Category Archives: health

An Appalling Failure of a Great City

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I just posted New York City is Back! https://shiningseausa.com/2023/06/03/new-york-city-is-back/ And it is.

But I remain astonished and appalled that New York City, whose history is bound so closely to the subway system used by millions of people to get around the vast city every year, has failed to address the problem of access for the elderly and physically limited traveler in any meaningful way after all these years.

The passenger-use data tells an interesting story – the subway system consists of more than 6,455 cars that collectively traveled about 331,000,000 miles in 2021 through 472 stations on 665 miles of track. https://tinyurl.com/muksdukt Too big to comprehend but not too big to fail. In 2021, the first year of post-pandemic recovery, about 760,000,000 people rode the rails. While that is an amazing figure, it is less than half the volume that rode in 2016 (nearly 1.8 billion)!

I was forcefully reminded of this on our Memorial Day weekend trip, when, already worn out, we approached the 30thStreet Station in Astoria to find an elevated platform. The only observable means of getting to the train platform was to climb not one but two flights of stairs. I did it but I cannot imagine that many people my age or with other physical limitations could do so.

The 30th Street Station in Astoria is not the only such problem site. Only 98 of the 472 stations (covering all boroughs but not counting the Staten Island Railway) are ADA-accessible. https://new.mta.info/document/25961 Many stations counted as ADA-accessible meet that test in only one direction, or only for some subway lines or only at some times of day.

I understand that adding escalators and elevators would be very costly and, given the physical constraints, could result in reducing stairwell access in some cases. Given the substantial reduction in ridership since 2016, there is no better time to fix this problem than now. I am astounded that the people of New York City put up with this situation for so long and that New York politicians have been able to escape accountability for their failure to require the MTA to act.

I have read that a Judge Approves MTA Deal to Make Subways 95% ADA-Compliant by 2055 as part of a class action settlement [https://tinyurl.com/yc5398d2] but, seriously, by 2055? No doubt this was a victory of sorts, but that deadline, even if met, is 32 years away. The number of New York City residents with some form of disability is close to one million and more than 15 percent are 65 or over. It is unconscionable that their transportation needs have been ignored for so long and still are.

Let’s Hear It For the Women

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Any society that stagnates or retrogresses is unlikely to survive in a digitally unified world. Societies that are moving backward toward what is perceived as “better times back then” are almost certainly doomed in the long run. Cultural and ethnic diversification is a force that may be delayed for a while, even reversed, but not indefinitely. As it happens, one of the moving forces in this country, perhaps the only one that can save it in the long run, is the women. The women who marched for women’s rights, the women who went to work doing “men’s labor” during the last world war. Many of them never went back, mentally, to the “role that women are supposed to occupy.” While some men have not adapted to the new reality of equality, they face an unhappy and unproductive future. The tide of history cannot be stopped. The love affair of white men with male dominance is a mirage. Loss of status hurts. Get over it. Move on. Think of how exciting it is to know intelligent, thoughtful women who believe in themselves and what they can contribute. There is no going back.

Yesterday established that women will not be suppressed. Voters in all five states where there were ballot measures on abortion rights, the right of women to control their own bodies and health decisions, opted for freedom for women. The women have spoken, Republicans. Good for them. Good for all of us.

The Root of All Evil

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A Biblical quotation worked its way into the popular vernacular a long time ago: the love of money is the root of all evil. The quote is often abbreviated to “money is the root of all evil.”  I have no idea whether the attribution to Apostle Paul is correct, but I also don’t care. I don’t believe either version of it is true.

The love of money, like the love of many other things, both physical and otherwise, can certainly lead to problematic outcomes. But the opposite of love can equally lead to problematic outcomes. There are just too many problematic outcomes to assign all the blame on love of money or just on money. When I think about this, I am reminded of the wonderful Robert Frost poem, Fire and Ice:

Some say the world will end in fire,

Some say in ice.

From what I’ve tasted of desire

I hold with those who favor fire.

But if it had to perish twice,

I think I know enough of hate

To say that for destruction ice

Is also great

And would suffice.

In my view, ignorance is the real root of all evil. Donald Trump once said, “I love the poorly educated!” He knew something that had apparently escaped the notice of even experienced political analysts. It’s not that the “poorly educated” are unintelligent. Many of them are quite intelligent and can perform many tasks effectively. They can be successful in many lines of commerce and in life generally.

On the other hand, the “poorly educated” may be susceptible to believing misinformation/false information because they have not been exposed to the discipline of education and have not undertaken to study on their own. But they are not alone in that, so being poorly educated is neither explanation nor excuse, despite Trump’s claimed admiration for them. During the height of the pandemic, we saw nurses and doctors embrace conspiracy theories, promote quack remedies for COVID and resist vaccination. And many members of Congress who support insane conspiracy theories and engage in traitorous and illegal activities are highly educated.

