29. What Has Storytelling to Do With Avoiding Physician Burnout

July 26, 2016

I thought I was done writing for the day, having participated in an on-line discussion about voice dubbing by singers for famous films of 20th Century, which I had triggered with a couple of stories about my early accidental discovery of Marni Nixon, “the ghostess with the moistest” in the world of studio vocalists.

Marni died yesterday at the age of 86, of breast cancer. Back when I was 75 and she was 80, I had looked up her web site and had shared a story with her via e-mail about discussion I had when I was in my late teens and she would have been under 25.  I had been discussing singers  with a then already well known TV music director and the father of a friend, both named Irv Kostal. On a weekend visit to their suburban Long Island home, I took along a children’s record to which my little brothers had been listening called, “The Mother Magoo Suite” — a play on Ravel’s “Mother Goose Suite” (Ma Mere L’Oye), and the then popular cartoon character, Mister Magoo.

I had been doing a lot of singing in college, and had heard on the record what I thought was an absolutely gorgeous voice. “Big Irv” scoffed gently at my offering, saying anybody could sound good using an echo chamber, and countered with a record of a woman singing German tone poems written in Arnold Schoenberg’s 12-tone scale. The woman was hitting intervals that were entirely unexpected to the western ear, and therefore practically impossible to sing. And she was dead on pitch every time.

But the voice was sounding familiar. When I checked the record jackets, both were sung by Marni Nixon. Who, a dozen years later, sang the lead for West Side Story, “ghosting” for Natalie Wood, under the musical direction of… the very same Irv Kostal!

On that day in Long Island, Mister Kostal had also not paid adequate attention, I thought, to the other voice I had thought he might enjoy, a recording with the 19-year-old ingénue singing the lead role, of “The Boyfriend”, a British musical that had just appeared on Broadway, and which voice, from the first note, had pierced my soul in the last row of the top balcony a few weeks earlier. But Big Irv said he had grown to detest the ‘20s flapper music he had spent years playing on the road in an itinerant dance band. In consequence, I thought at the time, didn’t really give a fair hearing to young Julie Andrews either.  Of course, later when he was the music director for Mary Poppins and Sound of Music and I loved teasing him about that on the few occasions we met over the following decades.

Well, you will not have guessed from the foregoing, but what captured my attention this morning were two seemingly unrelated articles: one in an on-line medical news journal about physician burnout and a suggested method to prevent it, and another from Science Daily about whether reading and viewing fiction is good for our mental health.

The connection, for me, was storytelling. Like the stories above, about Marni Nixon and Julie Andrews.

First, the anti-burnout article from the Cleveland clinic, to which my immediate reaction was that it reminded me of the joke about Irish fiddle tunes. To the question of how you tell all these nearly identical tunes apart, the answer is… by the title.

The Cleveland Clinic Neurological Institutes research suggests a way of, “rekindling physicians’ job satisfaction”, and calls it “relationship-centered communication”, a nebbish of a title that could mean anything or nothing.

Looking the phrase up on line I discovered that it is merely a new Title for an ancient tune.

One course that purports to teach this “new” idea offers these goals:

• Understand the importance and value of effective communication
• Build rapport and relationships with others
• Acknowledge communication barriers
• Recognize another’s perspectives and concerns­­
• Negotiate an agenda for an encounter
• Ask questions using skilled open-ended inquiry
• Elicit another’s story
• Listen reflectively and respond with empathy
• Collaborate on a plan that others can follow

Oh, c’mon, really? People who have graduated from medical school don’t know how to talk to a person? Well, I guess that if they don’t, and think that talking doctor to patient is different from talking person to person, the work would soon become lonely and boring.

Now that I think back, I came back to pre-med, medical school and medical practice with an unusual advantage. First, I had been advised by Dorothea Starbuck Miller, my undergraduate advisor at the University of Chicago, and later dean of the Biological Sciences, that I should stay and finish law school and not transfer back to pre-med, because testing had indicated that my aptitude for language and communication was somewhat higher than my aptitude for science.

Second, at the end of my first year after transferring from law school to pre-med, I had stayed in summer school to raise my inorganic chemistry grade and had run out of money in the Fall Quarter. So I took off the Winter Quarter to replenish my savings, not realizing that taking off any quarter but the summer one would void my draft deferment. As a result of which I was drafted into the Army in 1957.

