Communications in a Political Campaign

Anyone who has ever taught or did public speaking rapidly learns that communication between and among people is difficult even under the best of circumstances.  What one person hears and understands may not be exactly what the other person was or is trying to convey.  What we hear is first filtered through our knowledge and life experiences before we interpret it. Further, words have nuances that may be difficult to grasp in a given situation; there are times when words have more nefarious purposes when they are used as codes to hide overt expressions of heinous thoughts and behavior.   And, sometimes people may not select – may not know – the most appropriate word(s) for a given situation while the listener may not know the definition of certain words.  Other complications may arise from the particular situation and what a listener wants or expects to hear.


I find it maddening – perhaps you do to – that in any political campaign candidates speak in generalities, take refuge in vagueness and provide as little detail on issues and possible solutions as they think they can get away with or direct the conversation to some inane subject such as meaningless personal attacks.  When pressed for specifics, they tend to resort with meaningless phrases: I have a plan: my staff is working on it: or, they drape themselves in the flag: I have the best interests of the American people at heart or the country will be so much better off with my (conservative, liberal or progressive) ideas.

The 2016 presidential campaign is not just replete with such progressed vagueness and inanities but it is also complicated by the fact that one of the candidates labels himself a democratic socialist – an emotionally laden label that screams for a more detailed description.  Further, in the past several decades, for a variety of reasons, what had been considered definable social and political realities, also have been undergoing changes the relative rapidity of which depends on the social and political views of the observer.


Therefore, there is the need for clarification to educate the voting citizenry, particularly the older groups.  As society evolves language mutations occur that reflect changes in new social and political realities, some of which are still in the process of evolving.  Young people grow up with the new definitions and are usually devoid of the desired historical background whereas the older people are not fully cognizant of the societal and political significance of the social and political developments.  It is not long before people are using the same words and phrases but, because of the differences in meaning, are not really communicating with one another: more likely, they are talking past one another.  The altered usages may be so extreme that the meaning of words and concepts may be the opposite of their classical use.  In fact, the changes may occur at rates sufficiently rapid that the general society may sense that there is a difference but may not really be aware of how far those differences have progressed and how little it has adapted to the changed situation.  Demagogues could easily take advantage of the resulting situation to benefit their personal agendas.


One of the unfortunate aspects accompanying these changes is the pejorative connotations that have been attributed to them as occurred with the words liberal and socialist.  The deprecatory undertones arose as a result of two other social phenomena, i.e., the increasing coarsening of American society and the rise of politically conservative talk radio some of which has a strong hate component.  Modern electronic communications permitted rapid dissemination of the derogatory views.  Conservative media commentators – particularly radio talk show MCs – for almost three decades greatly influenced the direction of the changes. Perfectly respectable words as liberal or socialist have become, among certain segments of the population, the equivalent of the worst of the traditional “dirty” words.  Further there is the deliberate misuse of the words such as concluding that socialism is identical to communism.  Also, for the past 40 years there was the slow but steady rise of a new phenomenon, championed by the political left, i.e., political correctness (PC) – the use of language so as not to offend anyone and to make all endeavors equivalent, i.e., the leveling of society and the destruction of value judgments.


Because of the pejorative connotation that accrued with the transformation from classical to modern liberals and liberalism, there has been, since the 1990s, the resurrection of an old word as a new label for liberals, i.e., Progressive.


It is my contention that modern Progressives are representative of the more extreme elements of the political left.  Many Progressives have adopted PC and anti-Semitism as axioms of their political faith so much so that it would appear that McCarthyism and Nazi style fascism were resurrected, modernized and returned to political discourse.  Thus, we have witnessed the evolution of the openness, inquisitiveness and universalism with a concern for workers, the poor and middle classes’ health and welfare, civil rights and a strong national defense of classical American liberalism epitomized by the combined best political traits of Presidents FD Roosevelt, HS Truman, JF. Kennedy, VP/Senator Hubert Humphrey, and Senators Henry “Scoop” Jackson and Ted Kennedy into a tyrannical fascist modern liberalism – Progressive – that despises America, Western culture and religions along with free speech and contravening ideas.  Just as the political left became polarized with the extreme driving its agenda, the political right also underwent a comparable change.  What used to be called a political center, either approached from the left or right, has essentially disappeared.  Yet, there are still classical liberals like me who are looking for a home in a highly polarized two party system.


I will attempt to provide a desideratum for what I perceive to be a much needed clarity.  If I am off the mark, I am sure the readers, if any, will try to set me straight.


Let us start with some fundamentals, i.e. government.  I define government from a realistic perspective: men and women in positions of authority whereby they can exert power.  I do not consider government as some mystical, ephemeral entity like Adam Smith’s invisible hand influencing economics.  Governments exist and function for and by people.  People in position to exert power derive their positions either through heredity, election or by appointment.


