DeMarco: If there was a vaccine for cancer that was 99% effective, would you take it?

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The Op-Ed Page

By Paul V. DeMarco
Guest Columnist

AUTHOR’S NOTE: The vaccinated among you who read this will rightly wonder why, as a doctor, I don’t make a stronger case for vaccines. First, plenty of frontal assaults on the unvaccinated have already been published. Second, it’s one thing to talk theoretically about vaccine hesitancy and another to have a one-to-one conversation about the vaccine with someone for whom you are providing medical care. Although I am frustrated and confused by the widespread resistance to vaccines, unleashing that frustration on my patients would do no good. If the piece leaves you wanting a more direct, robust argument, I sympathize. But I’m not writing for you. I’m hoping to address readers who can be convinced to join your ranks.

When I hear stories about illness, I often imagine that I am the physician for the sick person being described. So when I read about people who decline the opportunity to be vaccinated against COVID-19, I envision them sitting with me in one of my exam rooms. By now I’ve had hundreds of conversations about the vaccine.

In the winter, many of them were about where patients could get the vaccine most quickly.

Over the past several months, the discussions have evolved; now it’s mostly coaxing the unvaccinated to overcome their hesitation. Hard-won experience has taught me that as I attempt to persuade a reluctant patient to accept a therapy, the harder I push, the less I succeed.

I begin by asking whether my patients have been vaccinated. If they say yes, I exhort them to encourage everyone they know to follow suit. I have several vaccinated ministers who tell me that every week they implore the disinclined among their flocks to get the vaccine.

There are very few patients (myself included) who do everything their doctor recommends. Countless patients of mine have refused my offer of a flu shot because “I got the flu from the flu shot.” Despite my gentle rebuttal that it is impossible to get the flu from the flu shot (although you can get flu-like symptoms from the vaccine), I rarely win the argument. I recognize that my advice is only part of my patients’ decision processes: Personal experiences, advice from other people they trust, and information from media also inform their decisions.

With the COVID-19 vaccine, I have had more success with ambivalent patients, although the majority still decline. Since I have an office practice, I spend much of my time trying to prevent illness rather than saving lives. But during a pandemic, convincing a patient to get vaccinated can be lifesaving, and therefore has been a source of intense focus for me. Most of my patients are over 50 and have chronic diseases that put them at higher risk. Thus far, I’ve lost two patients to COVID-19. Several more of my patients have lost family members. One patient lost a brother, a sister-in-law, and a niece in the space of just a few days.

If patients says they have not been vaccinated, I ask “Do you want to talk about it?” Most do, and express legitimate concerns – it was created and tested quickly; it’s still under emergency authorization or it had been when I wrote this); there have been side effects (blood clots and heart inflammation, to name two); they are not in high-risk groups; they don’t go out much; and they social-distance. A number can’t articulate a reason except that they are afraid of the vaccine.

My response goes like this: I acknowledge their fears. I admit that I can’t guarantee that they will not have a rare side effect from the vaccine. For those who express fear of dying from the vaccine, I acknowledge that the risk of death is currently unknown. All I can say is that it appears to be exceedingly rare.

My argument for the vaccine is based on what we do know. The latest data I can find from the CDC (for the calendar year 2020) shows the COVID-19 death rate in South Carolina was 78 per 100,000, making it the third leading cause of death in our state behind heart disease and cancer. Since the beginning of the pandemic, approximately 10,000 South Carolinians have died. The vaccine is approximately 99% effective in preventing death from COVID-19. If there was a vaccine that had a 99% efficacy in preventing death from heart disease or cancer, I ask, would you take it?

Surprisingly, a few of my patients, when I ask whether they want to talk about being unvaccinated, say “No thanks.” If that is the response I leave it be, but I wonder what they are reading or watching to make them unwilling to hear from the person in whom they have entrusted their medical care.

I suspect their unwillingness is driven by cable news or internet media. One of the worst things that has happened during the pandemic is the unwarranted attachment of political and philosophical meaning to the virus. Recently, I heard a caller to a radio talk show describe people who wear masks as “our enemies.”

COVID-19 is no respecter of political party or religion. It’s a simple virus with no brain. All it knows how to do is reproduce itself in our cells. The longer it has susceptible hosts, the longer it will continue to infect us, and the more efficient it will become. The delta variant is the latest example of this. The longer it takes for us all to be vaccinated, the more likely another, even more infectious and more deadly, variant will arise.

You may not be my patient, but as a doctor I care about people’s health whether I know them or not. Please get vaccinated.

Paul DeMarco is a physician who resides in Marion, SC. Reach him at pvdemarco@bellsouth.net. This was first published as a column in the Florence Morning News on Aug. 18.

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153 thoughts on “DeMarco: If there was a vaccine for cancer that was 99% effective, would you take it?

  1. Barry

    I have no patience for people that do not choose to get the vaccine. getting the vaccine is no guarantee that someone will not get Covid or get really really sick from Covid. We all understand that vaccines are not 100%

    I’m really tired of listening to the anti-vaxxers who get sick and end up in the hospital on a ventilator and the last words out of their mouths is “please go get the vaccine” when they have spent months spreading lies and making fun of anyone that chooses to be careful.

    This past weekend yet another right wing conservative talk show host died of Covid. he spent over a year making fun of people that chose to wear a mask and take precautions against Covid stating that he felt he was immune to it and another time saying that he didn’t believe Cove was even a real thing. His family has come out pleading with people to get the vaccine so they will not be like their loved one

    When he passed, numerous conservative politicians in Tennessee expressed their condolences and thanked him for being an inspiration to them. I’m unclear as to what inspiration he provided other than “what not to do”

    After the news was announced, a senior writer at the conservative and influential publication/news organization Townhall.com posted on Twitter that he did not believe the story about Phil Valentine dying of Covid

    No amount of logic or facts will convince people whose entire reputations depend on them attacking reality.

    Reply
    1. Brad Warthen Post author

      Well, I don’t have any patience with them, either. If I’d written that, I’d have been tempted to say:

      When I hear stories about illness, I often imagine that I am the physician for the sick person being described. So when I read about people who decline the opportunity to be vaccinated against COVID-19, I envision them sitting with me in one of my exam rooms.
      Then I envision sedating them, giving them their first vaccine shot, then — once they wake up — telling them to come back in two weeks, or to never come back again…

      That’s why, I suppose, those folks are lucky that Paul is their doctor, and not me. He has the kind of patience, and respect even for foolish people, that might — just maybe — get them to listen. Which would be good for all of us.

      We’ll experiencing a very bizarre moment in history. But frankly, I noticed decades ago that a shockingly large portion of our society seems incapable of grasping the way our lives are interconnected, and how we depend on each other, whether we want to or not.

      Too many of these people Paul is trying to reach think in “I, Me, Mine” terms. They think I don’t need the vaccine because I, personally, am not in a high-risk group. Or I don’t want to get the vaccine because I perceive some potential (imagined) threat to me.

      Which completely misses the point. As Paul explains, we need the whole population to be vaccinated in order to make the virus go away, and stop mutating into more dangerous forms:

      All it knows how to do is reproduce itself in our cells. The longer it has susceptible hosts, the longer it will continue to infect us, and the more efficient it will become. The delta variant is the latest example of this. The longer it takes for us all to be vaccinated, the more likely another, even more infectious and more deadly, variant will arise….

      It’s not about you, or me. It’s about all of us

      And far, far too many people seem to have something missing in their brains, the lack of which keeps them from perceiving that obvious fact…

      Reply
      1. James Edward Cross

        While it is oh so tempting to let loose on those folks, it’s counterproductive. And you need more than “just the facts” in order to persuade them. As one might expect, there have been several articles, books, and other suggestions on how to do that. Some of them can be found here:

        https://getpocket.com/collections/how-to-talk-to-a-science-denier-a-reading-list?utm_source=pocket-newtab

        It does take time and patience but it can be done.

