Bob Schwartz

Month: October, 2020

VOTE

Above is this week’s Time magazine cover, created by visionary artist Shepard Fairey—most famous for his Obama “HOPE” poster. It is the only time in its history that the magazine has replaced its name on the cover. (I’ve referenced Shepard’s work multiple times before: here, here and here)

He writes:

I’m honored to have created my third cover for Time magazine, especially since this issue focuses on the civic duty of voting. The art I created for the Time cover addresses the very unique situation we are in as a country as we face the Covid-19 pandemic, unrest around police brutality and racial discrimination, voter suppression, and intense political division. In this illustration, the normally clear-cut rebel symbol of a bandana covering a face takes on a different meaning during Covid, becoming an emblem of safety, respect for one’s fellow citizens, and a sign that the wearer believes in science. The image on the bandana, including the ballot box speaker, is part of a piece of art I created called “Our Hands – Our Future.” Even though the subject in the portrait knows there are additional challenges to democracy during a pandemic, she is determined to use her voice and power by voting. The future is not shaped by voting alone, but voting is crucial to make a healthy, functional democracy. In my opinion, those who claim to believe in democracy and ask for the honor to represent the people should be looking for ways to make voting easier, not more difficult. I’d like to see the implementation of an election holiday as well as secure electronic voting options. Until then, mail in your ballot or mask-up and head to the polls… the future of our democracy is in your hands!
-Shepard

We will be transforming life and work after the pandemic. But will we transform ourselves?

We have transformed the ways we live and work during the pandemic, like it or not. That forced transformation will be continuing for a while. In fact, it is now predicted that some of those changes, like work at home, will last long after they are needed for public health reasons.

There has also been talk about how this has transformed us personally, individually and in our relationships. There’s not much doubt that some of those changes involve psychological and emotional effects that are negative and unwelcome.

There is one more layer beneath all this. Pandemic or not, working at home or in the office, in touch in person or online, last March when it began or next March when it might be over, we are who we are, but more importantly, we can be who we can be. In the times, with all the outside transformations, we can be transformed inside. We can transform ourselves.

How? Why? In what ways? There are thousands of guides, from massive religious traditions to smaller philosophical and psychological practices to individual books and teachers.

This extreme moment, extreme in many ways, has given us an opportunity rarely seen. We can’t go back and we can’t stand still. So, paying the price of cataclysm, we might as well do a complete assessment of how things are and who we are. And make of it and ourselves what we can. It doesn’t look like it right now, but this might be paradise, if we are brave enough to be the ones who live there.

After accepting explanations as to why respected officials and ex-officials are standing on the election sideline, I—and history—are through with those excuses.

Here are a few of those who should come forward in these two weeks before the election. Whether it has any effect on the election we don’t know. It will certainly establish what history will want to know: which side of history were you on?

Former President George W. Bush: It is hard to know exactly what Bush 45 is telling himself as he remains silent in the face of a possible Trump re-election. He certainly doesn’t believe Trump is any good for the country. Maybe W believes his voice is not needed, and that in a post-Trump Republican Party, sane leaders who didn’t take sides will be needed. His confidence in a Trump defeat is misplaced. And in the event of a Trump victory, his name will be added to the list of those who should have spoken up but didn’t.

The Generals: The Generals, including those who have served in various civilian national security and intelligence positions, have often expressed a chain-of-command reluctance to speak out and oppose Trump’s re-election. That is, Trump is still the commander-in-chief, even if they are retired. Again, this may work on that basis, but only if they are willing to be on history’s very naughty list.

Dr. Anthony Fauci: Trump is now abusing Dr. Fauci every day, including misusing him in ads, censoring his media appearances, and just today calling him a “disaster,” who if we had listened to, would have cost us hundreds of thousands additional lives. All of that unfortunate, since without Dr. Fauci, most Americans would have no one to trust in the administration. Dr. Fauci has been at his important national work for decades, and no doubt thinks that he can do more on the inside, even if minimized and abused, than on the outside. So he walks a tightrope, issuing measured responses that keep him on the job.

Dr. Fauci is wrong. Other than his huge public respect, he is not being listened to anyway within the administration. Whether he resigns or responds in a way that demands firing, his departure will end the Trump administration. And, in the event of a new administration, one of the first things to happen will be Dr. Fauci hired back in his old position at NIH, where he will actually be listened to and do the good he obviously can.

