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Title: Blog by Novelist William S. Frankl, MD

Archive for March, 2013

Dr. Ben Carson and ObamaCare

Tuesday, March 19th, 2013

Dr. Ben Carson might run for President in 2016. If so, he will be a dynamic and effective campaigner. Find out what he has to say about ObamaCare.

Newsmax
Ben Carson: Defunding Obamacare: ‘Fine’
Saturday, March 16, 2013 06:42 PM

By: Todd Beamon

World-renown pediatric neurosurgeon Dr. Benjamin Carson has no problems with losing Obamacare in the quest to find a more affordable, efficient, and patient-friendly healthcare system for the nation.

“There are many more economic models out there that can be used to give us much better healthcare than what we have now,” Carson said on Saturday in a speech to the Conservative Political Action Caucus outside Washington. “If we have to work within the framework of the Affordable Care Act, fine. If we can find a way to defund it, fine.”

His Obamacare suggestion brought rousing cheers from the audience at the Gaylord National Resort in Oxon Hill, Md. “We have to find more efficient ways.”

Carson, director of pediatric neurosurgery at the Johns Hopkins University in Baltimore, added: “Healthcare is one-sixth of our economy. If the government can control that, they can control anything.

“We were asleep at the wheel to let it happen,” he said, referring to Obamacare, “but we still have to find a way to make it work.”

Carson discussed the importance of health savings accounts in controlling spiraling medical costs.

“Eighty percent of the encounters between a patient and a healthcare provider could easily be handled by a health savings account, without the need to insinuate a third party or a bureaucracy that sucks out at least a third of the money,” he said. “There are ways we can do this: We can use bridge insurance and catastrophic insurance.”

The famed neurosurgeon, who also announced that he was retiring from medicine this summer, hinted at a possible White House bid. “What if you magically put me in the White House?” he hypothetically posed, also to cheers, in an earlier part of his speech.

Defensive Missile Follies

Tuesday, March 19th, 2013

Morning Bell
The Heritage Foundation
March 19, 2013

The Dangerous Position The Obama Administration Has Placed The United States vis-a-vis N.Korea, Iran, Russia & China

It would take only 33 minutes for a missile to reach the U.S. from anywhere in the world. That’s a sobering thought when North Korea is taunting America with threatening video propaganda about its nuclear capabilities and Iran is advancing its nuclear program.

In response to these threats, the Obama Administration announced Friday that it would increase the number of Ground-Based Midcourse Defense Interceptors protecting the U.S. from 30 to 44. These 30 interceptors allowed White House spokesman Jay Carney to state that the U.S. is “fully capable of defending itself” against a North Korean ballistic missile attack.

He didn’t mention that the Obama Administration has tried to undermine the long-range missile defense program since it came into office, including announcing the “restructure” of the advanced SM-3 IIB interceptor program designed to protect the U.S. and allies from a long-range ballistic missile threat. As Heritage’s Michaela Dodge explained:
When the Administration took office four years ago, it scaled down the number of interceptors protecting the U.S. from 54 to 30. This included cutting 10 interceptors in Poland and 14 in Alaska. The Administration justified its step by saying that the missile defense threat has not progressed as fast as the Bush Administration expected—this despite the fact that both North Korea and Iran have been very public about their efforts to develop long-range ballistic missile capabilities.

President Obama famously told Russia’s then-President Dmitry Medvedev that after the 2012 election, he would have more “flexibility” on missile defense. Just last Friday, his new Secretary of Defense, Chuck Hagel, announced a restructuring of U.S. missile defense priorities to focus more on Alaska-based and California-based missile interceptors. This shift away from commitments to deploy advanced interceptors to Poland and Romania is exactly what the Russians have been demanding.

Thirty years ago this week, President Ronald Reagan asked a question that is just as vital today: “[W]hich part of our defense measures do we believe we can do without and still have security against all contingencies?”

