Tuesday, April 23, 2024

EARTH DAY: Our Goldilocks Planet

My Nono and Nona emigrated from small villages in the province of Trapani in southwestern Sicily in 1898. My wife and I visited the region between Christmas and New Year, 1990-1991. We stayed in a little coastal village called Marinella di Selinunte, overlooking the Sea of Sicily, part of the Mediterranean Sea. I'm glad we went when we did, because the sea is advancing inexorably on Marinella.

We stayed in the Hotel Marimare in Marinella

Just down the road from our hotel were the ruins of Selinunte, a major city-state founded by the Greeks around 650 BC. We walked to the site and made our way along a broad expanse leading to the gigantic ruins of the Acropolis of Selinunte. All along the way we were surrounded by huge columns lying scattered about like a child’s building blocks.

Selinunte was a rich and extensive ancient Greek city of Magna Graecia on the south-western coast of Sicily

In its time, Selinunte had rivaled Athens in its splendor, but like Sicily generally, was subject to the predations of Phoenicians, Greeks, Romans, Byzantines, Arabs, Normans, French, Germans, and Spanish, among others. Today Selinunte is subject to the predations of tourists. Tomorrow, the rising seas, storm surges, and the occasional 'marrobbio' — a major tsunami-like event — will do to Selinunte what time alone could not accomplish — wipe it from history.

We had a wonderful time in Sicily. The weather was sunny, despite it being winter, the scenery was beautiful, the people were friendly, and the food was great; mostly seafood, for which Sicily is rightfully famous.

I particularly remember Rino, our young waiter. He spoke excellent English. His father was born in Sicily, immigrated to the US, and after thirty years decided to return to his homeland, hauling the 13 year-old Rino along. Rino was a tremendous help, since at the that time, relatively few Sicilians spoke English.

Ireland and Italy split apart from the supercontinent of Pangaea about 250 million years ago. My wife and I, fortunately, are still together. My wife is of Irish descent. Her clan, the O'Brien, populates the southwestern part of Ireland in the province of Munster. We visited Ireland in the Summer of 1991.

The province populated by the O'Briens is about 2290 mi from that populated by the Badalamentes, in Sicily. Our first stop in Ireland was Navan. On the way there we stopped at a little cafe to have lunch.  We were seated next to an elderly lady having tea.  She smiled at us, and I struck up a conversation with her, telling her that my wife was of Irish ancestry and had come to Ireland seeking her "roots."  She asked her surname, and I told her it was O'Brien. She said, "Ye should visit the graveyards, you'll find plenty there."

Ireland and Sicily share more than an ancestral interest for me. Both are islands, vulnerable to climate change on many fronts, but especially rising sea levels, storm surges, and ocean acidification.

The Sicilian coast, less than 20% of Ireland's, is great for swimmers, with its smooth sand beaches and hidden coves. The Irish coast is great for geologists, with its sheer cliffs and rocky outcroppings. Unfortunately, both coasts make the countries more vulnerable to climate change, just as Florida in the U.S. is more vulnerable to climate change than, say Missouri.

Cliffs of Moher, Ireland

Ireland's 2023 Climate Change Assessment states that, "Storm surges and extreme waves pose an ever-increasing threat to Ireland as sea levels continue to rise, including for many coastal cities such as Cork, Dublin, Galway and Limerick." The Assessment points out the seeming contradiction that heatwaves and flooding due to heavy precipitation may occur together with storm surges, to create challenging adaptation requirements.

A huge concern for the Irish, just as it is for the Sicilians, is migration of fish species due to warming seas. NOAA reports that the temperature of the water in some Irish seas was as much as four and five degrees Celsius higher in 2022 than between 1991 to 2020. Warm water southern fish, like those in the sea off Sicily's southern coast, are becoming increasingly abundant in northern waters, while northern fish more at home in colder water appear to have shifted further north and to deeper water to escape warming.

Cliff Collapse, Cliffs of Moher

Climate change poses significant challenges to both Ireland and Sicily, impacting coastal communities, economies, ecosystems, and cultural heritage. Adaptation strategies, such as coastal defense measures, sustainable land use planning, and efforts to mitigate climate change, will be crucial for both regions to cope with these challenges effectively.

Climate change is global. Its effects are felt everywhere from our home here in Washington to our ancestral homes, wherever they may be. When we show concern for the Earth, as we do most visibly every year on April 22nd, "Earth Day," we express our concern for everyone, the friendly people that greeted my wife and I when we visited Sicily, and Ireland, our friends and neighbors here, and indeed for all living things. As Rachel Carson wrote, "In nature, nothing exists alone."

