Pickleball Csarina

‘Tis the season for petty tyrants: Donald Trump, Vladimir Putin, Kim Jong Un, Nicholas Maduro, my HOA president, and his hand-picked Pickleball czarina.

            Admittedly, the Pickleball Czarina (hereafter referred to as PBC) has little effect on the world political scene. However, in terms of affecting my daily life, she’s a bigger obstacle than any of the other despots listed above. 

            For those who haven’t made the mistake, yet, think long and hard about whether living in an HOA is worth the harassment. Our HOA president bills himself as ‘the savior’ of our community, although his presence was an accident, and his input was much less than he brags about. Unfortunately, he is seen as a god by the residents who suffered through the bankruptcy of the developer of this community during the ‘Great Recession.’ Those of us who arrived later don’t understand why he has served multiple terms as president, or why a spineless HOA board allows him to bully them into bad decisions. His latest ineffectual negotiation led to the loss of the DirecTV bulk contract, and an immediate increase in residents’ expenses of about $100/month to secure TV services from either DirecTV or AT&T. (Who, it turns out, that even though DirecTV is owned by AT&T, compete with each other.)         

I’ll continue with my one example: Pickleball. There once was a thriving community of Pickleball players in my HOA. The numbers have slowly dwindled down to a fraction of the initial players, thanks to the PBC. Although she was instrumental in bringing PB to our HOA, she is incapable of of running an organization, except by fiat.

Case in point: visitors. None are allowed (in any scheduled activity, lest they add to the wear and tear of the court). There are an estimated 1000 people who live in our community. A generous estimate would be there were fifty people who played the game on a regular basis, twenty-five on MWF and the same number on TThS. About half that number now play, driven off by the PBC’s arbitrary edicts. Being an excellent player, the PBC plays on MWF and routinely suggests that less skilled players play on the “beginners’ days”: TThS. She doesn’t want to play with people who aren’t a challenge to beat, despite the fact that some of these so-called beginners have avoided her and played on TThS for going on two years. 

So, to use the MWF players as an example since I am most familiar with them, there may be at most 25 regular players, of which maybe 8-10 show up on any given MW or F. If everyone of us brought a guest twice a year, then that would mean 50 guests, spread out over (3 days x 52 weeks) 156 play dates. That’s about one guest per week. Two, if the TThS crowd also brought two guests per year. The additional wear and tear on the asphalt courts would be horrendous! Not! 

Still, the board is spineless enough to not make an exception to this dumb rule for Pickleball, or to rewrite it altogether for every activity. Petty tyrants abound. And this is only one small example of HOA rationale. Think twice about joining one. The name of this HOA is not mentioned above because I do not want to suffer any more harassment, having been banned from playing pickleball for a week for arguing the above point.

Referendum vs. Amendments

 

National Referendum

By now it should be obvious to most voters that the federal government has become dysfunctional, grid-locked, and almost evenly divided by politicians who care more about themselves or private interests than the country. It is unable to govern effectively because of the divisiveness. Our Constitution, written in the eighteenth century, although a giant leap forward in its time, is not suited for the present fast moving culture of the twenty-first century. The ability of the voters to modify the Constitution to fit present circumstances is woefully inadequate. A two-thirds majority of Senators and Representatives must approve the proposal and three fourths of the states must approve it.

In almost every statewide election in Florida, there are proposed changes in laws and regulations. I suggest the next Constitutional Amendment be The Referendum Amendment. Voters need to be involved with making timely changes in the Constitution.

The Referendum Amendment might work like this: If 5% of registered voters in every state sign identical petitions for an amendment, then that proposed amendment would appear on the next presidential election ballot. Every voter in the country would then vote on that amendment.

Conservatives would be able to put a balanced budget, line item veto, or term limits amendment to a national vote. Liberals could propose national health care, a ban on assault weapons, repeal of the Second Amendment, etc.

The National Referendum Amendment certainly beats having rioters in the Capitol or another Civil War.

Covid-19

This is going to seem pessimistic, but read it all the way to the end. By the time you finish, it may seem more optimistic than pessimistic.

First, some facts. These are my opinions and observations, no one else’s that I know of. I am a RETIRED physician. I no longer have a medical license. My areas of expertise were emergency medicine and urgent care. I dabbled in sports medicine. My main conflicts in the medical field were my inability to give patients unnecessary medications, i.e. antibiotics for viral infections and narcotic pain medications without a real need. My opinions sometimes were the source of conflict with patients. I didn’t retire early, but I don’t miss practicing medicine.

