Narcan To The Rescue

Where is Nancy Reagan when you need her? Interesting to note that Narcan has been approved for over-the-counter sales at pharmacies. According to the Wall Street Journal, Emergent Biosolutions is the first company to obtain approval to sell a nasal spray version of Naloxone, an opioid overdose reversal medication, without a prescription. It appears that we have moved on from “just say no” to “make sure you have your Narcan.”  What could go wrong?  Will Narcan’s ready availability become a security blanket of sorts, lulling drug users into a false sense of security that they can use opioids with impunity or perhaps increase the dose to dangerous levels under the assumption that someone will be on hand to administer the antidote?  And isn’t it strange, in a world where recreational pharmaceuticals are being tainted with lethal amounts of fentanyl, that we choose to prioritize the message that you can be rescued by another drug rather than avoiding using the drug that got you into this mess in the first place. How often have we heard the sob story that the victim succumbed to fentanyl overdose while using cocaine, heroin, or “oxy,” but never does anyone condemn the use of the drug that was the vehicle for the fentanyl?  I recall an interview in which the father railed against the proliferation of fentanyl, having lost his son to an overdose. Apparently, the son had an injury and, rather than seek the advice of a physician, he chose to score some oxycodone on the street, which was laced with fentanyl. I’m sorry for your loss, but how preposterous is it that your son chose a street pusher over a medical professional? There’s only one reason why you would do that. The use of pharmaceuticals for recreational use continues to plague America. The legalization of marijuana hasn’t helped. Studies show permanent alteration of brain chemistry, particularly in young users, and anyone who denies it is a gateway drug is lying to you. The fault lies not with the drug, rather with America’s insatiable appetite for getting high. 

Racism Run Amuck

My CRT rants of late dredged up an old memory that I felt was a perfect example of our current racial impasse, a no-win situation where everything is perceived as racism.  An incident told to me by a close friend, a practicing facial surgeon:  

“Back in my surgical training days, the residents got ahold of a young black female patient who was dissatisfied with her appearance.  She was what they call in the realm of facial analysis bimaxillary protrusive, meaning her jaws were skeletally situated forward in the facial plane. She also had a component of vertical maxillary excess whereby the upper jaw is taller, creating a high smile line, a high palatal vault, and a narrow nasal base, often with a prominent dorsal hump and a recessive chin. (pardon the medical jargon, but it's his storytelling). This results in a “gummy” smile where the patient shows a great deal of gum tissue above the upper teeth when they smile.  They also tend to be lip incompetent, so when the teeth are together, the lips do not meet when relaxed, and teeth show even at rest. Can you fix that? Sure.  Off to surgery, she went to move her jaws into a flatter facial profile and shorten the vertical height of the upper jaw, so she showed less teeth at rest and produced less of a gummy smile. The surgery accomplished those goals, although one could argue that using standardized norms of facial structure measurements as a guide, one could argue that it “Caucasianized” her facial features to a degree. It was, however, the patient’s choice to alter her facial appearance to her ideal aesthetic. 

But I digress. An unfortunate component of vertically impacting the upper jaw is that it can lift the nasal tip and broaden the nasal base, thus making the nose wider and rounding up the nasal openings, much like the effect kids get when they pull up their nasal tip to make a “pig face.” There are steps that can be taken to minimize this complication, but they were apparently not employed sufficiently, or they were ineffective in this case and resulted in a nose appearance the patient was not happy with.  So once again, the unhappy patient was whisked off to surgery, this time for a rhinoplasty, to narrow the nasal base, reduce the nasal tip lift and essentially restore her nose more to the pre-operative appearance.  Here’s where things get interesting.