        Reply
          1. Bob Amundson

            We should have data on who is not vaccinated; then send postcards to them saying your neighbors are vaccinated and now it’s your time. Nudge; if that doesn’t work, nudge harder …

            Reply
  2. Paul V DeMarco

    Barry,
    I share your frustration and disappointment. I am flabbergasted by the amount of disinformation out there. I am astonished that COVID, which could have united the country by having us make small sacrifices to protect one another, has instead been turned from a medical illness into a political weapon. Too many people, like Phil Valentine, who have no business opining about the virus, have decided they know as much as doctors and scientists who have devoted their lives to understanding viral illnesses and protecting populations from them.

    Reply
  3. Barry

    I know this is a little off topic but I heard a story today about a mother and her three small children who are “stuck in Afghanistan”

    apparently she’s from New York

    Then I remembered the numerous travel warnings that the administration has released over the summer warning people about Afghanistan.

    then I remembered that President Biden has talked about wanting to get out of Afghanistan quickly and I remember earlier this year the numerous times he said that they were winding things down and were trying to get out of Afghanistan as fast as possible

    and then I wondered why with a mother with young children who lives in Brooklyn would stay in Afghanistan when people like me sitting in South Carolina know that we are trying our best to get out as fast as possible and understands what that would mean.

    I do have sympathy for Afghani English translators but I’m not so sure that I have a ton of sympathy for people that ignored numerous- numerous -numerous warnings and statements from the United States government and decided to just stay against all common sense

    It’s like the stories that we heard 20 years ago when someone would be “hiking“ in Iraq or Iran and would get captured as if they were hiking in Asheville.

    Reply
  4. Ken

    I’m doubtful that many people have been reluctant to take the vaccine merely because it wasn’t fully approved. After all, these are often the same people who rail against government bureaucracy. And there is no substantive scientific difference, as far as I can determine, between emergency authorization and full approval — other than a few more bureaucratic hurdles.

    Vaccine refusal is not even entirely attributable to conspiracy theories and bad information. Instead, it seems to be part of a broader worldview in which trust is a rare commodity. A lack of trust in government, in other institutions and authorities. A lack of trust in anybody other than those one knows personally, and maybe not all of them entirely. And some folks still don’t think Covid is all that serious, not serious enough to disrupt life or warrant mandates.

    Vaccination should be a requirement for going to school (at least for ages 16+), attending events, dining out and going to work. We’ll see if the unvaccinated are willing to forgo all those things to remain true to their dubious “cause.”

    Reply
    1. Bryan Caskey

      Yeah, I agree there likely won’t be a huge voluntary rush for the vaccine among the unvaccinated due to the FDA approval. I think the needle will move with businesses leaning on employees to get vaccinated. Americans generally believe that private entities should get to set the rules of their own establishments, so they’ll tolerate employer mandates to a greater degree than they will a government mandate. Eventually, the schools are where we’ll get to near universal vaccination. Once it’s a requirement to attend school, that gets you 99.9% of people.

      Reply
        1. Bryan Caskey

          Well it was just approved by the FDA for 16 and up, yesterday. I’m not sure it’s fair to say the school districts should be requiring it yet, when it would only apply to the 10th, 11th, and 12th graders. Heck, they aren’t even requiring it for the adults working in the schools yet.

          Reply
      1. Ken

        “Leave it up to the marketplace” isn’t good public heath policy. To a (too) large degree, leaving this up to the market is what we’re doing now. And the market is always too fearful of public/customer backlash for it to be a vigilant enforcer. What I’m saying is that practically all venues where groups of people gather should be off limits to the unvaccinated.

        Reply
        1. Brad Warthen Post author

          I didn’t read what Bryan was saying that way. I read it as saying that leaving it up to employers would be more likely to have a positive effect on the holdouts, since THEY might “tolerate employer mandates to a greater degree than they will a government mandate.”

          In other words, I read it as being kind of like what Paul was saying: Meet them where they are.

          But perhaps he meant this was a better approach in other situations as well, with other audiences. If he did, then I disagree.

          And however employees or customers might react, I think a lot of businesses out there — particularly small ones that interact a great deal with the public — prefer the onus for a mandate to be on the government, so that customers don’t blame THEM for making the decision: “Hey, it’s not ME — it’s the LAW. I can’t help it!”…

          Reply
          1. Ken

            “they’ll tolerate employer mandates to a greater degree than they will a government mandate.”

            That’s the core of it. And it sounds like: let the market decide.
            But most employers and businesses don’t want to be put in charge of enforcement. Walmart supposedly has a mask mandate for its employees. But compliance is somewhat slack.

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        2. Bryan Caskey

          What I’m saying is that practically all venues where groups of people gather should be off limits to the unvaccinated.”

          That’s starting to happen, especially now the vaccine has the imprimatur of the FDA.

          For example, today, LSU announced that anyone 12 and over who wished to attend an LSU home football game this fall has to show proof of vaccination or a negative PCR test for COVID-19 from within the last 72 hours. And they are likely only the first of many schools to put this in place.

          Reply
          1. Ken

            Right direction.
            But too slow and too much of an uncoordinated patchwork. It can create confusion while also leaving too many gaps. A football game here or there won’t make a difference if many fans are gathering (unmasked) in bars and restaurants before or after, for example.

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              1. Ken

                Vaccine mandates for access to practically every public gathering place. You’ll say that’s politically impractical. I’ll respond that it’s only impractical in places where it’s being MADE impractical by people who aren’t thinking practically or with the public health foremost in mind. Leaving it to the market — which is the same as leaving it up to “individual responsibility” — is is a slipshod approach to communal care.

                Reply
                1. Bryan Caskey

                  So is that a state law you’re hoping for, or something else? (Federal law, county ordinance, etc.)

                  How are you defining “every public gathering place” in this law? I assume that would apply to places like the statehouse, Williams-Brice Stadium, the Colonial Life Arena, and the convention center because those places are all big-capacity places.

                  Does your proposed law cover everywhere, though? Does it apply to the McDonald’s at Gervais and Huger? Does it apply to my law office on the corner of Blanding and Pickens? What about my house if I host a big celebration of Vladimir Lenin’s Birthday?* Does it apply to the student housing in the Vista?

                  And how do we enforce this? Do we have everyone carry around their vaccine card like a driver’s license? Do we have a division of the government who enforces this or is it up to the businesses? For instance, if your law goes into effect and it applies to my office, am I required to check every client’s vaccination status before allowing them in?

                  Don’t get me wrong, I’m pro-vaccine, and I think everyone should get it. I just think it gets complicated pretty fast when you start mandating vaccine for access to “every public gathering place”.

                  * Footnote: Q: How do you know when a joke is communist?
                  A: When everyone gets it. 🙂

                  Reply
                  1. Ken

                    I’m not writing a law.
                    Neither am I interested in reacting to fusillades of rhetorical what-ifs and how-bouts.
                    However, mandates like this are in place in some places. Are they 100% problem- and loop-hole free? No, of course not. But they ARE more effective than leaving it up to the wide-open marketplace of “personal responsibility.”

                    Reply
                    1. Bryan Caskey

                      Sorry about the fusillades. I’ll try to also avoid cannonades of controversy, broadsides of belligerence, salvos of sarcasm, and volleys of vindication.

                      Did you at least think the communist joke was funny?

                    2. Brad Warthen Post author

                      Oh, I know you, brother — one broadside and you board ’em in the smoke! Ken is onto your capers, as well. Brought you up with a round turn!

                      Yes, the communist joke was funny, although not in the “lesser of two weevils” league…

                    3. Brad Warthen Post author

                      That’s funny. Not as funny. And the communist one has a broader scope, and would work at any time from Karl Marx’s day until now. You sort of have to be here and now to get the Rand Paul one.

                      But it’s funny, especially to someone who disagrees with Paul as much as I do…

                    4. Ken

                      For those of us who spent any time at all in communist countries (in my case: Hungary, Czechoslovakia and East Germany), the communist joke doesn’t work because it doesn’t reflect reality. Everybody didn’t get what they wanted. Or even necessarily what they needed. Only certain elites did. Which is a big part of why those regimes fell. So the joke’s a … joke.

                    5. Bryan Caskey

                      Some other good Soviet jokes:

                      A man goes into a store and says “You don’t have any meat?” “No”, replies the clerk, “We don’t have any fish. It’s the shop across the street that doesn’t have any meat.”