Power refers to people – hopefully – legally operating the legally constituted institutions designed by people through which they can create an atmosphere of trust and cooperation and set societal goals and seeing to their achievement, regulate relations between and among people in the society, maintain societal order, safety and security, promote the people’s health and welfare, judicial system, print and mint a stable supply of money and assure its value, and regulate agriculture and commerce and their interactions as well as develop and execute policies and regulations for society’s relations with all foreign societies.


To carry out these myriad functions several types of the legally constituted philosophical social structural entities mentioned above evolved through which power can be exerted.  It is these entities that are commonly referred to as governments.


The basic three types of legitimate governments described by Aristotle about 2500 years ago – monarchy, aristocracy, and polity (democracy) – are still true.  Since then a few subdivisions have been created.  The primary difference among the different governments was based on the number of people who exercised power, i.e., whether power was held by one, by a few, or by many.  Aristotle also conceived that each of these systems could be corrupted if the use of the power was abused for personal aggrandizement: they would then be perverted respectively into a tyranny, oligarchy, and a democracy characterized by mob rule.


Monarchy: power – authority, is vested in a single hereditary ruler, a king or queen: it has undergone some mutations from the absolute monarchy of ancient times to limited monarchy (rulers are dependent on a powerful nobility to retain their thrones) to constitutional monarchy, where the authority of the monarch is greatly curtailed, if not reduced to just ceremonial duties, when the authority and power of the monarch is replaced by a document – a constitution – created by the people, containing fundamental principles by which the state is to be governed, i.e. imposing specific rules on those who will be wielding authority and exerting power, defining its concept and character and defining its structure.


Aristocracy: political power is vested in a social and economic class based on privilege (birth, wealth), and, when power is restricted to a very few, it becomes an oligarchy.


Democracy (Aristotle’s polity): political power is vested in the citizenry whose power is derived from a legal document – a constitution – detailing how power is to be exerted and controlled – the rule of law (there are at least two types of democratic governments, i.e., parliamentary and presidential).


In the 20th century another form of government was created, the totalitarian dictatorship where power is concentrated in an individual (to date, a man) and his clique.


Just as there are different types of governmental systems there are different types of economic systems.  Unfortunately, there are times when the two systems are confused and conflated – either through ignorance or deliberate action – as if they are one.  The reason for this development is related to the fact that economic systems are intimately associated with political systems in which they tend to flourish.  There tends to be a positive feedback mechanism between capitalism and whatever political system it is associated.


Capitalism is an economic system in which the means of production and distribution are privately owned and controlled by a group of people called “capitalists” (also known as the private – non-governmental – sector).  Capitalists have capital (wealth) to make investments in manufacturing, delivering services and developing all aspects of modern electronics and communications systems, who provide resources for research and development and who provide salaries for workers. Capitalism is a people actuated economic system based on greed, selfishness and self-interest as well as relying on people’s talents, skills, intelligence, self-discipline, efficiency and willingness to work,  that tends to flourish in an environment where there is total freedom – no central (governmental) planning or control; no outside coercion – in running businesses and the economy.   Capitalism advocates that the invisible hand of supply, demand and competition between and among the suppliers of goods and services as well as the consumers of these goods and services will lead to a maximization of profits while meeting the needs of society at reasonable prices.


Because of its underlying philosophy, there are people who also consider capitalism to be a political system.  Unfortunately, capitalism is not without its limitations.  Capitalism invests heavily in controlling the workings of government for its advantages including controlling the behavior of workers.  These shortcomings have had devastating effects on society such that the result was that the consumers realized that their interests would be better served if some controls were introduced to curb capitalism’s excesses.


Socialism is a theoretical economic system based on an unproven utopian concept of cooperation rather than competition, in which the means of production and distribution are owned and controlled by the workers and the wealth derived from the production and sales of goods and services are expected to be used fairly for the welfare of all of the people: theoretically there is no separate elite class.  Depending on the nature of the socialist society, the ownership can be by workers groups such as trade unions or cooperatives or, more likely, by the state itself.  In a socialist society, instead of supply being determined by demand, as it is in capitalism, there tends to be an emphasis on central planning with the state controlling planning, production and distribution.


Whereas capitalism is based on known human behavioral traits, socialism, as noted above, is based on an untested, idealistic concept that society will become more ethical in the absence of class distinctions, especially classes based on wealth and privilege, and, when there is fairness in distribution of profits and health and welfare services and, thereby, will eliminate the need for competition to stimulate a desire to work.