Recall, the patient is unhappy with the appearance of her nose after jaw surgery altered it and wants something that more closely resembled her original nose appearance.  Got it?  I stopped by the OR on my surgical rounds. I had not scrubbed in, but as the senior fellow, I had reviewed the case and had an academic interest in the procedure. The surgeon, the surgical assistant, and the anesthesiologist were white, and the two nurses, the scrub and the circulator, were both black.  The patient was asleep on the table and was being prepped and draped for the procedure.  The attending surgeon saw me and gestured me over, maneuvering the nose to show me what he had in mind.  He stepped back and asked me what I thought of the plan, and what I would do to correct the nose.  What do you think of the appearance, he asked?  “It looks like a two-car garage,” I quipped, referencing the post-operative change in appearance after the first surgery.  “The nasal base has been widened, and the nasal tip lifted, making the case passages  big and round, an unnatural appearance on her face.”  “Yup,” he said, nodding in agreement.  We continued to banter casually about the incisions and the surgical procedure.  I wished them luck and excused myself to complete my rounds.

The next day, the attending surgeon told me, “we have a problem. The two black nurses in the room said my comments about the patient’s nose were racist.” “How’s that exactly,” I asked.  “They felt you were criticizing her ethnically black nose,” he said.  “That’s absurd,” I retorted.  “That’s not even her nose. The patient had elected to completely alter her facial appearance, and when the surgery resulted in an unfortunate change in the appearance of her nose, she herself had chosen to have that altered so as to resemble her original appearance.  So, in essence, the nose I was criticizing was not even her original ethnic nose (which I thought from pre-surgical photographs was fine, to begin with) rather, it was a nose that had been distorted by surgery so much so that the patient didn’t like its appearance.   So let me get this straight: I am being accused of racism for being critical of a surgically altered nose, not her natural nose, but one that the patient doesn’t like either?  That’s ridiculous.”  He thought about it for a moment and appeared confused by logic.  Then, he blurted out, “Well, they still think it’s racist.”

And there you have it: the impasse.  The circular argument. Why is it racist? Because I think it is racist.  But what makes it racist. Because I am an oppressed person of color, and I think it’s racist. End of discussion.  So we have reached the stage where proof is no longer required, merely perception. The supplanting of reason with “lived experience” so popular with the left. The goal is not to reason; the goal is to make declarations and not to open the floor for discussion. Therefore everything is now perceived as racism, from mathematics to menthol. It was recently declared that white people cannot text images or memes that feature black people because it is a form of digital racism. It has even been suggested that white people shouldn’t smile at black people because smiling is an overcompensation that covers for their innate racial bias.  Apparently, there is now a Neo-Nazi or a white supremacist lurking under every rock.  Even Whoopi Goldberg, recently mired in controversy for racial generalizations and historical misrepresentation, lamented that there should be a handbook of sorts telling you what you can and cannot say.

University departments of Diversity, Equity, and Inclusion have become bloated bureaucracies that must continue to promote the narrative of widespread racism as a raison d’etre. As Andrew Doyle articulated in his book The New Puritans, academia appears to have lost its purpose when there exists a university that boasts 95 members of its DEI department yet has only 13 history professors. It leads to Ph.D. dissertations such as “Whiteness Interrupted,” by Marcus Bell of Syracuse University, who asks “what it means to be white,”…… a fundamental question at the heart of critical whiteness studies….. (CWS) upends traditional approaches to the study of race and racial inequality by averting the gaze from racially subordinate groups and focusing it upon the racially dominant group.”  Critical Whiteness Studies?  How preposterous.  There are a lot of studies out there that are actually critical, but studying “color of your skin-ness” is not one of them. This is just more ruminations from activists, opportunists, and self-anointed experts in the fields of “whiteness studies” the way paved by author Robin DiAngelo , who in her landmark book “White Fragility,” seems more intent on projecting her own racial bias onto all of White America.  Yet the only measurable statistic most often held up to scrutiny is that of generational wealth, despite the overwhelming examples of success in sports, entertainment, business, medicine, and political control of urban enclaves that members of the black community, a mere 13% of the US population, enjoy.  We had a black president who certainly didn’t get voted into office by just the tally of votes from the black population alone. If white America is so inherently racist, exactly how could that have come to pass? Does racism exist?  Sure it does. Bias will always exist between people that don’t look alike, that don’t speak the same language, and that don’t have the same values. Witness ethnic enclaves worldwide where people that share the same culture, the same religion, the same ethnicity, bind together. We all may have as a survival instinct deep within our genome the same fears of otherness. But as Doyle astutely points out, despite our cosmetic differences, the human genome is remarkably consistent throughout all ethnicities. We are indeed biologically the same on the inside, and we need to be reminded. And despite the stain of slavery, one that America seems to bear alone despite a majority of enslaved Africans landing on other shores, this abrupt veering away from the teaching of the Reverend Martin Luther King into seeing color above all else, disregarding the content of one's character, this replacement of meritocracy with race-based quotas, is not ultimately going to be a unifying principle. Division and demagoguery are not the path to a unified America.

