Essays (Started 4 January 1980)
Table of Contents

No. Page
1 Balesisms
2 Refuge
3 Big Nanny (16 August 98)
4 Bureaucracy
5 Campaign Finance Reform
6 Military Bases
7 Palestine Liberation Organization
8 Social Security
9 The Disincentive Society
10 The Surplus
11 The Tyranny of the Telephone
12 The Clintons
13 Pet Peeves-Language Pet Peeves-Behavior
14 Capital Punishment
15 Bad Behavior Prevention
16 Abortion
17 Homosexuality
18 Women
19 Busing
20 Prayer
21 World Trade Organization
22. Drug Prescription
23 Tax Cut
24 The Election of 2000
25 Dr. Bales’ Medical Aphorisms
26 Parlor Partisans of the Poor
27 Stem Cells
28 The Attack on the World Trade Center
29 Afghanistan
30 Profiling
31 Predicting the Future
32 International Monetary Fund
33 Democratic Socialism
34 Obesity
35 Immunizations
36 Tobacco
37 Exercise
38 Diet
39 Art and Science in Medicine
40 Hypertension
41 Physical Examination
42 A Woman
43 Benjamin Franklin’s Theology
44 Dr. Bales Dumb Advice Essay
45 Lurching Toward Lawlessness
46 A Calm and Courageous Realist
47 I Like
48 Sex, Drugs, and Rock and Roll
49 Illegal Immigration
50 United Nations
51 Concerns about the U.S.
52 Citizens Police Academy
53 Attitude of Mind
54 Fatherlessness
55 Islam
56 Love
57 Luck
58 Heaven
59 Tail Gating
60 1940 Speech
61 Marijuana
62 Scots
63 Global Poverty
64 Here’s to your Health
65 Palestine
66. The New Entitlements
67 Tai Chi and Yoga
68 Healthy Aging
69 Addiction
70 Deficiency State
71 Self Reliance
72 Election of 2006
73 State of the U.S.
74 World War IV
75 Golden Boy
76 Nature Trumps All
77 Global Warming
78 Mensch

1. Some of my favorite sayings or thoughts: Balesisms Donald W. Bales

"Look before you leap."
"A stitch in time saves nine."
"An ounce of prevention is worth a pound of cure."
Form and technique are important.
"My word is my bond."
Lying used to be inefficient and wrong, but these days it seems that telling the truth is penalized and that lying is rewarded. The same seems to go for cheating.
The Ten Commandments-the last six apply in all religions, and should apply to atheists as well.
The Twenty-third Psalm
The Sermon on the Mount
The Lord's Prayer
The Golden Rule
One should be prudent, but not fearful. DWB
"Willful waste means woeful want." I don't know whether this was original with my maternal grandmother, Kate Tilden Davis, but that's where I heard it.
"A penny saved is a penny earned."
Mr. Micawber's advice (David Copperfield). Income has to be little larger than outgo
Cheaper is better if equal. DWB
"Penny wise and pound foolish."
"Not deciding is a decision." DWB?
"Procrastination is the thief of time."
Drive defensively. DWB, but many others
"Cast not your pearls before swine."
Suffer fools, but not gladly.
I am adding another saying to my list. (16 December 2001):
(Rosemary Sexton swims at the DB pool sometimes. Recently we were there waiting for the life guard to arrive. The lane dividers had been taken out of the pool, and the school people don't want us seniors in the water without a lifeguard present. Rosemary said, as she got in to put the markers in place:)
"It is easier to ask for forgiveness than it is to get permission."
(I have heard that this is a common saying, but I had never heard it before. I like it!)
All ideas are not equal-some are right and some are wrong. DWB?
Equality and Liberty are not compatible. DWB
All persons are not really equal. DWB
They are equal in the eyes of God. They should be equal before the law, but are not. Some are faster, some are smarter, some are stronger, some have better genes, and some have better environments.
I flunk one implied Christianity test:
I find it much easier to love the lovable than the unlovable although the unlovable need love more than the lovable.
Each person, regardless of his or her heredity or environment, is ultimately responsible for his or her actions. If a mentally ill person commits a heinous crime that person should be segregated to protect the rest of the population. I perceive an unwillingness in our society to punish or segregate criminals, and thereby our society seems sometimes to forget the victims.
Humans are malleable, but not infinitely malleable. When pushed beyond their limits of adaptation, humans will fail. We carry the burden or assets of our human nature and our past ancestry, and we ignore these facts at our peril. DWB
Go back to the Big Bang. What was there before that? Can something be that was not created? DWB
Can there be an effect without a cause?
I especially like the prayer that A.A. organization uses. They got it from some earlier source. Some say Rheinhold Niebuhr originated it. Others say it is older than that. It goes like this:
"Oh Lord, give me the strength to change what I can change
Give me the patience to accept what I cannot change
And give me the wisdom to know the difference."
When someone asks me, "Why did this happen to me?" I would say, "Think of a column of ants crossing the highway. Imagine a truck coming along. Some of the ants would be run over and other ants would be missed by the tires of the truck. Do you think the ants that got run over were any less worthy or more wicked than those that were missed? The killed ants just happened to be in the wrong place at the wrong time."
2. Refuge
Where can one go for refuge or haven? We all face adversity at some time. Some of us have more of it than others. Sometimes we provoke it, but other times it comes without our participating in the circumstances that cause it.
Our minister was speaking of the seven years of confinement and torture of Terry Anderson. He was taken by some terrorists in Beirut. He wrote and/or said that prayer helped him get through. This made me think about what mechanism I would use if I were in such a situation. This led me to write this essay.
There is no security except internal security. Possessions can deteriorate or be stolen or taxed away. Laws can help, but do not always protect. For example, in Germany during the Holocaust, nothing was done that was against German law. Societal norms or customs can help with protection, but again these do not always work. For example, mobs can do things against person or property and nothing be done about it. Sometimes the norms are not protective of the individual or his property.
Irrational or criminal persons can do whatever they are inclined to do. They may be prosecuted, but that will not restore the property, health, or life of the victim.
What I am getting at is the fact that, in my view, the only security or serenity comes from within. In case of some dreadful situation, one can always go within; that is, into the mind and try to create a way of tolerating; or, at least, accepting the terrible present with the idea that it will end. Of course, only death may make it end, but there will be an end. Of course, another solution besides death would be desirable.
I think of the U.S. servicemen captured by the Vietnamese and held for months or years. I also think of the hostages held in Iran, and those in the Korean War. Those persons in those bad circumstances who did the best had certain characteristics. Those with supportive family relations and those with a strong religious faith seemed to fare better. They resisted brain washing better, and had a higher percentage chance of surviving than those with a different background or attitude.
In case of otherwise discouraging or unmanageable circumstances one can always go within.Donald W. Bales

3. Big Nanny
Years ago George Orwell wrote a predictive book, "1984" featuring "Big Brother". Now we have the Federal Government attempting to regulate or run everything. I have debated with myself as to what name we should give to our present situation with regard to Washington. I thought of calling it "Big Mama", but "Mama" should not be used as a pejorative term. For the most part, Mamas are loving, supportive, and kind, although I have heard of and known some very malignant mothers. "Big Aunt" implies blood, or, at least, in-law kinship. So "Big Aunt" wouldn't do. "Big Sister" has the same drawback. I decided on "Big Nanny". Now I have no animosity to nannies-I think most of them are kind and helpful, but I wanted to call Big Government something slightly pejorative, or, at least, neutral. I surely did not want to call it something nice.
You may wonder why all the terms are female. I think the radical feminists are calling the tune in the country. I think only a small number of women are radical feminists, but the radicals are very vocal, and very strident, and exert much more influence than their numbers deserve. The anathema of liberals, Rush Limbaugh, says that there only a few, maybe ten or twelve, of what he calls "FemiNazis". The feminine activists, and I don't here refer to the FemiNazis, have access to the media while the majority of women do not. Hillary with her "It takes a Village" to raise a child is the leading advocate of "Big Nanny." Of course, the village she refers to is the Federal Government. I don't think the record of the Federal Government is very good in regard to efficiency or economy in any sphere of activity.
To me the three main functions of the federal government are protection of the citizens against foreign enemies, protection of the citizen from other citizens, and maintenance of a stable currency. At present we do have a reasonably stable currency, but we probably are at potential risk from the Chinese missiles through the actions or lack of actions by the Clinton administration. Drugs and illegal immigrants get in, as well as agents of foreign governments. Crime is rampant, although that is more properly under state and local government. Crime is down, but not due to Federal actions.
Our armed services have been degraded. Now don't get me wrong. I admire women, and even love some of them. I do not for one second downgrade their mental or physical abilities. I wonder, though, what will happen when our infantry with women in it meet an enemy infantry with no women. Women are superior to men in many ways. The female survives better from conception to ninety than the male human. Women tolerate tedious and nasty things better than men. Women are less likely to die of accidents or violence. Most women are not as strong physically as most men. I know that some women are stronger and faster than some men, but, in general, men are stronger and faster than women. The standards for physical activity in the armed services have been lowered to accommodate women. Men have higher testosterone levels in their bodies than women do. Testosterone is strongly related to aggression. This can be a disadvantage in some circumstances, but in war it would seem that aggressive tendencies would be desirable.
The idea seems to be widespread in some circles that the ordinary person is unable or unwilling to look after his or her own best interests. Certain elites seem to think that they know better what is good for people than the mass of the people themselves. For example, take cigarette smoking. Seventy-five or one hundred years ago cigarettes were called "coffin nails". Common people knew by common sense that smoking was not good for them. Of course, common sense is not politically correct. I am about as anti-tobacco as one could be, but I think any sensible person should know not to smoke. We tried prohibition of alcohol, which didn't stop the drinking of alcohol, but did promote the development of gangsterism. The present theme is to stop the children from smoking, but I think the main purpose of suing the tobacco companies and raising the taxes on tobacco is to impose increased taxes on the poor to get more money to spend on social programs. Since the lower economic group are more likely to smoke, the increased cost will fall on them. The people most in favor of the increased tax are also the ones who are most in favor of progressive tax rates and most opposed to retrogressive taxes. This seems contradictory. There is some justice in taxing those people more who incur more health care costs. However, some people have pointed out that most smokers will not live long enough to collect retirement benefits. Some wags have even suggested that smokers should be rewarded for taking a burden off the Social Security System. I don't think that the suits against the tobacco companies were justified. Even though the companies knew that tobacco was harmful, and even if they suppressed some facts regarding their knowledge of harmful substances in the tobacco, the users were not absolved of using their own judgement. The surgeon general had noted that tobacco was harmful in 1964. Some have argued that the companies lied about their products, but President Clinton’s lies under oath are considered okay by the same people who are so vehemently condemnatory to the tobacco companies for their lies. The billions the lawyers got makes an ironic result-"Never have so many been made rich at the expense of the poor". There will be a huge transfer from the poor (through taxes on cigarettes) to make lawyers rich.
The same idea applies to lotteries and other legalized gambling. Those who can afford it least are those most likely to gamble. In a way it is a mechanism to collect more tax from the poorest segment of society. I doubt that the total increased tax revenue and increased jobs will be greater than the total loss to the gambling establishment. There is likely a societal loss as well. Making something legal gives some support by government. Some might be deterred from gambling, if it is illegal.
When I saw the book title, "The Death of Common Sense" I was inclined to avoid reading it since I thought it would just make me angry. I was already angry anyway. It didn't make me any angrier-it just gave me more evidence to justify my anger.
Donald W. Bales

4. Bureaucracy
My definition of a bureaucracy is as follows: Any group with as many as three members is likely to be bureaucratic. The chief characteristics of a bureaucracy are as follows: It has no brain and no soul, but it does have rules. That is not to say that the bureaucrats don't have brains or souls,, but that they are not allowed to use either.
All societies seem to have or to have had bureaucracies. I'm sure ancient Egypt and ancient China had them. I'm sure the Aztecs, Mayans, and Incas had them. It seems it is a necessary evil. The problem is to preserve common sense action without excessive power and with accountability.
Some writers have suggested that the civil service bureaucracy in France was useful in allowing the country to continue to function in spite of multiple changes in government, so bureaucracies have some good points. A new administration could be hampered in carrying out its mandate if the civil servants wanted to drag their feet if they did not agree with the changes desired by the elected representatives of the people. The U.S. bureaucracy resembles a huge ocean ship. When the ship gets going in a certain direction, it takes a lot of time and energy to stop it or change its direction.
Donald W. Bales (Added to web page 20 September, 2003

5. Campaign Finance Reform
If less money went to Washington, and if the tax code was simpler and fairer, there would be much less incentive for people to try to lobby the Congress or the Administration. With less lobbying there would be less special interest legislation and probably less regulation. I will admit that some regulation is needed to try to prevent exploitation and corruption. Little attention is paid to present campaign finance laws, and nothing happens to anyone who violates the campaign finance laws, so that making a bunch of new laws seems useless, since the same thing is likely to happen with the new law that happened with the old. I would favor, however, that all campaign contributions be reported immediately as to the source, the recipient, and the amount. At least, the public would have a chance to know who got what from whom.


6. Military bases
Downsizing the number of people in the military would suggest that fewer bases would be needed. However, closing a base has been difficult due to the intervention of the representative or senator from the district or state involved. The money saved should have been used to upgrade the pay and living conditions of the members of the Armed Services and to upgrading or maintaining the level of training and supplies.
It seems odd that a President, who despises the Armed Services and who evaded military service has given the Armed Services more foreign assignments than usual, wants to cut the military budget. I note that in late December 1998 he has come out for increased military spending, which I agree with, but I think he did it to steal the Republicans' thunder about national defense. He has done such things before-balanced budget, welfare reform, and smaller government. We heard nothing of that during the two years he had a Democratic majority in the House and Senate-it was only after the 1994 elections that he got religion on those subjects. He wanted to save any surplus (there is no surplus-the Social Security non-Trust fund obscures the continuing deficit) for Social Security, but promoted increased spending in the last budget.
We still have brute regimes and enemies. North Korea, Syria, Libya, Iran, Iraq, and the radical Muslims in other countries. China is a potential enemy, and potentially the most dangerous, especially in the future. We cannot rely on the goodwill of the Russians toward us. Even the Israelis, who should be the most grateful, had spying carried out against us.
Added to web page on 6 October 2003, but written earlier.

7. Palestine Liberation Organization
This group only recently renounced its intention to put an end to Israel. The Clinton administration pressures Israel to give up territory without the PLO keeping its part of the bargain. It is only nine miles from the West Bank to the sea, and it would be foolhardy for Netanyahu to give up territory without some assurance that there would not be hostile artillery nine miles or less from Tel Aviv. The PLO should show by its deeds that it can prevent terrorists from attacking Israel or its citizens. If the Arabs or the PLO lose a war, they can continue to exist, but if the Israelis lose a war, they are finished.
It is a shame that they cannot live in peace. The Israelis have more educated people than they can utilize while the Arabs don't have enough. The Israelis were able to make the desert bloom, while the Arabs have not been at all successful with their deserts. Maybe the PLO and the Israelis will get tired of fighting, as I think the people in Ulster did. I think that had more to do with the fragile peace there than did Gerry Adams, Tony Blair, or George Mitchell. I believe the time was ripe for peace, as it had not been before.
Donald W. Bales

8. Social Security
I suppose I can't claim to be as conservative as my ancestry would suggest I should be. I think Social Security was and is a good thing. I'm afraid that I share the opinion of the elites that a high percentage of the people tend to be improvident. So I think enforced saving is not inappropriate. It is too bad that the legislators and the executive branch have seen fit to keep raising the benefits so that the program has become excessively expensive. The Social Security tax is regressive and a real burden on middle-class working people. It is no wonder that young people find it difficult to impossible to save enough to make a down payment on a home. The state and local taxes add to the tax burden. The cost of living raises built into the system should be realistic and reflect true costs. I believe privatizing one-fifth of the social security tax would be proper, but some safeguard should be put in place to assure prudence. I would oppose having a government agency choose the investments-the U.S. government has too much sway over the economy as it is. The stock doesn't always go up-it goes down as well.

9. The Disincentive Society
Dividends are taxed twice and maybe four times. The stocks are bought with taxed money, the corporation is taxed, the owners of the stocks have taxes on the dividend. There is probably another-hidden-tax. The interest on savings has a tax on the money used to put into the savings account, and the decrease in purchasing power by inflation of the saved money could be a hidden type of tax. So we have a disincentive to save or to invest. No wonder our savings percentage is so low.
The marriage penalty tax is another disincentive. Getting married costs people more in taxes. I believe that marriage is a societal device which promotes better care of children. I think many of our social ills are due to having no father in many homes. Many studies have suggested that children from one-parent homes are more likely to be in poverty, drop out of school, be truants, get on drugs or alcohol, get into trouble with the law, more likely to get venereal diseases and more likely to get pregnant than those from two-parent families. I think fathers have an important role to play in the family, and should be involved in raising the children. As my beloved daughter told me one day, "Daddy, you've always been active in family politics." Both boys and girls need a model of what a proper husband (and father) should be so that they will have a better idea of how to be one or choose one.
The welfare system made the mother-only family easier. Under the rules it was harder to get welfare if there was a husband or father in the house. It made it easy for the teen-age girl who had an out-of-wedlock baby to get welfare on her own. I have been told by nurses who work with pregnant teen-age girls that many of the girls get pregnant on purpose to get out of an unpleasant family situation, and others want to have something to love and something that will love them. I doubt that these girls have any idea of what looking after a child is all about. Another example of how a program designed to be compassionate wound up facilitating a very serious problem.
10. The Surplus
There is no surplus. Take away the Social Security funds and we still have a deficit. With the social security system the government has an obligation to retirees which will come due when the baby-boomers start to retire. It would seem that cutting spending, paying down the deficit and cutting taxes would be the way to go. Taxes act as a brake on the economy. Every dollar the government takes in taxes is a dollar taken out of the economy. That dollar could be used for investment. Of course, some government dollars can be considered investment, if they are used to build roads, airports, seaports, or other infrastructure that promotes wealth building activity, but much government money is wasted on unneeded projects and programs that do not work.
I perceive that the president and the legislators have a built-in bias toward more government spending. Every special interest group wants a piece of the government (tax payers’) pie. Those who favor fiscal restraint have no lobbyists and no real voice. Also almost every citizen wants something from the government. Those who are getting something from the government do not want to give it up. Even I don't want to give up my benefits. For example, each year I get a nice so-called dividend check from my National Service Life Insurance policy. I converted this policy from term to twenty-pay life in 1944. I paid the last premium on this policy in 1964. I have not sent any of these checks back. Julie and I also receive checks from Social Security each month. I use the National Parks and the Interstate Highways. I had thirty-three of my thirty-nine months of medical school paid for by the Army. Of course, I had twenty-two months of obligated service on active duty as a medical officer as a result of Army support. I think everyone feels that if others are getting government benefits, they should get theirs also.

11. The Tyranny of the Telephone
I have often been talking to someone-a clerk in a store, or a nurse at the hospital or someone else, and, in the midst of the conversation, the phone will ring, and the person will answer the phone instead of proceeding with whatever we were doing. It seemed that no matter who was calling, the call was more important than I was. I have been tempted to go get on a phone and call so I could get the attention the caller got. That would be one use of a cell phone (I don't have one at the time I am writing this.)
Calls at mealtime or in the evening is another phone "tyranny". "Begging" calls are even more annoying at those times. (I also get a lot of "begging calls" at any time). The begging is for contributions. The projects are often worthy, but there are so many of them! Recently I have been telling callers that I do not commit myself to a donation on the phone.

12. The Clintons
Bill Clinton is a tall well-formed good-looking man (of course, he was a little on the plump side, but that's the least of my problems with him). He has an excellent memory, except when being questioned about Monica Lewinsky. Then his memory seems more like Ronald Reagan's! Clinton is a fluent speaker, even though much of what he says is a lie. He has had a good chance to be well educated, and seems very intelligent. He must be very attractive to women, and, probably was, even before he had the power and prestige of high office. Women seem to be attracted to men with power or money. I think he could easily pass a lie detector test-I think he really believes that what he is saying is the truth at the time he says it, even if he says the opposite the next day. He surely put on a convincing performance when he said, "I did not have sexual relations with that woman, Miss Lewinsky." He takes, and gets in some quarters, credit for the good economy, but I don't think his policies have been the cause of the good economy. He takes credit for the balanced budget, but no effort was made on that front until the Republicans won the House and the Senate in 1994. He only admitted to the Lewinsky affair, when his DNA was found in the stain on the famous blue dress.
He has a long history of sexual infidelity. All of the known women have been systematically trashed as nuts, sluts, or liars, but one would have to believe all of them are lying and that the president is telling the truth, when he is a known, proven, and longtime liar. Even some of the Democrats think he is a liar, and that he had sexual relations with Monica Lewinsky even when he was denying it. Of course, we may use lawyer-talk to say that oral sex-fellatio-is not a sexual relationship. That is, he seems to maintain that Monica had sex with him, but he did not have sex with her!
Since he has never had any military service-by evading the draft-he has less understanding of military matters than those who served their country in the military. I hope that the contributions by the Chinese to his campaign did not influence his policies toward the Chinese, but I think they did. I hope that the transfer of control from the State Department to the Commerce Department was not also motivated by the contributions, but I suspect it was. I hope that the technology did not put this country at risk from Chinese missiles, but I think it did. It could have been just ignorance or incompetence, but neither quality recommends a person to be commander-in-chief. To me these are more serious than lying about sex on the job with a subordinate woman.
Hillary is attractive, and even pretty at times. She has attended elite educational institutions. I have some reservations about education in our elite leftist institutions. She is intelligent and fluent, and has great influence with many women. She has a Methodist background, so should know better. Unfortunately, most of her ideas are wrong. The health care plan is a good example of what she would like to do. However, I suspect that she might be the type of woman who might make a man want to look elsewhere. The idea that she had no knowledge of Bill's relation to Monica made her look rather foolish, and whatever she is, she is not that foolish. I think that she made a bargain to put up with the many acts of infidelity to share in the power and prestige of being Bill Clinton's wife. Sometimes they put on a good show of solidarity.
Friends of mine, knowing my political views, delight in telling me Clinton jokes. This is one of my favorites:
Question: "Have you heard about the Hillary Special at Kentucky Fried Chicken?"
Answer: "No. What is it?"
"Two big thighs, two small breasts, and one left wing."
The Clinton spin machine is a marvel. He must be coated with Teflon covered with silicon and oil. It is easy to see how he got the name, "Slick Willy". He really is slick. He has evoked strong feelings-both pro and con. However, he has about a third of the population who can't stand him. I think some people even hate him. He has a lot of people who like him, and seventy percent, according to the polls, approve of his performance as president. This is more a demerit for the electorate than of Bill Clinton.
Bill Clinton is a product of a dysfunctional family, which may account for some of his behavior, and even for some of his success as a politician. Some have thought that the lack of love in his childhood makes him want to please everyone. This may lead him to try to do so by saying whatever he thinks his current listener wants to hear. He may be the best "politician" of all time. By that I refer to the word “politician” in a pejorative way. He is a baby-boomer and a sixty’s person, and may reflect the values and behavior of the worst of that group. God help us! It doesn't look like the electorate will!
I think the country is doing well in several ways-inflation and unemployment are low, productivity is up, the deficit is smaller, interest rates are low, and we have relative peace in much of the world. When lying under oath is not only not condemned, but actually defended, I think we are in a bad situation. We lead the developed world in teenage pregnancy, in crime (especially murder), in percentage of our population in prison, suicide (especially in young people), and drug use. We are way down in educational achievement. We spend the most per pupil on education, and get the least bang for the buck.

13. Pet Peeves-Language
"Blood-thinner"-this term is used to refer to clot preventers. Patients would come in and say they were weak or cold-natured, and would attribute this to the fact that their blood was "thin." To me thin means less viscous; for example, if you add water to syrup, it becomes thinner, and, if you boil off some water, it becomes thicker. When a patient takes coumadin or heparin to prevent clots, the density of his or her blood is not all changed from when he or she was not taking the medications, nor is the viscosity of the blood altered. I know that most doctors use the term, but just because a lot of people say or do something doesn't make it correct. Early in his tenure ninety-five percent of the Germans thought Hitler was right, but they were all wrong.
"At this point in time" = now
"First of all" = first (bad)
“Second of all = second (even worse)"
‘Third of all = third (still worse)
"And so on and so forth" = nothing (Allen Keys says this often)
"If you like, and, if you will" = nothing
"You know" You don't know, usually, or there would be no need for the speaker to tell you.
Pet Peeves-Behavior
Litterers-I often find trash within five feet of a trash can.
Cigarette butts stamped on-on the pavement, or, even worse, on the floor.
Tail-gaters-they won't get there any sooner on a winding or hilly two-lane road, or if the left lane ahead has cars in it. They would still be behind a car. If the person in front stops suddenly, they will crash into the rear of the car. And the accident will be the fault of the person following too close.
Drivers who leave their turn signal on when they don't intend to turn.
Drivers who drive below the speed limit in the left (fast) lane.
People who walk up to join a pair or a group, and interrupt whoever is speaking, without waiting for a break in the conversation.
People who wear their billed caps backward. Of course, it does keep the sun off the backs of their necks to some degree, but the bill was intended to keep the sun out of their eyes and the rain off their faces.
Men who wear their head-coverings indoors. I make an exception for cowboys with ten-gallon hats.
People who try to break into a line.
"Victims"-people who want to be victims in order to get some special benefit.
"Rights"-people who want some right. Especially when they accept no obligation or responsibility
People who interrupt me in the midst of a joke or a story. Perhaps I should be interrupted. Perhaps the joke or story is not worth hearing. But it is rude.
Litigious people. I think everyone is entitled to his or her day in court, but not for trivial matters, and not when the defendant was not the cause of the result.

14. Capital Punishment
I became a physician in 1946, so I have spent two-thirds of my life trying to prevent suffering and premature death. I, naturally, have a bias in favor of life and against death. In regard to capital punishment, I am against it, since it leads society through its legal justice system into killing people. However, what do you do with a lifer who kills another prisoner, or, even worse, a guard? What do you do with a person who kills several people or rapes several women or men? Is there ruined merchandise? Are there persons who cannot be rehabilitated? Are there people who cannot be trusted to be out in society?
Some cite the "Ten Commandments" especially the one "Thou shalt not kill". However, the correct translation is “Thou shalt not murder (kill unlawfully).” The politically correct do not follow Christianity or Judaism, saying that church and state must be separate. Many of the unchurched do not believe in religion anyway, but will cite it when it furthers their agenda, and ignore it when it does not. The ancient Jews, at least, according to the Scriptures surely killed a lot of people sometimes, seemingly, with the help of God. God was said to have caused the death of all the people in Sodom and Gomorrah.
Christ did not invoke God's law against his own execution. Even though the message of the New Testament is love, mercy and forgiveness, I don't believe that Christ meant that a person could do just anything repeatedly and have no consequences for their misdeeds. Repentance means regretting the misdeed, and not doing it again.
Life imprisonment presents some problems. One could say that life imprisonment without hope of parole is cruel and unusual punishment. Homosexual rape and other cruelties done against another prisoner constitutes cruel and unusual punishment, even though it was not prescribed by the justice system. Putting anyone, even a hermit, in solitary seems just as cruel as taking his life. I believe that keeping a prisoner on death row for twenty years surely is a cruel and unusual punishment. It is tolerated only because of the unwillingness of the society to decide for or against capital punishment.
If the person who commits a heinous crime and is convicted with due process of law has a conscience, death might even be merciful. If the person has no conscience, he is not safe to be in or out of prison. I believe we have a lot of ruined merchandise that cannot be repaired.
Some mention the fact that we are the only so-called advanced country that still has the death penalty. That being so does not necessarily say that the others are right and we are wrong. History records many instances of a large majority believing something that was not only not accurate, but was also not right.
Of course, some think that all ethics should be situational and that there are no truths or certainties about anything. As you might surmise, I do not agree with that view. Presently there is a widespread unwillingness to judge anything-it is not politically correct. It is true that no one is without sin, but there is a big difference between white lies and murder.

15. Bad Behavior Prevention
I am a retired physician. I was in the private practice of internal medicine from 1 August 1952 until 29 June 1997 in Kingsport, Tennessee. Kingsport is located in the northeastern part of the state near the Virginia border. In fact, Gate City, Virginia is only eight miles away. During the early years of my practice I had the need to send some mentally ill patients to our state mental hospital in Knoxville, and, occasionally, to the Virginia State Hospital in Marion, Virginia. In those days it took certification by two physicians to start the process. Then it went to a judge who did the necessary legal action to commit the person. This would be done only if the patient was unwilling to be committed voluntarily. In some cases lack of money or hospital insurance would lead to such an action also.
Some elements in our society raised the question of mistreatment of the inmates. At any rate an effort was made to prevent "warehousing" of mentally ill patients. To me this had some merit. It is my understanding that the courts made a ruling that a person could only be kept in a mental hospital if he or she were a hazard to himself or herself or to others, and would have to be receiving active treatment.. I further understood that certain requirements were set up regarding the hospitals. Each physician could only have a certain number of patients and each nurse could have only a certain number of patients. Now one way of meeting the number requirements would have been to hire more physicians and nurses. Another would be to discharge enough patients to meet the requirement. Tennessee And many other states) evidently chose the latter. One of the problems regarding the physicians was the shortage of psychiatrists. Some of the doctors I spoke with regarding committed patients spoke English very poorly. I wondered if they could understand the Upper East Tennessee dialect or, indeed, English in general.
I suspect that our state government, which is hampered (and the taxpayers benefitted) by having a state constitution requiring a balanced budget, is always short of money. Tennessee is a low tax state, which is what the electorate has chosen. Therefore, the state authorities were only too glad to discharge the patients. I had the experience of sending a patient to Lakeshore (the old name was Lyons View-the name was changed to protect the guilty), and having the patient get back to Kingsport before the deputies who took them down there got back to town! It seemed that if the patient showed the least sign of sanity, he or she would be sent back. Some of these patients had been seen by a local psychiatrist as well as by me. I sent no one who was anywhere near normal. (Of course, the definition of normal is not always agreed on. To me normal meant absence of serious symptoms of psychological origin, ability to work, and ability to care for someone other than oneself.)
The theory was to have mental health clinics that could monitor and treat the patients in an outpatient setting. This sounded ideal. However, it didn't work out so well. Mental patients are notorious for being non-compliant. That is, they won't keep appointments and won't take their medications. Compliance is not good with non-mental patients. In fact, studies done by social workers have suggested that forty percent of patients have no intention of following the advice they receive. Naturally when the patient's mental processes are awry, the compliance would be expected to be worse.
In the old days, if a mental patient didn't take his medication or keep his appointments, the threat of being sent back to the hospital could be used to promote compliance. When Thorazine (chlorpromazine) came on the market, it revolutionized the treatment of schizophrenia. It didn't make the patients normal, but it made them sociable; that is, on medication they could be taken care of by their families, and some could even work. It was sedating, and the counter culture was very much opposed to psychiatric treatment, especially chemicals and electric shock treatment. For example, "Over the Cuckoo's Nest" gave psychiatric treatment an especially bad time. Of course, in the counter culture it was okay to take recreational drugs like marijuana, heroin, LSD, and so forth, but not okay to take anything prescribed by a physician.
Many years ago we had a public hearing here with the subcommittee on mental health from the legislature. The commissioner of mental health was in attendance. Several citizens rose to speak of problems. One in particular that I remember only too well. This woman's husband was schizophrenic, and had been hospitalized several times at Eastern State Hospital (Lyons View, Lakeshore). He was on Thorazine, and while he was on it was okay to be at home. Earlier, if he didn't take his medicine, his wife could get him to take it with the threat of his having to go back into the hospital. At the time this threat could no longer be used, and he would stop his medication, beat up his wife, she would call the police, and he would be arrested. This woman said, "My husband doesn't need to be in jail, he needs to be on treatment." The commissioner said, "The state plane has to get back to Nashville, so I will have to leave." He couldn't stand the complaints since he probably couldn't or wouldn't do anything to correct the situation. The fact was that the plane came to bring him, and would go back whenever he wanted it to.
Some will raise the objection that Thorazine had adverse effects, but schizophrenia has some bad effects, too. Even if the patient doesn't hurt anyone, he or she can disrupt the life of a family and cause a lot of suffering. Tardive dyskinesia (a Parkinson like disorder) is one of the complications of long term treatment with Thorazine and its cousins. It can cause a drop in blood pressure on standing, and can cause drowsiness and lack of alertness. Some of its more modern cousins have less adverse effect. You can't treat a major illness with a minor drug. "You can't drive a pile with a tack hammer!" “You can’t down an elephant with a flit gun.”
I am a great believer in law and order, and do not believe anyone should be deprived of his liberty without due process of law, but mentally ill people need treatment and protection. They probably, in general, are a greater threat to themselves than they are to others, but every now and then one of them does something that brings attention to the fact that they can harm others. Often there is a long history of abnormal behavior until the final defining incident.
Estimates suggest that up to one-third of the homeless are mentally ill, and another portion are chemical abusers-alcohol and others, and the other third are just shiftless or unlucky.. In my view it is a shame that a wealthy and compassionate society like ours will tolerate a situation where our citizens are living on the streets when a lot of them are really not mentally competent to decide what is in their best interests. This may sound strange coming from someone like me, who is in favor of personal freedom (and responsibility), and who thinks the government is trying to do too much, and not doing it very well, would advocate using laws and government to deal with the homeless problem.
Rusty Weston is a good example of the lack of prevention and promotion of treatment for someone who was known to be mentally ill for a long time before he went on his shooting spree at the Capitol.
(I offered this essay to the Kingsport Times-News. They said they would consider a three hundred word letter to the editor. I also offered it to Time magazine. They also declined stating that they only use staff writers. As you can see, I was considerably upset by Reston's shooting those two House of Representative guards.)
Donald W. Bales, M.D.

16. Abortion
I have a hard time with abortion. One question is: When does the fetus become a person? Some cutoff points have been posited-quickening (when the baby's first movements in the uterus are detected), viability (when the baby is mature enough to survive outside the uterus), and just prior to delivery (when partial birth abortion is sometimes done). None of these meet the biological test. For me an abortion in the first trimester is less bad than in the second, and one done in the second trimester is less bad than in the third. Abortion in cases of rape and incest (usually also a form of rape, and considered statutory and a crime before the age of consent of the rapee) seem somewhat acceptable, since the woman is rendered pregnant against her will. Even in those cases the fetus is deprived of life without its consent. The fetus is surely innocent of any misdeed.
A recent poll recorded that about three-fourths of the women replying favored abortion, so I am out of step with them. But my case may be similar to the Pope's. As Agriculture Secretary Butts said of the Pope, "He no playa da game, he no maka da rules". Butts got severe criticism in the media for that, but I thought criticism might more properly be about some of his decisions he made for his department.
An abnormal fetus presents a problem. Tay-Sachs syndrome (the baby is born blind and idiotic and will surely die by age two) is an example in which one could agree with abortion on a logical basis. Saving the life of the mother is another reasonable justification for abortion. Some fetal abnormalities are compatible with survival with a reasonable quality of life, but some are not.
Many abortions are done as a birth control method. Use of it as a back-up for contraceptive failures is more acceptable. All methods of birth control have a certain percentage of failures even if they are used properly and regularly. The only method of birth control which does not fail is abstinence from penis-vaginal intercourse. Abstinence would not be acceptable in marriages, but it would be a good preventive for pregnancy in unwed women.
If women want to play the sex game, they should be prepared to accept the consequences when they lose. Some would say that men should be responsible as well, but it's the women who have the babies. Responsible people should never have sex without considering the possibility of pregnancy or infection, and taking precautions against both. Of course, exclusively monogamous couples wouldn't have to worry about infection, unless one of them still had an infection from the past. I think all sex and all reproduction should be first degree, that is, premeditated. The morning after pill would be more acceptable than even early abortion. That early would be more like prevention than interruption. I strongly doubt that there are many cases that would justify partial birth abortion. One doctor who did a lot of them later repented and reported that most of the ones he had done were done to get rid of an unwanted child. Of course, I am opposed to anyone having an unwanted child-wanted children have a hard enough time.
I believe abortion should be safe and very rare.

17. Homosexuality
I don't know what causes this. At present, I am inclined to believe that it is inborn, at least, in males. The tendency often shows up very early. Certainly choosing a life style that still has a lot of prejudice against it, and even danger to life and limb, would be very illogical. Of course, I am well aware that humans often behave illogically. I doubt that it is hereditary, since exclusively homosexual persons are unlikely to reproduce. Of course, lesbians could be artificially inseminated, and gay men could contribute the sperm.
I am even less sure about female homosexuality. It could also be inborn, but our daughter, Virginia, who has done a lot of psychological counseling with survivors of incest, thinks that the women became lesbians because of their bad experiences with men. Many of these women are lesbians. She may be right. It is not hard to believe that sexual mistreatment of girls by men-fathers, brothers, uncles, grandfathers, cousins, or others-would lead those women to distrust, or hate, men.
I consider homosexuality to be unnatural, although it occurs in other creatures besides humans. The mouth has teeth, and the rectum has feces. Why would someone want to stick his penis in either opening, when the vagina is perfectly suited for the penis. The vagina has no teeth and no feces. Dr. Shelton Reed served with the Army during World War II, and told me of treating men whose penises had been bitten to the point that the urine was leaking out the side of it. These men had served in France. Apparently some men, including the president, prefer fellatio to vaginal intercourse. The spread of AIDS is facilitated by anal intercourse-in both with men or women. Tears in the anal lining helps the virus to get into the recipient's body. Pharyngeal gonorrhea is harder to treat than urethral or vaginal/cervical gonorrhea.
It is my understanding that lesbians are much less likely to get sexually transmitted diseases than gay men. "Gay" seems an odd term one for a life style associated with so many hazards and problems.
I oppose discrimination against (or for) homosexual persons. I do not believe we should recognize homosexual marriages. I believe societies have established marriage to give societal backing to the nuclear family with the motive being to promote the proper care of children. Further I do not believe homosexuals should be allowed to adopt or reproduce. Children have enough trouble without having additional burdens. I haven't decided what I think about their being teachers or otherwise involved in the guidance of children. I am well aware that many heterosexuals do not behave as they should toward their own children or toward other people's children. I oppose homosexual partners receiving spousal benefits. At least, I oppose legally mandating such coverage. Especially is this not right when we have a marriage penalty in the tax code.
It would be better for the homosexual community to avoid blatant exhibition of their status. Discretion and privacy would make homosexuality less obnoxious to the rest of society. The "in your face" tactics are likely to convert neutrals into opponents, and enrage the opponents even more. On some campuses political correctness demands that derogatory or belittling statements not be made. However, on those same campuses it is okay to do it to straights and, especially, to the religious.
Equal access to employment, housing and promotion is okay with me, but special privilege and preferential treatment is not.

18. Women
I love women, at least, I love some of them. I don't love the "FemiNazis", but there are very few of them. I don't love the radical lesbian feminists. There are not so many of them, but they are very vocal. I don't hate any of them, but I don't like some of their tactics and policies.
I have had and have a good relationship with all my female blood kin, and even with my female in-laws. So I have no bias against women based on any bad experiences with women. Women have always treated me extremely well. Of course, more of them have wanted to mother me than to smother me. (That may be good-otherwise I might have died years ago-ha, ha.) I have an intense and congenial relationship with the most important woman in my life-my beloved wife of fifty-three years. (1998)
So far as mental abilities are concerned, I try to judge women with the same standards that I use for men.
I believe women should get equal pay for equal work. However, the attempt to make men and women the same is absurd and against nature. The women have the babies, which makes them enormously different from men. Testosterone (the male hormone) and estrogen (the main female hormone) have very different effects. There are also inborn differences that cannot be changed by environment.
Women can do some things better than men and men can do some things better than women. There have been some interesting experiments reported in the book "Emotional Intelligence". In the best of all possible worlds the women would do those things they do better and the men would those things that men do better. A couple (heterosexual) who adopts this policy will get the maximum out of this arrangement. Of course, this might be different for each couple.

19. Busing
While we were on our Texas trip, Ida (Julie’s sister) and Jim Holmes raised the question of the benefit of busing. They maintained that it had raised the level of academic achievement of the blacks. I told them I didn't believe that. After I got home I found two books in the library on busing. "The Great School Bus Controversy" edited by Nicolaus Mills with articles by many different people who had a point of view and knowledge about the subject. The other one was "The Burden of Busing" by Price and Woodard-this one was about the busing in Nashville, Tennessee.
Somewhere I read that the busing for racial purposes was only 3% of the total of students who were bused. The laws regarding school consolidation (which led to the need for moving students other than on foot) began in 1838 in Massachusetts, 1903 in Tennessee, and 1913 in Nevada. So busing students goes back a way in time. 19.6 million students are moved by bus or public transportation now. The cost is 1.5 billion. The cost as percentage of the total cost of education varies from 0.7 to 6.9%. Total miles bused were 2.2 billion per year. In 1969-1970 43.4% of students were bused.
The first effort was desegregation. This moved on to integration. Equality moved on to affirmative action. Now there is a voluntary move to resegregation; that is, the students tend to gravitate toward sticking with their own racial group. The class distinctions of "Jim Crow" with legal separation of rest rooms, lunch counters, motels, and drinking fountains are gone.
Studies are hard to evaluate, but it seems that the academic achievement of the white students was not worsened by the presence of blacks. One of the authors remarked that if discipline had declined, it should have shown up in academic achievement levels. Since he cited no studies regarding discipline I believe this was an assumption. The blacks did improve, but there was general improvement with time in schools not effected by racial busing so it was hard to tell whether the busing had caused the improvement or not.
In Nashville (and in other systems) there was white flight. Since the evidence for decline in academic achievement was not provably obvious, the parents must have had another reason. However, they could have had the impression, even if erroneous, that the academic achievement of their children would be adversely effected. However, another fear was that the values of the black community would effect their children. The white middle class values of self-discipline, hard work, proper manners and deserved merit were contrasted with the perceived values of North Nashville. The question was raised if the black community had the proper values why was there so much violence, so many illegitimate children, and so many on welfare.
White flight seemed to be worse depending on the blackness of the school, the blackness of the neighborhood the school was in and the ability of the parents to pay for a private school or to be able to move to an area where the judge's order did not apply.
George Washington Carver thought the way to raise the status of blacks was personal and individual, while W.E. Dubois favored action to raise the group.
A few blacks-Thomas Sowell, for one-favors the Carver approach, and Ward Connally is opposed to affirmative action. These blacks are considered traitors by the best known black leaders as well as the NAACP and CORE.
We seem to have a quota for black cheer leaders here at Dobyns-Bennett High School, but no quota for white basketball players. Merit rules the day in athletics, but not in other areas. Of course, it is easier (and obvious) which is the best athlete. One can measure the performance. Academic and other performance is not so obvious, or so easy to measure, and one can say that the blacks have not had opportunities to excel in some other areas so they should have some extra consideration.
I am in favor of equality of opportunity, but not of result. The Coleman study of some years ago suggested that the educational and economic level of the parents was a more important factor in the success of a child in the academic world. The amount of expenditure per student doesn't seem to count very much, since Iowa and Minnesota spend the least and have the best scores, while New Jersey and Washington, D.C. spend the most and have the worst scores. We used to have thirty in a class and seemed to do pretty well. Now the push is for smaller and smaller classes. My view is that discipline has declined so much that it takes lower pupils per teacher.
So it comes down to this. The whites have not been brought down, the blacks have come up (whether this was due to busing has not yet been proven to my satisfaction). There may be a psychological benefit for the blacks in that they think something has been done to help them. If they believe this, perhaps it will help their morale and improve their efforts.
I think some of the famous black athletes could be better role models. The fact is that a black person has a much higher percentage chance of becoming a doctor, a dentist, or a lawyer than of becoming a professional athlete. After all there are only 12,000 people making a living as professional athletes, and there are many more blacks in other professions.
Donald W. Bales 25 April 1999

20. Prayer
Before I write about prayer, I should write about my religious beliefs. Since I cannot conceive of something out of nothing, I wonder about what was before the "Big Bang"; if indeed, that theory turns out to be valid. I suppose I am a Deist in that I believe in a Supreme Being. Every known society seems to have some sort of religion. One might think that there is something in the human psyche that yearns for a God. One could think that a group having a belief in something other than the material world and oneself could be a benefit to the survival of that group. One could also think that there is something to the idea of a Deity.
One of my favorite stories regarding religion goes as follows:
A man was standing on the sidewalk in conversation with a man of wealth. Another man came up and all he said was "Hello". The wealthy man got out his checkbook and gave the man a check, after which the man left. The first man said, "It's none of my business, but I am so curious I have to ask what was that about?" The rich man said, "That was someone from the church, and I gave him a donation." "I thought you didn't believe in religion." "I don't, but just suppose there is something to it."
The Trinity has always been confusing to me. I think I understand the concept, but, if there is a God, I think there can be only one. I suppose I am an Arian. To me Christ is more inspiring if he were human. I could hope to emulate a man, but I would not expect myself to emulate a God. Even if Christ did not rise from the dead, he still gave the best formula for living that I know of. Of course, no group has truly followed it. I am afraid that I think there are humans who would not respond properly to my turning the other cheek (or even three other cheeks).
Our preachers ask the members of the congregation to pray for themselves and for others. At this time in the service, I do think of-or pray for-a large group of people. I do not include those loved ones who have died, although I still love each one of them. Not being a Catholic I don't believe in praying people out of Purgatory. My thoughts (prayers) are for the living. A partial and usual list follows:
Donald W. Bales, Sr.
Julia Anne Stanton Bales
Virginia Lee Bales and Jay Gitlin
Basie Bales Gitlin
Bruce (Jay's brother) and Amy Gitlin and their children
Donald W. Bales, Jr. and Marghi Sowerwine
Katy Bales
Molly Bales
Elma Sowerwine (Marghi's mother)deceased
Chips Sowerwine and Aoud and their two daughters
Peter Sowerwine and his daughter and second wife
Cathy McMahan (divorced) and her three children
Hugh Barton Bales and Sally Shaw
Celia
Doug and Joan Shaw (Sally's parents) and their children
Andy Shaw
Cindy
Nancy
Betsy
John Stanton Bales and Dorothy Jean Barnhouse
Lucy
Ella
David and Mary Alice Barnhouse (Dorothy's parents)
Kitty and Lee Purgason and their two children
Steve and Emily Barnhouse
Roberta (daughter of my Aunt Annie Kate) and Orrin Jones (dead)
Bob and Kate Lochte
Camille and David Lashlee
Melanie married Jim (?James) Adams in November 2001
Amy to marry Chuck (?Charles) Vogel in February 2002
Murrell (son of my Uncle Edwin) and Joan Weesner
Becky Jo and Randy Moles
Susan and Kevin West and their two children
Mary Ellen and Kirk Horner and Erin
Winnie and Marty Seals and Matthew and another son
Jane Doggett (daughter of Annie Kate Weesner Doggett)
Bill (son of my Uncle William Weesner) and Twilla Weesner
Chad and Kathy and Kendall Scout Weesner
Ashley and Matt Jernigan and Addie Caroline
Robert (son of my Uncle William Weesner) and Michele Weesner
Joshua and his wife, Amy, baby due in August 2004.
Simon m. Debra Rose Scheunemann 5/9/99 (divorced)
Nathaniel (b. 04/02/00), Debra, and stepfather
215 Appaloosa Drive, Jacksonville, N.C.
William Roy (Bill-son of my Aunt Mary Ruth) and Glenda Alexander
Richard
Roy Barton Weesner (my uncle-only one left of that generation)
Charles Barton and his (fourth) wife Annie Weesner
Bart Weesner and Jennifer Marshall and Allison Nicole
Born 5 May 2003
Laura Weesner Staton and her husband Chris and Emme
Edwin (Eddie) Weesner (Down's syndrome)
Hugh Lewis (son of my mother's cousin Hope Davis Lewis)
Patia (Hugh's second wife)
Becky Lynn (Hugh's daughter by Hugh's first wife)
Becky Lewis Porter Fine (divorced from Porter then Fine)
Andy Porter and his wife
Griff Porter and his wife
Andy (Hope Lewis's son) and Janie Lewis
Beth
Katie
Matt and Drew (twins)
Robert Tipton Bales, III (son of my cousin R.T. Bales, Jr.)
Julia Fleming Bales
Hallene Bales (my cousin) and Ralph Doyal (he died 10 Jan 2000) Dwann Black (great-grandson of my aunt Dora Bales Noe) and his wife and three sons
Andrew Black (great-grandson of my aunt Dora Bales Noe) and wife
Sarah Elizabeth (Julie's sister) and John Garner
John Garner and his wife (Kathy-separated) and their daughter Rachel
Hugh Garner and his wife, Julie and Sarah and Emily (twins)
Virginia Louise (Julie's sister) and George Payne (dead)
George Payne, Jr. and Jeannie (her son by a previous husband
Charles Payne and Susan
Polly
Pippin
Hugh Wright Stanton, Jr. (Julie's brother) and Donna
Milner Stanton (Hugh's daughter by his first wife)
Cindy (Donna's daughter-adopted by Hugh)and Stewart (no. 2)
Sam (1st husband’s) b. 5 Sep 1997
Ben (2nd husband) b. 24 Sep 2004
Georgia Elinor Stanton Curtis (Julie's sister-widow)
Hugh Edward Curtis, and his second wife, Donna
Joe Curtis and his wife, Jean Marie
Thomas
Katie
Ida Wills Stanton (Julie's sister) and James Holmes
Lynn (Julie's niece) and Terry Blumenthal
Daniel
Sarah Anne
James Holmes, Jr. (Julie's nephew) and Joellen
Nathan Wesley
Julie (Julie's niece) and Greg McKenna
Aaron (born with left ventricular hypoplasia)
Mary Kathryn
Amelia Stanton Harper (Julie's aunt-widow-last of that generation)
Paul Harper (son of Amelia) (divorced-no children)
Lee Harper (died in a car wreck)
Bill Stanton (Julie's cousin) and his wife, Dorothy
Polly Stanton (widow of Julie's Uncle Jack Stanton)
Bob Stanton
John Stanton
Julie Bragg and her husband, Howard
John and his wife
William
Henry and his wife
Katherine Stanton (deceased), widow of Julie's Uncle George Russell and Laura Stanton (no children)
Katie Jane Stanton (divorced twice) no children
Elizabeth Wills Holman and Roselle (Del) Holman (both deceased) (Elizabeth was the older sister of Julie's mother)
Yerby Roselle Holman and his wife Emily and their children
Dr. Lyle Smith and his (second) wife Sarah
Carolyn and her husband Larry
Their children
Kim (suicide in 1999, his widow, Barbara, and their daughter, Anna
Hunt and his wife and two children
Dr. Robert and Jeanne Jernigan
Jeffrey (aortic regurgitation-an anesthesiologist at U.T. Memphis) and his wife, Carol (Hale), and their children
Mary and her husband and their children
John (infectious disease)and his wife and their children
Dr. John Powers (widower)
Sally (twice divorced) and her three daughters (black)
Elizabeth (never married) California
John (divorced with custody of two children, half Filipino) Kelly and Rhea-live near D.C.
Guy (chemical engineer-never married) Houston-Now China
Andy and his wife (Latino-? Mexican) and two children
Dr. Bob Jones (widower) and his five children
Jeff
Wendy (divorced, remarried)
Jack (divorced)
Leslie-family practice in Kingsport
Nancy and her husband and children
Dr. William Harrison (widower) and his five children
Marty (unmarried) lives in Vermont
Steve
Nick (a twin)
Tad (a twin)
Toby
William (Bill) and Caryl Griffin
Kim and her husband and new baby (we are now at 13 Jan 2000)
(Other daughter Beth died of Herpes Encephalitis in 1997)
All of the Philosophy Class, the staff, and all the members of First Broad Street United Methodist Church
All of my fellow swimmers and exercisers
On September 27,2001 Julie reminded me that I had not included
Mary Sue Still and her family and
Our neighbors Ralph and Marion Hudson and their six
This omission was not due to my having any lack of concern for those folks. It was just that I didn’t think of them at the time I made the list.
September 27, 2001: I am adding to my prayer list all the victims of the September 11, 2001 attack and all of their families. Also the Executive, Legislative, and Judicial members of the Federal government, the state, county, and city officials. And especially the members of the Armed Forces of the United States. And for all of the citizens of the United States. All are at risk in this war. Civilians were the main targets of the terrorists. Of course, they did hit the Pentagon so they got some armed services people as well, but the major assault was on civilians. This attack is an outrage, and I am very angry and want those who planned it and those who backed the planners brought to justice. And, yes, I want them dead. This may not be Christian, but I still feel that way. This may not be a good thing to put in an essay about prayer, but I don’t always pass the Christianity tests.
I am also adding Mike Boggan and praying for him to be able to lose weight. He quit smoking after I got after him, but gained thirty pounds, lost it and gained it again. I promised him last Friday that I would pray for him. I also pray for his family, especially his quadriplegic son of his first marriage.
I also pray for Charlie Eberhart-may he learn to handle stress and for his wife, Joyce and their children
Anne
Elaine
Charlie
Ray Carico (Ray’s wife, Carolyn Widener, worked for some of us from age 18 until her death at 64.)
Doyle Burdine, has Lou Gehrig’s disease and died of it.
All the Methodists, all the Christians, all the Jews, all the Muslims, even the radicals, all the Hindus and Buddhists, and all the Chinese, and all the rest of the six billion humans on Earth.
In recent times, I pray especially for all the people in the armed services, especially for all those in Iraq and Afghanistan.
I believe praying helps me. It might help those listed if they knew that I was praying for them. I don't conceive of God as a cosmic bellhop, and do not expect the laws of nature to be suspended just because I might seem to want them suspended. I really don't want the laws of nature suspended. It is nice to think that something in the world is reliable and can be counted on.
The longer I live the more I see that nature is orderly-or,
at least, has rules and can be understood. I have been reading about DNA and about the heavenly bodies (stars in the sky-not on earth). I have recently taken courses on art, music, current events and geography, U.S. and English history, Islam, Christianity, and Judaism. I have the feeling, perhaps not a correct one, that I am integrating all of this into a more coherent world view than I have had before.
About religion and prayer-just suppose there is something to it!
Donald W. Bales 9 November 1999 (edited on 15 November 2003)
21. World Trade Organization
Today (30 November 1999) the World Trade Organization was on the news. In Seattle-the site of the meeting of the delegates to the World Trade Organization-many demonstrators were out in the streets. Included in them were blacks, labor union members, civil rights activists, and environmentalist. It is ironic that a policy put forward by the Clinton Administration would be opposed by to so many key elements of the Democrat Party. I gather that the demonstrators perceive that freer trade, especially with China, would act against their values. They also seem to think that free trade is in favor of big business. They may be right about that.
To me the main reason to oppose the entry of the Red Chinese into the W.T.O. is that they have tried to meddle in the political affairs of the U.S. and have bought or stolen military secrets from us.
The business people have their eyes on the huge (1.3 billion Chinese) market in China, and seem to have forgotten all about national security and I think the Clinton Administration has little understanding or concern about national security. Perhaps secrets were stolen under previous administrations, but there has been no suggestion that the secrets were bought. Also the knowledge of the thefts was only made known during the present Presidency. Efforts to look into it were delayed, if not blocked, for several months. I am not even sure that the breaches in security have been dealt with.
Although I have little knowledge about economics, I have read that free trade promotes prosperity. Ginny asked, "Prosperity for whom?" That was a reasonable question. It is true that free trade, which includes free flow of capital and technology in our present time, may cause some individuals and even some groups to lose good paying jobs. However, other jobs will be created to serve the production of exportable goods or services.
Now to write of pies. One theory is that a country has a pie. Some citizens do not have as much of the pie as seems fair. Question: What does "fair" mean. Does is mean that everyone should share equally in the pie? This is unrealistic, and so far as I know has never happened. Attempts to divide the pie in a different way-that is to take from some and give to others seems very humane, but this will cause those who produce more goods and services to feel mistreated and to cease to make the same effort as before. "From each according to his ability-to each according to his need" sounds good, but when put into practice in Marxist countries never to make the people better off materially, and surely worse off as far as freedom was concerned.
Free trade seems to make the pie bigger, and even though some may benefit more than others with a bigger pie there is a better chance that everyone will have more than if the trade were restricted. Giving a person an incentive by letting him or her benefit from his efforts will be more successful than having a disincentive situation.
Do not misunderstand-I do not believe in unfair trade. To me it is unfair for a country to allow imports freely from another country, but that other country not allow our exports into their country freely. In that case I think our negotiators should be hard nosed, and say, "If you don't let our stuff in, we won't let your stuff in." Our market is so attractive. Our people want a lot of stuff and have the money to pay for it so everyone wants to get into our markets. It seems to me that they need us more than we need them.
In the case of oil we are more dependent on other countries than I like. Most of our oil imports come from Canada, Mexico, Venezuela, and Nigeria. I wish that we were trying to develop a way to use solar energy. I don't think wind, geothermal, tidal, or water can produce enough to make much difference. Atomic power had the drawback of hazard-the hazard of a plant blowing up (or being blown up), and also the hazard of the storage of long-lived atomic waste.
So as you can see I believe in free, but fair, trade.

22. Adding Prescription Drug Coverage to Medicare
The Medicare system is already in trouble. When the Baby Boomers retire, the costs will really go up. The coverage has been promised and the promises should be kept, and will be. Not because the politicians are honorable and keep their word. The older people vote and if they don’t get their coverage, they will vote the rascals out.
It doesn’t make any sense to add another entitlement to a system that is already over committed. The drug costs will be just like all other programs. The cost will be a lot more than predicted.
The majority of the elderly already have drug coverage. The proposed Gore plan if enacted will encourage the corporations to drop their present drug-covering policies, and the eighty percent of seniors already covered will be added to Federal list.
Federal drug coverage will lead to the temptation of lawmakers to institute price controls on drugs. That will be a disaster. It will dry up the motive for developing new drugs.
The cost of drugs could be lowered if the excessive judgments handed down by sympathetic, but naive, juries were somehow controlled and a limit put on amount. At present, a large percentage of any judgment goes to the lawyer. We have a new class of millionaires-plaintiffs’ lawyers.
The suits against makers of legal material is another scandal. Every one knows, or should know, that cigarettes are harmful. Every package has a warning on it. The same thing applies to gun makers. It is the criminal who uses the gun that causes the problem and not the gun. The only effect of gun laws would be to make it harder for law abiding citizens to get one. The laws will not prevent criminals from obtaining guns. However, passing gun laws will make some people feel better, even if research shows that they don’t help.

23. The Tax Cut
I believe that we citizens of the United States are over-taxed. When the average tax-payer pays more in taxes than he or she does for food, clothing, shelter, and transportation, the situation becomes ridiculous. Now that we have projection of an enormous deficit, it seems only fair that taxes be reduced.
First: If the money is left in Washington, the temptation to spend it will overwhelm even conservative Republicans-to say nothing of the effect on the tax and spend Democrats. It says in the Lord’s Prayer, "Lead us not into temptation but deliver from evil." So we should do that even though the Ten Commandments are not politically correct (even though every civilization has at least given lip service to the last six!)
Second: It may help to get some of the credit debt by citizens paid off. Of course, they may just spend the tax cut and borrow some more to get more into debt.
Third: In the past tax cuts have led to increases economic activity and the government has taken in more revenue even though a smaller percentage of the GNP.
Fourth: It isn’t right to take someone’s earnings and give it to someone else who hasn’t earned it.
Fifth: If one really believes in representative democracy, one must give the ordinary citizen credit for having some judgment. If he or she has the judgment to select the proper representative, he or she should have enough judgment to know how to spend his or her own money.
Sixth: I think the government is too big and trying to do too much. Much of what it does is wrong and doesn’t get the results hoped for or aimed at. We have a lot of unintended consequences.
Seventh: Often the intent of Congress is not carried out by the bureaurocrats or administators who carry out the legislation.
Eighth: Alan Greenspan has warned that paying down the debt before the Treasury Bonds come due would lead to having to pay a premium to retire them early, or, even worse, have the Government put the surplus in the private economy which would politicize the private economy and mess it up even worse than it is now by government regulation and lawsuits.
Donald W. Bales 8 March 2001

24. The Election of 2000
On November 6, 2000 we had the election. The outcome was very close and as I write a recount of the vote in Florida will determine who will be the next president. At this time Bush has a slight lead in Florida, but a recount is in progress. However, the absentee ballots have not been counted. A lot of service people use Florida as their legal address. I think they avoid an income tax that way. Service people usually vote Republican to a major degree so these votes should add to Bush's majority. All of the ballots in Oregon are mailed in. I don't think they have finished counting those, and the absentee ballots in Washington State and in New Mexico could change the electoral vote in those states.
Apparently the ballot in the Palm Beach area was confusing and a lot of voters voted for Pat Buchanan who meant to vote for Gore. And others punched two holes and so got their votes thrown out. There were said to be nineteen thousand of these. Buchanan got a lot more votes in that county than he did in the surrounding ones. The ballot was devised and approved by a Democrat, so it is not possible for the Democrats to blame this on the Republicans.
The map of the states going for each candidate was quite striking. Bush got twenty-nine or maybe thirty states, but Gore got the far West and the northeast-most of the big city states. Bush got forty-eight percent of the popular vote. Clinton got forty-three percent in 1992 and forty-nine percent in 1996. It is striking the incumbent vice-president had such a hard time when we have prosperity and relative peace. He should have been a shoo-in, but the Clinton scandals evidently played a part. Not only the Monica part, but other parts. Gore's exaggerations or lies didn't help him either, nor did his changes in presentation. The last minute story on Bush's DUI may have had more effect than people thought. The timing of the release of the information was suspicious. The newspaper in Kennebunkport knew of it three months ago. So I guess that was the "October" surprise that came in November this time.
The Congress is still narrowly Republican. The House majority is thinner, and the Senate is either 50 to 49 or 50 to 50. Of course, if Bush holds on, the Vice-President will get to vote in case the vote in the Senate is tied.
If Gore was to get in, then Lieberman would be Vice-President, and would have to give up his Senate seat. In that case the Republican governor of Connecticut would appoint a Republican to the seat.
The election didn't turn out as I hoped. I hoped that Hillary would lose, but she won. I hoped the Republicans would increase their majority in the House and Senate, and I hoped Bush would win more convincingly. But I'll take what I can get and be glad of it.
In my view, the less that the Federal government does, the better. Unless they want to undo some things they have already done in the past.
Donald W. Bales 9 November 2000

25. Dr. Bales Medical Aphorisms
"Taking a history is hard. The history is said to lead to the diagnosis in eighty-five percent of cases."
"Doing a targeted, but complete, physical examination may be even harder. The examination is said to lead to the diagnosis in ten percent of cases."
"That leaves five percent for imaging and chemical tests."
"Thinking about a case is the hardest task."
"The consultant is the one who does the rectal examination that no one has done."
"Being the last doctor to see a patient is an advantage. Often the previous attempts at history-taking have led the patient to remember crucial information that was not forthcoming earlier."
"More diagnoses are missed from not looking than from not knowing."
'You can't trust a patient-they will get all sorts of things wrong with them."
"Avoid saying or thinking "always" and "never."
"Be proud so that you can inspire confidence and can have the confidence to do for the patient whatever he or she needs. Be humble and realize you are not God, and that you don't know it
all."
"We cure a few, we help many, and we should comfort all."
"Remember the Golden Rule and treat patients and other doctors as you would want to be treated."
"Don't be slow in seeking consultation in difficult cases, especially, those that may have a fatal outcome."
"Keep thorough and up-to-date records. No one can remember all the details. Besides a record made at the time of the events can be your greatest protection in case of a lawsuit. The quality of the record correlates well with the quality of the care."
"People often lie about sex and chemicals. The patient wants your approval and doesn't want to admit the unhealthy things they are doing."
"You should assume that any woman between the ages of twelve and fifty is pregnant until you prove that she isn't. Sometimes they'll tell you the truth which can save time, expense, and errors."
"A physical examination is incomplete without a rectal examination in men and a pelvic and rectal examination in women."
"Be sure to diagnose and treat the treatable. It is very bad to miss a treatable condition. Be sure to diagnose the fatal even if it untreatable. The patient may need to make a will or change it or to become reconciled to estranged relatives or friends."
"Try to be a model and not a horrible example. People will watch what you do. Your actions may have more influence than your advice."
"Guard your own health. Avoid tobacco, abuse of alcohol, use of recreational drugs, obesity, lack of exercise, lack of vacations, and lack of attention to your wife and children. Try to find a way to deal with stress. Realize that you are not Superman and that you, too, have limits as to what you can stand."
"Remember that no one is indispensable. Any one of us can be replaced. If you got shot in the head, life would go on for your patients."
"In football, the coach used to say 'Don't let the blocker get into your body-use your hands to keep them away.' Don't let the patients get into your psyche, be caring but not too emotionally involved. If you do and the patient suffers or dies, you will be devastated and so be unavailable to help your other patients."
"It is sobering to think that unless a patient leaves your practice, they will die on you-unless you die first-no matter how good you are."
"A doctor can only do so much. So have mercy on yourself."
"Try not to think derogatory thoughts about your patients. There's no place for the word 'crock' or 'gofer'-even if the patient is poly-symptomatic and the physical examination is negative, he or she is still suffering and deserves what comfort we can give them. Psychiatric disease is just as real as cancer.
"Even malingers need compassion. Most of the time it will become known what they are and they will lose the respect of all worthy people. Psychiatric disease is real, and causes a lot of suffering and death."
"Be aware that depression is common and commonly missed. It is disturbing to have a patient kill himself or herself. Be sure you have done all you can to prevent it."
"In dealing with my patients, I had three goals: to relieve or prevent suffering, to prevent or ameliorate disability, and to avoid premature death. You should note, I didn't write 'prevent death' for sometimes death is the only relief the patient can hope for."
"Don't avoid your patients when they are dying. They may need you worse then than earlier. To be comfortable with a dying patient you have to come to grips with the idea of your own mortality."
"Don't do a test-chemical or imaging-unless it will contribute to the management of the case. That is, if the results of the test will not change the diagnosis, the treatment, or the prognosis, then perhaps it should not be done. An exception would trying to record some measurement to allow future comparison to see if the treatment is doing any good. For example, measuring the size of a tumor mass." (Added 8 July 2002)
Donald W. Bales, MD 12 January 2001

26. Parlor Partisans of the Poor
Several wealthy people purport to have great interest in bettering the status of the poor. Of course, most of them don't really know any poor people or have any contact with poor people. Their children go to private schools, but they are greatly opposed to vouchers for poor people. The public schools are fine for other people's children but not for their children! These partisans live in communities that have no poor people in them. They remind me of the "Parlor Pinks" of the past. These were liberal academics who sympathized with Communists and Socialists, but who never put themselves in any risk for their alleged beliefs. They still took the benefits of a capitalistic society-accepting their dividends and interest from their inherited wealth. I have sometimes thought that they were felt guilty about the behavior of their ancestors who accumulate the family fortunes and were expiating their guilt by dispensing the tax revenues taken from the working people to the poor. Some of them failed to give any of their own wealth-preferring instead to promote the drafted or commanded generosity of others.
Some of those that I suspect of belonging to the above group are the Kennedys and the Rockefellers and maybe the Fords, although the Fords have set up the Ford Foundation with their own money, as have the Rockefellers. I don't know of any charitable organizations that the Kennedy family have set up. But then the Kennedy fortune was not associated with any societal gain for the American economy.
A man that I had a lot of respect for-Thomas McCallie Divine told me once "Don, if you want to raise money for a worthy cause, don't ask liberals to contribute. Because they won't give you any of their money. No. If you want a contribution, go to a conservative. He will have money and he will give you some of it." That may not be a fair appraisal, but it was one I do remember.

27. Stem Cells
Recently we have had a lot in the news media about stem cells. These were first cultivated at the University of Wisconsin in 1998. President George W. Bush recently proposed a program allowing federal funding of research on stem cell lines already established, but not for any new ones. The current ones were obtained from in vitro embryos produced in conjunction with attempts to allow women to have babies who could not otherwise have them. These embryos were frozen when they were not implanted in a woman's uterus and if not used would be wasted.
The secular scientific people were dissatisfied with this since they would like all human embryo stem cell research to be supported with tax money. The religious people would like to have no tax money to support any human embryo research. At Johns Hopkins the stem cells were obtained from aborted tissues.
Adult stem cells can also be used. For example, for the past twenty-five years bone marrow stem cells have been used to treat some malignancies and some immune deficient disorders. Cord blood has stem cells in it also and it can be used as a source for stem cells.
Even though bone marrow transplants have been going on for a long time, all the kinks have not been ironed out. Graft failure is not uncommon and graft versus host disease is also common. The procedure is hard on the patient and doesn't always work and often causes death-20 or 30 percent. People over fifty are rarely chosen for this procedure. It is very expensive requiring up to four weeks in hospital, and is not always covered by insurance. So we may be a long way from clinical benefit from embryonic stem cells. The anti-religious liberal left is in favor of unlimited stem cell use, while the religious conservative right is in general opposed.
One problem is very vexing. When does personhood start? If one has a soul, when does one get it? Does that matter? This is the theme of the religiously inclined. The atheist group has a different view. All this is related to the problem of abortion and cloning. Are there some things that we can do that we ought not to do?
Recently I saw an article stating that stem cells had been used to produce red blood cells. If this turns out to be practical, it will be a great help. I understand that there is a blood shortage throughout the country. This was true even before the Trade Center and Pentagon destruction with all the injuries resulting from that terrorist activity. 12 September 2001

28. Terrorist Attacks on the Trade Center and Pentagon
Today, September 11, 2001, we had what I am calling "The Pearl Harbor of 2001." Hijackers flew passenger jets into each of the twin towers of the Trade Center. This led to the destruction of these buildings and the death of the ten thousand or more people in the towers as well as five thousand tourists. A section of the Pentagon was also hit.
It seems to me that the level of the attacks on the towers had to have been chosen by an architect or engineer or both. This would point to a sophisticated group of conspirators. We need to find out who is behind this and snuff them out. I don't mean the misguided zealots who are the foot soldiers in this war, but the people who provide the money and plans for it. Those who provide a haven for these terrorists are also guilty, and should also be punished.. The investigation should be quick as should the punishment. The way to kill a snake is to cut off its head.

