Hughesair (Inflection Point)

Retired physician and air taxi operator, science writer and part time assistant professor, these editorials cover a wide range of topics. Mostly non political, mostly true, I write more from a lifetime of experience and from research, more science than convention. Subjects cover medicine, Alaska aviation, economics, technology and an occasional book review. Globalization or Democracy documents the historical roots of Oligarchy, the road to colonialism and tyranny

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Location: Homer, Alaska, United States

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Monday, December 04, 2023

DNA Personal Data

 23andMe reported hackers gained data for 6.9 million people. The. Medical community takes the position that patients should not have access to their genetic data, which might cause fear and misdirection of care. 23andMe makes that information available to patients directly,  arguably a good thing. However, present regulations protecting patient confidentiality, make hospital and insurance data available to government, insurance company, electronic record companies, and hackers and hard to access for physicians and patients alike. The violation of DNA data for 6.9 million people makes a mockery of confidentiality if not already a joke.

The obvious solution, returns to a tradition of health data filed by the physician and secured by individual practices. Who should own a patients’ medical record? The physician who wrote it.

Friday, December 01, 2023

Gold Standard

 One might think about nationalizing all the gold mines to pay off the National debt. Then one might reduce the exchange rate for gold slowly over time to reverse inflation.

However, we mine about 250 metric tons of gold in a good year. That’s 551,155.7 lbs or $17,636,982,400 or 8,818,491.2 ounces at $2,000/oz. At that rate of mining production, it would take 2,000 years to pay off 35.2 trillion of debt. Buy back might furthermore raise the price of treasuries to be re-purchased. Alchemy will be our only gold solution.

Fort Knox as of 2020 was supposed to hold 4.583 metric tons of gold.worth $294,680,000,000. Thats no where enough.

The only out is hard work. We have to stop working from home or not working. End the trade deficit. That alone does a trillion a year. Export petroleum. 18,239,000 barrels in 2020. Thats another 1.3 trillion a year.

The velocity of our economy hovers just above 1.1 x. The GDP is a product of velocity multiplied by money supply. Prior to 2008 the velocity was as high as 15. It should not be too hard to reinvigorate that energy and productivity in our economy. We need a cheerleader however, one with leadership business knowledge and positive message, but mostly a cheerleader. We also need a resurgence in 2 parent family procreation with adequate care and education of children.

Additionally, stop the cannabis. It inhibits productivity and promoted accidents and irresponsible behavior. 

40% of the population works for the government at some level. Lower that percentage with a greater percent working in the private sector. That too will have a dramatic effect on productivity. 

Work harder against illegal drug imports. Criminalize the user, and make safer products more legally available - not cannabis, or cannabis as a controlled substance by prescription. It does have a legitimate medical use, but not among workers.

Quadruple the police forces with funding and training, training, training - even horseback.

Politics are another matter. If nothing else, criminalize all donations as presumed bribery. 

Wednesday, November 08, 2023

1177 BC

 The combination of all the risks facing us today form a perfect storm that threatens our very civilization.  The contemporary situation resembles the civilization collapse at the end of the Bronze Age in 1177BC.  Historians describe famine, drought, the invasion of the boat people, the technology of iron production and the collapse of global trade across the Mediterranean.  Sound familiar. I would add capital divergence, like a game of Monopoly, four hotels on Board Walk, all the money to the winner, game over.

The economy cycles, the shorter based on the cycles of growing debt and the need to pay it off. I would argue that the longer cycle of depression follows  that same capital divergence, which may also lead to war, pestilence, famine and mass migration. We add climate change. For that perfect storm. 

Friday, August 04, 2023

Flexner Report

 Abraham Flexner (1866-1959) was an American educator and scholar, best known for his seminal work, the Flexner Report, which significantly influenced medical education in the United States.

              Flexner was the 6th of 9 children born to German Jewish immigrants In Louisville, Kentucky. He graduated from Johns Hopkins in 1886. In 1991 after graduation, Flexner started a private school. He later studied at Harvard and in Europe. While in Germany, Flexner wrote a critical evaluation of American education. 

 

Contribution to Scientific Medical Education:

Commissioned by the Carnegie Foundation for the Advancement of Teaching, Flexner conducted a comprehensive evaluation of medical schools in the U.S. and Canada. His report, published in 1910, criticized the prevailing state of medical education, advocating for more rigorous scientific training and standardized curriculum. This report led to significant reforms in medical education and the closure of many subpar medical schools.

