I'm a Doctor and I Know Nothing About Aflliction

Bill,

Not really, anyway.

For better or worse, a common route to success in an academic career is becoming an expert in something obscure. In academic medicine that usually means mastering the ins and outs of a disease so uncommon that almost no one ever gets it, and that most doctors wouldn't have a clue as how to recognize or treat. As an example. the part of the US where you grew up has given its name to a rare tick borne infection, Rocky Mountain Spotted Fever, that produces an incidence of 6 cases/million. For the math challenged among our readers that means that the country sees about 1800 cases annually. In the aggravating way medicine works, the disease is much more common in a band that extends east-west from North Carolina to Oklahoma than it is in the Rockies.

I'm not ashamed to admit that I wouldn't recognize it if a patient entered my office with a sign on his back that said "I have Rocky Mountain Spotted Fever" or the dermatologic equivalent thereof.

In my case the rare disease expertise involves a family of inherited muscle disorders called the muscular dystrophies, most of which affect the heart with varying degrees of severity,  Muscular dystrophies are single gene disorders. The most disabling and deadly and among them, Duchenne's muscular dystrophy, is carried on the X chromosome, and so is passed from unaffected mothers to maximally afflicted sons. Duchenne's patients endure an inxorable course of increasing muscle weakness, fractures and resultant infirmity. The ordinary physical pleasures of childhood are denied these boys; walking without assistance commonly becomes impossible by the age of five or so. Because the body's largest and most powerful muscles, the quadriceps, are affected first, Ducheene patients learn to raise themselves to a standing position by walking their arms up their torsos in a maneuver called Gower's sign.

By their teen years Duchenne's patients are usually wheelchair bound. They require an astonishing (and expensive) amount of day-to-day care. As their respiratory muscles weaken they cannot clear their  phlegm in the way you and I do without thinking every time we cough. Pneumonia,thus common, weakens them further. The most essential muscle, the heart, declines relentlessly, leading to heart failure and death late in their teens or early twenties. 

These boys are my patients. In conjunction with other doctors with related expertise, I see them once a month at a nearby rehabilitation hospital. They arrive with a caretaker, usually mom or dad, or both. Affected brothers will come for their appointments together. I listen, offer what I can from my my doctor's bag of medicines and devices, and bear witness.  

While it once would not have been so, at this point in my career it is deeply pleasurable to be their doctor. These boys surely provide more for me than I provide to them. They have after all, an incurable disease that has robbed them of much, and soon will rob them of life itself. The success of the treatment I provide is modest at best. Placed in their wheelchairs, unable even to shake my hand, they are the embodiment of dignity, and their parents are the essence of devotion. The love these parents have for their children lies beyond hope or expectation, or volition, well beyond my ability to comprehend it. Try as I might, I cannot penetrate what's it's like to live in their skin. Still, they remind me by their presence, once a month, to keep on trying.

Eli 

Who is Misrepresenting the NSA Collection Programs?

Michael Hayden, former director of the NSA and CIA on Fox News Sunday, August 4, 2013

HAYDEN: There are several there I think the intelligence community is looking at right now, Chris, and to make Americans more comfortable about the programs. 

I've got to add, Chris, it doesn't make Americans more comfortable about the program to misrepresent it. This does not authorize the collection of content, period.

The New York Times, August 8th, 2013: "N.S.A. Said to Search Content of Messages to and From U.S."

WASHINGTON — The National Security Agency is searching the contents of vast amounts of Americans’ e-mail and text communications into and out of the country, hunting for people who mention information about foreigners under surveillance, according to intelligence officials.

Who is misrepresenting these programs to the American people?

Bill

Obama: The NSA is NOT looking at your emails. NYTimes: The NSA is looking at your emails.

June 7, 2013, "Transcript: Obama’s Remarks on NSA Controversy," from the Wall Street Journal:

Now, with respect to the Internet and emails, this does not apply to U.S. citizens, and it does not apply to people living in the United States. And again, in this instance, not only is Congress fully apprised of it, but what is also true is that the FISA Court has to authorize it.

August 8, 2013, "N.S.A. Said to Search Content of Messages to and From U.S." from the NY Times

WASHINGTON — The National Security Agency is searching the contents of vast amounts of Americans’ e-mail and text communications into and out of the country, hunting for people who mention information about foreigners under surveillance, according to intelligence officials. 

 If I send an email that "mentions" a foreigner under surveillance, am I then placed under surveillance and are those three hops from me under surveillance? If I mention a foreigner under surveillance, not a terrorist, but a foreigner under surveillance, in this blog, does anyone who reads this blog get placed under surveillance and all those three hops away?

Americans are being spied upon. Without a warrant. Every day. And in a bipartisan atrocity, it is supported by Republicans and Democrats.

Bill

Football on Your Phone. Awesome

Are you three hops from a terrorist? The NSA wants to know.

From Techcrunch.com, "How Obama Can Say “We Don’t Have A Domestic Spying Program” Without Lying," 

While the NSA is supposed to focus on foreign suspects, they can monitor any individual who corresponds (is “connected”) with terrorists. According to the NSA, surveillance programs sweep American communications up to 3 ‘hops’ from any suspect (a friend of a friend of a friend is 3 ‘hops’ in a network). 

Most Americans are three degrees away from hundreds of thousands or even millions of other citizens. If I have 100 friends, and they each have 100 friends, I’m 2 degrees from 10,100 people (assuming there’s no overlapping friendships).

The NSA and the administration and the apologists in Congress (McCain, King, Feinstein etc.) have consistently been proven to be shading the truth at best and lying at worst about the intrusiveness of the NSA's activities.

Bill

Thomas Sowell on "Busybody Politics"

Full story is here.

ObamaCare is perhaps the ultimate in busybody politics. People who have never even run a drugstore, much less a hospital, blithely prescribe what must be done by the entire medical system, from doctors to hospitals to producers of pharmaceutical drugs to health insurance companies.

Well said.

See also F. Hayek's Nobel Prize Lecture, "The Pretence of Knowledge." which includes this:

While in the physical sciences it is generally assumed, probably with good reason, that any important factor which determines the observed events will itself be directly observable and measurable, in the study of such complex phenomena as the market, which depend on the actions of many individuals, all the circumstances which will determine the outcome of a process, for reasons which I shall explain later, will hardly ever be fully known or measurable.

Bill

I Find the Actions of the NSA, and it Defenders, Despicable

http://abcnews.go.com/blogs/politics/2013/07/glenn-greenwald-low-level-nsa-analysts-have-powerful-and-invasive-search-tool/


Glenn Greenwald: Low-Level NSA Analysts Have ‘Powerful and Invasive’ Search Tool
Jul 28, 2013 10:17am

Today on “This Week,” Glenn Greenwald – the reporter who broke the story about the National Security Agency’s surveillance programs – claimed that those NSA programs allowed even low-level analysts to search the private emails and phone calls of Americans.

“The NSA has trillions of telephone calls and emails in their databases that they’ve collected over the last several years,” Greenwald told ABC News’ George Stephanopoulos. “And what these programs are, are very simple screens, like the ones that supermarket clerks or shipping and receiving clerks use, where all an analyst has to do is enter an email address or an IP address, and it does two things.  It searches that database and lets them listen to the calls or read the emails of everything that the NSA has stored, or look at the browsing histories or Google search terms that you’ve entered, and it also alerts them to any further activity that people connected to that email address or that IP address do in the future.”

Greenwald explained that while there are “legal constraints” on surveillance that require approval by the FISA court , these programs still allow analysts to search through data with little court approval or supervision.

“There are legal constraints for how you can spy on Americans,” Greenwald said. “You can’t target them without going to the FISA court. But these systems allow analysts to listen to whatever emails they want, whatever telephone calls, browsing histories, Microsoft Word documents.”

“And it’s all done with no need to go to a court, with no need to even get supervisor approval on the part of the analyst,” he added.

But the top Republican on the  Senate Intelligence Committee told Stephanopoulos he would be shocked if such programs existed.

“It wouldn’t just surprise me, it would shock me,” Sen. Saxby Chambliss, R-Georgia, said on “This Week” Sunday.

Chambliss said he recently spent time with NSA officials and was assured that the programs Greenwald describes have been exaggerated.

“I was back out at NSA just last week, spent a couple hours out there with high and low level NSA officials,” Chambliss said. “And what I have been assured of is that there is no capability at NSA for anyone without a court order to listen to any telephone conversation or to monitor any e-mail.”

Chambliss said that any monitoring of emails is purely “accidental.”

“In fact, we don’t monitor emails. That’s what kind of assures me is that what the reporting is is not correct. Because no emails are monitored now,” Chambliss said. “They used to be, but that stopped two or three years ago. So I feel confident that there may have been some abuse, but if it was it was pure accidental.”

But Greenwald said the existence of these analyst search programs are in line with the claims of Edward Snowden, who first leaked details of the NSA’s surveillance programs last month.

“It’s an incredibly powerful and invasive tool, exactly of the type that Mr. Snowden described,” Greenwald said.

NSA Director Gen. Keith Alexander and House Intelligence leaders have previously downplayed Snowden’s access to NSA data. Greenwald said the revelation of this search capability deserves a response from NSA officials when they testify before Congress again this week.

“NSA officials are going to be testifying before the Senate on Wednesday, and I defy them to deny that these programs work exactly as I just said,” Greenwald said.

Greenwald, who will join via video-link a separate bipartisan congressional group hearing from critics of the NSA’s surveillance programs on Wednesday, called on lawmakers to push for more information about the NSA’s practices.

“The real issue here is that what the NSA does is done in complete secrecy. Nobody really monitors who they are eavesdropping on,” Greenwald said. “So the question of abuse is one that the Congress ought to be investigating much more aggressively.”

Snowden, the former NSA contractor who leaked information about two sweeping intelligence programs, has previously warned that they are open to abuse by those with access. In a video interview with The Guardian , he said, “Any analyst at any time can target anyone… I, sitting at my desk, had the authority to wiretap anyone, from you or your accountant to a federal judge to even the president if I had a personal email.”

Snowden has been holed up in a Moscow airport for weeks. He is currently attempting to secure temporary asylum in Russia on the grounds that he would be tortured or face the death penalty if he returned to the United States.

Attorney General Eric Holder responded to Snowden’s appeal last week , writing in a letter to the Russian government, “These claims are entirely without merit.”


Today, Greenwald told Stephanopoulos that Snowden’s petition is still pending, but the former NSA contractor prefers that the focus be elsewhere.

“I think he’s content with having nothing happen so the focus isn’t on him, but is on the substance of the revelations that he came forward to shine light on,” Greenwald said.


Grey Korhonen contributed to this report.