you from Peoria, that is 48% for Trump and 52% for Biden. Organizations that want to serve the general public should stay out of politics, especially on issues where opinions are fairly evenly divided. Those companies have alienated 74,000,000 customers by becoming partisan.  There will be a response!  Granted, many people are not that political, but a lot are.  There will be a Boycott Backlash!  Coca-Cola will give up some of its business to Pepsi, which wisely remained non-partisan. Conversely, very few Pepsi drinkers will switch to Coca-Cola to reward them for their political stance. How many Republicans will fly Delta to the next Republican Convention said to be, of all places, in Atlanta, Georgia? It will likely not hurt Apple, they are just too big and just expand their already fastest-growing market in China. Tim Cook frankly does not care, but Aflac should have been smarter. UPS has a lot of competition, and FedEx may profit from the lack of political savvy of UPS. A few Redneck Baseball fans may just miss the All-Star Game.

Oysters, the Savior of Mankind?

After World War II a new fear swept the country and the world.  FAT was the evil we now were told we must avoid if we were to survive.  To punctuate it, the hero of the war and now the President of the country, Dwight David Eisenhower, had a heart attack, presumably due to the poison, Cholesterol, plugging up his coronary arteries.  A Harvard professor named Dr. Ancel Keys, popularized the idea that we had to give up fat. “People should know the facts,” he said, “then if they want to eat themselves to death, let them!” Dr. Keys made the cover of Time Magazine. He did the “Seven Country Study” to prove his conjecture. Like many scientists who have ulterior motives to prove their theory, he manipulated the data by cherry-picking and leaving out the countries that had the highest fat consumption, but not having the higher coronary deaths that he predicted. Nevertheless, the world bought it, and Dr. Keys got the government contract to develop survival food for the military which he self-aggrandizingly called “K” rations.

Our diet changed. Carbohydrates were substituted for the decrease in fat. The “Food Pyramid” told us what and how much we should eat. Various grains were given higher priority than protein and fat. Butter was vilified and replaced by,  “I can’t believe it’s not butter.” The more solid versions later turned out to be as bad as the real thing. Eggs were de-cholesterolized, and lard became an obscenity. With this change came new devils that can clearly be linked to an increase in obesity and a rise in Type II Diabetes. Whether we can blame the 19% increase in mental illness on the decrease in fat consumption remains an intriguing theory but still debatable.

With time we realized that it is more complicated. Fats are not all that bad. In fact, some fats are essential. Besides, a marbled steak is a lot more satisfying than a bowl of pasta. 60% of our brain consists of fat.  A particular family of fats is especially important; the omega-three fats. And one of them is the most important:  it is DHA (docosahexaenoic acid).  600 million years ago, animal life was evolving in the oceans, and DHA, a product of photosynthesis from algae, was the primary fat that contributed to the development of the brain.

The last Ice Age, the Quaternary, has been in progress since two and a half million years ago and is still evolving since 33% of the earth’s landmass is seasonally covered by snow and ice, but shrinks to only 12% that remains permanently during summer. We are still in the Holocene Interglacial Period that started 12,000 years ago. In the prior four Ice Ages, ice completely melted. There were no glaciers and no ice caps at the poles. I am thinking that some of those early hominids must have had SUVs!

Earth has been completely ice-free 80% of its time in existence, and the North and South Poles were covered with vast forests where wildlife frolicked, all of which have since turned into vast oil fields under the ice that is touted to be the next instrument of our extinction.  One hundred ninety thousand years ago, a glaciation known as Marine Isotope Stage 6 (MIS6) brought cooling and drying of the planet. Great ice sheets covered northern Europe, the Alps, North America, and the Antarctic. When the Laurentide glaciers retreated, it created the Great Lakes on the North American plate. It was connected to the still existing ice sheet covering Greenland.

Ironically this time, global cooling brought us to near extinction, with only a few hundred Homo sapiens still surviving.  We know this because the genetic variation in mitochondrial DNA contracted markedly, which could only occur because of the sharp decline of the breeding population known as a bottleneck.  Mitochondrial DNA is passed on only from females almost always, and our present mitochondrial  DNA does not have the variation it ought to have, which confirmed that only a small gene pool existed then. It gives rise to the “Eve Theory,” which says that the current human race stems from a single female. This is a bit Biblical and not entirely true; nevertheless, it suggests that just a few females were left to carry on our species.

Arizona State University archeologist, Curtis Marean, has been excavating a site on the South African coast called Pinnacle Point for over twenty years that he believes could be one of the sites where the few remaining Homo sapiens found adequate food for survival.  Thousands of years ago and still today, the shallow waters off Africa’s southern tip are packed with mollusks. It required us to rely on a seafood diet. Shellfish are particularly easy to harvest. No hunting is necessary.  The tides expose them just for the taking. Tests have shown that foraging shellfish under optimal tidal conditions can yield up to 3500 calories per hour.