How crazy is Donald Trump, really?

Note: I recognize that “crazy” is a non-clinical and unprofessional description. But this isn’t a clinical or professional observation; it’s a creative one.

Donald Trump believes he is Superman. Literally, not figuratively. We had a good sardonic laugh when we learned he actually considered revealing a Superman shirt beneath his suit on the White House balcony when he returned from the hospital. But that wasn’t a joke.

Professionals have been weighing in on his mental health for four years, using whatever diagnostic evidence was available. And there was plenty of it. Then his niece Mary Trump, a respectable clinician, used her decades of first-hand experience to reach her conclusion that he continues to suffer from lifelong pathologies.

For me, the event that finally tied it all together was the news from Trump’s ally Chris Christie. Trump’s Covid irresponsibility led directly to Christie’s infection and weeklong ICU hospitalization. Christie could have died.

Then I realized, based on reasonable surmise and absent any medical details from Trump, that he might have died too. But he wasn’t afraid, or pretended not to be, because he couldn’t die from Covid. Because he is invulnerable. He is Superman.

This explains why he says he is superlative in every way. Just yesterday, asked in his town hall what improvements he would make in a second term, he said there were no possible improvements, because he had already done the best job possible.

If a patient walked into a psychiatrist’s office and earnestly claimed to be Superman, treatment would be recommended. And if the patient was in a position to harm himself or others, treatment might be demanded. When a man walks into the White House, ready to reveal his true identity as Superman, what exactly is the treatment?

Does the pandemic ask us and allow us to question everything? (John Lennon edition)

I am sorry to say that I missed noting what would have been John Lennon’s 80th birthday on October 9. It should have been a bigger deal for me and the world, but we were apparently otherwise occupied.

Apart from what we believe in, there is reason to suggest that we are better off believing in somethings. But what those things are is a big question hanging over our individual and shared lives.

Loss and crisis are circumstances that prompt us to question our beliefs. Loss and crisis is the definition of this pandemic, in America and around the world.

It is more than okay to question and to doubt in these times. It is natural and necessary. But the questioning and doubt should not be free-floating. Find some tools to help you through the questioning and doubts. Just be careful not to confuse those helpful tools with answers. Digging is not about the shovel. It is about whatever you discover.

The song God was released in 1970 on Lennon’s first solo album. Happy birthday, John.


God

God is a concept by which we measure our pain
I’ll say it again
God is a concept by which we measure our pain

I don’t believe in magic
I don’t believe in I-Ching
I don’t believe in Bible
I don’t believe in Tarot
I don’t believe in Hitler
I don’t believe in Jesus
I don’t believe in Kennedy
I don’t believe in Buddha
I don’t believe in Mantra
I don’t believe in Gita
I don’t believe in Yoga
I don’t believe in Kings
I don’t believe in Elvis
I don’t believe in Zimmerman
I don’t believe in Beatles

I just believe in me, Yoko and me, and that’s reality

The dream is over
What can I say?
The dream is over
Yesterday
I was the dreamweaver
But now I’m reborn
I was the walrus
But now I’m John
And so, dear friends,
You’ll just have to carry on
The dream is over

Pandemic America: The never implemented October Plan in October

In July, leading public health expert Dr. Peter Hotez proposed a national plan that would allow America to begin a safer and more open life by October 1.

Within a few weeks [August], we will reach the awful milestone of 100,000 new COVID19 cases per day, next 225,000 deaths by October 30, and possibly 300,000 deaths by the end of 2020. However, it is not too late to chart a different course. By October 1, we could safely reopen our schools, colleges, and businesses. Potentially we could even launch a college football season or the NFL?

It appears that the projection of 225,000 deaths by October 30 was accurate. Today, 36 states have increasing cases, while none have fewer. Schools, colleges, businesses, college football, NFL? Some moving forward, some limping along, some still at a standstill.

Is it too late to start a plan targeted to October 1 in mid-October? Any science-based national plan would be better than none, anytime. Is it likely we will have a national plan anytime soon? If you are an American or an America-watcher, you know the answer. Will there be 300,000 dead by the end of the year? At least.

