Boreal B[l]og

I try not to get into too many arguments online.  It’s not possible to convince some that contrails are just condensate from aircraft exhaust and that yes, we really did land on the Moon.  I stopped arguing online about global climate change a few years ago.  I wasn’t going to change anybody, and I got tired of hitting my head against a wall.  I’m rooting for Mother Nature.

The other day, however, I perhaps influenced two men.  I should probably quit, and I probably will remain silent.  The first was an individual whose arguments were basically contrary to most things I believe in.  He is not stupid, but he certainly is on The Other Side. Yesterday, he and a friend of mine had about as nasty an exchange as I can think of.

I read where he used “whom” following “to,” which is acceptable, if whom is an object, like “To whom it may concern.”  In this instance, however, the “whom” should have been “who,” for the personal pronoun was the subject of an objective prepositional phrase.  Here’s an example: “I will give this to whoever can clearly explain the difference.” The last six words are the object of the preposition to, and it is an independent clause, the whole object.  “Who” is used for the subject.  “I will give this to whomever you recommend.”  Here, it is whomever, because the subject is “you” and the phrase “you recommend whomever” has whomever as an object.  I later deleted the comment, because it wasn’t necessary, but the individual saw it before deleting and agreed with the grammar.  OK, he leaned something, which is good, and so did I, along with the fact that the individual could be wrong.

Being wrong, and admitting the possibility one could be wrong is important to me before I engage in arguments.  Otherwise, I either remain silent or do a monologue. Silence makes me wish I had done something; a monologue makes me wish I hadn’t.   The woman’s march had just occurred, and another individual was in a Facebook Fight with a few women about unequal pay between the sexes.  He didn’t believe in the gap, and demanded evidence.  I went ahead and Googled an article about unequal pay and read it.  That led me to an American Enterprise Institute article, from the conservative think tank, and I read it, too.  While perhaps two or three points were reasonable, they were drowned out to me because of all the pejorative language against liberals and Obama’s statement in the Lilly Ledbetter case. I really expect more professionalism from AEI writers.  Frankly, I write better.  The title, referring to the evidence “as elusive as Bigfoot,” turned me off.  I suggested in my post that I would review the AEI article in detail if he would review another article in support of the claim.  I also mentioned that willingness to admit one might be in error (which I did in the post) leads to a lot more fruitful discussions.  Three hours later, with no comment, I just wrote, “I’m still waiting.”

To his credit, the individual answered, and so I went to the AEI article about unequal pay. It led me to a fact checking site, along with a few others, and in about 30 minutes I had a considerably more information about unequal pay between men and women.  This is the post I put out.

“It’s actually very interesting.  If one controls for the same job title, employer, and location, there is a gap—about 4-6%.  This is considerably less than the 23% (or 21%) often quoted, although over a career, it amounts to maybe a half million dollars both in earnings and benefits.

The AEI article has a point here, although one of their unanswered questions—have you ever heard of a female real estate agent making less than a man?—should have been answered by them, for it is one of the largest discrepancies of all, as is the female personal financial advisor, both cases showing that women make half as much as men or even less.  For cashiers, it is 92%, computer programmers 95%.

“The 21% comes from definitions of full time and comparing across all jobs.  Seniority has typically gone to men, which explains some of the gap.  It’s fair to examine seniority, but not in the context of equal pay for equal work.  This is not appropriate, although it has been used.  On the other hand, it is equally inappropriate to disparage all the data, because here and in all developed countries their is a gap, just not as large as is often stated.  Still, I chastise the latter (My Side) for saying it will be 70 years (or 170 for another measure) for full equality.  Yes, at the current rate, but that is not a sensible extrapolation in my view.

“I think the AEI would have done better to have admitted that equal pay for equal work is not present, what the number is, and dispensed with the statement referring to “Bigfoot sightings,” which given my propensity to hike in the Pac NW wilderness might actually occur (!)

“What I hope comes out of this argument is some learning by both sides as to the scope of the problem.  I certainly learned something from this, how the statistic is calculated, what should be measured, the fact that there is a gap, and in some professions very significant.  I’d like to think that most of us will look at some of the “sacred cows” in society and find the truth.

