Don't let "managed care" manage your care!

I was playing tennis with my friend David on a beautiful San Diego summer morning when the phone rang. We usually ignore our phones on the tennis court, but with medical appointments pending and the need to get treatment scheduled, I decided to stop and take the call. A nurse from our health plan was calling to tell me the HMO had turned down my request for an “out of network” second opinion. Instead, they scheduled an appointment with a surgical oncologist within their own group. Disappointed, I explained that the surgeon I found for a second opinion was a nationally known expert in the type of rare cancer the HMO’s own top gastrointestinal cancer surgeon believed I had, a GIST or gastrointestinal stromal tumor. We had already scheduled an appointment for the following week with the out of network GIST expert.

Before I go further a disclosure, a confession of sorts. For some reason being turned down for an appropriate second opinion upset me out of proportion to the real effect of the denial. Until the HMO informed me it would not pay for a second opinion outside of its network I had been doing pretty well. I was managing my emotions and staying focused and positive. The cost of the second opinion was just under four hundred dollars. We could pay for it if we had to. But that was not the point.

When I went home and checked on the HMO’s in-network choice for a second opinion I found out he was, indeed, a board certified oncology surgeon. But his principal expertise, experience, and practice were in treating breast and thyroid cancers. So I called the HMO’s nurse back and asked who was responsible for denying the outside second opinion. I asked if it would it be possible to speak with that person. She told me it was a physician and gave me her name. The nurse said she would set up a phone call for me to talk directly to the person responsible for the denial.

Doctor “no” and I spoke later that week. It was a conference call that included the doctor herself, and other members of the HMO staff. My wife, Jan, also joined the call. It became clear quickly that the HMO would not change its decision. If I wanted a second opinion out of network I’d have to pay for it. My emotion and indignation grew more intense during this short phone call. How could they not see the absurdity of referring me to a breast and thyroid surgeon for a GI tumor? And I asked repeatedly, why didn’t they want me to see a doctor with expertise in the cancer I likely had? The conversation was going nowhere fast. My wife wisely suggested we end the call. I was informed I could appeal the decision but the doctor who turned me down would not change her mind.

I appealed the denial through the HMO’s own system and was turned down twice. I wrote emails to the CEO of the healthcare organization of which the HMO is a part. Although gracious in his replies, the CEO would not intervene. He said it was a clinical decision and that he, who is not a doctor, did not get involved in clinical matters. I told him I respectfully disagreed; it was not purely a clinical decision but was also a business decision. In the end, the HMO did pick up the bill for the second opinion with the doctor who would wind up taking over my care. But it took an appeal to the California Department of Managed Health Care to get the HMO to do what it should have done from the start. Now it was clear, time to change insurance.

To be continued.

My experiences are in many ways different from what others with cancer endure. This is one patient’s experience, nothing more.

Finding the right surgeon

The radiologist’s report described the “mass” in my belly as “well-circumscribed,” possibly a benign tumor but it also said “malignancy” could not be excluded. Our next move, visit the respected gastrointestinal cancer surgeon affiliated with our HMO. My wife Jan, a nurse with nearly 30 years experience in the same healthcare group as the surgeon, had checked around. We heard good things. Consistent with those reports, we found  Dr. B to be a gentleman with good bedside manners, knowledgeable, and by all accounts a fine surgeon. After a thorough physical exam we walked over to the doctor’s computer and looked at the CT scan pictures. He showed us where the tumor was attached to the outside of my stomach and told us he was quite sure it was a gastrointestinal stromal tumor or GIST. The surgeon’s assessment was more definitive than the radiologist’s and contradicted the radiologist who had indicated the tumor was between the stomach and liver not attached to the stomach. We would still need a biopsy to confirm the diagnosis but we were ready to hear the surgeon’s treatment plan based on his belief we were dealing with a GIST.

Because the tumor was about five centimeters in size, the doctor told us I would need to take a pill everyday for about three to six months in order to shrink the tumor. When the tumor was smaller, he said, it could be removed using a laparoscope. That’s a minimally invasive procedure with a speedier recovery than getting cut open. But he wouldn’t do the surgery himself. Instead, he would supervise a younger doctor with more experience doing laparoscopic operations. And, trying to reassure us, he said if the minimally invasive approach weren’t going smoothly, he would step in and switch to the open procedure. This was not what we wanted to hear. And we still needed to get a biopsy. Time for a second opinion.

