Re: Sure, you're on my porch.

1

You pay him for the pizza.


Posted by: JP Stormcrow | Link to this comment | 08-18-09 7:12 PM
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"I've seen pictures of Bob Dylan from a long time ago, and he didn't look like Bob Dylan to me at all," Officer Kristie Buble told ABC News.

Time has a cruel surprise in store for Officer Buble.


Posted by: Gabriel | Link to this comment | 08-18-09 7:32 PM
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The shoes off the secret menu are still plenty springy.


Posted by: M/tch M/lls | Link to this comment | 08-18-09 7:50 PM
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They discovered that super-springy soles cause cancer, as Robert Novak learned to his sorrow.


Posted by: Walt Someguy | Link to this comment | 08-18-09 7:53 PM
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2: She says that beauty is a curse
I always answer I could think of much worse
She tells me glamor is a bore
I always tell her I could bore her much more

You're beautiful right now
But if you care to change that
I think time can find a way
to arrange that


Posted by: k-sky | Link to this comment | 08-18-09 7:55 PM
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I find the super-springy soles a little disconcerting -- they make my feet feel the wrong shape and confusingly disconnected from the earth. And yet I am willing, when not running, to wear high heels and wedges and things. I'm an enigma.

I like to run (the feeble short distances that I run) in Asics Onitsuka Tigers, because I am a fashion victim.


Posted by: redfoxtailshrub | Link to this comment | 08-18-09 8:02 PM
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Someone over at HuffPo quipped that Obama would be inviting Dylan and the arresting officer to the White House for a Bong Summit.


Posted by: pain perdu | Link to this comment | 08-18-09 8:04 PM
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|| I have bitten my lip in the same place like 5 times in the past 4 days. It's getting pretty torn up. |>


Posted by: paranoid android | Link to this comment | 08-18-09 8:07 PM
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i miss the old squishy shoes, too.

i used to run in Asics Cumulus, which were very soft, billowy even, replacing them every year with the new model (which just meant new stripe patterns on the side). then, a couple of years ago, they made the soles much much firmer, but kept the same name. after a few weeks in the new model, my knees, shins and hips all expressed their displeasure.

i miss billowy.


Posted by: cleek | Link to this comment | 08-18-09 8:22 PM
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||

Goddamnit. I'm trying to book a flight for my grandmother, who has quite reasonable requests, given that she's 91: only one layover, she'd prefer a 2+ hour layover, and not in Chicago if possible. (She's flying from Madison.) The expedia/travelocity/priceline flights are claiming that there does not exist such a flight on any day she could travel. Am I going to have to use a travel agent? Do they still make travel agents?

|>


Posted by: heebie-geebie | Link to this comment | 08-18-09 8:27 PM
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10: The options out of Madison are fairly limited, and Chicago is the obvious place to have a layover. Maybe your best bet would be American Airlines with a layover in St Louis? (Sorry if this is not helpful and you've already tried that.)


Posted by: essear | Link to this comment | 08-18-09 8:36 PM
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I think there probably are such flights, but the search mechanisms on the sites don't really look 2+ hours out on layovers if there are plenty of shorter options, which there are.


Posted by: heebie-geebie | Link to this comment | 08-18-09 8:38 PM
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Did you try going directly through the American Airlines site?


Posted by: essear | Link to this comment | 08-18-09 8:39 PM
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What I mean is, there are layovers in Minneapolis, Detroit, Memphis, and Dallas, just they're all too short, but accomodating accomodations probably exist.


Posted by: heebie-geebie | Link to this comment | 08-18-09 8:39 PM
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14: Understood. I'm just saying that if you go to the individual airline, you might get more choices listed than the ones that show up on Expedia or Travelocity. I see a lot of options with more than two hour layovers in St Louis or Dallas when I search at aa.com, but I'm just picking random dates, so maybe they're not available when you're looking.


Posted by: essear | Link to this comment | 08-18-09 8:41 PM
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13: I did. And the Northwest/delta website. There was a bigger gap in price than I was expecting. For some reason the individual sites were way expensive.


Posted by: heebie-geebie | Link to this comment | 08-18-09 8:42 PM
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15: Similar with Northwest.


Posted by: JP Stormcrow | Link to this comment | 08-18-09 8:42 PM
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yeah, I'm sure something will turn up. It's just a pain to go through individual sites. Also I'm trying to time her flight not to get in too late, in case something goes wrong.


Posted by: heebie-geebie | Link to this comment | 08-18-09 8:45 PM
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And trying to coordinate so that we all fly into the same airport together...it's complicated.


Posted by: heebie-geebie | Link to this comment | 08-18-09 8:48 PM
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And trying to coordinate so that we all fly into the same airport together

Oh, the destination isn't Austin? Maybe I was getting completely misleading search results, then. At any rate, good luck with it. I guess a travel agent might be necessary, since the idea of trying to call the airline and explain what you want and getting a useful result seems comically improbable from my experiences with airline customer service.


Posted by: essear | Link to this comment | 08-18-09 8:50 PM
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Badger bus/cab to Milwaukee, redcap there?


Posted by: lw | Link to this comment | 08-18-09 8:53 PM
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The SKM/M/ collective recommends kayak.com.

Although I'm not sure it will help with this particular set of parameters.


Posted by: M/tch M/lls | Link to this comment | 08-18-09 9:00 PM
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Also, I was going to post a "secret airline menu" joke, but figured I didn't want to completely wear out the "secret menu" joke for another 30 minutes or so.


Posted by: M/tch M/lls | Link to this comment | 08-18-09 9:01 PM
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For some reason the individual sites were way expensive.

This seems unusual. I usually find they're the same price of slightly cheaper. In cases where they aren't, it often seems to be that a price has just changed and Expedia or whatever hasn't updated it yet, but will shortly thereafter.


Posted by: essear | Link to this comment | 08-18-09 9:07 PM
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One of Lemieux's commenters gets it right.

except that I think if I were the cop, I'd be seeing headlines like "Police allow escaped nursing home patient to wander into traffic."

Balko's needs to get a grip. When you're out on a call of a 70 year old dude who's wandered into someone's yard, and said old dude claims to be a world famous rock star but has no i.d., there's a non trivial chance he is totally nuts and shouldn't be cut loose right away.


Posted by: gswift | Link to this comment | 08-18-09 10:17 PM
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heebie, they do still make travel agents, and believe it or not they can be amazing. internet fiend though I am, I still use a travel agent. get a recommendation from someone in your area. you wouldn't think they had access to better searches than you, but they do, or else they know tricks, or something. kick it old school.


Posted by: alameida | Link to this comment | 08-18-09 10:44 PM
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In the annals of famous people getting stopped by authorities, Sharukh Khan got detained at Newark airport last week. The article I read seemed to claim it was because of his last name, but geez, how many Khans must there be? Ironically enough, he is apparently making a movie right now about racial profiling of Indian Muslims in the U.S. after 9/11.


Posted by: Blume | Link to this comment | 08-19-09 12:17 AM
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25: he didn't have to jam that mop handle up his ass, though.


Posted by: Sifu Tweety | Link to this comment | 08-19-09 12:44 AM
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25 has it right. Particularly when even if he does turn out to be the rock star in question, there's still a non-trivial chance that he's completely nuts and shouldn't be cut loose right away.


Posted by: OFE | Link to this comment | 08-19-09 1:33 AM
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At the moment the trend in shoes is to get closer towards barefoot, meaning minimal soles (particularly heel lift) and cushioning. This apparently has several benefits, that the great Google will be happy to elucidate.

This is a way of saying that if you run in Onitsuka Tigers you're not a hipster, just concerned about the health of your feet.


Posted by: W. Breeze | Link to this comment | 08-19-09 1:36 AM
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30: or you walk like a girl.


Posted by: Sifu Tweety | Link to this comment | 08-19-09 1:45 AM
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Yeah, what Breeze said in 30.

Apparently there's been some research done [there was a summary article I read somewhere recently] on the correlation between cushioning and the cost of the shoe (on the one hand) and frequency of injuries on the other. The more expensive/cushioned the shoe, the more likely one is to get injured. People in cheap, thin soled shoes get injured less.


Posted by: nattarGcM ttaM | Link to this comment | 08-19-09 1:50 AM
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I've always known I have wide feet, but it took a recent run-in with foot pain for me to get my feet properly measured and I've discovered by feet have width H (UK) or, I think, 6E (US). I've been wearing shoes a size or two too big for years without realising it was because of this. I'm now trying to find a shoe that fits properly. The 4E New Balance shoes I've tried on don't fit. Apparently they make 6E shoes, but I can't find anyone who has them in the UK. Looks like I'm going to have to get custom made shoes, or risk buying off an Internet retailer. I've been going barefoot a lot recently.


Posted by: W. Breeze | Link to this comment | 08-19-09 1:58 AM
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32: that's just because they're less likely to have health care.

More seriously, it seems like you'd have to control for an awful lot of other variables (distance run, age, weight, experience with running, training methodology, even health insurance) to get a good result on that.


Posted by: Sifu Tweety | Link to this comment | 08-19-09 2:00 AM
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34: That's the blanket criticism you can apply to just about any research outside of the hard sciences. There's more than one study I believe.


Posted by: W. Breeze | Link to this comment | 08-19-09 2:06 AM
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34 cont'd: I'm not suggesting they didn't do those controls, I'd just be interested to see the actual research, and I bet there are people making the opposite claim in reasonably convincing ways.

Also, isn't the whole world of running injuries (as far as what counts as a knee injury, and whether those are a concern) kind of up in the air right now?


Posted by: Sifu Tweety | Link to this comment | 08-19-09 2:07 AM
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35: sure. And kind of a cheap criticism, too, admittedly. And the idea of barefoot running being healthier makes intuitive sense to me. I just get the sense that the current research landscape is both genuinely contentious (among people who really do know what they're talking about) and populated with a relatively large number of amateurs and shills.


Posted by: Sifu Tweety | Link to this comment | 08-19-09 2:11 AM
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37: The series on shoes and technique here:

http://www.sportsscientists.com/2008/01/featured-series-on-science-of-sport.html

provide a good overview of most of the relevant work. IIRC they are cautiously in favour of the barefoot side, but stress you need time to adapt (see post 9 above).


Posted by: W. Breeze | Link to this comment | 08-19-09 2:45 AM
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I struggle with shin splints so haven't really had a chance to run much in the past couple of years. I do have both [very] thin-soled and heavily cushioned/supporting shoes so would be interesting to do a personal comparison.

I do find I don't suffer from shin splints or from impact-type injuries when I do my martial arts thing, even though there's a fair bit of jumping, and a lot of stop/start sudden movements, changes of direction, etc. I wear a pair of cheap, old-fashioned squash shoes for that, which have a fairly tight heel-cup [to add a bit of lateral support when stopping suddenly or twisting] but very little cushioning at all. The soles are quite hard, and nothing like running shoes.


Posted by: nattarGcM ttaM | Link to this comment | 08-19-09 3:24 AM
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OT: Barney Frank for the win. Now *that's* the proper response.


Posted by: apostropher | Link to this comment | 08-19-09 4:50 AM
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I like the cushion in my Adidas shoes. What about those Nike Shox? Do they provide bounce?


Posted by: Bostoniangirl | Link to this comment | 08-19-09 5:03 AM
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The quote from the officer that I didn't see in the first couple articles I read was that when they really got suspicious was when he said, "I'm here on tour with John Mellencamp and Willie Nelson." IOW, "I own a mansion and a yacht."

In that light, I'm less unhappy with the cops, because it must have sounded to them like he was fucking with them.

Still, I don't love this "May we see you papers?" America we've built for ourselves.


Posted by: JRoth | Link to this comment | 08-19-09 5:56 AM
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40: I was just about to link to that! And to think that this man could be representing me in the US Senate before long! (I don't want to seem too morbid, here; obvs. I would much prefer it if Sen. Kennedy were to make a full recovery, but you know, brain cancer...)


Posted by: pain perdu | Link to this comment | 08-19-09 5:57 AM
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25: The very first short news blurb I saw on this made me think he was flagged/stopped for being a white person wandering around in a place where people thought he was trying to buy drugs. I don't know the local geography well enough to know if that was plausible, but from the tone and framing of the initial news story, I figured that was exactly what was going on.

On the "show us your papers" front, it's not so much the "stop and prove your identity" as the "outlandish claim not being immediately believed" part that makes me a bit sympathetic to the police.

Having dealt with a number of members of the public who believe themselves to be someone very important (royalty seems to be a common theme), I can understand the temptation toward skepticism. Plus, there's a lot of celebrities in the world. Note that I'm the person who got all the way through Dreamgirls without knowing that I was watching Beyonce.

On the other hand, marching him back so he can produce photo ID? A bit silly. Couldn't a quick phone call have taken care of it?


Posted by: Witt | Link to this comment | 08-19-09 6:55 AM
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YouTube is blocked at work. Can someone summarize, link to a transcript, etc.?


Posted by: Cyrus | Link to this comment | 08-19-09 6:56 AM
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40: Awesome! Someone should transcribe that for Cyrus.


Posted by: Di Kotimy | Link to this comment | 08-19-09 7:01 AM
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Barney to "Obama=Hitler" questioner: "Arguing with you would be like arguing with a dining room table."

There's more, but that's the line I will keep in my heart.


Posted by: JRoth | Link to this comment | 08-19-09 7:04 AM
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Barney to "Obama=Hitler" questioner: "Arguing with you would be like arguing with a dining room table."

There's more, but that's the line I will keep in my heart.


Posted by: JRoth | Link to this comment | 08-19-09 7:04 AM
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Dammit.


Posted by: JRoth | Link to this comment | 08-19-09 7:04 AM
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|| I have bitten my lip in the same place like 5 times in the past 4 days. It's getting pretty torn up. |>

My world and welcome to it. I do this all the time. Sadly, Iris has inherited it (of all the things to be heritable. Weirdest thing is that I would have blamed it on my overzealous eating, but Iris is the most desultory eater alive).


Posted by: JRoth | Link to this comment | 08-19-09 7:06 AM
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44: Witt gets it exactly right.


Posted by: JRoth | Link to this comment | 08-19-09 7:12 AM
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Heh, sounds cool. I'll try to watch it at home tonight.


Posted by: Cyrus | Link to this comment | 08-19-09 7:14 AM
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Heh, sounds cool. I'll try to watch it at home tonight.


Posted by: Cyrus | Link to this comment | 08-19-09 7:14 AM
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I blame JRoth.


Posted by: Cyrus | Link to this comment | 08-19-09 7:14 AM
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In the annals of famous people getting stopped by authorities, Sharukh Khan got detained at Newark airport last week.

I wonder if said authorities shouted "Khaaaan!" to stop him.


Posted by: Populuxe | Link to this comment | 08-19-09 7:19 AM
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When I was a kid I found at a yard sale a pair of the most absurd exercise/play dealy-boppers ever: They were like those old-school skates that strap on over your shoe, but instead of wheels they had big springs. Straight out of the ACME catalog of Roadrunner-catching gadgets, they were. A liability nightmare, too, as they had essentially no ankle support and lots of bits that promised to break in mid-hop.

This was ~1980, so I guess they must have been made in the early 70s or thereabouts.


Posted by: togolosh | Link to this comment | 08-19-09 7:19 AM
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55: No, but when they finally released him the airport was shut down for three hours for a big dance number with inexplicable smoke effects and lots of bubbles falling from the ceiling. It's really the least they could do.


Posted by: togolosh | Link to this comment | 08-19-09 7:23 AM
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56: Satellite Jumping Shoes or Kangaroo Shoes?


Posted by: Sifu Tweety | Link to this comment | 08-19-09 7:25 AM
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The question was: Why do you continue to support a Nazi policy, as Obama has expressly supported this policy. Why are you supporting it?

Frank: When you ask me that question I'm going to revert to my ethnic heritage and answer your question with a question: on what planet do you spend most of your time?

[something edited out]

You want me to answer the question? Yes. As you stand there with a picture of the President defaced to look like Hitler and compare the effort to increase health care to the Nazis, my answer to you is as I said before: it is a tribute to the First Amendment that this kind of vile, contemptible nonsense is so freely propagated. Ma'am, trying to have a conversation with you would be like trying to argue with a dining room table. I have no interest in doing it.


Posted by: apostropher | Link to this comment | 08-19-09 7:27 AM
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58: The mysterious third kind of ankle-breakers. All metal construction, except for the straps. Good to see that stupid ideas never go out of fashion.


Posted by: togolosh | Link to this comment | 08-19-09 7:36 AM
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There's a longer version here with more of her ridiculous question and more from Frank:

"This notion that something in this bill would require people who are elderly or sick to be denied medical care and killed is the single stupidest idea I have ever heard in all my years in politics."

And then: "What have I said that put anyone down...? Oh yes, I did tell the woman standing there with the president looking like Hitler, who compares us to the Nazis that I thought she was out of her mind. I did put her down. If you want to be on her side, OK."


