Dueling Doctors

In the blue corner, we have the joint statement on multiple patients on ventilators by the Society of Critical Care Medicine (SCCM), American Association for Respiratory Care (AARC), American Society of Anesthesiologists (ASA), Anesthesia Patient Safety Foundation (APSF), American Association of Critical”Care Nurses (AACN), and American College of Chest Physicians (CHEST) which recommends letting people die when spare ventilator reserves run out. And in the red corner, we have the VESper by Prisma Health fresh off of its recent victory to get regulatory approval under emergency use rules to allow ventilators to be used by up to four patients.

It is triage with its ugly logic of letting patients die vs hope and technical advancement to save everyone, live in the United States at Covid-19 virus hot spots across the nation. This may affect you personally so it is important that you know whether or not the hospital you might depend on to save your life has picked one side or the other in a thoughtful way.

Everybody could ask the question but it would be better if our press did ask and broadcast the answers. At the time of writing, they’ve had two days to do so. Are you informed on the issue? Are your neighbors? Is your hospital?

This lack of discussion is the death of journalism. This time ignorance can have deadly consequences for us all.

SARS-CoV2/COVID-19 Evening Update 2-25-2020: The Pandemic Hide the Name & Blame Games

The themes of this update will be on issues of COVID-19 spread, World Headlines, border closings, the CDC news conference, developments with fomite spread, how American Public Health institutions build a liablity law suit proof diagnostic test and how that limits tests for community spread and a new recommended COVID-19 sites, social media and videos section.
 
Top line, There are currently 80,420 confirmed COVID-19 cases worldwide, including 2,710 fatalities as of the 24 February 2020 at 5:24 p.m. ET time hack on the BNO News corona virus tracking site (https://bnonews.com/index.php/2020/02/the-latest-coronavirus-cases/) There are 39 nations including China plus three “Chinese special administrative regions” (Macao, Hong Kong and Taiwan) that have reported COVID-19 infections. China, Taiwan, Hong Kong, Japan, Thailand, Singapore, Italy, Iran and R.O.K. all appear to have local, or endemic, spread of the disease. Italy has spawned further spread in Spain proper, it’s Canary Islands possession, Austria, Germany, and possibly Croatia. And now Brazil in South America and Algeria reporting a case signals North West Africa have added two new regions to the Pandemic spread list. The virus has spread from Asia to Europe, North America, Australia and Africa.
 
All of the above meets the pre-COVID-19 WHO standard for a “Pandemic” that requiring endemic spread in multiple nations in multiple WHO regions. However, the WHO just decided that it was time to retire the term “Pandemic” because…something…[insert reasons here]. The WHO statement for doing so was a master piece of unintelligible double talk that boils down to “Lets not scare the “Normies” and set off more “Run, Hide & Hoard” panics like seized Italy, ROK and Singapore in the last few days. Meanwhile the WHO is cheering-on China’s “Hospice-Prison system for the infected” Quarantine as a “Model” in aiding China’s restarting the World economy.
ITALY COVID-19 Confirmed Cases and Deaths 25 Feb 2020
ITALY COVID-19 Confirmed Cases and Deaths 25 Feb 2020
 
World Headline Summary
o WHO warns the rest of the world “is not ready for the virus to spread…”
o CDC warns Americans “should prepare for possible community spread” of virus.
o San Francisco Mayor declares state of emergency
o Later, CDC says pandemic not a question of it, but when
o Brazil may have South America’s first coronavirus case
o Germany confirms 2nd case on Tuesday, brings total to 17
o Italy cases spike to 322; deaths hit 10
o Japan’s Shiseido tells 8k employees to work from home
o Trump Economic Advisor Kudlow tries to jawbone stock markets higher
o HHS Sec. Azar warns US lacks stockpiles of masks
o Italy Hotel in Lockdown After First Coronavirus Case in Liguria
o Algeria confirms 1st case
o First case in Switzerland
o Kuwait halts all flights to Singapore and Japan
o Iran confirms 95 cases, 15 deaths
o First case in Austria
o Spain reports 7 cases in under 24 hours, including in Madrid, Canary Islands, Barcelona
o Iran Deputy Health Minister infected with Covid-19
Pandemic Border Closures
Turkey, Iraq, Kuwait, Afghanistan, Pakistan, Turkmenistan, Georgia, Armenia, and UAE blocked border crossings by Iranians.
Russia, North Korea and Vietnam are blocking border crossings from China
Austria and Switzerlan are blocking border crossings from Italy.
El Salvador on Tuesday announced it would prevent entry of people from Italy and South Korea.
 