To protect America, all contingencies must be covered. And as Heritage President-elect Jim DeMint has said recently, missile defense works. It works because the only sure way to deter an attack against the U.S. is to make certain it isn’t worth it for the attacker. As Reagan said:
“Deterrence” means simply this: making sure any adversary who thinks about attacking the United States, or our allies, or our vital interests, concludes that the risks to him outweigh any potential gains. Once he understands that, he won’t attack. We maintain the peace through our strength; weakness only invites aggression.

Peabody’s Corner: Darcy

Saturday, March 16th, 2013

Darcy

Patrick Russell, MD LOT 22, Clarenden Road

Clarenden , South Australia,

5157, Australia

Peabody’s Corner is a monthly feature of the Texas Heart Institute Journal. It provides a view of medical care which typified Dr. Peabody’s dictum that “ . . . for the secret of the care of the patient is in caring for the patient.” The following short essay in the’s Journal’s last issue (40 (1): 15-16) points out what medicine and medical care should be . . . And used to be. Rarely today, alas. The essay is beautifully written by an obviously literate and caring physician. So here it is:

He had been in the war. Not in a supportive role, but in a Halifax bomber—the British, 4-engine, heavy bomber, equivalent to the B-17. A gunner or bombardier, I do not recall which, he was there in the thick of it with his teeth clenched.

Darcy. A girl’s name. What teasing I would have endured in my neck of the woods growing up, had that been my name. But he was Australian. I imagined the use of his name in the cockpit during the heat of battle, flak thundering through the fuselage, a nonplussed commander smoking a pipe and calling to him calmly over his shoulder with a scratchy Sherlock Holmes accent, “Darcy, be a good chap and release the bomb-bay doors, will you?” Or, if addressing a gunner: “Darcy, could you be so kind as to return fire to the bloody mongrels?”

That was then—a man’s man with a square jaw, a dimpled chin, and a girl’s name. But now he was a pale and pasty convalescent at the crumbly edge of his life. He had been in hospital for months, delirious from various insults, spending time in 4-point restraints, with one-on-one nursing, his condition complicated by hospital-acquired infections. His imaging, electroencephalogram, and lumbar puncture results were normal. He was thin, feeble, and confused. But in the last several weeks, the lucid intervals were coming more frequently, and he was becoming manageable again.

I did not ask him if he actually wanted to go outside. I told him where we were going and helped bundle him into the wheelchair. And why not? The day was beautiful.

I rolled the wheelchair out of the elevator and down the long hallway toward the front entrance of the hospital, passing healthy visitors right and left as the bright light at the end of the hallway grew larger and stronger until we moved through it and left the air conditioning behind. Suddenly, we were in a different world. The midday sun was bright and Australian. I took a seat on a park bench with him beside.

His chin rested on his chest, face downward toward the white hospital blanket in his lap. He sat, vanquished and silent. I spoke some, mostly banter, while I ate my lunch. After 5 minutes, his head slowly ratcheted up until he faced the warm sun directly. I said something without much substance, like, “Feels good, doesn’t it?” because it looked like it did. He didn’t answer, so I went back to eating my lunch and looked at him again a few moments later. As his face warmed in the full sun, his cheeks pulled back his lips to expose stained dentures. This time a tear was slipping down the nasolabial fold on one side, then the other. He wept, with a trembling lower lip and eyes closed, as if in a prayer of contrition. As if released. There wasn’t anything for me to say or do, except sit and let him be. I was witnessing a day in spring. After 5 minutes, I asked him how he was doing. “Okay,” he said, eyes still closed, lip still trembling, his voice raspy and weak. Then he opened his eyes and looked at me. And he really looked at me. Eighty-eight years’ worth of living: sweaty, depression-era farm dust from unpaved roads; young romance and a simple marriage; the unspoken terror and violence of war children born, some dying too soon; the elation of grandchildren; the death of the love of his life after half a century; many things that I simply would not yet understand. Deep-set eyes, wrinkles, and bristly chin, he stared at me sternly, too manly to care about the drying tears on his chin or the clear drip from his nose. “It’s been,” he paused, swallowed, then continued slowly without blinking or moving his eyes from mine, “6 months since I have been outside.” His stare was both gratitude and matter-of-fact observation … as if I had done only what I had been told to do and nothing more. He stared a moment more, then closed his eyes and lowered his head again, new tears falling freely to his lap. He lifted his head once more to the sun, eyes still closed as he sobbed, then sat quietly for several minutes more.“I’m ready,” he said.

