H1N1: Another Update

For those of you keeping score at home:

Paul Donnelly - 1
Dr. Margaret Chan - 0

What has become clear in the five months since H1N1 raised its not particularly ugly head?

1) As predicted, the effected cohort has skewed young.
2) There have been few hospitalizations and even fewer deaths attributable to H1N1.
3) As with 2, this assertion is entirely based on anecdote. Anecdotes from dozens and dozens of hospitals and individuals across the country reported in numerous media. Most of those infected report symptoms indistinguishable from other strains of flu.

"Oh the humanity, the humanity!"

For my regular readers who may be forgiven for asking "why won't he let this go?" and new readers asking "what is he talking about?' (See H1N1: The Rant, 08/19/89.)

I won't let go because of my strong belief that creating needless fear and panic is never justifiable, always reprehensible and a spectacularly ineffective public health strategy.

I also remain astonished that the term "pandemic" refers to some obscure bureaucratic metric that is not related to number of infections, severity of reaction or number of deaths. Really. So the next time you see the term pandemic you can just yawn and turn the page.

Deeds to Make Heaven Weep

A poet can write about a man slaying a dragon, but not about a man pushing a button that releases a bomb.

W. H. Auden

Although I attempt to make them generally thoughtful and well researched, I know that my postings can sometimes tend toward the snide and snarky. This will not be one of those postings. I am fairly resilient (see snide and snarky) in facing the despair and frustration that can be triggered by events around. I am an optimistic person, but sometimes that resilience and optimism are profoundly challenged.

That challenge can come from single momentous event.

For me the most shattering public event of my lifetime was the assassination of Robert Kennedy. I idolized Robert Kennedy and his death came at I time when I was too young to see evil in the world, but old enough to see very clearly what had happened. It was a vertiginous loss.

I have never met anyone of my parents’ generation, not one single soul, who could not say where they were when they heard about the attack on Pearl Harbor and how they heard about it. Or where they were when they heard that Franklin Roosevelt had died and how they heard about it. Sixty and sixty five years later, those events are as vivid as wedding days and the births of children. The memory of those events gained power for having been shared as a culture.

There have only been two such events in my lifetime. The assassination of Dr. King has, I think, gained iconic status and universality over time, but in 1968 our culture was too fractured to embrace his true significance. The two events were the assassination of President Kennedy and the horrors of September 11, 2001.

I was in third grade when President Kennedy was shot, an event that was beyond my comprehension in a literal way at the time. However, in the same day I saw nuns and my father cry. That terrified me. I felt that the most horrible thing that could ever happen must have happened.

There are very few Americans who didn’t see and respond in very personal ways to the events of September 11, 2001, but we also responded as part of a nation with a sense of unity and purpose that it would be a gift to be able to recapture today. My own effort to cope that day was to watch news coverage for twelve hours, watch tape of those planes flying into those towers over and over again. I wasn’t looking for a different outcome or indulging a morbid preoccupation. I was watching for the moment of impact that would suddenly make the whole nightmare make sense. That coin has yet to drop.

Sometimes resilience and optimism can be worn away by an accumulation of incivility and inhumanity.

The so-called “tea baggers,” whether they brought 40,000 or 400,000 people to the mall, reflect a disconnect and a rage that runs far deeper than any of the particular policies they espouse or oppose. They are terrifying for the fissures they reflect and for visceral hostility with which they express them. There is a there there no matter how painful that is for some of us to acknowledge. Americans seem to be an angry people, driven into bunkers with no apparent way out.  Does it really take planes flying into buildings to put our differences in perspective?

I also find that the numerous global and individual horrors reported in the news, today alone, have battered my spirit. CNN headlines for today include: Iran fires long-range missile in latest test, 3 charged with murder in Chicago teen's beating, and Boy says he was held in closet for years. From the intractable to the horrific and unimaginable. Maybe that’s the most debilitating part of all, that these horrors, children killing children and the vilest sort of abuse of children, have become not just imaginable but mundane.

In the face of such a world words feel wholly inadequate. Words can’t describe, words can’t prevent, words can’t heal.

That’s a difficult and debilitating thing for a writer to say and mean.

