The 10th Justice

Listening to Michael Pollan read his new book How to Change Your Mind while driving over the Cascade Mountains caused me to break out laughing a dozen times. The book is really funny. Not just his phraseology but his story telling ability about people from my youth like Ram Das, Timothy Leary, and Ken Kesey. I had forgotten how outrageous they all were, and how weirdly bent on gurudom. At Portland State University I saw Leary do his 'turn on, tune in, drop out' lecture. What is a 22 year old to make of that? Around the same time I also went to a lecture by Allen Ginsburg and afterwards asked him if the mind state induced by hallucinogenic drugs was the same as that acquired by years of meditation or other eastern religious practices. He hemmed and hawed and didn't really answer. But Pollan does answer and this brings us to the subject of this book and my take on it. The book is about psilocybin and LSD (psychelics) and the effect they have on the minds of the people who ...

Donald Trump defines himself by what is published about him. Most of what is published about him is critical because he is such as asshole. He just can't admit it. I just cannot state strongly enough how totally dishonest much of the Media is. Truth doesn’t matter to them, they only have their hatred & agenda. This includes fake books, which come out about me all the time, always anonymous sources, and are pure fiction. Enemy of the People! — Donald J. Trump (@realDonaldTrump)  August 30, 2018 Donald, the truth is that you are a bad person, and an ignorant one. You lie and you cheat. Do you step on people's feet like the old song? All that bad news is true. So read it and learn. Learn that rich people don't need more money at the expense of the poor. Coal is never coming back. You had fewer people at your inauguration than Obama. You lost the popular vote, fairly. You have tried to obstruct justice by firing Comey. You tried to buy off the women you had affairs wi...

The photograph at the beginning of Paul Krugman's column in todays New York Times was frightening. The young woman holding a MAGA hat and the middle aged woman beside her look enraptured. What woman with any sense would support this misogynist? What hold over these females does he have? Do they want him to grab them by their pussies? Is that what they are waiting for? Have I misinterpreted women all these years? Do they believe that reality TV is reality? What is going on? What is going on is the rise of fascism in America and the yeast that is making it rise is the Republican party. Only a fascist state can keep the Republicans in power. Without a change of the rules that has created the American democracy the white tribe will lose power and our country be thrown into a mixed racial stew from which, who knows what, might arise. Socialism even! Krugman gets right to the point in his opinion piece. The Republican Party has stopped playing by the rules since Obama was elected. Th...

If experience qualifies as expertise, then, on the subject of the physician-patient relationship, I am an expert. During my career as an emergency physician, I saw well over 100,000 new patients. As a patient I survived two cancers, multiple blood clots in my lungs, and a bunch of other non-lethal problems. In addition, I have read a number of books about the physician patient relationship. So, now that you know my credentials, here is what I have learned... All patients want to be treated with respect. They want the doctor to listen carefully, ask questions and respond in a non-demeaning manner. This needs to be done in person, with eye to eye contact. The information acquired needs to be in the doctor's head and not just in his computer. Information in the computer is for billing, to refer back to, or to send to another physician. A good doctor builds a model of the patient in his head consisting of age, sex, prior medical history, family history, psychosocial status, current s...

In an interview yesterday on Fox News, our president said the following about Jeff Sessions, the Attorney General of the United States, “And by the way, he was on the campaign,” Trump said on Fox. "You know, the only reason I gave him the job is because I felt loyalty. He was an original supporter.”  In the same interview Trump also said, “Jeff Sessions recused himself, which he shouldn’t have done, or he should have told me,” Trump said. “He took my job, and then he said, ‘I’m going to recuse myself.’ I said, ‘What kind of man is this?’ ” For these two statements alone Donald Trump should be kicked out of office. In the first statement Trump admitted that he had not appointed Sessions because he thought he was the best candidate for the job of attorney general but because he was loyal. The appointment of Sessions was a payback for support during the campaign. I know that all politicians appoint like-thinking persons to positions of power. However, the fir...

(This was written on August 18th. Today I see that Manafort was convicted of 8 charges so I think I should post it before it actually happens!) As I read about the Manafort trial and see the photos of him looking nicely dressed and unworried, I have a nagging concern. Today that concern increased when Mueller asked for six months jail time for Papadopoulos, who doesn't look worried either. Could it be that The Fix is in? Has Trump promised them all that he will pardon their crimes against America? He has even talked about pardoning himself. Certainly he will pardon Donald Jr. rather than letting him go to jail. And if this happens, how will the Republicans respond? Trump has already played with the pardon, one of his favorite presidential toys, just to see if and how it works. I think he is getting ready to use it in a more sinister way. The last test, his pardoning of Sheriff Arpaio was a politically controversial, and a build up to the next and most dangerous travesty. The trav...

