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By the Speaker of the House of Representatives, that is. Did you see the interview with the good Speaker Pelosi? The normally placid environment (that solid wooden table!) is not so placid with said guest visiting. Petty to note, perhaps, but I felt as if I were watching a performance, and the performer was a nervous and jittery one.

Anyway, judge the quality of the interview for yourselves. Here are a few choice excerpts from the transcript at Real Clear Politics:

Pelosi: “People are more optimistic outside of Washington D.C. than they are inside of Washington. They want to — they want to be sure that we stick to our path which is to take us out of this economic challenge and not be afraid to do so” – What?

Pelosi: “When the president began and he said that he called for swift, bold action now. And the public responded to it in a very positive way. And he said in a very shall we say professorial way, but also inspirational way, we will harness the sun and the wind and the soil to fuel our cars and run our factories, and we’ll invest in science, have better healthcare innovation and schools for the 21st century.” – What?

Pelosi: “Universal healthcare. It’s a place where we are recognizing the damage to our planet by decision that said we have made that we need to reverse. It’s a place where we have to go — we had the industrial revolution, we have the technological revolution. Now we have to have a green revolution.” – What?

Pelosi: “I think there is a realization among all people that all the things we want to do, we need to think in public private — public, public, all different kinds of different combinations on how we get them done, so we can leverage our dollars in a safe way, but leverage our dollars so we get more than just the appropriate dollars.” – What does that even mean?

I could go on and on. What do you suppose she’s saying?

SUPER-DUPER MASSIVE AND IMPORTANT UPDATE: I screwed up – the link is to the 2010 Rose interview that I recently watched, while the excerpts are from the 2009 interview. I honestly did not pick up on that while reading the transcript, obviously. In my defense, here’s an excerpt from the correct transcript:

“It’s so historic. It’s so exhilarating to be part of
history that each one of us in the Congress is on the brink of making
history. This is Social Security, Medicare, health care for all Americans.
So it is its own — it has its own encouragement to it. ”

“It has its own encouragment to it.” Well, there you go. Make fun of me and my faulty memory, and her statement, in the comments. Or just me. Whatever.

Zooey Deschanel has a kind of classic Thirties, Old Hollywood, comedic actress vibe – that is still, somehow, very modern….
 
This is a sweet video and song.
 
 

1. It’s worth reiterating something Rich and Jeff Anderson have pointed out: The focus on reconciliation in the past few days confuses things a bit. The question in the health-care debate at the moment is whether Nancy Pelosi can get enough of her members to vote for the version of Obamacare that passed the Senate late last year. If the House passes that bill, it will have passed both houses, will go to the president, and will become law. – Yuval Levin, NRO

2. So if, in the end, this process works as the White House wants it to work, it will do so because of core Democratic and liberal beliefs. Republicans and conservatives need to understand that; the political horror faced by every Democrat who does not have an entirely safe seat can be mitigated in part by the belief that there may be enough Democrats who can live their lives proud to have brought this measure to fruition. – John Podhoretz, Commentary

Obama health care plan online. (Relax. It’s a joke. Or, is it?)

The image is by editorial cartoonist Winsor McCay and I came across the image at the wonderful art blog linesandcolors.

Update: In the comments, Michael Kennedy adds: “CBO says there are not enough details to score the new “bill.” What else is new?”

Yes. What else is new? Also, this via Drudge: “An unapologetic Danny Williams says he was aware his trip to the United States for heart surgery earlier this month would spark outcry, but he concluded his personal health trumped any public fallout over the controversial decision….This was my heart, my choice and my health,” Williams said late Monday from his condominium in Sarasota, Fla.”

Be aware: If the health care plans don’t work as smoothly as gamed by the white paper crowd, the connected will exempt themselves from the worst of it. They always do. Do Senators tend to fly coach?

