MONDAY and TUESDAY, MARCH 31 and APRIL 1, 2003

As I watch and read the news and news coverage of this war, including some of the news briefings - where critical speechifying by correspondents is supposed to pass for legitimate tough questioning, the events of the last several months recall another difficult period for the world, when the world failed:  the League of Nations, Japan's invasion of Manchuria, Hitler's occupation of the Rhineland, Mussolini's attack on  Ethiopia, Hitler's advance into neighboring countries - all with no response from the world community - except for Neville Chamberlain's approval of the whole enterprise.  And then there was Tokyo Rose.  Her siren songs were  different from the constant carping and distortion coming out of liberal news outlets.  But the effects can be the same:demoralizing our armed forces and  giving aid and comfort to the enemy.  Notable exceptions include the work of Tom Brokaw and Jim Lehrer.  The  media's job can be done right.  Bottom line: Americans can pro-actively defend ourselves against enemies where they live, and thereby dissuade them from their plans; or we can resign ourselves to walking around the world with a target on our back, waiting for the next blow.

GS

SUNDAY, MARCH 30, 2003

Hold on to your hat.  The "Education Establishment" has another new idea.  As reported in the New London Day today (section A, p1), "High School rankings are on the way out".  To be replaced by what?  "Self-Image"?  Given the job that the Education professionals have done with public education in this country in the last 30 years, a little skepticism is definitely in order here.  And the reported fact that colleges and universities "don't need them any more" is not at all reassuring, given the well-known de-valuing of their standards.  The only thing that can guide a student today is his or her own self-actuation to do the very best that he can do...and not to be deluded regarding how the real world operates.  Please see my letter "To The Students of Public Schools, in New London and Elsewhere", and other offerings  in the Category "Public Education" on this web site.

GS

FRIDAY and SATURDAY, MARCH 28, and 29, 2003

When the history of this war is written, two foolish ideas will stand out: 1) the expectation that a campaign of "shock and awe" would carry the day in a region where war and brutality have been a way of life for millennia; and  2) the idea of 'imbedding' reporters in active military units and allowing them to announce their interpretations as well as information about the precise whereabouts of specific units and their missions. (Please see Rapid Response, Monday, March 24, below).  What happened to the military requirements of both clearance for security and a need-to-know, neither of which elements exist for the world's population on a real-time basis.  And what other lessons can we now already glean from events of the last two weeks? A) We waited much longer than prudent to start the war, allowing too much hypocracy to vent amoung our "allies" and in the U.N.  B) We seem to have allowed the politics of military call-ups to trump the wisdom of the Powell Doctrine: where is the over-whelming force? C) The entire concept of relying on Reserves and National Guard to be first responders instead of being "reserves" must be revaluated; in this world we need a larger standing Army, and so we need to return to the Draft, which would be a boon to our country and to 18-20 year olds everywhere - as it was in the past.  D) In this war with a totally unprincipled enemy, white flags and Red Cross "hospitals" must be required to prove their bona fides with no prior assumptions on our part: every vehicle is a weapon; and every stranger is the enemy until he has dis-armed and dis-robed to a bare minimum and at a distance. E) Forget urban warfare, and instead lay siege.  Americans had to rise up against the oppressor to gain our freedom; Iraqis must do no less.  See also, The Federalist website.

GS

THURSDAY, MARCH 27, 2003

What a way to start the day!  8:00 AM, The Today Show, Katie Couric and Matt Lauer (NBC) presenting the news as they see it, with their usual liberal "gravitas".  And what are the three lead stories to bring us all up to date on war news of the previous twelve hours? 1) American and coalition casualties; 2) Iraqi allegations that we intentionally bombed a Baghdad neighborhood; 3) views of some New Yorkers lying down in the streets of the city in protest.  They don't even try to hide their bias.  But isn't that what we expect from them?  Later, President Bush and Prime Minister Blair gave a refreshingly candid - and united - view of our efforts and of the reasons for those efforts.  The lesson here, as always, is: get your news directly from the news-makers; or at least get it from at least two independent news sources.  The Wall Street Journal is a fine source and is a good counter-balance to the New York Times.  One final thought: Daniel Patrick Moynihan, a good man.  May he rest in peace.

