2012: Who Will It Be For The GOP

Here we are at the beginning of 2012 which is the start of 2012 presidential campaign. I guess we know who the democratic nominee will be. I don't think anyone has a chance of competing with BO. Hillary doesn't have a chance since BO will get 98% of the black vote in any challenge and this is too much of a head start for Hillary to overcome. She does not want to be seen as the anti-black candidate and will have to wait for BO to leave office for her to give it another go. No one else could give a serious challenge.

The republicans though, provide an interesting picture. Palin is an automatic loser and a guarantee of four more years of BO. She is not presidential material and I really hope she knows it. She is great at rallying the people on the right and is terrific for the party. She will get out the vote, raise lots of money for republican candidates, and help in many state and local elections. She should be the cheerleader in chief for the republicans not try to be the commander in chief.

Romney is difficult because of Romney care. No matter how much he tries to separate Romey care from Obama care it is an impossible feat. Health care is one of the most important issues of the election and he will not be able to provide a vision that is significantly different from Obama care. This sinks his candidacy.

Newt is the smartest idea man of the republican party and if I had my choice I would want him as my president. But unfortunately I think he is unelectable. There is a certain staleness that I feel a politician gets after he has been around for a while. People lose their excitement after a while and I think he would suffer from that.

Huckabee, I have never been to thrilled about as a candidate. I don't think he generates much connection with the voter and I don't think he would create significant turnout.

So who is it going to be for the GOP? I think it is going to be someone who is not yet on the radar screen. The best person would be a governor over a senator or congressman. Governors are natural precursors to presidents as they run a state government with responsibility for budgets. Contrarily, congressmen fight over bills without the individual onus of the success of the country.

The nominee should be from a state which has shown that republican ideals have improved the financial outlook of the state. They should have been in office for a minimum of three to four years. They should have made inroads into cutting government size and intrusion as well as government spending. They should be seen as being able to stand up to unions and special interest for the benefit of the taxpayer. These policies are exactly what the American people want and having demonstrated they could implement them in there states, the electorate will want them implemented nationally.

I am sure such an individual exists but right now they have not taken to the stage. In the next few months we will see who enters the race.

Rationing Health Care Part II

My daughter texted me last week that she didn't quite get the last blog entry, so I wanted to expand a little on that topic. I also wanted to mention that I am not opposed to industry discovering and profiting on new health care modalities. Free market forces promote the development of new techniques and drugs and the profit that follows is the reward for taking the chance on such a development.

People in the pharma industry would defend the high cost of new drugs in the following way. They note that the cost to bring the drug to market is very expensive. Only one in a hundred molecules that go through expensive trials actually make it to market so they have to recoup the cost of not only the marketable drug but also the molecules that were developed and tested that never made it. They also would mention that by keeping people with chronic diseases healthy with newer technology, other costs such as long term hospitalization or institutionalization have abated. Lastly, they would stress the enormous impact that new drugs and technology have had both by lengthening people's lives and improving the quality of those lives. Is there any price to be placed on those factors?


Sometimes by looking at an extreme example you can clarify the problem and possible solutions. Lets say that an imaginary drug company named Eternity Therapeutics develops two drugs. Drug A can cure cancer but you must take it for the rest of your life. Drug B can stop you from aging but must also be taken daily or the aging process will resume.(Btw, these are not fantasies but research is now taking place to achieve both of these). The cost of each drug is one million dollars per year. Why is it so expensive? Maybe it has ingredients that are extremely rare and thus is in limited supply. Maybe Eternity Therapeutics knows they can get their price so they price it at whatever the market will bear.

So who should pay for drugs A and B? Private insurance companies will not include these drugs in their benefits. Their premiums would have to be too high to include these drugs. If government included these drugs in their benefit packages, the country would go broke (I should say, even more broke than they are currently). Ultimately , it is unaffordable and only the rich will be able to get them. At some point the cost of extending peoples lives will just cost too much for society. The only question is where is that point. Will we be able to have the discussion without the opposition declaring death squads or throwing granny under the bus.

My point in the previous blog was not to demonize private industry regarding the cost of new drugs/techniques. Hopefully, they can continue to develop drugs and profit without charging exorbitant fees. Their profit should be generated from all countries not just the USA which pays higher fees than other countries. The point was only to raise the notion that the costs of new technology have outpaced the ability of society to pay for them. What's the use of developing new drugs if society cannot afford them. Eventually, industry will conclude that if there is no profit to be had further innovation will cease. Everyone loses.

Rationing Health Care, A Must

I was talking to a friend of mine who works in the pharmaceutical industry last week. He was on a trip trying to market the use of a drug for multiple sclerosis. He was circulating amongst neurologists in my area trying to encourage these doctors to use his drug. Out of curiosity, I asked him how much the medicine costs and he responded $48,000 per year. I told him that I thought that was a ridiculous price and he responded by asking if I knew how much it costs to investigate new drugs and bring them to market.

So here is the problem. We are discovering drugs and new medical devices that can extend the duration and quality of people's lives. That is wonderful but the problem is we cannot afford it. The advances in the medical and pharmaceutical industries have outpaced our ability to pay for it. There is no way government can afford to pay 48K for one drug per year to extend peoples lives with MS. Insurance companies would have to charge such high premiums if this drug was included in their benefits that it would be unaffordable. That is a sad statement but indicates ultimately the requirement at some level to ration care. At some level there must be a limit to an individuals medical consumption and the population of this country needs to understand that and establish the limits.

In Europe the governments decide which medications and technologies are allowed in the country. Part of their determinations are guided by a cost/benefit analysis. Can we afford to pay for this procedure or this medication? Is it worth the benefit received by the individual and society as a whole? In fact, I asked my pharmaceutical friend if the MS drug is being used in Europe and he said it was rejected. Likely due to cost as its efficacy has been proven. We in the US need to have this conversation and set limits. As technology continues to advance we will surely bankrupt ourselves using more and more expensive modalities.

People should be able to choose an insurance policy that would cover these extremely costly medications and they would be required to pay the fair premiums. People should also be allowed to buy a bare bones or catastrophic policy in which case they would not be covered for expensive drugs and would either not get it or have to pay out of pocket. In both cases, with private insurance the individual sets the limits by purchasing the appropriate policy/benefits. The problem is if you are on government insurance. What are the limits that should be set? Who should set it? Very difficult questions that we have to confront, but we absolutely must and soon.

Barney the Dinosaur

Barney the purple dinosaur sings never talk to strangers that's very good advice cuz you just can't tell if they're good or bad even though they may seem nice. After traveling to Israel over Thanksgiving I experienced a glaring difference between life here in the states and life in Israel. It is so embedded in our culture to be wary of strangers. Barney the dinosaur is indoctrinating our three and four year old kids to avoid any interaction with strangers as they are not to be trusted. Of course, this is necessary in our society as we are so disconnected with each other and bombarded with criminal activity every night on the news. It is a survival tactic that we learn at a young age. Contrarily in Israel, where people are interconnected by their religion, heritage, and nationalism there is much less wariness of strangers.

While traveling in Israel, for the most part, I traveled as a tourist. Stayed in a touristy hotel, went to touristy restaurants and went to historical sites visited by tourists. But I traveled by buses to get around, not by cabs, and this gave me a feel for life in Israel. Conversations take place on the buses between strangers all the time and sometimes get pretty heated. What struck me was when women with strollers would get on or off the bus there was always some stranger helping her with the stroller. My daughter who is studying in Israel tells me she would fall asleep on the shoulder of a stranger sitting next to her on the bus. She would wake up suddenly and apologize but the stranger would encourage her to put her back down and go back to sleep. Little children go on buses by themselves, something one would never see here.

Contrast that with public travel in New York. When I go on a subway everybody has their heads buried in a book being careful not to look up and actually look a stranger in the face. We become expressionless and dare not eyeball anyone in the subway car lest this lead towards an acknowledgment of another's presence. I do not recall ever seeing strangers helping each other as we are all too suspicious of each other's motives.

Life in Israel is tough but the interconnection between complete strangers is a benefit of living in a more uniform society. Life is easier here but we live in our little cocoons detached from each other. We live with constant suspicion of everyone and trust only our inner circle. They live with the threat of a bomb coming from an external enemy and we live with the threat of crime by our fellow American. Both locations have positives and negatives and I don't suggest that one is better than the other, just different.

Last week after I came home I saw a 3 year old black girl in the office who sang to me the Hebrew alphabet. She learned it from Barney the dinosaur and anyone with little kids knows that tune. By this little girl learning my culture Barney is creating connections between people but at the same time he is disconnecting people by warning about strangers. Seemingly a contradictory message.
Who knew the purple dinosaur was so deep and complex?

No Scan, No Fly

I just returned from a week abroad and I was prepared for a scan to be performed by security at the airport. For whatever reason, there was only the usual metal detector and conveyor belt for carry-on items. No scan or pat down. I must say I was a little disappointed by the lack of the most up to date security system present at my flight. I want to fly with the knowledge that my fellow air travellers on board have been subjected to the greatest scrutiny possible.