For what it’s worth, below is a rerun of Dr. Hotez’s plan.


COVID19 in America: An October Plan

Within a few weeks, we will reach the awful milestone of 100,000 new COVID19 cases per day, next 225,000 deaths by October 30, and possibly 300,000 deaths by the end of 2020. However, it is not too late to chart a different course. By October 1, we could safely reopen our schools, colleges, and businesses. Potentially we could even launch a college football season or the NFL?

Our homeland security threat

COVID19 has gone beyond dangerous levels in America. We just surpassed 65,000 new cases per day, and I estimate that currently one-quarter of all the world’s COVID19 cases now occur in the Southern US. Soon we will reach Dr. Anthony Fauci’s projected apocalyptic benchmark of 100,000 new cases per day (https://www.nytimes.com/2020/06/30/us/politics/fauci-coronavirus.html). In addition, we are experiencing dramatic increases in hospitalizations and ICU admissions across the southern half of the United States, and as predicted, the number of deaths has spiked. The University of Washington just estimated that 225,000 Americans will die by October 30 (https://covid19.healthdata.org/united-states-of-america), and potentially that number could reach close to 300,000 by the end of 2020. To place that number in perspective the terrible 1918 influenza pandemic that lasted until 2020 (or some say 2022) caused 675,000 deaths in the US (https://www.cdc.gov/flu/pandemic-resources/1918-pandemic-h1n1.html). This COVID19 public health impact does not include the many “recovered” patients with long-lasting disabilities resulting from virus injury to their lungs, vascular system, and heart, as well as potentially long-term neurologic and cognitive deficits.

Soon, practically every American will personally know someone who has gotten very sick or hospitalized with COVID19.

Still another aspect is my concern that low-income neighborhoods across the South – where social distancing is often more difficult and essential workers must physically be in their place of employment – are now being decimated. COVID19 is a health disparity, and LatinX, African American, and Native American people are pouring into emergency rooms, hospitals, and ICUs. For me this is the most heart-wrenching aspect of COVID19 and a reason I speak out.

It is more than public health

Beyond the dire public health impact of the 2020 COVID19 epidemic in America are the socioeconomic effects. The impact on jobs and the economy has been well-reported, but equally important is the fact that now millions of Americans feel unsafe. Many of us are fearful of leaving our homes or having our children in school. It is also impossible to imagine how schools can be considered safe in areas of the country where virus transmission is accelerating. Within a few weeks of opening schools in the South, teachers, staff, bus drivers, parents will become ill, and require hospitalization. School staffs will become demoralized, and schools will again close. In time, a collective feeling of futility and hopelessness will become pervasive. Our nation will be left vulnerable due to internal unrest, cybersecurity attacks, and more, as COVID19 transitions to a homeland security threat.

We do not have to live this way

Adding to America’s frustration is the knowledge that many European and other nations are now returning to normalcy in the aftermath of their springtime COVID19 epidemic. Transmission is way down, allowing schools and colleges to reopen safely, while people return to work and enjoy cafes (https://www.bbc.com/news/world-europe-52935145), and restaurants.

What went so terribly wrong?

Why did Europe successfully emerge from its COVID19 epidemic while America still struggles and even faces a much larger threat in the coming weeks and months?

The successful nations implemented a national plan and roadmap with a target date and target goals of reaching defined levels of virus containment.

There are different metrics used to define containment. For some it means, one prevalent COVID19 infection per million residents (http://www.healthdata.org/sites/default/files/files/Projects/COVID/Estimation_update_041720.pdf). For others, one new case per million residents per day. Under these circumstances, public health measures, including testing, contact tracing, syndromic surveillance, and effective public health communication can would prevent a resurgence.

In contrast, the US never really had a federal plan and roadmap. There was no federal directive or visible champion for implementing a national strategy. In its place, our federal government ceded control to the states. It forced the states to make its own decisions, while the US government provided important FEMA and other support, including ventilators, protective equipment, and supply chain management.