Socialism is not without its limitations.   A bureaucracy whose function was to do all aspects of the social engineering developed and grew and relegated authority and power unto themselves.  The only pure socialist societies – actually sub-societies within a larger society – that truly existed were the Israeli kibbutzim; in truth, they succeeded only because they existed within the larger state structure with a democratic government.  Eventually, for a variety of social, political and economic reasons, the kibbutz movement fell apart.


Communism may be looked upon as an economic system that is more extreme than socialism.  The two systems share many attributes in common.  Both communism and socialism are utopian economic, also political systems that try to promote equality by controlling resources, production and distribution and by eliminating social classes.  Under both systems, the basic needs of the workers are met by the community.  Understandably, there are those, who, for whatever reason, use the two terms interchangeably. Unlike what exists in communist ideology, socialist ideology permits workers, not the state, to own the facilities and tools for production.

I once read an aphorism that may help explain the subtle difference between socialism and communism: it is a variation of an adage introduced by Louis Blanc and popularized about a half century later by Karl Marx and was used, in a somewhat different sense, as a motto by the Denver Jewish Hospital.  Under communism the adage is the well-known statement:  “From each according to his ability, to each according to his needs.”  Under socialism the adage is changed to “From each according to his ability, to each according to his deeds.”


There never has been a true successfully functioning socialist or communist society.  Every such society has fallen apart.  Instead what has evolved is a society in which some degree of socialism has been incorporated into a democratic society along with varying degrees of regulation and oversight..  Such has been the case with many European nations and even the USA.  In such societies, workers pay a portion of their wages as taxes to the government who use the money for advancing the health and welfare of the citizenry.   Some common socialist policies that nations adopted are unemployment insurance, medical insurance, and subsidized education and safety laws.


Although reluctant to admit it, capitalists, who generally oppose such public benefits, also benefit from corporate welfare (crony capitalism, socialism for the rich) in the form of government subsidies, tax breaks, bail outs and grants:   for example, in agriculture and energy exploration as well as in the use of public funds (from at least the late 1960s) to clean up the destruction of the environment caused by corporations that have used public air, land and water supplies as their private sewer systems.  Another term used for this mega billion dollar hypocritical economic phenomenon is “privatizing profits and socializing loses,” i.e., corporations keep all profits while society absorbs the losses.  One of the more egregious examples of this was the use of public funds for bailing out the banks following their involvement in creating the great recession of 2007.  Another example is the unconscionable blackmail tactics of professional football teams in demanding that cities use public funds to build stadia for them else they will move their teams to cities that will accede to their economic blackmail.  To soften the rape of the public tax system for their own economic gain, some capitalists have introduced the term compassionate conservatism.  The cynical question that is immediately raised, based on past capitalist behavior, is: To who are they really are going to be compassionate to?


Under the American capitalistic system, there is no control over planning, production or distribution of goods and services other than attempts at regulating those activities that which may be harmful to the health and welfare of the public.


The above is what I favor.

One of the reasons I started on this essay was the fact that in this 2016 presidential primaries, Senator Bernie Sanders (Democrat) used the appellation “democratic socialist” to describe his philosophy but never really seemed to define it.  Thus, the pundits all mentioned it but no one seemed to really understand what he meant by that term. In fact, several conservative talk radio and TV pundits either use the description of Bernie Sanders in a sneering and contemptuous tone or outright refer to him as a communist, apparently implying that there is no difference between socialists, of any stripe, and communists while mixing economic systems with political systems.  There is no need for mischaracterization.  These people have a chance to educate the public and do not do it.  They take advantage of ignorance to promote their political agendas.

In trying to unravel all of this for myself, I received certain statements from friends: I can attribute one to a specific person but but I have no person(s) to whom I can attribute the others to.


The first is the following:  Socialism without Capitalism is Communism. Capitalism without Socialism is Fascism. Democratic Socialism is the Balance between Communism and Fascism.


I think the following statement of Vice President Henry Wallace – although written at a different time and for different circumstances – may help in understanding that statement:  “The American fascists are most easily recognized by their deliberate perversion of truth and fact. Their newspapers and propaganda carefully cultivate every fissure of disunity… They claim to be super-patriots, but they would destroy every liberty guaranteed by the Constitution. They demand free enterprise, but are the spokesmen for monopoly and vested interest. Their final objective toward which all their deceit is directed is to capture political power so that, using the power of the state and the power of the market simultaneously, they may keep the common man in eternal subjection.”

Then there is what I consider to be close to a definitive explanation:  “A Democratic Socialist is not a Marxist Socialist or a Communist. A Democratic Socialist is one who seeks to restrain the self-destructive excesses of capitalism and channel the Government’s use of our tax money into creating opportunities for everyone.  Democratic Socialists believe that both the economy and society should be run democratically – to meet public needs, not to make profits for a few.  A Democratic Socialist does not want to destroy private corporations, but does want to bring them under greater democratic control.  The government could use regulations and tax incentives to encourage companies to act in the public interest and outlaw destructive activities such as exporting jobs to low-wage countries and polluting our environment.  Most of all, socialists look to unions to make private business more accountable.”