Posted by: emdash | Link to this comment | 08-19-09 7:42 AM
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Oh yes, I did tell the woman standing there with the president looking like Hitler, who compares us to the Nazis that I thought she was out of her mind. I did put her down. If you want to be on her side, OK."

I hadn't seen this bit, and now I love him even more.


Posted by: LizardBreath | Link to this comment | 08-19-09 7:47 AM
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Specifically, that he's willing to assume that he doesn't have to treat craziness with cautious respect, and assume that anyone who disagrees with him about that is being silly.


Posted by: LizardBreath | Link to this comment | 08-19-09 7:52 AM
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Was anyone else struck by the fact that the crazy woman in the Barney Frank video looked kind of...well..swipple?

To date, all the teabagger crowds I have seen have been more stereotypical yahoos--white guys* with paunches, overweight red state types, old ladies with blue hair, etc. This lady was a svelte, well-groomed, moderately affluent-looking suburban type with educated enunciated and no noticeable regional accent. For some reason this scares me. Mind you, I know lots of people who fit the above description and nonetheless have revoltingly right-wing opinions, but I haven't known any to buy into this Nazi euthnasia nonsense.


*Yeah, yeah, I know about the brother with the AR-15.


Posted by: pain perdu | Link to this comment | 08-19-09 7:53 AM
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So, she *is* a LaRoucher. God, those people have come out of the woodwork recently.


Posted by: apostropher | Link to this comment | 08-19-09 7:54 AM
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61.3. Gotta love the implication that calling the President Hitler is civil discourse, but suggesting the nice lady is out of touch with reality is mean!


Posted by: Di Kotimy | Link to this comment | 08-19-09 7:55 AM
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66. No it's not. I stand here amazed at his moderation.


Posted by: OFE | Link to this comment | 08-19-09 7:58 AM
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64: Nat Hentoff has signed up for the Nazi euthanasia nonsense. OK, fine, he never says "Nazi," but he sure seems to giving these folks cover. (And you have to admire the headline: "I am finally scared of a White House administration.")


Posted by: oudemia | Link to this comment | 08-19-09 7:58 AM
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68: Missing "be"!


Posted by: oudemia | Link to this comment | 08-19-09 7:59 AM
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I guess it's a sign. After resisting twice, I must now delurk to say that Willie Nelson's Hallelujah is a must-listen. If you like Willie Nelson.


Posted by: andido | Link to this comment | 08-19-09 8:00 AM
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65: Once in Munich I saw a giant poster with "Lincoln, Kennedy, LaRouch" and pictures of all three men. The guy standing with the poster was a giant of a man with hands the size of a fielder's glove. I was curious, so I asked him what was up. Apparently, LaRouch married a Bavarian.


Posted by: Moby Hick | Link to this comment | 08-19-09 8:02 AM
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What I want to see is someone come out and say "These claims about death panels and the like are straightforward lies, and the people making them are liars and anyone who continues to take these liars seriously after having their lies repeatedly exposed is an idiot. These are the same people who claimed to have proof of WMD in Iraq. These are the people who wanted to put your Social Security money into the stock market just 18 months before it collapsed. These are the people who want to use the same approach to the health care crisis that brought us the Savings and Loan collapse, the collapse of Long Term Capital Management, and the mortgage crisis. These people are not on your side, and they are playing you for fools."

Frank, unfortunately could not make that speech, due to his involvement in the various financial messes, but Obama could.


Posted by: togolosh | Link to this comment | 08-19-09 8:03 AM
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Oh my God, I love Barney Frank.


Posted by: Jackmormon | Link to this comment | 08-19-09 8:03 AM
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Apparently, LaRouch married a Bavarian.

Yes, and they have some sort of center near Frankfurt. I think it's called the Schiller Institute (so as to be confused with the Goethe Institute).


Posted by: Jackmormon | Link to this comment | 08-19-09 8:05 AM
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74: When I first saw the sign, I thought LaRouch had been shot. I hadn't seen a newspaper in a while.


Posted by: Moby Hick | Link to this comment | 08-19-09 8:06 AM
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You'd think by now I'd be over being shocked at the ignorant hypocrisy of right-wingers on health care, but it's kind of amusing that they're all up in arms about the possibility of trying to reduce Medicare expenditures. When it comes to spending government money on health care for old people, no expense must be spared! But god forbid we want to spend money on health care for young people, or poor people, etc.


Posted by: emdash | Link to this comment | 08-19-09 8:07 AM
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I once got in a long argument with a LaRoucher at a mall. Ordinarily I agree with Barney on the benefits of engaging them, but I was super, super drunk and dressed like Santa. They have a surprisingly robust worldview, which I guess goes with the utter craziness.


Posted by: Sifu Tweety | Link to this comment | 08-19-09 8:09 AM
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Apparently, LaRouch married a Bavarian.

Yes, Helga Zepp.


Posted by: apostropher | Link to this comment | 08-19-09 8:10 AM
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the possibility of trying to reduce Medicare expenditures.

And that's just craziness itself. Is there any more specific argument than "Health care will be expensive. Something the government spends money on will have to be cut. ZOMG, it'll be Medicare!"?


Posted by: LizardBreath | Link to this comment | 08-19-09 8:12 AM
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77: If a drunk Santa isn't persuasive, they must be pretty set in their ways. I didn't try to persaude this LaRoucher is anything because his English wasn't the best and I don't speak German. And because he was roughly double my weight with probably a lower percentage of body fat.


Posted by: Moby Hick | Link to this comment | 08-19-09 8:13 AM
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Frank, unfortunately could not make that speech, due to his involvement in the various financial messes, but Obama could.

The other day Shearer linked to a particularly damning clip of Frank saying the collapse wouldn't happen. Bizarrely, Frank said that the housing industry was not like the dotcom bubble because it wasn't heavily leveraged.

I don't think anyone with real power could make the "you are being played for fools" speech. If you have power, you are implicated in the scam, and anyway have been carefully vetted to be the kind of person who doesn't rock the boat.


Posted by: rob helpy-chalk | Link to this comment | 08-19-09 8:16 AM
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79: Based on the craziness I've skimmed (I can't bring myself to read closely) I think they're worried about comparative effectiveness research, and things like that. And, you know, Medicare expenditures probably will need to be reduced, over the long term, I'm just not sure what in the current proposal(s) does that.


Posted by: emdash | Link to this comment | 08-19-09 8:16 AM
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67: See, I was noting in 66 that whoever accused Frank of putting people down (the statement he was responding to in 61.3) apparently thought it was awful that he was being so mean. But since the person Frank "put down" was a lady who called health care form a Nazi policy and defaced a picture of the President to look like Hitler, apparently the person who didn't like Frank putting people down didn't consider accusing people of being Nazis or Hitler to be in any way unkind. I thought that juxtaposition was amusing; I was not suggesting Frank's response was immoderate or in any way short of awesome.


Posted by: Di Kotimy | Link to this comment | 08-19-09 8:16 AM
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I propose the obvious solution for poor people who get sick. I want Inna-Gadda-Da-Vida, the LIVE version, IN FULL.


Posted by: Entity | Link to this comment | 08-19-09 8:16 AM
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Barney Frank's greatest strength is that he genuinely doesn't like people.


Posted by: Sifu Tweety | Link to this comment | 08-19-09 8:17 AM
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What was the Larouchie dressed like? Moses?


Posted by: Entity | Link to this comment | 08-19-09 8:18 AM
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85: Also most people don't expect a gay guy with a lisp to have the personality of a Pit Bull. When he unleashes it's a genuinely beautiful sight.


Posted by: togolosh | Link to this comment | 08-19-09 8:20 AM
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According to the GAO, if Medicare expenditures are not reduced, spending on Medicare, Medicaid, and Social Security will take up all of government revenue by 2010.

To solve this problem, we are going to have to stop overtreating large classes of people. Right now, we pay for hip replacements for nonogenarians. One way or another, that's going to have to stop. Inevitably, it will be portrayed as the workings of a death panel.


Posted by: rob helpy-chalk | Link to this comment | 08-19-09 8:20 AM
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Barney Frank's greatest strength is that he genuinely doesn't like people.

Yup.


Posted by: Witt | Link to this comment | 08-19-09 8:20 AM
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And that's just craziness itself.

What it is mostly is racial panic brought to a head by having a black president. Trying to find the kernel of actual logic underneath it all is pointless.


Posted by: apostropher | Link to this comment | 08-19-09 8:20 AM
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One thing I find fascinating is the way Obama's election has brought the anti-semitism of the LaRouchers to the surface. Where'd that come from?


Posted by: Sifu Tweety | Link to this comment | 08-19-09 8:21 AM
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"Where'd that come from?"

Bavaria?


Posted by: Moby Hick | Link to this comment | 08-19-09 8:22 AM
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According to the GAO, if Medicare expenditures are not reduced, spending on Medicare, Medicaid, and Social Security will take up all of government revenue by 2010.

I'm not even going to check this to find the typo, but there's a typo in here somewhere. 2010? If we brought defense, debt service, and all other government spending to zero, reducing the budget only Medicare/caid and SS, we'd be running a deficit next year?

No. Not even close.


Posted by: LizardBreath | Link to this comment | 08-19-09 8:23 AM
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To put the point another way, comparative effectiveness research is going to yield recommendations that some people really, really don't like. People who are old and sick, particularly in America, want every dramatic intervention possible, and feel they are entitled to it.


Posted by: rob helpy-chalk | Link to this comment | 08-19-09 8:23 AM
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that was type. 2020.


Posted by: rob helpy-chalk | Link to this comment | 08-19-09 8:24 AM
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anti-semitism of the LaRouchers to the surface. Where'd that come from?

Right from the top, actually.


Posted by: apostropher | Link to this comment | 08-19-09 8:24 AM
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That was a typo. The breaking point is 2020.

Ack, I'll stop now.


Posted by: rob helpy-chalk | Link to this comment | 08-19-09 8:24 AM
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Do you have a link for that? I don't even buy it for 2020. The defense budget is colossal, as is debt service.


Posted by: LizardBreath | Link to this comment | 08-19-09 8:26 AM
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Barney Frank's greatest strength is that he genuinely doesn't like people.

Is that original? It has the makings of one of those epithets that becomes someone's epitaph. I'm not even sure it's true (I trust that Sifu has a closer perspective), but it's the kind o thing that's just plausible enough to stick.


Posted by: pain perdu | Link to this comment | 08-19-09 8:26 AM
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I'll get the link when class is out.


Posted by: rob helpy-chalk | Link to this comment | 08-19-09 8:28 AM
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And speaking of epithets that become an epitaph, wasn't it Frank who said of Michael Dukakis "The best thing about Mike is that he takes the T to work. The worst thing is that he gets off at the statehouse"?


Posted by: pain perdu | Link to this comment | 08-19-09 8:28 AM
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98: I don't buy it either. I'd heard a similar estimates, but none hit that soon.


Posted by: Moby Hick | Link to this comment | 08-19-09 8:28 AM
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83: "defaced" s/b "edited" or "Photoshopped" or "painted over". Talking about someone "defacing" a picture of the president, when not in the context of vandalizing something belonging to someone else, sounds too Dear Leader-ish.

On preview, I guess Di was just quoting apo in 59, quoting Frank. And Frank could be expected to look out for Obama. I guess I'm being even more pedantic here than nosflow usually is, but still.


Posted by: Cyrus | Link to this comment | 08-19-09 8:30 AM
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Medicare's financial status is much worse. As was true in 2008, Medicare's Hospital Insurance (HI) Trust Fund is expected to pay out more in hospital benefits and other expenditures this year than it receives in taxes and other dedicated revenues. The difference will be made up by redeeming trust fund assets. Growing annual deficits are projected to exhaust HI reserves in 2017, after which the percentage of scheduled benefits payable from tax income would decline from 81 percent in 2017 to about 50 percent in 2035 and 30 percent in 2080. In addition, the Medicare Supplementary Medical Insurance (SMI) Trust Fund that pays for physician services and the prescription drug benefit will continue to require general revenue financing and charges on beneficiaries that grow substantially faster than the economy and beneficiary incomes over time.


Posted by: apostropher | Link to this comment | 08-19-09 8:31 AM
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Hey helpy-chalk, ixnay on the ationingray. Don't you know how to keep a secret?

Besides, you're ignoring the fact that any Medicare recipient under the Obama plan will be permitted to opt out of the death panel by the simple expedient of renouncing Jesus, converting to Islam, and consenting to gay sex with an illegal immigrant.


Posted by: pain perdu | Link to this comment | 08-19-09 8:31 AM
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I once had a long discussion Debra Freeman, who ran LaRouche's business in Baltimore, back in the early '80s when they were browbeating old people out of their life savings. She, like a lot of LaRouchies, is an "ex-Jew."


Posted by: Entity | Link to this comment | 08-19-09 8:33 AM
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Here's a link to a GAO report. If I'm reading it right, under the more pessimistic of their two scenarios, then in 2030, Medicare/caid, Social Security, and debt service will together just about equal revenues. Still bad, but not what Rob was saying.


Posted by: LizardBreath | Link to this comment | 08-19-09 8:34 AM
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103: Oh for Pete's sake. Perhaps I should just stop commenting on this thread. It's like commenting on a dining room table.


Posted by: Di Kotimy | Link to this comment | 08-19-09 8:35 AM
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"Hey, that's a nice dining room table you have there, but isn't it a bit... contentious?"


Posted by: essear | Link to this comment | 08-19-09 8:36 AM
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I don't think anyone with real power could make the "you are being played for fools" speech.

This actually strikes me as an area where Bill Clinton make himself useful.


Posted by: Spike | Link to this comment | 08-19-09 8:37 AM
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I DON'T WANT TO TALK TO YOU MOTHERFUCKERS EITHER.


Posted by: OPINIONATED DINING ROOM TABLE | Link to this comment | 08-19-09 8:38 AM
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108: My dining room table has Corrian for the top. I want a real wood one, but with the toddler and the all of the related banging, I'm waiting. In about two years, I'll be happy to hear your views on dining room tables.


Posted by: Moby Hick | Link to this comment | 08-19-09 8:39 AM
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Couldn't Frank, you know, admit he was wrong about the housing bubble? So he was on the wrong side of that one, but that doesn't mean he can't call a lie a lie now.


Posted by: LizardBreath | Link to this comment | 08-19-09 8:40 AM
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You can use the bedroom for banging, Moby. In fact, with a toddler around, the enhanced privacy recommends it even more.


Posted by: Cryptic ned | Link to this comment | 08-19-09 8:41 AM
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I was super, super drunk and dressed like Santa.

In that state, you're practically required to go hunting for LaRouchers.

(I've always said "LaRouchite." "LaRoucher" sounds like a European chocolate.)

It isn't an original observation by any means, but what pisses me off the most about the health care "debate" is how people who were perfectly willing to give the government the authority to declare dubious wars, to detain and torture at will, to wiretap, etc., now suddenly want to pretend that a friggin' public health care plan is Nazism.


Posted by: Populuxe | Link to this comment | 08-19-09 8:41 AM
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90 to 115.last.


Posted by: apostropher | Link to this comment | 08-19-09 8:42 AM
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how people who were perfectly willing to give the government the authority to declare dubious wars, to detain and torture at will, to wiretap, etc., now suddenly want to pretend that a friggin' public health care plan is Nazism.

Heh. I had a post a while back with Eli Lake talking about Iraq on Bloggingheads. He spent half an hour talking about how they should love us for bombing them, because it was keeping them safe from terrorists. When Philip Carter suggested that we might also fork over some development-type foreign aid -- schools and such -- Lake jumped on him saying that we didn't have the credibility to interfere in another country like that.

People are weird.


Posted by: LizardBreath | Link to this comment | 08-19-09 8:44 AM
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77: at a mall. ...but I was super, super drunk and dressed like Santa.

Bad Santa was based on Sifu?


Posted by: JP Stormcrow | Link to this comment | 08-19-09 8:45 AM
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107: That's the report I was thinking of. Sorry, I seem to have gone from 2010 to 2020 to 2030. I'm trying to do two things at once here. The basic point remains that we will have to reduce medicare spending.


Posted by: rob helpy-chalk | Link to this comment | 08-19-09 8:47 AM
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Or, put another way, we will have to not increase medicare by as much as we are projected to do.


Posted by: Cryptic ned | Link to this comment | 08-19-09 8:48 AM
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I predict a nasty moonbat will be elected President in 2012, after a moonbat majority gets the House in 2010, and we'll slide even further into a nightmare world. Then the epidemics will hit, brought back by troops fighting in Iran and Korea.


Posted by: Entity | Link to this comment | 08-19-09 8:51 AM
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And the lower-revenue alternative scenario is going to be more of a problem than the baseline scenario.

I mean, health care cost increases are a genuine problem, but that's health care generally -- there's nothing magically fucked about Medicare.