They looked at my liberal arts degree, law school and pre-med, and instead of the medical corps I had hoped for, decided to make me a journalist.  About the only thing the Army didn’t know about me was that I had been the Editor in Chief of my high school paper, a two-page mimeographed bimonthly, so how they landed on ‘journalist’ is beyond my ability to imagine.

But they sent me for 16 weeks of training at the bar-none best, most efficient and effective school I ever attended, the Army Information School at Fort Slocum, New York. And I spent the following two years interviewing people in Germany and Holland, and composing short news stories about them. These stories and features were published every day on the wire services, hometown newspapers and the Stars and Stripes.  And this process of asking questions, listening to answers and composing a story, it could be said, I continued to do for the succeeding forty years in interviewing and listening to patients, and writing their histories into the charts.

Abstracted to simple terms, the common feature was that when I sat down with someone, whatever was going on with them was of vital importance to them and I was very curious to understand it in detail in order to figure out what was going on within the contexts of the relevant medical metaphors.

My impulse from the beginning was, from the first moments of the encounter, to find points of similarity between my own life and that of any new patient. I was a young father with three kids even when I first started practice, and later a fourth. I had endured many sleepless nights when my kids were babies. I had done dozens of summer and part-time jobs when I was a student, had been in the Army overseas, had been in the Merchant Marine. I played the guitar, sang folk songs and was a folk dancer. I spoke a little German and French. I was an amateur astronomer and ham radio operator. When I was a boy I helped my family build a house in which we later lived. I drank beer. My father was a recovering alcoholic who had died young when I was in medical school. I cannot remember a single patient with whom I was not within seconds able to identify, automatically and without any conscious effort, some common interest or experience, some place in the world we had both been, some aspect of work or family life, some hobby or interest.

These things helped me feel that I was spending my days with people I knew; with people who knew me, and when I made my notes I was writing stories about people who had shared stories with me that were vitally important to their lives. I assisted at surgery practically every day for the first three decades, so in addition to all that transpired between us, in addition to the more than a hundred babies I had delivered as an intern and palpating and listening to my patients’ exteriors, to their limbs and joints, I had had my hands on my patients’ lungs and hearts, their stomachs, livers and kidneys, their very brains. After each surgery I dictated a couple of pages of operative reports, each another little story about the patient.

The Cleveland Clinic can call that ‘relationship-centered communication’ if they like, and believe it is a new thing. I just thought I was being a doctor, hearing and retelling the patients’ stories.  But then, my own family doctor, the one I had known from birth, was William Carlos Williams, a famous writer and poet, although his patients didn’t know it at the time.

Which brings me to the Science Daily report on psychologist Keith Oatley’s article suggesting that reading fiction that stimulates the imagination somehow helps in the development of empathy.

Reading certain kinds of literary fiction simulates a social world, fostering understanding and empathy in the reader.

In studying neuroscience for three years, when I became a psychiatrist in the last decade of my medical career, I gradually developed what was for me a useful metaphor, that there is somewhere in the brain a function I called, “the storyteller”, that has to do with the establishment of reality.

For example, while on long road trips I have not infrequently awoken in a motel, where I usually leave a light on in the bathroom and the door cracked open, so that I will have enough light to orient myself if I awake in the dark. Actually, I do the same thing at home, so, after driving for 12 or 14 hours and going to bed exhausted, I had sometimes awakened a bit confused when the light is on the wrong side of the bed from home.  At which point my storyteller, probably in the frontal lobe somewhere, searches through some old and some new memories, examines what little sensory input there is, and then concludes, “I am Denis. I have been driving for several days. I am in a motel. The bathroom is over to the left.”

Which proves to be the case.

This is an example of what neuroscientists are coming to believe we all do in order to construct or “confabulate” what we think of as “reality”.

When we have disrupted the train of memory with drink or some trauma causing unconsciousness, the first thing we ask when we open our eyes is……

You got it… “Where am I?” We already remember who we are.

If we have experienced some sort of amnesia and we awake, we first want to know… “Who am I?” Because whenever we awaken, we first reconstruct reality by a process of telling ourselves a story about who and where we are, and whatever else we remember and is relevant, like, “Who is this in bed with me?!”

When we read a story or watch a movie, it is an active process, wherein we are taking in the information provided and simultaneously telling ourselves the story of what is going on? Contrary to our assumption, it isn’t the page or the screen that tells us what is going on, it is the brain’s storyteller making up a story consistent with the perceived visual and auditory sensations coming in through the sensory switching center, or thalamus.

