70. Acute psychosis as One Cause of Rampage Violence

September 6, 2021

Rarely do our so-called “mass media of communication” provide such a clear picture of the chain of causation of an event that leaves most people shocked, stunned and confused about what to do next.  I happened to catch todays update to an evolving story in the Wall Street Journal, but it also reflected that reported by many other news stories.

Yesterday’s rampage shooting in Lakeland, Florida, of several randomly chosen strangers, including babies and children, clearly illustrates one kind of rampage shooter who especially mystifies and terrifies people.  Its aftermath always brings many questions about how to prevent recurrences in the future.

These are the elements of yesterday’s events:  1)  The shooter is said to be a young ex-marine sharpshooter, age 33, named Brian Riley, with combat tours in the Middle East.  

2)  Since his discharge from the military he has been working as armed security and has a  concealed weapon permit. 

3)  His girlfriend says he has been suffering from PTSD.

4)  His girlfriend says that not long ago, after working as armed security at a church, he came home and told her that while at church he discovered that he could hear God talking to him –and that since that time he has been able to talk directly to God.

5) On Saturday evening he approached a home not far from his own, and told the person who answered the door that he was there to see “Amber”, whom he said was intending to kill herself.  As there was no Amber in that house and his words and behavior were very disturbing, others in the home came to the door and told him to leave or they would call the police.  He left.

6)  Sunday at about 4 in the morning the police were again called to the house and found the young man inside the home, armed and wearing body armor.

7)  Riley fired on the officers, who returned fire. An intense gunfight ensued between the officers and Riley, who was wounded in the battle.  Police later found 4 dead, as well as other wounded individuals, all presumably having been shot by Riley including an 11-year-old girl with several gunshot wounds.

8) Riley later explained he had gone there on direct verbal instructions from God to kill some people.

9)  While he was receiving medical treatment, it was determined that Riley was using methamphetamines.

Though I am a former State Hospital Forensic Psychiatrist  and have treated patients, murderers,  with key features similar to Riley, what follows will not be a diagnosis of Brian Riley. It will be just my educated guess as to what may have happened.  Hopefully, understanding the actual cause of the violent behavior may suggest, how and whether this kind of thing might be prevented in the future.

This story exactly matches several well established and well understood patterns.  The first pattern is of the acute onset of a psychotic state, wherein the mind is in the grip of either one or both of two things: delusions or hallucinations.

In a psychotic state the strange things the mind sees, hears  or believes are completely real to the psychotic individual.  There is absolutely no insight on the part of the psychotic that they are being imagined or generated within his own brain, and do not exist in the real world.  The delusional belief, in this case that he is speaking directly to and receiving direction from God is literal.  It is not an illusion or a metaphor.  Which is why the law does not hold people accountable for their actions while they are in a psychotic state, as long as they are not aware at that moment of the real-world consequences of their acts, or that the act is wrong.

There can be several causes of psychotic episodes.  Among those that are likely relevant to this appalling story are schizophrenia and certain drugs.

Particularly relevant to the present story is the fact that the incidence of Schizophrenia, resulting from miswiring and malfunction of brain circuits, peaks in males in the late teens and twenties.  Its symptoms are often recognized by family and friends only after weeks and months of increasing bizarre  speech and behavior.  It often takes a long time for them to be able to believe that what their son, brother or friend is doing and believing is really happening and is really abnormal.  

However, following instructions directly from God and hearing God’s voice are classic phenomena associated with psychosis and schizophrenia.

Marijuana use can bring out symptoms of schizophrenia much earlier than they would have otherwise appeared.  And methamphetamine use can produce very severe psychosis even without an underlying schizophrenia.

One of my patients stabbed his 18-month-old daughter to death with a butcher knife while in a meth-induced psychotic state, because his voices, representing God, told him that the baby  was (literally) the Devil and would kill the family if he did not kill her.

When these terrible and disturbing violent rampages happen we ask ourselves, “how can we prevent this from happening again”?

I suggest that the only possibility of prevention depends upon understanding the actual causes.  Those with an agenda, or those with a responsibility for protecting our safety but who lack the requisite knowledge or power to do so will fix the blame anywhere other than themselves.

Often they will suggest it’s “the guns”, and seek to disarm everyone.  

But that makes as little sense as saying, “It’s young men”,  and jailing all males between 15 and 40 to prevent such killings.

In cases like the present one, if schizophrenia is the cause, without knowing a way to predict the future, there is probably no possible way to prevent inevitable recurrences, because these young man look perfectly fine, and as often as not the killings they do are among the first manifestations of their hidden and undetectable illness. 

If the methamphetamine has been the cause of a psychosis, a preventive strategy would be to curtail the use of meth, one of the most prevalent of the abused drugs and the mainstay of many regional drug markets in America.

I offer this case as a suggestion as to how to arrive at actual, effective preventive measures, by first making an accurate assessment of the mechanics of causation.

There are only a few common patterns of homicidal violence.

For example, 1) there is the psychotic rampage exemplified here.  2) There is the mass-murder/suicide rampage perpetrated by people with narcissistic borderline, and sociopathic personality disorders, who take their lives when their characteristic rage has nowhere else to go and turns inward.  And who feel entitled to take others with them.  3) And their is gang-related, drug-related street violence and murder associated with street warfare — and low level political and civil warfare.

Each category requires a different kind of solution.

It wouldn’t be all that difficult.  But I don’t sense that many of our leaders are at all interested  in doing that.


69. Doctor, what do you say to your patients who are reluctant to obtain a COVID19 vaccination?

July 16, 2021

As between individual doctors and patients, between medical colleagues and between one neighbor and the next, it’s a boundary issue.  We offer our best ADVICE,  complicated by today’s overabundance of misinformation and inadequately proven assertion and opinion.  Then each of us gets to decide FOR HIMSELF OR HERSELF whether to become vaccinated.

Under what is called the “police power of the state”, which covers matters pertaining to the health, safety or general well-being OF THE PUBLIC, the state legislature has the authority create and its administration to enforce laws governing the BEHAVIOR OF OTHERS.  As individuals, institutions, political parties or doctors, we do not have this power.  Never have.

This has long been established: that in the case, for instance, of individuals declining medical treatment for themselves, they are free to do so.  If others, e.g. family, feel that individuals are not competent to decide for themselves, or if they are making decisions for their children that may result in harm to or the death of the child,  petition may be made to the courts by doctors and hospitals for a court order to proceed with treatment.  Both sides may be represented by lawyers and the court will decide.

Yesterday I had an encounter that illustrated this boundary issue for me. 

My next door neighbor had invited me to dinner with a new neighbor and two others from the next block.  When she stopped yesterday to tell me about a change in the date, I asked whether she knew the vaccination status of all the guests, indicating that I was vaccinated.

Drawing back and lifting her chin as if offended that I had asked, her response was, “I don’t think that’s anyone’s business.”

I said it made a difference to me because I am still wearing a mask for any indoor gatherings that include any people who are unvaccinated.  And that I would need to know whether to wear my mask or remove it. 

Her reaction was, “That makes no sense to me!”

(It was sounding to me as though she would be offended if I took it upon myself to ask her guests in her home whether they were vaccinated.)

I responded with a smile intended to be tolerant, but which she may have taken to be condescending, that it made sense to me and that as things stood I would not be able to attend the dinner, adding,”But thanks for the invitation.”Again, intended to be sincere, but which she may have taken to be sarcastic.

Fortunately, for the most recent half of my 86 years I have been able to accept the things I cannot change with a modicum of serenity.


68. Shunning the National Anthem…

June 30 2021

In the news this week was the controversy regarding the black female olympic athlete who turned her back on the singing of the Star Spangled Banner.

Apologists suggested she was protesting the third verse of the anthem.

For the full lyric as written by Francis Scott Key see: 


The question I ask myself is, how should the behavior of this woman be examined and judged?

Here is the verse in question:

“And where is that band who so vauntingly swore,

That the havoc of war and the battle’s confusion

A home and a Country should leave us no more?

Their blood has wash’d out their foul footstep’s pollution. [I suggest: Their footprints on our land were expunged by their own blood.]

No refuge could save the hireling and slave

From the terror of flight or the gloom of the grave, [I suggest: Mercenaries and subjects of a monarch fled from our country or were killed by free and brave men.]

And the star-spangled banner in triumph doth wave

O’er the land of the free and the home of the brave.”

Recalling how difficult it was to learn to interpret the poet’s meaning in the abstractions and metaphors of the writing,  I suggest that our first act might be to engage scholars to investigate and attest to the meaning of the verse at the time it was written. 

For one thing, Key’s poem was written not during the civil war, though its imagery is often associated with the defense of Fort Sumpter against the South Carolina militia.  It was written in 1814 about the “Defense of Fort McHenry” against the British attack during the war of 1812.

…”where is that band who so vauntingly swore,

That the havoc of war and the battle’s confusion

A home and a Country should leave us no more?”  

… Can only refer to the army of the British king in 1776, included in which were Hessian mercenaries  – “hirelings?” – and arguably it was King George’s British subjects who were referred to by Key as “slaves”, when comparing their lot to that of the free citizens of the United States.

As a matter of fact, a primary trigger for the war of 1812 was British warships boarding unarmed American merchant ships at sea and “pressing” sailors into involuntary servitude in the British Navy.  England claimed the right to do this because they asserted that the sailors were English and therefore subject to being “impressed” into involuntary military service at the whim of the king.  This was at a time when the King’s “Press Gangs” roamed the waterfront drinking establishments rounding up mostly drunk men, who woke up in the morning miles at sea on a Navy ship, embarked upon years-long enlistments.  Many British soldiers and sailors were, by American standards, “slaves”, and it seems quite possible to me that it is those slaves to whom Key refers.

