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Wednesday, November 9, 2016

A note to my fellow Democrats

I didn't say much about politics in this blog for the last 15 months, although I did write in July 2015 that the media was making a mistake by not taking Donald Trump's candidacy seriously. Now I want to say a few things.

Democrats, take a few days to get the angst out of your system, and then be sure it's out. The time is now to go to work for 2018 and to resist whatever legislation put forward that conflicts with your values. Hard work lies ahead of you, but if you roll over and play dead because of despair, you make things worse.

However, this does not mean opposition merely for the sake of opposition. Our country has seen too much of that already. Be constructive whenever possible. Not every idea put forward by Trump will be bad.

Practical effort is better than despair. Politics is very rough, even when the elections are not so negative. You win some, you lose some. It's the cyclical nature of politics. You got beat this time. Listen to the voters, learn from the loss, and move on.

Bear in mind that Hillary Clinton was always a vulnerable candidate. Proof? Barack Obama came from seemingly nowhere in 2008 to grab the nomination from her. More proof? She had a very difficult time this year putting away her opponent Bernie Sanders, who was probably farther to the left than any presidential aspirant in the last 100 years. The "email thing" eroded trust in her, as did the poorly executed push in 1994 for national healthcare that first gave Republicans control of the U.S. House. Ironically, Colin Powell (no fan of Trump!) had warned that "Everything HRC touches she kind of screws up with hubris." If she had just come clean with the American people years ago and admitted that she made a mistake with the emails  — despite the fact that others made the same mistake —  she might have been able to put the mess behind her. But she didn't, in the same way that Bill Clinton defended his unethical behavior with Monica Lewinsky. I think how it's how they think. Hubris.

Going into the next election, do not believe any poll unless it shows a margin of 55-45 or more. Otherwise you get false hopes that are too easily deflated. Polls have become notoriously unreliable.

Most importantly, don't indiscriminately demonize everyone who voted for Trump. I have family members (extended family) who voted for Trump. They aren't racist, although their political views differ greatly from mine. If you demonize everyone who voted for Trump, not only do you contribute to more poisonous rhetoric, you do unto them exactly what you say they do unto others.

Some number of people voted for Trump because they're dissatisfied with the economy. Take a trip through rural North Carolina and you could easily understand why. Yes, the economy is far better in Raleigh (for example) today than in 2008, but that's not the case in Hoke County. Some voters were particularly irate about the impact of free trade, which in general Bill Clinton supported. Ross Perot's "giant sucking sound" is still ringing in the ears of many Americans, and our federal government has not done enough to help those citizens. They're mad as hell and I hear them.

Tuesday, November 8, 2016

Stuff I used to travel with

Do these items look familiar to you?

The Pocket edition of the Official Airline Guide was a must. Published every month, it had all the airline schedules for the U.S. and Canada. In those days there were more airlines than today, and they honored one another's tickets in many cases —  so if your flight was delayed, the OAG could help you find identify a re-reroute.

This small item from Rand McNally (remember them?) had road maps of about 75 major cities… very handy when planning a trip or finding one's way when lost. I supplemented these with a collection of the freebie maps that rental car companies gave out.

Everyone used payphones at airports, and these were indispensable to make telephone calls at reasonable prices. Also useful in hotel rooms.

Another useful item when planning a trip. I had a collection of these directories from fifteen or twenty hotel chains. When someone said "Go to Saskatoon!" (and someone really did tell me that once), I wanted to have my own data about where I might sleep.

That child seated next to you is really unhappy halfway through a four-hour flight? Here's the fix. I kept a supply of them to give away and usually succeeded in not eating them myself.

When traveling overseas, travelers checks were the best way to obtain currency in the local country. They would also come in handy during an extended trip within the U.S.

Phenylpropanolamine (PPA) was, by far, the best over-the-counter decongestant.