Amon Basin, Richland, Washington

In 'Our Fragile Moment,' Michael Mann writes, "We live on a Goldilocks planet. It has water, an oxygen-rich atmosphere, and an ozone layer that protects life from damaging ultraviolet rays. It is neither too cold nor too hot."

 That's our Earth. Celebrate it. Protect and sustain it. Advocate for it. You are the most important factor in ensuring future generations can survive and thrive on our Goldilocks planet.

Saturday, April 6, 2024

Hindsight is 20/20

Down goes Saddam

October 10, 2006

Andy ____________, COL, USMC (Ret.)
One postage stamp away, USA


Dear Andy;                             

Objecting to my criticism (constant, I’m afraid) of George W. Bush’s so-called “war on terrorism,” you asked me what I would have done had I the responsibility post-9/11 “to protect the homeland?” The problem with the question is that I have the advantage of hindsight and would be tempted to say something like, “I sure wouldn’t have done what that idiot did!” You wouldn’t give that response much credence, would you? No, of course not.

In fact, it would be difficult for me to layout a strategy and plan for responding to 9/11 without either calling upon what I know now, or at any rate, being accused of doing so… “Easy to be a Monday morning quarterback.” In order to avoid this pitfall, I would need to move back in time a good quarter of a century to the Yom Kippur War and the ensuing oil crisis brought about by OPEC’s refusal to ship oil to countries that supported Israel in that war and trace my reasoning through our debacle in Iran in 1979 up to September 12, 2001. I would need to do that just to prove that my response to your question was based on something other than the catastrophe that Bush’s bungling has brought about.

That’s too much work. I’d rather play golf. So just let me summarize what I would have done.

I would start three thrusts simultaneously:

Set the US national security community the task of hunting down and capturing/killing the perpetrators of the 9/11 attack. Once the FBI had determined that responsibility for the attack lay with al-Qaeda and Osama bin Laden, I would order the DCI to track the movements of al-Qaeda leaders and order the SECDEF (and it wouldn’t be Donald mister supercilious Rumsfeld, whom I had the misfortune to run into at DIA HQ – he is in person just as much an a**hole as he seems on TV) to formulate a plan for capturing/killing them.

When it had been determined that bin Laden was in Afghanistan, I’d go after him with everything we had and, if necessary, I would pursue him into Pakistan (I would inform Musharif that we intended to do this, but wouldn’t threaten to bomb his country into the “stone age”). I would ensure that our forces pursued bin Laden and his henchmen (I would not give over the capture of bin Laden at Tora Bora to corrupt local militias!). I would ensure that I understood and approved the rules of engagement embedded in the SECDEF’s op plan and those ROEs would not condone torture.

At the same time, I would order my Secretary of State to begin assembling the best minds available throughout the U.S. and internationally and give them the job of formulating a GLOBAL STRATEGY for addressing the escalating threat from international terrorism, with a focus on Islamic extremists across the globe (including Indonesia and other regions of the world besides the Middle East). I would coordinate and cooperate with the international community and use international fora to promote a global response to terrorism. Throughout, I would make this an international problem (which, of course, it is).

Middle East policy would be a facet of this examination, including the US relationships with Israel and Saudi Arabia, among others. My intent would be to develop a comprehensive strategy that encompassed social programs, not just a military response (Patty Murray was right to suggest that Hezbollah might be doing something right in their approach to winning the hearts and minds of the Arab constituency, despite the Republican attack ads jumping all over her for doing so – IO is a key element of any comprehensive strategy).

I would promulgate the Badalamente doctrine stating that countries that sponsor terrorists who attack US interests at home or abroad will be treated as enemies of the US and will be subject to direct military reprisals – “You can’t get away with using surrogates to do your dirty work!”

I would have my cabinet assemble a team under the direction of my counterterrorism chief and in cooperation with the Director of the Department of Justice develop an updated threat matrix and examine US security vulnerabilities and develop a plan to address them, with a focus on “low hanging fruit” (fix the cockpit doors, inspect the cargo, for Christ sake!). My team would be instructed to examine any changes needed in policy/law to permit better tracking of terrorist threats and coordination between intelligence and law enforcement agencies. If I felt it necessary to infringe on civil liberties, I would explain myself to the American public and ensure my policies were constitutional and not just expedient.

Running the government would need to continue during all this and:

I would continue containment of Saddam and I would promote WMD inspections in Iraq during this time, and I would begin examining new options for dealing with the DPRK’s and Iran’s escalating nuclear weapons programs. I would work for sanctions on countries that failed to cooperate on non-proliferation.
I’d make sure that FEMA was robust and led by someone with relevant experience (not a horse show promoter – give me a break!)