“He was a bold man that first ate an oyster.” So said Jonathan Swift, author of Gulliver’s Travels.  To crack open an oyster and scoop out the salty, slimy grey muck and put it in your mouth must have taken a bit of courage, a strong stomach, and a weak gag reflex. It turns out, however, that seafood has a lot of DHA, a major contributor of fat for the brain.

It is a tantalizing idea, and not inconsistent with recent nutritional research, that if you eat what your brain is made of, you could improve its function. Omega-3’s are now thought to slow the senescence of neurons.  Could it be that eating oysters in the past not only saved us from going extinct, but made us smarter, and presently is helping to prevent dreaded Alzheimer’s disease and other forms of dementia?

Some of the ideas in this essay are taken from the book, A History of the Human Brain by Bret S. Stetka, MD

It is not unusual to keep the Health of American Presidents Secret

It was a cold, miserable day when Grover Cleveland rode down Pennsylvania Avenue with President Harrison, whom he was to replace as President of the United States. They both had previously attended the Vice -Presidential Inauguration of Adlai Stevenson (You may recognize this name. He was the grandfather of Adlai Stevenson II, who was the presidential candidate in the election of 1952 and 1956 against Eisenhower), Cleveland then took his own oath of office.  It was not a good time. The country was in a severe depression, and the economy was in shambles. Several months later, on May 5, he noticed a bump in his left palate by one of his left molar teeth, the side he was fond of chewing his ever-present cigar.  By June, it had doubled in size, and on July 1, 1893, he took a secret cruise, advertised as a fishing trip on the Oneida, one of his friend’s yachts, and six surgeons performed an operation that today would be a six-hour ordeal.  In 90 minutes, the tumor was removed along with half of his palate and six teeth. That remained a secret for 24 years.  He had to wear a rubber prosthesis to correct the facial distortion and speech from the loss of volume in the upper part of his mouth. With the rubber prosthesis and the fact that the incisions were all inside the mouth, there were no external signs of this rather radical surgery. It was cancer. (In 1980, that was reconfirmed on review of the original slides). The operation was a success.  He died 15 years later of a heart attack with no recurrence of cancer.  

It is not unusual to keep the President’s health a secret.  Woodrow Wilson had a cerebral event, likely a stroke, on September 25, 1919, while on a speaking tour. He was severely disabled, with paralysis and loss of cognitive functions.  Edith Wilson, his wife, shielded him from everyone but his doctor, even “guiding” his hand to sign documents. She, de-facto, became the Chief Executive of the United States until his second term concluded in March 1921.  She was our first woman president!!

Warren G. Harding was institutionalized for mental problems that were disguised as fatigue. He was President from 1921 to 1923 when he died in office at age 57, presumably from a heart attack.

Franklin Roosevelt had paraplegia, which most people did not know.  It was kept from the public by the media, never showing him in a wheelchair. He had small strokes that incapacitated him in his last few months of life. At 3:35 pm on April 12, 1945, he complained of a “terrific headache,” and shortly after that, he was dead, just months after he was elected to his fourth term.

Eisenhower’s first heart attack was hidden as “a digestive upset.” And Kennedy had Addison’s disease, a failure of his adrenal glands, which he and his doctors denied. He took steroids secretly. He had two episodes of complete collapse.

The assassination attempt on Ronald Reagen in 1981, led to his being unable to discharge his duties as the President. He was in and out of consciousness.  It was Alexander Hague, Secretary of State, who took charge, forgetting that the Vice President then the Speaker of the House, and finally the Senate’s President Pro Tempore came before him in the line of succession. Hague unceremoniously usurped power when he said, “As of now, I am in control here!” Reagan was diagnosed with Alzheimer’s disease in 1994, five years after his term of office ended, but it was suspected by journalists, and even his son, long before his doctors agreed.

It is becoming increasingly difficult to shield our current President from concerns about his health. The Air Force One stair incident, stumbling not once but three times, is one of those events that has put even the most ardent supporter on notice, along with the rest of the world. “The United States does not have the qualification to say that it wants to speak to China from a position of strength,” quoted from Yang Jiechi, director of Foreign Affairs Commission of China. Vladimir Putin ridiculed our President by mockingly challenging him to a public debate, saying he could do it after the weekend. Putin smells weakness! And China would not have been so brazen with our former President.  An insult of that nature would not have gone unchallenged! Unfortunately, a rubber insert, like the one that hid Cleveland’s deformity, would not hide the many gaffs our President makes with many of his public appearances.