GS

TUESDAY and WEDNESDAY, MARCH 25 and 26, 2003

More information on SARS, Severe Acute Respiratory Syndrome (see also Rapid Response...Monday, March 17):  Rapid world-wide medical detective work now suggests that the virus responsible for this serious illness is a "corona virus", and that adequate supportive care provides time for a patient's own antibody rersponse.  (See "Labs Collaborate World-Wide To Identify Deadly Virus", WSJ, Wednesday, March 26, Marketplace, pB1 and B5).  Reports so far give little special insight regarding how to treat the condition.  However, "corona virus" is one of several viral groups know to produce enough acute respiratory tract inflamation to cause serious and prolonged coughing and wheezing - even in non-asthmatics and otherwise normal individuals.  Other viruses in this group include RS virus and Para-Influenza virus. We physicians have seen an increasing number of such cases in recent years, especially during this winter.  Such cases must be treated aggressively from the outset with bronchodilators and with inhalational (and sometimes even with oral) steroids, which treatment should continue for at least two weeks after the cough and / or wheezing have subsided.  Otherwise, the condition can last weeks or months, or can even produce  long-standing bronchial asthma (probably "chronic asthmantic bronchitis"). If the inflamation is severe enough and debilitating enough, it can result in a cascade of body "defenses" that can kill the patient (so-called "Adult Respiratory Distress Syndrome").  I hope that physicians charged with treating patients with SARS, and the involved families, consider this approach - in addition to everything else used - early in the treatment program.  I have reported this insight to the Connecticut Department of Health and  to the CDC.

GS

MONDAY, MARCH 24, 2003

What is going on here?  The media  reporters "imbedded" with our troops in Iraq appear to be broadcasting detailed locations of specific battle units and real time commentary on their activities.  If this is not dis-information...is this smart?  Meanwhile, the media at home in America are outdoing themselves, either broadcasting the propaganda of  Iraq's representatives more efficiently than their own TV stations can, or interviewing worried and  bereaved American families, or getting American fighting men to admit that they too are worried.  In another age, this used to be called "giving aid and comfort to the enemy".  In this age of "political correctness", what should we call it now?  And while we're on the subject, since when does the "resentment" of  a grenade-throwing  sergeant become a synonym for treason and murder?

GS

SATURDAY and SUNDAY, MARCH 22 and 23, 2003

The first weekend of war.  No comment, except for a prayer for all involved.

GS

FRIDAY, MARCH 21, 2003

What to make of all the protests against America's response to the Iraq and world terrorism crises?  We have already addressed the reactions of our hypocritical "allies", especially the French.  What about the Vatican and other voices of religion? As should be the case, they hope and pray for peace.  So do we all.  But a little reflection will remind them  that the morality of self-defense encompasses also the right of pre-emptive self-defense.  Furthermore, in today's article by George Will, we are advised  that "it can be moral to use violence to economize violence." (The Day, pA11). What about  the street protesters here and elsewhere in the world?  Some heart-felt conviction; some uninformed naiveté; much political posturing.  And then there is Senator Tom Daschle, carping about the "great failure at diplomacy."  Now that statement, after watching fjor several months the agonizing contortions of the United Nations before and since Resolution #1441, is just plain stupid. Democrats must really have a death-wish.  I am reminded that, unless we find a way to change human nature,  the Roman maxim is still current.  If you want peace, prepare for war.

GS

THURSDAY, MARCH 20, 2003

As the conflict in Iraq begins, the recent world diplomatic conflict is now finally being acknowledged as to its true issues:

Many of our "friends" and enemies are really worried that the Bush Doctrine of pre-emptive defensive action has teeth.  They should be worried.   Only when those individuals and nations currently inclined to support and shield terrorists become more fearful of America's reaction toward them  than of the terrorists, will we be more secure.

The strong surge in some quarters in recent years towards "Internationalism" has now been unmasked for what it  has always  been: an attempted power-grab by un-elected "diplomats" to trump the legitimate authority of elected governments and their employers, the people.  It reminds me of a James Bond movie.  Instead, what we really have are ad-hoc coalitions of the self-interested willing, supported in large part by the United States in the United Nations. The time has come for a world-wide re-appraisal by America of what is really in our self-interest.  Stay tuned.