 I would insist on a farsighted and far-reaching reexamination and reformulation of our energy policy, with the aim of reducing dependence on foreign oil. I’d insist on raising the CAFÉ standards and removing the loophole for SUVs – the Escalade is not a commercial truck! I would do this in the open, not behind closed doors with oil company executives.

I would fix Social Security and Medicare/Medicaid (means testing would be part of my strategy), and I would address the escalating cost of health care by using the leverage inherent in government purchasing of health care to pressure providers, such as pharmaceutical companies, to lower prices.

I would create a bipartisan congressional committee to address immigration reform, and campaign finance reform (I would have Jack Abramoff arrested and sent to a secret prison in Romania – Oh, I wouldn’t have any secret overseas prisons, so it would have to be Iowa).

I would NOT cut taxes (how dumb would that be?). I’d raise taxes and tell the people that if they didn’t like it, elect a Republican next time!

I would NOT immediately reorganize the intelligence community or domestic security agencies, but rather identify fixes to the communications barriers that prevented them from being as effective as they should have been. The information to do this would come from my vulnerability assessment.

Not everything I did as president would turn out as anticipated/intended, but I would take responsibility for my actions and freely admit my mistakes. I would listen to voices of reason, not attack them because their views might differ from mine. I would serve as an example to my party in the way I conducted myself on policy matters with the opposing party, promoting compromise rather than partisanship. My focus would be on doing my job to the best of my ability – not getting elected for a second term.

I would wear blue dress shirts and paisley ties.

Respectfully yours,

and etc.

Wednesday, February 21, 2024

A Darker Past


Broadway & 6th, Los Angeles, 1956


I was born in Los Angeles in 1938. My dad, and mom, and brother and I lived in a little 2-bedroom home, in a modest neighborhood off West Temple St., about 2 miles west of downtown LA. I walked, or ran to my elementary, middle, and high schools. My father’s flower shop was in what was then the Elk’s Bldg. on 6th Ave. When I was in my teens I’d walk there after school and help out until closing.


The house where I was born in 1938 in LA

I didn’t give much thought to what I would do after high school until I was in my senior year. By then it had dawned on me that playing running back on the USC Trojans wasn’t in the cards. I graduated from high school in 1956 when my playing weight was 140 lbs. The Trojan’s running back that year was C.R. Roberts, who at 6'3" and 202 lbs, with a sprinter's speed, set a single-game rushing record against Texas in 1956 that stood for 20 years. I didn’t learn till much later that when the USC team arrived in Austin for the game, Roberts and other Black players were denied hotel accommodations because they were Black.

C.R. Roberts (#42) leads USC to 44 - 20 win over segregated Texas in Austin

I also didn’t know about LA’s racist past. Although California entered the union in 1850 as a free state, it didn’t take long for the growing White majority to systematically create racial segregation, largely through restrictive covenants that prevented property from being bought or sold to non-Whites. They also did it through eminent domain, when mixed-race communities like mine were split off from White communities in more affluent neighborhoods by freeways. My street was cut in half by a stretch of the Hollywood Freeway (US-101) built in 1954, preventing me from racing down the hill on my fat-tire Schwinn bike into the ritzier Silver Lake Gardens neighborhood.

Building the Hollywood Freeway, 1950

Freeways not only bisected neighborhoods, they aided the exodus of Whites from the increasingly brown and black neighborhoods in around downtown LA. This “White flight” led to an organic racial segregation that in turn, led to abandoned properties, urban decay, crime, and the “inner city” schools that suffered from insufficient funding due to the diminished tax base, one of which I attended.

Granted some Whites stayed put, but this didn’t mean they accepted the possibility of a more diverse community. There were pockets of resistance, sometimes violent, that became known as “sundown towns,” so named because Blacks and other persons of color who might be working there had to be out before sundown or face unpleasant consequences. Anaheim, home of the “Magic Kingdom,” was one of some 100 sun down towns in LA. I didn’t know this growing up in, El Pueblo de la Reina de Los Angeles, roughly translated, the “City of Angels.”


Columbia River, Richland, Washington

It goes without saying that LA wasn’t the only city, and California wasn’t the only state where individual prejudices were translated into physical, legal, and social barriers. In fact, such barriers were endemic in the union that formed from the free and independent states that ultimately became the United States of America. They are still with us.

I left LA LA Land in 1961 and headed off on a twenty-year sojourn in the United States Air Force. There was a lot going on in the social fabric of the country whose Constitution I had sworn to defend "against all enemies foreign and domestic," as well as in the military itself; a military that up until my 10th birthday, had been segregated. I was blithely unaware of the military's fits and starts in its efforts to integrate and ensure equal opportunity, often fighting the vocal opposition of members of Congress, who objected to the military's intrusion into what they considered a strictly domestic matter.