About a year ago, I was asked, “Is it possible for a doctor to diagnose dementia without examining the patient?” I hesitated to answer the question because they had a point.  For any diagnosis, an examination by the physician is considered standard of care, but to do a full examination, taking the blood pressure, listening to the heart and lungs, etc. is not relevant to diagnosing a brain condition, especially one that deals with cognition, that can be evaluated by listening to the patient talk. Does the patient forget common words? C’mon man! You know “the thing!” Do they mix up who is a sister and who is a wife? Or when the patient consistently elevates the Vice-President to the Presidency, and things like that? Do they forget where they are? Even if they have a stuttering problem, the healthy brain of a person that stutters does not make mistakes like that. Just walking can tell you a lot about the patient.  Is their gait shuffling?  Do they stumble? Is their balance off? Just observing his/her behavior gives plenty of clues.  But I should have answered the critics. The answer is a resounding, “Yes, a doctor can diagnose dementia without actually laying hands on a person.” It is now so obvious that nine out of ten McDonald’s hamburger flippers can diagnose that dementia is the likely diagnosis. Of course, it is much easier now. To make it even easier, nearly half of people at age 80 have signs of dementia. That is why the airlines make pilots retire at age 65, and in Japan, surgeons over 62 are not allowed to operate. This would not be the first time in modern history when millions have been misled by propaganda. Joseph Göbbels certainly knew how to do it.

 

 

 

The Fall of Neanderthal

The last of the Neanderthals’ remains were found in Gibraltar at a place called Gorham’s cave. These date back 24,000 to 40,000 years ago.  Neanderthals survived on earth for over 400,000 years. That is longer than Homo sapiens have been on earth by a factor of two.  They were not direct ancestors but cousins of ours. We are, in fact, kissing cousins, as some of their DNA is in our double helix spiral.  We met them several times on the European side of the Eurasian plate and inbred. The Neanderthalers are named for the valley they were first found, the Neandertal, near Düsseldorf, Germany known for its Pilsener Beer. That likely contributed, especially around “October Fest”, to the fact that there is 1-4% of their DNA in Europeans, also in Asians, but to a lesser extent. Asians have more Denisovan DNA. The Denisovans are probably an earlier split from Homo heidelbergenis 800,000 years ago.  We have very little remnants of Denisovans, only a tooth and a phalanx of the fifth finger. This was, however, sufficient to map their DNA and establishes them as a separate species.

A colleague of mine took great offense when I, in one of my previous essays, suggested having less Neanderthal DNA might be the reason that Asians score higher on the SATs. And they do to such an extent that Harvard will only allow a certain percentage of Asians into Harvard, a sort of upside-down discrimination, or should we call it what it really is, naked racism as defined by Webster (the belief that racial differences produce an inherent superiority of a particular race). My colleague, who is Korean, disputed my DNA theory.  He pointed out that Asian parents are much more obsessed with the education of their offspring. They send them to special schools after regular school, and they monitor their grades carefully. My nephew, who teaches at one of these special schools after regular school, claims Asian kids are not allowed to have a life because of this obsession.  My counter-argument to my Korean friend was that this preoccupation with academic success could be genetically determined as well.

Conversely, there is very little Neanderthal DNA in Africans.  The Neanderthals never lived that far south, unlike some European Homo sapiens that doubled back to Africa to leave some of their DNA.  However, genetic studies in West Africa turned up some ancient DNA that was not native, not Denisovan, but European, and even had a tiny snippet of Neanderthal DNA that traveled with those European nomads. These may be species separate from Homo sapiens, not given a Genus/species name so far. They are, for lack of a better name, called the “Ghost Species.” It seems everyone mated with everyone else.

That brings up the point, what did happen to the Neanderthals?  They were all over Europe, getting as far as southern Asia.

Many theories have evolved.  Did we, Homo sapiens, kill them?  Was it climate change or a Neolithic version of COVID? Did we outcompete them in survival skills? Or did we just absorb them?  There is evidence for all of those ideas.  There have been Neanderthal bones found with butcher marks on the bones and splitting them open for the marrow, suggesting cannibalism.  The Neanderthals survived much more severe weather than Homo sapiens did, having gone through longer ice ages and several glaciations, so climate change is an unlikely cause.  Homo sapiens’ hunting weapons were more sophisticated, which made them better hunters, perhaps taking away meat from Neanderthals. 

Neanderthal hominids did have language.  One cannot make fairly sophisticated stone tools and weapons, and go out hunting for the Wooly Mammoth without being able to communicate with your fellow tribesperson.  Evidence from the conceptual reconstruction of their voice box was higher in the neck and smaller that they could not speak vowels, and that their vocal cords, being shorter, made a higher-pitched sound just like the short strings in a piano are higher pitched. The structure of their nasal passages and sinuses produced a more squeaky sound.  The tongue also being anchored on the  Hyoid bone higher in the neck was not as articulate as the tongue of Homo sapiens. The language they spoke was more rudimentary and simple. As a consequence, their grammar probably allowed for split infinitives to more succinctly explain themselves, and prepositions at the end of their sentences, notwithstanding.

They even had culture.  Cave art that goes back 65,000 years ago, before Homo sapiens got to Spain, shows they had that desire to put paint on walls for decorative or spiritual reasons. They did bury at least some of their dead and often with some memento that signified a sense of spirituality, perhaps belief in an afterlife.

