Grumble, grumble

CMS released the hounds a couple of weeks back. The single most important project under Obamacare came out. It is the CMMI Innovations Challenge. A one billion dollar free for all to demonstrate actual working projects that make care better and cheaper. It's looking for the magic bullet that makes everything all right.

It's a frustrating process. First there are the 'webinars'. Information programs where government representatives give out some information and try to act calm when the 89th guy asks the same dumb question someone else asked 4 seconds earlier. I hate these things because the only people who ask questions are 1) idiots who didn't listen to the presentation, and 2) gas bags who never pass up open mike day as a means to demonstrate their self-proclaimed superior knowledge.

Next, there's the Letter of Intent. It must contain a description of how you will change the world in 750 characters - including spaces and punctuation! I suppose I should be glad they didn't demand it be put into Haiku.

Then the proposal. Everything - letters of support, budgets, research plans, models, technology, training, administration - all has to fit in 40 pages of 12 point font double spaced. 20 pages of text in other words. Fix the healthcare system in 20 pages.

One has to wonder how many great ideas these days miss out because some innovator isn't good at sound bytes.

Oh well...

grumble, grumble.


Rich Lowry is Wrong; Again

That's not too much of a surprise. I usually just wrap old coffee grounds in his column and move on. But today I feel the need to comment.

Rich is atwitter about the negative comments directed at Denver Bronco's quarterback, Tim Tebow's on field praying. As usual, Rich misses the point entirely.

The issue is not Tebow's religiousity - it's more about whether making a big production of praying for success in a football game presents a really good role model for Christians. Now, I know that I'm making an assumption here, but I don't think it's too much of a stretch. I doubt he's praying for world peace after the huddle.

Is that what praying is about? Getting a new car, winning a game, getting a promotion? I know kids pray for material things but is that adult behavior? If it is, then don't be too surprised when other people make fun.


My Dark Place

My Halloween short story for the year... A bit darker than usual...

I miss my family.

But really not much else.

My only real tie to the past are a few wrinkled pictures. Loving and kind faces that have no place in what's left of this world.

In retrospect, I suppose I should thank the drunk driver. He sparred my wife and kids a worse fate. The accident was only three weeks before the Fall. Their death was instantaneous and at least I got to bury them in a proper grave, uneaten. More than most got. Certainly a better deal than the POS drunk driver got when the undead overran the jail.

I didn’t shed a tear for him, of course.

Honestly, the fact that I was waist deep in my post loss anger phase probably was the reason I survived the first few weeks. I’d been on the verge of homicide before the Fall. The zombies were a perfect and acceptable outlet for years of pent up anger and frustration, amplified by the loss of the wife and kids. I got plenty of opportunity to work out my hostilities in those first weeks. Unfortunately, I’ve become even less discriminating as time has passed.

The speed of my adaptation to this new world scares me. Or did. Not so much now. I have these vague memories of somebody who looked like a softer version of me. A lot softer. A person with limits. Not me now, that's for sure. No one ever wants to admit these things, but I suspect that mine was less a transformation and more just releasing something that had been hold up in a dark place all along. Waiting for its chance. It gets lots of chances now. The beast is out and he is a bad ass.

In the world of zombies, the cunning man without remorse or attachment is king. I thrive in the zombie world. It’s a clash of two opposing forms of antisocial behavior. The zombies are slow, relentless machines that kill at close quarters. I am a fast relentless machine that kills at long distance. There are more of them, but my speed, cunning and lethal reach more than balance the scales. So far.

Zombies have a certain appeal to me.

No. Appeal’s not the right word.

I suppose I should say they have a strangely refreshing simplicity. Zombies are without guile. They mill around instinctively until they sense a living creature and attack without remorse or cunning. There’s no organization or planning. They are more forces of nature than true adversaries. Savage killing machines who bear a strange resemblance to your neighbors. It’s a dangerous world with them about but most really aren’t much more self-centered as walking corpses than they were among the living. My opinion of them hasn’t changed that much to be honest. More a matter of degree and no more etiquette. I no longer have to feign interest in their existence or goings on. If I need something and they're in the way, I take them out. No one left to make me behave.

Conflicts are fast, direct and can end in only one way. No more need to talk through problems or take part in empathetic roll playing. No guilt. I don’t ponder zombie motivations. See one - shoot it in the head. It’s become a very black and white world out there. Even the living have to play by different rules with me. No more waiting in lines or patience with some bureaucratic nonsense aimed at the social least common denominator. The most extreme form of objectivism. Ayn would be so proud.

We survivors, like the zombies, have become laws unto ourselves. Our laws are harsh. I can’t say that I ever liked being told what to do. I hated hearing no. Zombies don’t talk so that’s never going to be a problem again. There aren’t enough surviving humans to cramp my style much either and most are way to busy surviving to pay much attention to me. For the most part.

Some people I’ve met are spooked by the fact that zombies go around in uniforms, suits and ties, and even with those little name tags you used to get working at the mall. Not me. I find it a plus. I’m not saying this is a good thing. Or that it doesn’t reflect something pretty dark about my character. It just is. Every person who ever screwed or annoyed me in life has a zombie familiar. I suppose I shouldn’t admit it, but sometimes it’s cathartic to shoot them. Without the civilized veneer that my family and career provided, I’ve found that I’m a pretty cold bastard. Particularly since the old social fabric of fighting fair is out the window. I don’t fight fair. I fight to survive. Zombies don’t have a rule book and there are no fouls. I don't fight at all really. I kill preemptively without visible remorse.

Why I chose to go on living in a world where everything I care about is dead, is a bit of a mystery even to me. I guess my survival instinct is just as mindless as their blood lust. I’m little more than a survival machine. It’s sort of become a surreal game I play. How many levels of Resident Evil can I survive with only one life and no replays. So far, my fifty cent token has gone a lot further than most. Plus, I’ve always been stubborn. It may boil down to the simple fact that I’m just too stubborn to quit. I'd always imagined people were trying to pull me down, and feed on my carcass - metaphorically. I wasn't allowed to shoot them before.

On a positive note, I’ve gotten a lot buffer. All that fresh air and exercise. And the total absence of fast food - for the living at least. On foot, I move with the sort of steady determined trot that you used to see in all those nature films about the big cats. Pistol in hand and at the ready. I keep the pistol out for two reasons. One, it’s a lot lighter than the assault rifle, and two, the danger while transiting is from pop up zombies who appear at close quarters. Close range combat requires ease of movement potentially in a tight space. Handguns work well for that. I only shoulder the assault rifle if I need to clear a path.

