Exploring Human Potential

Abigail Adams Message To Clarence Thomas

Posted on | December 13, 2022 | 6 Comments

Mike Magee

“We the People of the United States, in Order to form a more perfect Union, establish Justice, insure domestic Tranquility, provide for the common defence, promote the general Welfare, and secure the Blessings of Liberty to ourselves and our Posterity, do ordain and establish this Constitution for the United States of America.”

This striking and sweeping statement of values, the Preamble to our Constitution, was anything but reassuring to the wives, mothers, sisters and daughters of the Founding Fathers. Abigail Adams well represented many of them in her letter to John Adams in March, 1776, when she wrote:

“Remember the Ladies, and be more generous and favorable to them than your ancestors. Do not put such unlimited power into the hands of the Husbands. Remember all Men would be tyrants if they could. If particular care and attention is not paid to the Ladies we are determined to foment a Rebellion and will not hold ourselves bound by any Laws in which we have no voice or Representation.”

Her concern and advocacy for “particular care and attention” reflected a sense of urgency and vulnerability that women faced, and in many respects continue to face until today, as a result of financial dependency, physical and mental abuse, and the complex health needs that accompany pregnancy, birth, and care of small infants.

The U.S. Constitution is anything but static. In some cases, the establishment of justice, or the unraveling of injustice may take more than a century. And as we learned in the recent Dobbs case, if the Supreme Court chooses, it may reverse long-standing precedents, and dial the legal clock back a century overnight. 

Roe v. Wade was a judicious and medically sound solution to a complex problem. Perfection was not the goal. But in the end, most agreed that allowing women and their physicians to negotiate these highly personalized and individualized decisions by adjusting the state’s role to the reality of the 1st, 2nd, and 3rd trimester made good sense. But getting physicians to step forward and engage the issue was neither simple nor swift.

In July, 1933, McCall’s magazine published one of hundreds of ads that year for contraceptive products. This one was paid for by Lysol feminine hygiene. It pulled punches, using coded messages, and suggesting that the very next pregnancy might finally push a women over the edge, and that would indeed be a “travesty.” The ad read: 

The most frequent eternal triangle:

Few marriages would flounder around in a maze of misunderstanding and unhappiness if more wives knew and practiced regular marriage hygiene. Without it, some minor physical irregularity plants in a women’s mind the fear of a major crisis. Let so devastating a fear recur again and again, and the most gracious wife turns into a nerve-ridden, irritable travesty of herself.

Birth control had by then become a huge and unregulated business. As one report noted, “Capitalizing on American’s desire to limit family size in an era of economic hardship, pharmaceutical firms, rubber manufacturers, mail-order houses, and fly-by-night peddlers launched a successful campaign to persuade women and men to eschew natural methods for commercial devices whose efficacy could be ‘scientifically proven’. . . with the industry’s annual sales exceeding $250 million, Fortune pronounced birth control one of the most prosperous new businesses of the decade.”

This was a decided shift from the Roaring 20’s when coded messaging was the rule rather than the exception, and the AMA maintained a respectful, self-protective distance from the controversy. 

As one report described, this was “…an era when the American Medical Association did not consider contraception part of medicine . . .The goal of the birth control movement in the 1920s and 1930s was to take power away from the commercial advertiser and place it in the hands of the physician.”

For Margaret Sanger, medicalizing women’s autonomy over birth decisions was essential. Having highly respected and politically powerful physicians as allies in the struggle provided much needed shielding nationwide. Sanger’s efforts to expand women’s health services, especially to immigrants fleeing the war clouds settling over Europe, demanded partnerships with physicians. But physicians were leery when it came to going public in support of birth control. Even noted academic supporters feared being accused of advertising birth control for profit which was distinctly outlawed under the AMA code of ethics.