The problem is more complicated than the simple explanation that the “poorly educated” mistakenly thought Trump as president would be good for them. In trying to understand this, I have read numerous books, articles, theories, and studies. Most recently I discovered Strangers in Their Own Land, by Arlie Russell Hochschild, professor emeritum of sociology at the University of California, Berkeley, and the author of many notable books. The book was a 2016 Finalist for the National Book Award. This work is based on her personal research conducted in post-Katrina, post-Deepwater Horizon coastal Louisiana. The date of publication, 2016, was just before Trump was elected president and all that ensued. The book nevertheless seems wholly predictive of everything that followed.

Hochschild defined her mission at the outset as an effort to explore feelings, the “emotion in politics.” Strangers at 15. Some of those feelings were disturbing – she notes that “reminders of the racial divide were everywhere.” Strangers at 20. She did not draw much on that fact of coastal Louisiana life but indirectly seemed to acknowledge its abiding and broad influence on political life there.

Strangers focuses on what Hochschild calls the Great Paradox, stated roughly as the massive disconnect between the economic and life interests of the local people and their devotion to the Tea Party which was in full flower in the period covered. The locals were adamantly opposed to regulation, especially federal regulation, that might help restore the opportunity to continue the livelihoods they had pursued for generations in fishing/hunting/farming the abundant natural resources of coastal Louisiana.

One of the Tea Party’s darlings was Bobby Jindal. As Hochschild notes at the end of the book, Louisiana was left a “shambles” after eight years of Tea Party-style leadership by Governor Jindal. Yet his support among locals never waned. They bought into the capitalism mythology completely. Such devotion also led to support for Republican congressman David Vitter who opposed all federal environmental intervention, voted to terminate the Environmental Protection Agency and more. Strangers at 48.

The author said she was struck by what political candidates avoided in their pitches to voters: “that the state ranks 49th out of 50 on an index of human development, that Louisiana is the second poorest state, that 44 percent of its budget comes from the federal government – the Great Paradox.” Strangers at 59. People with little to begin with worried more about what others were getting (“non-working, non-deserving people”) than about destruction of the environment or years lost to bad health conditions.  Somehow this was seen as a loss of “honor” and that was more important than more tangible issues. Strangers at 60-61.

They knew that Big Oil and Big Chemical had undeniably wrecked the local environment, but they adhered to the mythology that the companies also brought jobs and other economic benefits that could not be secured under any form of regulation. They concluded that the honorable thing was to muddle through, accepting their fate while continuing to assert their” principles.”

Hochschild notes three paths by which Tea Party believers arrived at their profound dislike for the federal government:

their religious faith (the government curtailed the church, they felt),

hatred of taxes (which they saw as too high and too progressive), and

the government’s impact on their loss of honor …. [Strangers at 35]

They bought into the belief that taxes went to lazy welfare cheats and “government workers in cushy jobs.” Id. They thought climate change was bogus science. They resented what they perceived to be bias against the “little guy,” meaning mainly the little white guy, and interference with the role of God in overseeing humanity. Strangers at 52. Those are easy myths for resentful people to embrace without having to make the effort to understand complex systems and ideas. Indeed, for many, the outcome was in the hands of their God and humans thus had little responsibility for outcomes.

In portents of things to come, Hochschild notes that at the Republican Women of Southwest Louisiana meeting,

I heard a great deal about freedom in the sense of freedom to – to talk on your cellphone as you drove a car, to pick up a drive-in daiquiri with straw on the side, to walk about with a loaded gun. But there was almost no talk about freedom from such things as gun violence, car accidents, or toxic pollution. [Strangers at 71]

The perplexing reality is that people living with more pollution are more likely to believe in less regulation and more likely to be Republicans. Strangers at 79. This mental orientation set them up for manipulation and exploitation.

The initial tip to the problem of the book’s analysis comes at the beginning. Hochschild observes that the reason for population shifts in the United States had changed: people moved less to find better jobs, housing or (she didn’t mention this) education but rather to align more closely with people of similar political views. The sharpening of political division is, she says, attributable to the ‘right moving right.’ Strangers at 6-7. She recounts the dire economic conditions afflicting the southern states, Louisiana being among the worst of the worst:

Given such an array of challenges, one might expect people to welcome federal help. In truth, a very large proportion of the yearly budgets of red states – in the case of Louisiana, 44 percent – do come from federal funds. $2,400 is given by the federal government per Louisianan per year.

But Mike S_____ doesn’t welcome that federal money and doubts the science of climate change. “I’ll worry about global warming in fifty years,” he says. Mike loves his state, and he loves the outdoor life. But instead of looking to government, like others in the Tea Party, he turns to the free market. [Strangers at 9]

He turns to the same “free market” exploited by Big Oil and others to wreak havoc on the state that Mike purported to love so much. Thus, again, the Great Paradox.

The other major theme in the book is the Deep Story, the myths by which social groups, or tribes, are developed and sustained. Strangers at 135. Here perhaps is the core principle at work. In coastal Louisiana the Tea Party promoted, and locals accepted, the idea that undeserving people were cutting into the line ahead of hard-working “true Americans.” While their perceptions of race are complex, older whites interviewed by Hochschild saw Blacks especially as a problematic class afflicted by special issues not shared by most white people.

