Tom's Musings

I can remember the good old days when my doctors would actually look at me during a medical visit, or recognize that we were in the same room during the exam. Now, they spend our time together glancing at the clock or focusing entirely on their Epic systems keyboard. I am old enough to recall the days when there was time during a medical checkup to chat about stuff in general, about politics or books that we had just read, or why the U.S. medical system was going down the crapper. Ah, the good old days for sure.

Now, just getting a freaking appointment is a struggle. I’m not totally sure what has gone wrong, though I always have a hypothesis or two on every topic. The thing is, I live in Madison Wisconsin. This is a regional medical center where doctors love to live and practice, and where the prestiguous University of Wisconsin Hospital is located. Drive around the west side of my city and you stumble across a medical building on every other block (sometimes every block). I’m not talking about an individual doctor’s office like you would see in Florida but a whole building filled with highly trained medical professionals who presumably could be devoted to my medical well-being. Okay, too often they are dedicated to narrow part of my health or to singular afflictions … the G.I. system or my left ear or my aching butt. Nevertheless, they seem to be everywhere.

Despite being in this medical care heaven, just try to see a real physician. I dare you … just try. I used to be able to see my internist promptly and without issue. I recall getting my periodic colonoscopy scheduled in a couple of weeks (back in the old days). Hah, my internist ordered my most recent one back in November. His association used to have a general surgeon in house, and it seemed easy to get the procedure done in a very reasonable time.

Now, however, I am referred to a specialist in another one of these ubiquitous clinics. I was told not to even call the clinic for at least two weeks to permit time for my request to get into their system. When I did call, the first opening was some five months out. I asked the gal who had the pleasure of seeing my backside (admittedly my best side) why the long wait. She mumbled something about Covid causing delays and then a lower age threshold for initiating screenings. Possibly, but still. I can remember when Republicans asserted we surely did not want socialized medicine in the U.S. like they have in Canada because of the delays in getting service. Duh, we have a for profit system (in part) and the wait times to be treated are excruciatingly long. I’ve never, ever heard a foreigner (no Canadian for sure) say they wanted to move here for our health care system

One more example! In every visit my dermatologist usually finds another spot or two that needs excavation to remove a cancerous growth of some sort. I spent too much tiime in my debauched youth out in the sun and not enough time studying in the library. Fortunately, none have been Melanoma but they often require the Moh’s protocol (developed at Wisconsin) which can be a lengthy procedure but which ensures that all the cancer will be removed.

Again, I usually could get that operation scheduled within a very reasonable amount of time. How things have changed, it has been several months since my latest spot was identified on my facial cheek and another Moh’s procedure deemed necessary. I’ll be lucky if my cheek doesn’t fall off before they get to me. I like my dermatologist and we usually can chat about literature during the lengthy Moh’s procedure. But I’m a bit concerned that I now have enough time between diagnosis and treatment to write another one of my 500 plus page books.

The other day, I saw my new ear specialist. My former ear doc was one of the best in the State. I was bumped to him by another surgeon since he was one of two in the state who could handle a delicate operation that involved removing a deeply embedded tumor in my left ear without damaging the surrounding facial nerves or slicing through an artery. It was a 5.5 hour operation and I was grateful for his expertise. But he, like several of my other docs, has retired recently. Most are bailing out early these days and I’m beginning to wonder if they are trying to escape me personally. Only my neighbor, a rather reknowned infectious disease doc, has continued to work into his 80s.

So, I have a new ear doc since there is some suspicion that the tumor may be coming back. He breezes in (with medical residents and students in tow), putzes in my ear for a bit, mentions something about an MRI in a year and is gone. I hardly had time to start an argument with him about our insane health care financing system though, when I raised the issue, he did not score points with me when he blamed bad lifestyle decisions by patients for the comparatively higher health costs in the U.S. While that is undoubtedly a contributing cause, our systems failures cannot be ignored.

He obliquely did mention the Epic system though. he noted that, when he was training at Duke medical school, they introduced the Epic system. He made the point that the number of patients being seen dropped by one-third but the program remained revenue neutral (no loss of income). Before I could push him on whether that was good or bad from his persepctive, he was gone. But that did not sound good to me.

I should say that he personally is not to blame for treating me as a cog on the assembly line. In most professions, everything is driven by the bottom line these days. Medical facilities are now profit centers and nothing must slow up the assembly line. The clock is ticking when the doc enters the door and, in my ear doc’s defense, he does strike me as competent. Still, it is discomforting that you hesitate to ask a question knowing that will make your medical professional uneasy. After all, any delay will put him behind in the daily grind of assembly line medicine.

Fear not, though. There may be an answer on the horizon. I just read about recent research illuminating the wonders of AI technology. A study by researchers at the University of California-San Diego comparing responses to 200 medical questions from an artificial intelligence program (ChatGPT) as compared to highly trained human medical personnel. The responses were then subject to a blind assessment by a panel of medical professionals. So, how did the machine do compared to real doctors?

The machine generated responses were three to four times more reliable and accurate than those from human docs. The machine was less likely to make things up if it didn’t know the answer.

Shockingly, the machine were judged to be seven times more empathetic as their human counterparts.