People complain about the imposition on their privacy rights by being forced into these scans. I say if it improves security and lessens the chance of a bomb being smuggled onto the plane then I am all for it. I don't even want the option of a pat down. If you fly you must be scanned, period. A pat down, I believe, is more susceptible to human error and I do not want to take the risk that an error was was made on my fellow passenger resulting in a tragedy. If you refuse the scan then you do not fly. No exceptions.

People complain about the radiation risk. I saw a statistic that the amount of radiation exposure from a security scan is equivalent to the exposure while flying at 30,000 feet for 30 minutes. The risk of terrorism is greater than the risk of cancer from the radiation exposure of a security scan. A trivial argument.

People complain that the TSA person will be able to see you essentially naked and object to the scan on that basis. It is not as if the person who is watching the scan is the one at the security counter looking at the image of your naked body while looking up at your face. The image is piped to another location where the agent/computer evaluate the image without a facial image. No connection at all between the body images and the individual.

I can tell you as a doctor that after seeing complete bodies hour after hour and day after day, it is not an erotic experience. In fact, the constant exposure diminishes the experience when it should be stimulative, as in marital relations. Furthermore, if you see the average person travelling in the airport most of them you would not want to see naked. With obesity rates over 50% and morbid obesity rates at 15-20% you couldn't pay me enough to sit behind a monitor and look at fat bodies all day.

So lets drop all the modesty nonsense and lets make the safety of the flying public the major goal. Lets also drop the claim of the reach of government going too far. Air safety is a good role for government as it can be combined with intelligence to maximize our safety and not be motivated by profit. They should try to hire ex-military and ex-police as they have the experience to ensure security.

Scans should be mandatory. If you refuse to be scanned you do not fly, end of conversation. Flying is a privilege, not a right. Remember, there's always Amtrak.

Reasons for Optimism

I apologize if I have been too pessimistic in my entries. Specifically last week, writing about the race to the bottom was definitely a downer. But I think there is a lot to be hopeful about. Most of the hope lies in situations where people have bucked the usual trends and have achieved success in spite of being labeled as bad students or disabled or poor. They succeed not because of government assistance but in spite of it. They all use their particular skill sets to advance and not follow the accepted formula as dictated by society.

I was watching 60 Minutes last week and two of the three segments portrayed men who have succeeded in life despite early challenges. The first was a man who was a troubled youth and eventually landed in jail but changed his life to become a well known actor and director. The other was a man who was a terrible student but turned himself around to become a geneticist who unraveled the human genome. Finally, I refer to the person who responded to last week’s blog who was labeled as ADHD but overcame his label to be a successful automobile developer. The common thread amongst these men is their exploitation of their specific talents to succeed. They didn’t rely on government but succeeded by plowing a pathway themselves.

Everyone is born with certain skills and talents. The goal is to identify and encourage a person’s array of skills that will enable him/her to excel maximally. Since we are all different a specific pathway does not exist which could apply to all. Government attempts to treat everybody the same and pigeon holes people to fit into a specific mold/pathway (square peg in round hole). Government dulls a person’s sense of individualism and promotes conformity and uniformity. Ultimately this is detrimental for the individual and in an effort to help people government is really hurting them. A bureaucracy in Washington or at the state house is too removed from the individual to have the ability to explore and encourage an individual’s particular situation.

Each person has to be seen as an individual and allowed to find the pathway that best uses his/her particular skill set. For example, not everyone should go to college. Some peoples’ skill set are not conducive to college and would be better advanced by pursuing a different route. Teachers and parents need to recognize what makes their children/students unique and help them pursue those goals which optimize their talents.

This country at its core was built on principles to encourage the individualistic spirit and for government to get out of the way while its people succeed or fail based on their own ability. Its greatness lies in the fact that it encourages individuals to compete on a leveled playing field regardless of labels and the best man/woman wins while the loser learns from the failure and tries again. This micro-battle which occurs every day, everywhere and at all levels raises the entire nation as a whole. We are an excellent nation because we are made up of excellent individuals. Our national success is due only to the cumulative effect of our smaller individual successes. We should be optimistic since this country is the best place on Earth that allows each individual to exploit his/her innate and learned skill set to achieve success.

Extra Time, The Race to the Bottom

I saw a patient last week, a young lady, who demonstrated a very mild hearing loss on her hearing test. She was going to take the SAT and her mother wanted me to write a note saying she needs special attention because she would have a difficult time taking the test due to her VERY mild haring loss. I told the mom I didn't understand since the SAT is a test where hearing is not required. She said she wouldn't be able to hear the instructions or hear when time was up. I didn't continue my questioning but thought to myself if she cannot figure out how to take the exam without hearing the instructions and use a watch to gauge her time she has a lot more problems than a mild hearing loss. But this just demonstrates the desirability to be seen as handicapped or as a victim. These labels are used to receive special dispensations. As an attempt to level the playing field for people with true disabilities, gamers of the system will try to receive a leg up on the competition by claiming a handicap.

This is similar to the situation that goes on regarding granting of extra time on exams to certain kids who are diagnosed with attention disorders. Now all mothers want their kids to be labeled with an attention deficis since they receive extra time on exams. Some parents pay therapists to purposely label their kids in order to obtain a leg up on the competition regardless if they have an actual disorder. It wouldn't be so bad if grades on tests would be designated as having been obtained with or without extra time, but in our p.c. world we cannot place labels. So there is no downside in getting extra time because no one ever knows about it. So the college who is seeing the SAT score or the medical school who is evaluating GPAs have no idea which transcripts include extra time and which did not.

Extra time is granted in high school, on the SAT, in college and beyond. Isn't the point of examinations to let competition determine who is at the top versus the bottom. Isn't the point to select out those kids who can work under pressure within a certain time frame. The point is specifically not to level the playing field but to stratify it. The pc nonsense has us believing everybody is equal, that any poor performance is not due to inherent inabilities but due to a disorder that needs to be compensated for. It is the same nonsense that proposes that poor people are victims of outside forces not of their own inabilities. And the same nonsense that proposes that there are no evil people just victims of bad upbringings or psychological disorders, or impoverished childhoods.

In real life there is no extra time. When I am in surgery performing a difficult case on a sick patient every extra moment under anesthesia carries increased risk to the patient. I cannot turn to the nurse or the anesthesiologist and explain that I need extra time since I am having difficulty concentrating. I certainly cannot go out to the patient's family and explain to them that the surgery took twice as long because i needed extra time due to inability to focus. Do we really want our doctors/surgeons to be the ones who required extra time due to difficulty with paying attention to the task at hand?

It used to be that the kids who couldn't concentrate were considered slower. They either improved with practice and time and caught up to the rest or they performed poorer and chose professions not as intense. Nothing wrong with that. By perpetuating extra time these kids are placed into situations requiring too much intensity and eventually fail. Were they truly served well by extra time or propped up to eventually fail when real life approaches.

Everybody wants to be labeled as being disadvantaged. It may be claiming to have minority status or being handicapped or even to have a learning disability. In our upside down pc world this is somehow seen as advantageous. We are in a race to the bottom as more people claim victimization to receive special treatment. Don't be surprised when we end up there.

Future of Healthcare, Two Tiers

This country has a major problem which is bankrupting government at all levels and is making our corporations uncompetitive. There is no solution in sight and nobody is talking about the choices that will need to be made to address the problem. The issue is health care and how we provide and finance medical services to the citizens of this country.

The Obama administration in its attempt at health care reform only exacerbated the problem. They have increased the number of people eligible for government care without addressing the cost factor (the so called bending of the curve). It seems to me that eventually we will end up with a specific system which is inevitable. It will take time to get there in this country because government by its nature is a slow process. Other countries have arrived at this healthcare model and it involves a basic medical plan for everybody covered by the government, the medicare for all plan. This care is likely to be low paying to the doctor, involves wait times for specialty care, surgery and testing. The doctor will have to work in a low overhead environment to make a profit which means less office staff and a less attractive office, ie. a clinic setting. This will be a downgrade for many people’s care that they now receive but is crucial if costs are to be contained.

If an individual wants to be seen immediately or have his/her test or surgery done immediately then they have the choice of seeing the doctor outside the government system at his private office. This office will be in a nicer setting with short wait times and more staff. The individual can pay out of his/her pocket for this private care or may carry an insurance policy covering private care. The doctor will have two offices. One for his private patients and one for the clinic patients. He will see the clinic patients during limited hours during the day only. The private patients can be seen in the other nicer office with expanded office hours (nights and weekends) for their convenience. Two tiers of care, the public one desired by the left and the private one desired by the right.

The problem exists now that if a doctor participates in medicare he/she is not allowed to charge any more than medicare fees, in essence eliminating the option of a service being provided outside the medicare fee schedule. Even if the doctor does not participate with medicare he/she can only charge 3% over medicare fees. So if the patient cannot opt for private care he is stuck in the slow government system. It is critical this be changed to allow patients the choice to be seen privately at their discretion. This will be demanded by the public as fees to doctors decrease resulting in more doctors not being willing to accept medicare patients, limiting access to the doctor in the public system. They will demand the option of being able to see the doctor by paying out of their pocket.

The other critical ingredient to this system is malpractice reform. A doctor will not see patients only to be able to afford his/her malpractice insurance and pay off the lawyers before he works for pennies.

A doctor must be allowed to work in both the public and private system simultaneously and not have to choose one or the other (currently not possible). The patient will have the choice of where and when to be seen.