When Will It Stop

 So another school shooting, this time perpetrated by a female identifying as a male with the typical trappings reinforced by dramatic media coverage of previous incidents: an AR-style assault rifle, an assault pistol, a semi-automatic handgun, and a manifesto boasting of pending internet fame and a glorious death. Like a checklist for the deranged. Brought to you courtesy of video games, gun-free zones, and our failure to identify the mentally ill among us, specifically our drug-addled, gender-bending, social media-addicted, perpetually depressed youth. Working from home or just not working. What a bunch of coddled wankers. Yet what was the predictable knee-jerk response? President mumbles wasted no time blaming guns and the failure of Republicans to pass his proposed ban on assault-style weapons. Of course. The Washington Post, the rag most suited to house training your puppy, claimed: “the shooting focused attention on gun laws in Tennessee, which gun control advocates say are among the most lax in the country.”  What gun control advocates are those? Oh yeah, those who think all gun laws are the most lax in the country. Yet, in the very next paragraph, the flunkies at the Post found the solution but came to the wrong conclusion. “Hale (the shooter), who had legally purchased multiple guns, had previously been under a doctor's care for an undisclosed emotional disorder. Hale’s parents told law enforcement officials after the shooting that they had felt Hale should not own weapons.”  The solution? Red flag laws that are the rage in 19 blue states but failed to pass in Tennessee after a bill was introduced that, here you go: “met heavy opposition from state Republican leaders who described such statutes as unconstitutional.” And why was that?  Because they are unconstitutional. And ripe for misuse and haphazard application. Who is it that will differentiate between an actual threat and perception?  Or worse yet, petty disputes and domestic squabbles? He threatened me; he looked at me funny; I feel like my life is in danger; he was stalking me; he was not mentally stable. Or perhaps he’s just a Republican. Take his guns away. And all his cutlery as well. Deny him his constitutional rights. Yeah, that’s going to be a workable solution. And often, the application of these laws is left up to local law enforcement. The state police investigator in a red flag state, for example, who couldn’t be bothered when called on Christmas Eve for a suicide threat. Even after one of his officers was threatened as well. Just take his pistols but let him keep his hunting rifle, was the solution. Sure, can’t do any damage with that lever action .30-30. Idiots. This example actually happened, illustrating how unwieldy and impractical the law is in practice. Too much wiggle room, opinion, and innuendo. And the Supreme Court will find it unconstitutional when the 19 states come under scrutiny. But the solution is right there. We need an independent arbiter. And that has to be our mental health professionals. If you are diagnosed with “an undisclosed emotional disorder,” shouldn’t your mental health be the very yardstick for gun ownership?  Isn’t that your red flag? Isn’t that list of psychiatric medications that “dog whistle” that you lefties are always blowing? We don’t lock up the mentally ill anymore; we medicate them and set them loose. And sometimes, they take their meds and show up to follow-up appointments. And sometimes they don’t. But what about patient privacy and HIPAA, screams the left. What about it?  If you’re seeking to keep guns out of the hands of the deranged, mental competency is a good place to start. And I’m not talking about billboards proclaiming, “Bob’s a nutcase.” We have the background checks in place for the purchase of firearms nationwide. Don’t let the media fool you into thinking you can just stroll into a gun store and purchase an arsenal. That is nonsense. There is paperwork. They’re always paperwork. And a criminal background check. NICS, the national criminal instant background check, has been law since 1993. So without disclosure, the NICS system could add an adjudication of mental competency parameter and, without disclosure, simply deny the application. Like when your credit card is denied, the server doesn’t know why and often you don’t either. The mental health advocates will undoubtedly howl, claiming patients with only mild forms of depression will be caught up in the net. But surely a mental health physician will be able to differentiate between “I’m depressed because my dog died” and something more serious. Like John Fetterman, for example. Further, if you have been prescribed mood-altering drugs, specifically SSRIs or tricyclic antidepressants, which have been documented as potentially increasing suicide risk with adverse effects such as anxiety, agitation, and confusion, then perhaps these folks shouldn’t have access to firearms. It will be unpopular with the mental health community, and the NRA may even object on the grounds of potential for abuse, but if we are to put a stop to the carnage, we have to rationally examine the similarities in these perpetrators and stop blaming the gun. And that consistent similarity is mental health. 