                      A worker standing in line for vodka for hours finally says, “I have had enough of this, save my place in line, I am going to shoot Gorbachev.” Two hours late her returns to claim his place in line. His friends ask “Did you get him?” “No” he replies, “The line there was even longer than the line here.”

                      Happy Friday everyone.

          2. James Cross

            Why worry about venues? Pass a law that mandates that everyone needs to be vaccinated unless a medical condition prevents it, period. Because it is clear that a number of states would not do what needs to be done it would likely have to be a federal law. There might even be a legal precedent for it: Jacobson v. Massachusetts (1905) where the Supreme Court ruled in favor of state vaccination mandates for schools.

            And yes, I know it would be difficult to get such a law through Congress and that the Supreme Court could find a way around Jacobson. But if some people are claiming to wait because the government/President isn’t pushing hard enough well then, this is about as hard as you could push.

            Reply
            1. Bryan Caskey

              I think a state law would certainly have more solid foundation than a law at the federal level. It would be less complicated to require the vaccine rather than to require it in certain places.

              I wonder what the polling would look like on a state law requiring the vaccine.

              Reply
        3. bud

          Sort of like smoking bans. This all has such a familiar ring to it. As Yogi Berra once said, it’s Deja Vu all over again.

          Reply
    2. Barry

      There was a guy who called into a local right wing radio show on Monday who said he wasn’t going to take the vaccine because the Biden administration has been “wishy washy” on the vaccine as if if they had been more forceful he would have taken it.. Apparently he placed an incredible amount of his medical decision making on a President he doesn’t like.

      He was clearly lying to himself because no one listening to him would come away thinking “if Biden had only been more supportive of the vaccine, he would have signed up.”

      The host didn’t push back at all and accepted his statement as fact. So odd since Biden has promoted the vaccine nearly every single day he’s been president including getting the vaccine in public.

      As the caller continued talking, it was clear he was no fan of Biden or any decision he had ever made.

      So the question that was obvious to me, but foreign to the show host was, “why are you relying on what a president that you clearly don’t like says about a vaccine to the point you don’t take the vaccine? Why wouldn’t you simply listen to your doctor instead of a politician for something so serious as a medical decision?”

      Reply
  5. Mark Stewart

    “The longer it takes for us all to be vaccinated, the more likely another, even more infectious and more deadly, variant will arise.”

    The thing that Trump mined originally, and which has now got away from him, was the extent of social anxiety in America, and how corrosive this fear has become. Social structures of all kinds used to serve as a bulwark against this fearfulness tendency, by both reassuring the anxious and then, when needed, marginalizing them until they shut up and sat down. But now we have “social media” and the social connections and corrections have been supplanted by an endless barrage of unfiltered insanity aimed at the anxious. It isn’t surprising that they lap it up as if it is a cure. They know its just the opium speaking, but they soak it in anyway, for the rush of acceptance it brings.

    We might need gentle cajolers, but it seems more likely we need social enforcers. That role cannot be put on the government. We will need people to become their own social circle bullies in the old sense of ostracizing the non-compliant. “If unvaccinated, please consider yourself uninvited.”

    Reply
    1. Barry

      Did you hear snippets of Trump’s statements on the vaccine at his cray Alabama “rally” in the cow pasture?

      He recommended the vaccine, got considerable “boos” from the Conservatives in attendance and then immediately pivoted to their “freedoms.”

      In typical Trump fashion, the crowd runs him and leads him around by the nose.

      “And you know what? I believe totally in your freedoms. I do. You’ve got to do what you have to do,” Trump said. “But I recommend take the vaccines. I did it. It’s good. Take the vaccines.”

      Some boos rang out from the crowd, who were largely maskless.

      “No, that’s OK. That’s all right. You got your freedoms,” Trump said, echoing rhetoric from opponents of mask and vaccination mandates. “But I happened to take the vaccine. If it doesn’t work, you’ll be the first to know. OK? I’ll call up Alabama, I’ll say, hey, you know what? But [the vaccine] is working. But you do have your freedoms you have to keep. You have to maintain that.”

      Maintain what? Here is the right answer..

      “No, I hear some of you that disagree. That’s your choice but the way I look at it is that if you were to get sick, or die, or you make someone else sick and they possibly die, your freedoms will no longer matter at all. So I encourage everyone to get the vaccine. Protect yourself and your family. I got the vaccine. my family got the vaccine and here’s the dirty secret- almost everyone you are seeing on social media, on Fox like Tucker Carlson, and on your tv telling you about vaccines – they’ve taken the vaccine too. So have their families. Believe me. I know. Most all of of them have told me. They are just too cowardly to admit it. So take it. It’s your choice but take it.”

      Reply
  6. bud

    The people who are reluctant to get vaccinated are comparable to those stubborn naysayers who refuse to allow medicinal marijuana. Yes we are all in this together so why resist ANY common sense measure that would make people’s lives better. Which is something else to be disappointed with Biden. And don’t get me started on the SC general assembly. Wouldn’t it be simple to remove marijuana from the most schedule 1 drug designation? Then there would be no excuse to legalizing marijuana.

    Reply
    1. Brad Warthen Post author

      I suppose they are technically “comparable,” but once you do compare them, you’ll see they’re nothing alike.

      The medical cannabis issue is about the government allowing something it now bans, which makes it a fave issue for libertarians.

      Vaccination is pretty much the opposite. It’s a communitarian issue. It’s not about individuals seeking a personal right to do something. It’s about every one of us having an obligation to each other to get vaccinated in order to control, and perhaps even wipe out, a public health menace….

      Reply
      1. Brad Warthen Post author

        Oh, and by the way, if you’re promoting it you might want to call it “medical cannabis,” as I did, rather than “medicinal marijuana.”

        When I was helping James and Mandy promote their position in favor of it (different from my own position, which I would call “unconvinced”), I once posted a release on the campaign website, and made the mistake of using this artwork to go with it. I thought it worked, but James did not, and I quickly took it down. He didn’t want anything that looked like head shop decor…

        Dang! I couldn’t find the image in my files! I must have destroyed it or something. Anyway, it looked kind of like this, with the caduceus and the leaf. Wouldn’t you like to stick that one on your 1967 VW Microbus? Yeah, I think that’s why James didn’t like it…

        images

        Reply
      2. bud

        In some political vein medicinal marijuana and COVID vaccines may be viewed as different I suppose. But at the end of the day they are common sense measures that can help people. So why quibble over technicalities? If government can be useful either by mandating or by stepping aside isn’t that what good public policy should be about?

        Reply
        1. Brad Warthen Post author

          “If government can be useful either by mandating or by stepping aside isn’t that what good public policy should be about?”

          We are in total agreement…

          Reply
    1. Barry

      Well, many Conservatives – in fact – a majority- listen to fantasy on Fox News for their information.

      Fox is still putting on fake medical experts who then cast doubt on vaccines. No wonder so many Conservatives don’t believe in the COVID vaccines.

      Laura Ingraham recently had on a doctor, Dr. Bryam Bridle, who is a professor at a veterinary college in Canada to push debunked claims about a vaccine research paper.

      Two months ago, The Associated Press spoke with one of the authors of a study Bridle is citing, vaccine researcher William Matchett at the University of Minnesota, who said that Bridle left out key details of the research paper,.

      NEW YORK (AP) — When Dr. Alexa Mieses Malchuk talks to patients about the COVID-19 vaccine, she tries to feel out where they get their information from.

      “Sometimes I feel like the education I have to provide depends on what news channel that they watch,” the doctor in Durham, North Carolina, said.

      The mixed messaging can come from the same media outlet — and even the same source, Fox News.

      Reply
      1. Barry

        Now, I realize some on here dismiss Fox News. They assume because they don’t watch it and find much of it silly, that no one takes it seriously. That is, of course, 100% incorrect.

        Millions of Conservatives look to Fox News as a trusted source of information. Worse still, many GOP politicians from the national level to the local level not only watch Fox, they take marching orders from Fox and cater to the opinions of their talking heads- regardless of the opinions of the talking heads flip back and forth – flip flopping all over the place.

        Sadly, I know way too many folks that take Fox seriously. Some in my own family that have been totally brainwashed by the garbage tossed out by their hosts. People that were never political in their entire lives, now totally consumed with watching what a Fox News employee tells them to think and falling in line like a robot.