This satisfies the right and left with private and public options. It accomplishes universal coverage. Cost will be contained by government limiting benefit packages and compensation. The only argument will be that it is unfair that the rich can afford the top tier of care and the poor cannot. There is no acceptable answer other than eliminating the private option completely or giving everybody top tier care are nonstarters.

This is the future of medicine in America, can we just get there already.

The Enemy a la BO

I was sitting around with a few friends and one of them mentioned how he thought it was not right that BO is going around campaigning for democratic congressional candidates all over the country. The more I think about it the more I agree that it is not appropriate for him to spend public money which was obtained from all Americans to selectively campaign for democratic candidates. Regardless of the fact that he is a democrat, his election puts him in the position of president for all Americans. He now represents me (not a dem) and I do not support his partisan politics while he is in this position. Its a double slap in my face that he uses my money for his flights, security, etc. on these campaign trips.

Even worse is Michelle Obama who is cruising around the country campaigning for selected democrats. I would have no problem if she did this on her own dime. She is a free citizen who was not elected to office and does not have a position where she represents the people. But my suspicion is that all her expenses are being covered by the taxpayer. This is a blatant misuse of government funds (my money) for their own political benefit and with which I do not agree.

You can argue that Chris Christie should not be campaigning for other republican gubernatorial candidates as he has been doing for the last three months. There is a somewhat nuanced difference in that he is campaigning in states outside of his own jurisdiction. Assuming the NJ taxpayer is footing the bill (although I doubt it), that money is not going to influence NJ political races. I would be opposed if Christie campaigned for republican NJ state senate candidates as he is supposed to represent all New Jerseyans, dems and republicans. Regardless of this nuance, I think elected officials should not campaign for any other political races while in office. This should be the case even if they pay for it themselves and especially if they are using public monies.

But it hardly surprises me since BO at his core is a political ideologue, fierce partisan, and opportunist. He never intended to represent all Americans but only a certain segment of the population. His goal was to redistribute from one group to another that in his warped ideology has been oppressed. He always viewed the republican opposition, the wealthy, business people, non-union white people as the enemy. As he said this past week to a Hispanic group, "We're gonna punish our enemies". He's calling me the enemy? This is my president who represents me? All his campaign promises of post partisan politics and being a uniter not a divider were absolute, calculated lies.

His goal is not to elevate the entire country only to elevate one group versus the other. He is not the president of all Americans. He is certainly not my president. There is only one fact you have to know about this guy to understand where he lives. He has no problem calling his own constituents the enemy but cannot identify Islam as the source of world terrorism.

My View

I have been saying for years that in my next life I want to come back as a co-host of The View. What better job is there than to come on TV for one hour per day, yenta about some topic of which I have no knowledge, and get paid megabucks. The incident that occurred last week with O'Reilly on The View demonstrates the foolishness of the PC morons who just cannot arrive at the conclusion that there is a worldwide Muslim problem. Every place they live they cannot live peacefully with their neighbors and the majority of conflicts on the planet involve Muslims. They cannot even live amongst themselves without belligerence. What other evidence do you need to come to the logical conclusion? To differentiate that it is only a Muslim extremist problem is an excuse to minimize the actual danger we confront.

I was born in 1963 to a father who escaped the onslaught of Hitler into Austria. I grew up in a period of relative calm after WWII. I was too young for the Vietnam war and most of my life there was no danger of war. I think I was lucky and I believe that for my children they will not have the comfort of a similar scenario. More countries are converting their oil into weapons and many of those countries are autocratic fanatical regimes. Is there any doubt at all that those weapons will be used at some point in the future?

It is sad to say but I think my children will live through very difficult times. Their freedoms will be curtailed and their lives' efforts will be to counter the forces of evil that are building. Survival will be their goal not individual pursuits of comfort, wealth, and pleasure. The complacency that my generation lived through was a fluke and reality is approaching rapidly.

My children and I discuss what they should do with their lives in terms of occupation. I hope that is the biggest challenge of their lives. Perhaps The View will be looking for a co-host but I think they are way to smart for those knuckleheads.

Letter to Glenn Beck

I have posted this letter to Glenn. For those of you who watch his show you will understand these themes. For those of you who do not listen or watch Glenn, you may want to give it a try. I'll let you know if i get a response.

Dear Mr. Beck,
I have been watching your show for the past year or so and I, like you, seek to find out truths. I have followed the conclusions you have reached during your intensive search for truth and it amazes me that those conclusions are tenets of Judaism present for hundreds of years. I do not mean secularized, watered down Judaism but the strict, orthodox variety. As we have recently passed our holiday season, the messages transmitted through our traditions resonate with the themes you discuss on your show.

Collective vs. Individual Salvation
Rosh Hashanah is our new year but more importantly it is our day of judgment where we are all judged as individuals. Yom Kippur is our day to try to atone for those transgressions we may have committed in the past year. We pray for our individual salvation. Although we try to minimize the exposure of our wrongdoings by praying for repentance as a group ultimately we are judged and evaluated as individuals. The climax of the synagogue service on those days is a prayer called Unsaneh Tokef. That prayer states: Like a shepherd inspecting his flock making sheep pass under his staff deciding their fate we pass as individuals before the almighty as he determines our fate for the next year. It is a very powerful prayer and I have included a link in English. http://www.ou.org/chagim/roshhashannah/unetanehtext.htm

Firm Reliance on Divine Providence
A week after the seriousness of those days we continue into the festive holiday of Sukkot. One of the primary requirements is for each family to build a Sukkah. This is a temporary hut built out of fragile components and we are commanded to spend a week in the Sukkah. People leave their sturdy houses and eat, learn, some sleep, and enjoy family and friends company. This structure is a physical representation of our belief that ultimately it is the almighty that protects and sustains us. We leave the “safety” of our homes and live in a flimsy hut which is only protected by the grace of the almighty. The sukkah represents our firm reliance on divine providence. If you have never seen a Sukkah just google it and click on images. I think you would be very moved if you spent time in a Sukkah.

Loss of Connections
Every week orthodox Jews are commanded to observe the Shabbos. We must turn off all cell phones, televisions, computers and nintendos. We cannot travel in a car or bus and thus we are stuck in our houses and within our local community. This forces us to join with our family and friends and connect with each other without all the distractions of modern life. The children all play with each other and build relationships while the adults connect both within the family and between families. Shabbos is truly a wonder of creation in terms of a day of rest, a day of spiritual growth, and a day of maintaining our connections.

I am not a Rabbi. I am a 46 year old physician who was dragged into this lifestyle by my wife. I struggle with faith but I recognize and cherish the wisdom and value of our traditions transmitted over generations. The tenets are eerily similar to those you have discovered in your search. I do not know where your quest will end but it wouldn’t surprise me if one day you will be building your own Sukkah.

The Next Bubble

I've been meaning to write about this for a while but other topics come up that I cannot resist, like maggots. I think that we are going to see a significant run-up in the stock market over the next few months and into 2011. Several factors are contributing to that sentiment.

Most run-ups in the market are lead by a specific group of stocks that leads the market higher. The group that will lead us into the next bubble is anything to do with commodities or agriculture. It is an easy story line for the average person to understand. The population is increasing worldwide and there are limited resources. More of the human population will increase their standard of living and will demand more of those limited resources which will drive up demand and prices. Prices of food, oil, metals, lumber, etc. will all rise based on this demographic trend. Easy for the average Joe to understand, believe, and want to invest in.

Additionally it is easy for the average person to understand that the government is printing tons of money to support its spending. This will lead to future inflation which will also push up prices of commodities. It will also devalue the dollar so people will want to dump their dollars for something tangible.

Similarly, the dot com story was easily understood by the average person. Access to everything via the computer and internet. People saw this as revolutionary and loaded up the pick up truck with any stock that had to do with the internet. A bubble was created and people did not look at the underlying fundamentals. Remember the dot com period where taxi drivers were giving stock tips. That was the indicator that the bubble was ready to pop. When the stupidest guy on the street was buying that was the time to sell. Right now the average guy hasn't been buying commodities, yet. Additionally, there is no other asset class with reasonable returns and people will be looking to hop on the next "easy money play".

The smart money has already entered this market. It has already run up quite a bit and large profits have been made. But soon I think the stupid money will be entering as headlines keep stressing the record prices of gold, etc.. As the stupid money comes in prices will inflate beyond the fundamentals which will lead to bubble formation as people see it as an easy money play. As for me I have not invested in commodities but i think a commodity ETF or an agricultural ETF would be a wise move now. I think it has a long way to run. The trick is not to be greedy and get out when the taxi driver tells you how many gold coins he has accumulated.

Those Damn Maggots

So when you saw this week's title what did you think I would be writing about? Maybe the wealth redistribution of the current administration or the nanny state policies of the liberal democrats. Or was it the blood sucking lawyers or perhaps those parasites in our country that suck the system dry without producing anything. Well it is none those. I am actually writing about a patient so if you have a weak stomach (you know who you are) do not read any further.