The first thing we do,

let's kill all the cyclists. (With apologies to Shakespeare’s Henry VI, Part 2; act iv: scene ii.)

A few days ago I was making a right turn from a quiet side street onto a main through street in my quiet Atlanta suburb. The through street seemed too quiet for the middle of the day. After gratefully making my right I looked in my rearview mirror and saw two cyclists, carefully and deliberately occupying the center of the roadway, followed by a long, long, long line of motorists.

I thought at once of a similar journey along Massachusetts Avenue from Union Station to Dupont Circle in Washington, DC. At the height of the evening rush hour I enjoyed being part of a long line of vehicles slowed to a crawl by a single cyclist who was clearly enjoying the inconvenience and discomfort he was causing dozens of motorists.

These cyclists often claim to be friends of the earth as they employ a mode of transportation said to be friendlier to mother earth than the internal combustion engine. I do wonder how the environment is served by backing up and slowing down dozens of cars for blocks on end. Doesn’t this force them to belch their heinous polluting exhaust into the atmosphere far longer than if they had been able to proceed at a reasonable pace?

“Our bikes have as much right to the road as your cars,” these cyclists whine. Well, no. The reason for which most roads from suburban cul-de-sacs to surface streets to the interstate highway system were built (the doctrine of original intent as Mr. Justice Scalia might have it), was to support automobile and heavy truck traffic (Minnesota Department of Transportation, 2004).

Also no, because bicyclists contribute almost nothing to the maintenance and upkeep of roads at any level. Road and highway maintenance is funded primarily by gasoline taxes so unless there is a cyclist lead movement to heavily tax the sale of inner tubes, I’m not sure that bicycles do have the same right to access public roads as the cars for which they were built and that support their maintenance and upkeep. Perhaps toll bike lanes might be an answer?

Granting for a moment the unsupportable proposition that bicyclists do have the same right to access public roads as automobiles, then I must ask why bicyclists are under no obligation to observe laws governing vehicular traffic. Are bicyclists incapable of grasping what it means when the little light in the sky turns red? Or what the letters S-T-O-P mean? Or what lanes are for?

My observation of cyclists’ behaviors and attitudes lead me to offer, some time back, a modest proposal. Laws should be enacted requiring every licensed motorist to carry a handgun. These will be for use on inconsiderate and belligerent cyclists (redundancies, I’ll grant). Not only should there be no penalty for shooting cyclists, motorists should be offered a bounty for every cyclist skin they bring in.

I have come to realize that my proposal just won’t do. Shooting out the window of a moving vehicle is probably as dangerous and distracting as texting or exfoliating by a driver. I don’t want to endanger motorists or their passengers.

Considering the narcissistic, smug, superior conduct that typifies the cyclist and the benefits to society of their eradication, there is too much risk of distracted drivers missing. So I have revised my proposal (with apologies to my sisters) to require that all those who even own bicycles be smothered in their sleep.

This would not only benefit motorists and the environment. Think of how much less stressful urban streetscapes will be when pedestrians need no longer fear dismemberment by bike messenger. Think of how much more enjoyable weekend walks along shaded paths in bucolic parks will be if one doesn’t have to fear being jostled by bicyclists who are incompetent or overconfident. Will anyone really miss hearing the bellowed “LEFT!” followed by the vision of an adult who is not actually competing in the Tour de France whizzing by in a spandex Italian racing costume?

Let’s look for a moment at the other side of the coin. What benefits do cyclists provide to society? What contributions do they make to the world around them? In what ways would their loss be felt?

I couldn’t think of any either.

I’m sure if he were with us today and driving on urban streets, Shakespeare’s Dick the Butcher would agree that lawyers should most certainly be spared over cyclists.

The Threat to All of Humanity: An Update

My esteemed colleagues at CNN Health reported on Tuesday: "Since August, 13,434 cases of the flu have been reported by the 253 schools contributing data to the American College Health Association. Of the cases, there have been 21 hospitalizations." "The flu" meaning the dread threat to all humanity, the H1N1 virus. 21 hospitalizations out of 13,434 cases. That means that .0015631% of those infected have required hospitalization. These kids should be buying lottery tickets.