A political race is taking place in Eastern Washington that if important to everyone who is tired of Republican craziness and their support of the crazy-in-chief, Donald Trump. Lisa Brown, a Democrat, is running against the incumbent Cathy McMorris Rodgers, a Republican. Rodgers is the ranking woman in the House and deeply involved in protecting our president at the expense of 'truth'. Devin Nunes, head of the House Intelligence Committee, made it clear that he and his fellow Republicans prefer autocracy to democracy. At the fund raiser for Rodgers he said, "If Sessions won’t unrecuse and Mueller won’t clear the president, we’re the only ones, which is really the danger,” referring to his committee's responsibility. We always thought the responsibility of the House Intelligence Committee was to find the truth, but as we just found out from Rudi Giuliani, "Truth isn't truth." That is the group Cathy McMorris Rodgers runs with. Rodger has voted for Trump...

Who knows what the future holds? An epidemic of ebola or some other uniformly fatal disease could kill half the world's population, or an astroid could hit earth and destroy most of the living things here. But assuming neither of those happen and that everyone continues on as they are at present, the population of the earth will continue to increase. What is the likelihood that everyone will stay in the country they were born into? Unlikely, is the answer. The world will eventually be one race, a mixture of black, white, red, yellow, and brown. When I was 14 years old, in 1960, and the civil rights movement was raging, I thought what an easy problem to solve: start a pro-miscegination league. Once everyone was intermarried who could be prejudiced? When Obama (half black, half white) was president, America was reaching out to the countries of the world to solve the problem of increasing population. He did not open the borders of America to unlimited immigration, in fact, Obama dep...

Trump's hands symbolize for me everything I hate about him, and it isn't their size. It is the fact that the most substantial thing they have ever held is golf club. His hands have never used a hammer, saw or shovel, they have never tied steel, baked a cake, poured concrete, planed a board, gutted a chicken, dug coal, sewed a sleeve on a shirt, or filed a book on the shelf of public library. They are the hands of a 'taker' as the Republicans like to call people on welfare. His hands take what other people do for him and he doesn't pay them for their efforts. His are the hands of a person who has no respect for the value that workers add to the world. What is my evidence for these statements? Trump has gone bankrupt six times. Did he suffer personally from any of these failed business ventures? No. The people who suffered were the men and women who work for him, the waitresses, the brick layers, the accountants. Sure bankruptcy is legal, but is it right to not pay ...

The physician-patient relationship is a good example of the influence of business on the profession of medicine. Most people want their doctor to understand a little of who they are, what they need, care about their best interests, and to give advice based on the best and most current medical information. Some of this has been lost in the age of technology when physicians become technicians. I didn't understand this until I talked to a gastroenterologist after the patient's insurance company justifiably refused to pay for a colonoscopy because he had just one. When I asked the GI doctor about this, he said he was just doing what the general practitioner requested. So I asked if he took a history and he said "No, I'm just the technician." My gastroenterologist isn't this impersonal and most physicians aren't. However, some are. Recently I accompanied my wife to see an orthopedist for her shoulder pain. The office was an assembly line. We went from the windo...

Dear President Trump, Thank you for your tweet in which you suggest running down people of color. As one of your loyal followers I try to follow your example and in this case it isn't clear if you are speaking in the verbally denigrating sense or the automotive sense. Since you are not allowed to drive, you can't really set an example if you are referring to hit and run. Your examples are mostly of the scream and yell variety but then we have your encouragement at your last rally to lynch journalists. Running down people of color with automobiles seems to have a certain logic in the Trumpian sense in that most people of color are either illegal immigrants, criminals, or illegal voters and deserve some punishment. Just one more question. Do you offer pardons for vehicular homicide? Sincerely, Mitch McConnell

Last evening my wife and I had drinks on our neighbor's newly resurfaced deck. The sky was beautiful at sunset. As we talked I watched the buddhist prayer flags attached to a bamboo pole on the corner of his deck wave in the brisk breeze. The idea of these prayer flags is that the wind will carry the prayers away across the land bringing blessing on everyone that the breeze reaches. Our neighbor lives in the eastern half of our two-dwelling townhouse. We live in the west side. Each house is the mirror image of the other and both are three stories tall. So my wife and I have an almost identical deck on our side and in the corner of our deck is my pole. Mine is made of aluminum and has a set of rods pointing up and down on the top, a configuration called a ground plane antenna. As I sat there having drinks and talking about life, religion, politics and home improvement projects I marveled at the difference between our two poles. In an earlier blog I made an off hand comment about...

Medicine is a wonderful profession. The body of knowledge that in necessary to practice rationally is huge, interesting, and constantly evolving. That science is coupled to humanism when patients, often strangers, come to the physician and share the intimate facts of their lives and their troubles. It is a rare privilege to be allowed into another human personal realm. It is a challenging and complex task to apply scientific principles to the subjective states of the human organism The press and popular literature tends to focus on the problems of medicine in America such as cost, impersonal interaction between physician and patient, and the side effects of the ever increasingly potent medications. We don't hear much news about the many miraculous things that medicine can do.  The placement of new lenses in the eye to relieve the blurring of cataracts is simple and almost perfect. Cancer is still with us but it is increasingly being cured. I have been cured of two lymphomas. Card...