“The small bill aims to make health insurance more accessible, affordable, and portable — without increasing government control, jeopardizing the quality of care, or breaking the bank” Small-Bill Proposal for Sensible Health-Care Reform

“We have to learn to do health care in fundamentally new ways in the next twenty years. The changes needed are much more radical and sweeping than anything envisioned in the current legislation — and it will take a very different mindset to make them happen. The current bill is a classic example of steady state, blue social model thinking: it is more interested in keeping the status quo going by pumping more money into it than it is in the basic restructuring needed to build a system that will work in the future.” Walter Russell Mead

The latter excerpt (thanks to LG for the link) highlights, in a way, the frustration I experience practicing in a teaching hospital. It’s all chasing state and federal dollars and arguing reimbursement rates. Well, naturally. But the really innovative things that we could do? Who, exactly, is doing them stateside? The “cash-only” doc drop-outs? Walmart, Walgreens and CVS clinics? Concierge practices and out-sourced medical diagnostics? I suppose government regulation makes it impossible to be innovative in the most radical way.

Seriously, I am so in the weeds with the day-to-day – just crushed by it – that I have no idea. We should be thinking innovation and nimbleness, and instead, our thinking is staid, staid, statist-ly staid. Because the Walter Russell Mead post makes the point that technology is going to throw the medical profession for a loop, and I think we are not ready to absorb those changes as a profession. Despite all the academic blather (because of ?), we are not ready.

What do you think are the important health care trends the current national “discussion” is missing?

There are not enough words to describe my mad love for this Chicago band. And, her voice! A pure instrument. Wait for it, wait for the last ten seconds or so….

“When gunmen attacked 10 sites in Mumbai in November 2008, including two five-star hotels and a train station, Mumbai resident Kumar Verma sat at home glued to the television, feeling outraged and unsafe.” – Rama Lakshmi, Washington Post

I have no idea if the above is an oddity reported as a trend, or, in fact, is a trend. Interesting story either way. (Link thanks to commenter “elf”)

Update: Belated thanks for the link, Instapundit!

Watched Charlie Rose last night. He and some of his guests were discussing President Obama’s political fortunes – post a Scott Brown victory – and what the President might do in order to reverse the downward trend. To give you a flavor of the conversation, I present the following excerpts from the transcript:

“CHARLIE ROSE: Joining me now, Jon Meacham, editor of “Newsweek”
magazine, in Washington, Tom DeFrank of the “New York Daily News,” and Anne
Kornblut of “The Washington Post.” I’m pleased to have all of them here as
we take a look at this week, which is important for the president, and a
state of the union which is very important to him.”….

JON MEACHAM: “Well, he has clearly found that history is a more
complicated matter than the speechifying and the glamour, really, of the
campaign…..

ANNE KORNBLUT: “I guess it’s confusing to me why it’s so difficult for
them to show what his emotions are. All of us who have been around him or
covered the campaign know he isn’t a robot. He actually does have emotions
and a family he cares about, and he’s extremely good at talking about the
feelings he felt growing up in extraordinary circumstances.” ….

Seriously, the entire transcript and conversation are like that: He’s misunderstood, he’s misrepresented, he’s under appreciated for all that he has done! What?

- “The Taliban launched their initial attack into Arghandab in October 2007, after the natural death of Mullah Naqib. This assault marked the beginning of an intense campaign to erode the will of the population in Arghandab to resist Taliban control.

The Taliban gained control of Arghandab by using targeted violence to intimidate local leaders, supplemented with an intimidation campaign and the implementation of a judicial system to increase the Taliban’s legitimacy.”

- “The Dahla Dam and irrigation system, located in the heart of the province of Kandahar, is Afghanistan’s second largest dam. Eighty percent of Kandahar’s population lives along the irrigation system. Since it was built in the 1950s, years of disrepair have left the dam and irrigation system functioning at reduced capacity.”

- “The Kunar Provincial Reconstruction Team visited the Kunar Prison construction site Jan. 14 to conduct a quality assurance check and address security issues.

PRT leaders and engineers met with Afghan National Police representatives and the construction site engineer and foreman to discuss the progress on the prison.”

