Dr. Koop Speaks Out

[Originally posted October 30, 2009]

President Reagan's Surgeon General, C. Everett Koop, M.D., noteworthy for his public health pronouncements based on scientific facts during the onset of the HIV/AIDS epidemic, is now 93 years old. With his penchant for truth-telling, Dr. Koop recently described a troubling aspect of the mindset of Mr. Reagan's largely conservative cabinet in an interview that was printed in the Dartmouth Alumni Magazine:

"The attitude of President Ronald Reagan's cabinet was that the kind of people who got AIDS -- promiscuous women, homosexual men, drug addicts, people on heroin -- deserved what they got. Americans hadn't treated prisoners of war as badly." (DAM, Nov/Dec 2009, p. 96).

Dr. Koop is an equal-opportunity critic; in the same interview, he questioned the necessity of President Obama's wholesale reform of America's health care system. Such skepticism -- the laudable practice of looking before one leaps -- is a proper function of conservatism as a countervailing force to ambitious political agendas.

What Dr. Koop's observation about his fellow Reagan Administration political appointees confirms, however, is that the Republicans' attitude toward the defining public health disaster of the 1980s and 1990s was a matter not of principled, conservative caution but of active contempt for certain disfavored segments of citizens. It's a worthy contribution to the historical record from the former official who is still, in some minds, America's Physician.

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Epilogue: According to a Dartmouth College statement, "Former Surgeon General of the United States C. Everett Koop ’37, MD, a pioneer in the field of pediatric surgery, a leader in the fight to create a smoke-free nation, and founder of the C. Everett Koop Institute at Dartmouth’s Geisel School of Medicine, died peacefully at his home in Hanover, N.H. on February 25, 2013. He was 96 years old."

Lightning Quick

Lightning: A Novel, a small volume from a new hybrid genre of fictionalized biography, insinuated its way into my towering library borrowings stack.  It was a quick read with an educational payoff.

This is biography as storytelling, a narrative speculation on the life of neurotic, revolutionary inventor Nikola Tesla. The fictionalized specific events, closely based on the history of Tesla's inventions, and the author's speculations into Tesla's emotional state as the picaresque tale of his business dealings unfolds, place the book in the shaded area between historical fiction and popular history; the former is emphasized by the word "novel" on the cover and the use of "Gregor" rather than "Nikola" as the name of the protagonist.

French author Echenoz creates a story arc not through technological developments but through the use of recurring, colorful details as markers: Gregor's fondness for aviary companions; his fastidiousness of dress; his obsessive-compulsive habits. The product is a breezy, accessible introduction to the life of Tesla that could serve as a treatment for a one-man stage play.

My only hesitation in recommending this book, and others from the same author and genre, is that the story framework has the depth of a Wikipedia article; indeed, the sum of the author's background research could have been the Wikipedia article on Tesla.  By calling the book a novel and by emphasizing the subject's mindset over his technological contributions (other than to mention them serially as new examples of his propensity to get cheated), the author seems to be communicating the message: this is a work of narrative art, not history or technology; please don't criticize me for not including citations.

A Special Sunday at Miller Park

Whenever I go to Miller Park for a Brewers game, I glance around the tailgating crowd in the parking lot and the pre-game crowd milling around the concourses to see if I know anyone. I rarely do.

My Beloved Spousal Unit and I know most of the Brewers’ players on the field by sight, of course, as well as the manager, the coaches, maybe half of the opposition, one or two of the umpires. From our perch in the Terrace Level, we can see the radio booth and catch a glimpse of Bob Uecker or Cory Provus calling the game, and Bernie Brewer in his chalet, and the Racing Sausages, and the right field ballgirl with the terrific throwing arm. We take note when Faux Paul, my late brother-in-law’s doppelganger, is in his customary seat next to the Brewers’ dugout. We give a nod to the old-timers who man the stadium parking lots on the way in and the saxophone-torturing busker on the way out.