29. Afghanistan
Evidence suggests that humans lived in northern Afghanistan about 50,000 years ago and that farming communities there were some of the earliest in the world. After 2000 B.C. successive waves of people from central Asia moved into the area. In the first century A.D. an Aryan race, the Kushans, moved in. From the 3rd to the 8th century Buddhism was the predominant religion. At the end of the 4th century a Turkic people from Central Asia called the White Huns of Ephthalites moved in. After them some kingdoms were Hindu and some were Buddhist. In the 7th century the Arabs ruled the provinces of Herat and Sistan. After the Arab armies passed the people of those provinces revolted and returned to the old beliefs. In the 10th century Muslim rulers called Samanids from Bukhoro from Uzbekistan extended their influence into the area. A Saminid established the Ghaznavid dynasty. Mahmud, their greatest king, ruled from 998 to 1030 and spread Islam throughout the country.
In mid 12th century the Ghurid held sway in the west central area. This group was supplanted by the khwarizim Shahs, who in turn were swept away by the Mongol Genghis Khan. Near the end of the 14th century Tamerlane (Timur Lang) conquered the land on his way to India. His sons and grandsons, the Timurids, could not hold onto control. Babur, a descendant of both Genghis Khan and Tamerlane, took Kabul in October 1504 and then moved on to India where he established the Mughal (Mogul) empire.
In the 16th and 17th century the area was fought over by the Moguls in India and the Safavids in Persia.
In the 18th century Nadir Shah, the king of Persia, used the Abdali tribe of Pashtuns against the Moguls. After Nadir was assassinated in 1747, Ahmad Shah, who had held a high post in Nadir's army, established himself in Kandahar, and later was proclaimed Shah. The Afghans extended their rule to Delhi and Kashmir in the east, to Amu Darya in the north, and into northern Persia in the west.
In the 19th century palace rivalries and internal conflicts reduced the Afghan empire to roughly its present boundaries. The British in India and the Russians tried to bring the country under their control. This rivalry, called "The Great Games" led to two wars: the First Anglo-Afghan War (1838-1942) and the Second Anglo-Afghan War(1878-1880). After the second war the British had control of the foreign policy of Afghanistan.
In 1880 Ald-ar-Rahman Khan became emir. In 1893 the Durand Line border was drawn by the British between Afghanistan and India. Afghanistan became a buffer between Russia and the British. Rahman's son, Abdullah, reigned from 1901 to 1919. He tried to introduce some modern education and industry. His son, Amanullah, started the Third Anglo-Afghan War to end British control of foreign policy. The resulting peace treaty recognized the independence of the country.
Amanaullah tried to modernize the country. In 1926 he took the title of king. His attempt to get the women to give up the veil and the men to wear Western clothing offended religious and ethnic leaders. A revolt broke out and Amanullah left the country.
In 1930 four brothers restored order and one of them, Muhammed Nadir Shah, became king, but he was assassinated in 1933. His son, Muhammed Zahir Shah, became king. The royal family ruled the next four decades. Afghanistan joined the United Nations in 1947.
In 1953 Nadir's nephew, Daud, became prime minister, and started to modernize the country with the help of the Soviet Union. Relations with the Soviets deteriorated after Daud called for self-determination for the Pathans in northwestern Pakistan. In 1963 Daud was removed as prime minister to improve relations with Pakistan.
In 1964 a new constitution was instituted changing from an absolute monarchy to a constitutional monarchy. A severe drought in the early 1970's caused a lot of hardship and the government was less popular.
In 1973 Daud overthrew the monarchy and declared the country a republic with him as president. He tried to play the West against the Russians, but his dictatorial government was opposed by both the leftists and the traditionalist ethnic leaders. The leading leftist party, the PDPA, split into pro-Soviet Parcham faction, and a much more radical Khalq faction. They joined in 1976 to oppose Daud.
In 1979, after Daud tried to crackdown on the PDPA, leftist military officers overthrew him. The PDPA leader, Taraki, became president. He proposed some sweeping social changes. In late 1978 Islamic traditionalists and ethnic leaders, who objected to the changes, began an armed revolt. By the summer of 1979 the rebels got control of most of the country. Tarika was deposed and later killed.
His successor, Amin, tried to suppress the rebels and resisted Soviet efforts to make him change his policies. On December 25, 1979 Soviet forces invaded. They soon controlled Kabul and other centers and executed Amin December 27. The leader of the Parcham faction, Babrak Karmal, was installed as president. The rebellion continued for the next ten years. Three million refugees fled to Pakistan, and one and a half million fled to Iran. The rebels operated from Pakistan and to a lesser degree from Iran. They were supported by the United States, Saudi Arabia, Iran, and China. By the mid 1980's the US was sending hundreds of millions of dollars each year to the rebels. The Democratic Republic of Afghanistan was born on April 27, 1978.
By 1986 118,000 Soviet and 50,000 Afghani troops were facing perhaps 130,000 guerillas. In that year the US began to supply Stinger missiles which could shoot down Soviet helicopters. In May 1988 Afghanistan, Pakistan, USSR, and the U.S. agreed to end foreign intervention in Afghanistan. The Soviet withdrawal was completed in February 1989.
The rebels had not signed the agreement continued to fight against the government with weapons from the US through Pakistan. Najibullah, the head of the government continued to get aid from the USSR. In late 1991 the US and the USSR agreed to stop helping the factions. The Najibullah government fell in 1992 and an Uzbek and a Tajik from the north and central mountains took control in Kabul. They tried to keep the Pashtun leaders, who had usually held the power, out of the government. Kabul was besieged, beginning in 1992, at first by various mujahideen factions, and then by the Pashtun dominated Taliban, who wanted to reestablish Pashtun dominance.
The Taliban emerged in the fall of 1994 as a faction of guerilla soldiers who identified themselves as religious students. It started in the south and worked its way to Herat in the northwest and Kabul in the east. It made gains against the government using armor, heavy rocket artillery, and helicopters against government forces. They said their missions were to disarm the other factions and impose their strictly orthodox version of Islamic law. In spite of efforts by the government the Taliban took Kabul in September of 1996. In the late 1990's the Taliban controlled most of the country.
In 1998 after the bombings of the US embassies in Kenya and Tanzania, cruise missiles were fired at alleged terrorist camps in Afghanistan.
In early 1999 the UN produced an agreement among the warring factions for a cease-fire and a shared government. However, fighting broke out again almost immediately.
About the size of Texas, 770 miles east to west, and 730 miles north to south. Khyber Pass 3500 feet. Border countries: China 76 km, Iran 936 km, Pakistan 2,430 km, Tajikistan 1,206 km, Turkmenistan 744 km, and Uzbekistan 137 km. Arid to semi-arid, cold winters and hot summers, mostly rugged mountains, plains in north and southwest. Arable land 12%, permanent pasture 46%. Severe environmental problems: soil degradation, overgrazing, deforestation, desertification. Population 23,838,797 estimated 1990.
Life expectancy at birth 45.88 (US 76.7)
Fertility rate: 5.87/woman (2000 est.)
Birth rate: 41.82/1000 (US 14.5 1999)
Death rate: 18.01 /1000 (US 4.717)
Net migration rate 11.54/1000 (2000 est.)
Languages: Pashtu 35%, Dari (Persian) 50%, Turkic 11%
Literacy: 31.5%
GDP: $21 billion
GDP-per capita- $800 (1999 est.)
GDP-by sector
Agriculture: 53%
Industry: 28.5%
Services: 18.5% (1990)
Labor force: 8 million (1997 est.)
Exchange rate: 3000 afghanis to the dollar
Radio stations: AM 1, FM 1, shortwave 1
Radios: 167,000 (1999)
Railways: 24.6 km
Highways: 21,000 km Paved 2,793 km Unpaved 18,207
Waterways: 1,200 km, chiefly Amu Darya up to 500 DWT
Pipelines: petroleum products Uzbekistan to Bagram and Turkmenistan to Shindand, natural gas 180 km
Airports: 46 (1999 est.)
Military manpower-availability: males 15-49 6, 401,980
Military manpower: males age 15-49 fit for service 3,432,236
Illicit drugs: world's largest illicit opium producer >Burma a major source of hashish
US embassy in Kabul closed since January 1989 From various sources: Encarta and The World Factbook

30. Profiling
Many have written and spoken about how bad profiling is. If it is done to find disease, I think that it is just fine. For example, one would not expect to find a lot of venereal disease, pregnancy, or cervical cancer in nuns. One would not choose an ectomorph (thin small bones not much muscle) for one's weight lifting team. One wouldn't choose a five foot tall boy or girl to be center on one's basketball team. One wouldn't choose a fat girl for the ballet class.
If all the terrorism done by foreigners against the U.S. have been dark skinned men with Middle East accents, why would one look among white Germans. If a high percentage of the drug traffickers are black and have Spanish accents, why would one look at white men with a car full of children?
Willie, the Actor, Sutton was a famous bank robber. He was called the Actor because he was good at fashioning disguises that he used to get out of jail. A reporter asked him one day, "Why do you rob banks?" His answer, "Because that's where the money is!"
When trying to get the most mileage out of one's personnel and time, going "where the money is" is the way to do it.
So I don't think profiling is so bad. Of course, if it is just used to harass a certain group, it's wrong, but if it is being done to get the job done efficiently, it's the way to go.
One reason we looked so bad about the attack was that we had hamstrung ourselves in information getting against enemy groups inside and outside the country. In my opinion the CIA and FBI were not given the tools they needed to carry out their jobs.


31. Predicting the Future
Right after the election the Democrats tried to say that George W. Bush was not a legitimate President, and that he was not qualified for the job. The attack on September 11, 2001 surely changed things. No longer do we hear about chads or stolen elections or election by the action of the United States Supreme Court. Instead we hear a good number of dedicated Democrats saying they are glad to have W. in the White House rather than Al Gore. Before it was patient's rights and insurance coverage for the uninsured and other Democrat ideas. Now George Bush has high approval percentages and everyone is more concerned about the terrorists. Before few seemed to care about national defense, but now nearly everyone is for it. We still have the academics and the U.S. haters making their usual stupid statements.
When Falwell and Robertson suggested that the attack was due to bad behavior in our society the media made a big deal out of it, but when Bill Clinton said that we deserved the attack because of the bad behavior of the Crusaders, the bad treatment of the American Indians (excuse me, I meant to write the indigenous people of the Turtle), and slavery and mistreatment of the blacks, the mainline (I won't say mainstream because I do not think the media reflects the values of the majority of U.S. citizens) media had little critical to say about it.

32. International Monetary Fund
This organization is supposed to help countries with their economic problems. However, they often want the countries to raise taxes when the country is in debt and in recession. This often seems to make things worse. The usual problem is that the country has spent more than it took in and has borrowed from foreign sources. The way to correct the problem is to live within their means rather than to raise taxes when there is a downturn in the economy. They also often suggest devaluation of the money. This leads to a flight of capital or a lack on capital inflow. For supposed experts they don’t seem to have a clue.

33. Democratic Socialism
This morning I heard Christopher Morris of the Philosophy department of the University of Maryland talk about Democratic Socialism. He noted The Netherlands as one of the countries. Also the Scandinavians countries were mentioned. Sweden is noted for its comprehensive social services-welfare from before birth until death. Sweden remained neutral during both WWI and WWII and benefitted from selling to both sides. Denmark, Norway, and Finland were involved in WWII.
All the free countries of Europe, that is, those outside the Iron Curtain, have benefitted by being protected by the United States. None of them have had to spend much on national defense. So, in a sense, the U.S. taxpayer has subsidized the socialistic policies of the those countries. They could not have afforded spending so much on social services if they had been forced to provide for their own defense.
I have read that no additional jobs have been added in the past two decades. I also have read that the rate of unemployment is quite high in all the countries of Western Europe. However, they have had to allow immigration of people willing to do the menial work that their own citizens do not wish to do. Although they have many services, such as universal not-paid-for-by the-patient health care, drug coverage, good unemployment benefits, housing subsidies, liberal holidays and paid vacations (at least, in Germany), and government funded child car, they also have very high taxes-averaging fifty percent. I have read that the Swedes have high rates of alcoholism and a lot of out-of-wedlock pregnancies. The latter may not be such a problem with the welfare state.
The European Union has about three hundred million people and a big gross national product. It seems to me that they should bear more of their defense costs-the more so since they want to have a say in what the U.S. does to protect itself. They seem to want to share in decision making, but not supply the money or the men to carry out policies. They were unable or unwilling to take care of problems in their own backyard in the Balkans. They did nothing in Bosnia or Kosova until the U.S. provided the leadership and the military might. The actions there were really not in our essential national interests. Oh, it was motivated by humanitarian feelings, but it really wasn’t our business. Although in both cases it was for the welfare of Muslims, the U.S. got no credit in the Islamic world. Nor did we get any credit for our attempts in Somalia or Kuwait-two other Muslim areas. Of course, the action against Iraq was motivated by fear that the Saudi Arabian oil fields would come under the control of Saddam Hussein.

I looked up an article on democratic socialism and all through the article the hammer and sickle were displayed to the left of each paragraph. Now the hammer and sickle was the symbol of U.S.S.R. communism which was certainly not democratic.
I perceive that socialism presents an idealistic goal in that it holds the following idea: from each according to his ability, to each according to his need. To me that is against human nature. What would motivate someone to work hard and make a big contribution only to see the fruits of his efforts go to someone who worked less hard and made little or no contribution to the society or the economy? I do find the exorbitant pay of corporate executives to be obscene, however..
As you can see, I don’t have a very good opinion of socialism. I know that capitalism has its flaws, but it has provided more material benefits with less loss of liberty than any other system. Of course, we have a mixed system in the United States. It is a capitalism with a lot of government regulation and intervention. The socialists point to the evils of corporate bureaucratic control, but is government bureaucratic control any better? At least, a corporation can fail, and be replaced by a more efficient corporation, but governments can only be replaced by revolution or by the ballot but usually government mistakes are paid for by the taxpayers.
Donald W. Bales 16 March 2002

34. "Eating Too Much Will Make You Fat"
The above would seem to be so obvious that you may wonder why I wrote it. However, there is a class-action lawsuit being brought against four fast food chains-McDonald's, Burger King, Wendy's, and KFC by a man from the Bronx named Caesar Barber (70 inches tall and 270 pounds). He blames them for his being obese. Personal responsibility, like logic, justice, and common sense, is no longer in style and is not politically correct. It seems that nearly everyone considers himself or herself a victim, and always a victim of some person or some organization with deep pockets. Caesar Barber may win his suit. It's not what is true, but what a judge and /or a jury says is true that counts in the legal system
The tobacco companies had to pay off billions for selling a legal product to people-all of whom bought it voluntarily. Some would say that the tobacco companies lied, but many politicians and others in high places lie like a rug with relative impunity. When I was a little boy back in the 1920's people called cigarettes "coffin nails" implying that each cigarette smoked was driving a nail in your coffin (some coffins were wood back then). It seems that ordinary uneducated people knew then that smoking was harmful. After 1964 the surgeon-general of the United States had a warning put on the cigarette packages and there have been many articles written in newspapers and magazines about the harmful effects of smoking. Probably the only doctor in town who is more opposed to smoking than I am is Dr. Smiddy, so I hold no brief for smoking, but I do think that the law was misused in the suit against the tobacco companies. A large chunk of the settlements went to lawyers making a whole new group of millionaires. The rest that was supposed to be used to pay for treatment of smoking-related diseases such as lung cancer, emphysema, and heart attacks, and for programs to help prevent young people from starting the habit was mainly used for other purposes. Talk about greed-the lawyers who got the percentage and the attorneys-general of the states were the greedy ones.
This article really was supposed to be about obesity, not smoking, but I had to chase that rabbit while I was on its trail. Everyone knows or should know that overweight is the result of taking in more calories than are burned up. It's just a matter of arithmetic. If you take in more calories than you burn up, you gain. If you take in fewer calories than you burn up, you lose. People say, "But my whole family is fat!" I suspect if you go to those homes, you will find that the table is groaning under the load of good things to eat, and that the people are eating a lot of it. Some say, "It's my thyroid." I never saw a case where treating a low thyroid condition made someone get thin. One lady came in to see me one day and said, "Doctor, do you think my overweight could be due to a glandular condition." I was feeling humorous that day (but then I feel that way every day), and said, "I'm sure it is!" "Which gland do you think is causing the trouble?" "The salivary glands." "Oh." And her face fell. I felt a little guilty about saying that-but not much. Some twin studies have shown, however, that twins reared apart wind up with about the same weight. I don't believe that those extra calories got in by osmosis though! They had to be eaten.
It takes 3,500 calories to make a pound of fat, so each pound of extra fat on the body means that the persons have taken in 3,500 calories more than they burned up. Protein has four calories per gram, carbohydrates (sugars and starch) have four, fats have nine, and alcohol has seven. I put this in to identify the enemies. It is interesting, amusing, but a little sad, to see someone use artificial sweeteners in their coffee or tea and then have apple pie a la mode for dessert. My definition for a dessert: Something that is so good that you will eat it when you are already full.
Jews, in general, tend to get heavier as they get older, but none of the Jews put in concentration camps came out fat. The reason: They got very little to eat and they were forced to work hard. I never personally viewed any of the people who were rescued from the camps, but I have seen newsreels and documentaries. Those people were literally skin and bones. They were too thin even for me! Many of my former patients would never believe that I would say that about anyone. One day one of my patients came up to me in the restaurant and said, "Oh, do you eat?"
Billions of dollars (thirty-three billion in 1990) are spent on weight-loss schemes. There are no magic or easy diets. Most of them work if the person sticks to the program, but most people will regain their weight. It requires a great deal of nervous and emotional energy to diet. It is a problem three times a day, twenty-fours hours a day, seven days a week, fifty-two weeks a year, and for many years. You can avoid taking the first drink or the first cigarette, but no one can avoid taking that first bite. People are always wanting a simple easy solution to difficult problems. They do not find them. The prescription is simple-diet and exercise. It is the carrying out of the prescription that is the hard part. After more than fifty years of fighting the "Battle of the Bulge"-for others- not myself-I have decided that exercise plus dieting is more likely to help someone lose weight and to keep it off than just dieting alone. A former patient that I saw at Piccadilly today told me she showed her new doctor the last prescription I wrote for her, "Pitiful Portions." She was still fat, though, so the prescription didn't do her any good. She did get a laugh out of it, though.
Studies show that obesity causes a high percentage of the cost of health care for the elderly and is also one of the main causes of premature death. One mechanism is that type two diabetes-the type that comes on after age forty and is associated with obesity-is on the rise-to epidemic proportions. Type two diabetics comprise eighty percent of all diabetics. Type two is more hereditary than type one-the type that occurs in children and young people. Diabetes does not cause obesity. It is the other way around. Obesity promotes the development of type two diabetes. Type one diabetics are almost always thin. They will die without insulin whereas type two patients can often get by on diet, exercise, and/or oral tablets. Many of them have the disease for quite a while and don't even know it. Many obese diabetics could restore their glucose tolerance to normal. At least their fasting and the two-hours-after-a-meal glucose levels and their hemoglobin a1c level could also be restored to normal. (Hemoglobin 1ac is a test that looks back six weeks and tells the doctor whether the blood sugar has been normal during that time.)
What is bad about diabetes besides having to test your blood sugar, diet, take pills, or insulin? (I didn't mention exercise because it is very hard to get anyone to exercise). The complications can be divided into the big artery problems-arteriosclerosis (hardening of the arteries) of the coronary arteries-heart attacks and angina; of the arteries of the brain-strokes; and of the arteries of the legs-gangrene and amputation; and the little artery problems-of the eye causing blindness (one of the main causes of blindness in the U.S.); of the kidney causing kidney failure (diabetes is the commonest cause of kidney failure) requiring dialysis or a kidney transplant; and of the nerves of the lower extremities causing pain and numbness and sometimes leading to painless fractures of the foot bones and even amputation.
The sad thing about it is that if a fat person will use diet and exercise to attain and maintain a normal body weight, many of them will not even get diabetes or, if they already have it, they can get rid of it or, at worst, can make it less severe. I had a patient who had the disease. She didn't want to take tablets or insulin so she dieted, kept her weight down, and, as far as I know, doesn't have the disease now (I retired five years ago). I know a woman who was diabetic, but lost one hundred and seventy pounds. She was diabetic as are many members of her family. She is no longer diabetic-at least, her fasting blood glucose levels and her two-hours-after-a- meal blood glucose levels and her hemoglobin 1ac levels have all returned to normal. She used diet and exercise to lose all that weight over a two year period. So fat people can do it. It seems a strange thing for an internist to write, but I always wanted to do as much for a patient as I could without medication. Any medication can have adverse effects, as well as good effects. But life style changes are very hard to sell so I didn't get to treat without medications very often.
To quote Benjamin Franklin again, "An ounce of prevention is worth a pound of cure."
I always tried to sell preventive medicine, and tried to relieve suffering, ameliorate disability, and prevent premature death. Note the word "premature." Sometimes death is the only relief that someone living with pain, disability, and no hope of recovery can have.
Donald W. Bales, M.D. 29 August 2002

35. Immunization
I do not usually write letters to the editor, but a letter in the Times-News on 12 August led me to look this subject up on the Internet to try to be as up to date as possible and to send in this letter. We doctors have a hard enough time selling preventive medicine without sabotage of our efforts. I was not a pediatrician. I was an internist and have been retired for five years (after forty-five years of practice in Kingsport), but I am still interested in medicine and especially in preventive medicine. As Benjamin Franklin said and wrote so many years ago, "An ounce of prevention is worth a pound of cure".
In 1998 12 children were evaluated and the conclusion reached that there might be a link between MMR (measles, mumps, rubella-rubella is German measles) and autism. A later study on 500 children disproved this connection.
According to the CDC (Federal Center of Disease Control) before MMR there were three to four million cases of measles each year with a death rate of 450. Another 20% were hospitalized with the complication of encephalitis (inflammation of the brain) and brain damage. Since the vaccine has been available and used, practically all the deaths and complications have been eliminated. Most measles cases are imported now. In 1964-1965 there were 20,000 cases of congenital rubella with 2,100 deaths and 11,250 miscarriages, 11,600 babies born deaf, 3,580 born blind, and 1,800 born retarded. Mumps can cause sterility when it occurs in mature males, and can cause meningo-encephalitis (inflammation of the brain and its covering).
Recently there was a theoretical concern about the amount of mercury in vaccines used as a preservative in the Hepatitis B vaccine. At the urging of American Academy of Pediatrics the mercury was removed and the vaccine reformulated. Approximately 90% of infants born of mothers infected with the Hepatitis B virus will contract the disease and many will go on to develop chronic hepatitis (inflammation of the liver), and some will get cirrhosis of the liver, and some will develop liver cancer. Approximately 30% of those children who contact the disease have no predisposing risks, such as living with carriers, needle-stick, or blood product exposure. The only sure way to prevent the disease in these infants is by the vaccine.
Another researcher alleged that the Hemophilus B (HIB) vaccine given at 2, 4, 6, and 15 months caused an increase in the incidence of Juvenile Diabetes. He suggested only one vaccination at age 2. A review of his data showed faulty analytical methods. A ten year follow-up showed no difference in early and late vaccination groups. HIB attacks in the first six months of life. Before vaccination began, one in 200 children got the disease killing 600 per year and resulting in deafness, mental retardation, hydrocephaly (water on the brain), and seizures in others.
The U.S. Institute of Medicine (IOM) of the National Academy of Sciences - a private, independent organization created by the federal government to be an adviser on scientific and technological matters -- has established an independent expert committee to review immunization safety concerns, including thimerosal in vaccines. On October 1, 2001, the IOM Immunization Safety Review Committee issued its report "Thimerosal-Containing Vaccines and Neurodevelopmental Disorders," concluding, "The hypothesis that thimerosal exposure through the recommended childhood immunization schedule has caused neurodevelopmental disorders is not supported by clinical or experimental evidence."
After 20 years of experience Chickenpox vaccine has been found to give good long-lasting (90%) protection. Some children infected with the chickenpox virus get secondary bacterial infection with staphylococcal and streptococcal bacteria.
Vaccines have eliminated polio from most of the world and the smallpox virus remains only in some laboratories. There have been no cases of smallpox for many years. Vaccines are our best weapon against those diseases that formerly were disabling and killing so many children.
In medicine and in life, we should always be aware of the risk/benefit ratio. In the case of immunizations, the ratio overwhelmingly favors immunizations. Donald W. Bales M.D.

36. Tobacco
The successful lawsuit against the tobacco companies was a miscarriage of justice. From the time I graduated from medical school in 1946 up to the present I have been opposed to the use of tobacco. Of course, the scientific basis for that opposition became more convincing as time went on. When I was a boy growing up in Morristown, I would hear people refer to cigarettes as "coffin nails." The implication was that each cigarette smoked was putting another nail in your coffin. In 1964 the surgeon-general of the United States came out with a statement about the health hazards of smoking and warnings were required on the cigarette packages.
So you can see that I am not in favor of tobacco, but I am in favor of personal responsibility. Everyone knows, or should have known, that smoking and, indeed, use of tobacco in any form, is likely to be harmful to one's health. But tobacco is a legal substance. In fact, the Federal government subsidizes the tobacco farmers, thereby promoting the cultivation of it, and, by inference, approving of its use.
It is estimated that 400,000 deaths annually are related to the use of tobacco. Some say there are only 225,000 deaths, but that is still a very large number. We are alarmed and upset about 3,000 deaths in the Twin Towers attack, and I had and still have a cold anger about that. Tobacco is a much more common cause of serious disease and death than car crashes, illegal drugs, AIDS, and alcohol all added together.
Aside from the health hazards using tobacco is very expensive and will become more so. In New York City a package of cigarettes costs $7.50 a pack. At one pack a day that comes out to $2,737.50 per year. Just think what someone could do with that much money. Of course, it probably wouldn't be that much in some other places. The money obtained from the suits is mostly not going to prevent young people from starting nor for providing health care for people with smoking related disorders. A lot of it went to make a whole new group of millionaires-lawyers. The states have used the money for all sorts of things such as budget shortfalls and other purposes having nothing to do with the stated intentions when the suits were brought. If everyone stops smoking, the tax receipts will go way down so the authorities are being rather schizophrenic about it.
What are the health hazards of smoking cigarettes? Smoking is a strong risk factor for coronary artery disease (heart attacks and angina), for emphysema (chronic obstructive lung disease), for lung cancer, for urinary bladder cancer, and for cancers of the mouth, larynx, and esophagus. Women who smoke have more adverse effects from birth control pills. Smoking has an unfavorable effect on the fetus.. Cervical cancer is reported to advance more rapidly in women who smoke. Chewing and dipping are closely correlated with cancer of the mouth and tongue. It usually takes about twenty pack years to get into serious trouble with smoking cigarettes. Of course, the irritation of the bronchial mucosa and the cough comes on right away. Primary pipe and cigar smokers are said to have less risk than cigarette smokers. (Primary means the smoker started with a pipe or cigar.) But secondary pipe and cigar smokers are at higher risk. (Cigar and pipe smokers who learn to smoke on cigarettes are called secondary.) It is said that secondary smokers inhale the smoke more-I have no real personal experience with the use of any type of tobacco. Oh, when I was a child I tried rabbit tobacco, Indian cigars, corn silks, coffee, and cigarette butts, but I really didn't inhale. I even tried to chew Beechnut chewing tobacco and even tried long green once. I even tried snuff once, but I didn't like it-too nasty for me.

Some investigators think that nicotine is more addictive than cocaine. That may explain why it is so hard for some to give up the habit. I have seen smokers smoke up to their dying day. Of course, they all eventually stop smoking-when they die. Those who are unrepentant sinners may smoke again if they go the hot place. This doctor has to have his grim jokes. But grim jokes are better than no jokes at all.
Some wags have suggested that smokers should be given a financial reward. Many of them will never collect any social security except by being declared totally and permanently disabled before they reach the age of retirement. Many will not live until age sixty-five. However, it is expensive to care for someone with coronary disease, emphysema, or cancer so there will be an extra load on Medicare and insurance companies. The extra costs will be paid by non-smokers. It sometimes takes a long time for these diseases to cause death. That may cancel out the savings from not collecting Social Security payments.
Smoking is said to cause premature aging of the skin. And, of course, the smell of tobacco is not very inviting. Some people don't like to kiss a smoker. This might dissuade some women who are on the hunt to stop smoking. Some wags have suggested that girls who smoke are easier, though. That might give them an edge in the hunt. Smokers tend to pollute the atmosphere. Having a smoking section in a restaurant or other public establishment is like saying it is okay to urinate in a swimming pool.
I tried every trick I could think of to get my patients to quit smoking. I would give them literature to read. I would coax them. I would try to scare them. I would have ordered them if I had thought they would obey. One day I was talking to a patient and I said, "I've tried to inform you, I've tried to warn you; I've tried to scare you, but nothing seems to have worked. I don't know what else I can do." The man said, "You could pray for me." I was taken aback-not that I have anything against prayer. I don't feel it is part of a physician's practice to try to push religion except maybe by example, but I realized he was serious. So I said, "Well, let's bow our heads and we'll pray silently for you to find the strength to stop smoking." "Oh, no. You must pray out loud." Again I was taken aback, but said, "Let's bow our heads." Then I prayed, "Oh, Lord. Help this man to find the will to stop smoking." He went on his way (I don't know whether he went rejoicing or not.) He came back a year or two later for his annual physical. As I was reviewing his health history, I asked, "Do you still smoke?" He looked at me incredulously, and said, "Don't you remember praying for me?" So he had quit. I was preening myself about his success and told another man about what had happened. He, too, was a smoker. He went on his way and he returned in a year or two for his annual physical. I asked him, "Do you still smoke?." He had a surprised look on his face and said, "Don't you remember telling me about praying for that man?" So I didn't kill two birds with one stone, but I did get two smokers with one prayer.
I must relate one more story about smoking. A woman patient of mine was married to a United Methodist preacher. She asked me if I would preach at her husband's two churches on the fifth of October. I really didn't want to do it, and, since I was scheduled to be out of town that Sunday, I said, "I'm sorry, but I'll be out of town that day." "Well, how about the next Sunday?" I could see I wasn't going to get out of it, so I said I would do it..
So on October 12 I went to Cloud's Bend Methodist at nine. My message was entitled "Stewards of the Body." I found an Old Testament text that I thought was suitable, and a New Testament text. I don't remember what they were, but one of them went something like "Ye are the temple of God." I don't think the writer's point was exactly on target for my talk, but it came close enough. The theme of the talk was about how we are entrusted with our bodies and we should be good stewards of the wonderful gift we have received. I talked about unhealthy life styles and tried to outline what persons could and should do to promote health. At eleven I went to Depew's Chapel to speak a second time. The minister's older son was in seminary at Emory and at that service the minister's younger son taped my remarks to send to his brother in Atlanta.
Two years later I was in a grocery store and a man sidled up to me and asked, "Aren't you Dr. Bales?' "Yes, I am." "Didn't you speak at Cloud's Bend Methodist two years ago?" "Yes, I did." "I thought so. I went home after that and stopped smoking!" That made my day!
I must tell one more story. One of our surgeons had operated on this man for an abdominal aneurysm. The surgeon thought the man should have a medical doctor to follow his case and he asked me to take him. I was really busy then and really didn't want to take on a new patient. I said, "I'll take you if you will stop smoking." He said okay and did stop. However, about seven years later he came down with a lung cancer anyway. I thought it was unfair and I would have sent a night letter to God in protest, but I didn't know how to do that. He stopped too late. He was a fine old man (I probably wouldn't call him old now that I am eighty myself). Most of the time there is no justice in disease. Like the rain, disease and death fall on both the just and the unjust.
So, as you can see, I am very much against the use of tobacco, but it was not the fault of the tobacco companies that these people had health problems. It was their fault. But in these latter days, no one is responsible for his or her mistakes, it's always some one else's fault and it usually is someone with deep pockets.
As the old hymn says, "It's not my brother nor my sister, but it's me, Oh Lord."
Donald W. Bales, M.D.

37. Exercise 24 September 2002
The only thing harder to do than have people lose weight is to get them to exercise. I don't believe that I ever got anyone to exercise. I had a couple of men come to me to get clearance to exercise, but they had already decided that they were going to do it before they saw me.
At the risk of making this about me, I am going to relate something about my own experience with physical activity in the hope that it will help others to be more active. I was active as a small boy. The Tarzan funnies came out about then and I was fascinated. I used to spend a lot of time climbing trees. I had a small bicycle early on, but it didn't have a coaster brake on it. Later on my father got me a pony when I was eight and I learned to ride it pretty well. It was only about half broken and, when I tried to get on, would try to kick forward with his back foot. I was more adventuresome then so that suited me just fine. He would also kick up if I rode behind the saddle. So, of course, I would ride back there a lot.
I played sandlot baseball and yard tackle football. My parents had me take some swimming lessons.
When I was in the ninth grade I went out for football, but that year I only got into the game with the varsity on a few plays. I played enough in the tenth grade to get a letter, and was a regular in the eleventh and twelfth grades. I played forty-eight minutes in the 1939 game when Morristown beat Knox Hi for the first time in twenty-two years. We modestly called ourselves "The Great Team." During my senior year we had a poor basketball team-I was the tallest one on it so I played center. I lettered in basketball also. I was also on the track team, but did not letter. To earn a letter in track one had to place in a meet and I never did. I played some intramural basketball while I was at Harvard College, and played some more while I was in the occupation army in Germany, and some more while I was a medical resident at Ford Hospital in Detroit.
While our children were young, I would go with them to the swimming pool and played a little golf through the years.
When I was forty, I looked at my calves and they were too scrawny and I looked at my abdomen and it was beginning to protrude a little. So I resolved to do something about it.
The President's Council on Physical Fitness published an exercise book so I began to follow that. The fact that it came out during President Johnson's administration did not prevent me from using it. The Council was composed of some very knowledgeable people-Dr. Howard Rusk and Bonnie Pruden being the two that I remember. The little book advised a series of limbering and calisthenics type exercises and also had a aerobic component. It was quite similar to the Royal Canadian Air Force exercise manual.
Later on Major Kenneth Cooper came out with his book on Aerobics and I began trying to something aerobic several times a week. About that time a man came to see me for medical clearance. His wife wanted him to be examined before he began running again.(It's true: Married men really do live longer-it doesn't just seem longer!) He gave me a book on jogging. He also let me use his extra rebounder for several weeks. I began to jog and was in a number of 10K races. I was never any great shakes at running, but in one 10K I did get a third place medal for my age group. Four of us physicians went over to Nashville to compete in the HCA physicians two mile relay sponsored by Indian Path Hospital. We weren't the best runners, but we had the best looking warmup suits! I kept on with the running for several years. Then my arches started bothering me and I had to give it up.
About a quarter of a century ago I bought a used Motobecan ten speed bicycle, and I would ride it ten kilometers pretty often, but never entered a competition. I still ride it on the days that I cannot swim.
After I retired I began going regularly to the senior center workout room. Even though I do not have the build for being a weight lifter, I am quite a bit stronger than I was. I also took up swimming. Some of the people from the senior center who had seen me swim encouraged me to take part in the senior games, and I began to do so in 2000. First locally, then in the district (we swam at Freedom Hall in Johnson City) and then in the State Games at Clarksville. In 2000 I won four gold and one silver. Then last year I was in the local, the district, and state games again. In 2001 at Clarksville I won five gold medals. Last year I went to the National in Baton Rouge. The competition was stiffer there and the best that I could do was a bronze in the 100 yard breaststroke. This year we didn't have a local competition, but we did have a district one. At the State I was beaten in the 50 and 100 meter backstroke by about one second, but I was first in the 50 meter free style and breaststroke and the 100 meter breaststroke for the 80-84 men. I was pleased to have been able to set new records in both breaststroke events. I held the record for the 100 meter breaststroke for 75-79 men in 2001.
The bottom line is no matter how unathletic or out of shape you are, you can improve your condition by exercise. But it does take emotional and nervous energy and you have to keep at it. I always advise "Start low and go slow. Build up by small increments." Otherwise you are likely to get sore and become discouraged. Many exercise people advise alternating easy days and hard days. Studies in nursing homes have shown that even very elderly people with paralysis of the legs can develop increased strength in their arms with persistent training. The benefits of physical activity are not only physical but are also psychological. It boosts a person's morale to see that he or she is still able to be active. Someone asked me about exercise equipment. I said, "All you need are some walking shoes.”
."Don't waste your money buying expensive equipment”. Basements, garages, and attics are full of exercise apparatus-most of which have had little use.
It is inspiring to me to see some rather feeble elderly people continuing to try to exercise. We have two distinct groups at the weight room and at the pool: Those who have already had serious problems, such as a need for bypass surgery, total hip or total knees replacements, strokes, and partially paralyzed extremities; and those who have not yet had trouble, but are trying to prevent trouble, or, at least, trying to put it off for a while.
As you can see, I am very enthusiastic about physical activity. And exercise has a very important part to play in weight control.

38. Diet
As I was leaving the Renaissance building recently after a workout, a man asked me about my diet. I told him something like the following: Back in 1953 I gave a talk to the medical staff at Holston Valley Hospital on cholesterol. Studies of dietary habits in different countries of the world by Ancel Keys had suggested that a high cholesterol diet and high cholesterol levels in the blood were associated with an increase in coronary artery arteriosclerosis (hardening of the arteries of the heart) that leads to heart attacks and angina. After the meeting was over and as I was leaving the room, one of the doctors who had heard what I had to say told, "If you had kept on five more minutes you would have had them all at the foot of the Cross!"
Later on it became clear that it was not just cholesterol that caused the trouble, but that animal fats were even more important. Animal fats can be recognized because they are solid at room temperature whereas vegetable oils are liquid. The fat in cold water fish is not only not harmful, but is actually beneficial. That makes it easy to know the difference. So I began to try, within limits, to avoid foods with animal fats and cholesterol. I never met an egg that I didn't like, but I began to limit my ingestion of eggs to once a week or less.
The famous lady who lost 170 pounds in two years told me she had learned all she needed to know about nutrition in the fourth grade. Nearly everyone remembers how their mothers wanted them to eat their vegetables. (I don't call them "veggies" because that word is one of my pet peeves. It sounds so something-I don't know the right word to use. Is the word "affected?".)
Now many advise the Mediterranean diet. The people who live around the Mediterranean eat a lot of fruit and vegetables and pasta and not so much meat and seem to have a better record as to arteriosclerosis than others. Most nutritionists now recommend four or five servings of vegetables and four or five servings of fruit a day. Most advise avoiding animal fats-and cholesterol- as well as use of whole wheat bread and skim milk.
Many people, especially women, do not get enough calcium. One can get calcium without using dairy products, but it takes considerable effort. Osteoporosis (thin and weak bones that 39. Art and Science in Medicine
I thought I would write some of my thoughts about the art of medicine.
Science has ancient roots in medicine. Due to the acceptance of the authority of Galen, progress in medicine was delayed. However, the study of anatomy was a big step in the progress of medicine. The discovery of the circulation by Harvey was another. Someone has said that we stand on the shoulders of the giants of the past. Pasteur and Koch are two that come to mind. The discovery of micro-organisms led to an understanding of the infectious scourges of the ancient world and eventually led to measures of control of them. Doing post mortem examinations led to the discovery of the cause of death and of the anatomical changes associated with end stage disease. The Emperor Franz Josef of Austria-Hungary is said to have issued a decree that all the patients who died in the Allgemeine Krankenhaus (general hospital) in Wien (Vienna) must have an autopsy. This was a three thousand bed hospital. Some have thought that this led to Vienna becoming an important medical center. Vaccination against smallpox by Jenner and even earlier by a Scot opened up the possibility of control of infectious disease spread by inoculation or vaccination.
I thought that I was capable of doing the art of medicine, but I was always more comfortable when I could apply science to the problem at hand. I liked to analyze and categorize symptoms and signs and proceed in an orderly and systematic manner in other words to be methodical as a Methodist that I am should..
To me the art of medicine really means the application of psychology. I consider psychology to be a science, although not yet as well understood as astronomy or physics. However, a lot is known already about transference and rapport and about placebo and nocebo effects. (Nocebo is a word I coined for an unfavorable response of a patient to an inert chemical.) Jeffrey Jernigan, Dr. Bob Jernigan's son, calls some patients "alien patients." That is a patient who can't take any medicine or thinks he or she can't take any medicine. I firmly believe, but cannot prove, that a patient can have an untoward reaction or a symptom formation just by having the belief that he or she is going to have such. I learned that I might as well realize that, if a patient had a strong prejudice against a medication, that had better not prescribe it for the patient. The prescription might not be filled; or, if filled, not taken; or, if taken, might be associated with symptom formation.
Truly caring for the patient and the patient's welfare will be transmitted to the patient-possibly non-verbally, and will be the oil than lubricates the interactions of the doctor and the patient. One should be aware of-no, look for non-verbal cues when interviewing or examining a patient. Some people have a lot of emotional intelligence and others seem to have little or none. Emotional Quotient refers to picking up on the feelings of someone else. I used my own feelings to determine the feelings. I am not a fearful person, but, if I found myself feeling uneasy, I would suspect that the patient was uneasy. Then I might ask, "Are you feeling anxious?" If I began to feel angry, it might be because the patient was angry. I might then ask, "Are you angry about something?"If I began to feel helpless or hopeless, perhaps the patient was feeling that way. Then I might ask, "Are you feeling sad today?"And, if began to feel suspicious, it might be that the patient was suspicious. Then I might ask, "Are you worried about something?"
One day I told my nurse, "Now, don't leave me helpless." Meaning, of course, don't leave the room, or, if you do, come right back. The woman patient piped up, "Yes. You are about as helpless as a steel rapier!"
I made it a point to touch the patient and to examine the part complained especially carefully. Touch is very comforting and communicative. Of course, when a male doctor is examining a woman patient he has to be careful that such touching is not construed to be a sexual approach. In earlier days, When examining a woman, I insisted that a nurse be in the examining room with me, but in later years, especially with long standing patients, I was not so strict about that. I have had younger women allow the sheet to fall down away from their breasts, but not often. With those I was sure to have my nurse remain in the room. I had a nurse to assist or at least be present whenever I did a pelvic or rectal on a woman.
Another aspect of the art of medicine is non-verbal communication. This can give the doctor information that he can otherwise not obtain. If you ask the patient a question and they block, look away, or look down, it may be a very sensitive and important subject that needs to be pursued-if the patient can bring herself or himself to talk about it. Another cue is if the patient crosses their arms, that suggests they are trying to shut you out. The tone of voice can be revealing as well.
I suspect that intuition is really subconscious observation and reasoning. It may be inborn or it may be related to experience. I think some people have it more than others. I think I had some of it. I don't know whether it can be taught or not. I believe without any proof that it is not something mysterious or magical, but that can be explained by brain function. Emotional intelligence may be an important part of it. Donald W. Bales, M.D. retired as of 1997

40. Hypertension 28 October 2002
High blood pressure, or hypertension-the scientific or medical name for it-is very common. A high percentage of the people who have it are not aware that they have the disorder. It is highly hereditary, so, if you have a relative who has it, you have an increased likelihood of having it. It is very easy to diagnose. All you have to do is have someone take your blood pressure. The incidence increases with advancing age. Everyone should have their blood pressure checked. Even young people can have and there are some rare curable (by surgery) causes that can be found in children or youths.
Coaractation of the aorta is something a person is born with and consists of a narrowing of the big artery that comes from the heart carrying the blood to the whole systemic circulation (as opposed to the pulmonic or lung circulation). This narrowing is seen in the thoracic aorta before the blood gets down to the kidney arteries. The decreased pressure in the kidney arterioles provokes the kidney to release a chemical that raises the blood pressure in the upper body. This can lead to a stroke. It can be cured by an operation to get rid of the narrow place in the aorta.
Another rare surgically curable cause of high blood pressure is a tumor of the adrenal, or suprarenal, gland. In this condition the new growth releases adrenalin and its cousin noradrenaline. This causes the blood pressure to rise. Removal of the tumor restores the blood pressure to normal.
A third rare surgically curable cause of high blood pressure is another tumor of the suprarenal gland. This time, instead of it being the inside of the adrenal gland, it is the outside part. That is called the adrenal or suprarenal cortex. (Ad means to in Latin and refers to the gland in four- legged animals. Supra means above. The gland in question is located above the kidney in humans when the human is in the upright position.) If there is a distinct neoplasm (new growth) in one of the glands, it can be removed. If both glands are effected by enlargement of the gland producing excessive secretion of cortisone and/or its cousins, medication can be given to prevent the adverse effects on the blood pressure.
Another potentially curable cause of hypertension is renal artery narrowing due to arteriosclerosis (hardening of the arteries). This is likely to occur, however, in mature persons and many of them have other disorders, especially coronary artery disease (heart attacks or angina) that makes surgery less desirable and more hazardous.
All of the above disorders need to be discovered early, since if not found and treated early, the blood pressure may not come down even when the cause is removed.
After all that 95% of cases of high blood pressure are not due to any of them. It was formerly called essential hypertension (meaning it was of unknown cause). Some wags said the "essential" part of the name came from the doctors essentially not knowing what caused it.
As I wrote earlier, the majority of cases are hereditary. But these cases are eminently treatable and treatment really alters what happens to the patient. It can prevent heart attacks, strokes, and kidney failure. So early diagnosis and treatment are greatly to be desired. We have multiple medications to use for treatment. The large number suggests that no one medication is good for all cases.
The black population is particularly likely to have high blood pressure and black patients benefit more from sodium and salt restriction than do white patients. I think this is due to the fact the black people came from an area of the world where salt was scarce, whereas people from Europe always had plenty of salt and used a lot of it. Soul food (food that black people in the U.S. like and eat) is very salty.
I used to try to treat high blood pressure without medications. Weight loss, exercise, and salt and sodium restriction sometimes works, but I had little luck in getting patients to do any of those. It wasn't that I didn't try. So usually I had to use medications. It takes patience and time by both doctor and patient to find a treatment program that doesn't cause too many adverse effects (I don't call them side effects because they usually are right out in front), and are not too expensive. It is desirable that the patient be able to take his or her own blood pressure so that he or she can get constant information and feedback on how they are doing. Donald W. Bales M.D.

41. Physical Examination 20 October 2002
There are two types of physical examinations: The traditional one is a directed examination and follows up any clues found in the history obtained from the patient regarding any symptoms. The second type is the screening or annual type. Some efforts have lately been directed at making the screening examination more efficient with regard to the time used. For example, one article puported to show that examination of the rectum was not cost efficient. However, I do not accept this notion. It does take a glove or a finger cot and perhaps thirty seconds. What can one learn? If one felt a mass in the rectum, wouldn't that be useful knowledge? Some patients do not observe their stools-at least, some would not admit it. If one detected blood or noted that the stool was black, would that be of no value? What about detection of a nodule in the prostate? Of course, there is a controversy about whether the prostatic specific antigen test is of any use in saving lives. But the digital exam is much cheaper than the PSA test and should be as valuable. Although the PSA test might give evidence of earlier disease, it would be somewhat embarrassing to have the nodule discovered in the course of another examination by some other doctor such as a gastroenterologist or an emergency room doctor.
Some say that Pap smears are not needed if the woman is old and has had three consecutive negative Paps. But other disorders can be detected by a pelvic exam. Unfortunately, most ovarian cancers cannot be detected by bimanual pelvic exams. But it would be helpful in a lawsuit alleging a missed diagnosis to have a record of a negative exam on a certain date. Fibroids could be detected, but wouldn't necessarily mandate an operation. Vaginitis would usually cause symptoms, but sometimes asymptomatic infections might be detected. I have found foreign bodies in the vagina at times-once some brush bristles, and several times diaphragms. Not that those were serious findings. But you never know what you may find during an examination of any part, but you surely won't find it if you don't look and feel.
Skin cancers are curable in a high percentage of cases, but they will not be detected with the patient completely clothed. The yield from looking at the pupils and the eye grounds may not be great, but occasionally something might be found. Looking the ears may not show anything, but it would be nice to know that the patient had a perforated eardrum. Nasal exam could give a clue to nasal allergy or infection or dryness. Observation of the mouth and throat would seem desirable to check on the teeth and look for lesions that might be pre-cancerous or cancerous, especially in smokers. Examination of the neck, axillae, and inguinal region would usually not be revealing but lymph node enlargement might be detected. Palpation and auscultation of the carotids, especially in the elderly, might reveal bruits and lead to investigation of narrowing. Inspection, palpation, percussion, and auscultation of the precordial region and heart should certainly be done without intervening clothing. The lungs should be similarly be examined. Inspection and palpation of the abdomen could detect enlargement of the liver or spleen and rarely of a kidney. Abnormal pulsation of the aorta might reveal an early aneurysn. Other masses of the abdomen and/or pelvis might be found. They would certainly be missed if the abdomen was not examined. Listening for murmurs over the femoral arteries wouldn't take long. Inspection of the feet for any abnormality might show early changes. Testing the knee jerks and ankle jerks would show the sensory and motor connection function of the lower extremity. Testing for range of motion of the back, the neck, and the extremities could show abnormalities that the patient had not volunteered. And checking of the pedal pulses in the mature patient would seem to be proper.
I had my nurse take the patient's temperature, weight, and blood pressure. It the patient was on any medication that could cause postural hypotension, I had the blood pressure taken lying and standing. I had the height measured yearly. Loss of height could be due to osteoporosis-a disorder very common in elderly women, but one fifth of the cases occur in men.
I think the directed and the screening examinations should be done in exactly the same way and should be done in a systematic and orderly way. Without a set routine it would be easy to be distracted and fail to examine every part. In addition I think every part complained of should examined carefully-for two reasons: One to help with the diagnosis and two to assure the patient that his or her complaint is being taken seriously and is not being ignored. In the case of the directed examination additional attention should be given to the parts that have caused symptoms or that might confirm or deny the suspicion aroused in the doctor's mind by the history. A thorough physical examination can be very reasssuring to the patient and can dispel fears better than mere verbal reassurance. In the absence of a thorough examination the patient may feel the reassurance in not based on facts. A thorough examination is a good way to establish rapport and get the patient's confidence. break easily) is very common. It is usually thought to be a woman's disorder, but about 20% of cases are in men. Low calcium intake could contribute to the development of this condition. Calcium is one of the few supplements that seems to be needed. Some people go for mega-vitamin use. I think it is quite good for the stockholders of the companies that make and market the vitamins. I hold a similar view of herbal therapy and most other alternative medicine.
If a young person had asked me if they should drink alcohol, I would not have advised them to start, especially if they had a family history of problem drinking. Problem drinking is present if drinking has caused interference with one's job, one's marriage, or one's health. There is a strong hereditary element in alcohol abuse. However, one or two drinks a day for men and one drink a day for women seems to protect to some degree from arteriosclerosis. The restrained drinkers have a better record than teetotalers. Some writers think that red wine is better than other forms of alcohol and red wine surely is better than white wine. Some chemicals in the grape skin have beneficial effects. Some think the red wine is better than plain grape juice. I don't make the rules-I just know what some of them are. If you don't like the rules, take it up with the rule maker. Sorry-abstinence people. But imbibing wine wasn't a sin to Jesus. Maybe we should pay more attention to other behaviors. Of course, prevention only goes so far. There are many disorders that we don't have any idea how to prevent.
I used to joke and say that I knew how I would die-I would be run over while out jogging by a fat, drunk, cigarette smoking truck driver with hemorrhoids bit no brakes! So when I would hear a truck motor, I would get up on the bank beside the road. I don't jog anymore so I don't have to be concerned about that anymore. My arches don't like for me to run, but I miss it. I see someone out running and I think "I wish I could still do that."
It's not only important what you eat, but how much. A human needs about one gram of protein for each kilogram of body weight. It takes thirty grams to equal the weight of one ounce of water and a kilogram is 2.2 pounds. So that means that someone who weighs 154 pounds needs about 70 grams (2 1/3 ounces) of protein. That would be a piece of meat about the size of package of cigarettes. No one needs a 12 ounce steak. Half of an 8 ounce steak would be too much. Of course, one can get protein out of grains or beans or dairy products so that one does not need to get it all from the flesh of animals. I am not a vegetarian, and I am not that enthusiastic about vegetarianism. Pure vegetarians would have to take supplemental B12 since it is only found in animal products. Lact-ovo-vegetarianism is more acceptable-they add eggs and dairy products to their diets of plant food.. Avoiding meat appeals to some as a humanitarian thing to do. It takes about ten pounds of plant food to produce one pound of meat (maybe less with chickens) so the food supply would stretch farther if everyone one ate only plant food. In this country, though, even the poor are eating too much. There is a definite correlation between educational and economic level and over weight. But I will have to say, though, that I have seen a good many well-educated and prosperous people who are obese.
One day when I was younger (early seventies) one of the younger doctors noticed me choosing my food carefully at the doctors' dining room. He said, "It doesn't matter what you eat." I assumed he meant that I was so old that it didn't matter. And he said, "Besides you are too thin." I asked, "How much do you think I weigh?" "Oh, about 149." I asked, "How tall are you and what do you weigh?" "Oh, I am six feet tall, and I like to weigh between 165 and 170." I said, "I'm six feet tall and weigh between 165 and 170!"
I couldn't believe that it made no difference what some one eats for twenty-five years. (You can see that I am an optimist.) Some say we are what we eat. I don't weigh that much now. I have lost down to 155 since I retired. I am much more active physically now than I was when I was working, and am in better condition. I weigh the same now that I did when I played football at Morristown High School back in the late 30's. Donald W. Bales M.D..

Even if they complain about the pelvic and/or the rectal emaciation, that is not a reason not to do them. Occaionally when I was to see a polysymptomatic patient, I would reverse the order and do an especially thorough physical examination first and then take the history and the system review. This often led the patient to take less time relating her complaints. I had showed her I took her case seriously by my examination so she didn't have to exaggerate to get my attention.
I write "her" because almost all of these polysymptomatic patients with no findings were women. That is based of experience and is not based on sexism.
A physical examination is not painful (at least, not enough to be of any consequence) and it doesn't take a lot of time and for the information it supplies it is very cheap compared to the cost of laboratory tests or imaging.
I had an former patient tell me that he went to a well trained and well thought of doctor about a problem he had with one of his feet. The doctor didn't even have the patient take off his shoes and socks! Another patient told his doctor of nosebleeds and the doctor did not even look in his nose!
If the patient has a chronic disorder, the parts involved in such a disorder should be singled out for examination on every visit, but particularly during the annual visit.
It may be the way I was trained in medical school and in internship and in residency, but I think physical examinations should be head to toe and that the patient should be undressed. I told my nurse, "Be sure they take off enough clothes so that I can examine any part complained of!"
Donald W. Bales M.D. 20 October 2002

42. This is not an essay, but a poem that Frank Kelly gave me today, 12 August 2004
A Woman
She's angel in truth
A demon in fiction
A woman is the greatest
Of all contradiction.
She is afraid of a cockroach
She will scream at a mouse
But she'll tackle a husband
As big as a house.
She will take him for better
She will take him for worse
She will split his head open
And then be his nurse.
And when he is well
And can get out of bed
She will pick up a teapot
And throw at his head.
You fancy she is this
But you find she is that.
She will play like a kitten
And fight like a cat.

In the morning she will.
In the evening she won't.
So you're always thinking
She will when she won't.

43. The Theology of Benjamin Franklin From "Benjamin Franklin" by Edmund Morgan
He seems never to have doubted the existence of God and his Creation of the world. How else did everything get here?
In Boston in 1723 there were six Congregationalist Churches, some with two ministers, with a total of 1500 members. There also was an Anglican Church, a Baptist Church, and a small group of Quakers. He grew up in a Old South Church in Boston. They taught that Works could be the result of Faith. His father, Josiah Franklin, was a pious Congregationalist. Ben was supposed to become a minister, but schooling became expensive. He was the youngest son in a family of eleven children. He was apprenticed to his printer brother James, but he didn't like the tyranny of his brother so left Boston at age seventeen.
He came in contact with the Deists. At twenty he wrote a pamphlet in which he wrote that God left no room for religion, or any difference between right and wrong. Forty-six years later two friends used this excuse to refuse to pay back what he had lent them. He never accepted the Bible as Divine revelation or Jesus as the Son of God. Actions might be forbidden because they were bad for us or commanded because they were good for us.
In 1734 he was influenced by an assistant Presbyterian minister, Samuel Hemphill, who said, "Morality or Virtue is the End, Faith only a means to attain that end." Franklin ridiculed the idea than either Adam's sin or the righteousness of Christ could be "inherited"or "imputed" to Adam's posterity. Conversion was not needed.
Hemphill's sermons were cribbed from the Deists (Arians). He said, "Morality, or Virtue, is the End, Faith only a Means-to obtain the End and, if the End be obtained, it is no matter what the Means." The Synod dismissed Hemphill. Franklin left the church never to connect to another. But he was a friend to George Whitefield, a leading itinerant preacher of the time.
In Poor Richard's Almanack, he wrote, "Sin is not hurtful because it is forbidden, but it is forbidden because it is hurtful. Nor is a Duty beneficial because it is commanded, but it is commanded because it is beneficial." "Virtue, that is, morality, is the Essence of all true Religion.
Franklin listed thirteen Virtues:
1. Temperance: Eat not to Dulness Drink not to elevation
2. Silence: Speak not but what may benefit others or yourself. Avoid trifling conversation.
3. Order: Let all your things have their places. Let each Part of your Business have its time.
4. Resolution: Resolve to perform what you ought. Perform without fail what you resolve.
5. Frugality: Make no Expense but to do good to others or yourself, i.e. waste nothing.
6. Industry: Lose no Time-be always employed in something useful. Cut off all unnecessary Actions.
7. Sincerity: Use no hurtful Deceit. Think innocently and justly; and, if you speak, speak accordingly.
8. Justice: Wrong none by doing Injuries or omitting the Benefits that are your Duty.
9. Moderation: Avoid Extremes. Forbear resenting Injuries so much as you think they deserve.
10. Cleanliness: Tolerate no Uncleanness in Body, Clothes, or Habitation.
11. Tranquility: Be not disturbed at Trifles, or at Accidents common or unavoidable.
12. Chastity: Rarely Venery, but for Health or offspring. Never to Dulness, Weakness, or the Injury of your own or another's Peace or Reputation.
13. Humility: Imitate Jesus or Socrates.
Charity-love of fellow man is missing.
Eat to live and not live to eat.
To lengthen thy life, lessen thy meals.
Take counsel in wine, but resolve afterwards in water.
He that drinks fast, pays slow.
Nothing more like a Fool, than a drunken man.
Content and Riches seldom meet together.
If your Riches are yours, why don't you take them with you to the other world.
The use of money is all the Advantage there is in having money.
"What we have above what we can use, is not properly ours, tho' we possess it.
1750: "I would rather have it said, he lived usefully, than He died rich."
"Talents and Will are the same Person giv'n
The Man ennobled doth an Hero rise
Time and his Virtues lift him to the skies."
"tho' we are generally hypocrites, in that respect, and pretend to disregard Praise" August 2003

44. Dr. Bales Dumb Advice Book
Introduction
My medical practice in Kingsport began on 1 August 1952. I have always had an enquiring mind, and have been inclined to be philosophical and psychological in my attitudes. As I continued in my practice of internal medicine, I realized that certain patterns of behavior repeated themselves. For example, frequently I seemed to need to tell patients the most fundamental things that I was sure they already knew. However, I was fortunate enough in my formative years to be around people who had a lot of common sense. In particular, my grandfather Weesner, who was also a physician, really excelled at being able to apply common sense to any matter that he dealt with-whether medical or otherwise. I thought it might be useful to record some of my thoughts regarding "Dr. Bales's Dumb Advice". I intend to use the question and answer mode of communication:
"You say you have a hangover today?" "Don't get drunk tonight!"
"You say you are tired?" "Rest."
"You say you are too fat?" "Go on a diet and start an exercise program."
"You say you are too thin?" "Eat more."
"You say you are ignorant?" "Read a lot and go to school."
"You say you don't make good grades?" "Study. And, of course, don't lay out of school."
"You say you are poor?" "Get a job. Improve your skills."
"You say you are weak and out of condition?"
"Start an exercise program. Train and don't strain."
"You say you feel guilty?" "Seek forgiveness from those you have wronged, and stop doing
the things that make you feel guilty."
"You say you think you have something wrong with you?" "See a doctor."
"You say you feel bored?" "Take up a hobby, do something for others, take a vacation."
"You say your spouse says you don't pay enough attention?" "Pay more attention."
"You say people say you look dirty and unkempt?" "Pay attention to cleanliness and grooming."
"You say you don't take the medicine your doctor has prescribed?" "Take it. Tell the doctor.”
"You say you don't keep your appointments?" "Keep them."
"You say you are always late?" "Start sooner. Go by experience instead of calculating it wrong.” "
"You say people seem to be against you?" "Maybe you project hostility toward them. Try to be friendlier."
"You say you have a cough and are short of breath?" "Stop smoking cigarettes."
"You say you are nervous?" "Tell your doctor. He may be able to help you. If he can't, perhaps he can refer you to someone who can?"
"You say you feel alienated from your children?" "Show your interest on and concern for them?"
"You say you have a religious problem?" "See your pastor, priest, or rabbi. Maybe they can help.”
"You say you are hungry?" "Eat."
"You say you are thirsty?" "Drink."
It might seem that I do not have a good opinion of people's ability to solve their own problems. Many times I have thought that the person in question knew what to do, but needed encouragement or permission to do it. When I am in my car, I sometimes listen to some of the talk radio programs such as Dr. Joy Brown and Dr. Laura Schlesinger. So many of the callers need "dumb advice". In so many cases on these programs, and, in my office, the solutions seemed so logical and common sense, that I had some trouble believing that the people involved didn't know better. However, it is hard to be objective about yourself, and most of us can benefit from disinterested, but, not uninterested, advice.
I have always been in favor of prevention, and whenever I hear of something bad happening, I begin to think about some way of preventing. After all, as Poor Richard (Benjamin Franklin) said so many years ago "An ounce of prevention is worth a pound of cure."

Donald W. Bales, M.D.

45. Lurching toward Lawlessness
We have "Defining Deviancy Down" by Pat Moynihan and "Sloughing Toward Gomorrah" by Robert Bork, and now you have "Lurching Toward Lawlessness" by Donald W. Bales.
I have long been appalled and angered by the development of systemic and deliberate and cynical evasion and breaking of the law by many municipalities and even states with regard to illegal immigrants. Some law enforcement agents are forbidden to report the names of persons who are arrested for felonies and misdemeanors, who are found to be illegal immigrants, to the Immigration and Naturalization Service. It seems to me that this is a clear violation of a Federal law, and, if it isn't, it should be.
Furthermore, giving illegal immigrants a driver's license is dead wrong. The driver's license is as close as we have so far come to being a national identity card. The idea of providing these people, who shouldn't even be in the U.S., with health care, education, and welfare benefits is not consistent with my beliefs about justice and fair play. And giving them free college tuition or decreased tuition is even worse, and provokes me to disgust and anger.
We already have enough scofflaws and now we are producing a lot more of them.
Rats and mice can be trained by the pain-pleasure principle. By that, I mean that, if the animal is rewarded for a certain behavior, it is likely to repeat it. On the contrary, if the animal is punished for a certain behavior, it is unlikely to repeat it. If it will work on a rat or a mouse, isn't it likely to work on a human? Of course, some say that humans mostly use their big brains to justify doing what they know is wrong. If that is the case, it may explain a lot of human behavior (perhaps it would be better to use the word "misbehavior).
Donald W. Bales, M.D. 25 September, 2003

46. A Calm and Courageous Realist
Julie probably has always been calm and courageous. She had a submucous resection of her nasal septuum in high school as well as a tonsillectomy and adenoidectomy. I didn't know her then, but her report about those procedures did not carry any message of "ain't it awful" or any hint of undue anxiety about them.
When she had hearing impairment from otosclerosis, she accepted to wearing a hearing aid without complaint, although I suspect she had a problem adjusting to hearing incidental noise that she had not previously been able to hear. She just went on about her business. She never showed any evidence of thinking, "Why me?"
Agreeing to marry a poor man with a year to go in medical school showed confidence and courage. She accepted moving to Detroit away from her family without question or complaint. Then she traveled to Germany on a converted troop transport through a storm that resulted in nearly everyone on board either becoming seasick or having gastro-enteritis (vomiting and diarrhea-to put it clearly). It took twelve days to make a trip that usually took five. Except for being unusually glad to see me at the port of Bremerhaven, this experience didn't seem to faze her. I was a medical officer at the 130th Station Hospital in Heidelberg then.
Deciding to have a baby when I had a year of residency to go was another evidence of a courageous and optimistic (it turned out to be realistic) view of life. She was not at all anxious during her pregnancy. On the contrary she seemed to glow during the mid trimester with happiness and fulfillment (the use of the word "fulfillment" was inadvertent).
When she came to Kingsport for the first time, she was not favorably impressed with Kingsport, and said to herself, "Is this where I am going to spend the rest of my life?" With her accepting and serene attitude she was soon content. The next three pregnancies didn't seem to bother her or cause her any anxiety. Even having a close call about getting to the hospital on time with Bart didn't seem to bother her.
Her ear operations under local in 1960 and 1961 didn't seem to worry her at all. In each case we came home to Kingsport from Memphis the next day. She approached her glaucoma with the same calm acceptance-and used her drops exactly as prescribed. She had her first cataract as a matter of course and later the other one. These operations must have been done on a Wednesday-a double stamp day. After one of them she no longer needed the glaucoma eye drops.
The severe pain with her gall bladder attack shook her up a little, but only because of the pain. She didn't seem to be overly anxious about the situation. After her laparoscopic operation to remove her gall bladder, she didn't take any opiate pain medication. She did take two Tylenol one evening. She was found to have an angiomyolipoma of her right kidney. That is a benign lesion, but rarely can rupture and cause severe bleeding. If she was anxious about that, (and she knew about that possibility), she never showed it. Some think that I am a keen observer of people with ailments-both physical and psychological.
In 2000 she was found to have a heart murmur. This led to an Echocardiogram that confirmed that she had a stenotic aortic valve. She was aware of the implications of this condition.
When she had chest pain (a three on a scale of ten) for one hour at 5:30 A.M. on 28 September 2004, she was uncomfortable, but I think that I was more concerned about the possible cause of the pain than she was. The subsequent visit to Dr. Singh and his referral to Dr. Turner, an invasive cardiologist, and the Echocardiogram that Dr Turner recommended were all accepted in a calm good spirit. When advised she needed a cardiac catheterization she said, "I don't want that." After she thought about it (and after I told I wasn't ready for her to leave me just yet), she decided she wanted to go ahead with the recommended procedure. The cardiac catheterization showed that the aortic valve was a little worse than the echo had shown it to be. It also showed a seventy percent stenosis of the left anterior descending coronary artery.. Dr. Turner recommended that she have the aortic valve replaced and the narrowed artery bypassed. We had chosen Dr. David Sewell for the surgery. He saw her promptly and said he could do the operation the next day-a Friday. We decided to have it done the following Monday. I don't think anyone could have had a better attitude about the surgery than the one that Julie had..
I think her experience with her mother many years ago may have influenced her attitude about the surgery. When her mother was seventy, she fainted on the steps of the courthouse in Memphis. Her husband wanted her to go to Houston. Dr. Debakey replaced Mrs. Stanton's stenotic aortic valve with a pig valve that was supposed to last five years. She was the oldest patient with that disorder that he had operated on up to that time. Mrs. Stanton lived into her 89th year!
I think the consultation preoperatively with Dr. Smiddy about her lungs and the lung function test made her feel more comfortable about the surgery (I know it made me feel better about it. I was helped by Dr. Smiddy's assurance that her lung function was good enough to tolerate the surgery.). I am sure she was concerned, but, if she was anxious about it, it was not apparent to me. After fifty-nine years of knowing her, I doubt if she could have been a good enough actress to conceal a serious degree of anxiety from me.
I rest my case. Have I convinced you that she is a calm and courageous realist? She is a wonderful woman-even if she won't come on!
Donald W. Bales-Loving husband of Julia Anne Stanton Bales
26 October 2003

47. I like
I like my life. I like my house and I like my lot-the acre and three-quarters of land, but also my lot in life. I like my car and I like being retired. I liked the practice of internal medicine and I enjoyed being active as a doctor for fifty one years. Actually I began seeing patients as a medical student in the fall of 1944. I liked most of my patients. I like to swim and go to the gym and I like to write. I like to read and watch TV. I like to use my computer and to get on the Internet. I like doing email. I like-I love-my wife and my children. I like-and love- my children's spouses and they seem to like me. I like-I love-each one of my six grandchildren. I like my relatives, and Julie's relatives and the relatives of our children's spouses. I like my Monday lunch group, and the gym group, and the swim group, and the Kingsport Institute of Continued Learning faculty and students. I like the Philosophy Class (Sunday School) and I like my church-both the local one and the denomination although I think the central body of the Methodist Church is too liberal. I like (love) my country. I like the Declaration of Independence and the Constitution and I like our form of government and the freedom it makes possible. I have some concerns about the future. Even though Communism has been shown to be a failure in that it provides neither a good material life nor freedom, some people still think it could work. I don't like Socialism either even though its record is not as bad. I like the library and I like the Great Decisions seminars. I like the Symphony concerts, and I love popular music. I like movies, but it is rare that a modern one is any good. I like to travel and see new places and I like to visit relatives- especially our offspring. I guess I could say that I am a happy man. I don't like the inroads of age, but I have held up pretty well. I like to get the maximum out of everything. I like for things to be orderly and neat, but comfortable.
I also like living in Kingsport. Here I "swim in friendly seas" and I receive a good deal of respect. I like being as healthy as I am, and I think that I am getting more strength and stamina. I don't like having beginning cataracts, but I like knowing that I can have them removed if it becomes necessary. I don't hear as well as I used to or as well as I would like, but, if my hearing gets bad enough, I like knowing I can get a hearing aide if I need it. I don't like having to void so often and I don't like having to take a long time to get empty, but, if push comes to shove, I like to know that I can have another procedure on my prostate.
I like doing Tai Chi and yoga. I like being married to Julie. She is so kind and loving. o be.