Hmmm, one would think that humans would evidence a more human touch in patient-physician interactions. In fact, a full 60 percent of people surveyed still want to be treated by a human and not a machine irrespective of such outcomes. Your friendly (or not so friendly) doc is not likely to be replaced soon. Still, at first blush, it is shocking that machines are more sensitive and compassionate than our fellow humans. Okay, not so shocking. I’ve always felt that humans were way over rated.

On further thought, perhaps that is not so surprising. First, the machines are only mimicking what we think of as human reactions and can be trained to be better at it. Humans vary considerably along atributes such as empathy. In the future, who knows what the capabilities of machines might be. Perhaps they will evolve to feel real emotions.

It is more than that, though. With medicine increasingly driven by the bottom line, humans are not permitted to be human any longer. Docs are being reduced to assembly-line personnel … robots that look human but have institutionally been stripped of all their humanity. And like the specialization that Henry Ford introduced in Detroit a century ago, physicians have been forced into increasingly narrow specializations so that productivity can be maintained as the sick flow along the assembly line. Routinization, after all, is the key to efficience which drives up profits. When I met the woman who did my colonoscopy, I wondered if that was all she did. If that had been my job in life, I would have considered suicide within a year.

In addition, most medical interactions are reduced to gathering and inputing information into automated systems. Increasingly, communications with patients are done remotely through venues such as MyChart from Epic systems. Some docs aready complain that half their day is spent on the computer, not dealing one-on-one with patients. Routinized practice dominated by on-line automated systems requirements have become the norm. Would replacing the human factor be much of a change? Would we even notice the transition?

Will artificial doctors, especially when doing diagnostic and triage functions, be a bad thing? I cannot say. However, we cannot take much comfort in the salient trends evident in contemporary medicine, at least in the States. Experienced doctors are retiring early. They are burnt out and/or despairing in the face of mountains of paperwork, assembly line patient interactions, and corporate bottom lines. The young recruits to medicine might well be driven more by the money to be made than any sense of professional purpose. If that is the case, perhaps the machines cannot replace human doctors soon enough. After all, they don’t get tired or dissillusioned or cranky or distracted by the thought that they are late for their tee time at the club. [Note: My opthamologist, whom I thought highly of, did have a rather low single digit golf handicap which made me somewhat suspicious :-)).

On the other hand, what would prevent the next generation of AI medical healers from realizing that those pathetic human they are helping are hardly worth the effort. Why keep these talentless humans alive? How convenient for the machines if they have taken, or been given, control over the future health of the species as they realize just how useless we are. That is just a thought.

I can’t end another discussion on AI without sharing a poem one of them generated recently. It is on the topic of America’s pasttime … baseball.

“In Summer’s embrace,

Bats crack, balls soar through the air,

Baseball’s timeless grace.”

Next time I am tempted to write a book, I’ll just ask a machine to do it for me. As I keep saying, I’m so glad I’m old.

I know a great author. You might want to pick up one or two of his marvelous books for your Summer reading. You can thank me later.

Consider this. It is warm summer eve. The sun is setting over the calming waters. You wish to relax, perhaps entertain something within your restless mind or febrile imagination. A good book … that would do the trick. Well, I have just the literary offerings for you to consider. Keep scrolling!

Below are four fictional works to both engage and challenge you. Seriously, people really liked them.

I start with Oblique Journeys. This work, drawn in part from my own experiences, brings the reader back to the turbulent 1960s and the conflict that tore the country apart … the Vietnam war. It is a story experienced thousands of times … a young man must decide where his loyalties lie and what his moral center tells him he must do. Most of the narrative takes place over four decades in the future as he retired from an academic position in the country to which he fled so many years ago … Canada. Over the course of one week, Joshua Connelly comes to terms with himself, his conscience, and the relationships seemingly lost when he fled north at the onset of his adult life. Ultimately, it is a story of reconciliation and redemption.

The next three works (Palpable Passions, Ordinary Obsessions, and Felicitous Fates) are part of a series though, according to readers, each stands alone. There is plenty of backstory in each for the reader to get into the complex narrative no matter where they start. Essentially, the series deals with the saga of two familes, the Crawfords in America and later in Britain, and the Masoud clan, starting in Afghanistan before moving on the Britain. Both families engage in a two decade struggle against the push to establish autocratic and oppressive rule in their worlds. The Crawford children react to their far right patriarch as he pushes his autocratic vision in the States. The Masoud girls, Azita and Deena, are inspired to fight against the Taliban regime which would truncate their dreams as educated women. The two families come together by circumstance as their personal challenges are explored on several levels … relational, political, internal, and moral. In their stories, the central conflicts of our age are explored. All these works received very high reader reviews with Ordinary Obsessions getting 4.8 out of 5 stars.

By the way, the Connelly story and characters are reintroduced in the final work of the original series … Felicitous Fates.

Now we move on to the final work in the series, and my most recent literary gem … Refractive Reflections. Actually, Felicitous Fates originally was designed to end the saga involving the Masoud and Crawford clans. Then, the damn Taliban made a comeback in Afghanistan and the far right, at Trump’s urging, attempted a violent coup in the States. Obviously, the narrative drama had to continue. It proved to be an opportunity to bring greater closure to the Joshua Connelly story. Only time will tell if this is really the end. Refractive Reflections (below) is propbably my most thoughtful work though I try to balance several dimensions in all my writings … drama, introspection, relational conflict, moral and ethical questioning, and personal redemption (or not).