I am not going to be glib about the death rate. Both represent terrible losses to their families and friends. In 2004, 2,497 young people of college age took their own lives. Anecdote suggests that rate is not in decline. That puts two deaths in 13,434 cases into perspective for me.

It may be clear to even the casual reader that I have strong feelings about the hysteria that has surrounded the marketing of H1N1. I would refer anyone who would like to see how strong to my post of August 19, "H1N1: The Rant."

As a reminder to all, I was particularly offended by the assertion made by Dr. Margaret Chan, Director General of the World Health Organization: "After all, it really is all of humanity that is under threat during a pandemic." Not this pandemic, Dr. Chan. All humanity is under greater threat from a meteor the size of Australia hurtling into the Pacific.

In a Crowded Theater.

""Ma! Ma! Where's my pa? Gone to the White House, Ha! Ha! Ha!"

That slogan was not prepared in anticipation of John Edwards being the 2008 Democratic presidential nominee. No, that scurrilous attack was launched by the campaign of the Republican candidate James G. Blaine against his Democratic opponent, Grover Cleveland  in 1884. It seems that a woman of Mr. Cleveland’s acquaintance was simultaneously acquainted with several of his colleagues. When the inevitable child came along Mr. Cleveland stepped into the breach and offered financial support, as these colleagues were all married.

The Cleveland-Blaine imbroglio raises two observations of contemporary relevance. One, Mr. Cleveland was not married at either the time of his acquaintance with the lady in question nor at the time of the campaign. This left him with no spouse to betray or humiliate. Well might one ask, where’s the sport? Good lord, even Larry Craig had a wife to trot before the cameras.

Two, since the slogan took a man’s decency and kindness and used them to cobble together a venomous and mostly inaccurate personal attack I have to conclude that Blaine’s campaign was managed by the great-grandfather of Karl Rove.

Former President Jimmy Carter recently offered some observations on the context of Congressman Joe Wilson's outburst during the President’s health-care-reform-I-guess-if-Max-Baucus-says-it’s-okay address: “I think it’s based on racism. There is an inherent feeling among many people in this country that an African-American ought not to be president and ought not to be given the same respect as if he were white,”

To be fair, Cleveland was only a candidate when subject to the Blaine campaign's abuse.  Are there examples of non-African American presidents being subject to extreme disrespect?

“Hey! Hey! LBJ! How many kids did you kill today?”

How does “You lie” compare with “Hey! Hey! LBJ! How many kids did you kill today?” on the respect/disrespect-o-meter? I know how I’d vote based on visceral fury of delivery, based on capacity to wound, based on capturing of the zeitgeist. But then, I don’t twitter so perhaps I am missing the piercing, elegant brevity of “You lie.”

“Hey! Hey! LBJ! How many kids did you kill today?”

This was chanted by hundreds of thousands (not 40,000 sad, motley tea-baggers) of (okay, pretty motley) protestors carrying signs full of hate and rage and loathing who surrounded the White House, furious with a man who was wrong, just wrong in the decisions he had made and the advisors he had trusted and who prosecuted an immoral war that ultimately cost the lives of 60,000 members of our armed forces. It is all our tragedy that that war is his most enduring legacy, for Lyndon Johnson did exponentially more tangible good for African Americans and for Americans living in poverty than Barack Obama will ever consider doing but then set aside because it won't be possible to achieve consensus with enough Republicans to arrive at a bi-partisan mandate.

So, Mr. Carter, if things head south in Afghanistan, I will be chanting because I oppose a war and don’t want to see young Americans die the victims of wrong-headed leaders and not because the president is African-American. I have to admit that my great fear is that if things do come to that point, many who oppose the war will not step forward because they won’t want to be seen opposing our first African-American president.

And I did see where you attempted to qualify your NBC remarks, Mr. Carter: “I think it’s unprecedented to attack a president, wishing he were dead, and equating him with animals and Adolf Hitler. That was the point that I made.” Sir, did you spend the years before and after your presidency in some kind of suspended animation chamber? I have personally held signs that were every bit as vicious and personally pointed and that often referred favorably to Hitler before (Nixon/Vietnam) and after (GHWBush/AIDS) your administration.

