I Don't Have the Words

My wife and I are both Air Force veterans. We met and married at Bitburg, Germany, while assigned to the 36th TFW. I made the Air Force a career. My wife, an Air Force nurse, helped save my life, then raised our two boys.

I volunteered for Vietnam after my assignment to Bitburg. I did so because I had friends, guys like myself in their early twenties, putting their lives on the line to serve their country. News was coming back to us that some were KIA or MIA. I felt a need to serve, as they had, and to honor them in doing so.

I had one particularly good friend — let’s call him ‘Dan’— who was shot down and spent 6 years in the “Hanoi Hilton.” When the war was over, he transited Hawaii, where I was stationed at PACAF HQ, and spent an evening with us. We had music playing. He asked me to turn it off. He’d been beaten so often and so severely that what we heard as music was just a cacophony of noise to him.

As it turned out, the Air Force had other plans for me, and I didn’t end up going to Vietnam. I was afforded the opportunity to go back to college for an advanced education, and retired from the Air Force twenty years later with a PhD, and without the lining around my heart, which had been stripped during my assignment at Bitburg. I was probably the first Air Force officer cleared for worldwide duty after undergoing such a procedure.

I was lucky. So many of my generation weren’t. They gave the “last full measure of devotion” to their country — those who died, and those who live afterward with the scars of their service forever etched in their psyche.

I haven’t the words to express my emotions when hearing of Donald Trump’s disdain for our military, now an all-volunteer force. He will never understand, “what was in it for them,” because for him sacrifice is a sucker’s bet, and my friend Dan was a “loser,” because like John McCain, he got shot down.

I simply don’t have the words. 

John McCain, August 29, 1936 – August 25, 2018

Why Do Over Half of Men Polled Approve of Donald Trump's Handling of the Economy?

I heard on the news this morning, the 75th Anniversary of the end of World War II, that although Donald Trump’s poll numbers are relatively dismal, just over 50% of men approve of his handling of the economy. I’m puzzled by this. The U.S. national debt at over $26 trillion now exceeds the record debt incurred during WWII, but more troubling, debt as a percentage of GDP at 136% is its highest in history. According to economists, this level of debt-to-GDP slows economic growth, and as revenues decline the debt-to-GDP ratio climbs, and the “Greek Death Cycle” accelerates.

Maybe men see Trump as a hugely successful businessman, so under the circumstances he must have handled the economy as well or better than anyone could. But, in fact Trump is a terrible businessman, as has been thoroughly documented. Furthermore, the “circumstances” are largely of his own creation — surely no one would argue that he’s managed the coronavirus pandemic well, unless the predicted 200,000 deaths is acceptable.

Maybe men, especially those relatively well off, are attracted by the siren call of today’s advancing Stock Market. But the Market is a chimera buoyed by Fed bond buying, and propped up by stock buybacks, collateralized loan obligations, and other “unknown unknowns,” as Donald Rumsfeld might have said. In any case, according to Reuters, 84% of stocks owned by U.S. households are held by the wealthiest 10% of Americans. So the deregulatory fever under Trump has boosted the Market, but, as usual, it’s the rich getting richer.

Maybe more men are impacted by and therefore especially appreciative of the lower tax rates instituted under Trump. But first of all, the so-called Tax Cut and Jobs Act (TCJA) didn’t end up paying for itself, as promised. In fact, the TCJA substantially reduced revenues, adding further to the aforementioned monumental debt.

Secondly, it was corporations who gained the most from the TCJA; their taxes were reduced by 40%, and they are permanent, unlike individual tax cuts, which expire in 2025.

 

Finally, the TCJA increased disparities in after-tax income by giving the largest relative and absolute tax cuts to high-income households — the top 1 percent will claim 83%of the benefit of the bill. As Stephanie Kelton, a senior economic policy analyst has pointed out, “Trump’s plan will widen the country’s already dangerous wealth and income gaps, and because the gains go mostly to those at the very top, the tax cuts won’t do much to promote broad-based consumer spending or overall job growth.”

So, I remain puzzled. Who are the guys that approve of the way Trump is handling the economy and what explains their attitude?

America's Schools Are Indispensable: Shame On Us

In a July 7, 2020, talk in the White House East Room, President Donald Trump said, “We want to reopen the schools. Everybody wants it. The moms want it, the dads want it, the kids want it. It’s time to do it.”

The President went on to laud the declining COVID-19 death rate. “You know, our mortality rate is, right now, at a level that people don’t talk about, but it’s down tenfold.  Tenfold.”

Over 137,000 Americans have died of COVID-19 to date (7/11/20), and 64,600 new cases were confirmed — about five times more than the entire continent of Europe. Several U.S. states, including Arizona and Florida, currently have more confirmed cases per capita than any country in the world.