There are at least eight species of Homo, nine if you count H. denisova, including us described to date, but Neanderthal is the only one that co-existed with us.  If we met one on the street, we would instantly know they are not one of us.  They were generally shorter and squatter with a large barrel-shaped chest, longer arms, and the face had a prominent nose, a receding chin, prominent brows, and a forehead that was slanted toward the back.  My question is, “Would Harvard have let them in?

A SAD TIME FOR AMERICA

When I came to this country at age 11, I never thought it would come to this, Americans storming the Capitol, breaking windows, and desecrating the hallowed halls of Democracy.  But just as much as the right is guilty of destruction, so is the left in Portland, Seattle, Minneapolis, and New York.  Thank God that the “Defund the Police crowd did not take over totally.  What would have happened in Washington without the Police?  A herd of social workers would not have helped. The exact truth of what went on is still evolving.  Did the Capitol guard allow free access? Were there some paid agitators, and hired thugs?  I suppose it will all come out eventually.  Regardless Trump came out of this gravely damaged. When thousands of people are incited and told this is their last stand, people will do things that are desperate.  Talk of hanging the  Vice-President or executing Hillary is not helpful and does not promote a peaceful solution. Keep in mind that Hillary had more votes than Trump in the 2016 election.

Heal or heel are the operative words as to how this will all evolve. The cooler heads on both sides need to step forward. Impeachment or raising the 25th Amendment at this time would not likely create any common ground or goodwill that would aid in a resolution and bring around 74 million people to change their way of thinking, as Nancy Pelosi seems to think, or is revenge the only thing on her mind? It will take a lot more wisdom than what I see in the mix.

Ninety years ago, Germany had similar dilemmas, to go with the Nazis or the Communists.  They, too, didn’t fare so well. Had they gone the other way, would the outcome have been different? At that time, my family was devastated, torn appart, their property confiscated,  some murdered, and others imprisoned.  I, therefore, have a difficult time siding with the left now.  But siding with the right, has its own set of problems. I am truly in a quandary. Healing or Heeling is not going to be easy either way. Lindsey Grahm on the floor of the Senate said, “Count me out!” That is how I feel. Count me out.  I don’t want to deal with Biden, Ocasio-Cortez, Kamala, Trump, or the guy with the horns. I wish I could escape, just as my parents did, to a safe haven somewhere in Neverland. But all the safe places are gone.

Arnold Schwarzenegger gave an impassionate plea for reason, with reassurances that just as steel hardens with blows and fire, so will our Democracy.  This is wishful thinking, I wish he were right! There is, however, the likelihood this will continue to fester like the boil of the virus we a battling.  As soon as we seem to be getting the upper hand, it evolves, and more people die than ever before.  We can’t even agree to wear or not to wear masks, something I have done all my life as a working surgeon, and I am still alive. The same is true with our political impasse with 74 million on one side and 81 million on the other. How can I compromise on becoming more socialist when the Socialists took all my inheritance and murdered some of my family? I see more violence, bloodshed, and death ahead on both fronts without mutual compromise and understanding of all sides.

A common enemy would help solve our dilemma. I wish that the UFO’s, supposedly buzzing us are real, and we can come together to battle them as a united front.

Robert Zollinger a Surgical Giant on Whose Shoulders We Stand

ROBERT M. ZOLLINGER (1903-1992) WITH HIS MENTOR ELLIOTT C. CUTLER

Zollinger (the younger one with the determined demeanor, on the right) was kind to medical students, but once you got that M.D., he was ruthless! The stories that former residents tell are hair-raising and would bring forth all kinds of harassment charges in today’s environment. Nevertheless, he was beloved by his patients, although feared by his residents. He was famous for firing a resident going up the elevator on the third floor and rehiring him by the time they got off on the seventh floor. Zollinger was once asked what he wanted on his tombstone. His answer: “teacher, surgeon, soldier, farmer, and my wife may remember that I’m an amusing fellow to live with.” He won as many awards growing his gourds and roses, as he had accolades as a surgeon.

I have had the privilege of having exposure to several of his former residents as colleagues, and one of them became a UCLA professor who taught me. He too was tough, but nowhere near Dr. Zollinger. His name was Edward Passaro. Zollinger, just to get his goat, would call him “Pissaro,” accent on the first syllable. The poor guy had to tolerate that for five years before all the PC snowflake culture began. Dr. Passaro was a brilliant surgeon and an inspirational teacher for me. His work with Zollinger paid off, despite the abuse, and in my humble opinion because of it.

Zollinger expected perfection from himself and his residents. Once he didn’t like the way his Chief Resident was conducting the operation, so he took his gloves off, grabbed an IV pole, and taped the resident to the pole for the rest of the procedure. His association with Edwin Ellison, one of his residents, led to the discovery of the Zollinger-Ellison Syndrome, a non-beta cell endocrine tumor of the pancreas, that produced gastric, and duodenal ulcers due to the hormone, gastrin, which that tumor secreted.

