Going Crazy

My youngest daughter ,as a middle schooler, participated in a mock trial of Harry Truman for war crimes, specifically for the use of atomic bombs.

I thought the exercise very useful for students of this age and in my lifetime this topic has come up more than once.  For me, it begs the question, “If you were transported back in time and raised in the time would you have made the same decision? Why or why not?”

A wonderful insight on this topic came to me by way of a podcast by Dan Carlin who starts with the question and then the response from a relative who had been a sailor in the Pacific in 1945: “That bomb saved my life!”  Reviewing the question, Dan Carlin asks: ‘Why do we obsess about the use of the atomic bomb when for the previous year, we fire-bombed, with conventional weapons, urban areas with questionable military significance killing hundreds of thousands of civilians?” Why does the means of execution matter? His thesis is that war typically makes a society crazy and the point of view and decisions made during war often reflect that. Especially with respect to the Pacific War, people said and did things that if known to their grandchildren would elicit scorn, anger, and dismissal with all the labels we are familiar with: racists, monsters, immoral. Such behavior, which was to a degree acceptable then, was  not logical, but emotional (blind hatred), and yet our “logical brains” will make the “logical argument” for whatever decision is or was made—Whatever decision…..

Carlin goes on to suggest the common movie plot device, the caring soldier or government agent, needing to know vital information to save lives, usually from a loathsome criminal, shoots a limb or tortures that criminal to get the vital information. He points out that an individual whose kid’s life is on the line my think this a worthwhile tactic but—-do you really want your government to take on that kind of tactic as a general strategy? If you do, can you think of what might go wrong with that approach given how we change administrations and political orientation in Congress, the Senate, and even the Supreme Court, much less the presidency?

Our culture gone crazy is the point of the recommended podcast this month, the Trial of Tokyo Rose. I highly recommend it. It reflects on something that mostly conservatives of the MAGA species keep bringing up ie “the Deep State.”  I worry that  by this they have a goal to destroy the structure and principle of a neutral Civil Service. But wait, only woke people believe in a neutral Civil Service, right?  The idea of a neutral civil service deserves some thought.

Yes a “deep state” exists and reflects certain “norms”.

Whose norms?

Can you legislate such norms away? Democrats tried to do it in 1964.  Legislation may have blocked Jim Crow, but prejudice and legal adjustments continue to this day. For a century after the Civll was and Constitutional amendments securing their rights, the law was used to keep blacks down despite “legislation.” The treatment of the Japanese on the West Coast during World War II is another example of the “deep state” reflecting a cultural bias.

The podcast about Tokyo Rose has much to do with what we might call a right wing  deep state that was indifferent to a Japanese American’s plight from 1939 on when she found herself in Japan without a passport despite being an American citizen and graduate of an American High school.. My question as lawyer to a soldier on the stand at her trial—would you have changed places with her if you could?

This takes me to Texas: Yet Another Woman Has Died Because Of Texas’ Abortion Ban

https://crooksandliars.com/2024/11/yet-another-woman-has-died-because-texas?utm_source=flipboard&utm_content=topic%2Fhealth This event is so wrong at so many different levels………

I would not want to trade places with a doctor in Texas providing women’s health care right now. My training as a doctor found me with the skill to do a dilitation and Curettage (scraping the lining of the uterus). I have performed this in a catholic hospital to complete an incomplete miscarriage—as this is a long-standing medical practice done to  prevent the development of a uterine infection that sometimes follows a miscarriage—or abortion. In states with newly legislated anti-abortion laws, women who are no longer pregnant are dying from sepsis because medical systems and individual doctors don’t want to risk being accused by the state of murder—of a fetus. They violate a core principal: First, do no harm. I want to say they are cowards: how can the state sue you for murder when there is no living fetus anymore? And I ask myself, would I take on that risk as a young doctor? This needs to be done in a hospital and if I am willing but the hospital is not? Courage in the face of “the deep state” not to mention a culture primed to judge and punish is no small thing. We need brave people doing the right thing.

A liberal in 1949 might feel as MAGA does now about the deep state and the injustices that flow from it—they felt that way about how minorities were treated for example but the culture had no such problem. And feeling vindicated by people two generations later does not really help  those affected very much.

Our constitution has checks and balances and is cited by liberals and conservatives as a founding “holy” document. Like the Holy Bible, it is easily interpreted to get whatever opinion you want out of it. Our culture(s) drive which interpretation wins……for now……

To ally with a set of beliefs within your culture which you can stand by thirty years from now requires that you know yourself and have a meaningful grounding in how the world functions, and living it openly……….