“Not that I want to discuss the following in detail, but other examples include that most gun deaths are suicides and the number of deaths per 100,000 is flat.  I’m not saying that is good, but it is factual.

“I’m just tired of spending my days arguing and decided it was time to get both sides to look at an example of the other, and find where the grains of truth are.”

With some trepidation, I read the reply:  “That is truly beautiful.  Thank you.”

I tend to delete most of my posts on Facebook.  I try not to read too much, because it’s depressing what my friends post, it’s depressing what some believe, and it’s depressing to spend a day arguing with people who dig in and aren’t going to be swayed.  For some reason, I rightly picked a misplaced personal pronoun written by one who was not only intelligent enough to know what one was but also likely the type who would not want to have his post contain an error, I gently corrected his grammar, leaving the argument alone.  That action may have led me to decide not to assume the equal pay issue was what I had been told until I first fact-checked it, surprising me when I found that some data was misconstrued, even as the argument, if not quite as strong, was still valid.

I still remember a debate in junior high school about paving all dirt roads.  Back then, I was adamantly against it.  I had a wise teacher who made me argue in favor of it.  I hadn’t thought of that in years.

“Experimentation is an act of humility, an acknowledgment that there is simply no way of knowing without trying something different.”  Sendhil Mullainathan

I read this in the New York Times, somewhat surprised by that Mr. Mullainathan had yet to perform the experiment that he said would be an act of humility.  The experiment was whether or not to change the diet soda he was drinking, that’s all.  He did mention an example of a brief tube strike in London; when it ended, about one in 20 riders had found different means to get to work and got there faster.  The others resumed their old ways.  I don’t consider changing diet soda’s being a significant life experiment, but then again, I’ve kept shirts for 25 years.

Experimenting is a life style choice, not necessarily a virtue: my wife has had two major interests, aside from me and our cats.  The first is horses, which has been as close to lifelong as could be possible; the second, radiology, she spent 40 years doing before retiring.  Many of the new things she tried were through me, but horses and films are her world, where she has been content and extremely competent in both.  She is exceedingly good at considering new alternatives when I bring up issues in my life, priorities, or time.  Her father took up hobbies of carpentry, gardening, sailing and golf.  He tried them long enough until he was comfortable with his competence, and then he did something new.

I’m the same way.  I admit it takes me a while to change computers, morning habits, or routes to places I commonly go.  Habits are an efficient way to get things done, and most of my life I have had to be efficient.

When it comes to experimentation, however, I go far beyond what kind of diet soda I drink (none, for I gave it up years ago).  I even go beyond the experimentation with becoming vegetarian, which was a big change in my life 27 years ago, but hardly the biggest.  Or doing without caffeine and even alcohol.

In 1984, I saw three bright planets in the sky, thought others probably saw them as well and might wonder what they were. I wrote the newspaper, asking if they were interested in an astronomy column.  Not hearing back, which didn’t surprise me, I wrote again and finally called, reaching a staff member who asked for 3 different length columns, which I submitted for consideration.  I ended up writing 750 columns, self-illustrated, over a 20 year period.  I had no formal training in astronomy, but I knew how to observe, write, and find answers to questions, even before the Internet.

A few years later, at 43, I decided, not on a whim, that I was going to take a 6 month leave of absence from a busy neurology-neurosurgery group to go volunteer for the US Forest Service as a wilderness ranger in the Boundary Waters of Minnesota.  I was going to be away from home, in a place where I had no reputation, nobody I knew, and a job I wasn’t at all sure I could do but thought I could and would like.  I suspect more than one of my colleagues thought I would be back at the office in a month, but I found I could do the work, loved it, became competent, stronger than ever before in my life, and left somewhat sad, because I knew I had a very special experience, one I would never repeat.

I then did another experiment after I returned when I changed jobs at the peak of my earning power.  I left practice to become medical director of a hospital, a hybrid individual neither physician nor administrator, distrusted by both groups.  I stayed in the role 5 1/2 years, grew, became interested in quality improvement, rising to vice president in both state and local medical societies, respected for the analytical knowledge and approach I brought to my job.