48. My comments about:
Sex, Drugs, and Rock and Roll by Susan Lee WSJ 12 February 2003
Does human experience on planet earth teach us nothing?
I am a very strong believer in personal property rights and individual human rights. At the same time I am a communitarian; that is, I think each person has some obligation toward others, including the general body social. I believe in a social contract-I won't infringe on your rights if you won't infringe on mine. Unfortunately, too many do not want to do that and we must have government. To me government has three duties only: to protect us from foreign enemies, to protect one from fellow citizens, and the maintain a stable currency. All the rest is inessential and superfluous.
Some think that the Code of Hammurabi and the Ten Commandments (at least the last six) are just edicts that someone thought up. I perceive them to be the distilled wisdom of the ages. Some behaviors seem to result in more justice and harmony than other behaviors. And we deviate from these at our peril. How do societies fare that depart from them?
As to marriage, to me it is about the children. The nuclear family has been around a long time and, in general, has worked well. The human species is not extinct, is it? That is one test of the success of a species. Certainly extinction cannot be considered a distinction. It is obvious that fatherless families do not fare well. And motherless families may do even worse. Example is a great teacher-a lot better than preaching or teaching. "Do as I do" is a lot more likely to be followed than "Don't do as I do, do as I say."
My father didn't say it, but he implied it to me. He was fat, smoked, and drank-and died at age forty-four. But he did tell me, "A man's word is his bond." He followed that rule. I never saw him unclean, unshaven, ungroomed, or poorly dressed. His shirts were spotless and ironed, his pants had a crease, his tie had no spots, his shoes were shined, and I never saw him be discourteous to anyone. He also had a great sense of humor. I don't why I am writing this, but what we become is not a matter of chance-genes and environment shape us. Not to say that I don't think each person has a responsibility for his or her own actions. Of course, personal responsibility for one's behavior and fate is not politically correct. If anything goes wrong, it has to be the fault of someone else and it can only be someone or something with deep pockets.
This is one conservative (of sorts) who does oppose same sex marriage (see above), who does vehemently oppose illegal immigration and wholesale immigration (why should we take the sick and the criminal from other societies?), and who does not patronize or belittle or lack appreciation for women. Our society is decadent. Medical marijuana is a pretext for legalizing recreational marijuana. Recreational marijuana should stand or fall on its own merits or demerits. It will not enhance efficient behavior or thinking. Abortion used to be illegal-now it is legal. To show how broad minded I am I will even quote that famous Arkansas white trash, "Abortion should be legal, safe, and rare." Of course, the "rare" was just stuck in there, he didn't mean it. But I do. Most of the laws regarding sodomy are no longer operative or, if still on the books, are rarely enforced. As to censorship it is not only the conservatives who advocate it (and I do not)-the liberals are even worse with their speech codes.
As to sexual practices, nature doesn't seem to like promiscuity (if nature can have likes or dislikes), just look at all the penalties nature puts on it-syphilis, gonorrhea, chancroid, herpes, human papilloma virus, lymphopathia venereum, and that equal opportunity killer HIV-AIDS. Monogamy may be monotonous, but it's safe. The sexual revolution occurred when women and girls changed their behavior. The men then got to do then what they had always wanted and now the women and girls would let them, and even promote the activity. The pill and the condom and other methods that were supposed to allow sexual activity without pregnancy do not seem to have worked as they were supposed to judging by the number of unwanted pregnancies that have ensued. Of course, some young girls get pregnant on purpose (or so I have been told by nurses that work with the girls) in order to escape from an unpleasant or abusive home situation. Welfare has reduced the social and economic penalties for such behavior.
The parallel to Hayek does not compute. He had a lot of evidence on his side and a great deal of evidence against the other side from observation of economies and societies. Central planning (Socialism) just doesn't seem to work very well. It took the Russians seventy years to find it out. Now only North Korea and Cuba are the only ones still trying to use a Communist system-all the others are mixed. Even so-called democratic (representative is a better word since there are no true democracies) socialism is not doing too well. If the socialist countries in Europe had to pay for their own defense, they would be even worse off than they are.
Do we want to take a chance on throwing away the past and test postmodernism? All great societies of the past have gone into a decline and most of them seem to have rotted from the inside making them susceptible to attack from the outside.
To me the author, Susan Lee, set up a straw man conservative so the contrast with her admired libertarians would be more striking. Donald W. Bales 16 February 2002

49. Illegal Immigration
This is one of my pet peeves. I am in favor of law and order, but I perceive that the law has been hijacked or bastardized and is being misused by greedy lawyers, greedy clients, judges who do not follow the law, and juries who don’t realize that there is no free money. However, this can be a subject for another day. However, the law or the absence of enforcement thereof is an important part of this article.
Laws prohibiting illegal immigration are on the books, but are not enforced. Part of it is not enough people on the borders and lax application by the INS. But a more important part is the failure of employers to report illegals. In fact, they conceal the fact that they are illegal and exploit them for low wage help. Furthermore, in some cities the police are forbidden to report any illegals to the INS and will be censured or disciplined for doing so.
I don’t care if the businesses need low-cost help to do menial work and especially stoop work and I don’t care if a certain party wants lots of them for potential voters. Neither of these motives justifies the present situation. Some say they do useful work and pay taxes. I doubt that the net result overcomes the additional cost of providing education, health care, and other benefits.
When a person’s first act in the U.S. is a criminal one, what kind of citizenship can be expected of such a person? We are already a nation of scofflaws and we are allowing into the country a lot more of them. They learn that breaking the law pays off. As far as providing them college education at less cost than a citizen would pay-that makes no sense and it infuriates me. What good is it to be a citizen if a non-citizen receives more benefits? Giving them a driver’s license was even worse. The driver’s license is the closest thing we have to a national identity card. Fortunately, a governor with a little sense has stopped that nonsense.
I haven’t even mentioned the danger to national security. Most of the illegals from Mexico probably are not going to carry out terrorist acts, but, if people can get in without any checking of them, why can’t radical Islamists get in also. We have had some experience with what some of them have done and want to do. Of course, some terrorists get in legally. That is a subject for a later article, also. I blame the State Department for some of this, but I also blame the Bush administration for not leaning on them to cut down on people from countries under suspicion of harboring, supporting, or indoctrinating people who want to harm the U.S.
Winning votes or having cheap workers is surely not worth the risk of another September 11 or an even worse attack.
Donald W. Bales, M.D.
6 December 2003
Added to Essays 5 January 2004

50. United Nations
The UN was formed in 1945 as an organization of the victors. It was promoted by Franklin Delano Roosevelt and Winston Churchill and had fifty nations involved at the time. The hope was that it would prevent further wars and allow international disputes to be settled by peaceful means. United Nations day is 24 October.
The five permanent members of the Security Council were the U.K., the U.S., the USSR, China, and France. Anyone of the five could veto any action of the Security Council. At present there are nine non-permanent members of the Security Council-they do not have veto power. Present members are Germany, Pakistan, Romania, Spain, Philippine Islands, Algeria, Angola, Benin, and Brazil. The last five start 1 January 2004. The General Assembly was made up of the remainder of countries. Now there are 191 countries and of those 148 have populations of over one million. 48 countries are listed as developing countries. As of January 1996 Freedom House judged 20 % to be free, 42% partly free, and 39% not free. Free was defined as having majority rule involving free and open elections protection of civil liberties by a reasonably independent justice system. 49 countries are considered to be developing countries.
The UN is supported by member countries: U.S. 22%, Japan 20%. The staff has 9,118 members. The Secretary-General serves for five years. Ghanian Kofi Annan's term ends in December 2006.The President of the General Assembly is Julian Robert Hunte of Santa Lucia.
Fifty-five states are Muslim. Twenty-two are Arab.There are 1.3 billion Muslims. One state is Jewish. Only twelve million Jews on the planet. These facts may help one to understand the following:
From 1947 until 1989-321 resolutions by the General Assembly, none against any Arab states or the PLO. 49 Security Council resolutions against Israel and none against the Arab States or the PLO. Israel has one thousandths of the world's population and discussions about it use 30% of the meetings of the Security Council. The UN asked all nations to withdraw their missions from Jerusalem. Most of them moved to Tel Aviv. Israel is excluded from temporary membership on the Security Council. Syria, a "rogue" state is on it right now. Israel is also excluded from being on a regional group-the only country so treated.
20,000 Syrians were killed at Hama in 1982. Egypt used poison gas in 1966 and Iraq in 1988, but no condemnation or resolution by the UN. Resolution 242 against Israel in1967 and 338 in 1973 when Egypt was planning to attack Israel in 1967 and did attack it in 1973. In 1973 Israel withdrew from the Sinai-giving up oil wells and a geographic buffer.
In 1948 many Arabs left Israel-they were advised to do so by the Arab states with the idea that they could return when the Israelis were killed or driven out. Some say 750,000, some say 650,000 and some say only 472,000. At the same time 850,000 Jews fled Arab countries and 586,000 came to Israel where they were assimilated. None of the Arab refugees were assimilated by the surrounding Arab countries and the UN maintained refugee camps in those countries.
UNAWA helps Palestinian Arabs with humanitarian matters. UNHCR helps governments resettle refugees in Arab countries, but not Palestinian Arabs.
I have had a dim view of the UN. But I thought that WHO-World Health Organization-was one of the good parts of it. It did coordinatate the effort by the health departments of nations all over the world to try to get rid of smallpox. The last case other that from a lab accident was in the 1970's and we quit vaccinating people about 1974. Smallpox virus is still in labs in the U.S., in Russia, and maybe, illegally, and covertly, in some rogue states. A campaign against yaws (a spirochete disorder-syphilis is a cousin of yaws) was carried out in the 1940's. During the last three decades a campaign has been waged against onchocerciasis "river blindness," leprosy, and polio. The malaria campaign has been hampered by the outlawing of DDT-malaria still kills one million a year. As the infectious diseases are less rampant, WHO has turned to non-infectious health problems such as prevention of leg blood clots in air travelers, keeping the aged active, working against the use of cell phones while driving, and debt relief for poor countries. Also a program against tobacco, and against alcohol abuse in European teen agers. It also targets poverty, underdevelopment, and social inequality, and traffic accidents. These are worthy goals, but do not seem to be suitable for a health organization. Fifteen years ago an observer was riding in one of the few existing vehicles in an area of Madagascar and he saw a UN billboard saying "Wear your seat belt."
The UN budget is three billion. The Afghan mission budget was increased from 40 million to 65 million. Iraq was to have 45 million, but, since the UN pulled out, I don't know what the money will be used for. The mission is now in Cyprus. The amount spent on meetings and the executive board equaled the amount spent on immunizations, tuberculosis, and diarrheal diseases.
Six diseases account for 90% of all infectious disease deaths for people under the age of 44: Malaria, tuberculosis, measles, diarrheal diseases, acute respiratory disorders (including pneumonia) and AIDS. Someone calculated that $20 per case, and, in most, 35 cents could have prevented 11 million deaths in 1998. Even so it would have cost between 3.9 and 220 million total. That would have been 0.4 to 20% of the WHO budget for the year.
The point that I am making is that even WHO seems to be making poor use or inefficient use of the money they have.
The World Bank, Unicef, and Unesco are also under the UN.
Bill Gates and his wife gave a lot of money for use against AIDS, tuberculosis and malaria.
Resolution 713 in1991 imposed an arms embargo on all of Yugoslavia. In effect, this prevented the Bosnian Muslims from getting any weapons to defend themselves from the Serbs who had plenty of weapons already and could get more from the Russians. Kofi Annan listed some of the failures of the UN: Khmer Rouge in Cambodia, ethnic cleansing in the former Yugoslavia, and the 1894 genocide in Rwanda. The failure of the UN to provide, or to allow the U.S., to provide security in Baghdad was another failure. The death of a valuable and dedicated UN person, Sergio Vieira de Mello, could probably have been prevented. He will be hard to replace. The UN did not want to appear to be supporting the U.S. troops and incorrectly assumed that the terrorists would not attack people trying to bring humanitarian assistance to the Iraqi people. Now it is clear that the radicals do not care about the welfare of the Iraqi people and want to make things as bad as possible to provoke the populace to rise against the coalition forces.
Resolution 1441. Pressure on Iraq regarding inspections and consequences on non-compliance. All fifteen of the Security Council voted for it, but when non-compliance occurred, the Council refused to authorize the use of force implied in the unanimous resolution. By this failure to back up its own resolution the UN rendered itself irrelevant.

51. My concerns about the United States April 2004
First: My overriding concern is for the war with the radical Muslims. I call it World War IV. I deem the Cold War (it got very hot at times-Korea and Vietnam) to have been World War III. We won that by persistent opposition to the Communists by both Republicans and by Democrats. I give Ronald Reagan most of the credit, however. His clear denunciation of the USSR as an "Evil Empire," and his pressure on them by preventing the importation of oil handling equipment thereby cutting off the only real source of hard currency and his threat of SDI made the burden on their economy more than it could tolerate. Whether SDI was feasible is beside the point. The Soviets didn't know that it wasn't feasible and they couldn't afford what it would have taken to match it or counter it.
Now we have a large group of people in this country who do not take the threat seriously and somehow think that there is something that we can do to change the minds of these murderous radical Muslims who want to kill everyone who doesn't follow their brand of Islam. It doesn't seem to matter whether those killed are Jews, Christians, or Muslims who do not follow the Wahabbi line. It is my view that Iraq is pivotal in this war. The time for deciding whether we should be there is past. We are there and we have an obligation to those who have died, who are serving, and to those who are paying for it that it all not be in vain. At the least, Iraq can no longer be a hazard for supplying money and WMD's to terrorist groups.
It is my belief that Iraq had WMD's-as it was of the UN, and all the intelligence services of the world, and, indeed, of many of the Democrats who by hindsight say we should have known that none would be found. The delay occasioned by going back to the UN gave plenty of time to conceal, destroy, and transport the WMD's out of the country-possibly to the Becka'a valley in Lebanon or to somewhere in Syria.
The consequences of failing to win the war on the radical Muslims or to fail to control their activities would mean the end of the whole Western world. It is beyond me why the liberal elite in Europe do not understand that they would be next if the U.S. goes down.
Second: The failure of our education system is next. This is particularly true for the inner city K-12. The blacks and also the poor whites are not being educated to the level required for the students to be able to function in the modern world. When the average student in India can write English better than the average student in the U.S., we are really in trouble. In addition to the poor learning of the basics, we have indoctrination with politically correct notions. One of the most pernicious is the idea that somehow the U.S. is a bad country and that we should be ashamed of it and its actions. Granted the U.S. is not perfect, but we are not responsible for all the problems in the world.
An element in the problems is the view that all black people are victims. In addition there is a soft bigotry that says that blacks are not capable of making it without a lowering of standards. This implies that they are somehow intrinsically inferior. The black attitude against academic achievement is a serious barrier to education. Somehow the idea that it is "whitey" to want to excel in school leads many black children not to try. Added is the problem of fatherlessness. Children without functioning fathers in the home do worse on every social measure-whether it be academics, delinquency, truancy, out-of-wedlock pregnancy, drugs, alcohol, crime, venereal disease, and just about every other problem that a young person can have.
Higher education has its problems as well. In spite of the desire for diversity in the student body, there is little diversity in the faculty. The percentage of Democrats and liberals is in the ninety percent range. One person told me that was because the smart people are all liberal and Democrat. I don't believe that. Academia is the last refuge for Socialists. This in spite of the fact that the experience with Socialism clearly shows that it does not work. It surely didn't work in the USSR. It had to be and is being modified in China and in Vietnam. The two remaining Stalinist regimes are basket cases both socially and economically-Cuba and North Korea. The so-called Democratic Socialist regimes in Europe have not had the burden of providing for their own defense since 1945. If they had they would have been in worse condition than they are now. Their declining birth rates and their declining death rates are providing them with more people on welfare (I include the retirees in this) and fewer workers to support them. If current trends continue, Europe will have a majority of Muslims in fifty years. Currently no Muslim country is really prepared for the modern world. When the oil runs out, they are going to be in worse trouble than they are now.
Third: The Judicial system. We have policy being made by the courts rather than by the
legislature and the Constitution is being ignored. Words are being found in it that are not there,
and rights are being found in it that are also not there.
In addition we have an antiquated legal system. The Constitution calls for a speedy trial and this is honored more in the breach than in the performance. We also have a variety of judge malfeasance. In addition there is jury nullification. On the other side there is jury multiplication in that awards that are obscene are made without any realization that the money has to come from somewhere-either taxes or premiums or prices paid by workers and consumers. It is forgotten that there are consequences to actions. Extreme awards in medical liability cases leads to increased premiums leading doctors to quit doing procedures that may lead to suits, to retiring early, or to moving to another state. Another result of all this is a whole crowd of new millionaires-lawyers who get most of the awards from the lawsuits.
Fourth: The decline of the family. Now we have too many out-of-wedlock births. This leads to poverty for the mother and the child. It also sets the stage for problems for the children: drug and alcohol use, poor school performance, truancy, crime, teen-age pregnancy, marital failure, and depression. When children do not have a functioning father, the boys and girls do not have a model of what a man, a father, or a husband should be.
Fifth: The trade imbalance. It is my opinion that neither persons nor countries can continually live beyond their means. There must inevitably be a breakdown.
Sixth: Excessive spending. Pork is not productive spending. It may give jobs to some who administer and work on the pork projects, but it is not a rewarding process for the economy. .
Seventh: Big government. The more government we have the less freedom. Now the government is involved in more and more of the details of people's lives. It is not possible to make laws to cover every aspect of human activity. And someone must enforce those laws and courts must deal with them. That brings it back to individual or collective (juries) decision making.
Eighth: Racism. Now we seem to have more reverse racism and less direct racism. That is, there is less mistreatment of blacks and more mistreatment of whites. Every time one group gets special privileges over and above the privileges of other groups, it means discrimination on the basis of race. If it was wrong when it was done to blacks, it is wrong when it is done to whites.
Ninth: Lawlessness. It seems that certain groups do not believe in punishment. The same don't seem to believe in evil or badness. Every bad behavior is either medicalized or socialized. The person is mentally ill, and, therefore, not responsible for the misdeed, and is put in a mental hospital and put on treatment. Then some psychiatrist pronounces the person well and they are released. Or else the problem is societal-poverty, ignorance, bad parenting, racism, or some other social ill so that person is really not responsible either. Sometimes it seems the victims of crime are forgotten.
Then there is the problem of some city police being forbidden to report illegal immigrants who are arrested for a felony to the INS. Added to this is elected officials illegally marrying men to men or women to women when clearly such an act is illegal.
Tenth: Illegal immigrants. We have several million illegal immigrants in the U.S. Is it eight million? Or does anyone really know. I perceive poor control of the borders, poor control even at entry points, poor monitoring of visas given to visitors, very few deportations, and, in general, no real attempt at enforcing the laws. It is said that the Republicans want them for cheap labor, and the Democrats want them for cheap votes. If illegals are voting, I think it is wrong. Of course, many of them have relatives who are citizens and they can vote.
This is going to lead to the U.S. being bilingual. We have enough divisions in our society without losing a national language. I do not want to have the U.S. take up the social views of the countries that most of these immigrants come from. Another hazard of uncontrolled immigration is national security. How can we be sure that some of the Muslims are not agents for groups that want to destroy the U.S. and all it stands for?
Eleventh: The national debt. We will some day have to pay the piper.
Twelfth: The general decline in behavior. We have seen a coarsening of language and a decline in common courtesy. We have become accepting of lying, stealing, drug use, and lack of compassion for others. We have seen a decline in social capital. People don't relate to others as they did. Clubs, service organizations, gathering of groups, and interaction of neighbors and families seems to be less and has been well documented in the book, "Bowling Alone."
Thirteenth: Decline of the family. Divorce is rampant. In spite of the belief of some, divorce does adversely effect the children. Infidelity may have always occurred, but it seems more common and is more accepted than it used to be.

52. Citizens Police Academy 1 March-4 May 2004
In 1994 the police department learned of a program for citizens put on by Springfield, Oregon. Police Chief Keesling received the information, but nothing much was done about. Johnson City learned about it and asked if they could see the program. They went on and started their program, and won second place in a national competition. After that Chief Keesling demanded that our force get on with it.
1 March 2004: First session. Captain Paul Bowman made a brief talk about the organization. He is in the administrative division. The training officer was Jerry Robinson. Steve Hammonds was to show defensive tactics. Mark Addington is our current chief of police. The force numbers about 100 but they have others to help, including the officers who work the school crossings and the animal control people. The dispatch people are not part of the uniformed force. Neither are the parking control people and the jailer.
Kingsport has six police zones. The patrolmen work twelve hours to a shift. 6:30 to 6:30 and they have a complicated schedule of off days. Four platoons patrol the zones and they have a 5th and 6th platoon that works 8 P.M. to 4 A.M. when there is likely to be more illegal activity. Much of the crime is drug related-people stealing to get money for drugs or drugs sellers.
8 March 2004: The bomb squad brought in the dog. He is trained to sniff out drugs, but is also used against criminals. A student put on the bomb suit and they showed us the trailer used to contain a suspected bomb. They spoke of undercover agents who had fake I.D.''s and fake driver''s licenses. We were also told about the use of force. The steps were: Verbal request, verbal order, passive resistance, active resistance, empty hand control, pepper spray, use of impact weapons (truncheon-called PR 24-prosecutor 24 inches long), and deadly force. More exactly: Officer presence, verbal request or command, empty hand, pepper spray, hard hand, and deadly force. We learned of the 21-foot rule. Anyone within 21 feet with a knife could get to the officer before he could draw his weapon and fire. The officers carry 15 to 18 pounds of extra equipment. The standard weapon is a 45. It holds 14 rounds and they carry two extra clips.
15 March 2004: Use of force. The protective jackets used to be Kevlar, but now they have better ones. The Kevlar is bullet resistant and is effective against hand guns, but a rifle bullet will go right through it. The officer told us that he had never struck anyone with a PR 24. The body is color coded: Green-okay to strike including mostly muscles, yellow-bones, knees, elbows, groin, red-to avoid-neck, head, and sternum. The speaker said that in spite of the news that the LAPD was the bench mark force. The officers are being trained in Brazilian karate that is like Olympic wrestling. They have a few bad officers, but they didn't last long in the force. One officer was found to be addicted to cough medicine and another left because of rumors of criminal activity.
22 March 2004: Criminal investigation. David Cole had been on the force for 21 years, and had been a detective since 1990. He was involved with crimes against persons. Last year was their busiest year. They clear 59%. The routine is that (1) the patrolman gets the information that he can. Then (2) the case is assigned to a detective. They have four unsolved homicides. The oldest goes back to 1976-a drive-by shooter shot a boy friend in the throat, a man was killed on Miller Street-shot in the yard, ran over a boy''s mother (has a suspect, but no evidence), and a woman beaten to death (she was drunk a lot). We have a forensic vacuum. The FBI lab can analyze hair. Joseph Johnson killed a clerk. They were able to do tape liftings inside a car.(3) Search warrant, but you had better find something. A session's judge can give a warrant anywhere in Tennessee.
Forensic anthropology at U.T. Also can use TBI and FBI lab for evidence. But now the FBI is concentration on terror. Blood stain pattern analysis-how it reacts on a surface. Ricky Cole stabbed to death-unsolved.
An automatic costs $400-500 so a perp is not going to throw it away. Suicides are investigated as homicides. The definition of aggravated assault-serious injury (broken nose not evidence of a serious injury) or presence of a weapon. Aggravated robbery-use of a weapon. Aggravated kidnaping-? use of a weapon. Assault-use of the body.
He then outlined how they solved a murder. Fortunately, two civilians had observed the perp and were able to help. They check into relationships, recent activities, way of life, recent discord, past discord, usual practices, and find someone recently in residence or car. Outside the city it falls to the county officers. National Criminal Information Center..
3 April 2004: I spent several hours in dispatch. It has someone there 24/7. That evening there were three: Susan Wells had the police calls, Eric Clear had fire, and Patrick Sage had medical. Susan told me that they became familiar with many who call in. That it was the same people a lot of the time.
5 April 2004: Traffic Unit. Officer Farmer.
(1) Slide library
(2) Vehicle damage
(3) Conservation of momentum
(4) Airborne (falls, flips, vaults)
(5) Critical speed
Crash investigation, DUI enforcement, Patrol Dale Farmer, ACTHAR # 1182, accredited accident reconstructionist. 1991, 2001-test in Florida and in Boston.
Investigate traffic collisions (they, and I, don't call them "accidents"), traffic safety programs, special traffic details, radar, laser, enforce traffic laws, teach traffic-related courses.
Reconstructionist: Determine cause of crashes (90% driver error), vehicle speed (crushes and tire tracks), time and distance analysis, scale diagram-laser cuts a two and one half hour''s work to thirty minutes, occupant and vehicle positions, testifying in court.
Traffic facts: Age 16-25 are 27% of drivers, but are in 48% of crashes. States with graduated drivers'' licenses have a drop in crash and injury. Worst of all 16 year olds, both male and female. Also 16-25 on cell phones. People speed up 10 miles per hour in fogs. Talking and walking also speeds up in fogs. Speeding related to crashes. Speedometers have three miles per hour error. Failure to yield associated with 30 to 40% of crashes. Following too close is another common cause. 3 second rule. Reaction time averages 1.5 seconds. One car length for each ten mph is too close. At 55 1.5-2 seconds to stop. At 30 mph you are moving 80 feet per second.
Another cause is driver not paying attention-cell phones (I have read that eating or drinking is a more common distraction leading to crashes). Another is driver inexperience and, of course, alcohol and drug use.
The Advanced Visualization Lab at ETSU was able to make a video of a crash of two dray racers in Colonial Heights. They were going 93 on a curve that could only be negotiated at 73. The racers were driving a Camaro and a Mitsubishi. One car went into the left lane and hit a Town and Country minivan. They showed a simulated view from the standpoint of the driver of each vehicle as well as a simulated view as though from an overhead helicopter. The cost was only $26 because of ETSU, but would have been six to eight thousand if paid going rates.

Seat belt laws: At all ages over 18, belt in front seat. Anyone under 18-all in a seat belt. Most insurance companies won't pay if no seat belt. Helps reduce crash forces on the body. One in ten of high schoolers wear seat belts. Seat belts keep you in the vehicle. Out of 20,000 crashes only 2 or 3 on fire.
DUI: 0.08% guilty of DUI. This is federally mandated. The officer said that for a man of his size (?200 pounds) it would take 6 to 8 beers. For 350 pounds it would take 14 beers.
First conviction DUI: $350 fine and court costs, lose driver''s license for one year (can have limited license to go to work and back), 48 hours in jail, suspended sentence 11 months and 29 days, DUI school, probation, $18,000 to $20,000 (?car). If a passenger owns the car, a fine
Second conviction: 45 days in jail, fine. If a wreck, and someone says "I'm sore" charged with aggravated assault. If someone is killed, charged with vehicular homicide.
If blood level is 0.2, can be used against you going back ten years. Under 21 same fine passenger and consumption 0.2. If less than 18 , DUI 48 hour's detention and a fine.
Sobriety test: Standardized. 1. Nystagmus to horizontal (lateral gaze) < sense =" good">500,00 to England
First British Empire ended with Revolutionary War
Second British Empire-1/5 of the surface and 1/4 of the population of the planet.
John Wilson of Blackwood's Magazine "the sun never sets"
Charles Pasley- modern geopolitics
1887-after Waterloo (1815) British Empire grew by 100,000 sq. mi. per year
Scots had more skills and education than others
First Highland Watch 1778 Charles II
1740-1815 86 Highland Regiments, by 1800 the backbone of the British Army
Typhus, smallpox, cholera, scurvy, and yellow fever
During a five-month trip to India in 1782 230/1100 died of scurvy although Lind had found a preventive 60 years before
In June 1819-10 officers, 13 sgts., 8 drummers, and 254 others died of disease
1803 Duke of Wellington defeated the Maratha princes although outnumbered 10 to 1
The 74th Regiment lost 459 out of 495-92%
1776 Major Patrick Ferguson issued a breech loader-4 shots/minute at 200 yards (usual 100 yds.)
General Howe was furious at Ferguson and confiscated the rifles for the Battle of Brandywine in September 1777. Ferguson was killed at King's Mountain. It took 10 years to get breech loaders
Alexander Forsythe- percussion lock with potassium chlorate, but the flintlocks misfired 3/10
Joshua Shaw of Philadelphia made a tiny button of potassium chlorate, misfired 4.5/1000
The changes in technology raised threats to ancient cultures-India, China, Persia
The British had only small areas under their control in India-Bombay, Madras, Calcutta
1806 a Scot named James Mill was hired to write "The History of British India"
It took him eleven years . He was a friend and influenced by Jeremy Bentham
1806 Edinburgh educated Lord Minto became governor-general of India
1812 Thomas Munro in southern India reduced taxes on farmers and pushed for honest tax collection
John Campbell spent 16 years in the hill country rescuing victims of mariah (ritual sacrifice) saving 1500 lives
John Malcolm negotiated a treat with Persia and in northeast Afghanistan broke the power of the robber barons
A liberal imperialism-better schools, better roads, more just laws, and prosperous towns and cities, more money in the pockets of ordinary people, and more food on their tables
Governor-General George Beutjack "England's greatness is founded on Indian happiness."
Dugald Stewart-"the science of legislation"
1890 Afrikaaner South Africa
Scotland in the 1990's
1841 Charles James Napier governor of Sind (now Pakistan) Sind wars local rulers vs Sikh warrior bands; Muslims vs Hindus (1798 father of Charles, Maj. Gen. Napier and the Irish Revolt)
after annexation of Sind, governor general "a great thrashing first and great kindness afterwards"
Napier "a very advantageous, useful, humane piece of rascality"
He lowered taxes, established the port of Karachi, put steam ships on the Indus River, established a police force to maintain order, proposed irrigation, and banned suttee.
1848-1856 The Raj system began under Gen. James Dalhousie, Lord Ramsey, railways, telegraph lines, postal service, schools, roads, and irrigation projects.
Gained control of lower Burma, Oudh, and others. Abolished suttee, thuggee, and ritual sacrifice.
Social revolution in the treatment of women, abolished child marriage, polygamy, killing of unwanted female babies, and established first schools for girls
1857 Indian Mutiny
Opium was illegal in China, but many imperial officials addicted to it and were corrupt in letting it enter the country, but they kept the profits low on legal products like porcelain, silk, or tea
James Matheson and William Jardine became partners in 1827.
England had no drug problem (except for Thomas de Quincy Samuel Coleridge) nor did India
However in China 1% were addicts (about 2 million people) Smuggling
William Jardine, Lord Palmerstone, second Lord Minto, (First Lord of the Admiralty)
The "Nemesis" 184 feet long, 2 60 hp. engines, 2 thirty-two pounders, 5 six pounders, 1 Congreve rocket launcher. Watertight compartments so a waterline hit couldn't sink her, drew only six feet. Left Portsmouth 28 March, 1840. In one afternoon she sank 9 war junks, took out 5 forts, 1 battery, and 2 military supply posts. She was joined by the 510 ton "Phlegethon"
A peace treaty was signed in Nanking in August 1842. Jardine became tai pan of Hong Kong
In Canada and Australia Scots were the dominant influence. Nova Scotia and Newfoundland especially.
1759 James Wolfe and the Fusee Highlanders took the Heights of Abraham
Gen. James Murray (a Scot) first British governor. Scots from the Orkneys were active in the fur trade. Hudson's Bay Company (eastern Highlanders) 4/5 of the employees were Scots
Alexander MacKenzie traveled to Lake Athabasca (Alberta) went up the Mackenzie River 3,000 miles to the Arctic Ocean, also went to the Pacific Ocean
1821 Hudson's Bay and Northwest Cos. merged-largest corporate land holder in the world-3 million square miles (U.S. and China each about 3.7 million square miles)
George Simpson (President of the company-a Scot) presided over ten times more territory than any Roman Emperor.
Loyalist refugees from the Mohawk Valley to eastern Ontario and Scots from the Clearances
"Glengarry shantymen" lumberjacks
John Kenneth Galbraith-a Scot (but I don't claim him as one-DWB)
John MacDonald (a Scot) promoted the Canadian-Pacific Railroad.3,700 miles-900 miles of bottomless muskeg. At Kicking Horse pass 30-40 degrees below.
Lord Elgin (Scot governor-general) abolished feudal land tenure, promoted education, made a treaty with the U.S.1854 preventing a war.
John MacDonald To Glasgow from the Highland to Kingston, Ont. 1820, got a law degree
Liberals vs Tories, Presbyterians vs Episcopalians, French vs English, all vs Americans
Contempt for the English
Liberal Conservative Party Quebec Resolutions British North America Act by British Parliament 1867
1866 Confederation Conference (8 of the 10 founders were Scots)
Created the Royal Northwest Mounted Police. Brought in British Columbia, Manitoba, Prince Edward Island, and kept Nova Scotia part of Canada
Next Alexander MacKenzie. 1/3 of the business elite were Scots. They headed paper making, iron and steel, oil, and gas, and the fur trade. They promoted colleges and universities-Dalhousie University 1818, McGill 1821, U. of Toronto 1827.
Sandford Fleming-chief engineer of the Canadian-Pacific (At that time the U.S. had 100 different times) set up 20 time zones-each 15 degrees of longitude, On 17 November 1883 all clocks and watches were synchronized. (Railway schedules required some standardization of time)
1770 Australia-William Pitt established a penal colony and sent 1000 prisoners to Botany Bay in1888. Then 10,000 more. The prisoners were ill treated with beatings and hangings. If a prisoner served 4 years of a 7 year sentence, he could be freed. Or 6 years of 14 year sentence.
John MacArthur came out as a Lt. in the Army. He obtained a pair of long-haired merino sheep from George IV's private stock, crossed them with Bengal and Fat Tail sheep and set up a sheep farm. He prospered and established a 60,000 acre sheep farm called Camden Farm. The Australian sheep came down from this start.
William Bligh of the Bounty became military governor.
1809 Lachlan Macquarie governor-general Found the place in a mess. He banned the rum trade, closed the bars in Sydney during religious services on Sunday, and had the convicts go to church. Developed Liverpool Plains for farming. Back to England in 1821.
Thomas Brisbane
1840 Alexander Maconochie took over Norfolk Island (prison)-put in a library and an orchestra
1867 Convict ships were stopped
1880 Australia had the fastest growing economy and the highest per capita income. 20% of the borrowed capital used in Australia came from Scottish banks
Africa-African middle men. Mosquitoes on the coasts and swamps inland
1805 Mungo Park took a group up the Niger-all died
1823-1827 2/3 of the British soldiers on the Gold Coast died
1824 221/224 died
MacGregor Laird took 48 up the Niger and 9 survived
DAVID LIVINGSTONE got religion. Studied Greek and Latin at 14. Calvinist Congregationalist Studied chemistry and theology at Anderson College at University of Glasgow. Classmate of William Thomson (Lord Kelvin) and Lloyd (later Lord) Playfair
1838 M.D. wanted to go to China as a missionary, but the Opium War was on
December 8, 1940 Left Liverpool, at sea three months. From Cape Town 600 miles north to Moffat's Station at Kuraman, then 500 miles northeast. Lost the use of his right arm from an attack by a lion. Got malaria, but took quinine. Reached Lake Ngami at the upper reaches of the Kalahari Desert to Victoria Falls.
Zambezi River-the Portuguese controlled the headwaters and didn't allow exploration
1853-1856 Livingstone crossed Africa from ocean to ocean
Livingstone: Two great barriers to Christianity-commerce and "civil agitation." White racial prejudice and the slave trade
"The Zambezi and Its Tributaries"
1833 Britain frees its slaves
Arab slave traders and Zanzibar.
Livingstone, Mary Moffat Livingstone, son Robert Livingstone, brother Charles up the Zambezi in the world's first steel-hulled steamboat to Quebrabasa Rapids. Reached Lake Nyasi (now Lake Malawi)
1866 with only 30 porters searched for the source of the Nile
Henry Stanley (Scottish descent) to east-central Africa for two years. Found Livingstone at Ujiji in 1872. Livingstone died May 1, 1873. His heart was buried 70 miles from Lake Bangweulu. His body was carried to the coast and then taken to England for burial in Westminster Abbey.
Scots in the U.S.
3/4 million vs 5 million Irish. Most Scots could read and write English. They had the work ethic and moral discipline.
The Anglo-Saxons were a privileged elite. The middle class was Anglicized. The Irish immigrants crowded into the cities. The Scots were in the hinterlands competing with tribal warrior societies.
DAVID HUME'S secular Golden Rule: "You leave me alone and I'll leave you alone."
Traditional moral discipline (Presbyterianism)
BENJAMIN RUSH modeled the Pennsylvania medical school on Edinburgh and established Dickinson College in western Pennsylvania.
Dugald Stewart
George Jardine
James McCash (Queen's College in Belfast) to Princeton First used the word "campus" Scottish philosophy
The German university ideal of rigorous research and specialization was coming on.
McCash disagreed with Charles W. Eliot about allowing electives.
American philosophers were turning to Kant, Hegel, Auguste Comte, and Karl Marx
The intellectual climate was becoming more secular and skeptical
Scottish tradition-liberal arts colleges and universities
ANDREW JACKSON, JOHN C. CALHOUN, JAMES K. POLK, JIM BOWIE, DANIEL BOONE, WILLIAM CLARK, SAM HOUSTON, GENERAL WINFIELD SCOTT
Early 19th century another wave due to Clearances and a cholera epidemic
Textile mills, ship building, iron foundries, stone cutting, paper making, typemaking, dry goods
The department store was started by the French, but Scots headed them in the U.S.
David Nicholson in Philadelphia, Dugald Crawford in St. Louis, Robert Birtwick in Buffalo, Robert Dey in Syracuse, John Forbes in Kansas City, Carson Scott in Chicago, William Donaldson in Minneapolis, and Alexander Stewart in New York City.
John Kinzie and Alexander White were two of the founders of Chicago.
Early Mormons were often Scot converts: The first Colorado resident was John Gilroy. Other Scots Kit Carson, Isaac Gotham, Hugh Reid
James McKinley had ranch Santa Anita (now Pasadena)
James Wilson Marshall saw some gold at Sutter's Mill 1857 $500 million gold found
Donahoe-Irish but raised in Glasgow. Three brothers. Peter first steam engine for a U.S. naval vessel on the West Coast. First steam locomotive in California.
1873 Andrew Hollidie cable cars
William Anderson San Francisco's First Presbyterian Church
William Scott of San Francisco's Calvary-these two thought California would be the new Utopia
Scott saw the city as an Athens or a new Edinburgh
Methodist William Taylor, the most influential of the three, was dubbed "John the Baptist of the Gold Rush"
1854 "The Flying Cloud," a clipper ship, built by Donald Mckay, sailed from New York to San Francisco in 89 days 8 hours. 400 miles/day. Another clipper "Great Republic"
William Thompson's White Star Line from Aberdeen-Cutty Sark 1869-a China Clipper. These ships could beat the steamships of the day.
SAMUEL FINLEY MORSE-studied and was an artist, but got involved with the telegraph and devised the Morse code in 1834.
By 1854 23,000 miles of telegraph wire
ALEXANDER GRAHAM BELL Edinburgh U. 14 February 1834 patent
ANDREW CARNEGIE began as a telegraph messenger boy, first fortune in railroads, George
Pullman. Second fortune in steel. (Henry Bessemer was English.) Using his method by 1892 U.S. Steel was producing steel equal to ½ the total production of steel by England. U.S. Steel was vertically integrated.
(Charles Macintosh-rubber)
"Economy of scale" "Triumphant democracy"
Carnegie admired Herbert Spencer "The Gospel of Wealth"
Homestead Strike of 1892. The loss of life upset Carnegie.
J. P. Morgan wanted to buy U.S. Steel, told Carnegie to name his price. Carnegie wrote "480 Million" so Carnegie sold out.
$300 went to Carnegie. He gave $ 80 million to Scottish projects. 2800 libraries (2000 in U.S.), 7,689 pipe organs, Carnegie Hall, Carnegie Tech, and built Lake Carnegie at Princeton so that Princeton could compete with Harvard and Yale in crew.
Samuel Langley developed an airplane, but the Wrights got the patent in first
Alexander Bain, professor of logic, Marischal College founded "Mind"
William Thomson, Lord Kelvin U. Glasgow
James Clark Maxwell-the father of electro-dynamics Aberdeen
1890 James Frazier, "The Golden Bough" modern anthropology looked to German and French
1902 "Dreadnought" Made all the navies obsolescent
Glasgow 1 million people
1894-1916 Of five Prime Ministers three were Scots: Rosebery, Balfour, Bannerman
Ramsey MacDonald
Scotland: Poverty, Infant mortality. Disease and malnutrition. Lack of toilets.
1898 2/3 recruits were turned away unable to pass the physical
1900-1910 250,000 left Scotland
1870-1920 half the emigrants went to the U.S.
1872 first compulsory education for Scotland
1/7 to secondary school in Scotland
1/20 to secondary school in England
Alfred Harnsworth: Rise of tabloids Daily Mail 1896; Daily Mirror, Daily Express
ROBERT LOUIS STEVENSON: "Treasure Island" "Kidnaped" "Master of Ballantyne"
ARTHUR CONAN DOYLE (Roman Catholic): Sherlock Holmes (modeled on Dr. Joseph Bell, an instructor at Edinburgh Medical School) "The Lost World"
JAMES BARRIE: "Peter Pan"
Harry Lauder: Comedian on the stage
Whiskey: John Walker and Tommy Dewar
Field Marshall Lord Robertson, Sir Ian Hamilton of the General Staff responsible for the Gallipoli failure, General Douglas Haig Disaster at the Somme, Ypres, and Passchendaele by Haig. Robertson, despite misgivings, failed to intervene to stop Haig.
World War II Spitfires and Rolls-Royce Merlin engines
1950 Scotland 15% of the world's shipping
1960 James Bond (half Scot and half Swiss) by Ian Fleming
1853 "Casino Royale"
1296 Stone of Scone Lia Fail (Gaelic) taken to London by Edward I
1928 Formation of the Nationalist Scottish Party SNP
1996 Some young Scots stole it and took it back to Scotland
2001 Scotland got a separate Parliament
Now Scotland has become a computer center and a service center.
The Biggies
John Knox
Robert Burns
William Wallace
Adam Smith
James Boswell
David Hume
Andrew Jackson
James K. Polk
John C. Calhoun
Patrick Henry
William Lynch
James Madison
Alexander Hamilton
Thomas Reid
Dugald Stewart
Thomas Babington Macaulay
Sir Walter Scott
James Watt
William Cullen
Richard Bright
Thomas Addison
Thomas Hodgkin
James Lind
James Cook
Erasmus Darwin
Charles Darwin
David Livingstone
Benjamin Rush
William Clark
Sam Houston
Jim Bowie
Daniel Boone
Winfield Scott
Samuel Finley Morse
Alexander Graham Bell
Andrew Carnegie
Robert Louis Stevenson
Arthur Conan Doyle
James Barrie
James Bond (by way of Ian Fleming)
It may seem strange to include a fictional character in this list, but many people who don't know any of the above real persons probably know a lot about James Bond. I should add Sean Connery-his name is probably better known to the general public than many of the biggies listed above. And these two may have helped to define our present (modern) world-or not define it.
Donald W. Bales 12 July 2002

Ginny asked her mother about the main themes of the book. She read the printed copy-she doesn't like reading on the computer screen. She found some dates that were not correct-a 9 instead of an 8 or a 7. Even though she had read the book, my notes didn't add much to her understanding. That may be the case with each of you.
What are the major themes?
Literacy promoted by John Knox so people could read the Bible. They read a lot of other things-another example on an unintended consequence.
Moral focus from Calvinist Presbyterianism. The Anglican Church may have had less effect.
Protestants to Edinburgh. Only Episcopalians (Herman writes of them that way-I would have dubbed them Anglicans)
More economic freedom. ? less control by the landed aristocracy.
Free and open discussion of serious subjects by relatively well educated people who had some leisure. (Graham Leonard maintained that this is what gave rise to the Golden Age of Islam-750-970?)
Did living in a poor country lead people to be hardier and more concerned about bettering themselves?
At any rate the Scottish Enlightenment seemed to have had far reaching effects.

63. Global Poverty
During the spring session of 2005 I led a seminar for the Great Decisions Program of the Foreign Policy Association on global poverty. I used the March 14 Issue of Time Magazine article. The article was based on the book by Jeffrey D. Sachs. He is in charge of the Millennium Program. He was a tenured professor at Harvard at age twenty-eight.
One million (maybe three million) African children die of malaria each year.
(Rachel Carson's book "Silent Spring" may have contributed to this by leading to the outlawing of DDT.)
Eight million people are reported to die each year due to lack of food.
We give sixteen billion a year to these programs-0.15 % of our GNP.
Sachs refers to "clinical economics-"good development economics and good clinical medicine. Clean water, productive soils and a functioning health care system are as important as exchange rates.
He has another term "economic plumbing." This refers to the institutions needed for dealing with the poverty problem. The right ingredients are good harbors (but some are landlocked), contact with the rich world (but some are not on the beaten economic paths), favorable climates (but some are arid) and freedom from epidemic disease (but many have malaria and HIV).
The one-sixth (one billion) has the problem of AIDS, isolation and civil wars.
The population is up sixfold in two centuries-1820-2000. The per capita income is up ninefold during the same period. The U.S. per capita income is up twenty-five fold.
Sachs is the head of the UN Millennium project.
In Kenya the Sauri area consists of eight villages. It is in the Siaya district of the Nyanza province. Of two hundred households in Sauri malaria was present the three-fourths, orphans in one-tenth, bed nets (against malaria-carrying mosquitoes) in one percent, and fertilizer use in none although all would use it if they could afford it.
He thinks Kenya with thirty-three million people needs 1.5 billion and gets 100 million.
Total from the world for all of Sub-Saharan Africa" $30 per person. Of this $5 goes for consultants, $3 for emergency aid, $4 for servicing debts, and $5 for debt-relief operations. That leaves $12 of the $30 per capita for trying to alleviate the poverty of the local people. Sachs thought $70 per person would do the job, or $350,000 for all of Sauri.
One half of the six billion people on the planet is poor.
1.1 billion (2001) live in extreme poverty on less than one dollar a day, but this is down from 1.5 billion in 1981.
!.9 billion (2001) live in moderate poverty one to two dollars a day.
East Asia has dropped from 58% extreme poverty in 1981 to 15% in 2001. ( Some think this was due to changes in government policy (China) allowing contracts so foreign investment would come in and allowing more free enterprise.)
South Asia has dropped from 52% extreme poverty in 1981 to 31% in 2001. (Some think that this is due to a change from socialist practices to more free enterprise in India).
Africa still has half its population living in extreme poverty.
The IMF has often demanded austerity that made things even worse.
Sachs advocates five policies to combat poverty:
1. Boosting agricultural production.
2. Improving basic health
3. Promoting education
4. Improving power (electricity)
5. Clean water and sanitation
Some think the problem is related to corruption and misrule.
Malawi, Mali, and Senegal have had less corruption and misrule than others, but have still not improved. Possible causes: Lack of rain, landlocked, off the beaten paths, and difficult terrain.
Bangladesh, Indonesia, and Pakistan have done better, even though plenty of corruption and misrule. Not as dry and not off the beaten paths as much and terrain not as bad.
Sachs thinks that democracies (really representative republics) like Brazil, India, Nigeria, Senegal, South Africa, and others should lead the way to calling attention to the problems of the poor countries.
Sachs' main push is for the U.S. to give more money. He points out that one of the serious problems in Sub-Saharan Africa is the death of working age people due to HIV-AIDS. He suggests more money for treatment AIDS related disease. (But there was no mention of prevention, or of changing the culture of promiscuous heterosexual that is the principal mode of spread of the disease in Africa. Nor is that emphasized in the U.S. or elsewhere so far as I can tell.)
Now see what Star Parker thought about the Sach's plan.
Philanthropy is the best way to combat poverty
Columbia professor Jeffrey Sachs intends to cut world poverty in half. He outlines his plan in a cover story in this past week's Time magazine.
Sachs isn't just an academic sitting in an ivory tower writing provocative papers. As director of the U.N. Millennium Project, he has tens of millions of dollars financing his activities and clearly is someone who knows how to get attention and mobilize power and influence. Time's cover story is just the latest of high-profile press coverage that the professor has received, which includes major stories recently in The New York Times Magazine and The Economist.
What's his plan?
Quadruple U.S. foreign aid. Add a total of about $130 billion to foreign-aid expenditures of the world's industrialized countries and recycle these funds into spending programs in developing nations. According to Sachs, these programs will reduce global poverty by 50 percent by 2015.
Is there an echo in here? Aren't these "new" ideas something we've heard before?
Sachs talks about "ending poverty in our time," which we can do by adopting his "new method." Tax and spend to end our problems? A new method? The real question is what is this guy peddling to reporters to induce their amnesia.
Here's President Lyndon Johnson announcing the launch of his "war on poverty" and the Economic Opportunity Act of 1964:
...(F)or the first time in history, it is possible to conquer poverty...
The Act does not merely expand old programs or improve what is already being done. It casts a new course. It strikes at the causes, not just the consequences, of poverty.
When Johnson launched his "war," the percentage of the U.S. population in poverty was around 19 percent. By the early 1970s, it dropped to around 12 percent. However, the decline in the national rate of poverty was already headed downward well before 1964. The poverty rate in the late 1950s was 23 percent. U.S. poverty has fluctuated around 12 percent for the last 30 years.
Despite trillions of dollars of expenditures with questionable impact on the incidence of poverty, the greatest costs of Johnson's programs were the human costs. People were taught to turn to government rather than their families and themselves for the resources to contend with life's challenges. The psychology of victimization, passivity and dependency is the great legacy of Johnson's poverty programs.
The black poverty rate - 23 percent in 2001 - remains well above the national average. Incidence of out-of-wedlock births and fatherless households in the black community are triple today what they were when Johnson signed his legislation.
As Tom Sowell has pointed out, blacks were making great progress before the 1960s. From 1940 to 1960, not an easy time for blacks in America, the incidence of black poverty dropped 50 percent.
I find it particularly ironic that Sachs chooses to wave his finger most accusingly at his own country. Listening to Sachs, you would think that the United States, the world's greatest engine of prosperity, is the most guilty for current levels of global poverty.
This gets back to the fact that Sachs thinks that foreign aid (translation: government spending programs) is what creates prosperity. So, by Sachs's measure, the United States is stingy and not doing its part.
But government spending programs do not create prosperity. Free people do.
Regarding U.S. generosity, Sachs seems to have little interest in work done by Carol Adelman of the Hudson Institute, who has shown that U.S. philanthropy going abroad from private sources is three-and-a-half times larger than official U.S. government foreign aid.
Recently I had the privilege of meeting John Coors, a businessman, entrepreneur and Christian philanthropist. While flying over sub-Saharan Africa at night, he looked down from his plane and saw darkness, even though he knew he was flying over a highly populated area. He knew what to do. He started a program setting up energy stores and delivering batteries and small propane stoves to these communities. He found that families were willing to invest two months of their meager income to purchase these stoves. Coors is bringing light to Africa and he is doing it through his own initiative.
Certainly, I share Sachs' concern about poverty and suffering. But the answer is what Coors is doing. This option is open to Sachs. He could use his energy to mobilize private resources and private philanthropists and encourage freedom and the values that go along with this.
Sachs is promoting exactly the wrong message in parts of the world that need to hear the opposite of what he is telling them. I hope our own government does not cave in to his demands. We should listen to President Bush that freedom is the message America should be sharing with the rest of the world.
Star Parker is president of the Coalition on Urban Renewal and Education and author of the newly released book 'Uncle Sam's Plantation.'
This is not from the Time article. Uganda has done better with this than any other African nation. It has also done better at managing the economy. Botswana is said to be one country in Sub-Saharan Africa that is doing fairly well. Botswana has diamonds.
Zimbabwe was the bread basket of Africa until the change in government led to the exitus of the white farmers. Now Zimbabwe cannot even feed itself.
It is my opinion that the U.S. and other wealthy countries can and should help. The UN should help, but unless the countries try to help themselves, they are doomed to continue to starve and die of disease. I do not believe outside people can make enough difference to solve the problems.
Donald W. Bales, March 2005

64. Here’s to Your Health Donald W. Bales, M.D. 1975
Introduction:
Politicians, labor leaders, economists, social writers and even some physicians have written a lot about the health care crisis. Health Maintenance Organizations have been proposed ands funded with start-up money.
Much has been written about poor access to health care by the poor-rural and ghetto, and even about poor access by the middle class. More has been written about the high cost of health care and comparisons of the state of health measurements of the United States and of other countries have been quoted to the detriment of United States health and medical care.
The medical journal authors and other medical writers frequently suggest the doctors do not provide enough preventive care, that they do not take enough time, and that they do not make themselves available enough at night, week ends and holidays.
There may be some merit in the previously mentioned ideas. However, there is another point of view and constructive suggestions that have not been emphasized enough.
I have been in the private practice of internal medicine since 1952, and have been an observer and participant in the medical scene since 1943. I started in medical school on January 1 of 1943, graduated in March 1946, served fifteen months as an intern, was an Army medical officer 1947-1949, and was in a medical residency from 1949 until 1952.
I would like to present my ideas about the citizen and potential patient (or medical care consumer-to use the new terminology) can do to help himself of herself in promoting health, preventing suffering and disability, avoiding health or sickness costs and increasing his or her longevity.
Would you like to avoid suffering, disability, illness, injury, and increase your longevity? Foolish question? It’s like asking people if they are against motherhood and in favor of sin, although, as I think about it, this saying is not quite as acceptable as it once was.
It would be fairly simple to do the above things, at least, in part and for some people-for sure on the statistical level.
Since I want to aim this book at the general public, I do not want to obscure the message by constant reference to sources. Almost none of the information originates with me. Most of it will come from other sources. All this has been filtered through my knowledge-gained from formal education at Harvard College, University of Tennessee Medical School, internship, experience and study in the 130th Station Hospital in Heidelberg, Germany where, in addition, to my military duties and our journal club, I made rounds with the German doctors at the Ludolph-Krehl Clinic, internship and residency in medicine at the Henry Ford Hospital in Detroit, Michigan. I took additional short courses (four or five days) given by the American College of Physicians, of which I am a Fellow. I have also taken other courses given by various medical schools throughout the United States. I also took Audio-Digest Internal Medicine, Network Continuing Education (on videotape), plus continuing reading of medical journals, and participation in the American College of Physicians, of which three have been offered so far. I also took part in the recertification examination given last fall by the American Board of Internal Medicine, so I was certified in 1954 and again in 1974.
I was looking through some old papers recently and came across this. I wrote it in 1975. I was not happy with the writing, but I pretty much left it as it was with correction of a lot of typos and making some of the sentences shorter. I was rather pleased with the content as it reflected the knowledge available to me at the time. Sit-ups are no longer recommended-now crunches are recommended instead. I wrote this in1975.
Chapter One: Defense Against the Killers
Not long ago as an exercise in reality and to increase understanding of the patients’ problems, some medical students were asked to fill out a death certificate for themselves. Most would not do so, and those who did picked unrealistic disorders. Other studies have shown that doctors, even, or maybe especially, would grossly overestimate their remaining life span when compared to the expected life span for their age and sex.
The above is intended to indicate the difficulty most of us have in facing the fact that each of us is mortal. Everyone knows that man is mortal, but somehow we do mental tricks on ourselves to think that it won’t happen to us, or we are like Scarlett O’Hara in "Gone with the Wind," and say to ourselves that we’ll think of that tomorrow.
The leading cause of death in the western world is heart disease-about seven hundred and fifty thousand deaths each year in the United States alone, and about five million people are victims of that disease right now. This accounts for about half the deaths in this country, so a lot of us will die of heart disease. Most of this is due to arteriosclerosis (hardening of the arteries) that can effect any artery, but has a special tendency to involve the arteries of the heart.
The cause of this disorder in not clearly known. It is thought to be due to many different causes that working together in various degrees and combinations, seem, at least, to be associated in a statistical way to lead one to think it is cause and effect.
Men have more and earlier arteriosclerosis of the heart than women do. One theory is that boy babies’ arterial lining is thicker at birth than that of girl babies. Others have said that male hormone aggravates and female hormones decrease the tendency. It is uncommon for women who still have regular menstrual periods, or, who still have estrogen production (estrogen is a female hormone made by the ovary), even if the uterus (womb) has been removed, to have coronary heart disease (arteriosclerosis of the heart arteries). However, in men with cancer of the prostate who are given big doses of a synthetic female hormone to slow the growth of the cancer cells there is an increased death rate from coronary heart disease, but with a decreased death rate or a delayed death from the prostate cancer.
A current theory of causation is having a type A personality. This refers to a person who is time ridden, always hurrying, always fighting, the clock, and, who also may have much resentment and hostility. It may be with women’s liberation that more women will get into the type A personality behavior pattern and so will lose some of their immunity to the disease.
It is not practical to consider change of sex so, from the preventive point of view, men can only recognize the increased risk and try to identify and correct other unfavorable factors. It has not been proven that a type A person can change and become a type B, nor that, if he could, it would change his future. Drs. Rosen and Friedman (the proposers of the type A personality theory) think that both are possible.
Some families have an increased incidence of coronary disease at an early age. If you have this family history, you obviously cannot pick out different parents, but you can try to find and change any alterable adverse factors.
Some families have an inherited abnormality of the blood fats, namely cholesterol. This chemical is found in everyone’s blood and is related to bile salts and hormones. Cholesterol (sometimes with calcium) is found in deposits in the lining of the walls of the arteries. This decreases the size of lumen of the arteries, somewhat like the crusting inside a water pipe. When the lumen of the artery gets small enough that not enough blood can get to the tissues of an organ
served by the artery, the function of the organ is impaired. In the case of the heart the patient will get pain in the chest on exertion or excitement (anything that leads to the heart to pump more blood). This pain is called angina pectoris. Sometimes there is bleeding into the wall of the artery or a clot forms in the narrow or damaged part of the artery so that no blood goes through that artery and the patient has a heart attack as President Eisenhower and Johnson did.
Population studies have shown that animal fat consumption and elevated cholesterol in the blood is associated with a high incidence of arteriosclerosis of the arteries of the heart. On the other hand, countries with low animal fat consumption and low blood cholesterols have a low incidence of coronary heart disease.
We do not have good evidence that lowering animal fat consumption and blood cholesterol by diet and medications will change the future for a person with high cholesterol.
Most of our decisions are based in inadequate data -whether in medicine, or in economics, politics or even in the so-called hard sciences such as chemistry or physics.
I recommend a low animal fat diet as having a good deal of scientific rationale, no clear evidence of harm, and it will fit in with an approach to world food problems since it takes ten pounds of plant food to produce one pound of animal tissue. I have been on a low animal fat diet myself for many years, although I am not known to have anything wrong with me other than a bad temper. Some of my patients say I don’t even have that.
Some families have elevated levels of blood triglycerides-another blood fat. It is the same type of fat you see on ham or roast beef. The fat has to be made soluble (able to be dissolved in a watery solution). Our bodies are sixty to seventy percent water and all the chemicals in our bodies are dissolved in water unless in solid form like bone.
Triglyceride elevation responds best to avoidance of alcohol, avoidance of sugar, and to loss of weight if the person is overweight.
Smoking has been found to be associated with an increased incidence of coronary disease. Formerly it was thought that pipe or cigar smoking was not as bad, but recent studies have shown that primary pipe and cigar smokers do not inhale: however, secondary cigarette smokers, that is, previous cigarette smokers who quit cigarettes, do inhale, and, therefore get the tar and the nicotine into their lungs and into the blood stream as much as cigarette smokers do. Therefore, they are probably as much, or more, at risk than they were before. Filters are only a sop to the mind-stronger tobacco is used (previously the bottom leaves "suckers" were not used as being too strong) so that what comes through the filter is the same. The truly mild or highly filtered brands are described by smokers as "next to nothing" since the kick from the nicotine and the taste of the tar has been so cut down-or out, that the charm is gone. This is all second hand to me, since I have never really smoked (that is, never learned to inhale and never had a habit of smoking.)
A sedentary way of life has been linked to coronary disease. Studies have compared more active groups with less active groups. The active groups have usually had less disease. Some have criticized these studies because other factors were not controlled for or accounted for. No one has shown increased longevities with increased physical activity, although several have shown increased quality of life. Admittedly quality of life is hard to measure in a quantitative way.
I have been exercising since 1962, using the booklet, "President’s Council on Physical Fitness." It can be obtained from the Government Printing Office, Washington, D.C. I have been a jogger for several years, at first, per "Jogging" by Bowerman and Harris, and, later, per "The New Aerobics" by Kenneth Cooper.
"Train and don’t strain" is the proper motto. Careful examination by a physician interested in and concerned with exercise is mandatory before a sedentary obese middle-aged smoker starts an exercise program. Thousands, and, maybe millions, of people have coronary disease that they are not aware of, and vigorous unaccustomed exercise could, can, and has provoked fatal spells of abnormal heart beat (ventricular fibrillation-the most common cause of sudden death-most of it related to coronary heart disease).
High blood pressure or hypertension (that does not mean nervous tension) is often and usually familial. So, if you have relatives who have it or who had or died of strokes, kidney failure, congestive heart failure (dropsy), or a heart attack at a young age, you, too, might have high blood pressure. It produces no symptoms early on, so, if you wait until you are sick from it, it’s too late. It’s easy to detect-just have your blood pressure checked. We have good medications for it, and treatment has been proven to change the future of the patient-at least, as far strokes, heart failure, and kidney failure are concerned, but not so far as coronary disease or heart attack is concerned. However, some investigators think that the treatment was started too late to prevent the heart attack-that the damage process had gone too far before treatment was started, and that earlier treatment may prevent or postpone the coronary disease.
One of the problems with this and with other treatment situations is lack of compliance, that is, the failure of the patient to follow the treatment program. Some non-medical people (sociologists) have done studies that suggest that forty percent of the people who go to doctors have no intention before they go of following the advice that they receive. This may seem a high percentage, but I know from my own experience that compliance is lacking in some cases, and is inadequate in many. The best treatment is of no value unless it is followed.
Diabetes Mellitus (sugar diabetes), another adverse factor causing arteriosclerosis of the arteries of the heart and elsewhere, was uniformly fatal prior to the discovery of insulin. Since then, patients rarely die of keto-acidosis. That is a state due to lack of insulin to utilize the sugar. This led to the use of fat as fuel. When the fats were incompletely used up (oxidized), "ketone bodies" built up in the blood, and were excreted in the urine with alkali (base) and water. The elevated level of sugar in th blood led to the sugar being excreted in the urine so that the patient became dehydrated, and acidotic (the pH of the blood dropped), went into a coma, had a drop in blood pressure, and the patient died. Now the diabetic patient with severe diabetes survives, perhaps to have children who have a greater chance of being diabetic than the children of normal parents.
Diabetics, after years, develop complications of the disease such as kidney damage, nerve damage, damage to the retina of the eye (diabetes is the leading cause of blindness) or premature hardening of the arteries-of the lower extremity with gangrene of the foot or leg, or of the heart with angina or heart attack, or of the brain with a stroke. Poor control of the disease due to failure to follow a proper diet, to regulate physical activity, to take insulin or to have proper care of infections or other illnesses, causes those complications to be more common or to occur earlier than they otherwise would.
There is another group of diabetics who get the disease in older years. They are usually fat (the young severe ones are usually thin), who can get by on diet alone, and who would not really be diabetic in any practical way if they would attain and maintain ideal body weight. Many of these patients cannot or will not diet, and have so much sugar in their blood and urine that they must be given oral anti-diabetic agents. A recent large-scale study seemed to show a greater death rate from heart disease in those treated with diet and oral drugs than in those treated with diet alone of with diet plus insulin injections. Many diabetic specialists do not agree with these conclusions, but prudence suggests using these agents only if it is absolutely necessary, that is, when the patient cannot or will not diet properly, and if insulin is unacceptable to the patient. Some doctors, including me, have never used these oral drugs very much, so the study did not cause much concern for their diabetic patients.
It has been found that diets need not be weighed as was formerly thought to be the case. The use of food exchanges has made the diet less monotonous and easier to estimate as to fat, protein and carbohydrate components. The new U100 (100 units per milliliter) insulin is much purer and in smaller volume and is less painful and also less likely cause allergic and other reactions. Having only one strength will help to avoid confusion-previously and currently both U40 (40 units per milliliter) and U80 (80 units per milliliter) existed and each required its own syringe-when the older preparations are phased out as planned.
The second of the killers is cancer. Of these, cancer of the lung is the most common. There are several types of lung cancer. The most common one is squamous cell carcinoma, a malignant new growth of the lining of the bronchial tube. This is more common in urban than in rural areas probably related to pollution. It is more common in smokers than in nonsmokers. One can do little about atmospheric pollution except at the ballot box or through environmental organizations, unless one has a position of authority in some large corporation or in government, but each person has a choice to smoke or not to smoke. Smokers also have an increased incidence of bladder cancer-apparently some cancer-causing chemical is absorbed though the lung, enters the blood stream, is carried to the kidney, where it is excreted at a high concentration, and is held in contact with the bladder lining until the person urinates.
Cancer of the cervix seems to be related to sexual intercourse with multiple partners. Nuns have a low incidence of cervical cancer, while promiscuous young women seem to develop the disease earlier and with greater frequency than their less sexually-active contemporaries. Cancer of the cervix takes a long time to develop so the Pap smear can detect it at an early stage. I have always thought that the promoter of the smear was not named Mominowsky instead of Papanicalaou-then we could have called it the "Mom smear" rather than the "Pap smear" since it is mostly used for "Moms" and not for "Paps."
Cancer of the breast is very common, but lends itself to early detection by examination of the breast by the woman herself. I tell my patients to do the examination once a month-either the first Monday morning after the beginning of her period or the first Monday morning of the month. That would lead to an examination once a month. Doing it in the morning avoids losing a night’s sleep if she finds something. Doing it on a Monday gives her all week to get it checked and maybe biopsied before the next week end. It helps the doctor avoid getting frantic phone calls at hours or times when can do little to resolve the problem. (One should be practical.)
Cancer of the colon is most common in the rectum. Fifty percent are within reach of the doctor’s finger (with a glove on it, I hope.), and seventy-five percent are within reach of a ten inch (twenty-five centimeter) sigmoidoscope. The sigmoidoscope is a metal tube that is inserted (gently, I hope) into the rectum by the doctor after the lower bowel has been emptied of feces by an enema. During the insertion there is an obturator inside the tube to make the end rounded so it will go in more easily. After insertion the obturator is removed so that the doctor can look through the tube and see the lining of the rectum. A light is attached to the back opening of the tube to provide illumination of the inside of the rectum. Although the anus (the opening where the skin and rectal lining meet) is quite sensitive to pain, touch, and heat, the rectum is not so a person can have a large growth in the rectum without having any pain. Rectal cancer is the most easily found and most beneficially treated of all internal cancers, and is relatively common in both men and women. Anyone who has rectal bleeding, diarrhea, or constipation, especially if not explained and not temporary should be sigmoidoscoped. Bowel X-rays with instilling of barium into the rectum and colon is also helpful in finding colon cancer. The flexible colonoscope will allow more (sometimes all) of the lining of the colon, but this requires an expensive instrument and a skillful operator, and is not available everywhere.
Acute lymphatic leukemia of children and sometimes of young adults lends itself to treatment with multiple drugs and radiation so that prolonged remissions can be obtained in a good percentage so that even conservative physicians talk about long-term freedom from recurrence after months or even years with no further treatment.
Hodgkin’s disease in another malignant disease, not exactly cancer, but in the same general group, that lends itself to useful remissions or even "cure." Multiple toxic drugs are used, but you can’t kill an elephant with a Flit gun.
Cancer of the uterus (womb) is becoming more common at a time when the number of deaths from cervical cancer is declining. Abnormal uterine bleeding would call for a bimanual pelvic examination (and Pap smear although the Pap smear is not useful for detection of uterine cancer). In case of any doubt the patient should be referred to a gynecologist for dilatation and curettage of the uterine lining. The opening in the cervix is dilated and the lining of the uterus is scraped out for examination by microscope by a pathologist. If cancer is found, then removal of the uterus or radiation therapy is done. Sometimes both are used.
Cancer of the lip and of the exposed skin is common, visible, accessible, and early treatment can be curative. It is more common in those who are excessively exposed to the sun. Sun exposure also causes prematurely some of the changes associated with age.
The cause or causes of cancer are not clearly known, but likely causes are exposures to chemicals (new chemicals are being made right along and put into widespread use when their potential for harm cannot be known since there has been no previous experience with large numbers of people). Excessive exposure to radiation and possibly viral infections are other likely causes. Another promising line of study is of the immune mechanisms of the body.
Stroke is number three of the big killers. It can be due to the rupture of the wall of a brain artery with bleeding into the brain. That may cause loss of consciousness, weakness of an arm or leg on one side with or without weakness of the same side of the face, loss of speech; or it can be due to the plugging up of a brain artery with an embolus (a clot or another particle) that came from somewhere else such as the wall of an artery or from inside the heart; or it can be due to a thrombus (a blood clot) that formed in the artery locally. With clots or emboli the patient is somewhat less sick, less likely to have a convulsion (an epileptic type fit), less likely to have a headache or a fever, less likely to become unconscious, less likely to die, and somewhat more likely to get better quicker.
The big deal about prevention of stroke is to find and treat the high blood pressure before it can damage the brain arteries. Another big deal is to try to prevent arteriosclerosis. Sometimes, if a narrowed artery in the neck is suspected, an arteriogram (an iodine-containing chemical is injected into the artery to make the inside of the artery visible on an X-ray plate), is done to; show if and where the artery is narrowed. If the narrow place can be reached, a vascular surgeon can open and clean out the material that is causing the narrowing-the old villain, cholesterol, with increased artery lining cells-some of which are dead. Rarely the test, or the operation, will provoke the very thing that the doctor is trying to prevent-a stroke or even death.
One of our big problems in medicine, and, indeed, in all aspects of life, is unrealistic expectations. People expect miraculous results, but sometimes fail to realize that many of our outstanding achievements are only obtained at the price of considerable risk-to say nothing of considerable expense.
Chapter Two: Defense against the disablers
The big killers are also disablers, but the second largest cause social security disability payments is pulmonary emphysema. Although it does kill, it does not do so for a long time, but causes much suffering and disability. It’s a little hard to explain, but it is associated with the breaking down of the walls between the tiny air sacs in the lungs. The inside of the air sacs is separated from the blood in the capillaries (tiny blood vessels) by a thin membrane. The oxygen in the air in the air sacs passes through the membrane and attached itself to the hemoglobin molecule-a complex iron and protein containing substance. The oxygen is then carried through the lung vein into the left side of the heart-first into the left atrium (the receiving chamber) then into the left ventricle (the pumping chamber) and then out through the arteries to all the tissues of the body. The large number of air sacs provides a large surface area for gas exchange, not only for oxygen to get into the blood, but also for carbon dioxide to get out of it so that the carbon dioxide can be breathed out just as the oxygen is breathed in. The breakdown of the walls of the air sacs converted many little sacs into one larger one. That decreases the area for air sac-capillary contact and makes gas exchange more difficult. In addition there is loss of elasticity of the lung tissue making breathing out less passive, and requiring more effort to get the air out of the lung. Many of these patients have bronchitis (inflammation of the bronchial tube lining) with swelling of the lining. This decreases the size of the bronchial tube passage. There is also increased secretion of mucus, and sometimes constriction of the muscles in the wall of the bronchus. All three of these can cause wheezing (a whistling noise on breathing out). These patients often become infected with viruses such as influenza, fungi such as monilia, and bacteria such as the pneumococcus (a cause of a common type of pneumonia) or Hemophilus Influenza (unfortunate name-has nothing to do with the disease, influenza. The cause of this disease is unknown although a few lack an enzyme-an hereditary disorder. There is a very strong statistical association with pollution of the general atmosphere, such as smog, and the person’s atmosphere, such as cigarette smoke pulled into the lungs on purpose.
Treatment consists of avoiding the pollution-filters or moving for the general atmosphere: and stopping smoking for the person’s atmosphere. Prompt treatment of bacterial infections with antibiotics and immunization against influenza is mandatory. Other treatment might include bronchodilators, humidifiers, and intermittent positive pressure breathing treatments. This last is not considered helpful by some physicians, however.
Continuing to smoke is a sure way to ensure worsening of emphysema. It can cause a particularly distressing kind of suffering-shortness of breath-and a slow slide to the graveyard with episodes of infection in the lung requiring visits to the doctor or the emergency room visits and the hospital. A new intensive care unit has been established in many hospitals-the pulmonary intensive care unit, or, as one doctor called it, "the smokers’ ward," where artificial breathing machines are attached to endotracheal tubes (tubes put down through the nose (or mouth), into the layynx, into the trachea (windpipe) in those patients who have lost consciousness from retention of carbon dioxide and lack of oxygen in the blood due to poor lung function.
Rheumatoid arthritis is a common disorder of the joints, and sometimes of nearly the whole body. This is an inflammatory disorder of unknown cause. The severity varies from a little early morning stiffness and soreness of the finger joints (usually not the ones near the finger nails), the knuckles, or the wrists that is relieved by activity, by washing the dishes (application of heat), or taking of some aspirin all the way severe stiffness and confinement to bed or to chair. The disease is chronic, has unpredictable ups and downs, and is very discouraging to have or to treat.
The use of heat, aspirin, and exercise with careful avoidance of overuse of the involved joints and judicious rest can relieve much of the suffering and avoid some of the deformity that otherwise might occur. A common problem is the tendency of the patient to become discouraged and not apply the measures that can be helpful. This allows more suffering disability than would be necessary.
"Wear and tear" arthritis, or osteoarthritis, is another common disorder of the joints. This usually effects the weight-bearing joints, such as the low back, the hip, or the knee. The cause is not known, but it seems to be aggravated by being overweight (another reason to avoid this common problem) and by excessive and improper use of the joint. In this regard, occupational choice may play a part. The job activities ideally should be suited to the person’s equipment-a slender fine-boned small-muscled should have a job requiring heavy lifting. Don’t have a racehorse pulling a beer wagon. One type of osteoarthritis is hereditary with enlargement of the distal finger joint (the one nearest the nail). These joints may hurt a little and don’t look nice, but are important because the person thinks she has the early stage of a crippling disorder so fear of the future is more important than the present. There is nothing to do about the deformity. If it hurts, aspirin and local heat can be used, but most people soon get tired of this. They would rather just ignore the condition than to be bothered to treat especially since treatment doesn’t cure it or change the appearance. Incidentally, despite the widespread belief to the contrary we don’t cure many things. "Cure a few, relieve many, and comfort all" are limited goals, but is the ambition of many doctors. It would be nice if we doctors could do that much.
Low back pain is a pain to the doctor as well as to the patient. Some say that getting up on his hind legs was man’s original biological sin. Four-legged animals do not have inguinal hernia, varicose veins, hemorrhoids, or low back pain (hard for me to be sure about that last, though. Maybe my veterinarian friends can speak to that). One old doctor who apparently didn’t like women said, "A woman is a constipated biped with a backache." I hasten to write that is not my definition of a woman-my closest relative and ancestor was a woman, and I surely don’t feel that way about women.
At any rate, back pain is very common and it has many causes. In addition to pain arising from the muscles, joints, and ligaments of the back, there are referred pains from the prostate, bladder, kidney, uterus, aorta, pancreas, gall bladder, stomach, small bowel, large bowel, appendix, spinal cord, nerves, heart, lung, pleura, and brain. Of course, some of these do not cause low back pain, but they do cause back pain. During World War II there was a saying, "Oh, my aching back" that I believe denoted more a state of mind or feeling rather than an organic pain.
Posture plays an important part in back problems. "Swayback is bad" is the real message many experts on the back have tried to convey, and I think this is true. If one thinks of the low back as a bow and the muscles as the bowstring, you can understand that if the back muscles are strong and the abdominal muscles are weak, then the back is going to be curved in the lower portion. Strengthening the abdominal muscles tends to oppose sway back and maintains a more advantageous relationship of the lumber (lower) vertebrae to each other. The only natural activities than I can think of that strengthen the abdominal muscles are swinging hand over hand through the trees (not natural for us now) and copulation (most people can’t do this often enough or long enough at a time to get much strengthening from it. At least, I don’t see that many people with powerful abdominal muscles).
Running is said to strengthen the abdominal muscles as well as many others. From the practical standpoint I believe that leg-and-thigh bent sit-ups offer the best results from the least time and effort. I especially recommend the alternate touch-the-elbow to the opposite knee variety with the knees widely separated..
Tension and depression can aggravate and perhaps even cause low back pain.
Correct standing is obtained by standing up straight with the buttocks pulled in, the belly pulled in, the shoulders up and back, the head held up high-as though trying to stick an imaginary spike in the top of the head into to the ceiling. This will produce the "military" or "model" type of stance. I used to be struck by my ability to distinguish West Point graduates from Army of the United States officers when I was doing physical examinations while I was in the Army. The Regular Army officers seemed uniformly to have better posture.
Sitting posture is hampered by the design of furniture and car seats. The proper seating posture is the "ninety degree" type-feet ninety degrees to the leg, leg ninety degrees to the thigh, and thigh ninety degrees to the trunk and neck.
Lying posture is also important. When lying on the back, a pillow under the knees is desirable (to avoid that villain-"swayback"). When lying on the front, not only is a pillow not needed, it is detrimental (in 2005 I would suggest putting the pillow longways under the trunk, and I would suggest flexing the thighs when lying on the side).
Chapter Three: Trivial but not Unimportant
Man is heir to many things that, although not lethal, are very aggravating and common. Some of these can be prevented.and others made less severe. Sometimes we doctors don’t take these very seriously. It’s a little hard to shift gears from thinking about a person with a killing disease, present great suffering, and with an immediate threat of death to thinking about a person with a condition that although annoying does not carry any threat to life.
Omphalitis (inflammation of the navel) is one of these. The outer layer of the skin sheds. Over most of the body surface the shed skin sticks to the inside of the clothes or comes off in the bath water. In some places this does not happen, such as the navel, and the dead skin stays there. Sweat collects, it is warm there, and it is easy fo fungi or bacteria to collect and multiply. Fat people have more trouble if the fat tends to close up the navel, but some thin people have closed navels also. Washing out the navel seems to be something one would take for granted, but I have had to order them washed out on hospital patients. Sometimes a Q tip or some cotton on the end of a small wooden stick is needed. Soap and water is good, but sometimes hydrogen peroxide works even better. It’s important to get it dry. One old doctor said a dirty navel was a bad sign-that it meant that the patient would not pay his doctor bill. Some of the medical people call this "the Bales sign," but I do not deserve the credit.
cut short in the middle, if desired.
"Hey diddle, the cat and the fiddle
Long on the corners and short in the middle."
A good many people have peculiar feet. The foot bone behind the second toe sticks out more than the one behind to the big toe. The weight should be distributed over the heel, the head of the first metatarsal bone (the bone behind the big toe), and the head of the fifth metatarsal bone (the bone behind the little toe). When too much weight falls on the head of the second metatarsal bone the friction of the shoe on the skin under the second bone head causes a callus. This callus can be trimmed off cheaply by the patient or expensively by a foot "expert," but it will just come back. A metatarsal bar across the sole of the shoe can transfer the weight bearing, relieve the pain, and prevent the callus from returning.
. This is the material I used for my talk at the Philosophy Class on 4 May 2005

65. Palestine History From Esam Shashaa
Third Millennium B.C.: The Canaanites were the earliest known inhabitants. Jericho was one of their cities. They were reported to have an alphabet. Since the land is a connecting link to Egypt, Syria, Mesopotmia, and Asia Minor, it became a battleground for the adjacent empires. Egypt has control first, but it was challenged by invading Amorites, Hittites, and Hurrians. These invaders were defeated , and were absorbed by the Canaanites who then numbered about 200,000.
Second Millennium B.C.: About 1400 B.C. Semitic tribes from Mesopotamia, the Hebrews, came as did the Philistines, an Aegean people of Indo-Europan stock The traditional account is that the Israelites came to Canaan about 1200 B.C. after the exodus from Egypt. However, this is not established by archaeology. There may have been a dispute between two indigenous groups. About 1230 B.C. Joshua conquered the hill country. Some think that Israelites were pastoral, and were at first confined to the hills, and were excluded from the more fertile land in the flatter part of the land. The Merneptah Stela from Egypt suggested that Israel was an agricultural entity in the late 13th Century B.C. (The time of Gideon in the Bible).
1000 B.C.: David defeated the Philistines, who were then assimilated by the Canaanites.
922 B.C.: At Solomon’s death the kingdom was divided into Israel in the north and Judah in the south.
722-723 B.C.: Israel fell to Assyria
586 B.C.: Judah conquered by Babylon. The temple was razed. The Jews went into captivity.
539 B.C.: Cyrus, the Great, of Persia conquered Babylon. The Jews returned to Judea. The walls of Jerusalem were rebuilt. The Torah was codified. There is confirmation of the return in the Second Temple period of 538 B.C.
333 B.C.: Alexander, the Great, took the region. The country was ruled by the Ptolemy’s of Egypt, and the Seleucids of Syria.
141-63 B.C.: The Jewish Maccabees set up an independent kingdom.
132-35 B.C.: Judea was renamed Syria Palaistina.
63 B.C.: Rome appointed Herod king of Judea. He extended the Second Temple. Strife broke out between the pacifists and Zealots, and riots broke out against the Roman authorities.
34-4 B.C.: The time of Jesus
70 A.D.: Titus of Rome attacked Jerusalem and destroyed the Temple. The city was renamed Aelia.
313 A.D.: Roman Emperor Constantine’s mother visited Jerusalem, and it became a focal point for Christian pilgrimages. Most of the population became Hellenized and Christianized.
324 A.D.: Constantine of Byzantium rebuilt the city walls, and commissioned the Church of the Holy Sepulcher, and opened the city for Christian pilgrimage.
614 A.D.: Roman rule was interrupted by a Persian invasion, and later ended by a Muslim Arab army that captured Jerusalem in 638 A.D.
638 A.D.: This began 1300 years of Muslim presence in Filastin. Muhammad had designated Jerusalem as the first qibla (direction to be faced while praying). He is believed by Muslims to have ascended on a night journey to heaven from the area where the al-Aqsa Mosque is now. The city benefitted from trade and from being a religious center under the first Muslim dynasty, the Umayyads of Damascus.
750 A.D. After the power shifted to Bagdad with the Abbasids, Palestine was neglected. There was domination by the Seljuk Turks, Fatimids, and later by Crusaders.
1517 A.D.: The Ottoman Turks of Asia Minor defeated the Mamelukes, and, with few interruptions, ruled until 1917.
18 31-1840 A.D.: Muhammad Ali, the modernizing viceroy of Egypt, expanded his rule to Palestine.
1840 A.D.: The Ottoman Empire reasserted its authority.
1845 A.D.: The 12,000 Jews in Palestine increased to 85,000 bu 1914. (Jews from Europe began to move to Palestine in the 1880's buying land from absent Arab landlords, thereby displacing the Arab peasants from that land.)
1897 A.D.: The First Zionist Congress held in Basel, Switzerland, issued the Basel program on the colonization of Palestine.
1904 A.D.: The Fourth Zionist Congress decided to establish a national home for the Jews in Argentina.
1914 A.D.: Britain promised the independence of Arab lands under Ottoman rule, including Palestine, in return for Arab support against Turkey, who had entered the war on the side of Germany.
1916 A.D.: Britain and France signed the Sykes-Picot Agreement. That divided the Arab region into zones of influence. France got Lebanon and Syria, and Britain got Jordan and Iraq.
1917 A.D.: On November 2 Arthur J. Balfour promised the British Zionist leader the establishment of a national home for the Jews in Palestine.
1918 A.D.: Jews began to migrate to Palestine. Large scale Jewish agricultural and industrial enterprises began in Palestine.
1919 A.D.: The first Palestine Conference expressed opposition to the Balfour Declaration.
1920 A.D.: The San Remo Conference granted Britain a mandate.
1922 A.D.: The Council of the League of Nations issued a Mandate for Palestine to the British.
!929 A.D.: Arab attacks on Jews killed 133, while 116 Arabs were killed.
1936 A.D.: The Arabs staged a six-month strike to protest land confiscation and Jewish immigration.
1937 A.D.: The Peel Commission decided the mandate in Palestine was unworkable. It recommended a Jewish State, an Arab State, and a neutral sacred-site state to be administered by Britain.
1939 A.D.: A British White Paper restricting Jewish immigration, and offering independence for Palestine in ten years. This was rejected by the Zionists, who organized terrorist groups, and attacked the British and the Palestinians.
1947 A.D.: Britain decided to leave, and asked for UN recommendations. On November 29 it called for dividing Palestine into Jewish and Arab states, with Jerusalem as an international zone under UN jurisdiction. Arabs attacked Jewish settlements in retaliation to Jewish attacks on them.
1948 A.D.: The British decided to leave on the 17th. The Jews proclaimed a Jewish State. The armies of Egypt, TransJordan (now Jordan), Syria, Lebanon, and Iraq joined Arab and other guerillas in a full scale war. The Arabs lost. Gaza was left to Egypt. The West Bank was controlled by Jordan. 630,000 Arabs left Israel-leaving 130,000 Arabs in Israel.