 

Influence of Oliver Wendell Holmes Sr.:

While there's no direct evidence of Flexner being influenced by Oliver Wendell Holmes Sr., both men shared similar concerns regarding medical education. Holmes' advocacy for rigorous scientific training and hygiene in medical practice may have indirectly influenced the focus of Flexner's evaluation.

 

Influence of German Pathologists and European Medicine:

Flexner was influenced by the German model of medical education, which emphasized scientific research and laboratory-based learning. German pathologists and their emphasis on scientific rigor had a profound impact on Flexner's assessment of medical schools. He recognized the importance of research-oriented medical education, leading him to recommend reforms that incorporated laboratory-based instruction.

 

Significance of the Scientific Institute at Princeton:

Flexner established the Institute for Advanced Study at Princeton University in 1930. This institute was intended to be a center for advanced research and scholarship, fostering interdisciplinary collaborations among leading scholars. While not directly related to medical education, Flexner's vision for advanced scientific research and his commitment to excellence extended beyond medicine and influenced the academic landscape.

Oliver Wendell Holmes Sr. 1809-1894

            Homes, born in Cambridge, Massachusetts, short of stature and long on intellect, Homes wrote poetry, studied medicine in Paris, initiated medical reform and was best known for his son, Oliver Wendell Homes, Jr. a Supreme Court Justice.

            Homes graduated from Harvard in 1829, quit law school after 1 year and wrote the famous poem, “The Last Leaf,” a poem about Thomas Melvill, "the last of the cocked hats" and one of the "Indians" from the 1774 Boston Tea Party. Holmes would later write that Melvill had reminded him of, "a withered leaf which has held to its stem through the storms of autumn and winter and finds itself still clinging to its bough while the new growths of spring are bursting their buds and spreading their foliage all around it.” (1831)

 

I saw him once before,
As he passed by the door,
And again
The pavement stones resound,
As he totters o'er the ground
With his cane.

They say that in his prime,
Ere the pruning-knife of Time
Cut him down,
Not a better man was found
By the Crier on his round
Through the town.

But now he walks the streets,
And he looks at all he meets
Sad and wan,
And he shakes his feeble head,
That it seems as if he said,
"They are gone!"

The mossy marbles rest
On the lips that he has prest
In their bloom,
And the names he loved to hear
Have been carved for many a year
On the tomb.

My grandmamma has said--
Poor old lady, she is dead
Long ago--
That he had a Roman nose,
And his cheek was like a rose
In the snow;

But now his nose is thin,
And it rests upon his chin
Like a staff,
And a crook is in his back,
And a melancholy crack
In his laugh.

I know it is a sin
For me to sit and grin
At him here;
But the old three-cornered hat,
And the breeches, and all that,
Are so queer!

And if I should live to be
The last leaf upon the tree
In the spring,
Let them smile, as I do now,
At the old forsaken bough
Where I cling.

 

            Holmes quit law school after 1 year and switched to medicine. He traveled to Paris for a medical education. Pierre Charles Alexandre Lewis at école de médecine hosted many American doctors seeking knowledge not available in America. Homes learned infectious disease, autopsy, the stethoscope, percussion and microscopy from PCA Lewis, additionally the elementary use of statistics in rebutting the practice of bloodletting as a rational treatment for pneumonia. 

Harvard Medical College granted Holmes a medical degree in1836. In sharing knowledge of European medicine, Holmes wrote essays urging medical reform. He joined the Boston and Massachusetts medical societies and the Boston Society for Medical Improvement along with fellow Paris-trained doctors. Harvard granted Holmes the Boylston Prize for an article describing the use of the stereotype, new to American doctors. 

Holmes, disillusioned by the squaller of the dispensary, sought research, reform and teaching. In 1837, along with 3 colleagues from the Paris-school, Holmes started a medical school, upstairs above an apothecary at 35 Tremont Row. They taught autopsy, pathology, auscultation and microscopy. Their school soon merged with Harvard medical school. Holmes taught at the Dartmouth medical school, and in 1838, was elected to the American Academy of Arts & Sciences. He once commented, “If all of American medicine were to be thrown into the ocean, it would be an improvement, but would be bad for the fish.”

            Holmes lectured on medical fallacies, quackery, homeopathy and “other delusions.” In 1843 he published a paper linking the contagion of puerperal fever to infections carried from one patient to another by care givers and physicians. The paper was not widely accepted but did anticipate the experiments and findings of Ignaz Semmelweis in Vienna 4 years later. Holmes revised his paper on puerperal fever in 1885. 

