My final blog on Mr. Trump

I think one of the best thoughts on the candidacy of Mr. Trump came from John Bogle, the founder of  Vanguard funds and a man of about my age.  He says "I am going to vote for Ms. Clinton because she represents a risk I think I can understand."

Police and Racism

Police and Racisim

I watched President Obama’s excellent speech at the memorial service for the Dallas policemen.  The major issue is race relations.   Racism is very much with us and it doesn’t seem to be improving in spite of all the attention and money given to it.  I must admit that I personally have done nothing specific to improve race relations. I have always shown respect to persons of color and treat them cordially.  I have trusted in our Federal government and state and local officials to deal equitably with all peoples and provide whatever public support is available. What can I/we do at the present time to improve race relations?

I think back to Rodney king 25 plus years ago.  I watched that video of him being beaten by white police officers.  “Why are the police beating him up in this fashion?  If he has committed some serious offense, put him in the paddy wagon and take him to jail.  What is accomplished by beating him up?”  I think the police were meting out their own punishment as a lesson to Rodney as well as any other black youth that might be watching.  We saw this same approach in Ferguson, MO.   Pulling black youth over for minor auto infractions is the same as beating up Rodney King.  I see a pervasive negative ATTITUDE between both the black youth and the police.  Each believes the other side is the enemy.  These attitudes have become embedded in our society.  Here is what Swindoll says about Attitude:

“Attitude is more important facts.  It is more important than the past, than education, than money than circumstances, than failures, than successes, than what other people think or say or do.  It is more important than appearance, giftedness or skill.  It will make or break a company, a church…a home (or a country—my words).  The remarkable thing is we have a choice every day regarding the attitude we will embrace for the day.  We cannot change the past…we cannot change the fact that people will act in a certain way.  We cannot change the inevitable.  The only thing we can do is play on the one string we have, and that is our attitude.  I am convinced that life is 10% what happens to me and 90% how I react to it.  And so it is with you…we are in charge of our attitudes.”

 

I suggest we all begin to approach this race problem by first changing any negative attitudes we have toward the people of color and set an example by adopting a positive attitude in both comportment and speech as we enter a new chapter in race relations in our country

More on Guns

MORE ON GUNS

Three things happened to me today concerning guns.  First, I was cleaning out old files and came across a clipping from the Sacramento Bee on Sunday December 13, 2015 after the San Bernardino killings, written by Mr. Garen Wintemute.  The title “End to gun killings requires our passion and Persistence.”  He pointed out the shootings  at Columbine, Virginia Tech, Aurora, Sandy Hook and San Bernardino resulted in 97 deaths not counting the shooters.  He went on to point out that in the 10 years ending in 2013 we lost 89 people PER DAY to firearm homicide and suicide.  In the same 10 year period we lost more civilians to firearm violence than we lost in combat in World War II—more than we lost in combat during all other conflicts in our nations history.  I have to ask, when do these kinds of figures begin to sink in to our thinking.  My own father committed suicide using an WW II 45 caliber pistol.  I refuse to have a handgun in the house for fear I’ll injure myself or one of my family.   SECOND:  The Bee carried an article today “Australia Law may offer US a Lesson.”  Australia passed a law in 1996 following a mass murder of 35 people and wounding of 19 others.  They passed the National Firearm Agreement, banned with a mandatory buyback of semi-automatic rifles like those used recently in the US.  They bought back thousands of rifles and handguns.  Since then there hasn’t been a single mass shooting of more than 5 people.  Is Australia safer?  Who knows, but in my view the results speak for themselves.  THIRD, the House Democrats staged a sit in trying to force the Republicans to vote on the gun issue.  What goes around comes around.  Obama has only himself to blame.  He forced Obama Care through congress  without ONE Republican vote.  The Republicans got the message immediately that dealing with Obama and the democrats was going to be bare knuckle politics.

HOWEVER, reason has to prevail for the good of the country and the Republicans need to compromise and reach a satisfactory conclusion to this gun problem.  The NRA is in an untenable position.

                                                    Mr. Trump and Judge Curiel
The unprovoked outburst of Mr. Trump at Judge Curiel again tells a lot about Mr. Trump but nothing about judge Curiel.  First, Mr. Trump never apologizes; second, he never forgives;  third, he never forgets and fourth he never never wrong and if things go south it is not his fault.  He is quite paranoid.  He is unable to take any criticism  and call all who might oppose him "losers" or even worse names.  He is vindictive.  I am unable to respect a man with these qualities.

Asking Mr. Trump to lead our country without any sort of a plan is akin to asking him to perform major surgery on a patient even though he never went to medical school or had surgical training.  He could say he will know what to do when he gets there, which is his frequent reply.

I take Mr. Trumps campaign very seriously and ask all my friends to consider if he represents the kind of man they want to lead and UNIFY our country as we struggle to meet the demands of modern day society

More on Mr. Trump

A few months ago I wrote a blog about Mr. Trump and compared his rise in popularity to that of Hitler after lWW I.  This week one of the members of our Sacramento bike club, David Kirk, wrote a long treatise on the dangers posed by Mr. Trump comparing his rise to power as similar to that of Hitler and Mussolini.  He very eloquently details the issues here and how the german and italian people were taken in by his message of power to correct all ills and make “Germany Great Again.”