66. The New Entitlements Donald W. Bales November 2005
First are the entitlements to freedom of consequences for risky behavior:
1. Women should be able to indulge in promiscuous unprotected (no condom) sex-anal, oral and vaginal without getting pregnant or infected.
2. If they get pregnant, they should have access to abortion at any stage of pregnancy.
3. If they get infected, there should be an easy and free cure (no cure for herpes, human papilloma virus, and HIV-some gonorrheal organisms are becoming resistant to some antibiotics).
4. Alcoholism and drug addiction are diseases and those who have them should receive free treatment and should come under the American Disabilities Act as to employment.
4. Men should be able to indulge is promiscuous (no condom) sex-anal, oral or vaginal without causing pregnancy or getting infected.
5. People should be able to inject illegal drugs without using sterile precautions and not get infected with HIV or hepatitis. (No one has been cured of HIV, and the treatments for hepatitis are also unsatisfactory.)
6. Smokers should not get lung cancer, emphysema or any or the other bad disorders from tobacco. If they do get sick, they should be entitled to sue the tobacco companies for the illness.
Second are the entitlements to benefits not earned:
1. A person should have self esteem and the esteem of others without doing anything to earn it.
2. Students should get a good grade even if they don't go to class, don't study and do poorly on the exams.
3. A person with a black skin should get preferential treatment.
4. A person who can't read or understand English should have signs and instructions printed or spoken in his or her native tongue.
5. A criminal should receive a light sentence-or no punishment at all-since the offense is either societal (poverty, poor education, racism, bad parenting or prejudice) or is medical (due to emotional or mental illness). "The Socialization and the Medicalization of Bad Behavior."
6. All persons are entitled to not be judged. Everyone should be nonjudgmental.
7. People have a right to be rude. All minorities have a right to offend the majority.
8. People are entitled to be free of being fired-even if incompetent.
9. Pay should be equal without regard to performance.

67. Mind-Body Body-Mind: Yoga Tai Chi Donald W. Bales November 2005
Much has been written and said about the effect of the mind on the body. Not so much has been said or written about the effect of the body on the mind. Pain surely can effect the mind, as can shortness of breath. What we see and what we hear-both words and music-can effect the mind. Any brain disorder or brain effecting chemical can effect the mind and an orgasm surely can effect the mind. And, of course, any disorder of the brain can effect the mind since the brain is the seat of the mind. Both yoga and Tai Chi are methods of having the body effect the mind. I think I should give some background as to how I came to favor yoga and Tai Chi.
As most children are, I was physically active during my childhood. I played cowboys and Indians, wrestled with contemporaries, fought with a few of them, had a pony from age eight to eleven, played some sandlot baseball and some meadow football. I took a few swimming lessons shortly after Peneto Pool was built in Morristown (Tn.) in the late twenties, and swam quite a bit each summer until I went to high school.
When I was in the ninth grade I went out for football and was on the squad for four years. I played a little in some games as a sophomore, more as a junior and was out of the game only five minutes throughout my senior year. I was center on the basketball team in my senior year (we didn’t have a very good team that year). At six feet one I was the tallest on our team, but I had long arms-a seventy four inch span. I also went out for track, but never got a letter in track. One had to place in a track meet to attain that and I never did.
I was not a natural athlete. Most good athletes are mesomorphs (big bones and muscles). I was an ectomorph (most skin and nervous tissue). I was not fast or big or strong, or well coordinated. Nevertheless I was considered a pretty good center (first three years) and a pretty good right end and weak side linebacker my senior year. I was considered to be a smart player, but not smart enough to be afraid. I was considered for a football scholarship at Vanderbilt, but took the academic scholarship at Harvard instead.
During my time in the army in Germany (1947-1949), I played basketball on our hospital team. During my residency I played some on the Ford Hospital team also until I sprained my ankle.
In the early years of my medical practice in Kingsport, I played some golf and went to the country club pool with the children, but really didn=t do much physical activity.
When I was forty, I was not pleased with my scrawny calves and my beginning paunch and took up the exercises listed in the booklet put out by the Johnson Administration ACommittee on Physical Fitness. I began doing a series of exercises-mostly calisthenics with some aerobic components added on. Later on I had a patient who wanted to take up jogging. His wife insisted he have medical clearance by me. I became interested in jogging and in my fifties was in a number of ten kilometer races. I was never very good-once I was third for men my age.
I was somewhat reluctant to retire at age seventy-five-fearing that I would be bored or lost or feel useless. However, I took up swimming competitively in 2000 and have been to district, state and national games for swimming. I now have forty-nine gold, three silver and three bronze medals-the bronze ones from the national games in 2001 and 2003.
This gives some background as to how I came to yoga and Tai Chi. I found a VCR, “An Empowering Workout” at the library showing Tai Chi and I found a book there about yoga. The Tai Chi is not the continuous type taught at the senior center, but ten exercises preceded by some warm-up activities. The yoga is simpler and less demanding than the power yoga noted on a VCR given me by my son Jack.
Yoga is of very ancient origin in India. Some say 5000 B.C. Tai Chi is also very old-perhaps going back to the 14th century A.D. in China. Initially yoga taught unity of mind and body later duality and finally unity again. It emphasizes meditation, relaxation, flexibility, breathing and balance.
Tai Chi was probably derived from martial arts. In many countries the common people were forbidden to own swords so developed unarmed combat to protect themselves. Tai Chi is done slowly whereas martial arts are often, usually, very fast. Tai Chi is promoted in China for the elderly to maintain flexibility, balance and strength, hoping to prevent falls. It also has a meditative aspect to it.
I demonstated the Tai Chi exercises. I did not do so for the yoga since it required lying down on the floor and I had on my good clothes.
My interest has been more in the physical aspects. I believe vigorous physical activity can be favorable to the mind. Some articles promote the idea that jogging can do as much for mild depression as antidepressants. I don’t know that I believe that. I do feel better after a vigorous workout than I did before. And I feel even better after a swim. After a vigorous swim I feel both more relaxed and more energized. I feel good before I swim and even better after.



68. Healthy Aging Donald W. Bales, M.D. January 2006
`Well, here I am healthy and aging. How did I get here?
"If you want to live to be old, choose long-lived ancestors." If you want to be healthy in your old age, choose ancestors who remained healthy in old age.
My parents didn’t do very well-my father died at 44 (when I was ten), and my mother died at 62 (when I was forty). My grandfather Bales died at 77 and my grandfather Weesner died at 78, my grandmother Bales died at 83, and my grandmother Weesner died at 87. However, my father’s older sister lived into her 99th year. I sometimes say that I am going to emulate her, but there are two problems-one: she was female and I am male (even though a nurse once said, "Yes, Ma’am" to me. I told her that I was a male and that I could prove it, but she didn’t make me do it), and two: she never said anything bad about anyone and I have said a good many ugly things about several people-of course, they all deserved it. My mother’s youngest brother (my favorite of all my aunts and uncles) is still alive at 91. He is a widower, but lives in a condo in Wesley Commons in Greenwood, S.C.
I think my body build came down to me through my grandmother Weesner. She had five brothers-all of whom were tall and lean.
I have already lived longer than any of my ancestors except my grandmother Weesner. All four of my grandparents remained active. Granddaddy Bales did what he could on the farm in spite of having osteomyelitis of one of his heel bones. Pappaw Weesner died suddenly while arranging an appendectomy for one of his patients. Granny Bales ran the farm and remained interested in politics (she was a rabid Republican) and in the doings of the First Baptist Church (she was a Big Baptist). Mammaw Weesner was still baking her famous sugar cookies almost to the end of her life-my children (her great-grandchildren) used to head for the kitchen to look for those cookies whenever we would visit her.
The affection and emotional support from my immediate and my extended family provided me with emotional capital that I will never use up. This has helped me to deal with life in a way that would have been impossible without it.
Heredity has a lot to do with longevity and with health. When I was assembled in 1921, my genes did not carry the tendency to any diseases that would have caused disability or an early death. Male pattern baldness, myopia, astigmatism and old age hearing loss was about all the unfavorable genetic baggage that came to me. An asset was my ectomorphic build. I wanted to be a mesomorph when I was playing football, but mesomorphs do not always fare well as to health. Some of my fat friends think the reason that I am still thin is hereditary and not due to any efforts on my part.
The example shown me by my family helped me to be industrious. Somewhere along the line I got the idea that I was to do the very best that I could in whatever I tried. No one ever put it into words, but it has been a part of my life all along.
Luck plays a part in healthy aging. Not getting run over by a truck or getting some bad infection seems to be a matter of chance. I did have a viral infection of the liver when I was in the Army in 1948. I am sure that I had Hepatitis A. I know now that it rarely causes death or chronic liver disease. The treatment then was strict bed rest (not even getting up to use a bedside commode) for six weeks and eating a high protein low fat high carbohydrate diet. A diet low in fat is not very palatable. But I was very compliant. So when patients would try to tell me they couldn’t do something I advised, I would sometimes tell them about my experience.
I spent seven weeks in hospital, but recovered completely. I used the time in bed to read all of Cecil’s Medicine textbook.
Another thing about luck (or is it good judgement?) is marrying well. I was also lucky in that all four of our children were born whole and healthy. Ditto for our six grandchildren-I was lucky in that. I was also lucky in my choice of a profession-I really liked being an internal medicine doctor. I was somewhat reluctant to retire, but wanted to quit while I was at the top of my game. Also practice was not as much fun as it had been. I still dream about doctoring. Not surprising-I was an active doctor for 51 years. About the only thing medical now is going to the cancer conferences at Holston Valley. It sort of keeps my mind in. I also have lunch every Monday with some retired doctor friends. Some wag called us the rodeo’s-retired old doctors eating out. It is group therapy.
After my father died, I went to live with my Weesner grandparents. My uncles never smoked in their parents’ house, so smoking was out of the question for me. After I went out for football in the 9th grade, another strong reason not to smoke-the coach wouldn’t allow his athletes to smoke. My not smoking cut down my risk of getting coronary disease, emphysema and several kinds of cancer, especially lung cancer.
I continued to play intramural basketball in college, also played in the army and even in residency until I sprained an ankle. In the early years of my practice I was so busy that I didn’t have much time for physical activity, but I did play golf and would go to the pool with the children.
When I was sixteen, I got blisters on the top of my shoulders from the sun. Never again. In recent years I wear a head covering and sun glasses when out in the sun. Sun exposure is strongly correlated to all three kinds of skin cancer. It is also related ot cataracts and macular degeneration.
One day when I was 40, I noted that my calves were scrawny and that I was getting a little paunch. I began to use the program outlined By the President’s Council on Physical Fitness. This was during Johnson’s administration, but I showed my broad-mindedness by using it anyway.
It was a series of exercises including some aerobic ones. I still do some of them daily.
When the information came out in the early 1950's about cholesterol, I began to avoid it. Ditto for the hazards of animal fat later on. I began to avoid animal fats. I didn’t have to change the milk I drank-I liked "blue john" (skim milk) when I was a child.
Several years ago I had some gum trouble requiring peridontal surgery. Now I use a little brush between my teeth, dental floss, toothbrush and waterpik. The bacteria associated with gum disease has been suspected as contributing to coronary artery heart disease. The more teeth you have the lower the chance of a clot type stroke.
A man came to me to get medical clearance to take up jogging. He lent me a book and in my 50's I took up running. I was in a good many 10 K’s in the 1970's. Then my arches began to complain and I took up riding my ten-speed bicycle in the 1980's. After I retired at age 75 in 1997, I joined the senior center and began going to the gym there. I go to the gym 2 to 6 times a week.
I began to swim laps with the senior citizens at the high school. One of the women from the center saw me swimming and suggested that I enter the senior games. The competition is against people of your own age, beginning at 50 and going up five years for each category. I was swimming two to five times a week.. In the summer they let us seniors swim at the municipal pool . My events are 50 meter (or yard at the National) free style, breast, and back and 100 meter (or yard) breast and back. I took part in the local, then the district and then the state games in 2000. I have been to the district and state games four times in all. I hold the state record for men 75-79 100 meter breaststroke and for men 80-84 50 and 100 meter breast stroke. In 2001 I went to the national games in Baton Rouge-getting a Bronze medal for the 100 yard breaststroke. I went to the national at Newport News in 2003-getting Bronze medals for the 50 and 100 yard breaststroke. In 2005 I went to Pittsburgh, but got no medals, but did get 5 ribbons. I now have forty-nine gold, three silver and three bronze medals.
I took a yoga class at the senior center, but found a book that had yoga exercises in it that was more my style. I took a Tai Chi class at the center, but found a video that had ten exercises on it that suited me better. I do both of these nearly every day.
As you can see, I think exercise is important for healthy aging. Not everyone can do vigorous exercise, but everyone can do something. Studies have shown that 90 year olds with paraplegia can benefit from doing arm exercises regularly.
There is an old saying, "Mens sana in compore sano." "A sound mind in a sound body." So what about the mind. One of my daughters-in-law gave me her old computer. I used it as a word processor and began writing. I have a thousand pages of my memoirs. I have eight completed sci-fi novelettes and four more not finished, also three children’s stories, and a western. None of these have been published yet. I got a computer capable of going online in 2000. I use it to look up anything that someone asks me about and lots of other stuff also. I get a list of columnists every day and send comments to most of them. I get responses also-so far from about 70.
I also have sixty-six essays on my web page: http://home.earthlink.net/~baleslynnwood/. I get many emails every day-from Medscape (medical issues), newspaper headlines from the New York Times, the Washington Times, the Washington Post, columnists from Jewish World Review and TownHall.
After I retired I began taking six week courses in spring and fall with the Kingsport Institute of Continued Learning at the University Center. I also took part in the Great Decisions Seminars of the Foreign Policy Association once a week for eight weeks each winter. I led the discussion for some of these. I continue to read, but not as much as I used to.
As to the spirit: I believe a person has to have a philosophy of life. I like the Serenity Prayer. AA uses it, but they did not compose. It was claimed by Rheinhold Niebuhr, but some say he didn’t originate it. As you probably know, it goes like this. "God grant me the serenity to accept the things I cannot change; the courage to change the things I can, and wisdom to know the difference." I try to make lemonade out of lemons. It has been reported that people who attend church regularly are healthier and happier than those who don’t. I attend regularly. Some refer to those who do as the "religious remnant."
It’s not just the hand you get, although that is important. It’s how you play it.
What can people do to promote healthy aging? Have a personal physician in whom you have confidence. Report symptoms. Be compliant with the advice received. Be immunized to everything recommended. Don’t smoke. Don’t abuse alcohol. Don’t use recreational drugs. Be active in body and mind. If you drive, drive defensively. Take the 55 alive program. Don’t drive if you are not able to drive safely. Try to fall proof your house. Think prevention. Maintain your connections to family and friends. As Granny Bales told me, "That’s some of your folks, you must love them." Behave in such a manner that you won’t feel guilty. Practice the Golden Rule. I travel in friendly seas. I hope that you do. Life is for the living. Although I am a United Methodist, I have tried to apply the dictum of Pope XII, "Always choose the lesser of the two evils."
Attitude is important. I don’t know whether this is inborn or not. I am fairly sure it is also related to example and experience. Can a person with a bad attitude come to have a good one? I don’t know. I tried to help some of my patients with a bad attitude have a better one, but I am not sure that I did any good. Don’t give up-hang in there.
Good luck with your health and with your aging.

69. Addiction Donald W. Bales, M. D. December 2005
What is addiction? It is not tolerance. Tolerance occurs to anyone who takes increasing doses of addictive type drugs, such as opioids, benzodiazepines (Valium cousins), barbiturates (previous sleeping pills), alcohol, and nicotine. The brain cells downregulate the receptors so that it takes more to get the same effect. Having withdrawal symptoms does not prove addiction. Aanyone who takes an addictive type chemical regularly will have withdrawal symptoms. These effects have been called "physical dependence." Other drugs, such as cortisone, beta blockers and most anti-depressants, not considered addicting, can cause phyical dependence.
The term "psychological addiction" is now used. Some say addiction is manifested by persistence in using even in the face of obvious harm to health, work and relationships. Another definition is "uncontrolled, compulsive use, despite harm." Others add a return to use after all traces of the chemical have left the body and the withdrawal symptoms have gone away.
Humans have sought chemicals to alter the state of the brain for many, many years. Perhaps one of the earliest was alcohol. Any substance containing sugar can ferment and produce ethyl alcohol-also called ethanol. Wine and beer are typical examples, but horse cultures allowed mare’s milk to ferment, and they drank that. Opium has been around a long time also. Peyote was used by some western Indians. Ephedrine, called Ma Huang by the Chinese, has been around a long time also. Hashish (cousin or big brother to Marijuana) was used in the Middle East by the assassins (in fact, that is where the name, "assassin," came from). The Old Man of the Mountain would send these men out to kill those he perceived to be his enemy. This was in the distant past.
Some divide the drugs into "hard drugs" such as cocaine and "soft drugs" such as magic mushrooms or peyote.
The problem is very serious. For example, consider the following figures for the U.S.::
Smoking (nicotine is the addicting substance): 44.5 million 32% susceptible of all
Drinking (alcohol): 14 to 20 million problem drinkers (120 million drinkers,15% heavy)
Heroin: 810,000 23%
Cocaine: 2 million 17%
Meth (Methamphetamine): 12 million have used it (I couldn’’t find figures for addicts).
Stimulants other than cocaine 11%
Cannabis (marijuana 9%
Anxiolytics, sedatives, hypnotics 9%
Analgesics 8%
Psychedelics 5%
Inhalants 4%
Tobacco use in smoking. 28% of men and 25% of women smoke. 46% of high school dropouts smoke, but only 13 % of college graduates smoke. For people with advanced degrees the percentage is even less. Smoking has a bad record for causing disease such as cancer, heart disease, other artery disease and emphysema.
Heroin: It seems that heroin as well as other addicting substances increases the effects that dopamine produces. Dopamine is a pleasure producing chemical in the brain. However, the drugs prevent the normal production of dopamine. Since it is usually given into a vein, and, since users often do not use sterile technique, Hepatitis B and C and HIV are often transmitted.
Cocaine: It is often snorted and can cause perforation of the nasal septum. It can also cause artery constriction and provoke heart attacks. I couldn’t find a figure for the number.
Methamphetamine: This is a stimulant and, after that up effect wears off, there is a down effect that is apparently very uncomfortable. I could not get a figure for addiction, but five percent or twelve million have used it. It is said to be very difficult to take it only once.
The hereditary element in alcoholism is quite clear. Close relatives of an alcoholic have a much higher percentage chance of becoming alcoholics than matched groups without such relatives.
I share a belief in the idea that addicts are born and not made. That is, some people are more likely to become addicts than others. Obviously, if someone is never exposed to the addicting chemical, that person will not become an addict to that chemical.
Without regard to statistics or research, nearly everyone knows many people who drink beverage alcohol and nearly everyone knows an alcoholic or a problem drinker. A problem drinker is someone whose drinking has interfered with work, marriage or health. It is easy to observe that not everyone who drinks becomes an alcoholic.
From the standpoint of numbers of deaths and disease production, smoking is the clear winner in this sweepstakes. Of course, it does not cause the crime that the other addictions to illegal substances cause. Alcohol is not only related to crime, but also to the car crashes and injuries due to falls or poor judgement, like walking in front of a car, bus, truck or train. The production of meth has been associated with fires and explosions that have caused a lot of injuries. Cleaning up a meth lab after such an event can be very expensive-an expense usually not born by the people who operated the illicit lab.
I have not written about abuse or misuse or overuse of tranquilizers such as Valium and its cousins. Nor about Oxy Contin-but it presents the same problem that heroin and other opiates do.
I haven’t written about patients who have pain with advanced malignancies, but those who have experience with such patients report a low incidence of addiction. I have not encountered information about other painful disorders, such as rheumatoid arthritis, that are not as lethal or as rapidly fatal as advanced cancer.
A lot of research is going on to learn more about genes and about brain chemicals. This may lead to a better method of treatment.
Models proposed for addiction occurrence:
Moral Model-a character defect
Opponent Process Model-action and reaction Richard Soloman
Disease Model-impairment of healthy neurochemical and behavioral processes
Genetic Model-heredity
Cultural Model-alcoholism rare in Saudi Arabians, more common in Irish, common in American Indians, not common in Jews
Blended Model-mixture of many other models
Habit Model-Thomas Szasz says calling it addiction is an excuse to persecute someone.
The Genetic Biological Model-Hypoism Dan Umanoff
Endorphins may stimulate the production of dopamine. Increase in dopamine may decrease the number of dopamine receptors in the brain. This is termed down regulation and it produces a "let down" feeling. This is thought to be responsible for the development of tolerance of increasing doses and withdrawal symptoms. Some think that other neuroamines such as serotonin, norepinephrine and anandamide (endocannabinoid from Marijuana) are also involved in addiction.On a web site-NA-AA Recovery Zone, the writer suggests that those who need treatment for addiction may have one or all of the following: Induced chemical imbalance, genetic chemical imbalance, social and psychological problems and/or inhibited life and/or coping skills.
Even if a gene is found or a chemical imbalance is found, it will not, in my view, absolve the individual of personal responsibility for his or her own behavior. It wasn’’t someone else who made the person try the addictive substance. As usual, I come down on the side of prevention.
But prevention is very hard to sell. At least, I found, and find, it very hard to sell. But I have known people who controlled their behavior and stopped the addictive behavior in the case of smoking and of drinking. I had no experience in my practice with the other addictions.

70. A Deficiency State
Our country is the deficiency state I am writing about. Here we are four years after September 11. The deficiency is the lack of urgency. We still have poor control of visas for foreigners-both student and other. We do not have a way to keep up with legal aliens to know if they have overstayed their time limit or not.
The airport security is a joke (that’s not the right word-it is not at all funny-it is extremely serious). Time and effort are wasted on people who are extremely unlikely to be terrorists-very likely making it easier for terrorists to slip through the check points. Many of the containers and other materials coming into the country are not screened. Our borders are wide open with the ignoring for federal law by states and cities. Even the federal government does not obey or enforce the laws. Employers can hire illegals with impunity. Lack of jobs would take away a lot of the motive for coming. A child born in the U.S. to an illegal immigrant should be not automaticall become a citizen. This is rewarding an illegal act. That is a good way to get more or the illegal acts.
Some of our citizens seem to be overly concerned about the civil rights of ununiformed combatants (who have tried to kill our service people) and want them to have the rights under the Geneva conventions for which they are not eligible. Some want illegal immigrants to have all the privileges of legal immigrants and even of full citizens. Sometimes they even want the illegals to have special privileges not granted to legal immigrants or citizens. Free college tuition, for example.
Federal judges seem more concerned with protection of terrorists even more than they are of criminals. Many oppose the Patriot Act.
Why is this? First, I blame the old media. They do not perceive the peril and keep opposing anything that might increase our security. Then I blame the electorate-many do not realize that we are in a war-I call it World War IV (III was the Cold War-it got rather hot in Korea and Vietnam). Then I blame the politicians. They are so afraid of being deemed racist or politically incorrect that they do not want to do anything with urgency. The Democrats, of course, are automatically opposed to anything Bush does no matter how reasonable or necessary the action is.
I blame the Old Europeans for being blind, deaf and dumb about the peril that they are in. This encourages like minded people in this country.
I blame some of us Republicans and conservatives for not speaking up. Not me-I speak up every time I get a chance and have since September 11, 2001.
I hope that we do not have to experience a terrible attack-much worse than September 11 to wake up those of us who are still sleeping.
Now I fear that we may lose the war of radical Islam due to the apathy, opposition and blindness of the public of the United States. Donald W. Bales, 20 November 2005

71. Self Reliance
Self reliance seems to be out of style these days. Some people look to God to take care of them and others look to government. It is my view that both of these approaches are not desirable. I believe that God helps those who help themselves and I don’t believe that the government-whether Federal, state, county or city can take care of people. No one can possibly be as interested in a person’s welfare as that person. Parents can help by nurturing their children until they mature. They can also provide examples of how to behave and advise and instruct, but it is up to the children to benefit from all that.
There is no such thing as a self made man or woman. Everyone had to be cared for during their formative years. All of us rest of the shoulders of those who went before.
In my own case, my parents not only provided me with food, clothing and shelter, but also provided with loving care. In fact, both my mother and my father doted on me. After my father died when I was ten, my mother and I went to live with her parents. My grandfather doted on me also and my grandmother was extremely kind to me as well. I had five uncles and five aunts and all of them were kind to me, as were their spouses. I am and will be eternally grateful for the emotional capital provided me by my extended family.
As for me, I never knew any better than to do the very best that I could no matter what it was. I tried to be the best student I could be. I had an advantage in that. My mother had taught school before her marriage. So I had a favorable attitude toward school and learning. My father had gone to college briefly at Lincoln Memorial University and I knew about that.
I was extremely fortunate to have been awarded an academic scholarship by Harvard College-a great thing for a poor boy from Morristown, Tennessee. Some to the reasons for this was that I was valedictorian, played on the football basketball teams and had been active in extra-curricular activities. I was able to remain on the Dean’s List during my time at Harvard College.
I applied for admission to medical school at the University of Tennessee and was accepted. After six months in medical school, I was taken into the Army’s Specialized Training Program. I was second in my medical school class. After graduation and after serving my internship at Ford Hospital, I was on duty at a medical officer in Heidelberg, Germany. The Chief of the Medical Service there pressed me to become Regular Army promising me a promotion to Major in six months. Following that I had my internal medicine residency at Ford Hospital. During my third year there I was appointed one of five assistant resident physicians. We had the supervision of the work of the interns. Then I entered practice. At every step I did the very best that I could. I was certified by the Board of Internal Medicine in 1954 and recertified in 1974. I also became a Fellow in the American College of Physicians I served as President of the Medical Staff of Holston Valley Hospital twice and President of the County Medical Society once.
What I am trying to write is that although I had a great deal of help all along the way, still I think that my striving for excellence had a lot to do with the good things that happened to me.
I pray-even though I do not believe in intercessional prayer. I do not expect God to take care of me. I do not expect the government to take care of me. I do receive a social security check each month. It would be stupid not to accept it I paid into that system for many years. I worked full time until I was seventy-five.
Finally I believe people have the obligation to do the best they can to look after themselves and not look to God or the government to do for them what they can and should do for themselves. Donald W. Bales, M.D. 24 October 2006

72. Election November 12, 2006
The election was disappointing, but not surprising. The Republicans lost it.
Why did they lose?
Of course, the MSM and academia were dead set against them, but that is nothing new.
What ticked me off with them?
1. Spending like drunken Democrats. (Drunken sailors spend their own money.)
2. Adding another entitlement to an already over-committed system-Medicare.
To make it worse it won no political support and it was fiscally irresponsible.
3. Illegal immigration and amnesty. Apparently many did not agree with me about this.
4. Unwarranted optimism about the welcome and the modernization of Iraq. Too much faith in “democracy.”
5. Failure to profile at airports.
6. Failure to tighten visas from suspect countries.
7. Failure to push for confirmation of more Federal judges.
8. Failure to fight the affirmative action case more vigorously in Michigan.
9. Failure of Bush to emphasize the good economy news.
10. Misbehavior of some Republicans. Of course, it is easier to resist temptation if one is not exposed to it. The party in power has more power so more temptation to cheat.
11. Failure to condemn Palestinian and Gaza Arabs for their terrorist activity.
12. Failure of Bush to communicate better, but he may not be capable of doing it-not because he is stupid, but because he is not slick as Bill Clinton is. He may be partially dyslexic, although people report that in a small group he is fluent enough.
13. To me it was more that the Republicans lost than that the Democrats won. I will have to write that muzzling Pelosi, Reid, Kennedy and Schumer was smart as was running more conservative candidates in the South. John Kerry tried to help the Republicans, but it was too little and too late. It remains to be seen how those “conservative” or “moderate” Democrats will vote when pressured by the far left leaders in the House and the Senate.
Donald W. Bales

73. Problems in, for and of the United States 4 March 2007 Donald W. Bales
1. Blindness to being in World War IV.
2. Iraq War and Afghanistan
A. Poor execution of the “peace.”
Lawyers probably prevented getting Osama at Tora Bora
B. Consultation with enemies: Syria and Iran
C. Poor accountability: No one fired for incompetence until this week.
3. Illegal immigration
A. Mexicans-economic, social, security, linguistic, legal damage
B. Muslims-poor surveillance of mosques and visitors
4. Poor Homeland Security
A. Incoming freight and mail
B. Visa control
a. Issuing to natives of terror states
b. Failure to follow up on visas-students, and others
5. Obesity
6. HIV-too little effort and publicity about relationship of behavior to getting HIV
7. Spending
8. Failure to deal with entitlements
9. Trade deficit with China and with OPEC.
10. Oil importation from neutral or unfriendly states
11. Failure to move toward energy independence.
12. Broken legal system (class action suits, obscene and unjust awards)
13. Broken justice system (injustice system)
14. Broken moral (behavior) standard
15 Broken ethical standards
16. Lack of patriotism (issuing credit cards to illegals)
17. Academic liberalism
18. “Mainstream” media bias
19. Drugs
20. Child molestation-physical and sexual
21. National debt
22. Growth of government under Republicans-drug entitlement Donald W. Bales, April 2007

72. State of the U.S., July 2007
Donald W. Bales
First: World War IV. This war began in 1979 with the taking of the embassy personnel in Teheran as hostages. The pitiful response to this encouraged the radicals to think the eagle had no talons. We had a Pearl Harbor on September 11, 2001, but the anger and outrage soon faded.
The attack on the Taliban was appropriate and required.
It was expedient to try to work with the UN regarding the non-compliance of Iraq with the many resolutions. Unanimous consent was obtained from the security council to present Iraq with an ultimatum, but, when the time came to follow up on it, the UN showed itself to be the useless and irrelevant body that it always has been.
The delay between the demands and the invasion gave plenty of time for the Iraqis with the help of the Russians to remove tons of material to the Becka valley in Syria. All of the intelligence agencies plus the UN thought that Saddam Hussein has weapons or mass destruction. He had used chemical warfare on the Iranians and on the Kurds and on the Shiites in southern Iraq. He either thought he had them or lied that he had them rather than allowing the inspectors to prove that he did not have them.
The Europeans, with some exceptions, did not support or approve the Iraq War (Gulf War II) even though they were and are more dependent on oil from the Middle East than the U.S. is.
The Democrats were in favor of the war at first since they thought was popular with the public and would be an easy war. The war with the Iraqi army was soon over. Then the trouble started.
All those people who had been in the Iraq army were now unemployed as were many others who worked for the government. Iraq, in a sense, was a rentier state. The government had the oil revenues so could run the government without much input economically from the populace.
The anger built up by the actions of the controlling minority (Sunni 20%) against the
Shi-ite majority (60%) showed itself in taking revenge. Add to this the actions of al Qaeda and Iran and Syria supported others to disrupt any attempt to repair the economic status of Iraq and to foster a more representative and there were real barriers to establishing security in the country.
All this would be manageable, but the Democrats are invested in defeat in Iraq to further their return to power. They don’t seem to realize that they will have to deal with the consequences of a defeat of the U.S. by the radical Muslims with the resulting encouragement of our enemies and the discouragement of what friends the U.S. has. The MSM media has done all it can to poison the electorate and to promote defeat.
It is my view that most of the people of Old Europe (western part) and many of the people of the U.S. do not understand that there are millions of people who want to destroy the U.S. and Western civilization
Second: The illegal immigrant invasion of the U.S. by people from the south. They bring a different language, a different culture and threaten the social, economic, political and cultural basis of U.S. life. We are allowing criminals to enter the country with impunity and I am not writing about violent criminals or drug dealers. Everyone who enters the U.S. illegally is a criminal. What sort of citizen can be expected from someone whose first act in the U.S. is a crime? Again the main danger is the lack of understanding of many United Staters about the problem.
Third: The Federal deficit. I don’t really need to write about the danger from that.
Fourth: The trade imbalance. Don’t need to write about that either.
Fifth: Personal debt by citizens.
Sixth: The decline of integrity in politicians, business people, lawyers, doctors, judges, religious leaders, teachers, academia and the media. Lying and stealing is only bad if you get caught.
Seventh: Unwillingness to take personal responsibility. Now if anything bad happens, it is not the fault of the actions of the individual-it is always someone or something else-bad parenting, bad government policies, ignorance, poverty, drugs, peers. If anything bad happens, someone should be sued and someone should pay a big award even though it was the person who caused the problem.

World War IV with Radical Islamists
Attacks on U.S. interests
1979 Tehran Hostages
1981 Qaddafi threats
1983 Beirut Embassy
1983 Marine barracks Beirut
1983 Kuwait Embassy
1984 Wm. Buckley kidnaped (later killed). David Dodge, Terry Anderson, Peter Kilburn, Benjamin Weir kidnaped.
1984 Embassy annex Beirut attacked
1984 Hijacking Kuwait Airlines-2 Americans killed
1985 Stethem killed
1985 Achille Lauro Klinghoffer killed
1985 Rome and Vienna airport bombs
1986 Bombing of La Belle Discotheque Bertin U.S. soldiers killed Attack on Libya
1988 Pan Am 103 Lockerbie, Scotland
1998 Kenya and Tanzania Embassies. Bombing of empty training camp in Afghanistan and an aspirin factory in Kenya
2000 U.S.N. Cole attacked
2001 11 September-Twin Towers, Pentagon and field in Pennsylvania
In Their Own Words: What the Terrorists Believe, What They Hope to Accomplish, and How They Intend to Accomplish It
The Terrorists On September 11
Osama Bin Laden: The 9/11 Attacks Were "An Unparalleled And Magnificent Feat Of Valor, Unmatched By Any In Humankind." Bin Laden: "On the blessed Tuesday 11 September 2001 … they launched their attacks with their planes in an unparalleled and magnificent feat of valor, unmatched by any in humankind before them. … Yet with the destruction of the Twin Towers in New York, there occurred an even bigger destruction: that of the great American Dream and legend of Democracy." (Translation Of Purported Bin Laden Audio Message, Posted On Islamist Site, 2/14/03)
The Terrorists On Establishing A Caliphate Ruled By Their Hateful Ideology
Osama Bin Laden: The 9/11 Attacks Were "A Great Step Towards The Unity Of Muslims And Establishing The Righteous [Caliphate]." Bin Laden: "These attacks took off the skin of the American wolf and they have been left standing in their filthy, naked reality. Thus the whole World awoke from its sleep and the Muslims realized the importance of the belief of loving and hating for the sake of Allah; the ties of brotherhood between the Muslims have become stronger, which is a very good sign and a great step towards the unity of Muslims and establishing the Righteous Islamic Khilafah insha-Allah." (Translation Of Purported Bin Laden Audio Message, Posted On Islamist Site, 2/14/03)
Ayman al-Zawahiri: "The Whole World Is An Open Field For Us." Zawahiri "The war with Israel is not about a treaty, a cease-fire agreement, Sykes-Picot borders, national zeal, or disputed borders. It is rather a jihad for the sake of God until the religion of God is established. It is jihad for the liberation of Palestine, all Palestine, as well as every land that was a home for Islam, from Andalusia to Iraq. The whole world is an open field for us." (Al-Zawahiri's 'Full' Message On War In Lebanon, Gaza Strip, Posted On Jihadist Website, 7/28/06)
Zawahiri: "The Reinstatement Of Islamic Rule … Is The Individual Duty Of Every Muslim … With Every Land Occupied By Infidels." ZAWAHIRI: "Supporting the jihad in Palestine with one's life, money, and opinion is the individual duty of every Muslim because Palestine was a land of Islam that was occupied by the infidels. This means that its liberation and the reinstatement of Islamic rule there is the individual duty of every Muslim as unanimously decided by the nation's scholars. And such is the case with every land occupied by infidels." (Al-Zawahiri's June Video Message Supporting Palestinians, Posted On Jihadist Site, 6/11/06) The Terrorists On Killing Infidels
Osama Bin Laden: "Death Is Better Than Living On This Earth With The Unbelievers Amongst Us." Bin Laden: "O young people of Islam: Follow the orders of Almighty God and His messenger and kill those people. Follow the example of Muhammad Bin-Musallamah and his companions. Death is better than living on this earth with the unbelievers amongst us, making a mockery of our religion and prophet, God's peace and blessings upon him. Fear God, try to please Him, and do not consult with anyone regarding the killing of those unbelievers." (Translation Of Bin Laden’s 52-Minute Audiotape, Posted On Jihadist Website, 4/27/06)
Al-Qaeda Charter
"There Will Be Continuing Enmity Until Everyone Believes In Allah. We Will Not Meet [The Enemy] Halfway And There Will Be No Room For Dialogue With Them." (Al Qaeda Charter, Released By The White House Press Office, 9/5/06)
Al-Qaeda Training Manual
"Religious Scholars Have Permitted Beating … [And] The Killing Of A Hostage." "Guidelines for Beating and Killing Hostages: Religious scholars have permitted beating. … In this tradition, we find permission to interrogate the hostage for the purpose of obtaining information. It is permitted to strike the nonbeliever who has no covenant until he reveals the news, information, and secrets of his people. The religious scholars have also permitted the killing of a hostage if he insists on withholding information from Moslems." (Al-Qaeda Training Manual, Available At: http://www.au.af.mil/au/awc/awcgate/terrorism/alqaida_manual/, Accessed 9/5/06)
Al-Qaeda Training Manual: "The Confrontation That Islam Calls For … Knows The Dialogue Of Bullets, The Ideals Of Assassination, Bombing, And Destruction." "Islam does not coincide or make a truce with unbelief, but rather confronts it. The confrontation that Islam calls for with these godless and apostate regimes, does not know Socratic debates, Platonic ideals nor Aristotelian diplomacy. But it knows the dialogue of bullets, the ideals of assassination, bombing, and destruction, and the diplomacy of the cannon and machine-gun." (Al-Qaeda Training Manual, Available At: http://www.au.af.mil/au/awc/awcgate/terrorism/alqaida_manual/,
Al Anbar Plan: The Al-Qaeda Governing Structure Should Include An "Execution Unit" Responsible For "Sorting Out, Arrest, Murder, And Destruction." (Al Anbar Plan, Released By The White House Press Office, 9/5/06)
The Terrorists On Their "Bleed-Until-Bankruptcy-Plan"
Osama Bin Laden: "So We Are Continuing This Policy In Bleeding America To The Point Of Bankruptcy." ('Full Transcript' Of Bin Laden's Message, Posted On Al-Jazirah Site, 11/1/04)
Bin Laden: In The Attacks Of 9/11, "Every Dollar Of Al-Qaida Defeated A Million Dollars By The Permission Of Allah, Besides The Loss Of A Huge Number Of Jobs."
Bin Laden: "And it was to these sorts of notions and their like that the British diplomat and others were referring in their lectures at the Royal Institute of International Affairs. (When they pointed out that) for example, al-Qaida spent $500,000 on the event, while America, in the incident and its aftermath, lost – according to the lowest estimate – more than 500 billion dollars. Meaning that every dollar of al-Qaida defeated a million dollars by the permission of Allah, besides the loss of a huge number of jobs." ('Full Transcript' Of Bin Laden's Message, Posted On Al-Jazirah Site, 11/1/04)
Bin Laden: "It Is Very Easy To Target [America's] Flimsy Base And … We Will Be Able Crush And Destroy Them." Bin Laden: "In conclusion, America is definitely a great power, with an unbelievable military strength and a vibrant economy, but all of these have been built on a very weak and hollow foundation. Therefore, it is very easy to target that flimsy base and concentrate on their weak points and even if we are able to target one tenth of these weak points, we will be able [to] crush and destroy them and remove them from ruling and conquering the World." (Translation Of Purported Bin Laden Audio Message, Posted On Islamist Site, 2/14/03)
The Terrorists On Their Propaganda Strategy
Osama Bin Laden: Al-Qaeda Intends To Launch "A Media Campaign ... To Create A Wedge Between The American People And Their Government." (Letter From Osama Bin Laden To Mullah Omar, Released By The White House Press Office, 9/5/06)
Bin Laden: This Media Campaign Will Stress "That [The American] Government Would Bring Them More Losses, In Finances And In Casualties." (Letter From Osama Bin Laden To Mullah Omar, Released By The White House Press Office, 9/5/06)
Bin Laden: "[The American People] Are Being Sacrificed To Serve The Big Investors, Especially The Jews." (Letter From Osama Bin Laden To Mullah Omar, Released By The White House Press Office, 9/5/06)
Bin Laden: The Media Campaign "Aims At Creating Pressure From The American People On The American Government To Stop Their Campaign Against Afghanistan." (Letter From Osama Bin Laden To Mullah Omar, Released By The White House Press Office, 9/5/06) The Terrorists On Their Belief That America Is Weak
Osama Bin Laden: America's "Combat Strategy Is Heavily Dependent On The Psychological Aspect Of War … Which Hides The Cowardice And Lack Of Fighting Spirit Of The American Soldier." Bin Laden: "It has been made clear during our defending and fighting against the American enemy that this enemy's combat strategy is heavily dependent on the psychological aspect of war due to its large and efficient media apparatus and of course its indiscriminate aerial bombing which hides the cowardice and lack of fighting spirit of the American soldier. … Likewise, let me remind you of the defeat of the American forces in Beirut in 1982, soon after the Israeli invasion of Lebanon, when the Lebanese resistance was personified by the truck laden with explosives that struck the main military base of the US Marines in Beirut, killing 242 soldiers – towards Hell was their destination and what an evil destination that is." (Translation Of Purported Bin Laden Audio Message, Posted On Islamist Site, 2/14/03)
Bin Laden: "In Somalia … The United States [Pulled] Out, Trailing Disappointment, Defeat, And Failure Behind It."
Bon Laden: "We found that out from our brothers who fought the Americans in Somalia. They did not see it as a power worthy of any mention. It was the big propaganda that the United State used to terrify people before fighting them. Our brothers, who were here in Afghanistan, also tried the Americans. God gave them and the mujahidin success in Somalia and the United States pull out, trailing disappointment, defeat, and failure behind it. It achieved nothing. It left quicker than people had imagined." (Full Text Of Interview With Al-Qaeda Leader Osama Bin Laden, 10/21/01)
Ayman al-Zawahiri: "There Is No Hope In Victory." Zawahiri: "This is the fumbling that precedes the defeat. Bush and Blair are hiding the true disaster they are facing in Iraq and Afghanistan. They know better than others that there is no hope in victory. The Vietnam specter is closing every outlet." (Al-Qaeda's Al-Zawahiri Predicts Failure of US 'Crusade' Against Muslim States, Posted On Jihadist Websites, 12/7/05)
The Terrorists On The Importance Of Iraq
Osama Bin Laden: Baghdad Is "The Capital Of The Caliphate." (Text Of Bin Laden's Audio Message To Muslims In Iraq, Posted On Jihadist Websites, 12/28/04)
Bin Laden: "The Most Important And Serious Issue Today For The Whole World Is This Third World War … Raging In [Iraq]." Bin Laden: "I now address my speech to the whole of the Islamic nation: Listen and understand. The issue is big and the misfortune is momentous. The most important and serious issue today for the whole world is this Third World War, which the Crusader-Zionist coalition began against the Islamic nation. It is raging in the land of the two rivers. The world's millstone and pillar is in Baghdad, the capital of the caliphate." (Text Of Bin Laden's Audio Message To Muslims In Iraq, Posted On Jihadist Websites, 12/28/04)
Bin Laden: "This Is A War Of Destiny Between Infidelity And Islam." (Text Of Bin Laden's Audio Message To Muslims In Iraq, Posted On Jihadist Websites, 12/28/04)
Bin Laden: "The Whole World Is Watching This War And The Two Adversaries; The Islamic Nation, On The One Hand, And The United States And Its Allies On The Other. It Is Either Victory And Glory Or Misery And Humiliation." (Text Of Bin Laden's Audio Message To Muslims In Iraq, Posted On Jihadist Websites, 12/28/04)
Ayman al-Zawahiri: We Must "Establish An Islamic Authority … Over As Much Territory As You Can To Spread Its Power In Iraq … [And] Extend The Jihad Wave To The Secular Countries Neighboring Iraq." Zawahiri: "So we must think for a long time about our next steps and how we want to attain it, and it is my humble opinion that the Jihad in Iraq requires several incremental goals: The first stage: Expel the Americans from Iraq. The second stage: Establish an Islamic authority or amirate, then develop it and support it until it achieves the level of a caliphate – over as much territory as you can to spread its power in Iraq … The third stage: Extend the jihad wave to the secular countries neighboring Iraq. The fourth stage: It may coincide with what came before: the clash with Israel, because Israel was established only to challenge any new Islamic entity." (Complete Text Of Al-Zawahiri Letter To Al-Zarqawi, 7/9/05, Available At: http://www.dni.gov/press_releases/20051011_release.htm, Accessed 9/5/06)
Bin Laden: "The War Is For You Or For Us To Win. If We Win It, It Means Your Defeat And Disgrace Forever." Bin Laden: "Finally, I would like to tell you that the war is for you or for us to win. If we win it, it means your defeat and disgrace forever as the wind blows in this direction with God's help." (Bin Laden Threatens New Operations, Offers 'Long-Term Truce,' Posted On Al-Jazirah Net, 1/19/06)
The Terrorists On Their Absolute Hostility Towards America
Hezbollah Leader Nasrallah: "Death To America." NASRALLAH: "Let the entire world hear me. Our hostility to the Great Satan is absolute. … I conclude my speech with the slogan that will continue to reverberate on all occasions so that nobody will think that we have weakened. Regardless of how the world has changed after 11 September, Death to America will remain our reverberating and powerful slogan: Death to America." (Hezbollah Leader Nasrallah Supports Intifadah, Vows 'Death to America,' Aired On Beirut Al-Manar Television, 9/27/02)
Iranian President Mahmoud Ahmadinejad: "We Will Soon Experience A World Without The United States And Zionism." Ahmadinejad: "Undoubtedly, I say that this slogan and goal is achievable, and with the support and power of God, we will soon experience a world without the United States and Zionism and will breathe in the brilliant time of Islamic sovereignty over today's world." (Iran's President Warns Muslims Of 'Conspiracies Of World Imperialism,' Available At: www.sharifnews.com, Accessed 10/26/05)
President Ahmadinejad: "Your Doomed Destiny Will Be Annihilation, Misfortune And Abjectness." Ahmadinejad: "Open your eyes and see the fate of Pharaoh. … Open your eyes and see what happened to the Portuguese Empire. See the final fate of the British Empire. … I am telling you [major powers], if you do not abandon the path of falsehood and return to the path of justice, your doomed destiny will be annihilation, misfortune and abjectness." (President Ahmadinejad Says Iran To Respond To Nuclear Proposals By 'End Of Mordad,' Aired On Islamic Republic Of Iran News Network Television (IRINN), 6/21/06)
President Ahmadinejad: "The Anger Of Muslims May Reach An Explosion Point Soon … [And] The Waves Of The Blast Will Not Remain Within The Boundaries Of Our Region." Ahmadinejad: "The anger of Muslims may reach an explosion point soon. If such a day comes, they [Western governments] should know that the waves of the blast will not remain within the boundaries of our region and will engulf the corrupt powers that support this fake regime too." (Iran: President Reaffirms Warning Of Explosion Of Muslim Anger In Tabriz
Address, Aired On Tehran Islamic Republic Of Iran News Network Television (IRINN), 7/11/06)
President Ahmadinejad: "If You Would Like To Have Good Relations With The Iranian Nation … Bow Down Before The Greatness Of The Iranian Nation And Surrender." Ahmadinejad: "And you, for your part, if you would like to have good relations with the Iranian nation in the future, recognize the Iranian nation's right. Recognize the Iranian nation's greatness. And bow down before the greatness of the Iranian nation and surrender. If you don't accept [to do this], the Iranian nation will later force you to surrender and bow down." (Iran: Ahmadinejad Says US, UK 'Resorted To Tricks' 'To Postpone' Cease-Fire, Aired On Tehran Islamic Republic Of Iran News Network Television (IRINN), 8/15/06)

75. Golden Boy (that’s what Louis Moore dubbed me)
Article from the Times-News on 23 September 2007
Dr. Donald Bales, 85, who recently won three medals and two ribbons in swimming competitions at the National Senior Games, credits heredity, luck and lifestyle for his longevity.
Going for the gold
85-year-old retired doctor wins three medals, two ribbons in swimming at the National Senior Games
By Nathan Baker nbaker@timesnews.net
When describing Kingsport resident Dr. Donald Bales, a number of words come to mind: Outspoken, methodical and intelligent are among the many you could choose. Some words that would not be suited for this retired octogenarian are broken down, inactive or, least of all, lazy.
The 85-year-old Bales recently won three medals and two ribbons in swimming competitions at the National Senior Games, the Olympics for a more mature section of the athletic community.
The National Senior Games are held biennially in a venue suited to hold the 12,000 qualified 50 and older athletes and the 20,000 spectators that come to be a part of the 800 scheduled events.
This year, the games were held in the Kentucky Exposition Center and the University of Louisville in Louisville, Ky.
“There’s always a big crowd at the nationals, and it’s always interesting,” Bales said. “It’s a friendly, nice atmosphere. You almost never meet anybody who goes to the games that’s nasty.”
To make it to the national level, Bales had to qualify at both the district and state levels, something he said would be more difficult if he had more competition.
“One thing about district and state is that sometimes there wouldn’t be anybody else in my age group,” Bales said, smiling. “I guess if you can’t out swim ’em, outlive ’em.”
All jokes aside, Bales’ performance in the pool is quite an accomplishment. He has attained state records for the 100-yard breaststroke in the 75 to 79 age group, and also for the 50- and 100-yard breaststroke in the 80 to 84 age group.
This year, in his age group, he won a gold medal in the 50-yard breaststroke, a silver in the 50-yard backstroke and a bronze in the 100-yard backstroke.When added to the previous medals he won at all levels since he began competing in 2000, Bales has 55 gold medals, five silver and four bronze.
Always a modest man, the retired doctor refuses to put his awards on display, preferring to keep them in a bowl on top of the piano in his family room.
“Somebody said I ought to get a board and hang them, but that just seemed a little bit vain,” he
said..
Bales’ competitive spirit originated in high school in his hometown of Morristown, Tenn. There, he was a minor athlete on the basketball, track and football teams.
Regrettably, Bales’ athletic interests took a back burner when he began building his medical career.
When he was in his 40's, the President’s Council on Physical Fitness inspired Bales to take up an active lifestyle again through a recommended exercise routine.
Bales then became an avid jogger until the pains in his arches told him it was time to try something new. So he switched to cycling and swimming.
After retiring from his practice in June 1997, Bales took up swimming at the indoor pool at Dobyns-Bennett High School. Fellow Kingsport Senior Center board member, Joan Wilder, coaxed im to swim competitively, and he took to it like a fish to-well, water.
Bales said he outlasted his contemporaries because of a critical mixture of three factors.
“A lot of people who were born the year I was are deadand in the graveyard, in a nursing home, in a wheelchair or they don’t know what they had for breakfast,” he said. “Time has been kind to the old man. I attribute my longevity to three things: heredity, luck and lifestyle.”
He’s had a full 85 years, but Bales said he’s only shooting for 15 more.
“I took one of those longevity tests that said my actual age was 68 and my life span will be 107,” he said. “I’d only counted on 100, if I make it past there, I’ll have to reexamine the situation.”
It’s been said that behind all great men is a supportive woman, and Bales is no different.
His wife of 62 years, Julia, goes along with him to his countless swimming competitions to act as a cheering section.
“Some of the luck that I had was picking my profession,”” Bales said. “Another was picking my wife. Two the most important things in life have turned out really well for me.”
Together, the Bales’s have four children who inherited their father’s proclivity for healthy living.
“They’re all lean, they’re all in superb physical condition, none of them smoke, none of them drink, and none of them are on drugs,” Bales said. “When I turned 70, they wrote a list for me called ‘70 Things I Learned From Daddy.’ One of them was lifestyle.”
He got one thing wrong in the article. I did not consider myself nor did the coach nor my teammates on the football team and the basketball team consider me a minor athlete. Perhaps I could have been considered a minor track man since I never placed in a meet-the criterion for getting a letter in track.

76. Nature Trumps All

Philosophers, psychologists, legislators, judges and social "scientists" can all have their say and their sway, but the women will still have the babies, and will still get pregnant if they do not use the "wonderful" liberating pill or the diaphragm or the men use the condom.

Sexual transmitted diseases, including that equal opportunity killer-HIV-AIDS, will continue to spread as long as people continue to engage in high risk behavior. Who can become infected with HIV (Human Immunodeficiency Virus): Intravenous recreational drug users, gay men who have unprotected anal sex (anyone who has anal sex) and those women who have sex with men in the two preceding categories. Others, innocent of high risk behavior: Those who need blood or blood products (unlikely since donors are screened and their blood tested), babies whose mothers have HIV, medical personnel who, in spite of precautions become infected. I do not know the percentage of “innocents” who get in infected, but it must be a very low percentage. The idea so promulgated by some that anyone can get it is dead wrong. It is highly related to high risk behavior. A true square is very unlikely to get HIV

Man's laws cannot change the laws of nature nor is there any appeal of the sentence.
There was a little window of time after the beginning of the sexual revolution (when women changed their behavior and began doing what men had been wanting them to do all along) before the coming of HIV-AIDS, that the consequences of high risk behavior were not so drastic. Of course, an unwanted pregnancy was inconvenient, but an abortion could fix that (or let grandma look after it, or maybe the "village" and some of the STD's were treatable and even curable (but some were not and as still not curable or even treatable). This window of time was also when gay men could indulge their wildest sexual fantasies without getting HIV.

Now we have the situation where there is a move afoot to mandate vaccination against human papilloma virus to prevent cervical cancer. We also have three middle schools in Maine that propose giving birth control pills to the girls.

This assumes that all girls will either be promiscuous and careless or that their sexual partners will have been. What a favorable development!

Donald W. Bales, M.D. retired internist October 2007

77. Global Warming
Donald W. Bales
12 November 2007

Although I believe that many-Al Gore, liberal Democrats, environmentalists, socialists,
anti-capitalists, anti-U.S. groups have a hidden agenda in trying to acquire more government power over everyone’s life, I must write that I do think that global warming is occurring and also that human activity, namely burning of fossil fuels, is an important cause of it.
Why have I come to the above conclusions?
Global average air temperature is reported to have risen 0.14 +- C. in the last 100 years. Projections (that may not be correct) are from 1.1 to 6.4 C rise during the 21st century. That is quite a range. 1.1 C is a lot different from 6.4 C. as to its effect on the earth.
In 1960 carbon dioxide in the atmosphere was 305 parts per million (ppm) by volume. It is now 383 ppm.
Greenhouse gases were discovered by Fourier in 1824 and first quantitated by Arrhenius in 1876, Water vapor makes up 35 t0 70 %, carbon dioxide makes up 9 to 26 % and is up 31% from pre-industrial times. Methane (CH4) was 4.95%. It has increased by 149%. Ozone is 3 to 7%. There is also a small amount of nitrous oxide (NO2).
The present level of carbon dioxide was last present 20 million years ago. Three fourths of the increase is due to fossil fuel use-the rest is due to deforestation.
Levels of carbon dioxide by 2100 are from 541 to 770 parts per million. Again this is quite a range. Not very precise numbers. The effect on the earth would be quite different for each of those numbers.
Global warming would lead to release of carbon dioxide from Siberian peat bogs as they melt.
Warming, however, would lead to more water vapor in the atmosphere favoring further warming. Information about cloud formation is incomplete. Clouds promote warming below them and cooling above them. There is also an albedo effect-that is snow and ice tends to reflect radiation while water or land tends to absorb it.
There is also the release of methane now trapped in seabeds that would increase greenhouse gases.
Solar variation is thought to have been 45 to 50% responsible for warming from 1900 to 2000 and 25 to 35% responsible for the warming from 1980 to 2000.
There has been cooling of the lower atmosphere since 1960. Reduction of ozone (late 70's) resulted in cooling.
Solar variation and volcanic action is thought to be the cause of warming from pre-industrial times until 1950.
The earth did have a warming (Medieval Warming) from 900-1500. Greenland was inhabitable for farming. Then we had The Little Ice Age from 1500 until 1850.
Since land accepts heat better than water the warming has been more in the northern hemisphere due to there being more land there than in the southern hemisphere. The article did not say so, but a lot more fossil fuel is burning the northern hemisphere.
Some believe that man began to influence the temperature as far back as 8000 years ago
when forests were removed when agriculture began and more 5000 years ago when rice cultivation in Asia led to irrigation (I presume due to more water vapor due to evaporation).
2005 was slightly less warm than 1998-the hottest year in recent times.
Sulfide aerosols in the atmosphere promote cooling.
Indirect evidence (coring of glaciers, seabeds) going back 800,000 years attest to eight glaciation in the past, so we have had coolings and warmings of the earth for a long time.
Increased carbon dioxide in the air would promote more being absorbed in the oceans. Carbon dioxide combines with water to form carbonic acid (not as strong an acid as sulfuric or hydrochloric, but still an acid). The ocean surface pH is reported to have gone from pH 8.25 to 8.14. That is still basic, but may have an adverse effect of plants and animals in the sea. Tthe increasing temperature of the water has had and would have more as the temperature rises.
Some have tried to put a dollar cost on each degree of warming. Warming could surely have effects-some predictable and others not so predictable.
On the other hand, efforts to cut down on the use of fossil fuels will have a great cost as well very likely leading to a decreased standard of living.
Some have estimated that putting into effect the Kyoto Proposals would have a negligible effect on the warming.
Will the population (or governments) of the world have the inclination or the will or the cooperation to do what would be required to make a real difference? Judging by the way the world is now-I have my doubts. Not that we shouldn’t do what we can.
To me the first and most immediate priority is to win or at least not lose World War IV with radical Islam. If we lose that, there will be no hope of doing anything about global warming. The U.S. would have to lead. To me the second and immediate priority would be stopping illegal immigration. If that is not stopped, the U.S. will cease to be the good country that is has been (in spite of all its flaws) and will not a beacon for the rest of the world.

To Be A Mensch
I am neither Yiddish nor Jewish nor German, although my middle name, Weesner, reflects some German background.
I have looked for an English (American, United States) word that has the same meaning that the Yiddish word, “Mensch” has.
I understand the word “Mensch” to mean “a good person.” It also has the connotation “a really good person.”
Now what is a good person? To me a good person doesn’t lie, doesn’t steal and does treat others as he would like to be treated. In fact, I believe a “Mensch” (good person) would obey or try to obey to the best of his ability the last six of the Ten Commandments.
For the non-Biblical (all Christians should know all of the Ten Commandments as should all Jews) the Ten Commandments are as follows:
Which Ten Commandments?
Protestant 1* Catholic 2 Hebrew 3
1. Thou shalt have no other gods before me.*
1. I am the Lord thy God. Thou shalt not have strange gods before me.
1. I am the Lord thy God, who brought thee out of the land of Egypt, out of the house of slavery.
2. Thou shalt not make unto thee any graven image, or any likeness of any thing that is in heaven above, or that is in the earth beneath, or that is in the water under the earth: Thou shalt not bow down thyself to them, nor serve them: for I the Lord thy God am a jealous God, visiting the iniquity of the fathers upon the children unto the third and fourth generation of them that hate me; And showing mercy unto thousands of them that love me, and keep my commandments.
2. Thou shalt not take the name of the Lord thy God in vain.*
2. Thou shalt have no other gods before Me. Thou shalt not make unto thee a graven image, nor any manner of likeness, of any thing that is in heaven above, or that is in the earth beneath, or that is in the water under the earth; Thou shalt not bow down unto them, nor serve them; for I the Lord thy God am a jealous God, visiting the iniquity of the fathers upon the children unto the third and fourth generation of them that hate Me; And showing mercy unto the thousandth generation of them that love Me and keep My commandments.
3. Thou shalt not take the name of the Lord thy God in vain: for the Lord will not hold him guiltless that taketh his name in vain.*
3. Remember thou keep the Sabbath Day.
3. Thou shalt not take the name of the Lord thy God in vain; for the Lord will not hold him guiltless that taketh His name in vain.
4. Remember the Sabbath day, to keep it holy. Six days shalt thou labor, and do all thy work: But the seventh day is the Sabbath of the Lord thy God: in it thou shalt not do any work, thou, nor thy son, nor thy daughter, thy manservant, nor thy maidservant, nor thy cattle, nor thy stranger that is within thy gates: For in six days the Lord made heaven and earth, the sea, and all that in them is, and rested the seventh day: wherefore the Lord blessed the sabbath day, and hallowed it.*
4. Honor thy Father and thy Mother.
4. Remember the Sabbath day to keep it holy. Six days shalt thou labour, and do all thy work. But the seventh day is the Sabbath in honour of the Lord thy God; on it thou shalt not do any work, neither thou, nor thy son, nor thy daughter, thy manservant nor thy maidservant, nor thy cattle, nor thy stranger that is within thy gates; For in six days the Lord made the heavens and the earth, the sea, and all that is in them, and rested on the seventh day; therefore the Lord blessed the Sabbath day, and hallowed it.
5. Honor thy father and thy mother: that thy days may be long upon the land which the Lord thy God giveth thee.*
5. Thou shalt not kill.* “Murder-kill unlawfully-was translated as “kill.”
5. Honour thy father and thy mother; in order that thy days may be prolonged upon the land which the Lord thy God giveth thee.
6. Thou shalt not kill.
6. Thou shalt not commit adultery.
6. Thou shalt not kill.
7. Thou shalt not commit adultery.*
7. Thou shalt not steal.
7. Thou shalt not commit adultery.
8. Thou shalt not steal.*
8. Thou shalt not bear false witness against thy neighbor.
8. Thou shalt not steal.
9. Thou shalt not bear false witness against thy neighbor.*
9. Thou shalt not covet thy neighbor's wife.
9. Thou shalt not bear false witness against thy neighbor.
10. Thou shalt not covet thy neighbor's house, thou shalt not covet thy neighbor's wife, nor his manservant, nor his maidservant, nor his ox, nor his ass, nor any thing that is thy neighbor's.*
10. Thou shalt not covet thy neighbor's goods.
10. Thou shalt not covet thy neighbor's house; thou shalt not covet thy neighbor's wife, nor his manservant, nor his maidservant, nor his ox, nor his ass, nor any thing that is thy neighbor's.
It is my opinion that all successful societies have some version of the last six commandments in their code of ethics or morality.