Arguably, it is is the ignorant and uneducated who are unable to distinguish  between  completely different contextual meanings, and  take affront because the poem uses a word that sounds “bad” to them.  The defective mental process is roughly equivalent to that of people who become upset at the use of the adjective niggardly, which has nothing to do with the N-word.

Still, I suggest that various experts might be sought to confirm that in the anthem, “slaves” refers neither to people of color nor to slaves in America.

Yet perhaps we could cut some slack for people who did not understand this and are merely ignorant.  On the other hand when they refuse to believe any other explanation and continue to be offended by and averse to the national anthem, I think it will be safe to assume they are among those just trying to pick a fight, and richly deserve to be ignored.

Again, if the scholars conclude that Key’s words do refer somehow to American slaves in the south, which makes no sense vis-a-vis the War of 1812, should we discuss cutting the verse out of the anthem?

 An addendum.

For a black woman to shun the National Anthem because it mentions slavery is understandable, but in a way ironic, given that our first war, in 1801 was fought against slavery sixty years before the civil war, and that the slaves were white and the slavers brown Africans.

According to our oldest references, slavery has been practiced for millennia, usually involving the enslavement of captured members of one warring group or tribe by another.  White  Americans didn’t go into Africa and capture slaves.  They bought people already captured and enslaved by one black tribe from another, and sold into the slave markets run by Muslim arabs in North and West Africa.

In the three hundred years leading up to the 19th Century, black and brown Arab Muslim pirates operating out of the Barbary states in North Africa had raided merchant vessels from Europe and America and had sold into slavery or ransomed between 1 and 1.25 million European merchant seamen.  By 1801 they were demanding ransom for American merchant seamen equal to the nation’s annual budget, as well as extorting tribute, or “protection money” to avoid further attacks and enslavement.

Thomas Jefferson and John Adams had gone to London to negotiate with the envoy from Tripoli, asking why our ships were being attacked without provocation.  They reported that the envoy had replied:  “It was written in their Koran, that all nations which had not acknowledged the Prophet were sinners, whom it was the right and duty of the faithful to plunder and enslave; and that every mussulman who was slain in this warfare was sure to go to paradise. He said, also, that the man who was the first to board a vessel had one slave over and above his share, and that when they sprang to the deck of an enemy’s ship, every sailor held a dagger in each hand and a third in his mouth; which usually struck such terror into the foe that they cried out for quarter at once.”

Upon his election as President, Jefferson sent the Navy and Marines to fight, along with Sweden, on “the shores of Tripoli”, in the First Barbary War, to end the capture and enslavement of European and American merchant sailors.

On the other hand, I have just see references that indicate that Francis Scott Key was not only the product of a slave-holding, plantation family.  He was a rich and powerful slave-owning lawyer with published opinions about the racial inferiority of African slaves in America.  Which, for me, leaves the meaning of the third verse of his poem about the star-spangled banner open to serious question and possible pejorative interpretation.  So I’m still not ready to criticize the black olympic athlete who shunned the anthem to make that point.

I will remain attentive to any thoughtful discussion of the matter.

One concept does cross my mind that I believe to be relevant. It is a key feature of certain personality disorders, for example Borderline and Narcissistic, to engage in a thing called “splitting”, which is to see other people, situations and ideas as either all good or all bad, excluding any middle options. Sometimes this is called “black and white thinking”, which might be an ironic clue into the nature of the present controversy, and which raises the question in my mind as to whether it is useful to limit ourselves to either revering or despising the founders of our nation – or the nation they founded.

It is natural for the human brain in its first few months of development to fail to understand the continuity of people and things from one day to the next, and to literally believe that the hateful parent who displays neglectful or abusive behavior today is actually a different person from the same parent who was yesterday nurturing and loving. However, it is a failure in the development of the wiring and architecture of the brain not to recognize, within the first year of life, that the same person may exhibit a spectrum of behaviors over a period of time, and they are not entirely characterized by any single one of them.

As this controversy progresses, I will be interested in the ideas of those whose brains have matured beyond seeing everything as black or white.


67. SEXUAL ALCHEMY — Transmutation of the Elements.

MARCH 22, 2021

At six fifty-five this morning I was visited by one of those hypnopompic moments of clarity.  I awoke with the answers already forming in my head, to a question that had puzzled me increasingly for the past two or three years.

It is not terribly surprising that some among us will have a different view of our sexual identity than is indicated by our genetic, anatomical and physiological architecture.  There are, after all, many powerful influences that shape our views of ourselves and the nature of our attachments to others.  Various of these views are found among members of the Lesbian, Gay, Bisexual and Transgender (LGBT) community.   What has been astonishing to me is how a small number of individuals could possibly expect to convince the rest of us that we also should see them in exactly the way they see themselves, and should adopt their self-designations, terminology and values as our own.

This morning I think I am discovering a way to think about that phenomenon that will help me understand what is going on within and between us.

At this point, a brief digression may be in order, to mention that one modern view of reality is that it is a story each of us tells him or her self repeatedly during waking hours, to answer the question, in its various forms, “What is going on around here?”  This storytelling function of the brain is currently thought to reside in a dorso-medial area of the frontal lobes and starts to go to work as the Ascending Reticular Activating System wakes us from sleep and the inter-laminar nucleus of the thalamus begins to allow sensory inputs to reach the cortex.  The moment there are lights, images, sounds or other sensations to explain, the cortical storyteller puts them together with recent memories and starts giving us a “best-guess” version of who we are, where we are, and what is going on.

Little wonder then if various puzzlements of the previous day, fragments of which may have been drifting around in the storyteller circuits during sleep, seem suddenly to receive a clear answer during the moments of awakening.

Fact and Fiction

Once when I was a very little kid and had offered my mother some elaborate but fanciful explanation for some questionable behavior or other, she complimented my imagination and my ability to tell a really good story, and went on, “but you really need to tell us when something is made up and didn’t really happen.  Otherwise we may never know whether to believe you or not”.  And that could be important, she counseled, when I really needed to be believed.

Sounded fair enough to me, and a reasonable request, so I began to be careful to let her know when I was making stuff up.  But it hasn’t been without a cost.  Sadly, I think that the need to preserve my credibility has impaired my ability to create fiction, and I always wind up telling stories about things that really happened.

However this misfortune has not befallen more than a hundred million of my American contemporaries.

Though I, myself have spent a lifetime at work, constructing the stories of patients’ illnesses in an effort to correctly detect and name their true physical and biological causes, many of my contemporaries, those who followed after us, and even I in my leisure time, have had less interest in actualities than in the imaginary world.  I refer, for instance, to all those who enjoy science fiction, a major pastime even for my college classmate, Carl Sagan, to whom I was introduced in 1951 by a mutual friend who knew we shared that interest.

More recent examples widespread and extensive fascination with magic include such fantasy and role-playing games as Dungeons and Dragons, played by more than 40 million gamers since 1974.  Not to mention the huge popularity of J.K. Rowling’s Harry Potter series, where the rules of earthly causation apply only to “muggles”, and Hogwarts’ magicians make far more amusing and exciting things happen with incantations and magic wands.

Even before these modern manifestations of our wish to believe in magic, and prior even to Tolkien, are the ancient fairy tales, and myths about the gods and goddesses that informed people of the earth about the nature of reality.

Children too young to understand actual causations often think that when something for which they wished occurs, that it was their wish that caused it to happen.  This, to a tiny person, as you may imagine, can be very encouraging.  The need to believe that they have power and control over events, people and circumstances may be very strong, especially if driven by towering rage or great fear.

In early Egypt, at the dawn, 4,000 years ago, of the understanding of the physical world, when only a few elements, mostly metals, had been identified, ancient chemists sought to use magic, in the form of a substance they called “philosopher’s stone”, to transmute those to which humans had assigned little value, into the one to which the greatest value had been assigned: gold.  From the time of the Egyptian mystic, Hermes Trismegistus, alchemists have sought by the application of magic processes, incantations and substances, to turn lead into gold: to change one element into another.

It occurs to me that this ancient need to believe in magic as having real-world power is still very much with us, as has more recently been expressed in the belief by the sexually uncertain community that its members actually can, by some metaphysical combination of desire, determination, role-playing, repetitious incantation and will, and especially by the use of magical pronouns, transmute themselves from one sex to another.

As I said at the beginning, I believe that, within the limits of the law, people have a right to dress, speak and behave in a way consistent with their self image. And that groups of consenting adults have a right to support one another by agreeing to “see” and transact with the images that others wish to project.  But now I think I also understand that the desire for magical power is so deep and extensive in humans that, even now, some groups of people can manage to believe that they have the magical power, like Lamont Cranston, to “cloud men’s minds” so that all will see and believe that, and only that, which they wish us to see and believe.

That, however, is not entirely true.  Only those who are willing can be hypnotized.



March 21, 2021

I don’t remember whether I have previously offered my observations on the death of George Floyd, but now that the trial of officer Derek Chauvin is empaneling a jury and will soon get under way I will add my opinion to the others regarding what happened, my view largely being drawn from observation of the body-cam videos that had “disappeared” from American press coverage until they were published by The Guardian in Britain.