At the beginning of the week I received a consult on a patient to evaluate a situation described by the nurse that when she was suctioning the patient see saw something crawling out of the patient's nose, It was sent to be identified and was determined to be maggots. FYI maggots are the early stage of flies similar to a caterpillar and a butterfly. So the fly lays its eggs in someone's nose and it develops into maggots which eventually become flies. Maggots feed off dead tissue so the eggs are laid on a corpse or rarely on dead human tissue such as a bed sore or cancerous regions which have caused tissue death. In fact, some believe in using maggots purposely to clean dead tissue in a would since they will rid the dead tissue and preserve the healthy tissue.

Well, I never treated a patient with nasal maggots so I googled maggots in nose. Believe it or not you can see videos of maggots being removed from peoples noses. I have pasted the links below if you have any interest. Isn't the internet great? When I went to see the patient I couldn't identify any more maggots in his nose and I suspect this was because his nose was healthy and there was nothing for the maggots to feed on so they left. So that ended my maggot consult.

I started thinking how much one would pay to have maggots removed from their nose. I think the insurance company would pay me less if I had to remove them surgically versus what a plumber would receive relieving a blocked toilet, although that is pretty important too. I think the exterminator gets paid more to spray my house and definitely the eradication of bed bugs would be more profitable. Come on, if you had maggots crawling in your nose is there any price I can quote that you would not pay to have them removed?

I was originally going to write about something else this week but I coudn't resist sharing this experience. I realize it may not appeal to some, so sorry. Enjoy the videos. (paste into tool bar)

http://www.liveleak.com/view?i=87f_1249968683
http://www.youtube.com/watch?v=kXzFDtxp-Vk

The Great Toilet Bowl of Essex County, NJ

I have the fortunate situation of living in Essex county, New Jersey, the county that contains that ultimate example of the American dream, Newark. Just last week I could have sworn I heard an enormous toilet bowl flush from that city as 100 million dollars were donated by the facebook guy and is destined to go down the Newark educational toilet. Newark currently spends $24,000 per student which is significantly more than most private schools. Yeah, like another 100 mill will make them geniuses.

Why can't these knuckleheads understand that it is not the money that is the limiting factor. Answer: Because it is too politically incorrect to assign the blame to anything but money, like poor parenting which is the root cause of Newark's educational disaster. And since government cannot fix poor parenting they just throw additional money down Newark's educational toilet bowl.

I had a patient a couple of months ago who worked in the Newark schools. He told me of a successful situation in Newark where a charter school removes children from their homes and puts them into boarding schools. These children have strict rules while in school. Limited TV if at all. Longer class hours and study periods at night. Large class loads. Mandatory curfews and healthy meals. These children excel dramatically. They outperform because they are removed from their homes and parents not because of additional monies. How sad that the only way for these kids to excel is to remove them form their detrimental familial environments.

Yes, there are kids in suburbia who underperform even with good parenting and there are kids in Newark who excel even with bad parenting. But overwhelmingly, the trends are that supportive parents who take an interest in their kids school work and stress the importance of their kids educational success translate into better learning and better outcomes.

No matter how many millions are sent to Newark, they will all go into the toilet until it is realized that the problem is the parents. It is not the money, or the building, or the number of smart boards. All it takes is a parent who cares and this is not something money can create.

Octamom and Darwin

I am completely disgusted after hearing that the Octamom, Nadya Suleman, has applied for welfare in order to support herself and her 14 children. If this doesn't demonstrate the absolute decent of this country into the abyss, I don't know what will. It is reprehensible on so many levels but the main one is the most politically incorrect to discuss (I cannot resist). The encouragement and support of the lowest segment of society to have multiple children which expands the DNA of the least fit into our gene pool.

For hundreds of thousands of years humans have evolved to where we continuously improve upon ourselves through the process of natural selection. Darwinian principles, the survival of the most fit, as harsh as it seems ultimately lead to a more evolved being. We have developed bigger brains and more intelligence which has been our strategy to increase our survivability. This continues to go on in parts of the world. In the last hundred or so years humans in "developed" societies have determined that they will subvert natural selection by not allowing nature to select out those least fit to survive. Governments have stepped in to ensure their and their progeny's survival. Since parents at the bottom of the socio-economic scale do not feel the pressure of the need to feed their children, (since government will), they are free to multiply without end or disincentive. These government programs have the unintended consequence of promoting the expansion of DNA into our gene pool of the LEAST likely to survive. I am not saying this is wrong policy just making an observation.

On the contrary, successful people, people with means, are more likely the intelligent segment of society. This segment has to support their offspring and may be disinclined to have multiple children as they alone are responsible for their necessities. This decreases the volume of DNA from the most intelligent into the gene pool. So we have a situation where the DNA from the most successful is decreasing and the DNA from the unsuccessful is increasing. We will not see the result of this experiment for many generations but I can assure you that it will have an effect. Draw your own conclusions.

Again, these are just observations. My feelings are that humans may try to outwit nature and its laws of selection but the power of Darwinian principles are too strong. Eventually we will be overpowered by those laws and again those with the most ability will survive. The Earth is not limitless in its resources and the population is increasing at an unsustainable rate. Eventually we will go through a natural selection and Octamom and her progeny will have to compete to survive not just apply for welfare and have the government take from me and give to her.

The Melting Pot, a Positive or Negative?

I wanted to expand a little regarding what I finished with last post. There is no doubt that the decrease in religious participation has coincided with a deterioration of cultural values worldwide and in the US in particular. Let me just explain that I am not a fanatically religious person. Yet I do believe that participation in a faith based community is important and especially so for the population of the US as compared to other countries. I will explain why.

Last post I discussed the culture of gluttony and overconsumption we now have. If we humans are simply a bunch of carbon atoms amassed into molecules, cells, and organs. If we are basically glorified gorillas which have evolved larger brains and walk on two feet then I can understand why we overconsume. It is a matter of Darwinian survival, every man for themselves. I will overspend, overeat, and overconsume because there is no incentive to care about my neighbor as he is just a competitor in survival. If we are to survive as a group we must find ways to interconnect.

This is where religion plays a critical role. It connects people to each other in a way that secular institutions cannot. It connects people to each other within their church, within their community, and within their faith both nationally and internationally. It also connects people to each other through the belief that we are all products of god's creation resulting in connections between religions. Being part of a faith based institution is not only about faith but more importantly about establishing connections between people.

In any other country where there is uniformity and everybody is Icelandic or Swiss or Russian there is an inherent connection between all its citizens. People would be less likely to overconsume at the expense of their neighbor. On the contrary, this country is formed by numerous disconnected groups. This diversity provides great advantages but also results in a disparate and fragmented society. In the US people overconsume without guilt because they are disconnected from their neighbor who may be negatively effected by their overindulgence. They do not see and do not care about their neighbor only about there own sense of entitlement. It is all about them, what the individual can amass, without seeing the larger results of their behavior. This individual disconnectedness is especially inherent in this country due to its diversity and why the need to connect through religious organizations is so critical to our survival.

A Nation of Gluttons

Last week I was consulted on a patient in the hospital with an ear infection. She was a young woman and weighed over 300 pounds easy. I was rounding on her one day and her friend came in who also cleared 300 after just having gone to the cafeteria to bring up something for the two to eat. She brought two enormous slices of strawberry shortcake with mounds of whipped cream on top. They were neither embarrassed by their glutony or had any remorse in devouring these calorie laden snacks.

I have also seen incidences where an obese individual takes food from home and I am curious as to what they are bringing. I have seen one lady bring in granola, fruit, and yogurt every day thinking she must be trying to lose weight. But day after day, month after month there is no change. Now I feel sorry for her if in fact she eats a low calorie diet and cannot lose weight. But I suspect she goes home and gorges on yodels and ring dings. She brings in the healthy stuff to work just for show.

I just do not get it. What goes through these peoples mind as they add more girth to their bods and take years off their life. And don't give me the arguement that they are ignorant of the health effects or that they are so obese that they no longer care. If the fear of a shortened life with disease doesn't incentivize these individuals from restricting their intake then there is NOTHING that will. No government intervention, tax on certain foods, or public education will fix this problem. It is a national crisis and a huge economic burden on the health care system with no solution.

It is an American cultural problem of over consumption without thinking there is a payback. We over consume everything. We overconsume energy to the point of destroying our environment. We overspend and overborrow money to the point of bankrupting ourselves and our children. We overeat ourselves to the point of disease and death. We feel we can do anything to our bodies, our country, and our world because we are entitled. We have lost a sense of humility and self control. We care only about what we can consume at anybody's expense, even our own. We truly have a pathologic culture of conceit and self importance and I see no way to reverse it.

We need a national shrink to redirect our priorities and I think the only one who could do it is the man upstairs. Shana Tova

The Economic Tide

There is a simple truth which is lost on this administration. The fact is that the method to improve the lot of the poor and middle income people in this country is to improve the situation for business and the upper class which will raise everyone's standard of living. This so called supplied side economics or trickle down theory has historically been shown to be the most effective way to secure an improving future for most Americans and for future generations. But this simple reality is completely antithetical and an anathema to BO's ideology.

The problem lies in the fact that this administration is so ideologically rigid in it's idea that the rich have had all the advantages for so long at the expense of the poor. BO came in declaring now that I am here I will change the rules and the advantages will now go to the poor at the expense of the rich. They refuse to understand that it is not a battle of rich versus the poor, one having the advantages over the other. It's role is to improve both group's position and the best way to do this is not to take from the rich and give to the poor but to put in place policy that will enhance everybody's opportunity to succeed. A rising tide will raise all boats.

