Scalise released from hospital

The New Neo Posted on by

Excellent news:

Rep. Steve Scalise has been discharged from MedStar Washington Hospital Center, the hospital said in a statement Wednesday, six weeks after he was shot at a congressional baseball practice.

Six weeks is quite a while to be in the hospital these days, but Scalise’s initial condition was extremely serious and he had complications afterwards, as well.

There seems to be an error in that report, however—it says, “He will now begin a period of intensive inpatient rehabilitation. ” Inpatient?? I thought he’d just been released. Wouldn’t that make it “outpatient”?

In or out, I wish him a speedy and uneventful recovery.

Mama said there’d be days…

The New Neo Posted on by

…like this:

I hadn’t listened to that song in many decades, and so I didn’t recall it was about romance—although, since so many songs are, I would have guessed it. My day today was about something else.

After just a few hours of sleep, I spent the morning and much of the afternoon helping a sick friend, including doctor and hospital visits. The hospital visit was supposed to be for a quick test, but ten minutes before we arrived there was a power outage. They had a generator but it only powered one machine, so the wait was considerably longer than expected. I went to get the friend’s medication, and insurance had refused to approve it.

And then when I got home my computer was going haywire. My mouse cursor was twirling around erratically and randomly, and I need to use the mouse rather than the touchpad because the latter tends to inflame my arm injuries. My computer was insisting I update some random useless program I’ve never felt the need for, but when I tried to tell it “No!” it simply ignored me and showed me the box again and again and again…and again. While the box was up there, the computer wouldn’t allow me to navigate anywhere else. The problem persisted after I tried rebooting, so I had to uninstall the stupid worthless program—which I probably should have done ages ago. That took longer than it should have because the instructions were written by people from Mars.

So if you wonder why I’m a bit late checking in today—and a bit cranky—that’s your answer.

Cosmos mariners

The New Neo Posted on by

Commenter “Stan McQueen” wrote on the Conrad Aiken thread:

I was especially touched by the inscription of “Cosmos Mariner-Destination Unknown” on his tombstone, which is in the shape of a bench.. He saw a ship by that name and looked it up in the port logs and found the notation “Destination Unknown”. He apparently likened that ship to himself.

I found that intriguing, too. Here’s the tombstone, which can be found in Savannah, Georgia, Aiken’s birthplace:

“Cosmos Mariner”—I like it, although I’m not so sure that most of us have either the tools or the charts. Have we lost our ability to steer? Did we ever have it?

Vote on Obamacare repeal

The New Neo Posted on by

This afternoon the Senate is voting on Obamacare repeal:

After months of tedious deliberation, behind-the-scenes deal making and countless setbacks, Tuesday afternoon’s vote will determine if the Senate can start floor debate on legislation to overhaul the Affordable Care Act even though there aren’t any guarantees the votes are there to eventually pass it — and it’s unclear what a final bill will look like.

Several Republican holdouts have announced they will vote for the motion, bringing McConnell close to the 50 he needs to pass it.

Sens. Rand Paul, Dean Heller and Shelley Moore Capito say they will vote “yes.” Ohio Sen. Rob Portman will also back the motion, the Columbus Dispatch reported.
Fifty votes will be needed to advance the bill, and with only 52 Republicans in the Senate — no Democrats willing to back Obamacare repeal — there is no margin for error. Vice President Mike Pence will be on Capitol Hill in case he needs to break a tie.
Adding to the drama: Arizona Republican Sen. John McCain, who has been away from Washington after surgery and a diagnosis of brain cancer, is flying back Tuesday for the vote.

People who are enraged at the Republicans for not having done this earlier (and they are legion) sometimes forget, or perhaps don’t care, how slim is the margin in the Senate. Even 52 makes for a majority, of course, and is important in terms of the leadership remaining in GOP hands. But it doesn’t leave room for error or a few RINO or Libertarian defections.

This bill is nice window dressing, and I think it’s necessary at this point. But it just kicks the can down the road. At the moment, I’d settle for it. They better not kick it so far down the road that they lose that majority, though.

Why is Trump attacking Sessions?

The New Neo Posted on by

Well, it did always seem like one of those marriages that would never last.

Jeff Sessions was one of the earliest Trump supporters, mainly because of immigration. But their histories and personal styles are so at variance that it’s not surprising they’re at odds right now.