Posted by: LizardBreath | Link to this comment | 08-19-09 8:51 AM
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I will become Medicare eligible in 2036. Therefore, it will go broke in 2035.


Posted by: Moby Hick | Link to this comment | 08-19-09 8:52 AM
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Category error, 121. "Moonbat" is the word crazy right-wingers use to describe crazy left-wingers. The word crazy left-wingers use to describe crazy right-wingers is "wingnut".


Posted by: Cryptic ned | Link to this comment | 08-19-09 8:52 AM
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and consenting to gay sex with an illegal immigrant.

Man, the future looks great. apo and I have a fraternity brother who is going to live forever under this plan.


Posted by: Robust McManlyPants | Link to this comment | 08-19-09 8:52 AM
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Cryptic ned, you saw that on TV, right?


Posted by: Entity | Link to this comment | 08-19-09 8:54 AM
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"Wingnut" I can understand as a shortening of "Right Wing Nut", combined with a popular type of metal fastener - but what the hell is the etymology of "Moonbat" anyway?


Posted by: Spike | Link to this comment | 08-19-09 8:55 AM
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From the GAO report the following is why I do not think it is wise to lump Social Security in with Medicare and Medicaid in these discussion fraught as they already are with the right-wing/mainstream media "generational wars" trope (even here sometimes) and Social Security usually ends up getting the majority of the attention:

Although Social Security is a major part of the fiscal challenge, it is far from the biggest challenge. Spending on major federal health programs (i.e. Medicare and Medicaid) represents a much larger, faster growing and more immediate problem.

And LB is right in 122.2, and this is one of the driving reasons for healthcare reform now. The beltway, however, would love to do SS first.


Posted by: JP Stormcrow | Link to this comment | 08-19-09 8:56 AM
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"defaced" s/b "edited" or "Photoshopped" or "painted over". Talking about someone "defacing" a picture of the president, when not in the context of vandalizing something belonging to someone else, sounds too Dear Leader-ish.

Just because you have formed a negative association with a particular word doesn't mean that the word's definition has changed. If I take a photo of someone I don't like out of my own scrapbook and draw horns and fangs on it then I've defaced it.


Posted by: mcmc | Link to this comment | 08-19-09 8:56 AM
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I say the Gov't should ration health care like it rations other expenditures: the rich will get terrific subsidies, the able-bodied poor will be sent out to become disabled in Central Asia, and the poor, sickly and old will be told to cure themselves with fish oil. "More of the same" is always a safe bet.


Posted by: Entity | Link to this comment | 08-19-09 8:58 AM
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what the hell is the etymology of "Moonbat" anyway

It's derived from the batsignal when projected on the moon and reflects the way crazy people on the left believe in superheros.


Posted by: Di Kotimy | Link to this comment | 08-19-09 8:58 AM
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what the hell is the etymology of "Moonbat" anyway?

Brief googling suggests it began as a right-wing mockery of George Monbiot, that then generalized.


Posted by: apostropher | Link to this comment | 08-19-09 8:59 AM
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Isn't there a connection with Jerry Brown, who was known as Governor Moonbeam?


Posted by: LizardBreath | Link to this comment | 08-19-09 9:00 AM
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129: And I felt much better, too.


Posted by: mcmc | Link to this comment | 08-19-09 9:01 AM
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I thought it was a combination of 'moon unit' and 'bat-shit crazy'.


Posted by: Moby Hick | Link to this comment | 08-19-09 9:01 AM
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I also have the impression that it's less organic an epithet than wingnut. The left side of the blogosphere started using wingnut spontaneously, from "right wing nut", and then the conservative bloggers consciously made up a matching epithet. I don't have links for this history, but I think that's what happened.


Posted by: LizardBreath | Link to this comment | 08-19-09 9:02 AM
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Is it related to "moon-calf"?

1. a congenitally grossly deformed and mentally defective person.
2. a foolish person.
3. a person who spends time idly daydreaming.


Posted by: Cryptic ned | Link to this comment | 08-19-09 9:04 AM
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Back in the winter of '99-'00, in Berkeley, CA, I heard "wingnut" used to mean the kind of left-winger who'd protest anything remotely unfair to anybody. Evidently definitions change.


Posted by: Entity | Link to this comment | 08-19-09 9:05 AM
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What this sight needs is a token insane conservative, who we could ask this kind of thing. And then ignore the rest of the time.


Posted by: Spike | Link to this comment | 08-19-09 9:06 AM
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135: Moon Unit Zappa had nothing to do with Batman going crazy!


Posted by: Entity | Link to this comment | 08-19-09 9:07 AM
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I first encountered the term as "barking moonbat," in a context that suggested an etymology derived from "barking at the moon" or "barking mad."

Not that it matters. I'm a moonbat by any right wing definition, and as I like both the moon and bats, I'm fine with that.


Posted by: togolosh | Link to this comment | 08-19-09 9:16 AM
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Doing a little Google group googling by date, I see some use of "wingnut" in the current sense starting a little before 2000 and going strong in the next couple of years. "No "moonbats" at all before 2000, a handful referring to general craziness in 2002, and specific use referring to lefties starting in 2003 (and for the one post I looked at, some of the replies were asking what a moonbat was).


Posted by: JP Stormcrow | Link to this comment | 08-19-09 9:18 AM
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I don't care for the moon.


Posted by: Spike | Link to this comment | 08-19-09 9:18 AM
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Moon Unit Zappa had nothing to do with Batman going crazy!

True, but she has a certain amount to answer for wrt valley girl.


Posted by: soup biscuit | Link to this comment | 08-19-09 9:19 AM
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we might also fork over some development-type foreign aid

Apparently my dad is moving to Afghanistan. To do USAID things. He says "don't worry, the job is safe", but also that no one can come visit him there because it is too dangerous.


Posted by: Cecily | Link to this comment | 08-19-09 9:20 AM
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People are weird.

That's awfully restrained in context, LB.


Posted by: soup biscuit | Link to this comment | 08-19-09 9:22 AM
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145. As long as he doesn't go to any weddings...

Seriously, props to the guy, whether USAID actually does any good or not, but sorry, he's right about visiting.


Posted by: OFE | Link to this comment | 08-19-09 9:26 AM
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143: I like the moon.


Posted by: togolosh | Link to this comment | 08-19-09 9:26 AM
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I can't even read the word 'moon' these days without thinking of the Mighty Boosh...


Posted by: nattarGcM ttaM | Link to this comment | 08-19-09 9:30 AM
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Nah, the moon is way more trouble than its worth. Tides? Light pollution? Werewolves? All are a huge pain in the ass.


Posted by: Spike | Link to this comment | 08-19-09 9:30 AM
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Nah, the moon is way more trouble than its worth.

According to some authorities, thanks to tides it's responsible for enabling multicellular life. We wouldn't be here... Oh, wait.


Posted by: OFE | Link to this comment | 08-19-09 9:33 AM
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137: The Moon Calf Collective!


Posted by: oudemia | Link to this comment | 08-19-09 9:35 AM
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Without the moon, Medicare would go bankrupt in 2028.


Posted by: Moby Hick | Link to this comment | 08-19-09 9:38 AM
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thanks to tides it's responsible for enabling multicellular life

Yeah, but what have the tides done for me lately.


Posted by: Spike | Link to this comment | 08-19-09 9:41 AM
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I don't care for the moon.

That's okay. The moon is a harsh mistress.


Posted by: Bave Dee | Link to this comment | 08-19-09 9:43 AM
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Without the moon, Medicare would go bankrupt in 2028.

Or so the moonmen would have you believe.


Posted by: apostropher | Link to this comment | 08-19-09 9:46 AM
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But, oh what a little moonlight can do!


Posted by: bob mcmanus | Link to this comment | 08-19-09 9:49 AM
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specific use referring to lefties starting in 2003

That makes sense. It wouldn't surprise me if "moonbat" came from LGF originally. I associate it with "fisking" and "anti-idiotarian" and that first burst of pro-war political blogging. Lileks used the word in a newspaper column in Oct. '03. A quick search in Lexis turns up a '91 story in The Toronto Sun disparaging "the U.S. administration's simplistic notion of Saddam as the wingnut of the Near East" but nothing earlier than an '02 Sun story uses the word in its right-wing sense (to refer to Pat Buchanan).


Posted by: Populuxe | Link to this comment | 08-19-09 9:53 AM
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137: The Moon Calf Collective!

Enough already with this mellow "Incense and Peppermints" vibe! Let's break out the mushrooms and dance naked, strap on the goat skull headgear, sacrifice a few infants.


Posted by: essear | Link to this comment | 08-19-09 9:54 AM
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Ice! Floe! Nowhere to go! Ice! Floe! Nowhere to go! Lost in the blinding whiteness of the tundraaaaaaaaaaaaaa

Natagrcm, you may be interested to know that the medium by which British stoner comedy is entering the US is actually the Cartoon Network. It started showing "Look Around You" and "The Mighty Boosh" this year, after entering the world of live-action with a couple extremely low-budget homegrown 15-minute shows last year.


Posted by: Cryptic ned | Link to this comment | 08-19-09 9:55 AM
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Phillip Carter

It tickles me that blogging (and other activities) can lead to such a post.


Posted by: md 20/400 | Link to this comment | 08-19-09 9:59 AM
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Let's break out the mushrooms and dance naked


Posted by: apostropher | Link to this comment | 08-19-09 10:00 AM
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re: 160

Late at night, I hope? We wouldn't want little Josh and Amy-Sue to be exposed to the horror that is the Hitcher [Eels!] or the Crack Fox...


Posted by: nattarGcM ttaM | Link to this comment | 08-19-09 10:01 AM
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162: someone put on the boss music from final fantasy 6 and then shoot me.


Posted by: nosflow | Link to this comment | 08-19-09 10:13 AM
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Oh yes. The same time they show cartoons like this.


Posted by: Cryptic ned | Link to this comment | 08-19-09 10:15 AM
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AB uses "wingnut" simply to mean a complete loony (she's never read political blogs), which throws me off every time.


Posted by: JRoth | Link to this comment | 08-19-09 10:17 AM
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The Drinky Crow Show was cancelled.


Posted by: nosflow | Link to this comment | 08-19-09 10:21 AM
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164: You didn't like it?


Posted by: apostropher | Link to this comment | 08-19-09 10:31 AM
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168: I love it. I love it so much.


Posted by: A White Bear | Link to this comment | 08-19-09 10:40 AM
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I liked it, but I'm ashamed that I recognized the music so quickly.


Posted by: nosflow | Link to this comment | 08-19-09 10:47 AM
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79

And that's just craziness itself. Is there any more specific argument than "Health care will be expensive. Something the government spends money on will have to be cut. ZOMG, it'll be Medicare!"?

The reason the attacks resonate is that most people are vaguely aware that from a cold cost-benefit perspective society spends way too much on medical care for old people in general and dying old people in particular. Hence it is a logical place for cuts.


Posted by: James B. Shearer | Link to this comment | 08-19-09 10:48 AM
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That's not exactly a straightforward cost-benefit calculation. What is palliative end-of-life care worth? To the person dying/ To the loved ones watching the person die? To those of us not presently dying (in an immediate sense) but who might enjoy some benefit of entrenching cultural values which make palliative care for us in our final days more likely?


Posted by: Di Kotimy | Link to this comment | 08-19-09 10:52 AM
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People don't spend too much on palliative care. They spend far too little on palliative care! They spend far too much on heroic end-of-life treatments that, if successful, will increase the subject's lifespan by a few weeks or so, while not removing any misery or pain.

BUT THEY'RE ALIVE, RITE??


Posted by: nosflow | Link to this comment | 08-19-09 10:56 AM
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It's derived from the batsignal when projected on the moon and reflects the way crazy people on the left believe in superheros.

If Gotham City could project a batsignal all the way to the moon, they probably wouldn't need a super hero. They could just use their amazing super powered laser technology to blast the mean streets clean. Also, they could only use the signal during a new moon, so it would be more a question of semi-statutory holidays for criminals than effective policing.


Posted by: Ginger Yellow | Link to this comment | 08-19-09 11:03 AM
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171-73: Yeah, there's a problem there. Doctors and hospitals currently have a huge financial incentive to overtreat dying patients; trying to make it clear that removing that incentive is not equivalent to providing an incentive to push older patients out to sea on an ice floe (in the face of a noise machine insisting that that's what's happening) is tricky.


Posted by: LizardBreath | Link to this comment | 08-19-09 11:04 AM
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113

Couldn't Frank, you know, admit he was wrong about the housing bubble? So he was on the wrong side of that one, but that doesn't mean he can't call a lie a lie now.

Politicians don't like to admit they were wrong about anything ever. For example Hillary Clinton (or Kerry) and the Iraq war vote.

And how much do you want Frank to confess to? He wasn't just oblivious to the bubble he advocated policies that contributed to it. For example pushing home ownership in general and for poor and minority people in particular.


Posted by: James B. Shearer | Link to this comment | 08-19-09 11:05 AM
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173. They still do under socialised medicine, if it's any comfort to the knuckle walking confederates out there. When my mother died, she was unconscious and, basically, her liver had dissolved. My sister was present and I was running for a train. There were two doctors involved, and they asked us what to do. Neither of them tried to strong arm us, but their opinion was clear. The older doctor favoured letting nature take its course; the younger one wanted to take heroic measures, which would have let her lie in bed feeling terrible for another three weeks before she died. It would also have cost thousands.

Fortunately, she had made a living will. We said goodbye.


Posted by: OFE | Link to this comment | 08-19-09 11:07 AM
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Let's break out the mushrooms and dance naked

Wow. That's some kind of crazy.


Posted by: Parenthetical | Link to this comment | 08-19-09 11:08 AM
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It's performance art.


Posted by: nosflow | Link to this comment | 08-19-09 11:09 AM
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People don't spend too much on palliative care. They spend far too little on palliative care! They spend far too much on heroic end-of-life treatments that, if successful, will increase the subject's lifespan by a few weeks or so, while not removing any misery or pain.

This is why hospice needs to have a higher profile than it does. And why we should do more end-of-life-counseling. But of course, that's tantamount to the Nazi's, so we probably should just scrap the whole program.


Posted by: Parenthetical | Link to this comment | 08-19-09 11:10 AM
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that contributed to it. For example pushing home ownership in general and for poor and minority people in particular.

Bullshit. Pushing home ownership in general has been the policy of the federal government for generations -- it's stupid, but pinning it on any particular politician at this point is nonsense. And Fannie Mae and Freddie Mac were not, in fact, significant drivers of the bubble.


Posted by: LizardBreath | Link to this comment | 08-19-09 11:10 AM
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That's some kind of crazy.

It's performance art.

I believe these two things are synonyms.


Posted by: Parenthetical | Link to this comment | 08-19-09 11:11 AM
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I think 179 was just clarifying which kind of crazy.


Posted by: essear | Link to this comment | 08-19-09 11:13 AM
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Shearer is right in 171. The issue goes beyond even replacing largely futile heroic measures at the end of life with paliative care. To be sure, changing the incentives around heroic measures at the end of life is important. But we also need to shift resources away from various forms of elective surgury for the elderly and towards children. Better prenatal and early childhood care for poor children is really, really cost effective.

Of course, that is the least likely shift to happen, because not only does it look like you are putting grandma out on an ice floe, but you are doing it to help someone who is likely to be a minority. Not politically popular.


Posted by: rob helpy-chalk | Link to this comment | 08-19-09 11:20 AM
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But we also need to shift resources away from various forms of elective surgury for the elderly and towards children.

Does this mean "We ought to" or "It's necessary to control costs" or "I think we will"?


Posted by: LizardBreath | Link to this comment | 08-19-09 11:27 AM
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185: I was still thinking from Shearer's cold cost-benefit analysis perspective. If you are simply trying to maximize good consequences, it is entirely backward to have the best public health care for people over 65 and then 3 million uninsured children. If you want to restrict public heath care funding to one age group, make it people under 18, rather than over 65.

So this is just an ought in a utilitarian perspective. I don't know if it is necessary to keep medicare solvent. It could easily be that shifting away from heroic end of life measure to paliative care will do that.

I have no confidence that this will actually happen.


Posted by: rob helpy-chalk | Link to this comment | 08-19-09 11:39 AM
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Some statistics:

Infant mortality nationally is 6.9 deaths/1000 births, but among African-Americans it is 14.1 deaths.

The USA is now 28th in infant mortality, a ranking comperable to members of the former Soviet bloc.


Posted by: rob helpy-chalk | Link to this comment | 08-19-09 11:39 AM
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Whenever I say things like 187, I am told that this is only because of illegal immigrants. You'll have to be prepared to defend that.


Posted by: Cryptic ned | Link to this comment | 08-19-09 11:43 AM
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188: Isn't it more about the legacy of institutionalized racism against African-Americans in this country and the lasting effects?