By 1937, however, the AMA felt the winds of change blowing. FDR already knew a war was coming and that availability of contraception would be a critical factor in avoiding outbreaks of venereal disease among the troops as the nation had experienced in WW I. On the morning of June 9, 1937, the nation awoke to front page headlines in the top two columns of the New York Times that read “Birth Control Is Accepted By American Medical Body: Association Backs Doctors in Use of ‘Legal Rights’ on Contraceptive Advice.”

The body of the article explained that the association’s house of delegates – defined as “the supreme court of American medicine” – adopted two recommendations dealing with the issue. First, “that the American Medical Association investigate the various forms of contraception with a view to disseminating authoritative information on the subject to the medical profession”, and second, “that the association promote the teaching of proper methods of birth control in the medical schools.”

Labeling the action as “another landmark in the annals of American medicine,” they offered perspective noting that “For many years all efforts to gain official status for birth control, as a legitimate part of medical practice, have been bitterly fought and successfully blocked by powerful groups, religious and otherwise, within the ranks of American medicine.”

In the very next paragraph, the Times article asserted that, with this issue now out of the way, the delegates were focused on “the most important problem facing American medicine today – whether to give official recognition to the principle that  “the health of the people is the direct concern of the government, and that a national health policy directed to all groups of the population be formulated…Whatever the outcome, every one here realizes that organized medicine in America now stands at the crossroads and that it can no longer champion the status quo as it has done in the past.”

Roughly three decades later, on June 7, 1965, in a 7 to 2 decision titled Griswold v. Connecticut, authored by Justice William O. Douglas, the Supreme Court issued a 7–2 decision and struck down Connecticut’s last state law banning the sale and advertising of  contraceptives.

In the Majority Opinion, Douglas wrote: “Would we allow the police to search the sacred precincts of marital bedrooms for telltale signs of the use of contraceptives? The very idea is repulsive to the notions of privacy surrounding the marriage relationship.”

Griswold v. Connecticut became one of the most referenced landmark cases in history. All Americans now had their “sexual privacy” protected from government intrusion. As a result, a series of cases were successfully built on top of this precedent setting ruling. These included:

Eisenstadt v. Baird (1972) – Contraceptives for Single Adults.
Roe v. Wade(1973) – Abortion Legal in Non-viable Fetus.
Lawrence v. Texas (2003) – Texas Anti-Sodomy Law Unconstitutional.
Obergefell v. Hodges (2015) – Same Sex Marriage Legal.

When the Dobbs decision that effectively reversed Roe v. Wade was handed down, Justice Clarence Thomas in a concurrence statement wrote, “…in future cases, we should reconsider all of this Court’s substantive due process precedents, including GriswoldLawrence, and Obergefell.”

In a Clarence Thomas world, historic precedent and scientific progress be damned. Bodily autonomy is a product of the state. Health is a luxury, doled out in small measure only to those who toe the religious party line. Abigail Adams words resound: “Remember all Men would be tyrants if they could.”

As Balwani and Holmes Head To Jail, Others Will Follow In Their Wake.

Posted on | December 8, 2022 | Comments Off on As Balwani and Holmes Head To Jail, Others Will Follow In Their Wake.

Mike Magee

This morning’s headlines seemingly closed a chapter on the story of medical research criminality in America. Ramesh “Sunny” Balwani, former president and COO of Theranos has been sentenced to 13 years in prison for fraud. That’s 2 years more than his ex business and romantic partner, Elizabeth Holmes.

Criminal defense attorney for all things science tech, Michael Weinstein, took the opportunity to trumpet out a confident message that crime doesn’t pay in Medicine with these words, “It clearly sends a signal to Silicon Valley that puffery and fraud and misrepresentation will be prosecuted, there will be consequences and the end result is potentially decades in prison.”

The smooth talking fraudsters played a good hand for years, buoyed by a Board, asleep at the $9 billion valuation wheel, with the likes of George Shultz, Henry Kissinger, Rupert Murdoch and Larry Ellison. But attorney Weinstein and all associated with Health Tech entrepreneurship would do well to read again a classic piece of health journalism from fifty-six years ago.