Religious Nonsense: Jews For Jesus

David Brickner, executive Director of the Jews for Jesus movement, denounced the Pope for doing the right thing: marking the 50th anniversary of Nostra Aetate by issuing a long over due document, i.e., “The Gifts and Calling of God are Irrevocable,” (created and released by the Vatican’s Commission for Religious Relations with the Jews) which said, in effect, that the Catholic Church must not try to convert Jews to Christianity and that the “Catholic Church neither conducts nor supports any specific institutional mission work directed towards Jews.”

Why are Brickner and the Jews for Jesus leadership upset?  If they are truly Jews, they should be happy that there are signs of reason in the current papacy.  After all, the document indicates that the Roman Catholic hierarchy is trying to remove one of the greatest sources of antisemitism in existence.

If the Jews for Jesus people are not Jews, but, in reality, Christians whose desire is to convert Jews, then their response to the Pope’s actions are expected and rational.  After all, the Pope is undermining their uncivilized lying behavior.

Thus, the actions of the Jews for Jesus movement prove what most of us have been saying ever since its inception – they are not Jews.  Jews who have joined the JFJ movement are no longer Jews.

By definition, Jews for Jesus is an oxymoron.

However, the subject is religion and any nonsense said in its name – even the term Jews for Jesus – will be accepted by some as truth and that nonsense is automatically expected to become sacred and is expected to be accepted by all under the freedom of religion clause of the First Amendment.

Jews for Jesus is religious nonsense.

Their own behavior validates that conclusion.

A Hanukkah/Seasons Greeting

The following is the seasons greeting that Eda and I sent out this year.


Dear Family, Friends, & Neighbors
An ancient observation made by people as they age is that time seems to speed up.  The expression: where has time gone to? is heard more often.  Yet, try as hard as we can, we have not been able to find an Einsteinianexplanation for this phenomenon.  About eleven or so decades ago, Einstein introduced his theory of relativity.  One of the consequences of that theory, which has proven to be true, is time dilation, i.e., from a position at rest, the time between ticks of a moving clock increases – time appears to go slower:  the faster the clock moves the slower time goes by.  Yet, despite the development of quantum mechanics and the other great advances in physics during the 20th century – and now the 21st century – no one has been able to incorporate this well established sense of time speeding up (it doesn’t, it just seems to) in their mathematics. Thus, we find ourselves saying, ye gads, it’s that time of year again.
Once again the revolving Earth brings us to the season of short days and long nights, at least in the Northern Hemisphere.  The end of fall and the beginning of winter, with its cold short days and long nights, is a season associated with light.  After the winter solstice, everyone eagerly awaits the coming of the longer days, their increasing warmth and the re-emergence of the beauty of nature in all of its colors within a background of green.  We must not forget that virtually all multi-cellular life on this planet is dependent on light.  It is no wonder that this season is also associated with great joy.  The phenomenon of light is replete with physiological and psychological significance.  Light is associate with the attributes we associate with life; light casts away the gloom and uncertainty  associated with darkness; light represents knowledge in a world of ignorance;  light represents cultural life in a world in which there are forces desperately trying to extinguish it; light represents the forces of good in a world infested with evil.
For those of the Jewish faith, late fall early winter is the season for celebrating Hanukkah, the Festival Of Lights, a very joyous festival.  It is one of several times of the year, at least in Jewish culture,  when people express warm wishes and good fortune to each other.  And, why not express good wishes at this time of the year – (as a matter of fact, why not all year long?) – the time of the Hanukkah festival, the occasion that recounts the first recorded fight for freedom of conscience, the right and need for self-defense and need to fight tyrannical regimes, the triumph of the few over the many and the weak over the strong?  (As an aside: One of famous sayings attributed to Jesus – Blessed are the Meek for they shall Inherit the Earth – primarily had its antecedents in the Psalms of Hebrew scripture and may even have derived from the meaning of Hanukkah.)
Unfortunately, not too many people realize that Hanukkah also represents a very  important connection between Judaism and Christianity.  About 163 years before the birth of Jesus, the Maccabee family led a successful revolt against  Antiochus IV Epiphanes and the Hellenistic culture of the Syrian Greeks thereby preserving Jews and Judaism – the people and the religion Jesus was born into.  If there was no Hanukkah there would be no Christianity.
It is at this time of the year that Christians celebrate Christmas, the religiously accepted date for the birth of a God, Jesus, which, in their tradition, is a holy occasion celebrated with lights.
Many members of the Black community celebrate a relatively new holiday, Kwanzaa, with the lighting of candles, each of which has a special meaning.
And, a month or two earlier, the Hindus celebrated Diwali – the Hindu Festival of Lights.
Irrespective of the tradition, these religious and cultural events have two common themes, i.e., the primary theme of the triumph of good over evil and the secondary theme of hope, a rebirth and a re-dedication – a looking forward to the coming of a bright future.
Irrespective of your heritage, at this time of the year  and throughout the coming year(s), we wish each of you and your respective families a most joyous holiday season (a happy Hanukkah for those who are Jewish, Merry Christmas for those of you who are Christian, a joyous Kwanzaa for those who celebrate their racial heritage and whatever is the appropriate greeting for those of you who celebrate some other seasonal or December event).
May your lives be filled with goodness, joy, peace, guidance, knowledge, health, good fortune, warmth  and love, that is associated with the growing glow and warmth emitted by the lights of the Hanukkah candles as they increase daily for eight days  (the Rabbi Hillel tradition) – from one to eight – along with all the the other lights.
We also wish each of you and your families a very happy secular New Year.  May it be a year filled with good health, joy, nachas, prosperity and peace.
Warmest regards
Eda and Shelly