Emeritus Professor Oatley concludes:

“What’s a piece of fiction, what’s a novel, what’s short story, what’s a play or movie or television series? It’s a piece of consciousness being passed from mind to mind. When you’re reading or watching a drama, you’re taking in a piece of consciousness that you make your own. That seems an exciting idea.”

If a particular person’s brain is capable of generating feelings, which some are not, a feeling may be elicited in the reader similar to the one experienced in the circumstances described by the writer. Oatley reports that experiments indicate that the level of these empathetic feelings can be enhanced by social experience, even one simulated by a writing or a film.

It seems to me that this may be because the brain developed long before any experience was possible beyond the limits of vision, hearing, or the other commonly understood senses. Therefore anything sensed is considered by the brain to be real and immediately and concurrently present. If we see a film about another culture, that culture becomes that much more real to us, and our limbic (emotional) system may regard it as more trusted and safe than strange and frightening.

By the same token, humans judge risk by their immediate experiences. But they do not distinguish between TV and real experience. Therefore in the presence of ever-increasing 24-hour world-wide coverage of mostly bad news we conclude that the world is becoming more dangerous, whereas according to Steven Pinker in, “The Better Angels of our Nature”, the world is safer now than it has ever been.

So if Oatley is right, we are just as likely to be affected by adverse images in books and movies as we are by favorable ones. In other words those who have been telling us that the content of TV can have a bad effect upon our beliefs and behaviors are right, and violence in the media begets violence in life.

Meanwhile by asking and listening and writing stories about people all day long, I have always felt bathed in intimacy with other humans during my work hours, and have not experienced the need to get away from work in order to assuage the pain of a lonely, depressed and exhausted inner child.

END

28. What is the Meaning of “A Well Regulated Militia” ?

July 23, 2016

“Felix, qui potuit rerum cognoscere causas.” — Virgil

Happy is he who knows the causes of things.

Some of my moments of clearest thinking seem to occur during my morning shower, which probably means that they occur during sleep and that I am remembering them during the hypnopompic moments I spend soaping and rinsing.

I went to bed late last night too tired to begin this essay, the thought of which has excited me ever since I began to discover the answer to the title question.   In the half hour before arising, between sleep and waking fully, I remember thinking that what underlies nearly all “gun control” sentiment and logic is ignorance: Ignorance about firearms themselves, ignorance of why the U.S. Constitution was set up above all other local, state and federal laws, ignorance of history more ancient than Lady Gaga or Burning Man, ignorance about the nature and causes of violence, ignorance about the depth or significance of the racial divide in America, ignorance about the nature of mental illness including the health care system that tries to address it, profound ignorance regarding what can and cannot be done about violence, and finally, ignorance of the English language, of which I was myself, in this particular instance, also possessed until a couple of days ago.

Knowing that the Supreme Court, (SCOTUS) had decided the issue of whether the Second Amendment conferred an individual right to keep and bear arms, I had always skimmed over the first clause: “A well regulated militia, (why is that comma there?) being necessary to the security of a free state, …”, and focused on the last, “…the right of the people to keep and bear Arms shall not be infringed.”

Although at 81 I am well beyond having to move my home in order to be near work, I do migrate annually between the locations of some of my kids and grandchildren, and they are sometimes uprooted for work and professional reasons, which is why, at the end of last summer, I found myself moving to a notoriously gun-unfriendly state, to a notoriously liberal college town and to a county with a sheriff who is manifestly unfriendly to the rights of gun owners, specifically in the area of concealed carry weapons permits. But that is a story for another time. The connection here is that I have recently begun joining the local ham radio club members at a weekly dinner and gab-fest, and this week a discussion of the Second Amendment arose. The fellow across from me, Jim, a fiftyish young man with a gray beard, raised the issue of the “well regulated militia” clause, with the implication that the Constitution meant gun owners should be well-vetted and trained members of a military force, and not just any Tom, Dick or Harry.

While passionate, the discussion was friendly. Over the next day or two, for the first time I was moved to learn more about that puzzling phrase, “well regulated”, which, truth be told, I had never really understood myself.

“Militia” I understand. History is clear that the colonists had long relied for their defense upon a quick gathering of ordinary citizens, expected to bring their then modern implements of warfare with them. That process, only slightly more formalized, carried the colony successfully through their Revolution against the king and his standing army.

