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The contents of this website are for contemplative purposes only. No medical advice will be given, and emails asking for medical advice will be ignored.

Although patient vignettes are based on my experiences with real individuals, I liberally change details to maintain patient confidentiality.

I also reserve the right to change old postings to correct errors, and to delete comments that include obscene language or that I deem abusive to me or other commentators.  If you are looking for a open mind, I suggest you consult a neurosurgeon.

Katrina Blog Project

Protesting the National Anthem

About this this kneeling at sports contests business: The main objection to athletes doing this seems to be that they are at work, and shouldn't be allowed to protest at work.

Well..I work too, and never in my work career have I been asked to stand up and sing the National Anthem. There is nothing in any pro athlete's contract that requires him or her to pay respect to the National Anthem at the beginning of games. They are paid to play football, or baseball, or basketball.

There is a reason for this arrangement, for not saying the Pledge of Allegiance or singing the Anthem at work. First, not all employees are American citizens. There is a such thing as a green card, and asking a Canadian, for instance, to sing the Anthem at work is silly. Second, work is about getting work done, not about patriotism. Business owners and workers know they can say the Pledge any time they want to, when they are off. There is no reason to clutter work with patriotic ceremony. And finally, a company isn't the government or society. It is the government's and society's job to inspire patriotism, not the night manager at CVS pharmacy. Businesses intelligently see no need to bring up matters at work that have nothing to do with getting the job done.

As much as we all yearn for common ground, including respect for the flag and the Anthem, forced patriotism is not patriotism. Making people do what they are not inclined to do builds society on a lie.

I don't like public disrespect for sacred objects either, but I am not so stupid as to think that forcing people to do what they do not want to do is the answer. It doesn't change anything. In fact, the more you suppress feelings like this, the more resentful the protesters become. Doesn't anyone remember the 1960s?

Isn't it true that the more people comment negatively on the kneeling, the more it is happening? Of course it is. After Trump's whine fest yesterday, a baseball player did it for the first time. Now that Trump has engaged Steph Curry, it is almost certain to become more common at basketball games as well.

Just let it go. People will always protest. It human nature to protest, and complain, and whine, and make grievances known. The way to make it go away, if that is your goal, is to listen to them in the first place. Most reasonable people feel less need to protest, or to support other people's protests, when concerns are heard.

If you want to stop this, listen. Listen, hear, and reflect compassionately.


Farewell, Steely Dan

This past week Walter Becker, half of Steely Dan, died. The band of smoky rhythms and salty lyrics, jazzy-but-not-jazz, probably the best band of the nineteen seventies. Walter Becker and Donald Fagen, the duo that called themselves Steely Dan, take time to get to know, introverted in music as they were in life. But the best ones always are. In art, to be the best you have to be knowable, but not easy to know. The ones easy to know aren't usually worth knowing, Mark Twain and Oscar Wilde excepted. Art doesn't have to be personal, but if you put a lot of yourself into something, even if it is not you, it will be like you, tending to wind complex and deep like a network of cypress roots.

Becker and Fagan forgot more about recording than I ever could know. It is said that their 1977 best-selling album Aja was so sonically perfect that engineers use it to test audio systems for flaws. And yet for their formidable skills in the mixing booth, they never went for electronic or digital effects, instead seeking to make music sound like music and not like something else. No electronic sound effects, no synthesizers -- the electric piano was the most exotic sound they sought; their sound was natural instrumentation. They were interested in recording music, not making recordings, and there is a difference.

This traditiona approach appeals to me. Always has. Steely Dan’s adherence to standard voice and musical instruments, pure and clean, no distortion or overdrive or vocal filtering — music and nothing but — was a traditional approach to music. Music that could be replicated onstage with standard equipment, provided the musicians had the nerve to perform songs that were so clean and sonically transparent that mistakes were inconcealable. This traditional style may have limited the breadth of their sound, a slick blend of jazz and rock, but tradition notwithstanding, the tracks they laid down sounded only like them.

That is my theory of art as well -- you get more mileage out of stretching traditions than breaking them. I don't get much from music that takes a vocal note and electronically washes it into something that sounds like an electric violin. I don't go for the helicopter sounds, or the sound of a car squealing to a halt transformed into a closing coda. I like musicians to be musicians and to stick to their instruments. That doesn't mean I reject modern sound techniques. But I don't like them, sonically, as much as I like a really good guitarist squeezing the last drop of timbre out of his instrument. Like the guitar solo in "Rikki Don’t Lose that Number," for my money the finest guitar lead in rock history.