It is a heartbreaking experience for a family to decide when its loved one is truly brain dead and to pull the plug on all the modern contrivances that function to maintain the pretense that the individual is still alive. This tragedy is multiplied when one considers that there are people who could survive or whose quality of life could be greatly improved if they could receive one or more viable organs from the humanitarian donations from those who are brain dead, assuming the family, deep in its grief and consumed with guilt over a decision that is so difficult to make, is in a condition to do so and is sufficiently motivated to make such a civilized, compassionate and charitable decision.

In situations such as end of life determinations, it would be highly desirable to have essentially a non-debatable technique for determining the extent of brain injury that would determine simultaneously how much, if any, potentially recoverable brain tissue there is.   Persistent vegetative state (PVS) is difficult to diagnose and according to some neurologists is often misdiagnosed.  

Such a technique would greatly assist in diagnosing persistent vegetative states and provide insight as to whether it would be monetarily and emotionally productive to try to maintain life in the hope that the condition could be reversed and the patient brought back to a functioning conscious state.

Also, the use of such a technique would greatly minimize unscrupulous reasons that people may have for requesting withdrawing life support from any patient.  Conflict of interest on part of spouses, parents, children, surrogates etc. comes to mind as does the deliebrately unconscionable political uses of such cases as occurred in the Terri Schaivo episode.

Yet, there is such a technique, but, unfortunately, it is not being used.  As I pointed out in a previous post (October 14, 2015), the technique of combining SPECT scanning of the brain before and after a single exposure to hyperbaric oxygen was introduced primarily for diagnosing and treating brain injury.  Persistent vegetative states would be an ideal area in which to extend the technique’s usefulness.  What a boon it would be to families that have to make exceedingly difficult decisions about loved ones.   Such a technique would also be of benefit to all those involved in the care of PVS patients or who could be brought in to adjudicate difficult cases, i.e., physicians, care takers, lawyers, judges, clergy, ethicists and hospital administrators.

One of the most famous of the end of life cases was the above aluded to Terri Schiavo case – the legal struggle over end-of-life-care in the USA that lasted a decade and a half: 1990 to 2005. This case is infamous because of its politicization, the unnecessary involvement – interference – of officials at the highest levels of state and Federal government: then Florida Governor Jeb Bush, Congress, President George W. Bush, the Florida State Supreme Court and the US Supreme Court.  One development the public is unaware of is that Richard A. Neubauer, MD – the lead author of the published paper in which this technique was first described –  offered to test Terri Shaivo at his expense, but was turned down.  Had he been able to do so, he could have saved the families and the government huge amounts of money and unnecessary anguish.  He could have ascertained much of the information concerning the functioning of the cerebral cortex and several subcortical structures that was subsequently obtained at autopsy.  How do I know this to be the true?  Neubauer told me about this in one of our numerous telephone conversations.  We were colleagues and friends and I was a co-author of his on the original published paper.

Ignorance is appalling.  Unwillingness to adopt new technologies is inexcusable.  Unwillingness to adopt new knowledge because of potential conflicts of interest and ties to potentially competing technologies, in my value system, borders on the criminal.  Unwilling to adapt new knowledge for new uses is inexcusable.  Worse than such negative behavioral traits is hiding one’s ignorance behind one’s academic degree, especially when making pronouncements about the ineffectiveness of the new technology, i.e., falsely using the degree as a shield of knowledge.

Unfortunately, over the decades, I have witnessed all these behaviors coming from highly educated and trained practitioners concerning the use of hyperbaric oxygen as an adjunct in the diagnosis and treatment of brain injury including stroke and multiple sclerosis.  