Donald W. Bales, Kingsport, Tennessee 5 December 2007


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Essays (Started 4 January 1980)
Table of Contents

No. Page
1 1 Balesisms
2 Refuge
3 3 Big Nanny (16 August 98)
4 Bureaucracy
5 Campaign Finance Reform
6 Military Bases
7 Palestine Liberation Organization
8 Social Security
9 The Disincentive Society
10 The Surplus
11 The Tyranny of the Telephone
12 7 The Clintons
13 Pet Peeves-Language Pet Peeves-Behavior
14 Capital Punishment
15 Bad Behavior Prevention
16 Abortion
17 Homosexuality
18 Women
19 Busing
20 16 Prayer
21 World Trade Organization
22. Drug Prescription
23 Tax Cut
24 The Election of 2000
25 Dr. Bales’ Medical Aphorisms
26 26 Parlor Partisans of the Poor
27 Stem Cells
28 The Attack on the World Trade Center
29 27 Afghanistan
30 Profiling
31 Predicting the Future
32 International Monetary Fund
33 Democratic Socialism
34 Obesity
35 35 Immunizations
36 Tobacco
37 Exercise
38 Diet
39 Art and Science in Medicine
40 Hypertension
41 Physical Examination
42 A Woman
43 48 Benjamin Franklin’s Theology
44 Dr. Bales Dumb Advice Essay
45 Lurching Toward Lawlessness
46 A Calm and Courageous Realist
47 I Like
48 Sex, Drugs, and Rock and Roll
49 Illegal Immigration
50 United Nations
51 60 Concerns about the U.S.
52 Citizens Police Academy
53 Attitude of Mind
54 Fatherlessness
55 Islam
56 Love
57 Luck
58 72 Heaven
59 Tail Gating
60 1940 Speech
61 Marijuana
62 Scots
63 Global Poverty
64 Here’s to your Health
65 103 Palestine
66. The New Entitlements
67 Tai Chi and Yoga
68 Healthy Aging
69 Addiction
70 113 Deficiency State
71 Self Reliance
72 2006 Election
73 State of the U.S.
74 World War IV
75 122 “Golden Boy”
76 Nature Trumps All
77 125 Global Warming
78 Mensch










1. Some of my favorite sayings or thoughts: Balesisms Donald W. Bales

"Look before you leap."
"A stitch in time saves nine."
"An ounce of prevention is worth a pound of cure."
Form and technique are important.
"My word is my bond."
Lying used to be inefficient and wrong, but these days it seems that telling the truth is penalized and that lying is rewarded. The same seems to go for cheating.
The Ten Commandments-the last six apply in all religions, and should apply to atheists as well.
The Twenty-third Psalm
The Sermon on the Mount
The Lord's Prayer
The Golden Rule
One should be prudent, but not fearful. DWB
"Willful waste means woeful want." I don't know whether this was original with my maternal grandmother, Kate Tilden Davis, but that's where I heard it.
"A penny saved is a penny earned."
Mr. Micawber's advice (David Copperfield). Income has to be little larger than outgo
Cheaper is better if equal. DWB
"Penny wise and pound foolish."
"Not deciding is a decision." DWB?
"Procrastination is the thief of time."
Drive defensively. DWB, but many others
"Cast not your pearls before swine."
Suffer fools, but not gladly.
I am adding another saying to my list. (16 December 2001):
(Rosemary Sexton swims at the DB pool sometimes. Recently we were there waiting for the life guard to arrive. The lane dividers had been taken out of the pool, and the school people don't want us seniors in the water without a lifeguard present. Rosemary said, as she got in to put the markers in place:)
"It is easier to ask for forgiveness than it is to get permission."
(I have heard that this is a common saying, but I had never heard it before. I like it!)
All ideas are not equal-some are right and some are wrong. DWB?
Equality and Liberty are not compatible. DWB
All persons are not really equal. DWB
They are equal in the eyes of God. They should be equal before the law, but are not. Some are faster, some are smarter, some are stronger, some have better genes, and some have better environments.
I flunk one implied Christianity test:
I find it much easier to love the lovable than the unlovable although the unlovable need love more than the lovable.
Each person, regardless of his or her heredity or environment, is ultimately responsible for his or her actions. If a mentally ill person commits a heinous crime that person should be segregated to protect the rest of the population. I perceive an unwillingness in our society to punish or segregate criminals, and thereby our society seems sometimes to forget the victims.
Humans are malleable, but not infinitely malleable. When pushed beyond their limits of adaptation, humans will fail. We carry the burden or assets of our human nature and our past ancestry, and we ignore these facts at our peril. DWB
Go back to the Big Bang. What was there before that? Can something be that was not created? DWB
Can there be an effect without a cause?
I especially like the prayer that A.A. organization uses. They got it from some earlier source. Some say Rheinhold Niebuhr originated it. Others say it is older than that. It goes like this:
"Oh Lord, give me the strength to change what I can change
Give me the patience to accept what I cannot change
And give me the wisdom to know the difference."
When someone asks me, "Why did this happen to me?" I would say, "Think of a column of ants crossing the highway. Imagine a truck coming along. Some of the ants would be run over and other ants would be missed by the tires of the truck. Do you think the ants that got run over were any less worthy or more wicked than those that were missed? The killed ants just happened to be in the wrong place at the wrong time."
2. Refuge
Where can one go for refuge or haven? We all face adversity at some time. Some of us have more of it than others. Sometimes we provoke it, but other times it comes without our participating in the circumstances that cause it.
Our minister was speaking of the seven years of confinement and torture of Terry Anderson. He was taken by some terrorists in Beirut. He wrote and/or said that prayer helped him get through. This made me think about what mechanism I would use if I were in such a situation. This led me to write this essay.
There is no security except internal security. Possessions can deteriorate or be stolen or taxed away. Laws can help, but do not always protect. For example, in Germany during the Holocaust, nothing was done that was against German law. Societal norms or customs can help with protection, but again these do not always work. For example, mobs can do things against person or property and nothing be done about it. Sometimes the norms are not protective of the individual or his property.
Irrational or criminal persons can do whatever they are inclined to do. They may be prosecuted, but that will not restore the property, health, or life of the victim.
What I am getting at is the fact that, in my view, the only security or serenity comes from within. In case of some dreadful situation, one can always go within; that is, into the mind and try to create a way of tolerating; or, at least, accepting the terrible present with the idea that it will end. Of course, only death may make it end, but there will be an end. Of course, another solution besides death would be desirable.
I think of the U.S. servicemen captured by the Vietnamese and held for months or years. I also think of the hostages held in Iran, and those in the Korean War. Those persons in those bad circumstances who did the best had certain characteristics. Those with supportive family relations and those with a strong religious faith seemed to fare better. They resisted brain washing better, and had a higher percentage chance of surviving than those with a different background or attitude.
In case of otherwise discouraging or unmanageable circumstances one can always go within.Donald W. Bales

3. Big Nanny
Years ago George Orwell wrote a predictive book, "1984" featuring "Big Brother". Now we have the Federal Government attempting to regulate or run everything. I have debated with myself as to what name we should give to our present situation with regard to Washington. I thought of calling it "Big Mama", but "Mama" should not be used as a pejorative term. For the most part, Mamas are loving, supportive, and kind, although I have heard of and known some very malignant mothers. "Big Aunt" implies blood, or, at least, in-law kinship. So "Big Aunt" wouldn't do. "Big Sister" has the same drawback. I decided on "Big Nanny". Now I have no animosity to nannies-I think most of them are kind and helpful, but I wanted to call Big Government something slightly pejorative, or, at least, neutral. I surely did not want to call it something nice.
You may wonder why all the terms are female. I think the radical feminists are calling the tune in the country. I think only a small number of women are radical feminists, but the radicals are very vocal, and very strident, and exert much more influence than their numbers deserve. The anathema of liberals, Rush Limbaugh, says that there only a few, maybe ten or twelve, of what he calls "FemiNazis". The feminine activists, and I don't here refer to the FemiNazis, have access to the media while the majority of women do not. Hillary with her "It takes a Village" to raise a child is the leading advocate of "Big Nanny." Of course, the village she refers to is the Federal Government. I don't think the record of the Federal Government is very good in regard to efficiency or economy in any sphere of activity.
To me the three main functions of the federal government are protection of the citizens against foreign enemies, protection of the citizen from other citizens, and maintenance of a stable currency. At present we do have a reasonably stable currency, but we probably are at potential risk from the Chinese missiles through the actions or lack of actions by the Clinton administration. Drugs and illegal immigrants get in, as well as agents of foreign governments. Crime is rampant, although that is more properly under state and local government. Crime is down, but not due to Federal actions.
Our armed services have been degraded. Now don't get me wrong. I admire women, and even love some of them. I do not for one second downgrade their mental or physical abilities. I wonder, though, what will happen when our infantry with women in it meet an enemy infantry with no women. Women are superior to men in many ways. The female survives better from conception to ninety than the male human. Women tolerate tedious and nasty things better than men. Women are less likely to die of accidents or violence. Most women are not as strong physically as most men. I know that some women are stronger and faster than some men, but, in general, men are stronger and faster than women. The standards for physical activity in the armed services have been lowered to accommodate women. Men have higher testosterone levels in their bodies than women do. Testosterone is strongly related to aggression. This can be a disadvantage in some circumstances, but in war it would seem that aggressive tendencies would be desirable.
The idea seems to be widespread in some circles that the ordinary person is unable or unwilling to look after his or her own best interests. Certain elites seem to think that they know better what is good for people than the mass of the people themselves. For example, take cigarette smoking. Seventy-five or one hundred years ago cigarettes were called "coffin nails". Common people knew by common sense that smoking was not good for them. Of course, common sense is not politically correct. I am about as anti-tobacco as one could be, but I think any sensible person should know not to smoke. We tried prohibition of alcohol, which didn't stop the drinking of alcohol, but did promote the development of gangsterism. The present theme is to stop the children from smoking, but I think the main purpose of suing the tobacco companies and raising the taxes on tobacco is to impose increased taxes on the poor to get more money to spend on social programs. Since the lower economic group are more likely to smoke, the increased cost will fall on them. The people most in favor of the increased tax are also the ones who are most in favor of progressive tax rates and most opposed to retrogressive taxes. This seems contradictory. There is some justice in taxing those people more who incur more health care costs. However, some people have pointed out that most smokers will not live long enough to collect retirement benefits. Some wags have even suggested that smokers should be rewarded for taking a burden off the Social Security System. I don't think that the suits against the tobacco companies were justified. Even though the companies knew that tobacco was harmful, and even if they suppressed some facts regarding their knowledge of harmful substances in the tobacco, the users were not absolved of using their own judgement. The surgeon general had noted that tobacco was harmful in 1964. Some have argued that the companies lied about their products, but President Clinton’s lies under oath are considered okay by the same people who are so vehemently condemnatory to the tobacco companies for their lies. The billions the lawyers got makes an ironic result-"Never have so many been made rich at the expense of the poor". There will be a huge transfer from the poor (through taxes on cigarettes) to make lawyers rich.
The same idea applies to lotteries and other legalized gambling. Those who can afford it least are those most likely to gamble. In a way it is a mechanism to collect more tax from the poorest segment of society. I doubt that the total increased tax revenue and increased jobs will be greater than the total loss to the gambling establishment. There is likely a societal loss as well. Making something legal gives some support by government. Some might be deterred from gambling, if it is illegal.
When I saw the book title, "The Death of Common Sense" I was inclined to avoid reading it since I thought it would just make me angry. I was already angry anyway. It didn't make me any angrier-it just gave me more evidence to justify my anger.
Donald W. Bales

4. Bureaucracy
My definition of a bureaucracy is as follows: Any group with as many as three members is likely to be bureaucratic. The chief characteristics of a bureaucracy are as follows: It has no brain and no soul, but it does have rules. That is not to say that the bureaucrats don't have brains or souls,, but that they are not allowed to use either.
All societies seem to have or to have had bureaucracies. I'm sure ancient Egypt and ancient China had them. I'm sure the Aztecs, Mayans, and Incas had them. It seems it is a necessary evil. The problem is to preserve common sense action without excessive power and with accountability.
Some writers have suggested that the civil service bureaucracy in France was useful in allowing the country to continue to function in spite of multiple changes in government, so bureaucracies have some good points. A new administration could be hampered in carrying out its mandate if the civil servants wanted to drag their feet if they did not agree with the changes desired by the elected representatives of the people. The U.S. bureaucracy resembles a huge ocean ship. When the ship gets going in a certain direction, it takes a lot of time and energy to stop it or change its direction.
Donald W. Bales (Added to web page 20 September, 2003

5. Campaign Finance Reform
If less money went to Washington, and if the tax code was simpler and fairer, there would be much less incentive for people to try to lobby the Congress or the Administration. With less lobbying there would be less special interest legislation and probably less regulation. I will admit that some regulation is needed to try to prevent exploitation and corruption. Little attention is paid to present campaign finance laws, and nothing happens to anyone who violates the campaign finance laws, so that making a bunch of new laws seems useless, since the same thing is likely to happen with the new law that happened with the old. I would favor, however, that all campaign contributions be reported immediately as to the source, the recipient, and the amount. At least, the public would have a chance to know who got what from whom.


6. Military bases
Downsizing the number of people in the military would suggest that fewer bases would be needed. However, closing a base has been difficult due to the intervention of the representative or senator from the district or state involved. The money saved should have been used to upgrade the pay and living conditions of the members of the Armed Services and to upgrading or maintaining the level of training and supplies.
It seems odd that a President, who despises the Armed Services and who evaded military service has given the Armed Services more foreign assignments than usual, wants to cut the military budget. I note that in late December 1998 he has come out for increased military spending, which I agree with, but I think he did it to steal the Republicans' thunder about national defense. He has done such things before-balanced budget, welfare reform, and smaller government. We heard nothing of that during the two years he had a Democratic majority in the House and Senate-it was only after the 1994 elections that he got religion on those subjects. He wanted to save any surplus (there is no surplus-the Social Security non-Trust fund obscures the continuing deficit) for Social Security, but promoted increased spending in the last budget.
We still have brute regimes and enemies. North Korea, Syria, Libya, Iran, Iraq, and the radical Muslims in other countries. China is a potential enemy, and potentially the most dangerous, especially in the future. We cannot rely on the goodwill of the Russians toward us. Even the Israelis, who should be the most grateful, had spying carried out against us.
Added to web page on 6 October 2003, but written earlier.

7. Palestine Liberation Organization
This group only recently renounced its intention to put an end to Israel. The Clinton administration pressures Israel to give up territory without the PLO keeping its part of the bargain. It is only nine miles from the West Bank to the sea, and it would be foolhardy for Netanyahu to give up territory without some assurance that there would not be hostile artillery nine miles or less from Tel Aviv. The PLO should show by its deeds that it can prevent terrorists from attacking Israel or its citizens. If the Arabs or the PLO lose a war, they can continue to exist, but if the Israelis lose a war, they are finished.
It is a shame that they cannot live in peace. The Israelis have more educated people than they can utilize while the Arabs don't have enough. The Israelis were able to make the desert bloom, while the Arabs have not been at all successful with their deserts. Maybe the PLO and the Israelis will get tired of fighting, as I think the people in Ulster did. I think that had more to do with the fragile peace there than did Gerry Adams, Tony Blair, or George Mitchell. I believe the time was ripe for peace, as it had not been before.
Donald W. Bales

8. Social Security
I suppose I can't claim to be as conservative as my ancestry would suggest I should be. I think Social Security was and is a good thing. I'm afraid that I share the opinion of the elites that a high percentage of the people tend to be improvident. So I think enforced saving is not inappropriate. It is too bad that the legislators and the executive branch have seen fit to keep raising the benefits so that the program has become excessively expensive. The Social Security tax is regressive and a real burden on middle-class working people. It is no wonder that young people find it difficult to impossible to save enough to make a down payment on a home. The state and local taxes add to the tax burden. The cost of living raises built into the system should be realistic and reflect true costs. I believe privatizing one-fifth of the social security tax would be proper, but some safeguard should be put in place to assure prudence. I would oppose having a government agency choose the investments-the U.S. government has too much sway over the economy as it is. The stock doesn't always go up-it goes down as well.

9. The Disincentive Society
Dividends are taxed twice and maybe four times. The stocks are bought with taxed money, the corporation is taxed, the owners of the stocks have taxes on the dividend. There is probably another-hidden-tax. The interest on savings has a tax on the money used to put into the savings account, and the decrease in purchasing power by inflation of the saved money could be a hidden type of tax. So we have a disincentive to save or to invest. No wonder our savings percentage is so low.
The marriage penalty tax is another disincentive. Getting married costs people more in taxes. I believe that marriage is a societal device which promotes better care of children. I think many of our social ills are due to having no father in many homes. Many studies have suggested that children from one-parent homes are more likely to be in poverty, drop out of school, be truants, get on drugs or alcohol, get into trouble with the law, more likely to get venereal diseases and more likely to get pregnant than those from two-parent families. I think fathers have an important role to play in the family, and should be involved in raising the children. As my beloved daughter told me one day, "Daddy, you've always been active in family politics." Both boys and girls need a model of what a proper husband (and father) should be so that they will have a better idea of how to be one or choose one.
The welfare system made the mother-only family easier. Under the rules it was harder to get welfare if there was a husband or father in the house. It made it easy for the teen-age girl who had an out-of-wedlock baby to get welfare on her own. I have been told by nurses who work with pregnant teen-age girls that many of the girls get pregnant on purpose to get out of an unpleasant family situation, and others want to have something to love and something that will love them. I doubt that these girls have any idea of what looking after a child is all about. Another example of how a program designed to be compassionate wound up facilitating a very serious problem.
10. The Surplus
There is no surplus. Take away the Social Security funds and we still have a deficit. With the social security system the government has an obligation to retirees which will come due when the baby-boomers start to retire. It would seem that cutting spending, paying down the deficit and cutting taxes would be the way to go. Taxes act as a brake on the economy. Every dollar the government takes in taxes is a dollar taken out of the economy. That dollar could be used for investment. Of course, some government dollars can be considered investment, if they are used to build roads, airports, seaports, or other infrastructure that promotes wealth building activity, but much government money is wasted on unneeded projects and programs that do not work.
I perceive that the president and the legislators have a built-in bias toward more government spending. Every special interest group wants a piece of the government (tax payers’) pie. Those who favor fiscal restraint have no lobbyists and no real voice. Also almost every citizen wants something from the government. Those who are getting something from the government do not want to give it up. Even I don't want to give up my benefits. For example, each year I get a nice so-called dividend check from my National Service Life Insurance policy. I converted this policy from term to twenty-pay life in 1944. I paid the last premium on this policy in 1964. I have not sent any of these checks back. Julie and I also receive checks from Social Security each month. I use the National Parks and the Interstate Highways. I had thirty-three of my thirty-nine months of medical school paid for by the Army. Of course, I had twenty-two months of obligated service on active duty as a medical officer as a result of Army support. I think everyone feels that if others are getting government benefits, they should get theirs also.

11. The Tyranny of the Telephone
I have often been talking to someone-a clerk in a store, or a nurse at the hospital or someone else, and, in the midst of the conversation, the phone will ring, and the person will answer the phone instead of proceeding with whatever we were doing. It seemed that no matter who was calling, the call was more important than I was. I have been tempted to go get on a phone and call so I could get the attention the caller got. That would be one use of a cell phone (I don't have one at the time I am writing this.)
Calls at mealtime or in the evening is another phone "tyranny". "Begging" calls are even more annoying at those times. (I also get a lot of "begging calls" at any time). The begging is for contributions. The projects are often worthy, but there are so many of them! Recently I have been telling callers that I do not commit myself to a donation on the phone.

12. The Clintons
Bill Clinton is a tall well-formed good-looking man (of course, he was a little on the plump side, but that's the least of my problems with him). He has an excellent memory, except when being questioned about Monica Lewinsky. Then his memory seems more like Ronald Reagan's! Clinton is a fluent speaker, even though much of what he says is a lie. He has had a good chance to be well educated, and seems very intelligent. He must be very attractive to women, and, probably was, even before he had the power and prestige of high office. Women seem to be attracted to men with power or money. I think he could easily pass a lie detector test-I think he really believes that what he is saying is the truth at the time he says it, even if he says the opposite the next day. He surely put on a convincing performance when he said, "I did not have sexual relations with that woman, Miss Lewinsky." He takes, and gets in some quarters, credit for the good economy, but I don't think his policies have been the cause of the good economy. He takes credit for the balanced budget, but no effort was made on that front until the Republicans won the House and the Senate in 1994. He only admitted to the Lewinsky affair, when his DNA was found in the stain on the famous blue dress.
He has a long history of sexual infidelity. All of the known women have been systematically trashed as nuts, sluts, or liars, but one would have to believe all of them are lying and that the president is telling the truth, when he is a known, proven, and longtime liar. Even some of the Democrats think he is a liar, and that he had sexual relations with Monica Lewinsky even when he was denying it. Of course, we may use lawyer-talk to say that oral sex-fellatio-is not a sexual relationship. That is, he seems to maintain that Monica had sex with him, but he did not have sex with her!
Since he has never had any military service-by evading the draft-he has less understanding of military matters than those who served their country in the military. I hope that the contributions by the Chinese to his campaign did not influence his policies toward the Chinese, but I think they did. I hope that the transfer of control from the State Department to the Commerce Department was not also motivated by the contributions, but I suspect it was. I hope that the technology did not put this country at risk from Chinese missiles, but I think it did. It could have been just ignorance or incompetence, but neither quality recommends a person to be commander-in-chief. To me these are more serious than lying about sex on the job with a subordinate woman.
Hillary is attractive, and even pretty at times. She has attended elite educational institutions. I have some reservations about education in our elite leftist institutions. She is intelligent and fluent, and has great influence with many women. She has a Methodist background, so should know better. Unfortunately, most of her ideas are wrong. The health care plan is a good example of what she would like to do. However, I suspect that she might be the type of woman who might make a man want to look elsewhere. The idea that she had no knowledge of Bill's relation to Monica made her look rather foolish, and whatever she is, she is not that foolish. I think that she made a bargain to put up with the many acts of infidelity to share in the power and prestige of being Bill Clinton's wife. Sometimes they put on a good show of solidarity.
Friends of mine, knowing my political views, delight in telling me Clinton jokes. This is one of my favorites:
Question: "Have you heard about the Hillary Special at Kentucky Fried Chicken?"
Answer: "No. What is it?"
"Two big thighs, two small breasts, and one left wing."
The Clinton spin machine is a marvel. He must be coated with Teflon covered with silicon and oil. It is easy to see how he got the name, "Slick Willy". He really is slick. He has evoked strong feelings-both pro and con. However, he has about a third of the population who can't stand him. I think some people even hate him. He has a lot of people who like him, and seventy percent, according to the polls, approve of his performance as president. This is more a demerit for the electorate than of Bill Clinton.
Bill Clinton is a product of a dysfunctional family, which may account for some of his behavior, and even for some of his success as a politician. Some have thought that the lack of love in his childhood makes him want to please everyone. This may lead him to try to do so by saying whatever he thinks his current listener wants to hear. He may be the best "politician" of all time. By that I refer to the word “politician” in a pejorative way. He is a baby-boomer and a sixty’s person, and may reflect the values and behavior of the worst of that group. God help us! It doesn't look like the electorate will!
I think the country is doing well in several ways-inflation and unemployment are low, productivity is up, the deficit is smaller, interest rates are low, and we have relative peace in much of the world. When lying under oath is not only not condemned, but actually defended, I think we are in a bad situation. We lead the developed world in teenage pregnancy, in crime (especially murder), in percentage of our population in prison, suicide (especially in young people), and drug use. We are way down in educational achievement. We spend the most per pupil on education, and get the least bang for the buck.

13. Pet Peeves-Language
"Blood-thinner"-this term is used to refer to clot preventers. Patients would come in and say they were weak or cold-natured, and would attribute this to the fact that their blood was "thin." To me thin means less viscous; for example, if you add water to syrup, it becomes thinner, and, if you boil off some water, it becomes thicker. When a patient takes coumadin or heparin to prevent clots, the density of his or her blood is not all changed from when he or she was not taking the medications, nor is the viscosity of the blood altered. I know that most doctors use the term, but just because a lot of people say or do something doesn't make it correct. Early in his tenure ninety-five percent of the Germans thought Hitler was right, but they were all wrong.
"At this point in time" = now
"First of all" = first (bad)
“Second of all = second (even worse)"
‘Third of all = third (still worse)
"And so on and so forth" = nothing (Allen Keys says this often)
"If you like, and, if you will" = nothing
"You know" You don't know, usually, or there would be no need for the speaker to tell you.
Pet Peeves-Behavior
Litterers-I often find trash within five feet of a trash can.
Cigarette butts stamped on-on the pavement, or, even worse, on the floor.
Tail-gaters-they won't get there any sooner on a winding or hilly two-lane road, or if the left lane ahead has cars in it. They would still be behind a car. If the person in front stops suddenly, they will crash into the rear of the car. And the accident will be the fault of the person following too close.
Drivers who leave their turn signal on when they don't intend to turn.
Drivers who drive below the speed limit in the left (fast) lane.
People who walk up to join a pair or a group, and interrupt whoever is speaking, without waiting for a break in the conversation.
People who wear their billed caps backward. Of course, it does keep the sun off the backs of their necks to some degree, but the bill was intended to keep the sun out of their eyes and the rain off their faces.
Men who wear their head-coverings indoors. I make an exception for cowboys with ten-gallon hats.
People who try to break into a line.
"Victims"-people who want to be victims in order to get some special benefit.
"Rights"-people who want some right. Especially when they accept no obligation or responsibility
People who interrupt me in the midst of a joke or a story. Perhaps I should be interrupted. Perhaps the joke or story is not worth hearing. But it is rude.
Litigious people. I think everyone is entitled to his or her day in court, but not for trivial matters, and not when the defendant was not the cause of the result.

14. Capital Punishment
I became a physician in 1946, so I have spent two-thirds of my life trying to prevent suffering and premature death. I, naturally, have a bias in favor of life and against death. In regard to capital punishment, I am against it, since it leads society through its legal justice system into killing people. However, what do you do with a lifer who kills another prisoner, or, even worse, a guard? What do you do with a person who kills several people or rapes several women or men? Is there ruined merchandise? Are there persons who cannot be rehabilitated? Are there people who cannot be trusted to be out in society?
Some cite the "Ten Commandments" especially the one "Thou shalt not kill". However, the correct translation is “Thou shalt not murder (kill unlawfully).” The politically correct do not follow Christianity or Judaism, saying that church and state must be separate. Many of the unchurched do not believe in religion anyway, but will cite it when it furthers their agenda, and ignore it when it does not. The ancient Jews, at least, according to the Scriptures surely killed a lot of people sometimes, seemingly, with the help of God. God was said to have caused the death of all the people in Sodom and Gomorrah.
Christ did not invoke God's law against his own execution. Even though the message of the New Testament is love, mercy and forgiveness, I don't believe that Christ meant that a person could do just anything repeatedly and have no consequences for their misdeeds. Repentance means regretting the misdeed, and not doing it again.
Life imprisonment presents some problems. One could say that life imprisonment without hope of parole is cruel and unusual punishment. Homosexual rape and other cruelties done against another prisoner constitutes cruel and unusual punishment, even though it was not prescribed by the justice system. Putting anyone, even a hermit, in solitary seems just as cruel as taking his life. I believe that keeping a prisoner on death row for twenty years surely is a cruel and unusual punishment. It is tolerated only because of the unwillingness of the society to decide for or against capital punishment.
If the person who commits a heinous crime and is convicted with due process of law has a conscience, death might even be merciful. If the person has no conscience, he is not safe to be in or out of prison. I believe we have a lot of ruined merchandise that cannot be repaired.
Some mention the fact that we are the only so-called advanced country that still has the death penalty. That being so does not necessarily say that the others are right and we are wrong. History records many instances of a large majority believing something that was not only not accurate, but was also not right.
Of course, some think that all ethics should be situational and that there are no truths or certainties about anything. As you might surmise, I do not agree with that view. Presently there is a widespread unwillingness to judge anything-it is not politically correct. It is true that no one is without sin, but there is a big difference between white lies and murder.

15. Bad Behavior Prevention
I am a retired physician. I was in the private practice of internal medicine from 1 August 1952 until 29 June 1997 in Kingsport, Tennessee. Kingsport is located in the northeastern part of the state near the Virginia border. In fact, Gate City, Virginia is only eight miles away. During the early years of my practice I had the need to send some mentally ill patients to our state mental hospital in Knoxville, and, occasionally, to the Virginia State Hospital in Marion, Virginia. In those days it took certification by two physicians to start the process. Then it went to a judge who did the necessary legal action to commit the person. This would be done only if the patient was unwilling to be committed voluntarily. In some cases lack of money or hospital insurance would lead to such an action also.
Some elements in our society raised the question of mistreatment of the inmates. At any rate an effort was made to prevent "warehousing" of mentally ill patients. To me this had some merit. It is my understanding that the courts made a ruling that a person could only be kept in a mental hospital if he or she were a hazard to himself or herself or to others, and would have to be receiving active treatment.. I further understood that certain requirements were set up regarding the hospitals. Each physician could only have a certain number of patients and each nurse could have only a certain number of patients. Now one way of meeting the number requirements would have been to hire more physicians and nurses. Another would be to discharge enough patients to meet the requirement. Tennessee And many other states) evidently chose the latter. One of the problems regarding the physicians was the shortage of psychiatrists. Some of the doctors I spoke with regarding committed patients spoke English very poorly. I wondered if they could understand the Upper East Tennessee dialect or, indeed, English in general.
I suspect that our state government, which is hampered (and the taxpayers benefitted) by having a state constitution requiring a balanced budget, is always short of money. Tennessee is a low tax state, which is what the electorate has chosen. Therefore, the state authorities were only too glad to discharge the patients. I had the experience of sending a patient to Lakeshore (the old name was Lyons View-the name was changed to protect the guilty), and having the patient get back to Kingsport before the deputies who took them down there got back to town! It seemed that if the patient showed the least sign of sanity, he or she would be sent back. Some of these patients had been seen by a local psychiatrist as well as by me. I sent no one who was anywhere near normal. (Of course, the definition of normal is not always agreed on. To me normal meant absence of serious symptoms of psychological origin, ability to work, and ability to care for someone other than oneself.)
The theory was to have mental health clinics that could monitor and treat the patients in an outpatient setting. This sounded ideal. However, it didn't work out so well. Mental patients are notorious for being non-compliant. That is, they won't keep appointments and won't take their medications. Compliance is not good with non-mental patients. In fact, studies done by social workers have suggested that forty percent of patients have no intention of following the advice they receive. Naturally when the patient's mental processes are awry, the compliance would be expected to be worse.
In the old days, if a mental patient didn't take his medication or keep his appointments, the threat of being sent back to the hospital could be used to promote compliance. When Thorazine (chlorpromazine) came on the market, it revolutionized the treatment of schizophrenia. It didn't make the patients normal, but it made them sociable; that is, on medication they could be taken care of by their families, and some could even work. It was sedating, and the counter culture was very much opposed to psychiatric treatment, especially chemicals and electric shock treatment. For example, "Over the Cuckoo's Nest" gave psychiatric treatment an especially bad time. Of course, in the counter culture it was okay to take recreational drugs like marijuana, heroin, LSD, and so forth, but not okay to take anything prescribed by a physician.
Many years ago we had a public hearing here with the subcommittee on mental health from the legislature. The commissioner of mental health was in attendance. Several citizens rose to speak of problems. One in particular that I remember only too well. This woman's husband was schizophrenic, and had been hospitalized several times at Eastern State Hospital (Lyons View, Lakeshore). He was on Thorazine, and while he was on it was okay to be at home. Earlier, if he didn't take his medicine, his wife could get him to take it with the threat of his having to go back into the hospital. At the time this threat could no longer be used, and he would stop his medication, beat up his wife, she would call the police, and he would be arrested. This woman said, "My husband doesn't need to be in jail, he needs to be on treatment." The commissioner said, "The state plane has to get back to Nashville, so I will have to leave." He couldn't stand the complaints since he probably couldn't or wouldn't do anything to correct the situation. The fact was that the plane came to bring him, and would go back whenever he wanted it to.
Some will raise the objection that Thorazine had adverse effects, but schizophrenia has some bad effects, too. Even if the patient doesn't hurt anyone, he or she can disrupt the life of a family and cause a lot of suffering. Tardive dyskinesia (a Parkinson like disorder) is one of the complications of long term treatment with Thorazine and its cousins. It can cause a drop in blood pressure on standing, and can cause drowsiness and lack of alertness. Some of its more modern cousins have less adverse effect. You can't treat a major illness with a minor drug. "You can't drive a pile with a tack hammer!" “You can’t down an elephant with a flit gun.”
I am a great believer in law and order, and do not believe anyone should be deprived of his liberty without due process of law, but mentally ill people need treatment and protection. They probably, in general, are a greater threat to themselves than they are to others, but every now and then one of them does something that brings attention to the fact that they can harm others. Often there is a long history of abnormal behavior until the final defining incident.
Estimates suggest that up to one-third of the homeless are mentally ill, and another portion are chemical abusers-alcohol and others, and the other third are just shiftless or unlucky.. In my view it is a shame that a wealthy and compassionate society like ours will tolerate a situation where our citizens are living on the streets when a lot of them are really not mentally competent to decide what is in their best interests. This may sound strange coming from someone like me, who is in favor of personal freedom (and responsibility), and who thinks the government is trying to do too much, and not doing it very well, would advocate using laws and government to deal with the homeless problem.
Rusty Weston is a good example of the lack of prevention and promotion of treatment for someone who was known to be mentally ill for a long time before he went on his shooting spree at the Capitol.
(I offered this essay to the Kingsport Times-News. They said they would consider a three hundred word letter to the editor. I also offered it to Time magazine. They also declined stating that they only use staff writers. As you can see, I was considerably upset by Reston's shooting those two House of Representative guards.)
Donald W. Bales, M.D.

16. Abortion
I have a hard time with abortion. One question is: When does the fetus become a person? Some cutoff points have been posited-quickening (when the baby's first movements in the uterus are detected), viability (when the baby is mature enough to survive outside the uterus), and just prior to delivery (when partial birth abortion is sometimes done). None of these meet the biological test. For me an abortion in the first trimester is less bad than in the second, and one done in the second trimester is less bad than in the third. Abortion in cases of rape and incest (usually also a form of rape, and considered statutory and a crime before the age of consent of the rapee) seem somewhat acceptable, since the woman is rendered pregnant against her will. Even in those cases the fetus is deprived of life without its consent. The fetus is surely innocent of any misdeed.
A recent poll recorded that about three-fourths of the women replying favored abortion, so I am out of step with them. But my case may be similar to the Pope's. As Agriculture Secretary Butts said of the Pope, "He no playa da game, he no maka da rules". Butts got severe criticism in the media for that, but I thought criticism might more properly be about some of his decisions he made for his department.
An abnormal fetus presents a problem. Tay-Sachs syndrome (the baby is born blind and idiotic and will surely die by age two) is an example in which one could agree with abortion on a logical basis. Saving the life of the mother is another reasonable justification for abortion. Some fetal abnormalities are compatible with survival with a reasonable quality of life, but some are not.
Many abortions are done as a birth control method. Use of it as a back-up for contraceptive failures is more acceptable. All methods of birth control have a certain percentage of failures even if they are used properly and regularly. The only method of birth control which does not fail is abstinence from penis-vaginal intercourse. Abstinence would not be acceptable in marriages, but it would be a good preventive for pregnancy in unwed women.
If women want to play the sex game, they should be prepared to accept the consequences when they lose. Some would say that men should be responsible as well, but it's the women who have the babies. Responsible people should never have sex without considering the possibility of pregnancy or infection, and taking precautions against both. Of course, exclusively monogamous couples wouldn't have to worry about infection, unless one of them still had an infection from the past. I think all sex and all reproduction should be first degree, that is, premeditated. The morning after pill would be more acceptable than even early abortion. That early would be more like prevention than interruption. I strongly doubt that there are many cases that would justify partial birth abortion. One doctor who did a lot of them later repented and reported that most of the ones he had done were done to get rid of an unwanted child. Of course, I am opposed to anyone having an unwanted child-wanted children have a hard enough time.
I believe abortion should be safe and very rare.

17. Homosexuality
I don't know what causes this. At present, I am inclined to believe that it is inborn, at least, in males. The tendency often shows up very early. Certainly choosing a life style that still has a lot of prejudice against it, and even danger to life and limb, would be very illogical. Of course, I am well aware that humans often behave illogically. I doubt that it is hereditary, since exclusively homosexual persons are unlikely to reproduce. Of course, lesbians could be artificially inseminated, and gay men could contribute the sperm.
I am even less sure about female homosexuality. It could also be inborn, but our daughter, Virginia, who has done a lot of psychological counseling with survivors of incest, thinks that the women became lesbians because of their bad experiences with men. Many of these women are lesbians. She may be right. It is not hard to believe that sexual mistreatment of girls by men-fathers, brothers, uncles, grandfathers, cousins, or others-would lead those women to distrust, or hate, men.
I consider homosexuality to be unnatural, although it occurs in other creatures besides humans. The mouth has teeth, and the rectum has feces. Why would someone want to stick his penis in either opening, when the vagina is perfectly suited for the penis. The vagina has no teeth and no feces. Dr. Shelton Reed served with the Army during World War II, and told me of treating men whose penises had been bitten to the point that the urine was leaking out the side of it. These men had served in France. Apparently some men, including the president, prefer fellatio to vaginal intercourse. The spread of AIDS is facilitated by anal intercourse-in both with men or women. Tears in the anal lining helps the virus to get into the recipient's body. Pharyngeal gonorrhea is harder to treat than urethral or vaginal/cervical gonorrhea.
It is my understanding that lesbians are much less likely to get sexually transmitted diseases than gay men. "Gay" seems an odd term one for a life style associated with so many hazards and problems.
I oppose discrimination against (or for) homosexual persons. I do not believe we should recognize homosexual marriages. I believe societies have established marriage to give societal backing to the nuclear family with the motive being to promote the proper care of children. Further I do not believe homosexuals should be allowed to adopt or reproduce. Children have enough trouble without having additional burdens. I haven't decided what I think about their being teachers or otherwise involved in the guidance of children. I am well aware that many heterosexuals do not behave as they should toward their own children or toward other people's children. I oppose homosexual partners receiving spousal benefits. At least, I oppose legally mandating such coverage. Especially is this not right when we have a marriage penalty in the tax code.
It would be better for the homosexual community to avoid blatant exhibition of their status. Discretion and privacy would make homosexuality less obnoxious to the rest of society. The "in your face" tactics are likely to convert neutrals into opponents, and enrage the opponents even more. On some campuses political correctness demands that derogatory or belittling statements not be made. However, on those same campuses it is okay to do it to straights and, especially, to the religious.
Equal access to employment, housing and promotion is okay with me, but special privilege and preferential treatment is not.

18. Women
I love women, at least, I love some of them. I don't love the "FemiNazis", but there are very few of them. I don't love the radical lesbian feminists. There are not so many of them, but they are very vocal. I don't hate any of them, but I don't like some of their tactics and policies.
I have had and have a good relationship with all my female blood kin, and even with my female in-laws. So I have no bias against women based on any bad experiences with women. Women have always treated me extremely well. Of course, more of them have wanted to mother me than to smother me. (That may be good-otherwise I might have died years ago-ha, ha.) I have an intense and congenial relationship with the most important woman in my life-my beloved wife of fifty-three years. (1998)
So far as mental abilities are concerned, I try to judge women with the same standards that I use for men.
I believe women should get equal pay for equal work. However, the attempt to make men and women the same is absurd and against nature. The women have the babies, which makes them enormously different from men. Testosterone (the male hormone) and estrogen (the main female hormone) have very different effects. There are also inborn differences that cannot be changed by environment.
Women can do some things better than men and men can do some things better than women. There have been some interesting experiments reported in the book "Emotional Intelligence". In the best of all possible worlds the women would do those things they do better and the men would those things that men do better. A couple (heterosexual) who adopts this policy will get the maximum out of this arrangement. Of course, this might be different for each couple.

19. Busing
While we were on our Texas trip, Ida (Julie’s sister) and Jim Holmes raised the question of the benefit of busing. They maintained that it had raised the level of academic achievement of the blacks. I told them I didn't believe that. After I got home I found two books in the library on busing. "The Great School Bus Controversy" edited by Nicolaus Mills with articles by many different people who had a point of view and knowledge about the subject. The other one was "The Burden of Busing" by Price and Woodard-this one was about the busing in Nashville, Tennessee.
Somewhere I read that the busing for racial purposes was only 3% of the total of students who were bused. The laws regarding school consolidation (which led to the need for moving students other than on foot) began in 1838 in Massachusetts, 1903 in Tennessee, and 1913 in Nevada. So busing students goes back a way in time. 19.6 million students are moved by bus or public transportation now. The cost is 1.5 billion. The cost as percentage of the total cost of education varies from 0.7 to 6.9%. Total miles bused were 2.2 billion per year. In 1969-1970 43.4% of students were bused.
The first effort was desegregation. This moved on to integration. Equality moved on to affirmative action. Now there is a voluntary move to resegregation; that is, the students tend to gravitate toward sticking with their own racial group. The class distinctions of "Jim Crow" with legal separation of rest rooms, lunch counters, motels, and drinking fountains are gone.
Studies are hard to evaluate, but it seems that the academic achievement of the white students was not worsened by the presence of blacks. One of the authors remarked that if discipline had declined, it should have shown up in academic achievement levels. Since he cited no studies regarding discipline I believe this was an assumption. The blacks did improve, but there was general improvement with time in schools not effected by racial busing so it was hard to tell whether the busing had caused the improvement or not.
In Nashville (and in other systems) there was white flight. Since the evidence for decline in academic achievement was not provably obvious, the parents must have had another reason. However, they could have had the impression, even if erroneous, that the academic achievement of their children would be adversely effected. However, another fear was that the values of the black community would effect their children. The white middle class values of self-discipline, hard work, proper manners and deserved merit were contrasted with the perceived values of North Nashville. The question was raised if the black community had the proper values why was there so much violence, so many illegitimate children, and so many on welfare.
White flight seemed to be worse depending on the blackness of the school, the blackness of the neighborhood the school was in and the ability of the parents to pay for a private school or to be able to move to an area where the judge's order did not apply.
George Washington Carver thought the way to raise the status of blacks was personal and individual, while W.E. Dubois favored action to raise the group.
A few blacks-Thomas Sowell, for one-favors the Carver approach, and Ward Connally is opposed to affirmative action. These blacks are considered traitors by the best known black leaders as well as the NAACP and CORE.
We seem to have a quota for black cheer leaders here at Dobyns-Bennett High School, but no quota for white basketball players. Merit rules the day in athletics, but not in other areas. Of course, it is easier (and obvious) which is the best athlete. One can measure the performance. Academic and other performance is not so obvious, or so easy to measure, and one can say that the blacks have not had opportunities to excel in some other areas so they should have some extra consideration.
I am in favor of equality of opportunity, but not of result. The Coleman study of some years ago suggested that the educational and economic level of the parents was a more important factor in the success of a child in the academic world. The amount of expenditure per student doesn't seem to count very much, since Iowa and Minnesota spend the least and have the best scores, while New Jersey and Washington, D.C. spend the most and have the worst scores. We used to have thirty in a class and seemed to do pretty well. Now the push is for smaller and smaller classes. My view is that discipline has declined so much that it takes lower pupils per teacher.
So it comes down to this. The whites have not been brought down, the blacks have come up (whether this was due to busing has not yet been proven to my satisfaction). There may be a psychological benefit for the blacks in that they think something has been done to help them. If they believe this, perhaps it will help their morale and improve their efforts.
I think some of the famous black athletes could be better role models. The fact is that a black person has a much higher percentage chance of becoming a doctor, a dentist, or a lawyer than of becoming a professional athlete. After all there are only 12,000 people making a living as professional athletes, and there are many more blacks in other professions.
Donald W. Bales 25 April 1999

20. Prayer
Before I write about prayer, I should write about my religious beliefs. Since I cannot conceive of something out of nothing, I wonder about what was before the "Big Bang"; if indeed, that theory turns out to be valid. I suppose I am a Deist in that I believe in a Supreme Being. Every known society seems to have some sort of religion. One might think that there is something in the human psyche that yearns for a God. One could think that a group having a belief in something other than the material world and oneself could be a benefit to the survival of that group. One could also think that there is something to the idea of a Deity.
One of my favorite stories regarding religion goes as follows:
A man was standing on the sidewalk in conversation with a man of wealth. Another man came up and all he said was "Hello". The wealthy man got out his checkbook and gave the man a check, after which the man left. The first man said, "It's none of my business, but I am so curious I have to ask what was that about?" The rich man said, "That was someone from the church, and I gave him a donation." "I thought you didn't believe in religion." "I don't, but just suppose there is something to it."
The Trinity has always been confusing to me. I think I understand the concept, but, if there is a God, I think there can be only one. I suppose I am an Arian. To me Christ is more inspiring if he were human. I could hope to emulate a man, but I would not expect myself to emulate a God. Even if Christ did not rise from the dead, he still gave the best formula for living that I know of. Of course, no group has truly followed it. I am afraid that I think there are humans who would not respond properly to my turning the other cheek (or even three other cheeks).
Our preachers ask the members of the congregation to pray for themselves and for others. At this time in the service, I do think of-or pray for-a large group of people. I do not include those loved ones who have died, although I still love each one of them. Not being a Catholic I don't believe in praying people out of Purgatory. My thoughts (prayers) are for the living. A partial and usual list follows:
Donald W. Bales, Sr.
Julia Anne Stanton Bales
Virginia Lee Bales and Jay Gitlin
Basie Bales Gitlin
Bruce (Jay's brother) and Amy Gitlin and their children
Donald W. Bales, Jr. and Marghi Sowerwine
Katy Bales
Molly Bales
Elma Sowerwine (Marghi's mother)deceased
Chips Sowerwine and Aoud and their two daughters
Peter Sowerwine and his daughter and second wife
Cathy McMahan (divorced) and her three children
Hugh Barton Bales and Sally Shaw
Celia
Doug and Joan Shaw (Sally's parents) and their children
Andy Shaw
Cindy
Nancy
Betsy
John Stanton Bales and Dorothy Jean Barnhouse
Lucy
Ella
David and Mary Alice Barnhouse (Dorothy's parents)
Kitty and Lee Purgason and their two children
Steve and Emily Barnhouse
Roberta (daughter of my Aunt Annie Kate) and Orrin Jones (dead)
Bob and Kate Lochte
Camille and David Lashlee
Melanie married Jim (?James) Adams in November 2001
Amy to marry Chuck (?Charles) Vogel in February 2002
Murrell (son of my Uncle Edwin) and Joan Weesner
Becky Jo and Randy Moles
Susan and Kevin West and their two children
Mary Ellen and Kirk Horner and Erin
Winnie and Marty Seals and Matthew and another son
Jane Doggett (daughter of Annie Kate Weesner Doggett)
Bill (son of my Uncle William Weesner) and Twilla Weesner
Chad and Kathy and Kendall Scout Weesner
Ashley and Matt Jernigan and Addie Caroline
Robert (son of my Uncle William Weesner) and Michele Weesner
Joshua and his wife, Amy, baby due in August 2004.
Simon m. Debra Rose Scheunemann 5/9/99 (divorced)
Nathaniel (b. 04/02/00), Debra, and stepfather
215 Appaloosa Drive, Jacksonville, N.C.
William Roy (Bill-son of my Aunt Mary Ruth) and Glenda Alexander
Richard
Roy Barton Weesner (my uncle-only one left of that generation)
Charles Barton and his (fourth) wife Annie Weesner
Bart Weesner and Jennifer Marshall and Allison Nicole
Born 5 May 2003
Laura Weesner Staton and her husband Chris and Emme
Edwin (Eddie) Weesner (Down's syndrome)
Hugh Lewis (son of my mother's cousin Hope Davis Lewis)
Patia (Hugh's second wife)
Becky Lynn (Hugh's daughter by Hugh's first wife)
Becky Lewis Porter Fine (divorced from Porter then Fine)
Andy Porter and his wife
Griff Porter and his wife
Andy (Hope Lewis's son) and Janie Lewis
Beth
Katie
Matt and Drew (twins)
Robert Tipton Bales, III (son of my cousin R.T. Bales, Jr.)
Julia Fleming Bales
Hallene Bales (my cousin) and Ralph Doyal (he died 10 Jan 2000) Dwann Black (great-grandson of my aunt Dora Bales Noe) and his wife and three sons
Andrew Black (great-grandson of my aunt Dora Bales Noe) and wife
Sarah Elizabeth (Julie's sister) and John Garner
John Garner and his wife (Kathy-separated) and their daughter Rachel
Hugh Garner and his wife, Julie and Sarah and Emily (twins)
Virginia Louise (Julie's sister) and George Payne (dead)
George Payne, Jr. and Jeannie (her son by a previous husband
Charles Payne and Susan
Polly
Pippin
Hugh Wright Stanton, Jr. (Julie's brother) and Donna
Milner Stanton (Hugh's daughter by his first wife)
Cindy (Donna's daughter-adopted by Hugh)and Stewart (no. 2)
Sam (1st husband’s) b. 5 Sep 1997
Ben (2nd husband) b. 24 Sep 2004
Georgia Elinor Stanton Curtis (Julie's sister-widow)
Hugh Edward Curtis, and his second wife, Donna
Joe Curtis and his wife, Jean Marie
Thomas
Katie
Ida Wills Stanton (Julie's sister) and James Holmes
Lynn (Julie's niece) and Terry Blumenthal
Daniel
Sarah Anne
James Holmes, Jr. (Julie's nephew) and Joellen
Nathan Wesley
Julie (Julie's niece) and Greg McKenna
Aaron (born with left ventricular hypoplasia)
Mary Kathryn
Amelia Stanton Harper (Julie's aunt-widow-last of that generation)
Paul Harper (son of Amelia) (divorced-no children)
Lee Harper (died in a car wreck)
Bill Stanton (Julie's cousin) and his wife, Dorothy
Polly Stanton (widow of Julie's Uncle Jack Stanton)
Bob Stanton
John Stanton
Julie Bragg and her husband, Howard
John and his wife
William
Henry and his wife
Katherine Stanton (deceased), widow of Julie's Uncle George Russell and Laura Stanton (no children)
Katie Jane Stanton (divorced twice) no children
Elizabeth Wills Holman and Roselle (Del) Holman (both deceased) (Elizabeth was the older sister of Julie's mother)
Yerby Roselle Holman and his wife Emily and their children
Dr. Lyle Smith and his (second) wife Sarah
Carolyn and her husband Larry
Their children
Kim (suicide in 1999, his widow, Barbara, and their daughter, Anna
Hunt and his wife and two children
Dr. Robert and Jeanne Jernigan
Jeffrey (aortic regurgitation-an anesthesiologist at U.T. Memphis) and his wife, Carol (Hale), and their children
Mary and her husband and their children
John (infectious disease)and his wife and their children
Dr. John Powers (widower)
Sally (twice divorced) and her three daughters (black)
Elizabeth (never married) California
John (divorced with custody of two children, half Filipino) Kelly and Rhea-live near D.C.
Guy (chemical engineer-never married) Houston-Now China
Andy and his wife (Latino-? Mexican) and two children
Dr. Bob Jones (widower) and his five children
Jeff
Wendy (divorced, remarried)
Jack (divorced)
Leslie-family practice in Kingsport
Nancy and her husband and children
Dr. William Harrison (widower) and his five children
Marty (unmarried) lives in Vermont
Steve
Nick (a twin)
Tad (a twin)
Toby
William (Bill) and Caryl Griffin
Kim and her husband and new baby (we are now at 13 Jan 2000)
(Other daughter Beth died of Herpes Encephalitis in 1997)
All of the Philosophy Class, the staff, and all the members of First Broad Street United Methodist Church
All of my fellow swimmers and exercisers
On September 27,2001 Julie reminded me that I had not included
Mary Sue Still and her family and
Our neighbors Ralph and Marion Hudson and their six
This omission was not due to my having any lack of concern for those folks. It was just that I didn’t think of them at the time I made the list.
September 27, 2001: I am adding to my prayer list all the victims of the September 11, 2001 attack and all of their families. Also the Executive, Legislative, and Judicial members of the Federal government, the state, county, and city officials. And especially the members of the Armed Forces of the United States. And for all of the citizens of the United States. All are at risk in this war. Civilians were the main targets of the terrorists. Of course, they did hit the Pentagon so they got some armed services people as well, but the major assault was on civilians. This attack is an outrage, and I am very angry and want those who planned it and those who backed the planners brought to justice. And, yes, I want them dead. This may not be Christian, but I still feel that way. This may not be a good thing to put in an essay about prayer, but I don’t always pass the Christianity tests.
I am also adding Mike Boggan and praying for him to be able to lose weight. He quit smoking after I got after him, but gained thirty pounds, lost it and gained it again. I promised him last Friday that I would pray for him. I also pray for his family, especially his quadriplegic son of his first marriage.
I also pray for Charlie Eberhart-may he learn to handle stress and for his wife, Joyce and their children
Anne
Elaine
Charlie
Ray Carico (Ray’s wife, Carolyn Widener, worked for some of us from age 18 until her death at 64.)
Doyle Burdine, has Lou Gehrig’s disease and died of it.
All the Methodists, all the Christians, all the Jews, all the Muslims, even the radicals, all the Hindus and Buddhists, and all the Chinese, and all the rest of the six billion humans on Earth.
In recent times, I pray especially for all the people in the armed services, especially for all those in Iraq and Afghanistan.
I believe praying helps me. It might help those listed if they knew that I was praying for them. I don't conceive of God as a cosmic bellhop, and do not expect the laws of nature to be suspended just because I might seem to want them suspended. I really don't want the laws of nature suspended. It is nice to think that something in the world is reliable and can be counted on.
The longer I live the more I see that nature is orderly-or,
at least, has rules and can be understood. I have been reading about DNA and about the heavenly bodies (stars in the sky-not on earth). I have recently taken courses on art, music, current events and geography, U.S. and English history, Islam, Christianity, and Judaism. I have the feeling, perhaps not a correct one, that I am integrating all of this into a more coherent world view than I have had before.
About religion and prayer-just suppose there is something to it!
Donald W. Bales 9 November 1999 (edited on 15 November 2003)
21. World Trade Organization
Today (30 November 1999) the World Trade Organization was on the news. In Seattle-the site of the meeting of the delegates to the World Trade Organization-many demonstrators were out in the streets. Included in them were blacks, labor union members, civil rights activists, and environmentalist. It is ironic that a policy put forward by the Clinton Administration would be opposed by to so many key elements of the Democrat Party. I gather that the demonstrators perceive that freer trade, especially with China, would act against their values. They also seem to think that free trade is in favor of big business. They may be right about that.
To me the main reason to oppose the entry of the Red Chinese into the W.T.O. is that they have tried to meddle in the political affairs of the U.S. and have bought or stolen military secrets from us.
The business people have their eyes on the huge (1.3 billion Chinese) market in China, and seem to have forgotten all about national security and I think the Clinton Administration has little understanding or concern about national security. Perhaps secrets were stolen under previous administrations, but there has been no suggestion that the secrets were bought. Also the knowledge of the thefts was only made known during the present Presidency. Efforts to look into it were delayed, if not blocked, for several months. I am not even sure that the breaches in security have been dealt with.
Although I have little knowledge about economics, I have read that free trade promotes prosperity. Ginny asked, "Prosperity for whom?" That was a reasonable question. It is true that free trade, which includes free flow of capital and technology in our present time, may cause some individuals and even some groups to lose good paying jobs. However, other jobs will be created to serve the production of exportable goods or services.
Now to write of pies. One theory is that a country has a pie. Some citizens do not have as much of the pie as seems fair. Question: What does "fair" mean. Does is mean that everyone should share equally in the pie? This is unrealistic, and so far as I know has never happened. Attempts to divide the pie in a different way-that is to take from some and give to others seems very humane, but this will cause those who produce more goods and services to feel mistreated and to cease to make the same effort as before. "From each according to his ability-to each according to his need" sounds good, but when put into practice in Marxist countries never to make the people better off materially, and surely worse off as far as freedom was concerned.
Free trade seems to make the pie bigger, and even though some may benefit more than others with a bigger pie there is a better chance that everyone will have more than if the trade were restricted. Giving a person an incentive by letting him or her benefit from his efforts will be more successful than having a disincentive situation.
Do not misunderstand-I do not believe in unfair trade. To me it is unfair for a country to allow imports freely from another country, but that other country not allow our exports into their country freely. In that case I think our negotiators should be hard nosed, and say, "If you don't let our stuff in, we won't let your stuff in." Our market is so attractive. Our people want a lot of stuff and have the money to pay for it so everyone wants to get into our markets. It seems to me that they need us more than we need them.
In the case of oil we are more dependent on other countries than I like. Most of our oil imports come from Canada, Mexico, Venezuela, and Nigeria. I wish that we were trying to develop a way to use solar energy. I don't think wind, geothermal, tidal, or water can produce enough to make much difference. Atomic power had the drawback of hazard-the hazard of a plant blowing up (or being blown up), and also the hazard of the storage of long-lived atomic waste.
So as you can see I believe in free, but fair, trade.

22. Adding Prescription Drug Coverage to Medicare
The Medicare system is already in trouble. When the Baby Boomers retire, the costs will really go up. The coverage has been promised and the promises should be kept, and will be. Not because the politicians are honorable and keep their word. The older people vote and if they don’t get their coverage, they will vote the rascals out.
It doesn’t make any sense to add another entitlement to a system that is already over committed. The drug costs will be just like all other programs. The cost will be a lot more than predicted.
The majority of the elderly already have drug coverage. The proposed Gore plan if enacted will encourage the corporations to drop their present drug-covering policies, and the eighty percent of seniors already covered will be added to Federal list.
Federal drug coverage will lead to the temptation of lawmakers to institute price controls on drugs. That will be a disaster. It will dry up the motive for developing new drugs.
The cost of drugs could be lowered if the excessive judgments handed down by sympathetic, but naive, juries were somehow controlled and a limit put on amount. At present, a large percentage of any judgment goes to the lawyer. We have a new class of millionaires-plaintiffs’ lawyers.
The suits against makers of legal material is another scandal. Every one knows, or should know, that cigarettes are harmful. Every package has a warning on it. The same thing applies to gun makers. It is the criminal who uses the gun that causes the problem and not the gun. The only effect of gun laws would be to make it harder for law abiding citizens to get one. The laws will not prevent criminals from obtaining guns. However, passing gun laws will make some people feel better, even if research shows that they don’t help.

23. The Tax Cut
I believe that we citizens of the United States are over-taxed. When the average tax-payer pays more in taxes than he or she does for food, clothing, shelter, and transportation, the situation becomes ridiculous. Now that we have projection of an enormous deficit, it seems only fair that taxes be reduced.
First: If the money is left in Washington, the temptation to spend it will overwhelm even conservative Republicans-to say nothing of the effect on the tax and spend Democrats. It says in the Lord’s Prayer, "Lead us not into temptation but deliver from evil." So we should do that even though the Ten Commandments are not politically correct (even though every civilization has at least given lip service to the last six!)
Second: It may help to get some of the credit debt by citizens paid off. Of course, they may just spend the tax cut and borrow some more to get more into debt.
Third: In the past tax cuts have led to increases economic activity and the government has taken in more revenue even though a smaller percentage of the GNP.
Fourth: It isn’t right to take someone’s earnings and give it to someone else who hasn’t earned it.
Fifth: If one really believes in representative democracy, one must give the ordinary citizen credit for having some judgment. If he or she has the judgment to select the proper representative, he or she should have enough judgment to know how to spend his or her own money.
Sixth: I think the government is too big and trying to do too much. Much of what it does is wrong and doesn’t get the results hoped for or aimed at. We have a lot of unintended consequences.
Seventh: Often the intent of Congress is not carried out by the bureaurocrats or administators who carry out the legislation.
Eighth: Alan Greenspan has warned that paying down the debt before the Treasury Bonds come due would lead to having to pay a premium to retire them early, or, even worse, have the Government put the surplus in the private economy which would politicize the private economy and mess it up even worse than it is now by government regulation and lawsuits.
Donald W. Bales 8 March 2001

24. The Election of 2000
On November 6, 2000 we had the election. The outcome was very close and as I write a recount of the vote in Florida will determine who will be the next president. At this time Bush has a slight lead in Florida, but a recount is in progress. However, the absentee ballots have not been counted. A lot of service people use Florida as their legal address. I think they avoid an income tax that way. Service people usually vote Republican to a major degree so these votes should add to Bush's majority. All of the ballots in Oregon are mailed in. I don't think they have finished counting those, and the absentee ballots in Washington State and in New Mexico could change the electoral vote in those states.
Apparently the ballot in the Palm Beach area was confusing and a lot of voters voted for Pat Buchanan who meant to vote for Gore. And others punched two holes and so got their votes thrown out. There were said to be nineteen thousand of these. Buchanan got a lot more votes in that county than he did in the surrounding ones. The ballot was devised and approved by a Democrat, so it is not possible for the Democrats to blame this on the Republicans.
The map of the states going for each candidate was quite striking. Bush got twenty-nine or maybe thirty states, but Gore got the far West and the northeast-most of the big city states. Bush got forty-eight percent of the popular vote. Clinton got forty-three percent in 1992 and forty-nine percent in 1996. It is striking the incumbent vice-president had such a hard time when we have prosperity and relative peace. He should have been a shoo-in, but the Clinton scandals evidently played a part. Not only the Monica part, but other parts. Gore's exaggerations or lies didn't help him either, nor did his changes in presentation. The last minute story on Bush's DUI may have had more effect than people thought. The timing of the release of the information was suspicious. The newspaper in Kennebunkport knew of it three months ago. So I guess that was the "October" surprise that came in November this time.
The Congress is still narrowly Republican. The House majority is thinner, and the Senate is either 50 to 49 or 50 to 50. Of course, if Bush holds on, the Vice-President will get to vote in case the vote in the Senate is tied.
If Gore was to get in, then Lieberman would be Vice-President, and would have to give up his Senate seat. In that case the Republican governor of Connecticut would appoint a Republican to the seat.
The election didn't turn out as I hoped. I hoped that Hillary would lose, but she won. I hoped the Republicans would increase their majority in the House and Senate, and I hoped Bush would win more convincingly. But I'll take what I can get and be glad of it.
In my view, the less that the Federal government does, the better. Unless they want to undo some things they have already done in the past.
Donald W. Bales 9 November 2000

25. Dr. Bales Medical Aphorisms
"Taking a history is hard. The history is said to lead to the diagnosis in eighty-five percent of cases."
"Doing a targeted, but complete, physical examination may be even harder. The examination is said to lead to the diagnosis in ten percent of cases."
"That leaves five percent for imaging and chemical tests."
"Thinking about a case is the hardest task."
"The consultant is the one who does the rectal examination that no one has done."
"Being the last doctor to see a patient is an advantage. Often the previous attempts at history-taking have led the patient to remember crucial information that was not forthcoming earlier."
"More diagnoses are missed from not looking than from not knowing."
'You can't trust a patient-they will get all sorts of things wrong with them."
"Avoid saying or thinking "always" and "never."
"Be proud so that you can inspire confidence and can have the confidence to do for the patient whatever he or she needs. Be humble and realize you are not God, and that you don't know it
all."
"We cure a few, we help many, and we should comfort all."
"Remember the Golden Rule and treat patients and other doctors as you would want to be treated."
"Don't be slow in seeking consultation in difficult cases, especially, those that may have a fatal outcome."
"Keep thorough and up-to-date records. No one can remember all the details. Besides a record made at the time of the events can be your greatest protection in case of a lawsuit. The quality of the record correlates well with the quality of the care."
"People often lie about sex and chemicals. The patient wants your approval and doesn't want to admit the unhealthy things they are doing."
"You should assume that any woman between the ages of twelve and fifty is pregnant until you prove that she isn't. Sometimes they'll tell you the truth which can save time, expense, and errors."
"A physical examination is incomplete without a rectal examination in men and a pelvic and rectal examination in women."
"Be sure to diagnose and treat the treatable. It is very bad to miss a treatable condition. Be sure to diagnose the fatal even if it untreatable. The patient may need to make a will or change it or to become reconciled to estranged relatives or friends."
"Try to be a model and not a horrible example. People will watch what you do. Your actions may have more influence than your advice."
"Guard your own health. Avoid tobacco, abuse of alcohol, use of recreational drugs, obesity, lack of exercise, lack of vacations, and lack of attention to your wife and children. Try to find a way to deal with stress. Realize that you are not Superman and that you, too, have limits as to what you can stand."
"Remember that no one is indispensable. Any one of us can be replaced. If you got shot in the head, life would go on for your patients."
"In football, the coach used to say 'Don't let the blocker get into your body-use your hands to keep them away.' Don't let the patients get into your psyche, be caring but not too emotionally involved. If you do and the patient suffers or dies, you will be devastated and so be unavailable to help your other patients."
"It is sobering to think that unless a patient leaves your practice, they will die on you-unless you die first-no matter how good you are."
"A doctor can only do so much. So have mercy on yourself."
"Try not to think derogatory thoughts about your patients. There's no place for the word 'crock' or 'gofer'-even if the patient is poly-symptomatic and the physical examination is negative, he or she is still suffering and deserves what comfort we can give them. Psychiatric disease is just as real as cancer.
"Even malingers need compassion. Most of the time it will become known what they are and they will lose the respect of all worthy people. Psychiatric disease is real, and causes a lot of suffering and death."
"Be aware that depression is common and commonly missed. It is disturbing to have a patient kill himself or herself. Be sure you have done all you can to prevent it."
"In dealing with my patients, I had three goals: to relieve or prevent suffering, to prevent or ameliorate disability, and to avoid premature death. You should note, I didn't write 'prevent death' for sometimes death is the only relief the patient can hope for."
"Don't avoid your patients when they are dying. They may need you worse then than earlier. To be comfortable with a dying patient you have to come to grips with the idea of your own mortality."
"Don't do a test-chemical or imaging-unless it will contribute to the management of the case. That is, if the results of the test will not change the diagnosis, the treatment, or the prognosis, then perhaps it should not be done. An exception would trying to record some measurement to allow future comparison to see if the treatment is doing any good. For example, measuring the size of a tumor mass." (Added 8 July 2002)
Donald W. Bales, MD 12 January 2001

26. Parlor Partisans of the Poor
Several wealthy people purport to have great interest in bettering the status of the poor. Of course, most of them don't really know any poor people or have any contact with poor people. Their children go to private schools, but they are greatly opposed to vouchers for poor people. The public schools are fine for other people's children but not for their children! These partisans live in communities that have no poor people in them. They remind me of the "Parlor Pinks" of the past. These were liberal academics who sympathized with Communists and Socialists, but who never put themselves in any risk for their alleged beliefs. They still took the benefits of a capitalistic society-accepting their dividends and interest from their inherited wealth. I have sometimes thought that they were felt guilty about the behavior of their ancestors who accumulate the family fortunes and were expiating their guilt by dispensing the tax revenues taken from the working people to the poor. Some of them failed to give any of their own wealth-preferring instead to promote the drafted or commanded generosity of others.
Some of those that I suspect of belonging to the above group are the Kennedys and the Rockefellers and maybe the Fords, although the Fords have set up the Ford Foundation with their own money, as have the Rockefellers. I don't know of any charitable organizations that the Kennedy family have set up. But then the Kennedy fortune was not associated with any societal gain for the American economy.
A man that I had a lot of respect for-Thomas McCallie Divine told me once "Don, if you want to raise money for a worthy cause, don't ask liberals to contribute. Because they won't give you any of their money. No. If you want a contribution, go to a conservative. He will have money and he will give you some of it." That may not be a fair appraisal, but it was one I do remember.

27. Stem Cells
Recently we have had a lot in the news media about stem cells. These were first cultivated at the University of Wisconsin in 1998. President George W. Bush recently proposed a program allowing federal funding of research on stem cell lines already established, but not for any new ones. The current ones were obtained from in vitro embryos produced in conjunction with attempts to allow women to have babies who could not otherwise have them. These embryos were frozen when they were not implanted in a woman's uterus and if not used would be wasted.
The secular scientific people were dissatisfied with this since they would like all human embryo stem cell research to be supported with tax money. The religious people would like to have no tax money to support any human embryo research. At Johns Hopkins the stem cells were obtained from aborted tissues.
Adult stem cells can also be used. For example, for the past twenty-five years bone marrow stem cells have been used to treat some malignancies and some immune deficient disorders. Cord blood has stem cells in it also and it can be used as a source for stem cells.
Even though bone marrow transplants have been going on for a long time, all the kinks have not been ironed out. Graft failure is not uncommon and graft versus host disease is also common. The procedure is hard on the patient and doesn't always work and often causes death-20 or 30 percent. People over fifty are rarely chosen for this procedure. It is very expensive requiring up to four weeks in hospital, and is not always covered by insurance. So we may be a long way from clinical benefit from embryonic stem cells. The anti-religious liberal left is in favor of unlimited stem cell use, while the religious conservative right is in general opposed.
One problem is very vexing. When does personhood start? If one has a soul, when does one get it? Does that matter? This is the theme of the religiously inclined. The atheist group has a different view. All this is related to the problem of abortion and cloning. Are there some things that we can do that we ought not to do?
Recently I saw an article stating that stem cells had been used to produce red blood cells. If this turns out to be practical, it will be a great help. I understand that there is a blood shortage throughout the country. This was true even before the Trade Center and Pentagon destruction with all the injuries resulting from that terrorist activity. 12 September 2001

28. Terrorist Attacks on the Trade Center and Pentagon
Today, September 11, 2001, we had what I am calling "The Pearl Harbor of 2001." Hijackers flew passenger jets into each of the twin towers of the Trade Center. This led to the destruction of these buildings and the death of the ten thousand or more people in the towers as well as five thousand tourists. A section of the Pentagon was also hit.
It seems to me that the level of the attacks on the towers had to have been chosen by an architect or engineer or both. This would point to a sophisticated group of conspirators. We need to find out who is behind this and snuff them out. I don't mean the misguided zealots who are the foot soldiers in this war, but the people who provide the money and plans for it. Those who provide a haven for these terrorists are also guilty, and should also be punished.. The investigation should be quick as should the punishment. The way to kill a snake is to cut off its head.