So, what became of these items? The OAG, maps, and directories were replaced by websites and eventually apps on smart phones — the Swiss army knife of the road warrior. Likewise, calling cards have almost disappeared. Most parents became too concerned with nutrition to give their kids candy or too mistrustful of strangers to accept it. ATM networks (and ATMs with multi-lingual user interfaces) did away with travelers checks. The FDA banned PPA because of side-effects; but passenger aircraft today provide better control of the cabin altitude, making it easier for the allergy-afflicted to keep one's ears clear during descent.

Thursday, November 3, 2016

Indian Lives Matter

The history of native Americans is recurring disaster. European invaders, among whom I count my ancestors and probably yours, killed most of the native Americans, pursued the survivors across the continents, subjugated them, seized their lands, destroyed their means of existence, relocated them, profaned their religion, and finally left them in the 20th century with little hope of the upward mobility that America is supposed to offer but increasingly does not. In an act of dubious generosity, though, we did interpret our twisted treaties with them to allow casinos.

Why do a growing number of people see the current controversy at Standing Rock as so significant? The answer is not found in the pro's and con's of a pipeline. Rather, the irreducible matter is this: when the white people of North Dakota found out that the path of the pipeline would endanger their water supply — specifically the water supply of Bismarck, the state's second-largest city —  authorities shifted the route of the pipeline to a point half a mile upstream from the Standing Rock Indian Reservation. The argument by politicians and planners of the pipeline surely was, there aren't many of those Indians and they just don't matter.

From 1950 to 1975, urban freeways were disproportionately routed through African-American neighborhoods. It's the same racism.

Wednesday, October 12, 2016

Force majeure? Not so fast

North Carolina can be divided geographically into three parts: Appalachian mountains in the west, the "Piedmont" (rolling hills) in the center, and the coastal plain in the east. The Eastern Continental Divide passes along the spine of the mountains, and surface water from the small portion of NC west of the ECD eventually enters the Mississippi River. But east of the ECD, all surface water in NC goes to the Atlantic Ocean via the Piedmont and the coastal plain.

There are peculiarities about the coastal plain in NC. It has no large river going to the Atlantic, unlike the Potomac and the James in Virginia, or the Santee and the Pee Dee in South Carolina, or the Savannah on the SC-Georgia border. The rivers that pass through the NC coastal plain — the Cape Fear, the Neuse, the Tar, the Roanoke, and the Chowan — are small in comparison. They don't have the natural capacity of rivers in adjacent states.

Furthermore there are few large lakes along these rivers in the NC coastal plain, whereas SC has situated numerous large lakes along its corresponding rivers in the coastal plain. Lakes serve an important role in flood control by buffering inflow while increasing outflow by a lesser amount over a longer period of time. North Carolina, in contrast, placed dams such as Falls and Jordan upstream in the Piedmont. That's understandable because the geography in the Piedmont is more amendable to deep lakes that don't require so much surface area and also because the populous Piedmont needed sources of drinking water. But the consequence is that Falls Lake and Jordan Lake are too far upstream to prevent the catastrophe that began Saturday.

The NC coastal plain is naturally vulnerable to broad floods, but this vulnerability has been intensified by the rapid population growth of the Triangle. Growth creates impervious surfaces such as roofs, parking lots, and roads. Although the Piedmont counties have attempted to mitigate this ever-increasing runoff with their own small-scale lakes — I live near one, Lake Lynn in north Raleigh — the attempt was only partly successful, in part because the growth of the Triangle has exceeded all estimates from the 1970s when these lakes were planned, in part because ongoing construction in the Triangle has silted up these lakes and reduced their capacity to hold temporary floodwaters.

And we have the sad story of the Woodlake Dam, built expressly to provide a scenic and recreational environment for a country club and resort development. The weakness of this dam has been known for some time, but there was no sense of urgency to fix it. The odds of a storm anytime soon that could overwhelm the dam seemed very low to officials.

