Thoughts of a retired physician

  I am preparing a Current Events session for our group at MonteCedro on the continuing war in Gaza. We discussed this in the fall of last year when it started but it has become obvious that an update is (sadly) necessary. The death toll in Gaza has passed 32,000 but as the New York Times notes, it is likely much higher than that.   “ Gaza has become a 140-square-mile graveyard, each destroyed building another jagged tomb for those still buried within.” I have read through numerous accounts from a wide variety of news sources. The Hamas attack of 7 October 2023 was unprecedented, barbaric, and horrible: 1143 dead, 250+ hostages taken, rapes and sexual assaults. Israel’s response was predictable but equally horrible in its consequences. Dead: 32,000 and counting. Wounded: many, many thousands more. Gaza became a major humanitarian crisis overnight with forced evacuations from Gaza City to the south followed by an air and land assault of immense size. Famine looms, especially threaten

  As an infectious diseases physician, I have read widely about the history of development of antibiotics in the 20th century. One of my favorite books is The Mold in Dr. Florey’s Coat: The Story of the Penicillin Miracle by Eric Lax. The stories in the history of medicine are fascinating and this one is no exception, as good as any novel you might pick up. Penicillin has been in clinical use since World War II; the emergence and prevalence of resistance to it has diminished its utility but it remains the premier drug to treat a long-standing human scourge – syphilis. The long story of syphilis itself is another engrossing tale. Treponema pallidum met its match with penicillin. Cures now number in the uncounted millions worldwide. Although there are reports of gene mutations in T. pallidum related to penicillin resistance no documented penicillin resistance has been reported .  After my Navy career I was the medical director for the sexually transmitted diseases clinics for the Chic

  Here in Altadena we are a little more than 9 hours from the New Year. It would be too easy to lament all the problems we faced in 2023 and they will follow us as 2024 dawns. But I thought that some perspective was in order and in her last column of 2023, Jennifer Rubin gives us that perspective. I gifted the column on my Facebook and Twitter pages and the link is here . Here is her first paragraph: “Nostalgia is a powerful political tool. Wielding nostalgia for a bygone era — one that is invariably mischaracterized — is a favorite weapon for fascist movements (Make America Great Again ), harking back to a time before their nation was “polluted” by malign forces. In the United States, such nostalgia none-too-subtlety appeals to white Christian nationalism. Even in a more benign form (e.g., “ Politics didn’t used to be so mean ,” “ Remember the days of bipartisanship?” ) plays on faulty memories. If you really go back to study U.S. history, you would find two things: The past was worse

  We are now at less than 11 months until the 2024 elections. The polls indicate that Donald Trump will be the Republican nominee. President Biden by the polls consistently lags behind Trump and is blamed for the “poor economy”, the war in Gaza, and for being too old. Trump, indicted 91 times in multiple jurisdictions, meanwhile signals strongly that he will take on the mantle of a dictator if he is inaugurated in January 2025. He has vowed to install nothing but vetted loyalists to senior positions in a second administration; to fire thousands of civil servants so that he can do the same al lower levels in the Executive; to curb the media and anyone who criticizes him; and top take vengeance on those he hates personally (because he feels they have humiliated him). If that does not remind you of Germany in the 1930s, you failed history. Robert Kagan’s essay in the 30 November New York Times was a bleak read. The fact that we already have a government of the minority and a flawed syst

  Obesity is increasing in prevalence worldwide. It isn’t only a problem in rich and developed countries but also in poorer and lesser developed countries. For our Current Events program here at MonteCedro, I prepared a presentation on obesity and the newest approach to it – drugs like Ozempic that reduce appetite and increase satiety. Their original use was as a treatment for Type 2 diabetes but the ancillary finding of weight loss during their use has promoted an awful lot of hype. Below the line is a list of references that I used in preparing the talk. I hope to provoke commentary about not only the health effects that surround obesity and these newer medications but also to look at obesity through a comprehensive biopsychosocial lens. Obesity has been labeled a disease by the World Health Organization and the American Medical Association but I wonder if it truly is a disease. Hope the links spur some reading and thought. =========================  Another Ozempic side effect? Faci

  The Republicans managed to elect a new Speaker of the House today after 3 weeks of chaos and turmoil. He is Mike Johnson of Louisiana, first elected to Congress in 2016. A far-right Trumpist conservative, and now 2nd in line to the presidential succession after Vice President Kamala Harris, his elevation to the speakership should send shivers up the spine of everyone who supports democracy. In the British Parliament, he would be described as a back-bencher. He sits on two important House committees, Judiciary and Armed Services. He is also a member of the Republican Study Committee, a group of about 150 Republican House members who push conservative legislation. He is cozy with the House Freedom Caucus, a group of anarchists that include Jim Jordan, Matt Gaetz, Scott Perry and other assorted bomb-throwers who were responsible for the nonsense of the past three-plus weeks and whose seeming raison d’etre is the obstruct and destroy the United States government. They favor the right-wi

  Politics today is an endless cultural war. Democrats seem intent on policy issues such as infrastructure, strengthening the economy from the bottom up and the middle out, voting rights, dealing with the menace of climate change, while Republicans focus on limiting the rights of LGBTQ+ people, banning books, turning education into indoctrination – and of course, pursuing the war on women’s health by limiting reproductive choice.  In her Letters from an American from 1 September (which I repost daily on Facebook and Twitter), Heather Cox Richardson writes that  Meanwhile, Republicans continue to focus on ending abortion, and their determination is leading them to assert power over citizens of Republican-dominated states in a way that is commonly associated with authoritarian governments. Having won the battle over Roe v Wade in last year’s Dobb’s decision by a Trump-packed Supreme Court, the Republicans have found out (and continue finding out) that when you decide to ride a tiger