Don’t like fiction! Not to worry, I have more for you. The three works below are memoirs, each written with great wit and considerable insight (in my humble opinion). A Clueless Rebel is the story of my struggle to figure out who I was. It is also a nostalgic trip back to the post World War II period when life was lived in a simpler manner and yet the possibilities appeared endless. The Amazon readers of an early version gave this 4.9 out of 5 stars, just about the best response you can get.

A Wayward Academic: Reflections from the policy trenches tells the story of my professional life. As it turned out, I stumbled into a career as a policy wonk that put me in the center of one of the more challenging issues of my generation … welfare reform and what to do with our poor. It was one hell of a ride which I recount once again with considerable wit. One of the best Washington-based advocates I know said that I was the only writer he knew who could discuss welfare reform and still make people laugh.

Finally, Our Grand Adventure is the story of my Peace Corps Group, India-44. We were volunteers during the period known as the ‘wild west’ of the PC experiment back in the 1960s. We also served in what was widely known as one of toughest sites at that time … India. To make it even more challenging, we were city kids who were given a bit of training and told too be farming experts. That was a bad idea. Our antics and efforts are hilarious and worth the price of admission.

Now, if you are looking for something of a more serious or intellectual flavor, I will throw out two possibilities. You might try Confessions of an Accidental Scholar. I think of this as the best thoughts of Tom Corbett and draws on my extensive professional writings, mostly from FOCUS, a widely admired policy publication of the Institute for Research on Poverty at the University of Wisconsin-Madison. I have always tried to write for an audience beyond the small band of scholars who frequent peer reviewed journals. If you like public policy, you will love this book.

Just to fill in the range of possibilities, I’ll suggest Evidence-Based Policymaking. This is a real academic work co-authored with Karen Bogenschneider and deals with the impediments to better employing science and reason in the policy arts. This was a topic of enormous interest to Karen and I. Warning, this is not a light read but not as bad as most academic tomes.

Well, there should be plenty here to keep you busy this summer. And then, when they make movies of some of these classics, you can say that you knew me when I was a nobody :-)!

I love running across historical facts and oddities that have heretofore escaped my attention or which suddenly catch up my interest or perhaps pop into my restless (and mostly unused) brain. Obviously, there are legions of such stories out there so I will occasionally lay out a few from time to time for your edification. I really do need to get a life. Aren’t you thrilled to be following my blog. Where else can you be entertained like this?

Let’s start with Cleopatra, the Greek seductress of Egypt who mesmerized Caesar and Marc Antony. But here’s the thing about her. She is closer (time wise) to the IPhone than to the great Egyptian Pyramids. Yup, some of them were erected in 2,500 BC while Cleo was doing her thing almost 2,500 years later. It has been only two millenia since she stopped doing her feminine mischief and offed herself.

Speaking of Caesar, as a young man he was more or less an ordinary soldier but from a family with some means. He was captured by some pirates at one point and held for ransom. While in captivity, he disprespected his captors and even promised to kill them all when he had a chance in the future. They never took him seriously and, in fact, laughed at his boasts. Eventualy, he was released upon receiving the ransom demand. Bad mistake on their part since Caesar made good on his boast. He raised a fleet of ships before returning and executing them all. Some people are more than blowhards.

Now, Joseph Stalin was not a blowhard. In fact, he never said very much at all, especially in public where he was embarrassed by his heavy Georgian accent (the country, not the state). He was ruthless though and not always the sharpest knufe in the drawer. In 1941, his spies and other officials from neighboring countries screamed at him that Hitler was about to invade. He refused to believe them. Unbelievably, Stalin trusted another tyrant more than his friends. (Hmm, reminds me of Trump’s love match with Putin.) Then, in response to the invasion many saw coming, he got drunk and stayed drunk for several days. Fortunately, he had not killed Georgy Zhukov during his 1937 purges of the miltary and political leadership. This brilliant general bailed him out and Stalin managed to become a hero to his people despite his insane insecurities and murderous rampages. Stalin was so feared that, when he collapsed and died, no one wanted to touch the body just in case he was still alive. As the story goes, the cleaning lady was the only one brave enough to determine that this tyrant really had gone to meet his maker.

Did a wrong turn cause the 20 million deaths of World War I? Who knows for sure. But the fact remains that the dominoes toward war began with the assassination of Archduke Fedinand by a Serbian nationalist during a State Visit. The plotters thought they had failed to knock of the heir apparent to the Austro-Hungarian throne when a grenade thrown under his car only managed to injure nearby spectators. One of the group, Gavrilo Princip, was sitting dejectedly at a cafe despairing that they had missed their chance. Suddenly, and unexpectedly, the car carrying the Archduke and his wife stopped right in front of him. The driver had taken a wrong turn, got confused, and then experienced dificulty with the vehicle. Gavrilo broke out of his depression, stood up, walked across the street, pulled out a pistol, and killed Ferdinand and his wife Sophia. The rest, as they say, is history.