        Over the summer, I was at a family event where a father of 4, while we were celebrating his youngest child’s birthday with cake and ice cream was unable to tear himself away from the insane ramblings of a maniac named Sean Hannity on Fox News long enough to watch his 5 year old blow out his candles on his birthday cake. A man who, just 10 years ago would not have given 2 cents for any tv show, is obsessed and consumed by the political rantings of fools on tv enough to where now it nearly dominates his life.

        When someone like Laura Ingraham, who hosts a 10pm national Fox show brings on a professor at a veterinary college, those Conservatives that tune into such shows take this type of misinformation as truth. They simply don’t ask themselves why she’s focused so much on a veterinary professor. They chalk that up to “well, it takes a professor of veterinary science to tell us the truth.”

        That the doctor is not a trusted source of medical information for vaccines makes what he says even more truthful to this crowd- and this crowd is a large and influential part of the Republican and Conservative base. In many cases, the less that someone qualifies as an actual expert, the more seriously he/she is taken.

        Last October, when Laura Ingraham was making fun of face coverings, and about the same time was spotted along the periphery of a Trump rally in Michigan wearing a face covering, Conservatives didn’t consider her a hypocrite. They considered anyone that pointed out her hypocrisy as anti American and “not a patriot.” (Those that are “Patriots” and those that are not considered “Patriots” are major talking points on Fox- so much so that such framing is now a major talking point with grass roots Conservatives).

        In Conservative and Fox News world, being a “Patriot” is seen as the ultimate achievement. But of course not everyone can be a “Patriot.”

        First, you have to support Donald Trump. There is no alternative.

        Second, it doesn’t matter if you served in the military. It doesn’t matter if you had your legs blown off flying a helicopter in Iraq, if you don’t support Trump and don’t parrot Conservative talking points, you hate America.

        Example- Tucker Carlson, the highest rated cable host in the United States who never served in the military calling Tammy Duckworth, who lost both legs in Iraq, a “coward” and “moron.”

        Of course his derogatory comments about Tammy Duckworth were cheered loudly by Conservatives and especially by Fox News viewers and other Fox News hosts.

        Ms. Duckworth is not a “Patriot” in Conservative circles. That’s because her life and opinions have not led her to fall in lock step with Conservative political viewpoints or Conservative approaches to problems. Therefore, she is not a Patriot and doesn’t love America.

        Oh yeah- she hates God too- another Conservative and Fox News talking point. Can’t forget about hating God. That’s a big one.

        Reply
        1. Brad Warthen Post author

          Here’s the thing about Fox News…

          Before it existed, we all lived in a universe in which the people who would later love Fox just yammered all the time about how “the media is biased.”

          Which I always took this way: What they meant was, the media were (not “was;” I just used the singular above because that’s the way those people speak) not biased, in that it failed to skew everything toward those folks’ point of view. They didn’t like the detached perspective; they wanted media to identify with them and reflect their thoughts and emotions.

          And of course they felt this way especially strongly about television, because they weren’t readers. But to the extent they thought about us in the press at all, they lumped us in with the folks on the idiot box.

          Then Murdoch came along and created a medium that deliberately reflected their perspective, that didn’t hold them and everyone else at arm’s length. And of course, they loved it….

          I may enlarge upon this in a separate post, including such points as the lessons I learned in 1998, which have been a major cause of the reason I write so many things that cause certain readers here to cry “false equivalence!” Because, you see, folks aren’t the right aren’t the only ones who want media to reflect them. It’s just that they tended to predominate before that year…

          Reply
          1. Barry

            A few things:

            1) People still yammer on about the media being biased. Fox News viewers are some of the most ardent “the media is biased” yammerers. Well, of course except for Fox. They aren’t biased at all except they aren’t as supportive enough of Trump. If they were, they’d really be unbiased- that is the thinking.

            2) I seek out new analysis shows that don’t cater exclusively to my beliefs. That’s why I enjoy the POTUS channel on Sirius radio so much.

            The morning show is led by veteran journalist Julie Mason who interviews politicians, reporters, and newsmakers on all sides. Sometimes I get frustrated at her interviews because she’ll be giving someone like Steve Scalise a medium to spout his crazy, but then she’ll interview Tim Ryan of Ohio.

            Reply
  7. Barry

    On Michael Smerconish’s website today

    Nearly All US Presidents Had a First Friend: Did Donald Trump?

    One of the questions I’ve been asked most frequently in the six weeks since my book on first friends of U.S. presidents was released is: “Who is Donald Trump’s First Friend?” I wanted to find someone who shared fully his interests and values, could speak honestly and bluntly to him, provide him with emotional support and respite…………….. Until I made a disquieting discovery. Donald Trump doesn’t have a best friend. What I found instead was that Trump – perhaps alone among the 45 men who have occupied the Oval Office – not only lacked a best friend but neither needed nor ever wanted one.

    The rest of the article..

    https://www.smerconish.com/exclusive-content/all-us-presidents-had-a-best-friend-except-donald-trump

    Reply
    1. Bob Amundson

      Long term speed freak – ADHD and then Adult ADHD. No drugs or alcohol? Addicts don’t have many friends and tend to be very Narcissistic.

      IMHO – I am not a psychiatrist and I did not sleep at a Holiday Inn Express last night.

      Reply
  8. Barry

    I’m still trying to understand why there are hundreds of thousands of Americans living in Afghanistan 8 months into an administration that said we are leaving Afghanistan

    after the previous administration said we are leaving Afghanistan by May 1st.

    It feels much like waiting on one of my kids to get in the car at 9:10am after telling him/her 10 times that we are leaving at 8:50am.

    I heard this question asked this morning to someone in the media who was talking to a former CIA station chief — and the station chief really couldn’t answer the question either.

    I guess they just assumed a US President would never actually leave after promising to do so. Probably a good bet until Joe Biden took office.

    Reply
    1. Bryan Caskey

      Or maybe they assumed from Biden’s July 8 statements that they had time. Either way, the President seems to be taking the position that he isn’t going to help them, and if they get killed, well…that’s their own fault.

      Reply
      1. Bryan Caskey

        How many Americans in Afghanistan were mulling whether to heed State’s warnings and depart when they watched this Biden presser on July 8 and felt reassured in staying put?

        It’s not as if the Taliban was going to overrun the country in the course of a weekend, right?

        Reply
        1. Brad Warthen Post author

          I’m having a little trouble following your point, Bryan.

          What are you saying? Do you think the president was lying in July? Do you think he shouldn’t be president? Do you think — God forbid — the country and Afghanistan would be better off if Trump had won the election? (In which case we would have withdrawn far more hastily and recklessly, without anyone in a command position listening to ANYONE with expertise in the region or the situation.)

          What’s the point you’re making?

          You know my position: It was wrong to withdraw from Afghanistan. And — but this position I hold much less strongly, because it’s a cheap, easy thing to say in such a complex situation — if we were going to withdraw, we should have done it more skillfully somehow. In fact, I’m not sure I hold that position at all, except perhaps wishfully. One big reason we didn’t withdraw for 20 years after toppling the Taliban was that it was going to be a God-awful mess when we did. I find it hard to imagine a scenario in which it would NOT have been, which is why I didn’t want us to withdraw.

          That’s my position. I’m having trouble understanding your position…

          Reply
          1. Brad Warthen Post author

            I like what Frank Bruni had to say today: “Stop Politicizing the Misery in Afghanistan.” And no, he wasn’t just saying, “Republicans should stop being mean to Joe!” An excerpt:

            Democrats are panicked that the debacle in Afghanistan will shake American voters’ confidence in not only President Biden but also the rest of the party, potentially costing it control of the Senate and the House in 2022. They’ve said as much — to me, to other journalists, to anyone who will listen.

            I wish they’d stop, because their political fate is nothing next to the fate of Afghans on the wrong side of the Taliban. And every time they communicate as much concern with the party’s near future as with Afghanistan’s, they inch toward the very destiny they dread….

            I may write a separate post about it, and go far beyond Afghanistan. Because as stupid as our politics have become, I hate to see ANY issue forced to fit such aims…

            Reply
          2. Bryan Caskey

            “Do you think the president was lying in July?”

