Archive for the ‘Uncategorized’ Category

TRUE FRIEND

March 30, 2017

I got another one of those “copy and paste, don’t share” posts on Facebook from somebody who was trying to send a message against cancer.  I was told that “the true friends of mine” would be the ones who did that.

Initially, I felt the urge to do something.  After all, who among us turns down a chance to be a true friend?  Then the feeling turned into annoyance, and I started to wonder how well I knew this person, whom I do see every week.  It is emotional blackmail, and I don’t like it.  I practiced medicine for 20 years, was in the medical field for about 35, and diagnosed and treated many people with cancer.  I allowed many to die without prolonging their pain.  I lost a brother to esophageal cancer, and I treated thousands of people who had various neurological conditions affected by cancer.  That was my contribution.  I won’t be copying and pasting to my profile. The best message we could send would be to protest the billion dollar cut to the NIH, the current budget of which is the net worth of each of four Waltons. Stated another way, if each Walton donated his or her entire net worth, they could fund NIH for a year. Mathematically, that is a $1000 a second for a year.  That would do more to further cancer research than pasting a post.

I don’t do certain things on Facebook, such as to share whatever somebody tells me. I’ve shared three things in the eight years I’ve been on it.  I don’t put likes on pages where somebody wants a certain number of likes.  I don’t contribute money to undoubtedly good charities when asked; I have my own list.  I don’t post certain pictures, even ones of nature, for somebody’s collection.  I comment where I should and try not to comment where I shouldn’t.  I delete a lot of my comments.  The most likes I’ve had came from a comment I almost later deleted, because it sounded too hokey, about being a third generation American whose maternal grandfather came over from Ireland. I wrote that I while I was proud of my heritage, I was prouder that I served America as a shipboard naval officer, even though I didn’t do much more than fill a billet on an amphibious cargo ship in the Western Pacific for twenty-three months.  Sure, I did two appendectomies at sea, one by myself, probably reassured some on board, and maybe because of my presence a few slept better at night, but it wasn’t like I was “In Country,” that being Vietnam, which I was 25 miles off the coast of one night, but not in a combat role.  Anyway, that comment got 285 likes and a lot of thanks for my service, which I neither wished nor frankly deserved, since most of us had to serve back when I was in my 20s.

I’m not going to be a “true friend,” because true friends don’t ask others to do something to show their friendship.  Someone I call a good friend was chewed out at the hiking club’s executive meeting for having organized the first trail clearing we did after the ice storm devastated the city and the trails. Several of us showed up, including club board members, and we all worked together, nobody nominally in charge.  We took safety precautions, with hard hats, didn’t do things we weren’t comfortable doing, and cleared a lot of debris.

The head of the trail maintenance committee chewed my friend out at a board meeting, without involving me or two others who “led” trail clearing hikes.  That wasn’t fair.  My friend, one who did every hike he could, stopped hiking so much and started hiking in the closed area, since we had already knew what the trail condition was like.  The closed area was filled with dog walkers and trail runners, and the signs stating closure were poorly visible with no enforcement.  The club wasn’t hiking there, but one snowy morning, my friend called me and asked if I wanted to do a “rogue hike,” as he called it, up the mountain.  I was game, so I went by bus as far as I could, he picked me up, we went to the trailhead and up the mountain.  Frankly, it was the best hike I’ve ever done there, and I’ve done it well north of 100 times.  He later posted that I was a “true friend,” and I had I guess a warm feeling, but  I was more in it for myself.  I haven’t quite felt the same about the club ever since.  We did nothing wrong, and while I will participate in hikes and continue leading, both will be much fewer in number.  That’s too bad. I don’t look at some of my other friends there in quite the same light after this event.

There are people I know never read my posts.  No reason they should.  I’ve been unfriended twice, both from Germans; I prefer to block offending posts or offending people without unfriending them.  Each to his or her own; life is too short to argue about such matters.

I just got back from Nebraska where I had the honor, privilege and pure joy to take several hundred people over the space of eight days out to the viewing blinds where they could see the arrival of the Sandhill cranes at the Platte River at night and their departure in the morning.  I’m selfish there, too.  I go to Rowe Sanctuary because I want to see Sandhill cranes.  I get a big charge out of watching 25,000 birds lift off the river, or land that night.  If that means I have to staff the gift shop, clean toilets, or run the information desk, so be it. I will. I like doing those jobs, too. I like to teach, and I can tell people in all three places, including the toilets, why the cranes are there, where they came from, how long they will stay, and where they are going.

Yesterday on Facebook one of my friends said that after viewing my pictures and videos, his wife said they ought to go to Nebraska next year.  I replied that I don’t use the word “should” in the second person, for I find that too judgmental.  I simply wrote that I found the place unique and magical.  No volunteer at Rowe would dispute those two words.  Not one.  Most would add several other terms, like spectacular, mind-blowing, jaw-dropping, or once in a lifetime.  I hope he and his wife come there next year, but I won’t push it, any more than I am pushing people to see totality in August.

Good friends offer information and suggestions when asked, show up when they are needed.  Otherwise, they offer support rather than advice, don’t keep score or quote a price.

IMG_8447.JPG

Sunset on the Platte, March 2017.  Sandhill Crane migration.

 

IMG_5215.jpg

My friend tackling a downed tree after the ice storm.

A LA CARTE

March 16, 2017

“Politics is not just about power and money games, politics can be about the improvement of people’s lives, about lessening human suffering in our world and bringing about more peace and more justice.”  Paul Wellstone

I miss Paul Wellstone.  The American Health Care Act (AHCA) was pushed through the House at lightning speed.  Fortunately, House bills don’t go directly to the President.  There is the Senate.  The idea, however, was to get this bill passed, so the representatives could go back to their districts without dealing with angry constituents.

Oh, there will be some angry confrontations to be sure, but unlike the roll out of the Affordable Care Act, there will be no debate at town halls.  Then representative Gabrielle Giffords had raucous ones, including one that ended rather quickly when a firearm fell out of a guy’s pocket.  This was, after all, Arizona.  I’d say that Giffords was shot by Tea Party activists, but that isn’t true, not that the truth matters much in today’s America.  No, she was shot by a mentally ill individual who had access to a gun (another story that is going to likely happen again in today’s America, but I won’t discuss that issue here).  The Tea Party was thrilled, I’m sure, since they have no shame, and they are thrilled that the hated “Obamacare” is again repealed.

It is obvious that the Republicans had no health care plan ready for rollout, or they would have had it on the table 3 January, had it passed and to the Senate on 21 January, if they worked on Saturday, which many of “the little people” do.  This bill was cobbled together with little input from many, including other Republicans, who are likely going to be wrong about the anger of their constituents, since the Senate will not pass this bill as it stands.  There appear to be three groups of Republicans: those who like the bill, those who think it didn’t go far enough, and a small, but important few who think what we had was worth preserving.

There is a lot about the AHCA that I could address, but I will stick to five comments.  First, what people call it is important.  A significant number think Obamacare and the ACA are different, and the Republicans succeeded in making “Obamacare” a hated name.  Shame goes to the Democrats and journalists who bought into that.  Currently, there is some effort to tell us not to label the AHCA “Trumpcare,” which Paul Krugman says we should.  I agree with him, even if I have to use the name.  I prefer Voldemort.