Lest one think that I went from one high powered job to another, without any risk of failure, I then undertook, at 49, one of the biggest “experiments” of all.  I bet my career on being able to become a Masters trained statistician who was also a physician.  To do that, I had to apply and get accepted at an out of state university, review calculus I hadn’t seen for 30 years, and then commute nearly 300 miles one way, every week, to be a graduate student, about as lowly as a medical student, for two years.

Somehow, I got through the first semester of Mathematical Statistics, my happening to know (in class) one day the integral of log (x) dx*, which the professor, later my advisor, told me, “I realized then you were for real.”  School wasn’t easy, and every night I cussed at integrals, matrices, computer programs, at the same time as I was teaching two days a week and caring for my class.

When I got my Masters, alas, I had not taken a course in marketing.  I found minimal work discovering I could understand “no” by the sound of the disinterested voice on the other end.  I failed economically, but by then, despite my bitterness at the medical community, which took me 5 years to get through, I looked for new opportunities and found them in several other fields.

I became interested in medical errors, their similarity to aviation with the exception that aviation had a system where one could learn from them, and back then medicine did not.  I wrote two bills for the Arizona legislature creating a reporting system for medical errors.  The bills died, but from that failure, I was asked to write a monthly column for the medical society.  I became a writer.  I wrote three different monthly columns at one point: astronomy and reasons we make errors being the two others.  I won the Creative Expression Award for Human Values in Neurology in 2003 and my article “Astronomy for Writers and Editors” was a finalist in the Writer’s Digest Competition.

I brought my math to bear in the public schools as a ten year volunteer, before becoming a substitute teacher for four years in one district, my statistical and real world knowledge of math helping me immensely with the students.

In 2008, I became a volunteer at Rowe Sanctuary in Nebraska, and two years later, after seeing my eleventh total solar eclipse with a German tour group, I decided to learn German. I had no idea I would teach people about cranes, see as many (17) total solar eclipses as I have, all over the world, and could learn, if only to the intermediate level, a foreign language.  I watch German Krimis (crime movies) for relaxation.

Life is to be lived.  I sometimes envy my wife, who is satisfied with a deep knowledge and love of horses. I have never been able to stick with an interest as long.  On the other hand, to any who might envy my interest in so many facets of the world, I say simply to keep your eyes and ears open, for opportunities are common but are not often announced.  Failure is a big, often recognized, opportunity. It is your life to live, and it is your decision—nobody else’s, unless you cede authority—to choose.  Finding yourself truly content is a sign you are probably living properly, regardless of whether you run “experiments.”

*log(x) dx is integrated by parts

u=log x; dv=dx

du=dx/x; v=x

From this, the result is uv-int(v*int(du))=xlog(x)-int(x*dx/x)=xlog(x)-x or x(log(x)-1) (+C).

I was medical director at a hospital back when medical directors/physicians in management were relatively new.  There were two Catholic hospitals in town, each with a medical director, and at the time there was a loose arrangement of the two hospitals with one overall medical director, my boss.

I went to a meeting one day at the other hospital about the roll out of an integrated medical delivery system, which I assumed wouldn’t involve me too much, but would start integrating practitioners in both hospitals and add a third hospital in a rural city to the network.

That night, I failed to show a major Profile in Courage moment: to stand up for what is right when one has absolutely nothing to gain and a great deal to lose.  My boss, whom I respected and liked, was passed over for the job of medical director, for which she was perfectly qualified, in favor of a family practitioner who was an EEG tech when I was a resident. I didn’t speak up against this outrage.  I can still remember hearing the name of the new network medical director. No, I didn’t stand up to the elderly nun, an institution in the hospital and community, to say, “Sister, this is wrong. Unless you reconsider, I am resigning.”

Yeah, I was making good money, but my wife and I could have swung it had I quit. Maybe I was so stunned that the doctor chosen didn’t have the qualifications. Maybe I was afraid.  But I certainly failed to speak up, that is quite clear, and I should have.  I might not have changed the decision, and I might have been fired had I not resigned, but the chance to do the first and risk the second was a risk I should have taken.  My boss resigned, the family practitioner had a very uncomfortable first meeting with me and was gone from his job within a year.

I subsequently worked under a new senior medical director, part of the executive team (I was never allowed into that sphere) before I had enough and finally left for graduate school, two years later.