And chord changes. Slinky, grooving chord changes. Chord changes are what really make music, because without them all you have is a beat, and a beat is not music. Melody is music, but entirely too thin to hang a song on. You can whistle a tune but not a chord, which is why no one ever pays money to listen to someone whistle, or even to hear a solo instrument that can’t bang out two notes at the same time. No, it takes harmony to bring music to life, and a chord is harmony.

Chord changes are harmony going somewhere, and Steely Dan was in love with chord changes. Chord changes in popular music tend to be simple, so simple as to be non-existent, I to IV to V and back to I, with the occasional minor chord thrown in -- the simplest changes possible (trust me if you don't know music, I-IV-V chord sequences are is the first thing you learn). But they doesn't turn me on like the wicked G6/9-F#7#9-F6//9-E7#9-Eb6/9-D7#9 business that opens “Peg.” This sequence is not simply the musical tension typical of jazz, with the ninths and the sharps going for it, but also a smooth stepdown from beginning to end, G-F#-F-E-Eb-D, a half-step with each change, that ease-on-down that is the spirit of jazz slink.

Becker and Fagan wanted to produce good music, and they wanted music that sounded good on every level. Isolate the drums, the bass, keyboards, anything on a Steely Dan song, and there is enough going on to listen to that single thread all the way through. Even on paper, all those sharps and flat look better, like something’s goin’ on.

It looks like thought went into it. Like you can trust it. When a master artist works, you can trust that every stroke is intentional — nothing is happenstance, no effect unintentional, every word or gesture or brushstroke or musical note meant to be there. The jazz giant Thelonious Monk famously said that the best music comes from mistakes, but he didn’t mean that he made errors in his work and then made the best of them. He meant that in a great work of art, the eccentricities of the work were meant to be there and belong, every bit as much as the more comprehensible parts. He meant that every note in a really good song matters, and they all play off each other. No mistakes, only happy faults — abnormalities that belong in the overall plan just as much as the more conventional elements do, like the way a knot in a plank of wood makes it look more real than if the entire board is made up of flawless wood fibers running the same way.

When a master artist goes to work you know the mistakes were meant to be there. The discord is just as intentional as the harmony. You can listen to it, think about it, without concern that you are wasting your time considering an accidental effect, one that never occurred to the artist. You can trust that the mistakes belong.

That's what it is — trust. I trust Steely Dan. Trust them anew with every re-listen.

Photo of Steely Dan at the Pori Jazz Fesival courtesy of Kotivalo, posted in Wikicommons.


Hurricane Harvey / Katrina 12 Years

I had a post ready about Civil War statues, but that may have to wait awhile. As a Katrina survivor, I feel the need to say something about Hurricane Harvey.

Our hearts and prayers go out to the people affected by Harvey. A total of fifty inches of rain are expected to fall in Houston this week -- an almost incomprehensible amount of rainfall. And Houston is a much bigger city than New Orleans is, meaning Harvey has a potential to do much more damage than Katrina did. Southeast Louisiana, the first landing point for Katrina, has about two to three million people living in it. Coastal Mississippi, which was also hammered by Katrina, had maybe another million. All told, including inland areas of Mississippi such as Hattiesburg and Jackson, Katrina probably directly impacted about four to five million people.

     Texas is much larger. Houston and its immediate area has at least 5 million people. Add all the people living between Galveston and Corpus Christi and we are looking at 10 million souls, or at least double the affected population of Katrina. So, even if Harvey is only half as destructive on a mile-by-mile basis, it can still cause the same amount of damage and loss of life.

     And so we offer prayers, good wishes, and our funds to support this disaster. I will be giving to the Red Cross, and the Catholic Archdiocese of Houston-Galveston for the recovery. And if any Texans flee the hurricane all the way to Jackson, Mississippi, I can assure them personally that they will get the finest medical care available.

Besides offering immediate help, now is a good time, while Harvey continues to pour rain, to think about climate change. Climate scientists have always warned that a warmer planet will mean a higher frequency of extreme weather events, and Harvey certainly qualifies as extreme weather.

     I am not arguing, nor can it be argued, that Harvey is definitely a result of global warming. Global warming increases the probability of bad weather, but it cannot be directly blamed for any specific weather event.