Though unsolicited and unofficial, my narrative is one I have not seen presented in any other place, not that I have followed the case in any complete or systematic way.

The bare facts of the infamous case hardly need repeating.  Minneapolis officers attempted to detain or arrest Mr. Floyd, who had been accused by a shopkeeper of attempting to pass a counterfeit bill.  They had difficulty in getting Mr. Floyd out of the driver’s seat of his Mercedes SUV and into the back seat of a police car, a process he resisted both vocally and physically. Bystander video showed Mr. Floyd prone on the ground being held down by two or three of the officers, one of whom, Officer Chauvin, has his knee on the back and right side of Mr. Floyd’s neck.  Mr. Floyd is heard repeatedly, almost continuously, protesting in plaintive tones that he cannot breathe.

What I had not seen until about a month ago was the police body cam footage that recorded the approximately 25 minutes of the encounter prior to the officers restraining Mr. Floyd on the ground.

As the officers open the driver’s door of his vehicle and order him to get out, one officer assisting with his service pistol drawn, Mr. Floys begins to plead with them not to shoot him.  This seems a little incongruous, but there is a drawn gun and to an urban black male, even in broad daylight with bystanders present, that alone could have been a source of fear.

Still, it is unclear at that point.  Is this guy playing to the camera or is he really in fear of his life?

Gradually the officers move Mr. Floyd to the read door of the police car and this is where things escalate.  At this point, Mr. Floyd, seated momentarily in the back seat of the police car becomes visibly more agitated.  His constant stream of talk has changed to: “I’ll die if I go in there! and I can’t breathe”.  And he struggles physically to get out of the car’s back seat.

He is saying, “I can’t breathe”, while visibly breathing deeply and rapidly. To the average witness, this appears incongruous at best, fake at worst, unless one is familiar with so-called hyperventilation syndrome, or panic disorder, something I have seen and treated several times.  In which case this incongruity is absolutely classic.

To the patient, taking in huge breaths,  it feels subjectively like someone has removed the oxygen from the air, and the breaths are  simply “not working”.  What the breathless patient almost always says is, “I can’t breathe”, while to the average observer it appears he is breathing quite well.

Meanwhile, the patient really thinks he will die in the next few seconds for lack of air, and if constrained he will almost surely struggle to be free to get more air.

If he is feeling claustrophobic, as Mr. Floyd demonstrated by struggling to get out of the police car, an attempts to restrain him will only increase his panic and he will struggle the more frantically.  He cannot “just quiet down first” as others may be telling him to do. 

To the police at the scene, if they are unfamiliar with what hyperventilation syndrome or a panic attack looks like, the individual appears to be over-breathing if anything.  In fact in the later stages of hyperventilating, the patient, who has plenty of oxygen in his system frequently has blown off too much carbon dioxide.  This makes the blood alkaline, causing blood calcium to precipitate out of solution, which in turn causes severe tingling around the lips and mouth, and next, severe tetanic contraction of hand and arms muscles.  These bizarre symptoms further convince the patient something is terribly wrong and he is going to die.

As many people do know, the emergency treatment for the hyperventilation syndrome is to have people breathe in and out of a paper bag, returning the expired carbon dioxide to the lungs, and thus preventing the emergence of the frightening neurologic symptoms.

Not surprisingly, however, the police, in the middle of trying to force a man accused of a serious, though not violent crime, to allow himself to be arrested, might not be in a position to use the reassurance and paper bag trick to end the panic attack — that is if they even knew what was going on with Floyd.  Moreover Floyd was being arrested for being a trickster, passing phony money, so their safety might require that they not give him the benefit of assuming he was credible in the midst of a physical struggle.

After watching the videos my working conclusion was that there had been an unfortunate misunderstanding that prolonged the struggle to constrain Mr. Floyd.

Since viewing the videos I have learned two more things that are relevant and helpful in analyzing the sad outcome of this arrest:  

  1. It is the standard training in the Minneapolis police department to place a knee on the back of the neck of a prone man in order to control his movements.
  2. George Floyd had taken what for a person hot habituated to the drug, more than a lethal dose of fentanyl, as well as a lesser amount of methamphetamine and cannabis.

These facts resolved two puzzles for me, why Mr. Floyd had experienced the panic attack in the first place, and why the officer kept his knee on the back of Mr. Floyd’s neck, despite being told by the young officers he was training that the man “couldn’t breathe”.

First, when he was trained, Officer Chauvin would have been told by his instructors, as I myself observed while watching the Chauvin/Floyd video, that with the individual prone, a knee on the back or back “corner” of the neck could in no way interfere with the person’s airway, nor could it possibly cut off blood flow to the brain.  I do seem to remember that the training and policy of the department was to not maintain the neck pressure for more than a certain number of minutes — like four, or six.  And I concur that is a good rule of safety.

But second, I had been puzzled as to the origin of Mr. Floyd’s panic attack, which, it now seems to me, could well have been related to the fentanyl, which is a fast-acting anesthetic.  In the amount found in his bloodstream, fentanyl could easily have interfered with Mr. Floyd’s ability to think clearly, and with the decisions and conclusions that caused him to be so afraid.  The amphetamine was present in a low dose, but combined with fear generated by fentanyl-induced confusion and impaired cognition, could have contributed to panic, an outpouring of adrenalin from his adrenals, and a fatal arrhythmia.  

This is an important possibility because a sudden cardiac arrhythmia is one cause of sudden death that leaves no trace.

The public and the lay press, on the other hand, have always indicated a belief that Officer Chauvin’s actions “strangled” Mr. Floyd by cutting off his air.  Of which, as I understand it, the autopsy has found no indication.  And the video and witnesses, I understand, have indicated Mr. Floyd was talking almost continuously right up to the time when he became unresponsive, indicating his death was not likely to have been caused by, “not breathing”. 

Addendum: March 25, 2021

In a video produced on the basis of his investigation of the incident, by George Perry, a former federal and state prosecutor, further autopsy information suggested a slightly different view of what led to the fatal arrhythmia.  


The level of fentanyl in Mr. Floyd’s  system, 11 ng/ml, was described by the medical examiner as being capable of causing pulmonary edema, fluid collecting in the lungs that would interfere with the patient absorbing oxygen from the air. That this did occur was evidenced by the fact that Mr. Floyd’s lungs were two to three times their normal weigh at autopsy. 

At three times the lethal dose, the fentanyl was also sufficient to have caused the agitated and combative delirium exhibited by Mr. Floyd, which, by causing an outpouring of adrenalin in his body could easily have triggered a fatal heart arrhythmia.  This would only have been made more likely by the residual from the methamphetamine Mr. Floyd had taken earlier.

My observations are based upon the few items of evidence that have become public, and I will yield to the opinions of the judge and jury when they have seen all the admissible facts, but I fear that the image and symbolism of the white oppressor with this knee on the neck of the black man will, for the public and the press, outweigh any actual facts that survive the courtroom fight.

If Officer Chauvin is not drawn and quartered despite any amount of evidence of reasonable doubt, I predict that the mob will exact punishment of its own from whomever they assign to be his surrogates.

On the other hand, if he is found guilty, I predict that there will be no rioting by his supporters and that he will win on appeal after a long and financially ruinous legal battle.  And that thousands of more police officers will find other employment rather than face the same risks.

I hope I am wrong.  In a few weeks we will know.



February 10, 2021

San Francisco — The whole thing started with Ma Heaney, really.  In her youth, hospital legend had it, Ma had been a nurse-anesthetist up in Shasta County, delivering babies in the back country at the foot of the mountain with her country doctor husband.

As I heard the story, in winter they traveled by horse and sleigh through deep snow, out to the farms and ranches, to attend women in labor and help them through the difficult hours that brought their children into the world.  

By the time I met her in 1964 she was nearing retirement as the Delivery Room supervisor at St. Mary’s Hospital, near the panhandle of Golden Gate Park in San Francisco, and didn’t take any crap from the July harvest of a dozen freshly graduated new interns, of which I was one.

By the time I rotated onto the obstetric service part-way through my first year out of medical school, I think I had a bit of a reputation myself.  I was five years older than the average graduate, and while few med students were married in those days, I was an Army vet and had a couple of kids of my own.  I was a hard worker and capable enough that I didn’t put up with any of the casual bullying by senior residents and nurses, nor even by the few staff physicians who liked to throw their weight around.  

At medical school in Philadelphia, rather than scoot off home from night call at the first opportunity, I had hung around at the hospital where, technically, I was supposed to remain when on call anyway.  I hoped that when things got busy in the Emergency Department, surgery, or OB, the senior doctors would discover something useful for me to do. 

Clinical training, with actual patients, begins in the third year of school, after we had spent the first two years cramming our heads full of medical information about anatomy, biochemistry, physiology, pathology and the rudiments of medicine, surgery, pediatrics, neurology and obstetrics.  In the third and fourth years therefore, we divided our time between classroom and making rounds with our professors on the wards.  Eventually we attended the various outpatient clinics, and in our final year on surgical rotations and delivery rooms we got to scrub up, gown, and stand at the side of the operating and delivery tables as observers.  For practice, we took histories from live patients and did admission physical exams.  On certain nights we were assigned to be “on call” in various locations.  There was often little to do and we were sometimes bored and ignored.  Most students, sleep-deprived as they always were, slipped out when things were quiet and went home to get some much needed rest.

Maybe an upperclassman tipped me off or maybe I just thought I’d give it a try, but I usually stayed around my assigned places of duty, particularly the Emergency Department.  Sure enough, hanging around until the ER docs and nurses got used to my presence eventually resulted in my being given some task or other they were far too busy to attend to.  

