Rarely is the front page of a newspaper the place for laughs, but today's New York Times is a noteworthy exception. I laughed out loud when I read the headline, "U.S. To Take North Korea Off Terror List."

What's so funny, you may ask? North Korea, you may recall, is a member of George W. Bush's famous Axis of Evil, along with Iran and Iraq. Bush coined the term in a 2002 State of the Union address to emphasize to the American public how dangerous these nations are and how important it is that we be tough with them (read: go to war).  Now, suddenly the Axis is one member smaller, and not because we crushed them with nukes, but because we negotiated an agreement with them.

That's right, negotiated. Negotiated. Let's all say it together: ne-GO-ti-ated.

As in, we talked to them for a long time, and they agreed to back off on their nuclear enrichment program. No less than Mr. Bush himself says that the verbal agreements in place could greatly improve tensions in East Asia: “This can be a moment of opportunity for North Korea. If it continues to make the right choices it can repair its relationship with the international community.”

Simply amazing what diplomacy can do when you give it a chance. 

The rest of this essay writes itself. If this approach worked with North Korean dictator Kim Jung-Il, widely regarded as one of the most unprincipled and brutal dictator in the world, why wouldn't it have worked with Saddam Hussein? Why won't it work with Iran? What excuse could anyone possibly give me for the war in Iraq now that would dissuade me from believing we did it (1) for oil, and (2) because the Bush administration thought it could win the 2004 election if we were at war.

The irony is galling. We had to invade Iraq over WMDs that didn't exist, and succeeded in cutting a deal with North Korea over WMDs that probably do. Almost 5,000 Americans dead, 30,000 wounded, hundreds of thousands of Iraqis dead, and over 2 million refugees now homeless because Bush said diplomacy was not an option.

We have all known somebody in our lives who always knows better, the hardheaded fool who has to do things his own way no matter what anybody says, and who, after everything else fails finally does what people told him to do from the start and he succeeds at last.

There is nothing to do but laugh at them. It beats crying. 

Just last week we had to listen to conservatives whine because the Supreme Court overturned a law denying U.S. military prisoners in Guantanamo Bay the right to habeas corpus.  How dare they, people like John McCain intoned, give legal rights to war prisoners. They're guilty, they don't need rights! They need to be punished for the crimes we can't prove they committed!

Lest we think that politicians are only interested in taking rights away from guilty people, Congress is this very day moving to take rights away from the innocent. Since 2006, George Bush has been pressing Congress to pass a law that not only allows the President to tap any phone call in the United States without a warrant as long as he says he is doing it to prevent terrorism, but also grants immunity to any telephone company that did an illegal wiretap in the past. 

That's right. Any phone call you make any time can be tapped. Without a warrant. And there is nothing you can do about it. You can't even sue the government to find out the reason you were tapped. You have no rights. All your phone calls are free for the government to pluck, whenever they feel like it, and you can't do a damn thing about it.

I've written about this before. Earlier in the year, members of Congress tried to push a similar bill through, but were blocked by a filibuster. So they are trying again. What Congress and the President want to do is to make it illegal to sue a telephone company for a warrantless wiretap. Why is this a big deal? Because there are 40 or so lawsuits against telecom companies for illegal taps in the courts right now. If this law passes, all the lawsuits will be dismissed. These lawsuits are the only chance the public has of ever finding out what the White House was tapping and why. We don't know if the Bush administration was really hunting terrorists or if they were collecting information to blackmail people and win elections, or even to find out illegal stock tips they could use to steal money in the stock market. We simply don't know.

The government certainly has to do some things in secret. But secrecy should be a last resort, not the norm. If this law passes, secrecy becomes the norm. No citizen, now or ever, will be able to challenge the validity of a federal wiretap. 

This is amnesty for criminals. The criminals are the telecom companies who tapped calls without a warrant, and the government officials who told them to do it. These criminals get off scot-free, and the law that got them off the hook could go down the same week conservatives howl because detainees now have the right to a court hearing in which the evidence against them is presented. I am both furious, and afraid, of the people in charge of this country.

One of the most outrageous parts about this bill is that it was drafted up with the approval of Democratic leadership. President Bush is 9 months from leaving office, his approval ratings are below 25%. He is weak as a kitten. Why won't the Democrats stand up to him? The only answer I can come up with is that some of the people in the Democratic leadership are hiding something that will come out if the telecom lawsuits come out. Perhaps they took money. Perhaps they used the wiretapping for their own advantage. Whatever it is, it appears both the White House and the Democratic leaders have done something terribly wrong and they are pulling every stop to legally cover themselves. If we citizens do nothing about it, they will get away with their criminal behavior. 

It is said we are at war. War is no excuse for taking rights away from citizens. Throughout its history America has mostly fought wars for rights -- what a sad end we are coming to if we consider war a good reason to flush rights down the toilet. 

A National Public Radio essay this morning alerted me that today is Loving Day. I had never heard of it. Loving Day, it turns out, commemorates the 1967 U.S. Supreme Court decision Loving v. Virginia.  Mildred and Richard Loving were an interracial couple jailed in the 1960s for violating Virginia's ban on interracial marriage. Eventually they fled the state rather than face more jail time, but from their new home in Washington, DC they filed suit in federal court, arguing that the ban was unconstitutional. The case made its way to the Supreme Court, and on June 12, 1967 the court struck down the Virginia law, effectively voiding laws against interracial marriage in 16 states. Richard Loving died in a car accident in 1975; Mildred died last month. Together they had 3 children.