It took awhile to get my combat kit just right. I even tried a couple of Molotov cocktails in the beginning. Bad idea. I almost bought it. See, all a Molotov cocktail does to a charging zombie is turn it into a flaming charging zombie. The undead have no survival instinct. Turns out it’s really hard to cook one enough to achieve a mobility kill. Obvious now, really. Don't do it.

Despite those few fits and starts, I’ve pretty much figured out the zombie menace. You can’t drop your guard but they are predictable.

When it comes right down to it, It’s the surviving humans you have to worry about. The survivors are either simply lucky - a trait you can’t continue to bank on, delusional, tribal, narcissistic or sociopathic. The lucky ones tend to put far too much stock in their abilities, like any successful card player. They think that luck is some kid of system.

See a zombie and they attack. Very binary. No angles or subterfuge. It’s the humans who may smile and then stab you in the back. So not much has changed in that department. Before the Fall, people would drag your ass down to the deep to get one more breath even if stranded alone in the middle of the ocean. You can’t trust them on a good day and the last of those was months ago.

Fate selected the survivors simply. It wasn’t on merit. We were either off somewhere secluded when this started, weren’t in the confusing first few waves of victims, or survived long enough to witness what was actually happening without being paralyzed by the shear f’ed up nature of it all. The media was little help. All their little mobile vans accomplished was to get eager reporters eaten in the second or third wave while out hunting for exclusives. Details weren't forthcoming at 11.

Not many people of the privileged seemed to last. A sense of entitlement is not helpful in an apolitical food chain. Some soft former exec tried to bribe me into taking him along. He offered me jewelry and gold to help him out. I just shook my head. Anything that doesn’t keep me warm and dry, treat my aches and pains, fill my belly or come out the business end of a weapon has no intrinsic value now. And he could neither trot nor shoot. He had a use though. When he bought it, it kept the zombies busy long enough and saved me a lot of ammunition. Probably the first thing he ever did that actually benefited someone else. If I sound hard, well...

No, the remaining survivors share only one trait. A willingness to do what is necessary to survive. The definition of that has changed drastically since this time last year. But people haven’t changed that much. Get three of them together, and two will take sides against the one. Right up to the point when the zombies remind them of the new paradigm. I suppose there could be some good ones out there, but there's no way to tell until it's too late. The best one's would be smart too. So they won't advertise their presence. Best to assume the worst and avoid them all.

As for the tribes, they come in two flavors: outlaw gangs or clingers on. The clingers generally want to preserve the old way of life and don’t realize yet that its gone for good. They want to elect leaders and shit. But the best and the brightest faired poorly in the first rounds with the undead. So the leadership pool is shallow. Again, not much has changed. The really smart ones that are left tend to keep to themselves. Democracy is of little use at the most fundamental levels of Maslow’s hierarchy. In fact, it’s detrimental. Myself, I prefer to be a nation of one.

It’s really ironic that our tribalism, which presumably evolved to help us survive predators in the wild, is really a disadvantage in zombie world. The predators we face are different. They aren’t fast and cunning. They are slow, relentless and numerous. Huddling around a camp fire keeps big cats at bay. It only attracts zombies to the smorgasbord. Speed and mobility is life. Clinger tribes are slow.

The outlaw gangs are a lot different but are easy in that you never feel remorse when you handle them. I treat them like fast moving semi-organized zombies with a greater kill radius. Not entirely true since I really can’t seem to hate the zombies all that much. The target kill zone of an outlaw is a lot more generous than for a zombie, of course. That’s a plus. You don’t always need a clean kill or even a mobility kill. Slow them down and the fetid clean up crew will finish it.

The gang leaders are usually cunning and sometimes intelligent. They’re always cruel and depraved. But never diabolical. At least not yet. No, that’s my edge. Because I am. They never see me coming. The expect everyone to fear their machismo. I like an opponent with a big head - it's a bigger target. They thrive amongst the living and the dead only because the remaining living cling to the obsolete morality of a dead world. The living hesitate when preemptive action is required. The outlaw gangs expect that. Depend upon it for survival. It’s a fatal approach when dealing with an ambush predator like me. Most survivors instinctively want to talk or negotiate which gives the gangs their opening. They also incorrectly view the zombies as the greatest threat. The clingers on are only worried about not attracting the attention of zombies. But zombies don’t track and hunt. Don’t kill for sport like the gangs. Really, the gangs are the most evil of the lot. I spend more time being ready for them than I do the zombies.

I never use the long gun for zombies. Only the gangs. 400 to 600 meters is my domain, though I have a couple of gang leaders that I plinked at close to a 1000. Take out a couple of the top dogs and the zombies will usually be able to effect the clean up within a few days. The gangs really are like the zombies in one respect. They always attack even when a tactical retreat would better serve them. Their stones remain larger than their brains. I’ve hit both at range.

Damn gangs ruined my resort spot. If I’d been in it at the time, I’d have bought it for sure. Fortunately, I was foraging at the time. It had been perfect. I found an old Airstream. I welded a steel frame around it and I towed it out onto a train viaduct. I used a loader and a few come-alongs to suspend it from the underside of the bridge. I had a rope ladder to get in and out. It was close in to the city but impossible for them to get at. Safety and foraging convenience are hard to come by. Any Zombies that tried for it, always fell into the river below and were carried off. They always slid off the round edges of the trailer. Like I said, it was perfect.

Propane was easy to come by so I had hot water and food for a change. It was very comfortable and safe - from zombies. Of course the asshole biker gang had to ruin it for me. Oh well. It was their last bad act. Plink, plink. Their leader had some time to think before the zombies got him.

Pissed me off something fierce. That was the day I started hunting the gangs. Call it my civic duty. I’ve closed at least 3 local biker chapters. Like I said, they assume that everybody else is prey. Driving around on their motorcycles just telegraphs their approach for miles. It's like Charlie and the aircav back in Vietnam. Aircav had mobility but you can hear a helicopter for miles. Plenty of time to pick your vantage point. They might have had better luck against me on foot. It's a lesson I make sure they never learn. I don't give them any time to improve their tactics.