What we saw Saturday was our own highly improbable but very real "perfect storm". The combination of Hurricane Matthew and a cold front moving rapidly from the northwest to the southeast produced far more rain than anyone expected. The National Weather Service has confirmed one reading of 18.38 inches in Elizabethtown (for my European friends, that's almost half a meter of rainfall). At my house I measured 10 inches. There was brief flooding in the Triangle, but the real problem began on Sunday and Monday as the bolus of rainfall departed the Piedmont rapidly and moved into the coastal plain that would have had difficulty expelling the rain it got itself, much less what came from upstream.

The catastrophe is upon us. Many have died. No, not as many as in Haiti, but deaths nevertheless. Property damage and economic disruption will be extensive. After similar floods in 1996 from Hurricane Fran and 1999 from Hurricane Floyd, the coastal plain took 10 years to recover. In some cities such as Rocky Mount, the recovery was never full. The coastal plain, in general, has not enjoyed the economic prosperity of the Piedmont or the beaches. Financial resources of coastal plain counties were already stretched thin before Saturday.

And what people in NC aren't keen to discuss is that the lowest elevations of inhabited land in the coastal plain are disproportionately occupied by African-Americans, Latinos, and Native Americans who cannot afford to live on higher land. Metro New Orleans saw this too in the aftermath of Hurricane Katrina. The poor will suffer not only a loss of life and property, but also a loss of livelihood because many businesses in the affected areas will close indefinitely. Yes, there will be jobs in construction but the poor often have no skills for those projects and the number of openings for unskilled labor will not nearly match the number of people looking for work. Meanwhile, our NC General Assembly has cut employment insurance benefits to the bone.

The perfect storm would have inflicted misery, for sure, but our own choices have multiplied that misery.

Wednesday, October 5, 2016

My brother, Ben Stiller

Ben Stiller has disclosed that he is recovering for treatment of prostate cancer, which afflicted him at age 46. Without PSA screening that detected the cancer before it became symptomatic and (more importantly) before it metastasized, he believes he would have died.

I'm with you, Ben. That's my story, too. I was 51 when my PSA test showed a problem. Like him, my "Gleason score" was 7. Like him, I underwent laparascopic surgery assisted by a robot. Like him, I am alive today with a zero PSA level — which, after one's prostate has been removed, is an unambiguous statement that no prostate cancer remains.

Unfortunately, the U.S. Preventive Services Task Force continues to tell men that they should not have PSA testing in the absence of symptoms. It's absurd. Their position effectively condemns men like Ben and myself to an early, unnecessary death.

The argument from USPTF is that a PSA test is not specific to prostate cancer. Non-cancerous diseases of the prostate can elevate one's PSA. That's true. In order to diagnose prostate cancer, one's prostate must be biopsied. This is a painful procedure that has its own risks and has a high price tag. That's true. There is a chance that the biopsy will give a false negative (in other words, that it will not find cancer even though the cancer is present). That's true. There is a possibility that some men will panic and rush to treatment by surgery or radiation, even though their particular type of prostate cancer is so slow-growing that it would not pose a threat for 10 or 20 years. That's true. There is also a possibility that some doctors practicing defensive medicine or hungry for income will encourage patients to get treated when waiting would be a better decision. That's true.

But in cases like Ben's and mine, the situation simply doesn't play out that way. Ben and I had 35-40 years of projected lifespan ahead of us; we were not octagenarians likely to die of something else soon. Our cancers were asymptomatic; I had "digital exams" (guys, you know what that is) by at least ten physicians before surgery. None of them could feel anything amiss, and of course I hadn't noticed any symptom myself. Our cancers were fast-growing, not slow-growing. His PSA level was rising rapidly, and so was mine. In fact, in the months it took between my initial test and my surgery, I passed from the zone of intermediate risk (PSA=15) to the zone of high risk (PSA=25). Usually a PSA of 6 is considered ominous, if it continues to rise. After my surgery it came to light that my cancer had just begun to spread outside the prostate.

