Psychiatrists masquerading as real doctors

(OK, before any of you harangue me about the post title, it is meant totally [mostly] in jest. Of my very best friends from medical school, three went into psychiatry. I briefly flirted with switching to psychiatry during residency. But most [honest] psychiatrists will also tell you that they turn a ghostly shade of pale when confronted with any non-psychiatric medical problem. Anyhow... onward.)

One of the nurse practitioners in the office forwarded an article to me from Fox News. (There is next to no chance I would ever have seen this otherwise, because Fox News makes me break out in itchy, itchy hives.) She was not amused:

Nurses Masquerading as Doctors

The growing shortage of medical doctors, which will be made much worse by health care reform, will mean more and more patients are cared for entirely by “nurse specialists” and nurse practitioners, instead of physicians. Nurses are lobbying for increased prescribing privileges and for the right to be addressed as “doctor” in health care settings.

I'm actually going to go through this bit by bit, because there's just so very much crap to deal with. First of all, the author (one Dr. Ablow) stumbles right out of the gate, because apparently he cannot tell the difference between nurses and nurse practitioners. The latter have much more training, which is why they are allowed to prescribe medication. In addition, so far as I am aware, the "nurses" who are lobbying to be called "doctor" are ones who have a doctorate in nursing. While I have some qualms with that (there is genuinely a difference between medical training and nursing training, even to the level of doctorate), Ablow does not bother to make the distinction.

People who can afford to bypass insurance altogether and simply pay to see doctors will increasingly do so. Why? It’s simple: Doctors go to medical school, which is much more rigorous academically and intellectually than nursing school. They also were admitted to medical school, which is a much more competitive process than being admitted to nursing school. The average doctor has more training, relevant experience and raw intellect than the average nurse–period.

Well, most nurses probably possess sufficient training, experience and raw intellect to know the difference between a nurse and a nurse practioner.

Let's just pause now, and clarify something. Nowhere have I ever seen anyone in any
health care setting cared for by a nurse when a doctor should have been involved. Plenty of people get cared for perfectly appropriately by nurse practioners, but this distinction is completely absent from Ablow's rant. As such, it is totally devoid of merit, because he is describing a phenomenon that does not actually exist, and conflates two different categories of medical provider.

Saying such things plainly isn’t popular, of course. The fact that the health insurance premiums of Americans won’t even get them access to the minds of doctors in many clinics and ERs and even ORs (where nurse anesthetists work behind gowns and masks, just like anesthesiologists) is one of the “dirty, little,” gigantic secrets of how our health care system is giving consumers less for more. No one is supposed to offend anyone with the truth, anymore, after all.

Behind gowns and masks?!?!? Just like doctors? (And also scrub nurses?) Don't they know those are special, "doctors-only" items. Nurses are supposed to wear those cute little hats, white hose, and saucy expressions.

Want to know something that Ablow doesn't mention? Any evidence that nurse anesthetists (who, like nurse practitioners, have training far beyond that of ordinary nurses) have worse outcomes managing anesthesia than anesthesiologists. Wanna know why? Because there isn't any.

Want a little truth right now? No man or woman in his or her right mind would prefer to routinely talk to an on-call nurse when his or her child is sick, rather than a doctor. No one sensible would want a nurse, rather than a doctor, assessing whether to get an MRI or CT scan or neither one after an episode of head trauma. No one would want a nurse, rather than a doctor, to decide whether to get a cardiac stress test in the setting of chest discomfort.

Want a little truth now? Many, many offices use triage nurses to answer routine questions. Like, for example, mine. If, in the middle of the night, the phone nurse needs to consult me, I get called. It's a system that works just fine.

Want a little more truth? No nurse would be making the decision about head scans or stress tests Ablow posits. Maybe a nurse practitioner might.

Want just a teensy bit more truth? Every single nurse practitioner I have ever worked with (and I have worked with them in many settings, managing everything from chemotherapy to contraception to eczema) has had an appropriate appreciation of his or her level of knowledge and expertise. They have consulted me or my colleagues when they felt they needed back-up (just like I do when I want another opinion), and no-one's care has suffered as a result of an inappropriate blurring between doctors and "nurses."

How about some more truth to go with all that truth? Sometimes, for fields where I don't have as much experience or training (psychiatric medication management springs to ming), I have consulted with nurse practitioners!! Because, contra Ablow, they are trained medical professionals who know what they're doing.

How come no one is flying into an American city today to see a famous nurse, while people arrive from countries around the world to visit with noted American physicians? How come no one in Congress would be able to tell you a story about that incredible nurse who diagnosed the rare condition in his or her child? How come nurses either failed to be admitted to medical school or didn’t try? You think it’s because they thought nursing school would train them better to take care of patients? C’mon. It’s because nursing school is easier–as in, 10 times easier.

I'll let you in on a little secret. You know those people who fly from all over to go to the best medical centers with all them famous doctors? I'm willing to bet that many of them received care at one point or another from a nurse practitioner. Because a lot of those famous-doctor-having centers also employ nurse practitioners.

Also, many nurses were admitted to nursing school because they wanted to be nurses, a possibility that seems to have escaped Ablow.

I almost feel sorry to be so blunt. I don’t want to hurt anyone’s feelings. If nurses stop impersonating doctors, I’ll stop writing about them impersonating doctors.

I almost feel sorry to be so blunt, too. Dr. Ablow is an idiot. (I don't care that he went to Brown and Johns Hopkins. I have met plenty of idiots at fancy schools.)

Until then, just follow the money; people with enough of it will hire physicians, every single time, when they have real health concerns. The vast majority of Americans, on the other hand, whose health insurance is rapidly costing more and buying them less, will see health care workers who chose not to go to medical school and probably would have been turned down, anyhow.

Oooooh. Guessing! I love guessing!

Maybe Dr. Ablow went into psychiatry because he couldn't get into a more competitive residency! Maybe that's why he's a self-help-book-writing hack who can't tell the difference between two different kinds of health care providers! Maybe he writes for Fox News because they thought he was too dumb for MSNBC!

Or maybe he's the kind of self-important prat who gives doctors their reputation for unjustified arrogance. Either way, he doesn't know what the hell he's talking about.

I'm no legal scholar, but...

I'm pretty sure I know what this means:

Section 1. All persons born or naturalized in the United States, and subject to the jurisdiction thereof, are citizens of the United States and of the State wherein they reside. No State shall make or enforce any law which shall abridge the privileges or immunities of citizens of the United States; nor shall any State deprive any person of life, liberty, or property, without due process of law; nor deny to any person within its jurisdiction the equal protection of the laws.

I think the only proper response to this is "Why does the 14th Amendment to the Constitution hate America?"

Over to you, Rep. Duncan Hunter (R - 18th Century):

Rep. Duncan Hunter said he would support deporting U.S.-born children of
illegal immigrants, adding that "it takes more than walking across the border to
be an American citizen."

The San Diego-area Republican congressman spoke Saturday at a video recorded tea party rally in Ramona. Hunter was asked by someone in the crowd if he backed deporting natural-born American citizens who are the children of illegal immigrants.

"I would have to, yes," Hunter said.Hunter said in the video that some of his critics believe his stance is mean-spirited.

"And we're not being mean. We're just saying it takes more than walking across the border to become an American citizen," he said. "It's what's in our souls."

Take that, huddled masses yearning to breathe free! To all of you real Americans, I'm very sorry my ancestors didn't drag themselves back to the shtetl where they belonged. Having all those depressing ethnic types milling about probably made it really hard to enjoy your DAR garden parties.

Sadly for Duncan's razor-sharp immigration policy reasoning, there appears to be no mention of soul content in the text of the Constitution. I love how the AP gingerly treats this little fly in the ointment:

Hunter also supports a House bill that calls for the elimination of automatic birthright citizenship for children born to undocumented immigrants. It is unclear whether the bill would be constitutional.

To me, it seems a little less unclear.

Given the changing demographics of the American electorate, you'd think Rep. Hunter would consider the long-term harm his xenophobic rhetoric was doing to his and his party's political prospects. I guess it's a good thing for him there are no Hispanics in San Diego.

Meanwhile, in bizarro world

Sweet merciful crap! I think I may need to go lie down. First Alito, now this!