I am greatly alarmed by Mr. Trump and believe his message represents a real and ever present danger to our country and our cherished freedoms and institutions.  He must not be elected to the presidency.   Mr. McConnell, Republican leader of the senate, stated this week that he supports Mr. Trump and thinks there are enough checks and balances to prevent him from doing too much harm.  I disagree with that assessment.  The executive branch has almost unlimited power to do what they want to do.  Look at all the upstanding citizens he has threatened this week.  I do not visualize his approach or attitude will change if he becomes president.

I want to call everyone to think seriously about the threats posed by Mr. Trump and to do whatever you can to prevent him from being elected to the presidency.  The Sacramento Bee published an article today by Adam Liptak of the New York Times “Scholars  say Trump threatens the rule of law” and he suggests the checks and balances will not be enough to stop Mr. Trump.  Mr. Trump is not a good man and he threatens everything we stand for as Americans.  Lets make great use of the social media to prevent him from becoming president.

To access this blog go to Frinkscorner.blogspot.com.  To make a comment go to the bottom of the page and click on NO COMMENTS.  The NO refers to number of comments and not that you should not comment.

WHAT TO EXPECT IN THE EMERGENCY ROOM

WHAT TO EXPECT IN THE EMERGENCY ROOM

The treatment of a heart attack has changed dramatically in the past 20 years.  Heart attack patients are no longer admitted to the hospital to be observed and kept at bedrest for two weeks.  Emergency rooms (ER) are now designed to place heart attack patients on a fast-tract to immediate, interventional, treatment.

A heart attack is caused a thrombotic (a blood clot) obstruction of one of the coronary arteries.  The chest pain associated with this obstruction is due to injury or damage to the heart muscle supplied by that artery.  The heart attack may be large or small, but all heart attacks are serious and are treated similarly.  There are no “mild” heart attacks.  Injured heart muscle can recover, but dead heart muscle cannot.  The aim is to reduce heart muscle damage by restoring blood flow in the affected artery.  Blood flow is restored by opening the artery and getting rid of the blood clot (thrombus) with a tiny balloon catheter in a Catheterization Laboratory (Cath Lab).  The longer the artery is obstructed the greater will be the heart muscle damage so we want to go to the cath lab as quickly as possible.  The aim, in ideal circumstances, is to open the artery within 90 minutes of the onset of the chest pain. 

Once the cardiologist arrives in the ER and the diagnosis is established, the ER becomes a flurry of activity.  Laboratory work, x-rays, ECG, I-V fluids, and oxygen must be obtained and started.  The procedure must be fully explained to the patient and the family to get the necessary permits signed.  This is a difficult time for the patient and family because there is some risk in the cath lab.   There is also risk in not doing anything.  My advice is to sign the permits and get to the cath lab as quickly as possible.  This approach to the heart attack patient has been approved by the hospital and the medical staff and the results are closely monitored.  The goal here is to stop further cardiac muscle injury.  This is modern day cardiology .  See blogs 12 and 13. 

Summary:  If you suspect a heart attack, call 911 and get to the hospital as quickly as possible.  I will devote a later blog to help you recognize the type of chest pain associated with a heart attack to assist you in deciding whether or not to call 911. 

THE SMOKERS PARADOX

THE SMOKERS PARADOX

I receive, by email, the contents of leading cardiology journals as a way to keep up with the changes in cardiology.  I can download an abstract, or, in some cases, the entire article, free of charge.  Recently an article looked at the prognosis of smokers (S) and non-smokers (NS) who were successfully resuscitated from sudden cardiac death.  The results showed it was the S who had a better survival than NS and the S were more apt to leave the hospital with brain function that was better than the NS.  This was called a S paradox because multiple studies, including my own, show that S die of heart disease approximately 10 years sooner than NS, but have less extensive and less severe atherosclerosis.    The real question, not answered by the authors, is how can these results be explained in view of the accelerated plaque development in S.  

This is my explanation, based on what I have seen under the microscope.  I am assuming that the majority of these patients received CPR (cardio pulmonary resuscitation) which involves compressing the heart between the sternum and the spine.  Please remember that the heart is a midline structure and only protrudes into the left chest.  This explains why coronary chest pain is in the middle, not the left chest and why compressing the sternum compresses the heart.  Sixteen years ago I published a paper (J Invas Cardiol 1997:9;578-585) showing that CPR was associated with direct injury to the heart in the form of cracks in the coronary arteries.  In compressing the heart between the sternum and the spine you naturally compress the coronary arteries as well.  The coronary arteries become steadily more calcified as we grow older, making them more brittle.  Thus the coronary arteries in the younger age S are less calcified and more pliable and more easily compressed without injury compared to the older NS patient with more extensive calcification.   If the artery is injured and cracked and is unable to dilate or contract this will affect coronary blood flow and overall cardiac function.  Figure 1 shows a calcified (blue color on right side of photo) coronary artery with fracture and wall rupture in a 61 year old man.  Figure 2 is a fracture of a large calcified plaque with leakage of red injection mass into the artery wall.