A militia, therefore, had these features: An organization somewhat looser than an army, but with ranks and a chain of command, the officers of which might have a smattering of knowledge about tactics if not strategy, and a body of men who kept their military arms at home, used them for hunting and defense, practiced and competed with them, and brought them along when called to duty for a specific purpose or to meet a specific threat. In 1792 every able-bodied man between age 18 and 45 (the average life expectancy of a citizen in the 18th Century was 35 years) was designated a member of the militia.

The Swiss are famous for this militia approach to military service. When I was a boy in New Jersey during WW II a neighbor from Switzerland still had his bolt-action Vetterli rifle that I was allowed to handle very carefully on several occasions.

Nowadays the Swiss militiaman keeps the SIG SG 550 at home: a fully automatic assault rifle. At the conclusion of his active service he may purchase the weapon, which is then converted from fully automatic to semi-automatic (one trigger pull – one shot).

So what is a well regulated militia?

It turns out that our puzzlement over that phrase is caused by the fact that “well regulated” has not been in common usage for more than a hundred years. But it was in common usage in 1791 when the Second Amendment, along with the rest of the Bill of Rights, was adopted.

And it had a common meaning that virtually everyone at that time would have been able to enunciate.

Taken from the website of the Constitution Society: “The phrase “well-regulated” was in common use long before 1789, and remained so for a century thereafter. It referred to the quality or property of something being in proper working order. Something that was well-regulated was calibrated correctly, functioning as expected.”

http://www.constitution.org/cons/wellregu.htm

Also see: http://www.lectlaw.com/files/gun01.htm

The Constitution Society also offers several quotes from the Oxford English Dictionary (O.E.D.) dating from the time of the adoption of the Second Amendment, which clarify its meaning and appear to support the “properly functioning” view of the term, as opposed to the “regulated by law” view favored by modern liberals.

1709: “If a liberal Education has formed in us well-regulated Appetites and worthy Inclinations.”

1714: “The practice of all well-regulated courts of justice in the world.”

1812: “The equation of time … is the adjustment of the difference of time as shown by a well-regulated clock and a true sun dial.”

[Ed. From their invention in 1656 until the 1930’s pendulum clocks, many models known as Regulator clocks, were the most precise timekeeping method in the world.]

1848: “A remissness for which I am sure every well-regulated person will blame the Mayor.”

1862: “It appeared to her well-regulated mind, like a clandestine proceeding.”

1894: “The newspaper, a never wanting adjunct to every well-regulated American embryo city.”

The Constitution Society finally argues: “Establishing government oversight of the people’s arms was not only not the intent in using the phrase in the 2nd amendment, it was precisely to render the government powerless to do so that the founders wrote it.”

Of course there are those who come to a different conclusion but I find the evidence of the O.E.D. persuasive.

To me, the syntax of the Second Amendment makes perfect sense just as it is, without embellishment or further specificity, if “well regulated” means “A properly functioning militia (of armed citizen soldiers) being necessary to the security of a free state”, as opposed to a standing army under the control of the federal government or a monarch.

I am grateful to my dinner companion for his level-headed question about the meaning of the clause, and comfortable with the understanding my search for an answer has produced.

END

27. Generalists vs. Specialists

July 19, 2016

Two articles have come to my attention that may be more closely related than at first they seem.

The first was the article by Maria Popova about Buckminster Fuller on synergistic thinking:

https://www.brainpickings.org/2013/03/08/buckminster-fuller-synergetics/

In which Fuller is very critical of specialist education and thinking.

And the second was a seemingly lighter piece by Sheilamary Koch —

http://exclusive.multibriefs.com/content/for-children-to-be-independent-thinkers-we-must-teach-autonomy/education — which begins:

“When I asked junior high students to look back on their school career and describe the assignment that stood out most for them, most named activities where they were in the driver’s seat. They claimed having the opportunity to take responsibility for their learning motivated them to achieve their best.”

For me, the “Aha!” moment came 30 years ago when I was reading a passage from Marshall McLuhan’s, “The Medium is the Message”. In it the celebrated Canadian professor of communication theory spent a few pages talking about the difference between generalists and specialists.

At the time I was practicing Family Medicine, which had then only recently changed its name from General Practice. I was acutely aware of both the value and the limitation of medical specialization, and had just survived the urgent swerve of the late 1960’s that sought to elevate specialization at the expense of the medical privileges of the general practitioner.