Disheartening News

The news on either side of the aisle is not very encouraging. Between the banking crisis bandaids and denial that a problem even exists, to the probing of our responses to crises on the world stage, from Chinese balloons to missile tests by the North Koreans, and now Iranian rockets lobbed into our coalition bases, the wholesale parceling out of our ocean real estate to foreign green energy companies destroying fishing grounds, wildlife and vistas for a technology that will have no effect on climate change, the reversal of Trump era “right to work laws” reinstating costly union control over industry, the push to electrification without a grid to support it, the banning of fossil fueled stoves and furnaces in new construction, preposterous squatter laws that punish land owners and threaten real estate value, and the never-ending tax, spend, and now print monetary policies that continue to fuel inflation and cripple middle-class retirement plans  ……this administration seems intent on allowing us to be “Alinskied”, torn down on all fronts, social, political, economically, and militarily so that we can be rebuilt to a leftist utopian standard. When Biden campaigned on the slogan “Build Back Better,” who knew he meant to tear it all down first? 

New Puritans

I am knee deep into the CRT section of the New Puritans and my conclusion is that we, as a nation, are toast. How can we reconcile, or at the minimum seek common ground, when the narrative that not only portrays “whiteness” as being inherently evil, but seeks as an alternative the tearing down of all things deemed white?  It is a punitive plan designed to supplant not to conjoin. And in the final analysis, isn’t this a form of identity politics that seeks to use blackness as the new yardstick for cultural and social dominance?  And what will that solve? Replacing one theory, that white supremacy is the foundation of our culture, and it is a theory mind you, with actual racism. Gone will be meritocracy because the very concept of merit is a white construct and that too is racist. It is circular reasoning at its finest. Anything that does not ascribe to the theory that institutional and social racism is the backbone of our culture, anything that is contrary to the narrative is racist. Why is it racist?  Because it is contrary to the narrative. Once again, control the language, even if you have to redefine it, and you control the conversation. It’s insidious and counterproductive to a functioning republic. 