Second, the bill has a mandate that if somebody lets his or her insurance lapse, they must pay a 30% increase in premiums to get covered again.  This mandated tax—let’s call it what it is—will hurt many, those who don’t understand insurance, don’t get, open, or understand their mail, and may throw things out without realizing how important they are.  These very people—and there are many of them— stand to be hurt by an increase in premiums, and I suspect their health is normally not very good.  A lot them are poor, elderly, people of color, uneducated, unemployed or underemployed, who won’t be able to understand their coverage.

Third, the notion of à la carte insurance presupposes people know what medical problems they will have in their lifetime.  I’m a neurologist who trained until he was 32, knew a great deal about disease, and I would not have guessed the things I’ve had that I wouldn’t have suspected.  We don’t know what medical conditions we will have. Individuals don’t have that knowledge, Mr. Ryan. When they get ill, they want help and treatment, not to shop to compare insurance companies and enjoy a “free market” with “competition,” comparing plans in the comfort of their trailer home which isn’t paid for, and may not have food or heat.  People don’t have the knowledge to know what the insurance company is offering and more importantly not offering.  Those Mr. Ryan thinks will benefit from competition won’t, because they can’t understand the complexity of medical care.  No, I don’t want people trying to choose what medical conditions they want to cover. They can’t and shouldn’t.

Finally, catastrophic care should be covered, even if it once failed to pass, because it would have taxed only the elderly.  My late father, the epitome of a rational person, became totally unglued about the Catastrophic Care Act of 1988.  I didn’t dare mention it in his presence. Such conditions strike at any age and are almost by definition unpredictable. The biggest killer of people 15-44 is unintentional injury (read: accidents), double that of suicide, homicide, cardiac disease, and cancer, all of which are about the same.  The common causes of ED visits are fever, otitis media, open wounds, contusions, sprains and strains: 1 in 5 in the ED were not insured (in 2010), and given the heavy use of CT and MRI imaging, injuries are expensive to treat.

À la carte coverage, like insuring oneself for what one thinks he will need, should be banned.  As for those who believe men shouldn’t have to pay for women’s health care, this is a slippery slope for people like me who might say I shouldn’t have to pay for people who don’t eat right, smoke, chew, drink, have guns in their homes, don’t wear seat belts, are overweight, don’t exercise, take recreational drugs, and aren’t vegetarian, for a start.  It doesn’t work. We can vary premiums a little, but when we start treading into areas that people are genetically or physically unable to control, we are asking for trouble.  No, I can never get pregnant, but a woman can’t get prostatitis and has a lower incidence of cardiovascular disease than I do.  As for paying for birth control, I can’t think of many better cost-effective remedies, since fewer unwanted children takes pressure off young families, schools, jobs, and the whole health care system.  We ought to pay women for taking birth control pills and tax men who use anti-ED drugs, since we need fewer sperm floating around.

Finally, we need a single payer system, like the one John Conyers introduced again, as he has since 2003.  This would decrease overhead percentage dramatically, allow for standardization where it matters, require negotiation for drug costs, and track illnesses, treatment, quality, and yes—errors.  A single payer system wouldn’t cover everything, but it would cover what Medicare does.  It wouldn’t cover abortion, but it would cover contraception.  It would cover what is scientifically known and rapidly cover what appears to be known. Insurance companies could sell supplementals with varying deductibles, for those who wish them to cover those conditions not necessarily covered under the standard policy, ED drugs being my favorite for non-coverage, but hey, I’m willing to bargain.

My bottom line: repealing the ACA before knowing how many million would lose coverage  was heartless. People will die because of this bill, should it become law. Long term thinking would say providing medical care to the whole country would save money in the long run and be in keeping with our ideals.

At least the ideals we once had.

WHY REPLACE THE PLANETARIUM PROJECTOR?

March 10, 2017

“I have a question for you!”  I looked down at the four-year old girl, accompanied by her mother.  I had just finished an afternoon planetarium show at The Science Factory, a local children’s hands-on museum, and I got down on my knees so our heads were at the same level, and asked what her question was.

“Who named the stars?”

“What a great question!” I answered.  The mother was a little embarrassed, I think, but the little girl demanded an answer.  “Why, they were named by the ancient Arabs, the Persians, and the Greeks,” I said, “who lived in places where it was clear at night and real, real dark, because there was no electricity.  I find some of the names beautiful, like Shaula, Adhara, Albireo, Nunki, and Denebola. What do you think?” She was fascinated but liked Regulus the best. She liked lions.   I think her mother enjoyed the interchange, too. The question made my day.  Maybe I made both of their days, too.

Examples like this are the reason I am writing in support of replacing the planetarium projector, which finally burned out, and I am willing to back up my support as a four figure donor, which information I normally don’t give out, but times are hard.

I’ve used a planetarium show to point out that escaped slaves on the Underground Railroad knew how to find the North Star, whereas very few Americans today can find Polaris.  Knowing how to find north mattered.  Nowadays, a large plurality of Americans would rather study astrology than find north.  I can think of three other ways to find north—without a compass.  Many think Polaris is the brightest nighttime star.  Nope.  It ranks 49th; Sirius is the brightest.  You learn that in the planetarium. I’ve discussed, during and after a show, how one can learn her way around the night sky, treating it like a map of a city, going from the major streets to the minor ones.  It’s easy in the planetarium, when all the major landmarks are on the dome above you, exactly as they appear in the night sky on any date, time or place in the world we choose.

I have volunteered in the planetarium the past two years. The Science Factory needs it as an anchor and Eugene needs it as a tourist attraction.  When I lived in Tucson, Flandrau Planetarium was an excellent astronomy museum, but it was on the University of Arizona campus, where parking was difficult. The Science Factory is easy to find in Eugene, parking is 100 yards from the facility, and a good planetarium is a major attraction, where parents and children together can learn science and the night sky.  The planetarium can inspire questions, teach people how to find the bright stars and planets and learn about the effects of light pollution on our ability to see the night sky.  We could use lectures, I suppose, but the ability to take people on a tour of the night sky in daytime can’t be done anywhere else but in a planetarium.  I’ve had fun turning the calendar forward 10,000 years to see what the sky would look like.  Or change the latitude and longitude and pretend I’m in New Zealand, where back in ’86 I was under some of the darkest skies I ever have seen, on the main road on the west side of South Island by Lake Moeraki.  I wrote two columns about the fabulous Southern sky down there.

I find it ironic that this year, when a long-awaited, exceedingly rare total solar eclipse will race across Oregon, the loss of the current projector makes some on the Board consider closing the planetarium. Boards don’t like to spend money or make tough decisions, I guess.  Boards like things simple, I think. I’m not sure, because other than medical societies, I’ve never been asked to serve on a Board.  I’m not an important person, except when it comes to donating money.  Then I’m courted by many.  But when it comes to ideas, experience, doing something differently, taking some risks, well, we need important people to do that, not some retired science nerd without connections.

Of course we need a planetarium in Eugene, and indeed, the eclipse this August makes it an excellent time to have a fund drive to replace the projector. Normally, I don’t tell people how much I am willing to donate, but since most of the good I’ve done in life appears to have been donations, I figured I would put my money where my mouth is and tell those important people on the Board what I was willing to donate, after I wrote a shorter, more polite, version of the above, so they knew that I had a brain and knew astronomy, planetariums, and the night sky, besides having money to donate.