More than 20 states have some mechanism for citizen-driven legislation, either through ballot initiative or referendum. In 2009, when Washington state granted domestic partners "everything-but-marriage" rights, a group called Protect Marriage Washington submitted petitions, signed by 138,500 residents, calling for a referendum to repeal the law. Washington's Public Records Act makes those names a matter of public record in the interest of transparency and public inspection. But the signatories—citing harassment and threats against those who organized for Proposition 8 repealing gay marriage in California—asked a court to enjoin publication of their names. A federal court blocked the release of the signatures, but the 9th Circuit reversed, saying that the signatures are collected in public and shown to public officials and that the release of the names furthers the important governmental aim of preserving electoral integrity. Then the Supreme Court stepped in, halted release of the names, and took the case.

[snip]

Then Scalia tags in to ask, "Do you have any case in which we have held that the First Amendment applies to activity that consists of legislating or of adopting legislation?" Working himself into an Originalist froth, Scalia notes that "for the first century of our existence, even voting was public—you either did it raising your hand or by voice," and then scolds that "running a democracy takes a certain amount of civic courage. And the First Amendment does not protect you from criticism or even nasty phone calls when you exercise your political rights to legislate." Scalia ends with the admonition that "[y]ou are asking us to enter into a whole new field where we have never gone before." [italics in original]

[snip]

Then Scalia, wiping his hands on his own thick skin blurts: "Oh, this is such a touchy-feely, oh, so sensitive. …You know, you can't run a democracy this way, with everybody being afraid of having his political positions known!"

This is precisely the point I was trying to make here. [Confidential to GJ: I think the precedent you cited in your comment on that post dealt with simple membership in a party, while the question in this case is confidentiality for people who are hoping to effect a change in the law. To my mind, they occupy different spaces in our shared civic lives.] If one expects one's signature as a citizen to be part of the process of changing the law, then one should have the courage of one's convictions and stand by it.

Dear God. Antonin Scalia and I agree about something. Someone please go outside and check to make sure the rain is still falling downward, willya?

2666: the penultimate section

In a comment over at the main Bolaño page, Paul wrote:

I’m starting to think that Bolano is something of like a cubist painter: he tries to show you every possible angle of a scene in full detail, even things that don’t seem relevant

This is somewhere close to how I've come to understand this book. I'm saving my big "compare and contrast with Infinite Jest" post for my last one (and I'm sure you're all just ill with giddy expectation), but one thing they share appears to be an attempt to describe just about everything going on in the lives and thoughts of everyone who comes into contact with the action of the novel. Viewing it in this way has helped me turn the corner into genuine appreciation.

I have only a few thoughts about this particular portion of the book. My primary reaction is that this is the first part with characters I think Bolaño actually likes, and that I have liked as well. Certainly, the description of the publisher Bubis's office is magical and wonderful and like an entryway to a Borges story. The characters of Bubis and his wife (the mysterious Baroness) are similarly compelling. Perhaps because this section tends more toward a more straight-forward narrative form and away from the vague, obscure, "poetic" writing that other people seem to like but that I find tedious.

I wonder if Archimboldi is the giant that Klaus Hass ominously warns will visit Santa Teresa. (Why he would be so menacing about a visit from the tall author is a lingering question for me.) I was struck by Ingebord's musing about men who kill their wives and get away with it, and how this resonates with the entire Part About the Crimes. And of course, we get to learn about Mrs. Bubis, first introduced to us in the Part About the Critics. We're getting a bit of narrative closure, which is nice.

I'm going to go a bit meta now, and talk a bit about the experience of participating in a collective online reading group. 2666 is probably an atypical example, as it's a pretty polarizing book. The Crimes are graphic and unexplained within the structure of the novel. The prose is often obscure, a trait for which I have little patience, and laden with imagery and metaphor that strike me as frankly nonsensical. And I've already spent time aplenty (as have others) on my gripes with what I still consider an unhealthy preoccupation (to use Maria's friend's term) with homosexuality and its associated pejorative.

Even though I've had some company, it's been not entirely wonderful being the guy who keeps saying "I hate it." I think part of the problem has been trying to keep with the schedule, which means one gets mired down and forced to linger with negative feelings that arise in various passages. Part of it is that I'm a gay man, and am far less likely to forgive or explain away certain slights that others might note in passing with a mere raised eyebrow, and thus my affection for the author was pretty frayed well before we got to the most unpleasant parts of the novel. And part is that I simply do not care for authors who can't be bothered with the once-cherished notion of clarity, and who expect us to furrow our brows trying to suss out what they meant by, say, comparing powerful politicians to rampaging pheasants. Maria has commented that it would be great if we were all discussing this in a cafe, but I'm pretty sure she would have stabbed me with her fork by now. It's no fun being the one who doesn't like what everyone else is digging, and my sympathy for Avery Edison has increased exponentially.

Anyhow, we're nearly done. Thanks to everyone who's stuck with me through all of this. I'm glad I've read this book, as it's been rewarding in its own way. But maybe not the way I would have hoped.

In which I agree with Sam Alito

Will over at Ordinary Gents highlights an interesting (but disturbing) detail in a recent Supreme Court decision.

Disclaimer: the "speech" in question involves production of specialty "fetish" videos of a particularly depraved nature. Any discussion will come from the Times, and is safe for work. (For the record, I will never write or post anything that is not safe for work.) However, the behaviors involved are very unsettling, and sensitive readers may want to avoid further reading. I would sincerely regret causing anyone distress.

Will quotes Stanley Fish at the Times:

The proverbial ordinary citizen, however, may be surprised to learn that, according to Chief Justice John Roberts’ majority opinion, the First Amendment must be read to allow the production and dissemination of so called “crush videos,” videos (and I quote from Roberts’ opinion) that “feature the intentional torture and killing of helpless animals” often by women wearing high-heeled “spike” shoes who slowly “crush animals to death” while talking to them in “a kind of dominatrix patter” as they scream and squeal “in great pain.” How has it come to this?

Even though it should go without saying, I'm going to say it anyway -- people who make or watch "crush videos" (the existence of which I was blessedly unknown to me until about half an hour ago) are reprobates of the absolute worst degree. I have a pretty "live and let live" attitude toward how people get their jollies, but if you're into crushing small animals for sexual kicks, I hope you get crushed underneath a large one.

Anyhow, it seems that the question was decided on a fine point. The behavior itself is illegal (and probably remains so) as animal cruelty, but the filming and dissemination are protected speech. In other words, if you're doing the crushing, you can (and should) go to jail, but if you're the [redacted] doing the filming, you're off the hook.

I do not agree with this decision. Roberts wrote:

Chief Justice Roberts rejected the government’s analogy to a more recent category of unprotected speech, child pornography, which the court in 1982 said deserved no First Amendment protection. Child pornography, the chief justice said, is “a special case” because the market for it is “intrinsically related to the underlying abuse.”

However, Alito in his dissent agreed with Solicitor General (and likely Supreme Court nominee) Elena Kagan:

In his majority opinion, Roberts acknowledges that in child pornography cases the argument that the market for the “product” was integrally related to the incidence of child abuse was found “persuasive.” Alito and Kagan try the same argument in response to the point that while the actions depicted in the crush videos are certainly illegal, depicting them is not because the portrayal of illegal acts is not itself an infringement of law.

Not true, Kagan and Alito reply: the illegal acts occur in large part because there is a market for the videos that depict them; take away the traffic in videos and you will reduce the number of crimes. Indeed, says Alito, those “criminal acts . . . cannot be prevented without targeting . . . the creation, sale, and possession for sale of depictions of animal torture.” Moreover, the effect of the ban “on trafficking in crush videos” would also help “to enforce the criminal laws and to ensure that criminals do not profit from their crimes.” Not to mention, Kagan adds, preventing “the harm to living animals occurring in the creation of the depictions, as well as associated harms arising from the acts of violence.”

The only meaningful difference that I can perceive between child pornography and crush videos (other than that the victims in the former at least [physically] survive the experience) is that one involves humans and the other involves animals. I do not buy Roberts' argument that the market for child pornography creates the underlying abuse but that the market for crush videos is somehow distinct from the cruelty itself. If anything, I suspect the opposite is true, with participants in child pornography doing so for their own depraved gratification (with the production of the pornography being a secondary goal) while crush video participants do so primarily for the purposes of making the video itself.

I think the majority got this case wrong, and I hope Congress writes a narrower law aimed at making sure this small but horrifying market remains bone dry.

Someone please slip something into Andrew Sullivan's tea

Dude needs to relax a little bit.