Realizing that deaths lag emerging cases, Dr. Fauci cautioned against becoming complacent in light of the decreased death rate. Perhaps he’s visited some of the refrigerator trucks serving as morgues in Arizona and Texas.

Trump went quickly from talking about the coronavirus pandemic to the U.S. economy and a rebound in the Stock Market, likely revealing why he wants schools to open. Parents need to get back to work, and schools need to babysit their kids so they can do so.

Vice President Pence took the podium after the First Lady touted her “Be Best” initiative. Mrs. Trump stressed the importance of recess. Pence pointed out that some 7 million American children suffer from either mental illness or emotional disturbance, and stated that they principally receive care from health and mental services at their school. Might we ask why?

OECD Family database

The sad fact is that when it comes to caring for America’s children, we are all delinquent. Let’s start at the beginning.*

• In America, the infant death rate is twice as high as in similarly wealthy countries.
• In America, for every 100,000 live births, 28 women die in childbirth or shortly thereafter. In Canada, the same figure is 11. Black women in America die having a child at roughly the same rate as women in Mongolia.
• In America, we spend less of our gross domestic product on family benefits than all other OECD countries, save for Mexico and Turkey, whose combined GDP is less than a tenth of ours.
• In America, we do not guarantee impoverished parents welfare. The Temporary Assistance for Needy Families program provides benefits to fewer than one in four poor families.
• In America, our child poverty rate is higher than in nearly all other OECD countries — two, three, or even four times as high as in nations comparable in terms of per capita income.
• In America, as many as 1.5 million families caring for three million kids live on less than $2 per person, per day, in cash income.
• In America, in any given year there are 2.5 million kids that experience homelessness.
• In America, we profess to support mothers, and encourage them to keep working when they have children, but we have no paid maternity, parental, or home-care leave entitlement. We are the only OECD country for which that is true.
• In America, both Republican and Democratic administrations claim to support early childhood education and care, yet as a percentage of GDP, we are truants, ranking practically at the bottom of the list on spending.
• In America, 10 to 15 percent of children in some states have no form of health insurance, no way to pay for vaccinations, medications, counseling, etc.
• In America, teenagers are 82 times more likely to die from a gun homicide than their peers in other wealthy nations.
• In America, rich kids have better schools than poor kids, largely because we link school funding to property taxes. As a result, the so-called “poverty gap” in standardized test scores is 40% larger today than it was a generation ago. Our kids rank in the bottom third of OECD countries in terms of reading and mathematics, and only three in five American kids are proficient in those subjects by 8th grade.

The area in which America is far and away the leader is in our criminal “justice” system. We have the highest rate of incarceration on Earth, and we lead in putting minors behind bars; fourteen states have no minimum age for when a child can be prosecuted and punished as an adult.

The United States of America is the only country that has not ratified the UN’s Convention on the Rights of the Child.

Hillary Clinton wrote a best-selling book in 1996 addressing America’s dismal history of educating and caring for its children. It was titled, “It Takes a Village.” Clinton said “I chose that old African proverb… because it offers a timeless reminder that children will thrive only if their families thrive and if the whole of society cares enough to provide for them.”

Mrs. Clinton is well-known as a “policy wonk,” and her book is a study in specific policy fixes for America’s glaring deficits in educating and caring for its children. Critics at both extremes of the political spectrum had plenty to dislike about Clinton’s prescriptions, but Republican reaction was particularly scathing, assailing her vision as paternalistic, anti-religious, and that old reliable Republican bugaboo, socialistic.

What’s missed in all the nitpicking and gnashing of teeth over the book, is the fact that Mrs. Clinton presented a broad vision for dealing with childhood education and care, and an integrated, systematic approach for realizing that vision. How refreshing. This is something sorely lacking in today’s chaotic approach to societal division and disintegration; a situation now exacerbated by an unforgiving contagion equally poorly managed and contained.

The Trump Administration’s insistence that we must reopen schools in the Fall in light of America’s miserable excuse for a childhood education and care system is not just irresponsible, it is indefensible.

Show us you can manage the pandemic, Mr. Trump, then we’ll talk about reopening schools.
________________________________
*I have borrowed heavily in this list from the comprehensive article on this subject written by Annie Lowrey for The Atlantic, June 21, 2018. Refer to that article for original sources (https://www.theatlantic.com/ideas/archive/2018/06/how-america-treats-children/563306/).

Reflections on Independence Day 2020

My friend Bill Pennell reflects on his heritage as he considers Independence Day 2020.