            It doesn’t matter what I think. My point is that the President said these things. When the President of the United States says things, it’s reasonable to suppose that the things he says will have an effect on other people and their decisions. It’s the “effect on hearer” exception to the hearsay rule in our rules of evidence.

            The President said the Taliban takeover wasn’t inevitable. That turned out to be wrong in a very short period of time. The President seems to have been wrong when he said: “That is not true” to the statement of “Your own intelligence community has assessed that the Afghan government will likely collapse.” As an aside, the Intelligence Community seems to be claiming Biden lied on this point, but that’s an intramural fight between Biden and his own people. Again, my point is that Biden specifically said these words.

            The President also said: “There’s going to be no circumstance where you see people being airlifted of the roof of a US Embassy in Afghanistan”.

            Accordingly, I am having a hard time casting such an large amount of blame on every American for being in Afghanistan to the extent that we completely abandon them to the hands of barbarians from the 7th century, It might be the case that some of the Americans who are being left behind might feel they were somewhat misled.

            Reply
            1. Barry

              “The President also said: “There’s going to be no circumstance where you see people being airlifted of the roof of a US Embassy in Afghanistan”.

              Accordingly, I am having a hard time casting such an large amount of blame on every American for being in Afghanistan to the extent that we completely abandon them to the hands of barbarians from the 7th century, It might be the case that some of the Americans who are being left behind might feel they were somewhat misled.”

              I think this is the reasoning we see after Hurricanes from people who knew what was coming because they are on the ground in the zone, and somehow looked to a politician who was 12,000 miles away as their guiding light.

              A politician who, for over a year had been saying he was getting out -pulling out all troops fast (While a President was in office saying he was pulling out troops fast no matter what).

              I’m also still looking for the first Conservative who isn’t in office to complain about the Trump administration abandoning the Kurds leaving them to be killed.

              I guess those allies don’t matter though.

              Reply
          3. Bryan Caskey

            “Do you think he shouldn’t be president?”

            If you’re asking me if he was properly elected to the position, of course he should be the president. he was the duly elected person for that office.

            “Do you think — God forbid — the country and Afghanistan would be better off if Trump had won the election?”
            I don’t know. I’m sort of having trouble seeing how it could go worse.

            “What’s the point you’re making?”

            My point is that I would not be Pontius Pilate and wash my hands of the Americans and our allies in Afghanistan.

            Reply
            1. Brad Warthen Post author

              That’s not something I worry about — Joe Biden becoming Pontius Pilate.

              Even though he did, like people across the political spectrum (and I’d still like to hear which alternative out there to Joe would not have done this) decide to wash our hands of Afghanistan…

              Reply
            2. Barry

              What is your plan for withdrawal from Afghanistan?

              I’m not talking about leaving 4,000 troops there because that’s not withdrawal.

              I’m still waiting for the plan that would have made this go smoothly. I’ve heard a lot of talking heads on tv, but I’ve yet to hear a workable plan.

              Reply
              1. Bryan Caskey

                For starters, I wouldn’t have abandoned Bagram AFB, nor would I have agreed to an artificial withdrawal deadline of 8/31.

                Reply
                1. Barry

                  ok-

                  So you would have done something that wasn’t on the table with Trump or Biden, do I have that right?

                  and regarding Bagram, you’d have stayed there, so no actual withdrawal.

                  Ok.

                  So I’m still looking for the plan I guess for withdrawal because leaving troops there isn’t an option in a withdrawal at some point, people pack up and get out of dodge.

                  Reply
                    1. Barry

                      Bagram isn’t exactly near the civilian population. It’s surrounded by mountains.

                      I realize there is an argument about keeping it open but those that think that keeping it open would have given us another way to get folks out probably aren’t being realistic.

                    1. Barry

                      That isn’t surprising though.

                      Heck, our military leadership has been working closely with the Taliban since the Feb 2020 agreement.

                      and yes, you wouldn’t have handed over those names. That’s fine.

                      and when a bus was blown up headed to the airport because of mistaken identity, you’d have to live with it.

                      War always stinks. That’s why we should have left over a decade ago.

                2. Ken

                  JCS Milley:

                  “Securing Bagram is a significant level of military operating forces,” Milley says. “It would also require external support from the Afghan security forces. Our task, given to us at that time, our task was to protect the embassy. If we were to keep both Bagram and the embassy going, that would be a significant number of military forces…that may have exceeded what we had, or stayed the same as what we had. So you had to collapse one or the other. And the decision was made, the proposal was made, from CENTCOM commander and the commander on the ground, Scottie Miller, to go ahead and collapse Bagram. That was all briefed and approved and we estimated that the risk of going out of KIA, or the risk of going out of Bagram, were about the same, so going out of KIA was the better tactical solution…in accordance with getting the troops down to a 600, 700 number.”

                  Reply
                  1. Bryan Caskey

                    Exactly. Biden didn’t give the commander the level of troops necessary to hold Bagram. So he had to fold it. He had no choice.

                    A terrible mistake from Biden.

                    Reply
                3. Bob Amundson

                  I wish there was at least one veteran on the blog. Bryan and Brad both seem to understand my stated biases better. There was a military solution – kick ass. Again, civilian led military ok ’cause kicking ass not always the solution.

                  Our Marines were HORRIBLY EXPOSED as they protected terrified soft targets. Many children …

                  Reply
                  1. Ken

                    Good thing there aren’t more current and former service members of this view. Though there are still too many.

                    The military is a fundamentally POLITICAL INSTRUMENT — especially in a democracy. Thankfully, the more enlightened military recognize that. “Kick ass” is not a strategy. It’s the waling bleat of a BDF.

                    Reply
                    1. Ken

                      From a memo by an US Special Ops officer from 2009:

                      “you should never try to convince them that you will stay for the long-term. They will not believe you. You must do your best to give them a sense of empowerment that they can protect themselves and their loved ones. This is easier said than done, but the bottom line is the Pashtuns don’t trust the ANA/ANP and they view the Taliban as better fighters. The key to FID with the Pashtuns is forming militias with enough power to aggressively defend their territories and out G the G, so to speak. ”

                      “There is an emerging Taliban shadow state that rivals the Afghan government in its ability to enforce and govern many parts of the country. You see a greater percentage of tax collection in areas under Taliban control than you do in areas under so-called government control. At the moment the Taliban can offer a far better deal. In return, the Taliban can offer some justice, some stability, some security, but maybe not very much opportunity. Consisting of at least five knowledgeable people, the Taliban provincial authorities are responsible for enforcing discipline on the fighters operating in their provinces. According to Taliban sources, ‘Every province must make a court with one judge and two Islamic experts so they can solve problems that the leader and elders cannot solve.’”

                      None of this involves “kinetic activity.” It involves political and administrative capacities.

                    2. Mark Stewart

                      I’m not anti-military at all. Bias free as it were. That said, I have always felt that military operations in Afghanistan was a dead man walking scenario. The military should be used as a kinetic force; the idea that the US military can do nation-building should have been a long-dead conceptualization. It can’t. Can we move on from that now?

                      We were always going to have to leave. Therefore, we were never going to be able to build a nation. Beside that, we never gave them the chance to stand for themselves, either.

                      Generals make poor political strategists. Our problem is that they often make better strategists than politicians. Next time, we need to learn that the military is the muscle, not the brains of warfare and what comes after.

                      The US military hit its strategic wall in 2003. That was a long time ago. Nothing transpired after that except the loss of life, treasure and reputation. It is really time that people internalize that fact and make it part of their thinking. Pretending that there was a “winnable” military solution in Afghanistan is just silliness. There wasn’t. So the military – and our political leadership and citizenry following along with the boots on the ground – marched right off the cliff. Let’s not do that any more, shall we?

                    3. Bob Amundson

                      Mark, you do seem to be anti-military. My experience, from serving on an Admiral’s Staff (Sinatra! No CNATRA – Chief of Naval Air Training), is that Nation Building is a political decision that complicates the military mission. The Senior Officers with whom I served were brilliant – l love my Marine Corps Aviation Brothers.