I know I've mentioned this before (somewhere in the vast nether regions of the Bleakonomy archives; I'll have our archivist get right on finding the link), but does anyone else remember the salad days of Sullivan's hating Hillary Clinton? Remember how he used to seem totally unhinged about her? Remember? Remember?

Now that she seems to be doing a creditable job as Secretary of State (cue certain commenters to start composing comment about how Hillary Clinton is inept and will bring about Armageddon), and has somehow managed to avoid pushing Obama onto any nearby sharpened objects, he's turned down the volume on that particular song.

Anyone who has read the Dish in the past couple of years knows that his new belfry bat is Sarah Palin. And I, of course, agree whole-heartedly that former half-term governor Palin is a risible clown of a joke of a disgrace of a politician. However, I really don't understand Sully's certainty that Palin has any chance of winning the White House.

She has wanted to be president for much of her adult political life. She wanted it well over a decade ago. She risked a huge amount in saying yes to John McCain, a gamble of monumental proportions, in the pursuit of that goal. She believes sincerely that she is on a mission from God, that she is the Esther of the End-Times. Why is any of this hard to understand? By her words and her actions, she wants to be the GOP nominee. And at a time when Republican extremism is the brand, who better represents the party than she?

For a much more sane take on the question, check out Sully's Atlantic co-blogger here.

I do not know what the "monumental" gamble for Palin was in saying "yes" to McCain. What on earth did it cost her that has not since demonstrated a perfect willingness to shed? Her governorship? Her credibility? Her... help me out here.

My guess is that she will "run." It will do nothing but increase her already blinding visibility. She will make some feints and appearances and raise a ton of money. But I doubt she will win much real support where it counts, in early primary states and in building a competent national campaign. Hell, half of the Tea Partiers say they would never support her, and she can't be bothered to show up at CPAC.

Plus, it would be a huge pay cut.

Parsing Tom Tancredo

I have read and reread and reread again the following quote, and cannot come up with a cogent explanation. Anyone care to help? Speaking about the awful, draconian new immigration law in Arizona:

Former Congressman Tom Tancredo -- the same guy who said we should send the president back to Kenya and said a Supreme Court nominee is part of the "Latino KKK" -- said this weekend that the new Arizona immigration law goes a little too far.

"If I had anything to say about it, we'd be doing it in Colorado," Tancredo told Denver news station KDVR. But, he said, "I do not want people here, there in Arizona, pulled over because you look like should be pulled over."

Sooo, he wishes they were doing it where he lives, but he thinks they shouldn't be doing it there? I do not understand.

Although, considering the source, I guess I shouldn't be surprised.

Thoughts on the Project Runway finale

I suppose it should go without saying that, if you're a fan of Project Runway but haven't yet seen the final episode, then you should skip this post since it will be rife with spoilers.

How relieved am I that Emilio lost? (OK, fine. All things considered, not that relieved. It's only a TV show, after all.) That was one ugly, dowdy collection. No matter how many times they tried to describe it as "commercial" (or whatever term they use for "something one expects plebeians to buy" in the fashion world) and contrasted it with his more attractive work during the season, those clothes were boring and plainly unattractive. His color palette was awful (seriously? pea green?), and the dresses themselves would be too dull for Talbots (no offense meant to Talbots), much less New York Fashion Week. Given all the ego Emilio oozed from the get-go, I was expecting something much better. Which is to say, "good." On the other hand, given that he sent the most god-awful thing we saw this season down the runway, he never should have made it to the final three in the first place.

And, while they tried to set Mila up to be this season's goat, I liked her collection much better. I didn't love it, but I didn't think it was terrible, either. She does color-blocking and retro-chic relatively well, and she also seems like a perfectly nice person. (More on that later.) I would have booted Emilio before her, but I suppose nobody honestly thought she would win, so it made for better TV to heighten the drama by making it between Emilio and Seth Aaron.

Of the final three, the only one whose collection was at all interesting was Seth Aaron. I'm a bit skeptical that he'll end up being a particularly successful designer, but at least he had a distinct point of view. I suspect he'll appeal to the same demographic that goes for Betsey Johnson. He may not end up being the next Christian Soriano, but at least he'll probably do better that the past two seasons' winners (who we've already forgotten).

I've no idea why they thought Faith Hill would be a good guest judge. As far as I know, she's not known as a style icon. (Country fans, correct me if I'm wrong.) She seemed nice enough (though Carrie Underwood might disagree), but she didn't have much to say. (Saying less would have worked better for the surprisingly-idiotic Lauren Hutton earlier this season.) She mainly just nodded, which is neither incisive commentary nor compelling television.

The last wee little bit I'd like to discuss came in the half-hour "special" they ran during the Models of the Runway spot. (Did anyone watch that show this season? We watched last season, and it was a total snooze-fest. Did I miss anything?) It's pretty rare that you get to witness someone saying something so flagrantly horrible that it sucks all the air out of the room. (Or maybe it's not all that rare any longer. I don't watch much TV.) So, you've got to hand it to Jay Sario. His appalling, nasty comment to one of the models (who had dared to comment negatively but not personally about his aesthetic) about her teeth and legs was so unbelievably petty that it provoked shock and horror from everyone else in the room (and an admonishment from Nina). Congratulations, Jay! You've gone from "cute if a bit overly emotional little gay guy" to "nasty, bitchy queen" in one fell swoop. That's your last impression for our popular judgement, and I hope you enjoy your obscurity.

So, that's it for this season, which was better than the last one but still kind of blah. Let's hope they make it work better next time.

Update: A fantastic recap of the reunion show is here.

A wee bit behind on 2666

It's been a very busy week up here around the Bleakonomy Northern Office, and I'm a wee bit behind in my reading.

For those of you anxiously awaiting my thoughts on the penultimate section of 2666 (don't all yell at once), I'm hoping to catch up tonight and post something tomorrow.

*insert sound of palm slapping forehead*

There's only one thing that bothers me much about this story:

As the global economy crashed and burned, certain top staffers at the Securities and Exchange Commission were busy watching porn. Instead of policing Wall Street, some were surfing for smut. This is the revelation making headlines today after the leak Thursday night of a summary of 33 probes of SEC employees using government computers to access pornography over the past five years. For the most part, the summary (PDF) resurfaces information that was already public; and it's worth noting that it was requested by Republican Sen. Chuck Grassley, and is now being used as political ammunition by the GOP.

The details are as follows: 31 of the investigations took place during the financial meltdown and, as the extent of the crisis became clear in 2008, the number of investigations ballooned from two the previous year to 16. Many of the porn-watching staffers held senior positions and six-figure salaries, and the cases run the gamut from employees simply accessing X-rated material during off hours on a government-issued laptops to watching porn for as many as five hours while on the job.

Am I peeved that SEC personnel were watching porn instead of saving us from the depredations of the financial sector? Sure. But it's not really the time wasting per se that bothers me.

How is it that financial oversight was entrusted to people too stupid to know that you shouldn't surf for Internet porn on the work computer??!??! Did they not notice that even PG-rated celebrity gossip pages will put "NSFW" on pictures of wardrobe malfunctions or Tiger Woods text messages? Did they not know what that stands for?

Don't. Use your work computer. For porn. If you're too dumb to know that, then what on earth are you doing working with one, much less for the federal government? Yeesh.

In defense of juvenile provocateurs

I found the movie The People vs. Larry Flint deeply irritating, if admittedly well-done. (The best things about it were Courtney Love's brief, shining moment as an almost-respectable movie actress and the song she wrote about the experience, all of which I found hilarious. Too bad she's gone completely off the deep end since.) Yes, I think we can all agree that the First Amendment is great. But I have a hard time celebrating an epic smut-peddler as some kind of free-speech martyr.

I feel similarly about this:

“South Park,” the Comedy Central series, is an animated show that tries its best to push buttons and the boundaries of free speech by mocking every high-profile target in sight, from Hollywood celebrities to religious figures. But its creators may have gotten more than they bargained for with two recent episodes that satirized the Prophet Muhammad — one that elicited an ominous message from an Islamic group based in New York, and one that was censored by the cable network that shows it.

[snip]

Cognizant that Islam forbids the depiction of its holiest prophet, Mr. Stone and Mr. Parker showed their “South Park” characters agonizing over how to bring Muhammad to their fictional Colorado town. At first the character said to be Muhammad is confined to a U-Haul trailer, and is heard speaking but is not shown. Later in the episode the character is let out of the trailer, dressed in a bear costume.