I am a great acceptor and practitioner of the concept that education can help overcome prejudices.  I hope that my writing about the subject will help educate the public as to the benefits of hyperbaric oxygen in neurological disorders.




As one compares the highly mechanized, electronic world of today to the world just decades ago one can readily observe some marked social/political/economic changes.  There even are changes in individual behavior which has become the norm even in social settings.  People who do not have a smart phone – or some similar electronic device – to confer with every ten seconds – are considered to be from the Paleolithic era.

However, there are aspects of social/political behavior that has not changed.

The statistical material below was sent to me (I apologize for not being able to provide proper attribution as to the genius who created this political cartoon) demonstrates one possible change in the social/political arena in the past 70 years.

However, as one looks at the data more closely, one can draw a different conclusion, i.e. that the world has not really changed.  In 1944 rockets were directed at a Christian nation: the Anglican Church of England, a denomination of Christianity is the state recognized religion of England. Whoever is the sovereign also holds the title ‘Defender of the Faith and Supreme Governor of the Church of England’.  It was, still is, perfectly acceptable for Christians to defend themselves by responding to such assaults.

In 2014, the rockets are fired at Jews and the Jews had (have) the audacity to respond as free and independent people without first getting prior approval of Christians.  This active response on part of the Jews is so unlike what they did in the past thousand plus years and unlike the 1930s and 40s, when Jews were being beaten, shot and rounded up to be sent to their deaths and to the crematoria, without seemingly fighting back and the world was silent.    This time the Jews not only had the audacity to respond, without first getting permission, but they did so successfully!

In 1944 the world witnessed and was complicit in creating and carrying out the Holocaust.  In 2014 the world is once again silent, and, as a result of its silence and other actions, it is even complicit as it witnesses on-going efforts to create another Holocaust.

Harry Golden, the late great observer and commentator of the social/political scene concluded that antisemitism was the one constant in Western Civilization.  These data tend to prove him right,

Read, think, learn


Thanks to the marriage of the popularity of American football with the American culture of celebrity, the public finally has become aware of the danger of sports-related and other head injuries – concussions – and their long term effects.  For a while, the problems current and former athletes who suffered concussions were experiencing dominated the sports coverage. The pressure being exerted on the National Football League by these athletes to address the immediate and long range problems of brain injury greatly enhanced the dissemination of vital information to the public. Occasional commentaries appear(ed) in the print media – also the electronic media – that report(ed) on the prevalence and significance of brain injuries. The latest issue (October, 2015) of the AARP Bulletin has a special report: “Are Old Head Injuries Fogging Your Brain?” that served as the inspiration for this blog.

However influential these exposes have been in educating the general public to the short and long term dangers of closed head injuries (concussions), they all have at least one fault, i.e., understandably, they tend to be devoid of pertinent medical information that could influence the decision making process of the affected public.  Whenever I read one of these commentaries, I become annoyed and depressed.  Why?  Primarily because of the understandable medical ignorance of most reporters; second, the failure on their part to do the necessary in-depth research the subject requires; third, the need for the news media to emphasize the human interest aspect of the subject; fourth, to keep the material at a relatively superficial level so as not to lose the reader; and finally an arguably and incendiary fifth reason consisting of a potpourri of matters, i.e., an ignorance by many medical practitioners and their failure to admit to the lack of the specific new knowledge – which is no shame or crime  – with their ability to hide their ignorance behind their medical degree and, thereby, mislead the public and, for a variety of unscientific or medical reasons, an effort to keep important information from being made available to the public.

For the past two decades there have been two techniques available whereby it is possible not only to successfully treat closed head injuries but also to identify anatomically and physiologically which areas of the brain have been adversely affected by the injury while simultaneously ascertaining whether there is potentially recoverable brain tissue: it also can follow the course of therapy and help determine the end-point of therapy.  To enhance the recovery, there must be physical and occupational therapy.  Even though the details and successful use of these techniques and therapy have been published in respectable peer-reviewed journals over the past few decades, to the best of my knowledge neither of these techniques have been widely used nor even brought to the attention of the general public.

Although, I started by writing about sports-related brain injury, what is being said is also true for other causes of brain injury including strokes (primarily hematologic strokes as opposed to hemorrhagic strokes), and toxic and anoxic encephalopathies such as carbon monoxide poisoning, near drownings and near hangings.

The diagnostic technique involves combining a currently used brain scanning technique with the potential therapeutic technique to determine the extent of the injury and establish whether potentially recoverable brain tissue is present.  It includes comparing two SPECT (single photon emission computerized tomography) images:  the first image is taken as a base line and, later – hours to a day – the imaging is redone but following an exposure to oxygen under pressure (this is not the place to discuss the details of the exposure and the nature of the image display).  Suffice it to say, the difference between the two images reveals the sites and extent of the injury as well as the presence and amount of potentially recoverable brain tissue.  Then, by following the protocol of the appropriate hyperbaric oxygen therapy combined with PT and OT, efforts are directed at recovering this tissue.