The only one’s I feel any sympathy for are the occasional families. I’m careful to sympathize at a distance, though. They have no chance. Kids simply shift the survival equation irretrievably toward the ‘not’ category. Kids compromise the freedom of movement and stealth that are required for survival in zombie world. Kids are a priceless possession. In zombie world you sometimes have to let go of possessions in a pinch. Even a good rifle. I avoid families for a whole host of reasons. I can’t afford any sentimentality. Not since we left the plains of Africa have feelings been this big of a survival no-no. Plus, their parents will do anything to protect the kids. Including killing me in my sleep for my supplies. Natural selection has never been about planning for the future or what’s the best for the race. Then as now, it’s simple survival. The meaning and significance of who survives, if any, and who doesn’t is something the future will ponder. Not us. Not me. If humanity survives, I suspect this period of intense and wholly unnatural selection will result in a very different being. Not a pleasant one, either. A real nasty one.

Or maybe somebody just pushed a big reset button. The one that erases any of the moral gains we’ve accumulated over the centuries. Non of that matters and there’s no reason to think about it. well, that's another positive note - philosophy is dead at last.

The reason escapes me but I did share some hand written notes with a small enclave of families. I left the notes nailed to a tree where they could find them in the morning. They never saw me. Not a good predictor of their longevity. I pointed that out in the text. The notes contained some of my collected wisdom. Maybe it’ll help them. Maybe they already know, but I doubt it from what I saw. They still seem to be as hungry for some sense of normalcy as the zombies are for their flesh. Normalcy is something that hell has already had in short supply.

What’s my advise? My collected wisdom? That’s easy. Like I told them:

  • Zombies aren’t forever. That’s important to remember. Whatever caused them in the first place seems to only spread by exposure to the infected’ fluids. People (the very few) who die of natural causes don’t seem to reanimate. Zombies are decaying. In a few months they won’t be able to cause anymore problems. Hold out. As the Brits used to say “Keep calm and carry on”.
  • Save your ammo! Never shoot a zombie that isn’t directly a threat and that you can’t out pace. Tomorrow you may need those rounds. It’s a zombie eats dog world unless the dog kills the zombie first.
  • Don’t anthropomorphize. Zombies aren’t human no matter what they look like. Zombie etiquette is easy;
  • Elderly female zombie - shoot it in the head
  • Toddler zombie - shoot it in the head
  • Cute girl zombie - shoot it in the head
  • Zombie in a wedding dress - shoot it in the head
  • Sad woman zombie - shoot it in the head
  • Child with doll zombie - shoot it in the head
  • Minister zombie - shoot it in the head
  • You get the idea. If not, you’ll die.
  • Observe humans at a distance. You can sometimes benefit from the human herd without actually having to get too close. Don’t advertise your existence or location. Many of those left alive survived because they are worse than the undead. At the first sign that a band of humans is a threat, kill them without warning. If you survive, the history books will be yours to buff as needed.
  • Never slow down.
  • No such thing as a wounded zombie. They are either a threat or they are headless.
  • Zombies don’t climb. Hide and rest in places that can only be reached by hand over hand climbing. Make sure you leave yourself plenty of escape routes because if not;
  • Zombies are patient. They’re dead so it’s not like they have any place to go once they spy your tender flesh and;
  • Zombies love crowds. Zombies instinctively know that a bunch of other zombies only mill around food. A large patient band of zombies will be the end of you unless you are lucky.
  • Railroad bridges are your friend. They are narrow so zombie approach paths are limited. You can sling a hammock off the pilings and then have 3 different escape routes should you need it. They are a lot easier to climb too.
  • Zombies don’t drive. If pursued by zombies, a vehicle will put some distance from you and the hoard. Practice hot wiring cars. Stick to the old models.
  • Zombies aren’t team players. One zombie is out for its bite only.
  • Zombies start out playing zone, then man to man.
  • Zombies are like moths. The walk toward lights and fires. Don’t use any unless it’s part of a roundup.
  • Zombies are slow. A normal walk is faster than a dead zombie can move. Don’t run, just hurry. Save your strength and only run to maneuver out of tight spots with many zombies.
  • Zombies don’t scare. Warnings are a waste of good air that you will need for escape and evasion. Pointing a gun at them doesn’t change their behavior. Blowing their head off does.
  • If at all possible don’t come closer than 100 meters to any zombie.
  • Enough zombie guts will stop any vehicle. Really important. It is tempting to plow through a crowd of zombies with a big truck. Don’t do it. Once enough of them mob the vehicle you’ll lose traction, then your life in a very unpleasant manner. If you have to drive through a crowd of zombies keep your speed around 25. It’s fast enough to squish them but not so fast that you’ll lose control from all the scattered debris.
  • Goggles are a must. Zombie juice in the eyes kills you just like getting bitten.
  • Zombies don’t travel. They stay around one area. Move to the rural areas. Fewer zombies and you can see them coming.
  • Don’t use wire - you may get caught in it and it’s harder for you to get clear of it than it is for them.
  • A locomotive is the greatest invention of Man. I like locomotives. It’s my preferred way to travel. It’s big and bad, can run over hundreds of zombies without missing a beat, is impossible for them to break into, and it pumps out gobs of AC electric power. A locomotive is a portable generator. I’ve used them to bait big crowds of the undead with lights. Get lots of them close then blow a couple of tank cars with volatiles and by by zombies. It’s quite a show. Everybody should experience this at least once.
  • Zombies don’t swim. With no air in their lungs, they drop like a stone. They aren’t coordinated enough for swimming. And lack the strength to swim to the surface.
  • The safest place to be is in a river. Zombies can’t swim and any current will carry them away. If you really need a rest period, anchor a boat in the middle of the channel and rest up. Careful pulling up the anchor though because;
  • Zombies don’t breath. A zombie caught on your anchor chain for hours is still dangerous.
  • Get used to the smell. Anything you use to cover it up will only mean that you will associate that ‘fragrance’ with rotting flesh forever if you make it through.
  • I’ve found a one thousand and second use for Duct tape - zombie armor. I’ve wrapped some of it around my sleeves and pants legs. It doesn’t slow me down and a zombie can’t break skin beneath it. It’s given me time to kill them without being bitten at least 3 times. Great defense against the pop up zombie that shows up unannounced.
  • A rock hammer is a great close quarter weapon. It’s light enough to carry and weld but will punch through a skull without a big windup.
  • If you break a leg, treat yourself like a horse. You aren’t going to make it. Eating a bullet is far better than being eaten.
  • Thank the gods for the crazy gun lobby. I’ve been able to keep my ammo stashes and weapons handy from the left overs of the dead.
  • Fire a round, top off the clip at the earliest possible moment. Never carry a weapon without a complete load. Since you should only fire when escape is otherwise not an option, then stay frosty and keep the ammo topped off. You will find yourself in a place where every round comes in handy.
  • Reload out in the open. A popup zombie is close quarters with an empty weapon is a death sentence.
  • Never venture out with less than 3 weapons: an assault rifle, and a high capacity 9 or 10mm, and a scoped rifle. The rifle is only for other humans. Rapid fire and high capacity are more important for close scrapes with zombies. I will admit that from time to time I have found a long gun and enjoyed a bit of zombie plinking until the ammo for the long gun was dry. I don’t use shotguns. Way too heavy and the ammo capacity too low. The stopping power is awesome but for zombies it’s all about the kill shot to the head. A high capacity handgun is better. Besides zombie blood spray is dangerous.
  • If surrounded by zombies, don’t panic. Pick an escape route and take out the closest zombies to the left and right of your desired path. Then trot and fire at the ones directly ahead of you. As long as you don’t stop, never look back. If you do stop, you’re dead. Move fast enough to put some distance behind you but not so fast that you can’t fire accurately. Slow and steady keeps from being eaten alive. You always outpace the ones behind at a slow trot. So the only ones you need to worry about are straight ahead. It’s tempting to look back, but don’t. The danger is out in front.
  • Never never NEVER try to take something off a dead zombie. It might not be dead and there’s nothing of value that they are carrying. I’ve yet to find a zombie with a slung AKM or M4. If I ever do, maybe I’ll be tempted to violate this rule, but probably not even then. There’s no place to spend money or hock jewelry anyway.
  • Never advertise your location. No one’s left to rescue you. By now, anybody that’s left is likely worse than the zombies.
  • Don’t use grenades on zombies if you find any. Save a couple of grenades for yourself. A bullet might not do it or you might mess up and only wing yourself. A grenade does it quickly and reliably. Plus the zombies like it better anyway. Makes it easier to share.