The next day the “South Park” episode was criticized by the group Revolution Muslim in a post at its Web site, revolutionmuslim.com. The post, written by a member named Abu Talhah Al-Amrikee, said the episode “outright insulted” the prophet, adding: “We have to warn Matt and Trey that what they are doing is stupid, and they will probably wind up like Theo van Gogh for airing this show. This is not a threat, but a warning of the reality of what will likely happen to them.”

[snip]

A spokesman for Comedy Central confirmed on Thursday that the network had added more bleeps to the episode than were in the version delivered by South Park Studios, and that it was not permitting the episode to be shown on the studio’s Web site. Comedy Central did not broadcast a repeat of the new “South Park” episode at midnight as it usually does, and instead showed a previous episode from this season. The channel was scheduled to do the same Thursday night.

Well, faaaaaaaaaantastic. Now Andrew Sullivan is falling all over himself praising Stone and Parker, treating them like they're heroes instead of comedically talented but juvenile attention seekers. They're the guys who made fart noises in your eighth grade English class, except now their televisual whoopie cushion is being mistaken for a latter-day version of The 95 Theses.

If I am forced to take a side, then yes, I agree that it was cowardly for Comedy Central to pull the episode. Freedom of speech is one of the cardinal values of our country, and there is no excuse for any form of censorship or coercion through threat of violence. Stone and Parker should be able to make fun of who they want without fear for their lives.

However, let's all just acknowledge that they did this for precisely this reason. They had no point to make beyond creating this exact stir. They poked a hornets nest for the sole purpose of getting us all mad at the hornets.

We now must defend them, but let's not mistake them for heroes.

Update: Puh-leeeeeeeeeeze.

Sue Lowden needs better health policy advisors

Sue Lowden is very likely to clean Harry Reid's clock this November. [Confidential to political junkies -- yes, that link is to Rasmussen, but in this case their house bias is consistent with just about all the reliable polling out there.] Frankly, this makes me admire Harry Reid rather more, in that he went to bat for health care reform even though it probably doomed his chances of re-election. However, that's beside the point.

Being as it were that Ms. Lowden is probably headed to the Senate, I really hope someone sits her down and explains that health care policy doesn't work this way:

The feathers are flying in the political attacks over Nevada Republican Senate candidate Sue Lowden's declarations that people could control health care costs through the use of barter.

On Monday, Lowden doubled down on the barter idea. "Let's change the system and talk about what the possibilities are. I'm telling you that this works," Lowden said. "You know, before we all started having health care, in the olden days, our grandparents, they would bring a chicken to the doctor. They would say I'll paint your house."

This idea demonstrates a fundamental lack of knowledge of how the current health care system works. I know essentially nothing about Sue Lowden, and I'm willing to admit the possibility that she's a smart woman. But she should not be demonstrating such blatant ignorance.

The only kind of provider that could possibly accept chickens (or any other non-monetary form of compensation) is a private practitioner who owns his or her own office and takes no insurance. (I'm not even totally sure that it would be legal in that case, though I'm not aware of any specific law that would prohibit it.) Back when our grandparents were seeking care, that kind of provider was the norm. These days they are very much the exception.

Once you accept third-party payers of any kind, you are obligated to charge all of your patients the same fees for the same services. You cannot charge insured patients more, or accept non-monetary payments from uninsured or underinsured patients. To do so violates the contractual relationship providers have with the public and private insurance companies, in essence making them subsidize the care of patients not enrolled in their plans. To undercharge based on ability to pay is fraudulent, so I am obligated to document and code for visits uniformly, even when I know the family will have a hard time affording my fees. (Situations like this formed the foundation for my support of the health care reform package recently signed into law.)

Lowden's suggestion was just completely out of touch with how the health care system works. Someone really needs to make sure she closes this gap in her knowledge before she is sworn in.

I hate siding with these people

There was an interesting "Sidebar" column in the Times the other day about a couple of free-speech cases that will be coming before the Supreme Court. What caught my eye is that both of them have to do with gay rights.

Case #1:

On Monday, the justices considered the rights of a Christian student group to bar gay members from leadership positions.

[snip]

The student group, the Christian Legal Society, bars “unrepentant participation in or advocacy of a sexually immoral lifestyle,” which it says includes “all acts of sexual conduct outside of God’s design for marriage between one man and one woman, which acts include fornication, adultery and homosexual conduct.”

A public law school, Hastings College of the Law in San Francisco, part of the University of California, withdrew official recognition from the group after it refused to comply with a school policy that forbids discrimination on various grounds, including religion and sexual orientation.

At Monday’s argument, Justice Stephen G. Breyer wondered what the group would have to say about a prospective member who said, “I don’t believe in sexual relationships before marriage, and that’s why I want to work for homosexual marriage.”

Michael W. McConnell, the group’s lawyer and a former federal judge, said taking
that position would be enough to disqualify the student.

For any new readers (Hi! Welcome!) unfamiliar with my worldview, I'll state the otherwise obvious point that the Christian Legal Society is precisely the kind of organization I wouldn't want to join, anyway. I try to make a point of not attending parties where I know I'm not invited.


On its face, I would say that the Christian Legal Society should either comply with University policy or lose its recognition. While I don't know what the loss of official recognition would entail, it seems to be rather straightforward that compliance with policies would be a requirement. So far, so good.


But a quick glance at the list of student organizations at Hastings reveals that there are several organizations there seemingly reserved for certain groups. Presumably non-Asian students aren't encouraged to join the Asian Pacific American Law Student Association, and men aren't welcome to join the Hastings Women's Law Journal. (To clarify, I have no objection to any of these organizations.) It's not clear that non-Jewish students are explicitly barred from the Hastings Jewish Law Students Association, but it's pretty strongly implied.


So why would women, racial minorities and other religious groups get to exclude members who don't fit the profile, but not conservative Christians? It seems that the former exclusions do, in fact, comport with the "reigning zeitgeist" (as the brief for the Christian group puts it), while the latter does not. I don't understand how one manner of exclusion is okey-dokey, but not the other. I am (and do) find the policies of the group odious, but suspect they may have a legitimate case.

Case #2:

Next week, the court will hear arguments about whether the names of people who signed a petition to place an anti-gay-rights measure on the ballot in Washington State should be kept secret.

[snip]

[T] case to be argued next week[is] Doe v. Reed, No. 09-559. The question there is whether Washington State’s open records law violates the free speech rights of people who signed ballot petitions by requiring their names to be made public. Some of those people say they fear retaliation and harassment from advocates of same-sex marriage.

I feel a little bit better about this one.

First of all, one doesn't particularly admire the signatories' courage of their convictions. Perhaps we have reached a point in our society where opposition to marriage equality is an unpopular stance (mirabile dictu), but if people feel strongly enough about the issue to want the issue brought to referendum, they should feel strongly enough to attach their names to it. Some of us feel strongly enough about the issue to stick our necks out rather far, and so I don't have a lot of sympathy for this argument.

However, that's more of an ethical argument than a legal one. I'm on shakier ground trying to discuss the law itself, but from what I understand the anti-equality side is on relatively weak ground. The Washington law was not created de novo for the marriage equality issue, and presumably all other petitions of this kind are part of the public record. Just as the Christian Legal Society should not be uniquely subject to regulations otherwise inconsistently applied, I don't see why the signatories to this particular petition should be uniquely shielded. I understand that it's a hot-button issue, but nobody forced them to sign the petitions. Them's the brakes.

Anyhow, there's your armchair legal analysis from Dan. Anyone with more expertise is welcome to weigh in.

What not to say

I know it's hard to know what to say to someone whose child has a genetic disorder that results in severe cognitive disability. Before I had such a kid, I would have had no idea what to say. It would have been terribly awkward, I'm sure, and I worry that I would have been less inclined to hold the child, play with him, coo over him.

(Before I go any further, the absolute best thing you can do is listen to the mom as she rants about how everything sucks and all the family's lives are over, and in the next breath brags about how completely awesome her disabled child is. The friends who have let me blather are the best, and have saved my sanity. You know who you are.)

So I understand awkward. Really I do. But there are some things that go beyond awkward and into a different, less pleasant place. Please do not say the following:

"Everything happens for a reason." Unless the reason you have in mind is that sometimes random genetic mutations happen, keep that reason to yourself. I do not want to hear anything about how giving a child a disability makes the world somehow better.

