Ed Note: When Atul Gawande speaks, we should listen. He is one of the best thinkers in medicine and an amazing analyst of systems. This article is a bit long, but worth reading! Let’s hope against hope, the Federal Government is listening.
o get out of this pandemic, we need fast, easy coronavirus testing that’s accessible to everyone. From the way people often talk, you might think we need a technological breakthrough to achieve this. In fact, we don’t have a technological problem; we’ve got an implementation problem. We could have the testing capacity we need within weeks. The reason we don’t is not simply that our national leadership is unfit but also that our health-care system is dysfunctional.
Many developed countries have met their testing needs, and ready access to speedy tests has been key to containing outbreaks and resuming social and economic activity. Whether you live in England or South Korea, scheduling is straightforward. No doctor’s order is required. Tests, where indicated, are free. And you typically get results within forty-eight hours.
In the United States, getting a test is anything but easy. Take a look at the Texas public directory of covid-19 testing sites, which features a bold, red-highlighted disclaimer: “ATTENTION: Unless otherwise stated, deductible, co-pay, or co-insurance may apply. May require physician referral or prior authorization. Please call site to confirm.” Congress has mandated that insurers fully cover the costs both of testing and of the medical-office visit that produces the test order. But providers may still require payment until the insurer has confirmed coverage. Some twenty-eight million Americans had no insurance before the pandemic, including eighteen per cent of Texans, and millions more have lost their insurance since it started. Although legislation allowed states to expand Medicaid to cover coronavirus testing-related costs for the uninsured, many states (including Texas) have yet to do so. Health-care providers are left to seek disaster-relief funds to cover testing costs for the uninsured. The Texas disclaimer also warns that its test-site directory is incomplete. On another page, the Web site alerts you to additional considerations to take into account when seeking a test site, including what the screening criteria are (sites vary as to whom they are willing to test); whether the site is covered by your insurer; and what types of tests they provide (some may have only antibody tests, which do not help establish a diagnosis).
Appointments can take days, results days more. Most testing in the United States is done by four companies—Quest Diagnostics, LabCorp, BioReference Laboratories, and Sonic Healthcare. Through early August, results routinely took four days or more, making the tests essentially useless. Times improved only when testing volumes declined, because many people gave up on getting tested. The vast majority of infected Americans, including those with symptoms, never get tested. And we have not even reached the fall, when flu season will hit and coronavirus-testing needs and demand are expected to rise substantially. As the saying goes, it’s as messed up as a pile of coat hangers.
State Treasurer Duane Davidson and 30th District State Representative Mike Pellicciotti will be joining us for our first-ever Skyline Candidate Forum for a statewide office on Tuesday, October 13th at 7:30 p.m.
The organizing committee is currently soliciting questions or question topics to be used during the forum. If you have a question, or a discussion area you would like to see raised during the forum, please send it to Jim Sanders at jimsanders1947@gmail.com. The committee will review and consider all questions.
While this office is one of the more obscure, it is significant in that the State Treasurer manages cash assets, debt, and other state finances, as well as assets held by multiple cities and other local jurisdictions. You may wish to review the State Treasurer’s website, as well as the websites for the candidates. These are:
Sunday and Monday will mark a time for this blog to rest a bit, get outside, take a walk – and, umm, get some work done. So stay tuned for next week when I’ll try to catch up. Honor the workers on Labor Day — the silent heroes of our world.
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When President Donald Trump canceled a visit to the Aisne-Marne American Cemetery near Paris in 2018, he blamed rain for the last-minute decision, saying that “the helicopter couldn’t fly” and that the Secret Service wouldn’t drive him there. Neither claim was true.
Trump rejected the idea of the visit because he feared his hair would become disheveled in the rain, and because he did not believe it important to honor American war dead, according to four people with firsthand knowledge of the discussion that day. In a conversation with senior staff members on the morning of the scheduled visit, Trump said, “Why should I go to that cemetery? It’s filled with losers.” In a separate conversation on the same trip, Trump referred to the more than 1,800 marines who lost their lives at Belleau Wood as “suckers” for getting killed.
Belleau Wood is a consequential battle in American history, and the ground on which it was fought is venerated by the Marine Corps. America and its allies stopped the German advance toward Paris there in the spring of 1918. But Trump, on that same trip, asked aides, “Who were the good guys in this war?” He also said that he didn’t understand why the United States would intervene on the side of the Allies.
