Leading Them By The Nose....

When I hear criticisms of Kerry as the Democratic candidate, I am often left wondering what it is that inspires those criticisms. That is, the speakers will declare something silly like, "Kerry doesn't excite me", or "He was picked because he was considered the most electable", as if... as if either statement has any significance, or as if parties should pick unelectable candidates. Or "Bush reminds me of a guy I'd drink a beer with", or "I like his swagger and confidence - he's like me" (which is pretty much what a blue collar attendee at a Nascar event said a few months back - as if Bush is anything like him). When you hear something more substantive, such as "Kerry flip-flops", and press for details, you're lucky if you get any. In my experience, pressing for details reveals these comments to be inspired not by the candidate, but by news coverage of supposed voter ambivalence and of the other side's attack ads.

I am often left to wonder what these people want in a candidate. Whose idea is it that you should want a candidate you would drink a beer with, or that you shouldn't want a candidate who instead drinks wine and likes fancy food? Or that you should have an (unelectable) candidate who excites you, rather than a staid, intelligent, and competent candidate who seems, well, staid, intelligent, and competent instead of "exciting". The media, I suppose, started to buy into the packaging and selling of a candidate, over the substance and competence of a candidate, after the Nixon-Kennedy debates. So "Dukakis looks silly in that helmet"-type nonsense often becomes the media's central focus, as opposed to the candidates' positions on the issues. (The media's distractability was very well highlighted by their response to the "Swift Boat Liars" nonsense - and the effort of even the New York Times to blame a candidate for its poor work. Sure, Dukakis didn't have to put on the helmet and get into the tank, but was that really a story?)

If you were "surprised" by John Kerry's performance at the first Presidential debate - which he is widely regarded as having "won" - here's some news for you: If you had been paying attention to the candidate as opposed to the spin, you wouldn't have been surprised.

You want a candidate who thinks in simple terms and speaks in pre-packaged sound bites, instead of one who understands the world's complexities and whose comments reflect thought and abstraction? Perhaps, then, you should do us a favor and limit yourself to voting for the county dog catcher. If you want more from a candidate, stop regurgitating the media's latest spin, and start listening to what the candidates are actually saying.

Party Affiliation & Polling

Here's a real shock - USA Today presents a table demonstrating that when polls include disproportionate numbers of people from one party or the other, the results of the poll skew toward the overrepresented party. With all due respect to Gallup's rationalizations for releasing polls which overrepresent self-identified Republicans, I think critics do understand the science (or lack thereof) behind this type of polling.

"Bad Baby" Cases

That sounds a bit strange, right? Maybe it has something to do with a small child who won't behave? Actually, it's lingo that some lawyers use to describe malpractice cases involving birth injuries. Realizing that most professions at times use expressions that are a bit unseemly, I can't get used to that particular example.

There are cases of obstetric malpractice which are truly appalling. But, as everybody knows, not all birth injuries are the fault of the doctor. And there is validity to complaints about lawsuits being filed over alleged birth injuries when causation can't be made more certain than a coin toss. Very few lawyers engage in this type of litigation - on the one hand, fortunately, there aren't that many cases to be litigated in any given state; on the other hand, it is far too costly a gamble for those who can't afford to specialize in this type of litigation. Very few attorneys can risk $100,000.00 or more in up-front costs on a coin toss. And, although doctors may argue otherwise, very few attorneys would want to engage in this type of practice.

The way it works is this: there's a birth case, where the baby has a serious injury that might be a birth injury, or it might be a congenital disorder for which the doctor has no fault. The medical evidence is equivocal - so the defense hires "experts" who testify that it was congenital or was an unavoidable consequence of birth, and the plaintiff hires "experts" who argue that the injury was caused by medical malpractice. The same experts often make a very handsome living from their testimony alone, be it for the malpractice insurance carrier or the plaintiff. The jury is then asked to pick a side by a "preponderance of the evidence" - which is why I referenced the coin toss. Whether one side persuades the jury that the plaintiff only proved a 49% likelihood of malpractice or a 51% likelihood of malpractice may turn more on external factors - such as whether the defendant doctor seemed arrogant when he testified, or whether the plaintiff came across as a greedy opportunist - than on the evidence.

If the lawyer wins one case out of two, the strategy is a big-time moneymaker.

There's another side to this type of litigation. It is this paradigm which is used as the rationale for sweeping "tort reform" measures which are designed not to make the jury's fact-finding more accurate, or to prevent the filing of "frivolous suits", but which are aimed directly at the most seriously injured victims of malpractice. The cry is that "obstetricians and neurologists pay too much for malpractice insurance", with the illogic that this necessarily means that all doctors should thus receive broad protections from liability for their mistakes - no matter how egregious the physician's conduct, and no matter how severe the patient's injury.