29. Afghanistan
Evidence suggests that humans lived in northern Afghanistan about 50,000 years ago and that farming communities there were some of the earliest in the world. After 2000 B.C. successive waves of people from central Asia moved into the area. In the first century A.D. an Aryan race, the Kushans, moved in. From the 3rd to the 8th century Buddhism was the predominant religion. At the end of the 4th century a Turkic people from Central Asia called the White Huns of Ephthalites moved in. After them some kingdoms were Hindu and some were Buddhist. In the 7th century the Arabs ruled the provinces of Herat and Sistan. After the Arab armies passed the people of those provinces revolted and returned to the old beliefs. In the 10th century Muslim rulers called Samanids from Bukhoro from Uzbekistan extended their influence into the area. A Saminid established the Ghaznavid dynasty. Mahmud, their greatest king, ruled from 998 to 1030 and spread Islam throughout the country.
In mid 12th century the Ghurid held sway in the west central area. This group was supplanted by the khwarizim Shahs, who in turn were swept away by the Mongol Genghis Khan. Near the end of the 14th century Tamerlane (Timur Lang) conquered the land on his way to India. His sons and grandsons, the Timurids, could not hold onto control. Babur, a descendant of both Genghis Khan and Tamerlane, took Kabul in October 1504 and then moved on to India where he established the Mughal (Mogul) empire.
In the 16th and 17th century the area was fought over by the Moguls in India and the Safavids in Persia.
In the 18th century Nadir Shah, the king of Persia, used the Abdali tribe of Pashtuns against the Moguls. After Nadir was assassinated in 1747, Ahmad Shah, who had held a high post in Nadir's army, established himself in Kandahar, and later was proclaimed Shah. The Afghans extended their rule to Delhi and Kashmir in the east, to Amu Darya in the north, and into northern Persia in the west.
In the 19th century palace rivalries and internal conflicts reduced the Afghan empire to roughly its present boundaries. The British in India and the Russians tried to bring the country under their control. This rivalry, called "The Great Games" led to two wars: the First Anglo-Afghan War (1838-1942) and the Second Anglo-Afghan War(1878-1880). After the second war the British had control of the foreign policy of Afghanistan.
In 1880 Ald-ar-Rahman Khan became emir. In 1893 the Durand Line border was drawn by the British between Afghanistan and India. Afghanistan became a buffer between Russia and the British. Rahman's son, Abdullah, reigned from 1901 to 1919. He tried to introduce some modern education and industry. His son, Amanullah, started the Third Anglo-Afghan War to end British control of foreign policy. The resulting peace treaty recognized the independence of the country.
Amanaullah tried to modernize the country. In 1926 he took the title of king. His attempt to get the women to give up the veil and the men to wear Western clothing offended religious and ethnic leaders. A revolt broke out and Amanullah left the country.
In 1930 four brothers restored order and one of them, Muhammed Nadir Shah, became king, but he was assassinated in 1933. His son, Muhammed Zahir Shah, became king. The royal family ruled the next four decades. Afghanistan joined the United Nations in 1947.
In 1953 Nadir's nephew, Daud, became prime minister, and started to modernize the country with the help of the Soviet Union. Relations with the Soviets deteriorated after Daud called for self-determination for the Pathans in northwestern Pakistan. In 1963 Daud was removed as prime minister to improve relations with Pakistan.
In 1964 a new constitution was instituted changing from an absolute monarchy to a constitutional monarchy. A severe drought in the early 1970's caused a lot of hardship and the government was less popular.
In 1973 Daud overthrew the monarchy and declared the country a republic with him as president. He tried to play the West against the Russians, but his dictatorial government was opposed by both the leftists and the traditionalist ethnic leaders. The leading leftist party, the PDPA, split into pro-Soviet Parcham faction, and a much more radical Khalq faction. They joined in 1976 to oppose Daud.
In 1979, after Daud tried to crackdown on the PDPA, leftist military officers overthrew him. The PDPA leader, Taraki, became president. He proposed some sweeping social changes. In late 1978 Islamic traditionalists and ethnic leaders, who objected to the changes, began an armed revolt. By the summer of 1979 the rebels got control of most of the country. Tarika was deposed and later killed.
His successor, Amin, tried to suppress the rebels and resisted Soviet efforts to make him change his policies. On December 25, 1979 Soviet forces invaded. They soon controlled Kabul and other centers and executed Amin December 27. The leader of the Parcham faction, Babrak Karmal, was installed as president. The rebellion continued for the next ten years. Three million refugees fled to Pakistan, and one and a half million fled to Iran. The rebels operated from Pakistan and to a lesser degree from Iran. They were supported by the United States, Saudi Arabia, Iran, and China. By the mid 1980's the US was sending hundreds of millions of dollars each year to the rebels. The Democratic Republic of Afghanistan was born on April 27, 1978.
By 1986 118,000 Soviet and 50,000 Afghani troops were facing perhaps 130,000 guerillas. In that year the US began to supply Stinger missiles which could shoot down Soviet helicopters. In May 1988 Afghanistan, Pakistan, USSR, and the U.S. agreed to end foreign intervention in Afghanistan. The Soviet withdrawal was completed in February 1989.
The rebels had not signed the agreement continued to fight against the government with weapons from the US through Pakistan. Najibullah, the head of the government continued to get aid from the USSR. In late 1991 the US and the USSR agreed to stop helping the factions. The Najibullah government fell in 1992 and an Uzbek and a Tajik from the north and central mountains took control in Kabul. They tried to keep the Pashtun leaders, who had usually held the power, out of the government. Kabul was besieged, beginning in 1992, at first by various mujahideen factions, and then by the Pashtun dominated Taliban, who wanted to reestablish Pashtun dominance.
The Taliban emerged in the fall of 1994 as a faction of guerilla soldiers who identified themselves as religious students. It started in the south and worked its way to Herat in the northwest and Kabul in the east. It made gains against the government using armor, heavy rocket artillery, and helicopters against government forces. They said their missions were to disarm the other factions and impose their strictly orthodox version of Islamic law. In spite of efforts by the government the Taliban took Kabul in September of 1996. In the late 1990's the Taliban controlled most of the country.
In 1998 after the bombings of the US embassies in Kenya and Tanzania, cruise missiles were fired at alleged terrorist camps in Afghanistan.
In early 1999 the UN produced an agreement among the warring factions for a cease-fire and a shared government. However, fighting broke out again almost immediately.
About the size of Texas, 770 miles east to west, and 730 miles north to south. Khyber Pass 3500 feet. Border countries: China 76 km, Iran 936 km, Pakistan 2,430 km, Tajikistan 1,206 km, Turkmenistan 744 km, and Uzbekistan 137 km. Arid to semi-arid, cold winters and hot summers, mostly rugged mountains, plains in north and southwest. Arable land 12%, permanent pasture 46%. Severe environmental problems: soil degradation, overgrazing, deforestation, desertification. Population 23,838,797 estimated 1990.
Life expectancy at birth 45.88 (US 76.7)
Fertility rate: 5.87/woman (2000 est.)
Birth rate: 41.82/1000 (US 14.5 1999)
Death rate: 18.01 /1000 (US 4.717)
Net migration rate 11.54/1000 (2000 est.)
Languages: Pashtu 35%, Dari (Persian) 50%, Turkic 11%
Literacy: 31.5%
GDP: $21 billion
GDP-per capita- $800 (1999 est.)
GDP-by sector
Agriculture: 53%
Industry: 28.5%
Services: 18.5% (1990)
Labor force: 8 million (1997 est.)
Exchange rate: 3000 afghanis to the dollar
Radio stations: AM 1, FM 1, shortwave 1
Radios: 167,000 (1999)
Railways: 24.6 km
Highways: 21,000 km Paved 2,793 km Unpaved 18,207
Waterways: 1,200 km, chiefly Amu Darya up to 500 DWT
Pipelines: petroleum products Uzbekistan to Bagram and Turkmenistan to Shindand, natural gas 180 km
Airports: 46 (1999 est.)
Military manpower-availability: males 15-49 6, 401,980
Military manpower: males age 15-49 fit for service 3,432,236
Illicit drugs: world's largest illicit opium producer >Burma a major source of hashish
US embassy in Kabul closed since January 1989 From various sources: Encarta and The World Factbook

30. Profiling
Many have written and spoken about how bad profiling is. If it is done to find disease, I think that it is just fine. For example, one would not expect to find a lot of venereal disease, pregnancy, or cervical cancer in nuns. One would not choose an ectomorph (thin small bones not much muscle) for one's weight lifting team. One wouldn't choose a five foot tall boy or girl to be center on one's basketball team. One wouldn't choose a fat girl for the ballet class.
If all the terrorism done by foreigners against the U.S. have been dark skinned men with Middle East accents, why would one look among white Germans. If a high percentage of the drug traffickers are black and have Spanish accents, why would one look at white men with a car full of children?
Willie, the Actor, Sutton was a famous bank robber. He was called the Actor because he was good at fashioning disguises that he used to get out of jail. A reporter asked him one day, "Why do you rob banks?" His answer, "Because that's where the money is!"
When trying to get the most mileage out of one's personnel and time, going "where the money is" is the way to do it.
So I don't think profiling is so bad. Of course, if it is just used to harass a certain group, it's wrong, but if it is being done to get the job done efficiently, it's the way to go.
One reason we looked so bad about the attack was that we had hamstrung ourselves in information getting against enemy groups inside and outside the country. In my opinion the CIA and FBI were not given the tools they needed to carry out their jobs.


31. Predicting the Future
Right after the election the Democrats tried to say that George W. Bush was not a legitimate President, and that he was not qualified for the job. The attack on September 11, 2001 surely changed things. No longer do we hear about chads or stolen elections or election by the action of the United States Supreme Court. Instead we hear a good number of dedicated Democrats saying they are glad to have W. in the White House rather than Al Gore. Before it was patient's rights and insurance coverage for the uninsured and other Democrat ideas. Now George Bush has high approval percentages and everyone is more concerned about the terrorists. Before few seemed to care about national defense, but now nearly everyone is for it. We still have the academics and the U.S. haters making their usual stupid statements.
When Falwell and Robertson suggested that the attack was due to bad behavior in our society the media made a big deal out of it, but when Bill Clinton said that we deserved the attack because of the bad behavior of the Crusaders, the bad treatment of the American Indians (excuse me, I meant to write the indigenous people of the Turtle), and slavery and mistreatment of the blacks, the mainline (I won't say mainstream because I do not think the media reflects the values of the majority of U.S. citizens) media had little critical to say about it.

32. International Monetary Fund
This organization is supposed to help countries with their economic problems. However, they often want the countries to raise taxes when the country is in debt and in recession. This often seems to make things worse. The usual problem is that the country has spent more than it took in and has borrowed from foreign sources. The way to correct the problem is to live within their means rather than to raise taxes when there is a downturn in the economy. They also often suggest devaluation of the money. This leads to a flight of capital or a lack on capital inflow. For supposed experts they don’t seem to have a clue.

33. Democratic Socialism
This morning I heard Christopher Morris of the Philosophy department of the University of Maryland talk about Democratic Socialism. He noted The Netherlands as one of the countries. Also the Scandinavians countries were mentioned. Sweden is noted for its comprehensive social services-welfare from before birth until death. Sweden remained neutral during both WWI and WWII and benefitted from selling to both sides. Denmark, Norway, and Finland were involved in WWII.
All the free countries of Europe, that is, those outside the Iron Curtain, have benefitted by being protected by the United States. None of them have had to spend much on national defense. So, in a sense, the U.S. taxpayer has subsidized the socialistic policies of the those countries. They could not have afforded spending so much on social services if they had been forced to provide for their own defense.
I have read that no additional jobs have been added in the past two decades. I also have read that the rate of unemployment is quite high in all the countries of Western Europe. However, they have had to allow immigration of people willing to do the menial work that their own citizens do not wish to do. Although they have many services, such as universal not-paid-for-by the-patient health care, drug coverage, good unemployment benefits, housing subsidies, liberal holidays and paid vacations (at least, in Germany), and government funded child car, they also have very high taxes-averaging fifty percent. I have read that the Swedes have high rates of alcoholism and a lot of out-of-wedlock pregnancies. The latter may not be such a problem with the welfare state.
The European Union has about three hundred million people and a big gross national product. It seems to me that they should bear more of their defense costs-the more so since they want to have a say in what the U.S. does to protect itself. They seem to want to share in decision making, but not supply the money or the men to carry out policies. They were unable or unwilling to take care of problems in their own backyard in the Balkans. They did nothing in Bosnia or Kosova until the U.S. provided the leadership and the military might. The actions there were really not in our essential national interests. Oh, it was motivated by humanitarian feelings, but it really wasn’t our business. Although in both cases it was for the welfare of Muslims, the U.S. got no credit in the Islamic world. Nor did we get any credit for our attempts in Somalia or Kuwait-two other Muslim areas. Of course, the action against Iraq was motivated by fear that the Saudi Arabian oil fields would come under the control of Saddam Hussein.

I looked up an article on democratic socialism and all through the article the hammer and sickle were displayed to the left of each paragraph. Now the hammer and sickle was the symbol of U.S.S.R. communism which was certainly not democratic.
I perceive that socialism presents an idealistic goal in that it holds the following idea: from each according to his ability, to each according to his need. To me that is against human nature. What would motivate someone to work hard and make a big contribution only to see the fruits of his efforts go to someone who worked less hard and made little or no contribution to the society or the economy? I do find the exorbitant pay of corporate executives to be obscene, however..
As you can see, I don’t have a very good opinion of socialism. I know that capitalism has its flaws, but it has provided more material benefits with less loss of liberty than any other system. Of course, we have a mixed system in the United States. It is a capitalism with a lot of government regulation and intervention. The socialists point to the evils of corporate bureaucratic control, but is government bureaucratic control any better? At least, a corporation can fail, and be replaced by a more efficient corporation, but governments can only be replaced by revolution or by the ballot but usually government mistakes are paid for by the taxpayers.
Donald W. Bales 16 March 2002

34. "Eating Too Much Will Make You Fat"
The above would seem to be so obvious that you may wonder why I wrote it. However, there is a class-action lawsuit being brought against four fast food chains-McDonald's, Burger King, Wendy's, and KFC by a man from the Bronx named Caesar Barber (70 inches tall and 270 pounds). He blames them for his being obese. Personal responsibility, like logic, justice, and common sense, is no longer in style and is not politically correct. It seems that nearly everyone considers himself or herself a victim, and always a victim of some person or some organization with deep pockets. Caesar Barber may win his suit. It's not what is true, but what a judge and /or a jury says is true that counts in the legal system
The tobacco companies had to pay off billions for selling a legal product to people-all of whom bought it voluntarily. Some would say that the tobacco companies lied, but many politicians and others in high places lie like a rug with relative impunity. When I was a little boy back in the 1920's people called cigarettes "coffin nails" implying that each cigarette smoked was driving a nail in your coffin (some coffins were wood back then). It seems that ordinary uneducated people knew then that smoking was harmful. After 1964 the surgeon-general of the United States had a warning put on the cigarette packages and there have been many articles written in newspapers and magazines about the harmful effects of smoking. Probably the only doctor in town who is more opposed to smoking than I am is Dr. Smiddy, so I hold no brief for smoking, but I do think that the law was misused in the suit against the tobacco companies. A large chunk of the settlements went to lawyers making a whole new group of millionaires. The rest that was supposed to be used to pay for treatment of smoking-related diseases such as lung cancer, emphysema, and heart attacks, and for programs to help prevent young people from starting the habit was mainly used for other purposes. Talk about greed-the lawyers who got the percentage and the attorneys-general of the states were the greedy ones.
This article really was supposed to be about obesity, not smoking, but I had to chase that rabbit while I was on its trail. Everyone knows or should know that overweight is the result of taking in more calories than are burned up. It's just a matter of arithmetic. If you take in more calories than you burn up, you gain. If you take in fewer calories than you burn up, you lose. People say, "But my whole family is fat!" I suspect if you go to those homes, you will find that the table is groaning under the load of good things to eat, and that the people are eating a lot of it. Some say, "It's my thyroid." I never saw a case where treating a low thyroid condition made someone get thin. One lady came in to see me one day and said, "Doctor, do you think my overweight could be due to a glandular condition." I was feeling humorous that day (but then I feel that way every day), and said, "I'm sure it is!" "Which gland do you think is causing the trouble?" "The salivary glands." "Oh." And her face fell. I felt a little guilty about saying that-but not much. Some twin studies have shown, however, that twins reared apart wind up with about the same weight. I don't believe that those extra calories got in by osmosis though! They had to be eaten.
It takes 3,500 calories to make a pound of fat, so each pound of extra fat on the body means that the persons have taken in 3,500 calories more than they burned up. Protein has four calories per gram, carbohydrates (sugars and starch) have four, fats have nine, and alcohol has seven. I put this in to identify the enemies. It is interesting, amusing, but a little sad, to see someone use artificial sweeteners in their coffee or tea and then have apple pie a la mode for dessert. My definition for a dessert: Something that is so good that you will eat it when you are already full.
Jews, in general, tend to get heavier as they get older, but none of the Jews put in concentration camps came out fat. The reason: They got very little to eat and they were forced to work hard. I never personally viewed any of the people who were rescued from the camps, but I have seen newsreels and documentaries. Those people were literally skin and bones. They were too thin even for me! Many of my former patients would never believe that I would say that about anyone. One day one of my patients came up to me in the restaurant and said, "Oh, do you eat?"
Billions of dollars (thirty-three billion in 1990) are spent on weight-loss schemes. There are no magic or easy diets. Most of them work if the person sticks to the program, but most people will regain their weight. It requires a great deal of nervous and emotional energy to diet. It is a problem three times a day, twenty-fours hours a day, seven days a week, fifty-two weeks a year, and for many years. You can avoid taking the first drink or the first cigarette, but no one can avoid taking that first bite. People are always wanting a simple easy solution to difficult problems. They do not find them. The prescription is simple-diet and exercise. It is the carrying out of the prescription that is the hard part. After more than fifty years of fighting the "Battle of the Bulge"-for others- not myself-I have decided that exercise plus dieting is more likely to help someone lose weight and to keep it off than just dieting alone. A former patient that I saw at Piccadilly today told me she showed her new doctor the last prescription I wrote for her, "Pitiful Portions." She was still fat, though, so the prescription didn't do her any good. She did get a laugh out of it, though.
Studies show that obesity causes a high percentage of the cost of health care for the elderly and is also one of the main causes of premature death. One mechanism is that type two diabetes-the type that comes on after age forty and is associated with obesity-is on the rise-to epidemic proportions. Type two diabetics comprise eighty percent of all diabetics. Type two is more hereditary than type one-the type that occurs in children and young people. Diabetes does not cause obesity. It is the other way around. Obesity promotes the development of type two diabetes. Type one diabetics are almost always thin. They will die without insulin whereas type two patients can often get by on diet, exercise, and/or oral tablets. Many of them have the disease for quite a while and don't even know it. Many obese diabetics could restore their glucose tolerance to normal. At least their fasting and the two-hours-after-a-meal glucose levels and their hemoglobin a1c level could also be restored to normal. (Hemoglobin 1ac is a test that looks back six weeks and tells the doctor whether the blood sugar has been normal during that time.)
What is bad about diabetes besides having to test your blood sugar, diet, take pills, or insulin? (I didn't mention exercise because it is very hard to get anyone to exercise). The complications can be divided into the big artery problems-arteriosclerosis (hardening of the arteries) of the coronary arteries-heart attacks and angina; of the arteries of the brain-strokes; and of the arteries of the legs-gangrene and amputation; and the little artery problems-of the eye causing blindness (one of the main causes of blindness in the U.S.); of the kidney causing kidney failure (diabetes is the commonest cause of kidney failure) requiring dialysis or a kidney transplant; and of the nerves of the lower extremities causing pain and numbness and sometimes leading to painless fractures of the foot bones and even amputation.
The sad thing about it is that if a fat person will use diet and exercise to attain and maintain a normal body weight, many of them will not even get diabetes or, if they already have it, they can get rid of it or, at worst, can make it less severe. I had a patient who had the disease. She didn't want to take tablets or insulin so she dieted, kept her weight down, and, as far as I know, doesn't have the disease now (I retired five years ago). I know a woman who was diabetic, but lost one hundred and seventy pounds. She was diabetic as are many members of her family. She is no longer diabetic-at least, her fasting blood glucose levels and her two-hours-after-a- meal blood glucose levels and her hemoglobin 1ac levels have all returned to normal. She used diet and exercise to lose all that weight over a two year period. So fat people can do it. It seems a strange thing for an internist to write, but I always wanted to do as much for a patient as I could without medication. Any medication can have adverse effects, as well as good effects. But life style changes are very hard to sell so I didn't get to treat without medications very often.
To quote Benjamin Franklin again, "An ounce of prevention is worth a pound of cure."
I always tried to sell preventive medicine, and tried to relieve suffering, ameliorate disability, and prevent premature death. Note the word "premature." Sometimes death is the only relief that someone living with pain, disability, and no hope of recovery can have.
Donald W. Bales, M.D. 29 August 2002

35. Immunization
I do not usually write letters to the editor, but a letter in the Times-News on 12 August led me to look this subject up on the Internet to try to be as up to date as possible and to send in this letter. We doctors have a hard enough time selling preventive medicine without sabotage of our efforts. I was not a pediatrician. I was an internist and have been retired for five years (after forty-five years of practice in Kingsport), but I am still interested in medicine and especially in preventive medicine. As Benjamin Franklin said and wrote so many years ago, "An ounce of prevention is worth a pound of cure".
In 1998 12 children were evaluated and the conclusion reached that there might be a link between MMR (measles, mumps, rubella-rubella is German measles) and autism. A later study on 500 children disproved this connection.
According to the CDC (Federal Center of Disease Control) before MMR there were three to four million cases of measles each year with a death rate of 450. Another 20% were hospitalized with the complication of encephalitis (inflammation of the brain) and brain damage. Since the vaccine has been available and used, practically all the deaths and complications have been eliminated. Most measles cases are imported now. In 1964-1965 there were 20,000 cases of congenital rubella with 2,100 deaths and 11,250 miscarriages, 11,600 babies born deaf, 3,580 born blind, and 1,800 born retarded. Mumps can cause sterility when it occurs in mature males, and can cause meningo-encephalitis (inflammation of the brain and its covering).
Recently there was a theoretical concern about the amount of mercury in vaccines used as a preservative in the Hepatitis B vaccine. At the urging of American Academy of Pediatrics the mercury was removed and the vaccine reformulated. Approximately 90% of infants born of mothers infected with the Hepatitis B virus will contract the disease and many will go on to develop chronic hepatitis (inflammation of the liver), and some will get cirrhosis of the liver, and some will develop liver cancer. Approximately 30% of those children who contact the disease have no predisposing risks, such as living with carriers, needle-stick, or blood product exposure. The only sure way to prevent the disease in these infants is by the vaccine.
Another researcher alleged that the Hemophilus B (HIB) vaccine given at 2, 4, 6, and 15 months caused an increase in the incidence of Juvenile Diabetes. He suggested only one vaccination at age 2. A review of his data showed faulty analytical methods. A ten year follow-up showed no difference in early and late vaccination groups. HIB attacks in the first six months of life. Before vaccination began, one in 200 children got the disease killing 600 per year and resulting in deafness, mental retardation, hydrocephaly (water on the brain), and seizures in others.
The U.S. Institute of Medicine (IOM) of the National Academy of Sciences - a private, independent organization created by the federal government to be an adviser on scientific and technological matters -- has established an independent expert committee to review immunization safety concerns, including thimerosal in vaccines. On October 1, 2001, the IOM Immunization Safety Review Committee issued its report "Thimerosal-Containing Vaccines and Neurodevelopmental Disorders," concluding, "The hypothesis that thimerosal exposure through the recommended childhood immunization schedule has caused neurodevelopmental disorders is not supported by clinical or experimental evidence."
After 20 years of experience Chickenpox vaccine has been found to give good long-lasting (90%) protection. Some children infected with the chickenpox virus get secondary bacterial infection with staphylococcal and streptococcal bacteria.
Vaccines have eliminated polio from most of the world and the smallpox virus remains only in some laboratories. There have been no cases of smallpox for many years. Vaccines are our best weapon against those diseases that formerly were disabling and killing so many children.
In medicine and in life, we should always be aware of the risk/benefit ratio. In the case of immunizations, the ratio overwhelmingly favors immunizations. Donald W. Bales M.D.

36. Tobacco
The successful lawsuit against the tobacco companies was a miscarriage of justice. From the time I graduated from medical school in 1946 up to the present I have been opposed to the use of tobacco. Of course, the scientific basis for that opposition became more convincing as time went on. When I was a boy growing up in Morristown, I would hear people refer to cigarettes as "coffin nails." The implication was that each cigarette smoked was putting another nail in your coffin. In 1964 the surgeon-general of the United States came out with a statement about the health hazards of smoking and warnings were required on the cigarette packages.
So you can see that I am not in favor of tobacco, but I am in favor of personal responsibility. Everyone knows, or should have known, that smoking and, indeed, use of tobacco in any form, is likely to be harmful to one's health. But tobacco is a legal substance. In fact, the Federal government subsidizes the tobacco farmers, thereby promoting the cultivation of it, and, by inference, approving of its use.
It is estimated that 400,000 deaths annually are related to the use of tobacco. Some say there are only 225,000 deaths, but that is still a very large number. We are alarmed and upset about 3,000 deaths in the Twin Towers attack, and I had and still have a cold anger about that. Tobacco is a much more common cause of serious disease and death than car crashes, illegal drugs, AIDS, and alcohol all added together.
Aside from the health hazards using tobacco is very expensive and will become more so. In New York City a package of cigarettes costs $7.50 a pack. At one pack a day that comes out to $2,737.50 per year. Just think what someone could do with that much money. Of course, it probably wouldn't be that much in some other places. The money obtained from the suits is mostly not going to prevent young people from starting nor for providing health care for people with smoking related disorders. A lot of it went to make a whole new group of millionaires-lawyers. The states have used the money for all sorts of things such as budget shortfalls and other purposes having nothing to do with the stated intentions when the suits were brought. If everyone stops smoking, the tax receipts will go way down so the authorities are being rather schizophrenic about it.
What are the health hazards of smoking cigarettes? Smoking is a strong risk factor for coronary artery disease (heart attacks and angina), for emphysema (chronic obstructive lung disease), for lung cancer, for urinary bladder cancer, and for cancers of the mouth, larynx, and esophagus. Women who smoke have more adverse effects from birth control pills. Smoking has an unfavorable effect on the fetus.. Cervical cancer is reported to advance more rapidly in women who smoke. Chewing and dipping are closely correlated with cancer of the mouth and tongue. It usually takes about twenty pack years to get into serious trouble with smoking cigarettes. Of course, the irritation of the bronchial mucosa and the cough comes on right away. Primary pipe and cigar smokers are said to have less risk than cigarette smokers. (Primary means the smoker started with a pipe or cigar.) But secondary pipe and cigar smokers are at higher risk. (Cigar and pipe smokers who learn to smoke on cigarettes are called secondary.) It is said that secondary smokers inhale the smoke more-I have no real personal experience with the use of any type of tobacco. Oh, when I was a child I tried rabbit tobacco, Indian cigars, corn silks, coffee, and cigarette butts, but I really didn't inhale. I even tried to chew Beechnut chewing tobacco and even tried long green once. I even tried snuff once, but I didn't like it-too nasty for me.

Some investigators think that nicotine is more addictive than cocaine. That may explain why it is so hard for some to give up the habit. I have seen smokers smoke up to their dying day. Of course, they all eventually stop smoking-when they die. Those who are unrepentant sinners may smoke again if they go the hot place. This doctor has to have his grim jokes. But grim jokes are better than no jokes at all.
Some wags have suggested that smokers should be given a financial reward. Many of them will never collect any social security except by being declared totally and permanently disabled before they reach the age of retirement. Many will not live until age sixty-five. However, it is expensive to care for someone with coronary disease, emphysema, or cancer so there will be an extra load on Medicare and insurance companies. The extra costs will be paid by non-smokers. It sometimes takes a long time for these diseases to cause death. That may cancel out the savings from not collecting Social Security payments.
Smoking is said to cause premature aging of the skin. And, of course, the smell of tobacco is not very inviting. Some people don't like to kiss a smoker. This might dissuade some women who are on the hunt to stop smoking. Some wags have suggested that girls who smoke are easier, though. That might give them an edge in the hunt. Smokers tend to pollute the atmosphere. Having a smoking section in a restaurant or other public establishment is like saying it is okay to urinate in a swimming pool.
I tried every trick I could think of to get my patients to quit smoking. I would give them literature to read. I would coax them. I would try to scare them. I would have ordered them if I had thought they would obey. One day I was talking to a patient and I said, "I've tried to inform you, I've tried to warn you; I've tried to scare you, but nothing seems to have worked. I don't know what else I can do." The man said, "You could pray for me." I was taken aback-not that I have anything against prayer. I don't feel it is part of a physician's practice to try to push religion except maybe by example, but I realized he was serious. So I said, "Well, let's bow our heads and we'll pray silently for you to find the strength to stop smoking." "Oh, no. You must pray out loud." Again I was taken aback, but said, "Let's bow our heads." Then I prayed, "Oh, Lord. Help this man to find the will to stop smoking." He went on his way (I don't know whether he went rejoicing or not.) He came back a year or two later for his annual physical. As I was reviewing his health history, I asked, "Do you still smoke?" He looked at me incredulously, and said, "Don't you remember praying for me?" So he had quit. I was preening myself about his success and told another man about what had happened. He, too, was a smoker. He went on his way and he returned in a year or two for his annual physical. I asked him, "Do you still smoke?." He had a surprised look on his face and said, "Don't you remember telling me about praying for that man?" So I didn't kill two birds with one stone, but I did get two smokers with one prayer.
I must relate one more story about smoking. A woman patient of mine was married to a United Methodist preacher. She asked me if I would preach at her husband's two churches on the fifth of October. I really didn't want to do it, and, since I was scheduled to be out of town that Sunday, I said, "I'm sorry, but I'll be out of town that day." "Well, how about the next Sunday?" I could see I wasn't going to get out of it, so I said I would do it..
So on October 12 I went to Cloud's Bend Methodist at nine. My message was entitled "Stewards of the Body." I found an Old Testament text that I thought was suitable, and a New Testament text. I don't remember what they were, but one of them went something like "Ye are the temple of God." I don't think the writer's point was exactly on target for my talk, but it came close enough. The theme of the talk was about how we are entrusted with our bodies and we should be good stewards of the wonderful gift we have received. I talked about unhealthy life styles and tried to outline what persons could and should do to promote health. At eleven I went to Depew's Chapel to speak a second time. The minister's older son was in seminary at Emory and at that service the minister's younger son taped my remarks to send to his brother in Atlanta.
Two years later I was in a grocery store and a man sidled up to me and asked, "Aren't you Dr. Bales?' "Yes, I am." "Didn't you speak at Cloud's Bend Methodist two years ago?" "Yes, I did." "I thought so. I went home after that and stopped smoking!" That made my day!
I must tell one more story. One of our surgeons had operated on this man for an abdominal aneurysm. The surgeon thought the man should have a medical doctor to follow his case and he asked me to take him. I was really busy then and really didn't want to take on a new patient. I said, "I'll take you if you will stop smoking." He said okay and did stop. However, about seven years later he came down with a lung cancer anyway. I thought it was unfair and I would have sent a night letter to God in protest, but I didn't know how to do that. He stopped too late. He was a fine old man (I probably wouldn't call him old now that I am eighty myself). Most of the time there is no justice in disease. Like the rain, disease and death fall on both the just and the unjust.
So, as you can see, I am very much against the use of tobacco, but it was not the fault of the tobacco companies that these people had health problems. It was their fault. But in these latter days, no one is responsible for his or her mistakes, it's always some one else's fault and it usually is someone with deep pockets.
As the old hymn says, "It's not my brother nor my sister, but it's me, Oh Lord."
Donald W. Bales, M.D.

37. Exercise 24 September 2002
The only thing harder to do than have people lose weight is to get them to exercise. I don't believe that I ever got anyone to exercise. I had a couple of men come to me to get clearance to exercise, but they had already decided that they were going to do it before they saw me.
At the risk of making this about me, I am going to relate something about my own experience with physical activity in the hope that it will help others to be more active. I was active as a small boy. The Tarzan funnies came out about then and I was fascinated. I used to spend a lot of time climbing trees. I had a small bicycle early on, but it didn't have a coaster brake on it. Later on my father got me a pony when I was eight and I learned to ride it pretty well. It was only about half broken and, when I tried to get on, would try to kick forward with his back foot. I was more adventuresome then so that suited me just fine. He would also kick up if I rode behind the saddle. So, of course, I would ride back there a lot.
I played sandlot baseball and yard tackle football. My parents had me take some swimming lessons.
When I was in the ninth grade I went out for football, but that year I only got into the game with the varsity on a few plays. I played enough in the tenth grade to get a letter, and was a regular in the eleventh and twelfth grades. I played forty-eight minutes in the 1939 game when Morristown beat Knox Hi for the first time in twenty-two years. We modestly called ourselves "The Great Team." During my senior year we had a poor basketball team-I was the tallest one on it so I played center. I lettered in basketball also. I was also on the track team, but did not letter. To earn a letter in track one had to place in a meet and I never did. I played some intramural basketball while I was at Harvard College, and played some more while I was in the occupation army in Germany, and some more while I was a medical resident at Ford Hospital in Detroit.
While our children were young, I would go with them to the swimming pool and played a little golf through the years.
When I was forty, I looked at my calves and they were too scrawny and I looked at my abdomen and it was beginning to protrude a little. So I resolved to do something about it.
The President's Council on Physical Fitness published an exercise book so I began to follow that. The fact that it came out during President Johnson's administration did not prevent me from using it. The Council was composed of some very knowledgeable people-Dr. Howard Rusk and Bonnie Pruden being the two that I remember. The little book advised a series of limbering and calisthenics type exercises and also had a aerobic component. It was quite similar to the Royal Canadian Air Force exercise manual.
Later on Major Kenneth Cooper came out with his book on Aerobics and I began trying to something aerobic several times a week. About that time a man came to see me for medical clearance. His wife wanted him to be examined before he began running again.(It's true: Married men really do live longer-it doesn't just seem longer!) He gave me a book on jogging. He also let me use his extra rebounder for several weeks. I began to jog and was in a number of 10K races. I was never any great shakes at running, but in one 10K I did get a third place medal for my age group. Four of us physicians went over to Nashville to compete in the HCA physicians two mile relay sponsored by Indian Path Hospital. We weren't the best runners, but we had the best looking warmup suits! I kept on with the running for several years. Then my arches started bothering me and I had to give it up.
About a quarter of a century ago I bought a used Motobecan ten speed bicycle, and I would ride it ten kilometers pretty often, but never entered a competition. I still ride it on the days that I cannot swim.
After I retired I began going regularly to the senior center workout room. Even though I do not have the build for being a weight lifter, I am quite a bit stronger than I was. I also took up swimming. Some of the people from the senior center who had seen me swim encouraged me to take part in the senior games, and I began to do so in 2000. First locally, then in the district (we swam at Freedom Hall in Johnson City) and then in the State Games at Clarksville. In 2000 I won four gold and one silver. Then last year I was in the local, the district, and state games again. In 2001 at Clarksville I won five gold medals. Last year I went to the National in Baton Rouge. The competition was stiffer there and the best that I could do was a bronze in the 100 yard breaststroke. This year we didn't have a local competition, but we did have a district one. At the State I was beaten in the 50 and 100 meter backstroke by about one second, but I was first in the 50 meter free style and breaststroke and the 100 meter breaststroke for the 80-84 men. I was pleased to have been able to set new records in both breaststroke events. I held the record for the 100 meter breaststroke for 75-79 men in 2001.
The bottom line is no matter how unathletic or out of shape you are, you can improve your condition by exercise. But it does take emotional and nervous energy and you have to keep at it. I always advise "Start low and go slow. Build up by small increments." Otherwise you are likely to get sore and become discouraged. Many exercise people advise alternating easy days and hard days. Studies in nursing homes have shown that even very elderly people with paralysis of the legs can develop increased strength in their arms with persistent training. The benefits of physical activity are not only physical but are also psychological. It boosts a person's morale to see that he or she is still able to be active. Someone asked me about exercise equipment. I said, "All you need are some walking shoes.”
."Don't waste your money buying expensive equipment”. Basements, garages, and attics are full of exercise apparatus-most of which have had little use.
It is inspiring to me to see some rather feeble elderly people continuing to try to exercise. We have two distinct groups at the weight room and at the pool: Those who have already had serious problems, such as a need for bypass surgery, total hip or total knees replacements, strokes, and partially paralyzed extremities; and those who have not yet had trouble, but are trying to prevent trouble, or, at least, trying to put it off for a while.
As you can see, I am very enthusiastic about physical activity. And exercise has a very important part to play in weight control.

38. Diet
As I was leaving the Renaissance building recently after a workout, a man asked me about my diet. I told him something like the following: Back in 1953 I gave a talk to the medical staff at Holston Valley Hospital on cholesterol. Studies of dietary habits in different countries of the world by Ancel Keys had suggested that a high cholesterol diet and high cholesterol levels in the blood were associated with an increase in coronary artery arteriosclerosis (hardening of the arteries of the heart) that leads to heart attacks and angina. After the meeting was over and as I was leaving the room, one of the doctors who had heard what I had to say told, "If you had kept on five more minutes you would have had them all at the foot of the Cross!"
Later on it became clear that it was not just cholesterol that caused the trouble, but that animal fats were even more important. Animal fats can be recognized because they are solid at room temperature whereas vegetable oils are liquid. The fat in cold water fish is not only not harmful, but is actually beneficial. That makes it easy to know the difference. So I began to try, within limits, to avoid foods with animal fats and cholesterol. I never met an egg that I didn't like, but I began to limit my ingestion of eggs to once a week or less.
The famous lady who lost 170 pounds in two years told me she had learned all she needed to know about nutrition in the fourth grade. Nearly everyone remembers how their mothers wanted them to eat their vegetables. (I don't call them "veggies" because that word is one of my pet peeves. It sounds so something-I don't know the right word to use. Is the word "affected?".)
Now many advise the Mediterranean diet. The people who live around the Mediterranean eat a lot of fruit and vegetables and pasta and not so much meat and seem to have a better record as to arteriosclerosis than others. Most nutritionists now recommend four or five servings of vegetables and four or five servings of fruit a day. Most advise avoiding animal fats-and cholesterol- as well as use of whole wheat bread and skim milk.
Many people, especially women, do not get enough calcium. One can get calcium without using dairy products, but it takes considerable effort. Osteoporosis (thin and weak bones that 39. Art and Science in Medicine
I thought I would write some of my thoughts about the art of medicine.
Science has ancient roots in medicine. Due to the acceptance of the authority of Galen, progress in medicine was delayed. However, the study of anatomy was a big step in the progress of medicine. The discovery of the circulation by Harvey was another. Someone has said that we stand on the shoulders of the giants of the past. Pasteur and Koch are two that come to mind. The discovery of micro-organisms led to an understanding of the infectious scourges of the ancient world and eventually led to measures of control of them. Doing post mortem examinations led to the discovery of the cause of death and of the anatomical changes associated with end stage disease. The Emperor Franz Josef of Austria-Hungary is said to have issued a decree that all the patients who died in the Allgemeine Krankenhaus (general hospital) in Wien (Vienna) must have an autopsy. This was a three thousand bed hospital. Some have thought that this led to Vienna becoming an important medical center. Vaccination against smallpox by Jenner and even earlier by a Scot opened up the possibility of control of infectious disease spread by inoculation or vaccination.
I thought that I was capable of doing the art of medicine, but I was always more comfortable when I could apply science to the problem at hand. I liked to analyze and categorize symptoms and signs and proceed in an orderly and systematic manner in other words to be methodical as a Methodist that I am should..
To me the art of medicine really means the application of psychology. I consider psychology to be a science, although not yet as well understood as astronomy or physics. However, a lot is known already about transference and rapport and about placebo and nocebo effects. (Nocebo is a word I coined for an unfavorable response of a patient to an inert chemical.) Jeffrey Jernigan, Dr. Bob Jernigan's son, calls some patients "alien patients." That is a patient who can't take any medicine or thinks he or she can't take any medicine. I firmly believe, but cannot prove, that a patient can have an untoward reaction or a symptom formation just by having the belief that he or she is going to have such. I learned that I might as well realize that, if a patient had a strong prejudice against a medication, that had better not prescribe it for the patient. The prescription might not be filled; or, if filled, not taken; or, if taken, might be associated with symptom formation.
Truly caring for the patient and the patient's welfare will be transmitted to the patient-possibly non-verbally, and will be the oil than lubricates the interactions of the doctor and the patient. One should be aware of-no, look for non-verbal cues when interviewing or examining a patient. Some people have a lot of emotional intelligence and others seem to have little or none. Emotional Quotient refers to picking up on the feelings of someone else. I used my own feelings to determine the feelings. I am not a fearful person, but, if I found myself feeling uneasy, I would suspect that the patient was uneasy. Then I might ask, "Are you feeling anxious?" If I began to feel angry, it might be because the patient was angry. I might then ask, "Are you angry about something?"If I began to feel helpless or hopeless, perhaps the patient was feeling that way. Then I might ask, "Are you feeling sad today?"And, if began to feel suspicious, it might be that the patient was suspicious. Then I might ask, "Are you worried about something?"
One day I told my nurse, "Now, don't leave me helpless." Meaning, of course, don't leave the room, or, if you do, come right back. The woman patient piped up, "Yes. You are about as helpless as a steel rapier!"
I made it a point to touch the patient and to examine the part complained especially carefully. Touch is very comforting and communicative. Of course, when a male doctor is examining a woman patient he has to be careful that such touching is not construed to be a sexual approach. In earlier days, When examining a woman, I insisted that a nurse be in the examining room with me, but in later years, especially with long standing patients, I was not so strict about that. I have had younger women allow the sheet to fall down away from their breasts, but not often. With those I was sure to have my nurse remain in the room. I had a nurse to assist or at least be present whenever I did a pelvic or rectal on a woman.
Another aspect of the art of medicine is non-verbal communication. This can give the doctor information that he can otherwise not obtain. If you ask the patient a question and they block, look away, or look down, it may be a very sensitive and important subject that needs to be pursued-if the patient can bring herself or himself to talk about it. Another cue is if the patient crosses their arms, that suggests they are trying to shut you out. The tone of voice can be revealing as well.
I suspect that intuition is really subconscious observation and reasoning. It may be inborn or it may be related to experience. I think some people have it more than others. I think I had some of it. I don't know whether it can be taught or not. I believe without any proof that it is not something mysterious or magical, but that can be explained by brain function. Emotional intelligence may be an important part of it. Donald W. Bales, M.D. retired as of 1997

40. Hypertension 28 October 2002
High blood pressure, or hypertension-the scientific or medical name for it-is very common. A high percentage of the people who have it are not aware that they have the disorder. It is highly hereditary, so, if you have a relative who has it, you have an increased likelihood of having it. It is very easy to diagnose. All you have to do is have someone take your blood pressure. The incidence increases with advancing age. Everyone should have their blood pressure checked. Even young people can have and there are some rare curable (by surgery) causes that can be found in children or youths.
Coaractation of the aorta is something a person is born with and consists of a narrowing of the big artery that comes from the heart carrying the blood to the whole systemic circulation (as opposed to the pulmonic or lung circulation). This narrowing is seen in the thoracic aorta before the blood gets down to the kidney arteries. The decreased pressure in the kidney arterioles provokes the kidney to release a chemical that raises the blood pressure in the upper body. This can lead to a stroke. It can be cured by an operation to get rid of the narrow place in the aorta.
Another rare surgically curable cause of high blood pressure is a tumor of the adrenal, or suprarenal, gland. In this condition the new growth releases adrenalin and its cousin noradrenaline. This causes the blood pressure to rise. Removal of the tumor restores the blood pressure to normal.
A third rare surgically curable cause of high blood pressure is another tumor of the suprarenal gland. This time, instead of it being the inside of the adrenal gland, it is the outside part. That is called the adrenal or suprarenal cortex. (Ad means to in Latin and refers to the gland in four- legged animals. Supra means above. The gland in question is located above the kidney in humans when the human is in the upright position.) If there is a distinct neoplasm (new growth) in one of the glands, it can be removed. If both glands are effected by enlargement of the gland producing excessive secretion of cortisone and/or its cousins, medication can be given to prevent the adverse effects on the blood pressure.
Another potentially curable cause of hypertension is renal artery narrowing due to arteriosclerosis (hardening of the arteries). This is likely to occur, however, in mature persons and many of them have other disorders, especially coronary artery disease (heart attacks or angina) that makes surgery less desirable and more hazardous.
All of the above disorders need to be discovered early, since if not found and treated early, the blood pressure may not come down even when the cause is removed.
After all that 95% of cases of high blood pressure are not due to any of them. It was formerly called essential hypertension (meaning it was of unknown cause). Some wags said the "essential" part of the name came from the doctors essentially not knowing what caused it.
As I wrote earlier, the majority of cases are hereditary. But these cases are eminently treatable and treatment really alters what happens to the patient. It can prevent heart attacks, strokes, and kidney failure. So early diagnosis and treatment are greatly to be desired. We have multiple medications to use for treatment. The large number suggests that no one medication is good for all cases.
The black population is particularly likely to have high blood pressure and black patients benefit more from sodium and salt restriction than do white patients. I think this is due to the fact the black people came from an area of the world where salt was scarce, whereas people from Europe always had plenty of salt and used a lot of it. Soul food (food that black people in the U.S. like and eat) is very salty.
I used to try to treat high blood pressure without medications. Weight loss, exercise, and salt and sodium restriction sometimes works, but I had little luck in getting patients to do any of those. It wasn't that I didn't try. So usually I had to use medications. It takes patience and time by both doctor and patient to find a treatment program that doesn't cause too many adverse effects (I don't call them side effects because they usually are right out in front), and are not too expensive. It is desirable that the patient be able to take his or her own blood pressure so that he or she can get constant information and feedback on how they are doing. Donald W. Bales M.D.

41. Physical Examination 20 October 2002
There are two types of physical examinations: The traditional one is a directed examination and follows up any clues found in the history obtained from the patient regarding any symptoms. The second type is the screening or annual type. Some efforts have lately been directed at making the screening examination more efficient with regard to the time used. For example, one article puported to show that examination of the rectum was not cost efficient. However, I do not accept this notion. It does take a glove or a finger cot and perhaps thirty seconds. What can one learn? If one felt a mass in the rectum, wouldn't that be useful knowledge? Some patients do not observe their stools-at least, some would not admit it. If one detected blood or noted that the stool was black, would that be of no value? What about detection of a nodule in the prostate? Of course, there is a controversy about whether the prostatic specific antigen test is of any use in saving lives. But the digital exam is much cheaper than the PSA test and should be as valuable. Although the PSA test might give evidence of earlier disease, it would be somewhat embarrassing to have the nodule discovered in the course of another examination by some other doctor such as a gastroenterologist or an emergency room doctor.
Some say that Pap smears are not needed if the woman is old and has had three consecutive negative Paps. But other disorders can be detected by a pelvic exam. Unfortunately, most ovarian cancers cannot be detected by bimanual pelvic exams. But it would be helpful in a lawsuit alleging a missed diagnosis to have a record of a negative exam on a certain date. Fibroids could be detected, but wouldn't necessarily mandate an operation. Vaginitis would usually cause symptoms, but sometimes asymptomatic infections might be detected. I have found foreign bodies in the vagina at times-once some brush bristles, and several times diaphragms. Not that those were serious findings. But you never know what you may find during an examination of any part, but you surely won't find it if you don't look and feel.
Skin cancers are curable in a high percentage of cases, but they will not be detected with the patient completely clothed. The yield from looking at the pupils and the eye grounds may not be great, but occasionally something might be found. Looking the ears may not show anything, but it would be nice to know that the patient had a perforated eardrum. Nasal exam could give a clue to nasal allergy or infection or dryness. Observation of the mouth and throat would seem desirable to check on the teeth and look for lesions that might be pre-cancerous or cancerous, especially in smokers. Examination of the neck, axillae, and inguinal region would usually not be revealing but lymph node enlargement might be detected. Palpation and auscultation of the carotids, especially in the elderly, might reveal bruits and lead to investigation of narrowing. Inspection, palpation, percussion, and auscultation of the precordial region and heart should certainly be done without intervening clothing. The lungs should be similarly be examined. Inspection and palpation of the abdomen could detect enlargement of the liver or spleen and rarely of a kidney. Abnormal pulsation of the aorta might reveal an early aneurysn. Other masses of the abdomen and/or pelvis might be found. They would certainly be missed if the abdomen was not examined. Listening for murmurs over the femoral arteries wouldn't take long. Inspection of the feet for any abnormality might show early changes. Testing the knee jerks and ankle jerks would show the sensory and motor connection function of the lower extremity. Testing for range of motion of the back, the neck, and the extremities could show abnormalities that the patient had not volunteered. And checking of the pedal pulses in the mature patient would seem to be proper.
I had my nurse take the patient's temperature, weight, and blood pressure. It the patient was on any medication that could cause postural hypotension, I had the blood pressure taken lying and standing. I had the height measured yearly. Loss of height could be due to osteoporosis-a disorder very common in elderly women, but one fifth of the cases occur in men.
I think the directed and the screening examinations should be done in exactly the same way and should be done in a systematic and orderly way. Without a set routine it would be easy to be distracted and fail to examine every part. In addition I think every part complained of should examined carefully-for two reasons: One to help with the diagnosis and two to assure the patient that his or her complaint is being taken seriously and is not being ignored. In the case of the directed examination additional attention should be given to the parts that have caused symptoms or that might confirm or deny the suspicion aroused in the doctor's mind by the history. A thorough physical examination can be very reasssuring to the patient and can dispel fears better than mere verbal reassurance. In the absence of a thorough examination the patient may feel the reassurance in not based on facts. A thorough examination is a good way to establish rapport and get the patient's confidence. break easily) is very common. It is usually thought to be a woman's disorder, but about 20% of cases are in men. Low calcium intake could contribute to the development of this condition. Calcium is one of the few supplements that seems to be needed. Some people go for mega-vitamin use. I think it is quite good for the stockholders of the companies that make and market the vitamins. I hold a similar view of herbal therapy and most other alternative medicine.
If a young person had asked me if they should drink alcohol, I would not have advised them to start, especially if they had a family history of problem drinking. Problem drinking is present if drinking has caused interference with one's job, one's marriage, or one's health. There is a strong hereditary element in alcohol abuse. However, one or two drinks a day for men and one drink a day for women seems to protect to some degree from arteriosclerosis. The restrained drinkers have a better record than teetotalers. Some writers think that red wine is better than other forms of alcohol and red wine surely is better than white wine. Some chemicals in the grape skin have beneficial effects. Some think the red wine is better than plain grape juice. I don't make the rules-I just know what some of them are. If you don't like the rules, take it up with the rule maker. Sorry-abstinence people. But imbibing wine wasn't a sin to Jesus. Maybe we should pay more attention to other behaviors. Of course, prevention only goes so far. There are many disorders that we don't have any idea how to prevent.
I used to joke and say that I knew how I would die-I would be run over while out jogging by a fat, drunk, cigarette smoking truck driver with hemorrhoids bit no brakes! So when I would hear a truck motor, I would get up on the bank beside the road. I don't jog anymore so I don't have to be concerned about that anymore. My arches don't like for me to run, but I miss it. I see someone out running and I think "I wish I could still do that."
It's not only important what you eat, but how much. A human needs about one gram of protein for each kilogram of body weight. It takes thirty grams to equal the weight of one ounce of water and a kilogram is 2.2 pounds. So that means that someone who weighs 154 pounds needs about 70 grams (2 1/3 ounces) of protein. That would be a piece of meat about the size of package of cigarettes. No one needs a 12 ounce steak. Half of an 8 ounce steak would be too much. Of course, one can get protein out of grains or beans or dairy products so that one does not need to get it all from the flesh of animals. I am not a vegetarian, and I am not that enthusiastic about vegetarianism. Pure vegetarians would have to take supplemental B12 since it is only found in animal products. Lact-ovo-vegetarianism is more acceptable-they add eggs and dairy products to their diets of plant food.. Avoiding meat appeals to some as a humanitarian thing to do. It takes about ten pounds of plant food to produce one pound of meat (maybe less with chickens) so the food supply would stretch farther if everyone one ate only plant food. In this country, though, even the poor are eating too much. There is a definite correlation between educational and economic level and over weight. But I will have to say, though, that I have seen a good many well-educated and prosperous people who are obese.
One day when I was younger (early seventies) one of the younger doctors noticed me choosing my food carefully at the doctors' dining room. He said, "It doesn't matter what you eat." I assumed he meant that I was so old that it didn't matter. And he said, "Besides you are too thin." I asked, "How much do you think I weigh?" "Oh, about 149." I asked, "How tall are you and what do you weigh?" "Oh, I am six feet tall, and I like to weigh between 165 and 170." I said, "I'm six feet tall and weigh between 165 and 170!"
I couldn't believe that it made no difference what some one eats for twenty-five years. (You can see that I am an optimist.) Some say we are what we eat. I don't weigh that much now. I have lost down to 155 since I retired. I am much more active physically now than I was when I was working, and am in better condition. I weigh the same now that I did when I played football at Morristown High School back in the late 30's. Donald W. Bales M.D..

Even if they complain about the pelvic and/or the rectal emaciation, that is not a reason not to do them. Occaionally when I was to see a polysymptomatic patient, I would reverse the order and do an especially thorough physical examination first and then take the history and the system review. This often led the patient to take less time relating her complaints. I had showed her I took her case seriously by my examination so she didn't have to exaggerate to get my attention.
I write "her" because almost all of these polysymptomatic patients with no findings were women. That is based of experience and is not based on sexism.
A physical examination is not painful (at least, not enough to be of any consequence) and it doesn't take a lot of time and for the information it supplies it is very cheap compared to the cost of laboratory tests or imaging.
I had an former patient tell me that he went to a well trained and well thought of doctor about a problem he had with one of his feet. The doctor didn't even have the patient take off his shoes and socks! Another patient told his doctor of nosebleeds and the doctor did not even look in his nose!
If the patient has a chronic disorder, the parts involved in such a disorder should be singled out for examination on every visit, but particularly during the annual visit.
It may be the way I was trained in medical school and in internship and in residency, but I think physical examinations should be head to toe and that the patient should be undressed. I told my nurse, "Be sure they take off enough clothes so that I can examine any part complained of!"
Donald W. Bales M.D. 20 October 2002

42. This is not an essay, but a poem that Frank Kelly gave me today, 12 August 2004
A Woman
She's angel in truth
A demon in fiction
A woman is the greatest
Of all contradiction.
She is afraid of a cockroach
She will scream at a mouse
But she'll tackle a husband
As big as a house.
She will take him for better
She will take him for worse
She will split his head open
And then be his nurse.
And when he is well
And can get out of bed
She will pick up a teapot
And throw at his head.
You fancy she is this
But you find she is that.
She will play like a kitten
And fight like a cat.

In the morning she will.
In the evening she won't.
So you're always thinking
She will when she won't.

43. The Theology of Benjamin Franklin From "Benjamin Franklin" by Edmund Morgan
He seems never to have doubted the existence of God and his Creation of the world. How else did everything get here?
In Boston in 1723 there were six Congregationalist Churches, some with two ministers, with a total of 1500 members. There also was an Anglican Church, a Baptist Church, and a small group of Quakers. He grew up in a Old South Church in Boston. They taught that Works could be the result of Faith. His father, Josiah Franklin, was a pious Congregationalist. Ben was supposed to become a minister, but schooling became expensive. He was the youngest son in a family of eleven children. He was apprenticed to his printer brother James, but he didn't like the tyranny of his brother so left Boston at age seventeen.
He came in contact with the Deists. At twenty he wrote a pamphlet in which he wrote that God left no room for religion, or any difference between right and wrong. Forty-six years later two friends used this excuse to refuse to pay back what he had lent them. He never accepted the Bible as Divine revelation or Jesus as the Son of God. Actions might be forbidden because they were bad for us or commanded because they were good for us.
In 1734 he was influenced by an assistant Presbyterian minister, Samuel Hemphill, who said, "Morality or Virtue is the End, Faith only a means to attain that end." Franklin ridiculed the idea than either Adam's sin or the righteousness of Christ could be "inherited"or "imputed" to Adam's posterity. Conversion was not needed.
Hemphill's sermons were cribbed from the Deists (Arians). He said, "Morality, or Virtue, is the End, Faith only a Means-to obtain the End and, if the End be obtained, it is no matter what the Means." The Synod dismissed Hemphill. Franklin left the church never to connect to another. But he was a friend to George Whitefield, a leading itinerant preacher of the time.
In Poor Richard's Almanack, he wrote, "Sin is not hurtful because it is forbidden, but it is forbidden because it is hurtful. Nor is a Duty beneficial because it is commanded, but it is commanded because it is beneficial." "Virtue, that is, morality, is the Essence of all true Religion.
Franklin listed thirteen Virtues:
1. Temperance: Eat not to Dulness Drink not to elevation
2. Silence: Speak not but what may benefit others or yourself. Avoid trifling conversation.
3. Order: Let all your things have their places. Let each Part of your Business have its time.
4. Resolution: Resolve to perform what you ought. Perform without fail what you resolve.
5. Frugality: Make no Expense but to do good to others or yourself, i.e. waste nothing.
6. Industry: Lose no Time-be always employed in something useful. Cut off all unnecessary Actions.
7. Sincerity: Use no hurtful Deceit. Think innocently and justly; and, if you speak, speak accordingly.
8. Justice: Wrong none by doing Injuries or omitting the Benefits that are your Duty.
9. Moderation: Avoid Extremes. Forbear resenting Injuries so much as you think they deserve.
10. Cleanliness: Tolerate no Uncleanness in Body, Clothes, or Habitation.
11. Tranquility: Be not disturbed at Trifles, or at Accidents common or unavoidable.
12. Chastity: Rarely Venery, but for Health or offspring. Never to Dulness, Weakness, or the Injury of your own or another's Peace or Reputation.
13. Humility: Imitate Jesus or Socrates.
Charity-love of fellow man is missing.
Eat to live and not live to eat.
To lengthen thy life, lessen thy meals.
Take counsel in wine, but resolve afterwards in water.
He that drinks fast, pays slow.
Nothing more like a Fool, than a drunken man.
Content and Riches seldom meet together.
If your Riches are yours, why don't you take them with you to the other world.
The use of money is all the Advantage there is in having money.
"What we have above what we can use, is not properly ours, tho' we possess it.
1750: "I would rather have it said, he lived usefully, than He died rich."
"Talents and Will are the same Person giv'n
The Man ennobled doth an Hero rise
Time and his Virtues lift him to the skies."
"tho' we are generally hypocrites, in that respect, and pretend to disregard Praise" August 2003

44. Dr. Bales Dumb Advice Book
Introduction
My medical practice in Kingsport began on 1 August 1952. I have always had an enquiring mind, and have been inclined to be philosophical and psychological in my attitudes. As I continued in my practice of internal medicine, I realized that certain patterns of behavior repeated themselves. For example, frequently I seemed to need to tell patients the most fundamental things that I was sure they already knew. However, I was fortunate enough in my formative years to be around people who had a lot of common sense. In particular, my grandfather Weesner, who was also a physician, really excelled at being able to apply common sense to any matter that he dealt with-whether medical or otherwise. I thought it might be useful to record some of my thoughts regarding "Dr. Bales's Dumb Advice". I intend to use the question and answer mode of communication:
"You say you have a hangover today?" "Don't get drunk tonight!"
"You say you are tired?" "Rest."
"You say you are too fat?" "Go on a diet and start an exercise program."
"You say you are too thin?" "Eat more."
"You say you are ignorant?" "Read a lot and go to school."
"You say you don't make good grades?" "Study. And, of course, don't lay out of school."
"You say you are poor?" "Get a job. Improve your skills."
"You say you are weak and out of condition?"
"Start an exercise program. Train and don't strain."
"You say you feel guilty?" "Seek forgiveness from those you have wronged, and stop doing
the things that make you feel guilty."
"You say you think you have something wrong with you?" "See a doctor."
"You say you feel bored?" "Take up a hobby, do something for others, take a vacation."
"You say your spouse says you don't pay enough attention?" "Pay more attention."
"You say people say you look dirty and unkempt?" "Pay attention to cleanliness and grooming."
"You say you don't take the medicine your doctor has prescribed?" "Take it. Tell the doctor.”
"You say you don't keep your appointments?" "Keep them."
"You say you are always late?" "Start sooner. Go by experience instead of calculating it wrong.” "
"You say people seem to be against you?" "Maybe you project hostility toward them. Try to be friendlier."
"You say you have a cough and are short of breath?" "Stop smoking cigarettes."
"You say you are nervous?" "Tell your doctor. He may be able to help you. If he can't, perhaps he can refer you to someone who can?"
"You say you feel alienated from your children?" "Show your interest on and concern for them?"
"You say you have a religious problem?" "See your pastor, priest, or rabbi. Maybe they can help.”
"You say you are hungry?" "Eat."
"You say you are thirsty?" "Drink."
It might seem that I do not have a good opinion of people's ability to solve their own problems. Many times I have thought that the person in question knew what to do, but needed encouragement or permission to do it. When I am in my car, I sometimes listen to some of the talk radio programs such as Dr. Joy Brown and Dr. Laura Schlesinger. So many of the callers need "dumb advice". In so many cases on these programs, and, in my office, the solutions seemed so logical and common sense, that I had some trouble believing that the people involved didn't know better. However, it is hard to be objective about yourself, and most of us can benefit from disinterested, but, not uninterested, advice.
I have always been in favor of prevention, and whenever I hear of something bad happening, I begin to think about some way of preventing. After all, as Poor Richard (Benjamin Franklin) said so many years ago "An ounce of prevention is worth a pound of cure."

Donald W. Bales, M.D.

45. Lurching toward Lawlessness
We have "Defining Deviancy Down" by Pat Moynihan and "Sloughing Toward Gomorrah" by Robert Bork, and now you have "Lurching Toward Lawlessness" by Donald W. Bales.
I have long been appalled and angered by the development of systemic and deliberate and cynical evasion and breaking of the law by many municipalities and even states with regard to illegal immigrants. Some law enforcement agents are forbidden to report the names of persons who are arrested for felonies and misdemeanors, who are found to be illegal immigrants, to the Immigration and Naturalization Service. It seems to me that this is a clear violation of a Federal law, and, if it isn't, it should be.
Furthermore, giving illegal immigrants a driver's license is dead wrong. The driver's license is as close as we have so far come to being a national identity card. The idea of providing these people, who shouldn't even be in the U.S., with health care, education, and welfare benefits is not consistent with my beliefs about justice and fair play. And giving them free college tuition or decreased tuition is even worse, and provokes me to disgust and anger.
We already have enough scofflaws and now we are producing a lot more of them.
Rats and mice can be trained by the pain-pleasure principle. By that, I mean that, if the animal is rewarded for a certain behavior, it is likely to repeat it. On the contrary, if the animal is punished for a certain behavior, it is unlikely to repeat it. If it will work on a rat or a mouse, isn't it likely to work on a human? Of course, some say that humans mostly use their big brains to justify doing what they know is wrong. If that is the case, it may explain a lot of human behavior (perhaps it would be better to use the word "misbehavior).
Donald W. Bales, M.D. 25 September, 2003

46. A Calm and Courageous Realist
Julie probably has always been calm and courageous. She had a submucous resection of her nasal septuum in high school as well as a tonsillectomy and adenoidectomy. I didn't know her then, but her report about those procedures did not carry any message of "ain't it awful" or any hint of undue anxiety about them.
When she had hearing impairment from otosclerosis, she accepted to wearing a hearing aid without complaint, although I suspect she had a problem adjusting to hearing incidental noise that she had not previously been able to hear. She just went on about her business. She never showed any evidence of thinking, "Why me?"
Agreeing to marry a poor man with a year to go in medical school showed confidence and courage. She accepted moving to Detroit away from her family without question or complaint. Then she traveled to Germany on a converted troop transport through a storm that resulted in nearly everyone on board either becoming seasick or having gastro-enteritis (vomiting and diarrhea-to put it clearly). It took twelve days to make a trip that usually took five. Except for being unusually glad to see me at the port of Bremerhaven, this experience didn't seem to faze her. I was a medical officer at the 130th Station Hospital in Heidelberg then.
Deciding to have a baby when I had a year of residency to go was another evidence of a courageous and optimistic (it turned out to be realistic) view of life. She was not at all anxious during her pregnancy. On the contrary she seemed to glow during the mid trimester with happiness and fulfillment (the use of the word "fulfillment" was inadvertent).
When she came to Kingsport for the first time, she was not favorably impressed with Kingsport, and said to herself, "Is this where I am going to spend the rest of my life?" With her accepting and serene attitude she was soon content. The next three pregnancies didn't seem to bother her or cause her any anxiety. Even having a close call about getting to the hospital on time with Bart didn't seem to bother her.
Her ear operations under local in 1960 and 1961 didn't seem to worry her at all. In each case we came home to Kingsport from Memphis the next day. She approached her glaucoma with the same calm acceptance-and used her drops exactly as prescribed. She had her first cataract as a matter of course and later the other one. These operations must have been done on a Wednesday-a double stamp day. After one of them she no longer needed the glaucoma eye drops.
The severe pain with her gall bladder attack shook her up a little, but only because of the pain. She didn't seem to be overly anxious about the situation. After her laparoscopic operation to remove her gall bladder, she didn't take any opiate pain medication. She did take two Tylenol one evening. She was found to have an angiomyolipoma of her right kidney. That is a benign lesion, but rarely can rupture and cause severe bleeding. If she was anxious about that, (and she knew about that possibility), she never showed it. Some think that I am a keen observer of people with ailments-both physical and psychological.
In 2000 she was found to have a heart murmur. This led to an Echocardiogram that confirmed that she had a stenotic aortic valve. She was aware of the implications of this condition.
When she had chest pain (a three on a scale of ten) for one hour at 5:30 A.M. on 28 September 2004, she was uncomfortable, but I think that I was more concerned about the possible cause of the pain than she was. The subsequent visit to Dr. Singh and his referral to Dr. Turner, an invasive cardiologist, and the Echocardiogram that Dr Turner recommended were all accepted in a calm good spirit. When advised she needed a cardiac catheterization she said, "I don't want that." After she thought about it (and after I told I wasn't ready for her to leave me just yet), she decided she wanted to go ahead with the recommended procedure. The cardiac catheterization showed that the aortic valve was a little worse than the echo had shown it to be. It also showed a seventy percent stenosis of the left anterior descending coronary artery.. Dr. Turner recommended that she have the aortic valve replaced and the narrowed artery bypassed. We had chosen Dr. David Sewell for the surgery. He saw her promptly and said he could do the operation the next day-a Friday. We decided to have it done the following Monday. I don't think anyone could have had a better attitude about the surgery than the one that Julie had..
I think her experience with her mother many years ago may have influenced her attitude about the surgery. When her mother was seventy, she fainted on the steps of the courthouse in Memphis. Her husband wanted her to go to Houston. Dr. Debakey replaced Mrs. Stanton's stenotic aortic valve with a pig valve that was supposed to last five years. She was the oldest patient with that disorder that he had operated on up to that time. Mrs. Stanton lived into her 89th year!
I think the consultation preoperatively with Dr. Smiddy about her lungs and the lung function test made her feel more comfortable about the surgery (I know it made me feel better about it. I was helped by Dr. Smiddy's assurance that her lung function was good enough to tolerate the surgery.). I am sure she was concerned, but, if she was anxious about it, it was not apparent to me. After fifty-nine years of knowing her, I doubt if she could have been a good enough actress to conceal a serious degree of anxiety from me.
I rest my case. Have I convinced you that she is a calm and courageous realist? She is a wonderful woman-even if she won't come on!
Donald W. Bales-Loving husband of Julia Anne Stanton Bales
26 October 2003

47. I like
I like my life. I like my house and I like my lot-the acre and three-quarters of land, but also my lot in life. I like my car and I like being retired. I liked the practice of internal medicine and I enjoyed being active as a doctor for fifty one years. Actually I began seeing patients as a medical student in the fall of 1944. I liked most of my patients. I like to swim and go to the gym and I like to write. I like to read and watch TV. I like to use my computer and to get on the Internet. I like doing email. I like-I love-my wife and my children. I like-and love- my children's spouses and they seem to like me. I like-I love-each one of my six grandchildren. I like my relatives, and Julie's relatives and the relatives of our children's spouses. I like my Monday lunch group, and the gym group, and the swim group, and the Kingsport Institute of Continued Learning faculty and students. I like the Philosophy Class (Sunday School) and I like my church-both the local one and the denomination although I think the central body of the Methodist Church is too liberal. I like (love) my country. I like the Declaration of Independence and the Constitution and I like our form of government and the freedom it makes possible. I have some concerns about the future. Even though Communism has been shown to be a failure in that it provides neither a good material life nor freedom, some people still think it could work. I don't like Socialism either even though its record is not as bad. I like the library and I like the Great Decisions seminars. I like the Symphony concerts, and I love popular music. I like movies, but it is rare that a modern one is any good. I like to travel and see new places and I like to visit relatives- especially our offspring. I guess I could say that I am a happy man. I don't like the inroads of age, but I have held up pretty well. I like to get the maximum out of everything. I like for things to be orderly and neat, but comfortable.
I also like living in Kingsport. Here I "swim in friendly seas" and I receive a good deal of respect. I like being as healthy as I am, and I think that I am getting more strength and stamina. I don't like having beginning cataracts, but I like knowing that I can have them removed if it becomes necessary. I don't hear as well as I used to or as well as I would like, but, if my hearing gets bad enough, I like knowing I can get a hearing aide if I need it. I don't like having to void so often and I don't like having to take a long time to get empty, but, if push comes to shove, I like to know that I can have another procedure on my prostate.
I like doing Tai Chi and yoga. I like being married to Julie. She is so kind and loving. o be.