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Summer Rerun: That Hideous Strength, by C S Lewis

That Hideous Strength, by C S Lewis

This was the first thing Mark had been asked to do which he himself, before he did it, clearly knew to be criminal. But the moment of his consent almost escaped his notice; certainly, there was no struggle, no sense of turning a corner. There may have been a time in the world’s history when such moments fully revealed their gravity, with witches prophesying on a blasted heath or visible Rubicons to be crossed. But, for him, it all slipped past in a chatter of laughter, of that intimate laughter between fellow professionals, which of all earthly powers is strongest to make men do very bad things before they are yet, individually, very bad men.

Mark Studdock is a young on-the-make sociologist, a professor at Bracton College, in an English town called Edgestow. He is is far more interested in university politics than in his research or teaching. and as a member of the “progressive element” at the college, he strongly supports Bracton selling a tract of property to  a  government-sponsored entity  called NICE. The NICE is the National Institute for Coordinated Experimentation,which Lewis describes as “the first fruits of that constructive fusion between the state and the laboratory on which so many thoughtful people base their hopes of a better world.”  What excites Mark most about the NICE is this:

The real thing is that this time we’re going to get science applied to social problems and backed by the whole force of the state, just as war has been backed by the whole force of the state in the past.  One hopes, of course, that it’ll find out more than the old freelance science did, but what’s certain is that it can  do  more.

Trigger Warning: There is something in this book to offend almost everybody.  It contains things that will offend technologists and believers in human progress…social scientists…feminists…academic administrators…bioscience researchers…and surely many other categories of people.  It will probably also offend some Christians, for the way in which Christian theology is mixed with non-Christian magic. By the standards now becoming current in American universities, this book, and even this book review, should be read by no one at all.  But for those who do not accept those standards…

The Basic Story. Mark has recently married Jane, a  woman with strong literary interests and with vague plans for getting an advanced degree. She has recently started  having disturbing, indeed  terrifying, dreams, which suggest that she has a clairvoyant ability to see distant events in real time. Afraid that she is losing her mind, Jane seeks advice, and is told that her dreams are actually visions, they are very real, will not stop, and are of utmost importance:

“Young lady,” said Miss Ironwood, “You do not at all realize the seriousness of this matter. The things you have seen concern something compared with which the happiness, and even the life, of you and me, is of no importance.”

Miss Ironwood warns Jane that extremely evil people will seek to use her gift, and that she would do wellboth for her own interests and those of the entire human raceto join the community of which Miss Ironwood is a part, located at a place called St Anne’s. Jane responds quite negatively to the invitation, afraid that membership in the St Anne’s group will limit her autonomy. She is not interested in the dreams’ meaning; she just wants them to go away.

Mark, on the other hand, responds enthusiastically when he is invited to take a position at the NICE, temporarily located at an old manor called Belbury.  One of the first people he meets there is the Head of the Institutional Police, a woman named Miss Hardcastle (picture Janet Napolitano), nicknamed the Fairy, who explains to Mark her theory of crime and punishment:

“Here in the Institute, we’re backing the crusade against Red Tape.”  Mark gathered that, for the Fairy, the police side of the Institute was the really important side…In general, they had already popularized in the press the idea that the Institute should be allowed to experiment pretty largely in the hope of discovering how far humane, remedial treatment could be substituted for the old notion of “retributive” or “vindictive” punishment…The Fairy pointed out that what had hampered every English police force up to date was precisely the idea of deserved punishment. For desert was always finite; you could do so much to the criminal and no more. Remedial treatment, on the other hand, need have no fixed limit; it could go on till it had effected a cure, and those who were carrying it out would decide when that was.  And if cure were humane and desirable, how much more prevention?  Soon anyone who had ever been in the hands of the police at all would come under the control of the NICE; in the end, every citizen.

Another person Mark meets in his first days at Belbury is the acclaimed chemist William Hingest…who has also come down to investigate the possibility of a job at Belbury, has decided against it, and strongly advises Mark to do likewise:

“I came down here because I thought it had something to do with science. Now that I find it’s something more like a political conspiracy, I shall go home. I’m too old for that kind of thing, and if I wanted to join a conspiracy, this one wouldn’t be my choice.”