Patrick Henry
E. William Sievers, Sculptor 1932

I consider myself patriotic. There is an American flag flying outside our house at this very moment on the 4th of July. On my mother's side of the family, I am descended from men who fought for our independence. Patrick Henry was the family's solicitor at the time, and yes, they were slaveholders. And on both sides, I am descended from men who fought on both sides of our Civil War.

Yet I recognize that our country is not perfect. Some things we have done and stood for do not hold up to scrutiny by contemporary standards. And some of them did not hold up to scrutiny by the standards of the day. As Patriots it is our duty to "see things whole" as John Wesley Powell put it. We need to recognize our virtues and our shortcomings and to do what we can to correct the latter.

____________________________

William T. 'Bill' Pennell served as director of the Atmospheric Science & Global Change Division at Pacific Northwest National Laboratory in Richland, Washington.

Reflections on Independence Day 2020

In the midst of the Coronavirus Pandemic, and worldwide protests around Black Lives Matter, a friend, Miriam Kerzner, reflects on Independence Day 2020.

On this Independence Day, let us model ourselves on the best of the Founding Fathers. Let us remember that we have values so that we can evaluate where we are and strive to do better. Let us have the ability to recognize failure, but see it as an opportunity to create something better.

Jefferson, a devotee of the Enlightenment, knew slavery was wrong when he wrote the words that "all men are created equal." It was a phrase that he could never live up to, but it has been the rallying cry throughout our history as our oppressed minorities have fought for recognition of their rights -- and won.

The initial United States, a confederation of independent countries, failed miserably because of too strong an emphasis on the individual, because of too great a fear of centralized government. In response, the Framers of the Constitution launched the second, quieter American revolution where they pushed back against the forces of dissolution and created a republican government that has survived for over 230 years. It proclaimed that government has a role beyond protecting individual rights. Legitimate governance will "establish justice, insure domestic tranquility, provide for the common defense, promote the general welfare, and pursue the blessings of liberty."

Perhaps most wisely, they called this second government a "more perfect union", recognizing the impossibility a creating one that could not be improved, but acknowledging our responsibility as "the People of the United States" to pursue that path nonetheless. Madison immediately wrote amendments to the Constitution to ensure that the people, and state governments, did not have to fear an imperial government. But those amendments, binding only on Congress, left people's rights dependent on their state governments.

The Civil War and the Reconstruction Amendments that followed, transformed the Constitution from a document that protected individuals and states from a too powerful central government to one that recognized that civil rights are often most at risk from those governments closest to us -- state and local. The Bill of Rights was extended to apply to these governments as well and, eventually, led to the Civil Rights Act of 1964 and the extension of civil rights to women and the LGBTQ+ community.

We are at another crucial point of another revolution. Once again we have the opportunity to push back against the forces of hate, of fear, of cynicism and ignorance, of our failure to apply the rule of law equally. This Fourth of July is a moment filled with hope that must be backed by determined activism. Those who came before us fought and won partial victories. On this Independence Day, may we work to give still greater voice to the better angels of all our natures and strive for a still more perfect union.

__________________________________

Miriam Kerzner is a member of the CBC faculty. She's an instructor in Political Science.

Former Military Leaders Reflect on Donald Trump's Photo Op

President Trump's photo opportunity in front of St. John's Episcopal church in Washington has set off criticism, as law enforcement used tear gas and force to clear a path for him to walk from the White House.

Marine Corps Gen. John Allen
Former commander of US forces in Afghanistan under Obama
Foreign Policy
"Donald Trump isn't religious, has no need of religion, and doesn't care about the devout, except insofar as they serve his political needs...To even the casual observer, Monday was awful for the United States and its democracy. The president's speech was calculated to project his abject and arbitrary power, but he failed to project any of the higher emotions or leadership desperately needed in every quarter of this nation during this dire moment.”

Navy Adm. Mike Mullen
Former chairman of the Joint Chiefs of Staff under George W. Bush and Obama
Op-ed  The Atlantic published June 2
"It sickened me yesterday to see security personnel—including members of the National Guard—forcibly and violently clear a path through Lafayette Square to accommodate the president's visit outside St. John's Church. I have to date been reticent to speak out on issues surrounding President Trump's leadership, but we are at an inflection point, and the events of the past few weeks have made it impossible to remain silent. Whatever Trump's goal in conducting his visit, he laid bare his disdain for the rights of peaceful protest in this country, gave succor to the leaders of other countries who take comfort in our domestic strife, and risked further politicizing the men and women of our armed forces. There was little good in the stunt.”

