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THE POWER OF “THANK YOU”

May 27, 2012

Richard DeBernadis founded El Tour de Tucson, a nationally known bicycle race, nearly 200 km around Tucson.  There are 3 shorter races, too, and a kids race.  Every November, the Saturday before Thanksgiving, El Tour takes place, rain or shine, often with wind.  One year it snowed.  And 5000 people showed up.  I was there one year with a starting temperature about 0 C., And 10,000 others were with me.

The Perimeter Bicycling Association of America (PBAA), which encourages riding around things, like cities or mountains, sponsors several events a year.  When I rode, I did all of them, including the Cochise County Classic, where I did the second longest ride (270 km) one year, in 8 hours and 20 minutes.  I was sixth.  Twenty of us rode.  It was an incredible experience.

The Tour of the Tucson Mountains is a late April event. One year, when I rode as Bike Patrol, Richard saw me before the race and asked if I could direct traffic at a “T” intersection, showing people where to park, to free him up.  Richard is a lot more important than I, so I directed traffic that year and the following year.  After my last bike accident, I gave up riding.  I left the cycling community.

But each year, for 2 hours one day in late April, I get up at 3:30 a.m., drive to Marana, and direct traffic.  As the cars come by, sooner or later Richard shows up, and for a brief second, his arm comes out the window, he shakes my hand, and says four words:  “Thank you so much.”

That action and those words are why I still volunteer, although now the race has been cancelled.  I directed traffic for eight years.  Richard thanked me every year, for two measly hours doing something anybody can do (although I was pretty good at it!)

For nearly a decade, I volunteered in the public schools.  I did so, because I strongly  believe in public education.  My parents were  both educators in public schools, and I believe strongly in Horace Mann’s six principles.

I stopped volunteering, primarily because I wasn’t busy enough, and I found, quite by accident, that I could have more influence if I became a substitute teacher.  Perhaps that is because when you charge for your services, it appears (I can’t prove it, but it sure does appear) that your services are more valuable.  I got thanked more as a well-off practicing physician than I did as a doctor on a Navy ship, one of those “government doctors,” who took care of 600 people, who got their care for free, often alone in a three quarters of a million square nautical miles of ocean.  And yes, those numbers are correct.

It was interesting.  The one teacher who really didn’t need me, for he was so good with students, always made it a point to thank me for coming and how helpful I was.  Others were different:  in one class, I volunteered during lunch, so the teacher could eat in the teacher’s lounge, have some privacy, and still offer tutoring.  She never once thanked me.  In another school, I got thanked once in a year by a teacher, for whom my presence on the day I came allowed him to do other things while I answered questions the students had.  Another teacher thanked me three times that year.  People are busy, but the busiest teacher was the one who thanked me each time I came.  I don’t think that is a coincidence.

I volunteered because I love teaching, and I am really good at math.  Indeed, I could offer areas where math is used outside the classroom, where many teachers could not. Being older, I had a little other wisdom to impart as well, about how to take tests, what to study, and what to ask.  Being thanked is one of those things in life that can’t be asked for, like love.  It has to be spontaneous, or it is meaningless.  Some people don’t particularly care whether or not they are thanked; I do.  I dress informally, and I am informal about what people call me.  But I am exceedingly formal when it comes to manners and grammar.

Thanking people, especially when they are thanked for specific actions, are very powerful.  Richard knew that.  I learned it when I was a child.  So did my only cousin, who married a Swiss ambassador and lived all over the world .  ”Please and thank you go a long way in any language,” she once told me.

Indeed, specific comments at the right time are incredibly powerful.  I was one of three people to send a sympathy card to a prominent nurse, whose husband died in a flash flood in the Rincon Mountains in 1978.  I must have shown surprise on my face, because her next comment was that she thought that people were afraid of death.

When I send sympathy cards, I always try to add something specific about the person.  When David Goldblatt, the editor of A Wise Owl, on this blog and the best thing I ever wrote, thanks to him, died, I wrote his widow and told her how much David meant to me and the specifics of our relationship, things she did not know.  She later wrote me and said of all the people who wrote her, and David was one of the most well-known neurologists in the country, those words from me meant the most to her.

I have kept every thank you note a patient every wrote me, and some of them are now 40 years old.  I seldom look at them, but I am not about to throw them out.  They mean something, during those days when I am hammered by my detractors or wonder why I even bother.  In my case, one harsh criticism can ruin a day….or a week. But one really good thank you note can make my day.  It has to be from the heart, and it can’t be forced.  I’ve known people who overuse them.  But I’ve learned the power of the right words at the right time, and if I can learn this, so can others.

Richard DeBernardis knows that I came back because he thanked me.  I was sure to tell the PBAA how much his words meant to me.  I’m sure he knew they did, but my making sure he knew probably made his day.  He made mine.

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ARE WE FIGHTING A WAR ON SCIENCE?

May 24, 2012

I have become very discouraged lately.  We appear to be fighting a war on science even as we enjoy the tools and the improved health science has given us.  Without doubt, I would be dead if it were not for science.  I had strep throats when I was younger, and without penicillin, I likely would have had rheumatic fever and rheumatic heart disease, the surgical treatment of which back then was far less effective than it is today.  In 20 years of practice, I never once saw rheumatic fever.

We have a vaccine rate that in Arizona is scary.  About 85% of public school students are vaccinated; 50% in charter schools.  There are many, who are convinced vaccines cause autism, because of the Thimerosal in the vaccine.  This has been disproven.  Indeed, some of the research stating such was shown to be fabricated.  A recent guest on Science Friday said she did not vaccinate her children, in part because they get a third more vaccines than people like me did.  Is this wrong?  If so, do we have good data and a good analysis of those data?

Let me talk about the past…60 years ago.  Back then, we had iron lungs for polio victims (my brother had polio), and kids didn’t spend summers in crowds, because we were convinced we would get polio, we were so scared.  Today, at a clinical pathological conference in the United States, asymmetric paralysis of a limb might well be misdiagnosed, for polio is so rare.  The Salk Vaccine trial was stopped early, because it was so effective.

We don’t need vaccines, some say, because these diseases are no longer present.  They are not present because we vaccinated against them.

“UCD”–usual childhood diseases–used to be on a patient’s chart.  What are the usual childhood diseases?  I had rubella.  When was the last time somebody saw a deaf child, because the mother had rubella during pregnancy?  My wife has a cousin, who lives with his mother as an adult, because his mother had rubella during pregnancy.  Today, if we vaccinate against rubella, we will never see this happen.  Rubella is a very mild disease, and it is possible not to know one is ill.  I had rubeola (measles), and I can still remember the dark room and the sickest I have ever been.  Measles kills 1 in a 1000 people and is extremely contagious.  It is now news when there is a small epidemic.  When I grew up, everybody had measles.