I started paying more attention when President Kennedy was assassinated in 1963 (like everyone else I've talked with about this, I remember exactly where I was and what I was doing when I learned about his assassination). One was pummeled by the seemingly endless shocks and calamities of an America embroiled in an unpopular war in a land far, far away, while fighting its own war at home in an effort to "ensure domestic tranquility;" a war that goes on to this day.

All these many years later I am a resident of Kennewick in a shrub-steppe area of Washington that belies its “Evergreen State” monicker. My city, hacked out of the brown hills along the Columbia River is one of the original three cities in Benton and Franklin counties that make up the Tri-Cities. These cities were sundown towns. I was already on my second assignment in the Air Force in 1964 before the first Black family was able to rent a home in Kennewick. According to the Tri-City Herald, property records in the counties are still being found that contain racially restrictive covenants.

D-Reactor, Hanford Nuclear Reservation, ca 1945

The Tri-Cities mushroomed out of the desert like the bomb Hanford, as part of the Manhattan Project, helped create. According to the National Register of Historic Places (OMB No. 1024-0018), Black workers recruited to Hanford by the prime contractor, DuPont Company, were disappointed to find Hanford "deeply, systemically discriminatory and segregated." Unlike Whites employed at Hanford, Black jobs were classified as temporary.

It isn't easy for people to admit that systemic racism exits in American society. Yet we fought a civil war over the right of Americans to own and profit from the labor of slaves imported from Africa. That war ended less than 160 years ago. I believe the collective mental block stems primarily from two things: first, people don't understand what "systemic" means; and second, people feel that admitting its existence is somehow a rebuke to them personally. Another problem that exists in some regions of the nation is state imposed amnesia.

Civil rights protest in Kennewick, 1963

I attempted to describe systemic racism in an opinion editorial I wrote for the Tri-City Herald during Black History month in 2023. At the time, I was lamenting the clamoring over Critical Race Theory, and the claims by some that CRT was being taught in Washington's K-12 schools to shame White students. This was nonsense, as anyone who knows anything about CRT will tell you; a fact the Herald stressed in their own editorial.

In my editorial I wrote,

We can come to understand how components of racism are interconnected: If you deny a Black person a quality education, you negatively impact their employment opportunity, degrade their health care, confine them to renting in low quality housing, expose them to criminal elements, perpetuate racial disparities in law enforcement, and then “red line” them from neighborhoods with good schools.
I recently ran across a June 2020 article by then Managing Editor of Tumbleweird, Logan Moonman, in which he traced the history of blatant racism in the Tri-Cities and more deftly than I, showed how systemic racism manifested. Moonman wrote;
Through subtle and not-so-subtle racism alike, restrictions on loans, neighborhood covenants and cooperation between landlords, real estate agents, the police, and others, racism physically shaped the way the Tri-Cities was formed.
Moonman went on to say to that;
Knowing our local history simply gives us more context for what people mean when they talk about systemic racism.


In October of 2021, I wrote an article titled, "How Critical Race Theory became a Thing." In it I pointed out that Christopher Rufo, a former director at the Discovery Institute — a place where despite what you may think, no one has a sense of humor — was tipped off about diversity training by a disgruntled Seattle City employee, and Rufo began researching the basis of the training. Rufo hit upon Critical Race Theory. He has tweeted (@realchrisrufo) that, 

We have successfully frozen their brand — ‘critical race theory’ — into the public conversation and are steadily driving up negative perceptions. We will eventually turn it toxic, as we put all of the various cultural insanities under that brand category.

Rufo threw his distain for diversity training into a petri dish, spit in a dash of dialectics, and a cup of conspiracy, whipped it into a froth and voila! A previously obscure theory debated by legal and social scholars in institutions of high learning, became a rallying cry for conservative demagogues.

Shortly before his defeat in the 2020 Election, Donald Trump, seeking a pivotal political issue to rally his base, issued an executive order excluding from federal contracts any diversity, equity, or  inclusion training interpreted as containing “divisive concepts,” race or sex "stereotyping,” and/or race or sex "scapegoating.” Among the content considered “divisive” was Critical Race Theory.

Christopher Rufo at DeSantis side at an Anti-Woke rally

Ron DeSantis made "anti-Wokism," and opposition to diversity, equity and inclusion, the focus of his successful 2018 run for Florida Governor, and has employed Chris Rufo as his chief strategist in rooting out any vestiges of DEI or CRT in Florida's public education, up and down the school system.