I continued, writing I found it additionally ironic that literally in the shadow of Autzen Stadium, where no dollar is spared for athletics, we might let The Science Factory—and Eugene–lose an important educational and tourist attraction that will influence people far more and far longer than a football game.  The last coach was fired with about $10 million left on his contract.  The new coach’s strength coordinator, on the second day of the job, put three players in the hospital with rhabdomyolysis, caused by an over strenuous workout likely hurting their renal function permanently, since two of them stayed for nearly a week.  You need to be diuresed when this happens, in order to try to save the kidneys.  For all I know, they might have even had temporary dialysis.  Another assistant coach was paid $61,000 before being fired for driving drunk and hitting another car, two weeks on the job.  The first game isn’t until September.  The last president at the University had a million dollar severance package when he was let go early.  I’m not Mr. Personality, but I have more people skills than this guy had. I’m sure the Duck Athletic Fund Board and the Regents are full of important people, but with all due respect, I think their financial management and judgment could be improved. Who knows, maybe a nobody like me might actually make better decisions.  Mind you, I didn’t say all that in the letter, but I left a lot of lines to read between.

I ended my letter with the answer I gave the girl’s question, rather than putting it in the body.  I wanted them to read wondering who named the stars. Not knowing something is good for people.  It takes them out of their comfort zone, so they have to wonder.  I like having to wonder.  It leads to thinking, asking, or looking it up, all a reminder that none of us is as smart as we think we are.

I later wrote my contact at The Science Factory to count me in as a donor for the planetarium and a volunteer projectionist when she needs me.  But I won’t give one red cent to the Duck Athletic Fund.

Priorities.

QUITTING BRIDGE…AGAIN

March 5, 2017

I like bridge, but I have found many who play it often less than charitable to those of us not skilled.  I started reading the bridge column fifteen years ago, read a few books about the game, liked it, and on a cruise ship to the 2005 eclipse, played a little. During the last few months of my father’s life, I played with him and his group.

I played “party bridge,” often disparaged by those who play duplicate, members of the American Contract Bridge League (ACBL) who get Master’s Points from tournaments, hoping some day to become a Life Master. I would be careful to disparage party bridge.  Good players can be anywhere, and dissing one style of play is like my saying that somebody who just learned basic algebra doesn’t know real math, because I know much more.  Good for the learner.  They learned something.

I wasn’t good at bridge.  Occasionally, I would do the right thing, because bridge is a game of probabilities, and sometimes the stars align.  With time, I did a few more good things, meaning I was learning, but too many people with whom I played were neither helpful nor nice.  “Four points?  I’ve never seen a response with four points.” I had four trumps, a side ace, and distribution, for those who know the game.  Or “Why didn’t you bid xxxx?”  There are a lot of mistakes one can make in bridge, and there is no shortage of critics, many of whom are dead wrong.  They have to be, because I was criticized on the same hand and being told contradictory things.  That happened a lot when I played basketball in city league, too, and I found it annoying.

At the beginning of the session, the head of the club said that comments about play were not to be offered unless asked for.  It was a nice thought, but it failed in practice.  One man was particularly nasty.  I didn’t understand his bidding, and he always had to have his style followed.  One day, he finessed me correctly for the king of hearts, knowing that eventually he would capture it.  I had 4 cards in hearts, including the king, and rather than not playing the king last, played it on the third round.  He took it and continued his play, rather surprised when I turned up with the missing heart at the end, sinking his contract.  I had learned through reading the technique of playing a “dead” honor sooner than expected.  I remained silent.  He hadn’t counted trump.

The last day I played at the club, my partner made a bid that I misinterpreted.  Had she passed, which she should have (she preempted over a preempt, for those who know the game, and one doesn’t do that), I would have defeated the contract four tricks.  Instead, my misinterpretation cost us being set two.  I was loudly criticized by the other three people at the table and never returned.

I read the bridge column every day; my wife and I occasionally deal out hands and play them.  These allow me time to safely think and process.

After a seven year hiatus, on a cruise to the 2016 eclipse in Indonesia, I decided to play on board, not surprisingly finding myself the worst player in the room.  Bridge is a sedentary game, and while I try not to be too judgmental, many there needed to do more physical activity.  I played duplicate bridge three afternoons, calling it quits after the third.  I was paired with a different person each day, and with a partner one doesn’t know, bridge is even more difficult. I wasn’t the only one who made mistakes, and the tone of voice may not have sounded critical to the owner, but it did to me, whether I was being criticized or somebody else.  There is a way to correct people that works, and good teachers know it.  Unfortunately, there are not many good teachers.

I ran into my last partner later in the cruise.  He had played for years and explained bridge players clearly, so clearly I wondered why I never figured it out.  You see, the irony is that I am good at numbers, probability, and have a decent memory, which should make me a great bridge player.  But I have a big deficit: I process slowly, bridge is a timed game, and most play it even faster.  I can’t keep track of cards when they are played quickly.  My partner simplified matters: “The best bridge players are options traders: they have to be quick with numbers and risk averse.”  That doesn’t describe me at all.

There are those who teach bridge, but I am reluctant to seek them out, because frankly, not many are good at teaching.  I am. I understand different styles of learning, I understand that not everybody knows something as well as I, and I try to be patient.  I do this when I tutor math, show people the night sky, or explain medical conditions.  I’m enthusiastic, not critical.

What I need is a bridge hand where everything is played slowly.  I need a chance to figure out who has what and decide what to play next, being gently guided with tips how to keep track.  The bridge I have played isn’t this way.  I know it exists somewhere, but not where I’ve been.  In a sense, bridge reminds me of learning German.  I was always in a group of better speakers, but I couldn’t find one who would work with me to make me better.  It is why after 3 years I eventually gave up trying to be fluent, yet can understand it well enough to teach beginners how to go about learning it, because the teachers and online methods I know are insufficient.

I will return to reading books on bridge and watching German videos alone. I enjoy both.  I will continue to devote efforts to volunteering as a math tutor both at the community college and online, where the comments about my teaching are “You are awesome,” or “Thank you for explaining everything so clearly <3.”

I understand math.  I understand that people have different learning styles, so I teach to the person.  Perhaps most importantly, I realize that many don’t “get” math the way I do and never will.  I am neither a language person nor a bridge person.  I can improve, but I am no longer going to hit my head against a wall trying to be something I cannot be.

Better I break down math walls and save some heads.  I’ll avoid options trading, too.

GO YOUR OWN WAY

March 2, 2017

Returning through the woods from the lava fields at Clear Lake, I came upon a lovely seasonal stream that was flowing downhill from a nearby hillside through the thick Douglas fir forest.  I had seen the stream on the way out a few hours earlier and decided I would stop on the way back to look more closely at it.  Had we been doing a loop around the lake, I might have stopped right then, for I’ve decided while hiking that if there is any question I should take a closer look or a photograph, I do it.

The stream had a snow bridge, nice flowing water, and when I looked a little more carefully in front of me, a few icicles as well.  The noise was pleasant, and the knowledge that in a few weeks this place would be dry reminded me how dynamic nature is.

IMG_8229.jpg

Tributary of Clear Lake, Oregon.

I posted those comments, and a good friend wrote that if I traveled more slowly I would see a lot more.  He’s not the first to tell me that, and he won’t be the last. He’s right, in a way. I think many have the sense I go through life in a big hurry and miss seeing things that others see.  Perhaps, it is true.  My father was always in a hurry, and I emulated him.  I have distinct recollections of those times in my life I was hurried to do things that weren’t a rush.  I became a hurried, harried practitioner, and the more I hurried, the less benefit I got from it.  Little I did seemed to me to be soon enough, right enough or timely enough.