I was struck by this case because my own marriage is, in a certain sense, interracial. I am white and my wife is Punjabi Indian. Since Indians are often included under the Caucasian umbrella, our marriage may or may not have qualified as interracial under the old laws. Still, my sympathies are deep.  Interracial marriage is not defined by the net difference in melatonin concentrations between two skin samples. It is defined by the way society reacts to your marriage, and the way it regards your children. Since my wife and I have at times experienced feelings of uncertain acceptance, I feel we have known at least a hint of what the Lovings knew. Moreover, since my wife is a first-generation immigrant, and her family's first language is Punjabi, not English, there is a cultural difference between us that is in some ways deeper and more nuanced than that experienced in an interracial marriage between two Americans.

It is hard to believe the Loving decision was in 1967, within the span of our lifetimes. My wife and I live in Mississippi, one of the states that had strong anti-miscegenation laws, and yet, I am happy to say, we have not had very many problems. That alone is a reason to celebrate.

But that is not what I am thinking about now. I am thinking how glorious it is to be married to someone who is different from you. How beautiful the differences are, how being married to someone from my same cultural background would at this point seem so, well, boring.  Our challenges have been our triumphs. Our scars are the testimony of love, far more so than a marriage certificate can ever be. It is sad to think that within a generation past there were laws to prevent such sublime joys, but we learn. There is no stopping us now.

Today is a great day. Happy Loving Day to all.

I started running today, after a relatively long hiatus. I didn't give up on exercise, instead deciding last year to focus on weightlifting. But I missed running, the steady, concentrated effort exerted over time, as opposed to the intense, short-burst effort of weight training. So I stepped out on the track tonight, for the first time in a long time.

Made it 1 and 1/2 miles, which is quite poor by my standards. I really thought the weight training would maintain my aerobic capacity at least a little, but I was very wrong. Not that I was ever a great runner, but there were times in my life when I regularly ran 4 to 5 miles, and long periods when I covered at least 3 miles a day.

For me, starting to run is like quitting cigarettes. I've done it a thousand times. Each time I go for several months, build up my endurance, then move on to something else. When I return to the track, I am back to the beginning, rewriting the oft-written running plan, this week 1.5 miles, next 1.75, 2.5 by the end of the summer, and on and on. When I limped off the track, I was reconstructing dreams of running a 10 k, maybe by the fall.

So here I am, at the beginning, again, wondering if I am too old for beginnings, but I don't have time to think about that. Gotta start figuring out a schedule. 

Recently I saw a patient in my office for a workplace accident. I had seen him 3 weeks prior to that, and at that last visit I ordered an MRI scan.  The scan had to be pre-approved by insurance, but it was, and we scheduled the scan. On this most recent visit, I reviewed his chart, only to find that we had never received the MRI report. We contacted the facility that did the MRI and asked to have the report sent by fax, but by the time the exam was over there was still no report. I had to send the patient home with medication and a promise that we would call him when the MRI report came in and I had made a decision about what to do next.

An MRI costs about $1500. Now, I consider this price scandalous, considering that in most developed countries MRIs cost a fraction of that, but no matter. The main point is that a hospital charged an insurance company $1500 for a test and never bothered to send the results to the doctor who ordered it. For $1500 the test report should be printed in gold leaf and hand-delivered to my desk by a Persian eunich.

This kind of thing happens all the time. I doubt 50% of the tests I order with a dollar value above $500 appear on the patient's chart in 2 weeks. 

I don't have a degree in business, but I have worked long enough to see that every business has a Top Priority, something that they value more than anything else. Top Priority may be making good hamburgers, or picking up the garbage on time, or having every order fulfilled by close of business. In the case of medicine, Top Priority too often is getting paid. In this case, we had to make phone calls in advance to get this MRI pre-approved. No money, no test. The MRI center made certain the check was in the mail before the patient was in the machine, but as for delivering the report to the right person on time, well, they'll get to that later.

Lest anyone think I am scapegoating the MRI people entirely for this situation, I will say that I have been on the other end of it. I have provided services to a patient, expecting to be reimbursed, only to be later denied. It's not a good feeling, and it is the kind of thing you don't forget the next time you are in the same situation. No one likes being cheated.

So many medical organizations put "Pay Me First" at the top of their priority lists. The problem is that when you make something #1, it tends to take the shine off whatever is at #2. I see it often: Medical organizations that worry so much about getting paid  that quality of care starts to slip. It's not greed -- well, not greed entirely -- that drives this. Most medical practices consider themselves lucky if 70% of the services they bill for are eventually paid. When 30% of your bills go into the uncollectible file for one reason or another, you tend to focus on getting your money whenever you can.

That being said, I alight again on "there's no exuse." The object of medical treatment is good health, not getting paid, and it is distressing that many organizations in medicine don't see it that way. If there is any urgent reason for health reform in this country it is this: Everybody worries about money all the time, and it puts us all in bad humor, and bad habits, and bad medicine.