Dr. E. Passaro discovered the prime area to look for the tumor,  which makes gastrin. It is called the Gastrinoma triangle, but more appropriately Passaro’s Triangle. This was in 1955 and is the first of many other syndromes that opened the door for the discovery of  endocrine tumors and the different hormones they produced,  now described as multiple endocrine neoplasia. Zollinger applied for an internship at Peter Bent Brigham Hospital in Boston, under the tutelage of Harvey Cushing. Cushing sent Zollinger to work with Elliott C. Cutler his favorite pupil. That association would span the next twenty years, and the two would produce the now-famous Atlas of Surgical Operations with eight more editions to follow. 

If this is interesting to you, there is much more in my book, We Stand on the Shoulders of Giants, with many  personal stories about the Giants of Surgery available on Amazon.com. The revised second edition will be out in a month with more chapters in a hardcover format.

 

 

 

 

 

 

 

 

 

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Democratic Socialist Success Stories

Bernie Sanders, a self-confessed Democratic Socialist, is leading the charge to convert us to another Democratic Socialist nation.  I thought it would be useful to look at other countries that have taken the plunge to see what happened to them.

In the 1950s, New Zealand was one of the richest countries in the world in terms of G.D.P., personal income, and freedom.  New Zealand was tied to Britain even more so than to Australia, their neighbor.  As Britain became more Socialistic, so did New Zealand, with more regulation, higher taxes (over 60% at the highest marginal rate), government control of transportation, utilities, telecommunication, agriculture, manufacturing, price control, labor practices, and others using a variety of methods such as subsidies, rent control, housing regulation, control of labor, etc.

In two decades, the country was close to bankruptcy. In 1984 they took a sharp turn to the right with the privatizing of government-run industry, reduction of regulations in housing, labor, agriculture, and also abandoning subsidies.  The highest tax rates went down to 33%, and prosperity returned, not such a good mark for the Democratic Socialists.

Of course, we all know what happened to the arch progenitor of Socialist governments, the U.S.S.R. (United Soviet Socialist Republics), starting in 1922 to 1991. It was founded on Marxist principles and led by Vladimir Lenin and Joseph Stalin.  It finally collapsed under Mikhail Gorbachev. The academic Socialists claim that Socialism has not worked because it has never been tried. But the Soviets had the longest run of any of them. The Soviet farms failed to produce enough food; people lined up for blocks to buy bread in Moscow. If they could not get it together in nearly seven decades, how long will it take our genius Socialists like Bernie, A.O.C., and Elizabeth Warren? 

Israel, India, and the United Kingdom all had a run at Socialism with little success.   After World War II, Britain’s Labor Party nationalized every major industry and introduced a variety of Socialist programs in England. For 30 years, Britain needed ever-increasing taxes to fund their social programs, to a peak of 83% on income and 98% on capital gains. Medical care became a function of the state, and the lines at the medical clinics were getting longer and longer, where some people were dying waiting to see a doctor. The unions constantly demanded a higher share that they achieved with strikes.  The garbage was not collected by the garbage trucks and piled up in the streets, and the bodies didn’t get buried by the striking grave diggers. Most major industries and housing were owned by the state. Britain had the slowest growing economy in all of Europe.  Margaret Thatcher won the election of 1979, and she immediately privatized major industry, allowed private medical practices, and cut taxes in half. The economy revived and went to second strongest only after Spain. Inflation fell from 27% to 2.5%, and G.D.P. rose to 3.2%.

India gained independence from Britain in 1947. Jawaharlal Nehru, under pressure from the Communist Party of India, instituted a Socialist government. This lasted almost 30 years. He nationalized almost everything, including banks. One of the leading economists of India declared that “the only improving productivity in India was crime.” Top personal income tax was a crushing 97.75%. It was Rajiv Gandhi, the son of Indira Gandhi, who became PM after his mother’s assassination, and the man who cast off the chains of Socialism. G.D.P. went up to 9%. The middle class doubled in size. In 2017 India overtook Germany in having the fourth-largest auto market in the world and was the second-largest smartphone producer, a position the U.S. had held previously.

Israel is unique in that it is the only country where Socialism actually worked, but only for a short time. It too adopted Socialism from its outset.  The principle that was cherished by the Israelis was that the economy should benefit all of society.  That rings very much like something Karl Marx might have said.  The connection between Jewishness and left-wing ideology is a curious phenomenon.  Marx was an ethnic Jew, although his parents had converted to Lutheranism to avoid anti-Semitism. Jews also have a strong hatred of Fascism for obvious reasons.  Leftist ideology is as far as you can get from Hitler. Most American Jews are Progressives or at least Democrats, but that is not the case in Israel. Israelis now have stong anti-Socialists sentiments in almost everything, especially economics.