And given that personal style of Trump’s, it should not be surprising that this is playing out so publicly. In fact, given the nature of Trump’s usual attacks on people, he’s being rather restrained here although, as Scott Johnson of Powerline writes:

Trump’s public humiliation of his appointed Attorney General is unprecedented. It is unseemly. It is also unnecessary. Trump could privately ask for Sessions’s resignation at any time; Sessions serves at the pleasure of the president. Trump somehow thinks that his public humiliation of Sessions to induce his resignation is preferable to seeking Sessions’s resignation directly.

But anyone who has studied Donald Trump—and I don’t just mean “Donald Trump, President,” but “Donald Trump, human being”—knows that once he decides that someone is his enemy or opponent, or is against him or defying him in some way, he releases the Kraken. Remember what he did in the primaries to Ben Carson and to Ted Cruz’s wife, just to name two? Or to this guy back in his golf course development days? Or this lady who stood in his way in Atlantic City? Makes his treatment of Sessions look like a love tap.

But of course it’s not. It’s a public dressing down when a private one would seem to do, if they have bones of contention (in this case, Sessions’ recusal and less-than-eager pursuit of Hillary’s wrongdoings). Did Trump try the private route, hoping Sessions would change his ways or resign, and only now is going public with it? And what is Trump’s ultimate goal? To get him to resign? To get him to stay on and do Trump’s bidding (or his bidding du jour; Trump’s been somewhat mecurial on the subject of Hillary Clinton and whether she should be investigated and/or prosecuted)? Or does Trump just like to vent his spleen?

I don’t see that any good can come of this, not just on a personal level but on a political one as well. Senators aren’t going to like it; they prefer that their dignity be respected. The public doesn’t seem to like it much, except for the ones who really wouldn’t blink if Trump were to shoot someone on Fifth Avenue. It’s not the sort of behavior that would make the job seem more appealing to any possible replacement for Sessions in the AG job—who would willingly let him or herself in for such treatment, if Trump can do that to such an early loyalist?

I think Trump is frustrated by the slow pace of government and by the way these investigations are hampering him, and he’s striking out in the way that’s familiar to him. I actually think that he feels as though these attacks on Sessions are relatively mild compared to what he’s used to unleashing. I think he believes that, if only Sessions hadn’t recused himself, it would somehow have prevented the appointment of special counsel Mueller. I think he’s accustomed to firing people and/or publicly humiliating them, so this is comfortable territory for him.

I think these are problems for a president and will be problems for this president, particularly if the GOP members of the Senate start turning on him.

[NOTE: If you want to see some of today’s coverage of the Trump/Sessions battle, here’s plenty of it.]

When trout swim down…

The New Neo Posted on by

Sometimes random associations lead to a post.

Earlier today I wrote about a story that’s big in the news: the legal, medical, ethical, and human issues involved in the case of Charlie Gard. While writing it, I noticed that the hospital in London where the child has been treated is called Great Ormond Street Hospital.

For me—maybe not for you, but for me—the words that immediately leapt into my head were “When trout swim down Great Ormond Street.” No, I’m not going daft; that’s a line from a highly anthologized poem of the same name.

Some poems can work like musical earworms, particularly some lines of some poems. That’s one of them—so catchy! Once you hear it, it may remain in your mind forever. The poem itself wasn’t one of my favorites, or I’d have recalled the whole thing, but I remembered that the mental image and the message of the poem is something like “When pigs fly…”—in other words, when something impossible happens—and that it ends with a declaration that only when that impossible thing occurs will the poet stop loving his beloved

Here’s the poem, conjured up almost instantaneously by the wonders of Google. I appreciate it more now than when last I read it so many moons ago (probably in adolescence). Such lyrical, improbable images! Here’s the gist of it:

When trout swim down Great Ormond Street,
And sea-gulls cry above them lightly,
And hawthorns heave cold flagstones up
To blossom whitely…

….And in the sunlight,

By the green margin of that water,
Children dip white feet and shout,
Casting nets in the braided water
To catch the trout:

Then I shall hold my breath and die,
Swearing I never loved you; no,
”˜You were not lovely!’ I shall cry,
”˜I never loved you so.’

If I had to guess, I would have said that it was written by Dylan Thomas. Wrong, wrong, wrong. It’s by Conrad Aiken, about whom I remembered absolutely nothing. So of course I had to look him up, too.

I would have thought he was British because of that Great Ormond Street reference. But no; he was American, although he lived for a while in England. He was very prolific in both poetry and prose, and was moderately famous but not extraordinarily so. He had a troubled life in many ways, beginning with an almost unspeakable family tragedy that occurred when he was eleven.