Varicella, or chickenpox, was a rite of passage, a time one had to stay home from school but felt perfectly fine.  Mumps caused orchitis, or testicular swelling.  When was the last time one saw a person who had mumps?  My other brother had mumps meningitis.

Hemophilus influenzae meningitis was a common disease in young children.  What happened to it?

Diphtheria killed thousands in my parents’ generation.  In 1972, Native Americans on the Crow Reservation were still getting it.  I know.  I was there.  When was the last time anybody heard of a case in the US?

Pertussis affected my mother.  This disease has lately come back, often in adults, and has caused deaths. That scares me, because this disease may be eliminated, as we have done with smallpox.  I have a smallpox vaccination scar; most Americans do not have one.  I saw one case of tetanus in my life….in Malaysia, when I was in the Navy.

Do we really want to take the chance these diseases will come back?  Maybe I am wrong, so I will make a prediction.  In Arizona, there will be a major epidemic of a preventable childhood disease in the next 10 years.

Science gave us safer automobiles.  We have a death rate from motor vehicle accidents half of what it was in 1980.  This is due to several factors, but seat belts and airbags have been the major ones, along with a push to decrease drunken driving, better highways, and better automotive design.

Science has given us better food safety, too.  We don’t see brucellosis from unpasteurized milk, although there are many who drink it and want the right to do so, as espoused by Ron Paul, during his campaign.  Prediction #2:  we will see at outbreak of brucellosis or milk-caused tuberculosis in the next 10 years.  I can be wrong, so I think it is only fair I make predictions….and hope I am wrong.

Science gave us better aviation safety.  When I grew up, airliner crashes were frequent.  We have often gone years without a major commercial aviation accident.  There are many factors:  Doppler radar, knowledge of windshear (change in wind direction with altitude), and the ability of pilots to safely report mistakes without retribution are among them.  Doctors would do well to learn from pilots; my medical safety reporting system was drawn up 11 years ago and went nowhere.  We don’t know how many people die from medical errors, but four members of my small family have suffered from their consequences.  The crash on Mt. Weather in the 1970s occurred, because pilots did not realize where the summit was on the approach to Washington, D.C.  Six weeks earlier, pilots on another airline noted that the summit was a potential danger point.  Because there was no safe way to report that fact, nearly 100 people died.  That issue is no longer present–in aviation.

Science has given us the ability to look up things we want to know about.  I remember encyclopedia salesmen and still have Bartlett’s book of quotations.  Why do I need it?  If I want to know something, I go to the Internet.  The problem with the Internet is that one can find any counterargument to any topic, because there is no peer review.  All technology has a downside.

Science has given us evolutionary theory, which has been politicized (court cases as to whether it should be taught in school would to me qualify as politicized), which over time has better–not worse–explained how we arrived on the Earth.  Our DNA is nearly 99% in common with some primates, and yet we still have a large number of people who disagree that we evolved.  For the record, we did not descend from monkeys; we descended, the evidence shows, which to me appears sound, from a common ancestor to both of us, that no longer exists.

The vast majority of climate scientists have concluded, with high confidence, that man has caused climate change and warming of the Earth, both terms must be used.  Instead of a fair discussion of the data, this issue has become one of the most polarizing topics I can think of, and it is sad.  I wrote a column on the subject for the Medical Society, when I was an invited writer, and I got absolutely hammered in the letters column.  I did my best to argue from facts, and try not to get caught up in the personalization of the arguments, which is so easy to do.

Here are some of the facts that I have looked at that helped me make my decision.

The Earth is clearly warming, we know that from long term trend analysis and we know that from the fact that nearly all (there are exceptions) glaciers are retreating, and the ocean is rising 3.2 mm a year (from satellite measurements, which is astounding that we can do that).  A recent downturn was explained by flooding in Australia and Amazonia.  The Earth goes through cycles of warming and cooling, so there have been questions raised as to whether this is cyclical.

Carbon dioxide levels have risen since the Industrial Revolution.  We know this from ice core analysis, and we are dealing with CO2 levels that have never been this high in the history of mankind.  In addition, the oceans are acidifying at a rate not seen in the past several million years.  The oceans are buffering CO2, but nobody knows for how long they will do so, or what the current 30% increase in hydrogen ion concentration will do to shellfish, coral, and a million other species in the ocean.  CO2 is a potent greenhouse gas, although water vapor is more common, and it would seem reasonable to think that this is the cause.

Correlation is not always causation, but it can be.  Tobacco correlated highly with lung cancer, and this was enough to remove advertising from TV (yes, that once occurred).  When carcinogens were discovered in tobacco smoke, then the correlation became causal.  The high correlation of [CO2] with global temperature rise to me is strong evidence, given that CO2 is a greenhouse gas.

Around the world, people are seeing climate changes they have never before have  seen, especially in the high latitudes and high altitudes, where the changes are much greater.  If the permafrost melts, methane, an extremely potent greenhouse gas, will  become a factor.

Is this a certainty?  No.  But there is high confidence such is occurring.  Do we assume it is wrong?  We have to balance the risks of changing our lifestyles with the risk that climate change is truly occurring.  If we are wrong on the front end, we have spent money we didn’t need to spend to change how we get our energy.  On the other hand, an oil or coal driven economy cannot continue indefinitely.

If we are wrong on the other end, we have changed the planet, perhaps irrevocably.  I think Americans who argue climate change should use Fahrenheit and not Celsius, so as to honestly keep the numbers fair.  Celsius is 55% of Fahrenheit, and 3 C. does not sound as bad as 5.4 F.  Warming of 1.4 F. of the Earth, which has occurred in the past 130 years, is not insignificant.  A month 1.4 F. warmer than normal is quite noticeable to people.  A month 6 F. warmer is a record.

What I do not understand is why Americans, almost alone in the world, have such low percentages of belief that climate change/global warming is occurring.  Only 12% are “alarmists,” to quote a poll, and roughly the same number are at the opposite end.  Most of the middle is concerned, but think we have a lot of time.  Interestingly, about 90% of  Europeans believe in global climate change.  Are we smarter?  Educational results wouldn’t seem to agree.  Is it because we live in a temperate climate, where we don’t see the changes, and many Europeans live at a Canadian latitude?  Why has this issue become politicized?  I simply don’t know, but on Facebook and among people I am around,  the issue is incredibly polarizing.

In part, I wonder whether it is because science education has become poorer in this country.  More people believe in astrology, which has been soundly shown not to be the true, then know why we have seasons.  My late father edited two high school science books 60 years ago, and his explanation of seasons is still the best I have ever seen.  Many of us cannot find Polaris, although uneducated slaves on the Underground Railroad knew it well, as they fled north 150 years ago.  Only a minority know what a year represents.  Many do not know how to compute the doubling time of money (72/interest rate), feet per second a car goes at 60 mph (88), number of feet in a mile (5280), or the weight of water (8.3 pounds per gallon), the latter of which perhaps explaining why so many people get in trouble, when they try to cross running water in an automobile.  All of the above have everyday applications.  Science works, and its predictions in many instances may be verified.  Perhaps that is why there is so much resentment of science; it predicts things–bad things–accurately.  Carl Sagan called science a “candle in the darkness,” a statement I particularly like.