48. My comments about:
Sex, Drugs, and Rock and Roll by Susan Lee WSJ 12 February 2003
Does human experience on planet earth teach us nothing?
I am a very strong believer in personal property rights and individual human rights. At the same time I am a communitarian; that is, I think each person has some obligation toward others, including the general body social. I believe in a social contract-I won't infringe on your rights if you won't infringe on mine. Unfortunately, too many do not want to do that and we must have government. To me government has three duties only: to protect us from foreign enemies, to protect one from fellow citizens, and the maintain a stable currency. All the rest is inessential and superfluous.
Some think that the Code of Hammurabi and the Ten Commandments (at least the last six) are just edicts that someone thought up. I perceive them to be the distilled wisdom of the ages. Some behaviors seem to result in more justice and harmony than other behaviors. And we deviate from these at our peril. How do societies fare that depart from them?
As to marriage, to me it is about the children. The nuclear family has been around a long time and, in general, has worked well. The human species is not extinct, is it? That is one test of the success of a species. Certainly extinction cannot be considered a distinction. It is obvious that fatherless families do not fare well. And motherless families may do even worse. Example is a great teacher-a lot better than preaching or teaching. "Do as I do" is a lot more likely to be followed than "Don't do as I do, do as I say."
My father didn't say it, but he implied it to me. He was fat, smoked, and drank-and died at age forty-four. But he did tell me, "A man's word is his bond." He followed that rule. I never saw him unclean, unshaven, ungroomed, or poorly dressed. His shirts were spotless and ironed, his pants had a crease, his tie had no spots, his shoes were shined, and I never saw him be discourteous to anyone. He also had a great sense of humor. I don't why I am writing this, but what we become is not a matter of chance-genes and environment shape us. Not to say that I don't think each person has a responsibility for his or her own actions. Of course, personal responsibility for one's behavior and fate is not politically correct. If anything goes wrong, it has to be the fault of someone else and it can only be someone or something with deep pockets.
This is one conservative (of sorts) who does oppose same sex marriage (see above), who does vehemently oppose illegal immigration and wholesale immigration (why should we take the sick and the criminal from other societies?), and who does not patronize or belittle or lack appreciation for women. Our society is decadent. Medical marijuana is a pretext for legalizing recreational marijuana. Recreational marijuana should stand or fall on its own merits or demerits. It will not enhance efficient behavior or thinking. Abortion used to be illegal-now it is legal. To show how broad minded I am I will even quote that famous Arkansas white trash, "Abortion should be legal, safe, and rare." Of course, the "rare" was just stuck in there, he didn't mean it. But I do. Most of the laws regarding sodomy are no longer operative or, if still on the books, are rarely enforced. As to censorship it is not only the conservatives who advocate it (and I do not)-the liberals are even worse with their speech codes.
As to sexual practices, nature doesn't seem to like promiscuity (if nature can have likes or dislikes), just look at all the penalties nature puts on it-syphilis, gonorrhea, chancroid, herpes, human papilloma virus, lymphopathia venereum, and that equal opportunity killer HIV-AIDS. Monogamy may be monotonous, but it's safe. The sexual revolution occurred when women and girls changed their behavior. The men then got to do then what they had always wanted and now the women and girls would let them, and even promote the activity. The pill and the condom and other methods that were supposed to allow sexual activity without pregnancy do not seem to have worked as they were supposed to judging by the number of unwanted pregnancies that have ensued. Of course, some young girls get pregnant on purpose (or so I have been told by nurses that work with the girls) in order to escape from an unpleasant or abusive home situation. Welfare has reduced the social and economic penalties for such behavior.
The parallel to Hayek does not compute. He had a lot of evidence on his side and a great deal of evidence against the other side from observation of economies and societies. Central planning (Socialism) just doesn't seem to work very well. It took the Russians seventy years to find it out. Now only North Korea and Cuba are the only ones still trying to use a Communist system-all the others are mixed. Even so-called democratic (representative is a better word since there are no true democracies) socialism is not doing too well. If the socialist countries in Europe had to pay for their own defense, they would be even worse off than they are.
Do we want to take a chance on throwing away the past and test postmodernism? All great societies of the past have gone into a decline and most of them seem to have rotted from the inside making them susceptible to attack from the outside.
To me the author, Susan Lee, set up a straw man conservative so the contrast with her admired libertarians would be more striking. Donald W. Bales 16 February 2002

49. Illegal Immigration
This is one of my pet peeves. I am in favor of law and order, but I perceive that the law has been hijacked or bastardized and is being misused by greedy lawyers, greedy clients, judges who do not follow the law, and juries who don’t realize that there is no free money. However, this can be a subject for another day. However, the law or the absence of enforcement thereof is an important part of this article.
Laws prohibiting illegal immigration are on the books, but are not enforced. Part of it is not enough people on the borders and lax application by the INS. But a more important part is the failure of employers to report illegals. In fact, they conceal the fact that they are illegal and exploit them for low wage help. Furthermore, in some cities the police are forbidden to report any illegals to the INS and will be censured or disciplined for doing so.
I don’t care if the businesses need low-cost help to do menial work and especially stoop work and I don’t care if a certain party wants lots of them for potential voters. Neither of these motives justifies the present situation. Some say they do useful work and pay taxes. I doubt that the net result overcomes the additional cost of providing education, health care, and other benefits.
When a person’s first act in the U.S. is a criminal one, what kind of citizenship can be expected of such a person? We are already a nation of scofflaws and we are allowing into the country a lot more of them. They learn that breaking the law pays off. As far as providing them college education at less cost than a citizen would pay-that makes no sense and it infuriates me. What good is it to be a citizen if a non-citizen receives more benefits? Giving them a driver’s license was even worse. The driver’s license is the closest thing we have to a national identity card. Fortunately, a governor with a little sense has stopped that nonsense.
I haven’t even mentioned the danger to national security. Most of the illegals from Mexico probably are not going to carry out terrorist acts, but, if people can get in without any checking of them, why can’t radical Islamists get in also. We have had some experience with what some of them have done and want to do. Of course, some terrorists get in legally. That is a subject for a later article, also. I blame the State Department for some of this, but I also blame the Bush administration for not leaning on them to cut down on people from countries under suspicion of harboring, supporting, or indoctrinating people who want to harm the U.S.
Winning votes or having cheap workers is surely not worth the risk of another September 11 or an even worse attack.
Donald W. Bales, M.D.
6 December 2003
Added to Essays 5 January 2004

50. United Nations
The UN was formed in 1945 as an organization of the victors. It was promoted by Franklin Delano Roosevelt and Winston Churchill and had fifty nations involved at the time. The hope was that it would prevent further wars and allow international disputes to be settled by peaceful means. United Nations day is 24 October.
The five permanent members of the Security Council were the U.K., the U.S., the USSR, China, and France. Anyone of the five could veto any action of the Security Council. At present there are nine non-permanent members of the Security Council-they do not have veto power. Present members are Germany, Pakistan, Romania, Spain, Philippine Islands, Algeria, Angola, Benin, and Brazil. The last five start 1 January 2004. The General Assembly was made up of the remainder of countries. Now there are 191 countries and of those 148 have populations of over one million. 48 countries are listed as developing countries. As of January 1996 Freedom House judged 20 % to be free, 42% partly free, and 39% not free. Free was defined as having majority rule involving free and open elections protection of civil liberties by a reasonably independent justice system. 49 countries are considered to be developing countries.
The UN is supported by member countries: U.S. 22%, Japan 20%. The staff has 9,118 members. The Secretary-General serves for five years. Ghanian Kofi Annan's term ends in December 2006.The President of the General Assembly is Julian Robert Hunte of Santa Lucia.
Fifty-five states are Muslim. Twenty-two are Arab.There are 1.3 billion Muslims. One state is Jewish. Only twelve million Jews on the planet. These facts may help one to understand the following:
From 1947 until 1989-321 resolutions by the General Assembly, none against any Arab states or the PLO. 49 Security Council resolutions against Israel and none against the Arab States or the PLO. Israel has one thousandths of the world's population and discussions about it use 30% of the meetings of the Security Council. The UN asked all nations to withdraw their missions from Jerusalem. Most of them moved to Tel Aviv. Israel is excluded from temporary membership on the Security Council. Syria, a "rogue" state is on it right now. Israel is also excluded from being on a regional group-the only country so treated.
20,000 Syrians were killed at Hama in 1982. Egypt used poison gas in 1966 and Iraq in 1988, but no condemnation or resolution by the UN. Resolution 242 against Israel in1967 and 338 in 1973 when Egypt was planning to attack Israel in 1967 and did attack it in 1973. In 1973 Israel withdrew from the Sinai-giving up oil wells and a geographic buffer.
In 1948 many Arabs left Israel-they were advised to do so by the Arab states with the idea that they could return when the Israelis were killed or driven out. Some say 750,000, some say 650,000 and some say only 472,000. At the same time 850,000 Jews fled Arab countries and 586,000 came to Israel where they were assimilated. None of the Arab refugees were assimilated by the surrounding Arab countries and the UN maintained refugee camps in those countries.
UNAWA helps Palestinian Arabs with humanitarian matters. UNHCR helps governments resettle refugees in Arab countries, but not Palestinian Arabs.
I have had a dim view of the UN. But I thought that WHO-World Health Organization-was one of the good parts of it. It did coordinatate the effort by the health departments of nations all over the world to try to get rid of smallpox. The last case other that from a lab accident was in the 1970's and we quit vaccinating people about 1974. Smallpox virus is still in labs in the U.S., in Russia, and maybe, illegally, and covertly, in some rogue states. A campaign against yaws (a spirochete disorder-syphilis is a cousin of yaws) was carried out in the 1940's. During the last three decades a campaign has been waged against onchocerciasis "river blindness," leprosy, and polio. The malaria campaign has been hampered by the outlawing of DDT-malaria still kills one million a year. As the infectious diseases are less rampant, WHO has turned to non-infectious health problems such as prevention of leg blood clots in air travelers, keeping the aged active, working against the use of cell phones while driving, and debt relief for poor countries. Also a program against tobacco, and against alcohol abuse in European teen agers. It also targets poverty, underdevelopment, and social inequality, and traffic accidents. These are worthy goals, but do not seem to be suitable for a health organization. Fifteen years ago an observer was riding in one of the few existing vehicles in an area of Madagascar and he saw a UN billboard saying "Wear your seat belt."
The UN budget is three billion. The Afghan mission budget was increased from 40 million to 65 million. Iraq was to have 45 million, but, since the UN pulled out, I don't know what the money will be used for. The mission is now in Cyprus. The amount spent on meetings and the executive board equaled the amount spent on immunizations, tuberculosis, and diarrheal diseases.
Six diseases account for 90% of all infectious disease deaths for people under the age of 44: Malaria, tuberculosis, measles, diarrheal diseases, acute respiratory disorders (including pneumonia) and AIDS. Someone calculated that $20 per case, and, in most, 35 cents could have prevented 11 million deaths in 1998. Even so it would have cost between 3.9 and 220 million total. That would have been 0.4 to 20% of the WHO budget for the year.
The point that I am making is that even WHO seems to be making poor use or inefficient use of the money they have.
The World Bank, Unicef, and Unesco are also under the UN.
Bill Gates and his wife gave a lot of money for use against AIDS, tuberculosis and malaria.
Resolution 713 in1991 imposed an arms embargo on all of Yugoslavia. In effect, this prevented the Bosnian Muslims from getting any weapons to defend themselves from the Serbs who had plenty of weapons already and could get more from the Russians. Kofi Annan listed some of the failures of the UN: Khmer Rouge in Cambodia, ethnic cleansing in the former Yugoslavia, and the 1894 genocide in Rwanda. The failure of the UN to provide, or to allow the U.S., to provide security in Baghdad was another failure. The death of a valuable and dedicated UN person, Sergio Vieira de Mello, could probably have been prevented. He will be hard to replace. The UN did not want to appear to be supporting the U.S. troops and incorrectly assumed that the terrorists would not attack people trying to bring humanitarian assistance to the Iraqi people. Now it is clear that the radicals do not care about the welfare of the Iraqi people and want to make things as bad as possible to provoke the populace to rise against the coalition forces.
Resolution 1441. Pressure on Iraq regarding inspections and consequences on non-compliance. All fifteen of the Security Council voted for it, but when non-compliance occurred, the Council refused to authorize the use of force implied in the unanimous resolution. By this failure to back up its own resolution the UN rendered itself irrelevant.

51. My concerns about the United States April 2004
First: My overriding concern is for the war with the radical Muslims. I call it World War IV. I deem the Cold War (it got very hot at times-Korea and Vietnam) to have been World War III. We won that by persistent opposition to the Communists by both Republicans and by Democrats. I give Ronald Reagan most of the credit, however. His clear denunciation of the USSR as an "Evil Empire," and his pressure on them by preventing the importation of oil handling equipment thereby cutting off the only real source of hard currency and his threat of SDI made the burden on their economy more than it could tolerate. Whether SDI was feasible is beside the point. The Soviets didn't know that it wasn't feasible and they couldn't afford what it would have taken to match it or counter it.
Now we have a large group of people in this country who do not take the threat seriously and somehow think that there is something that we can do to change the minds of these murderous radical Muslims who want to kill everyone who doesn't follow their brand of Islam. It doesn't seem to matter whether those killed are Jews, Christians, or Muslims who do not follow the Wahabbi line. It is my view that Iraq is pivotal in this war. The time for deciding whether we should be there is past. We are there and we have an obligation to those who have died, who are serving, and to those who are paying for it that it all not be in vain. At the least, Iraq can no longer be a hazard for supplying money and WMD's to terrorist groups.
It is my belief that Iraq had WMD's-as it was of the UN, and all the intelligence services of the world, and, indeed, of many of the Democrats who by hindsight say we should have known that none would be found. The delay occasioned by going back to the UN gave plenty of time to conceal, destroy, and transport the WMD's out of the country-possibly to the Becka'a valley in Lebanon or to somewhere in Syria.
The consequences of failing to win the war on the radical Muslims or to fail to control their activities would mean the end of the whole Western world. It is beyond me why the liberal elite in Europe do not understand that they would be next if the U.S. goes down.
Second: The failure of our education system is next. This is particularly true for the inner city K-12. The blacks and also the poor whites are not being educated to the level required for the students to be able to function in the modern world. When the average student in India can write English better than the average student in the U.S., we are really in trouble. In addition to the poor learning of the basics, we have indoctrination with politically correct notions. One of the most pernicious is the idea that somehow the U.S. is a bad country and that we should be ashamed of it and its actions. Granted the U.S. is not perfect, but we are not responsible for all the problems in the world.
An element in the problems is the view that all black people are victims. In addition there is a soft bigotry that says that blacks are not capable of making it without a lowering of standards. This implies that they are somehow intrinsically inferior. The black attitude against academic achievement is a serious barrier to education. Somehow the idea that it is "whitey" to want to excel in school leads many black children not to try. Added is the problem of fatherlessness. Children without functioning fathers in the home do worse on every social measure-whether it be academics, delinquency, truancy, out-of-wedlock pregnancy, drugs, alcohol, crime, venereal disease, and just about every other problem that a young person can have.
Higher education has its problems as well. In spite of the desire for diversity in the student body, there is little diversity in the faculty. The percentage of Democrats and liberals is in the ninety percent range. One person told me that was because the smart people are all liberal and Democrat. I don't believe that. Academia is the last refuge for Socialists. This in spite of the fact that the experience with Socialism clearly shows that it does not work. It surely didn't work in the USSR. It had to be and is being modified in China and in Vietnam. The two remaining Stalinist regimes are basket cases both socially and economically-Cuba and North Korea. The so-called Democratic Socialist regimes in Europe have not had the burden of providing for their own defense since 1945. If they had they would have been in worse condition than they are now. Their declining birth rates and their declining death rates are providing them with more people on welfare (I include the retirees in this) and fewer workers to support them. If current trends continue, Europe will have a majority of Muslims in fifty years. Currently no Muslim country is really prepared for the modern world. When the oil runs out, they are going to be in worse trouble than they are now.
Third: The Judicial system. We have policy being made by the courts rather than by the
legislature and the Constitution is being ignored. Words are being found in it that are not there,
and rights are being found in it that are also not there.
In addition we have an antiquated legal system. The Constitution calls for a speedy trial and this is honored more in the breach than in the performance. We also have a variety of judge malfeasance. In addition there is jury nullification. On the other side there is jury multiplication in that awards that are obscene are made without any realization that the money has to come from somewhere-either taxes or premiums or prices paid by workers and consumers. It is forgotten that there are consequences to actions. Extreme awards in medical liability cases leads to increased premiums leading doctors to quit doing procedures that may lead to suits, to retiring early, or to moving to another state. Another result of all this is a whole crowd of new millionaires-lawyers who get most of the awards from the lawsuits.
Fourth: The decline of the family. Now we have too many out-of-wedlock births. This leads to poverty for the mother and the child. It also sets the stage for problems for the children: drug and alcohol use, poor school performance, truancy, crime, teen-age pregnancy, marital failure, and depression. When children do not have a functioning father, the boys and girls do not have a model of what a man, a father, or a husband should be.
Fifth: The trade imbalance. It is my opinion that neither persons nor countries can continually live beyond their means. There must inevitably be a breakdown.
Sixth: Excessive spending. Pork is not productive spending. It may give jobs to some who administer and work on the pork projects, but it is not a rewarding process for the economy. .
Seventh: Big government. The more government we have the less freedom. Now the government is involved in more and more of the details of people's lives. It is not possible to make laws to cover every aspect of human activity. And someone must enforce those laws and courts must deal with them. That brings it back to individual or collective (juries) decision making.
Eighth: Racism. Now we seem to have more reverse racism and less direct racism. That is, there is less mistreatment of blacks and more mistreatment of whites. Every time one group gets special privileges over and above the privileges of other groups, it means discrimination on the basis of race. If it was wrong when it was done to blacks, it is wrong when it is done to whites.
Ninth: Lawlessness. It seems that certain groups do not believe in punishment. The same don't seem to believe in evil or badness. Every bad behavior is either medicalized or socialized. The person is mentally ill, and, therefore, not responsible for the misdeed, and is put in a mental hospital and put on treatment. Then some psychiatrist pronounces the person well and they are released. Or else the problem is societal-poverty, ignorance, bad parenting, racism, or some other social ill so that person is really not responsible either. Sometimes it seems the victims of crime are forgotten.
Then there is the problem of some city police being forbidden to report illegal immigrants who are arrested for a felony to the INS. Added to this is elected officials illegally marrying men to men or women to women when clearly such an act is illegal.
Tenth: Illegal immigrants. We have several million illegal immigrants in the U.S. Is it eight million? Or does anyone really know. I perceive poor control of the borders, poor control even at entry points, poor monitoring of visas given to visitors, very few deportations, and, in general, no real attempt at enforcing the laws. It is said that the Republicans want them for cheap labor, and the Democrats want them for cheap votes. If illegals are voting, I think it is wrong. Of course, many of them have relatives who are citizens and they can vote.
This is going to lead to the U.S. being bilingual. We have enough divisions in our society without losing a national language. I do not want to have the U.S. take up the social views of the countries that most of these immigrants come from. Another hazard of uncontrolled immigration is national security. How can we be sure that some of the Muslims are not agents for groups that want to destroy the U.S. and all it stands for?
Eleventh: The national debt. We will some day have to pay the piper.
Twelfth: The general decline in behavior. We have seen a coarsening of language and a decline in common courtesy. We have become accepting of lying, stealing, drug use, and lack of compassion for others. We have seen a decline in social capital. People don't relate to others as they did. Clubs, service organizations, gathering of groups, and interaction of neighbors and families seems to be less and has been well documented in the book, "Bowling Alone."
Thirteenth: Decline of the family. Divorce is rampant. In spite of the belief of some, divorce does adversely effect the children. Infidelity may have always occurred, but it seems more common and is more accepted than it used to be.

52. Citizens Police Academy 1 March-4 May 2004
In 1994 the police department learned of a program for citizens put on by Springfield, Oregon. Police Chief Keesling received the information, but nothing much was done about. Johnson City learned about it and asked if they could see the program. They went on and started their program, and won second place in a national competition. After that Chief Keesling demanded that our force get on with it.
1 March 2004: First session. Captain Paul Bowman made a brief talk about the organization. He is in the administrative division. The training officer was Jerry Robinson. Steve Hammonds was to show defensive tactics. Mark Addington is our current chief of police. The force numbers about 100 but they have others to help, including the officers who work the school crossings and the animal control people. The dispatch people are not part of the uniformed force. Neither are the parking control people and the jailer.
Kingsport has six police zones. The patrolmen work twelve hours to a shift. 6:30 to 6:30 and they have a complicated schedule of off days. Four platoons patrol the zones and they have a 5th and 6th platoon that works 8 P.M. to 4 A.M. when there is likely to be more illegal activity. Much of the crime is drug related-people stealing to get money for drugs or drugs sellers.
8 March 2004: The bomb squad brought in the dog. He is trained to sniff out drugs, but is also used against criminals. A student put on the bomb suit and they showed us the trailer used to contain a suspected bomb. They spoke of undercover agents who had fake I.D.''s and fake driver''s licenses. We were also told about the use of force. The steps were: Verbal request, verbal order, passive resistance, active resistance, empty hand control, pepper spray, use of impact weapons (truncheon-called PR 24-prosecutor 24 inches long), and deadly force. More exactly: Officer presence, verbal request or command, empty hand, pepper spray, hard hand, and deadly force. We learned of the 21-foot rule. Anyone within 21 feet with a knife could get to the officer before he could draw his weapon and fire. The officers carry 15 to 18 pounds of extra equipment. The standard weapon is a 45. It holds 14 rounds and they carry two extra clips.
15 March 2004: Use of force. The protective jackets used to be Kevlar, but now they have better ones. The Kevlar is bullet resistant and is effective against hand guns, but a rifle bullet will go right through it. The officer told us that he had never struck anyone with a PR 24. The body is color coded: Green-okay to strike including mostly muscles, yellow-bones, knees, elbows, groin, red-to avoid-neck, head, and sternum. The speaker said that in spite of the news that the LAPD was the bench mark force. The officers are being trained in Brazilian karate that is like Olympic wrestling. They have a few bad officers, but they didn't last long in the force. One officer was found to be addicted to cough medicine and another left because of rumors of criminal activity.
22 March 2004: Criminal investigation. David Cole had been on the force for 21 years, and had been a detective since 1990. He was involved with crimes against persons. Last year was their busiest year. They clear 59%. The routine is that (1) the patrolman gets the information that he can. Then (2) the case is assigned to a detective. They have four unsolved homicides. The oldest goes back to 1976-a drive-by shooter shot a boy friend in the throat, a man was killed on Miller Street-shot in the yard, ran over a boy''s mother (has a suspect, but no evidence), and a woman beaten to death (she was drunk a lot). We have a forensic vacuum. The FBI lab can analyze hair. Joseph Johnson killed a clerk. They were able to do tape liftings inside a car.(3) Search warrant, but you had better find something. A session's judge can give a warrant anywhere in Tennessee.
Forensic anthropology at U.T. Also can use TBI and FBI lab for evidence. But now the FBI is concentration on terror. Blood stain pattern analysis-how it reacts on a surface. Ricky Cole stabbed to death-unsolved.
An automatic costs $400-500 so a perp is not going to throw it away. Suicides are investigated as homicides. The definition of aggravated assault-serious injury (broken nose not evidence of a serious injury) or presence of a weapon. Aggravated robbery-use of a weapon. Aggravated kidnaping-? use of a weapon. Assault-use of the body.
He then outlined how they solved a murder. Fortunately, two civilians had observed the perp and were able to help. They check into relationships, recent activities, way of life, recent discord, past discord, usual practices, and find someone recently in residence or car. Outside the city it falls to the county officers. National Criminal Information Center..
3 April 2004: I spent several hours in dispatch. It has someone there 24/7. That evening there were three: Susan Wells had the police calls, Eric Clear had fire, and Patrick Sage had medical. Susan told me that they became familiar with many who call in. That it was the same people a lot of the time.
5 April 2004: Traffic Unit. Officer Farmer.
(1) Slide library
(2) Vehicle damage
(3) Conservation of momentum
(4) Airborne (falls, flips, vaults)
(5) Critical speed
Crash investigation, DUI enforcement, Patrol Dale Farmer, ACTHAR # 1182, accredited accident reconstructionist. 1991, 2001-test in Florida and in Boston.
Investigate traffic collisions (they, and I, don't call them "accidents"), traffic safety programs, special traffic details, radar, laser, enforce traffic laws, teach traffic-related courses.
Reconstructionist: Determine cause of crashes (90% driver error), vehicle speed (crushes and tire tracks), time and distance analysis, scale diagram-laser cuts a two and one half hour''s work to thirty minutes, occupant and vehicle positions, testifying in court.
Traffic facts: Age 16-25 are 27% of drivers, but are in 48% of crashes. States with graduated drivers'' licenses have a drop in crash and injury. Worst of all 16 year olds, both male and female. Also 16-25 on cell phones. People speed up 10 miles per hour in fogs. Talking and walking also speeds up in fogs. Speeding related to crashes. Speedometers have three miles per hour error. Failure to yield associated with 30 to 40% of crashes. Following too close is another common cause. 3 second rule. Reaction time averages 1.5 seconds. One car length for each ten mph is too close. At 55 1.5-2 seconds to stop. At 30 mph you are moving 80 feet per second.
Another cause is driver not paying attention-cell phones (I have read that eating or drinking is a more common distraction leading to crashes). Another is driver inexperience and, of course, alcohol and drug use.
The Advanced Visualization Lab at ETSU was able to make a video of a crash of two dray racers in Colonial Heights. They were going 93 on a curve that could only be negotiated at 73. The racers were driving a Camaro and a Mitsubishi. One car went into the left lane and hit a Town and Country minivan. They showed a simulated view from the standpoint of the driver of each vehicle as well as a simulated view as though from an overhead helicopter. The cost was only $26 because of ETSU, but would have been six to eight thousand if paid going rates.

Seat belt laws: At all ages over 18, belt in front seat. Anyone under 18-all in a seat belt. Most insurance companies won't pay if no seat belt. Helps reduce crash forces on the body. One in ten of high schoolers wear seat belts. Seat belts keep you in the vehicle. Out of 20,000 crashes only 2 or 3 on fire.
DUI: 0.08% guilty of DUI. This is federally mandated. The officer said that for a man of his size (?200 pounds) it would take 6 to 8 beers. For 350 pounds it would take 14 beers.
First conviction DUI: $350 fine and court costs, lose driver''s license for one year (can have limited license to go to work and back), 48 hours in jail, suspended sentence 11 months and 29 days, DUI school, probation, $18,000 to $20,000 (?car). If a passenger owns the car, a fine
Second conviction: 45 days in jail, fine. If a wreck, and someone says "I'm sore" charged with aggravated assault. If someone is killed, charged with vehicular homicide.
If blood level is 0.2, can be used against you going back ten years. Under 21 same fine passenger and consumption 0.2. If less than 18 , DUI 48 hour's detention and a fine.
Sobriety test: Standardized. 1. Nystagmus to horizontal (lateral gaze) < sense =" good">500,00 to England
First British Empire ended with Revolutionary War
Second British Empire-1/5 of the surface and 1/4 of the population of the planet.
John Wilson of Blackwood's Magazine "the sun never sets"
Charles Pasley- modern geopolitics
1887-after Waterloo (1815) British Empire grew by 100,000 sq. mi. per year
Scots had more skills and education than others
First Highland Watch 1778 Charles II
1740-1815 86 Highland Regiments, by 1800 the backbone of the British Army
Typhus, smallpox, cholera, scurvy, and yellow fever
During a five-month trip to India in 1782 230/1100 died of scurvy although Lind had found a preventive 60 years before
In June 1819-10 officers, 13 sgts., 8 drummers, and 254 others died of disease
1803 Duke of Wellington defeated the Maratha princes although outnumbered 10 to 1
The 74th Regiment lost 459 out of 495-92%
1776 Major Patrick Ferguson issued a breech loader-4 shots/minute at 200 yards (usual 100 yds.)
General Howe was furious at Ferguson and confiscated the rifles for the Battle of Brandywine in September 1777. Ferguson was killed at King's Mountain. It took 10 years to get breech loaders
Alexander Forsythe- percussion lock with potassium chlorate, but the flintlocks misfired 3/10
Joshua Shaw of Philadelphia made a tiny button of potassium chlorate, misfired 4.5/1000
The changes in technology raised threats to ancient cultures-India, China, Persia
The British had only small areas under their control in India-Bombay, Madras, Calcutta
1806 a Scot named James Mill was hired to write "The History of British India"
It took him eleven years . He was a friend and influenced by Jeremy Bentham
1806 Edinburgh educated Lord Minto became governor-general of India
1812 Thomas Munro in southern India reduced taxes on farmers and pushed for honest tax collection
John Campbell spent 16 years in the hill country rescuing victims of mariah (ritual sacrifice) saving 1500 lives
John Malcolm negotiated a treat with Persia and in northeast Afghanistan broke the power of the robber barons
A liberal imperialism-better schools, better roads, more just laws, and prosperous towns and cities, more money in the pockets of ordinary people, and more food on their tables
Governor-General George Beutjack "England's greatness is founded on Indian happiness."
Dugald Stewart-"the science of legislation"
1890 Afrikaaner South Africa
Scotland in the 1990's
1841 Charles James Napier governor of Sind (now Pakistan) Sind wars local rulers vs Sikh warrior bands; Muslims vs Hindus (1798 father of Charles, Maj. Gen. Napier and the Irish Revolt)
after annexation of Sind, governor general "a great thrashing first and great kindness afterwards"
Napier "a very advantageous, useful, humane piece of rascality"
He lowered taxes, established the port of Karachi, put steam ships on the Indus River, established a police force to maintain order, proposed irrigation, and banned suttee.
1848-1856 The Raj system began under Gen. James Dalhousie, Lord Ramsey, railways, telegraph lines, postal service, schools, roads, and irrigation projects.
Gained control of lower Burma, Oudh, and others. Abolished suttee, thuggee, and ritual sacrifice.
Social revolution in the treatment of women, abolished child marriage, polygamy, killing of unwanted female babies, and established first schools for girls
1857 Indian Mutiny
Opium was illegal in China, but many imperial officials addicted to it and were corrupt in letting it enter the country, but they kept the profits low on legal products like porcelain, silk, or tea
James Matheson and William Jardine became partners in 1827.
England had no drug problem (except for Thomas de Quincy Samuel Coleridge) nor did India
However in China 1% were addicts (about 2 million people) Smuggling
William Jardine, Lord Palmerstone, second Lord Minto, (First Lord of the Admiralty)
The "Nemesis" 184 feet long, 2 60 hp. engines, 2 thirty-two pounders, 5 six pounders, 1 Congreve rocket launcher. Watertight compartments so a waterline hit couldn't sink her, drew only six feet. Left Portsmouth 28 March, 1840. In one afternoon she sank 9 war junks, took out 5 forts, 1 battery, and 2 military supply posts. She was joined by the 510 ton "Phlegethon"
A peace treaty was signed in Nanking in August 1842. Jardine became tai pan of Hong Kong
In Canada and Australia Scots were the dominant influence. Nova Scotia and Newfoundland especially.
1759 James Wolfe and the Fusee Highlanders took the Heights of Abraham
Gen. James Murray (a Scot) first British governor. Scots from the Orkneys were active in the fur trade. Hudson's Bay Company (eastern Highlanders) 4/5 of the employees were Scots
Alexander MacKenzie traveled to Lake Athabasca (Alberta) went up the Mackenzie River 3,000 miles to the Arctic Ocean, also went to the Pacific Ocean
1821 Hudson's Bay and Northwest Cos. merged-largest corporate land holder in the world-3 million square miles (U.S. and China each about 3.7 million square miles)
George Simpson (President of the company-a Scot) presided over ten times more territory than any Roman Emperor.
Loyalist refugees from the Mohawk Valley to eastern Ontario and Scots from the Clearances
"Glengarry shantymen" lumberjacks
John Kenneth Galbraith-a Scot (but I don't claim him as one-DWB)
John MacDonald (a Scot) promoted the Canadian-Pacific Railroad.3,700 miles-900 miles of bottomless muskeg. At Kicking Horse pass 30-40 degrees below.
Lord Elgin (Scot governor-general) abolished feudal land tenure, promoted education, made a treaty with the U.S.1854 preventing a war.
John MacDonald To Glasgow from the Highland to Kingston, Ont. 1820, got a law degree
Liberals vs Tories, Presbyterians vs Episcopalians, French vs English, all vs Americans
Contempt for the English
Liberal Conservative Party Quebec Resolutions British North America Act by British Parliament 1867
1866 Confederation Conference (8 of the 10 founders were Scots)
Created the Royal Northwest Mounted Police. Brought in British Columbia, Manitoba, Prince Edward Island, and kept Nova Scotia part of Canada
Next Alexander MacKenzie. 1/3 of the business elite were Scots. They headed paper making, iron and steel, oil, and gas, and the fur trade. They promoted colleges and universities-Dalhousie University 1818, McGill 1821, U. of Toronto 1827.
Sandford Fleming-chief engineer of the Canadian-Pacific (At that time the U.S. had 100 different times) set up 20 time zones-each 15 degrees of longitude, On 17 November 1883 all clocks and watches were synchronized. (Railway schedules required some standardization of time)
1770 Australia-William Pitt established a penal colony and sent 1000 prisoners to Botany Bay in1888. Then 10,000 more. The prisoners were ill treated with beatings and hangings. If a prisoner served 4 years of a 7 year sentence, he could be freed. Or 6 years of 14 year sentence.
John MacArthur came out as a Lt. in the Army. He obtained a pair of long-haired merino sheep from George IV's private stock, crossed them with Bengal and Fat Tail sheep and set up a sheep farm. He prospered and established a 60,000 acre sheep farm called Camden Farm. The Australian sheep came down from this start.
William Bligh of the Bounty became military governor.
1809 Lachlan Macquarie governor-general Found the place in a mess. He banned the rum trade, closed the bars in Sydney during religious services on Sunday, and had the convicts go to church. Developed Liverpool Plains for farming. Back to England in 1821.
Thomas Brisbane
1840 Alexander Maconochie took over Norfolk Island (prison)-put in a library and an orchestra
1867 Convict ships were stopped
1880 Australia had the fastest growing economy and the highest per capita income. 20% of the borrowed capital used in Australia came from Scottish banks
Africa-African middle men. Mosquitoes on the coasts and swamps inland
1805 Mungo Park took a group up the Niger-all died
1823-1827 2/3 of the British soldiers on the Gold Coast died
1824 221/224 died
MacGregor Laird took 48 up the Niger and 9 survived
DAVID LIVINGSTONE got religion. Studied Greek and Latin at 14. Calvinist Congregationalist Studied chemistry and theology at Anderson College at University of Glasgow. Classmate of William Thomson (Lord Kelvin) and Lloyd (later Lord) Playfair
1838 M.D. wanted to go to China as a missionary, but the Opium War was on
December 8, 1940 Left Liverpool, at sea three months. From Cape Town 600 miles north to Moffat's Station at Kuraman, then 500 miles northeast. Lost the use of his right arm from an attack by a lion. Got malaria, but took quinine. Reached Lake Ngami at the upper reaches of the Kalahari Desert to Victoria Falls.
Zambezi River-the Portuguese controlled the headwaters and didn't allow exploration
1853-1856 Livingstone crossed Africa from ocean to ocean
Livingstone: Two great barriers to Christianity-commerce and "civil agitation." White racial prejudice and the slave trade
"The Zambezi and Its Tributaries"
1833 Britain frees its slaves
Arab slave traders and Zanzibar.
Livingstone, Mary Moffat Livingstone, son Robert Livingstone, brother Charles up the Zambezi in the world's first steel-hulled steamboat to Quebrabasa Rapids. Reached Lake Nyasi (now Lake Malawi)
1866 with only 30 porters searched for the source of the Nile
Henry Stanley (Scottish descent) to east-central Africa for two years. Found Livingstone at Ujiji in 1872. Livingstone died May 1, 1873. His heart was buried 70 miles from Lake Bangweulu. His body was carried to the coast and then taken to England for burial in Westminster Abbey.
Scots in the U.S.
3/4 million vs 5 million Irish. Most Scots could read and write English. They had the work ethic and moral discipline.
The Anglo-Saxons were a privileged elite. The middle class was Anglicized. The Irish immigrants crowded into the cities. The Scots were in the hinterlands competing with tribal warrior societies.
DAVID HUME'S secular Golden Rule: "You leave me alone and I'll leave you alone."
Traditional moral discipline (Presbyterianism)
BENJAMIN RUSH modeled the Pennsylvania medical school on Edinburgh and established Dickinson College in western Pennsylvania.
Dugald Stewart
George Jardine
James McCash (Queen's College in Belfast) to Princeton First used the word "campus" Scottish philosophy
The German university ideal of rigorous research and specialization was coming on.
McCash disagreed with Charles W. Eliot about allowing electives.
American philosophers were turning to Kant, Hegel, Auguste Comte, and Karl Marx
The intellectual climate was becoming more secular and skeptical
Scottish tradition-liberal arts colleges and universities
ANDREW JACKSON, JOHN C. CALHOUN, JAMES K. POLK, JIM BOWIE, DANIEL BOONE, WILLIAM CLARK, SAM HOUSTON, GENERAL WINFIELD SCOTT
Early 19th century another wave due to Clearances and a cholera epidemic
Textile mills, ship building, iron foundries, stone cutting, paper making, typemaking, dry goods
The department store was started by the French, but Scots headed them in the U.S.
David Nicholson in Philadelphia, Dugald Crawford in St. Louis, Robert Birtwick in Buffalo, Robert Dey in Syracuse, John Forbes in Kansas City, Carson Scott in Chicago, William Donaldson in Minneapolis, and Alexander Stewart in New York City.
John Kinzie and Alexander White were two of the founders of Chicago.
Early Mormons were often Scot converts: The first Colorado resident was John Gilroy. Other Scots Kit Carson, Isaac Gotham, Hugh Reid
James McKinley had ranch Santa Anita (now Pasadena)
James Wilson Marshall saw some gold at Sutter's Mill 1857 $500 million gold found
Donahoe-Irish but raised in Glasgow. Three brothers. Peter first steam engine for a U.S. naval vessel on the West Coast. First steam locomotive in California.
1873 Andrew Hollidie cable cars
William Anderson San Francisco's First Presbyterian Church
William Scott of San Francisco's Calvary-these two thought California would be the new Utopia
Scott saw the city as an Athens or a new Edinburgh
Methodist William Taylor, the most influential of the three, was dubbed "John the Baptist of the Gold Rush"
1854 "The Flying Cloud," a clipper ship, built by Donald Mckay, sailed from New York to San Francisco in 89 days 8 hours. 400 miles/day. Another clipper "Great Republic"
William Thompson's White Star Line from Aberdeen-Cutty Sark 1869-a China Clipper. These ships could beat the steamships of the day.
SAMUEL FINLEY MORSE-studied and was an artist, but got involved with the telegraph and devised the Morse code in 1834.
By 1854 23,000 miles of telegraph wire
ALEXANDER GRAHAM BELL Edinburgh U. 14 February 1834 patent
ANDREW CARNEGIE began as a telegraph messenger boy, first fortune in railroads, George
Pullman. Second fortune in steel. (Henry Bessemer was English.) Using his method by 1892 U.S. Steel was producing steel equal to ½ the total production of steel by England. U.S. Steel was vertically integrated.
(Charles Macintosh-rubber)
"Economy of scale" "Triumphant democracy"
Carnegie admired Herbert Spencer "The Gospel of Wealth"
Homestead Strike of 1892. The loss of life upset Carnegie.
J. P. Morgan wanted to buy U.S. Steel, told Carnegie to name his price. Carnegie wrote "480 Million" so Carnegie sold out.
$300 went to Carnegie. He gave $ 80 million to Scottish projects. 2800 libraries (2000 in U.S.), 7,689 pipe organs, Carnegie Hall, Carnegie Tech, and built Lake Carnegie at Princeton so that Princeton could compete with Harvard and Yale in crew.
Samuel Langley developed an airplane, but the Wrights got the patent in first
Alexander Bain, professor of logic, Marischal College founded "Mind"
William Thomson, Lord Kelvin U. Glasgow
James Clark Maxwell-the father of electro-dynamics Aberdeen
1890 James Frazier, "The Golden Bough" modern anthropology looked to German and French
1902 "Dreadnought" Made all the navies obsolescent
Glasgow 1 million people
1894-1916 Of five Prime Ministers three were Scots: Rosebery, Balfour, Bannerman
Ramsey MacDonald
Scotland: Poverty, Infant mortality. Disease and malnutrition. Lack of toilets.
1898 2/3 recruits were turned away unable to pass the physical
1900-1910 250,000 left Scotland
1870-1920 half the emigrants went to the U.S.
1872 first compulsory education for Scotland
1/7 to secondary school in Scotland
1/20 to secondary school in England
Alfred Harnsworth: Rise of tabloids Daily Mail 1896; Daily Mirror, Daily Express
ROBERT LOUIS STEVENSON: "Treasure Island" "Kidnaped" "Master of Ballantyne"
ARTHUR CONAN DOYLE (Roman Catholic): Sherlock Holmes (modeled on Dr. Joseph Bell, an instructor at Edinburgh Medical School) "The Lost World"
JAMES BARRIE: "Peter Pan"
Harry Lauder: Comedian on the stage
Whiskey: John Walker and Tommy Dewar
Field Marshall Lord Robertson, Sir Ian Hamilton of the General Staff responsible for the Gallipoli failure, General Douglas Haig Disaster at the Somme, Ypres, and Passchendaele by Haig. Robertson, despite misgivings, failed to intervene to stop Haig.
World War II Spitfires and Rolls-Royce Merlin engines
1950 Scotland 15% of the world's shipping
1960 James Bond (half Scot and half Swiss) by Ian Fleming
1853 "Casino Royale"
1296 Stone of Scone Lia Fail (Gaelic) taken to London by Edward I
1928 Formation of the Nationalist Scottish Party SNP
1996 Some young Scots stole it and took it back to Scotland
2001 Scotland got a separate Parliament
Now Scotland has become a computer center and a service center.
The Biggies
John Knox
Robert Burns
William Wallace
Adam Smith
James Boswell
David Hume
Andrew Jackson
James K. Polk
John C. Calhoun
Patrick Henry
William Lynch
James Madison
Alexander Hamilton
Thomas Reid
Dugald Stewart
Thomas Babington Macaulay
Sir Walter Scott
James Watt
William Cullen
Richard Bright
Thomas Addison
Thomas Hodgkin
James Lind
James Cook
Erasmus Darwin
Charles Darwin
David Livingstone
Benjamin Rush
William Clark
Sam Houston
Jim Bowie
Daniel Boone
Winfield Scott
Samuel Finley Morse
Alexander Graham Bell
Andrew Carnegie
Robert Louis Stevenson
Arthur Conan Doyle
James Barrie
James Bond (by way of Ian Fleming)
It may seem strange to include a fictional character in this list, but many people who don't know any of the above real persons probably know a lot about James Bond. I should add Sean Connery-his name is probably better known to the general public than many of the biggies listed above. And these two may have helped to define our present (modern) world-or not define it.
Donald W. Bales 12 July 2002

Ginny asked her mother about the main themes of the book. She read the printed copy-she doesn't like reading on the computer screen. She found some dates that were not correct-a 9 instead of an 8 or a 7. Even though she had read the book, my notes didn't add much to her understanding. That may be the case with each of you.
What are the major themes?
Literacy promoted by John Knox so people could read the Bible. They read a lot of other things-another example on an unintended consequence.
Moral focus from Calvinist Presbyterianism. The Anglican Church may have had less effect.
Protestants to Edinburgh. Only Episcopalians (Herman writes of them that way-I would have dubbed them Anglicans)
More economic freedom. ? less control by the landed aristocracy.
Free and open discussion of serious subjects by relatively well educated people who had some leisure. (Graham Leonard maintained that this is what gave rise to the Golden Age of Islam-750-970?)
Did living in a poor country lead people to be hardier and more concerned about bettering themselves?
At any rate the Scottish Enlightenment seemed to have had far reaching effects.

63. Global Poverty
During the spring session of 2005 I led a seminar for the Great Decisions Program of the Foreign Policy Association on global poverty. I used the March 14 Issue of Time Magazine article. The article was based on the book by Jeffrey D. Sachs. He is in charge of the Millennium Program. He was a tenured professor at Harvard at age twenty-eight.
One million (maybe three million) African children die of malaria each year.
(Rachel Carson's book "Silent Spring" may have contributed to this by leading to the outlawing of DDT.)
Eight million people are reported to die each year due to lack of food.
We give sixteen billion a year to these programs-0.15 % of our GNP.
Sachs refers to "clinical economics-"good development economics and good clinical medicine. Clean water, productive soils and a functioning health care system are as important as exchange rates.
He has another term "economic plumbing." This refers to the institutions needed for dealing with the poverty problem. The right ingredients are good harbors (but some are landlocked), contact with the rich world (but some are not on the beaten economic paths), favorable climates (but some are arid) and freedom from epidemic disease (but many have malaria and HIV).
The one-sixth (one billion) has the problem of AIDS, isolation and civil wars.
The population is up sixfold in two centuries-1820-2000. The per capita income is up ninefold during the same period. The U.S. per capita income is up twenty-five fold.
Sachs is the head of the UN Millennium project.
In Kenya the Sauri area consists of eight villages. It is in the Siaya district of the Nyanza province. Of two hundred households in Sauri malaria was present the three-fourths, orphans in one-tenth, bed nets (against malaria-carrying mosquitoes) in one percent, and fertilizer use in none although all would use it if they could afford it.
He thinks Kenya with thirty-three million people needs 1.5 billion and gets 100 million.
Total from the world for all of Sub-Saharan Africa" $30 per person. Of this $5 goes for consultants, $3 for emergency aid, $4 for servicing debts, and $5 for debt-relief operations. That leaves $12 of the $30 per capita for trying to alleviate the poverty of the local people. Sachs thought $70 per person would do the job, or $350,000 for all of Sauri.
One half of the six billion people on the planet is poor.
1.1 billion (2001) live in extreme poverty on less than one dollar a day, but this is down from 1.5 billion in 1981.
!.9 billion (2001) live in moderate poverty one to two dollars a day.
East Asia has dropped from 58% extreme poverty in 1981 to 15% in 2001. ( Some think this was due to changes in government policy (China) allowing contracts so foreign investment would come in and allowing more free enterprise.)
South Asia has dropped from 52% extreme poverty in 1981 to 31% in 2001. (Some think that this is due to a change from socialist practices to more free enterprise in India).
Africa still has half its population living in extreme poverty.
The IMF has often demanded austerity that made things even worse.
Sachs advocates five policies to combat poverty:
1. Boosting agricultural production.
2. Improving basic health
3. Promoting education
4. Improving power (electricity)
5. Clean water and sanitation
Some think the problem is related to corruption and misrule.
Malawi, Mali, and Senegal have had less corruption and misrule than others, but have still not improved. Possible causes: Lack of rain, landlocked, off the beaten paths, and difficult terrain.
Bangladesh, Indonesia, and Pakistan have done better, even though plenty of corruption and misrule. Not as dry and not off the beaten paths as much and terrain not as bad.
Sachs thinks that democracies (really representative republics) like Brazil, India, Nigeria, Senegal, South Africa, and others should lead the way to calling attention to the problems of the poor countries.
Sachs' main push is for the U.S. to give more money. He points out that one of the serious problems in Sub-Saharan Africa is the death of working age people due to HIV-AIDS. He suggests more money for treatment AIDS related disease. (But there was no mention of prevention, or of changing the culture of promiscuous heterosexual that is the principal mode of spread of the disease in Africa. Nor is that emphasized in the U.S. or elsewhere so far as I can tell.)
Now see what Star Parker thought about the Sach's plan.
Philanthropy is the best way to combat poverty
Columbia professor Jeffrey Sachs intends to cut world poverty in half. He outlines his plan in a cover story in this past week's Time magazine.
Sachs isn't just an academic sitting in an ivory tower writing provocative papers. As director of the U.N. Millennium Project, he has tens of millions of dollars financing his activities and clearly is someone who knows how to get attention and mobilize power and influence. Time's cover story is just the latest of high-profile press coverage that the professor has received, which includes major stories recently in The New York Times Magazine and The Economist.
What's his plan?
Quadruple U.S. foreign aid. Add a total of about $130 billion to foreign-aid expenditures of the world's industrialized countries and recycle these funds into spending programs in developing nations. According to Sachs, these programs will reduce global poverty by 50 percent by 2015.
Is there an echo in here? Aren't these "new" ideas something we've heard before?
Sachs talks about "ending poverty in our time," which we can do by adopting his "new method." Tax and spend to end our problems? A new method? The real question is what is this guy peddling to reporters to induce their amnesia.
Here's President Lyndon Johnson announcing the launch of his "war on poverty" and the Economic Opportunity Act of 1964:
...(F)or the first time in history, it is possible to conquer poverty...
The Act does not merely expand old programs or improve what is already being done. It casts a new course. It strikes at the causes, not just the consequences, of poverty.
When Johnson launched his "war," the percentage of the U.S. population in poverty was around 19 percent. By the early 1970s, it dropped to around 12 percent. However, the decline in the national rate of poverty was already headed downward well before 1964. The poverty rate in the late 1950s was 23 percent. U.S. poverty has fluctuated around 12 percent for the last 30 years.
Despite trillions of dollars of expenditures with questionable impact on the incidence of poverty, the greatest costs of Johnson's programs were the human costs. People were taught to turn to government rather than their families and themselves for the resources to contend with life's challenges. The psychology of victimization, passivity and dependency is the great legacy of Johnson's poverty programs.
The black poverty rate - 23 percent in 2001 - remains well above the national average. Incidence of out-of-wedlock births and fatherless households in the black community are triple today what they were when Johnson signed his legislation.
As Tom Sowell has pointed out, blacks were making great progress before the 1960s. From 1940 to 1960, not an easy time for blacks in America, the incidence of black poverty dropped 50 percent.
I find it particularly ironic that Sachs chooses to wave his finger most accusingly at his own country. Listening to Sachs, you would think that the United States, the world's greatest engine of prosperity, is the most guilty for current levels of global poverty.
This gets back to the fact that Sachs thinks that foreign aid (translation: government spending programs) is what creates prosperity. So, by Sachs's measure, the United States is stingy and not doing its part.
But government spending programs do not create prosperity. Free people do.
Regarding U.S. generosity, Sachs seems to have little interest in work done by Carol Adelman of the Hudson Institute, who has shown that U.S. philanthropy going abroad from private sources is three-and-a-half times larger than official U.S. government foreign aid.
Recently I had the privilege of meeting John Coors, a businessman, entrepreneur and Christian philanthropist. While flying over sub-Saharan Africa at night, he looked down from his plane and saw darkness, even though he knew he was flying over a highly populated area. He knew what to do. He started a program setting up energy stores and delivering batteries and small propane stoves to these communities. He found that families were willing to invest two months of their meager income to purchase these stoves. Coors is bringing light to Africa and he is doing it through his own initiative.
Certainly, I share Sachs' concern about poverty and suffering. But the answer is what Coors is doing. This option is open to Sachs. He could use his energy to mobilize private resources and private philanthropists and encourage freedom and the values that go along with this.
Sachs is promoting exactly the wrong message in parts of the world that need to hear the opposite of what he is telling them. I hope our own government does not cave in to his demands. We should listen to President Bush that freedom is the message America should be sharing with the rest of the world.
Star Parker is president of the Coalition on Urban Renewal and Education and author of the newly released book 'Uncle Sam's Plantation.'
This is not from the Time article. Uganda has done better with this than any other African nation. It has also done better at managing the economy. Botswana is said to be one country in Sub-Saharan Africa that is doing fairly well. Botswana has diamonds.
Zimbabwe was the bread basket of Africa until the change in government led to the exitus of the white farmers. Now Zimbabwe cannot even feed itself.
It is my opinion that the U.S. and other wealthy countries can and should help. The UN should help, but unless the countries try to help themselves, they are doomed to continue to starve and die of disease. I do not believe outside people can make enough difference to solve the problems.
Donald W. Bales, March 2005

64. Here’s to Your Health Donald W. Bales, M.D. 1975
Introduction:
Politicians, labor leaders, economists, social writers and even some physicians have written a lot about the health care crisis. Health Maintenance Organizations have been proposed ands funded with start-up money.
Much has been written about poor access to health care by the poor-rural and ghetto, and even about poor access by the middle class. More has been written about the high cost of health care and comparisons of the state of health measurements of the United States and of other countries have been quoted to the detriment of United States health and medical care.
The medical journal authors and other medical writers frequently suggest the doctors do not provide enough preventive care, that they do not take enough time, and that they do not make themselves available enough at night, week ends and holidays.
There may be some merit in the previously mentioned ideas. However, there is another point of view and constructive suggestions that have not been emphasized enough.
I have been in the private practice of internal medicine since 1952, and have been an observer and participant in the medical scene since 1943. I started in medical school on January 1 of 1943, graduated in March 1946, served fifteen months as an intern, was an Army medical officer 1947-1949, and was in a medical residency from 1949 until 1952.
I would like to present my ideas about the citizen and potential patient (or medical care consumer-to use the new terminology) can do to help himself of herself in promoting health, preventing suffering and disability, avoiding health or sickness costs and increasing his or her longevity.
Would you like to avoid suffering, disability, illness, injury, and increase your longevity? Foolish question? It’s like asking people if they are against motherhood and in favor of sin, although, as I think about it, this saying is not quite as acceptable as it once was.
It would be fairly simple to do the above things, at least, in part and for some people-for sure on the statistical level.
Since I want to aim this book at the general public, I do not want to obscure the message by constant reference to sources. Almost none of the information originates with me. Most of it will come from other sources. All this has been filtered through my knowledge-gained from formal education at Harvard College, University of Tennessee Medical School, internship, experience and study in the 130th Station Hospital in Heidelberg, Germany where, in addition, to my military duties and our journal club, I made rounds with the German doctors at the Ludolph-Krehl Clinic, internship and residency in medicine at the Henry Ford Hospital in Detroit, Michigan. I took additional short courses (four or five days) given by the American College of Physicians, of which I am a Fellow. I have also taken other courses given by various medical schools throughout the United States. I also took Audio-Digest Internal Medicine, Network Continuing Education (on videotape), plus continuing reading of medical journals, and participation in the American College of Physicians, of which three have been offered so far. I also took part in the recertification examination given last fall by the American Board of Internal Medicine, so I was certified in 1954 and again in 1974.
I was looking through some old papers recently and came across this. I wrote it in 1975. I was not happy with the writing, but I pretty much left it as it was with correction of a lot of typos and making some of the sentences shorter. I was rather pleased with the content as it reflected the knowledge available to me at the time. Sit-ups are no longer recommended-now crunches are recommended instead. I wrote this in1975.
Chapter One: Defense Against the Killers
Not long ago as an exercise in reality and to increase understanding of the patients’ problems, some medical students were asked to fill out a death certificate for themselves. Most would not do so, and those who did picked unrealistic disorders. Other studies have shown that doctors, even, or maybe especially, would grossly overestimate their remaining life span when compared to the expected life span for their age and sex.
The above is intended to indicate the difficulty most of us have in facing the fact that each of us is mortal. Everyone knows that man is mortal, but somehow we do mental tricks on ourselves to think that it won’t happen to us, or we are like Scarlett O’Hara in "Gone with the Wind," and say to ourselves that we’ll think of that tomorrow.
The leading cause of death in the western world is heart disease-about seven hundred and fifty thousand deaths each year in the United States alone, and about five million people are victims of that disease right now. This accounts for about half the deaths in this country, so a lot of us will die of heart disease. Most of this is due to arteriosclerosis (hardening of the arteries) that can effect any artery, but has a special tendency to involve the arteries of the heart.
The cause of this disorder in not clearly known. It is thought to be due to many different causes that working together in various degrees and combinations, seem, at least, to be associated in a statistical way to lead one to think it is cause and effect.
Men have more and earlier arteriosclerosis of the heart than women do. One theory is that boy babies’ arterial lining is thicker at birth than that of girl babies. Others have said that male hormone aggravates and female hormones decrease the tendency. It is uncommon for women who still have regular menstrual periods, or, who still have estrogen production (estrogen is a female hormone made by the ovary), even if the uterus (womb) has been removed, to have coronary heart disease (arteriosclerosis of the heart arteries). However, in men with cancer of the prostate who are given big doses of a synthetic female hormone to slow the growth of the cancer cells there is an increased death rate from coronary heart disease, but with a decreased death rate or a delayed death from the prostate cancer.
A current theory of causation is having a type A personality. This refers to a person who is time ridden, always hurrying, always fighting, the clock, and, who also may have much resentment and hostility. It may be with women’s liberation that more women will get into the type A personality behavior pattern and so will lose some of their immunity to the disease.
It is not practical to consider change of sex so, from the preventive point of view, men can only recognize the increased risk and try to identify and correct other unfavorable factors. It has not been proven that a type A person can change and become a type B, nor that, if he could, it would change his future. Drs. Rosen and Friedman (the proposers of the type A personality theory) think that both are possible.
Some families have an increased incidence of coronary disease at an early age. If you have this family history, you obviously cannot pick out different parents, but you can try to find and change any alterable adverse factors.
Some families have an inherited abnormality of the blood fats, namely cholesterol. This chemical is found in everyone’s blood and is related to bile salts and hormones. Cholesterol (sometimes with calcium) is found in deposits in the lining of the walls of the arteries. This decreases the size of lumen of the arteries, somewhat like the crusting inside a water pipe. When the lumen of the artery gets small enough that not enough blood can get to the tissues of an organ
served by the artery, the function of the organ is impaired. In the case of the heart the patient will get pain in the chest on exertion or excitement (anything that leads to the heart to pump more blood). This pain is called angina pectoris. Sometimes there is bleeding into the wall of the artery or a clot forms in the narrow or damaged part of the artery so that no blood goes through that artery and the patient has a heart attack as President Eisenhower and Johnson did.
Population studies have shown that animal fat consumption and elevated cholesterol in the blood is associated with a high incidence of arteriosclerosis of the arteries of the heart. On the other hand, countries with low animal fat consumption and low blood cholesterols have a low incidence of coronary heart disease.
We do not have good evidence that lowering animal fat consumption and blood cholesterol by diet and medications will change the future for a person with high cholesterol.
Most of our decisions are based in inadequate data -whether in medicine, or in economics, politics or even in the so-called hard sciences such as chemistry or physics.
I recommend a low animal fat diet as having a good deal of scientific rationale, no clear evidence of harm, and it will fit in with an approach to world food problems since it takes ten pounds of plant food to produce one pound of animal tissue. I have been on a low animal fat diet myself for many years, although I am not known to have anything wrong with me other than a bad temper. Some of my patients say I don’t even have that.
Some families have elevated levels of blood triglycerides-another blood fat. It is the same type of fat you see on ham or roast beef. The fat has to be made soluble (able to be dissolved in a watery solution). Our bodies are sixty to seventy percent water and all the chemicals in our bodies are dissolved in water unless in solid form like bone.
Triglyceride elevation responds best to avoidance of alcohol, avoidance of sugar, and to loss of weight if the person is overweight.
Smoking has been found to be associated with an increased incidence of coronary disease. Formerly it was thought that pipe or cigar smoking was not as bad, but recent studies have shown that primary pipe and cigar smokers do not inhale: however, secondary cigarette smokers, that is, previous cigarette smokers who quit cigarettes, do inhale, and, therefore get the tar and the nicotine into their lungs and into the blood stream as much as cigarette smokers do. Therefore, they are probably as much, or more, at risk than they were before. Filters are only a sop to the mind-stronger tobacco is used (previously the bottom leaves "suckers" were not used as being too strong) so that what comes through the filter is the same. The truly mild or highly filtered brands are described by smokers as "next to nothing" since the kick from the nicotine and the taste of the tar has been so cut down-or out, that the charm is gone. This is all second hand to me, since I have never really smoked (that is, never learned to inhale and never had a habit of smoking.)
A sedentary way of life has been linked to coronary disease. Studies have compared more active groups with less active groups. The active groups have usually had less disease. Some have criticized these studies because other factors were not controlled for or accounted for. No one has shown increased longevities with increased physical activity, although several have shown increased quality of life. Admittedly quality of life is hard to measure in a quantitative way.
I have been exercising since 1962, using the booklet, "President’s Council on Physical Fitness." It can be obtained from the Government Printing Office, Washington, D.C. I have been a jogger for several years, at first, per "Jogging" by Bowerman and Harris, and, later, per "The New Aerobics" by Kenneth Cooper.
"Train and don’t strain" is the proper motto. Careful examination by a physician interested in and concerned with exercise is mandatory before a sedentary obese middle-aged smoker starts an exercise program. Thousands, and, maybe millions, of people have coronary disease that they are not aware of, and vigorous unaccustomed exercise could, can, and has provoked fatal spells of abnormal heart beat (ventricular fibrillation-the most common cause of sudden death-most of it related to coronary heart disease).
High blood pressure or hypertension (that does not mean nervous tension) is often and usually familial. So, if you have relatives who have it or who had or died of strokes, kidney failure, congestive heart failure (dropsy), or a heart attack at a young age, you, too, might have high blood pressure. It produces no symptoms early on, so, if you wait until you are sick from it, it’s too late. It’s easy to detect-just have your blood pressure checked. We have good medications for it, and treatment has been proven to change the future of the patient-at least, as far strokes, heart failure, and kidney failure are concerned, but not so far as coronary disease or heart attack is concerned. However, some investigators think that the treatment was started too late to prevent the heart attack-that the damage process had gone too far before treatment was started, and that earlier treatment may prevent or postpone the coronary disease.
One of the problems with this and with other treatment situations is lack of compliance, that is, the failure of the patient to follow the treatment program. Some non-medical people (sociologists) have done studies that suggest that forty percent of the people who go to doctors have no intention before they go of following the advice that they receive. This may seem a high percentage, but I know from my own experience that compliance is lacking in some cases, and is inadequate in many. The best treatment is of no value unless it is followed.
Diabetes Mellitus (sugar diabetes), another adverse factor causing arteriosclerosis of the arteries of the heart and elsewhere, was uniformly fatal prior to the discovery of insulin. Since then, patients rarely die of keto-acidosis. That is a state due to lack of insulin to utilize the sugar. This led to the use of fat as fuel. When the fats were incompletely used up (oxidized), "ketone bodies" built up in the blood, and were excreted in the urine with alkali (base) and water. The elevated level of sugar in th blood led to the sugar being excreted in the urine so that the patient became dehydrated, and acidotic (the pH of the blood dropped), went into a coma, had a drop in blood pressure, and the patient died. Now the diabetic patient with severe diabetes survives, perhaps to have children who have a greater chance of being diabetic than the children of normal parents.
Diabetics, after years, develop complications of the disease such as kidney damage, nerve damage, damage to the retina of the eye (diabetes is the leading cause of blindness) or premature hardening of the arteries-of the lower extremity with gangrene of the foot or leg, or of the heart with angina or heart attack, or of the brain with a stroke. Poor control of the disease due to failure to follow a proper diet, to regulate physical activity, to take insulin or to have proper care of infections or other illnesses, causes those complications to be more common or to occur earlier than they otherwise would.
There is another group of diabetics who get the disease in older years. They are usually fat (the young severe ones are usually thin), who can get by on diet alone, and who would not really be diabetic in any practical way if they would attain and maintain ideal body weight. Many of these patients cannot or will not diet, and have so much sugar in their blood and urine that they must be given oral anti-diabetic agents. A recent large-scale study seemed to show a greater death rate from heart disease in those treated with diet and oral drugs than in those treated with diet alone of with diet plus insulin injections. Many diabetic specialists do not agree with these conclusions, but prudence suggests using these agents only if it is absolutely necessary, that is, when the patient cannot or will not diet properly, and if insulin is unacceptable to the patient. Some doctors, including me, have never used these oral drugs very much, so the study did not cause much concern for their diabetic patients.
It has been found that diets need not be weighed as was formerly thought to be the case. The use of food exchanges has made the diet less monotonous and easier to estimate as to fat, protein and carbohydrate components. The new U100 (100 units per milliliter) insulin is much purer and in smaller volume and is less painful and also less likely cause allergic and other reactions. Having only one strength will help to avoid confusion-previously and currently both U40 (40 units per milliliter) and U80 (80 units per milliliter) existed and each required its own syringe-when the older preparations are phased out as planned.
The second of the killers is cancer. Of these, cancer of the lung is the most common. There are several types of lung cancer. The most common one is squamous cell carcinoma, a malignant new growth of the lining of the bronchial tube. This is more common in urban than in rural areas probably related to pollution. It is more common in smokers than in nonsmokers. One can do little about atmospheric pollution except at the ballot box or through environmental organizations, unless one has a position of authority in some large corporation or in government, but each person has a choice to smoke or not to smoke. Smokers also have an increased incidence of bladder cancer-apparently some cancer-causing chemical is absorbed though the lung, enters the blood stream, is carried to the kidney, where it is excreted at a high concentration, and is held in contact with the bladder lining until the person urinates.
Cancer of the cervix seems to be related to sexual intercourse with multiple partners. Nuns have a low incidence of cervical cancer, while promiscuous young women seem to develop the disease earlier and with greater frequency than their less sexually-active contemporaries. Cancer of the cervix takes a long time to develop so the Pap smear can detect it at an early stage. I have always thought that the promoter of the smear was not named Mominowsky instead of Papanicalaou-then we could have called it the "Mom smear" rather than the "Pap smear" since it is mostly used for "Moms" and not for "Paps."
Cancer of the breast is very common, but lends itself to early detection by examination of the breast by the woman herself. I tell my patients to do the examination once a month-either the first Monday morning after the beginning of her period or the first Monday morning of the month. That would lead to an examination once a month. Doing it in the morning avoids losing a night’s sleep if she finds something. Doing it on a Monday gives her all week to get it checked and maybe biopsied before the next week end. It helps the doctor avoid getting frantic phone calls at hours or times when can do little to resolve the problem. (One should be practical.)
Cancer of the colon is most common in the rectum. Fifty percent are within reach of the doctor’s finger (with a glove on it, I hope.), and seventy-five percent are within reach of a ten inch (twenty-five centimeter) sigmoidoscope. The sigmoidoscope is a metal tube that is inserted (gently, I hope) into the rectum by the doctor after the lower bowel has been emptied of feces by an enema. During the insertion there is an obturator inside the tube to make the end rounded so it will go in more easily. After insertion the obturator is removed so that the doctor can look through the tube and see the lining of the rectum. A light is attached to the back opening of the tube to provide illumination of the inside of the rectum. Although the anus (the opening where the skin and rectal lining meet) is quite sensitive to pain, touch, and heat, the rectum is not so a person can have a large growth in the rectum without having any pain. Rectal cancer is the most easily found and most beneficially treated of all internal cancers, and is relatively common in both men and women. Anyone who has rectal bleeding, diarrhea, or constipation, especially if not explained and not temporary should be sigmoidoscoped. Bowel X-rays with instilling of barium into the rectum and colon is also helpful in finding colon cancer. The flexible colonoscope will allow more (sometimes all) of the lining of the colon, but this requires an expensive instrument and a skillful operator, and is not available everywhere.
Acute lymphatic leukemia of children and sometimes of young adults lends itself to treatment with multiple drugs and radiation so that prolonged remissions can be obtained in a good percentage so that even conservative physicians talk about long-term freedom from recurrence after months or even years with no further treatment.
Hodgkin’s disease in another malignant disease, not exactly cancer, but in the same general group, that lends itself to useful remissions or even "cure." Multiple toxic drugs are used, but you can’t kill an elephant with a Flit gun.
Cancer of the uterus (womb) is becoming more common at a time when the number of deaths from cervical cancer is declining. Abnormal uterine bleeding would call for a bimanual pelvic examination (and Pap smear although the Pap smear is not useful for detection of uterine cancer). In case of any doubt the patient should be referred to a gynecologist for dilatation and curettage of the uterine lining. The opening in the cervix is dilated and the lining of the uterus is scraped out for examination by microscope by a pathologist. If cancer is found, then removal of the uterus or radiation therapy is done. Sometimes both are used.
Cancer of the lip and of the exposed skin is common, visible, accessible, and early treatment can be curative. It is more common in those who are excessively exposed to the sun. Sun exposure also causes prematurely some of the changes associated with age.
The cause or causes of cancer are not clearly known, but likely causes are exposures to chemicals (new chemicals are being made right along and put into widespread use when their potential for harm cannot be known since there has been no previous experience with large numbers of people). Excessive exposure to radiation and possibly viral infections are other likely causes. Another promising line of study is of the immune mechanisms of the body.
Stroke is number three of the big killers. It can be due to the rupture of the wall of a brain artery with bleeding into the brain. That may cause loss of consciousness, weakness of an arm or leg on one side with or without weakness of the same side of the face, loss of speech; or it can be due to the plugging up of a brain artery with an embolus (a clot or another particle) that came from somewhere else such as the wall of an artery or from inside the heart; or it can be due to a thrombus (a blood clot) that formed in the artery locally. With clots or emboli the patient is somewhat less sick, less likely to have a convulsion (an epileptic type fit), less likely to have a headache or a fever, less likely to become unconscious, less likely to die, and somewhat more likely to get better quicker.
The big deal about prevention of stroke is to find and treat the high blood pressure before it can damage the brain arteries. Another big deal is to try to prevent arteriosclerosis. Sometimes, if a narrowed artery in the neck is suspected, an arteriogram (an iodine-containing chemical is injected into the artery to make the inside of the artery visible on an X-ray plate), is done to; show if and where the artery is narrowed. If the narrow place can be reached, a vascular surgeon can open and clean out the material that is causing the narrowing-the old villain, cholesterol, with increased artery lining cells-some of which are dead. Rarely the test, or the operation, will provoke the very thing that the doctor is trying to prevent-a stroke or even death.
One of our big problems in medicine, and, indeed, in all aspects of life, is unrealistic expectations. People expect miraculous results, but sometimes fail to realize that many of our outstanding achievements are only obtained at the price of considerable risk-to say nothing of considerable expense.
Chapter Two: Defense against the disablers
The big killers are also disablers, but the second largest cause social security disability payments is pulmonary emphysema. Although it does kill, it does not do so for a long time, but causes much suffering and disability. It’s a little hard to explain, but it is associated with the breaking down of the walls between the tiny air sacs in the lungs. The inside of the air sacs is separated from the blood in the capillaries (tiny blood vessels) by a thin membrane. The oxygen in the air in the air sacs passes through the membrane and attached itself to the hemoglobin molecule-a complex iron and protein containing substance. The oxygen is then carried through the lung vein into the left side of the heart-first into the left atrium (the receiving chamber) then into the left ventricle (the pumping chamber) and then out through the arteries to all the tissues of the body. The large number of air sacs provides a large surface area for gas exchange, not only for oxygen to get into the blood, but also for carbon dioxide to get out of it so that the carbon dioxide can be breathed out just as the oxygen is breathed in. The breakdown of the walls of the air sacs converted many little sacs into one larger one. That decreases the area for air sac-capillary contact and makes gas exchange more difficult. In addition there is loss of elasticity of the lung tissue making breathing out less passive, and requiring more effort to get the air out of the lung. Many of these patients have bronchitis (inflammation of the bronchial tube lining) with swelling of the lining. This decreases the size of the bronchial tube passage. There is also increased secretion of mucus, and sometimes constriction of the muscles in the wall of the bronchus. All three of these can cause wheezing (a whistling noise on breathing out). These patients often become infected with viruses such as influenza, fungi such as monilia, and bacteria such as the pneumococcus (a cause of a common type of pneumonia) or Hemophilus Influenza (unfortunate name-has nothing to do with the disease, influenza. The cause of this disease is unknown although a few lack an enzyme-an hereditary disorder. There is a very strong statistical association with pollution of the general atmosphere, such as smog, and the person’s atmosphere, such as cigarette smoke pulled into the lungs on purpose.
Treatment consists of avoiding the pollution-filters or moving for the general atmosphere: and stopping smoking for the person’s atmosphere. Prompt treatment of bacterial infections with antibiotics and immunization against influenza is mandatory. Other treatment might include bronchodilators, humidifiers, and intermittent positive pressure breathing treatments. This last is not considered helpful by some physicians, however.
Continuing to smoke is a sure way to ensure worsening of emphysema. It can cause a particularly distressing kind of suffering-shortness of breath-and a slow slide to the graveyard with episodes of infection in the lung requiring visits to the doctor or the emergency room visits and the hospital. A new intensive care unit has been established in many hospitals-the pulmonary intensive care unit, or, as one doctor called it, "the smokers’ ward," where artificial breathing machines are attached to endotracheal tubes (tubes put down through the nose (or mouth), into the layynx, into the trachea (windpipe) in those patients who have lost consciousness from retention of carbon dioxide and lack of oxygen in the blood due to poor lung function.
Rheumatoid arthritis is a common disorder of the joints, and sometimes of nearly the whole body. This is an inflammatory disorder of unknown cause. The severity varies from a little early morning stiffness and soreness of the finger joints (usually not the ones near the finger nails), the knuckles, or the wrists that is relieved by activity, by washing the dishes (application of heat), or taking of some aspirin all the way severe stiffness and confinement to bed or to chair. The disease is chronic, has unpredictable ups and downs, and is very discouraging to have or to treat.
The use of heat, aspirin, and exercise with careful avoidance of overuse of the involved joints and judicious rest can relieve much of the suffering and avoid some of the deformity that otherwise might occur. A common problem is the tendency of the patient to become discouraged and not apply the measures that can be helpful. This allows more suffering disability than would be necessary.
"Wear and tear" arthritis, or osteoarthritis, is another common disorder of the joints. This usually effects the weight-bearing joints, such as the low back, the hip, or the knee. The cause is not known, but it seems to be aggravated by being overweight (another reason to avoid this common problem) and by excessive and improper use of the joint. In this regard, occupational choice may play a part. The job activities ideally should be suited to the person’s equipment-a slender fine-boned small-muscled should have a job requiring heavy lifting. Don’t have a racehorse pulling a beer wagon. One type of osteoarthritis is hereditary with enlargement of the distal finger joint (the one nearest the nail). These joints may hurt a little and don’t look nice, but are important because the person thinks she has the early stage of a crippling disorder so fear of the future is more important than the present. There is nothing to do about the deformity. If it hurts, aspirin and local heat can be used, but most people soon get tired of this. They would rather just ignore the condition than to be bothered to treat especially since treatment doesn’t cure it or change the appearance. Incidentally, despite the widespread belief to the contrary we don’t cure many things. "Cure a few, relieve many, and comfort all" are limited goals, but is the ambition of many doctors. It would be nice if we doctors could do that much.
Low back pain is a pain to the doctor as well as to the patient. Some say that getting up on his hind legs was man’s original biological sin. Four-legged animals do not have inguinal hernia, varicose veins, hemorrhoids, or low back pain (hard for me to be sure about that last, though. Maybe my veterinarian friends can speak to that). One old doctor who apparently didn’t like women said, "A woman is a constipated biped with a backache." I hasten to write that is not my definition of a woman-my closest relative and ancestor was a woman, and I surely don’t feel that way about women.
At any rate, back pain is very common and it has many causes. In addition to pain arising from the muscles, joints, and ligaments of the back, there are referred pains from the prostate, bladder, kidney, uterus, aorta, pancreas, gall bladder, stomach, small bowel, large bowel, appendix, spinal cord, nerves, heart, lung, pleura, and brain. Of course, some of these do not cause low back pain, but they do cause back pain. During World War II there was a saying, "Oh, my aching back" that I believe denoted more a state of mind or feeling rather than an organic pain.
Posture plays an important part in back problems. "Swayback is bad" is the real message many experts on the back have tried to convey, and I think this is true. If one thinks of the low back as a bow and the muscles as the bowstring, you can understand that if the back muscles are strong and the abdominal muscles are weak, then the back is going to be curved in the lower portion. Strengthening the abdominal muscles tends to oppose sway back and maintains a more advantageous relationship of the lumber (lower) vertebrae to each other. The only natural activities than I can think of that strengthen the abdominal muscles are swinging hand over hand through the trees (not natural for us now) and copulation (most people can’t do this often enough or long enough at a time to get much strengthening from it. At least, I don’t see that many people with powerful abdominal muscles).
Running is said to strengthen the abdominal muscles as well as many others. From the practical standpoint I believe that leg-and-thigh bent sit-ups offer the best results from the least time and effort. I especially recommend the alternate touch-the-elbow to the opposite knee variety with the knees widely separated..
Tension and depression can aggravate and perhaps even cause low back pain.
Correct standing is obtained by standing up straight with the buttocks pulled in, the belly pulled in, the shoulders up and back, the head held up high-as though trying to stick an imaginary spike in the top of the head into to the ceiling. This will produce the "military" or "model" type of stance. I used to be struck by my ability to distinguish West Point graduates from Army of the United States officers when I was doing physical examinations while I was in the Army. The Regular Army officers seemed uniformly to have better posture.
Sitting posture is hampered by the design of furniture and car seats. The proper seating posture is the "ninety degree" type-feet ninety degrees to the leg, leg ninety degrees to the thigh, and thigh ninety degrees to the trunk and neck.
Lying posture is also important. When lying on the back, a pillow under the knees is desirable (to avoid that villain-"swayback"). When lying on the front, not only is a pillow not needed, it is detrimental (in 2005 I would suggest putting the pillow longways under the trunk, and I would suggest flexing the thighs when lying on the side).
Chapter Three: Trivial but not Unimportant
Man is heir to many things that, although not lethal, are very aggravating and common. Some of these can be prevented.and others made less severe. Sometimes we doctors don’t take these very seriously. It’s a little hard to shift gears from thinking about a person with a killing disease, present great suffering, and with an immediate threat of death to thinking about a person with a condition that although annoying does not carry any threat to life.
Omphalitis (inflammation of the navel) is one of these. The outer layer of the skin sheds. Over most of the body surface the shed skin sticks to the inside of the clothes or comes off in the bath water. In some places this does not happen, such as the navel, and the dead skin stays there. Sweat collects, it is warm there, and it is easy fo fungi or bacteria to collect and multiply. Fat people have more trouble if the fat tends to close up the navel, but some thin people have closed navels also. Washing out the navel seems to be something one would take for granted, but I have had to order them washed out on hospital patients. Sometimes a Q tip or some cotton on the end of a small wooden stick is needed. Soap and water is good, but sometimes hydrogen peroxide works even better. It’s important to get it dry. One old doctor said a dirty navel was a bad sign-that it meant that the patient would not pay his doctor bill. Some of the medical people call this "the Bales sign," but I do not deserve the credit.
cut short in the middle, if desired.
"Hey diddle, the cat and the fiddle
Long on the corners and short in the middle."
A good many people have peculiar feet. The foot bone behind the second toe sticks out more than the one behind to the big toe. The weight should be distributed over the heel, the head of the first metatarsal bone (the bone behind the big toe), and the head of the fifth metatarsal bone (the bone behind the little toe). When too much weight falls on the head of the second metatarsal bone the friction of the shoe on the skin under the second bone head causes a callus. This callus can be trimmed off cheaply by the patient or expensively by a foot "expert," but it will just come back. A metatarsal bar across the sole of the shoe can transfer the weight bearing, relieve the pain, and prevent the callus from returning.
. This is the material I used for my talk at the Philosophy Class on 4 May 2005

65. Palestine History From Esam Shashaa
Third Millennium B.C.: The Canaanites were the earliest known inhabitants. Jericho was one of their cities. They were reported to have an alphabet. Since the land is a connecting link to Egypt, Syria, Mesopotmia, and Asia Minor, it became a battleground for the adjacent empires. Egypt has control first, but it was challenged by invading Amorites, Hittites, and Hurrians. These invaders were defeated , and were absorbed by the Canaanites who then numbered about 200,000.
Second Millennium B.C.: About 1400 B.C. Semitic tribes from Mesopotamia, the Hebrews, came as did the Philistines, an Aegean people of Indo-Europan stock The traditional account is that the Israelites came to Canaan about 1200 B.C. after the exodus from Egypt. However, this is not established by archaeology. There may have been a dispute between two indigenous groups. About 1230 B.C. Joshua conquered the hill country. Some think that Israelites were pastoral, and were at first confined to the hills, and were excluded from the more fertile land in the flatter part of the land. The Merneptah Stela from Egypt suggested that Israel was an agricultural entity in the late 13th Century B.C. (The time of Gideon in the Bible).
1000 B.C.: David defeated the Philistines, who were then assimilated by the Canaanites.
922 B.C.: At Solomon’s death the kingdom was divided into Israel in the north and Judah in the south.
722-723 B.C.: Israel fell to Assyria
586 B.C.: Judah conquered by Babylon. The temple was razed. The Jews went into captivity.
539 B.C.: Cyrus, the Great, of Persia conquered Babylon. The Jews returned to Judea. The walls of Jerusalem were rebuilt. The Torah was codified. There is confirmation of the return in the Second Temple period of 538 B.C.
333 B.C.: Alexander, the Great, took the region. The country was ruled by the Ptolemy’s of Egypt, and the Seleucids of Syria.
141-63 B.C.: The Jewish Maccabees set up an independent kingdom.
132-35 B.C.: Judea was renamed Syria Palaistina.
63 B.C.: Rome appointed Herod king of Judea. He extended the Second Temple. Strife broke out between the pacifists and Zealots, and riots broke out against the Roman authorities.
34-4 B.C.: The time of Jesus
70 A.D.: Titus of Rome attacked Jerusalem and destroyed the Temple. The city was renamed Aelia.
313 A.D.: Roman Emperor Constantine’s mother visited Jerusalem, and it became a focal point for Christian pilgrimages. Most of the population became Hellenized and Christianized.
324 A.D.: Constantine of Byzantium rebuilt the city walls, and commissioned the Church of the Holy Sepulcher, and opened the city for Christian pilgrimage.
614 A.D.: Roman rule was interrupted by a Persian invasion, and later ended by a Muslim Arab army that captured Jerusalem in 638 A.D.
638 A.D.: This began 1300 years of Muslim presence in Filastin. Muhammad had designated Jerusalem as the first qibla (direction to be faced while praying). He is believed by Muslims to have ascended on a night journey to heaven from the area where the al-Aqsa Mosque is now. The city benefitted from trade and from being a religious center under the first Muslim dynasty, the Umayyads of Damascus.
750 A.D. After the power shifted to Bagdad with the Abbasids, Palestine was neglected. There was domination by the Seljuk Turks, Fatimids, and later by Crusaders.
1517 A.D.: The Ottoman Turks of Asia Minor defeated the Mamelukes, and, with few interruptions, ruled until 1917.
18 31-1840 A.D.: Muhammad Ali, the modernizing viceroy of Egypt, expanded his rule to Palestine.
1840 A.D.: The Ottoman Empire reasserted its authority.
1845 A.D.: The 12,000 Jews in Palestine increased to 85,000 bu 1914. (Jews from Europe began to move to Palestine in the 1880's buying land from absent Arab landlords, thereby displacing the Arab peasants from that land.)
1897 A.D.: The First Zionist Congress held in Basel, Switzerland, issued the Basel program on the colonization of Palestine.
1904 A.D.: The Fourth Zionist Congress decided to establish a national home for the Jews in Argentina.
1914 A.D.: Britain promised the independence of Arab lands under Ottoman rule, including Palestine, in return for Arab support against Turkey, who had entered the war on the side of Germany.
1916 A.D.: Britain and France signed the Sykes-Picot Agreement. That divided the Arab region into zones of influence. France got Lebanon and Syria, and Britain got Jordan and Iraq.
1917 A.D.: On November 2 Arthur J. Balfour promised the British Zionist leader the establishment of a national home for the Jews in Palestine.
1918 A.D.: Jews began to migrate to Palestine. Large scale Jewish agricultural and industrial enterprises began in Palestine.
1919 A.D.: The first Palestine Conference expressed opposition to the Balfour Declaration.
1920 A.D.: The San Remo Conference granted Britain a mandate.
1922 A.D.: The Council of the League of Nations issued a Mandate for Palestine to the British.
!929 A.D.: Arab attacks on Jews killed 133, while 116 Arabs were killed.
1936 A.D.: The Arabs staged a six-month strike to protest land confiscation and Jewish immigration.
1937 A.D.: The Peel Commission decided the mandate in Palestine was unworkable. It recommended a Jewish State, an Arab State, and a neutral sacred-site state to be administered by Britain.
1939 A.D.: A British White Paper restricting Jewish immigration, and offering independence for Palestine in ten years. This was rejected by the Zionists, who organized terrorist groups, and attacked the British and the Palestinians.
1947 A.D.: Britain decided to leave, and asked for UN recommendations. On November 29 it called for dividing Palestine into Jewish and Arab states, with Jerusalem as an international zone under UN jurisdiction. Arabs attacked Jewish settlements in retaliation to Jewish attacks on them.
1948 A.D.: The British decided to leave on the 17th. The Jews proclaimed a Jewish State. The armies of Egypt, TransJordan (now Jordan), Syria, Lebanon, and Iraq joined Arab and other guerillas in a full scale war. The Arabs lost. Gaza was left to Egypt. The West Bank was controlled by Jordan. 630,000 Arabs left Israel-leaving 130,000 Arabs in Israel.