On June 16, 1966, the New England Journal of Medicine published an article titled “Ethics and Clinical Research.” Written by a highly respected Harvard physician, Henry K. Beecher, the head of anesthesiology at Massachusetts General Hospital, the article referred to “troubling charges” that had grown out of “troubling practices” at “leading medical schools, university hospitals, private hospitals, governmental military departments (the Army, the Navy and the Air Force), governmental institutes (the National Institutes of Health), Veterans Administration hospitals and industry.”

Beecher then reviewed 50 distinct contemporary American clinical studies with ethical violations judged by standards at Beecher’s own Massachusetts General Hospital. These studies were performed in 1964 by academic clinicians in major institutions and published in peer-reviewed journals. In only 2 of the 50 was there any evidence of informed consent by the participants. In one of these studies, 109 servicemen with streptococcus—known to lead to rheumatic fever—had treatment with penicillin withheld as part of a placebo control group. In another study, four hundred and eight “charity patients” with typhoid were split into two groups. One group was given chloramphenicol, known to be effective in typhoid, while the other group received no treatment. Mortality rates in the two groups were 8 percent and 23 percent, respectively. 

In yet another study, 50 patients, ages 13 to 39 and drawn from mental institutions and juvenile delinquency facilities, were given an experimental drug, TriA, known to cause liver damage. Significant liver dysfunction occurred in 54 percent of them, and 8 underwent invasive liver biopsies. Even worse, 31 patients were anesthetized and given carbon dioxide through their breathing tubes to create toxic levels that would lead to cardiac arrhythmias, including deadly ventricular fibrillation. 

More incredible, 68 patients had their abdominal cavities entered through small incisions. Various organs were then retracted or pushed with instruments to gauge the effects on blood pressure levels. Mentally defective children were purposefully given live hepatitis virus to assess the infectiveness of the agent. Live cancer cells were injected into 22 human subjects to test immunity to cancer. A mother of a child dying from metastatic melanoma agreed to have the child’s melanoma cells injected into her to gain understanding of the disease and possibly help the child. The child died the next day, and the mother died a year and a half later—of metastatic melanoma.

How was this possible? “Since World War II,” Beecher explained, “the annual expenditure for research . . . in the Massachusetts General Hospital has increased a remarkable 17-fold. At the National Institutes of Health, the increase has been a gigantic 624-fold. This ‘national’ rate of increase is over 36 times that of the Massachusetts General Hospital. . . . Taking into account the sound and increasing emphasis of recent years that experimentation in man must precede general application of new procedures in therapy, plus the great sums of money available, there is reason to fear that these requirements and these resources may be greater than the supply of responsible investigators. All this heightens the problems under discussion. . . . Medical schools and university hospitals are increasingly dominated by investigators. Every young man knows that he will never be promoted to a tenure post, to a professorship in a major medical school, unless he has proved himself as an investigator. If the ready availability of money for conducting research is added to this fact, one can see how great the pressures are on ambitious young physicians.”

Six years after Beecher’s publication, Peter Buxtan, an epidemiologist for the US Public Health Service, finally and officially blew the whistle on the study of African American men being denied penicillin. This led to a July 26, 1972, New York Times report titled “Syphilis Victims in U.S. Study Went Untreated for 40 Years.”  Buxtan later said, “I didn’t want to believe it. This was the Public Health Service. We didn’t do things like that.”

The fundamental original sin – an integrated career ladder that allows medical scientists to move from academia to corporate to government and back again as they pursue vast riches – remains intact. For a time Balwani and Holmes were its beneficiaries. Without fundamental reform and reinstitution of appropriate checks and balances, it will continue to undermine public confidence in our medical establishment, and others will follow in their wake.

True, True, and Unrelated.

Posted on | November 29, 2022 | 4 Comments

Mike Magee

This is “high grandparenting season” at our home. That means it is possible on certain days on or between Thanksgiving and New Year’s Day to find up to 20 children and grandchildren under our roof. With my wife one of ten, and me, one of twelve, we are no strangers to chaos. Our kids believe we feed off it, and maybe they’re right.