I talked to an old friend who is a highly regarded oncologist at the University of California in San Diego. My conversation with her was eye opening. First, because I had a benign spinal tumor 19 years earlier and that type of tumor—a schwannoma—was mentioned as a possibility for this tumor, I was deluding myself thinking this one must be benign too. After all, some GISTs are also “low risk” or benign. Wrong approach. Our friend the oncologist told me in no uncertain terms to get moving on surgery. She gave me the names of three doctors to contact for a second opinion. And, she told me to get a surgeon with specific experience treating tumors in the upper GI area where mine was located.

We often use bellicose language when talking about cancer. It is a fight, a battle, war. And based on my own experiences and those of many we know who’ve fought the fight and continue to do battle, the terminology is appropriate. But it’s not just the bio-medical combat with the disease; there are financial and administrative skirmishes that are another front in the war on cancer. We had our first encounter on that front when we went for a second opinion outside our HMO network.

To be continued.

My experiences are in many ways different from what others with cancer endure. This is one patient’s experience, nothing more.

Living with cancer

I have a rare cancer described by doctors as “high risk.” As bad as that sounds, it’s not as bad as it sounds. Thanks to a targeted cancer drug called Gleevec (generic name is imatinib) my “high risk gastrointestinal stromal tumor”--or GIST--has a pretty good prognosis. A very expensive pill I take every day is designed to keep the cancer away.

Small indolent GISTs are considered benign. Not mine. Based on a number of criteria, including size of the tumor and mitotic rate (check your old biology text or follow the link), my GIST was cancer. Diagnosed almost two years ago, surgeons at the University of California Moores Cancer Center in San Diego removed the tumor along with part of my stomach in September of 2017. It’s taken me this long to report about my experiences living with cancer because it’s been difficult to write about. I keep asking myself, will what I have to say be meaningful to readers? With that in mind and the passage of time I believe I have enough experiences and insight to share my observations. I hope by telling this story it will contribute to better understanding the dreaded diagnosis of cancer.    

The first question I’m often asked is what led to my diagnosis. The short answer is Mexican food. I started having chest pains one evening after attending an afternoon charity fundraiser where they served some of the most delicious tacos I’d ever eaten. So, in the words of one my doctor’s notes, “After dosing with tacos (patient) experienced chest pains and went to the emergency department for evaluation.”

When you show up at the emergency room complaining of chest pains they don’t make you wait. I was rushed immediately to the treatment area and hooked up to an EKG. After four hours that included a chest x-ray, blood tests, a thorough examination and medical history, the ER doctor told me my heart is not the problem. “Follow up with your internist,” he added. So, over the course of the next two weeks I was referred to a gastroenterologist who ordered an abdominal ultrasound that revealed a “mass” growing somewhere in the neighborhood of my pancreas, liver, and stomach. Needing a clearer picture of what was growing inside me, the doctor ordered a CT scan of the area for a better look.

A few hours after my date with the scanner, the doctor called to tell me what the scan showed. The most encouraging words on the radiologist’s report were that it did not appear the mass was on or within the pancreas. But an actual diagnosis would require more tests, specifically a biopsy to find out what type of tumor was growing in my gut.

To be continued?

If you find this interesting and want to read more about my experiences with cancer please let me know. If you think this will be helpful to others, share it widely. Based on your responses I will decide whether or not to continue reporting my cancer chronicles. Topics I hope to cover include the psychological, physical, and financial demands on cancer patients and their families. Of course, my experiences are in many ways different from what others with cancer endure. This is one patient’s experience, nothing more.

-->

2019, off and running!

New beginnings for the New Year, 2017 ended with twin grandsons—joy of joys—and the realization that as a newly diagnosed cancer patient some things would be different. 2018 was adjusting to new realities in grand parenting and health care. Now adjusted, we begin 2019 refreshed. Grandsons are one year old and the lights of our lives. Cancer treatment is going well and tolerated so far with minimal side effects.

The state of the nation and world are another matter. Living 15 minutes from the world’s busiest land border crossing we see the effects of mean-spirited and destructive immigration policies first hand. Many we know have been volunteering to help the asylum seekers navigate their way during a difficult time. There are no easy answers, but have the hardline policies of the current administration really helped anyone? Your answer to that question may depend on your politics. But the judgments of history will not be kind to those who fail to support the most vulnerable in their time of need.

I post this (originally on Facebook) reluctantly because we’ve learned over the last ten years that political postings on social media tend to upset people. Some choose to ignore the political posts; others challenge or just “like”. Promoting respectful dialogue is a positive value and my wish. Inspiring hostile reactions is disappointing but an integral part of social media. If the medium is the message as McLuhan asserted, social media is a bar fight interrupted by savoring the “friendships” whether deeply rooted or just a passing good feeling.