     If this seems confusing, think about it this way. High speed is generally associated with car accidents. This is because the faster you drive, the less time you have to react to an event in front of you, such as another car darting out into your lane. If drivers were to suddenly decide to increase their driving speed by 20%, one would expect a sudden increase in accidents. It would not be true that every accident in this case would be caused by high speed driving. But higher speeds would make for more accidents. It would be difficult to blame any one accident on high speed, but the overall accidident spike could be.

     Same with Harvey. In a warming climate, an individual storm like Harvey is not definitely a product of global warming, but global warming will make such storms much more likely. Hurricanes are caused in part by warm ocean temperatures. Climate change is going to cause warmer ocean temperatures for a greater percentage of the year, and ocean water will be warm enough to sustain storms further north than it has in the past. And, warmer air can carry more water than cooler air, so storms in the future will produce more rain.

     So the odds should favor more storms with more rain, often landing farther north than we are used to.

     And there is one more thing to consider: growing population. In the last half-century, Americans have been moving towards the coasts. According to NOAA, 39% of Americans live in a county along the coast, a number that has increased by 40% since 1970. The trend is expected to increase, with the coastal population growing by another 8% by 2020.

     This means that, at a time when climate change will be generating more hurricanes, more people are moving to vulnerable areas. By ignoring both climate change and infrastructure improvements to help cities cope with bad weather, we are setting ourselves up for more Harveys, more often.

     We continue to move to the coasts and visit resort towns on the coasts. We continue to drain swamps and cut trees for golf courses and water parks near the beach without asking ourselves what we are setting ourselves up for. We won't raise roads, build sea walls, install pumps, or restrict building to areas we can protect from bad weather.

     In politics, are ignoring the very existence of climate change. In Florida, Governor Rick Scott has tried to limit all discussion of climate change by government employees. The words "climate change" and "global warming" are strongly discouraged; employees were advised to use terms like "sea level rise" and "weather events" instead.

     Bobby Jindal, the Louisiana governor who took office right after Katrina, dismissed climate science as "a Trojan horse" -- that is, as a false narrative to hide a more destructive liberal agenda.

     Haley Barbour, who was governor of Mississippi during Katrina, said in 2013 of climate change that "there are two sides to every issue." That is Exxon's position. It should not be a politician's position.

     While we watch Harvey bury Texas with rain and ask ourselves what we can do, let's remind ourselves that one thing we can do is demand that our politicians take seriously the idea that climate change might have something to do with it, and that rather than repeatedly spend billions on recovery and relief -- Katrina's bill was $120 billion -- we would prefer to spend that kind of money on preventative measures, limiting our risk in the future. This would save us far more.

     And it would prevent deaths, too. If anyone cares about prevention anymore.



Racism Visits Charlottesville

Charlottesville, Virginia was my home for more than eight years. It remains one of my favorite places on earth, and is the home of some of my most cherished memories. For this, and for many other reasons, I am greatly disturbed by the goings-on there over the last few days. Violence, murder, and the uglliest expression of hatred I've seen in this country since the segregationist protests in the 1960. All over a statue of Robert E. Lee. Not about schools, or where people are going to live, or who is going to vote. No. A statue.

Charlottesville is a college town, slightly left-of-center, as much Southern as it is the Liberal Northeast. It is so well balanced, North and South, left and right, rural and urban, that it is the very last place in America that I would expect to see a race confrontation. In all there years I was there, there was never anything like this. There was never the vaguest indication that something like this could happen. For me, this is as unexpected as if a gay pride demonstration broke out on the floor of the U.S. Senate.

I know Charlotteville extremely well. It is a sleepy, semi-rural, small town whose biggest worry is usually how to handle the weekend traffic during the Clemson game. It is a shock to me that a race riot could occur there.

But it did happen. It happened because our leaders have given us permission to hate other people. To insult and demean others based theoretically on our politics. But as we all know, politics is usually a stand-in for something more sinister.

On Friday, August 11, a group of white supremacist marchers appeared in front of the Rotunda at U.Va., the central structure of the Univeristy of Virginia. The Rotunda is an architectural landmark designed by Thomas Jefferson and completed in 1826, a UNESCO World Heritage site and symbol of free speech at the University of Virginia. The marchers claimed they were only there to prevent a statue of Robert E. Lee statue being removed from a local park, but their chant was "Blood and Soil," the English translation of "Blut und Boden," which was the motto of the Agriculture Department in Nazi Germany. They then switched to "You will not replace us," alternating with "Jews will not replace us."