But I’ll let him describe it. As he wrote in his mostly autobiographical work Ushant (the unspecified other person here was his mother, and the “his,” “he,” and “himself” is Aiken as a child):

After the desultory earlymorning quarrel came the halfstifled scream, and then the sound of his father’s voice counting three, and the two loud pistol shots and he tiptoed into the dark room, where the two bodies lay motionless, and apart, and, finding them dead, found himself possessed of them forever.

That’s a poet writing.

After that, he was farmed out to relatives, and spent the rest of his life picking up the pieces. I think that, despite multiple marriages and quite a bit of womanizing, under the circumstances he probably did a pretty good job.

Charlie Gard’s parents give up their court fight

The New Neo Posted on by

A sad ending to a sad story

Until today I hadn’t written about Gard’s parents’ legal battle to be allowed to fly him to the US for extraordinary experimental treatment for a very rare and destructive genetic disorder. The main reason I haven’t dealt with it till now is that I think the issues are very clear there’s almost nothing to discuss, and that just about everyone here would agree: the court had no business meddling in this in the first place.

When the government enters the medicine business—and in Britain, it’s much more heavily involved than it is here, even with Obamacare—the government increasingly controls medicine and how it is dispensed. But the distinguishing factor in this case was that, although infant Charlie is in a London hospital, his parents had raised enough money to pay for his US treatment and therefore it would seem the British government shouldn’t have had any say in the matter unless the parents had been planning to do something really outrageous and clearly harmful.

The case for allowing Charlie Gard’s parents to choose seems fairly cut and dried to me—but not to the British courts, where the parents have been involved in a five-month court battle to be allowed to make this decision:

On 24 February 2017, the hospital applied for mechanical ventilation to be withdrawn, but his parents Gard and Yates were opposed to this, and wanted to take the child to the United States for an experimental treatment. The case was heard at the High Court with a legal team representing the parents pro bono. On 11 April, Mr Justice Francis ruled that it was in the infant’s best interests for his treating clinicians to withdraw mechanical ventilation and provide him with palliative care only, maintaining his dignity. The judge noted that the US doctor proposing the nucleoside treatment said that it was “very unlikely that he will improve” with the proposed experimental therapy. He also noted that the treatment proposed had not been used in patients with the same mutation as Charlie Gard, nor with patients with encephalopathy, as he had. There have been no published case studies of the proposed treatment in any patient group

These are reputable physicians, however, and Charlie’s diagnosis is so very rare that it’s not the least bit surprising they have little or no experimental data. That’s no reason to deny the parents the right to make the decision. And I don’t see why it’s any more “dignified” to die with or without a ventilator in Britain versus dying with or without a ventilator in the US after a course of treatment in a reputable hospital.

This is the way today’s decision was made:

On 7 July, the hospital applied to the High Court for a fresh hearing, citing that this was “in light of claims of new evidence relating to potential treatment”, referring to possible new evidence on the benefit of nucleoside treatment…

Hearings took place on 13 and 14 July, and in the latter hearing the US doctor, Michio Hirano of Columbia University, agreed to be identified, and the judge ruled that Hirano could evaluate the child and consult with the hospital staff; the judge said he would issue a new ruling on 25 July, after he had received and reviewed Hirano’s report.

On Monday 24 July, the attorney for Gard and Yates appeared in the High Court and withdrew the parents’ request to fly their son to the US and their challenge to withdrawing mechanical ventilation and giving him only palliative care. The attorney said that Hirano, after examining the child and consulting with GOSH staff, was no longer willing to offer the experimental therapy because he saw no chance of it working due to irreversible damage caused by the disease. The attorney said that on 21 July Gard and Yates had decided to stop fighting and had spent the weekend with their son.

This is the sad situation, but at least Charlie’s parents were able to make the decision themselves based on the advice of a physician they trusted, one who was willing to treat their son if he felt there was any hope whatsoever. Meanwhile, of course, they had lost a great deal of precious time while the courts droned on.

When I first read that news, I thought that it probably was the case that the child could not have been saved even if he’d had access to the treatment when they first were able to afford it. I still believe that is highly likely to have been true.

But even if there was a 1% or less chance, it was the parents’ right to take it, and they missed that chance. Here is the relevant portion of their statement:

The American and Italian team were still willing to treat Charlie after seeing his recent MRI and EEG perform last week, but there is one simple reason why treatment cannot now go ahead and that is time. A whole lot of time has been wasted.

We are now in July and our poor boy has been left to just lie in hospital for months without any treatment whilst lengthy court battles have been fought.