Economic class distinctions tracked race and distinguished between “makers” and “takers,” with the latter being the “line-cutters” supported by the federal government, those people unfairly getting ahead of everyone else. This grievance was at the root of many white Louisianans’ attitudes unrelated to the reality of local social and economic standing. Strangers at Ch. 9, and at 157-159.

Despite noting the data showing that “the higher the exposure to environmental pollution the less worried the individual was about it” [Strangers at 253], Hochschild concludes that the continuation of the Great Paradox is not the result of ignorance. [Id.] But that view is remarkable because it’s not supported by most of the data cited in the book. One of dozens of examples is the belief that 40 percent of all U.S. workers are employed by the federal government. The actual figure at the time was 1.9 percent. Strangers at 161.

Such ignorance of economic reality was at the root of many local people’s vigorous resistance to all forms of regulation. Such interventions could have helped to restore the balance of nature and, along with it, the jobs and environment they claimed to cherish. Yet, by and large, they wanted none of it. Hochschild was aware of this because data in Appendix C to the book was often interspersed in the text to illustrate how the real facts refuted the central myths on which the resistance depended. Peoples’ explanations of their views were rife with classical political myths and massively wrong factual beliefs.

Locals that Hochschild interviewed appeared to believe that a woman’s role was to be completely subordinate to her husband. Strangers at 174. This attitude is consistent with the analysis of “what makes a Republican” in George Lakoff’s 1996 Moral Politics that, controversially, applies principles of cognitive science to politics. As summarized in Wikipedia:

Lakoff argues that the differences in opinions between liberals and conservatives follow from the fact that they subscribe with different strength to two different central metaphors about the relationship of the state to its citizens. Both, he claims, see governance through metaphors of the family.

Conspiratorial thinking was also rampant among Hochschild’s subjects. Few people believed science had made the case for global warming. Strangers at e.g., 183. They did not understand what the lives of the seriously poor were like, rejected much historical truth, adopted phantasmagorical solutions dependent upon the “free market” and adopted what has come to be known more recently as “replacement theory.” Strangers at Ch. 14.

In the end, it seemed to me that the author was profoundly fooled by the mannered façade she experienced in her research with the locals whose “good-hearted acceptance” of her, their “great personal warmth and famous Southern hospitality,” misled her to conclude that

in human terms, the [empathy] wall can easily come down. And issue by issue, there is possibility for practical cooperation. [Strangers at 233]

There is nothing in the buildup to the end of the book or in the data set out throughout it that would support such a conclusion. And, of course, the history under Trump’s presidency is the most profound refutation of the “we can all just get along” thesis. The author’s starry-eyed belief in future harmony and progress was, I believe, a grievous error by a researcher whose approach to her study was primarily based on just talking with locals, eating meals with them, and looking at the surrounding conditions that determine their lives and livelihoods.

The book confirms my suspicions in its treatment of the rise of Trump as a political power.

Three elements had come together. Since 1980, virtually all those I talked with felt on shaky economic ground, a fact that made them brace at the very idea of “redistribution.” The also felt culturally marginalized: their views about abortion, gay marriage, gender roles, race, guns, and the Confederate flag all were held up to ridicule in the national media as backward. And they felt part of a demographic decline; “there are fewer and fewer white Christians like us….”        [Strangers at 221]

Economically, culturally, demographically, politically, you are suddenly a stranger in your own land. The whole context of Louisiana – its companies, its government, its church and media – reinforces that deep story. [Strangersat 222]

Trump, consciously or otherwise, fed this sense of disaffection and loss.

His supporters have been in mourning for a lost way of life Many have become discouraged, others depressed. They yearn to feel pride but instead have felt shame. Their land no longer feels their own. Joined together with others like themselves, they now feel hopeful, joyous, elated … in a state of rapture… no longer strangers in their own land. [Strangers at 225]

Rapture indeed. This degree of magical thinking is beyond imagining: a Pew Research Center 2010 study reported that “41 percent of all Americans believe the Second Coming “probably” or “definitely” will happen by the year 2050.” Strangers at 125. Hochschild labels them “victims without a language of victimhood.” Strangers at 131, a missing element that Donald Trump readily supplied.

My overall conclusion about this book is that the people it discusses suffer from a central fatal flaw: they mistakenly believed that the land belonged to them in the sense that the whole of it was their natural right. Anything that challenged that idea was alien, undermining their sense of “our land.” This, I think, is about as un-American a concept as you will find. It ignores history, economic reality, and the nature of democracy. The root concept that “this land is ours then, now and always,” meaning us God-fearing white people who have an entitlement that others are unjustly trying to steal, fundamentally misunderstands the nature of the country, its origins, and its development.

This issue may be connected to education, but I suspect it’s much deeper than that. The possessory and superiority components of these cultural beliefs leave these people vulnerable to the “it’s ok to hate” message from a demagogue like Donald Trump who lacks any core value system of principles except greed. These people have less to fear from interlopers than from their own ignorance.

The problem, however, is that someone so ignorant is usually unaware of his ignorance and simply feels put upon by the forces of change. He just wants what he thought he had before, notwithstanding that the oil-based economy was a complete fraud on coastal Louisiana society, wrecking the environment while failing to deliver the economic benefits that locals were sure existed. It’s also often true that the ignorant are unwilling to learn; they lack empathy and see others’ gains mainly as their losses.