I was asked to debate this issue in the medical society and declined to debate. Doctors would do well to debate how we are going to improve health care access and quality, not climate science.  Yet many of my colleagues do not believe in evolution, which I have to admit I find astounding, given the evidence.  Then again, many believed surgery on asymptomatic carotid artery stenosis was beneficial, even when the data overwhelmingly showed it was harmful where I practiced.  I was unable to change something where we had clear, easy to understandable data; I don’t expect I am going to change something where the data are less understandable.

Lately, the hot button issue has been calling the issue climate change and not global warming.  That puzzles me.  Climate change occurs when our cities absorb so much heat that the nighttime temperatures rise and rainfall patterns change.  Climate change occurs when dust from Chinese coal plants lands in the Rockies, and the absorption of sunlight causes an early melting of snow and a change in runoff.  Climate change has occurred when 3/5 ths of the bird species in the Christmas Bird Count have the center of their range at least 160 km (100 miles) further north.   Climate change occurs when there are major changes in rainfall patterns.  Climate change occurs when a long standing lake in Gates of the Arctic National Park can no longer be used as a landing strip, because it is too shallow, from melting of the permafrost.  Many, many Alaskans are well aware of climate change.

The fact that nearly every climate scientist believes we are changing the climate does not, of course, mean they are right.  Science moves in fits and starts and is not based on what the majority believe.  It would appear, however, that the science behind the discussion is, if anything, under-predicting the severity of the issue.  A recent article I reviewed on Facebook used regression to show the Earth had cooled since 2002.  The regression line was not significantly different from zero, and the assumptions underlying the regression were not met.  That alone did not disprove climate change, of course, but all data used have to be subject to scrutiny by both sides, and poor data needs to be removed from the discussion.

Could my mind be changed?  Yes.  If my own city had 2 years in a row with normal temperatures–even 1 degree above normal would be acceptable–I might rethink my position.  If the Arctic Ice Cap increases in size every year for the next decade, the global temperature falls every year for the next decade, and the ocean rise stops, I would rethink my position.  I would have to.

The questions I do have are these:

Can you argue your position without personalizing it?  This is extremely difficult, but the subject is climate, not Al Gore, cap and trade, big government, conspiracy theorists or environmentalists.  It is about science.  I don’t think it is fair to state the numbers of scientists who believe there is no climate change when the vast majority do believe.  But again, science is not about majority rule; it is about facts and interpretation of facts.

Can you offer statistical evidence that shows confidence intervals that include zero (no change) or fail to include zero (a change), a p-value >0.05 (or any other value you think is worthwhile).

Can you state what it would take for you to change your mind, so that you are offering predictions as to what is going to happen to the climate?  This way, we can test your predictions versus other predictions.  If nothing will change your mind, then it is senseless to discuss the subject.

Can you state fairly what will happen to the Earth should you be wrong?  If you reply you cannot be wrong, then you are saying you can predict completely accurately the future of a complex system that we do not completely understand.  Nobody I know can do that.

It is high time we approached this issue sensibly, using the science that brought us vaccines that saved my life, transportation and food safety that keep us alive, moving and comfortable, and technology that makes our lives so much easier.  Science was at its best with Hurricane Irene last year.  With time, the models were revised and revised, so that the predictions were better and better.  If instead, we choose a path that Governor Rick Perry chose with Hurricane Rita, to pray that it stop and turn around, we are going to kill a lot of people.  We can choose to have an honest look at the science behind global climate, and look at the models, or we can choose a path that Congress did, passing a resolution, which denied climate change.  Resolutions don’t affect the climate; many factors do affect it, and we know many of them.  Right now, most scientists believe the factors are significant.  If they are wrong, we should know fairly soon.  The problem is that if they are right, then by the time there is convincing evidence for every person, it is going to be too late.  I guess that puts me in the “alarmist” camp, and I really want to be  in the “I was wrong” camp, hearing, rather than saying, “I told you so.”

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WE NEED JOBS–STEVE JOBS

May 7, 2012

“The difficult we do immediately. The impossible takes a little longer.” (Seabees)

Years ago, as a young neurologist, I made a midnight call to Detroit to tell a mother her beautiful 21 year-old daughter would not survive a rollover accident.  I can still hear the screaming “NOOOOOOO”. I treated uninsured young men who were severely brain-damaged from motorcycle accidents, some existing years in nursing homes.  I saw families torn apart by conflicts over what an elderly member with irreversible brain injury would have wanted.  Preventable deaths, high cost care without insurance and too few people with living wills are among the many flaws of our medical system.

It’s shameful.

The most important function I had as a physician was not curing patients but knowing when it was time to stop treatment and to allow people–including my parents– to die with dignity. If the Supreme Court or Congress overturn what is best called “Romney-Obamacare,” these issues–insufficient preventive care, uninsured young people, not enough advance directives– will return in full force.

Health insurance has been far from optimal: pre-existing conditions, lack of portability, lack of choice, changing rules, and a pharmaceutical morass come to mind.  Yet, without it, care is unaffordable for almost any significant condition.  Why should a 25 year-old become bankrupt if he develops appendicitis?  How does a single mother pay for her child with meningitis?  What about the unlucky young father with metastatic cancer?  Do we let them suffer or die in pain? Do we allow uninsured motorcycle accident victims to die at roadside?   Without doubt, we waste money in medical care: executive salaries, not learning from errors, and not applying current knowledge are just three examples.  Expansion of Medicare to cover pregnancy and children under 10 would be a good investment, and the bill would be a lot fewer than 2700 pages.

This years’ election is about all 3 branches of government.  We can choose to keep defense well funded and cut decades-old safety nets.  We can make changes to health care unconstitutional for the next half century, for the next presidential term will likely see 2 or 3 Supreme Court vacancies. I’m hoping we will find a Steve Jobs for medical care: someone who will push us to do great things we never thought possible.  Will fixing the system be expensive?  Yes. So was Iraq.  Will some think it not fair?  Yes.  But remember this:  each of us is one aneurysm, one drunk driver, one blocked vessel, one virus, and one malignant cell away from medical catastrophe.  Insurance is about all of us, for we are all, at varying levels of non-zero probability, at risk.  I am fortunate to so far have been healthy.  Most of the less fortunate are not lazy.  Many are women and children, unlucky, poor, and ill.  Each of us is a catastrophe away from joining them.

If we elect those who take us backward, suicide by poverty or suicide by ill health will join suicide by cop as part of the lexicon.  Perhaps, as Scrooge said, that will decrease the surplus population.