What is seeing a lot more?  Why am I out in the woods anyway?  I go my own way, and to me, there is so much to see and so little time to see it.  When I spent the summer of 1992 in the canoe country of Minnesota, I wanted to see every lake I could.  It was impossible, of course, but I got into more than three hundred.  I saw plenty—eagles, otter, beavers, moose, bear—but a big reason that I went was to cover ground or water, lots of it, every day.  It mattered to me.  Why?  It did.  Sure, I could have paddled four miles and found inlets with all sorts of interesting plant and animal life.  Occasionally, I did that, but the long days under pack and paddle was part of fulfilling my need.  I have wonderful memories of the 18 mile day in a cold October rain, where I saw nobody for the fourth consecutive day, a day that took me to Little Saganaga Lake, or the push the following day down to Alice, where I encountered a blizzard, solo, in October.  That trip has stayed in my mind as one of my great ones.  I went six days without seeing another soul.

I did the 26.6 mile McKenzie Trail hike last year, setting a good pace and finishing it in under 9 hours of walking.  The purpose was to hike the whole trail, my kind of hike, and I enjoyed it.  I did the 23 mile Duffy Loop, which carried me through an awful stretch burned over by the B and B fire 13 years earlier, solo.  I won’t go back, but I know what is out there.  There is no blank spot on a map when I look at it.  On the Noatak River, from near the headwaters by Mt. Igepak to Lake Matcharak, I know what that country looks like.  I’ve trod the ground, paddled the water.  I saw a lot of griz, caribou, and even a wolverine.

To me, the hard work, the long distances covered matter.  I have awakened and seen Orion’s reflection on a lake, the sunrise through thick fog, watched a smallmouth jump out of the water with my lure, and watched an osprey dive deep into a lake to come away with a fish.  It all mattered.  Speed on the trail is something I like.  I’m not the fastest, never could be, never would want to be.  I process nature as I go, and I process very slowly.  It is often later when I realize what a special scene I had encountered.  I saw it, and I spent as much time as I wanted to.  Then I moved on.  On the out and back trips, I remember certain areas as special to view, and as I return, the processing primes me for these views.

I posted a greatly abbreviated summary of the above, and then realized I needed to continue.  I was on the Owyhee River last year, where distance covered was not under my control, except on day hikes, and one of those I got dropped by a the guide and three other clients.  I realized finally that I couldn’t keep pace, and I didn’t much like the uphill bushwhacking that we did.  I stopped, said no more, and turned towards the river, taking the best pictures I took the whole trip.  Had I kept going uphill, I would have seen more and from higher.  But I went, which is what mattered, and I saw something very nice, by myself.

IMG_7096.JPG

Owyhee River, Oregon

Those who say I miss too much often don’t share the my values.  I don’t tell people what they should or shouldn’t see.  One clear night on the Owyhee, we had an opportunity to see the night sky from one of the darkest places in the contiguous states.  Almost nobody was interested.  I am encountering people who are not interested in seeing the total eclipse this summer, and almost nobody viewed the transit of Mercury that I had in my telescope last May.  These are all interesting, beautiful, and to me special.

IMG_6742.JPG

Transit of Mercury, 9 May 2016; large sunspot in upper center, with Mercury at the 4 o’clock position.

I could go as far as to say that if one is not interested in any of these, one is going through life too fast. But I don’t.  I want others to go through life at their own pace, listening to Nature, listening to the Earth, but listening more to themselves, always learning.

IMG_5809.jpg

Sunrise over Odell Lake, Oregon; 2 March 2017

STATISTICS AT THE PINNACLE-PART 2

February 15, 2017

I’d look at the audience and find two rows where I saw 22 people.  “What do you think the probability in these 22 there is at least one pair with the same birthday?”   I’d ask that because most people would think it is quite unlikely.  Our brains tell us that, but our brains can deceive us, not only the brains of others.  Turns out, the probability is about 50%.  I might even start with 7 rows containing 70 people, where the probability is 99.9%.  “This does not make intuitive sense,” I would add, “but is easily proven by taking the approach of the probability that two people don’t have the same birthday.”  My statistics advisor did this in a class where I happened to be attending as a graduate student, and the first student’s birthday matched mine.  He said the look on the face of the students was priceless. “Why does this matter?  It matters because sometimes the way you think is wrong, flat out wrong!  Your brain lied to you.  Your brain said the likelihood of two people in the same room’s having the same birthday was small, very unlikely with 22 people, which is not true.  Our brains lie to us about speed, direction, and up and down. They worry more about improbable losses than probable gains, and how certain major events in our lives shape our thinking, even if they are very unlikely to ever happen agan.   The solution to the birthday problem is also a good life lesson:  figure out what you don’t want and whatever is left over is what you want.”

I’d talk about the lottery and expected values. People play the lottery, because eventually somebody wins.  We can predict quite accurately the probability that somebody will win.  “You see,” I’d say, “low probability events happen; they just happen with low probability.  Take the lottery with a 1 in 110 million chance of winning.  If 330 million tickets have been bought, the expected value of jackpot winners is 3.  That doesn’t mean that 3 will win, but it is expected.  We can easily, and I mean easily calculate the probability of 0,1,2,3, and 4 with a calculator and a few key strokes.  Three people nationwide might win.  Three people, in the entire country.  Yes, it has to be somebody.  But do you think it is going to be you?”

If you have a disease, you have certain symptoms.  Medicine is the study of people who have certain symptoms and tries to figure out the probability of their having a disease.  Physicians and others would do well to understand the idea that not all who test positive for a disease have the disease.  “Suppose a disease has a 0.1% prevalence in the population, or 1 in 1000 people has it.  We would do well to teach percentages early in math and often, too.  Suppose if you have the disease, you test positive for it 98% of the time.  If you don’t have the disease, you test negative for it 99% of the time.  You test positive.  What is the likelihood you have the disease?

What is important here is the background frequency of the disease.  The fact the disease occurs in only 1 of 1000 means that it is unlikely somebody who tests positive will have the disease: only 9%.  

Anybody remember W. Edwards Deming?  He was ignored here but found the Japanese receptive to his ideas about data analysis and optimizing systems.  The Japanese cleaned our clocks in the automotive industry before the Big Three caught on, not because Japanese cars were fancy, but because they worked.  There is an apocryphal story about how a Japanese company was told by an American buyer that no more than 4% of ball bearings should be faulty.  In the next shipment, 4 at the top of every box were faulty.  When asked why they were there, the company spokesman said, ‘you didn’t want more than 4% faulty.  Here they are, on top.  The rest are perfect.’

“Deming taught that variability could be classified as “common cause” (noise) and “special cause” (signal, important).  It was he who said that considering every variation as significant was not only wasteful, such “tinkering” made the process worse.  How often do we hear comparisons of say a murder number in a city being more than last year’s and hearing somebody pontificate an explanation?  Have you ever heard that this is common cause variability, and that if you want to lower the murder number, you need to address the entire system?

