Medical Journal: 10/28/18

Had a moderately rough time in Prague, but suddenly today I’m feeling better: not normal, but better. As of this morning, I seem to be able to croak rather than whisper reliably, which makes a huge difference. And I just spent an hour on my feet in the Rijksmuseum without undue strain. Was going to cut my trip short by two days; now I’m shooting for one.

Where Is Blaise Pascal When You Really Need Him?

Both the Washington Post and the New York Times have reported that the Trump White House refused to approve the written testimony of Dr. Rod Schoonover for entry into the permanent Congressional Record. Dr. Schoonover had testified on Wednesday before the House Permanent Select Committee on Intelligence on the dangers that climate change poses to the security of the US.

Both the Post and the Times had links to the MS Word document of
Dr. Schoonover’s comments complete with the editorial comments of the WH censors reviewers. I have posted a copy of that document here. (I have added the RBC “Seal” and OCR’d the document.) Reading the document is more alarming than the fact of the suppression of Dr. Schoonover’s comments. It reveals a White House or NSC staff that is dominated with climate-denier ideologues.

For instance, one comment reads:

[T]here is nothing exceptional about current climate and it is profoundly incorrect to say that ‘characteristics of global climate are moving outside the bounds experienced in human history.” There was faster and greater Medieval warming around the year 1000 when Norse settled southern Greenland and developed a thriving agricultural society.

BJME 3.

The blog Skeptical Science shoots a hole in that nonsense:

Firstly, evidence suggests that the Medieval Warm Period may have been warmer than today in many parts of the globe such as in the North Atlantic. This warming thereby allowed Vikings to travel further north than had been previously possible because of reductions in sea ice and land ice in the Arctic. However, evidence also suggests that some places were very much cooler than today including the tropical pacific. All in all, when the warm places are averaged out with the cool places, it becomes clear that the overall warmth was likely similar to early to mid 20th century warming.


Since that early century warming, temperatures have risen well-beyond those achieved during the Medieval Warm Period across most of the globe.  The National Academy of Sciences Report on Climate Reconstructions in 2006 found it plausible that current temperatures are hotter than during the Medieval Warm Period.  Further evidence obtained since 2006 suggests that even in the Northern Hemisphere where the Medieval Warm Period was the most visible, temperatures are now beyond those experienced during Medieval times  (Figure 1).  This was also confirmed by a major paper from 78 scientists representing 60 scientific institutions around the world in 2013.


Secondly, the Medieval Warm Period has known causes which explain both the scale of the warmth and the pattern. It has now become clear to scientists that the Medieval Warm Period occurred during a time which had higher than average solar radiation and less volcanic activity (both resulting in warming). New evidence is also suggesting that changes in ocean circulation patterns played a very important role in bringing warmer seawater into the North Atlantic. This explains much of the extraordinary warmth in that region. These causes of warming contrast significantly with today’s warming, which we know cannot be caused by the same mechanisms.

However, at the center of the WH attack is the “uncertainty principle.” That is, the proposition that we cannot act on the threat of global climate change because it is possible that our conclusions are not airtight. Thus, they include this quote from Syukuro “Suki” Manabe: “Don’t put your model in a race with nature. Your model will lose this race.” The quote is literally accurate but taken out of context. What Manabe did in his work was to simplify his models, taking out complexities and, thereby, isolating specific factors in climate change. See here. Manabe believes in the reality of CO2 driven climate change and the basic accuracy of climate models.

Finally, we get to Blaise Pascal and his famous wager. In its most simple form, Pascal posits that we cannot by human reason either prove or disprove whether God exists. He points out that if a wager was between the equal chance of gaining two lifetimes of happiness and gaining nothing, then a person would be a fool to bet on the latter. He then concludes that it is irrational to risk an eternal life of happiness for the possibility of gaining nothing. (“If you gain, you gain all; if you lose, you lose nothing.”) (I’m certain that many of the members of the RBC would jump on me if I did not point out that one of the flaws in the wager is that there are many competing gods and that one cannot, using human reasoning, prove which is the true god.)

But that’s not the choice we face in addressing global climate change.

First, modeling, while not perfect, allows us to fairly accurately compute the future temperature rise and rise in ocean acidity due to CO2 buildup. Thus, we are out of “coin flip” territory. The probabilities of a disastrous outcome are, if not certain, very high.

Second, we can assess our costs, but downside and upside, with some degree of accuracy. We have projections of populated areas that are threatened by sea rise, species that are at risk of extinction, and the geographic shift of areas that can be used in agriculture.

Basically, Pascal basic approach was correct. Weigh the upside against the downside. He was in error in assessing the upside (i.e., that there are many competing gods) and could not calculate the probabilities involved. We are not so limited. Except in the White House.

Feline asthma

Cat asthma as a political argument to Republican pet owners.

This is about public policy, promise.

My elderly cat Hobbes now has a respiratory problem, as I do. It’s probably feline asthma. Cats get asthma like humans, while dogs don’t. One cause, say vets, is air pollution.

Credit: MeowValet on YouTube

The literature seems stronger on indoor air pollution than outdoor. Second-hand tobacco smoke is a culprit, as are wood fires and incense. I found a serious controlled Taiwanese study on indoor pollution making the link. The effect of outdoor pollution has been less studied for animals. One Mexican study creepily found similar lesions in the brains of big-city dogs to those found in humans with Alzheimer’s.

It seems safer just to rely on the parallelism in the symptoms and mechanisms of cat and human asthma, and the massive literature connecting the human form to air pollution, to conclude that all air pollution is bad for cats too. The effect is reinforced by the height difference: cats and dogs breathe in air at car exhaust level.

This hypothesis suggests a political strategy. In the USA, there are said to be 49.2 million households with a cat. There are 50.4 million with children under 18. That’s 39% each. I couldn’t find a combined breakdown, but let’s assume that the two are independent. That would give 30 million childless households with a cat. The real total will be different, but it’s still a very large number.

This demographic skews old, white and therefore Republican. It cares for its cats. It strikes me as a good argument to make to this group in favour of the energy transition and the GND that the policy will protect the health of their pets.

Some will say: this is ridiculous. Are there really a non-trivial number of voters who will be swayed by the health of cats but not the health of children? If there are, surely they are either “low-information voters” – idiots – or moral imbeciles, and lost causes in either case?

My answers are (a) quite likely and (b) no.

Let me make the case for the defence. The questions are linked by the broader issue of moral myopia.

Continue reading “Feline asthma”

Weekend Radio Show Recommendation

You read that arightly, I am recommending a radio drama rather than a film this week: 1938’s War of the Worlds (click here to listen). To the extent people have heard of it at all, they know it as the show that allegedly drove America into a national panic about invading Martians (in truth, very few people actually listened to the broadcast). What it ought to be remembered for is its high level of artistic achievement.

The radio play was performed by the Mercury Theater troupe founded by two wildly talented people: Orson Welles and John Houseman.
Howard Koch, who later became justly famous as the co-scripter of Casablanca, gets the credit for brilliantly adapting H.G. Wells’ novel to radio in a fashion that took advantage of everything the medium and the Mercury Theater company could do. The novel’s rather lengthy set-up chapters and some of its clunky plot development (i.e., having the narrator run into someone who provides crucial information) were a function of the book being told through the eyes of a single narrator. In contrast, staged as a fake news broadcast with scattered, breathless, reports coming in as the Martians wreak havoc, the radio play grips you by the throat immediately and gives the listener a range of details from different geographic locations in an utterly realistic fashion.

Radio also of course opens up opportunities to add sounds — the screams and footfalls of panicked crowds, the horrible, metallic, unscrewing of the Martian cylinders, and the terrifying zzzaaapppp of those heat rays! It’s high craftmanship that still leaves us the fun of imagining how it all looked.

Last, but not least, what an explosion of talent this troupe of actors represented! Not just the big names, but also people like Ray Collins, Dan Seymour, Kenny Delmar, and Frank Readick. They are all perfect at creating characters with voice alone, each of whom seems like a real human being responding to out of this world events. Some New York theater fans were disappointed when talented, stage-trained actors they admired began transferring to new, middle brow, media like radio and film, but the upside was that the whole country and indeed the whole world got to enjoy the dramatic gifts and skills of companies like the Mercury Theater.

I loved listening to radio play as a kid (the image above is of the record album of it my parents had) and it’s just as suspenseful and exciting for me today. War of the Worlds is in the public domain so you can give it a listen anytime. You won’t regret it.

p.s. If you want to see a film version of the same story, Walt Disney’s 1953 version provides way more entertainment value that Spielberg’s grim and weirdly lifeless, gazillion-dollar version.

Medical Journal: 9/14/18

Showed the swelling in my feet to Dr. SanFilippo, the radiation oncologist, at my weekly check-in with him Tuesday. He was very concerned, especially about the fact that the right foot was more swollen than the left. Diagnosis: possible blood clot in the thigh, with some risk that a piece of clotted blood would break off and lodge in the lung (very, very bad). Recommendation: a sonogram. This was a big problem for me, since I had a train to catch for an important meeting in Albany, but he was pretty insistent that the test couldn’t wait. The folks in that unit browbeat the imaging group into seeing me quickly.

The test is administered by a technician, not an M.D. According to the rules, he couldn’t tell me the results; that ritual is reserved for the priesthood. But he told me in advance that if he found a clot I would be on my way to the E.D. for a shot of blood thinner, and when the exam was done he said “You’re going home.”

Made the trip to Albany and back with no significant problem. Spectacularly successful meeting; now more likely than not that New York will create the first cannabis legalization program designed to protect public health.

Fortunately, my voice, which comes and goes, was reasonably strong at the meeting; sometimes it’s just a whisper. Dr. SanFilippo assures me both that I won’t lose my voice entirely and that it will recover fully. In the meantime, the telephone is a challenge.

There’s no doubt that hydralazine/isosorbide combination is helping with the shortness-of-breath problem, but the problem is still there, especially at night, and my exercise capacity remains alarmingly low. Even in advance of getting through to Dr. Weiss, I had boosted the isosorbide (which seems to give quick relief and which doesn’t have to be taken with food) from three a day to four a day.

Needed sedatives to sleep Wednesday night and last night, but they’re working. Wednesday was very bad; I had work to do Thursday morning that I wanted to be alert for, so I tried to get through the night without anything until I finally gave up at 3:30. Happily, what I took was Tramadol, and the major aftereffect was that I was cheerful all day. Last night it was oxycodone and Ativan, which left me a little bit draggy this morning.

The throat irritation is either getting less marked over time or I’m getting used to it.

The cramps responded well to some stretching Gary Emmett recommended plus being careful about my position when I lie down to read.

Finally got through to Dr. Weiss this morning, who agreed that boosting the isosorbide dose was safe. He’d like to get more aggressive, but most of what he could get aggressive with has kidney risk associated, so he’s going to have to compare notes with Dr. Bomback before proceeding. After the kidney numbers went South Dr. Bomback recommended that I stop taking hydrochlorothiazide (a diuretic) and Losartan (which controls blood pressure through some other mechanism I don’t understand). It’s possible that the rapid deterioration in heart function reflects no longer being on those meds. I haven’t asked whether it might also or instead be a side effect of the two stress tests; the timing raises that question. Dr. Weiss seems to think that he’ll be able to manage the problem. I certainly hope so, because the lack of cardiac capacity is now seriously limiting daily activities and the intermittent shortness of breath is quite frightening and distressing.

Lowry Heussler is staying with me now, and Mike O’Hare and Debby Sanderson will be here next week.

The Queen of Hearts

From today’s Meet the Press transcript, a portion of the colloquy between Chuck Todd and Sarah Sanders:

CHUCK TODD:
Well it sounds like you’re not — that’s my point. It doesn’t sound like you want him to do his job. It sounds like you, the president has already determined the outcome.
SARAH SANDERS:
Chuck, that’s the reason that he’s granted the attorney general the authority to declassify that information, to look at all the documents necessary is so that we can get to the very bottom of what happened. Once again, we already know about some wrongdoing. The president’s not wrong in that. But he wants to know everything that happened and how far and how wide it went.

I’ve posted the entire Sanders portion of the Meet the Press transcript here.


5 U.S.C. § 3(a) and (b) provide as follows:

§ 3. Appointment of Inspector General; supervision; removal; political activities; appointment of Assistant Inspector General for Auditing and Assistant Inspector General for Investigations
(a) There shall be at the head of each Office an Inspector General who shall be appointed by the President, by and with the advice and consent of the Senate, without regard to political affiliation and solely on the basis of integrity and demonstrated ability in accounting, auditing, financial analysis, law, management analysis, public administration, or investigations. Each Inspector General shall report to and be under the general supervision of the head of the establishment involved or, to the extent such authority is delegated, the officer next in rank below such head, but shall not report to, or be subject to supervision by, any other officer of such establishment. Neither the head of the establishment nor the officer next in rank below such head shall prevent or prohibit the Inspector General from initiating, carrying out, or completing any audit or investigation, or from issuing any subpena [sic] during the course of any audit or investigation.
(b) An Inspector General may be removed from office by the President. If an Inspector General is removed from office or is transferred to another position or location within an establishment, the President shall communicate in writing the reasons for any such removal or transfer to both Houses of Congress, not later than 30 days before the removal or transfer. Nothing in this subsection shall prohibit a personnel action otherwise authorized by law, other than transfer or removal.

5 U.S.C. § 3(g) provides as follows:

Each Inspector General shall, in accordance with applicable laws and regulations governing the civil service, obtain legal advice from a counsel either reporting directly to the Inspector General or another Inspector General.

The “investigation” being undertaken by Bill Barr at the direction of Trump is nothing more than a de facto removal from office of the Inspector General of the Department of Justice. When, as Sarah Sanders says, “we’re going to let the attorney general make that determination [of whether James Comey committed treason and should be arrested] as he gets to the conclusion of this investigation” (lines 95-99), what she is saying is that the Trump Administration is intentionally violating 5 U.S.C. § 3(g). That section goes to the core of the independence of the Inspector General. It makes it clear that the Inspector General can only seek legal counsel from an attorney who reports directly up the line to the Inspector General, not the head of the agency that the Inspector General is charged with overseeing.

 “Let the jury consider their verdict,” the King said, for about the twentieth time that day.
“No, no!” said the Queen. “Sentence first–verdict afterward.”
“Stuff and nonsense!” said Alice loudly. “The idea of having the sentence first!

Alice in Wonderland, by Lewis Carroll : Chapter XII

Shortly after that passage, Alice awoke:

‘Oh, I’ve had such a curious dream!’ said Alice, and she told her sister, as well as she could remember them, all these strange Adventures of hers that you have just been reading about; and when she had finished, her sister kissed her, and said, ‘It was a curious dream, dear, certainly: but now run in to your tea; it’s getting late.’ So Alice got up and ran off, thinking while she ran, as well she might, what a wonderful dream it had been.

Somehow, I don’t think that we will soon awaken from this dream. Certainly, we will not view it in retrospect as a wonderful dream.

Another Win for Original Intent

Tonight, the United States District Court for the Northern District of California (Gilliam, J.) issued an injunction as follows:

Defendants Patrick M. Shanahan, in his official capacity as Acting Secretary of Defense, Kevin K. McAleenan, in his official capacity as Acting Secretary of Homeland Security, Steven T. Mnuchin, in his official capacity as Secretary of the Department of the Treasury, and all persons acting under their direction, are enjoined from taking any action to construct a border barrier in the areas Defendants have identified as Yuma Sector Project 1 and El Paso Sector Project 1 using funds reprogrammed by DoD under Section 8005 of the Department of Defense Appropriations Act, 2019.

Slip op. at 55

The court’s reasoning is succinctly summed up in the conclusion of the opinion as follows:

Congress’s “absolute” control over federal expenditures—even when that control may frustrate the desires of the Executive Branch regarding initiatives it views as important—is not a bug in our constitutional system. It is a feature of that system, and an essential one. See [U.S. Dep’t of Navy v. FLRA, 665 F.3d 1339 (D.C. Cir. 2012)] at 1346–47 (“The power over the purse was one of the most important authorities allocated to Congress in the Constitution’s ‘necessary partition of power among the several departments.’”) (quoting The Federalist No. 51, at 320 (James Madison)). The Appropriations Clause is “a bulwark of the Constitution’s separation of powers among the three branches of the National Government,” and is “particularly important as a restraint on Executive Branch officers.” Id. at 1347. In short, the position that when Congress declines the Executive’s request to appropriate funds, the Executive nonetheless may simply find a way to spend those funds “without Congress” does not square with fundamental separation of powers principles dating back to the earliest days of our Republic. See City & Cty of San Francisco, 897 F.3d at 1232 (“[I]f the decision to spend is determined by the Executive alone, without adequate control by the citizen’s Representatives in Congress, liberty is threatened.”) (internal quotation marks and brackets omitted) (quoting Clinton, 524 U.S. at 451) (Kennedy, J., concurring). Justice Frankfurter wrote in 1952 that “[i]t is not a pleasant judicial duty to find that the President has exceeded his powers,” Youngstown, 343 U.S. at 614 (Frankfurter, J., concurring), and that remains no less true today. But “if there is a separation-of-powers concern here, it is between the President and Congress, a boundary that [courts] are sometimes called upon to enforce.” E. Bay Sanctuary Covenant, 909 F.3d at 1250; see also Ctr. for Biological Diversity v. Mattis, 868 F.3d 803, 825–26 (9th Cir. 2017) (“To declare that courts cannot even look to a statute passed by Congress to fulfill international obligations turns on its head the role of the courts and our core respect for a co-equal political branch, Congress.”). Because the Court has found that Plaintiffs are likely to show that Defendants’ actions exceeded their statutory authority, and that irreparable harm will result from those actions, a preliminary injunction must issue pending a resolution of the merits of the case.

Slip opinion at 54-55.

I have posted a copy of the opinion here.

Emergency Etiquette Help Needed

I am a past chair of the Section of Taxation of the Maryland State Bar Association. Tonight, May 22, the Section will be holding its annual dinner. The keynote speaker is the current I.R.S. Commissioner, Charles P. Rettig. I will be in attendance.

An article appeared in today’s Washington Post, revealing that there was a memo (perhaps simply a draft), that concluded that the Secretary of the Treasury does not have the authority to deny a request for taxpayer returns from the House Ways and Means Committee. Here’s a copy of the memo. I don’t have quick access to the relevant documents right now, but I’m am fairly certain that the obligation to enforce the tax code has been delegated to the IRS Commissioner and that this delegation order has (i) not been revoked and (ii) cannot be revoked except upon thirty days’ notice, which notice has not been made. So, Mr. Rettig would seem to be under a specific legal obligation to honor the Ways and Means Committee’s request.

Now, I try to remain civil and non-confrontational in face-to-face interactions. (My internet interactions are, um, somewhat different.) This leaves me in a bit of a quandary that I am hoping members of the RBC can help me resolve. Should I:

  • Question Mr. Rettig about the issue in a semi-confrontational matter (“Isn’t it true, Mr. Commissioner that . . . .”)
  • When Mr. Rettig is called to the rostrum, ostentatiously turn my back to him.
  • When Mr. Rettig is called to the rostrum, ostentatiously leave the room.
  • When Mr. Rettig is called to the rostrum, quietly and unobtrusively leave the room.
  • Simply maintain the ordinary sort of courtesies expected in such social and professional situations (ala Nancy Pelosi in her recent meeting with Attorney General Barr), remaining in the room and politely applauding Mr. Rettig after he finishes his remarks.
  • Any other suggestion?

I note that while I have never meet Mr. Rettig, I know a good number of my colleagues who have. They are unanimous in their appraisal of him that he is an intelligent, decent, and honorable man.

Shopping for a Comfortable Coach Airline Seat? Consider the ASSPHIT.

Here’s a travel tip you don’t hear every day: Can you guess how I upgraded all my ticketed airplane seats from basic to premium economy for free? I lost 20 pounds. With two inches taken off my waist, the spacing between me and the arms of my seat has increased to a level I could normally only get by paying for an upgrade. My personal journey of weight loss inspired some research that can benefit any cost-conscious flier, particular those who, like myself, have experienced being “gravitationally challenged.”

Passengers frequently rage at the airlines for restricting seat sizes, and with good reason. Data gathered by former Consumer Reports Travel Letter editor Bill McGee, supplemented by some research I did using Seatguru.com while wedged into seat 47Q, shows that the smallest seat width in coach class across American, Delta, and United Airlines declined around 15% over the past three decades.   

But examining airline seat size decline in isolation understates the march of rear-end pinch. Even if seat size had stayed constant, flying would still feel more uncomfortable because the proportion of Americans who are overweight swelled from 55% in 1989 to about 73% today. Clearly, the nation needs a new statistic to assess the combined impact of smaller seats and bigger (cough) seats. I therefore charted the ratio of minimum coach seat width to the proportion of U.S. adults who are overweight.  At the risk of being cheeky, I label this variable the Airline Seat Size to Passenger Heftiness Index Tracker (ASSPHIT), which reveals a startling 36% decline in posterior comfort over the past three decades. 

The extraordinary ASSPHIT of the first class section is mainly for the corporate traveler; what’s the best coach class choice for the corpulent traveler? Delta Airlines, with minimum ASSPHIT of .23 (and even better ASSPHIT on most of its airplanes) is your best bet among legacy carriers. In contrast, one of the seat configurations of a particular United Airlines narrow body jet offers a minimum coach width of just 16 inches. Even if you have a narrow body yourself, that’s one tight ASSPHIT.

As for my recent success at improving my personal ASSPHIT, the hard fact is that most people who lose weight gain it back again. Given how often I fly, I am hoping to beat those odds. I know I have your good wishes, particularly if you are crammed into the seat next to me.