Observations of a Retiring Surgeon

Pliny is retiring from clinical practice, if all goes well in the next few months. As I go, I have a few observations to share with those who will follow. Being a doctor is hard and often a challenge. It is still an amazing privilege if you keep your perspective. Some thoughts in no particular order.
  1. Fear of the unknown spirals out of control: In the absence of knowledge and informed discussion, people will seek to fill the dread void of uncertainty with anything available. This is in large part why quacks succeed. Uncertainty breeds fear, which seeks comfort anywhere that looks promising. Keep people informed. Let them know what to expect. Be their advocate.
  2. It’s their data, not state secrets: The job of a physician is not to shield a patient from their own data, it’s to synthesize it for them and help them understand its meaning. Most need to see it at least in passing in order to have trust in the synthesis presented. All this HIPAA nonsense is just an excuse to be lazy and not talk wit patients and families.
  3. If their call is important to you, then why not bloody well take it! Individuals care very little that you are busy. Nothing says ‘my time is more valuable than your angst’, than a voice-mail decision tree. You can’t complain about patients lacking loyalty when you treat them like an airline complaint desk.
  4. Schedule phone appointments: Delivering medical news is not the same as receiving a major appliance. Don’t expect a patient to wait around during some 4 hour window to get the results of their path.
  5. Say what you are going to do and do what you say.
  6. Honesty is the only policy: Often, what we do is really a life and death matter. You will forget. You will make mistakes. These are inevitable and forgivable as long as you are honest about it. Lie once, and it’s the dark side for you.
  7. Share your battle plan: Years ago, a colleague of mine related the following story to me on Monday morning after covering my practice for the weekend. A very ill ICU transfer patient developed a known complication of their very complex emergency procedure that was caught early enough to successfully intervene. The covering surgeon went out to talk with the family and as hem-hawing around about the complication, when the spouse said, “Oh you mean X occurred. Dr [Pliny] told us that if that complication was going to happen it would likely be this weekend, and that you would do Y to try and fix it.” The family was appropriately concerned but confident in the team since we had been very open about their loved one’s condition, the risks and benefits of our therapy and our battle plan for when things, on occasion, go wrong. My practice motto to patients and families was always simple - You hope for the best and I’ll prepare for the worst. I’ve never found a better method for helping patients and families achieve realistic expectations.
  8. Medicine is a business - being a doctor isn’t: It’s best to decide early on whether you want to be a well-paid technician or a patient advocate. It really is that simple. Good luck trying to be both. Like Darth Vader, you will eventually succumb to the dark side.
  9. You work hard? So what: A lot of people work just as hard or harder for a lot less money. If life were fair, urban firefighters would have the highest salaries in the world, not you.
  10. Tough love: Like parenting, being a physician isn’t always being popular. It’s being the adult. The truth is often unpleasant but it's always easier to remember.
  11. You’re the expert, take some responsibility: Imagine finding yourself thrown into a canoe a hundred yards from some ominous looking rapids ahead. There’s a guide along the shore who responds to your pleading gaze with, “well, you have a couple of paddles, an oar, your hands and feet, and an empty tin can. Any one of them may be appropriate in some circumstances. Let me know what you decide.” Patient autonomy is fine. But patients lack a physician’s knowledge and are (often) emotionally compromised. Be their advocate. Most of us would prefer the guide to yell, “Take an oar and paddle as hard as you can to the far bank and jump in the shallows.” On occasion, some know-it-all might ignore the guide’s suggestions and go over the falls. Regardless of what the person in the canoe decides to do, the guide can still walk up the hill and go home at the end of the day. Like the guide, the physician can take solace in the knowledge that bad patient decisions affect them, not you. I don’t need a waiter for a cafeteria plan. If it’s just a matter of reviewing my options and making up my own mind about it, what am I paying you for again?
  12. Imagine you are buying a car: A lot of docs I know are notorious pains when it comes to shopping for a new car. They investigate and study and check out this and that, visit and grill the sales staff, and are generally suspicious of anything they are told. Why then, do these same people get so upset when a patient they have never met, has a few questions and concerns before you trot them off to surgery where someone they meet the morning of surgery will poison them to the brink of death (otherwise known as general anesthesia...) and you will rearrange their internal organs? The residents always were shocked when before a really major surgery, I automatically suggested a second opinion and provided them a list of excellent surgeons to pick from. We belabor our choice of cellular phone plan more than our choice of surgeon. Very strange.
  13. Embrace the Internet. The patients will be looking stuff up. Be proactive. Have a list of authoritative sites available for your patients. Explain why you prefer them.
  14. Invoke Pliny’s test engine anytime you have doubts: Pliny’s test is simple. I have found it to be very useful over the last 25 years. If you are unsure about something clinical, use test one: Say what you are thinking out loud but preface it with the following phrase - “Well, Your Honor, it was like this...” You’ll know what to do. For ethical dilemmas use test 2: Say what you are considering, again out loud, but preface it with the following phrase - “Well, Dad, it was like this...”