Tragically having had Charlie’s medical notes reviewed by independent experts, we now know had Charlie been given the treatment sooner, he would have had the potential to be a normal healthy little boy.

Despite his condition in January, Charlie’s muscles were in pretty good shape and far from showing irreversible catastrophic structural brain damage.

Dr Hirano and other experts say his brain scans and EEGs were those of a relatively normal child of his age…

Charlie’s been left for his illness to deteriorate devastatingly to the point of no return.

This has also never been about ”˜parents know best’.

All we wanted to do was take Charlie from one world-renowned hospital to another world-renowned hospital in the attempt to save his life and to be treated by the world leader in mitochondrial disease.

We’ll have to live with the what-ifs which will haunt us for the rest of our lives.

I know I repeat myself, but I have to say this is incredibly sad. My opinion of the court’s role is that it has been outrageous. These parents weren’t going to remove the child from a hospital offering some hopeful treatment to take him to a quack somewhere. They were proposing to use their own money to take him from a hopeless situation to one that offered him (and them) an infinitesimal chance of hope, both in “world-renowned” hospitals.

It should have been their right as parents and as human beings to make that decision in a timely manner.

Will Mueller be fired, and if so what would happen next?

The New Neo Posted on by

The subject of this post is worthy of a tome. But I’m actually trying to go somewhere this afternoon (fancy that!) and so it will be a condensation, perhaps with a sequel to follow at some point.

Rumors are flying that President Trump is getting set to fire special counsel (similar to a special prosecutor) Mueller, and this is raising a ton of concern and controversy. Of course, although the discussion is of the possibility of Trump firing Mueller, Trump would not actually be empowered to do it himself, because the law requires it be done through the AG’s office (see this):

The Special Counsel may be disciplined or removed from office only by the personal action of the Attorney General. The Attorney General may remove a Special Counsel for misconduct, dereliction of duty, incapacity, conflict of interest, or for other good cause, including violation of Departmental policies. The Attorney General shall inform the Special Counsel in writing of the specific reason for his or her removal.

There is a caveat, though: “the current special counsel regulations were promulgated by the Justice Department and have no underlying statutory basis.”

However—as President Nixon learned* during the event known as The Saturday Night Massacre (see this for more details)—such a firing would almost certainly be politically dangerous. In Nixon’s case, it took him some time to get someone in the Justice Department to refuse to resign, do Nixon’s bidding, and fire Archibald Cox. The entire episode was instrumental in ultimately sealing his fate, because the GOP turned on him.

Trump isn’t a popular figure in the GOP; he’s merely tolerated at this point. I think if he fired Mueller without clear and obvious and nearly unequivocal cause, enough of the GOP would turn on him that his position would become untenable. That prediction may be incorrect, but I’m making it. And I’m making still another prediction, which is that Trump won’t actually have Mueller fired.

No matter what party they are appointed to investigate, I have a non-partisan dislike of the entire idea of pecial prosecutors/counsels. Let Congress investigate, or the FBI if it must. But independent counsels are invitationss to fishing expeditions and the temptation of the power granted to the attorneys involved is just too great. The check on this power—the ability to fire for cause—can hardly ever be put into effect because the political hue and cry would be way too great.

We don’t want a chief executive with no checks on his power, but neither do we want an unelected special prosecutor with no checks on his power, and yet at this point it’s hard to trust Congress to check either of them.

[NOTE: *The law has been changed since Nixon’s time, but it’s not substantially different in most important respects. See this.]

Good news and bad news on ISIS

The New Neo Posted on by

First, the good news: the war on ISIS has been going well lately:

ISIS in Iraq and Syria has been “dismantled,” with tens of thousands of its jihadist fighters dead…

The bad news? Thanks to our media, which continues to have its own arrogant agenda:

…[A] promising lead on its leader “went dead” after a media leak, according to a key U.S. military official.

“We have absolutely dismantled his network,” Gen. Tony Thomas, speaking of Abu Bakr al Baghdadi, said at the Aspen Security Forum. “I mean everyone who worked for him initially is dead or gone. Everybody who stepped to the plate the next time [is] dead or gone. Down through a network where we have killed, in a conservative estimate, 60,000 to 70,000 of his followers, his army.”…

“Unfortunately, [a good lead on the leader’s whereabouts] was leaked in a prominent national newspaper about a week later and that lead went dead,” Thomas said. “The challenge we have [is] in terms of where and how our tactics and procedures are discussed openly. There’s a great need to inform the American public about what we’re up to. There’s also great need to recognize things that will absolutely undercut our ability to do our job.”