Samples have to be random, which is a way of saying everybody in the population, the group of people one is studying, has a definable non-zero chance of being chosen.  That doesn’t mean, ‘They didn’t ask me, so the sample is no good.’  It’s no good if the sample is done in the Deep South and the sampler wants to extrapolate it to the whole country.  One living in New York or Ohio never had a chance of being sampled.  Most people think large samples mean more useful results, but bias in a sample of 200 continues to be bias in a sample of 200,000 if the methodology doesn’t change.  The mathematics of sampling are not difficult to understand, and if one wishes to be a little less confident, 90% rather than 95%, and the margin of error for a dichotomous (yes-no) question allowed to rise to 8 or 9%, rather than 1-2%, the sample size needed decreases dramatically.

“I’ve worn out my welcome, but let me finish by mentioning the concept of 2-3 standard deviations from the mean, which most people take as being a significant outlier.  That all depends whether the curve is Bell-shaped.  If it is, then the probability of something more than 2 standard deviations from the mean is 5%.  But it is possible, depending upon the distribution of the data, to have up to 25% of items more than 2 standard deviations from the mean, hardly a significant outlier.  For 3 standard deviations, it is 3 in 1000 chance with a bell-shaped curve, but with some distributions, up to 11% of the observations.  I wonder how many who have been 2-3 standard deviations on the wrong side of the curve have been punished unjustly.  Five standard deviations?  4%.  It is 1/25, which is 5 squared.  This is known as Chebyshev’s Inequality.

“Finally, I would like to see students learn how to make good graphs instead of the ones I see today.  I would make Edward Tufte’s books required reading.  I would like to see more line graphs, dot plots, and box-and-whisker graphs with fewer multi-color pie charts.  I said I could go on for three more pages about statistics.  I have. Statistics has many day-to-day encounters, it is often used poorly, both by those who don’t know it and worse, by those who want to fool you.  It’s not lies, damned lies, and statistics but rather lies and damned people who lie using statistics.” 

LIFELONG LEARNERS

February 12, 2017

The man had a lot of miles on him.  Smelling of tobacco and woodsmoke, my age or a little older, I had been helping him understand the rules of exponents.  His partner joined us briefly, and I wondered what both of their goals were.  I should have asked.  Then a young man in his late 20s or early 30s walked in to the lab, and since I was the only tutor in an uncrowded room, asked if I could help him solve a math problem he said his teacher couldn’t.  I had an “Uh Oh,” sort of moment, thinking I would face something awful, but the problem itself was fairly straightforward:

percent of opening= (air mixture-x)/(outside air temperature-x).  Solve for x.

It didn’t seem too difficult, and I solved it.  Then he said, “Oh, I forgot, this is an absolute value problem.”  Oh.  That made it a little more difficult, but I worked it out and came up with two solutions, which absolute value problems have, both of which checked, and looked at the rest of the problem, commenting, “so this might be how a thermostat works, right?”

“Yes,” he replied.  “This is a cooling unit, and this equation solves for how much the damper should be open.”

“Wow,” I said.  “I’ve just learned something.”

“This type of cooling industry has only been around for two years,” the young man said.  I didn’t ask him details, but without too much effort, later I found myself looking at Heat and Mass Exchange (HMX) technologies and found something that looked very much like the equation the student gave me.  Efficiency of cooling systems has increased significantly, to 60%; what I was reading sounded like science fiction.

I’m not surprised.  When I substituted in math in Tucson high schools, I told the students that they would be working at jobs that not only didn’t exist today, they couldn’t even be imagined today.  This student would have a job which didn’t exist when I moved here.

Thomas Friedman writes about these changes in Thank you for Being Late.  Friedman is a successful columnist leagues beyond my limited success, but I can relate to how chance meetings or chance thoughts can help create a column or produce a major change in one’s thinking.  Friedman writes how technology has moved well beyond the ability of society to adapt to it; technology is exponentially increasing, but our ability to adapt is linear with a small positive slope.  This is difficult for many, especially the twenty year-olds who entered the labor force and didn’t realize they would have to be lifelong learners.  The current president was elected in large part from many who think that somehow all we need to do is bring back the high paying jobs that were once available for people with limited education.  At best, those jobs are now modestly paying, higher paying being reserved for those who have learned enough to navigate Friedman’s “Supernova,” a term he likes better than the “Cloud”.

My student was becoming a lifelong learner.  Like the elderly man learning exponents, he is at the community college obtaining math skills that he never learned when he was younger.  The job he has is not likely to be his only one.  The days of being in the same field for 40 years are not gone; Thomas Friedman is still a journalist.  The days of doing the same work for 40 years are mostly over, except in simple work, the kind that is likely to be automated.  Journalists no longer queue up at a telephone to send a story.  It’s streamed.  In energy production, rather than having miners underground, the entire earth over a seam can be sadly removed.  But even coal’s days are numbered, at least as a primary source of energy.  I think most fossil sources of energy days’ are numbered, not because of climate change, but because the technological advances in cleaner energy are so rapid that they are competing favorably, even despite a non-level playing field.  Solar energy efficiency has doubled in the last 30 years to 20-45%;  I remember when it “jumped” to 6%.

The ability to connect and to do things is greater than ever before, but one must have a decent education, meaning STEM subjects and ability to write decently,  communicate, good interpersonal skills, and…., willingness to keep learning throughout one’s lifetime.  Put bluntly: you never finish school.  This isn’t going down well in places that were once manufacturing hotbeds, like Middletown, Ohio, in A Hillbilly’s Elegy.

Not only will people need to become lifelong learners, they must be collaborators, requiring social skills, too. We need well-educated socialized  graduates with proven competency, a tall order.  Here’s my world:  recently, a friend asked me to look at a paper she and three others wrote. She is Colombian, now in school in Germany, has learned 2 languages in the past 5 years, and studies VaR (Value at Risk) near Berlin.  The paper was written in decent English, 5000 words and well referenced.  I had never heard of VaR before, although I should have, for it is a statistical financial measure.

Education is different.  Research has exploded, open source software common, and people all over the world are collaborating.  I have my name on a meteorological paper written about pollution in Tabriz, Iran, because I helped an Iranian learn English.  She’s now living in Spain. A journalist friend of mine in New Delhi has changed jobs twice since I’ve known her, and she works hours that even I in my medical training didn’t work.  I’m not well connected, but through teaching English on various web sites I communicate at least weekly with people on five continents. I’ve communicated in German as well as English, and I’ve been offered teaching English jobs in both China and Brazil.  I bet I could get one in Iran too, if I dared go. A couple snowshoeing with me yesterday teach English in China, because the energy market crashed here.  She’s from New Zealand originally; both know a smattering of Mandarin.

A Kurdish woman I know in Iraq couldn’t find work as an engineer, so she re-invented herself as a travel agent and doing well.  A Syrian asked me to help her sister with her English writing.  How she survived the past six years I have no idea.  The next paper I get from her sister will be an essay about the war.  A friend is German, on her way to Moscow to prepare for the launch of a satellite she helped design to one of the Lagrangian Points (equidistant from the Earth and Sun) to look at X-Ray radiation.  Still another is Russian, learning two languages to be able to become a translator in Europe.  Another emigrated from Iran to Australia, has a permanent stay card in Australia and hopes to become a medical professional.  I helped with some geometry problems a while back.  I get all sorts of perspectives about America, good and bad.

If I were young, I’d be learning at least two other languages, probably German and Russian, and maybe studying abroad.  In this era, having connections world-wide is important and  not too difficult to obtain, given the connectivity today.