This approach was doomed to fail from the beginning:

  • Many states did not have the epidemiologic knowledge and models to make informed decisions about when it is safe to loosen social distancing and other measures.
  • States lacked detailed information about the impact of selected measures on the projected number of cases, ICU admissions and deaths.
  • Back in April (and still today) Governors were under intense political pressures to make decisions that go against public health recommendations.
  • They needed the cover of the federal government, especially the CDC, to say to lawmakers, “look I hear what you are saying, but the CDC tells me if I don’t do this or that, thousands of people will die in our state”. I believe those conversations rarely happened.

The result was predictable: A fragmented, arbitrary, and broken COVID19 response.

The consequence: The US is the epicenter of the global COVID19 pandemic, and we will maintain this status in the future.

In the current trajectory, COVID19 will only get much worse as we head into the fall and winter. Compounding our epidemic is the likelihood that season influenza will soon return, and we could see another measles resurgence given the decline in vaccination rates (https://www.cdc.gov/mmwr/volumes/69/wr/mm6919e2.htm).

The default is that we might soon endure the greatest public health catastrophe in the history of the United States over the last hundred years.

The Fix: A New National Plan

We have an option. Through federal leadership and guidance, we could bring our entire nation towards a level of containment sufficient to safely open schools, colleges, and even host sporting events. We could return Americans safely to the workplace.

To do this by October 1 we now need to do the following:

  • Shape a national plan with an objective of a national level of containment.
  • Some experts benchmark containment as one case per million residents per day, but we might select less strict criteria.
  • Upon achieving this level, it would be possible to reopen schools, colleges, and businesses safely, provided a full and functioning health system is in place.
  • With containment, contact tracing actually becomes feasible, whereas this is not the case currently across most of the nation.
  • Each state would either agree or be required to meet that containment benchmark.
  • Some of these states, such as those in northern New England (NH VT ME) might already be close to that level. Others, such as FL TX AZ may require aggressive stay-at-home measures.
  • Starting October 1, we could begin a national re-opening for schools, colleges, and even outdoor high school (“Friday Night Lights”), collegiate and professional sports.

We have few choices

Doing nothing or continuing a strategy based on states in the lead will only invite further tragedy. By late in the fall every American will personally know someone who is severely ill or hospitalized with COVID19. Hospitals across America will be overrun, hospital personnel will become sick in droves, and we might experience 300,000 deaths by the end of 2020. Moreover, we won’t have a safe and effective COVID19 vaccine anytime soon. My earliest timetable is the middle of 2021, and even then, that timeframe would be a world land speed record.

This will become one of the most unstable times in the history in the United States.

Implementing the October 1 plan will force America to make some difficult choices, but none as devastating as the mounting deaths if we choose to simply stay the course.

Peter Hotez MD PhD is Professor of Pediatrics and Molecular Virology & Microbiology, and Dean of the National School of Tropical Medicine at Baylor College of Medicine where he is also Co-Director of the Texas Children’s Center for Vaccine Development.

Is America’s pandemic failure based on its religiosity?

There are two obstacles to finding a single factor to explain something as substantial as America’s catastrophic failure to effectively respond to the pandemic. Situations like this are complex. And what you find may be a correlate and not a cause.

Still, I thought I might look at the ways America is distinctly different than all the rest of the developed world. A first place I looked was education, believing that some degree of critical thinking is needed to sort through the scientific analysis and recommendations. While America does not lead the world in the education of its students, it is far from the bottom.

I did, however, find one way that America is “exceptional.” According to the Pew Research Center, “Americans are far more religious than adults in other wealthy nations.”:

In fact, Americans pray more often, are more likely to attend weekly religious services and ascribe higher importance to faith in their lives than adults in other wealthy, Western democracies, such as Canada, Australia and most European states, according to a recent Pew Research Center study.

For instance, more than half of American adults (55%) say they pray daily, compared with 25% in Canada, 18% in Australia and 6% in Great Britain. (The average European country stands at 22%.) Actually, when it comes to their prayer habits, Americans are more like people in many poorer, developing nations – including South Africa (52%), Bangladesh (57%) and Bolivia (56%) – than people in richer countries.

As it turns out, the U.S. is the only country out of 102 examined in the study that has higher-than-average levels of both prayer and wealth. In every other country surveyed with a gross domestic product of more than $30,000 per person, fewer than 40% of adults say they pray every day.