The Bandwidth Wars Heat Up!

A couple of months back our household cut the cable. We decided to save more than a hundred dollars a month that we were spending on cable TV. 570 stations and nothing on... We bought a couple of Roku's (you'd know what I'm talking about if you weren't addicted to your TV set...) to stream video and indoor antennas for the local stations. We tried it a month before jettisoning the cable. It works for us and saves a lot of time and money. It's a bit more effort to watch TV but that is a good thing since we watch a lot less of it.

Quest, unfortunately is our DSL provider. I hate Quest. I hate what ever company they changed their name to in a Philip-Morris-to-Altrea-like move they hoped would distance them from the stench of their crappy history of service. (Shakespeare said it -"A steaming pile by any other name...") They still suck. They also still charge us for DSL service that is about as reliable as pony express service after Little Big Horn. It's S-L-O-W on a good day. Few days are good.

And if that weren't bad enough, last night eldest daughter was hogging all the bandwidth! I went in to the guest room and she was there with the TV on streaming Gossip Girls, talking on her cell to a friend, while fussing with facebook on a laptop with her online school document folders open and iTunes at the ready.

My how times change but fathers stay the same. My dad used to complain, "Hey, stop hogging the bathroom so someone else has a chance."

Now I say, "Hey, stop hogging all the bandwidth so someone else has a chance - to watch TV...


A Different Slant on the End of Life

End of life determinations should be among our most personal and private matters. Unfortunately various groups, with a wide range of ideological dogs in the hunt, refuse to allow this. Sure, there are societal interests to be protected, but these really are about ownership, protecting the interests of at risk individuals, etc. Not whether a person has the right to determine the manner and hour of their death in the face of its impending certainty. Those who object on ‘philosophical grounds’ usually belong to groups that insist on extending their pet ideology into others' lives. One wishes they would find other hobbies.

Though there are no doubt other reasons, to me situations where one might chose to end their own life include intractable pain and loss of self.

All pain cannot be well controlled. I have been involved in the treatment of pain for around 25 years. While most people’s pain can be controlled, some can’t. Anybody who claims otherwise is either ill informed, part of a political agenda, or unaware of #2 on the above list.

Number 2, the loss of self, is rarely discussed in the context of pain management. Knowing what we know of neurochemistry and the pharmacology of pain medications and sedatives, it is clear that these drugs alter human cognition. For some (the opiods are the classic example), that’s how they actually provide pain relief. They alter a patient’s perception. When used to treat recoverable injury (including surgery) we accept these effects as a passing inconvenience on our road to recovery.

But what about the intractable pain of some terminal illnesses? The doses of these centrally acting medications that are required often impair cognition even when combined with NSAID's and other medications. Is the pharmacological loss of self in the face of pain any less important than structural losses such as severe head injury or coma?

What do you think?


Natural Election 4.0: Those Were the Days!

Michele Bachmann
(from a speech at the Family Research Council)

With the GoP record on providing services to the children of the poor, one has to assume that the earlier times people like Michele long for includes scenes like these.

Stop your complaining! Not until you get a proper job!

Ahh, Those were the days...


To the Legislature of Michigan...

Nothing. Absolutely nothing.

But if religious beliefs are a legal excuse for otherwise criminal behaviors, it has a potential downside (upside?)
Therefore: Religious beliefs = Mental illness, diminished mental capacity.

Is that what you were aiming for?


My 1/4 Cents Worth

Watching a video of John Haught debating Jerry Coyne it all seems to boil down to this: Is our sense of things more important than the facts of things? A huge number of people seem to prefer the former to the later.

Haught’s position was that a person must allow themselves to be in the proper mindset that will allow them to experience ‘higher levels of meaning’. The mindset he describes (he did eventually call it faith) will allow a person to accept the existence of invisible forces that allegedly govern reality without empirical proof. Indeed forces which conflict with actual empirical observation and science. Where's the proof? In one's own perceptions, that's where. QED.

In every area of life and society, save religion, we recognize the unreliable nature of personal perception. The reason that science has been so successful is, at long last, we have a mechanism to combat cognitive bias. Theology, which arguably owes its continuing existence to cognitive bias, understandably, doesn’t like this.

How we perceive the universe affects our sense of happiness, contentment and purpose. That’s fine. But how the world is, should control our shared decisions.

Haught makes the argument that absent his beliefs, humankind has no purpose. Nonsense. To my mind, Haught and others like him create a worse problem. By sticking their heads in the sand to actual reality, they divert energy away from actually working to make the world more like what we imagine it could be, or even should be.



NOTE: Any similarity of this sandwich to real or imagined products is purely coincidental and should not be interpreted as reflective on any real vile and disgusting products by any vendor.


Cutting Through the ...

The notion that true arguments require empirical data as a basis is, I believe, one of the distinctions between science and philosophy. Science ultimately seeks a data driven basis for claims while philosophy does not require it.

This should not be news to anyone claiming sophistication in thought and logic since the notion of validity versus soundness is something taught in that oft-mentioned philosophy 101 course.

Valid vs sound, as used to describe logic, is a critical distinction. It’s also a huge part of why apologists can clog the Internets with an endless stream of drivel. It’s a lot easier to create valid arguments than to create sound ones.

Valid arguments are those that follow logically from the initial claims. As example, ‘If A and B, then C’, makes a claim. The claim is valid, if C really is a logical outcome of A and B. If not, the argument is invalid.

This is arguably the basis for almost all apologetics. A claim is made that can only be answered by the existence of deity x. Ergo, the apologist shouts triumph.

“Not so fast”, should be the response.

Important to the truth of the claim, is whether the argument is not just valid, but also sound. Sound arguments are those that are based upon true assumptions. That's the key.

For example let’s return to, ‘If A and B, then C’, but substitute the following for A, B, and C.

A- “All dogs are alien lifeforms.”
B- ”Rex is a dog.”
C- Therefore, Rex is an alien lifeform.