DeSantis appointed Rufo one of a new Conservative Board of a Trustees of New College of Florida. The newly-appointed Board then ousted the sitting college President, Patricia Okker, and replaced her with Richard Corcoran, a close ally of DeSantis.

Under the new board majority, the college denied tenure to five professors who were already previously recommended to receive it. Following this, a third of the college's faculty departed. Between fall 2022 and fall 2023, the college lost 27 percent of its student body. In the 2023 U.S. News and World Report rankings of top liberal arts colleges in the country, New College dropped 24 spots compared to the previous year.

Christopher Rufo said, "The takeover of New College has changed the dynamics of America’s culture war and, if successful, will provide a model for conservatives across the nation."

Ron DeSantis said, "In Florida we are taking a stand against the state-sanctioned racism that is critical race theory. We won’t allow Florida tax dollars to be spent teaching kids to hate our country or to hate each other."

Unfortunately for DeSantis, Donald Trump coopted CRT, and DEI in his bid for the 2024 Presidency. DeSantis never grained traction in the campaign, and dropped out of the race, subsequently endorsing Trump. He can rest easy in the knowledge that despite his ignorance of the issue, Donald Trump will make CRT whatever he thinks his base wants to think it is, and DeSantis can continue his war against Woke, without interference from a new Trump Administration.

"Getting critical race theory out of our schools is not just a matter of values, it’s also a matter of national survival. We have no choice, the fate of any nation ultimately depends upon the willingness of its citizens to lay down and they must do this, lay down their very lives to defend their country. If we allow the Marxists and Communists and Socialists to teach our children to hate America, there will be no one left to defend our flag or to protect our great country or its freedom." Donald Trump, March 12, 2022

All this sturm and drang over diversity, equity, and inclusion, the imagined insidiousness of "intersectionality," the indoctrination of secondary school children to hate their White race, is at best a distraction from the serious issue of systemic racism, and at worst, an outright and organized attack on freedom of thought and expression.

Turning a blind eye to injustice is in effect collaborating with its perpetuation; with the public policies, private practices, and institutional systems that build and sustain disparities in opportunities and outcomes. Turning a blind eye to history blinds us to why things are as they are, and risks us returning to a darker past.
It is particularly unfortunate that Gender non-conforming, e.g., LGBTQ people, have also been targeted by the Anti-Woke "warriors." Last March the Florida Legislature passed HB 1557, the “Parental Rights in Education” bill, also dubbed the Don’t Say Gay bill. Here in the shrub-steppe, the Kennewick School Board passed a resolution strongly opposing two bills in the Washington Legislature related to books and curricula on historically marginalized and underrepresented groups, including, LGBTQ people.



Sunday, October 1, 2023

Further Media Consolidation a Bad Idea

Nearly six decades ago the question of America’s media; newspapers, radio, and an emerging television broadcast medium, came before the Supreme Court in a case involving the First Amendment. The Court ruled that, "the widest possible dissemination of information from diverse and antagonistic sources is essential to the welfare of the public; a free press is essential to the condition of a free society."

In consideration of the SCOTUS ruling, the FCC adotped a cross-ownership rule that barred common ownership of a broadcast station and a daily newspaper in the same market. The rule was designed to promote two of the Commission’s longstanding goals in broadcast regulation – competition and diversity of information sources. The Commission first adopted the rule in 1975, when there were approximately 1,700 daily newspapers, 7,500 radio stations, and fewer than 1,000 TV stations. Three national commercial broadcast networks that had a combined prime time audience share of 95%.

Despite the recognition that a diverse media landscape was essential to American democracy, the profit imperative dictated another direction, so that by 1983, 50 corporations controlled a majority of American media. Now that number is six. And Big Media may get even bigger, thanks to the FCC’s consideration of ending the rule preventing companies from owning a newspaper, and radio and TV stations in the same city.

Monday, September 25, 2023

Ignorance of the Extreme Risk Protection Order Law May Be Fatal

Most people have heard the expression, ignorantia juris non excusat, although perhaps not in Latin. Broadly translated it means, "ignorance of the law is no excuse." But there’s another expression from Roman law, ignorant lures nocet, which means, "not knowing the law is harmful." In the case of Extreme Risk Protection Order Laws, that’s a better fit.

I wrote a Guest Commentary for the Yakima Herald, published Sunday September 10th, that asked the question, “Why aren’t we using our 'red flag' law?” The commentary spoke to our failure to effectively implement the Extreme Risk Protection Order law (RCW 7.105.100), especially in Benton and Franklin counties. The ERPO law has been in effect in Washington for over five years, and to say it has been used only sparingly is an understatement. The biggest impediment to the law's employment is the public’s ignorance of its existence. The League of Women Voters of Benton and Franklin counties is working to change that.