 (submitted to the Arizona Daily Star as an opinion piece)

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RESIGNED TO MY FATE

May 1, 2012

I just resigned from my column “Reality Check” in the medical society magazine, Sombrero, after nearly a decade of writing.

I wrote about 80 columns during my tenure, and it is sad that I will write no more.  The writing made me better, for one needs to practice to write well.  And that is the primary reason I left.  There is now a counterbalance column, so to speak, to my  column.  The primary issue is not that the writer has a far right wing perspective, but that he writes poorly.  The magazine deserves the best writing possible.

This individual had his first column published a few months ago, and I was not told, as an invited columnist, that he would be a regular.  That was unfortunate.  The first column  was about climate change being not true, using evidence from 3 cold days last winter and a cold winter in Iceland as examples.  This to me showed an inability to distinguish climate from weather.  At the same time he wrote, northern Scandinavia experienced temperatures nearly 13 degrees F. (7 C) above normal throughout the autumn, and while I won’t say the presence of Sandhill Cranes over winter in Nebraska is due to climate change, any more than 3/5s of the bird species in the Christmas Bird Count have the center of their range at least 160 km (100 miles) further north, it is suggestive. Nearly every climate scientist thinks manmade climate change is occurring, and most of those who don’t believe the Earth is warming.  Those who believe neither are truly on the fringe.  Of course, the fringe might be right, but everything we are seeing suggests under predicting of the effect.  It isn’t just warming, it is the rapidity at which it is occurring, that is an issue.

Conrad Anker, the world famous climber, who is going to take a group of physiologists up Mt. Everest, says the change in the high altitudes is incredible.  Routes that were snow covered 35 years ago no longer are.  I can speak to changes in the high latitudes.  As Mr. Anker put it, if one plays golf in Kansas, one doesn’t see climate change.  But if one is at high latitudes or elevations, or happens to live in the Seychelles or Bangladesh, where the oceanic rising is occurring, it is another story.

The writer was in favor of drilling in the Arctic National Wildlife Refuge (ANWR), calling it a “god-forsaken place” where only “Birkenstock clad hikers go.”  I have been to ANWR twice, I think it is one of the most beautiful places on Earth, and I fail to see what hikers wear (I don’t have any Birkenstock outfits) has to do with climate change.  How much oil is in ANWR is a controversial subject; what is clear is that we should use every conservation method possible before even beginning to consider drilling in what many call the “American Serengeti.”

The editor of the magazine is libertarian-right wing, and has consistently argued many times about what I have said, yet he did not check these climate statements out.  The heat island effect is the simplest proof of manmade climate change; the rapid acidification of the oceans (pH has fallen 0.1 unit, which is nearly a 30% increase in hydrogen ion concentration) is a quiet problem that is going to devastate world food supplies, should there be an interaction between acidity and oceanic warming, which many scientists feel there is.  An interaction means that the sum of two variables is greater than simple addition.

Today, the new writer’s fourth column appeared; 8 column inches longer than mine, rambling, and with false statements, such as he paid $500,000 into SSI, when the current rate is about 5% on $106,000.  He said it would take him until age 137 to get that money out, when in fact if he started at age 70, it would take him 17 years to obtain $500,000.  This shows a lack of attention to detail, unwillingness to check important numbers for validity.

Edmund Burke once said, “All that is necessary for the triumph of evil is that good men do nothing.”  I have done plenty, without much to show for it.  In any case, it is up to the medical society to decide whether they want a writer who writes 1200 words of vitriol and doesn’t check facts.  It is not up to me to respond.  I will continue to post on my blog, where I will fire salvos when I think necessary, but pay attention to detail as well.

Would I return?  It is difficult to say.  I would have several requirements, and I don’t see any of them being met.  I am leaving quietly, with no fanfare, no final column, no goodbys.  It is the same way I will be leaving Tucson, when the time comes, now getting sooner.  I will leave quietly with no fanfare and goodbys to perhaps five people.

There are few things worse than staying too long, be it as a guest, a writer, a worker, or a sports star.  The best stop sooner, rather than later.  I won’t say I am the best, but I think I made a few people think.

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BWCA, 2012. TRIP 60. SOLO TRIP 20.

April 29, 2012

I needed to get my head on straight.  Really.  I am one of those who needs to get into the woods, the wilderness, or take a long hike periodically.  How long I can go in between varies.  But I know all the signs.  I get angry easily, I am short-tempered, I get upset at minor issues, and there is a part of me that says “get away from all of this.”

In 2006, we established a scholarship in our name at Vermilion Community College, a 2 year school in Ely, MN, on the Iron Range, at the end of the road to the Boundary Waters.  VCC students live on the edge of the wilderness….and poverty.  I was at the age where leaving a legacy–the woodpile a little fuller than I found it–mattered, and the scholarship was awarded at the annual VCC scholarship banquet, held in Ely.  I have attended 5 of the last 7 banquets.

In 2009, I partnered with the Friends of the Boundary Waters , one of those small organizations that has a few dedicated staff and leverages a lot of volunteers, to create a second scholarship.  I offered to pay for the scholarship myself; the Friends matched it, and this year, with a new employee in the Northland, he would present it, and I no longer would, which suited me fine.  The Friends kept a tall cellphone tower away from Ely, so it would not be visible from the wilderness.  Unless you have spent time in wilderness, it is difficult to explain how sounds and sights from civilization can degrade the experience.  A cell tower would degrade the wilderness, where cell phones read “No Service,” and one is on his own.

Worse, PolyMet is trying to build a Molybdenum mine in the area, which is of great concern to the water supply, due to the toxicity of the element.  It is jobs vs. wilderness, except the wilderness gives jobs.  The outfitter got money from me, and so did restaurants and motels I used, before I went into the woods.  We are going to risk the cleanest water in the US for mining something that is safe until it suddenly isn’t?  (Prince William Sound, 1989, Chernobyl, 1986, Fukishima, 2011, Challenger, 1986).

The third scholarship was the Brekke/Langhorst scholarship, named for two brave young men, cousins from Moose Lake, Minnesota, who died in Iraq…or as a result of Iraq.  One died 7 April 2004, which was almost certainly in Fallujah.  The other died from complications of PTSD, which should have been anticipated before we went to war, which was unnecessary and probably illegal.  But that is another story.  Young men are often the pawns of old white men, most of whom have never spent a day in uniform or served in harm’s way.  As a veteran, I wanted to contribute to a scholarship for veterans, and the family honored me by allowing me to do so.  No family member has presented the scholarship; I and a few others have.  This is a very deep honor for me.

So, I had plenty of reason to go to Minnesota in late April.  In 2010, I took a short trip, stayed about 3 hours from Ely, and in the space of one day drove to Ely, rented a canoe, did an eleven mile day trip in to Pipestone Bay, came out, presented the scholarships (there are about 50, now), and drove 3 hours back to my hotel.  That was a bit much.