We also recognize a half-dozen regular Terrace Box denizens. Talk Your Ears Off and Son Of Talk Your Ears Off sit behind us and narrate loudly during every pitch and every interval between pitches in great, gory detail and imagine that this is a public service welcomed by their neighbors. There’s Zoom Lens Couple, who’ve never seen a live ballgame except through his-and-her rangefinders. Looks Like Billionaire County Executive sits on the other side of the Zoom Lenses and is a congenial chap, despite not being a billionaire. (We think.) Radio Headset Man, sitting over the portal, may look a bit stoned, but he’s managed to locate the stadium’s low-power FM frequency for the radio broadcast of the game, and that’s an accomplishment that’s eluded us.

In the communal sense, though, we hardly ever see a neighbor, or someone we work with, or someone else from around town that we know. Our encounters at the ballpark are largely transactional rather than social. Our relationship is with the whole scenario rather than the specific actors.

Today, however, was different. In a sense, we knew everyone at the game today: Brewers fans, Phillies fans, locals, sports tourists from afar. On this 10th anniversary of the horrific events of September 11, 2001, everyone in attendance was in reflective communion. We’ve all had a shared experience, one that exceeded our prior imagination, a nightmare that we can barely fathom to this day.

The sea of blue jerseys and t-shirts and caps that Brewers fans wear in common were merely a cover today; the real solidarity, the reason every pre-game step toward the sports cathedral seemed meaningful, the reason it felt almost tearfully good to see the green grass and diamond of dirt as we emerged from the portal into the sunlight, was that these steps shadowed the shell-shocked steps we took nearly ten years ago in this same venue, when we first resumed attending baseball games to try to chase the shock and numbness away.

The game itself was a festival of seriousness and silliness, both real and symbolic, full of inspiring plays and errors, two-base hits and strikeouts, patriotic songs and sausage races. Does it matter who won? Absolutely, it does! The Brewers are in a divisional race, and if divisional races matter in peacetime, they do so even more in times of peril and anxiety, when we need their distraction the most. So I’m happy to report that the Brew Crew salvaged the last game of the four-game set with Philadelphia, winning 3-2. Blue-clad fans breathed a sigh of relief when Corey Hart, Nyjer Morgan, and Ryan Braun finally delivered clutch hits, scarce commodities of late, in the late innings. Yovani Gallardo whiffed twelve batters while going seven strong, and closer John Axford allowed two batters to reach before completing yet another anxious, perilous save. The "magic number" for the Brewers to clinch the NL Central crown, their first divisional title in nearly three decades, is now ten, with a mere fourteen games to play.

Moreover, the chicken curry in fish sauce that my Beloved Spousal Unit conjured up for our pre-game picnic was delicious -– and our creative cuisine was the envy of the tailgating families to our left and right! All in all, a perfect Sunday afternoon in September, despite the somber occasion. Or perhaps, with deliberate intention, because of it.

My only regret about this memorable day, apart from our inability to tune into the radio broadcast and tune out the bozo behind us, is that we once again didn’t see anyone we know personally at the ballpark. Maybe next time I’ll bring a camera along and ask our Terrace Box neighbors for their expert advice on buying a zoom lens. It might be time for a new resolution.

Healthcare Reform: It's All About the Benjamins

My continuing objection to the U.S. healthcare model, with or without the currently proposed reform legislation, is that it relies upon an obsolete, anti-growth employment model that includes four invalid, or soon-to-be invalid, assumptions:

(1) Employment is continuous, or at least sequential, and each job has a duration on the order of several months or more;

(2) Employment compensation consists of only traditional salary or wages that correspond to time served rather than value added;

(3) Employment occurs, and healthcare benefits therefore accrue, within a single political jurisdiction;

(4) Ability to pay healthcare costs and insurance premiums depends upon one's salary or wages rather than one's accumulated wealth (as does the income tax, for that matter).

