13 December 2019

Dear Interested Readers,

 

How Good Are Things? It Depends On Who You Are And Where You Live.

 

It’s hard to put the drama in Washington out of mind. If you have had the time, you may, like me, have spent many hours watching the House hearings. Every newspaper, every evening news program, most of the talk shows, and dozens of emails from political organizations remind us many times a day that we are experiencing a moment in history. 

 

This is my third such moment of history. I was 29 in 1974 when Nixon resigned to avoid impeachment and a Senate trial. I was 53 when Clinton was impeached by a Republican majority on December 19, 1998 by a vote of 228 to 206 for perjury before a grand jury and obstruction of justice. I am 74 as President Trump earns his special place in history. If an event occurs three times in forty five years that occurred only once between 1789 and 1974, is there some basic system change that we are overlooking? If there is something historic going on, it may be that what is historic is as much about the rest of us, as it is about what the three presidents did or did not do. 

 

Nixon’s offenses rose to the level of high crimes and misdemeanors as he sought to cover up “a third rate burglary.” Clinton’s initial failure was one of personal morality, a failure of character. He compounded his problem by lying to a jury. We are still listening to the debate about what crimes, if any, President Trump has committed. 

 

We have heard about the essential components of the sorry situation so many times that it seems unnecessary to restate them, but let’s do it one more time. The core complaint of the House Democrats is that President Trump abused the power of the presidency by holding up money approved by Congress for military aid to Ukraine in a plot that was essentially an attempt at extortion. He tried to use a the military aid plus a visit to his office as leverage for his demand that the Ukrainian president announce an investigation of the Bidens, and his concern that Ukraine, not Russia, had interfered in our 2016 election. After a “whistleblower”  reported the attempted transaction during the president’s July 25 phone call with the Ukrainian president, the president released a summary of his call with the Ukrainian president where he asked for a “favor” during the discussion of the military aid that Ukraine needed. There is no disagreement over the facts of what happened. The president proudly proclaims the call as “perfect.” The disagreement lies in the interpretation of the president’s intent. Then, there is the side story of the activities of Rudy Giuliani and the “three amigos” as an “alternative” path for diplomacy, but those bizzare activities are only suggestive of how far from the norm things are, and they are not included in the impeachment complaint.  

 

The president doesn’t see a problem with using the money that Congress had approved as support for the Ukrainian defense against Russian aggression as leverage for a request that might be of benefit in his efforts to be reelected. The Democrats add stonewalling the House’s rightful request for papers and testimony from members of his administration as a second cause for impeachment.  They infer that his refusal to cooperate with their inquiry should be considered as circumstantial evidence that he is guilty of extorting the Ukrainian president. That formulation makes sense to me. It would seem that if getting an advantage in the election was not the reason for his request and his order to delay the delivery of the aid, he would readily offer documents and ask officials to defend him with testimony taken under oath. 

 

The president’s defenders are resourceful and strategic. They have spent many hours of broadcast time during the televised hearings decrying the unfairness and lack of legitimacy of the process. They have contended that impeachment has been planned since the day of the election. The have contended that the charge of “abuse of power” should be directed at Democrats like “publicity hungry” Congressman Adam Schiff, the chairman of the House Intelligence Committee, Congressman Gerald Nadler, the chairman of the House Judiciary Committee, and the Speaker of the House, Nancy Pelosi. Complaints about process have been followed by claims that since the aid was finally released and a meeting with the Ukranian president did occur, then there was no crime. The Republicans have also made the argument that all of the actions taken by the president were within the broad perogratives and responsibilities of his office. 

 

Both sides argue their side from the point of concerns about the future. The Democrats assert that they are protecting the Constitution and the separation of powers that have protected our democracy. The Republicans contend that they are protecting the powers that future presidents will need. If a president is wrongly impeached, subsequent presidents will be vulnerable. 

 

The cynical souls among us say it has always been about politics. The first common prediction is that Democrats will pull off the impeachment in the House to satisfy their base that they will hold the president accountable for the Ukranian incident and many other violations of the “norms” of his office. The second prediction of those in the know is that the Republican controlled Senate will rather quickly find that the president is not guilty of an offense that requires removal from office. From the beginning, knowledgeable observers have predicted that there is no way that 20 Republican senators will join all Democratic senators to result in the 67 votes necessary for removal from office. Some commentators suggest that there may be 8 Republican senators who will decide to vote against the president for their own political reasons. 

 

Given the uphill road that Democrats must travel for removal to occur, there are only two explanations that make sense to me for why the House Democrats have come this far. First, Impeachment does mark the president in history. Impeachment does count as a defense of the Constitution and could be a warning that reduces future abuses of power, if not by this president, then perhaps by future potential authoritarians who might get elected. Second, forcing Republican senators to defend an unpopular president could lead to a Democratic takeover of the leadership of the Senate. Your judgment on the advisability and necessity of impeachment is as valid as the idea of any other citizen. At the moment it is a toss up. About 50% of the country favors impeachment.  It is interesting to note that John Kelly, the retired Marine General who was Trump’s chief of staff, now says that when Trump fired him, he told the president that he would be impeached if he hired a “yes man” to replace him. 