It seems to me that violently and vehemently objecting to the policies of an African-American president is not inherently racist. Quite the opposite, it is reacting to him as we in a free society are entitled to react to all public figures. Even Joe Wilson.

The president’s press secretary, Mr. Gibbs has made it clear that the White House is determined not to view citizens’ engagement in public policy, however intemperately addressed, through the prism of race. For that I sincerely salute the president. There are too many real issues of racial disparity, prejudice and injustice that need to be addressed in our society to allow this false issue to become a distraction.

Bozo & His Cherished Foes

Pop Quiz –

Who is Marcia Fudge?

Wally Herger?

John Spratt?

Joe Wilson?

You’re one for four on the quiz, I’ll bet.

I’ll return to the one you know momentarily. I picked the other three names at random from the Official Alphabetical List of the House of Representatives of the United States, One Hundred Eleventh Congress.

It seems that none of these poor souls has ever behaved inappropriately on camera. None has unleashed a string of profanity at a child, spouse or staffer. None has had a spouse change residence in the middle of their term. None has even been seen kicking a mangy dog.

How do they ever expect to achieve clout and renown? How will they ever have their fundraising enhanced by censure from their colleagues? How will they ever achieve buzz about higher office or a book deal or an appearance on America’s Next Top Chef, if tape of their misconduct isn’t played over and over and over and over and over and over … again on Fox and ABC/CBS/NBC and CNN or some media outlet people actually watch?

Given their media savvy deficits, I want to briefly answer the “who is” question for the first three members:

Marcia Fudge is a Democrat representing Ohio’s 11th Congressional District. She serves on the House Science & Technology and the House Education and Labor Committees. She is in her first full term, having been elected to fill the remainder of the term of the late Stephanie Tubbs Jones in November 2008.

Wally Herger represents California’s 2nd District. As a Republican, he is the ranking member of the Health Subcommittee of the House Ways & Means Committee. This is a man upon whom our President would undoubtedly love to do a full Lyndon Johnson.

John Spratt is a Democrat representing South Carolina’s 5th District. He is the CHAIR of the House Budget Committee. Yes we’ve all heard of Bozo the Clown. I wager you can tell me the state if not the actual district he represents. That would be the 2nd. It is directly south of the 5th. Still few of us have heard of Rep. Spratt who arguably has more impact on the course of our daily lives than our mothers.

So thanks to his rudeness and violation of House protocol Bozo has raked in over a million dollars. Can’t beat bad press if you’re a right wing zealot. Now Bozo is clearly a flavor of the week so his renown and fundraising prowess should decline pretty rapidly (I give you Joe the Plumber) as a new flavor of the week predictably emerges. Unless the Democratic caucus does as the Democratic caucus seems hell bent on doing and censures Bozo for his outburst.

This will be the most useless sort of political grandstanding, it will send either side scuttling back to their base while accomplishing nothing. At best, the Democrats will appear like a prissy, constipated, purse lipped seventh grade teacher shrieking, “This … this will go on your permanent record!” We all know how much that meant and so does Bozo.

But Bozo’s base will be able to carry on as though some grievous injustice has been perpetrated and that Bozo is a hero and a martyr. Not a martyr as in arrows and a loincloth or being stoned to death or flayed alive, but martyr in the sense of “click on donate and send what you can today.” Or, I’m a martyr now, no more flavor of the week for me. Martyrs have staying power.

Why can’t the Democratic caucus see that if they stiffle their ersatz outrage, ignore Bozo and move on with the business of the House, that the media will quickly grow tired of Bozo and he will fade back into the grey legion of ill-mannered Republican back-benchers? Back benchers who follow an equally ill-mannered leadership.

If the Democratic caucus needs to censure someone for his conduct during the President’s address, I commend to their attention Eric Cantor. Censuring Cantor would send a valuable signal to all Americans that texting or otherwise attending to a devise while an actual human being is in the room speaking to you is completely unacceptable and worthy of the highest censure.

I could then be prevailed upon to send a generous donation.

Bartleby, the President.