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Trump’s understanding of concepts such as patriotism, service, and sacrifice has interested me since he expressed contempt for the war record of the late Senator John McCain, who spent more than five years as a prisoner of the North Vietnamese. “He’s not a war hero,” Trump said in 2015 while running for the Republican nomination for president. “I like people who weren’t captured.”
There was no precedent in American politics for the expression of this sort of contempt, but the performatively patriotic Trump did no damage to his candidacy by attacking McCain in this manner. Nor did he set his campaign back by attacking the parents of Humayun Khan, an Army captain who was killed in Iraq in 2004.
Trump remained fixated on McCain, one of the few prominent Republicans to continue criticizing him after he won the nomination. When McCain died, in August 2018, Trump told his senior staff, according to three sources with direct knowledge of this event, “We’re not going to support that loser’s funeral,” and he became furious, according to witnesses, when he saw flags lowered to half-staff. “What the fuck are we doing that for? Guy was a fucking loser,” the president told aides. Trump was not invited to McCain’s funeral. (These sources, and others quoted in this article, spoke on condition of anonymity. The White House did not return earlier calls for comment, but Alyssa Farah, a White House spokesperson, emailed me this statement shortly after this story was posted: “This report is false. President Trump holds the military in the highest regard. He’s demonstrated his commitment to them at every turn: delivering on his promise to give our troops a much needed pay raise, increasing military spending, signing critical veterans reforms, and supporting military spouses. This has no basis in fact.”)
Trump’s understanding of heroism has not evolved since he became president. According to sources with knowledge of the president’s views, he seems to genuinely not understand why Americans treat former prisoners of war with respect. Nor does he understand why pilots who are shot down in combat are honored by the military. On at least two occasions since becoming president, according to three sources with direct knowledge of his views, Trump referred to former President George H. W. Bush as a “loser” for being shot down by the Japanese as a Navy pilot in World War II. (Bush escaped capture, but eight other men shot down during the same mission were caught, tortured, and executed by Japanese soldiers.)
When lashing out at critics, Trump often reaches for illogical and corrosive insults, and members of the Bush family have publicly opposed him. But his cynicism about service and heroism extends even to the World War I dead buried outside Paris—people who were killed more than a quarter century before he was born. Trump finds the notion of military service difficult to understand, and the idea of volunteering to serve especially incomprehensible. (The president did not serve in the military; he received a medical deferment from the draft during the Vietnam War because of the alleged presence of bone spurs in his feet. In the 1990s, Trump said his efforts to avoid contracting sexually transmitted diseases constituted his “personal Vietnam.”)
On Memorial Day 2017, Trump visited Arlington National Cemetery, a short drive from the White House. He was accompanied on this visit by John Kelly, who was then the secretary of homeland security, and who would, a short time later, be named the White House chief of staff. The two men were set to visit Section 60, the 14-acre area of the cemetery that is the burial ground for those killed in America’s most recent wars. Kelly’s son Robert is buried in Section 60. A first lieutenant in the Marine Corps, Robert Kelly was killed in 2010 in Afghanistan. He was 29. Trump was meant, on this visit, to join John Kelly in paying respects at his son’s grave, and to comfort the families of other fallen service members. But according to sources with knowledge of this visit, Trump, while standing by Robert Kelly’s grave, turned directly to his father and said, “I don’t get it. What was in it for them?” Kelly (who declined to comment for this story) initially believed, people close to him said, that Trump was making a ham-handed reference to the selflessness of America’s all-volunteer force. But later he came to realize that Trump simply does not understand non-transactional life choices.
“He can’t fathom the idea of doing something for someone other than himself,” one of Kelly’s friends, a retired four-star general, told me. “He just thinks that anyone who does anything when there’s no direct personal gain to be had is a sucker. There’s no money in serving the nation.” Kelly’s friend went on to say, “Trump can’t imagine anyone else’s pain. That’s why he would say this to the father of a fallen marine on Memorial Day in the cemetery where he’s buried.”
I’ve asked numerous general officers over the past year for their analysis of Trump’s seeming contempt for military service. They offer a number of explanations. Some of his cynicism is rooted in frustration, they say. Trump, unlike previous presidents, tends to believe that the military, like other departments of the federal government, is beholden only to him, and not the Constitution. Many senior officers have expressed worry about Trump’s understanding of the rules governing the use of the armed forces. This issue came to a head in early June, during demonstrations in Washington, D.C., in response to police killings of Black people. James Mattis, the retired Marine general and former secretary of defense, lambasted Trump at the time for ordering law-enforcement officers to forcibly clear protesters from Lafayette Square, and for using soldiers as props: “When I joined the military, some 50 years ago, I swore an oath to support and defend the Constitution,” Mattis wrote. “Never did I dream that troops taking that same oath would be ordered under any circumstance to violate the Constitutional rights of their fellow citizens—much less to provide a bizarre photo op for the elected commander-in-chief, with military leadership standing alongside.”