This is a valid argument. If all dogs are aliens, and Rex is a dog, it follows logically, that Rex is an alien.

Of course, we recognize this as (logical) nonsense because the claim A, “all dogs are alien lifeforms’, is untrue. Therefore, the argument for claim C is unsound because one of it's dependencies is false.

It's important to note that an argument can be made that Claim C is valid based upon the logic of A and B. But the argument is unsound because the basis of one or more of its claims is silly. This is really key: a logical argument can be valid and at the same time, be unsound. Understanding that distinction can save you a lot of time and energy sorting through arguments.

Confronted with such an argument, at least four responses are possible:
  1. “Oh, wow! I didn’t know that! Tell me more.”
  2. Slowly back away because this person is obviously delusional.
  3. “Oh, let’s talk about this argument of yours, which differs from my own understanding thusly...”
  4. “Don’t bother me again, you twit, until you have proof that all dogs are aliens.”
Response 1 suggests that the respondent is an idiot; 2, rational; 3, misguided or deluded into thinking this can be a rational discussion, and 4, rational, blunt, and bigger than the claimant.

This example is pretty easy to see through. Even if the advocate of the claim insisted that you were dumb or ignorant because you didn’t believe the claim, I doubt you’d lose sleep over it. (It's interesting that we use the word delusional to describe valid but unsound arguments in those with mental illness, but it gets called sophisticated theology in other contexts.)

Other equally unsound claims may appear, on the surface, more difficult.

What if claim A were something like, ‘All things require a cause’. It’s easy to create all kinds of B’s and therefore C’s in combination with this, but the claimant must never be allowed to focus his or her slight of hand to the validity of the argument until the soundness of the assumptions is proven or strongly supported. That's how apologetics work - the apologist makes a claim then gets the reader bogged down in the details of the logic argument which may be valid within the context of the presented claims. But if the underlying assumptions for the claim are untrue, it's a form of slight of hand- the illusion of substance.

The wiser move may be to simply return to the assumptions (claims) and demand the apologist provide support for the soundness, the foundation of truth, to the claims since logical arguments can be valid, and unsound. There is no reason to argue about validity, unless the argument is sound in the first place. It also sidesteps another apologetic tactic - fashioning an argument so as to require the respondent to prove a negative (something we can’t do). Examining the assumptions (initial claims) for soundness puts the onus on the apologist to prove the positive for the assumptions that form the basis of their arguments. This is how science approaches these discussions. Of all candidates for determining whether or not a claim is factual, empirical data is probably the best means to determine the soundness of an assumption.

Going back to the ‘all things require a cause’ claim the facts of radioactive decay and the appearance of virtual particles negates this claim, period. These are empirical data that prove that the claim is false. So any argument using this claim is unsound - period. It's hard to argue with repeatable data.

A rational respondent may legitimately ignore any arguments using this claim as a basis. They cannot be sound (no matter how valid sounding) since one claim is false. That's the proper response to the apologist who may fire back that you need to read all the literature on the subject before you render judgement. Hardly, once a claim is proven false, there is never any rational need to dig further. One’s time will be better spent elsewhere. Arguments about truth are a house of cards. They are negated when any claim is proven unsound. Anyone who insists otherwise is either ignorant of the need to support claims with evidence, or has an agenda other than truth.

That takes us back to one of the fundamental differences between science and philosophy. Science spends a great deal of time on testing the soundness of claims through experimentation. Philosophy, not so much.


The Pattern is Full: The Return of the Hardcore Bike Commuter.

A lot has changed since I last posted on bike commuting in Biketown USA. For one, the size of my thighs finally exceeds the girth of my previously fat a---. Old Pliny’s body contour has been in flux! The biggest problem I face right now is that walking around for me, is sort of like being an astronaut on the moon. When I started this process, my legs were carrying a bunch more mass and weight about and were acclimated to working out at that weight. Now faced with a fraction of the effort I have to be careful when getting out of a chair, lest my leg muscles propel me to the ceiling.

Portland is even more bike friendly than before, though the same can’t always be said of the riders themselves. More bike lanes and all those little bike path markers that cost us $450 a pop. Being bike friendly is easier than dealing with the homeless, enticing businesses to move here, or restoring a wrecked economy. Eventually, Portland will be populated by nothing other than bike enthusiasts, the homeless and barristas. Who’ll support the city on parking ticket revenues then? Hard to know. One thing’s for sure, the bike community is like that mouse with the cookie.

But I digress. Time for my relaxing morning ride.

It’s morning and I begin to gear up for the 5.5 mile commute one way to work in the predawn light. Lots of hills to crush. It’s cold and rainy so most of the pretenders and Humpty Dumpty’s won’t be cluttering up the route. Plus fewer Gazelles, Cellheads, barrage balloons, and Cartwrights. That is good. It’s safer for them and for me. Just the usual Zombies, Spandicks and T-rex’s but they have mostly learned to avoid the Ghost Biker.

I check my ride. I circle it like a big cat or a pilot in preflight. Tire pressure, ride height, signs of rust or debris, spoke tension, the disc brakes. All check out. No glass in the rubber. My ride is like no other. Started off the shelf but quickly morphed in to my unique ride. Including that wonderful seat made out of the same stuff as the old Stretch Armstrong dolls. The old seat was about as comfortable as a TSA pat down when you object to extra nadrads. (Every bump in the road shouldn’t make you feel like you lost at roshambo.) New pedals, and those magnificent red Axiom waterproof bags. They hold 50 pounds if for some reason one foolishly felt compelled to shlep 50 extra pounds up the hills. Right now they just hold my Clark Kent persona and garb for what waits at the end of the ride. And more lights than Radio City. Unless you burn the driver’s retinas there’s no such thing as too many lights. Don’t forget the Greek chariot front axle just in case somebody gets too close. Get that neon leg thingy that keeps your pants from getting wrapped up in the sprockets? check. Lost a good pair of pants that way once. The road crew vest visible from space? check. Long-billed fishing hat for the rain? check. Keeps the rain out of the eyes. And the shiny chromed bike helmet. A climber’s helmet actually, protection is more important than aerodynamics. Don't look in the mirror because I'm sort of dressed like I should be outside a Tea Party gathering...

Saddle up for the morning show. Once more into the breech and into traffic. Eyes peeled for all the people who can’t be bothered to devote their full attention to the road even in poor visibility. Easily the most dangerous activity any of them pursues. So many bikes of so many descriptions. Looks like something out of steampunk.