With over 150 years under our collective belts, we two are – if nothing else – optimistic, resilient, and somewhat wiser then we were in our early years. For example, we know that the mere temporal or geographic approximation of two incidents or events does not necessarily prove cause and effect. 

That point was reinforced the morning after Thanksgiving when our 11 year old granddaughter informed me that the basement toilet was clogged. She then provided a thumbnail sketch of the events the night before after we had bailed early – the toilet overflowed (nobody knows how or why), a frantic search for a plunger failed even though all were enlisted in the effort, and eventually everyone retired satisfied that the now unusable toilet was quiescent.

Channeling my long gone and much beloved father, who had lived through and honorably managed many a clogged toilet in his tour of duty, all without much complaint, I focused on the plunger issue. First off, I knew we had one, and not just any plunger. I had an orange plastic bellows accordion MasterPlunger that was always surprisingly effective.

I thought it was is the garage, so I went there first. No plunger. Then successively I searched two different basement storage areas, three bathrooms multiple cabinets, and finally an outdoor shed, all the while still clad in my Nautica pajamas. Nothing. So I went back to ground zero, the garage, and after a careful piece by piece search, found the amazing tool under a mountain of outdoor collapsible beach chairs.

With two or three quick thrusts, the toilet outflow was liberated and back in service. No harm done. By Sunday afternoon, the house was emptied of family, most of the major clean up was done, and work began on Christmas decorations. That included multiple trips up and down to the basement, and the rebirth of a boxed artificial Christmas tree, which, with some minor difficulty was assembled, and lit without incident, drawing the same response from my wife that it has for the past 5 years – “I wish we had gotten the colored bulbs instead of the clear ones.”

Anyway, shortly after the tree lighting, and before any ornaments resurfaced, my wife came up from the basement and asked that on my next trip underground I check one of the basement bedrooms adjacent to the toilet overflowing bathroom because it smelled “a little musty.” Not having had any sense of smell for over 30 years, I rely on her nose. So I went down to the bedroom, and noticed in the corner, bordering the bathroom, that the rug was wet and the sheet rock was soft in the area to a height of about 18 inches.

I freed up the wall-to-wall carpet and under padding, and figuring it was stained with toilet water, cut away the damaged portion till I reached dry concrete floor. By now, my wife’s warnings of impending black mold were enough for me to cut back the affected sheet rock revealing wet framing and insulation, part of which had the trade mark droppings of house bound mice. No big deal – rural New England is rural New England. The clean up was quick and included the shop vac and a range of standard tools. 

Opening the wall had exposed a 4 inch copper major drain pipe that seemed to be heading straight up to the main floor. Still believing the source of the mess was the clogged toilet, I brought my wife down to inspect my work and assure her that mold was not a threat. She agreed, but while we were standing next to the slightly exposed wall, she asked, “Do you hear something dripping?” And sure enough I did. There was a thin, but significant, stream of water coming from above streaming down the copper pipe. 

So I asked her, do we have any water running, and she said only the washing machine on the floor above. So we turned it off, and the next morning we called the plumber, who promised to come on Thursday, but asked me to test other appliances that might be tied to this drainage line. So I (Monday) turned back on the washer, and sure enough, recreated the stream. But by now I was curious enough to wonder where this vertical pipe went. So I took my sheet rock knife and removed an 8 foot by 8 inch piece of wall. Now a fuller length of the 1950’s vintage 4 inch copper pipe was exposed. The pipe went through a 2″ by 6″ stud into the ceiling. Above the stud, no water. Below the stud, water.

Having reached a decision point that involved deeply ingrained “there’s no going back now” brain circuitry, I got my DeWalt “super-saw” and freed the pipe from the wooden ceiling anchoring  that was obscuring the site of the leak. And as you can see, I was rewarded with a diagnosis. Here fully exposed for the first time (except for the USAA Home Owners insurance people) is the hole at a soldered joint site in the copper elbow. 