Another explanation is more quotidian, and aligns with a broader understanding of Trump’s material-focused worldview. The president believes that nothing is worth doing without the promise of monetary payback, and that talented people who don’t pursue riches are “losers.” (According to eyewitnesses, after a White House briefing given by the then-chairman of the Joint Chiefs of Staff, General Joe Dunford, Trump turned to aides and said, “That guy is smart. Why did he join the military?”)
Yet another, related, explanation concerns what appears to be Trump’s pathological fear of appearing to look like a “sucker” himself. His capacious definition of sucker includes those who lose their lives in service to their country, as well as those who are taken prisoner, or are wounded in battle. “He has a lot of fear,” one officer with firsthand knowledge of Trump’s views said. “He doesn’t see the heroism in fighting.” Several observers told me that Trump is deeply anxious about dying or being disfigured, and this worry manifests itself as disgust for those who have suffered. Trump recently claimed that he has received the bodies of slain service members “many, many” times, but in fact he has traveled to Dover Air Force Base, the transfer point for the remains of fallen service members, only four times since becoming president. In another incident, Trump falsely claimed that he had called “virtually all” of the families of service members who had died during his term, then began rush-shipping condolence letters when families said the president was not telling the truth.
Trump has been, for the duration of his presidency, fixated on staging military parades, but only of a certain sort. In a 2018 White House planning meeting for such an event, Trump asked his staff not to include wounded veterans, on grounds that spectators would feel uncomfortable in the presence of amputees. “Nobody wants to see that,” he said.
Punctuation is dead – or is it? If you’ve ever texted ‘im here’ or ‘its in the car’, you’re in good company. Most of us have, at some point since the dawn of texting, transgressed the boundaries of good grammar, and swallowed one apostrophe or another in the name of speed or convenience. Studies have shown that such textisms as deliberate spelling mistakes, abbreviations and omission of apostrophes don’t deteriorate language skills, but boost them – provided such texting goes hand in hand with ‘proper’ grammar education.
Suppressing the little typographical hook that is the apostrophe might, however, pose graver issues when it occurs in public, such as in ads or pub signs, or even street names. Is it different if the state flaunts language rules? Enter the international Apostrophe Protection Society, with its attempts to call out misuse and spread good practice. But November 2019 saw the announcement of the society’s demise, and owing not only to the highly respectable age of its founder John Richards (96): it would close, the society said, because of the ‘ignorance and laziness present in modern times’. The announcement made global news, sky-rocketing the traffic on the charmingly old-school website some 600 times, which led to its temporary disappearance from the web, and an outcry against the society’s closure. Punctuation habits might be changing, but we still care.
Are prescribed grammar rules necessary, though, or a relic of some fussy conservatism and elitist era? Do we really need apostrophes (or any other mark of punctuation for that matter) or could we get rid of them for the sake of brevity? Is Princes Street rather than Prince’s or even the formidable Princes’ Street really a sign of our careless inattention to detail today? If punctuation can fall away and the words still make sense, why did we need it in the first place? Punctuation, like any other cultural production, has a tumultuous history full of public good and personal interest.
Michael Hebb is often regarded as the originator of the modern underground dinner. Currently, Hebb is a part of the Summit series culinary team, crafting the upcoming program in Los Angeles where foodie-beloved folks such as Chez Panisse’s Alice Waters, BS Taqueria’s Ray Garcia and Hitchcock’s Brendan McGill will be talking food, politics and serving up thought-provoking bites. Recently, Hebb and I caught up to talk about the power of gathering communities and how the Greek symposium is reflected in Summit.
Eve Turow Paul: How did you first become interested in organizing dinners?
Michael Hebb: I actually came at food through architecture and studying classics at Reed College. When I was 20 an architect, Mark Lakeman, and I built teahouses for people in Portland. We also built piazzas, gathering spaces, for people in residential intersections, where we inspired and cajoled neighbors to come together and paint their streets.