Whereas G.P.’s had, for example, until then performed appendectomies, tonsillectomies, other simple surgeries and had delivered most of the babies born in the United States, there was a powerful political movement, led by the university hospitals that did most of the specialist training and had by that time produced an over-abundance of surgeons, to restrict all but certified specialists from doing even the simplest hands-on procedures.

This movement had purely economic roots, but was clothed in the medical pseudo-logic that it was for the good of patients. Of all the private and public funding available for medical school teaching, overgrown departments of surgery, internal medicine, and obstetrics and gynecology were already consuming lion’s share and were hungry for the rest.

It wasn’t until the Robert Wood Johnson Foundation threw its weight into the struggle that the specialty departments were forced to acknowledge that an ever-growing surplus of surgeons and internists had created a scarcity of G.P.’s and a serious maldistribution of medical services, particularly in rural and inner city areas.

Ironically but not unexpectedly, the solution from medical academia in 1969 was to create yet another official board Certified specialty, the twentieth, called Family Practice, requiring three years of residency training beyond medical school. However, instead of creating Departments of Family Practice equal in stature to the departments of Surgery or Obstetrics and Gynecology, many of the medical schools designated “Divisions” of family practice, within the administrative and budgetary control of the already existing Departments of Internal Medicine. By which they funneled newly available funds designated by federal and private sources solely for family practice training, into an established administrative structure designed to support a specialty that had constituted part of the problem, not part of the solution. Devious buggers.

For the first couple of years after its creation, those of us already in practice were allowed to sit for the exam based upon our experience and independent study, and without the residency training, which I did in 1972, becoming board Certified in Family Practice.  Again ironically, it was the first of three medical specialties in which I became Board Certified. In addition to those three, there were two others in which I became eligible to sit for the exams, but chose not to do because of matters of timing and money. In those two cases I was about to transition into another field, or to retire from practice altogether.

You see the irony: that if a person successfully pursues five medical specialties, is he or she better described as a serial specialist, or rather, a generalist with areas of deeper interest?

I had not thought about that (too damned busy you see) until I ran across the passages from McLuhan, where he described a generalist as one who looks up at what exists and sees it as an environment. But as he or she learns more about it, organizes it and reduces parts of its amorphous complexity into a meaningful story or metaphor, those parts become an artifact of his or her construction. An example would be the beguiling mystery of life reduced to medicine’s story of, “how the body works”. After savoring that for a bit, the generalist again gazes up at what remains: the unexplained, unreduced environment, and begins to think about it, organize it and perceive it as another coherent story or metaphor. Which again becomes an artifact of the mind.

And so the generalist begins to gaze at what remains….. and so on.

As I understood him, McLuhan was saying that the generalist is repeatedly curious about and fascinated by that which he or she does not understand.

The truth is I can’t remember what he said about specialists. Other than that they are moved to learn everything there is to know about one narrow topic.

Thinking in terms suggested by the Popova and Koch articles and using the language of Eric Berne’s Transactional Analysis, whereas the generalist is driven primarily by a natural Child’s unrestrained curiosity about everything, the specialist more resembles the Adapted Child, trying to meet and match the expectations of parents and teachers by learning and repeating everything they seek to teach. Is what governs specialists a fear of being caught not knowing?

But perhaps I am being unfair. Perhaps both apply the same energy. curiosity and intensity, but the difference is in the direction of gaze: that the generalist is looking upward and outward at everything that is, and the specialist merely happens to be looking down and into the depths of a particular phenomenon.

I do remember clearly that in medicine, as a Family Physician it often fell to me to keep in mind the whole picture, and the patient as a whole person, and therefore to use the consultations of the specialists regarding a particular organ or body part within that larger context, to which some specialists were somewhat oblivious. (Others were obviously generalists who happened to be practicing a specialty.)  Clearly both skills are necessary, but the management decisions of the generalist, made in conjunction with the person who is ill, are better.

If Popova’s Fuller is right, that it is a good thing to keep the generalist within each child alive and well, so that there are enough of us that are able to cross-connect information, it seems to me that Koch’s story about science teacher Monserrat Alverado provides useful guidance: encourage independence of study at a much earlier age.  [Ed.  In 2019 I learned from my grandson who paid an extened visit to their schools,  that this constitutes the core of a new, extremely successful, educational practice in Finland.]