- “As U.S. Defense Secretary Robert Gates is visiting Pakistan for the first time in three years to encourage greater cooperation between Washington and Islamabad and ask what the country’s plans are for a possible military offensive against extremists in the tribal region of North Waziristan, a Pakistani Army spokesman said any action there would not happen in the next 12 months, citing the Pakistani government’s desire to consolidate current gains.”

- “Images from the most-talked about place of 2009.“

The above is from Herta Muller’s novel, The Appointment. We’ve talked previously about Muller (2009 winner of the Nobel Prize in literature) here and here.

The words are brisk, painful almost, when spoken aloud. Speak them: I’ve been summoned. Thursday, at ten sharp. A young woman working in a factory in communist Romania has been sewing notes into the trouser linings of men’s suits – suits that are to be sent to Italy. She is looking for a “Marcello”:

After the business with the first notes, I put Italy out of my mind completely. It took more than linen suits for export to land a Marcello, you needed connections, couriers, and intermediaries, not trouser pockets. Instead of an Italian I landed the Major.

Major Albu has summoned the young woman, at ten sharp, to be interrogated about her conduct. She has been ratted out by another factory worker – a man she has rejected romantically. For this “crime” (wanting to escape the dictatorship by marrying a mythical Italian “Marcello”), her life is completely shattered. Or rather, the shattering is accelerated because the world was never whole to begin with. Freedom is approximated only, and in short bursts, while riding on the back of her boyfriend’s motorcycle: Once or twice a week we’d go for a ride out of town, to the river. The lane through the beanfields – now that was happiness, good fortune, luck. The bigger the sky grew overhead, the more light-headed I felt.

The novel takes place on a tram ride to the interrogation. As she rides, the main character thinks about her past, her present, her future, all in a fragmented and non-linear dream-state. The writing is intense, vivid, impressionistic. It approaches prose poetry in some sections, and yet, the poetic elements seem utterly corrupted: how dare we extract beauty from such evil!

Fellow Chicago Boyz contributor TM Lutas has said that Herta Muller’s novels will be difficult to read. And this novel is hard to read – it meanders, it pokes, it cuts, it stings. The very pages bleed.

*How is it that such an ideology took hold of the imagination of some Western intellectuals? I can never understand it. And, speaking of capturing the imagination, is anyone familiar with the following project? I stumbled across it during one of my internet rambles:

With these failures in mind, Hamilton attempts to explain the wide acceptance of Marxist claims throughout the 20th century. The answer, he says, lies not in the theory itself, but in the way it is disseminated as people vouch for it, political parties adopt it, and academics and journalists embrace it. Hamilton draws on social psychology, conformity studies, and theories of cognitive dissonance to explain this persistence. – The Marxist Rhetoric: On the Relationship of Practice and Theory, Richard Hamilton (Mershon Center for International Security Studies)

A commenter at the Guardian (!) on the recently passed Senate Health Care bill. The entire thread is worth reading, particularly for her comments:

Maybe I’ll cash in by starting my own insurance company. “Jennifer’s House of Health Insurance and Vintage Clothing.” The premium will be a flat $100 per person per year, with a five-million-dollar deductible. “But Jennifer!” you might protest. “If I have enough money to pay five million dollars a year in health costs, what the hell use is your insurance company to me?”

Read the rest of this entry »

“One of Irina’s grandsons, nicknamed Riri, was sent to her at Christmas. His mother was going into hospital, but nobody told him that. The real cause of his visit was that since Irina had become a widow her children worried about her being alone. The children, as Irina would call them forever, were married and in their thirties and forties. They did not think they were like other people, because their father had been a powerful old man. He was a Swiss writer, Richard Notte. They carried his reputation and the memory of his puritan equity like an immense jar filled with water of which they had been told not to spill a drop.” – from the short story Irina, by Mavis Gallant (Paris Stories collection)

Paris Stories is a beautiful collection. The short story Irina has the most vivid sense of place – it’s all a feeling of hushed, chilled, snowy air outside, and the quiet of an apartment unused to children inside:

“At half past four, when the windows were as black as the sky in the painting of tulips and began to reflect the lamps in a disturbing sort of way, they drew the curtains and had tea around the table. They pushed Riri’s books and belongings to one side and spread a cross-stitched tablecloth. Riri had hot chocolate, a croissant left from breakfast and warmed in the oven….”