 

One unexpected “observation” that I have extracted from the agonies of the past two months and the expectation that the process will continue into January is an appreciation for the diversity within the Democrats in Congress. There are twenty four democratic members of the committee, and seventeen Republicans. If you click on the link you can see all of the committee. Fifteen of the Republicans are caucasian men and the other two Republicans are cuacasian women. The Democrats are more diverse. There are thirteen men and eleven women. Eleven members appear to be non hispanic caucasians. Eight members appear to be African American. Three members are hispanic.  One member, Ted Lieu of California immigrated with his family to Cleveland from Taiwan when he was three. Another member, Pramila Jayapal of Washington, is also a naturalized American from South Asia. The Democrats definitely are closer to reflecting the diversity of the country and the fact that we are moving toward a minority majority. There are no Republicans on the committee from the Northeast and only one from the West Coast, Tom McClintock of California. Most of the members are from the Southeast, the Midwest, or the Southwest. Is it any wonder that there are significantly different views of the president’s behavior?

 

One frequently hears that the best way to manage the behavior of the president is through the election of 2020. I agree, but I have concerns. The president frequently points to the stock market and the very low rates of unemployment as evidence that he is doing a good job. I hear the same thing from many of my retiree friends who are living off of the bounty of their retirement accounts. Not everyone agrees that the bounty that many are experiencing is attributable to the actions the president has fostered like the tax law of 2017, or his stance on trade. 

 

You don’t see many of the folks who are not doing well in this economy if you live in Westchester County, Boston’s western suburbs, Shaker Heights, Naples, Palm Beach, or Scottsdale. Those people may be working in the kitchens at a ski resort like Aspen, or doing the gardening at any of the gated communities that are becoming so popular. We are getting quite good at not seeing the poverty that is hiding in plain sight. It remains hard to explain why the president is popular in many impoverished parts of the South or in “flyover” America, or why the urban poor seem so disinterested in politics of any flavor. 

 

Perhaps the two most disturbing facts that the president is not addressing as he dickers with Putin and harasses NATO while disregarding the environment and upping tariffs on the Chinese are that the health of America is deteriorating as is reflected by the falling life expectancy, and the fact that 40% of American families would need a loan if presented with an unexpected bill of $400. Our appearance of health and wealth is like a thin veneer on a very cheap piece of furniture. Are these two facts grounds for impeachment? Certainly not, but they should be of concern to both a president and a party that loves to say that they are addressing the concerns of the American people. Perhaps the majority of the American people are filled with a hope that good fortune and good health are about to trickle down to them. I fear sometimes that many Americans have just disconnected from hope and are sinking out of site. It’s easy to go about our successful lives and never see them in the shadows of small towns and inner city zip codes where life is not a function of issues discussed in the Judiciary Committee and no one has much concern about the 401K they don’t have. 

 

One of my sons is an LICSW who works with children in the Albuquerque Public Schools, and sees a Medicaid population in a part time office practice. He sees things that I don’t see. He sent me a link this week that was both informative and reminiscent. It has a very long title, “Harvesting the Blood of America’s Poor: The Latest Stage of Capitalism, Blood has become big business in the United States and there is no shortage of corporations ready to exploit America’s most vulnerable populations in order to get a piece of the pie.” Have you ever sold your blood or plasma? 

 

Over fifty years ago when I was in medical school, I was very short of extra cash. My wife worked in Needham as a newly minted junior high school teacher for $6000 a year.  We had daycare expenses and we were a long way from the family resources we had previously enjoyed. I will not say that we were poor, but we did want for a little more. One of my classmates mentioned that he was selling his platelets at Dana Farber for $25 a week. It sounded good to me. Gas was $0.32 a gallon and milk was $0.44 cents a gallon, so $25.00 was a lot of money. I was surprised on my first trip when the technician approached me with a 14 gauge needle. She explained that the larger needle was better because it made things happen faster. As I looked around the room I saw some “regulars” who did not have the sort of “pipes” I had for antecubital veins. Some had “tracks”down their arms, and to my horror some had antecubital scarring from encountering the “big” needle every week. 

 

I don’t like needles. I winced and felt a little sick as that big needle went into my arm. Before long it was over, and I left with my $25 and a return appointment for the next week. After a few weeks, I was dreading my appointment. As I remember the process, a “vacation” was required after the tenth trip. One night I woke up in sweats with a needle related nightmare. That was when I promised myself that I would quit after the tenth time, or if they ever had to stick me twice. On the ninth visit, the nurse claimed that my vien “rolled.” She apologized and stuck me again. That was it. I was done. After they gave me my red cells back and I got my $25, I walked out and never went back. I did not need the money enough to justify the ordeal. 

