Thoughts of a retired physician

  I have again spent a great deal of time reading and thinking about gun violence. The recent mass shootings in Atlanta and Boulder added to the pile of such events that have become too common in the past three decades. Even during the worst of the Covid-19 pandemic in the U.S. during 2020, mass shootings continued and in fact increased . Although mass shootings account for only 1 to 2% of all firearm-related deaths, they garner media and political attention out of proportion because they illustrate that everyday acts such as going to the supermarket to buy a loaf of bread or going to school to be educated or going to the movies to relax can turn into violence, bloodshed, and death. We see the political dimensions, especially in the Senate, where the free flow of millions of NRA $$$ (almost all to Republicans) has long blocked useful efforts to address the gun problem in this country. Thus we have a nation of 330 million people with 393 million guns in civilian hands. Please do not t

  This is cheating (a little). I wrote an article for our local League of Women Voters Pasadena Area about the filibuster and it seemed reasonable to share it here. In Republican hands over the past 12 years, the filibuster has become simply an obstructionist tactic that prevents legislation from being enacted and delays or preempts presidential appointments from occurring. I firmly believe this anachronism must be euthanized now. Here is the article: The Filibuster -- Good or Bad? Filibuster - an action such as a prolonged speech that obstructs progress in a legislative assembly while not technically contravening the required procedures.  Cloture - the only procedure by which the Senate can vote to place a time limit on consideration of a bill or other matter, and therefore end a filibuster. The word filibuster does not appear in the Constitution. The word was originally from the Dutch vrijbueter (freebooter), with contributions from Spanish and French. The genesis of the filibuster

  At the end of an active life, I find two things that most shaped me as an adult. The first and most obvious was a choice of medicine as a career. Sometimes frustrating but always fulfilling and intellectually stimulating, it was always an anchor point for me. The second is also obvious to anyone who knows me. Becoming a Naval officer and spending a career in the United States Navy had the same dimensions as medicine. The fact that the two were fused for me was simply a plus. I have deep feelings for the Navy and the military and they are a part of my being -- and always will be. The military is far from a perfect place. As with all organizations, it may be described as a consensual hallucination; its members bring themselves to it, add something, and leave it either more or less enriched than they found it. What I am concerned about of late is the growing evidence of white supremacist ideas and culture in the military. Military leaders recognize this, especially after the failed insu

  The big lie of voting fraud and a stolen election (the Presidential election of 2021 was NOT stolen) prompted the second storming of the U.S. Capitol on 6 January. We are going to deal with the repercussions of that lie and that event for a long time to come. The #FormerGuy and his minions filed dozens of lawsuits in an attempt to have courts reverse the election results. #FormerGuy hoped that at least one of these would be heard by the Supreme Court where his three conservative appointees would (of course, in his addled thinking) side with him (loyalty to the brand) and put him back in office. That did not happen.  The GOP does see the handwriting on the wall. They were beaten at the polls because voters who were tired of #FormerGuy turned out in greater numbers than the current personality cult that is the Republican Party. At the federal level, Congress is attempting to pass voting rights expansion to counteract the reversion in many states to laws that inhibited voting, espec

  For the next current events session here at MonteCedro, the group wanted to discuss pandemic preparedness. Since both Margan and I are infectious disease physicians and epidemiologists who were involved in preparedness planning for many years in both military and civilian organizations, this will probably be fairly easy. I thought it might be useful to write a little about how this important topic came to be and, in light of the Covid-19 pandemic, what went wrong. Pandemics are a relatively recent problem. In human history, only in the last 10,000 years have we had the conjunction of agriculture, which fostered larger populations of more sedentary humans, along with constant contact with domesticated animals, whose microorganisms we came to share in a variety of ways. Tuberculosis and measles originated in bovine animals. Influenza is primarily a disease of fowl and pigs. Human immunodeficiency virus (HIV) arose in nonhuman primates in Africa and likely spread to humans through c

  In December 2020, the FDA issued emergency use authorization for two unique mRNA vaccines to deal with the Covid-19 pandemic. Both the Pfizer-Biontech vaccine and the Moderna-NIH vaccine were spectacularly successful in large Phase 3 clinical trials in preventing severe disease, hospitalization, and death from Covid-19. Furthermore, the safety profile of both vaccines was impressive. This was tremendously good news. Even so, negative press about these vaccines soon followed and unfortunately continues to this day.  In the United Kingdom, which began vaccinating before the U.S., there were several early reports of anaphylactoid reactions . Soon after vaccinations began in the U.S., similar reports occurred. CDC looked at these and found a rate of 11.1 cases of anaphylaxis (none fatal) per 1 million first doses of the Pfizer vaccine. Anaphylaxis is reported with many other vaccines and usually occurs within 30 minutes of receipt of the vaccine. It is treatable with epinephrine. Th

  After the presentation of overwhelming evidence of Donald Trump’s incitement of a mob that invaded the Capitol, sought to harm or kill elected officials, and wanted to overthrow the U.S. government, 43 Republican Senators decided that their political party and continuing power was more important than their country, the Constitution, and the oath they swore to defend that Constitution against all enemies, foreign and domestic. Trump is a domestic enemy. Shame on them and may they be damned forevermore as the traitors they are.