In 2011, I wanted to go into Basswood Lake, and the ice went out the day before I arrived.  However, the weather was not at all cooperative, with high winds, big waves, and frigid water.  Not being in paddling shape, I thought in unwise to go into the woods, and camped at Fall Lake Campground, where I was alone, did some day hikes in snow, saw a Pileated Woodpecker, among other birds, and enjoyed myself.

This year, I decided to go in overnight and look at the results of part of the Pagami Creek Fire.  My wife persuaded me to spend two nights, in case of inclement weather, which turned out to be a wise idea.

I flew to Minneapolis, did the usual 4 1/2 hour drive up north, and got settled in Ely for the night.  The next day, I got the rest of the equipment I needed, put it on the car, and drove out to the Lake One landing.

I got on the water on a bright 60 ish day (16 C), and in an hour found a decent campsite about 3 miles  (5 km) in  .  I was going to rest that day, but the forecast was good for that day and not so good for the next day, so I had lunch, hopped in the canoe, and portaged twice into Lake Two.  I expected a wasteland, but it was a mile before I saw any sign of fire.  But there were signs.  The campsites at the west end had some burned areas, and the beautiful white pines on the west end of the channel into Lake Three were no more, as that area had been subject to a back burn.

Channel between Lakes Two and Three, with tall burned white pine.

I paddled into Lake Three and was pleasantly surprised again not to see a wasteland but a significant part of the forest was burned.  There were mosaics of green amid blackened trunks.  The water was more turbid than usual, especially by the campsites, but also along the shore in general.  It will take some time for this to clear.  Some of the islands were scorched, others were completely untouched.  The south end was heavily burned, although campsites survived fairly well, in large part because most of the fuel in this area has been picked over by campers for their evening fires.

The wind was a little worse than I liked, and although a 2 foot chop is not difficult to handle, I needed to realize I had about 5 hours to explore, including time to get back to my campsite.  Wind, muck , and rapids are three things that can stop a solo canoeist, so I turned back to the north end and started to head back, stopping at one campsite that bordered the fire area.  The wind abated, so I took an open channel at the north end of the lake, which I had never before seen open, and went into the northeast bay.  The one campsite the late Mike Manlove and I had stayed at in 1993 was in the middle of a heavily burned area, and the north shore was fairly heavily involved.

Northeast Bay of Lake Three, heavily burned.

I had told everybody I would not go into Lake Four, and I believe firmly in never deviating from one’s itinerary, when one is solo. A lot of bad things can happen in the woods, and solo, what may be minor can become life threatening.  I looked around, took some pictures, and then headed back to the campsite on Lake One, the whole 13 miles (22 km)  or so taking me a little over 4 hours.

I had nothing to do when I returned so lay in the tent, not sleeping, but actually encountering a few mosquitoes, at least five weeks earlier than I am used to.  After dinner, the lowering clouds suggested that the next day might not be so nice, and I was really glad I got into the burn area when I did.

Indeed, I was awakened to the sound of rain, and I awoke under darker skies although no rain.  It was noticeably cooler, too.  I hung around the campsite for a while and then paddled about 1 1/2 miles down to Pagami Creek, far back in the depths was where the fire started.  I took a look at the western sky, and while the barometer had not changed, I did not think going further was a wise idea.  I turned around and paddled back to camp, arriving about 10 minutes before the first onset of rain.  It rained off and on through dinner.

I was really, really glad I hadn’t gone into Lake Three that day–wind, rain and cold weather would have made the trip a bad idea.  I have long learned never to squander good weather in the woods, be it 5 minutes or 5 hours.

I spent the evening looking along the shoreline for anything I could find.  Such scanning has found moose, beaver, otter and other animals.  This time, it was a raven and two crows who provided the entertainment.  The raven flew across the lake and landed in a jack pine across the small channel.  Two crows were beside themselves and called at him, each other, and probably to the general universe.  Periodically, the raven called, too.  I videoed the event, catching the raven flying off, still harassed.  Random scanning is often interesting.

The next morning, the tent was hard, as like a rock, and I went outside to see ice on the tent and snow on the ground!

Spider Web with frost

The stove was out of fuel, and while I had another cannister, it was cold, I was coming out of the woods anyway, and I had enough to eat.  I broke camp, got in the canoe, and paddled back to the landing.  The hardest thing I had to do was horse the canoe up on the car and tie it down.

I got my head back on straight.  I was out 2 days, and it felt like a week.  I saw the burned area, and next year, I have to go back one more time to Lake Insula, as sad as seeing the south shore will be for me.  I haven’t given the lake a proper good by, and who knows?  Maybe we can do our September trips there again, if I find the area isn’t too depressing.  One thing is clear–I need to tie the scholarship banquet in with a camping trip.

The banquet went well.  I met Ian Kimmer, the Friends’ person in the North Country, who presented the Friends scholarship.  I presented my two, stayed for the whole banquet, then headed south.  We’ll be back in September, headed out Fall Lake into Jackfish Bay on Basswood.  It will be a good trip.  All BW trips are.

Burned area.

Canoe with snow on it.

Posted in BOUNDARY WATERS/QUETICO, BWCAW 2012, UNPUBLISHED OUTDOOR WRITING, VERMILION COMMUNITY COLLEGE SCHOLARSHIPS | Leave a Comment »

DEATH IN THE YOUNG….AND SUICIDE, NOT BY COP, BUT BY POVERTY.

April 22, 2012

A while back, my wife got a call from an ultrasound tech, who was shaking, she was so upset.  A young individual, in their 20s, who recently had an uncomplicated appendectomy, had presented with abdominal pain.  There was gas in the liver and no portal vein was visible on the ultrasound.

CT was not performed with contrast, due to the elevated creatinine.  But another “old fashioned study,” a contrast BE, had shown, on separate days, nearly no movement of contrast except through a tiny lumen, suggestive of an intussusception.  I was interested in the fact that high tech studies, with high costs and high radiation doses, didn’t make the diagnosis in this woman, but controlling imaging studies and radiation in medicine appears to be another issue where I speak out alone.

The young person died.  Yes, people die here in Arizona from appendicitis and uncomplicated appendectomies.  I appear to speak out alone when I ask why we aren’t learning from these cases.  We should drive the mortality rate from appendicitis to zero.

This person did not live in Saddlebrooke, Cobblestone, one of the country clubs, and have a seven figure income or an eight figure net worth.  I am not sure who is going to pay for the costs of care, which were limited by the early death.  But how do the young and uninsured, who have appendectomies, or even mesenteric adenitis, pay for the costs of an ED visit with a CT scan?  Many are young, gorgeous, and broke, to quote Suze Orman.