I am not naive. Hatred will always be with us. But this kind of hatred used to be reserved for cranks, for people on the fringe of society. People who could be safely ridiculed and ignored. (Watch the movie The Blues Brothers from the 1970s if you want to see evidence of a time when Nazi sympathizers were an object of ridcule.) But you can't ignore people who show up on your front yard and parrot Nazi slogans under the protection of the First Amendment. 

The First Amendment, by the way, is one of the things thousands of American soldiers went to Europe in 1941-45 and died to defend. And the thanks these dead soldiers get is a violent Nazi protest in front of the Rotunda at an important center of higher learning.


I don't know what the answer is, but acceptance isn't one of them. Denunciation helps, and that's what I am doing here, but our dear President has declined to do. But until he and everyone else decides we want absolutely no part of this, nowhere, ever, it will continue to happen. I favor tolerance. Of speech. What happened in Charlottesville this past week was not speech.

I wish I could write more. But non-four-letter words fail me.


President Revenge

“When he gets attacked, he’s going to hit back… He’s not going to sit back and be attacked by the liberal media, Hollywood, elites -- and when they hit him, he’s going to hit back.” — Sarah Huckabee Sanders, June 29, 2017

Among his critics, the usual response to the President’s Twitter posts is to say that they are undignified. Not rising to the level of the office of the presidency.

This is missing the point. Dignity in politics has been dead for quite some time now. The last shred of it, in my view, vanished in the second presidential debate, when Donald Trump brought in several women who have accused Bill Clinton of sexual assault. Others might counter another example, but it doesn’t matter. We can all agree that politics is a disgrace right now.

More to the point is the statement by Ms. Sanders, which obviously represents the opinion of the President himself. His wife repeated the sentiment in almost the exact same words on the exact same day. Hit the President, she said, and he will back "10 times harder."

Consider for a moment what this means. It means that the President’s political policy — in fact, the clearest political policy we have from him since “I will build a wall” — is revenge. His announced plan for handling political adversity isn’t to produce more thoughtful legislation, or to become a more magnetic leader. It isn’t to champion peace or ethics or equality or to lead bipartisan compromise. It’s to knock the crap out of anyone who tries to lay a glove on him.

Revenge. That’s it. That’s what his dialog with the press is all about. Don’t you dare say anything I don’t like or I will slap the skin off your face.

His defenders will probably use the more-sinned-against-than-sinning argument, but here is the problem with that: He is the President. Although his behavior in office suggests that he thinks the Oval Office is his own personal property and pleasure palace, this is not the case. There were 44 presidents before him, and there will be, God willing, many more presidents after.

He didn’t create the office. He didn’t win it in a contest. He didn’t earn it as the last man standing on a reality television show. The presidency is not his to do with as he sees fit. The powers of the presidency belong to the people. It is defined in the Constitution, the first three words of which are "We the people." A president acts on behalf of the people, exercising powers that the people confer upon him. Powers that can be revoked at any time. He no more owns the Oval Office than I owned the public park bench I sat on the other day.

The point is this — since the powers of the office are not his, and he has no right to use those resources to settle personal scores. His "hit and I will hit back harder" mantra is an illegitimate and illegal use of the office.

Indeed, why is he spending any time at all tweeting out personal attacks? The reason most past presidents have been restrained in their public remarks is that they understood this. While Barack Obama may have been upset by the birthers, he didn’t spend time on the clock raging about it. Ronald Reagan got pretty harsh treatment about his age and supposed memory lapses and he shrugged it off. There are certainly examples of presidents who have settled political scores on the job. But there is a big difference between political conflicts, which are part of the job, and personal conflicts, which are not. Chris Christie is about to be unemployed for exactly this reason.

When you are the President, you don’t get to use the office to get even for perceived insults, even if they are unfair. It isn’t about dignity. It is about using the resources of your office on behalf of the people, not on your own behalf, as if the Oval Office were a newly acquired wing of Trump Tower.

Some would defend him by saying Twitter is not a public resource. Bull. He has millions of followers because he is President. And when he says something outrageous, his press secretary and many other government officials find themselves having to defend what he said. As Ms. Sanders did, on the public dime. Or as the First Lady did, through her own spokesperson, another public employee.

If the President wants to settle personal scores, he needs to quit his job. Then he can attack whomever he wants. But if he wants to engage in personal attacks out of his office, he is abusing his powers.

So, you ask, is the President just supposed to take it on the chin? Actually, yes. A big part of being President is knowing when to keep your mouth shut. When you are President, you speak for the American people or you don’t speak at all. This isn’t too much to ask of someone who could, with unguarded words, trigger a war.

Revenge is not acceptable public policy.