So that’s it for now from the lower left corner of America’s map. Wishing everyone a good year ahead. Stay focused.

-->

The age of ignorance

Call me a coastal elite and you’ll be making my point. Now that we’ve gotten that out of the way, let’s begin.

One of the many disappointments of the Trump era is not only the emergence of  “alternative facts” and downright disregard for truth, it is the certainty and defensiveness of those holding to clearly ill founded notions of reality. For example, on Facebook recently, the wisdom of getting flu shots drew comments both pro and con. There are legitimate reasons for someone to choose to forgo yearly flu shots. But some of the reasons cited for not getting a flu shot were gross exaggerations or simply not true. When I pointed out that flu shots save lives, one reply stated, “they also claim lives.” That comment drew support from somebody asserting that “everyone” who gets a flu shot gets the flu. Without belaboring the point, it is true that in rare cases a severe allergic reaction might lead to a death. And someone getting a flu shot might still get the flu, particularly in years when the strains chosen don’t match the predominant varieties afflicting people. But these exceptions are casually cited as if dominant reality in an attempt to discredit the benefits of an important public health tool. The point here is not to argue about whether or not to get vaccinated. Simply, it’s to point out that popular gossip and hearsay, in some quarters, take on the status of settled fact sometimes masquerading as greater wisdom.

The most disturbing part of this is that alternative facts, deliberate misinformation, are being promoted by not only the President of the United States, but political and cultural partisans with the intention of deceiving those who will believe anything that re-enforces their own points of view. The notion of testing hypothesis and critically evaluating information is not nearly as important to them as proving that they are right especially when they are dead wrong. If you don’t like what someone says, call it “fake news.” Truly fake news should be recognized and exposed. But having the critical thinking skills to be a literate news consumer is the foundation for making such judgments.

I’m afraid Bob Dylan nailed it decades ago in “Idiot Wind”, though today’s context is different. “Now everything’s a little upside down, as a matter of fact the wheels have stopped, what’s good is bad, what’s bad is good, you’ll find out when you reach the top, you’re on the bottom.” 

I, and those who might share my views, have no monopoly on wisdom and knowledge. But respect for wisdom, knowledge, and truth have to re-emerge as important values in today’s discourse. This should not be a “right/left” conflict. It is simply about respecting truth.

May the USA and countries of the world, along with the greater universe, survive the celebration of ignorance that has become so popular today.

An open letter to President Trump

-->

The Honorable Donald J. Trump

President of the United States

Dear Mr. President:

I write to you today as one who opposed your candidacy and spoke out against your rhetoric, proposals, and platform.

Though we have never met, I feel as though I know you. After all, we both grew up in Queens and are in the same general age group. I wrote a few months ago about the way good bull shitters are regarded in the New York area. Having a “good line of bullshit” is not necessarily a bad thing. Surely you realize, however, that many of our countrymen and women actually take you at your word. When confronted with some of your more outrageous statements, and I am paraphrasing here, Mike Pence replied “that’s Donald,” the implication being to not always take you literally. Unfortunately for all of us, in your current role, words matter more than ever.

You are quick to invoke the charge of  “fake news” when something reported in the media is not to your liking. And your attacks against specific news organizations and reporters remind many of the way authoritarian leaders suppress opposition in countries whose values are diametrically opposed to historically American governance. You have the most compelling platform in the world to offer your version of events and policies. But when your spokeswoman suggests that your press secretary offered “alternative facts” the impression is that you operate in an alternative universe. As the late New York Senator Daniel Patrick Moynihan taught, “everyone is entitled to his own opinion, but not his own facts.”

You and your candidacy deepened divisions in our country and coarsened the dialogue. Yes, we were deeply divided before you ran, but most leaders try to bring people together. You had an opportunity to reach out to those who opposed you throughout the inaugural weekend but chose instead a combative stance that furthered division.

I will continue to oppose your positions and policies with which I mostly disagree. You were elected by people who knew what you intended to do as president. But it’s time to raise your game and recognize that great leaders grow. Find a softer more humble pitch. Take aim at the hateful rhetoric that some of your coalition delights in projecting. Tweet about that. You won the election. Instead of attacking celebrities who challenge you—remember you were an opposition celebrity before you became a politician—show some respect for the opposition. That’s the only way you’ll earn the respect you want from them and the millions of Americans who voted against you.

I will end by saying I don’t expect this letter to make much difference in the way you govern. For the sake of our great nation, I  hope I am wrong.

Thank you.