I will ask my colleagues again where the money is coming from to pay for care for all Americans, since the young, who think they will live forever, won’t, and they can have catastrophic medical issues, including bad motor vehicle accidents.  We have pretty much tried to say vaccines are bad, radiation good, evolution didn’t happen, the Earth is a few thousand years old.  I am waiting for the concept that young people don’t get sick and the rest of us don’t really die.  I once reviewed a paper for a right-wing medical journal (volunteer, of course), that purported the FDA killed 10,000 people a year by not allowing drugs on the market.  The statistics in the paper were awful.  And I still remember thalidomide.

As a matter of fact, I wonder what will happen if we do away with social security and Medicare.  My wife and I will survive, so long as we don’t have a catastrophic illness, but when insurance companies will have premiums high enough to cover their overhead (read: eight figure salaries), we may become old, not so gorgeous, miserably ill, and broke.

Most people who live to ninety have some degree of dementia.  It is a fallacy to think we will live to a ripe old age, and then, just before bad things happen, quietly die in our sleep.  Visit a few nursing homes if you wish.  Heck, there is a life at any cost group that will keep me alive even if my wife doesn’t want me to suffer.  Or keep her alive, when I don’t want her to suffer.

The facts are these:  most women over 85 are widowed, and a lot fewer men.  Let’s look at the women.  Most are not living at La Paloma having nice dinners with their friends at 85.  Most are trying to get by, not clear what the bills mean, are subject to scams, can’t get around well, and fear for their safety.  Maybe they have children, maybe they don’t.  The children have lives of their own.  Come on, we all know the picture here.

Suicide by poverty will join suicide by cop as the new America.  We aren’t as fortunate as the African Dik-dik, who dies, when his/her mate dies.  Some of us just keep on going.  That’s fine, until we need to stop keeping on going.  I know what that is for me, and I have it in my living will, so clear that even somebody who lives in Arizona can understand it.

But I have left my point:  how do we figure out a way to care for people who have catastrophic needs at any age?  Is spending $400 billion a year on war (defense is such a nicer word, but it was once–and still should be–the Department of War) really appropriate?  After 9/11, I said that we needed covert operations, which would be far more effective, to deal with terrorism.  Two wars and a decade later, a small, brave group of men killed Osama bin Laden.  He could have been dispatched without the money and lives lost in either war.

In these pages, I have offered a host of solutions, not one of which has been adopted.  That is unfortunate, not because I didn’t get the credit, but because those who were in power have not solved the problem.  We can and will, as soon as we say, “We can care for everybody in America appropriately, and we can pay for it.”

Then it will fall upon us to figure out a way to do it.  Once we make up our mind it will happen, we will find a solution.  Heck, I might even come out of retirement to offer a few thoughts of my own.  Ten, twenty, and thirty years ago, they were ignored.  Maybe now they won’t be.

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SEEKING FIRST TO UNDERSTAND, THEN, AND ONLY THEN TO BE UNDERSTOOD

April 22, 2012

Many years ago, as a hospital medical director, I attended a meeting we had with one of our payers.   I remained quiet throughout most of the meeting, and when the time was right, I spoke.  I process slowly, but I process well.

When I spoke, the mood in the room was tense.  I summarized the payer’s points, asking whether I was correct.  I wasn’t, so I continued summarizing until they agreed that I had understood them.  The tension went out of the room like air out of a balloon.  I don’t remember who “won,” but I learned something that day.

During my tenure as medical director, I received many complaints about the hospital and doctors, and I handled them the same way.  Rather than defending, I summarized the complainant’s points, discovering that I could hear tension go out of a telephone conversation, too.  People were amazed that somebody was listening to them.  Sometimes, that’s all people want.  Try it with your spouse some time.

 

I was asked to debate climate change.  I try to do things that will make a difference, and my debating climate change is not going to change policy.  Debating requires good public speaking skills, which I have, but only when I teach.  I doubt I will teach anybody anything in a debate.  Debating also requires fast processing skills, which I do not have.  That is why I am a writer.

Debates also have other problems, too.  They have winners and losers, and winning and losing have become toxic.  The desire to win has overshadowed the desire to look for new solutions.  Steve Jobs was deeply flawed, but he had the ability to move people to find solutions to problems that they thought impossible to solve.  We need that sort of approach in medicine.  Debates don’t offer it.

In medicine, we would have done well to have first studied the efficacy of  CABG, CEA, angioplasty, stents and EC-IC bypass.  Had we, millions of people would have been helped or not harmed.  Of the five, only EC-IC bypass was properly studied, and we found it didn’t help.  The scientific method is more helpful than the often screaming debates I heard, sometimes directed at me in the case of CEA.

In the past 15 years, national discourse on many topics, at one time bipartisan, disappeared. There are several reasons, but it is a fact that many issues that are scientifically based, and should be treated that way, have become politicized. Such polarization is toxic, and it can be transmitted.  I caught it.

The idea of seek first to understand, then to be understood, Covey’s Fifth Step, is one of the most powerful.  It goes with “if you want to influence people, you must first allow yourself to be influenced.”

I’ve also been guilty of misuse of the language, using such words as “most”, rather than “many”; adjectives and adverbs I chose might have been better.  Words matter.  I am deeply concerned about Internet anonymity and the loss of critical thinking skills; lessening of emphasis on science and math education might be the cause.  Apple outsourced to China in part because we didn’t have the engineers here.  We have far too much name calling, prejudice–not just in the racial or religious sense–but politically.  For those like me, who process very slowly, this fast-paced prejudice puts me at an disadvantage, for if I process, often the conversation is over without my participation, and if I don’t process, I risk saying something I later regret.

I’m often glad I’m pushing 65.  It isn’t always fun, and with each passing year, like the great tight end Jerry Rice, I have to work harder and harder to do the things I have done all my life, knowing at some point, I will have to hang those things up.

But I am glad I won’t be alive in a world that will be people rich and resource poor.  Wilderness will disappear.  Quiet is disappearing, too, along with our great heritage of dark skies.  I do not want to live in a crowded world, where I can no longer find solitude in the wilderness and feel more comfortable there than with a lot of people.  The first thing I notice in Europe and Asia is the pushing and shoving.   The second thing I notice is the smoking.  The third thing is the relative lack of obesity, the fourth the number of solar panels in a latitude 20 degrees further north than the one I live in.  Europe has wonderful public transportation, polyglots, downtowns that work, and good use of the available space, which is not a lot.

There are many softer words in our language; we would do well to use them more often, in hope that maybe others will catch on.  We need to discuss medical care in this society, not debate it.  I don’t know what the right system will be, but many of us think it needs to be changed.  The irony is that not all of us are doctors or payers, but all of us are patients at one time or another.  That gives us something in common.  How should patients be treated?  How do we pay for it?  How do we do what is necessary and avoid what is not?  How do we die, when it is time?  When and how do we deny care, because we simply can’t afford it?

It is easy to criticize.  It is far more difficult, but far more rewarding, to first ask “Let me see if I can summarize what you said, for it is very important I do so correctly.  Please correct me if I make any mistakes.”