GS

WEDNESDAY, MARCH 19, 2003

As we wait anxiously for the start of  the pre-emptive defensive strike against Iraq, thoughts turn to how Americans would react to another attack here on the order of Sept. 11, 2001.  The national alert levels and related pronouncements have subtly sensitized us to the next crisis, if it comes, although not in the way terrorists hope.  We would react, not with panic and horror, but with a sense of rage that would be hard to contain.  Indeed, we might over-react  to attack and punish any plausible opponents in our midst, as we did toward the Japanese in December, 1941.  This should give pause to both supporters of terrorists and to those who can identify them, both inside and outside our borders.  For at such a time we might not be too concerned about the nuances of the Bill of Rights.  It would not be right; it would just be human nature.  This is not a threat, but it is a prediction.

Meanwhile, let us not dump too heavily on the poor French, all dressed up and with nowhere to go.  Anyone who has been to Paris will recognise that the only way to deal with some of them is as the weird aunt of the family who shows up at times,  and who is best ignored.

GS

TUESDAY, MARCH 18, 2003

In 1940, during the London Blitz, when large numbers of Londoners were required to stay in bomb shelters for long periods of time, it soon became evident to the authorities that - to avoid panic and mob action - the people had to be given  regular doses of news, some sensory input.  The most common input was: "Ladies and gentlemen, the news is...there is no news." Today, Saddam Hussein and his sons declined to go into exile.  France, Germany, Russia, and China, all economic bed-partners of Hussein for many years, continued their hypocritical and cynical tirades, allegedly on behalf of "peace".  The Democrats continued doing "something stupid", attacking President Bush while over 70% of Americans polled this morning favor war in Iraq now.  Liberals everywhere continued to demonstrate the adage: "they're the first to leave the room when the fight starts". And the Eastern media spent their output today trying to scare us witless with stories of possible simultaneus massive attacks all over this country. We all are saddened by the fact that an unavoidable, defensive, but  prudently pre-emptive war is about to begin.  But: "Ladies and gentlemen, the news is...there is no news."

GS

MONDAY, MARCH 17, 2003

The latest threat to this weary world's elusive calm is the World Health Organization's Alert regarding a new respiratory tract illness.  God forbid, could it be the first sign of another pandemic?  No one knows yet; and great efforts are being applied to its analysis.  We physicians are receiving several e-mails daily from State health resourses regarding what is known so far.

I'm told  that patients are recovering from the illness, with variable reported severity including death in respiratory failure.  I also notice that health care personnel are most frequently affected. This suggests to me that the disease is not as severe as the 1918 influenza; that it definitely is something new; and that contagion may require very close contact, as occurs between doctor or nurse and patient.   Health care workers generally stay more healthy than their patients by catching everything around - and thus by developing immunity to these bugs.  It may be that we in the field are acting as the "canaries" for this danger.

One other observation has been reported:  these patients often show a reduced white blood cell count and a reduced platelet count.  This could be helpful in triaging patients with similar flu-like symptoms.

In any case, persons who develop flu-like symptoms with cough and/or shortness of breath should not wait for more before consulting with their physician, especially if they have recently travelled to the Far East or have had possible contact with someone who has.

More will follow, as information develops.

GS

SUNDAY, MARCH 16, 2003

Last night, at the Garde Theater Center in New London, Ct., my wife and I had the opportunity to re-live the last 40 years by viewing a performance of "The Presidents" by Rich Little and company.  The Cuban Missile Crisis, President Kennedy's assassination,  President Johnson's troubles with the Civil Rights Act and with Viet Nam, President Nixon's paranoia and our Constitutional crisis, President Ford's peccadilloes (like pardoning  Nixon), etc., etc....

Know what?  We didn't like it: too painful to go through the last 40 years again.  Once was enough.
This morning on Tim Russert's Meet The Press, Vice President Cheney gave every reason why we have to deal with Iraq now.  The most important is the fact that 9/11/01 changed all the rules; and the Bush Doctrine has responded in kind.  No sanctuary, no overt or hidden support, no doing business with terrorists.  And the United States will be pro-active, with pre-emptive strikes if necessary.  Let any supporters of terrorists everywhere be on notice.  And let the world know that we take care of our own, with or without coalitions - including the impotent United Nations.

The only unfortunate part of the interview was the 60 seconds spent, during the one hour program, barely mentioning the Israeli - Palestinian issue.  Big mistake, past and present.  Please see my offerings under the category "September 11".

GS