“You mean, I suppose, that the element of social planning doesn’t appeal to you? I can quite understand that it doesn’t fit in with your work as it does with sciences like Sociology, but“

“There  are  no sciences like Sociology. And if I found chemistry beginning to fit in with a secret police run by a middle-aged virago who doesn’t wear corsets and a scheme for taking away his farm and his shop and his children from every Englishman, I’d let chemistry go to the devil and take up gardening again…I happen to believe that you can’t study men, you can only get to know them, which is quite a different thing. Because you study them, you want to make the lower orders govern the country and listen to classical music, which is balderdash. You also want to take away from them everything that makes life worth living and not only from them but from everyone except a parcel of prigs and professors.”

Nevertheless, Mark decides to remain at Belbury, and is drawn ever-deeper into its activitieswhich, as only those in the innermost circles of that organization realize, are not only consistent with the goals of the 20th-century totalitarianisms, but go considerably beyond them.  The NICE seeks to establish a junction between the powers of modern science and those of ancient magic, accessing the latter by awakening the medieval wizard Merlin and using him for their purposes.  At the same time, Janedespite her reservationsbecomes increasingly involved  with the company at St Anne’s and is entranced with its leader, a Mr Fisher-King. (His name comes from the Wounded King in Arthurian legend.)  The St Anne’s group is aware of the truth about NICE and its ultimate goals, and exists for the primary purpose of opposing and, hopefully, destroying that organization.

I will not here describe the war between the forces of Belbury and those of St Anne’s (in order to avoid spoilers), but will instead comment on the characters of some of the protagonists and some philosophically-significant events in the novel, with appropriate excerpts. Hopefully this will be enough to give a sense of the worldview that Lewis is presenting in this book.

Mark Studdock. His character is largely defined by his strong desire to be a member of the Inner Circle, whatever that inner circle may be in a particular context.  The passage at the start of this review where Mark agrees to engage in criminal activity on Belbury’s behalf is proceeded by this:

After a few evenings Mark ventured to walk into the library on his own; a little uncertain of his reception, yet afraid that if he did not soon assert his right to the entree this modesty might damage him. He knew that the error in either direction is equally fatal.

It was a success. Before he had closed the door behind him all had turned with welcoming faces and Filostrato had said “Ecco ” and the Fairy, “Here’s the very man.” A glow of pleasure passed over Mark’s whole body.

That “glow of pleasure” at being accepted by the Belbury’s Inner Circle (what Mark then  thinks  is Belbury’s Inner Circle) is strong enough to overcome any moral qualms on Mark’s part about the actions he is being requested to perform.  Lewis has written a great deal elsewhere about the lust for the Inner Circle, which in his view never leads to satisfaction but only to a longing for membership in another, still-more-inner circle. In That Hideous Strength, there are concentric Inner Circles at Belbury, which Mark does penetrateand each is more sinister than the last.

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Po nan Jwèt la: Asymétri Kache nan Lavi Chak Jou

Taleb, Nassim N., Skin in the Game: Hidden Asymmetries in Daily Life. New York City: Random House, 2018.

NB: precisely because I regard Taleb as a national treasure and have considerable respect for his work, I am not going to pull punches here. I get to do this because I have … skin in the game, and not only in Haiti[1] (where I wrote this post over the past ten days, thus the Kreyòl Ayisyen title), but in a couple-three moderately hair-raising situations back in KC, which I will relate when appropriate. Which might be never; see Matthew 6:1-4 (cited by Taleb on page 186).

Getting this out of the way—buy this book, read it, and recommend it to others. I say this very much irrespective of what might be called the Manifold-Taleb delta, which is not altogether trivial, as I will explain in some detail—again, as a sign of respect—below. Immediately below, in fact.

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Further Musings prompted by Sgt. Mom

Another Minnesotan, whose reputation like Keillor’s is pretty tawdry, seems about to be pushed from the Senate. Well, I am not all that sorry. Franken is reputed to be truly obnoxious. I was appalled by his posturing during the questioning of Gorsuch; his first election was shady. But Minnesotans re-elected him. The willingness of the Senate Democrats to discard him may say something about his general unpleasantness but probably a good deal more about their political calculations – recording preening, virtue signaling statements for use later.

Given his colleagues’ demands, we might remember the first came from Gillibrand. This is the woman who tied herself firmly to the Clintons, both of whose actions toward women were far more despicable than anything Franken has been charged with; on the other hand, she was quite willing to destroy the accused and comfort the accuser in what turned out (as any mature person expected) a hoax (or delusion) by a drama queen with mental problems, mattress babe. She dealt cynically and opportunistically with a girl who needed counseling a good deal more than a seat at Obama’s “State of the Union” address.

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