And of course there are the peds. Peds, Peds everywhere. Even in the designated bike lanes, the peds clog the thoroughfares. They should have to wear signs saying, “I’m a clueless idiot and your responsible for me.” That’s what the greek front end is for.

Uh oh, a barrage balloon about 75 meters ahead. Clueless dog lover with a long tether who thinks that everyone must love his little ankle biter as much as he/she. Thinks that the rest of the world must bend to accommodate their actions. Darting across the bike lane in random patterns. Give ‘em a wide berth - but not too wide. They need to feel the heat from the Ghost Biker’s passing. Maybe they’ll learn, maybe not.

I pass a Humpty Dumpty within the first half mile of the ride. No helmet. The King’s men would have an easier time gluing those egg shell bits together than a neurosurgeon will if your head hits the concrete at speed with no protection. No limiting rules for them, by god. Except gravity and inertia don’t grant wavers to even the most narcissistic among us. [Important safety digression, being as I actually take care of such people: The Humpty Dumptys are full of excuses for not wearing a helmet. My favorite is, “I ride slowly and safely on back streets.” Hey clueless! Your skull evolved to protect your brain from ground level falls in dirt. Yours is not the skull of a great ram. Falling on concrete or asphalt will hurt your brain. Now back to my regularly scheduled rant, already in progress...]

Half way down the stretch and my speed is maxed out. Bloody Hell! Intersecting to and fro Cartwrights! Little chance of not having to hit the brakes. Little chance, but turns out it’s enough. Groups of people walking in line abreast chatting away about something of universal consequence cluttering up the pattern. Ben, Adam, Hoss , and Little Joe they ain’t. Feel the heat clueless! Dirty looks and shouts easily outdistanced. Sign language in order? The vitriol created suggests that an alternate route might be best for a couple of days.

People moving like zombies covered in soiled blankets. Moving from their night time lares under the bridges to their daily feeding grounds. Moving slow to conserve energy. Not hard to avoid but you need to remember they are unaware of your approach and unconcerned about collision. The local economy and mild weather have made the ranks swell. That and the complete dismantling of mental health services. Muttering to themselves for the most part. The packs of youngish ones are the only ones to really be concerned about. But Jim Bowie’s design is easily recognized even at a distance. They may be feral but not dumb. Best defense is to look like way too much trouble amongst easier pickings. True most places in life.

A Gazelle is ahead near a narrow turn. Jinking back and forth across the path like a great cat was in hot pursuit. In tune to music from their buds. I want to come back clueless in my next life! Ringing the bell to alert them to my approach. She turns to show her distain for being bothered. Six weeks in traction from a collision would be a bigger bother I suspect.

Bloody Hell in spades! The Steel Bridge is going up. To allow a huge yacht to pass by. That bad boy uses more fuel in a minute than all the stopped bikers watching in disgust save in a year. 15 minutes lost waiting for USS (or is it ASS?) Conspicuous Consumption to trundle by. Then I’m back on the path.

A T-Rex is approaching head on and considering cutting me off to round some Cartwrights in his lane rather than break. Thinks better of it and huffs at the inconvenience of not being able to do whatever he wants - ie force me to break. T-Rex’s are most pathological subset of the spandicks. Guys who deliberately try to minimize the amount of upper body work they do since arm strength equates with weight that doesn’t get applied to the road. They better hope they have the legs to get them out of trouble when they cut somebody off because their little arms won’t be of much help when someone with a more balanced muscle mass catches up with them.

Bunch of peds along the river. THINK FAST walkers. No coincidence that our handlebars would not look out of place on a bull’s head. Running in Pamploma would be safer than walking the concourse during the daily bike commute.

Cellhead is up ahead. Flailing their arms to make a point that the guy on the other end of the conversation can’t really appreciate.
(Pliny's suggestion for new bike lane signage was rejected.)
Turn the corner for the egress off the river walk and up a hard hill. ARGH! Somebody is feeding the stupid pigeons! Covering the bike lane. This rainy stretch of concrete is slick enough without the addition of the Pigeon guano. Plus the Biker isn’t too interested in picking it off of his pants legs at the end of the ride.

Big hill at the finish. So steep that I have to traverse it but at least I don’t have to walk the ride anymore.

Work, work, work, work. Quitting time. WOOHOOO!

Day’s end. Stopped at a light waiting for the signal when a spandick half my age rides around me so as to be able to get a jump at the light and not be inconvenienced by anyone. I’m surprised he doesn’t shoot himself when I pass him on that long hill. The BTU’s radiating off my leg muscles must be contributing to global warming. Rain has stopped at least. Time for the evening ride back to the barn and navigate all the road work. How can you tell it’s spring in Portland? Easy - road crews have every major artery blocked down to one lane. They must meet in secret each spring and plan so that no path in or out of the city is free of obstructions and gridlock. They decide to block two lanes of one of our remaining bridges for - what exactly? Can’t actually see anything they are doing. It’s faster to bike than drive in summer. They’ve added all these new bioswails and jogs in the main streets to - “calm the traffic”. Gotta love bureaucratic speak. May calm the traffic but it sure pisses off the drivers engulfed in it. But Portlanders stew in silence. Hardly ever hit the horn regardless of the idiotic infraction in front of them. I swear they’d sooner starve to death in gridlock than honk their horn. Me, I tend more towards a Chicago/New York style of driving... If you aren’t going to use the horn may as well pull it off and save the weight... Heck if I could, I’d get a horn that’s like a sperm whale sonar - one that would actually stun the idiot in front. Ahhh. Biking is so much more relaxing than driving... ;)


Apologetics 101: We Adore Moving Metaphors

The apologetic philosopher can learn a lot from observing (take a breath and do not panic at that word. Fear not, empiricism will not be required) a squeezed balloon.

This method of argument has been successfully employed for centuries. It never goes anywhere but eventually they will tire and you can declare victory!



On another blog, someone posted the wisdom of WL Craig, renowned Catholic apologist. While drinking deep of its intellectual bounty I was bothered by a nagging feeling that I had encountered this argument and style before. The bits in dark gray are allegedly quotes from Craig.

I’ll make you a wager. Your philosophy against
science. If I win, you must release the Princess.

Your science against my metaphysics! A debate? HA, I accept.

Not so much a debate, which often has far more to do with wordplay and rhetorical skill than truth. I'm more interested in an exploration of truth. Are you game?