            In 1847 Holmes taught Anatomy Physiology as the basis of disease at Harvard. He took over as Dean of the new Harvard medical school 1847 until 1853 but continued teaching until 1882. Students called him Uncle Oliver. Holmes passion for scientific medicine and reform foreshadowed the Flexner Report of 1910. 

History, Globalization or Democracy

            North Korea invaded South Korea inJune of 1950. In October the Chinese crossed the Yalu River. I was a senior with a major in economics on track for graduate school in international trade. My year was cut short, I spent the war concerned with downed pilots in Siberia or turned over to the Russians for brainwashing. After the war, I went to medical school on the GI Bill, but macroeconomics and the market remained a fascination, especially trade deficits. 

 

           In 1992, Diane and I worked on the Ross Perot campaign. Perot called it a giant sucking sound. Economists call it capital divergence, a phenomenon, which repeated throughout history, associated with depression, war, famine, pestilence and the fall of civilizations.

            

International trade is good, right? It raises all boats, or does it? Our trade deficit added up to 6.5 trillion since 2001with China alone, and that’s just wholesale. The real loss to the middle class, job loss and the loss of economic velocity rivals our national debt. 

            Follow the money —- to Silicon Valley, multinationals, international banking, Wall Street, oligarchs and the CCP, 70% of wealth now in the top 10% of our population.

 

            How does that work? A macroeconomic equation shows the trade deficit offset by loss of personal savings, increased investments and increased government deficit. Think trillions. 

 

That was the economics. Darker forces were at play. 

 

1969 Brzezinski wrote, 

          “The nation state as a fundamental unit of man’s organized life has ceased to be the principle creative force. International banks and multinational corporations are acting and planning in terms that are far in advance of the political concepts of the nation state.” 

Therein lies the post-Vietnam rejection of American instructions and ultimately our constitutional republic in favor of a vague international totalitarian government. 

 

1953 Stalin died; Eisenhower negotiated an armistice with N. Korea.

1954 a year later, Dien Bien Phu and Vietnam 

1968 Peak antiwar protests

1970 Council on Foreign Relations magazine

1971 Nixon took us off the gold standard. 

1972 Kissinger, Nixon to China

1972 Jane Fonda to Hanoi

1973 Carter, Brzezinski & Rockefeller, Trilateral Commission 

1977 MiddleEast oil, Japanese and German cars

1996 China temporary MFN

2001 China permanent MFN

2010 Supreme Court, corporate donations, free speech

2011 China claims the 9-line South China Sea

2014 Russia invades Crimea. 

2016 Brexit, Theresa May “

2016 Reaction to open borders

2016 Trump, nationalism, populism & X TriComms

20117 25% tariffs 

2019 WEF, Davos, Xi, Belt & Road, 

2019 Riots, looting, arson.

2019 Schwab World Government, 

2019 Covid19

2/23/22 Putin invades Ukraine. 

2023 A further international wave of populist nationalism 

 

After 2020 & 2022 elections, the tangled web of Globalization becomes more visible. Multiple threads of greed include international banking & Wall Street, Silicon Valley giants, Unions seeking international expansion, Oligarchs seeking world government for power and profit. Many are willing to burn the Constitution rather than to loose out on globalism. Don’t forget the CCP seeking World conquest, colonial power, and destruction of the US, or Russia’s quest for territory and continued subversion of Western Democracies 

 

Globalization or Democracy, you can't have both, traces these conflicting economic beliefs through western history.

Monday, July 24, 2023

Hippocrates

 The political rejection of Hippocrates, the oath and the law sets medicine, science and healthcare back to the Dark Ages. Scientific medicine emerged from widespread mythology in ancient India, in Egypt, as evidenced in the Old Testament, but most spectacularly in the golden age of Greece. Not unlike Steve Jobs or Elon Musk, young Hippocrates sought a scientific explanation for disease, including nutrition, sanitation and the environment. Most significantly he put the patient first.

            Scientific medicine continues its struggle with mythology in many forms to this day. Religious restrictions against cutting-of-flesh, suturing, touching women and the threat of Sharia Law interfered with medical care in Africa. Expressing scientific belief contrary to the church during the Dark Ages or Reformation, led to sever consequences as well.

            Today, politics and bureaucracy replace the interface from the church. With little or no environmental or diagnostic consideration algorithms and protocols replace medical judgement. One size fits all, standardized care, equality. 

            Medical school admission, to be more inclusive, lowers the standards of admission with the belief that minorities from impoverished communities will return and better serve a constituency. Is that to say that a poor doctor will better serve the poor? Meanwhile, the medical bureaucracy in its wisdom, pays less for healthcare in lower income or rural areas. Insurance companies do it one better by attempting to pay less for the care of lower income patients.