It was now easy to establish that the only source of water came from the washing machine line, and not from any toilets or faucets in the house somehow tied to the line. And the plumber will easily replace the exposed ancient copper elbow with a PVC replacement, and insurance will cover the bit of carpet and wall repair. 

But what have we learned? First, the toilet overflow had nothing at all to do with the leak and mess just a few feet away. Second, had it not been for the toilet overflow, we may not have noticed the more significant problem for weeks. And by then, maybe there would have been black mold. And finally, everyone should invest in and have available an orange bellows accordion MasterPlunger, visible and accessible.

Now lastly, it is fair to ask, what does this have to do with health, beyond baseline sanitary prudence? Well, in our third year of Covid, it is not surprising that all of us have a tendency to associate are manners of symptoms and disorders with the virus or its vaccines. Like the overflowing toilet and latter pipe leak, it is guilt by association which may or may not prove to be true. The evidence required was initially lacking. So it is with Covid and/or the vaccines. Don’t jump to conclusions. Adjacent medical issues may or may not have anything to do with this infectious disease. Give evidence time to surface. And have tools, like home tests, available and accessible as needed.

“Wright” and Wrong According to Justice Alito.

Posted on | November 21, 2022 | 2 Comments

Mike Magee

Justice Samuel Alito surfaced this past week once again around issues of judicial independence and his network of friends. Late last week, Rev. Rob Schenck, who for years led a shadowy anti-abortion movement in Washington, DC, “Faith and Action,” had a serious change of heart. He reported that the leakage of this year’s Dobb’s decision (which Alito wrote) was part of a pattern of transgressions dating back more than a decade.

Now an all-in whistle-blower, Schenck reported that “Sam” (as he referred to the Justice) and wife Martha-Ann, were “besties” with his major donor, Ohio real estate moguls Donald and Gayle Wright. (Also on the private social list in Wright e-mails were “CT” and wife Ginny). Their friendship had been cemented at weekend hunting visits to the Wright’s Jackson Hole, WY, retreat. At a private dinner with the Alito’s in June, 2014, Schenck said that the Justice tipped the Wrights off regarding the future decision (not yet announced) of the Hobby Lobby case. This allowed conservatives to fully prepare for the public backlash certain to follow a decision in their favor.

One response to the decision came from the 55,000 gynecologists strong American Congress of Obstetricians and Gynecologists(ACOG) which rang the now current themes of women’s autonomy and enfranchised citizenship, stating, “a woman’s boss has no role to play in her personal health care decisions…The value of family planning, including contraception, is clear. It allows women to time and space their pregnancies, leading to more optimal health outcomes for mother and for baby. And it helps to prevent unintended pregnancy; in America, nearly one half of all pregnancies are unintended.”

In that 5-4 decision in favor of Evangelical Christian purveyor of all things crafty, Hobby Lobby, corporate entities “gained a conscience”, just like individuals, and the right to pick and choose from the menu of 20 forms of contraception required under the Affordable Care Act. Hobby Lobby chose to delete 2 morning after pills and 2 intra-uterine devices (IUD’d) they considered to be abortion inducers.

As important, that early success provided “proof of concept” that intense socialization with Justices and their spouses, through non-profit intermediaries like Pat Robertson’s American Center for Law & Justice, the Supreme Court Historical Society, and “Faith and Action”, could move decisions in conservatives favor, and provide early intelligence to manage political and public repercussions of controversial opinions.

The coalitions built around the “Hobby Lobby” victory also reinforced efforts to develop and advance conservative Catholic justices, and (with Obama nominations blocked and Trump in office) ultimately reverse Roe v. Wade.

Justice Alito’s reliability has been an anchor during this transition. His May 3, 2022 leak of the future Dobbs decision should be viewed through the lens of the testimony provided by Justices Kavanaugh, Barrett, and Gorsuch, under oath, on the topic during their confirmation hearings. Alito and these co-signers on his recent draft assured that Roe v. Wade and Planned Parenthood v. Casey were different since “[a]bortion destroys . . . potential life” and “none of the other decisions cited by Roe and Casey “involve the critical moral question posed by abortion.” 