I hope I am not mistaken when I say that hopefully we still have time.  But not much.

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ROWE SANCTUARY, 2012

April 12, 2012

This was my fourth year volunteering at Rowe, and the crane viewing was the best I’ve seen.  I flew into Kearney and was picked up by Margery Nicolson herself, the widow of the man for whom the center is named for, Iain Nicolson.

I hit the ground running.  Three hours after arrival, I was guiding a group to Stevie’s Blind, the first of the 19 consecutive tours I would guide.  We were busy; for the first time, I experienced all 5 blinds being open simultaneously.  I was in Jamalee 7 times, Stevie 5, East 3, Tower 2, and North 2.  All the trips were good for crane viewing.  I got to see cranes in the fog one morning, which was very special, as the birds appeared like ghosts in fog as the light slowly increased.  A few took off, but it was special, and there were remarkably few birds we saw, although we heard thousands more!!

Crane taking off in fog.

As a guide, I speak with my co-guide before we go to the blinds.  In the evening, we have a lot of time, because we usually arrive at the viewing blinds 30-45 minutes before the cranes land.  I try to show my enthusiasm at the beginning, then mention why the cranes come to the Platte every year.  Then, I go through crane viewing etiquette.  We have to be silent, nothing can protrude through the plane of the outside wall, and if anybody needs to use the Portapotty, they have to ask permission, so we can open the blind door quietly.

We return in the evening as a group.  Once people are in the blind, they must stay there unless there is a medical emergency.  Those take priority.  Personal inconvenience does not take priority over crane inconvenience.  Those who are hungry, cold, bored, or otherwise not interested, thankfully a very small number, have to live with being on a tour for two hours.

Photography is a big issue and at times a problem.  All flashes must be turned off and even taped, if there is any question.  The automatic focuser must be taped, so no light can show.  This does not affect the photography.  I ask for automatic rapid fire photography to be shut off, and only manual shutters to be used.  I have had photographers brag about 8 GB of photos taken, and one person told me that he had taken 3000 pictures during one blind session, averaging 40 a minute.  I have to wonder how many of these pictures are ever looked at over and over again, and how many pictures one needs of a Sandhill Crane, if that individual is an amateur.  I find the sunsets striking, and the great flocks of birds flying at sunset are wonderful to see.

On the river and a large group overhead.

The problem with photographers can be severe at times.  In 2011, one man had his camera lens protrude about 15 cm (6 inches) outside the blind window.  I told him 3 times to bring it inside, and he got upset each time.  The third time, he was visibly shaking with anger, and his wife had to calm him down.  I have the right to make him sit down and take no more pictures.  That is a personal inconvenience, not a medical emergency.  If we spook the cranes at night, they may hit nearby power lines and die.  That must never happen on my watch.

I have had people get angry with me for taping their camera, when they think all is fine.  I ask them to point the camera at me and shoot a picture of my ugly face.  If I see any light, I make them tape the camera shut.  I have that duty.  We put post-it notes over the LED screens, to decrease reflection off the face.  The problem we are dealing with more and more is the sound from cameras, which clearly detracts from the experience of hearing the sound, at least until it gets too dark.  There are three, two-person individual photography blinds at Rowe, but they are booked in advance, and the waiting list for cancellations is equally heavily booked.  We don’t have a solution to this problem yet.  Cell phones must be turned off as well.

If we have time in the evening, once we arrive in the blinds, I can talk about crane facts.  In general, however, more and more I allow people just to look and experience the phenomenon for themselves.  The good guides I trained with did that, and I try to emulate them.

Mornings are more difficult, because we need to get to the blinds early, before it gets light.  Therefore, about the only things we can say are welcome, this is a wonderful experience, few know about it, and these are the rules.

Large flock of cranes. The true words for plural are sedge, siege, or herd. But we use flock.

In the blinds, if people have questions, they ask me, and I will spend as much time as I can with them, so long as they are interested.

In the evening, we must leave as a group, because the cranes are on the river.  In the mornings, we leave at 0830, but often, I or my co-guide will stay until 0900, for those who wish to view longer.  After that time, there may only be two or three people, and so long as they are quiet, most of the birds are off the river, and it is not a problem for them to leave alone.

I have other pictures, the best I shot, at the following link.

Cranes over setting Sun.

I love the guiding, for I get to teach and watch cranes, and there isn’t much better in my life in Nebraska than those two things!!

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MUST WE DEBATE EVERYTHING?

April 4, 2012

1983:  I am in court testifying that a woman post cardiac arrest is irreversibly brain damaged.  Her husband wants to discontinue support; her sisters sued to keep her on the ventilator.  Nothing I said in the hospital had changed the sisters’ mind.  I knew the science and the outcomes of persistent vegetative states after cardiac arrest, and I agreed with the husband.  Eventually, he prevailed.

February 1988:  I show a nurse the conjunction of Saturn and Uranus in the morning sky.  She said they were in Capricorn (the proper name is Capricornus), but the two planets were visibly in Sagittarius.  I argued with her for 5 minutes before realizing nothing I said would change her mind.  Their next conjunction is in 2032.

Later, a man got a great deal of publicity for supposedly having discovered a new planet near Neptune.  I got a call at home from the man, who told me the planet was moving rapidly.  I stated that at Neptune’s distance from the Sun, the planet would move about a finger breadth at arm’s length every year among the stars.  No matter.  The man was convinced.  Nothing I could say would change his mind.

A physical therapist took me to lunch and told me that manipulation of the bones in the skull got rid of headaches.  I told him that skull bones were fused in adults.  No matter.  “It works!” he said; nothing I could say would convince him otherwise.

1984-1994: I said that the science underlying asymptomatic carotid artery stenosis meant that operations should be done only if the surgeon had a complication rate of less than 0.5%.  No matter.  Many were done at the hospitals I practiced; the major complication rate was 14%.  I got screamed at and threatened a few times, for intimidation, repetition, and reputation often trump facts.  I did not prevail.

2005:  Terri Schiavo.  Senator Frist, a physician, said she had cognition, despite clear evidence she was vegetative (smiling is part of the vegetative state).  Congress intervened briefly, an example of government’s dictating medical care if ever there was one.  Fortunately, science (amicus curiae brief by the American Academy of Neurology) and the court prevailed; indeed, the 600 gm brain with large ex vacuo hydrocephalus at autopsy confirmed what we neurologists knew.

March 2012:  I am in Tower Blind at Nebraska’s Rowe Sanctuary, guiding people to a suitable place to see the Lesser Sandhill Crane migration, one of Jane Goodall’s top 10 sights in nature and one of my top three.  As we waited for the cranes to land, my co-guide, an elderly woman, told me how she saw an egg stand upright on the recent equinox.  I said that can happen any day of the year.  The equinox is an instantaneous point in time, like the tangent to a function, with no influence on egg behavior.  No matter.  She was convinced.  Nothing I could say would change her mind.