Speaking of history, Hannibal, the great Carthaginian military leader, took on the great Roman Empire just as it was emerging into its glory. In fact, he did one hell of a job. Helped by his secret weapon, a bunch of elephants, he circled around though the Iberian peninsula and over the Alps (no small feat) before beating the Roman legions in three battles. It is estimated that some 20 percent of Roman adults were killed during the so-called Punic Wars. That should have been enough to bring most empires to their knees but the Romans fought on. Eventually, Hannibal was defeated, and the grounds around Carthage were salted so crops could not be grown in the future. Rome now controlled the Mediteranean and went on to become the empire we remember. But it was a close run thing and maybe we would be studying the Carthaginian empire if it had turned out differently.

We ignore so much of history, usually focusing on our world and that of our closest ancestors. For example, the Taipeng Rebellion in China took place around the same time as our Civil War. A cult leader named Hong Xuiguan claimed, oddly enough, to be related to Jesus Christ. While that seems an odd way to lead a revolt against the existing Chinese Imperial leadership, it worked. A long and bitter Civil War ensued in which it has been estimated that anywhere from 10 to 100 million died in battle or from starvation. Most put the figure in the 30 to 40 million range, higher than WWI but less than WWII. To put it in perspective, our Civil War cost between 600,000 and 700,000 American lives, by far the worst conflict in our history. Yet, few of us have heard of this more devastating catastrophe on the other side of the world.

Speaking of China, did you know that there is evidence that Christianity may have reached that remote land before it reached northern Europe. There is evidence that Nestorean Christians had settled in China as early as the 7th century. So, perhaps the aprochyphral story of a rebellious leader claiming to be a relative of Christ is not so far fetched. Then again, it stikes me that Asian spiritual beliefs are more cultural in character and less institutional. They can more easily absorb new thought and traditions and weave them into existing frameworks. I don’t recall the Catholicism in which I was raised being so adaptable.

Now, here’s an odd little fact. Who remembers Audie Murphy? Well, he was the most decorated American soldier in World War II. His start toward military fame was, however, less than auspicious. He was rejected by the Army, Navy, and the Marine Corps as being unfit for service. He kept trying to sign up to fight. I suppose that any life, even one in battle, had to be better than living in Texas. So, after his older sister lied about his age for him, he finally squeeked into the Army. Again, as they say, the rest is history. After the war and the publication of his heroics in a book titled To Hell and Back, he parlayed his military fame into a pretty decent movie career though, as I vaguely recall, he couldn’t act worth a damn.

Sometimes, things happen that many of us find difficult to understand from afar. Britain was so grateful to Winston Churchill for bringing them through to victory over the Nazis in 1945 that they resoundedly voted his government out of office. It seemed odd timing since the war in the Pacific was yet to be won. Instead, they ushered in Clement Atlee as the Labor (or should I spell it Labour) Party Prime Minister. Clement is not known to us as well as Churchill of course. No one has made a movie about him (as far as I know). However, he is ranked as one of the better PM’s in British history and is credited with introducing the modern welfare state and the country’s National Health Service (NHS). I recall the 2012 Summer Olympics held in London. During their opening ceremony, they organized a part of it to honor their NHS, something in which they obviously take pride. Can you imagine America honoring the shambles we call a health care ‘system?’ There are better organized riots than our so called system.

Speaking of leaders, do you realize how close we came to not having FDR during a crucial time in our history. Roosvevelt was visiting Miami in early 1933 after defeating Hoover for the Presidency but before being sworn in. A nutter decided to kill the President-elect and had a clear shot at him from the crowd at a short distance. Apparently, the would-be assassin was jostled at the key moment just as the Mayor of Chicago leaned into the open car to shake FDR’s hand. The mayor was hit and died within days. If FDR had been killed, we would have had John Nance Garner to lead us through the Depression and perhaps the War. Garner was from Texas and a conservative. While helpful to FDR at the beginning, he came to oppose much of the New Deal. You have to wonder what would have happened had he been in the White House during the the hard days of the 1930s.

One final note from my memory. I recall my dad telling me about the outcome of a sports event that impacted the lives of some in a big way. In New England back then, the Boston College-Holy Cross football rivalry was a big deal. These were two fine Jesuit Colleges located only about 40 miles apart. Then, Holy Cross annually played Penn State, Syracuse, Army, and other big powers. Anyway, in 1942 Boston College had a powerhouse team. They had outscored their opponents that year by a 249-19 margin and were headed for the Orange Bowl. On the other hand, the Holy Cross Crusaders stunk big time. A rout was anticipated. And a rout there was, but the Crusaders came out on top by an unbelievable 55-12 score, a game often referred to as the biggest college football upset ever. But here’s the thing, a large number of Boston supporters had reserved places at the Cocoanut Grove Night Club to celebrate what they were certain would be an undefeated season. Stunned, and dismayed, they cancelled their plans. That very night (November 28, 1942), the Cocoanut Grove burned down in a flash fire that took 492 lives. It was to be the 2nd most fatalities associated with a single fire in U.S. history.

So, there you go. All the stuff you could have lived the remainder of your life without knowing. You can thank me later.

I’m going out to see if I can find a real life now.

I get daily emails from Republican and Conservative sources asking me for money and support and then for more money. They are often addressed to Dear Patriot and have a fixation on whether or not I LOVE AMERICA which, they insist, is the greatest country on earth, without question. Sometimes I answer their query with a strong negative response just to see if they are listening. In case you are wondering, they are not. The next day I get the same request for money and the same question is repeated.