Trump and the holidays in fewer than 300 words

-->

Donald J. Trump will become President of the United States in four weeks. Christmas and Hanukkah begin in two days, an unusual year—in so many ways—when the two holidays fall on the same day. Some friends on the right say give Trump a chance. Others, many others, say be vigilant and make sure to oppose moves by the new administration that are bound to be authoritarian and corrupt.

A woman we knew liked to remind us, according to Christian scripture, Jesus was a homeless Jewish baby when he was born in Bethlehem. Some dispute that characterization saying Jesus, Mary and Joseph were away from home but not truly homeless. Hanukkah includes stories within stories but ultimately celebrates religious freedom. Freedom has a price, however, also part of the Hanukkah story. Christmas promotes peace on earth and celebrates a pathway to redemption by a loving God. For Christians, the King of Kings is also a humble man.

As President-elect Trump gets closer to the Oval Office, my hope and prayer for this holiday season is that love and sacrifice, the willingness to give of self for the freedoms we enjoy, and a recognition that those without a bed to sleep on may be the true queens and kings, don’t get lost in the bluster that consumes much of what we see and hear during these troubled times.

I fear the lessons of the season may be lost on the president-elect. His words and actions have indicated a different philosophy of governing and life. Those who embrace the messages of the season, for religious or other reasons, need to also live those values. Love and sacrifice will keep America great. No one person alone can make that happen.

Thanksgiving day election reflection

 

Happy Thanksgiving everybody.
 
With the benefit of two weeks since the election, and in the interest of wrapping things up, here are some thoughts on what happened and where we go from here.

Let’s get real folks. Trump won. Whatever you think of the Electoral College, that’s the system we have. But let’s also remember that Clinton will probably have a margin of two million more votes than Trump. That would mean she will have received more votes for president than anyone in history not named Obama. Just sayin’.

As for how the respective sides are lining up in the aftermath of the election, let’s get real about that too. When Obama won eight years ago he inherited a s*** storm. Now, I don’t normally use language like that in writing or conversation but sometimes one has to make a point strongly. The economy was tanking. It was the worst economic catastrophe since the Great Depression. Trump is taking office during a much better economy, extremely low unemployment (and please don’t make the argument that we cannot trust the figures. They use the same methodology as when Obama took office, apples to apples!). The stock market—and that includes many retirement accounts—is in record high territory. The economic problem that Trump ran on was slow growth and the need for creating good jobs. We’ll see how that goes in the years ahead. Unlike Republicans, whose stated goal was to make Obama a one-term president, I am hearing Democrats, Senator Cory Booker yesterday on NPR, say they want to work with Mr. Trump and grow the economy.

As for the argument that Trump’s election was a repudiation of Obama’s eight years, here are a few facts. President Obama currently enjoys a reasonably high approval rating, much higher than Trump’s even with his post election bump. To his credit, the president-elect is now saying good things about Obama. He should. So why did the Democrats lose? Well, for one thing, and this is important, since Truman’s election in 1948, only once has either party held the White House longer than two terms. That was from 1980-1992 when George H.W. Bush succeeded Ronald Reagan. As we know, that President Bush only held the office for one term. So change in the White house after two terms, though not inevitable, is the norm. People wanted a change and the choices were dramatic. Donald Trump is different. The people spoke.

This election was ugly. Between the false facts thrown around without shame, to the coarseness of the dialogue, we can, should, must, do better. As for the news media, that’s a discussion for another time.

Mr. Trump has an opportunity to lead. His words are mutable to put it politely. But, as the cliché goes, actions speak louder than words. So let us remain vigilant. We shall soon see what kind of a leader Donald J. Trump really is.

Trump, Queens, and the art of crap detection

 

Donald Trump and I have something in common. We both grew up in Queens. As a proud child of the borough, I offer a bit of background for those less familiar with that part of New York City.

Queens is where working people live, civil servants, office workers, cops and firefighters, construction workers, small business owners, and to this day, upwardly mobile ethnics. The late New York Governor Mario Cuomo—like Donald and me, a Queens “boy”-- once remarked, and I’m paraphrasing, in Queens, arguing is a way of life. There is a certain in your face honesty that is particular to the region. There is also another communication characteristic that will be useful to understand in the days ahead. To put it directly, I can imagine Donald hanging around the schoolyard in 1961 regaling the other kids with stories and keeping their attention. After he left, one of the kids  might say to the others, “Donald has a great line of bullshit.” Understand, that would have been meant as a compliment as much as a criticism.