Now, the bad news: Covid-19. Now, more bad news: this is a corona virus, similar to the corona viruses that cause the common cold. Corona viruses mutate frequently. The reason THERE IS NO CURE FOR THE COMMON COLD is that it is difficult to make a vaccine for a virus that MUTATES FREQUENTLY, because when viruses mutate a vaccine resistant form frequently develops. There may NEVER be a vaccine for Covid-19. The good news here is that IF there is a vaccine effective against Covid-19, there may eventually be an effective vaccine for the common cold. MAYBE.

More bad news: Covid-19 is unique and new to Homo sapiens. That means, very few people are immune to it. Think smallpox and Native Americans. The good news here is that Covid-19 is nowhere near as deadly as smallpox. After all the numbers are added up and everyone is tested, it may turn out to be less deadly than the yearly influenza we put up with every winter.

Even more bad news: This virus is VERY, VERY, VERY contagious, much more so than the influenza. So, even though it may be less deadly, many more people are going to get it. Many more people are going to die from it than die from the flu. It is likely that EVERYONE is going to get it eventually. Some of us will have a natural immunity. Having seen a myriad of corona viruses in the past, our immune system MAY reject this virus immediately. That may leave you with NO symptoms, although you MAY be a carrier for 2-3 weeks, capable of infecting others. Some of us will experience symptoms similar to (but less or more severe) than a common cold. Some of us will die. You need to prepare for the last one. Eventually, every one of us will die. With this pandemic, it may happen sooner than you had assumed (as if you can plan such a thing). So, take this isolation time to get your affairs in order. Better safe than sorry.

Viruses are parasites. It is not in a parasite’s best interest to kill its host, because it then dies also. Parasites have evolved to infect a host, live long enough for the host to pass on the infection, and thereby spread their genes and the resultant disease. The good news here is that parasites tend to mutate in the direction of decreasing lethality. That way they stay around longer, and infect more hosts. If they mutate to a more lethal form, they can be so deadly that they kill the hosts before they are passed on.

The ultimate bad news: The United Sates of America is inadequately prepared to participate in this pandemic. We have no universal health care. We have a ponderous government, run by elected officials who seem to respond only to severe emergencies (like government shutdowns over budgets). The present administration may have slowed its response by gutting the CDC and pandemic response unit. But probably not by much, given the brash denial of scientific facts espoused by a good portion of Americans. They realize that being ignorant of scientific knowledge is one of their God given rights. They will champion those rights, by God, even if it kills them. And it has.

Social distancing and wearing masks have their merits. There are not enough ICU beds, or medical workers, in the USA to care for all the acutely ill patients if everyone comes down with this virus at the same time. Social distancing helps spread out the occurrence of the disease in time, so fewer people are sick at one time (flattened curve). This way there may be enough respirators and ICU beds when they are needed. Although, health care workers are going to be running a marathon and we may run short of them. This pandemic is going to last a LONG time.

Sweden has taken a different approach. Being a socialistic/capitalistic country, they have universal health care. They care for their citizens from cradle to grave. Their government has looked at all the same information our government has, and has decided they can’t fight the virus. They are sacrificing a small percentage of their population in hopes that most Swedes will prove to be immune, or sufficiently strong enough to survive the virus. It’s likely a financial decision, too. The fewer old folks in expensive nursing homes and ICUs, and on respirators, the better they can care for the young.

Unless someone finds a cure, a lot of people are going to die. Unless someone develops a vaccine, the same is true. YOU are going to get this virus. PLAN on it. If you are lucky, there will be a respirator available at the time, if you need it. With luck, the number of health care workers still able to work will be able to handle the workload when you need them.

I apologize if you knew all of the above and I have wasted you time. Stay safe and get your exercise.

A Pox on Us

                                                          

            The first scam that affected me personally was the call to arms to fight in the Vietnam War. LBJ masterminded that. I spent seventeen months on aircraft carriers in the Gulf of Tonkin, never directly in harm’s way, but close to pilots, air crewmen, and ship crewmen who died from enemy action and accidents.

            Richard Nixon was a crook. He is probably the patron saint for the CEOs of today.