I threw my half-finished sandwich to the ants, wheeled him around past the college students waiting for the bus, white wires descending from their ears, and back to the ward.

We took trips outside almost daily. I ate lunch while he watched people getting on and off the buses. Sometimes he talked, telling short bland stories about the war, about growing grapes, about his family. With time, his expressions became more animated and his recollection crisper. After several months, he was discharged to a low-care nursing home, almost completely independent again.

There is no doubt that much of his apparent recovery happened as a result of good supportive medical care—attention to detail, vigilance for superimposed infection, avoidance of sedation, adequate hydration—a medical regimen in which every little bit counts. But good medical care often also includes things not necessarily learned in medical school: fetching a warm, wet rag for the face of someone vomiting; helping the nurse change the bed pad of someone incontinent of urine or feces, rather than delegating that to the busy staff to be done later; and taking the patient at risk of delirium outside for a bit of grounding with the sun. These are all kindnesses whose worth cannot be proved in terms of outcome, and they will never win anyone the Nobel Prize. But going outside seemed to help Darcy. At the very least, it was something I did for him that he enjoyed but could not reciprocate. It was an attempt to mitigate by some small bit the wintry suffering that happens in hospital. It was an attempt to help usher in spring. I once read that Osler’s dictum might be summarized as, “Do the kind thing and do it first.” Hospital work has further taught me that kindness need not be accompanied by deep compassion or empathy. I do not have to feel compassionate, in order to be compassionate. By small, kind gestures made quietly, as well as the grandstand diagnoses and the big saves, I make my life noble.

Surely Dr. Osler would agree. Surely Dr. Peabody would agree as well.


Articles from Texas Heart Institute Journal are provided here courtesy of Texas Heart Institute

Senator Rand Paul Defends the Constitution

Saturday, March 16th, 2013

Heritage Foundation’s Morning Bell:

Senators Bring Stirring Filibuster Against Obama CIA Nominee

Posted By Steven Bucci On March 7, 2013 @ 7:20 am In Protect America

“I rise today to begin to filibuster John Brennan’s nomination for the CIA. I will speak until I can no longer speak. I will speak as long as it takes, until the alarm is sounded from coast to coast that our Constitution is important…”

That was Senator Rand Paul (R-KY) on the Senate floor yesterday just before noon. With the help of several conservative Senators, he continued his filibuster until after midnight [1].

In an unexpected twist during Brennan’s confirmation fight, these Senators have raised uncomfortable issues for the Obama Administration. Despite failing to head off the earlier confirmations of weak national security nominees like Chuck Hagel [2] and John Kerry [3], conservatives are digging in on Brennan.

Once again, we have a marginally suited nominee with questionable policy choices and actions in his past. Brennan is being savaged for being the originator of and prime mover behind the overuse of drones [4] and for ignoring the ideological basis (radical Islam) of the terrorists the U.S. is now facing.

While the general concept of the use of drones to attack our enemies is well established, the recent comments [5] by the Attorney General that there was an existing authority to use armed drones domestically against Americans has brought the issue a new scrutiny.

As Heritage has stated before [6], use of armed drones inside the U.S. would be foolish and wrong. The Administration’s assertion is a dangerous overreach. In general, the overuse of drones as the counterterrorism method of choice has turned into Obama’s equivalent of Bill Clinton’s use of cruise missiles. Both appear to be cheap and easy. Unfortunately, when used at the exclusion of other military and intelligence means, all you get is press coverage, but not lasting results. The President must utilize a comprehensive counterterrorism policy [7] that uses all the tools available.