And now, Urban Sketchers:

The above drawing – by Cathy Gatland – is from the website, Urban Sketchers. Urban Sketchers is one of the most interesting sites I have encountered this year. It’s a group blog for people who draw, and they draw, charmingly, what they see: The city life around them! It’s dizzying, the talent on display.

I love teaching lecture courses, but then, when I was a student, I loved taking lecture courses. I was a sucker for lectures from my first day of college, because I was already infatuated with the beauty of words, and a good lecture is nothing if not an art form. Efficient communication it may be, but a lecture can no more be reduced to the delivery of information than a Ferrari can be reduced to fuel injection. A lecture aims at imparting not just what is true but what is beautiful.

But, when it comes to craft and polish, seminars cannot compete with lectures. Nor can they compete with the challenge of keeping an audience’s attention. Meet them halfway, and today’s students will turn off their iPhones and pay attention. – Minding the Campus (via Arts and Letters Daily)

I agree: a well-delivered lecture is a beautiful thing. It’s still a useful tool for disseminating information. Old-fashioned person that I am (and, quite frankly, as a ham that loves to perform) I don’t understand the beating the form takes in educational circles. So faddish, sometimes.

Update: I should have been more clear in my original post. I don’t think lectures superior to seminars, or labs, or on-line courses, or whatever. My introduction to medical school pedagogy – which is very, very recent – has confused me, a bit. Lectures seem a reasonable way to teach groups of students in certain circumstances. I don’t understand the need to make everything everywhere the same because of the latest paper. I am, however, new to the area and may be misunderstanding an awful lot. Pile on in comments if you think that I am!

The Obama administration and congressional Democrats long ago gave up any pretense of working to rationally reform American health care. The exercise now underway in the Senate is a mad dash to get to 60 votes, and nothing more. That’s why some Democratic senators who had no idea exactly what is in the “breakthrough deal” announced by majority leader Harry Reid last week immediately hailed it as a milestone. They’re for anything that creates a sense of “momentum” and “inevitability.” - The Weekly Standard

I’ve given up trying to understand what is going on with the Health Care Bills. The complexity is a feature not a bug for some….

Update: As the commenters remind me, rightly, the sausage-making is never pleasant to watch. I guess I’m expressing frustration. I am trying to be a good citizen and doctor. I just don’t understand the stuff even as I try. Ugh.

Another Update: Commenter Marty writes, “All the talk about mandated coverage, community rating, Medicare buy-in, ‘is it a tax?’ and all the rest is just the topic du jour as the Dems try to glue wings on this dead bird and then pretend it can fly.” (I edited, for clarity, the first update above).

Fellow, sometime-and-in-some-fashion, academics or others dabbling in paper writing?

Dixon looked out of the window at the fields wheeling past, bright green after a wet April. It wasn’t the double-exposure effect of the last half-minute’s talk that had dumbfounded him, for such incidents formed the staple material of Welch colloquies; it was the prospect of reciting the title of the article he’d written. It was a perfect title, in that it crystallized the article’s niggling mindlessness, its funereal parade of yawn-enforcing facts, the pseudo-light it threw upon non-problems. Dixon had read, or begun to read, dozens like it, but his own seemed worse than most in its air of being convinced of its own usefulness and significance. ‘In considering this strangely neglected topic,’ it began. This what neglected topic? This strangely what topic? This strangely neglected what? His thinking all this without having defiled and set fire to the typescript only made him appear to himself as more of a hypocrite and fool. ‘Let’s see,’ he echoed Welch in a pretended effort of memory: ‘oh yes; The Economic Influence of the Developments in Shipbuilding Techniques, 1450 to 1485…’

Lucky Jim, by Kingsley Amis.

I never tire of this book – it’s one of my favorites – even as I pretty much dislike the main character and the object of his affection, the tepid and colorless Christine. What are your favorite campus, or academic, satires?