Relatively speaking, I simply no longer find much to admire in my home country. I did as a child but that admiration is long gone. There is no need to list all of our failings, they are legion and include deficiencies in health care access, environmental slackness, hyper-inequality in income and wealth, and an embarrasing level of gun related carnage. To focus, let us take one widely used metric of national health and well-being … life expectancy or LE. Basically, how long can we expect to live? In case you are wondering, I should have ‘kicked the bucket’ two or three years ago. Yikes … How did that happen?

If anything, this measure is a proxy for all kinds of dimensions associated with quality of life and national policies. As such, it is an excellent social indicator or statistic that goes far toward how we are doing as a nation, and how well we are taking care select societal subgroups like minorities and the vulnerable (old and young). Moreover, many factors go into determing LE, most of which are amenable to policy influences such as ease and affordability of health care and violence prevention. Perhaps the modal genetic makeup of a population seems impervious to control, yet even that variable can be influenced by immigration and emigration policies over the longer run. Even better, LE does not depend on self-reported status. Officials usually know when a person is dead or not though many an observor has concluded that I ‘bought the farm’ years ago. I should get off the couch more and move to indicate continued life.

But here’s the thing. During the Covid Pandemic, LE fell in the U.S. by some two years, the biggest drop in this measure since the Second World War. Of course, that was during a global crisis so such a dip was experienced in most countries with reliable data. Nothing to raise an eyebrow there. But in those wealthy nations that might serve as our peers, their dips were somewhat less extreme and they bounced back when Covid abated. The U.S. LE number has remained flat after the Covid peak while others have seen their LE figure begin to climb again in positive directions. Something insidious is going on here, another example of negative American exceptionalism.

Currently, the LE number here has been between 76 and 77 years (a number I have already passed as noted.) In all the nations we often use as references, the figures range from the low to the high 80s. Japan leads the pack with a figure approaching 90 years (should I start learning Japanese?). One estimate suggests that between 1980 and 2019 (before the pandemic), the U.S. had some 11 million excessive or amenable deaths assuming that we could have extended our life expectancy to match that of our peers. Another way of looking at it is to suggest that each early death truncates life by some 7 or 8 year (the difference between our mean death age and that of comparison jurisdictions), pushing the loss to some 77 to 88 million lost years of life. Whether they would be quality years is another matter altogether.

All this is no surprise. A National Research Council study from a decade ago reported that the gap in survival rates and in health outcomes between the U.S. and its peer nations started on divergent paths in the 1950s and that has remained a pervasive trend. In the early 1950s, the U.S. ranked 12th in LE. By 1968, it had fallen to 29th. By 2019, we ranked 40th among populous countries, lower than Lebanon and Albania. ALBANIA? Hetrogeneity is part of the problem here, not only in demographics but in policy regimes. The data clealry show that even people in their primes die earlier when they live in states dominated politically by conservatives. I will state the obvious … policies matter and conservatism kills! I might point out that this was an era where countries strengthened their safety nets with many adopting universal health care regimes.

Then, during the pandemic, we managed to kill off our citizens at a higher rate than others, a tragedy oft associated with resistance to masking and vaccination opportunities and with a struggling health care system that was unprepared and disorganized. Political confusion and unthinkable disinformation from mostly conservative sources also played a part along with embarrassing levels of inequality that leave too many vulnerable. Poverty stricken neighborhoods are not healthy places to live and we have some of the worst among wealthy nations.

Shockingly, our increasing mortality rates are even found among those in their midlife years (21-64). While we traditionally have lagged behind others in preventing post-natal deaths (we rank in the middle of the pack and after most rich nations), those in the prime of life are dying off faster than they should be. Epidemiologists look to rampant substance abuse and suicide to explain some of this. These are endemic to the widespead anxieties and despair felt by too many here (we don’t rank at all high on national happiness scales). Poor lifestyle choices contribute to high levels of cardio-metabolic diseases to be sure. But racism, disgraceful levels of societal inequality, and the fact that America has become a freaking free-fire zone adds to our woes here.

I must pause to note that Canadian officials recently issued a warning to their citizens intending to visit the U.S. They are concerned about the higher risks of their tourists becoming a gun fatality since similar levels of violence do not exist in their home country. They suggest Iraq, Somalia, and Afghanistan as safer alternatives. Okay, that part is a joke but not the warning, which I see as a sign we are descending into banana republic status.

The sad part of all this is that the gap between us and our peers can be diminished. It is amenable to correction through common sense public policies. What if we finally got around to passing even minimally sensible gun and firearm regulations? Perhaps we could cut into our rate of one or more mass shootings per-day. What if we had more preventative public health policies and better approaches to nutrition. Have you ever compared what we serve our kids at school versus what they get in other nations (pizza and burghers versus healthy alternatives)? What if we adopted the policy that exists in EVERY OTHER FREAKING RICH NATION of guaranteeing accessible health care to all. What if we started to ratchet back on the factors that result in unacceptable levels of inequality and poverty by strengthening labor market protections (e.g., raising the minimum wage), enhancing the social saftey net, and reintroducing a progressive tax structure. Much more might be said and none of these basic measures are secrets by any stretch of the imagination.