Neil Postman (1931-2003) was a brilliant scholar of communication. He was also from Queens. In his career as an NYU professor, Dr. Postman offered insight into mass media, culture, and yes, bullshit. In his classic discourse, Bullshit and the Art of Crap Detection, Postman explains, “sensitivity to the phony uses of language requires, to some extent, knowledge of how to ask questions, how to validate answers, and certainly, how to assess meanings.” By the way, the essay (abbreviated version), linked above, is a worthwhile read and not too long.

A few months ago, Bill Maher and his guest Rob Reiner were discussing how having grown up in the New York area, they were able to recognize much of what Trump was saying as BS. They speculated that people from other regions of the country might not be as familiar with the particular style and  brand of BS Mr. Trump spews.

So, let’s see how this all plays out. Will the president-elect build a wall along the length of the Mexican border and get Mexico to pay for it? Will tariffs on foreign goods bring good jobs back to the USA? Will he even be able to impose the tariffs he’s promised? Will he deport all those he said he would send back? Will he really push for congressional term limits? The list could go on but you get the point. Real or BS? Guess we’ll soon find out. 

That's my opinion. What's yours?

(Addendum--11/16/16)

With the benefit of observing the president-elect for a full week in his new role, here are additional observations.

Because Mr. Trump is prone to BS we should be ever more vigilant. As Postman points out, bigotry is a particularly malignant form of BS. And although when he's president much of the BS may never become reality, but too much will with a same party Congress. Words themselves have power. We are seeing each day that coarse language and hateful rhetoric have dire consequences, empowering bigots and motivating intimidation. We must not acccept this as the new normal. Stand up; speak out; remain true to the best in us, not the worst.

Which American makes you proud? Opinion poem

-->

Fallen hero’s father, eloquent, brown,

Speaking slowly to the nation,

While opposing a clown,

But this clown’s not funny,

He’s a danger to all,

His calling card’s money,

Though he’s rather small,

His height’s not in question,

He towers above,

It’s about learning a lesson,

Stop hating try love,

Captain Khan gave his life,

So his soldiers could live,

Bravery amidst strife,

What more can one give,

Then the candidate tells,

Of his own sacrifices,

Creating buildings he sells,

And getting good prices,

A reporter then asks,

Is that sacrificial?

No shame, he just basks,

Harsh tweets his epistle.

Political poem for after the conventions

-->

 To thinking republicans of good will:

A contrast so sharp it’s hard to tell,

Is the Republican party now an empty shell?

Reagan said, “tear down the wall,”

Trump’s vision: make it tall,

Yes, indeed, a different fence,

But one’s for freedom, the other tense,

Many friends of the G-O-P,

Seem lost and searching, though most can see,

The man named Trump is not really theirs,

He’s for himself, selling broken wares,

A political fight based on ideas,

Now replaced with empty dares,

So please consider and do it fast,

That voting choices of the past,

Have become today a stark decision,

Hopeful light or dark derision,

Hillary, too, has her flaws,

But she’s steady smart, and broke no laws,

The FBI and Congress investigated,

No indictment anticipated,

So let’s move on and make a pledge,

Vote your conscience, stay off the ledge,

The man who tweets, markets well,

But what he’s selling can go to hell.

Election blog in six verses

A pivot point in history,

Confronts us all today,

To most it’s not a mystery,

But for others, hard to say,

Making news, the Donald man,

With words meant to arouse,

Fear filled folks, a dangerous plan,

Playing to the crowds,

Hillary, oh Hillary,

Now see what has been wrought,

They pillory and pillory,

They say that you’ve been bought,

Though neither one a perfect choice,

Still not hard to choose,

Hard work and smarts, giving love a voice,

Although she still might lose,

That is why we must unite,

Send a message loud and clear,

With Trump it’s not a future bright,

It’s false promise built on fear,

The time to vote is months away,

Though not soon enough,

For choosing wrong, we all will pay,

The choice is not that tough.

Reunion reflections

-->

Now the years are rolling by me
They are rocking easily
I am older than I once was
And younger than I’ll be
But that’s not unusual
No, it isn’t strange
After changes upon changes
We are more or less the same
After changes we are
More or less the same

Former students who attended Forest Hills High School, in Queens, New York, held a reunion this past weekend. It was a multi-year gathering, covering most of the 1960s and the early 70s. I graduated in 1969 and joined a few hundred of us who shared the experience of attending one of New York City’s best public high schools during exciting but turbulent times. The words above were written by FHHS alum Paul Simon. He graduated in the late 1950s. Simon wrote those words as an additional verse to “The Boxer” after the original recording was released. It’s an anthem about struggling to survive. Those words are a nice summary of my take-away from an evening of reminiscences, mostly sweet.