Education must be flexible with new courses quickly developed to understand new knowledge.  How we determine competency must also change, a piece of paper less important than proven skills.  Home and online study will be important, but isn’t the answer.  One needs a guide, a mentor, and a teacher all rolled into one.  How America will address education will be painful and very different from not only what it is today, but likely what we can even imagine. We will be required to deal not only with the Supernova-Cloud, collaborate internationally, but simultaneously educate people with limited means, financial and neuronal, so they have some floor under them to keep them grounded, rather than to looking for a wall to hang on, to quote Mr. Friedman.  Stay tuned.

Thank you for coming into the Math Lab, young man.  Had I not met you, I never would have seen so clearly what Mr. Friedman was writing about.  I don’t have the answers for society; I don’t even have them for me, but Mr. Friedman did write that knowing what questions to ask would be essential in the new world, and we statisticians make our living not by having all the answers, but trying to ask the right questions.

 

SAY MORE, ARTHUR BENJAMIN!–STATISTICS AT THE PINNACLE–PART I

February 7, 2017

One of my good hiking friends posted a TED talk by Arthur Benjamin on why we should teach statistics at the pinnacle of math education, rather than calculus.  I had only two complaints with his talk: first, it was too short, fewer than 3 minutes.  He should have gone on for an hour with that audience.  They would have learned a lot from him. Second, I’d add that statistics can teach us a lot about life lessons.

I commented briefly, saying that I could easily write for 3 pages.  Then I thought, “Why not?” Few will read it, because it’s math, and well….

Anyway, I’d start off with a deprecatory statement about my field:  “We statisticians are almost never right.  That’s remarkable. Never right.  BUT, we know how wrong we are likely to be, because our estimates have a margin of error.  Any estimate that does not have a margin of error is, to us, worthless.  If that fact went to the Halls of Congress, if somebody said that “Social Security will be bankrupt by 2028,” I’d like someone to ask, “What is the margin of error?”  Why?  Because somebody made a prediction about the future with data.  If somebody made a different prediction with slightly different assumptions, they would have gotten a different answer.  How different?  That is what margins of error are all about.  We’re talking about the future, and we can’t predict the future with utter confidence.

“What is confidence?” I would ask. “Let me first define probability: Probability is the likelihood an event will occur in the future, not the past.  It can be 0, no possibility at all; 1, certain it will occur, or any number in between those two.  Those who gamble know something about probability.  Good bridge players know probabilities of various distributions of cards; six missing cards in a suit are more likely to divide 4-2 than 3-3.  What we need to learn in this society is the idea that probability is not always equal if there are only two options.  Heads-tails is 50-50; boy-girl is close enough, although not exactly 50%. Millions of illegals voted in the last election or did not, or vaccines cause autism vs. they don’t, and you still have two possibilities, but now they aren’t equal.  I wish the media would learn that and not assume all sides deserve equal billing.  As a corollary, I wish the media would remember that strong statements require strong evidence.

“Roll a die, and there is 1/6 chance a 3 will come up; all 6 possibilities have equal probability.  But when you roll two dice, there are 11 possible sums, from 2-12 inclusive, and their probabilities are not all 1/11.  If you disagree, please see me with your wallet in hand and we will play, because the expected value of my winnings, which is the likelihood of my profit or loss over a period of time, will be in my favor.  If I can bet on the fewest sums that will in the long run pay me money, I will choose 7, which has a 1/6 probability, 6 and 8, which each have (5/36) probability, and either 5 or 9, each of which has 1/9 probability.  In the long run, the probability will be 20/36 in my favor.  We need to teach that competing ideas do not necessarily have the same probability.  That means we shouldn’t give equal time to people who think alien abduction occurs, because it either does or doesn’t, and they feel they should have equal say.  When we get to more significant probabilistic questions, such as smoking significantly increases the likelihood of lung cancer or heart disease, or that polio vaccination dramatically decreases the likelihood of contracting polio, we can and should make appropriate public policy.  Liberal theories?  Nope, just laws of mathematics that can be proven and which may be applied to everyday life.

“Furthermore, probability can be independent or dependent, and failure to remember that was in part was behind the Challenger shuttle disaster. Independence means that the results of one trial don’t affect the next.  Dice don’t have a memory.  Dependence means that they do.  When one O-ring fails, the likelihood of another’s failing increased.  Pull three aces out of a deck of cards, and the probability I will draw an ace from the remaining cards is now 1/49.  That is a conditional probability.

“When we make an estimate of something, we need a margin of error, a wonderful concept which teaches us to be humble and say, “I could be wrong,” four words every man ought to learn before getting married, and a breath of fresh air again in the Hallowed Halls of Power.  A caution, however, in that a margin of error doesn’t mean anything goes, that “anything is possible.”  Anything is possible if one’s idea of possibility is a one in a trillion event matters.  Statistics discusses things like million, billion, and trillion, so let me describe likelihoods for various scenarios:

  • 1 in 1000: about the likelihood of getting a straight flush in poker or correctly picking a second at random that I have chosen which occurred in the last 17 minutes.
  • 1 in 10000: about the likelihood of guessing right a kilometer I am thinking of between Chicago and Tokyo, or picking a minute correctly that I am thinking of that occurred in the past week.  
  • 1 in 100,000: correctly picking a millimeter at random that I am thinking about on a football field from the back of end zone to the back of the opposite end zone.  Correctly pick an hour chosen at random in the past 12 years.
  • 1 in a million: Correctly pick a person chosen at random in a large city; a second chosen at random in the last 12 days; an acre I am thinking of in a large wilderness area 50 x 30 miles size.
  • 1 in two billion:  Correctly pick a second, chosen at random, from the 1 January 1955 to now.  A single second. Correctly pick a randomly chosen acre in the US.
  • 1 in a trillion: Pick a day at random since the Earth was formed.  

I think that every legislator be compelled to know the differences among million, billion and trillion before they are allowed to run for office, so we don’t get silly statements of “billions and billions, and billions of acres are locked up by the federal government.”  The whole country has fewer than 2 billion acres.  If you don’t have the sense of what a billionaire is, you can’t appreciate how much money that is.  A billionaire could spend two thousand dollars a minute for a full year, day and night, before they would run out of money.  Ten million dollar house bought Monday morning?  Paid off Thursday evening.

“We use something called a confidence interval.  That is a range around an estimate where we state how confident we are that the true value lies in the interval.  It isn’t probability, it’s confidence.  You see, there exists a true value, but it is unknown and unknowable.  The range we have will either contain that true value or it won’t.  That is a 100%-0% question and not helpful.  We have 95% confidence intervals to explain that if we were to take 100 different samples, obtain 100 different estimates and confidence intervals, 95% of them would contain the true value, but we wouldn’t know which 95.  See?  We don’t know the answer.  But we are highly confident we can construct an interval wherein it lies.

Knowing confidence intervals would have been useful for journalists who reported on the once famous 44,000-98,000 deaths annually due to medical errors.  They rounded the latter figure up to 100,000 and used it, but the point estimate of 71,000 was the single best number.  Zero was not possible, nor 10,000, nor a million, not possible if we are going to remain sensible about the world.

“Global climate change likelihood is prediction, which lends itself to statistics and to confidence intervals, and the IPCC was more than 95% confident years ago, a strong statement of science.  It means that the interval they calculated was highly likely not to contain 0, no temperature rise.  It is incumbent upon those who disagree to come up with a confidence interval so that we can look at their data and see what assumptions and calculations their models have.  This would prevent a lot of unnecessary arguing, and the arguments we have would be more appropriate.