I'm all for hearing proposals from physicians on how to make the birth injury situation more fair. (Or, for that matter, the somewhat similar situation for neurosurgeons, who may end up being sued as the result of a horrific maloccurrence - a fancy word for a 'bad outcome' - from a high risk surgery, even in the absence of malpractice.) But when it comes to making the system better, doctors and their lobbyists are almost universally silent. They instead want to arbitrarily limit the damages received by the most seriously injured victims of malpractice, in the most meritorious of cases. That's at least as immoral as going to court on a coin toss over a "bad baby" case.

Bad Coverage of Bad Polls

As poor as U.S. news coverage can be of the important issues of the day, it perhaps isn't surprising that CNN's coverage is particularly bad when it turns its spotlight on itself. CJR Campaign Desk observes CNN's coverage of MoveOn's criticism of the methodology of recent CNN/Gallup polls:

Anchor Judy Woodruff began by briefly outlining MoveOn's complaint: "[R]ecent polls have shown George W. Bush leading John Kerry and MoveOn.org claims Gallup's polling techniques exaggerate Republican support." Woodruff then gave Gallup editor-in-chief Frank Newport almost three minutes to respond, uninterrupted, to the charges. Naturally, Newport defended Gallup's methodology, but essentially asked viewers to take it on faith that he knows what he's doing.

Afraid of Hardball Questions

The Bush campaign can reasonably anticipate the type of softball questioning of past debates - but they apparently fear that hard questions might be posed by the guy at the other lectern, so....

Still, officials of the debate commission said they were agreeing primarily to those things Mr. Bush's aides had emphasized as especially important to them: a strict time limit on candidate responses, an electronic warning when candidates exceed their speaking time that can be seen and heard by viewers at home, and a prohibition against the candidates' directly posing questions to each other.

Gotta keep the ugly truths from being aired....

Tax Returns as Public Information?

In London's Guardian, a columnist notes that the rich are getting away with paying far less than their fair share of taxes, but that the country's politicians seem to have little interest in closing loopholes and creating a fairer system. (Sound familiar?)

So, if the super-rich won't pay because no one's interested in making them pay, what on earth can be done? How can the public's interest in fair taxation be revived? How could the government find the courage to stop the tax cheats?

I have a cruel and unusual proposal: everyone's tax returns should be published. If the teachers and dustmen of this country could see that certain multi-millionaires are paying less tax than they are, they'd be so angry that the government would surely be obliged to act.

(I think the teachers and dustmen would first check the tax returns of their neighbors and supervisors, and the media would certainly go after controvercial public figures and politicians.... But most people would probably be very uncomfortable with the disclosure of their personal financial information.)

Common Sense, Ohio Style?

The Dayton for Kerry website has reproduced an article (PDF format) describing how Ohio's Secretary of State, J. Kenneth Blackwell, has declared that counties must ignore voter registration cards submitted on paper stock of less than 80# weight.

The requirement is because the forms are designed to be mailed like post-cards and must be thick enough to survive mechanical sorters at the U.S. Post Office, according to Blackwell's spokesman Carlo LoParo.

"Our directive stands and it is specifically in place to protect new registrants to make sure the forms are not destroyed," LoParo said.

Yes, you heard that right. In order to protect registrants from having their registration forms destroyed in the mail, those which arrive intact but aren't on sufficiently thick paper stock are to be discarded.

To make sure that this new ruling is fair and consistent in its application, Blackwell has exempted Cuyahoga County from the rule, and has additionally declared that registration forms downloaded from the federal Elections Assistance Agency must be accepted regardless of the paper they are printed on.

Suicide

It can be difficult to mark the moment when self-confidence turns into gradiosity, or when a suspicious nature turns into paranoia, particularly in someone you see regularly. But when you speak with somebody only a few times a year, the progression is more marked.

When we lived in the same community, I knew somebody who would at times share theories of conspiracies which were, for the most part, plausible but unlikely. He was an intelligent professional, and he spun a lot of fact into his stories.

At some point, his theories became far more involved and personal. He became deeply wedded to the notion of a conspiracy reaching to the highest levels of government, in which he was the target of a range of efforts to discredit him or to have him killed, because the nation's most powerful people were afraid of what would happen if the world found out what he knew.