For example, only a few days into my time in the ER an elderly drunk had wandered in from a nearby alley with a five-inch laceration on his face.  He was still rambling and half-asleep on the gurney.  For the first time, but not the last, I smelled the distinctive metallic pungency that results from the mixing of ethyl alcohol and blood.  The man was making belligerent noises but was not combative.  As I watched the E.R. doc explore and clean the  wound, he began to explain what he was doing at each step, and why.  He then asked if thought I could suture the wound.  I had read the texts, studied the illustrations, and once in the service when Frankfurt suddenly turned cold and we had nothing left in my private’s monthly pay packet, had sewn my wife a passable winter coat out of an Army blanket  So I said, “Sure, I can do it.”  

Leaving me to attend to other problems, he came back to check my progress a few times and then examined the result when I was finished.  I had paid attention in my plastic surgery lectures, and my tiny, closely spaced stitches with 6-0 nylon looked like they were going to leave our patient with as little scarring as anyone could rightfully hope for, probably less than if the work had been done with bigger, fewer stitches by a harried emergency room doc.

After that, every time I was on call in the E.R. I was given a steady stream of wounds to sew up, each one with another careful instruction on how to assess the particular underlying damage prior to beginning the closure, and with intermittent coaching as I worked. Once at three a.m. when a patient required a super-specialist to do a complicated repair of the nerves and flexor tendons of his injured hand, and the hand surgeon’s own resident couldn’t be found, the E.R. doc recommended me as a competent assistant, and I went into the operating room for my first official experience as a surgical first assistant.

On the obstetric rotation, the student’s job was mainly to sit with the patients through their hours of labor and observe the process attentively from beginning to end.  We were assigned patients as they were admitted, and stayed with them for the entire labor.  Among the patients to whom I was assigned, the longest labor was 36 hours. She was a very overweight teen who had not known she was pregnant when she came to the hospital that day with severe abdominal pain, which proved to be labor.  She was there on her own, as terrified with the whole idea of being pregnant as she was at being in labor. With no preparation for the event and altogether overwhelmed, she screamed at the top of her lungs with each contraction for the entire 36 hours. Poor kid, no matter how I tried, I was powerless to comfort or reassure her in any way.

Attending staff, residents and sometimes interns delivered the babies, but there was one job no one really wanted.  When parents had requested it, the interns performed circumcisions on their three-day-old boys.  After I had watched a few, one intern taught me how to do circumcisions with the two main types of clamps that had been invented for the job.

Then, when the nurses called him in the middle of the night for a circ,  he had the them call me instead.  Of course the first time or two he got up anyway and came in to make sure I was doing OK, but after that I was on the regular rotation to do the tiny but critically important task.   Often when the nurses had difficulty reaching an intern and I was on duty, they called me.

I became a mini-celebrity among the med students on the obstetric rotation.  A Jewish classmate told me with a grin that I was, “the Irish Mohel of Philadelphia”.  

A couple of weeks and many circs later, an excited classmate woke me in the on-call room, saying that his intern was in trouble with a circ and wanted me to come and help him.  Arriving, I found the intern pale and sweating bullets, his eyes big and scared.  There was a lot of blood and raw tissue where the head of the penis should be and the intern was terrified that he had cut too deep.  Terror had shut down his ability to think and he was about to faint.

It scared me too.   It took me a full minute of calm, systematic  inspection to figure out what lay before us, but I finally realized that the probability was that he had been too hesitant and had not cut completely through the foreskin. We were looking at, I decided – I hoped – was the bloody interior tissue of the foreskin itself.  After confirming my theory with a thin probe gently inserted between foreskin and glans penis, I made one very careful snip through the remaining innermost layer of the foreskin, which, falling aside, revealed the completely uninjured head of the kid’s penis.  After we both took a few deep breaths of relief, I encouraged the shaken intern to finish the surgery himself, and stayed with him for moral support while he did it. I suspect I made a friend for life.  And if the newborn boy had known what was going on, it would have been two friends.

It chanced that after med school I never did another circumcision.  Decades later I concluded that since the original rational for male circumcision, potential infection under the foreskin, was no longer difficult to prevent or treat, it was probably a ritual that was, a) medically unnecessary and, b) impossible to rationalize on any other basis.

The larger lesson I leaned from hanging around rather than absconding as most exhausted students did in the middle of the night, was that at 3 a.m. when something goes wrong, the powers and abilities of even most junior trainee become magnified by the complete absence of anyone more qualified.

Two years after the my experience as a “circumcision consultant” to an intern, I was myself an intern (nowadays called a first-year resident) at a large private hospital in San Francisco.  The fact that it was a private hospital, with few non-paying clinic patients and with full staff of private doctors, meant that interns and residents rarely got to do hands-on surgical procedures, of the kind they did at the county hospitals.   Private patients expected to see their doctor at the wheel.

Despite the scarcity of opportunities for solo experiences, St. Marys had a cadre of excellent medical staff volunteers, called the “Teaching Staff”, to make sure we got all the training we could handle. In return for their service as our teachers, interns were assigned to all of their patients to do detailed and complete admission histories and physical exams, to write admission orders, and to be available day or night when the nurses needed a doctor to answer a question, evaluate a problem, make a decision, order a test or prescribe a medication.  Only if the intern couldn’t handle the given situation would the attending physician need to be called.

During two-month rotations on obstetrics, interns watched the attending doctor deliver a lot of babies and maybe got to suture up the episiotomy incision, if they were lucky.  In the first few months one or two interns may have gotten to deliver a baby or two.

Though I liked OB and might have hoped for more experience, I was willing to live with that, but then something entirely different happened.  

There was something unusual going on in the delivery room that year.  It was the mid-sixties and Michael Flanagan, the Chief of the OB Department had learned a new and safer way to administer anesthesia for labor and delivery.  It was essentially a local anesthetic, a later version of novocaine, administered through a seven-inch needle at a precise moment early in labor, into the partly dilated cervix at the four and eight o’clock positions.  Just as in the dentist’s office, the anesthetic numbed the cervix so that its subsequent dilation and the contractions of the uterus were pretty much painless.  And late in labor just before the work-space inside the vagina  disappeared and the pelvic floor was stretched by the baby’s head, the same needle, and a guide, called an Iowa trumpet, delivered more local anesthetic through the vaginal wall to the pudendal nerves on either side, numbing the pain of the stretching of the opening.  Deadening those nerves also allowed enlarging the opening a bit with an episiotomy, later to be sewn back up after the baby was born.

Called a Paracervical and Pudendal Block, the local anesthetic, though it had to be injected into a very precise location at a very precise moment in order to work, avoided the necessity of giving the mom medications and anesthetics that could make both mother and baby very drowsy.  But it was a new technique, very hands-on for the obstetrician, who ordinarily left pain control to the anesthesiologist.  At St. Mary’s only Doctor Flanagan was using the nerve-block technique.

So I began my rotation on obstetrics sitting with patients, and doing what I was told.  Even the few clinic patients we had were delivered by the chief OB resident, a kind of abrasive guy, I thought, so I avoided him.

But Flanagan was friendly and energetic, so I asked him to teach me — show me really because I had no one on whom to to practice once shown — how and when to do the injections for the nerve blocks.  Which he did with enthusiasm. On several occasions he let me watch closely in order to identify the precise location on the cervix into which he injected the anesthetic.  At his request one or two of his patients allowed me to do a vaginal examination in order to memorize by feel, the landmarks on the pelvic bones that bracketed and therefore precisely located the pudendal nerves for the second-stage injections.

That accomplished, we both intended that would be that.

Meanwhile, at some point Ma Heaney had come up as I arrived on the ward and asked me to countersign for a sedative she had administered during the previous night to a patient of one of the staff obstetricians.  She had done this to other interns, some of whom had gotten huffy with her about expecting them to approve, after the fact, the somewhat heavy sedation she sometimes employed without waking up the attendings for an order, and without consulting in advance with an intern trained in the modern philosophy of avoiding heavy sedation of mothers in labor.

But I had been in the Army, and I knew better than to be the newly fledged lieutenant who gets into an pissing contest with the platoon’s master sergeant.  Besides the medications had been given hours earlier and the mother and baby were fine, so I said sure, and signed the retroactive order, adding with a chuckle, trying to come off as being unconcerned and with no hint of rebuke — “a hundred of Seconal…sounds like that kid may be a little sleepy when he gets here”.

She gave me a speculative look, but said nothing.  Hell, before I was born that woman was out in the middle of the night in the dead of winter on some isolated farm in the mountains giving medications to a woman in labor by the light of an oil lamp.  Medical fashion might have changed slightly over the decades, but her experience gave her good reason to know that mother and baby would be fine with whatever part of her medication was left in their systems by the time the baby was born.  Since…

There was another liberty she took, again because she judged the rules to be in conflict with reality.  Technically, nurses weren’t supposed to do pelvic exams on women in labor.  In order to minimize the risk of introducing an infection, a terrible problem a hundred years earlier, the number of exams was to be limited to those done by the obstetricians themselves.  On the other hand, every obstetrician on the staff relied on Ma Heaney to know exactly when to call him in to deliver the baby.  That service allowing them all to sleep as long as possible at night or see a few more office or hospital patients during working hours, and still get to the delivery on time.  She was to call them from wherever else they were when the cervix was at seven centimeters dilation.  Seven was two centimeters short of the nine that signified that a delivery was imminent.  The final two centimeters of dilation would provide enough time for the doctor to get to the hospital from home or office.  There was only one practical way to discern the precise dilation of the cervix in a labor bed — by how the rim of the cervix on the baby’s scalp felt to the gloved hand of a skilled and experienced examiner.