‘Tis The Season

It’s tax season, and most of us are up to our ears in alligators. Is there any reason why our tax code has to be this complex? And not just complex but punitive. If you try to climb the ladder to success, the government greases the rungs. And now President Biden is suggesting he wants more out of our hide. Apparently, according to his appraisal, I’m rich. It could have fooled me. But satisfying that definition is no longer a very high bar, as it increasingly can be defined as simply being employed!  It’s really the perfect storm for my particular peer group. We nearing retirement, trying to maximize our end-of-career savings, max out our pension plan contributions and pay off debt. We are just on the threshold of high income, the bottom tier of the one percent, subjected to punishing taxation but unable to afford the hoards of attorneys and accountants to protect us. The only thing worse than being wealthy in this country is being almost wealthy. We are business owners, beaten down by regulation, permitting, inspections, and the constant drip, drip, drip of fees and fines that suck the profit out of your margins. Using New York as an example, it has instituted a fire inspection and a furnace inspection for businesses, both requiring fees. If you’re in the medical or dental field, you’re required to have your x-ray units inspected, a procedure that was once performed by a state inspector with a registration fee. Now, practitioners have to pay for both the registration and the inspector. New York’s regulatory apparatus even requires a license for braiding hair. Inflation has taken a huge bite out of the bottom line as overhead costs soar. Small business the country over has been hit the hardest, with employee salaries skyrocketing as employers have to compete with Walmart and Mcdonald's, offering upwards of $19 an hour for unskilled labor, with benefits and signing bonuses. And it’s slim pickings for them at that. Despite the government’s insistence that we are at full employment, the figures have been skewed by a change in definition. You’re now counted as unemployed only if you are actively looking for work. And few are. Again, using New York as an example, 36% of able-bodied citizens of working age are enrolled in Medicaid. In this labor market, with a help wanted sign in every window, how can that be? With generous public assistance and rubber-stamped unemployment benefits, that’s how. Many choose to play the system, alternating between brief stints of employment and long stretches of government benefits. Covid has shown us the way. A plant manager in Kentucky told me that his factory workforce was constantly in a state of flux, so attuned they were to working the system, they knew just how long they could remain employed before returning to the dole so they could maintain the highest level of government payments. That plant, incidentally, has since closed its doors. No longer is the employer protected from these employee scams. At one time, if an employee quit, they could not receive unemployment benefits as their job was available to them. It was their choice to give up the position. Those days are over. The unskilled worker is actually highly skilled in their ability to work the system. A small business owner had a worker who consistently called in “sick” the day before long holiday weekends and vacations. When reprimanded, she bristled and immediately quit. She promptly filed for unemployment benefits, claiming she wasn’t actually sick but was needed at home to “care for her sick children, and the employer was asking her to choose between her job and the health of her kids.” Cue the tears. Bingo, the state granted her request, and the small business was stuck paying her unemployment benefits. An obvious scam, if there ever was one. Blue state, of course. And with yet another hit to the bottom line, what recourse does a small business have? Let’s see: they can raise their prices for goods and services and risk alienating their customer base. That’s not good for business.  They can decrease salaries and employee benefits and risk losing employees. That’s not an option. As I mentioned, Walmart and McDonald's above and others like Home Depot they can reduce the number of employees, forcing the remaining employees to pick up the slack. That results in reduced efficiency but leaves them the prerogative to carry on. Not so for the small business owner caught between employees and government-imposed overhead; they’re the only ones whose salary is going down year after year. Those small businesses that are our largest employers! Their fate close the business. That’s when local politicians whine about the community “losing its character” and Main Street shuttering its storefronts. And consumers lament the loss of convenience despite having chosen to buy cheap Chinese manufactured goods at the big box stores all these years. But alas, Florida is booming. Nashville remains one of the hottest markets in the country. Texas has a thriving economy, and the Dakotas are battling to see who can lower their taxes the furthest while state coffers are overflowing with revenue. How can those red states remain prosperous while states like New York and California suffer economic and cultural decline and impose punitive taxes and regulations, worship at the altar of climate change, stifle business and drive out the entrepreneurs and innovators?  I think I just answered my own question.