I wonder if there was more that could be done to help, but at the same time recognize that every effort to provide assistance was greeted with suspicion, and that the more aggressive efforts at intervention inspired new conspiracy theories, with those attempting to help transformed into villains trying to destroy him. There was no chance of getting court intervention, as he gave no evidence of being a danger to himself or others, and was quite rational when addressing issues other than his paranoid fantasies.

The most aggressive effort at intervention, which pressured him to seek voluntary, intensive psychiatric care or possibly lose his professional license, backfired. He put himself beyond the reach of everybody who wanted to help him, and was largely isolated for the past year. He contacted me every few months, and we even discussed on a few occasions how I might be able to help him, but unfortunately he didn't follow through. A couple of times I must have pressed too hard, as I received emails indicating that I was forgiven (for whatever it was that I had been perceived to have done), but that he knew that I was nonetheless "one of the good guys".)

I hadn't heard from him for quite a few months, then learned of is death through the proverbial grapevine. I can't say that I am surprised at this outcome, but I am saddened.

It's All The UN's Fault

Today, Babbling Brooks blames the impasse on Darfur on the United Nations - the poor United States did everything right, but those darn diplomats in the UN just won't move on the crisis. But, funny, nowhere in his column does he discuss the Security Council resolution the United States submitted to the Council demanding the declaration that events in Darfur constitute genocide, demanding military intervention, calling for the dispatch of peacekeeping forces, or authorizing any nation to intervene to stop the bloodshed. What? You mean, the U.S. didn't submit any such resolution? Go figure. As As Nat Hentoff points out:

On September 18, the U.N. General Assembly passed a watered-down U.S.-sponsored resolution saying "it shall consider" possible oil sanctions on Sudan, but not, at the present time, any sanctions against Khartoum's murderous leaders.

So what Mr. Brooks seemingly means is that the U.S. engaged in a series of diplomatic moves meant to make Bush look good, but without taking any constructive or binding steps toward ending the violence. Without exercising genuine diplomacy, to overcome international resistance to effective intervention, or to build an actual coalition which might act. Which, as it seems, is all Babbling Brooks wants of his beloved President.

Nat Hentoff, while criticizing both parties for their falure to take a stand on this issue, also points out:

John Kerry, at the National Baptist Convention in New Orleans, in a speech hardly mentioned in the media except notably by Stanley Crouch in the September 13 Daily News, "got a standing ovation by calling on President Bush to take leadership in 'the immediate deployment of an effective international force to disarm militia and facilitate the delivery of humanitarian assistance in Darfur.'"

So one might expect Babbling Brooks to expend a sentence or two endorsing Kerry's position. Or suggesting that, as Kerry indicated, the President could do more about the situation. Or expressing that it is a shame that the President chose a watered-down resolution over the type of authorization Kerry called for.

Well, no. If you know the work of Babbling Brooks you had no such expectation - something that might reflect a modicum of insight or balance. If you read Brooks and actually expect such balance, I leave you with the words of Homer Simpson.

Come On Now, Be Strange

Well, that's how I heard the lyric when I was three. Apparently, Tom Ridge still hears it that way - and takes it as an imperative.

I'm Dogbert?

Okay, a bit scary, but it definitely could be worse. Who are you - Wally?

Newsclowns At Work

How to write a headline, from CJR Campaign Desk.

(For explanation of the term "newsclown", please see the works of Philip K. Dick.)

Forged Documents

In case you were thinking that the prior two posts represented the worst of Today's issue of the times.... Wrong! That prize goes to Bill Safire, who declares,

Some person or persons conceived a scheme to create a series of false ... documents and append a photocopied signature to one of them. ... Who was the forger? Did others conspire with him or her to present a seeming government document - with knowledge of its falsity and with intent to defraud...? Who was to benefit and how?

Wow. Is Safire reconsidering his blind support for Chalabi's declaration that he had thousands of documents establishing unprecedented corruption and avarice, provign that pretty much every anti-War voice in the West had received bribes from the "Oil for Food" Program? Um... no.

Well, then.... Perhaps Safire is reconsidering his blind support for the childish forgeries which "proved" that Iraq was trying to obtain uranium from Niger? Um... that wouldn't be it either.

Actually, as you may have guessed, Safire's peevishness is directed at CBS, for airing forged documents about Bush's (non-)service in the National Guard. And, surprise - he's as conspiratorial as ever (perhaps a side-effect of his work in the Nixon Administration):

What benefit did the Bush-hating Burkett gain from CBS in return for his fake documents? One plausible answer: he got coveted access to someone high up in the Kerry campaign.