Proceed if you dare...

Very well. Beyond, personal belief and established lore,
what proof have you of the existence of your particular deity?

Hmmm, What proof you ask. Mine are rational arguments! There are literally thousands of proofs at my disposal. You must be one of those poor dolts bound by naive evidentialist epistomology. I’ll wager you aren’t versed in the the kalam cosmological argument are you?

I am, and in the various ways it’s been refuted. Most damning being the fact that it merely pushes the problem of first origins backward in time. Never mind, that even if it were sound, it’s a long way from there to your particular sect.

What I find disturbing is even when these arguments are shown to be unsound you seem incapable of abandoning them. Science depends upon the ability to falsify claims, but not theism it seems. You insist we prove you wrong, but can’t prove yourself right. You call that a victory. Which is the opposite of the scientific approach.

You’d like to think that, being an immoral atheist who fears death. But it is not true. Here’s an example for you heathen: If the universe were discovered to be eternal, we'd be obliged to give up biblical inerrancy (as well as the kalam cosmological argument), since the Bible teaches that the universe was created a finite time ago. But obviously, that wouldn't imply that God does not exist or that Jesus didn't rise from the dead.

Truly you have a dizzying control of words if not the intellect to match. And an infinite capacity for rationalization. So your faith is a cafeteria plan not requiring internal consistency. But if the Bible wasn’t inerrant how would you know which, if any, pieces were true?

PFFFT! We have many personal accounts of the truth of those really important bits and the belief of millions.

None of which is a reliable measure of truth in any other arena. What about other believers from other faiths who claim just such revelations?

Of course, anyone (or, at least any sort of theist) can claim to have a self-authenticating witness of God to the truth of his religion. But the reason you argue with them is because they really don't: either they've just had some emotional experience or else they've misinterpreted their religious experience. So you present arguments and evidence in favor of Christian theism and objections against their worldview in the hope that their false confidence will crack under the weight of the argument and they will come to know the truth.

So, the same could not be said for you? What you call the
Holy Spirit might just be an emotional experience? Other than your argument from authority, I don’t see the difference. Seems to me that nothing would dissuade you from your belief. Hardly the position for an intellectual to defend, is it not?

BAH! There are many things that I would take as proof for disbelief. Say, If Jesus' bones were actually found, then the doctrine of his resurrection would be false and so Christianity would not be true and there would be no witness of the Holy Spirit. So if Jesus' bones were found, no one should be a Christian. Fortunately, there is a witness of the Holy Spirit, and so it follows logically that Jesus' bones will not be found. But I have proven that I am open to evidence against my faith should it be found HA!

First, Isn’t that a Websters-worthy example of tautology?
Second, how would one ever know if a set of bones once belonged to Jesus? Not much of a risk there. Wouldn’t you simply deny the authenticity of the find? Or come up with some equally convenient excuse?

HAHAHA! I really have you now! For not only should I continue to have faith in God on the basis of the Spirit's witness even if all the arguments for His existence were refuted, but I should continue to have faith in God even in the face of objections which I cannot at that time answer. The first claim is not really all that radical: I think most theologians, not to mention ordinary believers, would say that arguments of natural theology are not necessary in order for faith in God to be rational. In the absence of some argument for the truth of atheism, I can be perfectly rational to believe in God on the basis of the Spirit's witness.

Amazing - not the argument, but your inability to see the irony in what you just said. Back to the burden of proving you wrong rather than being right. Isn’t that a spurious argument, since the question is not whether a god exists, but rather whether a god is required to explain observed facts, which it is not?

You obviously missed the class on Aquinas.

No, but I also attended the classes about the vast store of scientific achievements in the following 700 years.

Have you read all of the works on christian apologetics, hmmmm?

No, nor have I read all of Jacklyn Suzanne but I read enough to
stop seeking answers to life’s meaning there either. I would expect more than an “emperor’s new clothes” response from one so versed in logic. To disagree with you is not to lack understanding or education. One need not handle every piece of dung, to recognize its stench. Don’t you see that your retreat to the mystical sanctuary of catholic doctrine might weaken your claim to intellectual openness?

I find it odd that because I also believe that there is a self-authenticating witness of the Holy Spirit, that fact is thought to somehow undermine the arguments and evidence I present.

So you don’t see how appealing to experience and mysticism out one side of your face while spewing unsound arguments out the other might undermine your credibility? Or that your flat admission that no facts would sway you, might call into question the purpose of all your rhetoric? Is obfuscation of the nature of your blind faith the extent of your rational argument?

I’m just getting started! I haven’t even talked about contingent beings yet! But first, What I'm claiming is that even in the face of evidence against God which we cannot refute, we ought to believe in God on the basis of His Spirit's witness. Apostasy is never the rational obligation of any believer, nor is blasphemy against the Holy Spirit. God can be trusted to provide such powerful warrant for the great truths of the Gospel that we will never be rationally obliged to reject or desert Him."

So basically you are saying, “screw the evidence,
feeling is believing.”

If it were proven that morality were merely a socio-evolutionary tool, then theism would be false and there would then be no witness of the Holy Spirit, since God would not exist. For theism entails that objective moral values and duties exist. So if they didn't, theism would obviously be false. The key here is the word "merely." We can agree that the way in which we come to know moral values and duties is through the evolutionary process, but to conclude that they are therefore not objectively real would be to commit the genetic fallacy of trying to invalidate a view by showing how someone came to hold it. Absent a proof of atheism, the socio-evolutionary account of our moral beliefs does nothing to negate their objective validity.

Again, with the claim of authority. You’re stalling, and not answering my questions. Useful debate strategies, yes, but not the methods of real seekers of truth.

NO I”M NOT STALLING! I’m using rational argument!

You are using that word again. I do not think it means what you think it means.


If I may capture your attention once again. Isn’t there something more important than rational arguments?

Such as?


INCONCEIVABLE! What I claim is that for the person who attends to it the witness of the Holy Spirit overwhelms the putative defeaters brought against the truths to which He bears witness.

But that makes absolutely no sense.

You only think that it makes no sense! Since you failed to study all 28,276 theological apologetics you cannot grasp my rational arguments. And since you can’t summarize all the knowledge of science into a single trite comment, I WIN! I WIN!


What happened to him?

Well Princess, I think he finally choked on his convoluted rhetoric. It was inevitable.

Enough of him. Time to head into the fire swamp to deal with other ROUS'...