I conclude that S do better than the NS after resuscitation from cardiac arrest, because the heart and the coronary arteries in the S are not as severely injured as the NS and they recover heart function and cardiac output more rapidly, resulting in less brain damage.  Smoking has no redeeming features and no one should start smoking on the basis of this recent report.

HOW DO PLAQUES GROW?

In our first blog, using coronary calcification as an illustration, I showed arteriosclerosis (AS) is a dynamic, active, progressive disease process.  AS, in many ways, is similar to tuberculosis.  Shown here is a cross section of a coronary artery of a patient who died of heart disease containing a plaque that narrows the channel of the artery about 50%.  I would not consider this to be serious narrowing.  The red color is dye material I have injected into the artery to get it fully distended.  The plaque is the white material to the right of the red color, showing the plaque affects only 1 side of the artery wall, leaving the other side unaffected.  This is a typical plaque.  

We call plaque growth the “proliferation” of tissue.  Proliferation is the initial response or the first sign of arteriosclerosis.  The reason plaques begin to grow is believed to be started by a small focal injury (unknown injurious agent) to an area of the artery wall.  The body responds to this injury by growing scar tissue.  We call this the “proliferative phase” of arteriosclerosis.  It is easy to see that as the plaque continues to grow it could, in the fullness of time, completely obstruct the artery channel.

SUMMARY:  AS is a chronic progressive disease, initiated by focal injury to the artery wall, followed by progressive growth and proliferation scar tissue.  The proliferation of tissue should be viewed as a defensive response or an attempt to heal the injury.  However this tissue is fatally flawed and in the fullness of time will undergo degeneration and destruction, resulting in an “Atheroma.”

To Be Continued.

ISSIS and Mr. Obama

Mr. Obama and ISSIS:  I am appalled by the response of our President to the Belgium terror attacks.  He continues to believe these attacks pose no significant threat to the U.S.  What can he be thinking?  We resect tiny cancers and ISSIS is certainly a cancer.  I want to ask him what kind of event will it take for him to call a spade a spade?  What is your response when someone declares war on you?  It is only a matter of time before we have another 9/11.  Think of all our huge athletic events where thousands are gathered.  Recently I saw a picture of the beautiful lobby of Grand Central Station in New York and thought that would be a wonderful target for a Jihadist.  We have no idea of what Mr. Obama has been doing that we know nothing about, but I am getting more and more concerned about his ultimate purposes.  I think we will find many disturbing things when he leaves office.  Basically I am not reassured by anything he says

Donald Trump

DONALD TRUMP

Most of us are having a hard time thinking about Mr. Trump.  I thought I would jot down some of my present day thoughts about him. 

My first real look at Mr. Trump was a film presented at the Palm Springs, CA film festival in January 2014.  The film documented his luxury home and golf course development on the Northeast shore of rural Scotland.  He had obtained permission to build this resort from the British Parliament, but the film did not go into the details of how he obtained this permission.  As I recall there was mention that the development would result in more jobs for the Scottish citizens.  Knowing Mr. Trump we can assume there was money involved at some point in the approval process.

The most revealing part of the movie was his attitude toward the long time, relatively poor, residents of this sparsely settled part of Scotland facing the North Sea.  These Scots had virtually no influence with the government and when they started to complain Mr. Trump was caught on film saying their objections were meaningless because they had no power to halt the development.  These were little people with no power and therefore no need for him to consider their complaint.  The vision I took away from this film was that of a brutal Capitalist with his boot on the neck of a defenseless person.  In other words, “a loser.”

It appears to me Mr. Trump is interested only in having the power to do all that he wishes.  We all admire strength and power appropriately managed, but Mr. Trump’s desire for power and adulation is pathological.  He is a vindictive person.  He hates to lose.  We all see through that.  When he lost Iowa, his first words spoken were that Mr. Cruz had “stolen” the election.  My reaction was “sour grapes” and losing is not his fault, but someone else.

His success in the polls has come from his motto “I am going to make America Great Again.”  As if America is not already great or that America is going in the wrong direction.  He has appealed primarily to the young and the relatively poor in our society, assuring them he will lead away from the approaching abyss.

Mr. Trump’s message and approach reminds me of the way Adoph Hitler gained control of destitute Germany following WW I.  He was going to make Germany great again, primarily by appealing to German youth and the jobless.  This comparison may sound a little far fetched, and perhaps it is, but not by much.  He admires Putin and the Chinese for the way in which they crushed those trying to make a more just society.  This is not the American way.

I am also reminded of the Joe McCarthy hearings of the early 50’s.  He destroyed thousands of careers by accusing people of being communists.  Again, it was power gone amuck.

I am hoping sensible Americans will sit back and take a good look at this man and his desire for personal power is not in keeping with an American president endeavoring to lead our country and the world in a difficult time.