Update: David Foster and Jim Bennett, in the comments section, both voice the same thought I had on re-reading the above excerpt: an article on the economic impact of shipbuilding techniques sounds pretty darn interesting, actually. I think the scene says something about the main character, Dixon, and his lack of interest in the very topics he is meant to research and study. In short, his heart’s not in it. Either that or Kingsley Amis had zero interest in economics and the title struck him as the most vapid imaginable. Anyone know?

Jonathan highlights an Instapundit discussion that caught my eye, too. The discussion is about mammograms and the latest proposed guidelines for screening: do the guidelines represent good science, or are they simply meant to save money (these are not mutually exclusive goals)? I don’t know the science, and don’t have any reason to distrust the health care professionals proposing the guidelines, but I understand that an element of distrust is introduced by the current health care debate.

Anyway, the above linked discussion brings up many interesting points. One is the Public-Health fallacy that Jonathan discusses. Another is the changing relationship between doctor and patient in a system where the federal government intrudes so heavily. Guidelines become suspect. Who is the real beneficiary of the guidelines – the individual patient, or the ‘greater good’ of the population as designated by a government official? The government guidelines, or official, become a third party between the patient and the doctor. The relationship is altered. To some extent, this is already the case with third-party payers and the current level of regulation, but the proposed health care bills take it to another level, entirely.

You see the same phenomenon of distrust when a patient talks about ‘greedy’ doctors and drug companies. I think that distrust will be transferred to Washington under the ‘D.C.-centric’ health-care bills that are being considered. And, in the political fight between constituent groups (patients and others), we may end up with a system where large public health bureaucracies will need to be placated first – a bit like California and the public service unions, or the British NHS*. The entire nature of the doctor-patient relationship will be changed. What do you all think? I’m a physician, and like many physicians, have my own levels of distrust. They are currently being directed at the government takeover of health care.

*I recently watched an old “Yes Minister” (Brit sitcom from the 80s) in which a government minister tries to shut down a hospital with no patients (it has a very large staff). A funny joke, yes? Well, the running joke of the show is that the unions resist by making the following claim – who cares if there are no patients? The greater good is served by all those public sector jobs. So, who “owns” the doctor-patient relationship in that sitcom scenario? Soon, alas, to be ours, perhaps?

Update: Think I used the word distrust enough in the above post? It’s like I’m trying to make a point, or something….
Another Update: Hey, a belated thanks for the link, Instapundit!

Hearts and minds? Overrated. If you want to run a successful counterinsurgency, it all starts with the person at the top.

On Thursday, December 3rd, Mark Moyar will appear at the Pritzker Military Library to discuss his new book, A Question of Command: Counterinsurgency from the Civil War to Iraq.

Small Wars Journal

I’m not sure that I’ll be able to make this program at the Pritzker Military Library (Chicago). It’s always touch-and-go with me and early evening talks – work and all that. Hopefully, some of the chicagoboyz readership will be able to attend!

Update: Thomas Rid reviews the book here, “Mark Moyar pitches his book as a challenge to that thesis. Counterinsurgency must not be just population-centric. Nor can it be merely enemy-centric, as conventional wars against opposing armies were. No, successful counterinsurgency is “leader-centric.”

To say that in a planned society the Rule of Law cannot hold is, therefore, not to say that the actions of the government will not be legal or that such a society will necessarily be lawless. It means only that the use of the government’s coercive powers will no longer be limited and determined by pre-established rules. The law can, and to make a central direction of economic activity possible must, legalize what to all intents and purposes remains arbitrary action. If the law says that such a board or authority may do what it pleases, anything that board or authority does is legal – but its actions are certainly not subject to the Rule of Law. – F.A. Hayek, The Road to Serfdom.

Health Choices Commissioner, “pay czars”, the Kelo decision, bail outs! To this layperson all of it seem so, well, arbitrary. It’s as if we in the U.S. are moving toward a system where just about anything can be justified because some government official says that it should be so. It’s all for the greater good, right? What are pesky little things like individuals and predictable rules in the face of all that wonderful greater goodness?

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