When the phone rang at 1 a.m. a couple of weeks into my OB rotation it was OB nurse-Carol Rogan.  “Doctor Franklin,” she said, “Ma Heaney wants you to come in and deliver a clinic patient who’s just come in.”

“But Carol”, I explained, “I’m not on call tonight.”  Charlie, the truculent chief OB resident had was on call that night and she had made a mistake… I thought.

“No, Ma says she doesn’t want him to take care of this patient, she wants you.”  

Leery of pirating my boss’ clinic patient, I still hesitated. In the short silence, Carol finally explained the circumstances, “The patient is Ma’s granddaughter.  She’s eighteen and single.  Ma wants you to give her a paracervical and pudendal and deliver her with forceps.”  Application of forceps, in this case to protect the baby’s head, control its emergence and thereby minimize the risk of tearing of the mothers vaginal and perineal tissues.  Forceps.  Another thing I had never done.  Although I had performed one uncomplicated delivery in med school and theoretically knew how to apply forceps, itself a little tricky, I had never applied the steel utensil, except miming in the air with no mother or baby present.

“Carol, I’ve watched them but I’ve never done a paracer….” I began, but Carol cut me off with, “Ma says she knows you can do it and she wants you to come over.”

Already wearing scrubs I slipped on my shoes and was out the door in seconds.  St. Mary’s had built a brand new six-story interns and residents apartment building just across the street from the back door of the hospital.  My intern classmates and I were its first occupants.  A St. Mary’s intern’s  salary was only $3,000.00 a year in 1964, but a brand new San Francisco apartment for my wife and (then) two kids made choosing that internship a no-brainer for me.

Striding into the Delivery Suite two minutes later I was met by Ma Heaney, who listened while I listed all the reasons why I was not qualified to do what was proposed, then said,  “Flanagan taught you how to do it.  I know you can do this.”  She and Charlie had some sort of history and it was clear she really didn’t want him taking care of her granddaughter.  Besides, she was right.  What Doctor Flanagan had taught me wasn’t that hard to do if it was done at exactly the right moment and at just the right anatomical spots.

That settled, Ma took me to meet my patient.  Even at first glance she seemed to be a great kid.  A scared teen, she was being brave so as not to embarrass her tough old pioneer grandma.  Dark-haired, small and pretty, she looked determined to do her part and to trust us to do ours.

As with all the patients, I was able to sit with her so that we could get to know one another a bit, and I explained to her exactly what was going to happen. Ma went off to do other things, and, I thought, in order to take the pressure off of me.  With encouragement from Carol and me, the young woman bore the initial contractions bravely until it was time to move her from her bed and in to a table with stirrups for the paracervical block.  Which went very smoothly.  The ‘Iowa trumpet’ needle guide was shorter than the needle, and allowed the needle protrude to just the right depth, depositing the lidocaine among the fibers of the dense paracervical nerve plexus on each side of the cervix, or neck of the womb. The anesthetic soon deadened the nerves that carry the pain messages to the brain.  Within a couple of minutes while still fully alert, the young woman was having no pain with her contractions.

Later when the cervix was fully dilated and the baby’s head moved further down the birth canal with each contraction, we again put her on the delivery table as she continue to push the baby out. With the baby descending, it soon came time to put the second set of locals into the pudendal nerves before the workspace was filled with the baby’s head.  Again, it worked just as Mike Flanagan had shown, much to my relief.  Then, with the area completely numb I made an episiotomy incision to make plenty of room for the forceps, which slipped on just as the textbook described they would.  It seems illogical to cut perfectly healthy flesh, but the surgical cut heals cleanly, quickly, and with minimal scarring, whereas if the tissues do tear, significantly more scarring and lasting damage occurs.

Before long the brave granddaughter delivered a healthy, wide awake little girl, to everyone’s delight and my relief.  There is no happier place in the world than a delivery room in the moments after the safe arrival of a new child.  And I have had few greater pleasures than to have shared those moments with new parents and the delivery room team.

The granddaughter had done her grandma proud, and I was enormously proud of her for it.

A few midnights later I was working on a chart at the nursing station and I heard Ma on the phone with one of the staff obstetricians.  She was saying, “Doctor, I’m calling to tell you that your patient is ready.”  From under his warm covers he must have asked, “seven centimeters already?”, to which she responded.  “No, not seven centimeters yet.  She’s just reaching six centimeters and is perfect for a paracervical.”

I could hear and alarmed squawk from the phone, and a faint, “Paracervical?  I don’t do paracervicals!”  And then Ma delivered the hook so matter-of-factly he never felt it go in:  “No, but Doctor Franklin does them.  He did my granddaughter and he’s right here.”   Sleepy and confused, he must have told her to have me go ahead and call him for the delivery, because she beamed a smile at me and hung up the phone.

With Ma explaining her doctor’s decision to the patient, off we went to the delivery room. No sooner had I put the paracervical block in when her OB popped into the room, in a state of mild confusion.  Who the hell is Doctor Franklin, he was wondering? And why is he giving the anesthetic to my patient?  

I imagined how this must appear to the patient.   I was standing at the foot of the table, scrubbed, gloved, masked and gowned, and the newly arrived attending had taken a position at the side of the delivery table, didn’t exactly know who I was nor what a paracervical block was.

At that moment the patient began to have another contraction, the first since the block, and I asked,  “Are you having any pain?”  The doctor, with his hand on her belly feeling a strong contraction said, “Yes”, at the very moment she calmly said, “No.”  His head snapped around only to catch her smiling, peaceful expression.

As he turned back to me, I explained I had just injected local anesthetic into the cervix at the 4 and 8 o’clock position and in a few minutes I’d inject locals into the pudendal nerves on either side and do an episiotomy.  He knew that the baby would be born within the next few moments after that. 

The doctor was asking me questions and to the patient it would have seemed as if I was teaching him what I was doing.  With the patient seeing me as some sort of consultant, and with her own doctor at her side, neither of them seemed to mind when I just naturally proceed with the pudendal block, episiotomy and delivery.  Besides which, because of the steady march of events, it would have been awkward for the attending physician to switch places with me at the last minute.  In addition to which he wasn’t scrubbed, gowned or gloved.

Holy smoke, I had just delivered a baby with the private OB standing right there.  That was two deliveries for the OB intern, already tying our intern class record.  

Ma made that same phone call every time I was on duty, and by the end of my two months on the obstetrical service I had done 100 deliveries.  

Of course the staff doctors must have figured out what was going on.  Perhaps they checked with Doctor Flanagan, but in any case no one ever objected and I was not aware of any declining the paracervical for their patients.  I even delivered the baby of the niece of one of the staff obstetricians, Gil Ayotte who had begun as a country doctor in Quebec and had a wonderful French-Canadian accent that always reminded me of Maurice Chevalier.

Delivering those babies was probably the most fun I had in all my years of training. 

At the end of my rotation, Carol Rogan and a delegation of delivery room nurses came to me and asked me to please apply for the obstetrics residency program when my internship ended.  I was moved and gratified, but declined.  I explained that I had loved my time there as an intern, sitting with the patients and staff and being part of the joyful outcomes, but I knew that as practicing obstetrician I would never have time to spend hours with the women in labor, and would have to rush in at the last minute, having missed most of the fun.  Ruefully, they said they understood.

Over the next few years hospital staffing showed the first signs of a massive shift that has taken decades, and doctors began making a career of working full-time in hospitals.  If that kind of practice had been available for obstetricians in 1964, I’d have done it!

A year after my obstetrics rotation as an intern, when my wife was in labor with our third, a daughter, I was catching a nap in the on call room when Carol Rogan rushed in and told me the labor had accelerated dramatically, and they couldn’t find Doctor Flanagan who was somewhere in the hospital. There were some pager dead-spots at St. Mary’s and Flanagan, who had already done the nerve blocks, was in one of them!  As I was completing my five-minute scrub at the sink, from a few feet away at the delivery table, Carol nervously urged me to hurry because the baby was, “really on the way!”  As I gloved and approached the table I said, “It’s OK, Carol … just don’t let the head pop.”  (If the head emerges too quickly during birth and suddenly decompresses, the pressure change can cause veins to break in the newborn’s brain, resulting in the potential for damage.)  She placed three fingers atop the baby’s head and as she eased it out I stood by and let her finish the delivery.  I knew it wasn’t her first, but I wanted her to know how much I trusted her.  We clamped and cut the umbilical chord.  Then she took Lisa up to meet her mom while I delivered the placenta and massaged the uterus to stimulate the final contractions that stop it from bleeding.

Good thing she knew not to let the head pop.  That little baby, with all her wits about her and two boys of her own in college, is working as a prosecutor, protecting kids in this county’s family court system.



January 23, 2021

In the year we entered World War II, Rutherford was a small residential town, of the kind that later came to be called a bedroom community, in the Greater New York area.  Like many eighteenth and Nineteenth Century towns in Europe and Great Britain, the focal point of Rutherford’s map was the railroad station.  

Five main streets radiated out, and still do, from the square centered on the northeast edge of town and named Station Square for the red brick railroad station that dominates it.