It is not surprising that the early government of Israel was left. Israel was born out of creating a homeland for Jews, an idea that came from Theodor Herzl in his book, The Jewish State (1896). There was plenty of motivation to avoid a right-wing Capitalistic style of government. The Socialistic idea that Capitalism exploits the worker, and the only correction is to give the government the means of production to the state as proposed by a landsman, Karl Marx, in his book, Das Kapital.

At first, Socialism was accepted by the Israeli population.  Most of the early settlers in Israel were survivors of the Holocaust and immigrants from the Slavic countries of Europe. Almost all young people worked in collective farms called “kibbutzim,” where people worked for food, shelter, and a small stipend. There was no private property. People ate together and socialized together. Any money they earned outside of the collective farm was given to it.  In 1965 the chickens came home to roost, as they say, and the Six-Day War made things worse. Inflation of 17% took the few perks they had.  Socialism vs. Free Market Economy became a publicly debated subject.  Inflation rose to a peak of 450%.  In 1977 the Likud party won the elections. They were the Pro-Free Market Party. The Nobel Laureate, Milton Friedman, was called in as a consultant. His advice to the policymakers was, “Set your people free!” Privatization followed. “The most successful experiment in Socialism appears to have resolutely embraced Capitalism,” as quoted from a prominent economist.

China is a special case.  It is nominally still Communist.  The government pays lip service to the principles of Communism, but these principles have been laundered ever since Mao Tse-Tung died in1976. The Communist party allows investors, including foreign investors, to buy into state-owned companies, but always maintains majority interest.  There are over 150,000 state-owned businesses that provide jobs for millions of Chinese, but the state maintains control.  China is slowly turning Capitalist but with a Chinese flavor. This has given rise to a large middle class that enjoys the rewards of Free-Market Enterprise. China is another example that Socialism is not the answer.

The Nordic countries of Denmark, Norway, and Sweden do not qualify as Socialist since most of the means of production are in the hands of private ownership. In Sweden’s last election, the Democratic Socialists garnered only 30% of the vote. They, however, regulate wealth accumulation through taxes, but have had to modify their confiscatory rates, as they were causing high-earning productive citizens to leave the country, and they had to trim their public expenditures dramatically, as the country was facing bankruptcy. For the last thirty years, they have fostered a Free-Market Economy with the abandonment of “Keynesian” economics. The current center-right government of Sweden has cut taxes four times, abolished the wealth tax, and eliminated the inheritance and gift taxes. They are now in better economic health than ever!

I cannot talk about Venezuela and North Korea, as they are total disasters that no one holds up as successful Socialist countries.  North Korea’s yearly per capita income is $1,523, which is laughable, if it were not so tragic. Venezuela is not far behind. It ranked last among all 32 countries in the Americas in overall economic health. Cuba used to be one of the most successful countries in Latin America.  It ranked 5th in our hemisphere in per capita income and 2nd, only to the U.S., in car ownership. That has slipped under the magic of Socialism. Two-thirds of Cubans earn less than $100 a month. Household staples are rationed, and their G.D.P. is negative.

In conclusion, Democratic Socialism has no success stories!

Mistakes of the Left

The Left embraces Progressivism, even though I suspect that many of them are not clear what that really means. Progressives that do know, want to advance new ideas that are based on science and technology, or so they claim.  That is what Karl Marx proposed when he wrote the Communist Manifesto, “new ideas based on science.” Many of these new ideas are untested and come from the minds of Marx, Engel, and others who actually never had any formal experience or training in economics, government, social science, or psychology. They just made it up!

Take, for example, rent control, a good idea with disastrous consequences. Landlords are prevented from going above a certain point in raising rents.  As things get more expensive to maintain, landlords stop fixing things, and the building gets run down.  Sooner or later, the building and the neighborhood become a slum.  Another dubious practice is when you send checks to people that are not gainfully employed, fewer people will seek work (think universal basic income -UBI). That is the nature of people, especially if the system is rigged so that you actually make more money not working, and that is not unheard of.

Woodrow Wilson’s administration was the beginning of Progressivism’s opposition to constitutionalism.  Wilson was firmly convinced that individuals are not capable of governing themselves, much less participating in the governance of the nation.  He felt that it required technocrats to make the rules and set the standards.

The Constitution provided for three branches of government, legislative, judicial, and executive, to provide a system of checks and balances to govern.  Progressivism favors technocrats that organize, create, and make the roadmap for us.  The Progressives are gradually winning the war against the separation of powers, not realizing, the more one concentrates power, the more government resembles Fascism.   They, who are the most arduous Antifa, employing many Nazi tactics, are in fact the real Fascists, with their demagogic leadership, extolling the virtues of violence, destroying other people’s property, employing the culture erasing tactics used extensively by the Nazis, such as book burning, taking down statues (book-burning on steroids), and violently attacking journalists that don’t agree with them.