                      Mark, you have not served. That does create some sort of bias, just as I am biased because I have served. And for so many Veterans, we never stop serving. At least we try. PATH FORWARD.

                    4. Brad Warthen Post author

                      Yes, I agree with Bob about how political decisions complicate things.

                      And I disagree with Mark somewhat, in that I never saw the mission in Afghanistan as being nation-building, although I do love me some nation-building in many circumstances — I’m one of those civilians who cause the problems, right?

                      The mission in Afghanistan was first, getting the Taliban out of power — which was accomplished very quickly and easily (which unfortunately gave Bush and Rumsfeld some really unrealistic ideas about how to approach Iraq), and pursuing al Qaeda (which was initially bungled and much later more or less accomplished) and then after that, to keep the Taliban out of power, with the enormous benefit that there would be no more 9/11s — at least, not coming out of THAT country.

                      And we met that requirement for 20 years, until one day we quit…

                    5. Bob Amundson

                      To find OBL was primary. Believe me, those in country observed women and children being abused. Instead of Nation Building, how about protecting women and children from the horrible concept that they are just chattel for men? At times I am so disgusted to be cis.

            3. Barry

              “Do you think — God forbid — the country and Afghanistan would be better off if Trump had won the election?”
              I don’t know. I’m sort of having trouble seeing how it could go worse.

              LOL. That’s comedy gold right there. A good joke.

              H.R. McMaster told a Wilson Center interviewer on Aug. 12 that a “sound strategy” he helped devise for Afghanistan in 2017 had been “abandoned” in “capitulation negotiations conducted under Ambassador [Zalmay] Khalilzad” — Trump’s special envoy to Afghanistan who was retained in that role by the Biden administration.

              So intense was Trump’s intention to withdraw that he persisted even after the 2020 election. According to a report published by Axios in May, Trump signed a memo in November that would have withdrawn all U.S. troops by mid-January (just five days before his term was to end). His top national security team, civilian and military, persuaded him not to issue the order but to leave the withdrawal date at May 1.

              Trump has since said none of the current mayhem in Kabul would be happening if he were still president. Researchers will need to ascertain how many exit visas for Afghans had already been arranged before Trump left office, or what sort of procedures he might have had in place for Americans and Afghans wishing to leave. But lacking such evidence, and given Trump’s timetable and concessions made to the Taliban, it is easier to imagine the current situation happening that much sooner.

              Trump in fact had complained at his June 26 rally in Ohio that the Biden administration was dragging its feet and ought to get out faster.

              https://www.npr.org/2021/08/18/1028607717/strange-bedfellows-indeed-the-trump-biden-consensus-on-afghanistan

              Reply
              1. Bob Amundson

                H.R. McMaster told a Wilson Center interviewer on Aug. 12 that a “sound strategy” he helped devise for Afghanistan in 2017 had been “abandoned” in “capitulation negotiations conducted under Ambassador [Zalmay] Khalilzad” — Trump’s special envoy to Afghanistan who was retained in that role by the Biden administration.

                Yup. Our coward ex-POTUS DJT; he who shall no be named. Your name is Mudd is passé – your name is Trump the future.

                Reply
        2. Barry

          I’m also not following Bryan- The tweet misrepresents what Blinken said.

          How about not post tweets that are intentionally misrepresenting something he said?

          He said a significant deterioration could well happen – but he didn’t think it would happen quickly. He was clearly wrong about that because it did happen quickly. –

          He DID NOT say there is nothing to worry about- and he clearly didn’t tell any Americans to stay in Afghanistan.

          Do Americans living there need to take the word of the Sec of State about their own situation in Afghanistan when they live there and see what is happening around them?

          Biden on July 8th talking about SIVS

          “Since I was inaugurated on January 20th, we’ve already approved 2,500 Special Immigrant Visas to come to the United States. Up to now, FFEWER THAN HALF have exercised their right to do that. Half have gotten on aircraft and com — commercial flights and come, and the other half believe they WANT TO STAY — at least thus far.”

          Reply
      2. Barry

        Well, I guess they had to ignore Biden’s repeated statements before than that we were pulling out – But..

        This July 8th statement?

        “When I announced our drawdown in April, I said we would be out by September, and we’re on track to meet that target. Our military commanders advised me that once I made the decision to end the war, we needed to move swiftly to conduct the main elements of the drawdown.

        We’ve already dramatically accelerated the procedure time for Special Immigrant Visas to bring them to the United States.

        Since I was inaugurated on January 20th, we’ve already approved 2,500 Special Immigrant Visas to come to the United States. Up to now, fewer than half have exercised their right to do that. Half have gotten on aircraft and com — commercial flights and come, and the other half believe they want to stay — at least thus far.

        And, starting this month, we’re going to begin relocation flights for Afghanistan SIV applicants and their families who choose to leave. ”

        So again- what about those comments says “Let’s stay here in Afghanistan until the last possible second because I’m sure it will be very smooth given the history here?”

        Reply
        1. Barry

          I understand they want to help, but hundreds of thousands in a terrorist, war zone?

          After Biden repeatedly said we were pulling out?

          After trump said we were pulling out?

          I want to help too but I’m not uprooting my children and moving to Afghanistan when the president has been telling people for over a year he’s pulling everyone out.

          Reply
          1. Bob Amundson

            And of course that is your choice! As Bryan might say, “your mileage may vary.” A small part of me wants to go, but I’m too old, too tired of the fight. Others are capably filing in any gaps.

            Reply
            1. Barry

              That’s fine they want to help.

              I hope they realize when they do, they might not come back.

              As one of my old camping buddies use to say, “ you can go down that trail if you want, but you are on your own if you end up needing help.”

              Reply
              1. Bob Amundson

                Barry, respectfully I see comparing “this” to camping in any way a strong example of false equivalence. It is ok to want peace – but I sense a great deal of implicit bias against the military on this blog. I believe others are at times frustrated with strong opinions from those on this blog that don’t always seem to be aware of their biases. We all can be guilty of that mistake.

                I AM NOT POINTING FINGERS! Just sayin’.

                Reply
    1. Bob Amundson

      Thank you. I believe the military is shining in spite of the politics. That stated bias is unlikely to change.

      Reply
  9. Bob Amundson

    OMG. They were so young. Most were just babies when this war began; and two were our courageous women warriors! They died together and their memory will always live on.

    Reply
  10. Ken

    So the Grand Censor behind the virtual curtain is now squelching me AND a special ops officer I quoted?
    Rather ignominious.

    Reply
  11. Ken

    It’s now being reported that some, perhaps many, of the Afghans killed by gunfire may well have been killed by Americans firing into the crowd immediately after the suicide bombing. So much for training and discipline.
    This is what a “kick ass” mentality gets you.

    Reply
    1. Brad Warthen Post author

      I would strongly, strongly doubt such reports.

      But if something like that DID happen, this is the kind of insane situation in which it might be possible….

      Reply
      1. Ken

        “He was impregnably armoured by his good intentions and his ignorance.” – Graham Greene, The Quiet American.

        Meanwhile:
        “A U.S. drone strike targeting the Islamic State-Khorasan, the group’s offshoot in Afghanistan, killed 10 civilians in Kabul, including several small children, family members told The Washington Post on Monday. Those killed were all from a single extended family and were getting out of a car in their driveway when the strike hit a nearby vehicle.”

        Sorry, folks, just kickin’ a little ass here.

        Reply
        1. Bryan Caskey

          I don’t know if this is true or not. These claims are made after every US strike.

          Also, if you believe the Pentagon, the munition used should not have produced such a large explosion. The large explosion is claimed to have been a secondary explosion, caused by the ignition of explosives in a car that was being prepped for use as a vehicle-borne IED.

          If that’s the case, then it was a good strike. As for the civilian casualties: Well, it’s the same dilemma we always face. Terrorists deliberately place their bomb labs in civilian areas to dissuade us from hitting them.

          But we have to hit them.

          So, if everyone’s telling the truth, then this was a good strike.

          If everyone’s telling the truth. How much confidence should we have in that?

          Reply
          1. Bob Amundson

            IMHO, not much. That HURTS! 20 years and 1 trillion dollars. I am doing business in rural America, my home. Rural America is hurt – 1 trillion may have helped assuage some of that pain. In the meantime, I’ll do what I can, through servant leadership/enlightened self-interest/social entrepreneurship, to help begin the healing process. Learning leadership through the military is a HUGE part of who I am. STILL SERVING!