It has never ceased to amaze me that we can be mezmerized as a nation about the murder of one person, perhaps following the news or trial on that case for months. Yet, tens of thousands die annually in ways subject to policy amelioration and we simply yawn with indifference. How freaking sad!

American exceptionalism my ass.

NOTE: I’m reposting two of my favorite graphs below!

I have finally achieved it … male perfection. Okay, that may be a bit of an overstatement but I think I’m better than most of my bretheran… finally. Unfortunately, that’s not saying much since the Y chromosome doesn’t appear to add much of value to the species. Personally, I still can’t do any of those practical things that men are expected to do. You know, things like fix a car or repair a leaky faucet or fend off a grisly bear in the wild. But I am finally good on the one thing that makes men special to most women … I listen to them without expecting anything in return. I’m way better at that now that I am in my dotage … not caring about physical intimacy that is which, in my experience, was never particulary high on the female list of wants. This ability to eschew the usual male predatory role, to be sure, arrived late in life.

Perhaps you find this amusing but I’m serious. There is no greater burden imposed on young men, and by extension young women, than excessive testosterone. Why, you ask or probably not? Lust hits a teen male like a runaway freight train, just as soon as puberty rears its ugly head (bad pun intended). Women do not appear to be afflicted with this crippling affliction. Physical need, to the extent that they experience it at all, creeps up slowly on them, taking years if not decades to arrive.

They have no freaking idea how lucky they are. Okay, they are set upon by their own peculiar array of hormones but I have no idea what they are … other than they cloud the judgment of young females to seek out ‘bad’ boys. On that score, I have no freaking idea why they prefer losers, nor do any of my male peers. On the other hand, they do have these ‘nesting’ hormones in abundance … one kiss and they are off to Bed, Bath, and Beyond for ‘his and hers’ floral towels.

Back to the male animal before I get into even more trouble. You are going along in life as a kid about to embark on your carefree teen years, clueless yet happy, when you wake up one morning as horny as hell. It is all downhill from there, until this enervating condition thankfully passes on a number of decades down the line. On that fateful teen morn, though, you suddenly are reduced to a wimpering excuse of a human being who follows any and all female counterparts around like a hapless puppy dog, hoping against hope that one of them will take pity on you. The things you do in this state … we better not go there.

Alas, in my day, the 1950s, none of them did. They were all Catholics, or so it seemed. I think they all pledged themselves to the Virgin Mary of the Purest Corporeal Vessel or some such nonsense. Chastity and purity became their highest calling. No doubt, they would rather be dipped in a vat of boiling oil than give it up to a horny guy like me, or any horny guy for that matter. Thank God none of my buddies seemed to score. That was a kind of blessing since my ego was never strong and being left behind on the sexual battlefield would have been a crushing blow from which recovery was extremely unlikely. In any case, I recall looking ahead to a long life of celibacy or marriage or, most likely, a marriage that was celibate to all extent and purposes. None of these seemed like palatable alternatives.

It was even worse than that, if you can imagine. After you were shot down some 70 or so times, or was is 700 times, you do lose count after a while, you begin to wonder what women want. You know it is not your body, that’s for damn sure. But what is it, then? Most likely it is some abstraction that you represent … the social status that goes with snaring a guy, protection from being hit on by other male predators, a source of resources (assuming you had some which I didn’t), and other such goodies. You were merely an inconvenient path to things they really valued. Ironically enough, those of the female persuasion complained that men ONLY wanted them for their bodies. Those of the male persuasion would love to be desired JUST for their bodies … if only once. That, by the way, is the lure of mainstream pornography for most males … the illusion of females desiring sex.

If you are blessed by not having any human sensitivities, the male-female game is easy. The rules are expressed in many aphorisms … the woman needs a reason to have sex, the male just needs a place; women seek relationships and wind up liking the sex, male seek sex and wind up liking the relationship (on occasion); and the list goes on.

The point of all this, learned early on, is that men really are from Mars and women are from Venus but from planets NOT in the same solar system, nor even the same galaxy. While both appear to be members of the same species, that is a cruel trick being played by some malevalent divinity. The two genders clearly are driven by very different chemistry and by distinct internal wiring which makes communication difficult and inter-gender understanding vitutally impossible.

The core difference is this. Males are driven by a primitive drive-reduction need while females use sex in a transactional sense … exploiting male need for things they find attractive. Exploiting may be a strong word but I can’t come up with another more acceptable yet accurate. The bottom line is this … men are primitive idiots, females way more complicated. In thinking about the long term survival of the species, women are essential while men are peripheral at best, an outmoded version of something long since rendered useless.

When I was a young man, primed by excess testosterone, I figured out the game. You promised love to get sexual release. Simple rules, really. I had a guy I roomed with once. I thought he was an amiable loser, always high on something and not going anywhere in life. However, he was very successful with the females. He even used my life story one nght in a bar to score with a gorgeous blond … he used MY life! Damn it, that never worked for me.