66. The New Entitlements Donald W. Bales November 2005
First are the entitlements to freedom of consequences for risky behavior:
1. Women should be able to indulge in promiscuous unprotected (no condom) sex-anal, oral and vaginal without getting pregnant or infected.
2. If they get pregnant, they should have access to abortion at any stage of pregnancy.
3. If they get infected, there should be an easy and free cure (no cure for herpes, human papilloma virus, and HIV-some gonorrheal organisms are becoming resistant to some antibiotics).
4. Alcoholism and drug addiction are diseases and those who have them should receive free treatment and should come under the American Disabilities Act as to employment.
4. Men should be able to indulge is promiscuous (no condom) sex-anal, oral or vaginal without causing pregnancy or getting infected.
5. People should be able to inject illegal drugs without using sterile precautions and not get infected with HIV or hepatitis. (No one has been cured of HIV, and the treatments for hepatitis are also unsatisfactory.)
6. Smokers should not get lung cancer, emphysema or any or the other bad disorders from tobacco. If they do get sick, they should be entitled to sue the tobacco companies for the illness.
Second are the entitlements to benefits not earned:
1. A person should have self esteem and the esteem of others without doing anything to earn it.
2. Students should get a good grade even if they don't go to class, don't study and do poorly on the exams.
3. A person with a black skin should get preferential treatment.
4. A person who can't read or understand English should have signs and instructions printed or spoken in his or her native tongue.
5. A criminal should receive a light sentence-or no punishment at all-since the offense is either societal (poverty, poor education, racism, bad parenting or prejudice) or is medical (due to emotional or mental illness). "The Socialization and the Medicalization of Bad Behavior."
6. All persons are entitled to not be judged. Everyone should be nonjudgmental.
7. People have a right to be rude. All minorities have a right to offend the majority.
8. People are entitled to be free of being fired-even if incompetent.
9. Pay should be equal without regard to performance.

67. Mind-Body Body-Mind: Yoga Tai Chi Donald W. Bales November 2005
Much has been written and said about the effect of the mind on the body. Not so much has been said or written about the effect of the body on the mind. Pain surely can effect the mind, as can shortness of breath. What we see and what we hear-both words and music-can effect the mind. Any brain disorder or brain effecting chemical can effect the mind and an orgasm surely can effect the mind. And, of course, any disorder of the brain can effect the mind since the brain is the seat of the mind. Both yoga and Tai Chi are methods of having the body effect the mind. I think I should give some background as to how I came to favor yoga and Tai Chi.
As most children are, I was physically active during my childhood. I played cowboys and Indians, wrestled with contemporaries, fought with a few of them, had a pony from age eight to eleven, played some sandlot baseball and some meadow football. I took a few swimming lessons shortly after Peneto Pool was built in Morristown (Tn.) in the late twenties, and swam quite a bit each summer until I went to high school.
When I was in the ninth grade I went out for football and was on the squad for four years. I played a little in some games as a sophomore, more as a junior and was out of the game only five minutes throughout my senior year. I was center on the basketball team in my senior year (we didn’t have a very good team that year). At six feet one I was the tallest on our team, but I had long arms-a seventy four inch span. I also went out for track, but never got a letter in track. One had to place in a track meet to attain that and I never did.
I was not a natural athlete. Most good athletes are mesomorphs (big bones and muscles). I was an ectomorph (most skin and nervous tissue). I was not fast or big or strong, or well coordinated. Nevertheless I was considered a pretty good center (first three years) and a pretty good right end and weak side linebacker my senior year. I was considered to be a smart player, but not smart enough to be afraid. I was considered for a football scholarship at Vanderbilt, but took the academic scholarship at Harvard instead.
During my time in the army in Germany (1947-1949), I played basketball on our hospital team. During my residency I played some on the Ford Hospital team also until I sprained my ankle.
In the early years of my medical practice in Kingsport, I played some golf and went to the country club pool with the children, but really didn=t do much physical activity.
When I was forty, I was not pleased with my scrawny calves and my beginning paunch and took up the exercises listed in the booklet put out by the Johnson Administration ACommittee on Physical Fitness. I began doing a series of exercises-mostly calisthenics with some aerobic components added on. Later on I had a patient who wanted to take up jogging. His wife insisted he have medical clearance by me. I became interested in jogging and in my fifties was in a number of ten kilometer races. I was never very good-once I was third for men my age.
I was somewhat reluctant to retire at age seventy-five-fearing that I would be bored or lost or feel useless. However, I took up swimming competitively in 2000 and have been to district, state and national games for swimming. I now have forty-nine gold, three silver and three bronze medals-the bronze ones from the national games in 2001 and 2003.
This gives some background as to how I came to yoga and Tai Chi. I found a VCR, “An Empowering Workout” at the library showing Tai Chi and I found a book there about yoga. The Tai Chi is not the continuous type taught at the senior center, but ten exercises preceded by some warm-up activities. The yoga is simpler and less demanding than the power yoga noted on a VCR given me by my son Jack.
Yoga is of very ancient origin in India. Some say 5000 B.C. Tai Chi is also very old-perhaps going back to the 14th century A.D. in China. Initially yoga taught unity of mind and body later duality and finally unity again. It emphasizes meditation, relaxation, flexibility, breathing and balance.
Tai Chi was probably derived from martial arts. In many countries the common people were forbidden to own swords so developed unarmed combat to protect themselves. Tai Chi is done slowly whereas martial arts are often, usually, very fast. Tai Chi is promoted in China for the elderly to maintain flexibility, balance and strength, hoping to prevent falls. It also has a meditative aspect to it.
I demonstated the Tai Chi exercises. I did not do so for the yoga since it required lying down on the floor and I had on my good clothes.
My interest has been more in the physical aspects. I believe vigorous physical activity can be favorable to the mind. Some articles promote the idea that jogging can do as much for mild depression as antidepressants. I don’t know that I believe that. I do feel better after a vigorous workout than I did before. And I feel even better after a swim. After a vigorous swim I feel both more relaxed and more energized. I feel good before I swim and even better after.



68. Healthy Aging Donald W. Bales, M.D. January 2006
`Well, here I am healthy and aging. How did I get here?
"If you want to live to be old, choose long-lived ancestors." If you want to be healthy in your old age, choose ancestors who remained healthy in old age.
My parents didn’t do very well-my father died at 44 (when I was ten), and my mother died at 62 (when I was forty). My grandfather Bales died at 77 and my grandfather Weesner died at 78, my grandmother Bales died at 83, and my grandmother Weesner died at 87. However, my father’s older sister lived into her 99th year. I sometimes say that I am going to emulate her, but there are two problems-one: she was female and I am male (even though a nurse once said, "Yes, Ma’am" to me. I told her that I was a male and that I could prove it, but she didn’t make me do it), and two: she never said anything bad about anyone and I have said a good many ugly things about several people-of course, they all deserved it. My mother’s youngest brother (my favorite of all my aunts and uncles) is still alive at 91. He is a widower, but lives in a condo in Wesley Commons in Greenwood, S.C.
I think my body build came down to me through my grandmother Weesner. She had five brothers-all of whom were tall and lean.
I have already lived longer than any of my ancestors except my grandmother Weesner. All four of my grandparents remained active. Granddaddy Bales did what he could on the farm in spite of having osteomyelitis of one of his heel bones. Pappaw Weesner died suddenly while arranging an appendectomy for one of his patients. Granny Bales ran the farm and remained interested in politics (she was a rabid Republican) and in the doings of the First Baptist Church (she was a Big Baptist). Mammaw Weesner was still baking her famous sugar cookies almost to the end of her life-my children (her great-grandchildren) used to head for the kitchen to look for those cookies whenever we would visit her.
The affection and emotional support from my immediate and my extended family provided me with emotional capital that I will never use up. This has helped me to deal with life in a way that would have been impossible without it.
Heredity has a lot to do with longevity and with health. When I was assembled in 1921, my genes did not carry the tendency to any diseases that would have caused disability or an early death. Male pattern baldness, myopia, astigmatism and old age hearing loss was about all the unfavorable genetic baggage that came to me. An asset was my ectomorphic build. I wanted to be a mesomorph when I was playing football, but mesomorphs do not always fare well as to health. Some of my fat friends think the reason that I am still thin is hereditary and not due to any efforts on my part.
The example shown me by my family helped me to be industrious. Somewhere along the line I got the idea that I was to do the very best that I could in whatever I tried. No one ever put it into words, but it has been a part of my life all along.
Luck plays a part in healthy aging. Not getting run over by a truck or getting some bad infection seems to be a matter of chance. I did have a viral infection of the liver when I was in the Army in 1948. I am sure that I had Hepatitis A. I know now that it rarely causes death or chronic liver disease. The treatment then was strict bed rest (not even getting up to use a bedside commode) for six weeks and eating a high protein low fat high carbohydrate diet. A diet low in fat is not very palatable. But I was very compliant. So when patients would try to tell me they couldn’t do something I advised, I would sometimes tell them about my experience.
I spent seven weeks in hospital, but recovered completely. I used the time in bed to read all of Cecil’s Medicine textbook.
Another thing about luck (or is it good judgement?) is marrying well. I was also lucky in that all four of our children were born whole and healthy. Ditto for our six grandchildren-I was lucky in that. I was also lucky in my choice of a profession-I really liked being an internal medicine doctor. I was somewhat reluctant to retire, but wanted to quit while I was at the top of my game. Also practice was not as much fun as it had been. I still dream about doctoring. Not surprising-I was an active doctor for 51 years. About the only thing medical now is going to the cancer conferences at Holston Valley. It sort of keeps my mind in. I also have lunch every Monday with some retired doctor friends. Some wag called us the rodeo’s-retired old doctors eating out. It is group therapy.
After my father died, I went to live with my Weesner grandparents. My uncles never smoked in their parents’ house, so smoking was out of the question for me. After I went out for football in the 9th grade, another strong reason not to smoke-the coach wouldn’t allow his athletes to smoke. My not smoking cut down my risk of getting coronary disease, emphysema and several kinds of cancer, especially lung cancer.
I continued to play intramural basketball in college, also played in the army and even in residency until I sprained an ankle. In the early years of my practice I was so busy that I didn’t have much time for physical activity, but I did play golf and would go to the pool with the children.
When I was sixteen, I got blisters on the top of my shoulders from the sun. Never again. In recent years I wear a head covering and sun glasses when out in the sun. Sun exposure is strongly correlated to all three kinds of skin cancer. It is also related ot cataracts and macular degeneration.
One day when I was 40, I noted that my calves were scrawny and that I was getting a little paunch. I began to use the program outlined By the President’s Council on Physical Fitness. This was during Johnson’s administration, but I showed my broad-mindedness by using it anyway.
It was a series of exercises including some aerobic ones. I still do some of them daily.
When the information came out in the early 1950's about cholesterol, I began to avoid it. Ditto for the hazards of animal fat later on. I began to avoid animal fats. I didn’t have to change the milk I drank-I liked "blue john" (skim milk) when I was a child.
Several years ago I had some gum trouble requiring peridontal surgery. Now I use a little brush between my teeth, dental floss, toothbrush and waterpik. The bacteria associated with gum disease has been suspected as contributing to coronary artery heart disease. The more teeth you have the lower the chance of a clot type stroke.
A man came to me to get medical clearance to take up jogging. He lent me a book and in my 50's I took up running. I was in a good many 10 K’s in the 1970's. Then my arches began to complain and I took up riding my ten-speed bicycle in the 1980's. After I retired at age 75 in 1997, I joined the senior center and began going to the gym there. I go to the gym 2 to 6 times a week.
I began to swim laps with the senior citizens at the high school. One of the women from the center saw me swimming and suggested that I enter the senior games. The competition is against people of your own age, beginning at 50 and going up five years for each category. I was swimming two to five times a week.. In the summer they let us seniors swim at the municipal pool . My events are 50 meter (or yard at the National) free style, breast, and back and 100 meter (or yard) breast and back. I took part in the local, then the district and then the state games in 2000. I have been to the district and state games four times in all. I hold the state record for men 75-79 100 meter breaststroke and for men 80-84 50 and 100 meter breast stroke. In 2001 I went to the national games in Baton Rouge-getting a Bronze medal for the 100 yard breaststroke. I went to the national at Newport News in 2003-getting Bronze medals for the 50 and 100 yard breaststroke. In 2005 I went to Pittsburgh, but got no medals, but did get 5 ribbons. I now have forty-nine gold, three silver and three bronze medals.
I took a yoga class at the senior center, but found a book that had yoga exercises in it that was more my style. I took a Tai Chi class at the center, but found a video that had ten exercises on it that suited me better. I do both of these nearly every day.
As you can see, I think exercise is important for healthy aging. Not everyone can do vigorous exercise, but everyone can do something. Studies have shown that 90 year olds with paraplegia can benefit from doing arm exercises regularly.
There is an old saying, "Mens sana in compore sano." "A sound mind in a sound body." So what about the mind. One of my daughters-in-law gave me her old computer. I used it as a word processor and began writing. I have a thousand pages of my memoirs. I have eight completed sci-fi novelettes and four more not finished, also three children’s stories, and a western. None of these have been published yet. I got a computer capable of going online in 2000. I use it to look up anything that someone asks me about and lots of other stuff also. I get a list of columnists every day and send comments to most of them. I get responses also-so far from about 70.
I also have sixty-six essays on my web page: http://home.earthlink.net/~baleslynnwood/. I get many emails every day-from Medscape (medical issues), newspaper headlines from the New York Times, the Washington Times, the Washington Post, columnists from Jewish World Review and TownHall.
After I retired I began taking six week courses in spring and fall with the Kingsport Institute of Continued Learning at the University Center. I also took part in the Great Decisions Seminars of the Foreign Policy Association once a week for eight weeks each winter. I led the discussion for some of these. I continue to read, but not as much as I used to.
As to the spirit: I believe a person has to have a philosophy of life. I like the Serenity Prayer. AA uses it, but they did not compose. It was claimed by Rheinhold Niebuhr, but some say he didn’t originate it. As you probably know, it goes like this. "God grant me the serenity to accept the things I cannot change; the courage to change the things I can, and wisdom to know the difference." I try to make lemonade out of lemons. It has been reported that people who attend church regularly are healthier and happier than those who don’t. I attend regularly. Some refer to those who do as the "religious remnant."
It’s not just the hand you get, although that is important. It’s how you play it.
What can people do to promote healthy aging? Have a personal physician in whom you have confidence. Report symptoms. Be compliant with the advice received. Be immunized to everything recommended. Don’t smoke. Don’t abuse alcohol. Don’t use recreational drugs. Be active in body and mind. If you drive, drive defensively. Take the 55 alive program. Don’t drive if you are not able to drive safely. Try to fall proof your house. Think prevention. Maintain your connections to family and friends. As Granny Bales told me, "That’s some of your folks, you must love them." Behave in such a manner that you won’t feel guilty. Practice the Golden Rule. I travel in friendly seas. I hope that you do. Life is for the living. Although I am a United Methodist, I have tried to apply the dictum of Pope XII, "Always choose the lesser of the two evils."
Attitude is important. I don’t know whether this is inborn or not. I am fairly sure it is also related to example and experience. Can a person with a bad attitude come to have a good one? I don’t know. I tried to help some of my patients with a bad attitude have a better one, but I am not sure that I did any good. Don’t give up-hang in there.
Good luck with your health and with your aging.

69. Addiction Donald W. Bales, M. D. December 2005
What is addiction? It is not tolerance. Tolerance occurs to anyone who takes increasing doses of addictive type drugs, such as opioids, benzodiazepines (Valium cousins), barbiturates (previous sleeping pills), alcohol, and nicotine. The brain cells downregulate the receptors so that it takes more to get the same effect. Having withdrawal symptoms does not prove addiction. Aanyone who takes an addictive type chemical regularly will have withdrawal symptoms. These effects have been called "physical dependence." Other drugs, such as cortisone, beta blockers and most anti-depressants, not considered addicting, can cause phyical dependence.
The term "psychological addiction" is now used. Some say addiction is manifested by persistence in using even in the face of obvious harm to health, work and relationships. Another definition is "uncontrolled, compulsive use, despite harm." Others add a return to use after all traces of the chemical have left the body and the withdrawal symptoms have gone away.
Humans have sought chemicals to alter the state of the brain for many, many years. Perhaps one of the earliest was alcohol. Any substance containing sugar can ferment and produce ethyl alcohol-also called ethanol. Wine and beer are typical examples, but horse cultures allowed mare’s milk to ferment, and they drank that. Opium has been around a long time also. Peyote was used by some western Indians. Ephedrine, called Ma Huang by the Chinese, has been around a long time also. Hashish (cousin or big brother to Marijuana) was used in the Middle East by the assassins (in fact, that is where the name, "assassin," came from). The Old Man of the Mountain would send these men out to kill those he perceived to be his enemy. This was in the distant past.
Some divide the drugs into "hard drugs" such as cocaine and "soft drugs" such as magic mushrooms or peyote.
The problem is very serious. For example, consider the following figures for the U.S.::
Smoking (nicotine is the addicting substance): 44.5 million 32% susceptible of all
Drinking (alcohol): 14 to 20 million problem drinkers (120 million drinkers,15% heavy)
Heroin: 810,000 23%
Cocaine: 2 million 17%
Meth (Methamphetamine): 12 million have used it (I couldn’’t find figures for addicts).
Stimulants other than cocaine 11%
Cannabis (marijuana 9%
Anxiolytics, sedatives, hypnotics 9%
Analgesics 8%
Psychedelics 5%
Inhalants 4%
Tobacco use in smoking. 28% of men and 25% of women smoke. 46% of high school dropouts smoke, but only 13 % of college graduates smoke. For people with advanced degrees the percentage is even less. Smoking has a bad record for causing disease such as cancer, heart disease, other artery disease and emphysema.
Heroin: It seems that heroin as well as other addicting substances increases the effects that dopamine produces. Dopamine is a pleasure producing chemical in the brain. However, the drugs prevent the normal production of dopamine. Since it is usually given into a vein, and, since users often do not use sterile technique, Hepatitis B and C and HIV are often transmitted.
Cocaine: It is often snorted and can cause perforation of the nasal septum. It can also cause artery constriction and provoke heart attacks. I couldn’t find a figure for the number.
Methamphetamine: This is a stimulant and, after that up effect wears off, there is a down effect that is apparently very uncomfortable. I could not get a figure for addiction, but five percent or twelve million have used it. It is said to be very difficult to take it only once.
The hereditary element in alcoholism is quite clear. Close relatives of an alcoholic have a much higher percentage chance of becoming alcoholics than matched groups without such relatives.
I share a belief in the idea that addicts are born and not made. That is, some people are more likely to become addicts than others. Obviously, if someone is never exposed to the addicting chemical, that person will not become an addict to that chemical.
Without regard to statistics or research, nearly everyone knows many people who drink beverage alcohol and nearly everyone knows an alcoholic or a problem drinker. A problem drinker is someone whose drinking has interfered with work, marriage or health. It is easy to observe that not everyone who drinks becomes an alcoholic.
From the standpoint of numbers of deaths and disease production, smoking is the clear winner in this sweepstakes. Of course, it does not cause the crime that the other addictions to illegal substances cause. Alcohol is not only related to crime, but also to the car crashes and injuries due to falls or poor judgement, like walking in front of a car, bus, truck or train. The production of meth has been associated with fires and explosions that have caused a lot of injuries. Cleaning up a meth lab after such an event can be very expensive-an expense usually not born by the people who operated the illicit lab.
I have not written about abuse or misuse or overuse of tranquilizers such as Valium and its cousins. Nor about Oxy Contin-but it presents the same problem that heroin and other opiates do.
I haven’t written about patients who have pain with advanced malignancies, but those who have experience with such patients report a low incidence of addiction. I have not encountered information about other painful disorders, such as rheumatoid arthritis, that are not as lethal or as rapidly fatal as advanced cancer.
A lot of research is going on to learn more about genes and about brain chemicals. This may lead to a better method of treatment.
Models proposed for addiction occurrence:
Moral Model-a character defect
Opponent Process Model-action and reaction Richard Soloman
Disease Model-impairment of healthy neurochemical and behavioral processes
Genetic Model-heredity
Cultural Model-alcoholism rare in Saudi Arabians, more common in Irish, common in American Indians, not common in Jews
Blended Model-mixture of many other models
Habit Model-Thomas Szasz says calling it addiction is an excuse to persecute someone.
The Genetic Biological Model-Hypoism Dan Umanoff
Endorphins may stimulate the production of dopamine. Increase in dopamine may decrease the number of dopamine receptors in the brain. This is termed down regulation and it produces a "let down" feeling. This is thought to be responsible for the development of tolerance of increasing doses and withdrawal symptoms. Some think that other neuroamines such as serotonin, norepinephrine and anandamide (endocannabinoid from Marijuana) are also involved in addiction.On a web site-NA-AA Recovery Zone, the writer suggests that those who need treatment for addiction may have one or all of the following: Induced chemical imbalance, genetic chemical imbalance, social and psychological problems and/or inhibited life and/or coping skills.
Even if a gene is found or a chemical imbalance is found, it will not, in my view, absolve the individual of personal responsibility for his or her own behavior. It wasn’’t someone else who made the person try the addictive substance. As usual, I come down on the side of prevention.
But prevention is very hard to sell. At least, I found, and find, it very hard to sell. But I have known people who controlled their behavior and stopped the addictive behavior in the case of smoking and of drinking. I had no experience in my practice with the other addictions.

70. A Deficiency State
Our country is the deficiency state I am writing about. Here we are four years after September 11. The deficiency is the lack of urgency. We still have poor control of visas for foreigners-both student and other. We do not have a way to keep up with legal aliens to know if they have overstayed their time limit or not.
The airport security is a joke (that’s not the right word-it is not at all funny-it is extremely serious). Time and effort are wasted on people who are extremely unlikely to be terrorists-very likely making it easier for terrorists to slip through the check points. Many of the containers and other materials coming into the country are not screened. Our borders are wide open with the ignoring for federal law by states and cities. Even the federal government does not obey or enforce the laws. Employers can hire illegals with impunity. Lack of jobs would take away a lot of the motive for coming. A child born in the U.S. to an illegal immigrant should be not automaticall become a citizen. This is rewarding an illegal act. That is a good way to get more or the illegal acts.
Some of our citizens seem to be overly concerned about the civil rights of ununiformed combatants (who have tried to kill our service people) and want them to have the rights under the Geneva conventions for which they are not eligible. Some want illegal immigrants to have all the privileges of legal immigrants and even of full citizens. Sometimes they even want the illegals to have special privileges not granted to legal immigrants or citizens. Free college tuition, for example.
Federal judges seem more concerned with protection of terrorists even more than they are of criminals. Many oppose the Patriot Act.
Why is this? First, I blame the old media. They do not perceive the peril and keep opposing anything that might increase our security. Then I blame the electorate-many do not realize that we are in a war-I call it World War IV (III was the Cold War-it got rather hot in Korea and Vietnam). Then I blame the politicians. They are so afraid of being deemed racist or politically incorrect that they do not want to do anything with urgency. The Democrats, of course, are automatically opposed to anything Bush does no matter how reasonable or necessary the action is.
I blame the Old Europeans for being blind, deaf and dumb about the peril that they are in. This encourages like minded people in this country.
I blame some of us Republicans and conservatives for not speaking up. Not me-I speak up every time I get a chance and have since September 11, 2001.
I hope that we do not have to experience a terrible attack-much worse than September 11 to wake up those of us who are still sleeping.
Now I fear that we may lose the war of radical Islam due to the apathy, opposition and blindness of the public of the United States. Donald W. Bales, 20 November 2005

71. Self Reliance
Self reliance seems to be out of style these days. Some people look to God to take care of them and others look to government. It is my view that both of these approaches are not desirable. I believe that God helps those who help themselves and I don’t believe that the government-whether Federal, state, county or city can take care of people. No one can possibly be as interested in a person’s welfare as that person. Parents can help by nurturing their children until they mature. They can also provide examples of how to behave and advise and instruct, but it is up to the children to benefit from all that.
There is no such thing as a self made man or woman. Everyone had to be cared for during their formative years. All of us rest of the shoulders of those who went before.
In my own case, my parents not only provided me with food, clothing and shelter, but also provided with loving care. In fact, both my mother and my father doted on me. After my father died when I was ten, my mother and I went to live with her parents. My grandfather doted on me also and my grandmother was extremely kind to me as well. I had five uncles and five aunts and all of them were kind to me, as were their spouses. I am and will be eternally grateful for the emotional capital provided me by my extended family.
As for me, I never knew any better than to do the very best that I could no matter what it was. I tried to be the best student I could be. I had an advantage in that. My mother had taught school before her marriage. So I had a favorable attitude toward school and learning. My father had gone to college briefly at Lincoln Memorial University and I knew about that.
I was extremely fortunate to have been awarded an academic scholarship by Harvard College-a great thing for a poor boy from Morristown, Tennessee. Some to the reasons for this was that I was valedictorian, played on the football basketball teams and had been active in extra-curricular activities. I was able to remain on the Dean’s List during my time at Harvard College.
I applied for admission to medical school at the University of Tennessee and was accepted. After six months in medical school, I was taken into the Army’s Specialized Training Program. I was second in my medical school class. After graduation and after serving my internship at Ford Hospital, I was on duty at a medical officer in Heidelberg, Germany. The Chief of the Medical Service there pressed me to become Regular Army promising me a promotion to Major in six months. Following that I had my internal medicine residency at Ford Hospital. During my third year there I was appointed one of five assistant resident physicians. We had the supervision of the work of the interns. Then I entered practice. At every step I did the very best that I could. I was certified by the Board of Internal Medicine in 1954 and recertified in 1974. I also became a Fellow in the American College of Physicians I served as President of the Medical Staff of Holston Valley Hospital twice and President of the County Medical Society once.
What I am trying to write is that although I had a great deal of help all along the way, still I think that my striving for excellence had a lot to do with the good things that happened to me.
I pray-even though I do not believe in intercessional prayer. I do not expect God to take care of me. I do not expect the government to take care of me. I do receive a social security check each month. It would be stupid not to accept it I paid into that system for many years. I worked full time until I was seventy-five.
Finally I believe people have the obligation to do the best they can to look after themselves and not look to God or the government to do for them what they can and should do for themselves. Donald W. Bales, M.D. 24 October 2006

72. Election November 12, 2006
The election was disappointing, but not surprising. The Republicans lost it.
Why did they lose?
Of course, the MSM and academia were dead set against them, but that is nothing new.
What ticked me off with them?
1. Spending like drunken Democrats. (Drunken sailors spend their own money.)
2. Adding another entitlement to an already over-committed system-Medicare.
To make it worse it won no political support and it was fiscally irresponsible.
3. Illegal immigration and amnesty. Apparently many did not agree with me about this.
4. Unwarranted optimism about the welcome and the modernization of Iraq. Too much faith in “democracy.”
5. Failure to profile at airports.
6. Failure to tighten visas from suspect countries.
7. Failure to push for confirmation of more Federal judges.
8. Failure to fight the affirmative action case more vigorously in Michigan.
9. Failure of Bush to emphasize the good economy news.
10. Misbehavior of some Republicans. Of course, it is easier to resist temptation if one is not exposed to it. The party in power has more power so more temptation to cheat.
11. Failure to condemn Palestinian and Gaza Arabs for their terrorist activity.
12. Failure of Bush to communicate better, but he may not be capable of doing it-not because he is stupid, but because he is not slick as Bill Clinton is. He may be partially dyslexic, although people report that in a small group he is fluent enough.
13. To me it was more that the Republicans lost than that the Democrats won. I will have to write that muzzling Pelosi, Reid, Kennedy and Schumer was smart as was running more conservative candidates in the South. John Kerry tried to help the Republicans, but it was too little and too late. It remains to be seen how those “conservative” or “moderate” Democrats will vote when pressured by the far left leaders in the House and the Senate.
Donald W. Bales

73. Problems in, for and of the United States 4 March 2007 Donald W. Bales
1. Blindness to being in World War IV.
2. Iraq War and Afghanistan
A. Poor execution of the “peace.”
Lawyers probably prevented getting Osama at Tora Bora
B. Consultation with enemies: Syria and Iran
C. Poor accountability: No one fired for incompetence until this week.
3. Illegal immigration
A. Mexicans-economic, social, security, linguistic, legal damage
B. Muslims-poor surveillance of mosques and visitors
4. Poor Homeland Security
A. Incoming freight and mail
B. Visa control
a. Issuing to natives of terror states
b. Failure to follow up on visas-students, and others
5. Obesity
6. HIV-too little effort and publicity about relationship of behavior to getting HIV
7. Spending
8. Failure to deal with entitlements
9. Trade deficit with China and with OPEC.
10. Oil importation from neutral or unfriendly states
11. Failure to move toward energy independence.
12. Broken legal system (class action suits, obscene and unjust awards)
13. Broken justice system (injustice system)
14. Broken moral (behavior) standard
15 Broken ethical standards
16. Lack of patriotism (issuing credit cards to illegals)
17. Academic liberalism
18. “Mainstream” media bias
19. Drugs
20. Child molestation-physical and sexual
21. National debt
22. Growth of government under Republicans-drug entitlement Donald W. Bales, April 2007

72. State of the U.S., July 2007
Donald W. Bales
First: World War IV. This war began in 1979 with the taking of the embassy personnel in Teheran as hostages. The pitiful response to this encouraged the radicals to think the eagle had no talons. We had a Pearl Harbor on September 11, 2001, but the anger and outrage soon faded.
The attack on the Taliban was appropriate and required.
It was expedient to try to work with the UN regarding the non-compliance of Iraq with the many resolutions. Unanimous consent was obtained from the security council to present Iraq with an ultimatum, but, when the time came to follow up on it, the UN showed itself to be the useless and irrelevant body that it always has been.
The delay between the demands and the invasion gave plenty of time for the Iraqis with the help of the Russians to remove tons of material to the Becka valley in Syria. All of the intelligence agencies plus the UN thought that Saddam Hussein has weapons or mass destruction. He had used chemical warfare on the Iranians and on the Kurds and on the Shiites in southern Iraq. He either thought he had them or lied that he had them rather than allowing the inspectors to prove that he did not have them.
The Europeans, with some exceptions, did not support or approve the Iraq War (Gulf War II) even though they were and are more dependent on oil from the Middle East than the U.S. is.
The Democrats were in favor of the war at first since they thought was popular with the public and would be an easy war. The war with the Iraqi army was soon over. Then the trouble started.
All those people who had been in the Iraq army were now unemployed as were many others who worked for the government. Iraq, in a sense, was a rentier state. The government had the oil revenues so could run the government without much input economically from the populace.
The anger built up by the actions of the controlling minority (Sunni 20%) against the
Shi-ite majority (60%) showed itself in taking revenge. Add to this the actions of al Qaeda and Iran and Syria supported others to disrupt any attempt to repair the economic status of Iraq and to foster a more representative and there were real barriers to establishing security in the country.
All this would be manageable, but the Democrats are invested in defeat in Iraq to further their return to power. They don’t seem to realize that they will have to deal with the consequences of a defeat of the U.S. by the radical Muslims with the resulting encouragement of our enemies and the discouragement of what friends the U.S. has. The MSM media has done all it can to poison the electorate and to promote defeat.
It is my view that most of the people of Old Europe (western part) and many of the people of the U.S. do not understand that there are millions of people who want to destroy the U.S. and Western civilization
Second: The illegal immigrant invasion of the U.S. by people from the south. They bring a different language, a different culture and threaten the social, economic, political and cultural basis of U.S. life. We are allowing criminals to enter the country with impunity and I am not writing about violent criminals or drug dealers. Everyone who enters the U.S. illegally is a criminal. What sort of citizen can be expected from someone whose first act in the U.S. is a crime? Again the main danger is the lack of understanding of many United Staters about the problem.
Third: The Federal deficit. I don’t really need to write about the danger from that.
Fourth: The trade imbalance. Don’t need to write about that either.
Fifth: Personal debt by citizens.
Sixth: The decline of integrity in politicians, business people, lawyers, doctors, judges, religious leaders, teachers, academia and the media. Lying and stealing is only bad if you get caught.
Seventh: Unwillingness to take personal responsibility. Now if anything bad happens, it is not the fault of the actions of the individual-it is always someone or something else-bad parenting, bad government policies, ignorance, poverty, drugs, peers. If anything bad happens, someone should be sued and someone should pay a big award even though it was the person who caused the problem.

World War IV with Radical Islamists
Attacks on U.S. interests
1979 Tehran Hostages
1981 Qaddafi threats
1983 Beirut Embassy
1983 Marine barracks Beirut
1983 Kuwait Embassy
1984 Wm. Buckley kidnaped (later killed). David Dodge, Terry Anderson, Peter Kilburn, Benjamin Weir kidnaped.
1984 Embassy annex Beirut attacked
1984 Hijacking Kuwait Airlines-2 Americans killed
1985 Stethem killed
1985 Achille Lauro Klinghoffer killed
1985 Rome and Vienna airport bombs
1986 Bombing of La Belle Discotheque Bertin U.S. soldiers killed Attack on Libya
1988 Pan Am 103 Lockerbie, Scotland
1998 Kenya and Tanzania Embassies. Bombing of empty training camp in Afghanistan and an aspirin factory in Kenya
2000 U.S.N. Cole attacked
2001 11 September-Twin Towers, Pentagon and field in Pennsylvania
In Their Own Words: What the Terrorists Believe, What They Hope to Accomplish, and How They Intend to Accomplish It
The Terrorists On September 11
Osama Bin Laden: The 9/11 Attacks Were "An Unparalleled And Magnificent Feat Of Valor, Unmatched By Any In Humankind." Bin Laden: "On the blessed Tuesday 11 September 2001 … they launched their attacks with their planes in an unparalleled and magnificent feat of valor, unmatched by any in humankind before them. … Yet with the destruction of the Twin Towers in New York, there occurred an even bigger destruction: that of the great American Dream and legend of Democracy." (Translation Of Purported Bin Laden Audio Message, Posted On Islamist Site, 2/14/03)
The Terrorists On Establishing A Caliphate Ruled By Their Hateful Ideology
Osama Bin Laden: The 9/11 Attacks Were "A Great Step Towards The Unity Of Muslims And Establishing The Righteous [Caliphate]." Bin Laden: "These attacks took off the skin of the American wolf and they have been left standing in their filthy, naked reality. Thus the whole World awoke from its sleep and the Muslims realized the importance of the belief of loving and hating for the sake of Allah; the ties of brotherhood between the Muslims have become stronger, which is a very good sign and a great step towards the unity of Muslims and establishing the Righteous Islamic Khilafah insha-Allah." (Translation Of Purported Bin Laden Audio Message, Posted On Islamist Site, 2/14/03)
Ayman al-Zawahiri: "The Whole World Is An Open Field For Us." Zawahiri "The war with Israel is not about a treaty, a cease-fire agreement, Sykes-Picot borders, national zeal, or disputed borders. It is rather a jihad for the sake of God until the religion of God is established. It is jihad for the liberation of Palestine, all Palestine, as well as every land that was a home for Islam, from Andalusia to Iraq. The whole world is an open field for us." (Al-Zawahiri's 'Full' Message On War In Lebanon, Gaza Strip, Posted On Jihadist Website, 7/28/06)
Zawahiri: "The Reinstatement Of Islamic Rule … Is The Individual Duty Of Every Muslim … With Every Land Occupied By Infidels." ZAWAHIRI: "Supporting the jihad in Palestine with one's life, money, and opinion is the individual duty of every Muslim because Palestine was a land of Islam that was occupied by the infidels. This means that its liberation and the reinstatement of Islamic rule there is the individual duty of every Muslim as unanimously decided by the nation's scholars. And such is the case with every land occupied by infidels." (Al-Zawahiri's June Video Message Supporting Palestinians, Posted On Jihadist Site, 6/11/06) The Terrorists On Killing Infidels
Osama Bin Laden: "Death Is Better Than Living On This Earth With The Unbelievers Amongst Us." Bin Laden: "O young people of Islam: Follow the orders of Almighty God and His messenger and kill those people. Follow the example of Muhammad Bin-Musallamah and his companions. Death is better than living on this earth with the unbelievers amongst us, making a mockery of our religion and prophet, God's peace and blessings upon him. Fear God, try to please Him, and do not consult with anyone regarding the killing of those unbelievers." (Translation Of Bin Laden’s 52-Minute Audiotape, Posted On Jihadist Website, 4/27/06)
Al-Qaeda Charter
"There Will Be Continuing Enmity Until Everyone Believes In Allah. We Will Not Meet [The Enemy] Halfway And There Will Be No Room For Dialogue With Them." (Al Qaeda Charter, Released By The White House Press Office, 9/5/06)
Al-Qaeda Training Manual
"Religious Scholars Have Permitted Beating … [And] The Killing Of A Hostage." "Guidelines for Beating and Killing Hostages: Religious scholars have permitted beating. … In this tradition, we find permission to interrogate the hostage for the purpose of obtaining information. It is permitted to strike the nonbeliever who has no covenant until he reveals the news, information, and secrets of his people. The religious scholars have also permitted the killing of a hostage if he insists on withholding information from Moslems." (Al-Qaeda Training Manual, Available At: http://www.au.af.mil/au/awc/awcgate/terrorism/alqaida_manual/, Accessed 9/5/06)
Al-Qaeda Training Manual: "The Confrontation That Islam Calls For … Knows The Dialogue Of Bullets, The Ideals Of Assassination, Bombing, And Destruction." "Islam does not coincide or make a truce with unbelief, but rather confronts it. The confrontation that Islam calls for with these godless and apostate regimes, does not know Socratic debates, Platonic ideals nor Aristotelian diplomacy. But it knows the dialogue of bullets, the ideals of assassination, bombing, and destruction, and the diplomacy of the cannon and machine-gun." (Al-Qaeda Training Manual, Available At: http://www.au.af.mil/au/awc/awcgate/terrorism/alqaida_manual/,
Al Anbar Plan: The Al-Qaeda Governing Structure Should Include An "Execution Unit" Responsible For "Sorting Out, Arrest, Murder, And Destruction." (Al Anbar Plan, Released By The White House Press Office, 9/5/06)
The Terrorists On Their "Bleed-Until-Bankruptcy-Plan"
Osama Bin Laden: "So We Are Continuing This Policy In Bleeding America To The Point Of Bankruptcy." ('Full Transcript' Of Bin Laden's Message, Posted On Al-Jazirah Site, 11/1/04)
Bin Laden: In The Attacks Of 9/11, "Every Dollar Of Al-Qaida Defeated A Million Dollars By The Permission Of Allah, Besides The Loss Of A Huge Number Of Jobs."
Bin Laden: "And it was to these sorts of notions and their like that the British diplomat and others were referring in their lectures at the Royal Institute of International Affairs. (When they pointed out that) for example, al-Qaida spent $500,000 on the event, while America, in the incident and its aftermath, lost – according to the lowest estimate – more than 500 billion dollars. Meaning that every dollar of al-Qaida defeated a million dollars by the permission of Allah, besides the loss of a huge number of jobs." ('Full Transcript' Of Bin Laden's Message, Posted On Al-Jazirah Site, 11/1/04)
Bin Laden: "It Is Very Easy To Target [America's] Flimsy Base And … We Will Be Able Crush And Destroy Them." Bin Laden: "In conclusion, America is definitely a great power, with an unbelievable military strength and a vibrant economy, but all of these have been built on a very weak and hollow foundation. Therefore, it is very easy to target that flimsy base and concentrate on their weak points and even if we are able to target one tenth of these weak points, we will be able [to] crush and destroy them and remove them from ruling and conquering the World." (Translation Of Purported Bin Laden Audio Message, Posted On Islamist Site, 2/14/03)
The Terrorists On Their Propaganda Strategy
Osama Bin Laden: Al-Qaeda Intends To Launch "A Media Campaign ... To Create A Wedge Between The American People And Their Government." (Letter From Osama Bin Laden To Mullah Omar, Released By The White House Press Office, 9/5/06)
Bin Laden: This Media Campaign Will Stress "That [The American] Government Would Bring Them More Losses, In Finances And In Casualties." (Letter From Osama Bin Laden To Mullah Omar, Released By The White House Press Office, 9/5/06)
Bin Laden: "[The American People] Are Being Sacrificed To Serve The Big Investors, Especially The Jews." (Letter From Osama Bin Laden To Mullah Omar, Released By The White House Press Office, 9/5/06)
Bin Laden: The Media Campaign "Aims At Creating Pressure From The American People On The American Government To Stop Their Campaign Against Afghanistan." (Letter From Osama Bin Laden To Mullah Omar, Released By The White House Press Office, 9/5/06) The Terrorists On Their Belief That America Is Weak
Osama Bin Laden: America's "Combat Strategy Is Heavily Dependent On The Psychological Aspect Of War … Which Hides The Cowardice And Lack Of Fighting Spirit Of The American Soldier." Bin Laden: "It has been made clear during our defending and fighting against the American enemy that this enemy's combat strategy is heavily dependent on the psychological aspect of war due to its large and efficient media apparatus and of course its indiscriminate aerial bombing which hides the cowardice and lack of fighting spirit of the American soldier. … Likewise, let me remind you of the defeat of the American forces in Beirut in 1982, soon after the Israeli invasion of Lebanon, when the Lebanese resistance was personified by the truck laden with explosives that struck the main military base of the US Marines in Beirut, killing 242 soldiers – towards Hell was their destination and what an evil destination that is." (Translation Of Purported Bin Laden Audio Message, Posted On Islamist Site, 2/14/03)
Bin Laden: "In Somalia … The United States [Pulled] Out, Trailing Disappointment, Defeat, And Failure Behind It."
Bon Laden: "We found that out from our brothers who fought the Americans in Somalia. They did not see it as a power worthy of any mention. It was the big propaganda that the United State used to terrify people before fighting them. Our brothers, who were here in Afghanistan, also tried the Americans. God gave them and the mujahidin success in Somalia and the United States pull out, trailing disappointment, defeat, and failure behind it. It achieved nothing. It left quicker than people had imagined." (Full Text Of Interview With Al-Qaeda Leader Osama Bin Laden, 10/21/01)
Ayman al-Zawahiri: "There Is No Hope In Victory." Zawahiri: "This is the fumbling that precedes the defeat. Bush and Blair are hiding the true disaster they are facing in Iraq and Afghanistan. They know better than others that there is no hope in victory. The Vietnam specter is closing every outlet." (Al-Qaeda's Al-Zawahiri Predicts Failure of US 'Crusade' Against Muslim States, Posted On Jihadist Websites, 12/7/05)
The Terrorists On The Importance Of Iraq
Osama Bin Laden: Baghdad Is "The Capital Of The Caliphate." (Text Of Bin Laden's Audio Message To Muslims In Iraq, Posted On Jihadist Websites, 12/28/04)
Bin Laden: "The Most Important And Serious Issue Today For The Whole World Is This Third World War … Raging In [Iraq]." Bin Laden: "I now address my speech to the whole of the Islamic nation: Listen and understand. The issue is big and the misfortune is momentous. The most important and serious issue today for the whole world is this Third World War, which the Crusader-Zionist coalition began against the Islamic nation. It is raging in the land of the two rivers. The world's millstone and pillar is in Baghdad, the capital of the caliphate." (Text Of Bin Laden's Audio Message To Muslims In Iraq, Posted On Jihadist Websites, 12/28/04)
Bin Laden: "This Is A War Of Destiny Between Infidelity And Islam." (Text Of Bin Laden's Audio Message To Muslims In Iraq, Posted On Jihadist Websites, 12/28/04)
Bin Laden: "The Whole World Is Watching This War And The Two Adversaries; The Islamic Nation, On The One Hand, And The United States And Its Allies On The Other. It Is Either Victory And Glory Or Misery And Humiliation." (Text Of Bin Laden's Audio Message To Muslims In Iraq, Posted On Jihadist Websites, 12/28/04)
Ayman al-Zawahiri: We Must "Establish An Islamic Authority … Over As Much Territory As You Can To Spread Its Power In Iraq … [And] Extend The Jihad Wave To The Secular Countries Neighboring Iraq." Zawahiri: "So we must think for a long time about our next steps and how we want to attain it, and it is my humble opinion that the Jihad in Iraq requires several incremental goals: The first stage: Expel the Americans from Iraq. The second stage: Establish an Islamic authority or amirate, then develop it and support it until it achieves the level of a caliphate – over as much territory as you can to spread its power in Iraq … The third stage: Extend the jihad wave to the secular countries neighboring Iraq. The fourth stage: It may coincide with what came before: the clash with Israel, because Israel was established only to challenge any new Islamic entity." (Complete Text Of Al-Zawahiri Letter To Al-Zarqawi, 7/9/05, Available At: http://www.dni.gov/press_releases/20051011_release.htm, Accessed 9/5/06)
Bin Laden: "The War Is For You Or For Us To Win. If We Win It, It Means Your Defeat And Disgrace Forever." Bin Laden: "Finally, I would like to tell you that the war is for you or for us to win. If we win it, it means your defeat and disgrace forever as the wind blows in this direction with God's help." (Bin Laden Threatens New Operations, Offers 'Long-Term Truce,' Posted On Al-Jazirah Net, 1/19/06)
The Terrorists On Their Absolute Hostility Towards America
Hezbollah Leader Nasrallah: "Death To America." NASRALLAH: "Let the entire world hear me. Our hostility to the Great Satan is absolute. … I conclude my speech with the slogan that will continue to reverberate on all occasions so that nobody will think that we have weakened. Regardless of how the world has changed after 11 September, Death to America will remain our reverberating and powerful slogan: Death to America." (Hezbollah Leader Nasrallah Supports Intifadah, Vows 'Death to America,' Aired On Beirut Al-Manar Television, 9/27/02)
Iranian President Mahmoud Ahmadinejad: "We Will Soon Experience A World Without The United States And Zionism." Ahmadinejad: "Undoubtedly, I say that this slogan and goal is achievable, and with the support and power of God, we will soon experience a world without the United States and Zionism and will breathe in the brilliant time of Islamic sovereignty over today's world." (Iran's President Warns Muslims Of 'Conspiracies Of World Imperialism,' Available At: www.sharifnews.com, Accessed 10/26/05)
President Ahmadinejad: "Your Doomed Destiny Will Be Annihilation, Misfortune And Abjectness." Ahmadinejad: "Open your eyes and see the fate of Pharaoh. … Open your eyes and see what happened to the Portuguese Empire. See the final fate of the British Empire. … I am telling you [major powers], if you do not abandon the path of falsehood and return to the path of justice, your doomed destiny will be annihilation, misfortune and abjectness." (President Ahmadinejad Says Iran To Respond To Nuclear Proposals By 'End Of Mordad,' Aired On Islamic Republic Of Iran News Network Television (IRINN), 6/21/06)
President Ahmadinejad: "The Anger Of Muslims May Reach An Explosion Point Soon … [And] The Waves Of The Blast Will Not Remain Within The Boundaries Of Our Region." Ahmadinejad: "The anger of Muslims may reach an explosion point soon. If such a day comes, they [Western governments] should know that the waves of the blast will not remain within the boundaries of our region and will engulf the corrupt powers that support this fake regime too." (Iran: President Reaffirms Warning Of Explosion Of Muslim Anger In Tabriz
Address, Aired On Tehran Islamic Republic Of Iran News Network Television (IRINN), 7/11/06)
President Ahmadinejad: "If You Would Like To Have Good Relations With The Iranian Nation … Bow Down Before The Greatness Of The Iranian Nation And Surrender." Ahmadinejad: "And you, for your part, if you would like to have good relations with the Iranian nation in the future, recognize the Iranian nation's right. Recognize the Iranian nation's greatness. And bow down before the greatness of the Iranian nation and surrender. If you don't accept [to do this], the Iranian nation will later force you to surrender and bow down." (Iran: Ahmadinejad Says US, UK 'Resorted To Tricks' 'To Postpone' Cease-Fire, Aired On Tehran Islamic Republic Of Iran News Network Television (IRINN), 8/15/06)

75. Golden Boy (that’s what Louis Moore dubbed me)
Article from the Times-News on 23 September 2007
Dr. Donald Bales, 85, who recently won three medals and two ribbons in swimming competitions at the National Senior Games, credits heredity, luck and lifestyle for his longevity.
Going for the gold
85-year-old retired doctor wins three medals, two ribbons in swimming at the National Senior Games
By Nathan Baker nbaker@timesnews.net
When describing Kingsport resident Dr. Donald Bales, a number of words come to mind: Outspoken, methodical and intelligent are among the many you could choose. Some words that would not be suited for this retired octogenarian are broken down, inactive or, least of all, lazy.
The 85-year-old Bales recently won three medals and two ribbons in swimming competitions at the National Senior Games, the Olympics for a more mature section of the athletic community.
The National Senior Games are held biennially in a venue suited to hold the 12,000 qualified 50 and older athletes and the 20,000 spectators that come to be a part of the 800 scheduled events.
This year, the games were held in the Kentucky Exposition Center and the University of Louisville in Louisville, Ky.
“There’s always a big crowd at the nationals, and it’s always interesting,” Bales said. “It’s a friendly, nice atmosphere. You almost never meet anybody who goes to the games that’s nasty.”
To make it to the national level, Bales had to qualify at both the district and state levels, something he said would be more difficult if he had more competition.
“One thing about district and state is that sometimes there wouldn’t be anybody else in my age group,” Bales said, smiling. “I guess if you can’t out swim ’em, outlive ’em.”
All jokes aside, Bales’ performance in the pool is quite an accomplishment. He has attained state records for the 100-yard breaststroke in the 75 to 79 age group, and also for the 50- and 100-yard breaststroke in the 80 to 84 age group.
This year, in his age group, he won a gold medal in the 50-yard breaststroke, a silver in the 50-yard backstroke and a bronze in the 100-yard backstroke.When added to the previous medals he won at all levels since he began competing in 2000, Bales has 55 gold medals, five silver and four bronze.
Always a modest man, the retired doctor refuses to put his awards on display, preferring to keep them in a bowl on top of the piano in his family room.
“Somebody said I ought to get a board and hang them, but that just seemed a little bit vain,” he
said..
Bales’ competitive spirit originated in high school in his hometown of Morristown, Tenn. There, he was a minor athlete on the basketball, track and football teams.
Regrettably, Bales’ athletic interests took a back burner when he began building his medical career.
When he was in his 40's, the President’s Council on Physical Fitness inspired Bales to take up an active lifestyle again through a recommended exercise routine.
Bales then became an avid jogger until the pains in his arches told him it was time to try something new. So he switched to cycling and swimming.
After retiring from his practice in June 1997, Bales took up swimming at the indoor pool at Dobyns-Bennett High School. Fellow Kingsport Senior Center board member, Joan Wilder, coaxed im to swim competitively, and he took to it like a fish to-well, water.
Bales said he outlasted his contemporaries because of a critical mixture of three factors.
“A lot of people who were born the year I was are deadand in the graveyard, in a nursing home, in a wheelchair or they don’t know what they had for breakfast,” he said. “Time has been kind to the old man. I attribute my longevity to three things: heredity, luck and lifestyle.”
He’s had a full 85 years, but Bales said he’s only shooting for 15 more.
“I took one of those longevity tests that said my actual age was 68 and my life span will be 107,” he said. “I’d only counted on 100, if I make it past there, I’ll have to reexamine the situation.”
It’s been said that behind all great men is a supportive woman, and Bales is no different.
His wife of 62 years, Julia, goes along with him to his countless swimming competitions to act as a cheering section.
“Some of the luck that I had was picking my profession,”” Bales said. “Another was picking my wife. Two the most important things in life have turned out really well for me.”
Together, the Bales’s have four children who inherited their father’s proclivity for healthy living.
“They’re all lean, they’re all in superb physical condition, none of them smoke, none of them drink, and none of them are on drugs,” Bales said. “When I turned 70, they wrote a list for me called ‘70 Things I Learned From Daddy.’ One of them was lifestyle.”
He got one thing wrong in the article. I did not consider myself nor did the coach nor my teammates on the football team and the basketball team consider me a minor athlete. Perhaps I could have been considered a minor track man since I never placed in a meet-the criterion for getting a letter in track.

76. Nature Trumps All

Philosophers, psychologists, legislators, judges and social "scientists" can all have their say and their sway, but the women will still have the babies, and will still get pregnant if they do not use the "wonderful" liberating pill or the diaphragm or the men use the condom.

Sexual transmitted diseases, including that equal opportunity killer-HIV-AIDS, will continue to spread as long as people continue to engage in high risk behavior. Who can become infected with HIV (Human Immunodeficiency Virus): Intravenous recreational drug users, gay men who have unprotected anal sex (anyone who has anal sex) and those women who have sex with men in the two preceding categories. Others, innocent of high risk behavior: Those who need blood or blood products (unlikely since donors are screened and their blood tested), babies whose mothers have HIV, medical personnel who, in spite of precautions become infected. I do not know the percentage of “innocents” who get in infected, but it must be a very low percentage. The idea so promulgated by some that anyone can get it is dead wrong. It is highly related to high risk behavior. A true square is very unlikely to get HIV

Man's laws cannot change the laws of nature nor is there any appeal of the sentence.
There was a little window of time after the beginning of the sexual revolution (when women changed their behavior and began doing what men had been wanting them to do all along) before the coming of HIV-AIDS, that the consequences of high risk behavior were not so drastic. Of course, an unwanted pregnancy was inconvenient, but an abortion could fix that (or let grandma look after it, or maybe the "village" and some of the STD's were treatable and even curable (but some were not and as still not curable or even treatable). This window of time was also when gay men could indulge their wildest sexual fantasies without getting HIV.

Now we have the situation where there is a move afoot to mandate vaccination against human papilloma virus to prevent cervical cancer. We also have three middle schools in Maine that propose giving birth control pills to the girls.

This assumes that all girls will either be promiscuous and careless or that their sexual partners will have been. What a favorable development!

Donald W. Bales, M.D. retired internist October 2007

77. Global Warming
Donald W. Bales
12 November 2007

Although I believe that many-Al Gore, liberal Democrats, environmentalists, socialists,
anti-capitalists, anti-U.S. groups have a hidden agenda in trying to acquire more government power over everyone’s life, I must write that I do think that global warming is occurring and also that human activity, namely burning of fossil fuels, is an important cause of it.
Why have I come to the above conclusions?
Global average air temperature is reported to have risen 0.14 +- C. in the last 100 years. Projections (that may not be correct) are from 1.1 to 6.4 C rise during the 21st century. That is quite a range. 1.1 C is a lot different from 6.4 C. as to its effect on the earth.
In 1960 carbon dioxide in the atmosphere was 305 parts per million (ppm) by volume. It is now 383 ppm.
Greenhouse gases were discovered by Fourier in 1824 and first quantitated by Arrhenius in 1876, Water vapor makes up 35 t0 70 %, carbon dioxide makes up 9 to 26 % and is up 31% from pre-industrial times. Methane (CH4) was 4.95%. It has increased by 149%. Ozone is 3 to 7%. There is also a small amount of nitrous oxide (NO2).
The present level of carbon dioxide was last present 20 million years ago. Three fourths of the increase is due to fossil fuel use-the rest is due to deforestation.
Levels of carbon dioxide by 2100 are from 541 to 770 parts per million. Again this is quite a range. Not very precise numbers. The effect on the earth would be quite different for each of those numbers.
Global warming would lead to release of carbon dioxide from Siberian peat bogs as they melt.
Warming, however, would lead to more water vapor in the atmosphere favoring further warming. Information about cloud formation is incomplete. Clouds promote warming below them and cooling above them. There is also an albedo effect-that is snow and ice tends to reflect radiation while water or land tends to absorb it.
There is also the release of methane now trapped in seabeds that would increase greenhouse gases.
Solar variation is thought to have been 45 to 50% responsible for warming from 1900 to 2000 and 25 to 35% responsible for the warming from 1980 to 2000.
There has been cooling of the lower atmosphere since 1960. Reduction of ozone (late 70's) resulted in cooling.
Solar variation and volcanic action is thought to be the cause of warming from pre-industrial times until 1950.
The earth did have a warming (Medieval Warming) from 900-1500. Greenland was inhabitable for farming. Then we had The Little Ice Age from 1500 until 1850.
Since land accepts heat better than water the warming has been more in the northern hemisphere due to there being more land there than in the southern hemisphere. The article did not say so, but a lot more fossil fuel is burning the northern hemisphere.
Some believe that man began to influence the temperature as far back as 8000 years ago
when forests were removed when agriculture began and more 5000 years ago when rice cultivation in Asia led to irrigation (I presume due to more water vapor due to evaporation).
2005 was slightly less warm than 1998-the hottest year in recent times.
Sulfide aerosols in the atmosphere promote cooling.
Indirect evidence (coring of glaciers, seabeds) going back 800,000 years attest to eight glaciation in the past, so we have had coolings and warmings of the earth for a long time.
Increased carbon dioxide in the air would promote more being absorbed in the oceans. Carbon dioxide combines with water to form carbonic acid (not as strong an acid as sulfuric or hydrochloric, but still an acid). The ocean surface pH is reported to have gone from pH 8.25 to 8.14. That is still basic, but may have an adverse effect of plants and animals in the sea. Tthe increasing temperature of the water has had and would have more as the temperature rises.
Some have tried to put a dollar cost on each degree of warming. Warming could surely have effects-some predictable and others not so predictable.
On the other hand, efforts to cut down on the use of fossil fuels will have a great cost as well very likely leading to a decreased standard of living.
Some have estimated that putting into effect the Kyoto Proposals would have a negligible effect on the warming.
Will the population (or governments) of the world have the inclination or the will or the cooperation to do what would be required to make a real difference? Judging by the way the world is now-I have my doubts. Not that we shouldn’t do what we can.
To me the first and most immediate priority is to win or at least not lose World War IV with radical Islam. If we lose that, there will be no hope of doing anything about global warming. The U.S. would have to lead. To me the second and immediate priority would be stopping illegal immigration. If that is not stopped, the U.S. will cease to be the good country that is has been (in spite of all its flaws) and will not a beacon for the rest of the world.

To Be A Mensch
I am neither Yiddish nor Jewish nor German, although my middle name, Weesner, reflects some German background.
I have looked for an English (American, United States) word that has the same meaning that the Yiddish word, “Mensch” has.
I understand the word “Mensch” to mean “a good person.” It also has the connotation “a really good person.”
Now what is a good person? To me a good person doesn’t lie, doesn’t steal and does treat others as he would like to be treated. In fact, I believe a “Mensch” (good person) would obey or try to obey to the best of his ability the last six of the Ten Commandments.
For the non-Biblical (all Christians should know all of the Ten Commandments as should all Jews) the Ten Commandments are as follows:
Which Ten Commandments?
Protestant 1* Catholic 2 Hebrew 3
1. Thou shalt have no other gods before me.*
1. I am the Lord thy God. Thou shalt not have strange gods before me.
1. I am the Lord thy God, who brought thee out of the land of Egypt, out of the house of slavery.
2. Thou shalt not make unto thee any graven image, or any likeness of any thing that is in heaven above, or that is in the earth beneath, or that is in the water under the earth: Thou shalt not bow down thyself to them, nor serve them: for I the Lord thy God am a jealous God, visiting the iniquity of the fathers upon the children unto the third and fourth generation of them that hate me; And showing mercy unto thousands of them that love me, and keep my commandments.
2. Thou shalt not take the name of the Lord thy God in vain.*
2. Thou shalt have no other gods before Me. Thou shalt not make unto thee a graven image, nor any manner of likeness, of any thing that is in heaven above, or that is in the earth beneath, or that is in the water under the earth; Thou shalt not bow down unto them, nor serve them; for I the Lord thy God am a jealous God, visiting the iniquity of the fathers upon the children unto the third and fourth generation of them that hate Me; And showing mercy unto the thousandth generation of them that love Me and keep My commandments.
3. Thou shalt not take the name of the Lord thy God in vain: for the Lord will not hold him guiltless that taketh his name in vain.*
3. Remember thou keep the Sabbath Day.
3. Thou shalt not take the name of the Lord thy God in vain; for the Lord will not hold him guiltless that taketh His name in vain.
4. Remember the Sabbath day, to keep it holy. Six days shalt thou labor, and do all thy work: But the seventh day is the Sabbath of the Lord thy God: in it thou shalt not do any work, thou, nor thy son, nor thy daughter, thy manservant, nor thy maidservant, nor thy cattle, nor thy stranger that is within thy gates: For in six days the Lord made heaven and earth, the sea, and all that in them is, and rested the seventh day: wherefore the Lord blessed the sabbath day, and hallowed it.*
4. Honor thy Father and thy Mother.
4. Remember the Sabbath day to keep it holy. Six days shalt thou labour, and do all thy work. But the seventh day is the Sabbath in honour of the Lord thy God; on it thou shalt not do any work, neither thou, nor thy son, nor thy daughter, thy manservant nor thy maidservant, nor thy cattle, nor thy stranger that is within thy gates; For in six days the Lord made the heavens and the earth, the sea, and all that is in them, and rested on the seventh day; therefore the Lord blessed the Sabbath day, and hallowed it.
5. Honor thy father and thy mother: that thy days may be long upon the land which the Lord thy God giveth thee.*
5. Thou shalt not kill.* “Murder-kill unlawfully-was translated as “kill.”
5. Honour thy father and thy mother; in order that thy days may be prolonged upon the land which the Lord thy God giveth thee.
6. Thou shalt not kill.
6. Thou shalt not commit adultery.
6. Thou shalt not kill.
7. Thou shalt not commit adultery.*
7. Thou shalt not steal.
7. Thou shalt not commit adultery.
8. Thou shalt not steal.*
8. Thou shalt not bear false witness against thy neighbor.
8. Thou shalt not steal.
9. Thou shalt not bear false witness against thy neighbor.*
9. Thou shalt not covet thy neighbor's wife.
9. Thou shalt not bear false witness against thy neighbor.
10. Thou shalt not covet thy neighbor's house, thou shalt not covet thy neighbor's wife, nor his manservant, nor his maidservant, nor his ox, nor his ass, nor any thing that is thy neighbor's.*
10. Thou shalt not covet thy neighbor's goods.
10. Thou shalt not covet thy neighbor's house; thou shalt not covet thy neighbor's wife, nor his manservant, nor his maidservant, nor his ox, nor his ass, nor any thing that is thy neighbor's.
It is my opinion that all successful societies have some version of the last six commandments in their code of ethics or morality.

Donald W. Bales, Kingsport, Tennessee 5 December 2007


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