            Greed runs rampant, not because physicians are greedy, but because certificate-of-need laws turned hospitals into monopolies, prioritizing corporate administration over patient care, expensive treatments and procedures over diagnosis and safety.

            Hippocrates served as a guiding light for two and a half millennium. Physicians studied Greek, translated Hippocrates and traveled to leading medical centers to become great physicians. Since the Flexner Report 1910, American medicine lead the frontiers of scientific medicine. A new wave of dysfunctional socialism, however, erases that leadership. Is it not time for physicians to rum healthcare, not the bureaucracy, the politicians, the hospitals, the pharmaceutical industry and not the insurance companies? Hippocratic medicine remains a sacred calling that puts science and the patient first.

Monday, June 19, 2023

Inflation

The Fed follows an old myth while gaging interventions on the wrong thing.  The Phillips principal relates inflation with high employment rates. A last century concept, inflation and employment may be associated, but is there a cause and effect relation? Fed uses an old theory that does not work today, hopping to check inflation with unemployment.

Any business with a tight budget and narrow margin that’s nearly all of them, must raise prices when faced with lower volume and increased cost - not even a question. Increased interest rates most certainly add to business cost and curtail hesitant consumer spending. 

Many former employees will never return to work. Reluctant customers add to their credit cards to cover increased cost of energy and non-discretionary expenses with even higher interest. What Liquidity there is, seeks, equities, T bills, and gold to hedge inflation.

Only salvation, will be a competitive increase in production of goods and services. Increase turnover / velocity. Facilitate an inexpensive, competitive supply of energy. Lower interest rates to a desirable sustainable rate and keep hands off. The M1 is down. With increased productivity, velocity will soar. 



Wednesday, May 24, 2023

Existentialism, the Tragedy of Deception

Oxford Dictionary 

         Existential, adj.

Relating to existence, "The climate crisis is an existential threat to the world,” concerned with existence, especially human existence as viewed in the theories of existentialism.

"The existential dilemma is this: because we are free, we are also inherently responsible,” (For a proposition) affirming or implying the existence of a thing. "The existential proposition that truth and reality are constructed fictions."

         Existentialism, noun

A philosophical theory or approach which emphasizes the existence of the individual person as a free and responsible agent determining their own development through acts of the will.


Stanford Encyclopedia of Philosophy

           Existentialism, published Jan 6, 2023

“As an intellectual movement that exploded on the scene in mid-twentieth-century France, “existentialism” is often viewed as a historically situated event that emerged against the backdrop of the Second World War, the Nazi death camps, and the atomic bombings of Hiroshima and Nagasaki, all of which created the circumstances for what has been called “the existentialist moment” (Baert 2015), where an entire generation was forced to confront the human condition and the anxiety-provoking givens of death, freedom, and meaninglessness.”

       

         Thus, existentialism paints reality as an expression of one person’s own reality. From a scientific perspective, deductive reasoning of an individual. “Truth and reality are constructed fictions.”

           While the word existentialism was whispered on the steps of the University Liberty as a new and mysterious thing, it spread throughout America as a synonym for truth. 

Political parties fight over contradictory realties.

Media fact checks from ever more contradictory realities.

Truth becomes whatever you want it to be.

Gender dysphoria becomes gender affirmation. 

The criminal becomes the victim. 

Existentialism in medicine defines evidence as whatever profits the regulators.

Children are taught to be victims of their parents. Hate surfaces as a byproduct.

           We theorize that civilizations reach their full potential, and then end as a result of some inherent flaw. We consider famine, environmental extremes, war, even the poverty of capital divergence, but few would consider a existential shift in the collective wisdom of its population.

           As a conjecture, the collective wisdom of a population metaphorically resembles a hive. Statistically the N number for the collective thoughts of the hive yield a high value of collective-wisdom. That wisdom drifts this way and that based on generational experience. It has societal rules that result in a culture, which when successful drives a high degree of cooperation and productivity. Cooperation and productivity seem an antithesis to the personalization implicit in existentialism. Now, with an ever greater embrace of existentialism, it would seem that the collective mind of the hive, shifts to a narcissism incapable of exercising a common culture of cooperation, productivity, or collective wisdom. “Existentially,” in its common use, unintentionally, gives away a clue to the fiction which follows.

Time for Aristotle’s Sophistical Refutations and common sense. 