There are proven physiological, biochemical and pharmacologic bases that underlies the theory and application of the above mentioned techniques and therapies. Two of the most important are that brain injury interferes with the energy supply of the brain including interruption of the local circulatory system.  Among a slew of other positive effects, oxygen improves the energy production of the injured brain and promotes the growth of new blood vessels (neovascularization).  Not only is there no drug or combination of drugs available that can exert all the positive physiologically effects of oxygen but also there is no drug or combination of drugs that can act as quickly and as effectively as oxygen!  And, because of the combination of the physical and chemical properties of oxygen with its unique evolutionary derived biological roles, it is safe to predict that there will never be a drug or combination of drugs that will replace oxygen.   

Those who are working  to develop pharmaceutical agents that could be used in treating brain injury, should consider testing the effectiveness of their agent(s) in combination with hyperbaric oxygen therapy.  It is possible that such a combination could enhance the effectiveness of the agent(s) – or the oxygen.  Also, such a combination may lower the dose of a therapeutic chemical thereby decreasing the chances of developing adverse side effects.

There is one caution pertaining to charlatanism I must make the public aware of that is rarely, if ever, discussed in the public venue.  Just because some physicians or medical centers have access to one or more pressure chambers does not mean that they know how to diagnose and treat brain injury by these techniques and this may even pertain to their use of hyperbaric oxygen for other disorders.  There have been a number of facilities that claim they do hyperbaric therapy just to make money by gouging the public with outrageous pricing.  In these cases, the medical degree is being used as a front for a questionable operation.  I spent most of my professional scientific activities studying the biological effects of oxygen.  For a long while I served on the Education Committee of the Undersea and Hyperbaric Medical Society (nee The Undersea Medical Society) and was the second person to serve as it Chair.  I also was a founding member of the society’s Hyperbaric Oxygen Therapy Committee and served on the committee for the first decade of its existence: it was at this time vengeful politics intervened and I was no longer reinstated to the committee.  As a result of my professional activities it was not unusual for me to visit hyperbaric facilities as my wife and I travelled around the country and the world – at times the children, when they were young, accompanied us. Some time back, I visited a hyperbaric facility and learned very quickly, that it was being run by a physician who had little knowledge of hyperbaric therapy: I saw them treating a multiple sclerosis patient with a questionable pressure protocol.  On another occasion, I visited another facility where I experienced a reception I had never encountered previously at the dozens of facilities I had the good fortune to visit: the person “in charge” when I arrived, spoke to me in the entrance lobby and would not honor my request to see their pressure chamber facilities nor would he tell me the type of cases the facility was treating nor tell me the name of the supervising physician until he called the facility’s director to come to the site.  This unusual reception, seemingly shrouded in secrecy, put me on guard and sufficiently piqued my interest that I waited the half hour for the director to arrive.  It seemed that there was a fear of being inspected.  He and I spoke for a while, in the lobby – I was never given the courtesy of being invited into an office – and he still refused to honor my request to see the facility nor would he discuss the type of cases they were treating, the cost of therapy nor reveal the name of the hyperbaric physician even though I assured him that my interest was simply professional – a continuation of my decades long activity of visiting hyperbaric facilities wherever we went as well as part of my natural interest in the field and wanting to learn what people were doing and the type of success they were having.   I had similar discussions with directors and staff of all the hyperbaric facilities I had visited. Never had I been denied access to any of the information.   In fact, everyone was eager to share their knowledge and experience.  During the discussion, he evinced extreme nervousness.  Independently, I had learned from patients who I inadvertently met during casual meetings as guests in the home of mutual friends, about the existence of the facility and its costs. The cost to the patients was exorbitant – way above what the average costs were throughout the country.  When I left, I feared for health and welfare of patients who went there.  I wondered whether they even required hyperbaric therapy.  I already had experience with one facility, in the early days of modern hyperbaric oxygen medicine, where patients were being treated unnecessarily.  By unnecessary, I mean that based on the known pathophysiology of the disease at that time, there was no scientific basis for such a treatment.  And, the person making the decision to treat the patients was not a physician but the prime investor of the facility.

How does a patient know, in advance, that any given facility is safe and qualified to do what it claims? They really have no way of knowing unless they consult with someone who really knows who is who and what’s going on.  This is neither the time nor place to educate the public on how to get the requisite information before making an educated decision.  A very unfortunate aspect of this field is the sordid history of the internal politics that created a toxic atmosphere and held back its development and acceptance.