Posted by: Parenthetical | Link to this comment | 08-19-09 11:45 AM
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Uh, scratch and its lasting effects. It's as though I forgot what legacy meant.


Posted by: Parenthetical | Link to this comment | 08-19-09 11:46 AM
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If you want to restrict public heath care funding to one age group, make it people under 18, rather than over 65.

But framing it this way implies that extending coverage to more people necessarily means reducing services for people who now get Medicare. And that's not true -- while tradeoffs have to be made generally, Medicare isn't the only possible source of funds from which to insure poor children. (Higher taxes? Lower defense spending?)

I'm sensitive to that logical leap, because I see it made a lot. ("You want to do X. Well, X costs. If you want X, that means Y has to go. Which is it? X, or Y? Thinking you can have both X and Y is shamefully unrealistic -- we have to face facts. And obviously getting rid of Y is impossible, so logically there's no way you can have X." When in actuality there's a universe of possibilities for paying for X that don't involve getting rid of Y.)


Posted by: LizardBreath | Link to this comment | 08-19-09 11:48 AM
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Yes, the high infant mortality rates are among blacks and hispanics, many of whom are illegal. Also most of the uninsured belong to these groups. I am proposing moving money away from old white people towards poor brown people. It will never happen.


Posted by: rob helpy-chalk | Link to this comment | 08-19-09 11:54 AM
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The answer, rob, is to travel back in time and build a giant wall between here and Mexico. Since that never happened, it is pointless to compare us to "other" "advanced" "democracies".


Posted by: OPINIONATED REPUBLICAN | Link to this comment | 08-19-09 11:57 AM
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I'm actually in favor of voluntary euthanasia, provided we get "put down" as gently and effectively as I've watched vets do it several times with cancer-ridden ferrets. In fact I'd volunteer; in cases like mine they'd probably have to restrict access to it. ("No Mr. Entity, a migraine two days in a row does not qualify as Severe and Intractible Illness, not even if you stubbed your toe walking to the bathroom in the dark.")


Posted by: Entity | Link to this comment | 08-19-09 12:00 PM
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191: to be clear, I think public health care should be available to everyone, regardless of age. Mostly, I'm going on about this because I'm tired of the standard liberal-left line "Health care reform will not lead to health care rationing, and anyone who thinks so is a crazy swastika waving birther." Health care reform will lead to rationing. In any system health care is rationed. Right now it is rationed by ability to pay, which is a stupid way to do it.


Posted by: rob helpy-chalk | Link to this comment | 08-19-09 12:00 PM
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Health care reform will lead to rationing.

You can be as tired of the standard leftwing rhetoric as you want, but 'will lead to' is still wrong -- you'd only say it that way if you meant that rationing wasn't happening now, and would come about as a result of reform. What you mean is something more like "Health care reform won't make cost constraints on the provision of health care go away -- they're still going to exist. It may distribute those constraints more equitably, but there will still be constraints."


Posted by: LizardBreath | Link to this comment | 08-19-09 12:06 PM
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195: right on.


Posted by: Entity | Link to this comment | 08-19-09 12:06 PM
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LizardBreath wording is a "kinder, gentler" way to state the obvious, but the problem there is she uses too many Big Words like "equitably." Don't forget most Americans went to public schools, which were always underfunded relative to, say, the "defense" and "public safety" side of things. People who don't realize Medicare is a government program need things spelled out in small soft chunks.


Posted by: Entity | Link to this comment | 08-19-09 12:13 PM
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Maybe I should just put it like this "I am in favor of a government entity that rations health care based on effectiveness, something like the NICE program in the UK. Not only that, I think something like this is going to have to be instituted to contain costs in a fair fashion."


Posted by: rob helpy-chalk | Link to this comment | 08-19-09 12:15 PM
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Rob, maybe you could say that of course health care reform won't lead to rationing.


Posted by: nosflow | Link to this comment | 08-19-09 12:26 PM
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Rob, no matter how logical and obvious it may seem to you, it is far from inevitable that health care reform will lead to rationing.

First of all, no one--and I mean no one--in a position of authority in the federal government has proposed making it illegal to pay for supplemental health insurance or to pay for procedures out of pocket. So "rationing" under a strict definition will never take place in this country.

But even relaxing the definition of rationing to mean "won't be paid for out of the treasury or a pooled risk fund", there's no reason it has to happen. Yes, I'm aware of the argument that demand for medical treatment has no logical limit and will inexhorably swallow up our entire GDP, but other countries have shown that relatively modest "nudge"-type modifications of the decision architecture can all but eliminate excess demand. Why is it that the horror stories about rationing either come from the UK (where global budgets are notoriously stingy) or, if they come from Candada, involve non-life-threatening conditions? Why are there no rationing horror stories from France and Switzerland? Where are the German grannies being left to die?


Posted by: pain perdu | Link to this comment | 08-19-09 12:26 PM
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199: That's fine, but don't complain to us when your students show up at your class holding up pictures of you with a Hitler mustache.


Posted by: peep | Link to this comment | 08-19-09 12:28 PM
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UK (where global budgets are notoriously stingy), but where it is, of course, perfectly legal to pay for supplemental health insurance or to pay for procedures out of pocket.


Posted by: OFE | Link to this comment | 08-19-09 12:29 PM
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Why are there no rationing horror stories from France and Switzerland?

Republican hacks don't speak French?


Posted by: rob helpy-chalk | Link to this comment | 08-19-09 12:41 PM
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198: Entity, blaming the misery of our public discourse on the underfunding of public schools is shallow and snobby, not to mention inaccurate. Step up your game.


Posted by: k-sky | Link to this comment | 08-19-09 12:49 PM
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no one--and I mean no one--in a position of authority in the federal government has proposed making it illegal to pay for supplemental health insurance or to pay for procedures out of pocket. So "rationing" under a strict definition will never take place in this country.

Right. We likewise don't have food rationing in this country, despite the fact that you can't buy an unlimited amount of food with food stamps. Rationing is what happened back in WWII, when even if you had a ton of money you still could only buy so much sugar or whatever per month. Rising health care costs are only really an issue for the country to the extent to which the government is picking up the tab. Individuals can pay for all the full body scans they want, it's their money.


Posted by: Matt F | Link to this comment | 08-19-09 1:00 PM
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Rush Limbaugh's riposte to Frank's "On what planet do you spend most of your time?" barb:

"We all know that Barney patrols Uranus."

The guy knows his craft, I'll give him that.


Posted by: pain perdu | Link to this comment | 08-19-09 1:06 PM
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That's some kind of crazy.

Which gets back to the matter of Bob Dylan. His detention is questionable on civil-liberties grounds (perhaps minne and gswift can sort that out), but is it not in some way defensible given the Christmas album?


Posted by: Jesus McQueen | Link to this comment | 08-19-09 1:14 PM
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So k-sky, I take it you're against improving public education?

I myself have always been appalled when, e.g., people advocate going to war against countries they can't find on a globe or map. Examples of such stupidity abound; what makes it worse is that most of these ignorami somehow graduated from public high schools funded by public taxes. Note that I'm saying I think "the broad masses" are indeed educable and that society must try harder to fulfill our obligations.

Characterising my statement as "inaccurate" is debateable, it is indeed possible that I'm wrong and you're correct. I suspect what you really object to is that I sound "shallow and snobby," i.e. insufficiently "polite" or charitable. It's precisely such "charitability" that has allowed ignorance to triumph, at great expense, through "social promotion," "grade inflation" and similar wastes of time, money and human potential.

Surely you don't believe that it's futile to "throw more money at the problem" because "those people are unable to learn."

I'm not saying that an increase in total spending is even necessary. I hold that we can reallocate some of the money now going to lock so many people up into educating them well enough so they might not do the kind of stupid petty shit a lot of people get locked up for.

Anyway. To return to Bob Dylan, he lost me forever with "Gotta Serve Somebody." That spirit of slavishness is another thing that's wrong with America.


Posted by: Entity | Link to this comment | 08-19-09 1:31 PM
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Christmas albums = ick.


Posted by: apostropher | Link to this comment | 08-19-09 1:32 PM
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no one--and I mean no one--in a position of authority in the federal government has proposed making it illegal to pay for supplemental health insurance or to pay for procedures out of pocket. So "rationing" under a strict definition will never take place in this country.

And I suppose since I wasn't proposing that these things should be illegal, I wasn't really proposing rationing either. I'm just a lot closer to rationing than other people in the US feel comfortable with.


Posted by: rob helpy-chalk | Link to this comment | 08-19-09 1:32 PM
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Entity, you haven't been here long enough to earn the right to be that much of an asshole.


Posted by: pain perdu | Link to this comment | 08-19-09 1:34 PM
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||
I just missed my best chance to see a tornado. You know why? Because the sirens didn't go off until the tornado was already 2 suburbs north of here! Stupid government.

I take comfort in the fact that I got to see some circulation in a thunderstorm about a year and a half ago, even though it didn't turn into a full-fledged tornado.

Still, bummer.
||>


Posted by: minneapolitan | Link to this comment | 08-19-09 1:35 PM
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213: You should find a safer hobby.


Posted by: Moby Hick | Link to this comment | 08-19-09 1:38 PM
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181

Bullshit. Pushing home ownership in general has been the policy of the federal government for generations -- it's stupid, but pinning it on any particular politician at this point is nonsense. ...

By this standard there is no reason for Frank to admit being wrong about the bubble either.

... And Fannie Mae and Freddie Mac were not, in fact, significant drivers of the bubble.

I didn't say anythning about Fannie Mae and Freddie Mac. But they were part of the push towards relaxed underwriting standards. See this Village Voice article. And Frank opposed tighter regulation of Fannie Mae and Freddie Mac. See this 2003 NYT article.

Significant details must still be worked out before Congress can approve a bill. Among the groups denouncing the proposal today were the National Association of Home Builders and Congressional Democrats who fear that tighter regulation of the companies could sharply reduce their commitment to financing low-income and affordable housing.

''These two entities -- Fannie Mae and Freddie Mac -- are not facing any kind of financial crisis,'' said Representative Barney Frank of Massachusetts, the ranking Democrat on the Financial Services Committee. ''The more people exaggerate these problems, the more pressure there is on these companies, the less we will see in terms of affordable housing.''


Posted by: James B. Shearer | Link to this comment | 08-19-09 1:40 PM
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214: Maybe so, but what's time to a pig?


Posted by: minneapolitan | Link to this comment | 08-19-09 1:40 PM
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I always too "you gotta serve somebody" as more of a logical point than an imperative. Any time you act, you are either acting for good (serving the lord) or evil (serving the devil.) You don't get to opt out of the game.


Posted by: rob helpy-chalk | Link to this comment | 08-19-09 1:40 PM
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216: Huh?


Posted by: Moby Hick | Link to this comment | 08-19-09 1:41 PM
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octors and hospitals currently have a huge financial incentive to overtreat dying patients

I was just daydreaming this morning about whether anyone has done a rigorous study of doctors' versus nurses' ability to predict a patient's death. Like weather reports, there is actual empirical data and you could check to see who ended up being right.

My off-the-cuff hypothesis is that nurses are generally far better at it, for several reasons:

1. Less self-interest in deluding themselves.
2. Professional training is less likely to bias them in that direction (the trouble with a procedure-driven medical training is that it produces doctors who want to do procedures).
3. Greater daily experience with dying people, and more up-close witnessing of the dying process.

More accurate information about end of life would help patients and their families make decisions earlier -- and I don't mean a living will, I mean after the beloved is in the hospital and spiraling downhill and everybody is sleep-deprived and scared and upset and not thinking clearly. But still trying to figure out whether they should authorized X invasive medical procedure.


Posted by: Witt | Link to this comment | 08-19-09 1:47 PM
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218: Farmer, pig, apple tree, traveling salesman, punchline. See Bridgeplate, Standpipe. Jokes, Their Meanings and Explanations. London: Routledge and Kegan Paul, 1976.


Posted by: minneapolitan | Link to this comment | 08-19-09 1:47 PM
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219: It would be an even better study if they included some cancer-sniffing dogs and actuaries.


Posted by: minneapolitan | Link to this comment | 08-19-09 1:49 PM
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pain perdu, do you promise to let me know when I have enough seniority to express an opinion? If it's my manner you object to, will you volunteer to instruct me in the finer points of "win[ning] friends and influenc[ing] people?"

r h-c, first off, I believe in neither God nor the Devil. Second, it is the people who must be served through enlightened self-interest, not anybody in particular set up as a "master." So no, "Gotta Serve Somebody" is not really a logical imperative.

216, "What's the difference between a duck?"


Posted by: Entity | Link to this comment | 08-19-09 1:49 PM
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express an opinion ≠ be an asshole


Posted by: | Link to this comment | 08-19-09 1:51 PM
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220: Are you going to such lengths just not to admit that 216 was directed to 212 not 214?


Posted by: peep | Link to this comment | 08-19-09 1:52 PM
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What precisely is the difference?


Posted by: | Link to this comment | 08-19-09 1:53 PM
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187 188

Whenever I say things like 187, I am told that this is only because of illegal immigrants. You'll have to be prepared to defend that.

Since Hispanics have a slightly lower overall (Puerto Ricans are higher) infant mortality rate than whites this is unlikely. See here .

The problem in the US is primarily with blacks and may be genetic.


Posted by: James B. Shearer | Link to this comment | 08-19-09 1:55 PM
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I didn't say it was a "logical imperative." I meant it was more a descriptive point about the logic of action. There are no ethically neutral ways to navigate through life.

I'm not sure what it means to "serve the people through enlightened self interest," but I think it is clear that you serve someone, too.


Posted by: rob helpy-chalk | Link to this comment | 08-19-09 1:55 PM
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222: Well, of course, you disagree with Mr. Dylan's premises. But he still was not advocating behaving slavishly. Given his belief that our world is a battleground between the Lord and the devil, he was merely informing us that even if we wished not to get involved in this struggle we have no choice but to pick a side.


Posted by: peep | Link to this comment | 08-19-09 1:55 PM
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228: I also recall a Rush lyric that be relevant to this -- something about refusing to make a choice still being a choice. But Rush may be a little too deep for you, Entity.


Posted by: peep | Link to this comment | 08-19-09 2:02 PM
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224: Ooooohhhh, I get it


Posted by: minneapolitan | Link to this comment | 08-19-09 2:06 PM
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doctors and hospitals currently have a huge financial incentive to overtreat dying patients

Is this an actual thing? Almost all of my knowledge on the topic comes from disability-rights-type places, which are full of stories about doctors actively trying NOT to treat people even when the people and their families want the treatment.

Maybe (probably) I only hear one side of the story, ever. Maybe also there is a bigger difference between "very sick/disabled" and "dying" than I am reading into things. But I'm still curious- do you have links to things where doctors and hospitals are pushing for lots of end-of-life treatment?


Posted by: | Link to this comment | 08-19-09 2:16 PM
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As for the Xmas album, I like to sing a parody of "Grandma Got Run Over By A Reindeer" in a parody of Dylan's style. (It's worse than you might think, I'm somewhat hard of hearing and extremely tone deaf.) Will I soon get to hear Bob himself sing it? And more to the point, save it to a portable mp3 player to amuse passersby with? (Note that if I wanted to permanently injure somebody I'd caterwaul it myself.)

And peep, the point is not making the choice, the point is to whom one is accountable and why. Put it this way: is it wrong to mug an old lady because the act itself is wrong or because the Big Man's gonna get you if he catches you? If the act of mugging an old lady is wrong, is it wrong because some Authority has forbidden it or because it is intrinsically reprehensible?

Some people claim that atheists are incapable of being moral and that anarchy is another name for license. I dispute both assertions.

Get it yet, peep?


Posted by: Entity | Link to this comment | 08-19-09 2:16 PM
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doctors and hospitals currently have a huge financial incentive to overtreat dying patients

Is this an actual thing? Almost all of my knowledge on the topic comes from disability-rights-type places, which are full of stories about doctors actively trying NOT to treat people even when the people and their families want the treatment.

Maybe (probably) I only hear one side of the story, ever. Maybe also there is a bigger difference between "very sick/disabled" and "dying" than I am reading into things. But I'm still curious- do you have links to things where doctors and hospitals are pushing for lots of end-of-life treatment?


Posted by: Cecily | Link to this comment | 08-19-09 2:16 PM
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ahem.


Posted by: Cecily | Link to this comment | 08-19-09 2:17 PM
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232: I concede. You have out-condescended me.


Posted by: peep | Link to this comment | 08-19-09 2:19 PM
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Mugging old ladies is wrong because it displeases the gods.


Posted by: nosflow | Link to this comment | 08-19-09 2:20 PM
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I always too "you gotta serve somebody" as more of a logical point than an imperative.

Maybe. I thought it was just that "You gotta collaborate creatively with somebody" didn't scan.

Dylan's big career mistake was not retiring after "New Morning" and I'll only allow him that one because anyone deserves a second chance after "Self Portrait". Fuck the last 35 years of it.