Union Avenue led to the northwest to Rutherford’s western boundary at the Passaic River.  Park Avenue, the main shopping street, pointed to the southwest, ending at Lyndhurst, the next town in that direction, the border now marked by Route 3. 

Orient Way led to the southsouthwest, again entering Lyndhurst at what is now Route 3, built at the end of the war.  Erie Avenue, parallels the railroad track to southeast towards Hoboken and the ferries to Manhattan.

The length of the radiating streets in Rutherford is about a mile, with the longest diameter of town being less than a mile and a half.  The town is roughly diamond-shaped, with a long axis of less than two and a half miles and a short axis about a mile long.

270 Feronia Way lies near the southern tip of the diamond and, as best I can tell from the Google Earth renditions, (when did Google Earth stop using photographs?) is the same house in which I lived during the war years, a very modest three-bedroom, brown-shingled home, that at the time had an asphalt driveway but no garage.

In the 40’s Rutherford’s population was roughly 19,000, and since there is no way to increase the space in a town that is entirely circumscribed, it is likely to have about the same number of single-family homes and the same population now.

There were some areas of town where the houses and yards were larger than on Feronia way, but our streets were as wide as any.  One of the prominent functions of the borough government was fulfilled by the Shade Tree Commission.  Whose sole responsibility it was, to assure that large and well-tended sycamores, horse chestnuts, maples and oaks lined all its streets, with at least one and often two trees in front of each house.  It was, and is, a beautiful town partly because its residents have always cared for it lovingly.

Rutherford was one of the first stops on the Erie-Lackawanna Railroad  after leaving the ferry terminal from New York, and was desirable as one of the quickest commutes from the City, because between NYC and Rutherford was the complex river delta of the Passaic and Hackensack rivers and a wide cattail swamp known in those parts as “the meadows”.  Therefore, there were no other towns, stations or stops between the terminal for the New York ferries and Rutherford.  The term wasn’t applied at the time, but Rutherford was actually a disconnected suburb of the City, and closer to Times Square than many of the bedroom communities on the New York side of the Hudson River.

I have provided this level of detail because of what comes next, which is not in any way a demographic study, but is instead a personal story that may provide a glimpse into how things stood in such towns before today’s historical revisionists began to pretend that they invented the idea of “diversity”, without which we who came before would have continued to wallow in our ignorance and narrow-mindedness.

The reason that I write is that I woke up this morning thinking about my early playmates.  My fragmented recollections seemed to move out concentrically from  my own home at 270 Feronia Way, in the same way, perhaps, that my then ability to get around, first on a tricycle and later on a bicycle,  expanded with my age, to places further and further afield.

My first playmates were simply the kids on my own block, later including schoolmates who lived a little further away.

Going down the three porch steps to play in my front yard I often found picture-pretty Kathy Conlyn in the yard next door to the right. A couple of years older than me, she played out front with her friends.  Attracted by their laughter I’d start in their direction until, out from behind their big square Buick her younger brother Bobby would loom, a contemptuous smile on his face, to block my way.  A year older and bigger than me, he would stride up and, after uttering a few provocations and threats, he would punch me in the chest knocking me flat on my back in the dust of the yard.  It went on that way for a long time.  Kathy inviting me with a smile and Bobby knocking me down and running off.

If this seems a little too organized for kids still sporting their baby teeth, it turns out it was.  I later learned from my mother that, over time, she had observed Mrs. Conlyn, Joyce, send Bobby out to knock me down day after day, watching the whole encounter peeping through her front curtains.  Until the day I bloodied his nose and he fled crying.  But that’s a story for another time.

On the other side of our house, to the north, were the Stefanatzs, a quiet, dark-haired young couple with an accent different from ours.  I remember my mom being very excited one day because they had had a baby, who later became a playmate of my youngest brother, Lee. From the accent and the name I’m thinking now that they may have been from Austria.

Evans street teed into Feronia directly in front of our house.  Across the intersection, on the corner just to the right a handsome young man of about 18, Rudy Nicolosi, who later changed his name to Nicholson, worked on his motorcycle at the curb.  His folks had an accent which I eventually learned was Italian.

Next door to Rudy was his friend of about the same age,   Roland (Roley) Stabe, whose parents were also European.  Roley became a flier late in the war and afterward worked as a corporate pilot.   Next down that side of the street was a kid three years older than me, Fred Zanka.  He was fat, had a sullen pout, a bad complexion, and got picked on by the other kids.  The one time we had an encounter I had ridden my trike into his driveway to see if I could play with him and some other kid in his back yard.  I was small enough that I was confined to our back yard, but had thrown my trike over the low fence and climbed over after it to go exploring.

 By way of declining to have me join them, Fred and the other kid stuffed me forcibly back onto my trike and pushed me so fast down the driveway that I couldn’t get my feet onto the pedals to slow down.  It shot out into the street, straight into the rear wheels of a passing dirt-filled dump-truck.  My tricycle and body were cartwheeled to the left by the spinning wheel and my head hit the concrete hard enough that the swelling later literally doubled its size and the street scraped all the skin off the left side of my face.  Miraculously but barely still conscious, I managed to stand and stumble towards my house.   Along with the pain and nausea, my perceptions were severely distorted.   Fixated on making it to my front door, I watched my house grow tall and thin one moment and short and wide the next.

Taken to Passaic General Hospital in the back of a police car with the siren howling, over the course of some hours I was examined and my wounds cleaned and bandaged. It was finally pronounced that I was severely concussed but had suffered no skull or facial fractures.   I remember that until they pried my left eye open they were unsure whether it was still there.

I never played with Freddie after that.

Three more houses down the other side of the block was Millard Kline and and the Kline family of redheads. Millard was a tall, thin kid and one of the guys with whom I played baseball in the street.  His siblings were outside of our age range and I never knew any of them. 

When I was ten or eleven I got with bored being the only kid around on Sunday morning.  My mother read the bible every day and was a firm believer in a Christian god, but not a joiner, so we were not churchgoers.  We would learn three decades later that she was descended from Dutch Reformed ancestors, religious refugees, Walloons, that had been members of the original group of 30 families contracted by the newly formed Dutch West Indies Company to colonize, in 1624, that which is now New York .  

My dad’s dad, a first generation Irish-American electrician, had left the Catholic church after what he would only ever describe as, “I ran into a crooked priest”.  Neither parent went to church except for weddings and funerals.

I told my mom I wanted to go to church with my friends and she said sure, go ahead.  For the next two years I got up on Sundays, got dressed for church and went out on the front porch to wait, tagging along with whichever mate came along first.   Except for Millard and his family, who, like the Conlyns  were Catholic.  Saying they had checked with their priest, the Klines told me that as a non-Catholic, their church would not allow me to attend casually.  I specifically remember going to church with Methodists, Episcopalians, Presbyterians and Christian Scientists, but there were others.  Of course I wouldn’t have gone to synagogue because Saturday was movie day.

Back across my side of the street from the Klines, was George Bahue.  Another playmate who was older than me.  It turns out I was always more interested in what older kids were doing than kids who were exactly my age — or maybe it was just a matter of who was available.

Anyhow George was a handsome lad with dark curly hair.  His mother was a beautiful black-haired American woman with a beaming smile and a great laugh, and his father was an older man, balding, with an interesting accent.  George seemed a little afraid to disturb him, but his father was patient and kind with me the one time I was in their home. Though the same size as our little place, their house was filled with dark, polished furniture decorated with unusual objects and carpets covered with intricate designs.  Their home  contained the aromas of foods and spices I had never before experienced.  George’s father, he explained, was from Syria.  Bewildered, I was introduced to the idea that there were places in the world that were not like New Jersey, nor anywhere I had ever been.

Just over our low back fence on the street behind our house Lived the Buschels.  Joey, a couple of years bigger than me, was always busy with one project or another.  Taking care of the garden or their rabbits, or delivering newspapers, at which he allowed me to assist.  His parents were Swiss, he explained when I asked about why they called him Choey and his sister June, Chooney.  And he showed me is dad’s Swiss Army Rifle (a Vetterli 1870), from when he was in the Swiss citizen militia, carefully demonstrating how to open the bolt and make sure it was unloaded.   But there had always been a loaded .22 or shotgun behind my grandmother’s kitchen door in the country, to drive off or kill any critters that came after her chickens.  So before the age of five I knew about guns, how they sounded, what damage they could inflict if mishandled, and not to touch or explore them out of curiosity.

North of the Buschel house, after a vacant lot, was Paula Schlichting, an older woman, perhaps even a teen, whom I knew only to say hello to, though she and June Buschel were friends.

And to the south of the Buschels was Dante Fuglini, another pleasant and cheerful kid a little older than me.  Dante himself had the slight accent of a first-generation immigrant. 

The thing about the boys I played with that year was that after a few hours they would become bored with whatever we were up to and, I being the youngest and therefore the smallest of the litter, would begin to tease me or get a little mean.  Before long they were pummeling me or wrestling me to the ground, knuckling my scalp with an “indian burn” and yelling, “D’ya give?, d’ya give??”

But I didn’t want to give up, so it often got a bit rougher until they drove me off and left me on my own for the rest of that day.

Years later my mother told me that she had once asked George Bahue, who seemed to her to be quite a nice kid, from whom she would not have expected bullying behavior:  “Why do you boys pick on Denis?  Why don’t you just not play with him if you don’t like him?”

“Oh, we like him fine Mrs. Franklin”, he responded.  

“Well then why do you pick on him?, she asked, puzzled.  George thought about it for a few seconds, then came up with his conclusion:  “Because he can take it”.