The "cool" kids still seemed to be cool enough adults; the smart ones still smart; some of the jocks were still in shape; the quieter class members were still laconic; and many of the pretty girls and handsome guys still looked good. After almost 50 years in my case, just being there and sharing several meaningful moments was worth the journey back in time.

I don’t have pictures to share because I was so busy talking to people I missed the photo booth. So here are a few memorable moments from my first and only reunion.

1.     A fellow track team member, a year ahead of me, remembered that I ran the quarter mile and was on a good mile relay team. He and I are still both in shape after all these years and shared clear, positive stories about our track coach.

2.     One of my classmates going back to junior high days is now a teacher at FHHS. She and I shared some memories and talked about how things have changed. I enjoyed hearing about the school from her unique perspective.

3.     A minor mishap—that seemed quite serious at the time—from chemistry class was discussed with my classmate who was splashed in the face with a hot liquid as I heated a test tube. He is fine. But we both remembered it well.

4.     Shared hugs and smiles with many Facebook friends I didn’t know well in high school but have become closer with online.

There is another line from a Paul Simon song that I often think of and take personally, the opening words of Kodachrome. “When I think back on all the crap I learned in high school, it’s a wonder I can think at all.” As much as I admire the music and words of Simon, I am afraid that’s one line with which I disagree. Like many others, I was eager to move on from high school and leave the area where I grew up. But after all these years, looking back on all I learned in high school—not just in the classrooms—it was a pretty good time where we were encouraged to think critically with intellectual curiosity that survives. Thank you to all who were part of those days. Many are gone, but their memories survive. For those of us still at it, rock on.

A Girl from Brooklyn -- A Boy from Queens

-->

One of the endearing story lines after the recent death of Supreme Court Justice Antonin Scalia has been his close friendship with his colleague, Justice Ruth Bader Ginsburg. In a philosophically divided court, Scalia and Ginsburg represented the most conservative and the most liberal wings of that split. That they were close friends in spite of their political differences should give hope to us all.

Each of their soaring intellects was nurtured in the outer boroughs of New York City. Scalia grew up in Elmhurst, Queens, and Ginsburg is from Flatbush, Brooklyn. They were close in age. Ginsburg is almost exactly three years older than Scalia. And both went on to graduate with high honors from top law schools, Harvard for Scalia, Columbia for Ginsburg who started at Harvard but transferred when her husband took a job in New York.

Apparently, they laughed at many of the same jokes, enjoyed good eating, and their families celebrated New Years’ Eves together. So if two of the brightest legal minds in our country, that disagree on almost every substantive matter, can nurture a great friendship over decades, shouldn’t our political leaders do better?

Perhaps their similar upbringing, the Italian Catholic kid from Queens and the Jewish girl from Brooklyn, gave them a head start at friendship. But in terms of political philosophy, they went in opposite directions. Still, when they joined the high court, they found common ground and mutual respect in spite of their vast political differences. We could use much more of that.

In my mind, that’s how we make America great again.

The Trump Express is a dangerous ride

First, he went after the Mexicans. Then he went after the Muslims. Who's next?

Growing up in Queens, NY, I knew at least a half-dozen guys like Donald Trump. The blowhards I remember were all above average or outstanding in at least one facet of adolescent life. Good looking, smart, a legitimate “tough guy” or maybe an exceptional athlete or student, these loudmouths all had one thing in common. They were narcissists who believed their abilities or gifts entitled them to show others what to do or how to live their lives. The implied payoff was that if you follow their lead you will be like them and share in whatever notoriety or popularity they enjoyed. Those who followed the blowhards quickly learned that it was never about them, the followers, but always about burnishing the reputation or popularity of the narcissist. This type of person can come from anywhere; I just happen to find Trump's version familiar because we grew up in the same area.

So go ahead if you think the Donald is the answer. Jump on his train and see where it takes you. Despite his promises, you’ll find out in the end none of what he is selling is really about the greater good. Ultimately, it’s all about him. That’s the way it always is with these guys.

That's my view. 

Speaking of Sports (Not Only for Sports Fans)

"Speaking of Sports" is the name used by the late Howard Cosell for his radio reports on the ABC Networks. Cosell was more than a sports reporter and analyst. He connected the world of sports with the world itself. He became a champion for boxing champion Muhammad Ali. Howard Cosell could be bombastic but also eloquent. He made sports about more than a game, a match, a bout, a contest. Cosell would remind us that sports and society are intertwined and that sport often leads the larger culture in social change. Jackie Robinson's entry into Major League Baseball preceded the civil rights act by almost two decades. Muhammad Ali brought the Vietnam War into sharp focus by his conscientious objection to serving. And the massacre of Israeli athletes at the 1972 Munich Olympics exposed the vulnerability of peaceful events to the tactics of terrorists.