It is possible that this is merely a correlate of other attitudes having more to do with the pandemic response. But it does make sense. By the testimony of many Trump supporters, God answered their prayers by anointing a leader who would take care of the inequities that liberal progress inflicted on a once great nation. This latest infliction, in the form of a global virus, even if real, was merely another piece of the plan, one that the anointed one would vanquish.

Trump and the Twenty-Fifth Amendment

Ratified in 1967, in the wake of the JFK assassination, the Twenty-Fifth Amendment of the Constitution concerns the orderly way to deal with a president unable to carry out his duties.

There have for a while been discussions of whether the current president is mentally fit for office. This week, as he evidences the psychological effects of steroid therapy, of Covid, and of political stress, the question is more focused than ever.

By coincidence, this week sees the publication of Unable: The Law, Politics, and Limits of Section 4 of the Twenty-Fifth Amendment by Michigan State law professor Brian C. Kalt.

The long and complex Section 4 reads:

Whenever the Vice President and a majority of either the principal officers of the executive departments or of such other body as Congress may by law provide, transmit to the President pro tempore of the Senate and the Speaker of the House of Representatives their written declaration that the President is unable to discharge the powers and duties of his office, the Vice President shall immediately assume the powers and duties of the office as Acting President.

Thereafter, when the President transmits to the President pro tempore of the Senate and the Speaker of the House of Representatives his written declaration that no inability exists, he shall resume the powers and duties of his office unless the Vice President and a majority of either the principal officers of the executive department or of such other body as Congress may by law provide, transmit within four days to the President pro tempore of the Senate and the Speaker of the House of Representatives their written declaration that the President is unable to discharge the powers and duties of his office. Thereupon Congress shall decide the issue, assembling within forty-eight hours for that purpose if not in session. If the Congress, within twenty-one days after receipt of the latter written declaration, or, if Congress is not in session, within twenty-one days after Congress is required to assemble, determines by two-thirds vote of both Houses that the President is unable to discharge the powers and duties of his office, the Vice President shall continue to discharge the same as Acting President; otherwise, the President shall resume the powers and duties of his office.

This has never been invoked and there is no litigation on what it means or how it works. Two things are clear.

The phrase “unable to discharge the powers and duties of his office” (written in 1967, before the drafters understood that it made complete sense to neutrally say “the office” or “their office”) is open to interpretation. What does “unable” mean in this context?

The process is intended to be careful and onerous. It is not a judgment to be made lightly. The decision is spread among a large number of people, so the judgment of even the most partisan or least aware would be overweighed by the prudent and patriotic.

In the present case, even if Trump is mentally unfit, the chance that the amendment would successfully be invoked and applied is very small—even if his psychological condition continues to worsen.

In the future, who knows what becomes of the amendment? Maybe, with the current experience, it will be revised to include mental unfitness. And while they are at it, maybe they can implicitly acknowledge the possibility that the president might not be a “he.”

VP Debate: The Jewish Moment

The most fascinating moment of the VP debate—aside from The Fly—was VP Pence defending Trump on charges that he refused to denounce and encouraged white supremacists and Neo-Nazis:

“President Trump has Jewish grandchildren. His daughter and son-in-law are Jewish.”

We haven’t heard much of this defense before. It is delicate. It sounds too much like “some of my best friends are…”, only more so.

Like Trump, this line is disabled in so many ways that it is hard to know where to begin.

Identifying or practicing as a Jew doesn’t mean you are not intolerant, bigoted or morally challenged. That is not a criticism of the tradition, just a fact of life. I’ve made clear in previous posts that a number of people involved in the administration’s most debased policies are Jewish, at least by affinity. I’ve directly asked where their rabbis are in all this, and a while ago, Stephen Miller’s past rabbi—the man who bar mitzvahed him—publicly took his former congregant to task.

If it’s true that being Jewish is no defense, then the associative principle of only having Jewish relatives is even weaker.

Then there is the question of Trump’s frequently claimed faith. He is obviously faithless, just yesterday bizarrely claiming that his getting the virus was “a blessing from God.” Besides this being a facet of his possible psychosis and Messiah complex, any time a religious tradition is used in supportive reference to Trump, you can be sure it is hypocritical.