I don’t want to be told I’m a bad person if I don’t feel sorry for that [sick African child on TV with Christiane Amanpour]” Strangers at 128.

But even those who fancy ourselves as “not ignorant” are capable of delusional thinking. I have confessed multiple times to having fundamentally misunderstood the degree of disfunction in the country. I thought the election of Barack Obama was a sign that, overall, the country had changed. That was wrong.

The essential proof is that despite his record of lies, incompetence and corruption, Trump received 74 million votes in 2020. Joe Biden received many more, of course, but the thinnest of margins remains in both houses of Congress. People with short term concerns about things like inflation, and no or limited understanding of its causes, may drive the country back into an abyss from which democracy may not re-emerge. It can happen here. Only the voters can prevent it.

I heard recently from a reliable source that many young people, in their 20’s and 30’s, may not feel they are much affected by what is happening in politics. That absence of perceived impact often makes them indifferent to the outcome of critical issues. If that is true, we are in even more trouble than I imagined.

Republicans are highly motivated by their grievances and can be expected to turn out in large numbers in the 2022 mid-terms. If Democrats stay home, it’s game over. You have been warned.

The Faces

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Yesterday the reckoning began. In marches, rallies, and gatherings across the country, tens of thousands of Americans came together to declare war. The target is the death-mongers who value guns over human life, guns over children, guns over the elderly, guns over everything. The unique problem of Americans and guns has reached the breaking point. Mass shootings are almost as routine as car accidents. Death by gun in schools, places of worship, grocery stores, shopping malls, the streets. Only in America.

Yesterday you could see in the faces and the signs. Sadness, fear, anger.

The rally in Washington, DC attracted an estimated 40,000 people. An extraordinary turnout considering the foul weather. Sadness – why don’t more Americans care about us? Fear – am I or one of my loved ones the next to die by gunfire? Anger – the killing must stop; we cannot continue to live like this. Why do so many Americans care more about their guns than they do about their children and their parents and grandparents?

The crowd was very large, spread over the north side of the Washington Monument grounds.

One of the speakers lost his mother to gunfire a short time ago. She had lived 86 years, only to be gunned down while shopping for groceries. The average age of the people slaughtered in Buffalo was 62. Shopping for groceries. Slaughtered by an 18-year-old racist with a history of violence and mental health issues, none of which prevented him from legally buying assault weapons and armor plating. He live-streamed his deadly assault which he had been planning for months. He shot four people outside the store, a security guard inside, then eight more inside (six of whom died). When police arrived, he surrendered without resistance.

The faces of the people listening to speeches like that were grim but determined. They have had enough of Republican thoughts-and-prayers, the rote response to the uniquely American tragedy facilitated by legal systems that allow people with the maturity level of children buy assault weapons intended to kill as many people as quickly as possible.

Aside from the power of the speeches there were two moments of “drama” that we observed. The first involved a jerk who arrived in the middle of the presentations with a large poster on poles that said “Guns-Bacon” on one side (no idea what it meant) and Gun Control with a slash mark on the other.

When he set up in the middle of the crowd listening to the speeches, his sign blocked the view of the jumbo screens. Only a few seconds passed before two women rushed up behind him to block his signs and within a minute a multitude joined them.

The jerk was surrounded and engulfed in anti-gun signs. His face was covered the entire time. After a while security arrived and escorted him off the grounds trailed by comments from the crowd that are a bit too raw for a family-oriented blog.

The other excitement occurred during a moment of silence called for by one of the late speakers. Someone in the crowd yelled either “I have a gun” or “I am God,” according to reports. This sparked a very short-lived panic that subsided within seconds. Pay no attention to any news reports otherwise. We were at the back of the crowd when this happened and witnessed the entire thing. Nothing there but stupidity. We believe the fool was arrested, as he should have been.

As indicated, many of the speeches were hard to hear, coming from people who had directly experienced the horror of losing family and friends to gun violence. Some were in the schools when they were attacked (David Hogg, for example, at Stoneman Douglas High School). They remind us that children in grammar school are being subjected to active shooter drills.

Can you imagine the affect that is having on those kids? When I attended grammar school in the 1950s, we did nuclear attack drills, practicing hiding under desks as if that could protect us from the annihilation of a nuclear strike. It seemed unreal and had little impact. But active shooter drills when mass shootings occur almost every day and the kids are aware. The children subjected to this may be scarred for life. It seems like another form of grooming, making them afraid all the time that their lives or those of their friends could be snuffed out by a total stranger for no reason at all.

While preparing this post, I read in the Washington Post https://wapo.st/3zyYihF  that,

A bipartisan group of Senate negotiators announced Sunday that it had reached a tentative agreement on legislation that would pair modest new gun restrictions with significant new mental health and school security investments — a deal that could put Congress on a path to enacting the most significant national response in decades to acts of mass gun violence.