Sheriff's Deputy Ryan Clinkunbroomer

The critical importance of raising the public’s awareness of so-called 'Red Flag’ laws was brought home once again just recently, when a Los Angeles sheriff’s deputy was shot to death by Kevin Cataneo Salazar, whose family said he struggled with mental health issues, including “schizophrenia,” and wouldn’t take his medication. Law enforcement arrested the man and confiscated "several weapons" from his home. This case is eerily similar to the 2021 case of Ryan Kaufman here in Kennewick, reexamined in a February 2023 Tri-City Herald article by Cameron Probert.

Like Washington, California has a ‘Red Flag’ law, the court-issued Gun Violence Restraining Order (GVRO). This temporarily suspends a person’s access to firearms when they are found to pose a significant risk to themselves or others by having access to firearms, even if they obtained them legally, as the suspect in the deputy’s murder is said to have done. Only if the suspect had been evaluated by a competent behavioral health authority and certain conditions were documented, and if this was reported to the National Instant Criminal Background Check System (“NICS”), might a gun dealer have refused to sell a firearm to the suspect.

'I want you to know that my son has schizophrenia and delusional perceptions and the police know this.'

Marle Salazar, mother of Kevin Cataneo Salazar, the killer of Los Angeles County sheriff’s Deputy Ryan Clinkunbroomer told this to reporters in Spanish. But her son had no record of being involuntarily committed to a mental institution, and only the police were in a position to address the situation Mrs. Salazar described to them. According to Mrs. Salazar, they told her son they couldn't help him.

It should come as no surprise that people are reluctant to have family members, especially children dear to them, involuntarily committed for mental evaluation, let alone hospitalization. But the tragedy is that 46% of people who die by suicide had a known mental health condition. Firearm deaths associated with mental illness are nearly always suicides, and a suicide attempt with a firearm is almost always fatal.

Suicide deaths are typically impulsive acts, and are the number one cause of firearm related death in the U.S. According to the Washington State Department of Health, in Washington over a 5-year period, 76% of firearm deaths were suicides. Don’t want to have a family member committed? At least remove their access to firearms. Petition for an Extreme Risk Protection Order, or ask your local police to do it.

Learn more about Extreme Risk Protection Orders:

In Washington, here:

In Benton County, here:

In Franklin County, here:

Por instrucciones con formularios en español:

Remember, ignorant lures nocet, not knowing the law is harmful. In the case of gun violence, it may be fatal.

Tuesday, June 20, 2023

Video on Treating Back Pain with Various Categorioes of Medication

Michelangelo Buonarroti - Drawings

If you suffer from more or less constant back pain, as I do, you may find this video on how to treat the pain helpful. It is presented for the lay person, it is simple to understand, and concise. It is presented by Dr. Zinovy Meyler, a physiatrist with over a decade of experience specializing in the non-surgical care of spine, muscle, and chronic pain conditions. He is the Co-Director of the Interventional Spine Program at the Princeton Spine and Joint Center.

This is a transcript of the video

Different medications used to control back pain fall into different categories. Now, the broad spectrum of the categories can be broken down initially into the way we take the medication itself. So, oral medications, those that can be used as topical medications, and those that need to be injected.

So, to talk about the oral medications, which are more commonly used as an initial treatment. Over-the-counter medications that control the pain, such as Tylenol, can be used to control the pain itself. Now if we are to actually employ the use of the anti-inflammatory and pain control, we can seek the aid of non-steroidal anti-inflammatory medications. The most common ones are ibuprofen, naproxen, and the common brand names are Aleve, Motrin, Advil.

The other medications that can be used are steroids. If there is a lot of inflammation that causes the back pain, oral steroids can be employed. Now, generally, we don’t like to use oral steroids for a variety of reasons – they don’t tend to help pain that is axial, or in other words pain that is limited to the actual back without radiating into the extremities. So, we are actually using the steroids very sparingly because it has systemic effects - although minimal, but it does - and as with any treatment, we try to minimize the systemic effect or any side effect by achieving the highest yield in terms of relieving pain. So, steroids can be used, but are not commonly used.

Another type of medication is narcotic medication. Now, narcotic medications are opioids and they are used to dissociate the patient from the pain. They are usually used for severe, acute pain. They are meant to be used for a short period of time, such as the initial injury, or initial trauma, or initial onset of the most acute pain or they can be used in post-operative pain control. Another group of medications are muscle relaxants. Now, muscle relaxants are used to decrease the tone of the muscles and the reason to use them is because in many cases of back pain, muscle spasm is what usually accompanies it.