Sure. CBS is secretly brokering contacts between its confidential sources and "someone high up" in the Kerry Campaign.... And Ahmed Chalabi has the proof, if only those evil Kerry supporters hadn't somehow persuaded the Bush Administration to accuse him of funneling highly classified information to Iran (which, fortunately for Chalabi who is now safely ensconced in Tehran, frequently offers asylum to supporters of the U.S. who have not lent it any aid or comfort), simultaneously allowing a band of thugs to raid one of his investigator's offices and steal each and every document, whether on paper or in electronic form (including all backup copies) which would have documented the claim.

Oh, excuse me - I got this story crossed with Chalabi's story about "oil for food" which, as expressed in the idiotorial under discussion, Safire believes.

Kristof's Cure for Negative Campaigning

Boy, why didn't anybody else think of this?

The only hope for stopping the mudslinging is if well-meaning people try to police their own side.

Now that such a brilliant idea has been presented, certainly both sides will actively police against distortions of the record and muckraking in their own ads, and the ads of their supporters, and will actively condemn any misrepresentation. After all, it is better to lose an election than to win dishonorably.

Right?

"That Was Yesterday"

Apparently the Times disagrees with what it said yesterday, and thus in another unsigned editorial it declares,

It was sad that Mr. Kerry's commendable war record was clouded by the more outrageous of the Swift Boat Veterans for Truth's attacks, and it was somewhat surprising that Mr. Bush's National Guard service again became a big topic of debate.

Well, I guess they didn't technically contradict yesterday's claim that it was Kerry's fault that the outrageous Swift Boat Liar ads (that "keep on coming") and discussion of Bush's record (yes, yesterday that was Kerry's fault as well) clouded the issues. But they did suggest that other forces played a role.

Let's think for a moment.... Why is it "news" whenever new details Bush's poor service in the national guard emerge? Could it be because Bush has steadfastly refused to come clean about that record? Bush could have closed the book on this a long time ago, but instead, for political gain, chooses to misrepresent his service and his use and abuse of family political connections to get in and out of the Guard. Perhaps there's even an element of newsworthiness to that story? Or in the continuing saga of, "When we disclosed all of Bush's records, we somehow missed these key documents."

(As to the part of the editorial that compares past New York Times experience to present CBS pain from basing a story on "inadequately vetted documents from a highly questionable source", the analogy that comes to mind is not of Jayson Blair but of Judith Miller's atrociously bad prewar coverage on Iraq. For which the Times has paid no discernible price.)

Is This For Real?

Of course it is, and it serves as yet another reminder as to why newspapers publish unsigned editorials - in most cases they are poorly reasoned and nobody wants to take responsibility for them. Today's New York Times provides a case in point,

After weeks of politically damaging delay, John Kerry finally seems to have found his voice on what ought to be the central issue of this year's election: the mismanaged war in Iraq and how to bring it to an acceptable conclusion. It was none too soon. While the fate of the Iraqi people, the success of the war on terrorism and America's international standing have all been teetering ominously in the balance, Mr. Kerry has allowed the presidential campaign to veer off into squabbles about events long past - like the candidates' 30-year-old war records - and about Mr. Kerry's confusing and sometimes contradictory recent statements on foreign policy.

Oh, sure. It is Mr. Kerry's fault that when he gave the media the opportunity to act responsibly in relation to those remote events, the media instead gave undivided attention to the rantings and ravings of the now-discredited Swift Boat Liars.

But I'm sure the Times is only speaking for itself, and that if we go back to its coverage of recent months we will see it repeatedly decrying the irrelevant distraction of those attack ads, as opposed to providing extensive coverage of the allegations. Right? (How short do they think our memories are?)

Suicide and Antidepressants

There has been a lot of media coverage recently about youth suicide and antidepressants. The "post hoc, ergo propter hoc" story is essentially: a depressed young person goes on antidepressant therapy, subsequently commits suicide and thus the suicidal thoughts and behaviors were caused by the antidepressants (as opposed to, you know, the depression).

For those who have studied depression, it is a given that risk of suicide can increase following initiation of a successful treatment - that is, the severely depressed patient suddenly has more energy and can take more initiative, and is thus at increased risk of acting on sucidal thoughts. It follows that this will be the case with some younger patients who are responding to antidepressant therapy.

There is another factor at issue, which is that mental health care in this nation, particularly for depression, is now often handled by the family doctor. There are antidepressants which can cause agitation, or which can increase energy level, without necessarily providing an associated improvement in depressive symptoms. A health care provider might view the agitation or increased energy as evidence that "it is starting to work", but might not have the clinical awareness to know that such an increase in energy level could create risk of action on existing suicidal thoughts.