There is zero doubt that without PSA screening, my cancer would have become untreatable within a year and that I would not be alive today. No doctor familiar with my history believes otherwise. And when I wrote an MD at the USPTF to object, he didn't dispute my imminent and certain demise. He simply replied that in the aggregate, too much money is being spent on unnecessary treatments and the complications they cause. In other words, it's ok for men like Ben and myself to die prematurely just because other men and their doctors are making poor decisions.

I think that sucks.

Do we need a more specific test than PSA? Yes. Do we need more conservative treatment — in some cases, engaging in "watchful waiting"? Yes. Are those sufficient reasons to tell men not to get screened in the first place? No.

Someday the brotherhood that Ben and I belong to will be joined by one of physicians who participates in the USPTF. At that point, I expect to see change in the recommendation. Until then, ignore the USPTF and get screened. It could mean your life, too.

Thursday, September 22, 2016

What police can and cannot do

It's always risky to comment on a developing situation whose facts are uncertain, but I wrote the following in response to a family member who opined on Facebook.

"Police officers are not 'the law' [a quote from the post of my family member]. Police officers serve the law. They are under the law like everybody else. The law grants them powers but also imposes limits and holds them accountable if they don't stay within those limits.

"Whether the dead person had, in fact, a gun is one question that ultimately a jury will have to decide. Beyond that, open-carry in North Carolina has been legal for decades and concealed-carry in North Carolina is also legal with a permit. (No one knows whether the dead person had a permit or not.)

"I'm sure the officer believes the dead person had a gun. Whether or not that was, in and of itself, justification for a command to drop the weapon is a debatable point at law and there have been several court cases about that already. It's also a debatable point at law whether a LEO is justified in shooting someone simply because the person is armed and declines to disarm. There have been court cases about this too. The question is really whether the dead person made a threatening gesture or there was some other legitimate reason for the LEO to open fire.

"It's a borderline case based on the facts that have come to light. In short, LEOs do not have unlimited discretion to open fire — even in situations where a firearm is present. This is far from open-and-shut."

Saturday, September 17, 2016

Where art thou, First Union?

When it was clear in 1986 that Gail, Ryan and I would move from Atlanta to Raleigh, I wanted to open a bank account in Raleigh several months before the family would arrive. So, during a business trip I dropped by Crabtree Valley Mall and visited the branches of the "big three" banks in Raleigh at the time. Each heard the same story: I didn't have much time to talk, but I would leave my name and Atlanta home address so that they could send me a packet of available services and a fee list.

  • Nothing ever arrived from NCNB.
  • Wachovia sent something by first-class mail, and I received it five days later.
  • First Union sent me a package overnight.
I went with First Union and became a very happy customer. Ultimately First Union was acquired by Wachovia. I had misgivings about the takeover, but Wachovia turned out to be good, too.

But Wachovia got caught playing mortgage games in 2008-2009, and along came Wells Fargo.

Only two things good have happened since: on the rare occasions when I travel in the western U.S., there are more ATMs to use; and I prefer Wells Fargo's process for accessing a safe deposit box. Otherwise I've found Wells Fargo to be generally uncooperative compared to First Union or Wachovia, and I tired long ago of being upsold everytime I talked to a Wells Fargo person, used their ATM, or used their website. Look, if I want an additional service from Wells Fargo, I'll ask you about it!

But all that upselling was indicative of an underlying management problem, it turns out. I am not surprised by the disaster now revealed. I am surprised, however, that no head has rolled yet within the bank. Let's hope that the Federal Reserve, the Department of Justice, or the Congress plows into this situation. Civil litigation by customers of Wells Fargo is inevitable, but that's insufficient. Heads must roll, and the bank and relevant executives including the CEO and the president of the consumer banking division must be prosecuted, fined, and — in the case of the executives — jailed. That's the only way to prevent this from recurring.

As to whether Gail and I will take our banking business elsewhere, we haven't decided yet.