Another oral medication that can be used to control back pain is antidepressants and a variety of antidepressants can be used. An example of those would be tricyclic antidepressants or antidepressants like Cymbalta.

So, there are certain medications that can be used by just putting it directly on the skin over the area that is affected and that can be helpful. The benefit of these medications is that it is directly applied to where the pain is and where the injury is. The medications are either anti-inflammatory or pure painkillers. So the pure painkillers are things like lidoderm patch, which is lidocaine that is slowly released through a patch through the skin and that can be applied to used to just numb up the area and reduce the localized pain. Another type is the use of diclofenac, which is one of the older non-steroidal anti-inflammatory medications and that can be used in the form of a patch as a Flector patch or in the form of a cream, such as Voltaren or other formulations. The benefit of this is that it is localized and systemic absorption is quite limited. That limitation is the fact that it only penetrates a certain depth and so really the use is, to an extent, limited.

Another group of the medications are the medications that are injected and there are really two of the main ones that are used for back pain. One is non-steroidal anti-inflammatory medication that can be injected, such as Toradol, and that’s injected into the muscle and the effect is systemic - or in other words it affects the whole body - in reducing the pain and its anti-inflammatory action. Another one is anesthetic, which is anesthetic like lidocaine, bupivacaine, or any other form of an anesthetic that is used to numb up the area. That can be used either to break up a muscle spasm or to numb up an area so that other manipulations can be performed in order to relieve the pain.

Another medication that can be used as an injectable is a steroid. A corticosteroid, as opposed to an oral corticosteroid, goes directly to where the problem is. So, it doesn't have to be systemically absorbed - it bypasses the systemic effect - even though it is systemically absorbed to a small degree, but it bypasses the major systemic side effects and its concentration doesn't have to be diluted by all the processes that have to happen in our body in order to get that medication to the source of the pain.

So, that really is a general overview of the medications we can use in controlling, and relieving, and in treating back pain.

Sunday, June 26, 2022

The Salmon are going extinct and we won't be far behind

Coho salmon, here in full vivid spawning colors. One of many species of wild Pacific salmon in danger of extinction. (Jessica Newley)

I remember when I was younger -- around the time of the Spanish Civil War -- I used to listen to my parents and their friends talk with no little animation, about how the world was “going to hell in handbasket.” I never understood what that meant. What was a handbasket, and how did one go anywhere in a "basket," let alone to hell? On top of that, I didn’t think things were so bad when I was growing up in Los Angeles, California (the fact that World War II was going on during my early childhood seemed to have escaped me).

I still don’t know where that particular phrase comes from, but I tend to agree with the sentiment now. Maybe people my age just get cranky -- feel as though nothing’s as good as it used to be. But maybe not. Maybe there’s something to that observation. I’ll tell you this – fishing’s not as good as it used to be. Here in my adopted state of Washington and in the Pacific Northwest generally, native salmon are on the brink of extinction. So, that’s not a cranky old feeling. That’s a fact.

I’ll tell you something else. When I was growing up in Los Angeles back in the mid-Twentieth Century, you could smell the orange blossoms in the spring, and you could look up in the night sky and see the millions of stars, then wake up in the morning and see the San Gabriel and San Bernardino Mountains off to the East. Unless you think smelling exhaust fumes and squinting out with burning, red eyes at an orange-brown sky is a good thing, then I expect you’d agree things were better in LA back then.

But these are just my personal recollections. And they probably color my thinking about a lot of other things – like the way we live, the way we bring up our children, the way we run our country. Things like that.

It never would’ve occurred to me when I was graduating from the University of Southern California in 1961 that kids going to school today, Elementary School at that, would be searched for weapons because 12-year olds and younger are shooting each other to death. Come to think of it, it also never occurred to me that wealthy people -- investment brokers, celebrities, and the like -- would bribe test administrators and college coaches in order to get their kids into USC.

I used to worry about my kids when they were growing up in the Seventies and Eighties, but I will tell you, I never worried that they’d go to school one day and get gunned down by an 18-year old who bought two military-style AR-15s the day after his birthday expressly to go into an elementary school and murder children. As I recall, that was something like the 270th mass shooting in America in just the first half of 2022. But somehow, another 19 children slaughtered was just enough to pass a law on gun reform. Not a law that anyone who cares thinks is enough, but after waiting 30 years for something, well we hope it's the "slippery slope" that the NRA has been warning us about.