Justice Clarence Thomas wasted no time making the unvarnished conservative view at the Court perfectly clear in a concurrence statement , “…in future cases, we should reconsider all of this Court’s substantive due process precedents, including GriswoldLawrence, and Obergefell.” These cases respectively deal with legal contraception, anti-sodomy laws, and same-sex marriage.

The history and performance of these five Justices, their original and current supporters, their documented religious orthodoxy, and the web of conservative schools and think tanks that nurtured their well-entrenched biases all suggest “buyer beware.”

The AMA vs. Dobbs: “Advocacy” or “Action” in a MAGAGA World. Part 2.

Posted on | November 16, 2022 | 2 Comments

Mike Magee

(If you haven’t, read Part 1.)

On November 8, 2022, five days after the 2022 Midterm elections, the AMA raised its voice in opposition to Republican efforts to promote second class citizenship for women by exerting public control over them and their doctors intensely private reproductive decisions. At the same time they sprinkled candidates on both sides of the aisle with AMA PAC money, raising questions whether their love of women includes active engagement or just passive advocacy.

Trump and his now MAGAGA (“Make America Great and Glorious Again”) movement has now returned to center stage. With the help of Senate Majority leader McConnell, Christian Conservatives had packed the Supreme Court with Justices committed to over-turning Roe v. Wade. And they did just that.

On June 24, 2022, a Supreme Court, dominated by five conservative Catholic-born Justices, in what experts declared “a historic and far-reaching decision,” Dobbs v. Jackson Women’s Health Organization, scuttled the half-century old right to abortion law, Roe v. Wade, writing that it had been “egregiously wrong,” “exceptionally weak” and “an abuse of judicial authority.”

Not content to allow the decision to stand alone, in a consenting opinion, Justice Clarence Thomas, a modern day version of Anthony Comstock, suggested that this was just the beginning. The decision, he said, was part of a the “legal rationale” that could allow new challenges to legalized gay marriage, consensual homosexual conduct, and access to contraception.

It only took a few days for these true believers to realize that they had lit a political flame under the Republican party that would be difficult to extinguish. The September, 2021 amicus briefs and Congressional testimony of the AMA were easy enough to ignore. But when Kansans defeated an anti-abortion proposition on August 3, 2022, leading the Kansas For Constitutional Freedom, to call the 59%/41% victory “huge and decisive”, the path toward crushing Republican’s self-declared coming “Red Wave” was clear. Similar state abortion propositions were already cued up in Michigan, Kentucky, and Vermont, and now the successful messaging had been fleshed out ready to be applied to 30 and 60 second Ads.

In the Kansas Ad, the voice over stated “Kansans don’t want another government mandate that puts our personal rights at risk.” In Michigan, a burly, working class, white male declares “Let’s keep the government away from our doctors.” The Kentucky campaign put it this way, “The rights of people to control their own personal, private medical decisions are under attack across the country — it’s no different in Kentucky. … Don’t let politicians restrict your freedom.” And Vermont successfully went after its’ entire electorate with carefully constructed and poll tested messaging that emphasized preservation of enshrined Constitutional rights in a state with an historic commitment to personal freedoms.

But arguably the clearest messaging was constructed by successful Congressional candidate, Marie Gluesenhamp Perez (WA-3) who was running against incumbent Trump election denier, Joe Kent. Owner of a small auto-repair shop in rural Washington, she leaned into abortion when her opponent declared “I 100% support Roe v. Wade being overturned. I would move to have a national ban on abortion.” 

Congresswomen Gluesenkamp Perez’s response, enshrined in a 60-second tour-de-force:

“This is an extremist. Yeah, you know until you’ve been pregnant, you’re just not going to understand how complex pregnancies are, and how much can go wrong. And even if you have been pregnant, you know your sample size is pretty small. I miscarried. And you know what I needed? You know what the treatment for miscarriage is? It’s abortion. You know without treatment I might have not been able to have my son.. We deserve respect and autonomy in making those decisions, and privacy. I mean this is not about the minutia of constitutional law. This is about respecting people’s choices.”