A group of 20 senators — 10 Democrats and 10 Republicans — signed a statement announcing the framework deal. That indicated that the agreement could have enough GOP support to defeat a filibuster, the Senate supermajority rule that has impeded prior gun legislation.

I call B.S. on this. The bolded portions of the report explain why:

Under the tentative deal, a federal grant program would encourage states to establish “red flag” laws that allow authorities to keep guns away from people found by a judge to represent a potential threat to themselves or others, while federal criminal background checks for gun buyers under 21 would include a mandatory search of juvenile justice records for the first time.

It does not include a provision … that would raise the minimum age for the purchase of at least some rifles from 18 to 21. Handguns are already subject to a federal 21-and-over age limit.

Other provisions could funnel billions of new federal dollars into mental health care and school security programs, funding new campus infrastructure and armed officers. Several senators last week said they expected one cornerstone of the deal would be … to establish a nationwide network of “community behavioral health clinics.”

Those are nice things to have but they fall grossly short of what is required to address gun violence in a meaningful way. We need to be careful we don’t embrace the first simplistic glossy object thrown at us to “show progress” when the real effect is to further deflect substantive progress because Republicans do not intend to give real ground on these issues and thereby disappoint their arms industry funders.

The real solution, promoted by several speakers at the March for Our Lives, is “VOTE THEM OUT.” Unless and until that happens, Republicans will continue obstructing real progress to stop or even seriously mitigate the wave of gun violence that makes the United States stand out among all nations as the most dangerous in so many ways. VOTE THEM OUT is the only real answer and the opportunity to start is coming soon in the mid-term elections.

If you agree that the time is past for meaningful action on gun violence prepare to VOTE THEM OUT. In addition to voting, work the polls, offer transportation and money and other help to elect Democrats up and down the ticket.

Don’t forget that a majority of Republicans around the country still believe Trump was unlawfully defeated and are working very hard to take over the electoral machinery in the states. The sole purpose is to prepare Republicans to invalidate elections they lose and simply install Republican candidates as winners. The only way to stop this is with overwhelming Democratic majorities. Make it so. Make it so.

Thoughts & Prayers

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Bear with me.

One of the early lessons learned in law school related to the issue of causation and intent. We were introduced to this question through Scott v Shepard, an English decision from 1773. Yes, 1773. The decision known as the Famous Squib [firecracker]. Flying Squib, or Lighted Squib case was the subject of extended discussion and debate. Among its many lessons is the principle that intentionally doing an act with known or predictable consequences means that you intended those consequences, caused those consequences and are legally accountable for them.

Here, for your edification, is a published summary of the case:

Facts

The defendant threw a squib, which is a small, lit firework, into a busy marketplace with lots of people and stalls. In order to protect themselves and avoid damage, the squib was thrown on by two other people. When it landed near to the complainant, it exploded and caused injury to his face. He later lost the use of one of his eyes. The original thrower, the defendant, was charged with assault and trespass.

Issues

The defendant was found liable for trespass and he appealed this decision. The defendant argued that the injury to the complainant was not caused by his actions; it was not a direct act, as others threw the squib on. The issue in the appeal was whether the defendant throwing the squib caused the injury or whether other people broke this chain of causation and the injury was caused by novus actus interveniens.

Decision/Outcome

The court dismissed the appeal; the injury to the complainant was the direct and unlawful act of the defendant who originally threw and intended to throw the squib. The other people were not ‘free agents’ in this situation and threw on the squib for their own safety and this was justifiable. The throwing on was classed as a continuation of the defendant’s action, which was intended. Whatever followed this was part of the defendant’s original act. [https://bit.ly/3xfYZJL]

The class discussion of this case was a shock, an early admission to the inner sanctum of legal reasoning. This simple case introduced us to the complexity of the seemingly obvious, the intricacies of causation, intent and other themes that run through the law.

One principle we took away was this: if you take an action knowing the likely consequences, you will be presumed to have intended those consequences. It’s the same principle that underlies the limit on freedom of speech with which most rational people are familiar: you can’t shout “fire” in a darkened theater and disclaim responsibility for injuries resulting from the panic that ensues. It’s ultimately why you can’t drink yourself into a stupor, drive a car, have an accident, and deny responsibility for the results. The principle is fundamental.

So what? This. Republicans in Congress have consistently refused to consider any gun regulations, no matter how limited, claiming Second Amendment privileges. The result is the massacre of school children in Uvalde, TX and all the others that preceded it and that will inevitably follow it. The refusal to change the law, knowing what will result, means that the legislators who refuse to act must intend the resulting carnage. It means they are content with the hundreds and thousands of deaths and injuries that could be prevented or at least reduced. There are no excuses.

There was a hearing in the House on gun regulation a few days ago. The following is the entire testimony of Dr. Roy Guerrero. It is not easy to read but it is important. If you know someone who believes gun regulation is unnecessary, consider sending this to them:

“My name is Dr. Roy Guerrero. I am a board-certified pediatrician, and I was present at Uvalde Memorial Hospital the day of the massacre on May 24th, 2022, at Robb Elementary School. I was called here today as a witness. But I showed up because I am a doctor.

Because how many years ago I swore an oath — An oath to do no harm.