Fascism is a very complex form of leadership that is almost impossible to define because each “Führer” has his own interpretation.  Capitalism has a central theme, money. Communism’s central theme is state ownership and control.  Fascism does not have a central philosophy. It is more of a feeling of national pride, strength, obedience to a strong leader, always a male alpha wolf. It is this charismatic strong-man who steers the ship of state. This “Führer” changes the direction to suit himself and his philosophies. It is because of this that Fascism is different in various countries that have adopted Fascism. For example, with Hitler, the Jews were the main hated enemy that needed to be eliminated.  Not so with Mussolini, who had Jews in his inner circle; even his mistress was Jewish. The Fascism of Francisco Franco’s Spain was entirely different, bringing back the Monarchy and even remaining neutral in World War II. Today’s political strategies have elements of a variety of philosophies, and it is more of a matter of how much Fascism, Communism, and Capitalism we have in each of our systems of government.  It is all on a sliding scale.  Venezuela, for example, has a lot of Communism, almost no Capitalism, and a healthy dash of Maduro’s brand of Fascism. On the other hand, we still possess a lot of Capitalism but are getting more and more Socialistic with very little Fascism, our alpha wolf was voted out of office on November 3rd, and I don’t think anyone would call Biden an alpha wolf. 

Progressives are really Socialists in sheep’s clothing, and they chose to name it “Progressivism” because it sounds a heck of a lot better than “Socialism.” Bernie Sanders is one of the few honest ones that call it what it is. The problem with that is they espouse to control production. This is anti-property and, as a consequence, anti-freedom.  Property and democratic principles go together. A government can’t own and control the means of production without getting rid of capital and those who control it, which includes all of us that have even a small ownership in it. Property and the control of it by individuals are at the heart of liberty. The ability to go out and start your own business is intimately linked to free enterprise, the soul of Democracy.  Capitalism and Democracy are inexorably linked.  

Without property rights, we revert to a kind of feudal system where the individual belongs to the land instead of the land belonging to the individual.  This system is what drove the migration of Europeans to America.  People did not want to be indentured serfs, did not want to worship the God of their Lord, did not want to be dependent on the good intention and whims of the landowner, their Lord. Property gives the individual a stake (skin in the game).  When Stalin collectivized the farms, there was no incentive to grow crops because the state took them all and gave the peasant only a small share of what he had earned with the labor of his own hands. The Socialists depend on “communal ownership,” which means nobody really owns it. If everyone is responsible, no one is responsible. Humans respond to “what’s in it for me.” If we all get the same whether or not we put in the time and effort, we tend to “slack off.” Let someone else do it is a veritable trait of humans involved in groupthink, group work, and communal effort. China learned that lesson.  Once they gave the farmer his own little piece of the land, suddenly, the food shortages disappeared.

Few people know the story of the beginning of American Democracy.  King Charles II gave all the land between the Delaware and Connecticut rivers to the Duke of York, his brother. Land was then parceled out to Lord John Berkely and Sir George Carteret.  The inhabitants were expected to pay rent to the new owners. They explained to the two nobles that they owned the land already and did not wish to pay rent to anyone and certainly did not need a Lord to govern them.  A civil war raged from 1660 for almost a hundred years.  They called themselves the “Freeholders” and named their county seat “Freehold.” They eventually triumphed and outlawed what was essentially Feudalism. Democracy and property rights were born in Freehold, New Jersey, incidentally the hometown of Bruce Springsteen.

The majority don’t want Feudalism, Socialism, Communism, or Fascism either. Woodrow Wilson’s idea that the common man is not able to govern himself is the epitome of privilege of the aristocracy to which Wilson belonged. The central theme of Democracy is that the common man knows better than anyone what is best for him or her, and the majority comes up with the right path for all of us more often than the central committee or the alpha wolf. We do not need technocrats, social engineers, charismatic “Führers,” Lords, Kings, or the Central Committee to govern us and decide what is best for us.  Democracy and Capitalism has a 265-year track record with spectacular success to date. Let’s not fix what isn’t broken.

Socialism has Become a Confusing Term

 

Even educated people have a difficult time defining what Socialism is, and are often wrong.  The root word is Latin, sociare -to combine or share. We need to go back to basics and look it up in Webster’s Dictionary. Socialism’s strict definition, as found in Webster, is when a government utilizes political theory and practice of collective ownership and administration of the means of production and distribution of goods.  THERE IS NO PRIVATE PROPERTY, and the means of producing goods and services are controlled by the state.  There is not one mention in Webster or any other dictionary that mentions any action that helps people in need is Socialist. Somehow help for those in need gets mixed in with Socialism.  I often see in defense of Socialism, the idea that anything that gives aid to those in need, is a Socialistic idea. This has been mistakenly quoted by many, including Presidents of the United States.  Truman was one of those who said in a speech given in Syracuse, New York, on October 10, 1952:

Socialism is a scare word they have hurled at every advance the people have made in the last 20 years.