They must understand that there will always be rich people and poor people in a successful capitalistic society and in such a society the poor will be elevated economically as the entire pot increases. Success of the rich is not at the expense of the poor but to the benefit of the poor. The key is to provide OPPORTUNITY for all, not to guarantee the end result. Their job is to ensure a level playing field where anyone can excel based on his/her abilities but can also fail and be allowed to try again.

The administration must realize that the rich are not their enemies. The government must partner with business and the wealthy which then and only then will help the poor and middle class. Only business can produce wealth which can then be spread amongst all people and this idea is so distasteful to this administration. Their fault lies in the belief that they can short circuit the system by taking from the rich and giving to the poor without undermining the system. That government can orchestrate the distribution of wealth at it's whim and according to it's distorted sense of fairness spells the death of capitalism in the USA. It is said a rising tide can lift all boats, but contrarily, an ebbing tide will lower all boats however the rich will have the resources to move to a better shore.

Thank You and Goodbye

Thank You
A couple of weeks ago a 26 billion dollar package was passed by the government to deliver two main objectives. The first was to ensure that teachers would not be laid off and the second was to shore up medicaid programs in the states (government insurance for the poor). The next day I went to my children and thanked them for being so generous with their money. In essence the government is borrowing/stealing money which will be paid back in the future by my children and grand children. The government is basically taking their future income and giving it to me so I can take care of poor people. So thank you kids, for transferring your future wealth to me.

They are also transferring this stolen money to support ridiculous and unsustainable government pensions. This is instead of making the tough and necessary changes in those benefits just to continue pandering to secure votes and power. HOW IRRESPONSIBLE of these generational thieves to steal this money? They spend money as if there is no payback. Both parties are at fault (you know which one primarily) and are a bunch of pathetic cowards.

Good Bye
Yesterday I sent off my first child, my only daughter. She went to study abroad for 10 months before she starts college next Fall. I suppose I wasn't prepared for how difficult it was going to be for me. As if a piece of me has been removed, and one of my best parts. The years of her living with me under the same roof are over. It went way too fast. The memories are so numerous but it is difficult to think about them because they are by definition in the past and this marks the transition to a new stage for which I am not prepared. The memories just reinforce this painful change.

My daughter's main worry and apprehension was she didn't want things to change. She was worried that the dynamics of the family, the day to day relationship would be altered by her absence. Although I reassured her that things can never change between us, inevitably her absence produces a huge void in our household. Although this change is extremely difficult for me, it is good change. I know time will heal this emotional wound but in the meantime it is extremely difficult. As we enter a new and different stage in our father daughter relationship I know we will share experiences that exceed anything so far. So goodbye to my daughter for now. I miss you and love you so much.

Ground Zero Mosque, Too Close or Too Far

I think I have come up with the perfect location for the 9/11 mosque. Some say it is too close to the terrorist massacre that occurred but I say it is not close enough. I mean why should the mosque be built a whole two blocks away from ground zero. I propose that the mosque be located on the top floor of the Freedom Tower. Yes, one third of a mile up in the air in the replacement to the World Trade Center is the ideal place and fulfills several important goals.

I suspect it will be difficult to lease out the space on that floor. For whatever reason, companies and employees may fear occupying the top floor. By locating the mosque on that floor it alleviates this concern. Perhaps as time goes on they will need to expand and occupy more floors. Probably a Halal restaurant will need to be built on the floor. Maybe some office space or sleeping quarters for visiting Muslim leaders and dignitaries. Yes, put them all on the top floors of the Freedom Tower.

As tenants the Muslim community will be paying rent to support the existence of the replacement to the World Trade Center. This is a wonderful way to demonstrate their rejection of extremist Muslims. What better way to spend their dollars than to assist in the success of the building that was brought down in the name of Islam. Quite a statement by moderate Muslims that they will not be brought down by the extremists amongst their ranks.

The Mosque will be called the Cordoba Mosque in the Sky and will be the highest Mosque in the world attracting many tourists. The top floors will be packed with Muslim tourists from around the world to take in the views, be called to prayer, and to catch a bite at the Halal Windows of the World.

By putting a mosque on the top floor I think the chances of another similar attack on the building is brought way down. Al Quaeda will certainly be deterred from sending another plane or planting a car bomb in the basement if the result is the destruction of the Cordoba Mosque in the Sky along with their brethren in the building. It serves as a great deterrent.

Finally, Imam Rauf should have his top floor office facing New Jersey with all glass windows so he has a great view of any incoming aircraft.

9/11 Mosque, My Two Cents

Regarding the 9/11 mosque, there were two thoughts I heard that I thought were the most interesting. I am not sure where I heard the first but it alluded to the fact that the Muslims can build a mosque at ground zero when the Jews can build a synagogue in Mecca. This comment distinguishes the degree to which other religions are tolerated by Judaism and Islam. While the Jews and Christians are tolerant of Islam, unfortunately, the opposite cannot be said. By being intolerant of other religions, Islam engenders resistance when it requests to build a mosque based on our rules of equality, fairness, and tolerance.

The second was the comment by Newt Gingrich that if the goal of building the 9/11 mosque is to promote tolerance then why not have a building that houses a mosque, a church, and a synagogue. Let the religions co-exist in a building and be a microcosm of co-existence and tolerance. Let there be interfaith dialogue with classes, open debates, and courses that anyone can enrol into and potentially view over the Internet all over the world. If the religions can demonstrate peaceful coexistence and constructive communication in this building it will serve as an example to the entire world.

I think the sole purpose of this building should be as a symbol of tolerance amongst the religions. This is exactly the opposite of the mindset of the 9/11 terrorists and will have exactly the opposite outcome as the one intended by the terrorists (to instill terror). It should serve to eliminate suspicion and fear. Trust not terror should be the aim of this institution. It will hopefully serve as a deterrent to prevent future acts of intolerance and would also serve to encourage future generations to "buy in" to the idea of religious tolerance primarily amongst Muslims.

Unfortunately, the current plan does not appear to promote tolerance. In fact, it seems to be worsening the isolation of Muslims and promoting suspicion and fear. This is an enormous chance for moderate Islamic leaders to change their image that currently exists. By promoting inter-religious tolerance through this initiative they can impact future generations throughout the world.

OR Personnel

I was in the operating room a few days ago doing some procedures and a couple of things occurred which demonstrated the stupidity that has infiltrated the medical field. It also demonstrates the degree to which the legal profession has hamstrung the medical profession into the way we treat patients and in performing meaningless tasks which detract from patient care.

Besides the patient there are four professionals in the operating room. The surgeon, the anesthesiologist, the circulating nurse and the scrub tech (the person who assists the surgeon). The job of the nurse is to be available to the patient and the anesthesiologist throughout the procedure. In recent years all they have time to do is fill out the enormous volume of paperwork that must be completed for each procedure. In my case, a child was undergoing a procedure and the nurse was complaining that at the end of the procedure she had not yet completed her paperwork and was unable to help the patient. I do not blame her but I blame the lawyers who have created an atmosphere where everything has to be documented to such a degree in case anyone in the future needs to look back. More attention is paid to the paperwork than to the patient who is having surgery.

Due to the recent incidences of operations being performed on the incorrect side, the surgeon is asked to mark the site in the waiting room before entering the OR. My case involved an elderly gentleman who had a visible lesion on the outside of his ear. It was clearly evident to anyone who would look. The nurse asked me to mark the site. I said to her you must be kidding, the lesion is the mark. She agreed with me but told me this is the policy and I must comply. So here I was ridiculously making a mark next to a visible lesion to pacify some bureaucrat that created a policy to prevent lawsuits.

Although, the lawyers are supposed to institute changes which benefit the population, they have in certain circumstances created a system that forces that care to be diminished. We are so concerned with the threats of a lawsuit that our judgements are impaired and it is the patients that suffer. By instituting blanket policies it reinforces the belief not to use one's common sense but to create policies that dumb down everybody to pacify the lawyers.

In addition to the patient and the four professionals in the operating room I should truly add that invisible person that lurks in the shadows waiting to second guess, the patient's lawyer.

White or Black Racism is Racism

Growing up, it was always drilled into my head the concept of racism and how the white people are racist versus the blacks. But what seems to have been lacking is the reverse, the hatred of white people by blacks due to the color of their skin. For some reason this was never discussed and it seems that blacks would always get a pass when they would do or say something racist. I suppose the logic was since they historically have been the victim of racism (slavery) then they had the right to harbor hatred towards white people. I even heard that it is not possible for a black person to be racist towards whites because of their historical victimization. Or perhaps we feel so guilty regarding our anti-black racism we tolerate anti-white racism by blacks.

Whatever the case is or reason for this disparity white culture has come a long way in dealing with their racism. Years and years of education and media attention to promote tolerance by white people has worked. Blacks are given an equal opportunity to whites and some may even say they are given a leg up versus white people to compensate for their history. But what have the blacks done to temper their racist attitudes toward white people. The answer is very little and in fact the leaders stoke this hatred of white people as a way to maintain their leadership and it acts as a scapegoat for their own troubles.