In a truly innovative, venture-based economy, creative contributors might work several hours for one client, work a month and a half for another, and have an intermittent gig with a third -- and that's only in one's main line of business. There might also be a side project or two, perhaps some online sales, investment income, capital gains, etc. Or perhaps a high-mobility worker travels from jobsite to jobsite, his or her geographic flexibility across state and national boundaries, going to where the work is, representing a crucial contribution to an efficiently operating global economic system.

Having healthcare benefits associated with traditional, full-time employment makes little sense in the current economy in which traditional employment describes the circumstances of fewer and fewer citizens. The high-volatility economy simply doesn't square with the traditional workplace assumptions underlying the healthcare debate. To reconcile healthcare reform efforts with modern workplace realities, a historical perspective may, ironically, provide the most illumination.

Consider that, similar to today's venture-driven economy, many of the nation's founders, including Washington, Franklin, and Jefferson, pursued multiple lines of entrepreneurial business, often simultaneously. This suggests a conceptual litmus test for evaluating today's healthcare reform proposals: would any proposed system under discussion that is still based on salary and wage income have covered Washington's leeches, Franklin's syphilis treatments, and Jefferson's extended family?

My Constitutional Amendment

This retrograde flap about Barack Obama's citizenship and eligibility for the Presidency begs the real question: why shouldn't we welcome as a national leader an immigrant who has, or whose parents have, renounced other allegiances decades ago? Isn't America supposed to be about ideas rather than soil?

Here's what our Constitution says on the subject of Presidential eligibility, in Article II, Section 1:

"No Person except a natural born Citizen, or a Citizen of the United States, at the time of the Adoption of this Constitution, shall be eligible to the Office of President; neither shall any Person be eligible to that Office who shall not have attained to the Age of thirty five Years, and been fourteen Years a Resident within the United States."

Here's my simple tweak, er, proposed Constitutional Amendment:

"No Person shall be eligible to the Office of President who shall not have been for the consecutive thirty five Years prior a Citizen of the United States, and fourteen Years a Resident within the United States."

Have at it, Ah-nold.

Of course, a 34 year, 6 month old pro-life advocate could someday claim citizenship since conception. This, at a minimum, would make for intriguing interrogations of the parents. Where's Ken Starr when we need him?

Hail to the 1970's! (Or Not.)

Are you embarrassed by your own generation? I was, at the time: the mid-to-late 1970's. I still am, to an extent.

From the predictable, drunken calls for semiprofessional garage bands to faithfully reproduce "Freebird"; to my college classmate who squealed his tires in a trashy salute while pulling away from my grandparents' house; to sportscoats in patterns and colors not found in nature; it was not the best decade in terms of taste.

We started the decade with a power-mad, bombing-happy crook in office and ended it with a moralistic, tone-deaf technocrat. When President Carter phoned U.S. Olympic hockey coach Herb Brooks to congratulate him on the team's astounding Gold Medal victory, including the "Miracle on Ice" game against the Soviets, Carter explained that he didn't watch the games because he was working on the Afghanistan crisis. No complaint here about the man's priorities, but he could have worked on his audience identification.

Don't get me started about President Ford's "Whip Inflation Now" buttons.

When Reggie Jackson held up three boastful fingers to the camera upon hitting three home runs in Game 6 of the 1977 World Series, the social virtues of modesty and good sportsmanship flew out the window, forever lost to the ages. When you see T.O. autographing a football in the end zone, or Jim Edmonds turning a routine fly ball into a highlight-reel catch, think Reggie. Braggadocio is classic and human, but amplified bombast is what our culture produced in the 1970's.

A friend of mine calls us a Lost Generation. I say, it's all been downhill since the 1969 Mets and the moon landings.

Our next-door neighbor's dad had a theory about the previous decade: the reason that the 1960's kids were angry enough to protest was that their pants were all too tight. Disco notwithstanding, ours in the 1970's may have been too loose, culturally speaking. Thirty years on, it still shows.

Inauguration Day!