Sunday, May 21, 2023

Trump and Norman Vincent Peale

           President Donald Trump embodies a level of morality and Christianity that the media ignores even to the point of profanation. Trump’s parents raised their 5 children in Norman Vincent Peal’s Marble Collegiate Church in lower Manhattan. Reverend Peale’s sermons carried a powerful motivational message for life, demanding optimism, imagination and a commitment to take action and succeed, refusing failure and doing God’s work by building big. 
            Peale’s message so resinated that the oldest continues Protestant congregation in North America grew to become a mega church with a congregation in the thousands. Peale’s books including The Power of Positive Thinking. Published in 1952 spent 186 consecutive weeks on the New York Times bestseller list. By 1958, the book had sold at least two million copies. 

             Trump became an advocate of Peale and remained a follower. He and his first wife, Ivana, were married there in 1977. He and Melania, Roman Catholic, were married in an Episcopal Church in Palm Beach near Mar-a-Lago.One cannot assess Trump’s motivations without knowing the strong Christian motivational relationship he had with Norman Vincent Peale.

              If for no other proof of that philosophy from Peale, Trump raised 4 children to successful careers, does not do drugs or alcohol and x wives speak well of him, a feat which few of us can claim. Never mind his success in commercial Realestate, the most vicious segment of the business world, including multiple failures and comebacks, and his scholarship in business economics at Wharton School of Business.  Did not Donald Trump also bail out a NYC’s failed attempt at repairing their outdoor ice-skating ring with his own construction company at his own expense? He did not take a salary as president!
               Corporations depending on cheap forced foreign labor, spend billions to smear, defeat and discredit Trump. The unelected but vast bureaucracy participates because of Trump’s commitment to rid Washington of foreign influence and Washington’s growing rejection of US National interests, representative government and our Democracy.
              Politically, Trump may be the only person with economic and business knowledge, committed to and able to: curtail Communism, subversion, a growing US corporate excesses, fix the economy and return US manufacturing capacity. Plus I’d bet he has the gout.

Saturday, May 13, 2023

The Republic

 “I do not say that democracy has been more pernicious on the whole, and in the long run, than monarchy or aristocracy. Democracy has never been and never can be so durable as aristocracy or monarchy; but while it lasts, it is more bloody than either. … Remember, democracy never lasts long. It soon wastes, exhausts, and murders itself. There never was a democracy yet that did not commit suicide. It is in vain to say that democracy is less vain, less proud, less selfish, less ambitious, or less avaricious than aristocracy or monarchy. It is not true, in fact, and nowhere appears in history. Those passions are the same in all men, under all forms of simple government, and when unchecked, produce the same effects of fraud, violence, and cruelty. When clear prospects are opened before vanity, pride, avarice, or ambition, for their easy gratification, it is hard for the most considerate philosophers and the most conscientious moralists to resist the temptation.” – John Adams

Our Republic suffers the same risks of failure. To survive, the US must maintain: its Christian culture, its Constitution, the ruel of law, its anti monopoly fair trade rules and a strong Citizenship. 

Corruption, drugs, foreign subversion and inadequate or subverted education and globalism loom as the greatest threats to our Nation.


Wednesday, May 10, 2023

Domestic Management and Productivity, not Home Economics (A Business School for Women)




 

For generations, home economics taught cooking and sewing as the sum total of a woman’s place in the home. No wonder Feminism. In truth, however, the home offers women the choice of a multimillion-dollar lifetime enterprise, every bit as demanding of finance and entrepreneurship as any corporation.

Multiplying the number of homes in the US, yields a staggering product, and a large segment of the economy. Sadly, the minimum wage and other restrictions eliminate options and nearly all domestic labor leaving the CEO of the home with little choice but to escape and seek a job that utilizes her talent elsewhere. The fallouts from that economic restraint, include: the stifling of productivity in the trillions, neglected childcare, homelessness, broken families, a taxpayer burden, increased demand for social assistance, demand for elder care and adult children of fatherless families.

The solution requires only a high level of business education and the removal of restrictive regulations. The economy will adapt. Remove minimum wage, remove zoning restrictions against multiple generation housing, rental restrictions, and building restrictions. Most helpful of all, teach women advanced finance, construction and business management. The sewing and cooking will take care of itself with flexible wages and domestic housing. Seniors could experience family support rather than expensive assisted living. Productivity would return to the home-market-segment. 

This proposition depends on a woman’s choice for a high-level education in Domestic-Management-and-Productivity. It could be a highly progressive and highly rewarding solution to an intractable social problem and a massive boost to economic activity, the neglected Velocity multiple that drives the GDP.