Avid sports fans know well what Cosell was talking about when he extrapolated the world of sports and placed it in its larger role in international relations and domestic policy. The perpetrators of this month’s attacks in Paris chose a “friendly” football (soccer) match as one of the prime targets for their brutality. Sports at the highest level attract attention. Big events draw big audiences on television and in stadiums around the world. Watching great athletes is observing a form of artistry like no other. A LionelMessi goal from a seemingly impossible pass, LeBron James sinking a 25 foot bank shot while barely looking at the hoop, or Serena Williams hitting a down the line winner while running at full speed and off-balance, show us the fullest potential of physical achievement in a way that is satisfying and fun. To steal a phrase from ABC Sports of the late last century, “the human drama of athletic competition, the thrill of victory and the agony of defeat,” remind us that we are human, capable of greatness but always vulnerable.

Reports of cheating and corruption have tainted big time sports at the highest level. The NFL’s “Deflate Gate,” and FIFA’s top tier payoffs and charges of international bribery rightfully embarrass businesses that support the artistry of great athletes. And the cover-ups regarding concussions and more serious head injuries in gridiron football are a disgrace to that sport and the exploitation of athletes at its worst. Yet kids in America will put on helmets and strive to lead a team and throw a funny shaped “ball” with the accuracy and composure of Russell Wilson. Children around the world will lace up their cleats and play what we in the USA call “soccer” with hopes of running fast and striking the ball like Ronaldo or blocking shots with the reflexes of Hope Solo. These young dreams are real and joyful in ways impossible to explain to those who have not played at even the lowest level or who don’t appreciate the beauty of elite athletes at work.

As an ordinary sports fan who long ago gave up dreams of being the next Koufax or Clemente, I am hoping sports can once again lead the way. Our corrupt sporting institutions must purge themselves of exploitative liars whose main concern is their own enrichment. The illusion of fair play and concern for athletes has to be replaced by actual caring organizations that put the welfare of players before profits. With the world on edge and some politicians attempting to appeal to our worst instead of our best, sports can once again take a leading role in improving lives. The sports world can set an example of excellence with unselfish concern for those who provide uplifting moments on the field for those in the stands and beyond.

Real reform in big-time sports is unlikely anytime soon unless there are financial consequences for maintaining the status quo. But, the sports world has led the way before. So, there is hope. And as John Lennon put it, “You may say that I’m a dreamer, but I’m not the only one.”

Empathy in the Age of Facebook

Prior to the November 13^th terrorist attacks in Paris, I was thinking about how we interact on Facebook and other social media. Some “friends” share extremely personal details of their lives, everything from happy news of weddings and life cycle milestones to breakups, illnesses and deaths. Often, the response is a heartfelt “like” although liking bad news always seems a bit odd. Posts and responses about news--good and bad--are shared according to one’s privacy settings.

Because of today’s technology we are in touch with friends and contacts from decades ago; this makes the process even more intriguing. So when cataclysmic events shock and anger us, the responses and opinions shared can be both inspiring and terribly disturbing. We quickly learn—or have reinforced—who blames George W. Bush for getting us involved in Iraq or Barack Obama for getting us out. Sometimes, the vehemence of the comments is shocking and ridiculously personal. Questioning President Obama’s loyalty to the United States or his legal right to be president damages the questioner’s credibility even though it may endear him or her to like-minded followers. And those on the left who want to stifle all expression of views rooted in another time or born of  “white privilege” do a disservice because they prevent their more current and sometimes enlightened views from standing persuasively on their own merit. Banning speakers from universities is a disturbing trend. Those who spew hatred should not be invited. But differing political perspectives should not be grounds for bans. Remember, as Paulo Freire and others have pointed out, those subject to oppression can become oppressive themselves when they gain power.

Freedom of expression has always been a cherished value. So when I see comments at odds with my own views in response to my posts, I almost always let them stand. If there are factual errors I will point them out. In the words of U.S. Supreme Court Justice Lewis Powell, “Under the First Amendment there is no such thing a false idea. However pernicious an opinion may seem, we depend for its correction not on the conscience of judges and juries, but on the competition of other ideas. (Gertz vs. Robert Welch,1974).” And that’s the law of the land. False facts, on the other hand, deserve to be exposed and corrected.