END

26. Dallas – 2016

July 8, 2016

Being retired, I can watch marathon news coverage when I decide to.  This morning, the day after the Dallas shootings, I awoke to learn that five police officers have died so far, and that six others and two civilians were shot by from one to four shooters, one of whom was killed in a standoff.  Police took him out in a parking garage with the “disrupter” charge of a bomb-destroying robot.

So what do we know at this point?
        The police were protecting a peaceful protest organized by “I’m going to keep blowing shit up because Jesus told me to,” pastor, Jeff Hood.    (During an interview on the street this morning, Hood talked about last night as if it were all about him.  He reminded me of other piss-ant, narcissistic, apocalyptic cult leaders.)
        He organized the protest using social media, along with followers of the habitually belligerent “black lives matter” hate-group.  This is the movement that jumps the gun every time police kill a black man during an arrest, assuming from the fact of the shooting alone that the cause was racial animus on the part of the police, and that the killing was wanton, and unnecessary to protect the lives and safety of officers.
        That movement gave us the infamous, “Hands up!  Don’t shoot!” slogan that came out of Ferguson, and was later clearly shown to have originated in a lie told by the partner-in-crime of the criminal who was shot after attacking a police officer in his patrol car and trying to take his gun.  A criminal who did not have his hands up, and who was again rushing at the officer when shot.
        Even though the lie was contested from the beginning, it was immediately believed and accepted without any confirmation by many politicians, from the local level right up to Attorney General Holder and the President of the United States, Barack Obama.   Neither of whom ever backed away from their racist assumptions even after the lie was revealed in Grand Jury testimony.
        And what led to the massacre of police officers in Dallas?   Protests by Black Lives Matter over unrelated shootings in Louisiana and Minnesota, after cell phone video footage surfaced on the internet alleging to show what were called “unnecessary”shootings of two armed black men.
        In one case, while two officers struggled on the ground with a man who was reported to have drawn a gun on a bystander while selling something on the sidewalk, one (or both) of the officers fatally shot the man struggling beneath
them.
        In the other case, the video started rolling immediately AFTER a man, also known to be armed, and sitting in the passenger seat of a car, had been fatally shot by an officer standing at the passenger window with his gun drawn.
        Just because some people lack the imagination to envision circumstances that would justify the officers’ actions doesn’t mean that the shootings were not justified.  And of course, just because the shooters were police officers doesn’t mean that the use of lethal force was justified.
 
        In the first situation, for a man pinned to the ground and known to be armed with a pistol to continue to struggle may be enough to justify the use of lethal force.  The intensity of the struggle may be the determining factor.   In a struggle violent enough that it may have knocked both body cams askew or out of commission, it might well have been impossible for the officers to be sure the man was not reaching for, or had not already reached, a pistol he had pulled on bystanders only minutes earlier.  Moreover, as far as we know, they didn’t even know where his gun was concealed… in a pocket or his waistband.  With the gun concealed, unless his hands were up, away from his body, and splayed open, they could just as easily have been an inch from his gun…. and a split-second away from the death or injury; of the officers.  The video clearly shows a struggle on-going.  On the other hand, if the man was only wriggling a bit due to the discomfort of being pinned down, and if his hands were plainly visible or restrained, it may be there was no cause for officers to fear for their lives and shoot him.
        In that case we have a man who had armed himself, had brandished his weapon at others, and who then struggled with police trying to arrest him.  THAT’S ALL WE KNOW RIGHT NOW!  [Subsequently, several TV talking heads referred to the man’s firearm was “legal” because Louisiana is an “open carry” state, but this is not true if the firearm was concealed in his waistband or pocket.  Whether it was concealed when the police confronted him has never beed discussed.]
        In St. Paul the only information the public has right now is what is seen on the video of the man dying, and what his girlfriend who took the video has said.  Philando Castile appears to have been shot by police while sitting in the passenger seat of a car.
 
        The only version we have of what happened in the minutes preceding the shooting comes from HIS COMPANION, Lavish “Diamond” Reynolds.  IF EVERYTHING SHE SAYS is true, the shooting seems to have been have been unjustified, but there are several incongruous elements about the story that would cause a prudent person to want more details before deciding.
 