"They're all so sweet." Really? You've met all of them? Were you that patronizing when you met them, too?

"Sometimes the doctors are wrong." Yes. This is true. However, when you have this disorder, things do not suddenly just turn out okay - which is what people who say this seem to mean. The doctors are not wrong about that.

"Miracles sometimes happen, if you pray." A cruel God, who would withhold wellness from an innocent child unless his parents implored Him properly.

"If I were you, I would be too freaked out to have another child." Dear Lord.

"With everything that people eat and drink these days, it's no wonder these things are increasing."

"Don't forget to think about your older son." Oh, that's right! I had completely forgotten about him! He must be on the ledge playing with matches again as he cries that mommy never plays with him anymore.

"Every child has special needs." I'm not sure what this one is about. I think sometimes it's that people think that parents who say their kids have special needs are thinking of autism, and thinking that autism is BS. Other times it seems to be a your-child-is-really-no-different-from-any-other. Either way, it comes off as dismissive.

"They can do so much these days." This is fine if it's a genuine discussion about therapy or what have you. But if it's a way of saying something chipper (i.e., that my kid will be just fine) to change the subject, annoying.

Sorry. Bit of a rant I had to get off my chest. Done now.

John McCain goes hard to starboard

What seems like nineteen million years ago, I had some respect for John McCain. For the life of me, I can no longer recall why, but I have a lingering impression that once he stood for something or another. It's more a sense memory than anything else, at this point.

Sadly, McCain has decided to don some steel-toed boots and dance the watusi on the remains of his integrity. Via Politico:

Sen. John McCain praised a tough Arizona anti-immigration bill that will let police arrest people who aren’t carrying identification, the latest move in McCain’s rightward shift in advance of a tough Republican Senate primary this summer.

[snip]

Under the Arizona law, which passed the state Senate today and sent to Gov. Jan Brewer (R), police can arrest anyone on “reasonable suspicion” that they are an illegal immigrant. If they’re not carrying a valid driver’s license or identity papers, police can arrest them.

Got that, Dad? If you happen to find yourself in Arizona, better keep your naturalization papers handy. Otherwise, if the police catch you ordering tea in the mid-afternoon, they may toss you in the clink and ship you back to County Durham with nary a "fare-thee-well."

Ha, ha. I'm kidding, of course. My father is white, so I'm sure he can stroll the streets of Tucson with impunity. Somehow, I suspect that "reasonable suspicion" correlates strongly with skin melanin levels.

Why has McCain decided to throw his diminishing weight behind a draconian, flagrantly xenophobic law? Could it be his primary challenge from frothing reactionary J. D. Hayworth?

This is all hilariously short-sighted, of course. The Hispanic population is a growing demographic and voter block, and watching the GOP pander to its nativist base makes me wonder if anyone in the party hopes to launch a credible national campaign over the coming years/decades. But in the meantime, my primary lament is for the remains of John McCain's soul.

An appalling symmetry

Today is the 15th anniversary of the Oklahoma City bombing, at that point the worst terrorist attack on American soil. I daresay none of us need reminding of the horrors of that attack, nor do we need reminding of who perpetrated the mass murder and why.

Keeping that grim history in mind makes some of the rhetoric currently flying around all the more repulsive:

A Tea Party rally in Greenville, South Carolina over the weekend took some of the Tea Party's violent rhetoric to new levels, with speakers attacking everything from President Obama's citizenship to Sen. Lindsey Graham's sexuality.

[snip]

The event took place at the Bi-Lo Center in Greenville, and featured former Rep. Tom Tancredo (R-CO) as its keynote speaker. Tancredo, who ran for the Republican presidential nomination in 2008, said that Americans are "going to have to pray that we can hold on to this country." He added, referring to President Obama: "If his wife says Kenya is his homeland, why don't we just send him back?"

Pastor Stan Craig, of the Choice Hills Baptist Church, was particularly angry about the state of Washington, saying he "was trained to defend the liberties of this nation." He declared that he was prepared to "suit up, get my gun, go to Washington, and do what they trained me to do."

Before anyone dismisses this as wild rhetoric espoused by fringe idiots, I'd like to point out that numerous prominent Republicans have appeared at these rallies and egged on the crowds. While most have managed to avoid being overtly racist like the odious snake Tancredo, neither is their any effort on the GOP's part to distance itself from the incendiary speech and bellicose stance of the Tea Partiers.

This is a disturbing moment in American history.

Update: That being said, inflammatory and misleading headlines at Huffington Post about "Militias Descending on DC" aren't helpful, either.

2666: not really about this week's allotted reading

It's become clear to me that I am never going to be a fan of Roberto Bolaño. I've been pondering my response to 2666 a lot this week, and I've been trying to come up with a more generous interpretation. (More on that later.) Unfortunately, I think the best I can hope for is "appreciate," which while a lot better than "hate" is nowhere near the raptures I saw expressed by the critical masses. My opinion was cinched by the Bolaño short story "Prefiguration of Lalo Cura" in the recent New Yorker. I didn't like it.

Most of this is likely just a matter of taste. What I read as manifest nonsense other people seem to see as poetic. I find his writing florid, self-impressed and deliberately inscrutable. I am no more impressed by his fascination with whores and the demimonde than I was by Henry Miller's when I read Tropic of Cancer. And I think I've said enough about his adolescent attitudes toward homosexuality.

At this point, I'm going to pause and warn people that the next paragraph contains spoilers about Infinite Jest. I'll try to be vague, but if you haven't read it then skip the paragraph.

One of the biggest unresolved questions in IJ is whether or not the story about why Joelle wears the veil is true. There are hints in either direction, but one is free to decide which are more reliable and which are untrue. When David Foster Wallace died, I made an interpretive decision. I decided not to believe Molly Notkin. If I had to live in a world without my favorite author, at least I could decide on a happier fate for one of my favorite characters.

End spoiler.

I mention this because there is a lot of room for speculation in 2666. In particular, it's not at all clear what Bolaño is doing with the Crimes. The novel seems to revolve around them, and to move inexorably toward them in the first three Parts. But what the Crimes themselves are meant to say about the characters, the world of the novel and by extension the world at large is open to interpretation.

Are we meant to judge the characters by their relationship to and awareness of the Crimes? Are the Crimes the truest thing in the novel? Do we see the characters and actions of the novel only in their lurid light? Are the Crimes in some way a commentary on everything else that happens in the book? Or is Bolaño simply trying to write about various lives that intertwine with the Crimes (or glide right by them) but are not necessarily defined by them? Is the novel meant to be descriptive of its world without judgement, or are the other characters somehow implicated by the Crimes? By extension, are we?

My reaction to this book depends a lot on the answer the reader chooses. If the Crimes represent the truest thing in the world of 2666, then I simply have nothing good to say about the book at all. It's a worldview I reject. (I'll save any further ranting for my last post.) If Bolaño is creating a nuanced, dream-like world as completely as possible, then it's a task I can admire, even if I have serious gripes with the execution.

Anyone feel like weighing in? How do YOU view the Crimes as they relate to the novel as a whole? Are the other character indicted? Are you?

Like Sophie's Choice, but much, much crappier

Can I just admit up front that I am dying to see this? (Via Andrew.)

From the looks of that poster, one would guess that the movie is about One Woman's struggle with gas.

Andrew seems to imply that this movie is specifically about Sarah Palin, which apparently it is not. But, coming from the American Family Association, it's sure to be good anyway.

Speaking of our friends at the AFA, there's also this (also via the Dish):

"With an active homosexual on the bench, Lady Justice will no longer even pretend to be blind. She will be peeking out from under her blindfold to determine the sexual preference of those standing before her, then will let the fold slip back into place before ruling in every case to legitimize sexual deviancy. Bottom line: the American ideal of absolute equality before the law will inevitably be shredded by a homosexual judge. Neither the Constitution nor the American people should be subjected to that kind of judicial malpractice. We can and should expect more from those who occupy seats on the highest bench in the land," - Bryan Fischer, American Family Association.

Makes me want to pop up some Orville Redenbacher, lie back and watch a movie written by guys like him. Who's with me?