“Means and medians are basic concepts people should understand, because a mean, the average, is affected greatly by outliers, whereas the median is not nearly as sensitive.  Housing prices and salaries are much better described by the median.  

People talk about a non-existent term called the Law of Averages.  I’d not teach it, and maybe it would go away. There is The Law of Large Numbers, which says frequencies of events with the same likelihood of occurrence even out, given enough trials or instances.”

“I can see that a lot of you are yawning and looking fried.  I’m giving you a year’s curriculum in a few minutes.  Imagine, however, how useful all this stuff might be if I had a year to teach it to students.  I actually tried to do that in Tucson in 2011, for free, as a trial course, my swan song before leaving town 3 years later.  But I didn’t have an education degree, and the school had other priorities.  Such a shame, really.   OK, let’s take a break, and come back and I’ll finish the summary.”

TELESCOPES AND MARCHES

January 23, 2017

I was at the Eugene Astronomical Meeting the other night for the annual selling of astronomical stuff people no longer need, a sort of a swap meet-flea market atmosphere.  Several from the community came with telescopes they had received for Christmas and weren’t sure how to use them.

Because nobody had come forth to help one man in a wheelchair, who had a nice Newtonian ‘scope, I did what I could until another man came by giving me a curt “what are you doing, Bud?” before helping.  At my age, which was probably about 10 over his, I don’t like being called Bud.  I was a bit stung and left to wander around.  I don’t like being around a lot of people. Nearby, near the door of the planetarium, which is where we were meeting, I watched as a father, his presumed wife, and a pre-teen boy were getting help with a telescope.  This was clearly a father-son event, as the woman stood away quietly.  They got some help, then the father said he had to leave, because he was getting up at 1 am to work.  He was working two jobs.

Yeah, two jobs.  He’s looked like he was in his early 30s, got a son who is interested in the night sky, and bought a decent first telescope for both of them.  Two jobs. This is tough. Bringing up a kid, also tough, but he’s teaching the boy something about the night sky.  Good father.  Times are bad now, and they are going to be more so.  I have no idea what jobs the man was doing, only that nowadays, there exists the notion that somehow we can bring back the manufacturing era we once had, before just making steel was changed into making certain kinds of steel and other countries starting making their own, too.  We once made all the cars; we passed Japan in 2011 for second place, behind China, and have made as many as we ever have as of 2015.   As for mining, the big coal mining company Peabody went bankrupt last year, and coal, while cheap, is a less efficient-more polluting source of energy than natural gas, and renewables are competitive, especially if we factor in the environmental costs of coal and gas.  There isn’t a long term future in coal mining, only in trying to reclaim lands mined, and that’s a lost cause.

We could of course increase the forestry jobs in Oregon from the current 61,000 if we just cut everything down.  I use “cut down” over harvesting, because that is what we do.  Harvesting sounds a lot nicer, but harvesting corn works for me and harvesting trees doesn’t.  The forests are supposedly producing at a sustainable yield, but it sure bothers me to see the recent clearcut at the top of Cougar Summit on Highway 126 between here and Florence.  It will take decades to regrow. While replanting has to occur so that a tree is a certain height in 6 years, it will be a minimum of 60 and preferably longer years before the trees have begun to mature, in more or less a monoculture, meaning less biodiversity.  I realize we have to have wood, but we could do without a lot less paper, and the scars on the land, the aerial spraying of poison that wafts over people (documented high levels of atrazine in urine), and the loss of biodiversity.  If we had fewer kids, we wouldn’t need the 11-13 jobs paying $36K a year that a million board feet of lumber produces.  Of course, we could cut it all, damn the Murrelets and spotted owls, because we have a political party in power that can, but then after a flurry of jobs, there will be nothing, except complaints about how the Democrats killed the forest jobs.  It’s sort of like the collapse of the fishing industry off the Grand Banks.  The fish were thought to be infinite, but in the space of a few years they were gone.  If your time span of discretion, how long you plan ahead when you are dealing with life issues, is the next day, you cut everything down now.  If your time span of discretion is a decade, uncommon, then you don’t.

——————————————————

The two job guy had been on my mind for a while, when two days later I went to the Women’s March in Eugene, almost as an afterthought.  I don’t like to be around a lot of people, and I wondered whether it would really matter.  The one we had was big for Eugene, the biggest ever here, and we have a history of protests and marches. No, it wasn’t the half million in DC, but 7000 in a small town is impressive.  I was humbled by the diverse people who have always been around, only recently in a reasonable political climate able to exist freely and openly.  This includes women, LGBTQxx (the xx are mine, because I am frankly so far behind the curve in this area that I am probably missing something), and every group that voted for My Side last election.  I came because I thought I should.  I took the bus downtown, where we were stuck crossing the Willamette River in heavy traffic.  Eventually, the bus driver opened the doors for those of us who wanted to join the crowd, and I got off.

IMG_5476.jpg

IMG_5493.jpg

Harry Potter reference; personally, I have spent a lot of time in swamps, canoeing.

I took in everything I could, the energy of a heavily feminine crowd, the signs, the creativity of what they wrote, the anger they had about their treatment, yet anger tempered with a sense of humor, too.  I was in a group of mostly young, smart, articulate people who were damned if they were going to have to put up with what was coming.  As an old white guy, my presence probably helped some people realize not all of us are stodgy Republicans.

What struck me the most occurred later, when I saw an elderly woman, short to begin with, shorter still with the kyphosis of age.  She had to have been in her 80s or 90s.  She wore anti-white supremacy buttons and pushed a wheeled walker—in 43 degree temperature, rain, and significant wind.  She was there because this was a women’s rights march, she for whatever reason was not going to miss it.  I wondered what she did in life, her relationships with men, what she felt.  I was humbled by her presence and equally humbled seconds later by a couple my age standing on a corner, the woman dressed as a suffragette, carrying a sign saying “We Will Not Go back.”  Out in the street a group of women marched by holding a sign honoring women pioneers of all sorts, many of whose names I did not know. The young I knew would show up.  The middle aged ones I expected would.  The presence of the elders moved me deeply, and reminded me that half of humanity has not been allowed to reach its potential.

I needed to be there to support the elders; I needed to be there to be educated, to remember, and in some way to act.  I want to hide.  I must not, for I am in the position where I can help women, those less fortunate, and maybe those working two jobs.

1458.

IMG_5494.jpg

An Elder, marching.

IMG_5499.jpg

 

IMG_5500.jpg

Bernie’s supporters, se habla español también.

INTO THE LONG, DARK TUNNEL

January 18, 2017

A few years ago, I had dinner with an old friend, who brought his sister, an ED nurse.  In the conversation, she complained bitterly about people who didn’t have money who sought care in the ED.  They were dirty, smelly, unkempt, “frequent fliers” who misused the system.

My wife asked, “Should they just leave and die?”

The nurse replied, “Yes.”

I am not making this up.

I have been quiet regarding the future of the country.  In large part, I was worn out mentally from the sense I had had for months that the outcome would not be good.  I have long learned when people tell me everything is going to be OK, without solid facts to back up their assertions, it may not be.  I had said for a long time that the Democrats had a good chance of losing the election.  I was right.

We are now entering a time of darkness in America. I have been quiet, because I first had to process how this could have happened, then deal with conflicting emotions about what I was going to do or not do as a result.