Brennan insists that putting any focus on the radical ideology of the terrorists who presently threaten the U.S. would be counterproductive and wrong. This is ludicrous. How can a man lead the key U.S. intelligence organization when he rejects the explanatory values of ideology in this conflict? This is consistent with an Administration that called the terrorist murders committed by al-Qaeda disciple Nidal Hassan (the Fort Hood shootings) an “act of workplace violence [8].”

This President has gotten used to getting his own way—in policy, in personnel, even in the budget fights. The problem with a leader who gets such a taste of power is that he forgets the roles of the other branches of government. The issues being raised in the filibuster are legitimate and deserve real answers. Will the Senate stand up as a body and do its job? At least some of them are trying and are shining a light on subjects the powerful would prefer stay hidden.

Several of the U.S. Senators rallying to Paul’s side include some of conservatism’s rising stars: Mike Lee of Utah, Ted Cruz of Texas, Pat Toomey of Pennsylvania, and Marco Rubio of Florida. They likely wouldn’t be serving in the world’s greatest deliberative body were it not for the work of Senator Jim DeMint, Heritage’s president-elect. Conservatives should thank them for defending the Constitution and standing up for due process.

What We Still Don’t Know About Benghazi

Saturday, March 16th, 2013

Despite repeated requests for information concerning the catastrophe in Benghazi on September 14, 2013, there are nevertheless many elements unexplained and increasing evidence for a cover up by the Obama  administration area. I believe this is covered most completely by the Heritage Foundation’s Morning Bell 0n 3/14/13

Yesterday, President Obama nominated a new ambassador to Libya to succeed Christopher Stevens, who was killed in the terrorist attack in Benghazi last September 11. Six months after that attack—and two federal investigations later—we still have an alarmingly small amount of information about it.

The Obama Administration made quite a mess in the media with its conflicting accounts of the attack, originally blaming a controversial YouTube video for sparking protests abroad.

>>>Watch our video about the Obama Administration’s conflicting accounts of the Benghazi attack

After it came out that it was, in fact, a terrorist attack with ties to al-Qaeda, then-Secretary of State Hillary Clinton shocked Americans with her statement, “What difference, at this point, does it make?”

As Heritage expert James Phillips said, Clinton’s brush-off “indicates that the Administration misunderstands the nature and scope of the Islamist terrorist threat.”

With a new Secretary of State and a new Libya team on the way, Benghazi can’t just be swept under the rug—because the safety of all of our diplomats is at stake.

Both the State Department and the Senate have tried to figure out what went wrong in hopes of ensuring that such a tragedy would not happen again. So far, they have failed.

Heritage experts note in a detailed new paper that “Fully understanding the September 11, 2012, terrorist attack on the U.S. facility in Benghazi is vital to preparing for future security threats to American embassies, consulates, and diplomatic missions.” Lives depend on what the government learns from this attack.

Scott G. Erickson, Jessica Zuckerman, and Steven P. Bucci explain that four key questions remain unanswered:
1.
2.    Which counterterrorism and early-warning measures were in place to address security threats?
3.
4.    Which risk assessments were performed and which risk-mitigation measures were adopted before the attack?
5.
6.    What kind of contingency planning was undertaken and exercised to respond to armed assaults against U.S. facilities in Benghazi?
7.
8.    How was the interagency response to the incident organized and managed?
9.

These are fundamental questions—questions that should have been answered by now. And as the authors note, the conflicting accounts produced by the Obama Administration have made this inquiry unsettling from the start:
Given the conflicting narrative produced by the Obama Administration, there are two possible explanations. One possibility is that officials within the White House were uninformed, meaning communication with the State Department was woefully lacking. The other is that individuals within the White House consciously and deliberately promoted a public explanation of the Benghazi attack that was at odds with reality.

Our experts recommend that Congress establish a Congressional Select Committee to find answers. This type of committee steps in when there are sensitive issues relating to security—Select Committees investigated both Watergate and the Iran-Contra affair.

When dealing with the lives of American personnel abroad, it is not enough to issue a committee report. The State Department needs thorough answers, and then it needs to put the recommendations into action.

The life of the new ambassador to Libya may depend on it.


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