Posted by: OFE | Link to this comment | 08-19-09 2:20 PM
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Am I the only one excited to hear the Bob Dylan Christmas album? Very likely, yes.


Posted by: peep | Link to this comment | 08-19-09 2:21 PM
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The problem in the US is primarily with blacks and may be genetic.

The standard right wing explanation for everything they can't blame on muslims.

Within my lifetime the United States was performing medical experiments on black men without their consent and under false pretenses. When the attitudes that lead to that have fully faded, and the repercussions of the policies driven by those attitudes have been addressed, we can talk about what is or is not genetic. Poverty and the associated bad health outcomes are not genetic, for example.


Posted by: togolosh | Link to this comment | 08-19-09 2:22 PM
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Not true: it displeases most of the gods, but pleases some others. Thus it is neither pious or impious, or maybe both pious and impious.


Posted by: rob helpy-chalk | Link to this comment | 08-19-09 2:23 PM
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237: You don't even like "Blood on the Tracks" or "Desire"?


Posted by: peep | Link to this comment | 08-19-09 2:23 PM
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It displeases the right gods.

You can't propitiate all the gods all the time.


Posted by: nosflow | Link to this comment | 08-19-09 2:27 PM
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The problem in the US is primarily with blacks and may be genetic.

And even if it is, James, so fucking what? We don't look at mortality from childbirth or breast cancer and just shrug our shoulders because the chicks is got different chromosomes.

Not that I accept the premise, because I don't. There is a disturbing amount of evidence that Blacks are less likely to be prescribed appropriate treatment for certain conditions even after you control for income and health insurance.


Posted by: pain perdu | Link to this comment | 08-19-09 2:28 PM
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One of my favorite things ever written on the internet was Nick Gillespie as Mr. Mxyzptlk at suck.com:

But certainly we can hope that Dylan, who on his only indisputably great LP - 1979's Slow Train Coming - asked "his so-called friends ... to imagine the darkness that will fall from on high / when they will beg God to kill them and they won't be able to die," might at least feel really bad about the critical demimonde he has inspired

Emphasis mine, trolling his.


Posted by: k-sky | Link to this comment | 08-19-09 2:28 PM
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239
When the attitudes that lead to that have fully faded, and the repercussions of the policies driven by those attitudes have been addressed, we can talk about what is or is not genetic.

Why do liberals like you hate open, rational debate? All conservatives like Shearer are trying to do here is discuss whether black people are genetically inferior.


Posted by: Cyrus | Link to this comment | 08-19-09 2:31 PM
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||
213:I just missed my best chance to see a tornado.

For all my meteorological nerditude, when I did see a tornado I did not recognize what I was seeing. Admittedly it was the one in Pittsburgh on Mt. Washington (bluff above downtown where the inclines are) which is a most unlikely location for a tornado to touch down. And there was not a distinct funnel, but what looked more like vigorous thunderstorm rotation from my perspective looking at it across the downtown skyline.

|>


Posted by: JP Stormcrow | Link to this comment | 08-19-09 2:31 PM
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233: First, I'm spouting off without backup, so I'd need to look for some data here. But I think there probably is a serious difference between dying and disabled patients (my offhanded guess is that the first category is more likely to be looking at expensive hospital care and drugs, the second at longer-term but cheaper outpatient care), and there's also a huge difference between the incentives of the doctors/hospitals and the incentives of insurance companies.

Medical care providers have an incentive to overtreat, because the more treatment they provide, the more they get paid, as long as the patient is covered. Insurance companies have the reverse incentive. In the case of a dying patient, the provider has more leverage -- if the patient is covered for anything medically necessary, it's really hard to argue that any (conventional, non experimental) procedure that has any possibility of preventing death isn't medically necessary.

When you don't have that sort of immediate 'necessity', it's easier for the insurance companies to undertreat.


Posted by: LizardBreath | Link to this comment | 08-19-09 2:33 PM
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because the chicks is got different chromosomes.

I would be very surprised if one could find a significant genetic distinction between Americans based on skin color.


Posted by: bitchphd | Link to this comment | 08-19-09 2:33 PM
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doctors and hospitals currently have a huge financial incentive to overtreat dying patients

The financial incentive tends to exist with privately insured patients. I believe people with disabilities are disproportionately uninsured and/or on public insurance, and there is less of a financial incentive..

But I really wouldn't rank financial incentives as the biggest driving factor by any stretch of the imagination. The healthcare worker's professional training and biases, their personal assumptions and prejudices [am I treating a productive wage-earner or a "useless" person], the sheer momentum of the interventionist treadmill, fear of litigation, insurance company protocols for what treatment "should" be administered...it's all one big stew.

(And geeze Louise, Shearer, sometimes the casual trollishness just astounds.)


Posted by: Witt | Link to this comment | 08-19-09 2:34 PM
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Well, the genes that influence skin color are probably significantly different, for example.


Posted by: Cryptic ned | Link to this comment | 08-19-09 2:34 PM
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Ned, I'm just checking, but you're purposely being silly, right? Because if the question is literal pigmentation, that bears extremely limited resemblance to which racial category a person is socially sorted into.


Posted by: Witt | Link to this comment | 08-19-09 2:38 PM
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248: Certain kinds of blood pressure drugs are much less effective in black patients than in white patients.


Posted by: apostropher | Link to this comment | 08-19-09 2:38 PM
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do you promise to let me know when I have enough seniority to express an opinion

Your snotty and gratuitous equation of ignorance with public school education, I'm afraid, will never be welcome here.

But mind your manners and I'm sure folks will extend their customary hospitality.


Posted by: pain perdu | Link to this comment | 08-19-09 2:39 PM
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233

Is this an actual thing? Almost all of my knowledge on the topic comes from disability-rights-type places, which are full of stories about doctors actively trying NOT to treat people even when the people and their families want the treatment.

It depends on who is paying the bills. If the hospital is paying naturally they have an incentive to pull the plug (or at least find a way to move the patient elsewhere and stick someone else with the bills). On the other hand if the patient (or their insurance) is paying then the hospital as an incentive to overtreat.

And of course doctors have personal views on the subject which sometimes influence the advice they give independent of their financial interests.


Posted by: James B. Shearer | Link to this comment | 08-19-09 2:40 PM
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And poverty is associated with ill-health. Who are the poorest people in America? Gee, I have no idea. And what possibly could have caused it? Laziness, I bet.


Posted by: Parenthetical | Link to this comment | 08-19-09 2:40 PM
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213/246: I saw a waterspout over Lake Michigan up near Evanston about 10 years ago. That was pretty random, and, similarly, what I was seeing didn't quite compute until I saw it again on the news that night.


Posted by: oudemia | Link to this comment | 08-19-09 2:41 PM
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the sheer momentum of the interventionist treadmill,

I'm not meaning to impugn the motives of the individual health care providers ordering procedures. As I understand it, doctors are remarkably sheltered from considerations of cost. But setting up a hospital such that the doctors making treatment decisions are encouraged to make treatment decisions without any consideration of whether the usefulness of a treatment is commensurate with its cost has the result of increasing hospital revenues, and it seems reasonable to me that the way the system works is a result of the profit motive.


Posted by: LizardBreath | Link to this comment | 08-19-09 2:42 PM
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246: That must have been quit the thing to see, whatever you thought it was at the time.


Posted by: Moby Hick | Link to this comment | 08-19-09 2:42 PM
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quit s/b quite


Posted by: Moby Hick | Link to this comment | 08-19-09 2:42 PM
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I don't really disagree with 257, but when I used the term, I was think of something that is partially an emotional state -- like getting swept up in euphoria after a sports team win, or getting sucked into paranoia during a witchhunt.

In those circumstances, it's hard for doctors, patients, and patients' families alike to step back and say "Wait a minute. This morning Doctor X took blood for these three tests. Then you opened up her wound to check it. Then Dr. Y did a spinal tap for another test. Then the bloodwork came back and Dr. X decided she needs to have insulin injections. Then you said it would be good if we could get her to swallow barium for a scan.... for the love of heaven, this 85-year-old has now had fourteen procedures in ten hours. Do we really want to keep doing this?"


Posted by: Witt | Link to this comment | 08-19-09 2:47 PM
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Do we really want to keep doing this?

But she might die, Witt.


Posted by: nosflow | Link to this comment | 08-19-09 2:49 PM
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257: A fair number of hospitals and other treatment centers are at least partially owned by the doctors staffing them. I'm more than willing to believe that the profit motive exerts a significant influence on doctors, though they'll never admit it, even to themselves. Subconscious biases are very powerful.


Posted by: togolosh | Link to this comment | 08-19-09 2:50 PM
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I understand the logic behind why doctors would push for more care, and why insurers would push against it. I just haven't ever come across anyone who told a story in which the doctors actually behaved like this. I have come across lots of stories in which doctors pushed hard against care, seemingly because of (what I think are) misguided ideas about quality of life. Some of these stories have had elderly and/or terminally ill people as their protagonists, although of course I'm having trouble finding any specific examples right now.

Anyway, I am curious if the "doctors want expensive treatments" idea came from the idea that it would make sense for doctors to act like that, or from direct experience of doctors acting like that. Or from some other source!


Posted by: Cecily | Link to this comment | 08-19-09 2:51 PM
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peep @241. Sorry, I missed that - eating dinner. OK, I'll give BotT a pass, but no honours. I've heard Desire, but I honestly can't recall a note of it.


Posted by: OFE | Link to this comment | 08-19-09 2:52 PM
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264: Here comes the story of the Hurricane...


Posted by: minneapolitan | Link to this comment | 08-19-09 2:54 PM
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264: OFE, you are allowed to take a short break from Unfogged for dinner. No apologies necessary!


Posted by: peep | Link to this comment | 08-19-09 2:55 PM
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I don't have a lot of (any, really) experience with end of life care -- I was thinking about things like this -- research showing huge regional differences in medical spending without matching diffferences in outcomes.


Posted by: LizardBreath | Link to this comment | 08-19-09 2:56 PM
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To clarify, I don't have a particular opinion about (or any personal experience with) end of life care, or about if doctors should or should not be doing expensive procedures to dying patients. I was just surprised by the idea that "of course doctors would want to do lots of things" which is counter to my (biased, second-hand, anecdotally acquired) prior understanding of the topic.


Posted by: Cecily | Link to this comment | 08-19-09 3:01 PM
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I think Dylan was always over-rated, a product of the '60s hype machine, which can't be blamed on the Boomers themselves as they were still too young to have that much input. But then one of my favorite acts, Led Zeppelin, was also not really "Art." (Was it Page or Plant who dated Valhalla?)

247, I know what you're saying and I've seen it in my older relatives. E.g., extending a 90 year old's life by three months at great expense even if it means putting her through even more pain and suffering -- and charging too for the additional antibiotics, morphine and Intensive Care that the latest proceedure made necessary. Sometimes it's not even a terminal issue, as in the case of not-so-old folks who've had multiple back surgeries for the same problem. Somebody's got to say when enough is enough. So when you find hard data please share it.

And 249, I'm pretty sure, though I don't have have data here either, that a "useless person" (as I understand the term to be used) with deep-pockets insurance will get more "care" at greater cost than a "nice" person who happens to be flat broke and without insurance. Examples include recent Medi-Cal and Medicare "misuse" involving the disabled and Skid Row dwellers.

And peep, you totally missed the point. But never mind, I don't need that many "bad vibes."

And pain perdu, I'm not saying public school education makes people ignorant, I'm saying BAD public school education does so. I'm sure there are bad PRIVATE schools that turn out illiterate and innumerate high school grads, but there are fewer private schools (of whatever value) and they don't fail their mission with PUBLIC tax dollars. And for your information, I myself dropped out of public school in the 8th grade at age 13 (and got the GED at 16); besides learning to pay attention to what is said as intently as how it's put, you might want to alter your mental image of me accordingly. (Although to "throw you" gratuitously I'll "confess" that I recently registered to vote -- Republican.)


Posted by: Entity | Link to this comment | 08-19-09 3:12 PM
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I just haven't ever come across anyone who told a story in which the doctors actually behaved like this.

Cecily, forgive me for personalizing this, but you're in your 20s, right? Meaning that you and most of your friends haven't been the decisionmakers through the death of your parents? I think this stuff tends to be observed the most up close, or discussed among your peer group when everybody is going through the same thing. I've certainly been part of a number of ain't-it-awful discussions where a friend is venting about the exhaustion and family stress when a doctor wants to just keep treating and treating. Sometimes these people believe they are supposed to defer to the doctor as an authority. Other times they are just so tired and overwhelmed by raising kids and traveling back and forth to see a parent who is several hundreds of miles away that they don't have the mental or emotional reserves to resist.

And yes, I've been present when doctors pushed -- worse than that, assumed additional invasive treatments were to be carried out, even when they knew a living will existed and family members were deeply involved in care decisions.


Posted by: Witt | Link to this comment | 08-19-09 3:13 PM
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263
I understand the logic behind why doctors would push for more care, and why insurers would push against it. I just haven't ever come across anyone who told a story in which the doctors actually behaved like this.

My guess, although this is totally ex recto, is that it's not a matter of doctor's actively pushing for some treatment so much as presenting what he or she thinks is the best as a fait accompli, or very nearly, and the patient or the patient's guardian going along with it because they're shell-shocked or feel guilty to ask "is there a cheaper alternative"?


Posted by: Cyrus | Link to this comment | 08-19-09 3:14 PM
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If I may ask, out of sincere curiousity and not-snarkiness, have you been reading/lurking here long, Entity? I know that some do and some don't.


Posted by: Megan | Link to this comment | 08-19-09 3:15 PM
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263: I recently had a cyst removed that required only local anesthesia, but the doctor tried to talk me into having IV sedation in addition. I refused, the surgery went ahead with local, and there were no problems whatsoever. Still got dinged for the cost of having the anesthesiologist standing around for fifteen minutes while they did the operation, but I saved the insurance company a big old $200 since he didn't have to do anything. They sprang the IV sedation thing on me at the last minute, too. I'd have given in, but they insisted I have someone drive me home afterwards and wouldn't let me take a taxi right after (over concerns that my judgment might be impaired). If they'd merely discussed beforehand the fact that a routine outpatient procedure under local anesthesia would also involve IV sedation I could have saved the insurance company another $500 or so. Someone not alert to the idiocy of sedation for minor surgery under local would probably have just gone ahead without questioning it.


Posted by: togolosh | Link to this comment | 08-19-09 3:16 PM
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270- right, my "experience" is heavily weighted to people who are disabled and disability-rights coverage of end-of-life stuff. So I believe you! I just couldn't tell if the claims upthread were based in theory or reality.


Posted by: Cecily | Link to this comment | 08-19-09 3:20 PM
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Megan, I've been into Unfogged intermittently for a while. What difference does that make?


Posted by: Entity | Link to this comment | 08-19-09 3:20 PM
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270, 271: Yeah, I think that's probably right. Come to think of it, Cecily, part of what may be going on to create your impression is that (and this is all vague thirdhand impressions of mine) if the most aggressive care is a strongly assumed default, the only time a doctor is going to be even talking about options along these lines is when they're making a case for unusually not doing the most aggressive thing. So you'd never see a doctor arguing for aggressive care, because they'd just do it.


Posted by: LizardBreath | Link to this comment | 08-19-09 3:22 PM
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Greenwald:

This is how things always work. The industry interests which own and control our government always get their way. When is the last time they didn't? The "public option" was something that was designed to excite and placate progressives (who gave up from the start on a single-payer approach) -- and the vast, vast majority of progressives (all but the most loyal Obama supporters) who are invested in this issue have been emphatic about how central a public option is to their support for health care reform. But it seems clear that the White House and key Democrats were always planning on negotiating it away in exchange for industry support. Isn't that how it always works in Washington? No matter how many Democrats are elected, no matter which party controls the levers of government, the same set of narrow monied interests and right-wing values dictate outcomes, even if it means running roughshod over the interests of ordinary citizens (securing lower costs and expanding coverage) and/or what large majorities want.


Posted by: apostropher | Link to this comment | 08-19-09 3:24 PM
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260/261: What strikes me is the sense that you are both looking at this as principally the doctor's choice. It might be worth it to that little old lady to try the 15th test in hopes of not dying. Or she might be ready to go. Which fits with the initial point I was trying to make way upthread. The benefit of that life-sustaining measure may be valued differently by the 93 year old whose life is sustained than by nosflow who thinks she's been sponging off society long enough. It also has a value to me as I would very much like to see the value of not writing off old/sick people we think aren't worth keeping alive before I get so old/sick that nobody thinks I'm worth keeping alive.


Posted by: Di Kotimy | Link to this comment | 08-19-09 3:24 PM
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276: Yes, they'd just assume that "of course we'll do the right thing."


Posted by: Entity | Link to this comment | 08-19-09 3:25 PM
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248

I would be very surprised if one could find a significant genetic distinction between Americans based on skin color.