The boy who became my best friend in sixth grade lived straight out our front door and down Evans Street one short block, on the corner of Highfield Lane.  Richard Shere’s father Sam, was a Life Magazine staff photographer, and the man who took this picture you have all seen. 

Richard’s mother, like the Buschels, was Swiss and spoke English with a heavy accent.  Richard was smart and could easily remember years of  baseball statistics, and statistics relating to hunting rifles and race cars, but had trouble with reading and was in danger of being left back from graduating to junior high, now called middle school.  His parents promised me that if I would tutor him in reading, his dad would take us both to the next big sportsman’s show at Madison Square Garden.  We were eleven and the war had just ended.  We worked like hell, he was promoted, and we went to the exhibition as photographer’s assistants, carrying camera bags, having first had a tour and meeting the staff at the offices and photo labs of Life Magazine.

In the next house down the hill on Evans Street were two more of our playmates  Donnie and Bobby Hayman, whose parents owned the local appliance store and had the first TV set in the neighborhood, several years before there was ever one in our house.  I think the Haymans may have been Jewish, but I don’t know for sure because except for which direction families walked to attend religious services, if they did, it was irrelevant to us.

In the Spring we all played baseball in the street and in the Autumn, vacant-lot tackle football with whatever random shoulder pads and helmets some of us had managed to accumulate. In Winter, whenever there was snow on the streets, we went sledding down the hill on Highfield Lane, making the turn and continuing for a second block down Evans Street to Elycroft.

When we were old enough we went to the Rivioli to the Saturday matinee double feature, with a newsreel and cartoon, and were shocked when, after the war, the admission price went first from nine to eleven cents, and later to a quarter.

There was one other boy that I played with for a while, Willis Meyers.  Willis lived in the corner house at Feronia and Nevins, a block and a half south of me.  Some friends, I don’t remember who, took me to meet him when I was not much older than about six.    Willis was tall and lanky, a few years older than the rest of us, and liked to play in the garage behind his house where he kept his comic books, games and toys.  He was very inventive and dramatic, and he revealed, after I had gotten to know him a little better, that he particularly liked to act out the actions and dialog of comic book stories.

One day he invited me and another kid I didn’t know, to play an acting game he called “Dames”, where we were to pretend to be women, like Betty and Veronica in the Archie comics.  I didn’t really grasp the odd idea and wasn’t very good at the little dramas and the speeches, but Willis could put on a sultry voice and the seductive mannerisms of a Veronica that made us giggle, if a little uncomfortably.  

That day in the course of acting out a little story of his own invention, he took us to the loft of the garage where he continued to make up a narrative to match the action as he, as a “dame”, began to touch me sexually.  Of course it felt pretty good, but even having not the vaguest idea of what was really going on, I was pretty sure he shouldn’t be touching my genitals.  Making some excuse I soon left for home.  I never told anyone about it and never went back there. 

Until about 15 years later when, back home on a break from college or law school, and my parents having moved by that time to the other side of town,  I took a nostalgic  drive through the old neighborhood and, as I was leaving, decided to stop at the Meyers house, just on the chance Willis might be there. I was curios to ask him, retrospectively, his view of what he was doing the day he sexually assaulted a little kid. 

When I went up the steps of the front porch and rang the bell, it was answered by his mother, the same disheveled and depressed-looking dark-haired woman I remembered, now going gray.  From the look on her face, she had been prepared to send a salesman away, but when I asked if Willis happened to be at home she looked startled, then angry.  “Willis killed himself two years ago”, she said flatly, and closed the door without another word.

As you may or may not have guessed, my question is this:  Three Swiss immigrants, a family from eastern Europe, two Irish catholic families, a Syrian man, (maybe) a Jewish family two Italian families, an Austrian family, and a descendant of the very first Francophone colonists from Holland and Belgium.  Plus a predatory young homosexual male pedophile.  All living within two blocks of one another in a small Jersey town.  

What could have been more diverse than that?


63. Violence, Medical Research and Guns

November 2, 2020

I am a retired family doctor; have worked as an emergency department physician; later was an occupational medicine specialist; and still later a state hospital general, forensic and addiction psychiatrist, many of whose patients were murderers.  I have a certain amount of familiarity with violence.

In medicine, proficiency in the various specialized areas of medical knowledge is demonstrated by having passed the examinations of a certifying board, or, to a lesser extent, by having qualified by training and/or experience to be eligible to sit for those examinations whether or not they were taken.  In my case, during my forty years in medicine, I was board certified in three medical specialties, board eligible in two more, and appointed as a medical school Assistant Clinical Professor in two of the five.

Just after the Orlando nightclub rampage shooting in June of 2016, I exchanged thoughts on an internet discussion site with several friends.  One submitted, in free-verse form, an appeal about the Orlando shootings which I will reproduce here:

“I am not a father, but I mourn as Fathers’ Day nears, for:

“How does a father control his grief and rage, when a son or daughter will not be coming to share his day, or any future days…?

“How does a father act to protect his children from bigotry and violence?

“How does a father explain why it is so easy for anyone with a hate-filled heart to obtain a weapon of mass destruction?

“Fathers, mothers, children– take a step back, and then a giant leap forward:

“Banish all forms of discrimination, intolerance, indifference, and yes–

“Ban assault rifles.”

I’ll share with you my response to him: 

Well, I am the father of four grown children.  I feel a powerful empathy for the fathers of whom the author of the verse speaks.

I hadn’t, at the time of the event, followed the news of the tragedy in Orlando very closely, but I had picked up a few scraps of information from the TV being on while I was working around the house.  In some aspects, the case resembled the San Bernardino massacre, in which an assault rifle was used, widely claimed by anti-gun partisans to have been, “legally acquired”, by which they attempted to imply that already existing laws are not sufficiently plentiful or restrictive.

But the FBI, whom I personally heard initiate the assertion of “legally acquired” on live TV in the San Bernardino  case, was later proven to be wrong.  The obtaining of the weapons used in San Bernardino was already entirely illegal under three separate federal and California laws.  First:  they were purchased by a friend for two shooters who themselves could not have bought them.  This is called a “straw purchase” and is a federal crime.  Second:  Assault rifles are already illegal in California, and one defining characteristic of such a weapon is the push-button release of the magazine.  After purchasing rifles with fixed magazines, requiring a tool to remove the magazine, they were illegally modified to add a push-button release.  Third:  Magazines holding more than ten bullets are illegal in California, but the shooters obtained higher capacity magazines illegally, and used them in the crime.

What I am arguing is that what is lacking is not a sufficient number of laws, it is the enforcement of the 6,000 existing laws, and the enactment of laws that mandate reporting of individuals who are disqualified from gun ownership by mental illness or radical ideology, to the federal NICS database.  The enactment of more laws, while they will surely infringe the Constitutional rights of the law-abiding, will not, if past experience teaches us anything, significantly hamper Islamic terrorists or rampage shooters from obtaining weapons.

What little was known of the Orlando shooter in the days just after the crime, included the fact that he was a radical Islamic man who was also described as bipolar, and a violent spousal abuser.  He was the second member in as many years, of a tiny Florida mosque, who had undertaken a terrorist act.  The first had become a suicide bomber in Syria in 2014.

The father of the Orlando shooter is an Afghani who is reported to have been an angry and vocal supporter of the Taliban, both before coming to the U.S. and since.   The shooter himself, Omar Mateen, was thought to have been a regular attendee at the gay nightclub and is thought to have connected there with gay men.  One theory was that he may have suffered from the conflict between his proclivities and his religion, which is homicidally intolerant of homosexuality. 

Mateen had been taken into custody twice by the FBI because of his own ideological rants, but was found to have committed no crime for which he could be charged.

Once again, in the case of the Orlando shooting, we were the victims of the inherent fairness of our own culture, not of an insufficiency of laws.  As a wife-beating misdemeanant, Omar Mateen would have been prevented by federal and Florida law from purchasing a firearm.  The implication of the snippet of an interview of his ex-wife that I heard was that her family helped her get away from him after he became violent, but whether they notified the police was a question not asked in that interview.

As for the FBI, when they could find no proof of lawbreaking, they had to let him go.  Our laws protect those not found guilty of an existing crime in a court of law.  We don’t think it’s fair to take away the rights and freedoms of people not convicted of wrongdoing.  Wrong thinking is not a crime.

Unfortunately, the poetic recommendation of our on-line discussant, that we “banish” all forms of discrimination, intolerance, and even indifference, is decidedly un-American.  We can ban some kinds of discriminatory acts that we define as illegal, for example, discrimination on racial or religious grounds in housing or employment.  But we can’t ban beliefs, feelings or speech that is intolerant or discriminatory.  We cannot ban even these behaviors in people’s voluntary associations with one another.

In 2015 I read the entire Koran, word-for word, specifically looking for any of the expressions of religious tolerance or peaceful coexistence Islamic apologists claim it contains.  But after a very careful reading, I found the Koran to be unremittingly and violently intolerant of every religious belief but Islam as Mohammed defined it.  Nonetheless, we would be horrified if it were suggested to banish Muslims from the country.  Many find abhorrent even the idea of stopping Muslims or immigrants from certain countries from entering the U.S., even temporarily while better vetting processes are established…(e.g. processes that would have prevented Mateen’s Taliban-supporting father from coming here.)