The U.S. Constitution may be a living document, but as we recently witnessed, its capacity for movement is bi-directional. The Dobbs v. Jackson decision shifted our nation into reverse. But in over-reaching, MAGA (now MAGAGA) Republicans triggered and activated the Body Politic – Democracy’s corrective super-power.

From Michigan to Kansas, from Kentucky to Washington and Vermont, outraged citizens found their voices and uncovered messages that worked.

In the process, it proved three important points:

  1. Rights should never be taken for granted. They must be protected at every turn.
  2. Health rights are central to human rights. Autonomy and self-determination are determinative of life, liberty, and the pursuit of happiness.
  3. We are mutually inter-dependent. As FDR said, “Necessitous men are not free men.”  If we wish to reject the “tyranny of the minority,” and rebuild a culture of compassion, understanding and partnership, we must redress the current injustices and begin anew with an equitable, just, and effective national health plan.

The reality is that decisions related to women’s reproductive rights are highly individualized, and remarkably complex. This is why we entrusted them to women themselves and their physicians in secure and confidential settings. Intrusion into this space by government fundamentally compromises women’s overall rights and autonomy, and triggers a broad range of Constitutional health concerns for the general public.

If the goal of the Theocratic Conservative Justices and their political allies was to turn back the clock of time, probe the weaknesses of our checks and balances, and stimulate a deep dive into Constitutional law, Dobbs v. Jackson was an enormous success. On the other hand, if the intent was to ignite a “Red Wave” in the 2022 Midterm Election, it proved a giant negative that will be difficult to escape.

Citizens in every state in the union need to feel the heat of the AMA and its Federation in this ongoing battle. This is the moment to fully engage your power and reach, the time to send messages that are clear and definitive. If you leave your patients in the lurch now, they will neither forgive nor forget in the future.

(Return to Part 1.)

AMA and Dobbs: “Advocacy” vs. “Action” in a MAGAGA World. – Part 1.

Posted on | November 15, 2022 | Comments Off on AMA and Dobbs: “Advocacy” vs. “Action” in a MAGAGA World. – Part 1.

Mike Magee

Should anyone present know of any reason that this couple should not be joined in holy matrimony, speak now or forever hold your peace.”     Book of Common Prayer, Church of England, 1549

Last evening Trump rose from the ashes and declared it was time to “Make America Great and Glorious Again” (MAGAGA).

This past week, five days after the Midterm elections, AMA President, Jack Resnick, Jr., MD, raised his voice from the podium at the AMA Interim Meeting in Hawaii with the AMA’s own version of a call to action: 

“But make no mistake, when politicians insert themselves in our exam rooms to interfere with the patient-physician relationship, when they politicize deeply personal health decisions, or criminalize evidence-based care, we will not back down…I never imagined colleagues would find themselves tracking down hospital attorneys before performing urgent abortions, when minutes count … asking if a 30% chance of maternal death, or impending renal failure, meet the criteria for the state’s exemptions … or whether they must wait a while longer, until their pregnant patient gets even sicker…Enough is enough. We cannot allow physicians or our patients to become pawns in these lies.”

Over a year ago, they had signaled awareness that attacks on Roe v. Wade might fundamentally challenge patient autonomy and the sanctity of the patient-physician relationship. On September 21, 2021, the AMA with 25 other medical organizations filed an amicus brief in opposition to the restrictive Mississippi abortion law, Dobbs v. Jackson Women’s Health Organization.  And on  October 12, 2021, 19 medical societies, with the AMA in the lead, filed  an amicus brief in U.S. v. Texas, the abortion vigilante law signed by Gov. Greg Abbott.