  1. The car having been stopped for a busted taillight, according to Reynolds, Castile, the passenger, not the driver, is asked to produce his driver’s (?) license.
  2. Reynolds says the Castile tells police he has a permit to carry a concealed weapon and is carrying a pistol.
  3. Reynolds says the Castile then complies with an instruction to produce his license, telling the officer he is reaching for his wallet, not his pistol.
  4. As he reaches, Reynolds says, the officer fatally shoots the passenger through his right arm and into the chest.
 
        The video shows Castile slump over as Reynolds begins recording on her cell phone.  We don’t hear or see exactly what happened just before.
 
        As a person who has had concealed weapons permits and who has had some law enforcement training there are a couple of things that strike me as strange about this sequence of events, and, for me, calls the story as it stands into question.
  1. Why would a police officer, apprehensive enough to have his gun drawn and aimed at a man in a car, having been informed that the man is armed, instruct a man, or agree to allow a man, to reach into a back pants pocket for a license.
  2. Why would a man, just having informed the police about a legally concealed weapon, reach into his pocket even if ordered to produce his license, while an officer had a gun pointed at him? 

In a similar traffic stop, wherein in the end I was not cited, my registration and my legal handgun were both in the glove compartment.  Keeping my hands on the wheel and informing the officer there was a pistol in the glove compartment, I asked that another officer retrieve my registration, which he did.  After he had secured the weapon, I got out my driver’s license.

 
 
        Lavish Diamond’s story may be true and accurate, but it is certainly not safe or prudent to assume so,  even when to make such an assumption would have little or no consequence.
        [Looking at her heartrending, yet flagrantly anti-white racist Facebook rant just now, I saw her reveal what seems to me may have been the cause of this tragic event. The way she described it, instead of announcing that he was armed while his hands were in the air, it is possible he announced it to the officer just as he was complying with the instruction to produce his license, and was reaching for a fat wallet in his right-hand back pocket.  There may have been a coincidence of two tragic factors here, that together resulted in the shooting.  If the officer had been forewarned that the man was legally armed, he would likely have had him exit the car and would have secured the gun before proceeding with the production of a license. Castile, by all accounts a law-abiding, working and family man with a legal permit to carry concealed, may have been trying to comply with the advice given to all who hold concealed weapon permits, which is to advise the officer that he is armed.  Perhaps he was a bit flustered by the circumstances and being afraid not to comply immediately, didn’t keep enough separation between informing the officer about the gun and reaching for his wallet.  If they were simultaneous, to the officer his words could have sounded more like a threat than a statement of fact. It is also not clear from Lavish Reynolds’ account whether he was reaching for his wallet to show the officer his license to carry concealed, or for a driver’s license that the officer probably had no reason to see and may not have asked for.]
        When the consequences of assuming that these shootings were motivated by racial animus and utter disregard for black life are to encourage an outraged and very likely violent reaction from the black community, for outsiders to jump to a  conclusion of police racism within hours of the incidents as did Jesse Jackson and Barack Obama, is nothing short of anti-white-cop race-hustling.
        Here is the text of Obama’s statement:

All Americans should be deeply troubled by the fatal shootings of Alton Sterling in Baton Rouge, Louisiana and Philando Castile in Falcon Heights, Minnesota. We’ve seen such tragedies far too many times, and our hearts go out to the families and communities who’ve suffered such a painful loss.

Although I am constrained in commenting on the particular facts of these cases, I am encouraged that the U.S. Department of Justice has opened a civil rights investigation in Baton Rouge, and I have full confidence in their professionalism and their ability to conduct a thoughtful, thorough, and fair inquiry.

[Ed. This statement, and the pattern of instantly sending in the DOJ to investigate incidents where black men are shot by police, clearly implies the generalization that the ability of local departments to investigate racial incidents is tainted by racism to the point of incompetence.]

But regardless of the outcome of such investigations, what’s clear is that these fatal shootings are not isolated incidents. They are symptomatic of the broader challenges within our criminal justice system, the racial disparities that appear across the system year after year, and the resulting lack of trust that exists between law enforcement and too many of the communities they serve.

[Ed. This paragraph by Obama can only be interpreted to pre-judge the facts of this and all other police shootings of black people.]

To admit we’ve got a serious problem in no way contradicts our respect and appreciation for the vast majority of police officers who put their lives on the line to protect us every single day.

[Ed. Despite this empty and self-serving disclaimer, Obama’s paragraph does precisely what he says it does not do.]


It is to say that, as a nation, we can and must do better to institute the best practices that reduce the appearance or reality of racial bias in law enforcement.