Thomas appeared to be referring to a New York Times report in June 2015 that detailed how American intelligence agencies had “extracted valuable information.”

This is nothing new; these damaging leaks have been going on for a long time.

Reality and health care insurance reform

The New Neo Posted on by

I saw the title of this article by James C. Capretta at the American Enterprise Institute (“The GOP’s collision with health-care reality”) and, before I read it, I expected it would cover the fact that any bona fide Republican effort to reform our health care insurance system would be inherently difficult because the public wants to have its cake, eat it too, and pay next to nothing for it—and in addition, the GOP is hopelessly divided between moderates and conservatives.

But the article wasn’t really about the basics; it was mostly about tactics. Capretta points out that the GOP promised repeal without having a plan for replacement, and that Trump the candidate and then president has been very hazy about giving any specific direction and leadership at all. These things are certainly true, but I don’t think they get to the heart of the GOP’s failure to confront reality, which I think is even more basic than that and goes under the heading of “there is no free lunch” and “the MSM will tear into any flaws in any system the GOP can devise,” as well as “the public has gotten used to the perks of Obamacare and would like those perks without the drawbacks” (maybe that last one is the same as the first one).

Which brings us to Capretta’s final suggestion for the GOP, a piece of advice that seems even more divorced from reality than the GOP’s actual behavior:

To get a better result with a renewed push, the GOP should include willing Democratic senators in the conversation. The party should understand that the goal should be a plan that costs less, reduces regulations, and injects serious market discipline into the system, even while ensuring all Americans have ready access to insurance. That may mean finding a compromise approach on giving individuals strong incentives to enroll in health insurance. The party should also work with GOP governors to find a reasonable and affordable compromise on Medicaid, one that provides for significant reform of the program, with more state control and clear federal budgetary restraints, while also providing a safety net to all Americans with incomes below the poverty line.

It would have been easier, and more fruitful, to pursue a bipartisan deal of this kind in the weeks after the election. That was when Republicans had the most power. But they still have some leverage. They should use it when the time is right to begin the process of moving health policy in a direction more to their liking. That will inevitably be less satisfying to some than writing a bill entirely on their own because of the compromises that will be necessary, but this kind of legislation would be far more likely to pass, and also survive when political control inevitably changes again.

The sole exception to the disconnect from reality expressed there is one sentence that makes sense to me: “The party should also work with GOP governors to find a reasonable and affordable compromise on Medicaid…”. Other than that, I’m not sure what world Capretta is living in, but it’s not the one I’ve been observing for well over a decade. I don’t see any possibility of compromise on the part of the Democrats, who threw down the partisan gauntlet when they passed Obamacare in the first place. On Obamacare, the only compromise they will accept is complete capitulation from the GOP.

And even if reasonable compromise were possible, I doubt the GOP’s base would stand for it.

We’ve reached a pretty pass, haven’t we?

Sean Spicer resigns

The New Neo Posted on by

To tell you the truth, I can’t say I blame him. What a difficult job it must be:

White House Press Secretary Sean Spicer resigned Friday in a move apparently tied to the hiring of a new top communications aide, marking a major shakeup in the president’s press shop at an already tumultuous time.

Spicer’s departure was confirmed just moments after President Trump met with the man being tapped for White House communications director, Wall Street financier Anthony Scaramucci….

While Spicer is close to White House chief of staff Reince Priebus, Priebus told The Associated Press that he supports Scaramucci “100 percent.”

“We go back a long, long way and are very good friends,” Priebus said of Scaramucci. “All good here.”

There are rumors, however, to the contrary about Priebus:

…[Scaramucci’s] appointment would be unusual, given his lack of a traditional communications portfolio. But he has been seen as an avid and effective defender of the president on television…

Mr. Scaramucci was recently the subject of a retracted story by CNN that dealt with investigations into the Trump campaign’s ties to Russia. He accepted an apology from the network, but Mr. Trump’s supporters were gratified by Mr. Scaramucci’s approach to getting the story removed.

It is unclear if Mr. Scaramucci’s appointment will be blocked by Reince Priebus, the White House chief of staff. Officials have said Mr. Priebus helped jettison an earlier plan to put Mr. Scaramucci in the White House Office of Public Liaison.

Oh, so it’s that Scaramucci.

And now I’ve got an earworm. Want one too (hint: can you do the fandango?)? See 3:11 to 3:17: