After 28 years as a Fellow of the American College of Surgeons, I am done. Although it breaks my heart, I will no longer be Richard Bosshardt, MD, FACS. If you want to know why, read on.
When I was in my surgical training, I first noted that some of the attending surgeons had the initials, FACS after the MD behind their name. I learned that this stood for Fellow of the American College of Surgeons (ACS). The ACS represents all surgical specialties.
Fellowship in the College was more than just a matter of applying, paying a fee, and getting a certificate. To be considered, you had to have an unrestricted medical license and be board-certified in a surgical specialty by a member board of the American Board of Medical Specialties. You had to have been in a full-time practice in one location for at least one year. You had to have unrestricted hospital privileges and no reportable actions against you. You had to have references from two Fellows of the College. Once you were elected to Fellowship, there was a ceremony at the annual meeting of the ACS, very much like a graduation ceremony, in full cap and gown, at which new Fellows pledged to always adhere to, and uphold, the highest standards of surgical practice and always place the care of their patients first and foremost. (Please continue to page 2- see below)
The year was 1984. I was a chief resident in general surgery at the US Naval Hospital, Oakland, CA. I and my two co-residents were finishing the last of five years of training in general surgery. By now, we were functioning as nearly independent surgeons, operating on our own patients and helping train the residents behind us. We were allowed to operate without an attending surgeon present most of the time, but were expected to request assistance if we needed it on complex or difficult cases. By this time, we had enough knowledge and surgical experience to feel fairly confident in our capabilities.
Surgery is a strange amalgam of confidence coupled with humility. Confidence is a must in a profession where you are cutting people open as a matter of routine. Humility is equally important. People and the human body are simply too complex to be approached without some trepidation and with great respect. There has to be a balance, however. The over-confident surgeon is just as dangerous as the overly-timid one.
One of the traditions of our program, indeed, of most surgical training programs, was to send off the graduating residents with a banquet. It was attended by all of the residents and attending surgeons and their spouses. The graduates were toasted and roasted in equal measure in funny and, sometimes, embarrassing ways. For that evening, the general surgery service at the hospital was covered for emergencies by one of the other surgery services so that we all could attend and the day’s surgery schedule was shortened as well. For the graduating residents, it marked the transition from resident to attending surgeon and was highly anticipated.
“With Covid-19, we have thrown caution to the winds.”
I am no virologist, infectious disease specialist, or even a family physician, just a lowly plastic surgeon. Even so, friends, family, and even my own staff turn to me and ask what they should do about the Covid vaccine. Should they get it? Am I going to be vaccinated? I have reviewed this issue for a while to try to formulate a reasoned, evidence-based approach. Finally, I am ready to provide an answer. Happily, it is a validation of the approach I had already chosen for myself.
To begin, let’s review a little about vaccines in general and the Covid vaccine(s) in particular. My source? Dr. Paul Offit https://www.paul-offit.com/about-paul-offit-md, a pediatrician with impeccable credentials in the area of vaccines and co-discoverer of the rotavirus vaccine (more on this in a moment). My information came from a recent interview with Offit on the Peter Attia, MD podcast https://peterattiamd.com/pauloffit/.
The anti-vaccine movement stems from a fraudulent paper published in Lancet in 1998 by Dr. Andrew Wakefield and retracted soon thereafter, when it was proven that Wakefield falsified his data https://briandeer.com/mmr/lancet-paper.htm. The entire story can be accessed in the book, The Doctor Who Fooled the World, by Brian Deer. Suffice it to say that, despite a few residual outliers who simply refuse to accept the facts, it is a medical certainty that autism is not caused by vaccines, specifically in the case of Wakefield’s paper, the measle/mumps/rubella vaccine.
Offit worked for 26 years to develop a vaccine against rotavirus, which causes fever and diarrhea in children between 6 and 24 months of age. Before the vaccine, nearly every child in the US was infected by age 5, with 75,000 hospitalizations, mainly for dehydration, and 60 deaths annually. Worldwide, rotavirus killed 500,000 children per year. Offit made the point that a rotavirus vaccine that pre-dated his had a severe side effect that could not have been predicted, even by extensive studies, and was taken off the market within 10 months. This becomes important later, when discussing Covid vaccines.
To understand the unprecedented nature of the available Covid vaccines, you have to understand how vaccines are developed.
If you are like me, you are probably exhausted from all the discussion regarding the virus, SARS-CoV-2 and Covid-19, the illness it causes. A lot of discussion had understandably focused on the rate of serious illness and death from Covid. The rates of both have been frightening (although the true rates are not really known for many reasons not germaine to this post) and served as justification for unprecedented measures to end the pandemic. If it were not for that, Covid would have been regarded as just another annoying seasonal virus, little different from the other coronaviruses, rhinoviruses, RSV (respiratory syncytial viruses), parainfluenza, and others we have not yet identified. We live with those as a matter of course. We now have enough experience with the “novel” virus unleashed on the world by the Chinese Communist Party to know that it uniquely spares children, poses relatively little risk to healthy adults, and is most dangerous to adults over 70 years-old and those with certain chronic medical conditions.
Those conditions are medically termed co-morbidities and include illnesses such as cancer, heart disease, asthma and other lung problems, obesity, diabetes, immune-related conditions of every sort, kidney disease, and so on. Among them are four that are noteworthy because they are so common and so commonly associated with serious illness and death from Covid. These are obesity, type II diabetes, hypertension, and metabolic syndrome. The last is basically a melding of the first three. In addition to having in common the fact that they greatly increase the risk of serious illness and death from Covid is the fact that they are all largely preventable.
“If hypocrisy were currency, Democrats would be billionaires.”
Recent events have uncovered the unquestioned moral bankruptcy of the leadership of the Democratic Party, from the new administration on down. Dating this is not unlike trying to date some other antiquity; the origin tends to be lost in the mists of time.
I first took note of it during the Obama administration, but it really boiled to the surface during the Trump years. Something about The Donald sent democrats into a foaming frenzy, with calls for his impeachment even before he took the oath of office, including newly elected representative Rashida Tlaib’s rant on the floor of Congress, “Let’s impeach the mother*cker!” That frenzy never let up for the next four years overshadowing even major accomplishment of his administration. They never got beyond his admittedly boorish personality to look at what he was actually doing, some of it quite good. The nail in the coffin was the CCP virus and the pandemic, in which the administration could do nothing right and was blamed by the democrats and their mouthpiece, the mainstream media, for the many deaths, notwithstanding most seemed to come from states with democratic governors. This alone likely cost Trump a second term.
If hypocrisy were currency, democrats would be billionaires. Among other things, Trump was perhaps most accused of being boorish and uncivil, yet who can forget the spectacle of Nancy Pelosi tearing up the draft of the president’s State of the Union address in front of Congress? Trump now stands accused of inciting civil unrest in the wake of a relatively small mob of idiots storming the capitol building (while tens of thousands of peaceful protesters and Trump supporters were virtually ignored by the press), yet Pelosi and Kamala Harris are given a bye on doing exactly that during last summer’s “mostly peaceful” protests and riots. Democrats who accused Trump of being an autocrat, dictator, and threat to our constitutional freedoms now push for establishing enemy lists of Trump supporters and propose they be “re-educated”. Leading the charge is Alexandria Ocasio Cortez, the darling of the radical progressive left. The hypocrisy is so thick, you could cut it with a knife.
President Biden is on record as being against executive orders, going so far as to state, “This isn’t a dictatorship; you have to get the votes.” In a monumental irony that has not gone unnoticed, his first two weeks in office has been a frenzy of executive orders such that he now holds the record for more of them than any other president in such a short time span. He signed 22 in his first week, compared to 4 for Trump. Nearly all were clearly intended to reverse Trump’s policies, without regard to whether they had merit or not. Among them was a pledge to return to the discredited Paris Accords, cancellation of the Keystone pipeline with loss of thousands of jobs, a reversal of Trump’s progress in border security, cancellation of the 1776 project, resumption of indoctrination of federal government employees in critical race theory (which blames literally every wrong in society on racism and white oppression), and a likely reset of our relations with Iran, ignoring the gains made by Trump’s hard line against the rogue nation, and the unprecedented achievement of the Abraham Accords.
You would think, the democratic party would be satisfied at having defeated Trump and move on with their agenda to remake America in the image of a progressive, quasi (for now)-socialist state, but it is more than just morally bankrupt and hypocritical; it is also vindictive. It is not enough to have unsuccessfully impeached Trump while he was in office. Now, the goal is to impeach him after he has left, something never before attempted. Victor Davis Hanson has likened this to Achilles dragging Hector’s dead body around Troy, which had the unintended effect of making the unpopular Hector into a martyr. Hanson warns democrats of something they seem to have forgotten, “Americans hate one thing more than a sore loser, and that is an arrogant, vindictive- and bullying- winner.” Trump may be a billionaire, but against the might of the federal government, who is the bully now?