Blacks are more likely to have fraternal twins. See here .

Women of African descent have the most fraternal twins, and Asian women have the fewest. Caucasian women are in between. Australian geneticist Martin said in some parts of Africa, the rate of twins is more than 20 pairs per 1,000 deliveries, while in Japan, at the other extreme, the rate is 2.3 per 1,000. In Western Europe and America, the rate is about 8 per 1,000.


Posted by: James B. Shearer | Link to this comment | 08-19-09 3:26 PM
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None. I'm also thinking your tone is slightly out-of-sync, which isn't inherently wrong and maybe something Unfogged should have more of, and so I wondered. I'm reading you as defensive and was wondering whether that came with you from elsewhere or from a longer acquaintance with people here.


Posted by: Megan | Link to this comment | 08-19-09 3:27 PM
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It might be worth it to that little old lady to try the 15th test in hopes of not dying. Or she might be ready to go.

That was the whole point of the end of life counseling thing. The default now is to just aggressively treat everybody, even though some people would prefer not to do that if the choice is presented to them before they're incapacitated.


Posted by: Matt F | Link to this comment | 08-19-09 3:28 PM
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273: What a coincidence. I had two cysts removed yesterday, only local needed. By the time I got to the operating room I was really nervous about what the bill would be, though. I've had similar cysts removed three times before, and it's always been a simple procedure. Last time the insurance didn't cover it at all and it was about $300, IIRC - more than pocket change, obviously, but nowhere near the kind of horror story you read about health care in America. So I didn't worry about my insurance in advance of yesterday's surgery, because even if it doesn't cover a cent of it - which seems unlikely, since my plan is pretty good right now I think - I could live with the cost.

This time, though, the doctor needed what amounted to a preliminary appointment, and when it was time for the surgery they put me in a gown and in a wheelchair to get to the operating room and everything. There were two or three assistants in the operating room in addition to the surgeon. I have no idea what that is going to cost someone, and I hope it isn't me.

Relatedly, I took the bus home despite lots of concerned questions in the hospital, which in theory makes sense but, again, it was just local anesthetic. No problems, except for fellow passengers who looked at me and presumably saw a bad hair day.


Posted by: Cyrus | Link to this comment | 08-19-09 3:29 PM
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278: Well, then I phrased myself badly, because I was thinking of it as primarily the patient's family's choice,* and secondarily the patient if s/he is still compos mentis enough to weigh in. The doctor is really tertiary, although it would be very nice if they would take responsibility for disrupting the treadmill. I saw one do it once, and it was like a huge sigh of relief.

(Although I would desperately like to know if someone has done the study I proposed above, because I think doctors in general do a poor job of interpreting their role as being "Encourage the family to think about what kind and extent of treatment they are comfortable with.")

*In many states it is either outright illegal or overwhelmingly avoided in practice for a hospital to stop treating a patient who has a living will if family members want to override the will. So the patient really DOESN'T get the final say.


Posted by: Witt | Link to this comment | 08-19-09 3:30 PM
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What strikes me is the sense that you are both looking at this as principally the doctor's choice.

There's a sense in which it has to be largely the doctor's choice, though. The patient (or their proxy) is controlling their own care, but they're doing so by choosing between options presented by their doctors, on the basis of information provided by their doctors about likely outcomes. The patient is very unlikely to have the knowledge to be able to independently assess the likely costs and benefits of any particular treatment decision.

So a lot of this comes down to, e.g., how a doctor presents a given treatment as between "This has some chance of extending your life" and "Without this treatment, you'll probably live about a week and die comfortably. With it, you'll probably live about two weeks, both painful." It's still the patient's decision, but it's impossible for the doctor's judgment not to be a large part of the process.


Posted by: LizardBreath | Link to this comment | 08-19-09 3:32 PM
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Doctors, like lawyers, are trained to DO SOMETHING. We have the tools in our tool belt, and we want to use them.

It takes lots of confidence, experience, and restraint to not do something.

Also, we are more likely to get in trouble to for not doing something than we are for doing something.


Posted by: Will | Link to this comment | 08-19-09 3:32 PM
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Folks, Shearer could be arguing that skin color and/or "race" can be a visible marker for certain hereditary predilections. Other examples are obvious: people of visibly "sub-Saharan" African descent are far likelier to get sicke cell disease, and those of "northern Nordic" descent are likelier to get skin cancer (or to have freckles). His posts in this thread alone are not sufficient to convict him of Hitlerism.

And Megan, "out-of-sync" how? Please explain; I too am educable!



Posted by: Entity | Link to this comment | 08-19-09 3:34 PM
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Shearer, are you, to put it colloquially, nuts? Fraternal twins happen when two eggs are released from the ovaries. If I'm not mistaken, reproductive science has not advanced sufficiently for us to have clue what kind of genetic, environmental, or bio-environmental factors are known to influence a woman's body to ovulate twice like that. (Obviously hormones are involved, but what's driving the hormones?)

Seriously, as justification for a genetic claim? I'd say try harder, but I don't think this topic is useful to discuss.


Posted by: Witt | Link to this comment | 08-19-09 3:34 PM
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Megan, perhaps we should take it to email? Hover over my handle.


Posted by: Entity | Link to this comment | 08-19-09 3:35 PM
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281: YOU're defensive!


Posted by: Cecily | Link to this comment | 08-19-09 3:36 PM
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Hover over my handle.

...if you know what I mean.


Posted by: apostropher | Link to this comment | 08-19-09 3:38 PM
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YOU're in your TWENTIES!


Posted by: Megan | Link to this comment | 08-19-09 3:40 PM
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288: If you click on the story he linked, there does seem to be respectable data supporting it. Not that he's not guilty of Hitlerism generally, of course.


Posted by: LizardBreath | Link to this comment | 08-19-09 3:40 PM
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Apo, could you please explain what you mean?


Posted by: Megan | Link to this comment | 08-19-09 3:40 PM
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Your MOM's in my twenties.

HOVERING.


Posted by: Cecily | Link to this comment | 08-19-09 3:42 PM
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There's a Woody Allen bit somewhere where he's talking about the mating habits of dragonflies? as involving a step where the male hovers over the female, and goes on to mention that "I, myself, once hovered over a starlet for six weeks in the spring of 1962." (The bit doesn't seem to be online anyplace, but I think I'm pretty close.)


Posted by: LizardBreath | Link to this comment | 08-19-09 3:43 PM
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296: He may have used the same punchline with other setups, but I suspect you are referring to this:

If saucers come from outer space, why have their pilots not attempted to make contact with us, instead of hovering mysteriously over deserted areas? My own theory is that for creatures from another solar system "hovering" may be a socially acceptable mode of relating. It may, indeed, be pleasurable. I myself once hovered over an eighteen-year-old actress for six months, and had the best time of my life.


Posted by: JP Stormcrow | Link to this comment | 08-19-09 3:47 PM
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293: All right, I did click on the link, and there was way more substantive science there than I gathered from the excerpt.

So I'm sorry, Shearer. I didn't give you credit for having any real science behind your claim.

I revise my complaint to be: "Some genetic researchers think that their field may have the answer to why women have fraternal twins, but evidence to date is limited and mainstream news summaries of their research efforts disturbingly uses 'genetic' to conflate genes themselves and the internal biological environment in which those genes are expressed, making it hard to assess how definitive the research results might eventually be."


Posted by: Witt | Link to this comment | 08-19-09 3:48 PM
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290: Me, I'm only PROJECTING!

291: Apo, you're so witty. But then maybe I'm just envious: you have a URL, I only have an email address.

292: I'm FORTY-SIX! (And for that matter all my grandparents and my Dad are dead, and Mom, who's had cerebral palsy since birth, is now at 76, bedridden in a nursing home.)

But wait: am I missing allusions to some TV show here?

Anyway. Those who want to talk to me, whether to attach XXX jpegs, make death threats or just discuss things that my comments bring to mind, please email me. I want to be a Noted Persona but I don't mean to hog the whole damn site.


Posted by: Entity | Link to this comment | 08-19-09 3:48 PM
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[Dammit, I was actually one comma short up there.]


Posted by: Entity | Link to this comment | 08-19-09 3:48 PM
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275

Megan, I've been into Unfogged intermittently for a while. What difference does that make?

Just out of idle curiosity are you the entity formerly known as tripp?


Posted by: James B. Shearer | Link to this comment | 08-19-09 3:49 PM
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297: That's the bit. Dragonflies, aliens, whatever.


Posted by: LizardBreath | Link to this comment | 08-19-09 3:50 PM
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301: I'd bet serious money against it. Entity does seem vaguely familiar -- I might possibly have run into him someplace else, maybe under another name? But not Tripp.


Posted by: LizardBreath | Link to this comment | 08-19-09 3:52 PM
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301: tripp

I admit that I had that thought too based on tone, although it would only really work if there had been an Eternal Sunshine of the Spotless Mind operation in between.

302: Less *explicitly* sexual than your proposal, but creepier with the age specification.


Posted by: JP Stormcrow | Link to this comment | 08-19-09 3:54 PM
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HOVERING.
Now, AWB is going to be pissed at you.


Posted by: Will | Link to this comment | 08-19-09 3:58 PM
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Let's unpack Shearer's claim. In response to this:
I would be very surprised if one could find a significant genetic distinction between Americans based on skin color.

He wrote: Blacks are more likely to have fraternal twins. See here.

The problem, though, is that "Blacks" is a racial category, not a scientific one. Go to southern India or Sri Lanka. Plenty of folx there have skin that's about as dark as you can get, much much darker, in fact, than many US people of African descent. Do they have more fraternal twins? If they do, is it because of their skin color? It's not in dispute that ethnic groups will occasionally have genetic markers. The problem is conflating the actual historical and geographical existence of ethnicities with the problematic (to say the least) concept of "race."

Shearer has a extensive history of making these kind of allegedly inadvertent category errors, being called on them, backing away from his original statement, going away for a couple of weeks and then repeating the behavior. I don't know if I'd call that Hitlerism, but it does raise a legitimate concern about his analysis of race.


Posted by: minneapolitan | Link to this comment | 08-19-09 3:58 PM
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The patient is very unlikely to have the knowledge to be able to independently assess the likely costs and benefits of any particular treatment decision.

Yeah, and this is one of my (separate) gripes about the medical profession. Often, patients don't have the knowledge because doctors prefer to just give them "you should do X" rather than "the costs and benefits of X are this, compared to the other option, Y, which has these other costs and benefits and here's the medical data I think support X." I understand the time-constraints on informed consent, but still.


Posted by: Di Kotimy | Link to this comment | 08-19-09 4:11 PM
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Doctors, like lawyers, are trained to DO SOMETHING. We have the tools in our tool belt, and we want to use them.

It takes lots of confidence, experience, and restraint to not do something.

Also, we are more likely to get in trouble to for not doing something than we are for doing something.

This is kind of freaking me out, because I hadn't seen this piece until just now, but I got to know about end-of-life issues, this aspect particularly, when my dad weighed in during the controversy over keeping Karen Quinlan alive, and then many years later, when he was dying. The "death panel" rhetoric has me about as irate as anything has ever made me. People die. You have to know when to let them, and give them all the information they can use.


Posted by: Jesus McQueen | Link to this comment | 08-19-09 4:12 PM
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Your MOM's in my twenties.

I'm in your middle eight, preparing for the climax.


Posted by: nosflow | Link to this comment | 08-19-09 4:13 PM
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Also, we are more likely to get in trouble to for not doing something than we are for doing something.

Yeah, my friends in medicine complain of the pressures of "defensive medicine." Actively involving the patient in the decision making seems a good way to avoid that, though.


Posted by: Di Kotimy | Link to this comment | 08-19-09 4:15 PM
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Much as I think Shearer should be called out when he says things that are racist, I don't see why people are jumping on him for questioning bitchphd's "I would be very surprised if one could find a significant genetic distinction between Americans based on skin color", which is prima facie ridiculous. Of course skin color is correlated, in a statistically significant way, with any number of genetic distinctions. Whether those distinctions are related to Shearer's original claim about infant mortality is dubious, but the claim that skin color is related to genetics is not.


Posted by: essear | Link to this comment | 08-19-09 4:19 PM
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Maybe the interpretation of what bitch said depends on what the words "based on" means, though.


Posted by: essear | Link to this comment | 08-19-09 4:20 PM
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I'm guessing that Bitch meant significant as in 'meaningfully important' as opposed to 'statistically reliable'. At that point, eh. Is sickle cell disease meaningfully important? Depends on the context.


Posted by: LizardBreath | Link to this comment | 08-19-09 4:22 PM
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No, I'm not "tripp." Furthermore I pity that poor persona now.

304: What about Eternal Sunshine of the Spotless Mind? That sounds like cute movie though, I just put in a hold request for it.

306, I think we all know what "Black" means here: of "sub-Saharan African descent," more often than not having a broad flat nose and tightly curled hair, etc. When I was a kid a girl from southern India somewhere (I forget where, but I recall her name was Geetha and her English was very precise) explained that though she had darker skin than a lot of "Black" people she wasn't Black herself -- in fact she was a dark-skinned Aryan as we should see from her straight hair and "Caucasian" features (like her long thin nose and straight hair).

You seem to be forgetting that the visible markers for "race" are also hereditary: Michael Jackson's father did not have plastic surgery to give him dark skin, a broad nose and dark curly hair, but probably inherited those "Black" features from his African ancestors. It's coincidental that Blacks are likelier to have sickle cell than say Tamils (see for example the explanations and pictures here), yet it is the case. "White" people, so I've been told, are more likely to get MS. It's not a "racial" thing, though "race" is involved. (I'm sure I'm not putting that as well as someone better educated in the subject could, and on preview I see essear beat me to this, but still.)


Posted by: Entity | Link to this comment | 08-19-09 4:24 PM
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Apo's 252 is one meaningfully important genetic distinction in the health-care context, I would think (at least I think it would affect a much larger percentage of Americans than sickle cell disease does).


Posted by: essear | Link to this comment | 08-19-09 4:26 PM
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I'm not sure there are statistically reliable differences either. For example, this says that

While different genes for physical traits such as skin and hair color can be identified between individuals, no consistent patterns of genes across the human genome exist to distinguish one race from another. There also is no genetic basis for divisions of human ethnicity.


Posted by: Cecily | Link to this comment | 08-19-09 4:26 PM
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'Michael Jackson's father ... probably inherited those "Black" features from his African ancestors, along with an increased risk of carrying Sickle Cell.' (There, that might almost make sense.)


Posted by: Entity | Link to this comment | 08-19-09 4:30 PM
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315: IIRC (and this is pretty vague, if you're interested I'll try and find what I think I've read) at least some of the statistical differences as in Apo's 252 between African American and white American patients in terms of response to medical treatments, don't show up when you're looking at comparisons between white American and African African populations. If I'm right about that (and I'm not certain that I am), there are at least some statistically identifiable real physical differences in racial responsiveness to treatment that seem to be environmental rather than genetic.


Posted by: LizardBreath | Link to this comment | 08-19-09 4:31 PM
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Will all y'all people who refer to scientific studies please post or email me the URLS? I'd appreciate the chance to educate myself further, then I might not be so uh "defensive" sometimes.


Posted by: Entity | Link to this comment | 08-19-09 4:34 PM
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316: There aren't genetic ways to sort people into well-defined races or ethnicities, no. But sickle-cell disease is a good example: the gene for it is found in high proportion among people living in sub-Saharan Africa, so as a result, sickle-cell disease in the US will be predominantly found in people who identify as African-American in race (and this is clearly statistically significant). This doesn't mean that "race" is a well-defined concept, it just means that the fuzzy social category of race is correlated with concrete biological things.


Posted by: essear | Link to this comment | 08-19-09 4:38 PM
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Cecily, should I understand your quote to say that there's no genetic reason why most Zulus (e.g.) aren't blue-eyed blondes? I'm pretty sure that's ridiculous, that it's possible to find the DNA code(s) for "African" features (or their lack among Norwegians).

What those codes and features "mean" is another thing entirely, and is likely to be culturally, not genetically, determined. E.g., is the ditzy blonde down the street ditzy because she's "melanin-deficient" or because she went to a public high school where sports and cheerleading was valued higher than academic performance?


Posted by: Entity | Link to this comment | 08-19-09 4:44 PM
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318: This is one of the first things that Google turned up, so maybe the status of the difference in response to blood pressure drugs in African-Americans and white Americans isn't even clear.


Posted by: essear | Link to this comment | 08-19-09 4:45 PM
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321- she's probably blonde because she went to a public high school. For sure that's why I'M blonde, at least.


Posted by: Cecily | Link to this comment | 08-19-09 4:52 PM
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I went to a public high school, but I'm not blonde. Otoh, it was a dork school for math and science, so maybe that's why my hair didn't change color.


Posted by: Megan | Link to this comment | 08-19-09 5:04 PM
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320

There aren't genetic ways to sort people into well-defined races or ethnicities, no. ...

Actually there are. Cluster analysis on data from many genes reproduces the socially defined races. See here for example.

We have analyzed genetic data for 326 microsatellite markers that were typed uniformly in a large multiethnic population-based sample of individuals as part of a study of the genetics of hypertension (Family Blood Pressure Program). Subjects identified themselves as belonging to one of four major racial/ethnic groups (white, African American, East Asian, and Hispanic) and were recruited from 15 different geographic locales within the United States and Taiwan. Genetic cluster analysis of the microsatellite markers produced four major clusters, which showed near-perfect correspondence with the four self-reported race/ethnicity categories. Of 3,636 subjects of varying race/ethnicity, only 5 (0.14%) showed genetic cluster membership different from their self-identified race/ethnicity. On the other hand, we detected only modest genetic differentiation between different current geographic locales within each race/ethnicity group. Thus, ancient geographic ancestry, which is highly correlated with self-identified race/ethnicity--as opposed to current residence--is the major determinant of genetic structure in the U.S. population. Implications of this genetic structure for case-control association studies are discussed.


Posted by: James B. Shearer | Link to this comment | 08-19-09 5:06 PM
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That barely even counts as public, Megan. AS IF.


Posted by: Cecily | Link to this comment | 08-19-09 5:09 PM
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You're probably right. If there were ten blond people in my high school of 2,500 people, I never saw them.

YOU'RE a public high school!


Posted by: Megan | Link to this comment | 08-19-09 5:17 PM
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My public high school was a public high school named Hellgate High. I'm very proud of this fact and trot it out at parties whenever possible.


Posted by: Cecily | Link to this comment | 08-19-09 5:20 PM
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Was it in a town called Sunnydale?


Posted by: Cyrus | Link to this comment | 08-19-09 5:22 PM
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It was in a suburb of LA. BVN turf.


Posted by: Megan | Link to this comment | 08-19-09 5:27 PM
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329: Yes!

No, just kidding. It wasn't really. Sorry, everyone.


Posted by: Cecily | Link to this comment | 08-19-09 5:28 PM
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I did not know there was a Wikipedia entry for it. Not only does it tell you the origin of the name, but it also has encouraging facts about how students usually do well at Model United Nations. Hellgate sends upwards of fifty people every single year!


Posted by: Cecily | Link to this comment | 08-19-09 5:54 PM
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332: I thought it had to be in Montana but didn't bother googling. I'm glad to know my suspicions are correct!


Posted by: Parenthetical | Link to this comment | 08-19-09 5:57 PM
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I think we all know what "Black" means here: of "sub-Saharan African descent," more often than not having a broad flat nose and tightly curled hair, etc.

Still, the racial construct of "Black" conceals more than it reveals. There is at least as much genetic diversity within subsaharan Africa as there is between Africa and the rest of the world. A Ghanaian has a more proximate common ancestor with an Inuit than he does with a Khoisan.


Posted by: pain perdu | Link to this comment | 08-19-09 7:15 PM
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European variation "map"

So in a narrow sense it is possible to make a good guess where a family is from via a small number of alleles. Less likely to work with a single individual. Ovalocytosis, sickle cell anemia, and lactase persistence are well known phenotypes with strong geographic localization.

None of this has any proven bearing on fitness for life in an industrialized bureaucracy, and the long history of explicit racism in attempts to find fitter groups of humans should be enough to warn people away from speculative attempts at doing it again.


Posted by: lw | Link to this comment | 08-19-09 7:32 PM
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It's fun when Entity leaves.


Posted by: Sifu Tweety | Link to this comment | 08-19-09 7:45 PM
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334: quite a bit more, if I recall.


Posted by: Sifu Tweety | Link to this comment | 08-19-09 7:45 PM
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His posts in this thread alone are not sufficient to convict him of Hitlerism.

With a good lawyer (LB, perhaps?), I think Shearer could get the charges plea bargained down to second degree Francoism and one count of aggravated trollery. He is, however, a repeat offender, so the judge may be disinclined to accept a lenient sentence.


Posted by: pain perdu | Link to this comment | 08-19-09 7:53 PM
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Unfogged metaphysics are a metaphysics of entities.


Posted by: nosflow | Link to this comment | 08-19-09 8:07 PM
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I'm pleased to note that my new PCP has a special interest in end-of-life issues and palliative care. Just in case, you kno


Posted by: mcmc | Link to this comment | 08-19-09 8:56 PM
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334: Probably true enough. But remember, slaves in the Americas were usually taken from northern West Africa (such as the "Slave Coast"), or rather taken there to be sold to white folk by African slavers who captured them a bit further inland, so the U.S. population descended from slaves is unlikely to contain much Khoisan or even Kenyan "blood." (Surely you, unlike an awful lot of Americans, do know Africa is a very big continent, right?) Of course this somewhat limited sampling of "sub-Saharan African blood" has in the intervening centuries been mixed with the genes of Africans of other nations and regions, as well as with those of Native Americans co-captives and of course white rapists; I'd wager you'll find considerable genetic distance between the Blacks of say Memphis and those of Benin, and you'll probably find many American Blacks share a considerable degree of "cousinhood" with those partisans in the current League of the South. Be that as it may, what's your point? I suspect we agree "race" and "heredity" don't exactly coincide, and that one might be surprised to find a blue-eyed blonde with Sickle Cell though I'm sure it's happened. (And by the way, any good Pomo would point out that "genetics" is itself a cultural construct, as is "color" in the sense of "hue" -- "white" as opposed to "orange" for example.)

Speaking of "race" and "genetics," I'll troll you slightly (dear poulet perdue) by pointing out this example of what some might call "Nazi science."

But anyway. Quick question for "the masses" here: what "race" was Cleopatra? A lot of Americans (of all "races") get it wrong; I say that shows public schools need more help.

(Oh and Sifu Tweety, I've seen your blog; you're cute in your jammies!)


Posted by: Entity | Link to this comment | 08-19-09 9:01 PM
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Oh just go away.


Posted by: nosflow | Link to this comment | 08-19-09 9:07 PM
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We are witnessing new heights of condescending rhetoric, of a sort that even jaded blog comment readers never imagined could be possible.


Posted by: Cryptic ned | Link to this comment | 08-19-09 9:16 PM
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Too many "scare" quotes become "an annoyance" and give a "disagreeable impression of arch self-regard".


Posted by: mcmc | Link to this comment | 08-19-09 9:19 PM
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I have it on good authority that Entity is Zachary Quinto.


Posted by: Standpipe Bridgeplate | Link to this comment | 08-19-09 9:20 PM
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345: That might excuse the self-regard, but not the prose.


Posted by: mcmc | Link to this comment | 08-19-09 9:23 PM
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Bad, Zachary Quinto! Bad!


Posted by: Standpipe Bridgeplate | Link to this comment | 08-19-09 9:24 PM
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"I" "am" "Spartacus".


Posted by: JP Stormcrow | Link to this comment | 08-19-09 9:36 PM
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"Zachary Quinto" is an anagram of "Tachary Quizno". Fact.


Posted by: Jesus McQueen | Link to this comment | 08-19-09 9:46 PM
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"Wow"


Posted by: JP Stormcrow | Link to this comment | 08-19-09 9:48 PM
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349: That fulfills today's zany, rich quota for anagrams, I suppose.

(I must admit I didn't come up with that by myself. I used this thing, which I would like to understand the algorithm behind.)


Posted by: essear | Link to this comment | 08-19-09 9:49 PM
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Do note, pp, that I'm not arguing that any "race" is "better" (or smarter, or more "loyal," or whatever) than any other, and note also my testimony that most of the "no-counts," "criminals," "imbeciles" and other "undesireables" I've known were, like me, "White." Furthermore, I'm actually perversely proud of the fact that under the former laws of many U.S. States I'd be legally a "Negro." (I say "perversely" because intellectually I don't think one's "race" is anything to be proud of; it's not like I exercised great skill and courage in my choice of parents.)

Oh and Cryptic ned, some of that "condescension" it is directed at me. Surely you realize that, don't you? It could be that I'm just not as *good* at it as, oh, Mr./Ms. Purdue, who could give lessons in subtle terseness (admittedly not my forte').

And meme, you have a point, but I've also often found that when I omit such as "scare quotes" or italics some people misunderstand what they read so badly that I wish I'd used smileys :-) . Middle-class white liberals who grew up in the suburbs of the North or West usually can't read me right till they're past 35 (and then usually they have to have lived in big "diverse" cities for almost a generation); lest one credit my admittedly goofy prose style for that, it's even worse in person, when they're suprised that someone who looks like me can even read the "funny papers" without moving his lips. For this I credit not only our often inadequate educational system but also most American's over-reliance on TV as a substitute for personal experience. (Note: I'm not saying I don't do it myself, only that I'm on a different channel so to speak.)

Oh and Megan, to answer your question in public since you haven't emailed me: it's partly that I brought the expectation of finding "it" here, and partly that it was sho nuff here to find so easily. I hope that after a while we'll get used to each other, my three or four critics and I, and we'll learn to deal with each others' ways; I don't know how long it'll take some folks to figure out I mean no harm nor am I myself offended, and that I actually learn a lot this way. "Defensive" perhaps, but like I've just intimated I've always got to deal with being outnumbered by practicioners of a mindset -- a "reality" -- I myself find largely alien if not downright risible; one might also consider it stupid that I don't try harder to "be accepted" and "earn the right" to say some of the things I say -- which are really rather mild, considering -- but well, maybe I ain't too bright myself. (I expect some will be grateful I've had no issue and have been voluntarily vasectomised.)


Posted by: Entity | Link to this comment | 08-19-09 9:55 PM
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my three or four critics

s/b "Lurkers oppose me in email"


Posted by: Standpipe Bridgeplate | Link to this comment | 08-19-09 9:56 PM
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I'm vaguely offended that the best the anagram generator can do with my name is "QUENCH WET, SMALL-TIME JAM". Fuck you, anagram generator.


Posted by: Jesus McQueen | Link to this comment | 08-19-09 10:00 PM
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Mine comes up with Reticent Alpha. I like it.


Posted by: Parenthetical | Link to this comment | 08-19-09 10:01 PM
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You can always count on an Entity for a "goofy" prose style.


Posted by: essear | Link to this comment | 08-19-09 10:02 PM
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Middle-class white liberals who grew up in the suburbs of the North or West usually can't read me right till they're past 35

Has this always been the case? It must have been hard to have no peers until you were past 35.


Posted by: Parenthetical | Link to this comment | 08-19-09 10:02 PM
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SB, that was funny. But please stop, it's too late for me, in such a small apartment in a big building, to laugh out loud so loudly.


Posted by: Entity | Link to this comment | 08-19-09 10:03 PM
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You don't need to respond to everything. It's not all about you. RTFA.


Posted by: nosflow | Link to this comment | 08-19-09 10:04 PM
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Oddly, it returns a blank for "essear", rather than "erases". My real name gets more interesting results. Works best with middle name included.


Posted by: essear | Link to this comment | 08-19-09 10:05 PM
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"Hooray!"


Posted by: Entitties | Link to this comment | 08-19-09 10:06 PM
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Ha.


Posted by: nosflow | Link to this comment | 08-19-09 10:06 PM
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How dare you use the word "white" without putting it in scare quotes!


Posted by: Cryptic ned | Link to this comment | 08-19-09 10:07 PM
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It's not all about you.

Again, neb wounds me to the quick.


Posted by: Parenthetical | Link to this comment | 08-19-09 10:07 PM
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It puts the DVD in the Linux box or it gets the hose.


Posted by: Standpipe Bridgeplate | Link to this comment | 08-19-09 10:09 PM
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I suspect that 352 was bankrolled by Big Quotation Mark.


Posted by: Jesus McQueen | Link to this comment | 08-19-09 10:10 PM
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No, Paren, see, the reason it's not all about Entity is that it is all about you.


Posted by: nosflow | Link to this comment | 08-19-09 10:11 PM
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Besides, it's too late for me to wound you to the quick.


Posted by: nosflow | Link to this comment | 08-19-09 10:12 PM
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I feel so much better now.


Posted by: Parenthetical | Link to this comment | 08-19-09 10:12 PM
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Your disdainful sarcasm has hurt me full sore.


Posted by: nosflow | Link to this comment | 08-19-09 10:13 PM
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369 to 367, of course, but it might be more amusing to pretend I meant it in response to 368.


Posted by: Parenthetical | Link to this comment | 08-19-09 10:13 PM
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357 -- there it goes again: I didn't say I had no peers. I said it took a while for people to overcome their previous misindoctrination thanks to a faulty educational system and over-reliance on TV to shape reality. Do read that again, please, perhaps even where I said that 'it's even worse in person, when they're suprised that someone who looks like me can even read the "funny papers" without moving his lips.'

It's not peers I lacked, it's people on the same wavelength -- or even from the same planet. And yes, that's still very hard and very lonely; if it weren't for the like-minded people I've met via Internet I'd've offed myself a decade ago.


Posted by: Entity | Link to this comment | 08-19-09 10:13 PM
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even where I said that 'it's even worse in person, when they're suprised that someone who looks like me can even read the "funny papers" without moving his lips.'

I'm suddenly worried that you're my father. How old are you, again?


Posted by: Parenthetical | Link to this comment | 08-19-09 10:15 PM
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which I would like to understand the algorithm behind

I have questioned the scientific validity of it after it said a friend's best anagrammed name was Leach Rambo, rather than Belch Aroma or Herbal Coma.


Posted by: apostropher | Link to this comment | 08-19-09 10:17 PM
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What Entity is saying, guys, is that we've been educated stupid.


Posted by: nosflow | Link to this comment | 08-19-09 10:17 PM
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Gary Farber? Is that you?


Posted by: Cryptic ned | Link to this comment | 08-19-09 10:18 PM
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Parenthetical, I'm 46. And to my knowledge I've only made one woman "late" and that only by three weeks, back in 1983; fortunately that situation resolved itself in a motel bathroom in Salt Lake City. (She was happier about it than I was, fancy that.) I'll volunteer for a DNA/paternity test though, if you've nothing better to do either.


Posted by: Entity | Link to this comment | 08-19-09 10:20 PM
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Or that I'm an ET.


Posted by: Entity | Link to this comment | 08-19-09 10:21 PM
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Don't be ridiculous, Ned. Gary was Entity, like, two years ago.


Posted by: Standpipe Bridgeplate | Link to this comment | 08-19-09 10:21 PM
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377: I know who my dad is; just not his internet pseudonyms. There was just some scary overlap there for a moment. (Including the voluntary vasectomy - though you should be careful, there - one of those produced me.)


Posted by: Parenthetical | Link to this comment | 08-19-09 10:23 PM
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Entity, please don't share any more facts about yourself, even if asked.


Posted by: Standpipe Bridgeplate | Link to this comment | 08-19-09 10:24 PM
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Let me guess—after the vasectomy but before the spermy scalpel was cleaned, the surgeon slipped and let fly his blade, which passed clean through a woman standing nearby, thereby impregnating her?


Posted by: nosflow | Link to this comment | 08-19-09 10:25 PM
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This NYT article discusses genetics in relationship to racial disparities in premature birth.

Black women have significantly higher rates of premature birth than white women, and a new study suggests there may be underlying genetic factors even when other known risks are taken into account.

A little googling will find numerous scientific papers discussing this hypothesis.


Posted by: James B. Shearer | Link to this comment | 08-19-09 10:25 PM
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Let me guess--after the vasectomy but before the spermy scalpel was cleaned, the surgeon slipped and let fly his blade, which passed clean through a woman standing nearby, thereby impregnating her?

Exactly. A virgin birth, as it were.


Posted by: Parenthetical | Link to this comment | 08-19-09 10:26 PM
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Entity, here are some things I would love to teach you:

Write shorter comments and try to make your points more straightforwardly. To me, you seem to have affected the air of a professor from the 1910's droning on over sherry. That makes me dislike your comments.

If you're going to bring yourself up, do it with respect to the topic at hand, at least:

Furthermore, I'm actually perversely proud of the fact that under the former laws of many U.S. States I'd be legally a "Negro."

has some relevance to the topic at hand, but...

Middle-class white liberals who grew up in the suburbs of the North or West usually can't read me right till they're past 35

...is of much less interest.

Be generous to your audience. The people here will probably be familiar with the concepts that you're employing, even if most of the people you know are not. You don't need to qualify everything with long parentheticals or scare quotes. If you make an assumption that we can't follow, someone will ask you what you're talking about. If someone takes umbrage with one of your assumptions -- like I did regarding public school education being the root of all unenlightenment -- feel free to defend your position.

Obviously you don't have to follow any of this advice. And the fact that I'm issuing it probably speaks loads about how far we've dwindled here and how clannish we've become. Still, if you want to hang out here, I think this will come in handy.

RTFA means read the fucking archives and it is also good advice.


Posted by: k-sky | Link to this comment | 08-19-09 10:26 PM
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Are you sure, Parenthetical? Back before the big breakthroughs in DNA testing it was often true that motherhood was a fact but paternity was an opinion. Fortunately for my mom I've got a very rare and obvious deformation that's as rare as extra fingers that's an exact copy of my dad's (and he was an only child); those three weeks he was in the pokey might've been more meaningful otherwise. Just think, maybe you could sue me for a cut of my Food Stamps!


Posted by: Entity | Link to this comment | 08-19-09 10:29 PM
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If you're going to bring yourself up, do it with respect to the topic at hand,

I should probably follow this advice more often.


Posted by: Parenthetical | Link to this comment | 08-19-09 10:29 PM
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Impossible, Paren. Everything you say becomes the topic at hand.


Posted by: nosflow | Link to this comment | 08-19-09 10:31 PM
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Oh for crying out loud. Get a room.


Posted by: Jesus McQueen | Link to this comment | 08-19-09 10:32 PM
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382 somehow seems like it should have been a scene in Tristram Shandy.


Posted by: essear | Link to this comment | 08-19-09 10:32 PM
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Get a room.

We should really turn this into an acronym for ease of deployment. GAR. (Added bonus of having a certain amount of onomatopoeia.)


Posted by: Parenthetical | Link to this comment | 08-19-09 10:45 PM
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> > Furthermore, I'm actually perversely proud of the fact that under the former laws of many U.S. States I'd be legally a "Negro."

> has some relevance to the topic at hand, but...

Why?

> >Middle-class white liberals who grew up in the suburbs of the North or West usually can't read me right till they're past 35

> ...is of much less interest.

Maybe so. Okay. So where then do most Internet Users come from these days, in general as well as around here? And how many Unfogged folks are in and from, say, Mobile, AL or Clarksburg, WV? Back in the mid '90s when most Internetters still had .edu accounts the Ivy League and its near-approximations were over-represented, and I think it's a fair bet most of 'em weren't from Mobile or Clarksburg.

Anyay. I'm sorry if you feel I've misunderestimated your intelligence, education or cultural savvy. Kinda smarts, don't it? I'm so glad though that you're so sure most of the people here are brainier than most people I know, maybe I won't skulk off yet myself.

But by the way, I didn't say public school education is "the root of all unenlightenment" -- you thought that's what I said. The fault could well be mine, I clearly can't write for shit, but that's certainly not what I meant to say. Actually to be technical, the "the root of all unenlightenment" is fucked-up political realities and cultural expectations, such as, oh, the proportion of Black men in the penal system and the fact that most state colleges I've heard of are more celebrated for their *basketball* programs. The whole damn system here is skewed; to quote a wittier acquaintance of mine, we don't do that on MY planet. (Another example would be calling Obama a "socialist" or even a "progressive" -- as far as I can tell his program barely qualifies as center-liberal.)

Of course you don't have to give a fuck about what I say either. It's easier for us to talk past each other. I don't insist on it though, and despite your unsubtle condescension to me I'm open to learning from you; I'm even willing to forgive you your also evident unsubtle message that you're sure you have little to learn from me.



Posted by: Entity | Link to this comment | 08-19-09 10:56 PM
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390: Pray, my Dear, quoth my mother, startling Dr. Slop into violent clumsiness, have you not forgot to wind up the clock.


Posted by: JP Stormcrow | Link to this comment | 08-19-09 10:56 PM
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Is it so hard to ignore someone like Entity, in the (perhaps vain) hope that he'll just go away? Or am I missing something? Some glimmer of interest in anything he's said? I mean, I know that this place is in the market for a new troll, but really.


Posted by: ari | Link to this comment | 08-19-09 11:04 PM
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394: We're trying to work through our feelings of abandonment by John Emerson, ari. It's just so... *sob*... difficult sometimes...


Posted by: essear | Link to this comment | 08-19-09 11:08 PM
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395: Smarts Donut.


Posted by: JP Stormcrow | Link to this comment | 08-19-09 11:11 PM
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I know, essear. But Entity is no John Emerson.


Posted by: Lloyd Bentsen | Link to this comment | 08-19-09 11:13 PM
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385 again: I could say I wonder why you've dwindled here and how clannish you've become. I could, till I come across something like, oh, comment 394.


Posted by: Entity | Link to this comment | 08-19-09 11:14 PM
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That's quite a chip you're carrying, entity. Chafe much?


Posted by: soup biscuit | Link to this comment | 08-19-09 11:16 PM
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That's not a "chip," that's my 'amazingly small penis.' Or is that too 1995?

Now, PSST, see my email address? Feel free to use it, instead of cluttering up Unfogged and tempting me to do the same. I can be just as unthrilling in private, I swear. And even more unthrilled, myself. Or is the point showing off for your friends? If so, is that the best you can do? I've seen better flames from AOL in '96.



Posted by: Entity | Link to this comment | 08-19-09 11:22 PM
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In this context, this from today's Wikipedia is hilarious.

"Did you know...

Leopard shark

* ... that the leopard shark (pictured) feeds on anchovies by swimming into their schools with its mouth open and waiting for them to accidentally enter?"


Posted by: Entity | Link to this comment | 08-19-09 11:26 PM
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Feel free to not be tedious. Interesting we could use. (and really, 'flame'? Don't be obtuse)


Posted by: soup biscuit | Link to this comment | 08-19-09 11:31 PM
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Oh, and speaking of cultural savvy, cf. Matthew 7:3.


Posted by: Entity | Link to this comment | 08-19-09 11:43 PM
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By now I'm convinced you are all insane. But why? And how did this state of things come to be the way it is?


Posted by: Stanley | Link to this comment | 08-20-09 12:09 AM
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I've seen better flames from AOL in '96.

Christ. Figures that old Usenet trolls would show up here.

Oh dear god. You're not TheDavid come back under a different name, are you?


Posted by: Josh | Link to this comment | 08-20-09 12:10 AM
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Holy crap, I got it in one.


Posted by: Josh | Link to this comment | 08-20-09 12:20 AM
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You're good, Josh. I am impressed.


Posted by: A White Bear | Link to this comment | 08-20-09 12:29 AM
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I'm a little perturbed at my ability, actually. I think this means I spend too much time online.


Posted by: Josh | Link to this comment | 08-20-09 12:35 AM
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I'm just going to throw this out there: http://paste2.org/p/387927 (new and improved). Add your own list.


Posted by: | Link to this comment | 08-20-09 12:47 AM
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I know, essear. But Entity is no John Emerson.

Emerson is everywhere but here these days. Time to get over it.


Posted by: OFE | Link to this comment | 08-20-09 1:06 AM
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Um, Josh, whoever you are, what makes you think I'm "TheDavid"?

And oh, how cute, a kill file. From someone anonymous. Some people never grow up. Besides me, I mean. It's so ... heartening! "God's in his heaven," etc. It is too bad y'all are all I've got for "betters," but then I'm considering the price of admission.



Posted by: Entity | Link to this comment | 08-20-09 1:32 AM
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"Registrant ID:tu4oTxnQjizPqu73"

But there is "1212 555th St" in SF, CA 94102. Clearly a spoof. Very interesting, I've never heard of a spoof in Whois before. But the nameserver is some place in Medford, Oregon, which actually exists; they help you if your laptop crashes. Cute. What that means I don't know, probably nothing worth a dime.



Posted by: Anonymous | Link to this comment | 08-20-09 1:47 AM
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Er, '...there is NO "1212...'

I hate typos. Anybody have a greasemonkey script for fixing them oneself? That'd be right up there with spoofing Whois.


Posted by: Entity | Link to this comment | 08-20-09 1:49 AM
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A White Bear, is that what your mother saw when you were born? You were delivered in a zoo?


Posted by: Entity | Link to this comment | 08-20-09 1:51 AM
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In closing, it ain't because they're Black.


Posted by: | Link to this comment | 08-20-09 2:00 AM
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Which gets back to the matter of Bob Dylan. His detention is questionable on civil-liberties grounds (perhaps minne and gswift can sort that out)

The detention and identification seem pretty straightforward here. Assuming the account is correct, he went into someone's yard and looked into the windows of their house. The residents of the house noticed noticed a soggy old guy in a hoodie looking in their windows and called the cops.


Posted by: gswift | Link to this comment | 08-20-09 2:08 AM
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If I were to see a lost-looking old guy wandering around near my house, and, on closer inspection, I realised that he was Bob Dylan, I would be more, not less likely to call the police, for two reasons:
anecdotally, ageing very successful musicians seem more likely than the average person to become weird and/or dangerous (Michael Jackson, Phil Spector);
and I can't stand Bob Dylan.


Posted by: ajay | Link to this comment | 08-20-09 4:14 AM
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Maybe I should let this subject die, forgive me, but...

341
Quick question for "the masses" here: what "race" was Cleopatra? A lot of Americans (of all "races") get it wrong; I say that shows public schools need more help.

Do private schools do any better? Which ones? Why the difference?


Posted by: Cyrus | Link to this comment | 08-20-09 4:34 AM
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341. Macedonian. But why on earth would not knowing that sort of detail reflect badly on anybody who wasn't studying Hellenistic history?


Posted by: OFE | Link to this comment | 08-20-09 4:39 AM
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Hey, coincidentlally the NYT has a long article on palliative care doctors today.

Also, do I smell cookies? Oatmeal chocolate-chip sound good to me.


Posted by: Witt | Link to this comment | 08-20-09 4:56 AM
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Health Policy Trivia/ Personal Anecdote. I was talking to a registered dietician yesterday who works 2 days per week for a hospital and has a private, self-pay practice the other 3 days.

She was complaining (and of course this is self-interested) that Medicare will only pay for the services of a dietician if you have diabetes or kidney disease. Pre-diabetes isn't enough. She found this really frustrating, because she wanted to work on making and keeping people healthy and felt pretty strongly that with help people with prediabetes could prevent their condition from progressing to full-blown diabetes. Her Medicare patients were mostly men.

Her private practice was mostly women who wanted to lose weight, many of whom had grown up with their mothers permanently on Weight Watchers. Some of these women--particularly the college aged ones--were simultaneously overweight and kind of anorexic. She saw her job as teaching people to have a healthier relationship with food.


Posted by: Bostoniangirl | Link to this comment | 08-20-09 5:22 AM
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419: but everyone should be studying Hellenistic history, dammit. How else are we going to learn valuable lessons like "never get involved in ill-judged interventions in a civil war in Mesopotamia?" (Anabasis)


Posted by: ajay | Link to this comment | 08-20-09 5:26 AM
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405: Now that I'd buy.


Posted by: LizardBreath | Link to this comment | 08-20-09 5:26 AM
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423: And it most certainly is.


Posted by: JP Stormcrow | Link to this comment | 08-20-09 5:32 AM
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I used to worry about personal overuse of medical care to a degree that I'd really avoid seeking it, because I had drunk the cool aid about how people who are insulated from the cost of care seek too much of it.

I still sometimes feel vaguely squeamish about my sleep health habit. The sleep clinic I visit is well known and fairly aggressive. Most of the published research seems to say that severe sleep apnea clearly benefits from CPAP treatment, but that it isn't as important for less serious cases. My hypopnea really is mild, but the machine has made it easier for me to stay awake through the day, so I'm happy about that, and I try to be compliant with therapy--which is not that common. But the research doesn't demonstrate that health benefits are that strong for people with milder disorders, so I feel guilty.


Posted by: Bostoniangirl | Link to this comment | 08-20-09 5:32 AM
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How else are we going to learn valuable lessons like "never get involved in ill-judged interventions in a civil war in Mesopotamia?" (Anabasis)

But isn't this just a special case of "Never fight with your land army on the mainland of Asia" - (Montgomery)? Nobody ever learns this lesson, because they always think they're going to be like the exception, Alexander. (People born on the mainland of Asia are presumably given a pass on this.) Hellenistic history is actually rather dangerous in this context, because the spirit of Alexander looms rather large in it and gives people silly ideas.


Posted by: OFE | Link to this comment | 08-20-09 5:41 AM
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Nah, bugger Hellenistic history, stick to proper (i,.e Classical) Greek history, where the lesson is: never lead armies across significant bodies of water, with the Hellespont as a special case of the more general case of Ocean.


Posted by: Keir | Link to this comment | 08-20-09 6:04 AM
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never lead armies across significant bodies of water

I don't think this maxim holds even for classical antiquity, much less for the present age. The Romans showed that, given naval strength sufficient to keep sea lanes open, it's much easier to keep a land army in the field if you can supply them by water.


Posted by: pain perdu | Link to this comment | 08-20-09 6:15 AM
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Nah, strictly Classical antiquity: from the fall of the last Athenian Tyrant to the rise of Thebes.

(The Romans are merely classicising and not a counterexample in Classical antiquity, although a counterexample, as in the British Empire, which also had a tendency to fight and win land wars in Asia.)

I have an essay on the conventional in the depiction of the buddha to write for tomorrow, and i thus feel the urge to be irrationally strict on the internet.


Posted by: Keir | Link to this comment | 08-20-09 6:25 AM
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(As is the British Empire.)


Posted by: Keir | Link to this comment | 08-20-09 6:25 AM
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I have been wondering about the amount of arable land in Roman Egypt. Egypt used to feed other countries, and now can barely feed itself; I am curious. Either aggregate stats, or the location of marginally productive provinces would answer what I am wondering about.


Posted by: lw | Link to this comment | 08-20-09 7:43 AM
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What white people don't realize is that there are thousands, nay MILLIONS of different non-white ancestries. In fact, white people themselves are non-white! It's funny how blind they are to that fact.


Posted by: Cryptic ned | Link to this comment | 08-20-09 7:51 AM
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431. Just guessing, but Egypt has a current population (mouths to feed) of c 80m, which is about 80% of the population of the Roman Empire at its greatest extent. I don't suppose the area of arable in the Nile valley has changed much in the interim, though, what with the howling desert on either side. Sure, modern techniques and modern crop varieties will be more productive, but it's not a situation in which I would be looking to be a majore exporter of food staples.


Posted by: OFE | Link to this comment | 08-20-09 8:15 AM
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Not Thebes, sorry, Macedonia. Belgh,


Posted by: Keir | Link to this comment | 08-20-09 8:17 AM
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white people themselves are non-white!

Not me. I'm nearly translucent.


Posted by: apostropher | Link to this comment | 08-20-09 8:19 AM
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Didn't a lot of the Roman Empire's grain come from the rest of North Africa's Mediterranian coast? IIRC, which I easily may not, Egypt and "Africa" were separate provinces, and "Africa" was the breadbasket. I think the howling desert is more howling now than it was two thousand years ago, and there was more fertile coastal land then than there is now.


Posted by: LizardBreath | Link to this comment | 08-20-09 8:20 AM
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I'm white where it counts.


Posted by: Stanley | Link to this comment | 08-20-09 8:25 AM
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431: overpopulation leading to overcultivation, soil gets degraded, farmers move away, irrigation breaks down, scrub is overgrazed by herders and nomads, soil becomes desert.

430: the British Empire is irrationally strict on the internet? I think that's a bit unfair. Firm guiding hand, more like.


Posted by: ajay | Link to this comment | 08-20-09 8:26 AM
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And, yes, the rest of coastal North Africa was very productive as well. Can't help wondering if the collapse had anything to do with the change of rule from native farming-focused rulers, who understood the importance of irrigation etc, to invading Arabs who were mainly nomadic herders.


Posted by: ajay | Link to this comment | 08-20-09 8:27 AM
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436. A lot of it did. Peter Heather argues that the loss of Africa to the Vandals in the early 5th century was one of the things that crucially undermined the viability of the Western Empire. But Egypt was also important, at least at an earlier date. Vespasian's coup in 64 was helped along by his ability to impound the Egyptian grain fleet, which his troops could easily reach because they were deployed in Judaea at the time, kicking shit out of the Zealots.


Posted by: OFE | Link to this comment | 08-20-09 8:29 AM
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Not my area of expertise, but I'd have thought that the loss of arable land in Egypt had a good deal to do with construction of the Aswan High Dam, which fundamentally changed the Nile floods that had replenished the soil annually since forever.


Posted by: Gabardine Bathyscaphe | Link to this comment | 08-20-09 8:35 AM
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Entity is clearly a David Foster Wallace character.


Posted by: Bave Dee | Link to this comment | 08-20-09 8:56 AM
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440: Egypt was certainly very important to the Byzantine empire in the sixth century - Egyptian grain was used for the bread dole, etc.


Posted by: ajay | Link to this comment | 08-20-09 9:05 AM
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because now the running shoes are all reasonably cushioned, but there's no wheeee factor anymore.

Try the new Wii Jogging game.


Posted by: M/tch M/lls | Link to this comment | 08-21-09 10:27 AM
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Posted by: Entity | Link to this comment | 08-22-09 11:30 AM
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