I called the author of a newspaper article that appeared earlier this year and, after ascertaining his complete lack of awareness, I explained the diagnostic and therapeutic details to him including citing publications from highly recognized, peer reviewed medical journals, I asked him to consider writing a sequel.  As I expected, based on my previous experience with the media (save for the Mobile Register in Mobile, AL), he dismissed me following a friendly conversation during which he perfunctorily thanked me and said that he would consider including the material in a future article, should he write one.

My experiences in medical matters involving the electronic media mirror that of my friends and colleagues who were instrumental in treating baby Jessica in the Odessa-Midland region of Texas when she was extracted successfully from the well in which she was trapped. The public was and is still ignorant of the fact that there were two aspects to the saving of the “well baby.”  The first is the obvious one of the successful efforts getting her out of the well – which had world-wide coverage and about which a TV special was created.  The second story, which would have had equally great human interest as well as educational value, was the saving of Jessica’s leg: the public had not really been told of the fact that because of the position of her leg while in the well, the blood circulation to her leg was markedly interfered with.  The physicians were preparing to amputate her leg from the hip until the intervention of Dr. James Maxfield of Dallas and his Herculean efforts in convincing them to delay amputation until they first tried hyperbaric oxygen therapy as well as his continuing efforts to assure continuation of the therapy.  He knew of a hyperbaric oxygen chamber in the area that could be made available for her treatment.  It was in the home of one of his patients who he was successfully treating for multiple sclerosis.  Ultimately, the entire leg was saved with the exception of the amputation of one toe and a small amount of tissue. Think of all the severe trauma, pain and money that Jessica was saved by not having to undergo numerous surgeries, fittings with prosthetic devices and the associated rehabilitation sessions as she would be growing up. When it was learned that the TV program was being made, physicians met with and begged the powers involved to at least mention the saving of her leg.  They pleaded in vain.  BTW: Jessica grew up normally.

I am waiting for the day when a smart lawyer initiates a malpractice suit based on the failure to use the diagnostic and therapeutic techniques mentioned above.

Congressional Privilege: Why isn’t it malfeasance?

One of the criticisms recently leveled against Republican presidential candidate Senator Marco Rubio (FL) is that he missed too many votes in the Senate.  Of all the presidential candidates who are also holding public office, he has the worst record – he voted 191 times out of a possible 275 votes; he missed 84 votes or 30.5%.  As a comparison, Bernie Sanders missed less than ten.

For decades, it has been considered acceptable behavior by the two parties and other members of Congress that presidential candidates will miss some votes as a result of their campaigning.  How much missing is acceptable, I suppose depends on how popular an individual is within the mainstream party and by the electorate.  I am not going to go into the details of when he missed voting or which votes were missed.  Instead, I want to concentrate on the concept of missing votes.

When Sen. Rubio was asked why he missed a certain vote, he responded:  “Guys, I’m running for president,”  “When I miss votes, it’s not because I’m on vacation.”  This inane response speaks volumes, or should speak volumes.

First this response implies that Rubio is admitting that he has two jobs: 1. Senator; 2. candidate.  Of course, this situation holds true for all candidates who are also elected or appointed officials.

However, he (they) was (were) elected by the people of FL – or whatever state pertains to whichever candidate – to be its Senator, not for being a candidate.  He draws (they draw) a salary, from the public teat (not the private sector which Repubs are so fond of venerating, claiming that it is more cost effective and whose interests they love representing) – the very government that he and others claim is too big, inefficient and not cost effective, for being a Senator and not a candidate.

Therefore, when he takes on a second job, for which he gets no remuneration, but is supported by his salary from hard earned tax money, is he not cheating the public?  Does not the public have a right to demand that he (they) give full time attention to being the senatorial representative and doing the people’s business, not advancing a personal agenda for personal aggrandizement?  In Sen. Rubio’s case, he is spending almost one third of his time doing non-senatorial work and not fully representing the people of Florida.

Being a Senator is not a sinecure for self-aggrandizement.  It is a serious job that must be taken seriously.

Thus, the messages are at least twofold: 1. he and all the other politicians who are behaving similarly are hypocrites; 2. that public office is a joke.  He calls for smaller, more efficient government while he is creating a situation where he in essence, is stealing (a very strong word with which many may disagree) money from the public treasury.  Is this not malfeasance on their part?

If he, or any other elected or appointed official, desires to run for some other office, then he (they) should be required to resign their position and let someone else be appointed who will do the people’s business on a full time basis.  Good and efficient government demands the full time attention of its officials.  Anything less should not be tolerated by other officials and certainly not by the body politic.

Such aberrant, behavior on part of Senator Rubio and others of his ilk, is just one of the reasons why the American government is in such disarray and essentially non-functional.