In Herman Melville’s brilliant, if rather odd, short story, Bartleby, the Scrivener, the title character responds, I would prefer not to to every request that he take action no matter how trivial, no matter the source. The 24 hours that have elapsed since the leader of the free world delivered his remarks on revising the nation’s health care system have done nothing to abate my feeling that I had listened to Bartleby the President.

Let it not be said that the leader of the free world can’t build a smokin’ cadence. Let it not be said that the leader of the free world doesn’t know when to go up in volume and when to come down. Let it not be said that the leader of the free world can be beat for oratorical flourishes when he and his teleprompter are in sync.

Never let it be said that the leader of the free world is going to let his soaring rhetoric be bogged down with substance. Clearly, he would prefer not to. This is a man who was for the public option before he was against it. In the same speech. (Hint to my fellow progressives, or liberals as we were known when I was a boy, enjoy the view from under the train because that’s where we’ll be riding for the next 3-1/2 or 7-1/2 years. And the public option was just the beginning. I give you no federal dollars will be used to fund abortions.)

I am authentically surprised that even Joe Wilson could have topped the laugh that followed, And while there remain some significant differences to be ironed out … as the defining moment of the speech. At the time I thought it could potentially be the defining moment of the presidency. At another point in his remarks, the leader of the free world spoke critically of cynicism. Yet what could possibly be more cynical than to introduce a “plan” with significant differences yet to be ironed out a month after his initial deadline for congressional action? Might the time to offer a plan have been three or four months ago? Perhaps he preferred not to.

The plan, its timing and its lack of specifics were not the most egregiously cynical aspects of the leader of the free world’s remarks. He made his most cynical point several times, among them:

Second, we've estimated that most of this plan can be paid for by finding savings within the existing health care system, a system that is currently full of waste and abuse ...

Or …

The only thing this plan would eliminate is the hundreds of billions of dollars in waste and fraud...

Or …

Reducing the waste and inefficiency in Medicare and Medicaid will pay for most of this plan.

Waste, abuse, fraud, inefficiency … these are the last refuge of the demagogue. The other hallmark of demagoguery being a certain facility for public speaking. Waste, fraud, inefficiency and abuse do exist, but I don’t believe that calling for their elimination as a funding mechanism is any more effective than proposing harnessing unicorns to replace fossil fuels. I am willing to wager that when Lucius Tarquinius Collatinus addressed the Roman Senate in the sixth century BC he called for eliminating waste, inefficiency, abuse and fraud to pay for public works projects. I would not be surprised to learn that in the election of 1800 Adams and Jefferson pilloried one another for the waste, abuse, fraud and inefficiency that blighted construction of the new capital city.

At many points in the national debate over reforming our health care system a committed and responsible leader of the nation or even his party might have chosen to offer a plan that he was willing to own, a plan which enumerated specific mechanisms for achieving its stated goals, a plan that offered realistic cost estimates and honest strategies for how to meet them.

President Obama clearly preferred not to.

Oh happy day!

I don’t know why it has taken so long for this to come to my attention, but the August 9 edition of TIME.com contains an article by the evidently brilliant and insightful John Cloud called “Why Exercise Won’t Make You Thin.” (http://www.time.com/time/health/article/0,8599,1914857-1,00.html)

Take a moment, as I did, to savor the concept. Let the mix of delight and relief wash over you as it washed over me.

Notice the delicious absence of doubt. This is no namby-pamby “can exercise make you thin?” The underlying premise that it won’t is here a given.

Oh that we had known this truth for the past 50ish years! The abuse I took from Coach Earhart and Coach Jasper! (You think I could forget their names?) The hours I jogged. The gyms I joined. The Jane Fonda Workout Tapes (no, really). The goddamn Marine Corps Marathon!

And for what?

"In general, for weight loss, exercise is pretty useless," says Eric Ravussin, chair in diabetes and metabolism at Louisiana State University and a prominent exercise researcher.

"In general, for weight loss, exercise is pretty useless," say it loud and there’s music playing,
"In general, for weight loss, exercise is pretty useless," say it soft and it’s almost like praying,

My man John … May I call you “my man,” John? … Later in his canonical article observes:

Exercise, in other words, isn't necessarily helping us lose weight. It may even be making it harder.

I would do a little happy dance, but I don’t want that much exercise to ruin my diet.