That’s why, two years ago, I set up a Task Force on 21st Century Policing that convened police officers, community leaders, and activists. Together, they came up with detailed recommendations on how to improve community policing. So even as officials continue to look into this week’s tragic shootings, we also need communities to address the underlying fissures that lead to these incidents, and to implement those ideas that can make a difference. That’s how we’ll keep our communities safe. And that’s how we can start restoring confidence that all people in this great nation are equal before the law.

[Ed.  Unfortunately this is just the usual political bullshit, as indicated by the fact that even though nearly all the federal inquiries were dropped, neither Obama nor his DOJ have ever once announced that as a result of their investigation they have found the police shootings justified, while local and state tribunals have often found the officers not guilty of any wrongdoing].

In the meantime, all Americans should recognize the anger, frustration, and grief that so many Americans are feeling — feelings that are being expressed in peaceful protests and vigils. Michelle and I share those feelings. Rather than fall into a predictable pattern of division and political posturing, let’s reflect on what we can do better. Let’s come together as a nation, and keep faith with one another, in order to ensure a future where all of our children know that their lives matter.

Finally, I submit that it is not solely he job of police departments to somehow “get” the black community to love and respect them.  As a once young man who repeatedly yearned after women who were ever unattainable, I further submit that it is a practical impossibility to “get” someone to like you.  Moreover, it is the job of the parents of black children to raise them to respect and appreciate the police.  I have heard black fathers for whom I have great respect, say how difficult it is for them to have “the talk” with their sons, when they first warn them to be very careful when encountering the police, lest they be killed on some flimsy excuse because they are black.  And these are the fathers of black children who have fathers, not the 65% in the inner cities who do not.

 
But it had better be possible for black kids to learn to trust and respect the police, even if they do so warily and with great care.  If it is not impossible, then Dallas may have been what some feared (and some may have hoped) after the first fusillade, the opening salvo in a race war, wherein the only choice left is to pick a side.
 
What I learned in four decades of medical practice was that all I could do was my part.  I couldn’t do the patient’s part.  Eventually I learned that if I was working harder than the patient, it was a sign that something was wrong and it wasn’t going to work.  The police need to do their part, but only their part.  The rest has to be done by the fathers and mothers, but mostly the fathers, in the community the police are trying to serve.
 
Again, it had better be possible.
 
END

25. Fourth of July 2016

July 3, 2016

Independence Day

This morning I watched an Animal Planet channel documentary about three or four families living in the far northeast corner of Alaska.   They are among fewer than a dozen individuals who have had permission to build cabins on National Forest Reserve land. No more permits have been issued since the 1980’s and when these folks and their kids die, or within 100 years of the issuance, whichever is sooner, no one will be able to occupy the small cabins they have hand-built from logs.

One couple raised two daughters in their tiny dwelling, and the husband and wife still go there all winter to hunt game upon which to subsist, and trap furs for  a bit of income, now that the girls are grown.

One man has wintered alone in his cabin for 40 years and says with absolute certainty that he is the only human alive who knows the 200 square miles of mountains and woods in which he runs his trap lines. A third youngish couple is thinking about having a baby next year.

All spoke of the absolute freedom they experience. All mention that the price of that freedom has been their utter separation from other people they love.

The families move around from year to year among three or four cabins they have built, in order to allow the game and fur animals to replenish their populations sufficient to support the human predators who hunt and trap them.

The man living alone lost many of his supplies this winter when a bear broke into his cabin while he was away. This winter has been so cold that there has been no game whatsoever. Instead of a couple of hundred martin in his traps he has had none. Instead of a moose and a caribou to sustain him he has subsisted upon grouse, squirrel and rabbits and has not been able to maintain his weight. In the middle of the documentary, sad and discouraged, he gave up for the year and went back to the city to get a job.

The woodsmen and women all talked about how they loved the utter freedom of their lives, which caused me to reflect that freedom is only absolute when there is literally no one else around, and that all other circumstances necessarily make that freedom conditioned upon and relative to the needs of others. Freedom declines in some inverse mathematical relationship to the density of the population. And this sets up another inverse relationship between the desire of some people to control others, and the desire of others to retain as much freedom as is possible for all members of the community. It is this latter struggle within which most of us live out our lives.

I think the stories of individuals in the wilderness somehow made it more clear to me this morning that I have made a choice to live among other people, and to endure the inevitable disagreements about how to accomplish that.

END