Air Force Gen. Richard Myers
Former chairman of the Joint Chiefs of Staff under George W. Bush
Interview with CNN on June 4
"The first thing was just absolute sadness that people aren't allowed to protest and that, as I understand it, that was a peaceful protest that was disturbed by force, and that's not right. That should not happen in America. And so I was sad. I mean, we should all shed tears over that, that particular act. ...I'm glad I don't have to advise this President. I'm sure the senior military leadership is finding it really difficult these days to provide good, sound military advice.”

Who's watching the store? The military leaders who'd left the Trump Administration: Gens. John Kelly, James Mattis, Joseph Dunford, James Amos, John Allen, and John Paxton Jr. in Washington, DC, April 19, 2013.

Army Gen. Martin Dempsey
Former chairman of the Joint Chiefs of Staff under Obama
Interview with NPR on June 4
"The idea that the President would take charge of the situation using the military was troubling to me.”

William Perry
Former Defense Secretary served under Clinton
"I am outraged at the deplorable behavior of our President and Defense Secretary Esper, threatening to use American military forces to suppress peaceful demonstrators exercising their constitutional rights. This is a deeply shameful moment for our nation.”

Navy Adm. William McRaven
Former commander of US Special Operations Command under Obama
Interview with MSNBC on June 5
"You're not going to use, whether it's the military, or the National Guard, or law enforcement, to clear peaceful American citizens for the President of the United States to do a photo op. There is nothing morally right about that.”

Navy Adm. James Stavridis
Former Supreme Allied Commander of NATO
Commentary published by Time on June 3
"Our active duty military must remain above the fray of domestic politics, and the best way to do that is to keep that force focused on its rightful mission outside the United States. Our senior active duty military leaders must make that case forcefully and directly to national leadership, speaking truth to power in uncomfortable ways. They must do this at the risk of their career. I hope they will do so, and not allow the military to be dragged into the maelstrom that is ahead of us, and which will likely only accelerate between now and November. If they do not stand and deliver on this vital core value, I fear for the soul of our military and all of the attendant consequences.”

Army Gen. Raymond A. "Tony" Thomas
Former commander of US Special Operations Command under Obama and Trump
June 1
On Esper's use of the term "battlespace" when discussing quelling violence on the streets amid civil unrest: "The 'battle space' of America??? Not what America needs to hear...ever, unless we are invaded by an adversary or experience a constitutional failure...ie a Civil War…"

Air Force Gen. Mike Hayden
Former director of the CIA and NSA under Bush and Obama
June 2
On Milley joining Trump for his walk in front of the White House after protesters were cleared: "I was appalled to see him in his battle dress. Milley (he's a general?!?) should not have walked over to the church with Trump.”

Ash Carter
Former Defense Secretary under Obama
Statement on June 5
"The Department of Defense exists to safeguard our citizens, not dominate them. I was dismayed to see DoD drawn inappropriately this week into the President's response to protests. There is here no need, no warrant, and no excuse to bring active-duty military force into the restoration of order. I say this as a former Secretary of Defense who death with many situations where military intervention was helpful, even vital, in the homeland — past epidemics, hurricanes and floods, and so forth. Equally abhorrent to me was the inclusion of defense leaders in political theater.”

Leon Panetta and Chuck Hagel
Former defense secretaries under Obama
Joined Carter and 86 other former defense officials in Washington Post open letter on June 5

"As former leaders in the Defense Department — civilian and military, Republican, Democrat and independent — we all took an oath upon assuming office 'to support and defend the Constitution of the United States' as did the president and all members of the military, a fact that Gen. Milley pointed out in a recent memorandum to members of the armed forces. We are alarmed at how the president is betraying this oath by threatening to order members of the U.S. military to violate the rights of their fellow Americans.”

Marine Corps Gen. James Mattis
Former Secretary of Defense under Trump
Statement released June 3
"Donald Trump is the first president in my lifetime who does not try to unite the American people -- does not even pretend to try. Instead he tries to divide us. We are witnessing the consequences of three years of this deliberate effort. We are witnessing the consequences of three years without mature leadership. We can unite without him, drawing on the strengths inherent in our civil society.”

Marine Corps. Gen. John Kelly
Former Chief of Staff to Trump, Former commander of US Southern Command under Obama
Interview on June 5
"I would've argued against it, recommended against it," Kelly said of Trump's photo-op. "I would argue that the end result of that was predictable. I think we need to look harder at who we elect. I think we should look at people that are running for office and put them through the filter: What is their character like? What are their ethics?”

Marine Corps Gen. John Kelly, one of the U.S. military's longest serving commanders and the most senior officer since 9/11 to lose a child in combat, retired 2015.

Medications for Back Pain

by Zinovy Meyler, D.O.

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/drugs (NSAIDs). 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 Inflector 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.
_________________________________