There’s been a lot of press over the years about efforts to get the entertainment industry to tone down the violence in films, television, and video games. I agree with that, and I’d add the Internet to the list. But the industry argues that there’s “no evidence” that the subject matter in these media influences people’s behavior. In fact, they argue that the films and television that they produce simply reflect society itself. You know, I don’t buy it. The biggest “e business” on the Internet is pornography and it isn’t there because it’s producers are simply “reflecting society.” It’s there because the scumbags of the world are out to make a buck any way they can. Pornography debases society and no one needs a statistical study to know that.

I’ve never watched a whole lot of television, but I’ve watched it for some fifty years and I’ll tell you what – in today’s television, from comedy to drama, almost nothing seems to be out of bounds. In the past, sponsors seemed to take some responsibility for the content of shows on which their name and product were advertised. Now, their primary concern is ratings. In other words, they’re interested in what percentage of their target audience is watching, not what they’re watching.

Corporate “social responsibility” seems to be on the decline generally. The late Senator John McCain once tried to get a bill passed that would’ve held executives personally responsible if their companies withheld evidence of product defects that resulted in injury or death. Members of the Senate beholding to industry special interests killed the bill. What’s worse, they were able to do this anonymously.

Frankly, I feel strongly that one of the greatest threats we face as a democratic society is the unchecked influence of corporate and other special interests on our government. When George W. Bush, in his preliminary debate with John McCain before the 2000 Presidential Election, said that he wouldn’t support Campaign Finance Reform, I decided right then and there that I wouldn’t vote for him – ever –and I didn’t. I’m sorry that he was ever elected president. Little did I know that not supporting Campaign Finance Reform would be the least of his faults.

Of course, I’ve got a lot of reasons for not voting Republican: I am in favor of the so-called "safety net" programs, like Social Security, Medicare, Temporary Assistance for Needy Families (TANF). That makes me a socialist in the minds of Republicans.

I'm also in favor of everyone having "personal bodily freedom" That's my term for every human being having the freedom to choose what to do about their health and well-being. I know this is anathema to Evangelical Christians and the Republicans who pander to their religious beliefs, and panhandle for their campaign contributions, but overturning Roe v. Wade is wrong, and the rationale for doing so is stupid. "It says that from the very moment of fertilization, a woman has no rights to speak of. A State can force her to bring a pregnancy to term, even at the steepest personal and familial costs." This decision isn't the worst I've seen in my many years of watching one bad decision after another, but it's close, very very close.

Protestors attend the Bans Off Our Bodies rally at the base of the Washington Monument

Well, getting back to the safety net, I think we need to spend more money on education, not on the military (despite my 20 years in the Air Force). And I favor teaching science in our public schools, not hocus-pocus. George W. Bush wants creationism on the curriculum along side evolution. I say, “Nuts!”

Well, I’m rambling, but I’m old and that’s what old folks do sometimes. Now let me tell you what I’m reading. I’m reading an article in my automobile dealer’s magazine, of all things, “Drive,” from Subaru. It’s telling me that today – Saturday, October 7, 2000 – 116 square miles of rain forest will be destroyed; 250,000 newborns will join the World’s exploding population; “at least” 1.5 million tons of hazardous waste will be released into our air, water, and land; Americans alone will throw away enough garbage today to fill the Superdome in New Orleans twice; some 40 to 100 species will become extinct.

I’m a cranky old guy that, like my parents before me, thinks things are getting worse rather than better, and this article is telling me that at the end of today, “the Earth will be a little hotter, the rain a little more acidic and the water a little more polluted…crowded cities will be more crowded and the air…will be a bit dirtier…the web of life will be a bit more threadbare. Tomorrow it starts all over again” Hey, this is my automobile dealer talking to me! Guess what I’m reading in Audubon magazine, for crying out loud!

And speaking of “drive,” I don’t like paying six bucks for a gallon of gas any more than the next guy, but drilling in the Arctic Wildlife Reserve isn’t an option for me. Haven’t we done enough harm to the environment? And half the "cars" I see driving around the Tri-Cities are trucks, or big SUVs. Either buy more fuel efficient vehicles, or buy electric vehicles. Or stop bitching about gas prices!

So here’s my plan: Vote the Republicans out of office – they had their chance and screwed things up royally. Let the Democrats screw things up for a change.

I’m also thinking about meditation. If I understand it, you sit there and try not to think about anything. Hey, that could help. When I told my wife, she said, ”Meditation, hell. You need medication!” She could be right.

EARTH DAY: Our Goldilocks Planet

My Nono and Nona emigrated from small villages in the province of Trapani in southwestern Sicily in 1898. My wife and I visited the region b...