Fess Up Peggy

Congratulations are in order. Peggy Noonan has finally come to the conclusion in her Sunday WSJ editorial that “common sense points to a lab leak.”  Well, in a word: duh. Ms. Noonan, formerly a staunch, if not antiquated version of a conservative, has spent the last three years suffering from Trump derangement syndrome. She has used her platform to criticize, debase, demagogue, and harangue us about all things Trump. She has even taken to offering the democrats strategy suggestions, as she did in this recent entry, calling for Mr. Biden to “forge ahead, be honest” and “as things turn your way, as they will, it will get out there that you can be trusted.”  Really, Peggy?  She inexplicably seems to have soft spot for Biden, perhaps because when she was in the Reagan administration in 1984-1986, Mr. Biden was in his political prime. And she, at age 72, seems to long for those good old days. Do you remember when politicians treated us like mushrooms and when we expected transparency and honesty? All sorts of shenanigans went on behind closed doors. The kind of shenanigans Trump exposed to the light of day. Let’s call them the pre-plugs days of Biden. Did she ever offer Trump such soft-peddled advice?  Of course not, because Trump is an outsider, and it is becoming increasingly apparent that old Peggy is part of the swamp. For example, in last Sunday’s editorial, she gushed over Jimmy Carter. The previous week she offered glowing critique on Biden’s SOTU address, despite calling it “Trumpian” in what amounts to a backhanded compliment of sorts, closing the piece with praise, calling him “in charge and formidable” and “showing real mastery” when he lied about Social Security and elicited a jeering response from Republicans. So lying is now called mastery, is it? Trump was never given such praise when he provoked the opposition party. She even enlisted a former Reagan campaign manager who “opposed Mr. Trump from the beginning,” claiming “he’s not unbeatable now.”  Is Peggy now a democrat operative?  The previous week she offered criticism of both parties. Still, she dinged the Democrats for being “unable to accept a gift from history and become a normal party again,” In contrast, the Republicans took a more cynical beating, accused of “an inability to agree on what they stand for in this century and an inability to talk about the meaning of things.”  Brutally one-sided. She then went on to spend roughly a third of her piece criticizing George Santos. He’s a disgrace, to be sure, but for a center-right conservative, Peggy seems more adept at attacking our side of the aisle as opposed to pointing a finger at swarmy ideologues on the left. Swalwell, Schiff, Nadler, Pelosi, Schumer, and AOC immediately come to mind.  But most telling, in a half-page editorial detailing the mounting evidence that the pandemic was indeed caused by a Wuhan lab leak and subsequently covered up by the Chinese, never did she once utter the words: Trump was right all along”. Go ahead, Peggy, just say it.

Oath of Office

Enough of this divisive, Woke, Socialist, Counter Culture crap! It's time to return to our governing doctrine’s premise that promoted life, liberty, and the pursuit of happiness, our Declaration of Independence and Constitution. I have no idea how these dissidents managed to gain such a loud voice in our democracy in our society, but it’s time to put a stop to it. Our representatives in State and Federal offices have performed a disservice to their electorate, and to their country, in flaunting their solemn oath of office as stated in the constitution when they solemnly swore they would support and defend it against all enemies, foreign and domestic; that they will bear true faith and allegiance to the same—time to hold their feet to the fire for their lack of compliance. 

Schumer Twist

Chuck Schumer’s editorial in the WSJ recently attests to how the left is trying to spin the Republican's criticism of investment managers' ability to use ESG (environmental, social, and governance standards) as somehow “tying investors' hands.” Seriously, when did implementing more regulations ever result in more investment options?  “Let the market work,” says Schumer suggesting that a hands-off policy will lead “naturally” to the “consideration of ESG factors.”  Rubbish. Infecting markets with woke ideology will not pave the way to more investor options. “Eliminating ESG would do the opposite,” he says, “forcing their views down the throats of every company and investor.” By their, he means Republicans. But isn’t the imposition of ESG standards forcing woke ideology down those same throats?  Of course not, because it’s the left’s ideology.  The point that everyone is missing is that the Republican proposal is essentially a regulation to prevent more regulation. 

Retirees Beware

None of the blue states are exactly kind to retirees, some more so than others. Yet, it continues to amaze me when our elected officials keep using Social Security as a political football, knowing the program is headed toward insolvency as early as 2035. But never do they address Medicaid funding. Instead, we keep importing more low-skilled immigrants who will require public assistance. Between SNAP, the new catchy non-stigmatizing acronym for food stamps, home heating assistance, rent subsidy, WIC, a women, infants, and children supplemental food assistance program, and a myriad of other programs to benefit the poor, the average Medicaid recipient receives upwards of $60000 a year in benefits. And in Blue states like New York, 36% of the population is enrolled in the program. That’s 7.3 million people bellied up to the public trough. Granted, that number includes the truly needy and the disabled. But how many of those are non-disabled?  It’s not like the state social services will keep track of fraud; that system is understaffed and overwhelmed, particularly with New York State requiring social workers to have a master's degree. And is there an incentive to get off the program?  Or to have fewer children? Of course not. Instead, our government chooses to ignore the elderly, those who worked hard and paid into the system, choosing to heap more benefits on the non-productive segment of the population. In a word: Unsustainable.  And another: unethical.