Over the past year, the AMA had ample warning that the situation was spinning out of control. On June 27, 2022, I wrote: “My concern today, despite the strong messaging from Chicago, is that the AMA and its membership have not fully absorbed that this is a ‘mission-critical’ moment in the organization’s history… The strong words, without actions to back them up will permanently seal the AMA’s fate, and challenge Medicine’s status as a ‘profession.’”

I was reacting to the AMA’s statement three days earlier, on release of the Dobbs decision, which labeled the decision “an egregious allowance of government intrusion into the medical examination room, a direct attack on the practice of medicine and the patient-physician relationship…the AMA condemns the high court’s interpretation in this case. We will always have physicians’ backs and defend the practice of medicine, we will fight to protect the patient-physician relationship.”

At the time, I recommended that the AMA mobilize and orchestrate their Federation state and specialty societies to pursue acts of “physician ‘civil disobedience’ where appropriate to protect the health and well being of all women, regardless of age, race, sexual identity, religion, or economic status.”

This warning came six months after I highlighted Charles Dickens words in a “Tale of Two Cities” – “It was the best of times, it was the worst of times, it was the age of wisdom, it was the age of foolishness, it was the epoch of belief, it was the epoch of incredulity, …” – as a way to dramatize that we too are a “tale of two cities”  as this map of the United States, color coded for regressive legislation and tactics to disenfranchise women and children, people of color, the poor and the vulnerable, well illustrates.

On November 8, 2022, the AMA site posted a section titled “Advocacy in action: Protecting reproductive health.” But a constructive critic would be justified in suggesting that the plan is tall on “advocacy”, but short on “action.”

What does “action” look like? In Part 2 of this piece tomorrow, I’ll provide examples from Michigan, Kansas, Kentucky, and Washington.

Covid, The Plague, and Smart Students.

Posted on | November 10, 2022 | Comments Off on Covid, The Plague, and Smart Students.

Mike Magee

This semester at the President’s College at the University of Hartford I’ve been teaching a course on “The History of Epidemics in America.” Of course, epidemic disease knows no geographic bounds, and so we have been addressing how microbes have changed the world we live in over many hundreds of years and across all of our continents.

One of the many benefits of teaching is exposure to brilliant students. One of them approached me this week with the August 10, 2022 copy of the BBC’s History Magazine with the intriguing cover titled “The Big Questions of the Black Death.”  This was clearly “on-topic” since we had begun the course with a session on “The Plague” and Yale historian Frank Snowden’s memorable quote, “The word ‘plague’ will always be synonymous with ‘terror’.”

As you might imagine, a course on epidemics in 2022 never wanders far beyond Covid-19 and our continued struggles to gain an upper hand on this rapidly mutating virus. But history does instruct, and Stanford University medievalist historian of medicine, Monica H. Green, does just that in an interview published in this issue titled, “When the black death arrived in Europe, it was like striking a match in tinder.”

At the close of the interview, in a turn of the tables, Professor Green  is asked whether the present has changed her view of the past. Here’s what she says:

“One debate that is very current about Covid is how pandemics end. I’ve come to accept that pandemics last as long as the pathogen is still around in a way that can threaten human populations. That’s something that’s important to remember about the plague – that it didn’t just disappear in Europe after the 1340s. It came back between the 1350s and 1360s, and then in subsequent waves all the way through the 17th century. It hit one town and then it hit another. It was terrifying. It was still incredibly lethal, and no one knew when it was going to strike again.

“Plague and Covid are different diseases, but what defines a pandemic isn’t just the pathogen but also the human involvement in the transmission. Every pandemic – from cholera to HIV to flu – starts as a local disease. The question is, how does  a local disease become a global disease? That can only happen if humans are involved. The successful pandemic pathogen will be the one that can most effectively exploit our mechanisms of travel, migration and exchange, transportation, connection and communication.

“What has Covid done? It’s exploited aviation. What did plague exploit? The fact that so many different societies were majorly invested in the grain trade. So that’s the thing that we need to look at – the way that we as humans are creating the mechanisms to allow the pathogens to spread.”


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