I believe it was retired Supreme Court Justice Stevens who said during an interview that he had never heard a dollar bill say a word. Yet the Court has decided that money is equivalent to speech. Many people think that money is equivalent to anything that can be bought with it such as labor, goods, and entertainment. A dollar bill cannot talk so it is not speech, it cannot open a can of beans so it is not a can opener, it cannot keep you warm in winter so it is not a sweater, and it cannot feel so it is not love, although the reverse seems to be true, that people love money. I would like to argue money is not equivalent to anything except need. If you believe the studies, a few years old now but I'll use their numbers, individual incomes correlates with increased happiness up to an annual income of $75,000 then, as income rises above that, happiness seems to fall. According to Wikipedia, American income for a home with two earners of $150,000 is the 88 percentile of family income...

Since starting this blog I have focused on Trump and politics in America. Today I would like to move on to one of my pet ideas. This idea is unproven but over the last fifteen years it has stayed with me and the more I read the more likely it seems to be true. One of the problems and powers of religion is the belief in God. This belief is unshakable even in the face of NO proof. No matter what anyone says there is simply to evidence that God or any god exists. So why do people believe so strongly? Let's start with the book The Spiritual Life of Children by Robert Coles, a child psychiatrist. He interviewed a number of young children about their view of god and some drew pictures for him. Most of the pictures were of the face only, and if there were arms and legs they were small. Have children seen God? Maybe pictures of Jesus on the walls in childcare in churches. But I think the image comes from somewhere else: it is their memory of their parents face. Today I read an article ...

Mitch McConnell sees himself as Jim Bowie, another Kentuckian who died defending the Alamo from the Mexican hoards. I think this time, Mitch, you are on the wrong side. The symbol of the Alamo has power because it represented the battle between a depressed minority, the Texans, and the dominant Mexicans. Today, the colors have reversed. Obama's election as president was blame by the Republican party on changing racial demographics in America. After the election a group of Republican political educators was sent out to talk to all the state Republican groups, I assumed, about the changing demographics and how to bring persons of color into the Republican party. If white people became the minority and if the populace votes along racial lines, then the Republican were in trouble. I assumed this was the purpose of this educational road trip. I didn't hear the presentation but now I think I was wrong. Rather than saying 'let's make peace with our colored majority and offer...

With his flowing mane of orange hair, Trump may think of himself as Simba, the lion king, rising up from the exile of bankruptcy, to make America and himself great again. Maybe he doesn't know the difference between the two words: lion and lying. They sound almost the same but, sorry Donald, you are no lion and you are no king. Trump is a liar, not a lion. He lies because he is a businessman. The biggest and most common lie that business executives tell is that they can't pay their workers more because it would bankrupt the company. What they really mean is that if they pay their workers more then they can't pay themselves as much and maybe not be able to support the debt on their houses, boat, cars and mistresses. I learned that executives lie when I was an employed physician working for a large 'non-profit' Catholic hospital. We asked what percent we were getting paid of the money our work as doctors in the emergency room generated. The chief administrator, se...

Why does Trump vilify the press? Because he doesn't want his supporters to believe what reporters are reporting. Does anyone really think that the mainstream news is conspiracy of thousands of journalists? Does anyone believe they all conspire together before they report what they are seeing and hearing from the Trump administration? Of course not, because it isn't happening. What is happening is that most reporters agree on what they see and hear. If someone puts a chair on a stage and asks a thousand reporters to report on the event, some may say they saw an old wooden chair, some may report they saw an antique chair, some may not even describe the chair but just say they saw a place to sit on the stage. But they all will say about the same thing. This isn't a conspiracy, this is a consensus.  This is what you do every day. Trump wants you to believe that reporters are lying when they report that a chair is a chair. Trump wants you to believe it isn't a chair but is...

When I woke this morning I felt compelled to write about my fear of civil insurrection in America. At first I thought this essay would be a rant but as I began to really think about what to say I knew it would be a lament. Trump is ruining American unity. Growing up I worked. My father was an electrician who was raised on a south Texas dairy farm that was lost in the Great Depression. Like many people with similar stories he learned to value thrift and hard work and passed this on to me. I've forgotten a little of the thrift part over the years but the hard work part stuck. As a kid I worked part time jobs as a printer's assistant, movie theater ticket taker, photo technician, electrician helper during the summers, merchant marine seaman, and during medical school as a scrub nurse every fourth night. My medical career was spent in the emergency room in a big urban hospital seeing all comers, all classes, all types of problems; all unsorted, unplanned and distressed. As a resu...

After yesterday I feel the need to start speaking up to a broader audience than my family and friends: hence this blog. The title of my blog is The 10th Justice, a reference to Judge Learned Hand. Judge Hand sat on the 2nd Circuit Court for almost 50 years and an image of him stands on my desk. I keep him there to remind me of what America is all about. Hand said in his Spirit of Liberty speech that " The spirit of liberty is the spirit which is not too sure that it is right...". Right now our liberty is threatened by our own president. The partisan divide is widening. Maybe Judge Hand's neutrality, his careful consideration of the facts of the case can save us.  He was never appointed to the Supreme Court because he was not a partisan. In the fourteen presidential election in which he voted, six times he voted for the Republican, six times for the Democrat and twice for the independent. In this age of taking sides we need to get rid of sides and look at each issue with c...