After witnessing first-hand the carnage in my hometown of Uvalde, to stay silent would have betrayed that oath. Inaction is harm. Passivity is harm. Delay is harm. So here I am.

Not to plead, not to beg or to convince you of anything. But to do my job. And hope that by doing so it inspires the members of this House to do theirs.

I have lived in Uvalde my whole life. In fact, I attended Robb Elementary School myself as a kid. As often is the case with us grownups, we remember a lot of the good and not so much of the bad. So, I don’t recall homework or spelling bees, I remember how much I loved going to school and what a joyful time it was. Back then we were able to run between classrooms with ease to visit our friends. And I remember the way the cafeteria smelled lunchtime on Hamburger Thursdays.

It was right around lunchtime on a Tuesday that a gunman entered the school through the main door without restriction, massacred 19 students and two teachers and changed the way every student at Robb and their families will remember that school, forever.

I doubt they’ll remember the smell of the cafeteria or the laughter ringing in the hallways. Instead, they’ll be haunted by the memory of screams and bloodshed, panic, and chaos. Police shouting, parents wailing. I know I will never forget what I saw that day.

For me, that day started like any typical Tuesday at our Pediatric clinic – moms calling for coughs, boogers, sports physicals – right before the summer rush. School was out in two days then summer camps would guarantee some grazes and ankle sprains. Injuries that could be patched up and fixed with a Mickey Mouse sticker as a reward.

Then at 12:30 business as usual stopped and with it my heart. A colleague from a San Antonio trauma center texted me a message: ‘Why are the pediatric surgeons and anesthesiologists on call for a mass shooting in Uvalde?’

I raced to the hospital to find parents outside yelling children’s names in desperation and sobbing as they begged for any news related to their child. Those mother’s cries I will never get out of my head.

As I entered the chaos of the ER, the first casualty I came across was Miah Cerrillo. She was sitting in the hallway. Her face was still, still clearly in shock, but her whole body was shaking from the adrenaline coursing through it. The white Lilo and Stitch shirt she wore was covered in blood and her shoulder was bleeding from a shrapnel injury.

Sweet Miah. I’ve known her my whole life. As a baby she survived major liver surgeries against all odds. And once again she’s here. As a survivor.

Inspiring us with her story today and her bravery.

When I saw Miah sitting there, I remembered having seen her parents outside. So, after quickly examining two other patients of mine in the hallway with minor injuries, I raced outside to let them know Miah was alive.

I wasn’t ready for their next urgent and desperate question: ‘Where’s Elena?’

Elena, is Miah’s 8-year-old sister who was also at Robb at the time of the shooting. I had heard from some nurses that there were “two dead children” who had been moved to the surgical area of the hospital. As I made my way there, I prayed that I wouldn’t find her.

I didn’t find Elena, but what I did find was something no prayer will ever relieve.

Two children, whose bodies had been so pulverized by the bullets fired at them, decapitated, whose flesh had been so ripped apart, that the only clue as to their identities was the blood-spattered cartoon clothes still clinging to them. Clinging for life and finding none.

I could only hope these two bodies were a tragic exception to the list of survivors.

But as I waited there with my fellow Uvalde doctors, nurses, first responders and hospital staff for other casualties we hoped to save, they never arrived. All that remained was the bodies of 17 more children and the two teachers who cared for them, who dedicated their careers to nurturing and respecting the awesome potential of every single one. Just as we doctors do.

I’ll tell you why I became a pediatrician. Because I knew that children were the best patients. They accept the situation as it’s explained to them. You don’t have to coax them into changing their lifestyles in order to get better or plead them to modify their behavior as you do with adults.

No matter how hard you try to help an adult, their path to healing is always determined by how willing they are to take action. Adults are stubborn. We’re resistant to change even when the change will make things better for ourselves. But especially when we think we’re immune to the fallout.

Why else would there have been such little progress made in Congress to stop gun violence? Innocent children all over the country today are dead because laws and policy allows people to buy weapons before they’re legally even old enough to buy a pack of beer. They are dead because restrictions have been allowed to lapse. They’re dead because there are no rules about where guns are kept. Because no one is paying attention to who is buying them.

The thing I can’t figure out is whether our politicians are failing us out of stubbornness, passivity, or both.

I said before that as grown-ups we have a convenient habit of remembering the good and forgetting the bad. Never more so than when it comes to our guns. Once the blood is rinsed away from the bodies of our loved ones and scrubbed off the floors or the schools and supermarkets and churches, the carnage from each scene is erased from our collective conscience and we return once again to nostalgia.

To the rose-tinted view of our second amendment as a perfect instrument of American life, no matter how many lives are lost.

I chose to be a pediatrician. I chose to take care of children. Keeping them safe from preventable diseases I can do. Keeping them safe from bacteria and brittle bones I can do. But making sure our children are safe from guns, that’s the job of our politicians and leaders.

In this case, you are the doctors, and our country is the patient. We are lying on the operating table, riddled with bullets like the children of Robb Elementary and so many other schools. We are bleeding out and you are not there.