Black leaders have recently changed the subject when it comes to racism. Although, individual racist activity exists and will always exist against blacks (and whites, and Hispanics, and Asians, etc.) the number of incidences are few and far between and certainly have been decreasing. Instead of being able to produce examples of individual racism they now talk about institutional racism. A convenient method to prolong the racist claim.

So what is institutional racism and how do you prove it? The suggested proof lies in the fact that since blacks have not attained the same level of success as whites or other groups it must be due to racial preferences. The flaw in that proof is it assumes the lower social standing of blacks can only be due to racial oppression and not other factors. It completely absolves blacks of any responsibility for their own social level and places the blame on "institutional racism" which is a nebulous phenomenon that cannot be proved or disproved.

Ultimately, racism is a human phenomenon that exist in all races and victimizes all races. Racism is not inherently a white problem and blacks are not the only victims. We all must fight that natural tendency to group people based on their race, sex, religion, etc. The black community for too long has been given a pass for their racist activity and speech and it is time for this to be addressed and given the same attention as white racism. BO needs to step up.

The Pocketbook Phenomenon

I have come up with a few observations regarding pocketbooks that I would like to share with you. There are times when after seeing an elderly woman in the office I will pick up her pocketbook for her so she doesn't have to bend down and it astonishes me how heavy these bags are. Keep in mind that some of these women are quite old, have difficulty walking, and can barely bend down. Regardless, they carry these bags that definitely weigh over twenty pounds. What the heck are they carrying in there? No wonder they have back problems.

Another scenario arises while taking a history from a woman that I ask her a question and she responds that the answer is in her pocketbook and she will get it right away. Immediately, I know I am in for a five minute expedition while she searches the depths of this black hole known as the pocketbook. The search goes on and on as she exclaims I just had it, give me a second. She looks into pocket after pocket, compartment after compartment until I am ready to shoot myself while patients are waiting for me in the waiting room. Seriously gals, a pocketbook is just a bag of stuff thrown in no specific order that rarely gets cleaned out. It piles up loads of junk and it is nearly impossible to find anything in there.

The most surprising thing about this useless appendage that women carry is the obsession with them and the cost of these bags. They need a different one based on the color of their outfit and based on where they are going. And the costs of these pocketbooks goes into the thousands of dollars. Some women collect dozens of different bags. Not understandable to me.

Now I am not sure if it is my abnormality but I never notice a woman's pocket book. I never remember saying to myself wow, that pocket book just doesn't go with her outfit or it is so nice or so ugly. So I suspect the obsession isn't to impress a man but rather to outdo other women. They compete with other women over the beauty of their bags. Totally ridiculous.

I know I just do not understand women and certainly their obsession with a pocketbook. Maybe this is connected to a woman's inherent nesting impulses. Maybe there is a neurologic need to carry a portion of their belongings with them at all times. Who knows? Anyway, gotta go, I think that lady finally found what she was looking for in her pocketbook.

Racial Divide Deepens

It is amazing that having just elected a black president, this country is experiencing its worst flair up of racial tensions that I have experienced. Rather than promoting unity amongst the races, the administration is creating more polarization and worse is creating more radicals on BOTH sides. While BO, Holder et al. think they are doing black people a favor by treating them more favorably than the remainder of the population, in the long run they are creating more hatred and racism both against the blacks and black racism against whites.

A recent example is where the black panther in Philadelphia was engaged in voter intimidation and the case was dropped. An official at the Justice department testified that no case will be pursued where a black person is accused of racism. This exemplifies different standards of treatment based on the color of one's skin which is by definition racist. But by the law of unintended consequences, although BO thinks he is doing black people a favor by this policy, he is doing the complete opposite.

If black people feel there is no consequence to radical behavior then one would expect more episodes of these acts and perhaps much worse. If white people feel there is no law enforcement against black crimes then they will take the law into their own hands. It will also push whites into more radical racist groups. By treating people differently in front of the law based on skin color, people will see the law as arbitrary and lead to greater polarization of the races into more extreme ideologies.

We already hear a call to arms by black extremists and murder of cracker babies and their mothers. The administration does nothing to pacify these extreme voices. The media only reports about the radicals on one side and not the other. Both the administration and the media are unintentionally encouraging more radicalism by their inaction and bias.

This radicalism is likely to continue to worsen as this administration continues with its policy failures. Blacks will falsely blame BO's failures on racism as they have so much invested in this president's success. As BO become more unpopular and the GOP regains control this will further polarize the black community and they may become desperate as their great hope whithers. I predict we are heading into a time of extreme racial unrest and I fear where these trends leads to. Is it not logical to assume that violence will eventually be the outcome of this radical racial polarization.

To My Son

During the family vacation two weeks ago we went to see a couple of colleges with my son who will be a senior in high school this coming year. We often get into discussions of what he is interested in studying and I would like to give him good advice which usually just annoys him. The problem is I have no feel as to what would be a good and fulfilling job for the next generation. I don't suppose he would follow my advice anyway but let's assume he is at least listening to what I have to say.

Since I am a physician, naturally he has considered this as a choice but has pretty much dismissed it out of hand. I am not sure why but he has no interest in the health field in any capacity. Maybe he sees me and my life as an example (getting up in the middle of the night and going to the hospital and then complaining the entire next day how tired I am). He sees through me the negative aspects since I complain about the negatives more than I extol the numerous positives. I think because of this he has a distorted view of medicine and maybe he should reconsider.

Many people ask if I would recommend my children to go into the field of medicine. I usually tell them if my child truly loves medicine and that is their passion then they should do it. If they are looking at medicine as a field that will earn them a great salary then they should look elsewhere since there is no guarantee that the money will be there in the future. The amount of time spent in school and in training with intense competition and extreme work hours is an enormous sacrifice. The actual quality of life as a physician is mixed. It is extremely rewarding sometimes, painfully routine and boring sometimes, physically and mentally demanding, and highly stressful always.

So if my son has ruled out the health care field then what are his options. He says he wants to go into business but doing what? I have no business to give him so he would have to start from the bottom and work his way up. Probably very competitive and difficult to be successful. Law school may be a good option as a stepping stone into business, but if he becomes a practicing lawyer I would have to hate him. Ultimately, the only advice I can give him is to pursue what he is passionate about. Hopefully, the money will be there but if not at least he will be spending his time doing what he loves.

Exposed

One of the many good parts about going on vacation is that I generate a lot of material for the blog. It is probably a combination of the facts that without work I can think about other things and being outside of my normal environment exposes me to a variety of different material. Having spent two days at a water park in Virginia and then going to Virginia Beach I was exposed to a lot of people in bathing suits (most of whom I would have preferred not to) and I developed some anecdotal conclusions.

The prevalence of obesity in this country is at epidemic proportions and the percentage of obesity varies amongst races and genders. Although, obesity effects all races and is increasing in all races it appears to be most prevalent amongst African American (AA) females. I would watch crowds go by and notice one after another obese AA female, while only rarely seeing one over 40 years old and of normal weight.

The percentage of AA females with obesity and morbid obesity is astonishing and it appears that their body image is unaffected and/or ignored. Many walk around in highly revealing swimwear exposing their folds. I give them credit for not being fixated on the "perfect" body we are bombarded with in the media and feeling comfortable in their own skin. The incidence of eating disorders such as anorexia and bulimia are much less in AAs. They are much more mentally healthy about their bodies but it is at the expense of significant health risks and a shortened life span.

Some would say that healthy food costs too much and that is why a higher percentage of AAs are obese. I do not buy it. It seems as though the message of skinny equals healthy and fat equals disease has been lost in the AA culture or it is just chosen to be ignored. This is difficult for me to understand and I wish there was a way to remedy this.

On the other hand many white women are often fixated with their bodies and have distorted body images. Due to this obsession, they suffer from eating disorders in higher proportions. They tend to be overly concerned regarding their appearance. Although they may be physically healthy with lower weights they are mentally unhealthy with their body image.

So two racial groups with opposite problems. One obsessed with their bodies and one unconcerned. One leads to poor mental health and one leads to poor physical health. This is a deficiency in the two respective cultures. After coming home I searched to investigate the actual rates of obesity among different races and genders and my anecdotal conclusions were confirmed. Just an observation with no easy answers.
(http://obesity1.tempdomainname.com/subs/fastfacts/Obesity_Minority_Pop.shtml)

GPS Chick

I missed a week or two but I was crazy the week prior to vacation. Crazy work schedule, on call for the hospital and my daughter's high school graduation. Anyway, I am on vacation blogging from a Holiday Inn in Williamsburg, Virginia. We, or rather I decided that we should do a family vacation since my daughter will be traveling abroad for the next year and didn't want to do the usual vacation of leaving the kids at home while my wife and I travelled with friends. So here I am in Virginia going to amusement parks and checking out colleges for my son. In typical Griswald style we headed out on a drive to Wally world.

This is my first experience with a GPS. I had bought one for my daughter when she became a driver but I had never used it. Clearly, why would I, a man, need a machine to tell me directions when I could just as easily use my brain and consult with a map. But she convinced me to take the GPS along with us and I learned to use it. At first I thought wow, this is a terrific device. I could just plug in my destination and just listen to the GPS chick tell me where to go. But slowly my reaction became mixed.