So the question emerges, in the age of Facebook, do our differences become magnified while our ability to see others’ points of view diminishes? Can we really care about our “friends”, “like” the pictures they post of the new puppy or grandchild, but still respect them when they post political views sharply at odds with our own? More importantly, do we care? I ask the last question rhetorically and seriously. And my answer is that we should care. It’s too easy to write off a comment, with which we disagree or even find offensive, when the person making it is only real in our lives because we knew him or her decades ago. Ultimately, the root question is whether real dialogue can happen on social media. Or is it, to use the words of Stephen Stills, just a digital version of "carrying signs (that) mostly say hooray for our side (For What It's Worth, 1966)." If we only get our information from sources that reinforce our own views, we wind up in echo chambers and bubbles. So seek out different media. That is actually one of the best things about Facebook; if you have a diverse group of “friends” they will post from a range of media.

My hope is that on the grass roots level we can elevate the discourse and be empathetic about more than the tragedies and joys, personal and global, where it is easy to agree. Maybe our politicians could learn a few things. But having worked as a newsman for decades, I doubt the tone of political and cultural disagreements will change anytime soon. The challenge is for us to resist the crass and try to treat even those with whom we disagree with respect. But let’s agree that lies and falsehood are real enemies.

Brian Williams: Who knew and when did they know it?

Another thought on Brian Williams' recent apology for misstatements.

When I was running TV newsrooms I would often say that TV news is a team sport. Very little happens in a vacuum. Reporters don't get on the air without news photographers, engineers, editors, and producers. Brian Williams was not alone on that army helicopter in 2003. Others had to know, at different levels of the organization, that the version of events now in question was questionable. Very little happened in my newsroom without somebody "whispering in my ear" about what really happened out in the field. That's just the way it works. Another one of my adages: there are no secrets in newsrooms.

Brian Williams: Apology, memory, the fog of war or something else?

 
We learned this week that Brian Williams made misstatements about events in Iraq involving a downed US Army helicopter forced to land by enemy fire in 2003. Williams told audiences, on more than one occasion, that he was on that helicopter. Last night, on The NBC Nightly News, Williams apologized to the public and the soldiers on board the downed chopper. He told viewers he had not been on that aircraft. Instead, he was on a different helicopter, in the same group, that arrived on the ground later. He was moved to make the admission after a soldier who had been on the downed aircraft questioned Williams' version. But now, the pilot of the helicopter Williams was in says they did take small arms fire.  This may explain some inconsistencies in Williams' earlier statements.

Williams “explained” his earlier misstatements by saying he “conflated” what happened to his own chopper with the one that actually took heavier enemy fire and was forced to land. Blaming the fog of memory, he apologized and then spoke of his support and admiration for members of the military who do what they do.

So, at best, Williams has a flawed memory of memorable events confusing details that others who were there remember more clearly. At worst, he’s more interested in burnishing his own role and experience than reporting the truth. As more information emerges, viewers and the bosses at NBC will have to decide whether to give Williams the benefit of doubt or assume the worst.

Anchoring a television newscast is much more difficult than it looks. The ease with which good anchors do their jobs is an illusion. In large markets and at the network level, teams of writers, producers, engineers, technicians, and video craftsmen and women make it all work smoothly and seamlessly. The “talent” (that’s the person you see on the screen reading the news: The Anchor) has to be a good communicator and is usually physically attractive. Anchors earn huge sums of money for their work, millions of dollars a year for those at the top.

During times of crisis good anchors sometimes work for days at a time with little sleep. During the aftermath of 9/11, Tom Brokaw and Peter Jennings informed the nation with fine reporting and the ability to communicate clearly. They put events in context as the world watched in disbelief at what had happened in lower Manhattan, the Pentagon, and a field in Pennsylvania. Others anchored and reported responsibly and appropriately but Jennings and Brokaw stood out. They demonstrated to the nation and world why they were in such important positions by their professionalism during a frightening time. They helped us through those terrible days.

Given the importance of an anchorman or woman’s role, NBC will have to make some tough calls about Williams’ future. He is a talented man and by most accounts a good guy. And he’s very good at his job, at least he has been for most of his career. But can he recover and regain the trust of the public? It is critically important that viewers know the news is honestly reported and presented. More information will emerge as others who were with Williams come forward.

In the early days of network television news, Walter Cronkite was known as the “most trusted man in America.” Brian Williams will never rise to that level of esteem in the public’s eyes. Times have changed and audiences are much more fragmented. The question is can he win the trust of viewers who rely on him and his network for daily doses of news and for more in-depth reporting during times of crisis. He can do so only if there is an honest accounting of how and why his earlier misstatements were made and why they continued to be repeated until a soldier who was there when a chopper went down called out the anchorman by presenting the truth.