            Reply
          2. Barry

            I think it’s true.

            Saw the pictures of some of the kids today on Twitter including quotes from one of the family members. Had pictures of the car the kids were in. . Just awful, awful, awful.

            Btw – Trump said today he would reinvade Afghanistan. Conservatives online were in heaven. Nothing like a good invasion to get some conservatives all excited.

            Reply
            1. Bob Amundson

              Donnie is MY HERO. COME BACK DONNIE! F***ing idiot. “Your name is mud” I hope will soon be replaced with “Your name is Trump!” Mud become more popular after Dr. Samuel Mudd helped Booth.

              Reply
            1. Bob Amundson

              Your comment is awaiting moderation.

              Be glad the military was prepared to stop the coup. Please study the situation. I am …

              Say something nice please.

              Reply
              1. Ken

                The military was not prepared to do any such thing.

                And no, I’m not anti-military. I just don’t give them a blank check, like some (here) do.

                Reply
      1. Barry

        Have not seen the law.

        I guess I wasn’t up on the laws and lawmakers that give judges the ability to order drugs for patients against the treating hospital’s standard of care.

        The judge sided with a doctor that stated the CDC and FDA were engaged in a “conspiracy.”

        Reply
        1. Bryan Caskey

          I guess the legal issue to decide is: Who gets to be the final decision maker on a course of treatment, a patient and a doctor of his choosing, or the hospital’s doctor?

          Reply
          1. Barry

            The issue seems to be: is my chosen doctor, who doesn’t have privileges at the hospital, allowed to prescribe drugs that are contraindicated for my condition against the medical judgment of doctors at the hospital?

            Are judges now able to order that doctors that don’t have privileges should be given privileges?

            Are judges now going to order surgery and medical procedures, that are deemed not helpful and quite possibly not safe for my condition, if I want it?

            I understand each person is in charge of their own healthcare, in principle. However, now can we expect individuals to seek out judicial assistance if they disagree with their doctor abiding by CDC , FDA, or even accepted standards of care for broken bones, medical procedures, etc?

            Did or would the judge accept liability for any adverse outcomes for utilizing the medicine?

            Reply
            1. Bryan Caskey

              The judge didn’t order that anyone be given privileges. In fact, that doesn’t even seem to be an issue in dispute.

              Reply
              1. Barry

                The result of the order was that the doctor would have to have hospital privileges, even if temporary. So, yes he did.

                WBNS 10TV reached out to Ohio State’s Wexner Medical Center; the hospital says it has more people now asking them about using the medication.

                One doctor stated that she often has patients ask about certain medications but now worries that she will be required to give medication that another doctor recommends, that she doesn’t believe is needed or could be harmful.

                The Pharmacy Board of Ohio does not recommend use of the medication for COVID.

                Reply
            2. Bryan Caskey

              “Are judges now going to order surgery and medical procedures, that are deemed not helpful and quite possibly not safe for my condition, if I want it?”

              If one doctor says a treatment will not be helpful, but your doctor says it might be helpful, do you want the other doctor to prevent you and your chosen doctor from implementing a chosen course of treatment?

              Reply
              1. Barry

                But that’s not the situation in this case

                it’s not just the doctor. It’s also the hospital. it’s also the FDA

                it’s also the state pharmacy board of Ohio stating that such medication is not called for in this case

                This is not a situation where one doctor says one thing and one doctor says another.

                Reply
                1. Bryan Caskey

                  The hospital, FDA, state pharmacy board of Ohio, the local Church, the Ohio Butterfly Club, the local Biker Gang…none of them are the legal decision makers for the patient. It’s either the patient or his legal representative who makes the decision. Everyone else can offer advice. This isn’t a situation where we ask for a show of hands.

                  Reply
                  1. Barry

                    but doctors don’t typically prescribe whatever a patient asks for if they don’t believe it applies or works.

                    At least not any doctor I’ve seen.

                    If you go to the doctor for an ulcer, they don’t typically care if another doctor wanted to try metoprolol or flecainide. The doctors I’ve seen are going to prescribe what they feel like is the best thing for your ulcer.

                    But again, maybe that’s just me. Maybe there are a lot of people that go to the doctor expecting that the doctor better prescribe what they want, not what the doctor wants to do.

                    Reply
                    1. Bryan Caskey

                      but doctors don’t typically prescribe whatever a patient asks for if they don’t believe it applies or works.

                      Sure. In the Ohio case, the pulmonologist seems to truly believe it’s in the patient’s best interest.

                    2. Barry

                      You are spinning.

                      The pulmonologist isn’t treating him.

                      The guys’ wife went doctor shopping and found a doctor that believes Ivermectin cures COVID.

                      The doctors treating the patient at the hospital didn’t prescribe Ivermectin because they don’t believe it works.

                      The doctor shopping doc does.

                      So again….doctors don’t typically prescribe whatever a patient asks for if they don’t believe it applies or works. That’s why the doctors at the hospital actually treating the man didn’t prescribe it.

                      That’s the way it works. You go to the doctor for a stomach bug and ask for a heart medication. The doctors ignore you and give you medicine for the stomach bug. They don’t give you a drug because you want the drug.

                      Arthur Caplan, professor of bioethics at New York University’s Langone Medical Center, said, “it is absurd that this order was issued,” . “If I were these doctors, I simply wouldn’t do it.”

                    3. Bryan Caskey

                      No spin here. It’s just how the law works. You think this is the first person in the world to shop for a doctor?

                      In your view, people lose the ability to make their own medical decisions. That can’t be how it is, regardless of how much you disagree with their personal choice.

                      People check themselves out of the hospital AMA all the time. Would you prohibit that?

                    4. Bob Amundson

                      My reference is the difference between my ability to legally intervene with children versus adults; adults clearly have a choice to make bad decisions.

                    5. Barry

                      If he or his family want to check him out of the hospital, they can as long as they properly sign away their rights to hold the hospital accountable.

                      Or better yet, they could ask the judge to allow them, at their own expense, take their loved one out of the hospital and transfer him to a hospital where their doctor shopping doc has privileges.

                      Patients should not have the right to force a doctor, against their will, to treat them with a clearly unproven treatment.

                      “I still can’t get over this judge practicing medicine. So now, if a patient “does their research” and decides that their abdominal pain is d/t appendicitis instead of gall stones, is the judge going to force the surgeon to perform an appendectomy? Implications are huge.

                      the patient’s wife got an order from a physician outside the hospital. Hospitals are usually closed units—only attending physicians with privileges can write orders. And I have no idea of the legal implications for the nurse. The whole thing is whack.”

                      – Dr Emily Portman

                      Our hospital only accepts orders from attending, on-staff physicians. Using the judge’s logic, I could have my 2nd cousin’s podiatrist in Philly call the hospital in Chicago and order Vicodin for me.

                    6. Mark Stewart

                      Bryan, I think the potential implications are more serious than you imagine. In your world the judge is the final arbiter. However, here there are other issues at play, particularly medical ethics. It is much like our constitutional republic, there is a balance here. Otherwise, the hospital would be free to wheel the patient to the curb and close the door after the judge’s ruling. But they can’t. So we have an issue with potential serious future ramifications. For that reason, this judge is likely to be overturned on appeal, as he should be. Rights and responsibilities ought to always be held in balance.

            3. Bryan Caskey

              “Did or would the judge accept liability for any adverse outcomes for utilizing the medicine?”

              The Court is merely saying that the hospital can’t block a patient from a course of treatment that an outside doctor has prescribed. The Court isn’t taking a position as either opinion on the course of treatment. The Court is simply allowing someone to make a decision. I’m puzzled as to why you’re so upset about this. This isn’t really a controversial decision from a legal point of view. It may well be controversial from a medical standpoint, but that’s an entirely different question.

              Reply
              1. Barry

                Don’t be puzzled. That’s not good.

                I’m not upset. LOL

                this is just a very odd case that is interesting to me and that I see as quite strange

                “ The Court is merely saying that the hospital can’t block a patient from a course of treatment that an outside doctor has prescribed.”