More people believe in astrology than know why we have seasons.  Many believe we didn’t land on the Moon, that strange lights in the sky are aliens, who may abduct us.  A woman doing the luge at the Olympics held her neck in a certain way to “increase vertebral artery blood flow to the brain”; holding her breath would have been better.  Each of us has heard some remarkably odd ideas from people, totally convinced, totally wrong, about how the body functions.  Laetrile and colonic cleansing come to mind.

Our Sun is at least a second generation star, for elements heavier than iron must form in supernovae.  I believe in evolution and that vaccines are several orders of magnitude more helpful than harmful. I wish in the above instances I asked a simple question:  “Is there anything that you could learn that would convince you that you are incorrect?”  If the answer is “nothing”, then I am wasting my time.

We should change our beliefs when sound science shows that our beliefs are wrong.  When I learned that anticoagulation did not help vertebrobasilar insufficiency, I stopped using it.  When physicians at the University of Western Ontario discovered EC-IC bypass didn’t improve outcomes, they discontinued the operation.  They discharged four patients that very day.  There are many issues in medicine that we should study, in order to do the best for our patients; after all, each of us will be a patient.   We should discuss, not debate, the way we need to change American medicine, because I believe few are happy with the current situation.  We need to listen to and understand other points of view.  We must be willing to try new approaches, in order to learn from and modify them.  We need leaders able to convince people they can do great things that they never thought possible.  We need to use the best science available, even if it shows that our beliefs are wrong.

Children are born curious; alas, too many have it drummed out of them.  Perhaps if more were curious, we would look for answers, discover what we thought was true wasn’t.  That to me is moving forward.  Could I be wrong on climate change?  Yes. I don’t think I am, but yes, sound science could change my mind.  But I would rather discuss how we are going to fix medicine, locally and nationally.  My error reporting system has languished, unused, for 11 years.

I hope I am wrong about human-caused climate change; if I am, I will admit it.  Promise.

 

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LOONS, WOLVES AND OTHER NATIONS

March 13, 2012

Years ago, loons were killed in Minnesota, because they had the gall to eat fish that fishermen wanted to catch.

Anybody who has traveled the boreal wilderness knows that without the sound of the loon, the scenery would still be there, but the experience would be lost.  I have awakened on hundreds of nights to hear the sound of loons calling.  They have four different calls, and I love each of them.  Those who have not heard a loon in the wild, and that would be most, have missed one of nature’s great sounds.  Gavia immer is a heavy bird, because its bones are solid, not porous, so it can dive and stay underwater for a significant time.  The bird needs a few hundred meters to get airborne, but flies at 60 knots.

The wonderful ability of the loon to do so much is not unique.  To me, animals are other nations, not something we should destroy.  Loons are superbly adapted to the boreal lakes.  What will happen to them as we continue to overpopulate the Earth and damage their habitat, may spell their doom.  It’s just a bird, some say.  Well, there are many Americans who dehumanize humans by calling them Kaffirs, ragheads, and words I will never dare say to myself, they are so ugly.  Femi-Nazis has been used by Rush Limbaugh, along with his other vile comments.  Dehumanizing your enemy is perhaps a great way to win arguments and wars; however, the cost is horrific, not just in war, but how it has polarized American society.  Another way, common in my experience, is to take their words out of context, and deliberately replace them with charged words.  A lawyer did that to me one time in court, and I called him out on it each time. He finally threw a book at me.  In court.  Literally.  But I have others who do the same, former colleagues, some of whom owe me a lot, for what I have done for them, and I call them out on their language, too.  Words are important.

Fortunately, in the case of the loon, a few wildlife biologists did some good science to show that fish eaten by loons really did not adversely affect overall fish population.  Nature regulates populations well, and nature will regulate us, too, should we fail to do so ourselves.  What did affect the fish population were those who caught and didn’t release large fish, the breeders, who kept the population alive.  I know some guides, if they have a client do this, quietly go to another area on a lake to ensure their client catches nothing more the rest of the day.

During the Great Leap Forward, the Chinese killed the sparrows, only to realize later that sparrows kept insects in check.  Before one disparages the Chinese, we kill coyotes, which keep rodents in check.  Most everything belongs, including wolves, since they are, after all part of the ecosystem.  What is remarkable is the number of people, who profess being religious and patriotic Americans, who believe removal of predators a good idea.  In Alaska, people killed the national bird, the Bald Eagle, which is remarkable for a group that prides itself on being “real Americans.”  How many of you have seen a Bald Eagle or a wolf in the wild?  Perhaps it doesn’t matter, any more than reading a great book or listening to great music.  But I am better for having seen eagles, reading books, and hearing music.  Seeing a wolf in the wild, both of us alone, 4 meters away, was one of the best experiences in my life.

We face tough choices.  We have too many invasive species, and we must decide how to handle them.  None of the answers is easy.  We can bring in species to kill species, but new species can become a problem.  We can poison lakes, kill the fish, and then restock, hoping to remove invasive species.  Tucson Arundo removal is trying to remove one invasive plant.  Alone, over 10 months I removed 20,000 buffelgrass plants, another invasive species, in 8 acres, battling snakes, and heaving heavy bags up a berm.  Buffelgrass was imported from the African savannah into Mexico for forage about 80 years ago.  It was a bad idea.

Three months after I finished my work, it was like I had never been there.  Nobody cared.

There are no easy answers.  Sadly, there are plenty of talk show radio hosts and others who act as if there were.  Most of their answers are less government, which frightens me, less taxes, and more freedom.  Having seen how people trash the wilderness, even when they know the rules, I am frightened when I think what would happen without regulation.  Without regulation, we would have lodges all over the Boundary Waters and have dammed Curtain Falls, ruining Crooked Lake.  How many of you have seen Curtain Falls?

We would have logged every bit of forest, and we would have cell towers everywhere in the wilderness.  As I write, PolyMet wants to put a molybdenum mine in the headwaters of much of the country I love.  The company lawyers and managers say it will be safe.  Everything is safe, until suddenly it isn’t.  There won’t be an accident with the pipeline from the Canada tar sands to Texas, either, until there is one, and the Ogallala Aquifer is destroyed.  The Alaska pipeline was safe, until 1989.  Three Mile Island was safe, until 1979.  Unregulated, we would trash the forests, pollute the wilderness lakes, cut down all the trees, mine, and get rid of every government regulation, because people will do the right thing.

Yeah.  Right.  Have somebody tell you what it is like on opening fishing day for salmon in Alaska.

Eventually, of course, like the forests world-wide, the salmon, and the cod, the biomass will disappear.  A few will become very rich, support those who lie their way into public office and keep the cycle going.

Glad I won’t be around when the bill comes due.  Also glad we don’t have children who would ask why I didn’t stop it.  ”Because I couldn’t” seems pretty weak.

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