Lest Dr. Ravussin’s LSU credentials seem a little second tier, I give you Harvard:

"The most powerful determinant of your dietary intake is your energy expenditure," says Steven Gortmaker, who heads Harvard's Prevention Research Center on Nutrition and Physical Activity. "If you're more physically active, you're going to get hungry and eat more."

I’ll be right here on the sofa, watching HGTV while watching my weight.

Integral to the whole wrongheaded premise that exercise benefits weight loss (No it doesn’t. No it doesn’t! Ha, ha, no it doesn’t!!), is the assertion that “muscle weighs more than fat.” As I never tire of explaining, gently, to my loved ones, that’s idiotic. A pound of muscle weighs sixteen ounces, while a pound of fat weighs … ah … um … sixteen ounces. I will let Obesity Research shoot down the point this crew may be trying to make:

…, a pound of muscle burns approximately six calories a day in a resting body, compared with the two calories that a pound of fat burns. Which means that after you work out hard enough to convert, say, 10 lb. of fat to muscle — a major achievement — you would be able to eat only an extra 40 calories per day, about the amount in a teaspoon of butter, before beginning to gain weight.

I was with them right up until “a teaspoon of butter.” Who would eat a teaspoon of butter? I just went to the kitchen to measure. It would take four or five teaspoons of butter to cover half a baked potato. Just like doctors and auto mechanics and colorists, these science people would be a lot better off if they spoke in ways that reflected real people’s lives.

And I know exercise isn’t the only problem. I’ve been down the “I need more butter on this cheese, I’m on a diet” route. It was the only time I had a doctor call me an idiot to my face.

Exercise does have demonstrated benefits in alleviating and preventing any number of health problems. So? Does anyone exercise for health? No, really. I’m sure people say they do, but what’s the real skinny?  Are the grim and drawn faces atop the Stairmaster there for their health? Do the red-faced and grunting power lifters grunt for their health? The brightly-colored wide-hipped step aerobecizers? The huffing spinners competing with the air?

Health, my ass. 

But like this post, John’s article isn’t just about exercise or weight, it speaks to universal themes:

In 2000 the journal Psychological Bulletin published a paper by psychologists Mark Muraven and Roy Baumeister in which they observed that self-control is like a muscle: it weakens each day after you use it.

Self control weakens after you use it. This is a principle that has long guided my life. I am on a perpetual quest to conserve my self-control. I practice this conservation at the mall, as well as at the buffet table. I apply it to all my appetites with equal rigor. I think you will find great benefit in being as sparing with your self-control as I am with mine.

Doing Larry King

Well not “doing” in the frisky sense.

I'm so pleased to have that image in my head.

No what I meant was just vomiting out a string of poorly punctuated free association. Well, not vomiting ... too late, that filly is out of the chute.

My salute to the Kingster will take the form of an enumerated list:

1. Was Ted Kennedy the Michael Jackson of politics, or was Michael Jackson the Ted Kennedy of pop?
2. For a few hours I thought Farrah was robbed, then I realized that Michael saved us from weeks of Alana Stewart and Ryan O’Neal.
3. Please somebody; anybody beat Roger Federer in the Open! Even Tiger Woods has the grace to lose occasionally.
4. Is there a statute of limitations on the “youthful,” when candidates for public office are distancing themselves from “youthful indiscretions”? “Maybe I did write that stuff about the Jews in my thesis at Hermann Goring U., but don’t judge me on a youthful indiscretion judge me on the arc of my public career. I haven’t desecrated a synagogue in over 20 years!”
5. And since when was 34 youthful?
6. It’s easy to say $20,000 for a kidney is a bad thing when you have a job!
7. Whatever became of Barack Obama?
8. And how painful were the past six months for anyone who supported him before June 7, 2008?
9. Or were all those giddy campaign rallies just a string of youthful indiscretions?
10. Where is the Body Magic for men? We’re every bit as tired of diet and exercise.
11. Why is it easier to get sprung if you're a member of the Manson family than to get justice if you're a member of the Norfolk 4 or the Jena 6?
12. Are the Yankees on top of the AFC East? Do they currently have the best record in baseball? This is what is meant by the natural order of things.