I think that what Mr. Fisher really means to say is that, with a (purported but denied) lesbian like Elena Kagan on the Supreme Court, Lady Justice will shave her head, join Dykes on Bikes, and run off with a tattooed Statue of Liberty. We homosexuals simply won't rest until we've completely destroyed the fabric of America. (For my part, I've surreptitiously replaced every third vaccine I give with a small dose of gay. It's the medical version of judicial malpractice, and we're coming to a clinic near you.)

Another good step

From the Times:

President Obama on Thursday ordered his health secretary to issue new rules aimed at granting hospital visiting rights to same-sex partners.

The White House announced the rule changes, which will also make it easier for gay men and lesbians to make medical decisions on behalf of their partners, in a memorandum released Thursday night. In it, the president said the new rules would affect any hospital that participates in Medicare or Medicaid, the government programs to cover the elderly and the poor.

[snip]

Gay rights advocates said the rules change was inspired by one of those cases involving a same-sex couple, Janice Langbehn and Lisa Pond, who were profiled in The New York Times last year. After Ms. Pond was stricken with a fatal brain aneurysm, Ms. Langbehn was denied visiting rights in 2007 by a Florida hospital. Although Ms. Langbehn had power of attorney and she and Ms. Pond were parents to four children they had adopted, the hospital refused for eight hours to allow her and the children to see Ms. Pond, her partner for 18 years. Ms. Pond died as Ms. Langbehn tried in vain to get to her side.

It's not marriage equality by a long shot, but it's progress.

On the other hand, the case of Ms. Langbehn and Ms. Pond shows why marriage equality is so important. For all the squawking on the opponents' side about how legal safeguards already exist to protect the rights of gay and lesbian couples, those protections are flawed and weak. Despite Ms. Langbehn having power of attorney, she was denied access to her partner in the last minutes of her life, and her suit against the hospital was unsuccessful. While I am grateful to the President for this new set of rules, they are no reason to become complacent.

At least I never thought she was funny

My, but SNL alum Victoria Jackson seems to have gone rather around the bend. I've never been a big fan of the show, and I certainly wasn't back in the 80s. Still, I can't say I saw this coming:

I hadn't thought of that

I'm going to jump on friend and fellow poster Elizabeth's bandwagon a bit and write a little about our national problem with obesity. Marc Ambinder had an interesting post the other day that made me think a little bit (always a dangerous proposition):

Jumping off this article in the May issue of The Atlantic, I want to sketch out a few principles for what I think would be an enlightened, realistic approach to beating obesity. Here's where I'm coming from: I think the obesity crisis is real AND reversible; no one solution -- not banning high-fructose corn syrup, not soda taxes, not universal health care -- will be the panacea. Instead, a broad-based, metric-monitored national public health campaign, led by a strong political leader who has the authority and legitimacy to knock heads, can identify what works, what doesn't, and to persuade states, Congress, companies, and the culture at large to follow suit. I'm about additive solutions, not broad demonization, because additive solutions tend to work, and because selective demonization works much better.

This is nothing particularly new. Obesity is a major health concern, and it will take a multi-factorial approach to make any headway. But there was something in one of his points that hit home.

1. Recognize that what separates skinny people from fat people is luck, and not willpower. Either your genes or your unchosen social environment, will provide a shield against the pressures of the default obesogenic environment. If you're part of a chronically stressed population, have little or no access to quality public infastructure, find yourself growing up in a dysfunctional family, and have limited social mobility, the chances that you'll be able to summon some magical reserve of willpower is slim to none. If you're white, upper middle class, tend to be hopeful about improving your lot in life, and have the time and resources to diet and exercise, you might be able to find a weight loss regimen that works for you. Either way, don't give yourself credit, and don't blame other people who aren't as lucky. [emphasis mine]

Much of what Ambinder mentions as factors for success have already occurred to me. However, I honestly (and somewhat embarrassingly) never considered the psychological aspect of weight management in quite such clear terms. The impact of socioeconomic status is not limited to access health foods, exercise facilities and the ability to pay for them. If one has little hope for improvement in one's life circumstances as a whole, it makes perfect sense to have little investment in trying to lead a healthier lifestyle with regard to diet and exercise in particular.

I am one of those white, upper middle class types who probably gives himself more credit than is due. I've been raised to assume that investments I made in my well-being (whether academic, social or physiological) would yield dividends. After all, why wouldn't they? I've not had to face any institutional barriers to my success, at least not until I bumped into my first examples of rank homophobia amongst the surgeons in medical school, by which time my generally optimistic worldview was well-established.

Further, I was raised in a house where the snacks that were available were fresh fruit and yogurt. (Also, pretty much the only desserts available.) I lived in a nice, safe neighborhood with a mother that routinely booted me out of the house to go run around and play with the numerous other kids. I was established with healthy patterns early, and so now it's relatively easy for me to eat well and exercise because I have a good foundation. I have every expectation that good choices will pay off, because it has been ever thus. (Here is where I give my mother [who may or may not be a regular reader of my blog] props for the Good Parenting Choices.)

The reverse is obviously true, if unacknowledged. People who can reasonably expect to have limited success in life cannot be expected to throw themselves into a program of health improvement in defiance of their broader experience. Though this paints a very frustrating picture, at least it's a more realistic one.

Dept. of Comic Relief

This is too good to be true:

Michael Heath Running For Governor

Rapture!! It's rare that one gets to watch a train-wreck of such epic idiocy unfold, and I'm thrilled that Heath is giving us the gift of his remaining self-respect to demolish.

For those of you who have never heard of Michael Heath, he's Maine's two-bit answer to Tony Perkins. Or, rather, he was until the Maine Christian Civic League gave him the heave-ho last year.

When your own theocratic pack of reactionary fundamentalists thinks you've become too irritating and polarizing to keep around, I think we can all agree it's a great omen for your gubernatorial prospects. I join everyone in wishing Heath all the luck he deserves trying to scrape together the signatures and cash he'll need to get on the ballot, where (if he makes it) he will be able to siphon the idiot vote away from whichever Republican (including one I would actually vote for) gets that party's nomination.

I love these people

I give you my new heroes.

(I particularly like "I was promised donuts.")

Dept. of Free-form Ranting

When I read the news of the Jim Carrey/Jenny McCarthy split, I wondered what would become of their mutual crack-pot crusade to keep America safe for infectious diseases. After all, his face used to be plastered all over her lunatic anti-vaccine website. One wonders how strongly he will fight for the cause now that he and the movement's pneumatic queen are no longer in love.

However, I resisted the urge to do some kind of schadenfreude-induced dance of glee. Even people I detest have a right to a certain degree of respect, and to kick people when they're down shows a lack of class. I kept my cackling to myself.

It seems Carrey has kind of gone a little crazy in the wake of their relationship's demise. On that note, I just need to vent a little bit of spleen. (Bear with me.) As I never tire of reminding people, my most successful post over at Ordinary Gents was a fisking of a piece Carrey wrote for Huffington Post about the "evidence" linking vaccines and autism. It made me positively luminescent with rage that a man with no science background at all was peddling dangerous misinformation about scientific material he patently misunderstood (if he had even bothered to look at it at all, which I doubt).

None of this would matter if nobody paid them more attention than they deserve. But the Empress of All Media has decided to give McCarthy a platform, and people pay attention to what celebrities say. Including celebrities who clearly have a screw loose. Watching Carrey ramble incoherently since his break-up with McCarthy, it makes me wonder what the hell is wrong with people that they would pay any mind to the baseless "expertise" of an overpaid funnyman.

The value of a person

I saw a print ad in a magazine from the National Down Syndrome Society. There was a picture of a man holding an oboe, and a phrase saying something like "I am the face of Down syndrome." This person apparently plays six instruments and has been on Oprah.

I have no doubt that many people with Down Syndrome are very high-functioning. Some, like the man pictured, are much higher-functioning than some people with normal genomes.

But what is this ad trying to tell us? People with Down syndrome have the same abilities as you and me? Obviously, most do not, so I assume that's not it. I'm guessing the message is supposed to be something like this: respect people with Down syndrome, because some of them have higher cognitive abilities than you think.

Isn't that exactly the message that such a society should not send? What about people with Down syndrome who are not as high-functioning? Should we not respect them? What about the ones who are lower-functioning than most people realize, or who are not as happy or sweet as people assume the cognitively disabled are? What about people with a genetic disorder that is always on the low-functioning end? Are they worthy of respect? This ad has given us no reason to think so. Indeed, it reinforces the message that people are valuable insofar as they have cognitive abilities.