            I get multiple scam calls per day about extended warranties for my car, the IRS, and my credit card.

            Garmin, having sold me two lifetime updates for the maps on my GPS devices, has decided they made a bad business decision. Apparently, the fact that maps are available for free on most cell phones has hurt their pocketbook. They disabled both of my devices, and now want me to pay them to update the software that allows me to download those maps for which I already paid.

            Insulin and epinephrine, both discovered over a hundred years ago, are now so expensive that patients in need have to decide whether to eat, pay rent, or buy their medicine. Epinephrine has been manufactured for a hundred years; human insulin has ben manufactured for forty years.

            Razor blades are so expensive that growing beards make more sense.

            DirecTV and DISH scam customers with come-ons and bait and switch tactics. DirecTV offered me one service, signed me up for another because the first was unavailable. The DISH sales representative neglected to tell me that if I paused my account that all incentives would be null and void, and to restart the account would cost 50% more than the price he quoted me.

            CEOs make thousands of times what their average worker makes, more than they could spend in a lifetime.

            The tax rate on the richest people in the U.S. and successful companies doesn’t cover their cost to the country: for infrastructure use, the rule of law, the freedoms guaranteed by the Constitution, or protection of the country and citizens by the military.

            I am retired now. I was an adequate physician. I worked many, many different jobs because of one fault: I didn’t feel obligated to prescribe unneeded medication to patients just because they wanted it (antibiotics and narcotics, usually). Most clinic directors and hospital CEOS desire that patients go home happy, so they will return in the future. They don’t care if there is a national crisis, or two, with antibiotic resistance or opioids. I usually lasted a year or two before the number of complaints by patients made moving on a good option.

            Big Pharma bribes hospital CEOs and physicians with free meals, clinic presentations, continuing education, kickbacks, etc.

            Congress and local politicians line their pockets with lobbyists’ money. The Supreme Court sees no conflict with PACs or the corruption brought on by donations to political campaigns without controls by rich citizens and wealthy corporations.

            Software vendors statements about privacy and use of their products are so long and so full of legal jargon as to be unreadable and worthless.

            Scientific American recently published a study about bribery. People who think bribery exists tend to want to participate. That attitude is contagious. People who see speeders and aggressive drivers tend to assume that is normal and copy that style of driving. Corruption and selfishness breed more of the same.

            Until a sense of integrity is restored in the U.S., we are stuck with this mentality. 

            

Medicine & AI:


I just finished reading a really good book, “The Space Barons” by Christian Davenport. In it Elon Musk and Jeff Bezos, rocket rivals, are doing their best to bring down the cost of space flight and reprise the role of D. D. Harriman in Robert Heinlein’s novel, “The Man Who Sold the Moon.” By utilizing advanced technology they propose to deploy relatively inexpensive, reusable rocket boosters. I like the idea of applying advanced engineering and computers to bring down the costs of things.

Some wag once said if aviation or automobile development had mirrored the evolution of the computer, you would now be able to drive to California from New York for a quarter, in six hours. Or, you could fly to the moon for $1 in a day. Or something like that.

Computers make a huge difference. We need to apply them to the practice of medicine to lower the costs. And to the automobile and aviation industries, too, apparently.

But let’s start with medicine. MRI studies are way too expensive. Well, everything in medicine is way too expensive. It’s a for profit industry now, not a calling. It was a calling back when there really was no way to help a patient except to hold his hand and console him, or to make her comfortable while she passed away from an untreatable disease. Today, people can actually be cured! Epidemics of infectious diseases or Type II diabetes can be prevented!

As a result some people think there is a vast conspiracy to immunize them or starve them. Many have become hypochondriacs. They expect to die from that gas pain, which resulted from the CardiacArrestBurger they downed with a six pack of their favorite local brew or energy drink. Unnecessary measles outbreaks, obesity, diabetes, and visits to the ER help drive the cost of medicine upward.

No politician wants to try to balance the budget when everyone who might receive free medical care will expect to live to be 105. Well, no politician wants to try to balance the budget. At one time, the Republicans did, until they they realized they could vote themselves a huge tax refund and still get to complain about the ‘loafers on welfare’ at the same time. Besides, who knows if our trillions of dollars in debt mean anything?