My oath as a doctor means that I signed up to save lives. I do my job. And I guess it turns out that I am here to plead. To beg. To please, please do yours.”

– Dr. Roy Guerrero, Pediatrician, Uvalde, TX

Nothing left to say.

Memes Again — Devoted to Guns

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WARNING: many of the images here are disturbing to anyone who is not enamored of guns. DO NOT LOOK further if you think you may be emotionally damaged by these images. They tell a story but it is the saddest story I know. PLEASE be careful.

This first set of images was selected from the suddenly archived website of Daniel Defense, the company that made/sold the weapon used by the Uvalde, Texas school shooter.

The caption on this one read: “He is Risen.” Followed by a hands-in-prayer emoji:

Caption: Don’t miss the chance to spoil mom this Mother’s Day! Take 25% off all ladies’ tees and save on gifts that will have mom feeling like #1. Valid through May 9, 2022. Shop for mom today at danieldefensestore.com.
This one advocates using sound suppressors:

Finally, and most remarkable, with this caption: “Train up a child in the way he should go, and when he is old, he will not depart from it. 🙏”

The remaining images are from Twitter & Facebook posts.

You likely know that we lead the world in gun deaths. You also know that every effort to address the issues has been stymied by Republican politicians. You know what to do.

Acceptable Losses – How Many?

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Acceptable Losses — a military euphemism for casualties or destruction inflicted by the enemy that are considered minor or tolerable.

That is where we are. Supported by the money from the National Rifle Association, the Republican Party has decided that the losses of hundreds of children at the hands of gun-wielding men with grievances is acceptable. It has happened again – this time in Texas. So far, 19 dead children and two dead teachers. So far.

This year – 27 school shootings. https://n.pr/3MPgqaS But it’s only May. Plenty of time to slaughter more kids. Thoughts and prayers. The NRA/Republican Party mantra – thoughts and prayers – but our guns, come and take ‘em. Just try. Nineteen dead children – acceptable losses.

The Gun Violence Archive, an independent data collection organization, has counted 212 mass shootings that have occurred so far this year…. It defines a mass shooting as an incident in which four or more people were shot or killed, excluding the shooter.

Data on the mass shootings that have occurred so far this year can be found here.

The U.S. ended 2021 with 693 mass shootings, per the Gun Violence Archive. The year before saw 611. And 2019 had 417.

That’s the trend. A few weeks ago, another shooter killed ten people in a supermarket. The most “civilized/advanced country in the world,” we like to say, has more mass shootings, more children slaughtered by guns than any other country in the entire world.

How many would be enough? One hundred? A thousand? Think of it. A thousand dead children at the hands of angry men with guns. Would that be enough to move Republicans to moral action? How many? When do acceptable losses become unacceptable? Five thousand?

The ritualistic political reactions have, of course, already begun. Republican politicians holding press conferences, tweeting “thoughts and prayers.” I wonder what those “thoughts” actually are. And “prayers?  They comfort some people, I suppose. I wonder, though, if politicians’ prayers will comfort a parent or sibling devastated by yet another preventable massacre. It all seems just like ritual at this point.

Angry kid buys guns and slaughters helpless children in school. Police and others rush to the scene, usually killing the gunman. It’s always a gun man. But it’s always too late. The dead kids pile up and the Republican politicians head for the microphones to repeat the ritual. Thoughts and prayers. But no action.

I read now that Democratic political leaders are going to try yet again to negotiate some gun law improvements, anything at all that Republicans might accept. https://wapo.st/3NEE3CH But the past is almost certainly prologue. There is no reason at all to think Republican politicians will agree to anything meaningful. And if that’s true, the only point is to show the public, yet again, who the politicians are that resist all efforts to stop the massacres. Will it matter?

Consider that Republicans in Georgia have renominated Marjorie Taylor Greene to occupy a seat in the House of Representatives. The same one who embraced QAnon conspiracy theories and now said about the Texas massacre that the solution is to “embrace God.” Ritual. She really means, do nothing. Pray for help that will not come.

Consider that Republican voters in Georgia nominated Herschel Walker, a former football player, to occupy one of the 100 Senate seats. Walker seems to have trouble stringing two coherent sentences together. Republicans want him to represent them in the Senate, where he will be expected to think about and vote on complex budget and international policy issues, among many other subjects about which he has zero experience and likely even less knowledge.

Walker is running to displace the sitting Senator Raphael Warnock. Reverend Warnock grew up in public housing in Savannah. His mother grew up in Waycross where she spent summers picking tobacco and cotton. The Senator graduated from Morehouse College, earned a PhD, and was ordained in the ministry. For over 15 years, Senator Warnock has served as Senior Pastor at Ebenezer Baptist Church in Atlanta, the former pulpit of Reverend Dr. Martin Luther King, Jr. He is an exceptional orator and the youngest pastor selected to serve in that leadership role at the historic church.

Consider that multiple leading Republican politicians are going to attend the National Rifle Association conference in Houston this weekend. There they will engage in the ritual obeisance to the God of Guns and Ammo that funnels campaign contributions to willing recipients completely ready to do vote for the NRA’s agenda: keep the guns and to Hell with the children.