I would hope such a national organization would emphasize that people who are not high-functioning are also valuable. We should value people with Down syndrome not because some of them are high-functioning, but because a person's worth is not directly correlated to her intellectual ability. Even low-functioning people are valuable - they feel and think and emote and relate and form personal connections and have beliefs and desires. We value them even if they cannot play any instruments at all.

UPDATE: Found the ad. Got it a bit wrong, but the point still stands. The picture is of a guy with Down syndrome in Indiana Jones-ish garb, and the text says: "Sujeet Desai, THE TRAVELER. I play six instruments. I've visited eleven countries. I've traveled to thirty-two states, and been hnored by the President of Singapore. I've met Oprah, been featured in Time magazine, and performed on the clarinet before 14,000 people. I have Down syndrome and this is my great story. Do you have a story? Tell us at ndss.org/stories."

Childlike glee, redux

You guys!! A few months ago, I was a finalist (and won!!) a caption contest over at one of my all-time favorite blogs, Go Fug Yourself. (If you don't know that site, you should. It gets me through long, dreary workdays better than just about anything.) And it's happened again!

The inspiration for the contest is here. The rules were here.

And you can vote for my caption here.

I am, like the last time, more excited about this than a grown man has any right to be.

Jane Austen is a genius

"There are few people whom I really love, and still fewer of whom I think well."

Pulitzers

Gene Weingarten has won a Pulitzer for his article on parents who accidentally cause the death of their children by leaving them in cars. I posted on this article a while ago. It's an absolutely riveting, emotionally devastating article, one that still occasionally haunts me and moves me months after reading it.

Inglourious Basterds

Finally saw this. I'm shocked that it wasn't better reviewed. This is the movie Tarantino was born to make! His kitschy stuff is toned down (but still there to make it fun), and he finally used his sheer skill as a filmmaker to tell a great story, instead of merely dazzling us with technique. His encyclopedic film knowledge was an accent, not the subject of the film. Suspenseful, exciting, and really pretty funny!

I think it's the first comedy to deal with the topic of Nazi persecution of Jews successfully. To Be Or Not To Be and Life is Beautiful each have some moments, but both are ultimately failures.

Children: puppies :: Mike Huckabee: smart

Well, I guess this means I won't be voting for Mike Huckabee. Which is a shame, given how much I was hoping to vote for a theocratic huckster.

Via TPM:

Presidential hopeful and former Arkansas governor Mike Huckabee (R), in an interview with a college magazine, said the country shouldn't "experiment" by allowing gay couples to adopt children.

"I think this is not about trying to create statements for people who want to change the basic fundamental definitions of family," Huckabee told The Perspective, a magazine at The College New Jersey. "And always we should act in the best interest of the children, not in the seeming interest of the adults."

"Children are not puppies," he said. "This is not a time to see if we can experiment and find out, how does this work?"

Not puppies? But the Critter just goes crazy when we give him those bacon treats!

I'm in a very swear-y mood, but I will again refrain from using the words that leap readily to mind. Instead, I will defer to my colleagues in the American Academy of Pediatrics. (Besides, I've already spoken to this particular topic.)

Children deserve to know that their relationships with both of their parents are stable and legally recognized. This applies to all children, whether their parents are of the same or opposite sex. The American Academy of Pediatrics recognizes that a considerable body of professional literature provides evidence that children with parents who are homosexual can have the same advantages and the same expectations for health, adjustment, and development as can children whose parents are heterosexual.1–9 When 2 adults participate in parenting a child, they and the child deserve the serenity that comes with legal recognition.

Of course, Huckabee doesn't care that pediatricians have already weighed in on this. He doesn't care that we (pediatricians, not gay parents) already know that this is no "experiment," but simply loving parents raising kids. And we are well aware that children are not puppies, what with the career spent caring for them.

Huckabee doesn't care about the world as it is. He cares about his biases, his base, and his Q score, and he's willing to trash my family to keep himself in the news.

This is CNN?

All right. So some others have weighed in on what would save CNN. Here are my two cents.

I think CNN producers are misled by which stories get the most hits on the website. Murders and sex scandals get the most hits, I think they think, so let's play those up! But if I happen to be on the website, and there is a link to some sort of murder or sex scandal, I will often follow the link and read the story. And apparently others do, too. That said, I tend not to even go to CNN's home page precisely because it's littered with child sex abuse stories. So even though I do click on those links when I happen to be at CNN, the presence of those links makes me less likely to visit the site in the first place. Although my interest may be piqued when actually presented with the information, I do not seek this kind of story when my real goal is to see what's happening in the world.

I suspect the information on the most-clicked stories has also bled into their news operations.

I disagree with two proposed solutions to this problem. One is Ross Douthat's idea of a channel devoted to left/right debate. God forbid! That is exactly the problem with the current version of CNN: the idea that if you have a couple of yahoos yelling at each other from a basis of ill-thought-out ideological presuppositions, the truth or enlightenment somehow emerges. It does not, it turns out.

The other problematic solution is the idea of medium specificity. Conor Friedersdorf suggests that what CNN needs are compelling images, because this is TV, and TV is a visual medium. This is an old idea in aesthetics - that a work of art is good insofar as it exploits the resources that are available uniquely to that medium. This has never been a compelling aesthetic argument to me. I find films that emphasize visual images no better or worse, all else equal, than films that are talky narrative ones. And I enjoy theater productions that show scenes that film could do "better" (like, say, have a ship on an actual sea instead of a rocking stage set). And I definitely don't see why a magazine-type show would be the better for it. NPR has some great stuff, but some of their let's-use-the-medium-of-sound-in-a-novel-way stories are tiresome. Also, TV is crucially also a social and verbal medium, not just a visual one.

What NPR also has, that CNN would do well to imitate, is experts talking about stuff at some length. CNN could cultivate a more educated niche viewer who is willing to let news stories go for a bit longer. As others have noted, this has worked for NPR. And rather than having go-to political commentators, why not get actual experts in a given area who are not regularly employed by the station? I do think Friedersdorf idea of more magazine-oriented stories is a good one, but they don't necessarily have to be visually dazzling.

CNN could be a place that would be somewhat more literate, more leisurely, more informed. Not some sort of farcical left-right debate, but in actual analysis.

2666: pages 637 - 701

I feel almost bad about my reaction to this first section of the last Part. I'm pretty sure I would have liked it a whole lot more if I'd read it as a stand-along novel.

However, coming as it did on the heels of the Crimes, it made me angry. (At this point, I somehow suspect my anger at this book is no longer surprising.) After a couple hundred pages of the most graphic, deadpan descriptions of mutilated and murdered women, we veer into magical realism? (I don't care if Isabel Allende once ran over Roberto Bolaño's cat. If the fantastical, oneiric passages about the bottom of the sea and the Town of Chattering Girls aren't magical realism, I'd love someone to tell me what is.) It seems remarkably self-indulgent to me, no matter how much of a relief if it is.

That said, once that particular reaction faded, I enjoyed this Part more than any of the others thus far. While I can't say the characters are sympathetic per se, at least there's an engaging story, and the prose is mostly lovely. ("Smelled of mirror" on page 654 is an eye-rolling exception. Preposterous.) I'm deeply curious how this all bends back toward Santa Teresa, but I'm actually enjoying the book for the first time in... ever.

Except, of course, for that unsightly fly wriggling there in the ointment. Jeff (whose haiku may be the single best thing I've read about this book, period) has a good post about the homophobia in the book being a sign of its underlying structural misogyny. I agree that it is in keeping with the violence and degradation of women in and around Santa Teresa. However, at this point in the reading, I'm taking the "homophobic" label off of the characters and the culture, and slapping it squarely on Roberto Bolaño. Why?

I'm going to pause here, because I intend to swear. Readers who'd like to avoid my using nasty language can skip the remainder of this post. (This includes readers who may or may not be my mother.)

Roberto Bolaño can take his goddamned "faggot sea anemone" (page 647) and cram it right up his ass. Better yet, he can find a nice, heterosexual sea urchin and cram it right up along with it.

"Faggot sea anemone" is plainly idiotic, absurd and gratuitous in the extreme. I defy anyone to convince me that Bolaño is using that word differently than your typical 8th grade boy does. It is abject nonsense, used strictly for its own transgressive shock value. Other people can try to explain this away, but I no longer have any time or inclination to do so. The Large Hadron Collider could run for a thousand years and not find a particle small enough to describe my affection for this author.