I will start with the Affordable Care Act.  That is its name. Use it.  Words matter.  It will be repealed, should the Republicans have their way, and in the foreseeable future they will—8 years minimum in the Executive Branch (you don’t think the Democrats can win again in 4 years, do you?), a generation (20 years) or two in the Judicial, and judging by all the Democratic senators up for re-election in 2018, at least 8 years in the Senate, if not permanently—the ACA and other safety nets are on the chopping block.  I’m hoping the American public will eventually see through this unraveling, but I have little confidence in the American public, who could care less about ideas and competence and more about “scandals to go,” and fail to call bullies out on their lies.

The Republicans have had an irrational hatred of the ACA from its inception and now can kill it. If they had a solid plan to replace it (besides prayer, medical savings accounts, GoFundMe and staying healthy), that they were ready to roll out this spring, had the Democrats only been less intransigent, that would be another matter.  But no, the ACA is being repealed without a replacement.  The CBO (Congressional Budget Office) says this would increase deficits $137 billion by 2025 (about $350 billion total in the interval, from looking at their graph) and increase the uninsured 32 million , many of whom being poor rural whites who voted for the president-elect, ironically, because they didn’t seem to understand until now the consequences, because, well, Hillary couldn’t be trusted and what did we have to lose?….)

The incoming president says he will cover everybody with insurance, but Congressional Republicans have no knowledge of his plan.  Repealing something that is working, however imperfectly, without a plan to replace it is a bad idea.  I am reading letters and posts from people who complain that “the rest of us are subsidizing them.”  One who agrees, a good friend, has a pension and is on Medicare.  Those of us who bought his product and live in America pay for his health care, too.  It’s just not as obvious.  It’s like the Interstate Highway or the National Park System.  They are national, and those in the west for the most part enjoy them on the backs of taxpayers in the east, who are remarkably patient with us.  Of course poor people need subsidies to get medical care.  Did you think they suddenly became rich?  In the past, they were excluded by having pre-existing conditions or skipped care altogether, like columnist Nicholas Christoff’s friend, who one day saw blood in his urine, ignored it because of costs, and discovered months later he had Stage IV prostate cancer.  His friend is dead.  Is that what we want in America?  If I am wrong, please tell me, so I will know I no longer belong in this country, for I say it is NOT wrong to try to cover people who have illnesses that the rest of us should be glad we don’t have. The America I served in uniform overseas is about compassion, not a strict fairness/pull yourself up by your bootstraps/I made it by working and so should you/don’t be so damn lazy/it’s my money not yours. Each of us is a microbe, an aneurysm, a bad driver, a malignant cell, or a blood clot away from incurring a massive multimillion dollar hospital bill.  EACH OF US.  Not providing medical care when we could is immoral.  Yes, immoral.  Of course the ACA costs a lot of money.  Twenty million people are accessing medical care who either didn’t access it earlier or weren’t able to pay for it, and it was subsidized by medical personnel like me or hospitals, who couldn’t buy capital equipment or hire more nurses to improve staffing levels.  Some might say that hospitals should do that anyway and pay administrators less.  I agree, but as one who practiced medicine and became a medical administrator, let me assure you that practicing physicians have neither the knowledge, the discipline, nor the time to run a hospital.  Having a system that isn’t paying executives such outrageous sums would be a good start.  But it won’t insure millions of people.

The ACA has become like climate change, a hatred of something that goes beyond facts to an ideology that ignores facts. With climate change, there is a small definable chance the extremely high confidence we have that it is manmade is wrong.  To argue it can’t possibly be occurring means an individual knows all the salient parameters of the Earth and its atmosphere, how they interacted in the past and how they will interact in the future. That is simply not possible.  The ACA is working for many millions of Americans.  It is far from perfect, a fact due to the intransigence of Republicans who never planned to vote for it and who didn’t try to make it better, only tried to kill it, like the stimulus.  All sorts of catastrophes predicted did not come true.  The ACA hasn’t ruined America, but enough loud people have said that long enough that the public believes it without realizing the numbers of uninsured are at their lowest levels in since about mid-1960s,  when we had about 100 million fewer people in this country, medical care was far cheaper, back in the days when you called a doctor’s office for an appointment, the first question asked was about your medical problem, not your insurance.  Don’t remember that?  I sure do.

I remember In 1984, my colleagues and I basically bankrolled the Arizona Health Care Cost Containment System, Arizona’s answer to Medicaid, by not being paid for patients we saw (AHCCCS Non-Certified, which we pronounced Access Non-Cert) because the system didn’t find patients with no insurance until after they came to the ED.  We didn’t like it, but you know what?  We made good money anyway in spite of not being paid for these people. Yeah, I hated being called out at 2 am to see some uninsured drunk guy who wrecked his motorcycle and wasn’t wearing a helmet, because Arizona had repealed that law in 1976.  If the patient were lucky, he might have had enough brain function to cuss me out, threaten to sue me, and not end up in a nursing home vegetative.  It wasn’t fair to me, but life isn’t fair.  I got over it. You don’t let these people die at the side of the road, unlike what folk hero Dr. Ron Paul said, to great applause in 2008 and my friend’s sister said that night at dinner.  We don’t behave that way in my America.

Want to get rid of insurance company markups, high salaries and all sorts of exclusions?  Then expand Medicare, which has such a low overhead and high favorably rating by the elderly that some elderly argued against the ACA by saying, “Keep your government hands off my Medicare,” not even aware the Medicare was government subsidized medical care.  Yes, your taxes would go up, and you would lose money if you were not sick enough in a given year.  In exchange would be peace of mind that a major medical bill wouldn’t bankrupt you.  A physician friend’s husband had a $40,000 ED bill  for a kidney stone. Is it not a good thing to pay for insurance you may not use?  I consider it a good year if my veterinary medical bills are more than my personal ones.  If my house burns down, I have fire insurance. I have peace of mind, a concept apparently not appreciated  by many, because it doesn’t have a dollar sign preceding it.  People with peace of mind about their health tend to be happier. We learned that from the Oregon study where those who received insurance in a lottery didn’t spend time worrying about what would become of them if a child got meningitis, a person passed blood in their urine, they had chest pain, leg swelling, or a breast lump.  I don’t begrudge being taxed to pay for basic health insurance for everybody any more than I don’t begrudge repairing I-35 in Minnesota, for it is part of a national road system, or repairing tornado damage in Alabama. With the latter, however, to be honest, if those people are so anti-government, maybe they should try prayer, passing the hat, or just picking themselves up and doing their own repairs.  I protested paying for a war in Iraq that I felt was unnecessary and illegal, and I resent paying for the 75,000 major hospitalizations annually due to gun violence, when a few decide that we won’t even do background checks.  I resented paying for law enforcement to deal with the occupiers in Malheur, when they broke several laws, bullied people, ruined a small town, and tried to take over lands that belong to me, too.  Life isn’t fair.  Act to change things. I write. That’s my voice.

We have yet to deal with the quality of medical care, which the ACA addressed only slightly.  We haven’t adequately addressed end of life and preventive care, plus a host of other issues that would save money, help people and bring peace of mind simultaneously.  To repeal a major first step, because by God, nobody should get something for nothing in this country, is to condemn many people to bankruptcy, misery, and death.  I thought America was better, but I was conned.  Not by the presidential candidate, but by the gullibility and incredible cowardice of the media and the stupidity of the American public.

It’s time to enter the tunnel.  I will keep my light with me.  I also know which way north is.