I am not sure when, but at some point during the drive I realized that something was missing. The challenge of the open road, figuring out how to get to the next destination was lost. Using the GPS eliminated that sense of fulfillment and satisfaction I would gain upon reaching the next destination using my own navigation skills. I am convinced that our children who will always use a GPS will never attain those navigation skills. A loss? who knows.

Truthfully though, I just couldn't put down the map. Somehow I lacked complete trust in the GPS chick. A couple of times my calculated route conflicted with the GPS chick's and I didn't know whether to trust her or use my own judgement. Of course my wife would always side with the GPS chick and they would gang up on me. Now I had to contend with two women nagging me about directions, GPS chick and my wife, instead of just my spouse. If you include my daughter that's three females against me. How is a man supposed to endure an expedition with three women giving me orders to turn right or left? Very demasculinizing.

I wonder if there is a way to program the GPS to get a man's voice. Then I will call him the GPS guy. I would have a much easier time accepting directional orders from a masculine voice. Maybe they can get General Mcchrystal to do the voice now that he is out of a job. I would feel extremely comfortable taking his orders even if my wife and daughter would always side with him against me.

Facts? Whatever

Last week was incredibly frustrating for me. The response of the international community to the incident in the Eastern Mediterranean regarding the flotillas was the usual knee jerk response to pounce on Israel. It appears that no one can see the issue from the Israeli point of view and the necessity of Israel to protect its citizens from Hamas obtaining weapons.

Israel has no desire to punish the people of Gaza and this is seen by the tons of humanitarian materials that are brought to Gaza by the Israelis. But Israel cannot sit idly by while ships are going into Gaza without being inspected for weapons. The Hamas government has in its charter the eradication of Israel. They have been firing thousands of missiles into Israel and since elections have consequences the people of Gaza are suffering for their choice.

The frustration stems from the apparent inability of the international community to recognize these facts and immediately take the side of the underdog over the Israelis even though Israelis are in the right. In addition, there is a segment of the liberal left across the world (including many Jews) that sympathizes with the Gazan people and feels it is the Israelis that are causing their sorrow when it is in actuality their Hamas government. These bleeding hearts should focus their attention on Hamas which uses aid money to purchase weapons to use against Israel instead of for the benefit of their citizens.

I was discussing with my father the situation and how I cannot believe that people cannot see the facts that are directly in front of their eyes. How can people not come to the conclusion that Israel is fighting for its security and survival and needs to prevent weaponry from entering Gaza. I mentioned to my father my frustration and he said something that sent a chill down my spine. He said now you are seeing a little taste of we went through in the 1930s in Europe. The facts do not matter. The anti-semitism distorts people’s logical conclusions. Hatred of the Jew trumps all common sense.

The world does not seem to be able to tolerate Jews defending themselves. It is unfortunate that the only time the world sympathizes with the Jews is when they are marching into ovens.

The Law of Unintended Consequences

The government just doesn’t learn that everything they institute has effects that reverberate for months and years after their interventions. Even though they are done with good intentions, ultimately they often have long term effects which are detrimental and end up with the exact opposite result which was intended. I understand the government believes they are doing what is in the best interest of the American people but the truths are they overreach and micromanage and meddle in areas where they should not. Two examples are the mortgage mess and the oil spill.

The desire of the government to promote every American to own a home was a goal that seemed quite noble. The government created a situation where mortgages could be originated with minimal chances of them being paid back. FNMA and Freddie Mac would purchase these loans taking the risk away from the lenders and placing it on the taxpayer. If the lender had to keep these loans the lending standards would never had been so lax and so many bad mortgages would never had been originated. So as things turned out many people lost their homes through foreclosure and the American taxpayer is in the hole for billions through FNMA losses. Good intentions turned into disaster for so many individuals and the country as a whole.

The government in their desire to be sensitive to the environment decided that drilling on-shore or on the outer continental shelf or in ANWAR was not acceptable. The oil companies were forced to drill in the ocean or in the Gulf of Mexico and drill down a mile to reach oil. Now that there is a problem so far down it is looking as though we will be unable to plug the leak. Now we have an environmental disaster much greater than any impact that would have been created with drilling in ANWAR. Again, good intentions from the government resulting in an outcome exactly the opposite of what was intended.

In both of these cases it is not the government that is entirely at fault. With the oil spill human error and greed by BP played a role and with the mortgage crisis greed by banks, mortgage brokers, and individuals were a major factor. But it was the government that set the stage for theses crises. Human greed and human error are constants and will always exist but government is the enabler that allowed them to manifest. The government distorts market forces as well as natural incentives and disincentives which often promotes greedy behavior. There is a role for government, but by overreaching, even if well-intended, leads to consequences that can be disastrous.

Illegal Immigration, Good or Bad?

This past week I had some work done on my house. A few zones of my sprinkler system needed to be redone and I needed a pool company to come out because I had a malfunction of the filter. I tried on my own to fix the pool problem but after hours and hours of attempts I could not diagnose and remedy the problem. The sprinkler guy came with a team of six workers, all Mexican. The main guy, an Italian guy, told me the price and said he was only there for one thing, to collect the money. The Mexicans did all the work in 2 hours and did an excellent job. It was back breaking work requiring a lot of digging. The pool company sent out a team of two, both Mexican. They fixed the problem in twenty minutes (yes, I felt like an idiot) and paid 200 dollars for the visit.

I was thinking to myself what if these Mexicans weren't around. I suspect they are all illegal and get paid in cash from the employer. The employer sits in an office, gets the jobs, and sends out Mexicans ( cheap labor) to do the actual work. If the employer had to hire Americans to do the work, assuming any would take the job, it probably would cost me at least double the amount and the work would likely not be the quality as performed by the illegal Mexicans. So I benefit from the cheap available labor of the Mexicans in the form of lower prices and excellent workmanship.

I honestly believe you would not be able to find Americans to do these types of jobs. It is much better for them to be unemployed and collect a check from the government. The American employee would need to be paid much more than the illegal, would require periodic breaks and sick time, demand health care and probably be out on disability after three weeks of back breaking labor. The truth is we need these Mexicans and we all benefit from there presence.

To those who would say they do not pay taxes, that is a ridiculous argument. It is unlikely they make enough to pay income tax but they pay sales tax on everything they buy. If they actually had to fill out a tax return it is likely in this era of redistribution that they would receive more as a rebate than would actually have to pay.

Some would argue that they use social programs such as hospital emergency rooms and the prison system to incarcerate criminal illegals. Yes, they do drain some valuable resources but I think they add more to the economy than they take. If we were tried to eliminate the illegals we would likely lose the positive aspects the law abiding ones have on the economy but the bad apples would still find a way to get here retaining the negative aspects. We might as well keep both and attempt to reduce the negative as much as possible.

I do not agree with the anti-immigrant stance. I do not think the illegal immigrants should be given amnesty or be offered citizenship but I do not believe they should be deported either. They should be allowed to stay to fill jobs Americans do not want but not have access to the social benefits they would receive if offered amnesty (especially voting rights). We have the demand and they have the supply. If the jobs are available they will come in and fill them. If the jobs dry up then they will return to Mexico. In other words, things should stay exactly as they are. We benefit and they benefit.

Newt in 2012

It seems to be getting clearer and clearer that the time is perfect for Newt Gingrich to assume the leadership position in the Republican party. The right is yearning for a conservative figure to lead the republicans and he has the ability to rally all the various factions including the tea partyers, the evangelicals, the moderates and the more intellectual right leaning voters. I believe he also has strong appeal to the independents as the their main issue is fiscal responsibility and that is his strength. One fear regarding the tea partyers is that they would push the Republicans too far to the right shrinking the republican tent. I think Newt could capture their support as well as keeping a broad tent.

The 2012 election compares to the 1980 election when Ronald Reagan was chosen over Jimmy Carter. Carter was elected after the voters grew tired of Republican impropriety and were ready for a change. Carter was elected only because he was the non-Republican, not because of his policies. The voters rapidly tired of his left leaning policies. The people were ready for a true conservative to step up and assume leadership, hence Reagan was elected. Similarly now BO was elected only because of the circumstances surrounding the election including an unpopular war and economic collapse. The voters were not looking for a radical leftist to recreate America and now are rapidly moving away from him. This sets the stage for a strong conservative to step in and Newt is the one.

There is really no competition for him. Palin, although she has strong appeal to a certain sector of the population has been stereotyped as an unintelligent red neck and will fail terribly against the smooth BO. Romney will lose because he instituted Obamacare into Massachusettes which is very unpopular amongst the right leaning voters. He is not to the right enough for the tea partyers. Jindal, Huckabee, Sanford and Pawelnty all have potential but none have the appeal, the name recognition, and the ability to unite the Republican party.

In the 2008 campaign there was very little to discuss about BO's record especially since he voted present on so many issues. Now he has to defend a record. His only answer is it's Bush's fault. That will not stand and the American people are tired of that excuse. Newt will be awesome against BO in the campaign and the debates and will dramatically expand the Republican tent. He will win against BO in a landslide election. I am really excited for his campaign to start and to eventually rescue this country from the radical left.