My takeaway from that was that people have such a profound desire to gather and to deepen the meaning around why they’re gathering. I also realized that architecture is a lot of work. Building tea houses or piazzas or community gathering places or real buildings is just so much work. And the dinner table is already there asking to be re-thought, asking to be reinvigorated . In some ways, I consider it the first architecture. Shelter, in many ways, was provided for us in the natural environment, but the table is a very intentional space created for a communal act of eating together. It’s a pretty wild development in human history.
“The table is a very intentional space created for a communal act of eating together. It’s a pretty… [+] EVE TUROW PAUL, CANVARecommended For You
Turow Paul:Do you know when the first dinner table arrived on the scene?
Hebb: I don’t, but I know that the evolutionary leap from ape to man is actually due to cooking and concentrating calories. Our DNA and our evolution are forever tied to cooking. Apes chew seven hours a day; we chew 24 minutes. By outsourcing our belly to the fire as a place to cook, all of this new energy was given back to our body, and it was essentially bored and it was like, ‘What do I do with all this excess energy?’ And our brains got bigger and our jaws got smaller, so our heads had more room for brains because we weren’t chewing seven hours a day. There’s this direct link between who we are, how we’re evolving, and cooking and eating together.
Turow Paul: Why do you believe the dinner table so open for disruption today?
Hebb: Twenty percent of American meals are eaten in the car. And that doesn’t include how many meals are eaten on the couch or in bed. If you think about the state of the dinner table with those kinds of statistics, it’s pretty clear that a reclaiming and a reinvigoration is timely. And if you think that human connection is necessary for human evolution, then the dinner table does it better than almost any place.
American dinner tables generally collect mail and aren’t necessarily utilized as a place for human connection. I started to dream up ways to reimagine and fill it with energy.
One of the first of those ideas was with my ex-wife Naomi Pomeroy, who is a famous chef from Portland. We started a pop-up restaurant called Family Supper in our living room in 2000. As far as the press is concerned, they claimed it was the first pop-up or underground restaurant. Within about six months of hosting our first dinners we were on the front page of the dining section of The New York Times and they had called it “The beginning of a movement.” There wasn’t really anybody else doing it.
“If you think that human connection is necessary for human evolution, then the dinner table does it… [+] IMAGE BY EVE TUROW PAUL, CANVA
Turow Paul: How does your study of the classics influence your career today?
Hebb: The Greek symposium —Socrates and Plato and Aristotle—have continued to be and were my initial inspiration. Greek culture was formed at the symposium table. From this classical period in Athens, we get the concept of democracy. The concept of a legal system and a justice system also came from that period, and theatre as we know it. And the list goes on and on of things that we gained as a culture from the classical period of Athens. That isn’t just because they were brilliant people; it’s because their ideas had a place to live at the dinner table at these symposiums.
Realizing that if you’re going to create a fertile environment for innovation, for evolution, you need not just brilliant people and you need not just amazing stages, you need this incredibly fertile environment for ideas to be exchanged, for them to be deepened, for the connection around these ideas to happen.
I realized very early on that the table, as an institution, needs to be re-thought and re-instituted in order for us to do the work as a culture that we need to do right now.
The meal serves the purpose of being a kind of magnet. It’s a necessity to eat dinner. It’s a little bit like the water hole in the Savannah, taking advantage of the fact that people are drawn towards dinner and the table, and then deepening that experience into something that’s transformative.
Turow Paul: How does this all relate to your latest project with Summit?
Hebb: At Summit, every single one of the chefs and nutrition experts that will be in attendance is an activist. You sit down with them, and they’ll change the way that you think about food and culture. I guess my goal is that people see that the food is so much more than just something that they put in their mouths.
With Summit being multi-track, the “Choose Your Own Adventure” is just so rich and deep around food during this event that you can only imagine the conversations, connections, new businesses, new initiatives that are going to happen. There are all these beautiful doors that people are going to open, and it’s exciting to see that happen.
Apply and learn more about Summit and the culinary lineup planned for LA2017, here. Scheduled food-centric discussions include “How mushrooms can save the dying bee population” with Paul Stamets, and food will be served by Ghetto Gastro, among others. Also, discover how Hebb cultivates conversations about death through his international program Death Over Dinner.
Posted inAdvocacy, Cooking, Food|Comments Off on Why Gathering At The Dinner Table May Be The Most Transgressive – And Important – Thing To Do
The above link in an interview recently where I talk about the current COVID-19 pandemic, protests and isolation–and a bit about my book which will be released in late September.
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