In accusing Trump and Trump supporters of being immoral, or worse, it seems democrats are simply upset that someone else is swimming in their pool.
“You are not entitled to your opinion. You are entitled to your informed opinion. No one is entitled to be ignorant.” Harlan Ellision
This is going to be a long one. I am stepping way out of my comfort zone on this one, but I consider it a good object lesson on being careful about opining on things you know nothing about. For me, one of those things is finances, Wall Street, and the stock market. Toss hedge funds and things like short sells into my bag of ignorance. When I heard about the short selling of Gamestop and the alleged David versus Goliath shake up of Wall Street, my first impression was “Go, David!”. There is something satisfying about “sticking it to The Man” and, since the debacle of 2008, Wall Street has been on many people’s sh*t list because of the perceived inequities between big Wall Street firms and its major players and us, the little guys. On the other hand, as the analysis below shows, “we” are Wall Street. If we take it down, what happens to all the retirement accounts, pension plans, and savings of those of us who are not millionaires and just trying to build a nest egg for the future? When the dust settles billionaires and companies may have been stung, perhaps a few even bankrupted, but at what cost? A few gamers, or “retards” as they call themselves, may have made a lot of money, but the rest of us will be left with little, if anything, to show for all the fireworks.
Most people will never read beyond the mainstream media and online reports. Read on if you want to read an insider’s analysis and educate yourself. If you find yourself overwhelmed- it is in depth- just go to the bold, italicized sections, which are the heart of the matter, rather than the nuts and bolts. Enjoy
“A resolution is a promise to yourself that you haven’t broken….yet“
Now that the New Year has been rung in, leaving behind a year like no other, what next? If you are like me and most other people, you have probably made some resolutions for the New Year. The beginning of a new year is a natural starting point for making changes, which is undoubtedly why the tradition of making resolutions began. My definition of a resolution is a promise you make to yourself that you haven’t broken…. yet.
Breaking resolutions is as much a tradition as making them. I think many people set themselves up for failure. There are a number of principles that can help you to keep resolutions in 2021.
“And if everything we do saves even a single life, I’ll be happy. New York Governor Andrew Cuomo
Let me preface this post by saying that the pandemic is real and serious. All deaths due to the virus, directly or indirectly, are tragic and cause for making our best effort to mitigate the effect of the virus. Mitigation, however, must take into account much more than simple raw numbers. We must understand what the numbers mean and how best to apply them to a coherent, effective public health policy. Even those who advocate continued and more stringent lockdowns admit that the cost of these has been devastating, both to the economy as a whole and in human lives lost or otherwise destroyed. As we are blasted with ceaseless headlines regarding a deadly second, and even a third, wave of Covid cases, there is a pressing need for some sense of proportion on the pandemic.
I could hardly believe my eyes and ears. After months of shaking my head and saying to myself (and others) “this doesn’t make sense. It makes no sense,” others are beginning to do the same and openly declaring some scientific truth in the discussion of Covid-19 and our unprecedented response to it. It strikes me a bit like the story of the emperor’s new clothes where people were hesitant to openly state the emperor had no clothes on for fear of being ostracized by their friends, colleagues, and family for going against the conventional opinions. I would say conventional wisdom but for the fact that true wisdom seems to have been sadly lacking in much of the discussion of the current pandemic and what to do about it.
We have been given basically two choices. One is to lockdown the country, socially distance everyone from children to the elderly, wear masks everywhere, and cower fearfully in this fashion until we are rescued by a vaccine. The second is to open up the country and risk millions of dead. To advocate the second choice was regarded as political suicide by politicians, professional suicide for clinicians, and social suicide for citizens. Those of us who claimed there was a better way were regarded as callous, cruel, even homicidal by some. To even suggest we allow herd immunity to develop was tantamount to saying we wanted to kill off the old and infirm, never mind that the lockdown has likely killed more people than the virus.
“Social media has such an outsize presence and influence in our daily lives that it has become the proverbial elephant in the room.”
Don’t throw the baby out with the bath water. Everyone knows what this means. In discarding something bad or undesirable, take care that you do not throw out aspects that are good or desirable. Few things are totally bad or totally good. Much of life is nuanced in this fashion.
When it comes to social media, the term would more appropriately be: don’t throw out the elephant with the bath water. Social media has such an outsize presence and influence in our daily lives that it has become the proverbial elephant in the room.