Socialism is what they called public power. Socialism is what they called social security.

Socialism is what they called farm price supports.

Socialism is what they called bank deposit insurance.

Socialism is what they called the growth of free and independent labor organizations.

Socialism is their name for almost anything that helps all the people.

I must have the wrong edition of Webster’s dictionary because I do not see any reference to social welfare being Socialism. “They” whoever “they” are that called help for the needy Socialist, must have another version of Webster than I have. 

Helping people in need has never been Socialism in the past. Helping people in need goes back quite a ways, even before there was Socialism. Augustus, the Roman Emperor, gave grain to Roman citizens who could not buy it.  In 960 CE, China, the Song Dynasty housed the aged that were homeless.  Judaism, Islam, and Christianity all have organized means of helping those in need, and are not called Socialists.

History reveals the truth! It was actually an ANTI-Socialist effort by the right-wing government of Imperial Germany under Chancellor Otto von Bismarck that “invented” social security, health insurance, workmen’s compensation, and other social welfare programs in an effort to thwart Socialism as a package of his Anti-Socialist Law of 1878.  Making social welfare a Socialist invention was just a clever sleight of hand from the German system that had all the elements of a safety net of income security from “sickness” insurance, unemployment assistance, to old age assistance, that in-fact was the model on which Franklin Delano Roosevelt based the 1935 Social Security Act. Some claim that Bismarck was 65 when he introduced his social welfare program, and we still use that as the standard retirement age, the age medicare starts, and social security payments normally begin.

Because these programs were usually administered by the government, they evolved in the minds of many as Socialist ideas even though they were the opposite.  The real Socialists were quite happy with the Marxist ploy of: “From each according to his abilities to each according to his needs.” There was no reason for governmental organizations that parceled out to those in need because the government, in theory, already did everything.  Looking at the remaining five actual Socialist countries in the world, not one of them has a decent social welfare program. Social welfare and social security are falsely attributed to Socialism, which, as the dictionary says, requires ownership of the means of production and distribution.  Social welfare in the rest of the world does not depend on the government’s ownership of all the property. Yet in all those countries where pure “Socialism” is still practiced: North Korea, Cuba, Laos, China, and Vietnam, the state does own the means of production and distribution.  Indeed everything is automatically government controlled. In many of those countries, they build walls to keep the population from escaping the “worker’s paradise” despite the risks they take in climbing over the walls, and their social welfare programs don’t seem to be working all that well. In the early days of Socialism in the mid and late 1800s, Utopian Socialism even preached eugenics to create the master imperial race, which would make for better workers and better soldiers than the pale, anemic-looking young men of the times.  Only the Nazi branch of Socialists kept that crackpot Socialist tenant, and thankfully you don’t hear of eugenics anymore.

Socialism has several branches.  Utopian Socialism is just an early rendition. Marxist/Leninist is perhaps the most severe form if judged by the number of dead people they generated, but Hitler was a close second. Make no mistake, Hitler was a Socialist by his own admission and actions. I trust my parents infinitely more than what Wikipedia says about Stalin, Lenin, and Hitler and what they were, because they experienced those monsters up close and personal. Just like Democratic Socialism is still Socialism in word and deed. They are all blood brothers linked by who controls the total sum of product and its distribution of a nation and the need to have top-down control of people. To date, in all Socialist run nations, it has been the Central Committee run by a dictator. In order to take ownership of property, one needs guns and control of the military. Ownership is not surrendered voluntarily. The Socialist professors at the universities overlook that oxymoronic factoid.

Every government, regardless of what style of economies especially in Capitalism, provide some assistance to their population in need, be it starving people, banks that are about to close their doors for lack of funds, or workers who lost their jobs because of a global pandemic.  The level of support depends on the generosity of that government, their tax structure, their compassion, and their wealth.  Norway, for example, sits on huge natural gas reserves and can pay for public education up to and including college and professional schools. Sweden also has vast natural resources and can provide the same. Neither country, however, owns the major industries nor the means of distribution of their product, and by definition are not Socialist. The Saudi government can afford a baseline income for every Saudi national, yet no one would call them Socialist even though, in their case, their major product, oil, is under government control, but almost everything else is in private hands.

Socialists have cleverly adopted various unrelated issues that they then trot out and claim as their ideas. If you then disagree with a certain segment, you become a target. Ideas such as global warming, feminism, environmentalism, helping the poor (social welfare), all have different origins not emanating from Socialism.  It does not, for example, make a person who wants to keep the air clean or a woman who stands up for women’s rights a Socialist. It helps to go back to the original dictionary definition of Socialism, stripping away all the ancillary supposedly “Socialistic” characteristics. Socialism and Social welfare are only connected by the word “Social” with little if any substantive resemblance. All the folks that equate social welfare with Socialism ignore or are ignorant of history and how social welfare is practiced in the world by various economic models.