 

The article my son sent me, and other articles that I have found, suggest that plasma is a huge business. We exported about 25 billion dollars worth of plasma, vaccines, and blood last year to the EU, China, Japan, and Canada. Those countries don’t allow their poor to sell plasma.  There is a 2018 article in The Atlantic entitled, “How Blood-Plasma Companies Target the Poorest Americans: The industry’s business model depends on there being plenty of people who need cash quickly.” The piece is written by H. Luke Schafer and Analidis Ochoa. The article reports that we produce 70% of the world’s plasma, and use 40% of the plasma we make.

 

The article discusses the “big business” of plasma and is a nice companion to the first article that my son sent. Both articles touch on the fact that “donors” are also the same individuals living in areas where eating a good diet takes extra effort. It is hard to quantitate the impact of chronic plasma donation on the health of the people who attempt to earn a few hundred dollars a month to help cover their rent by “donating,” Near the end of the Atlantic article, after describing the big business that has been evolving to meet the demand, the authors write:

 

These companies’ expansion plans are not just a bet on the ongoing necessity of plasma, but also that there will continue to be plenty of potential donors who could really use the extra money. While there are altruistic reasons for donating blood—CSL Plasma’s website frames the act as something that will “help people around the world live healthier, happier lives”—the industry’s success is undergirded by the consistently high number of people who simply need cash, particularly in the United States.

This makes the ethics of plasma donations tricky. While it’s disturbing that cash-strapped Americans feel forced to monetize their bodily fluids, donations represent an income source that many couldn’t stand to lose. Selling plasma is probably preferable to other survival strategies that may be riskier (or less legal), though it’s worth noting how little long-term evidence there is about the health risks of frequent donation. At the very least, considering the strength and prospects of the industry, donors could stand to receive a bigger share of the revenue generated by plasma sales—few, if any, donors could ever dream of affording the treatment that they make possible for others. (No major plasma-collecting company mentioned in this article would discuss this moral dimension of plasma donations.)

 

As I contemplated the plasma industry and what it might mean about the economic and moral realities of our America, it just seems like a sad reality that must be integrated somehow into our leader’s pathway to making us great again. The president likes to imagine conspiracies. I wish that he was equally attracted to problems that are associated with data sets that are facts that are forming a picture that threatens millions now, and is likely to threaten more if he stays in office past January 2021. 

 

As we think about what is to come, maybe we should ask ourselves some simple questions. How good are things for you? How good are things for your neighbor, or for the woman who cleans your house, or for the lady who changes the linen in the hotel room you enjoyed on your last vacation, or for the young man who made you a sandwich at the deli down the street? They all are working and they are counted in the great employment results our president is so proud of, but what is ahead for them? Do you think they care about the stock market? Will they be part of the population of 750,000 poor people who may be losing their food stamps if he gets his way? Does donating plasma make you a contractor, and if so does that make you count as part of the workforce?  Are those people who try to make ends meet by donating plasma part of the America that Jim Jordan and Doug Collins are so vocal about protecting? Things are complicated. 

 

Now We’ve Got A Lot of Turkeys

 

It’s hard to believe that there were no turkeys in New Hampshire fifty years ago. There had been lots of turkeys in the 1700s and 1800s, but we ate them all. In the seventies a biologist, Ted Walski, at the New Hampshire Fish & Game Department decided to bring back the turkeys. In 1975 Walski with the help of some colleagues at Fish & Game brought in 25 turkeys from New York and Pennsylvania to the Connecticut River Valley, which is a few miles from my neighborhood. The farmland there was a great habitat. There was enough food from the fields to get them through the winter. Long story short, there are now 40,000 wild turkeys in New Hampshire. I see turkeys once or twice a week on my walks. I sort of consider them to be like rural pigeons. 

 

Last week I saw a little clip about Ted and turkeys on a local television show.  The very next day I looked out my kitchen window and saw ten big turkeys looking for something to eat in my front yard. I grabbed my iPhone to catch a picture, but when I opened the door to try to get a better shot they marched up my drive and then into the woods. I did catch them as they headed out. If you didn’t notice them in the header, scroll back up and count them. 

 

There has got to be some lesson for me in this, but so far I have not figured it out. A couple of days after I saw them in my yard I was on a walk with Tom Congoran and we were nearly bombed by a couple of big fellows who flew from high in a tree across Burpee Hill Road in front of us into a field on the other side of the road. They were like big jets landing at Logan. I can’t remember ever seeing turkeys fly. I love surprises and serendipity!

 

If there are no turkeys in your neighborhood, I am sure that there are other surprises. I hope that you will be out and about this weekend, and will be the recipient of some startling surprise this weekend. 

 

Be well, take good care of yourself, let me hear from you often, and don’t let anything keep you from doing the good that you can do every day,

 

Gene