Also, there is a thought that Trump himself is actually anti-Semitic. We know without question that his father was, and a number of the recent revelations about the president, including the book by his niece, confirm that Trump himself is. Which not only makes Pence’s defense strange, but raises even stranger questions about what Trump actually thinks about his Jewish daughter, son-in-law and grandchildren.

A final twisted aspect, probably bafflingly intentional, is that Kamala Harris is not Jewish, but is married to a Jewish man and has Jewish stepchildren. See, she is just like Trump and can’t criticize him! Or something like that.

We would all be better off never having to again hear that line from Pence or any other Trump defenders. Those of us in the tradition would be better off, too, as would Judaism.

Bigger Than Life (1956): A classic film about steroid-induced psychosis and delusions of grandeur

Nicholas Ray is the celebrated and iconoclastic director of movies such as Rebel Without a Cause. His film Bigger Than Life (1956) is unusual, even for him.

In the late 1950s, steroids were a new and experimental therapy. Some of the known side effects—side effects that are still an issue decades later—were the basis for the movie. A synopsis from AFI (emphasis added):

Schoolteacher Ed Avery is a devoted family man who moonlights as a cab dispatcher to support his wife Lou and young son Richie. When Ed begins to experience excruciating pains pulsing throughout his body, he tries to hide his condition from Lou until one night, after a bridge game, he collapses in agony. Upon learning that Ed has been enduring these spasms for months, his physician, Dr. Norton, calls in a specialist, Dr. Ruric, who puts Ed through a battery of tests that reveal that he is afflicted with a rare, deadly blood disease.

When Ruric concludes that Ed’s only hope lies in taking the experimental drug cortisone, Ed begins treatment under hospital supervision. Several weeks later, Ed is released from the hospital, and Norton cautions him that his drug dosage needs to be closely monitored and that he should immediately report any unusual symptoms. On his first day home, Ed ebulliently ushers Lou to an expensive dress store and insists that she purchase two frocks they can ill afford. When Ed begins to experience drastic mood swings that veer from manic depression to delusions of grandiosity, Lou suggests that he consult Norton, but he protests that he cannot afford to be sick again and begins to increase his dosage of cortisone.

At a PTA meeting, Ed deliberately insults both the parents and their children, causing his good friend, gym teacher Wally Gibbs, to become concerned. When Wally visits Lou to tell her about her husband’s strange behavior, Ed makes a snide remark about Wally’s interest in Lou, then declares that he is tired of petty domesticity and his marriage. After telling Lou that she is his intellectual inferior, Ed relents and agrees to stay married for the sake of his son.

Having consumed his entire prescription of cortisone, Ed poses as a doctor and forges a new prescription at a drug store. While playing football with Richie, Ed pushes the boy beyond his endurance, frightening Lou. Soon after, Wally shows Lou an article describing psychosis as a complication of cortisone consumption, but Lou fears that Ed will die without the drug. As Ed’s condition deteriorates, he continues to torment Richie, browbeating him about mathematical problems late into the night and driving him to tears. At dinner, Ed launches into a paranoid rant against Lou.

Desperate to stop his father from taking more pills, Richie raids the medicine cabinet, but Ed catches him and calls him a thief. As Richie cowers in his bedroom, Lou phones Wally for help, but is forced to leave a message because he is not at home. Decreeing that Richie considers himself above the law, Ed reads a passage in the Bible about Abraham sacrificing his son Isaac. When Lou begs Ed to spare Richie, he declares that they will all die together.

After Lou tries to stall Ed, he locks her in a closet, turns up the volume on the television set and then charges up the stairs to Richie’s room, scissors in hand. When Ed begins to hallucinate, Richie slips out the door just as Wally bursts into the house and wrests the scissors from Ed’s hands. After Wally knocks Ed unconscious, Lou phones the doctor, who heavily sedates Ed in the hospital.

Explaining that Ed is suffering from a psychosis induced by an overdose of cortisone, Norton warns that he may never return to normal. After stating that Ed will recover only if he remembers what has happened, Norton agrees to allow Lou to see her husband. In his hospital room, Ed awakens, disoriented, but soon recognizes Lou and Richie, and recalling the disastrous events of recent weeks, gratefully embraces his family.

If you know anyone, personally or publicly, who is being treated with powerful steroids, please watch out for any signs of psychosis and delusions of grandeur.