Then again, I was handicapped by a sense of right and wrong plus tons of amorphous guilt. Damn Cahtolic upbringing! Jimmy Joe (that was his name) was not better looking than me, he was definitely not as smart or interesting as I (in my humble opinion), and nowhere near as funny. But, in the end, he knew how the game was played. Play it he did and without any reservations. I doubt anyone was fooled, not even once, on either side of the gender gap. I would look on in amazement thinking ‘no woman could possibly fall for his line of BS.’ But they did, or at least appeared to, with regularity and predictability. Amazing!

The odd thing always was, and is, I always liked females. I found them more interesting than males in many respects. Sure, it was easy to chat with guys about sports and politics and things out there. But females were better attuned to the inside things where you never went with your buddies. Talk about feelings? Are you freaking kidding? Try that and you risked getting beat up or ridiculed at least. But you could go there with women and that was nice.

I never set out to do this this consciously but, over time, I realized my closest acquaintances and work colleagues often were women, especially in later years when I had more choices. The professional connections are easy to explain. Women are better organized and focused … attributes I missed when God was handing them out. They corrected for my obvious deficiencies.

In the early years, though, my gender dance was pathetic. I would be with a female who had not immediately told me she had to wash the dog that night (again!), or who intimated that she expected her aunt to die for the 6th time and had to get ready for the sad event. It would have been kinder if she had told me outright that she would rather die alone on a desert island than spend any more time with me.

There were times when said female might even be giving out the signals by touching her hair, by long looks into my eyes, by laughing at my stupid jokes, and by touching my arm or (gasp) my leg. Suddenly, even as the illusion that I might score was laid before me, I would be seized up with a dastardly thought … I don’t want to be just another typical male. I never wanted to play the usual game, the one that superficial Jimmy Joe played so well. I didn’t want to trade emotional comfort for physical release, no matter the need on my part.

I wanted to tell the woman opposite me in that moment that we could just talk and I would listen; we could share inner secrets and I would commiserate; we might even be emotionally connected but I would never send her a sexual invoice or come to collect the usual bill where she felt obligated to ‘put out.’ That is, I would not ask for payback in the currency of physical intimacy. I would be different, if freaking frustrated! I never wanted to be the typical predatory male.

Sometimes that magic worked, sometimes it didn’t and then I wound up being oh,so typical. I hated that. Decades go by, you do get girlfriends and lovers (somehow). You even come across responsive females whose orgasms seemed more powerful than yours, a mystery that yet requires an explanation. You get married (in my case very happily). And you do grow older. But, in the end, you grow no wiser. That other species called the female remains as mysterious as ever, beyond any form of comprehension or understanding for us hopeless and hapless males.

But here is the small miracle. One day you wake up and realize your testosterone level has diminsished … by a lot. You are not even sure when this miracle happened, the process being glacial. Sure, you still check out women but by habit, not need. And they still studiously avoid any eye contact with you. Some things never change. On the other hand, you realize that you have changed, slowly and imperceptibly. You are now a qualitiatively different man without appreciating how or when the change occurred. It is only apparent in retrospect.

The difference! Well, for me, it is this. I used to struggle to be this non-predatory male, with being what women wanted in a male without asking them to pay the usual price. Now, finally, it was easy. I was no longer interested in the expected price to be paid. I was still the same person who liked to listen and share and explore things. All that was the same but without any of the inconvenient strings attached. I just wanted companionship, coupled with some occasional suggestion of minor affection … something along the lines that they knew I was alive or just in the same room.

Oh boy! Oh liberation! I am finally the perfect man.

Okay, stop laughing now. I am still not rich (just comfortable). And if a woman is looking for protection, she is better off calling 911. And if she wants something fixed, I will still hand her the phone and suggest a handyman or handywoman she might call. But I ain’t bad. And all it took was simply surviving to old age. Who knew!

https://www.quora.com/profile/Gilbert-Carney/https-www-quora-com-Who-is-the-greatest-person-that-history-has-forgotten-answer-Adi-Redzic-1?ch=15&oid=95260483&share=47609ccf&srid=inlsB&target_type=post

https://open.substack.com/pub/heathercoxrichardson/p/may-29-2023?utm_source=share&utm_medium=android

https://open.substack.com/pub/jerryweiss/p/joe-biden-knows-how-to-negotiate?utm_source=share&utm_medium=android

I entered my teens in the late 1950s. I can still remember my mother saying that her teens were the best years of her life. That was such depressing news to my ears. My early teens were mostly awful for me. Not objectively bad, and I never considered doing anything harsh or irreversible, but they were not happy days for sure. Fortunately, in my case, mother was dead wrong. Things got much better as soon as I entered college and only declined for a period when my drinking got out of control as I approached 40 years of age. On the whole, life has not been bad at all. Fortunately, I didn’t listen to my mother back then (mother is not always right) and simply believed that things would get better.

It also struck me that my teen cohort seemed okay. Among the neighborhood kids, many of whom faced less than bright futures, all seemed normal for the most part. I never heard of anyone needing therapy or medication for a behavioral issue or winding up in juvenile court. The girls didn’t get knocked up and the boys didn’t run off to the military to avoid their parental responsibilities or stay out of the slammer. My neighborhood was far from the American dream, only cold water flats and families struggling financially, but there was this patina of normality. Sure, there were hierarchies and we picked on one another but never to the point where suicide became the preferred option. Nor did I ever hear of any kid being sexually abused by a Priest, parent, or some adult figure. In fact, our parents didn’t seem to be worried about our well-being in the least. Most often what I would hear hear after school as a young kid was ‘get the hell out of the house and don’t come back until the street lights come on.’