I think it is also true, from my discussions with people who have used even the current generation of "SSRI" antidepressant medications, that some people do experience changes in their thought patterns while taking SSRI's. I think it is pretty much taken for granted that such changes can be a side-effect of the older tricyclic and MAOI medications. Accordingly, it is appropriate for all patients trying a new antidepressant medication (and their doctors, and family members) to watch for any troubling changes.

I am not particularly impressed with the notion that SSRI's dont' work for teenagers, based upon narrow studies of particular SSRI medications, as it seems to be broadly the case that some people will not respond to particular antidepressant medications. Many depressed people have to try several medications, and in some cases pretty much all of them, before they find one that works for them. It is possible along the way to become discouraged, and assume that the only thing an antidepressant has to offer is a constellation of unpleasant side-effects. But if you find one that works for you, there will be no question left in your mind that an appropriate antidepressant has a genuine therapeutic value. Patients should not be deprived of that value merely because of their age - arguably (and in my opinion, almost certainly), it is the youngest patients who can see the greatest lifetime benefit from early, effective treatment.

It may well be that some SSRI's are less effective in younger patients - that should be studied, and the pharmaceutical companies have done their younger patients a disservice by pressing for (often off-label) prescriptions without having first tested their efficacy for kids and teens. If it turns out that some of those medications actually do not work in children or teenagers, or have higher levels of negative behavioral symptoms in young patients, the pharmaceutical companies which pushed for inappropriate use deserve any liability that follows.

What You Believe, Or What You Do?

The Guardian brings us some thoughts on religion from Rabbi Dr Jonathan Romain, minister of Maidenhead synagogue:

When Richard Harries reviewed a previous book of mine, he said it was typically Jewish - 280 pages on what to do and 20 pages on what to believe, whereas if it had been a Christian publication, it would have been the other way round.

* * *

For Judaism, it is the practical consequences of belief in God that are important, not the belief itself. If God exists, then the world has a purpose, life has meaning, all people are equal and every individual matters. The prayers, too, are not so much for God's benefit but for ours. By praising God for caring for the living, supporting the fallen and healing the sick, we are effectively saying these are godly/goodly attributes and mapping out our own tasks.

Over the centuries, this has led to an emphasis on action rather than faith, to the extent that the latter has become assumed to the point of neglect. It gives rise to the saying - somewhat tongue-in-cheek but containing a sizable grain of truth - that "to be a good Jew, you don't have to believe in God, just do what He says".

For some Jews, this is a parody of a faith that is brim full of God's glory; for others, it is a welcome description of a religion whose strength is that the heretic is not the person who believes the wrong thing, but who does the wrong thing.

I think that the same can be said of a split within Christianity, between those who believe that Christianity should emphasize the manner in which Christ lived his life, with the goal being to apply those lessons to live a good and ethical life, and those sects which focus instead on the manner of Christ's death, as exemplified by Mel Gibson and his "The Passion of the Christ". To those who believe that your life's work is meaningless unless you are "born again", the notion of more secular Christians that the best of Christianity comes from living an ethical and moral life derived from Christ's teachings may also seem like a parody of faith. To the more secular, though, the "born again" Christian who expounds a devout piety while leading what amounts to an immoral life - whether limited to preaching hate and intolerance, or whether delving further into a personal exploration of the "seven deadly sins" - seems more the parody.

There are people in both secularized and evangelical branches of Christianity who embrace the moral and ethical lessons of Christ's life, but sometimes they have a hard time seeing each other.

Crappy Polling?

Why do we have yet another poll that is out-of-line with common sense and other polls, showing a sudden and huge lead for GW? The Left Coaster (which sounds a bit like something we Midwesterners put under our drinks to protect the coffee table) dared to ask Gallup:

Because the Gallup Poll, despite its reputation, assumes that this November 40% of those turning out to vote will be Republicans, and only 33% will be Democrat.

(emphasis in original). For historic reference, the coaster references John Zogby:

If we look at the three last Presidential elections, the spread was 34% Democrats, 34% Republicans and 33% Independents (in 1992 with Ross Perot in the race); 39% Democrats, 34% Republicans, and 27% Independents in 1996; and 39% Democrats, 35% Republicans and 26% Independents in 2000.

[Insert eyeroll here]

Election Fairness In Florida? But Where's The Profit?

The Times today takes on the partisan hack who is presently Florida's Secretary of State, and is thus in charge of its electinos. Comparing the present Secretary of State, Glenda Hood, to her predecessor in partisan hackery, Katherine Harris, the Times suggests, "The nation cannot afford another tainted election. Governor Bush should quickly find an elections professional or academic of unquestioned neutrality to run Florida's elections." But where's the profit in that?