Screw you, Bolaño. (I really want to use a stronger word, but I will refrain because I'm sure I'd regret it later.) I am sick of your jaundiced world-view, your self-indulgence, and your homophobia. You get no (NO) generosity from me, and I cannot wait to be rid of your book.

The movie Greenberg in one sentence

Greenberg is a total asshole.

Why does Sarah Palin hate Jesus?

I've already read about Sarah Palin's... fascinating take on the new nuclear treaty with Russia. Other people have already offered their thoughts on what she said, so I don't really have to discuss it qua what it demonstrated about her understanding of the nuclear treaty itself (or lack thereof). But I was struck by how she chose to frame her typically un-nuanced criticism of the President.

Palin had said on Sean Hannity's Fox News show on Wednesday night that Obama's new nuclear policy was "kinda like getting out there on the playground, a bunch of kids ready to fight, and one of the kids saying, 'Go ahead, punch me in the face and I'm not gonna retaliate.'"

It sure does seem like Palin doesn't respect that one kid on the playground, doesn't it? I mean, only an idiot would fail to retaliate when they're about to get punched in the face, right?

Except that's exactly what this one guy, of whom Sarah Palin is very famously quite a fan, said we should do.

Maybe I'm just irritable

Boy, am I finding myself irritated a lot this week. I'm not enjoying the book I'm reading, the chairman of the Augusta Golf Club is making me roll my eyes, and the Times continues to annoy me with its Style section. (I will defend my right to find the Times Style section impossibly irritating until my dying day.) And now The New Yorker has gone and done it. This was the first thing I read last night when I started to leaf through the most recent issue:

Joe Bastardi, who goes by the title “expert senior forecaster” at AccuWeather, has a modest proposal. Virtually every major scientific body in the world has concluded that the planet is warming, and that greenhouse-gas emissions are the main cause. Bastardi, who holds a bachelor’s degree in meteorology, disagrees. His theory, which mixes volcanism, sunspots, and a sea-temperature trend known as the Pacific Decadal Oscillation, is that the earth is actually cooling. Why don’t we just wait twenty or thirty years, he proposes, and see who’s right? This is “the greatest lab experiment ever,” he said recently on Bill O’Reilly’s Fox News show.

Bastardi’s position is ridiculous (which is no doubt why he’s often asked to air it on Fox News). Yet there it was on the front page of the Times last week. Among weathermen, it turns out, views like Bastardi’s are typical. A survey released by researchers at George Mason University found that more than a quarter of television weathercasters agree with the statement “Global warming is a scam,” and nearly two-thirds believe that, if warming is occurring, it is caused “mostly by natural changes.” (The survey also found that more than eighty per cent of weathercasters don’t trust “mainstream news media sources,” though they are presumably included in this category.)

I go off the Good Liberal reservation on global warming. (Cue boos.) This is in large part due to the skepticism of a very smart person who happens to be an expert in energy issues, and who I know very well. (He may or may not be related to me.) He's skeptical, and he's done a big heaping ton of research on the issue, and thus I am skeptical. If we are expected to accept global warming on the strength of the authority of a bunch of scientists we don't actually know, then I feel like I am free to question it based upon the authority of a particular scientist I happen to know very well.

Thus, I get very irked when people who question the legitimacy of anthropogenic climate change are dismissed as charlatans or idiots. Just like Elizabeth Kolbert does above.

I will concede that part of Bastardi's argument is ridiculous. A major part of the argument for climate change legislation is that we are at a critical period to prevent further worsening of the problem. Simply waiting and seeing how things go for the next 20 years or so is not a neutral recommendation, no matter how blithe Bastardi may be about it.

However, the way Kolbert writes about "weathercasters" is also too clever by half. It is impossible to know from what she writes what qualifications the people surveyed have, but presumably a great many of them are meteorologists (like Bastardi). Meteorologists are, in fact, scientists. (I checked.) And while the American Meteorological Society does seem to generally endorse anthropogenic climate change, that does not mean that members of said society ("weathercasters" or otherwise) are not free to dissent. Such dissent is not a de facto negation of their right to be taken seriously, any more than my scorn at the AAP's recommendation that hot dogs be re-engineered voids my certification as a pediatrician.

These people spend their days talking about and studying the weather. Isn't it worth at least a moment's pause to consider if maybe their opinion about the weather is worth being taken the least bit seriously? But no. Instead, Kolbert writes them off because they don't trust "mainstream media news sources." (For what? Information about the climate? I don't trust the mainstream media news sources for information about medicine, either.) Idiots, apparently, every one of them.

As God is my witness, I would rather superglue my fingers together than defend Fox News, but maybe Bastardi chooses to air his views there because only Fox News will give him a say. (I know, I know. This is only because he already tells them what they want to hear. I won't argue that they're airing his views because of a sincere belief in intellectual honesty.) Maybe if "mainstream media sources" hadn't decided that all dissent on climate change is the work of frauds and morons, more of them would express their views in non-Fox media sources.

You know. Like The New Yorker.

Bob and weave

Can everybody stop pretending that Virginia Governor Bob McDonnell is regretting causing a firestorm about his proclamation celebrating Confederate history that didn't mention slavery? The firestorm is exactly his desired effect. He's not stupid; he's dog-whistling to that not-insignificant part of the Republican party that, even if they don't think slavery was such a hot idea, think the blacks just jump down someone's throat for no good reason ("Can't you say anything without being called a racist?") - and are now feeling sympathy for McDonnell.

Reason #445 why, even when Nancy Pelosi tempts me, I could never be a Republican.

And as someone who lives right near the border of Virginia, and goes to Virginia regularly, I would like to ask: do they really need any more damn Confederate memorializing? The place is absolutely lousy with signs, parks, designated picnic ares, etc. When directions to the mall tell you to take Jefferson Davis Highway (you know, that guy who led an armed rebellion against the U.S. government in order to protect local determination of the ability to own humans), one gets the sense the the Confederacy is honored quite enough.

Won't someone please think of the children?

I came across the criticism of Tiger Woods by Augusta National Golf Club chairman Billy Payne via Ordinary Gents. At their place, Matthew Schmitz calls it a good thing:

The notion that country-club chairmen and New York Times writers have a social duty to defend monogamy seems old-fashioned. But the decline of marriage and monogamy, and the related rise of inequality, suggests that we need to use private associations and public institutions as mild means of encouraging virtue. This is especially true, I think, if you oppose more stringent forms of morality legislation. Here’s hoping that we get used to exercising our index fingers once again.

I suppose in comparison to morality legislation, a little moral outrage on the part of our nation's golf club chairmen is a tolerable irritation. But it certainly is irritating. From Payne's remarks:

"Our hero did not live up to the expectations of the role model we saw for our children," said Payne.

"It is not simply the degree of his conduct that is so egregious here, it is the fact he disappointed all of us and more importantly our kids and our grand kids."

First of all, that second paragraph simply makes no sense. How did he disappoint anyone, if not in the degree of his misconduct? Further, I don't understand how the disappointment could be worse than the behavior that provoked it. It's a nonsense statement.

But worse than the perplexing syntax and topsy-turvy moral hierarchy is the tired squawking about our poor, disillusioned children. I am bothered by this for two reasons:

1) I have never understood why athletes are held up as heroes because they are particularly good at sports. While I am terrrrrrrrrrrrrrrible at sports myself, this has nothing to do with any cultural resentment of the primacy of athletics in this country. (Well, OK. Maybe a little.) Rather, I don't get why one's ability to dunk, pitch or tackle somehow translates into moral authority. Say what you will about Charles Barkley, I still agree with his "I am not a role model" argument, though I'm not sure he needed to go to such lengths to prove it. Perhaps this is a good opportunity for children to learn several important lessons, including that even people we admire can let us down, and that just because a person is good at one thing doesn't mean they're perfect.

2) I think it's preposterous when disappointed adults project their feelings onto "the children." I don't believe it was America's children that have been buying all those copies of Star Magazine and InTouch. Not one single parent has brought their child to see me because of Tiger Woods sex scandal-induced depression. Our nation's youth, "our kids and grand kids" will be just fine. It's okay for the grown-ups to admit that they, personally, are the ones who are so titillated bummed out by all of this. Enough already with our collective swooning about our poor, fragile little ones.