Obviously, bad things happened as was evident by the revelation of widespread abuse of boys in the Catholoc Church that emerged a generation or two down the road. In my day, though, there was wall of denial and slence. Problems within families were not discussed nor displayed for public consumption, and certainly not litigated. The authorities gave parents wide leeway over how children were to be raised even when their methods were highly questionable. A whack to the backside was considered good discipline, no matter what that Doctor Spock said. Nor were there the legion of mandated reporters (professionals required to report suspected child abise) as there are today. As a result, the incidence of child abuse and neglect were manageable, if not ignored.

When I worked for the State Human Services agency at the start of my professional career, I saw the numbers of reported child abuse neglect and abuse explode as if the world were falling apart. In my day, teen problems were assigned to isolated delinquent children and bad seeds. Minor infractions in school or with the police often were dealt with informally, not with heavy-handed zero tolerance policies. When I almost got in trouble with the law, I just called my good friend whose dad was a cop. He took care of it for me. Now a teen might end up with a record. Not a ‘Leave It To Beaver’ world but quite innocent on the surface.

Today, we seem to do far more to protect our children and teens. Yet, they are neither safer nor happier, or so it seems. The State Education Department in Wisconsin just released the results from the annual Youth Risk Behavior Study. The results suggest that a whole generation of young people are very stressed and unhappy, with many on the verge of self-harm . Respondents reported the following:

ALL FEMALES

Persistent Anxiety …………….. 52% 66%

Feelings of Depression ……….. 34% 46%

Self-Harm Ideation …………….. 22% 32%

Considered Suicide ……………. 18%

Almost 60% said that they had experienced at least one episode of depression, anxiety, self-harm or suicidal ideation over the prior year. The rate of depression, in fact, has risen by 11 percentage points alone since 2011.

All this strikes me as a lot of unhappy kids. The numbers caused me to look back to my childhood. Sure, we had challenges. I started working at age 14 and went to an academically demanding boys high school where the Catholic Brothers whe ran the place would whack you if you stepped out of line. Your parents then would whack when you got home if they learned that Brother had whacked you earlier that day, which you never confessed voluntarily. I was okay on the ball field but not as good as many others, which left me with feelings of inadequacy. I was also just a bit younger and naive compared to others in my peer group, thus was subject to constant teasing. And getting to second base with those of the female persuasion was considered next to impossible. What am I saying … totally impossible. So, we made due with looking for the ‘promised land’ only in the reflection off highly polished shoes the girls might wear at the sock hop. You were never going to explore those forbidden areas in reality. At least I wasn’t.

In all these bad numbers, there are a few hopelful signs. Though about one-in-five girls report being more or less forced to have unwanted sex, the overall proportion of girls having sex has fallen in recent years. Teen pregnancy rates have also fallen and then stabilized in the recent past. Likewise, the use of alcohol was at the lowest rate since the question was first asked in 1993. These numbers fly in the face of prevalent impressions of kids out of control and high schools as modern day versions of sin city. Then again, there are all these debates about whether stationing police in high schools is a good or bad thing, and aparently the law is called in to deal with unruly teens on a routine basis. Again, I cannot recall the cops ever being called to schools in my day, or perhaps I just wasn’t paying attention.

It is impossible to compare one generation with another and I may be glossing over problems from my early days. It was the 50s after all where cyber-bullying was not feasible and drugs were something that you heard about happening in the really big cities. I cannot assert with any confidence that my sense of warmth about ‘the good old days’ is warranted or a function of distorted recollections. I did have my share of bad moments, even despairing moments, especially when my mother insisted these would be the best days of my life. Damn good thing there were no guns in the house when she said that.

I’m on the left, before I realized pro sports were an impossible dream! This was in the area between our 1st floor flat and the ‘three-decker’ next door. We played at ‘war’ and ‘‘cowboys and indians‘ endlessly in and among the tenaments where we lived. And we would play games for hours in the streets. One just involved a tennis ball and hitting it off some steps across the street on the other side of these bushes. We created a whole baseball game oy of our imaginations with a ‘home run’ happening if the ball cleared those same bushes in back of us. We did amuse ourselves.

Today, kids have so much more and so much less. As I’ve said before, I would see the younger generation when they were debt-ridden college students. By then, they would be angst ridden about future prospects, focused on how they might get by in life. My college years were a challenge (I would work 11-7 in a hospital many a night before heading off to classes) but I loved them. I never worried all that much about the future. There was an implicit assumption that all would get better. My cohort would be okay. Life for all of us was on an uptick. We often talked not about survival but on reforming society to make it a better place for all. Self-delusion can be an incredible narcotic.

Optimistic me graduating from Clark University!

As inequality has increased in America and our culture wars and political divides tear us apart, we have lost something … hope! You can endure a lot; you can be poor but still happy; you can see the worth of trying hard and rising from little, but you need hope. Take that away and you see the rampant epidemic of despair and defeat you find among today’s teens. It doesn’t have to be this way.

Calling All Industrial Engineers – May 27, 2023