I recommend you go to NEWT.ORG to check out his newsletter as well as the video portions to see his recent speeches. You can use this link to see his most recent speech. Paste into the address bar.
http://www.newt.org/video/becoming-party-yes-newt-gingrich-speaks-southern-republican-leadership-conference

New Jersey and Greece, Perfect Together

There is a glaring similarity between the financial crisis in Greece and the crisis in several states in this country. Both belong to a larger union which have a single currency. Both are unable to print money. Both have borrowed way too much to fund their spending. Public employment is bloated with too many employees with unrealistic salaries, undeliverable benefits, and retirement packages which are completely out of line with the private sector.

In both situations they are are seeking the other more responsible states/countries in the union to bail them out. In the case of the US the Obama administration is funding bankrupt states with stimulus funds to prop up their failed bloated governments. This money is raised by taxation of all of the states including those that have made fiscally responsible choices. Additionally, there is no demand to control spending and effectively encourages the failed state's irresponsible behavior as a bailout is always around the corner.

In the case of Greece the European Union is offering a bailout. These funds are obtained from other countries in the union including Spain which itself is on the verge of needing a bailout. In addition the International Monetary Fund is offering a bailout and the irony is the IMF is funded by countries who themselves are running ridiculous deficits. The US would contribute to the IMF bailout while it is has a deficit of 12 trillion dollars. The American taxpayer will effectively be giving their money to some Greek public worker so he/she can have his promised benefits. Ridiculous.

And finally, both are having a very difficult time trying to institute changes in their public work force in order to be fiscally responsible. As Greece attempts to decrease its expenditures and cut the public workforce it is met with violent riots. In New Jersey when the new governor tries to bring the budget into balance and cut expenses he is met with radical protests, threats and demands that taxes be increased to cover the public jobs.

Taxes can no longer be increased to cover government runaway spending. The only option is to cut expenses and both the Greek and New Jersey public worker will have to suffer for the mistakes made by its government that expanded beyond what was realistic. It is not the fault of the current government trying to cut costs or the fault of the public employee who obtained the job. It is the fault of the government that was in place when the expansion took place and made promises to people that could not be fulfilled.

Ultimately, it is the idea of big government that has brought this pain to so many. It is a fault of the democratic system where government can spend money it doesn't have in order to garner votes to maintain power. This is happening all over the world. It will be very interesting to follow how the financial situations of Greece, New Jersey and elsewhere get resolved.

Reverse Boycott of Arizona

For all those people who believe it is the right of Arizona to protect its people when the federal government is derelict in its duty, we should make it our business to demonstrate this with our dollars. It is ridiculous that the people of Arizona have to endure the financial burden as well as the elevated crime created by the Mexican druggies coming across the border.

It is the federal government's responsibility to control the borders and it is clearly not willing to do so. It is crazy that the media is portraying this as a racial issue. It is a national security issue, an illegal foreign invasion, and a threat to individual tax paying Americans. BO should take the lead on this and loudly declare that the US will not tolerate this behavior and will protect Arizonans from this threat. BO will not make that choice to protect US citizens and would rather protect the Mexican drug lord illegally crossing the border. He clearly is throwing Arizona under the bus by not allowing them to protect themselves only for political reasons, to pander to the Hispanic community. He is so pathetic to not have the courage to stand up for the Arizonan tax payer.

The boycott against Arizona should be offset by a reverse boycott by those who agree with allowing Arizona to crack down on illegal immigrant criminals. Those looking to go on vacation should consider going to Arizona to spend their dollars. A trip to the Grand Canyon this summer would be a perfect getaway. Go to a convention in Arizona. If you are going to a baseball game this year make a statement and go to a Diamondbacks game. And when you are food shopping pick up some extra Arizona iced tea. Yeah, I know it is made in Long Island but it would still be a great message if Arizona iced tea sales increased. We need to demonstrate with cash our support for the citizens of Arizona.

Where to Get News

It is ironic that with so many media outlets including tv, cable, and print it is actually difficult to get accurate and reliable news. A lot of the news just skims the surface and it is difficult to find resources that look deeper into stories. In depth news about Israel seems quite hard to come by. These are a few of the sources that I go to on a regular basis.

I get the Wall Street Journal everyday and I usually turn to the back of the first section where the editorials, commentary, and letters are written. I find these to be very informative and consistent with my political bias. Beyond that, if I have time, I read the personal finance pages which often have good advice on my own financial situation. Then, the front pages and finally the financial data pages which I rarely get to.

C-SPAN has a show every morning called Washington Journal. It is a call-in show from 7-10 without a screener and the topics are fairly wide-ranging. The reason I like it is that people say what they truly feel. Periodically, they discuss Israel or the Middle East in general and it amazes me the number of calls that come in which are anti-Israel. Often they are discussing an unrelated topic and someone will call in blaming Israel. The guests on the show field questions from the public and the topics are discussed in depth.

Every night from 9-1am the John Batchelor show airs on talk radio 770. He has a very interesting show and has guests which are quite informative on foreign policy. I especially recommend Thursday nights when Malcolm Hoenlein is cohosting. There is usually an in depth conversation regarding the Middle East and Israel in particular. Malcolm Hoenlein can also be heard on JM in the AM on Friday mornings or you can go to the website archives and listen to his update from the computer (Jmintheam.org).

Finally, if I get home in time I like to watch Special Report on Fox News from 6:40-7pm. There is a panel discussion but I really only like to hear what Charles Krauthammer has to say about the events of the day. He has the ability to cut directly to the core of issues and explain them in a simple manner with excellent commentary. If anybody has other outlets, I would love to hear about them.

BO vs. Bibi

Ponder the following scenario. Hezbollah instigates Israel by kidnapping a couple of soldiers or sending a suicide bomber or placing their new Syrian/Iranian scuds on the border. Israel retaliates and the confrontation with Hezbollah escalates. Israel has has it with the Syrians supplying weapons to Hezbollah and decide to go after Damascus. Israel depletes its weaponry and asks the US to resupply its forces. Barack Obama must make a decision whether to supply Israel with arms to continues its mission. BO hesitates on the decision, perhaps by demanding tying rearmament to concessions. Iran says okay the US is hesitating on arming Israel, here is our chance and launches an all out attack to finish off Israel. Israel fights for it's existence. Far fetched? I do not think so.

Show me one action BO has done, not words, that demonstrate that he will be there for Israel when the time comes. By his inactions and negative behavior towards Bibi, BO is quietly giving the signal to the Arabs that their next chance to eliminate Israel is coming up. So not only will he stand by while Israel needs him but in effect, by his current behavior, he is instigating a conflict. The tiniest crack in the relationship between the US and Israel will be exploited by the Arabs.

The only reason BO involves himself with the Israel-Arab conflict is for his own self promotion. His mission is solely to put his name onto a peace accord regardless of the effect on the parties, specifically Israel. Just like in the case of health care he doesn't care about the substance of the legislation he just wants to glorify his name and ego by achieving something that has been elusive to previous administrations. It has always been and always will be about BO, not about the effects of his policies on the parties involved. His narcissism supercedes any potential damage to the underlying parties.

I would love to have a private conversation with Bibi and find out what he really thinks about BO. I can hear him saying privately to his wife when no one else listens that he is an antisemite, couldn't care less about Israel and that the American Jews threw Israel under the bus by overwhelmingly voting for this radical. Even though I didn't vote for him, I am ashamed as an American Jew that we assisted in getting him into office. My sincerest apologies to my brothers and sisters in Israel.

Your Tax Dollars At Work

I just wanted to inform the readers where their tax dollars are being spent. Let me do that by describing a patient who came to see me this past week. I called in a 35 year old man into the examination room from the waiting area. He walked in without any difficulty and as I looked at his chart I noticed his insurance was medicare, a government insurance for the elderly and disabled. Naturally, since he was not elderly I asked him the nature of his disability since I need to be aware of his past medical history which may be informative regarding his current visit. He informed me that he is disabled due to back problems and has had previous surgery for his back and thus cannot work. Let me repeat that he walked into the office without a cane, walker, or wheelchair. He ambulated without a limp, pain, or hunch.

The visit continued by asking him the reason he had come to see me. He told me he was in Mexico and on the airplane ride back suffered pain to his ears which hadn’t cleared since he returned one week ago. Of course, I inquired what he was doing in Mexico and he responded he was on a trip for R&R. My first thought was R&R from what? You are disabled and supposedly do not work. What do you need to rest from? My second thought was if you are disabled to the point of not being able to work, what were you doing in Mexico? Did you go swimming? Play some tennis? Maybe some beach volleyball? And thirdly, how can you afford a trip to Mexico and be on welfare?

Of course, I didn’t express these thoughts to the patient. I diagnosed and treated him as I would anyone else, and he walked out as sturdy and with the ease that he entered. I was curious to see what car he was driving so I watched as he left the office, entered his late model Lexus and drove away. Probably heading to his job where he gets paid off the books.

I am sure there are thousands of people who abuse and cheat the system like this patient. The government is incapable and/or unwilling to police their programs for cheaters. It is much easier for them to just increase taxes or borrow the money from our kids/China. There is no doubt in my mind this man could hold a real job but it is better for him to collect a government disability check, receive medicare benefits, and find a job off the books. I should be able to report him to the government for fraud and receive a whistleblower’s award. This way I can afford to go to Mexico instead of this thief. Just another example of your tax dollars at work.