The major disconnect, it seems to me, is between it being well known that a person is dangerous because of mental illness and/or malignant ideologically, and that concern being communicated to the people who maintain the “no-buy” list for firearms.  Again, fairness and concern for medical privacy play a major role.  A case in point is the GermanWings pilot who crashed a planeload of people into a mountain.   Many clinicians and airline officials knew he was dangerously ill and suicidal, but extreme German privacy laws and obsessive corporate privacy policies prevented that information from flowing to licensing authorities.

If we are to enhance prevention of these horrible crimes without trampling on the constitutional rights of, say, Muslims, or of one hundred and ten million law-abiding American gun owners, knowledge of such actual dangers, when they exist, must be communicated to the authorities who can do something about it.

The following Father’s Day I was indeed thinking not only of my own two boys and two girls, but of the fathers who had not been as lucky as I have been, to have their kids still with them.   Those young people slain in the Orlando gay nightclub in 2016 were not the victims of a shortage of laws, but of too many laws that have been poorly written, badly designed and inadequately enforced.

As far as the proposed Center for Disease Control (CDC) research is concerned, based as it is upon the hypothesis that political or insane rampages can usefully be defined as public health issues, it suffers certain contamination from the outset, by the political agenda of people who take the demonstrably absurd position that guns, themselves, are the root cause of violence.  This contamination is foreshadowed by the very linking of one word to the other in the proposed subject title:  GUN-VIOLENCE.

The error in this kind of thinking might be more easily seen in a different example.  Black race alone is actually four times more powerful as a predictor of violence than is gun ownership alone.  So what if one were to propose that the CDC study BLACK VIOLENCE?   Would not the bias in attributing causation be more obvious in this description of the problem?  Do you notice that in the previous administration many avoid mentioning ISLAMIC VIOLENCE?  Oh, dear, not very PC in the Obama White House.  Yet Vivek Murthy, appointed Surgeon General by President Obama, reportedly agreed with the president, in advance of the production of any research-based or statistical evidence, that Islam is incidental to violence, and guns are causal.

People who for whatever reason would like to see the world rid of guns, simply always draft laws into which that agenda is woven.  Though they fill their proposed “gun control” bills with outrageous and unnecessary abridgments and erosions of the Second Amendment, abridgments that will not stop the mentally ill and violent extremists from obtaining firearms, they characterize their proposed laws as “reasonable restrictions” and those who oppose them as extremist ‘gun nuts’.  To anti-gun ideologues, the political end justifies the dishonesty of the means.  It will be a distraction and a digression from achieving any scientific understanding of the problem of violence if that political faction is granted any influence, much less control, over any proposed CDC research process.


62. The roar of the greasepaint, the smell of the crowd!

November 1, 2020

In the summer of 1949 when I was fifteen, for eight weeks I was a junior counselor at a farm camp in Vermont where I had been a camper for the previous six summers.  I taught sailing to 50 boys, including my two younger brothers, and three or four girls who were there to keep the camp owner’s daughter company for the summer.

The farm property was 360 acres and in addition to a piece of the shore of a mile-wide lake, there were hayfields, riding trails and a ring for our six horses, cows to milk, archery and rifle ranges, some clay tennis courts, vegetable gardens to tend, and a craft shop for those who wanted, for instance, to make their own yew longbows or fletch a quiver full of arrows.

In the farmhouse living room the director read stories about Robin Hood, or  Ethan Allen and the Green Mountain boys in the quarter hour of quiet time before each meal.  And every week, pushing aside the tables used by chess, checker and card players, it was in that fireplace room that we staged talent shows and sing-songs on Friday evenings.  Once a summer we put on a vaudeville show; and once a summer a Gilbert and Sullivan operetta: HMS Pinafore or Trial by Jury. Late in the season, as the camp seeason was coming to a close, we put on an outdoor one-ring circus with side-shows, always during a weekend when parents were especially invited to visit.

The currency for the circus was dried navy beans, earned in the previous week by turning in pails of wild blueberries picked in the bushes that surrounded our hay fields, and in the forest clearings in which they flourished.  A large can full of berries earned a small paper cupful of beans to use as money at the circus.

The cook and her helpers turned the blueberries into pancakes and muffins, and with milk from the cows, using a hand-cranked ice cream churn charged with rock-salt and ice from the ice house, we made fresh homemade blueberry ice cream by the gallon.  After the circus the beans were collected, washed, soaked, cooked and made into Boston baked beans.

Out circus side shows were imaginative, amusing and sometimes educational.  The signage on one booth shouted “COME TROUGH THIS PORTAL  AND SEE THE EGRESS!”   Entering, the unwary found themselves outside the ropes and had to pay more beans to get into the circus again.  The campers being aged seven through fourteen, the booth always made money, and the boys never forgot that egress means exit.

The single ring, flanked by a freshly mown knoll from the slope of which spectators watched, featured various acts, including some fairly tame trick riding, for which dutiful parents applauded encouragingly.

Now, various groups at camp had their favorite activities.  Each camper signed up for three sessions a day.  But the activities could be fairly spread out, so there was a tendency to pick ones that were in some proximity to one another.   The riding stables and land activities were near the house, but the lake was about a three-quarter mile walk over a hill and  through the woods down to the lake.  So people who wanted to avoid having to rush to the next activity might pick, Riding, Archery and Tennis, or Sailing, Rowing and Canoeing.  

As a camper I had experience all of the activities, but had always been most drawn to the crystal clear water of Ray Pond, so I had become significantly less proficient at riding during my previous six years as a camper than my pals who would rather ride a horse than eat dinner.  Which was why I was very puzzled when Nancy Gore, older than me by three years and the daughter of the camp’s owners, came to me with the request that I learn a riding trick to perform in the circus, then still a couple of weeks away. 

I declined, but she was very persistent, and enlisted her two brothers, young adults and both senior counselors and camp managers, to convince me.  Still bewildered but outnumbered and outranked, I finally agreed.

What she wanted me to learn, was to ride standing barefoot, on the back of our only ‘quarter-horse’, Butch, a gentle brown and white piebald gelding, as he was cantered in a circle on a rope lead.  I had to learn a running mount to a bareback riding position, then carefully to get my feet under me and stand up.  I had never before ridden on a cantering horse standing up, nor even seen it done, but as it happened, it wasn’t all that difficult.  I also didn’t see why it would be that interesting, but she was satisfied.  She implied vaguely that something else would add to the spectacle, but wouldn’t elaborate.

On the day of the circus I showed up for my performance, as she had requested, a few minutes early.  I was a little nervous, but that soon turned to outright alarm when Nancy brought out the costume she intended  me to wear.  Which was a pink tutu and brassiere!  I was trapped and it was too late to back out. The audience was waiting, our riding instructor was beginning to trot Butch in his circle.  A nearby bush had been chosen for my dressing room.  

I stepped into the tutu and found the brassiere a bit tight for the breadth of my developing chest, but it worked because at least there was nothing else to fill it.

As I walked barefoot out of the bushes to the ring the crowd began to laugh and to applaud.  Somehow it had swelled in size and I gathered I was the only one who had not known what I would be wearing.  But somehow my inner clown took over and I waved, smiled and bowed my way out to my running vault onto the pony’s back.  The crowd went wild.

Charged with adrenalin, I managed to rise and stand where the cantering beast’s back began to broaden into its haunches and make it twice around the ring without falling off.  Rounding my arms into a circle above my head, in a burlesque of a ballet pose I even managed a tentative plie or two the second time around, before regaining my seat astride, then dismounting.  I have no recollection whether the pony had stopped or whether I managed a moving dismount.

As it turned out, of course, because of the hilarity of my costume, I hardly had to do anything at all to win a standing ovation.  And at least one of the reasons for selecting me for the job was clear at last.  Neither of the actual riding counselors, though they were far more expert riders, could have fit into the tutu.


61. Burning the Candle at Both Ends

November 1, 2020

[Ed.  This was written five years ago in June, and is just now emerging from the file of potential blog items.]

One of the most misunderstood idioms in Ameria is confusing because it was a metaphorical statement mistaken for a literal one.

The expression in question antedates the current age of electricity, when candles are used only for decorative purposes.  Though it is interpreted in this “new light” it actually derives from the days when candles were the only source of light.

My daughter gave me the key to something that has puzzled every child for the last hundred years.  Children are often very amusing to adults when they take things literally that are meant abstractly.  I recall being horrified at age seven when my favorite aunt was tearfully telling my mom that she was about to be fired from her job.  I thought they were going to burn her up!

The other evening I was chatting with my working daughter, the mother of two teen-aged boys, who was yawning with fatigue because she had been getting up before dawn to get the boys lunches and gear ready for school, and then staying up at night to finish up her lawyerly work.

“I’ve just been burning the candle at both ends,” she declared, explaining her inability to keep her eyes open.

And it hit my eighty-one-year-old mind for the very first time.  She was burning the candle at both of the dark ends of the day, not at the ends of the candle.  She was “burning the candle” for the light by which to do her work!

The expression is said to have originated in England, and it is now June and we are approaching the summer solstice.  At this season and in those latitudes working from dark to dark would have indicated an eighteen hour work day!

Searching the internet for the expression reveals images and definitions that indicate that nearly everyone  has first heard of “burning the candle at both ends” when they were so young as to have taken it literally.  Then of course Edna St. Vincent Millay, born at a time when she should have perceived the truer meaning, wrote her famous lines, 

My candle burns at both ends; it will not last the night; but ah, my foes, and oh, my friends — it gives a lovely light!

After which anyone would have been blinded to the the literal image by the brilliance of the poetic one.