                So your buddy has chest pains and has to be admitted to the hospital.

                A test reveals blockages in one of his arteries. at a minimum the hospital wants to prescribe heart medication and possibly do a heart Catheterization in their cardiac lab to determine if stents or a bypass is needed

                but your buddy has a caring family member who knows an unconventional doctor that will probably prescribe the previously touted miracle drug hydroxychloroquine.

                the family member gets the prescription and wants the heart specialist to administer the miracle medication. The hospital refuses because the standard of care from a medical standpoint in no way calls for the use of such medication.

                Thankfully, a family friend is an attorney and files a lawsuit to get a judge to order the hospital to treat the patient with the miracle drug. The judges reasoning? “Well, heck, it can’t hurt.” Sadly, the patient does not miraculously rebound.

                Now a lawsuit is prepared and filed against the hospital for violating its standard of care for heart patients. The hospital states it had no choice since a judge ordered them to follow the whims of an unconventional doctor. Suing the judge is off limits, heck, he was just saying follow the doctor’s advice and nothing daisy “freedom” like forcing the doctors at a hospital to administer medication and treatment that they believe won’t hurt, and could be harmful. After all, the judge says to himself, “no one knows any quack doctors.”

                Reply
                1. Bryan Caskey

                  That’s not at all the situation in this case. In your fact pattern, my buddy gets to decide what course of treatment he wants to follow – unless my buddy is incapable of making his own decisions and has a legal guardian or designated HCPOA.

                  That’s where you’re misunderstanding the situation. The Court isn’t saying “Well, heck, it can’t hurt.” The Court isn’t expressing an opinion one way or the other. The Court is simply allowing the person with the legal right to make the decision do so. The Judge wasn’t saying “follow the doctor’s advice”. The Court is saying, you’re the person legally authorized to make this specific decision. The Court is simply enforcing the existing rights of the decision-maker, not opining as to the decision.

                  Reply
                  1. Barry

                    The buddy doesn’t know. Heck, he’s on tons of medication to ease his chest pains. He’s barely able to give consent. He just trusts his family member who knows the unconventional doctor.

                    More importantly, the doctor trusts hydroxycholoriquine and that sounds right to your buddy because he’s heard about it a lot on Fox News and talk radio – well – I guess it’s more accurate to say that he USE to hear about it a lot until they started touting the latest miracle cure called ivermectin.

                    Heck, next month they might find a doctor somewhere that prescribes apple cider vinegar enemas and Flintstone vitamins for carpal tunnel syndrome.

                    The doctors at the hospital know that the medical standard of care calls for a heart cath. The doctors even call The Cleveland Clinic to verify their recommendations for care are indeed the required standard. They get the “ok” from the experts there who thought they were being pranked when the hospital cardiac specialist asked, “would hydroxychloroquine would be a viable alternative treatment for atherosclerosis?”

                    “What did you ask me? Are you being serious?” – came the reply.

                    But a heart cath is invasive and requires running small catheters in through the groin all the way up to the heart. There is no stinking way in the world he’s going to allow an experimental and medieval procedure like that.

                    thankfully he doesn’t need that because he has a friend that knows a doctor who trusts hydroxychloroquine.

                    But the hospital’s heart doctor isn’t going to follow the orders of a doctor he’s never heard of, especially when’s he’s prescribing something that he believes won’t help and would likely be harmful. After all, that’s common sense – or so he thinks.

                    But the judge, citing a recent Ohio case, orders the hospital to administer whatever drugs and treatments your buddy can get a doctor to prescribe.

                    After all, the duty of the doctor and hospital you visit is that they prescribe whatever treatments and medications someone somewhere else can come up with at the time.

                    Reply
                    1. Bryan Caskey

                      None of this is correct. First, either my buddy can consent to his own medical care or he can’t. If there’s a questions as to his capacity (or lack thereof) then either a HCPOA or a court-appointed Guardian makes the decision. None of your fact pattern is even remotely close to reality.

                    2. Barry

                      Sure it is. You just disagree with the implications.

                      Your opinion clearly is that if you were in the hospital you should be able to choose any doctor anywhere, even one that isn’t treating you and hasn’t examined you and force the doctors treating you at the hospital to follow the outside doctor’s course of treatment.

                      That’s ridiculous

                  2. Barry

                    the judge is saying that the doctors at the hospital have to offer the patient whatever an outside doctor wants to offer.

                    Again, who has the liability in such a case or even in similar cases if things go bad? Obviously, in this case things are awful regardless. But what about a situation where a drug is prescribed and the patient dies or is harmed because the proper medication wasn’t given?

                    Are hospitals required to offer patients whatever medication and treatment they can get an outside doctor to recommend?

                    If so, are they shielded from lawsuits?

                    Reply
                    1. Bryan Caskey

                      In the Ohio case, the family members offered to sign a document formally waiving liability to the hospital.

                    2. Barry

                      But signed documents don’t always mean a shield from liability.

                      We all know that- especially when in court it would be shown that

                      1) The hospital violated it’s own standard of care.

                      2) The FDA has specifically written that Ivermectin isn’t to be used to treat a patient with COVID.

                      3) that the Ohio Pharmacy board has specifically stated it’s not recommended.

                      Sounds like the basis of a good lawsuit.

                    3. Barry

                      Baloney.

                      Sure it does.

                      My sister, a nurse supervisor, was hauled into court, after being deposed, because one of the doctors she worked for was accused of violating the standard of care regarding an elderly patient.

                    4. Bryan Caskey

                      No, it doesn’t. Was your sister’s case one where the plaintiff signed a liability waiver for a specific issue as offered in this case? No, it wasn’t.

                      I’m not going to keep going back and forth with you on this, because we’ve played out this little conversation.

                    5. Barry

                      Liability waivers are not the end all be all. As we all know.

                      “You should never assume that you’re barred from pursuing compensation when an injury occurs. Whether you signed a liability waiver, participated in an activity with inherent risk, or even have been injured participating in an event with specific legal protections, you may still have options.”

                      Frank Gallucci, principal of Plevin & Gallucci Company, L.P.A., Cleveland, Ohio

                    6. Barry

                      “ Was your sister’s case one where the plaintiff signed a liability waiver for a specific issue as offered in this case? No, it wasn’t.”

                      As we all know, before nearly any surgical procedure, the medical staff will ask the patient or their rep to sign a waiver of liability.

                      My 18 year old signed his first waiver form when he had his heart procedure last month.

                      He didn’t want to when I told him what it was- but I told him he had no choice.

                      Yes, a waiver was signed in my sister’s case where she had to be deposed. ( I texted her to ask and she said that it was standard procedure) It was one of the issues in the case (but not an issue she was asked about).

          2. Barry

            The judge is a former local Republican Party chair.

            Already seeing a lot of posts online saying Ivermectin should be the standard of care – using the GOP judge as the rationale.

            Ok. Let’s give it a try.

            Reply
  12. bud

    I guess if you can find a doctor who believes in using leeches that ok too. This is a good case for jury nullification. Asking a hospital to violate the Hippocratic oath is unconscionable. I’d never rule in favor of a plaintive bringing a suit against a hospital for refusing to administer horse dewormer for a COVID patient.

    Reply
    1. Brad Warthen Post author

      Are you suggesting there’s a problem with using leeches? Next you’ll condemn any form of bleeding patients to rectify the gross humours…

      But seriously, folks…

      Once, for a brief moment, I thought maybe there was something salubrious and roborative about bleeding. The first time I ever donated a pint of blood at the Red Cross, I felt awesome afterwards.

      Of course, I think what I was feeling was relief, because I had just done something that had terrified me my whole life up to then.

      That particular effect never repeated itself, so I think modern science would probably dismiss it, since those folks are so empirical and all…

      Reply
  13. Bob Amundson

    Be glad the military was prepared to stop the coup. Please study the situation. I am …

    Say something nice please.

    Reply
  14. Bob Amundson

    Yeah, it’s all the military. Our Generals are all idiots and want outcomes like this. Yah think MAYBE the political withdrawal complicated the military withdrawal?

    I hate war – it is too bad some people do not understand we serve and protect.

    Reply

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