My failure to speak up remains a big regret, and I can date it, because there was a total lunar eclipse that night, and I still remember standing outside looking at it and wondering why I hadn’t said something.

Profile in Courage moments may be more minor, but they are clearly speaking out against injustice when staying silent is easier and safer.  At one medical conference, the organizer commented on work that had been done on lymphapheresis for multiple sclerosis.  He quoted a study I happened to know quite well.  Not sure what I was doing, I suddenly found myself standing up.

“I disagree with you, sir.”  That turned everybody’s gaze on the 31 year-old nobody well back in the room.  “I was one of the physicians involved in the study, and while as an academic I want publications on my resume, I asked to be removed from this one, because I thought the study was poorly designed, biased, the data incorrect, and the conclusions unwarranted.”  Shaking, as I do when I speak passionately in public, I sat down amid a lot of murmuring.  The organizer mumbled a few words, and I simply shook my head no.

I can think of another time when I suddenly stood up, which I knew enhanced my words, the shaking, and the passionate comments.  The chief of staff at the hospital had lambasted me in front of the Medical Executive Committee, saying that I was examining patients, and I had no business doing so.

“I was called by the nursing staff because the patient was admitted to cardiology, and no doctor the nurses called wanted to accept the patient.” (Yes, those sorts of things happened.)  “I examined the patient, wrote some covering orders, then called an internist I knew who took over the patient’s care.”  At this point, I was winding up, so I let go with one more.

“I have also taken over the care of a Parkinson’s patient whose family fired the doctor, so he just quit, which is unethical behavior.  It is incumbent upon the physician to transfer the care, and this one just walked away.”

If I remember correctly, I walked out of the room down the hall and outside and cried for a few minutes.  One of the better things I learned—too late in life but better late than not at all—was how to cry.

Like perfect squelches, words one says that are absolutely perfect in time, place, and content, Profiles in Courage are one—two—three—five in a lifetime events. I can date every one of the four perfect squelches in my life. I blew my big Profile in Courage moment.

We need more Profile in Courage moments in Washington.  We need elected representatives to speak out against a president who doesn’t belong in office.  Many are apparently saying this in private.  Mr. Flake did a decent job, but he limited his Profile in Courage moment.  He could have done what few politicians are willing to do: quit his party and caucus with the other, stay in office, and let the voters decide whether he was adequately representing them. Mr. Flake would have rocked the country in doing so. While he would have taken a huge amount of heat, maybe a recall election, he would have earned the respect of millions, including me.

We need someone in the halls of power to speak up and say the emperor has no clothes (the visualization of which is abhorrent), that Congress is co-equal and will act accordingly, with both sides of the aisle having a say in legislation, even if one side is outvoted.  We need someone to say that much as they like the chance to put through a conservative agenda, that to do so without addressing the dysfunction in the Executive Branch is wrong, and Congress can and must do something about it.

The irony to me is that before #metoo many Profile in Courage moments I’ve seen have come from Iranian women who don white every Wednesday to protest the forced hijab.  For years, many have removed the cover altogether and shown videos of themselves walking without it.  These women are very courageous.  Many are insulted. Some have acid thrown in their faces.  Others are beaten, arrested, even killed.  They are putting their lives on the line for something they believe in, and if the running of the United States of America is less important than whether an Iranian woman should cover her hair, then we would do well to open immigration to those women, should any actually want to come here, in hopes they might light a fire under our lawmakers.

We now have American women speaking out against sexual abuse, which has involved my own alma mater, which really hurts.  Many of these women never spoke up, but when the time came, they took their Profile in Courage moment and ran with it. Some won elected office.

In these days of Roy Moore, Michelle Bachmann, clean air is unhealthy, more guns makes us safer, $1000 savings in taxes allows one to buy a car, adding $1.5 trillion to the debt is a good thing, grabbing them by the pussy does not disqualify one from becoming President, taking off the clothes of a 14 year-old girl doesn’t disqualify one for the US Senate, each of us needs to be on the lookout for a Profile in Courage moment.

It’s fine to shake, to sweat, to speak passionately.  Don’t be afraid to pause.  Mr. Obama often paused when he spoke.  He did it for effect, but he also did it to think about what he was going to say next.  We need a lot of thinking these days.