Yes, the ritual will go on. And on. Until the American public finally says: ENOUGH! There is no reason to think we’re there now. I would, of course, love to be wrong about that, but the rational part of my mind says, don’t be a fool. Republican politicians across the country have continued to embrace Donald Trump’s Big Lie about the 2020 election. Republican voters for the most part are fine with the fantasy. Is there any reason to think such people are going to care about a bunch of children they don’t know? Not very likely.

So, what to do? Complaining isn’t going to change anything. Only voting will. Along with many others, I have continued to note that “we” outnumber “them” by a substantial margin. Yet the future of the country literally depends on an issue on which the nation’s record is far from reassuring. It’s all about turnout. Will enough people who understand what is at stake actually vote in the next elections? Or will the Republicans regain control of one or both Houses of Congress and end, once and for all, any chance of protecting and advancing democracy in America? That is literally what is at stake. Because as sure as you are reading this, nothing is going to change until the supporters of violence against children are removed from office. Nothing.

Democrats could, of course, accomplish a lot by removing the filibuster. But they won’t. They’re apparently concerned about what would happen if Republicans get control of Congress. But if Republicans get control (more than they already have now), they will exercise their power mercilessly. It’s time to act while action is possible.

Be afraid. Be very afraid. Democracy is under challenge around the globe. It will not save itself. Imagine what your life and the lives of your children and grandchildren will be like under a Republican managed government. Imagine.

What a Picture is Worth ….

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Island Paradise

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We returned recently from our twice-postponed [COVID] celebration of my wife’s birthday and our wedding anniversary. We have generally visited one or the other Hawaiian islands at least every other year. My wife lived there for eight years, and I have traveled there for business and pleasure many times. Hawaii remains one of the great travel experiences in the world.

The pandemic disrupted the rhythm of our visits and at a bad time. The second postponement was necessary because the Governor and health chief publicly announced that the islands could not handle a wave of COVID cases in visitors and, therefore, no one should come for a while. Extraordinary and sad for everyone.

Then the situation improved and off we went. The actual going and coming had some issues but we’ll just leave them unsaid. We want to share a few of the reasons Hawaii is special – photos of the birds, the flowers, the extraordinary trees and the “scenes.” These are a very small sample so, by all means, book yourself a dream trip. And while you’re there, book a birding tour with Oahu Nature Tours. It’s run by Michael Walther who is extremely knowledgeable about the wildlife and t geography/geology/history of the islands. He and his delightful partner Cecilia took on a great ride around the island in a Mercedes sedan. We went places you would never know about on your own and had a great day’s unique experience.

DC – Be More Like Hawaii

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We have returned from a twice postponed and much-needed vacation in Hawaii. We spent the entire week in Honolulu but, in our over-priced rental car, we toured the island as we always do, stopping for garlic shrimp at one of the local huts on the North Shore and marveling at the amazing scenery. We had a wonderful birding experience, about which more in another post.

The point now is to highlight an aspect of Hawaii life that we would do well to emulate here in the District of Columbia. It’s not hard to do and would contribute measurably to the quality of life here. Elsewhere as well.

I refer to the fact that virtually no one honks their car horn at other drivers in Hawaii. It is frowned upon as extremely discourteous, rude and … unacceptable. Associated with this wonderful custom is the concept of sharing the road. Traffic on Oahu, the island of which Honolulu occupies a big space and has most of the population, is, well, heavy. And on the few interstates, traffic tends to move fast when fast is possible. It resembles the interstates on the mainland in that regard. If you’re going to survive, you must pay attention to the road and other drivers and not so much the highly distractive surroundings.

That said, when it’s time to exit, giving a signal of your intentions reasonably in advance will almost always result in someone in the lane to your side allowing you to enter that lane and exit. The same is true for changing lanes to get into one whose speed is more comfortable. At congested points within Honolulu, and there are many, drivers, with rare exceptions, alternate with each other at choke points. You don’t have to force your way into the traffic. Other drivers seem to understand that they have been where you are and yield to you, if not willingly, still pretty consistently.

This degree of courtesy on the road can take some getting used to, but it doesn’t take long to realize that this is a culture change, a way of getting along with others who are all trying to do the same thing — reach their destinations safely.

The absence of routine angry horn honking and the common and almost universal courtesy of drivers yielding and sharing space with you makes for a quieter and calmer driving experience and general atmosphere. In DC, where we live now, I am convinced that the propensity of drivers to think they are somehow more important than everyone else and show this with blasting horns and insanely dangerous driving habits, leads to a kind of follow-the-leader atmosphere.  Horn honking leads to more horn honking. Hesitation at a light is not tolerated and often no space is given at merge points without forcing one’s way into the line of traffic. The more of this that occurs, the more it becomes the norm. Bad behavior begets bad behavior.

We can do better. Hawaii is proof that we can learn to accommodate each other, at least in this one respect, so that good behavior begets good behavior. You don’t have to visit Hawaii to figure this out, although it will do you a world of good to spend some time there. More about that in future posts. [I took over 1,000 photos in one week there.] Meanwhile, DC, try to be more like Hawaii.