As an aside, the news today, when editing this noted that a lawyer for Robert F Kennedy Junior is petitioning and starting a process to stop the distribution of polio vaccine. If this is correct, the world has turned itself upside down. Let me be the first to call this lawyer (and RFK jr if appropriate) a “snowflake.” The notion that the vaccine is so dangerous it should be pulled from the market would be like saying seat belts should not be installed in cars because sometimes, people are hurt—or even killed because the seatbelt caused them an injury or delayed their getting out of the car. The picture and dramatic number of lives saved is lost in such an argument.

A story about “Abortion."

Who are you, God?

As a doctor in training who genuinely wanted to do everything, I felt the extraordinary pull of obstetrics. We had a volume of such work in residency: an opportunity to acquire skill in the management of pregnancy and its many complications. Moving on from residency, I was a small town family doctor in Salinas, California, providing obstetrical care front-and-center in my business —-and my medical mission.

Delivering babies (or in Spanish,the proper description: asistir en un parto  ie to assist in a birth) was usually at odd hours, inconvenient, and stressful—but almost always a great joy.

There were exceptions. A young working woman in mid-pregnancy— her first —was not in any way unusual or memorable until one day she called in with concern. The receptionist recognized that something was, “off,” and had the nurse talk to her. The nurse poked her head in the door to ask me what she should do about this woman’s complaint which was, “Peeing on herself over and over.”

Something was off. We had her come in. She was composed and seemed fine. Her abdominal exam was normal and she let me know that she could feel the baby move. There were easily found heart tones with the ultrasound instrument. We got a urine sample from her and I performed a vaginal speculum exam, where I witnessed a stream of clear liquid  streaming forcefully from the opening of her cervix.

“Do you feel any pain or cramping?” I asked, watching this.

“I fell a little pressure is all and it is letting up now.” The flow of fluid stopped.

My assessment was that she had ruptured her membranes and was in early labor. She was perhaps 22 weeks along; in 1982, not everyone had early ultrasounds done and I ordered one now to secure a confirming estimate of how far along she was.  The ultrasound came back showing a distinct abnormality; the baby had hydrocephalus. This was bad. I spoke with her regarding this finding; her labor had been arrested with medication for now. She looked to me for a miracle.

I called a well known neonatologist who shared that the odds of the baby surviving were poor (22 weeks then as now is too young to survive a premature birth) and with survival would be neurological problems from the hydrocephalus. He advised that I call UC San Francisco and speak with the OB/Perinatolgy service, which I did. I reached a chief  resident who was clipped and direct. She acknowledged the challenge and then I sensed a little excitement.

“You know, we have new equipment and some expertise in intrauterine surgery. If you transfer the patient to us, we can try to shunt the baby’s head to relieve the hydrocephalus and delay labor for another month when we could then deliver the baby and manage the prematurity here.”

I found myself with a bad taste in my mouth. “You want to try a new technology on her with membranes ruptured?” My sense was that this mostly sealed the deal for a delivery within days or sepsis would likely occur.

“I think it is her only shot,” was the reply.

I thought and there was a socially uncomfortable delay.

“Hello?” She asked.

“I am not comfortable with your plan but I will present this option to her along with my sense that it is not in her or her baby’s best interest to do that.”

She did not hesitate, “Who do you think you are? God?”

Social convention found me stumble here. I had not been spoken to by a peer in this manner before. I was not thinking with anger or defensiveness at this, but remained concerned by the terrible choice my patient had to make. I don’t recall what I said, but got off the call quickly.

The obvious answer was, “No, but who is really playing God here?”

I did provide the mother with all the information I had—that the Specialty Center in San Francisco could offer a chance to treat and delay the delivery — and that I did not think it likely that this would go well. I listed all the things that could go wrong and the likely outcomes. She was brave. She took option B—letting the labor progress and deliver the baby.

We lost heart tones before the baby was born which from my point of view, solidified our decision and hopefully lessened her pain a little. The baby was not normal in appearance given the hydrocephalus.

I counseled a delay before attempting pregnancy again; hydrocephalus is not typically a hereditary condition so my belief was that she could hope and expect a normal pregnancy were she to try again.

I don’t recall seeing her after the post-partum check up, and I moved away within a year.

I would challenge the doctors in Texas and Idaho today: how would you manage such a patient and would you be fearful of being prosecuted for facilitating an “abortion?” Would you care and support such a patient regardless of her choice or just want her to go to the big center and let it be their problem? In defiance of propaganda about late term abortions, I believe that cases such as these are not abortions, but rather premature births. The outcomes are terrible. That is a shame, but no crime.