Where would free market competition and technology help with the expense of medical care? Suppose the government, some individual, or group sponsored several contests, like the Ansari X Prize for first reusable spacecraft. This ignited the free market space race of which Bezos and Musk are only the tip of the iceberg. A similar prize by Raymond Orteig sent Charles Lindberg to Paris, and is widely blamed for the cramped seating in present day airliners. The first maker of a portable, handheld, cheap MRI would win $20 million dollars. MRIs don’t produce radiation and are thus probably safe in the layman’s hands, as is ultrasound imaging. The spin-off technology would be exciting, even if every household could afford their own MRI.

MRIs by themselves won’t solve the problem. We would also need contests to develop an artificial intelligence (AI) to interpret the information obtained by the machine. Radiologists are paid too well to read every MRI or ultrasound image taken. The radiologists should be called upon when the AI is stumped. Later, when the AI is sufficiently trained, the radiologists will likely consult it when they are flummoxed. They could help each other, and lower costs.

We’ll also need a contest to help develop a diagnostic AI. Not everyone needs an MRI. People have infectious diseases, inheritable syndromes, autoimmune diseases, cancers, and other problems that only good diagnosticians can solve, or at least diagnose. A third AI may be needed to determine the best treatment for each individual.

Once these advanced technologies are in place, I would envision the interaction of an injured weekend athlete with a private MRI and Cloud AI to go something like this:

“Doctor Alexa.”

“Yes, John.”

“I fell playing Pickleball today and hurt my wrist.”

“Please scan your wrist with the MRI wand.”

“Done.”

“You have sprained radialulnar and ulnarcarpal ligaments in your left wrist. Ice and elevate it. Take two aspirin, and use the wrist support I just printed in the 3D printer. They might take a couple weeks to heal.”

“Thanks. Can’t we do anything about the pain right now?”

“If you do what I said the pain will diminish greatly.”

“But that might take twenty minutes….”

“Grow a pair, John. This is a minor injury.”

“What did that cost me?”

“Three cents in electricity and $1.51 in Cloud AI time.”

“Thanks.”

“No problem, wimp.”

Similar interactions would take place with sick individuals.
“It’s a virus, idiot. You don’t need an antibiotic.”
“A bland diet does not include jalapeño peppers, pizza, and beer.”

Some people might even be cured. Even though only a small percentage of the population has difficulty understanding scientific principles, they account for an inordinate amount aggravation for the rest of us.  The next step would be an AI with which preschoolers would interact to help prevent stupidity and the development of conspiracy theories that plague humanity.

If you do print this opinion, please add:
Bill Yancey is a retired physician and the author of two recently published novels: “Abandoned: MIA in Vietnam” and “An Autopsy of Vultures: Murder and Mayhem in an Active Adult Retirement Community.”

Bill Yancey
735 Copperhead Circle
St. Augustine, FL 32092
904-466-1003
wmbyancey@bellsouth.net

NRA

          The part in red is the part the NRA conveniently forgets to mention:

A well regulated Militia being necessary to the security of a free State, the Right of the People to keep and bear Arms shall not be infringed.

          This is the reason they forget to mention it:

We have several WELL REGULATED MILITIAS: National Guard, US Military Reserves, and the Active Duty US Military.

          The military at the time of the revolution was disbanded between wars or emergencies, only called to active duty when needed. In the modern world, the US Military is necessarily active at all times, protecting your freedoms. They deserve your thanks. And you don’t need an assault weapon.

Save a tooth. Prevent brain injury. It's easy.

     This is an 8.5x11handout I made. The woman's picture is in the public domain. The dentist who took the mouth guard picture gave me permission to use it. Please copy and spread around. Having had two central incisors broken off , I can empathize with kids who are teased if they lose a tooth.



Friends,
      I am hoping that all of you will send this to all of your email contacts (and they do the same), especially those who have children or grandchildren who play any sport in which they could take an elbow, foot, shoulder, head, or ball to the face; or fall to the ground or floor face first.
      Loosing a front tooth can be devastating to a child's self-image, especially if his parents cannot afford to replace it.
      Repeated concussions can lead to serious brain injury.
      The soft plastic cushion absorbs energy.  It does not interfere with breathing or playing sports.
      The woman's picture is in the public domain.  The mouth guard picture was lent to me by a dentist.  This handout should print out on an 8.5 x 11 inch sheet of paper if you want to print it and hand it out at practices.
      Thanks.

Bill Yancey, MD