Later On

A blog written for those whose interests more or less match mine.

Archive for August 24th, 2019

If Trump Were an Airline Pilot

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James Fallows writes in the Atlantic:

Through the 2016 campaign, I posted a series called “Trump Time Capsule” in this space. The idea was to record, in real time, what was known about Donald Trump’s fitness for office—and to do so not when people were looking back on our era but while the Republican Party was deciding whether to line up behind him and voters were preparing to make their choice.

The series reached 152 installments by election day. I argued that even then there was no doubt of Trump’s mental, emotional, civic, and ethical unfitness for national leadership. If you’re hazy on the details, the series is (once again) here.

That background has equipped me to view Trump’s performance in office as consistently shocking but rarely surprising. He lied on the campaign trail, and he lies in office. He insulted women, minorities, “the other” as a candidate, and he does it as a president. He led “lock her up!” cheers at the Republican National Convention and he smiles at “send them back!” cheers now. He did not know how the “nuclear triad” worked then, and he does not know how tariffs work now. He flared at perceived personal slights when they came from Senator John McCain, and he does so when they come from the Prime Minister of Denmark. He is who he was.

The Atlantic editorial staff, in a project I played no part in, reached a similar conclusion. Its editorial urging a vote against Trump was obviously written before the election but stands up well three years later:

He is a demagogue, a xenophobe, a sexist, a know-nothing, and a liar. He is spectacularly unfit for office, and voters—the statesmen and thinkers of the ballot box—should act in defense of American democracy and elect his opponent


The one thing I avoided in that Time Capsule series was “medicalizing” Trump’s personality and behavior. That is, moving from description of his behavior to speculation about its cause. Was Trump’s abysmal ignorance—“Most people don’t know President Lincoln was a Republican!”—a sign of dementia, or of some other cognitive decline? Or was it just more evidence that he had never read a book? Was his braggadocio and self-centeredness a textbook case of narcissistic personality disorder? (Whose symptoms include “an exaggerated sense of self-importance” and “a sense of entitlement and require[s] constant, excessive admiration.”) Or just that he is an entitled jerk? On these and other points I didn’t, and don’t, know.

Like many people in the journalistic world, I received a steady stream of mail from mental-health professionals arguing for the “medicalized” approach. Several times I mentioned the parallel between Trump’s behavior and the check-list symptoms of narcissism. But I steered away from “this man is sick”—naming the cause rather than listing the signs—for two reasons.

The minor reason was the medical-world taboo against public speculation about people a doctor had not examined personally. There is a Catch-22 circularity to this stricture (which dates to the Goldwater-LBJ race in 1964). Doctors who have not treated a patient can’t say anything about the patient’s condition, because that would be “irresponsible”—but neither can doctors who have, because they’d be violating confidences.

Also, a flat ban on at-a-distance diagnosis doesn’t really meet the common-sense test. Medical professionals have spent decades observing symptoms, syndromes, and more-or-less probable explanations for behavior. We take it for granted that an ex-quarterback like Tony Romo can look at an offensive lineup just before the snap and say, “This is going to be a screen pass.” But it’s considered a wild overstep for a doctor or therapist to reach conclusions based on hundreds of hours of exposure to Trump on TV.

My dad was a small-town internist and diagnostician. Back in the 1990s he saw someone I knew, on a TV interview show, and he called me to say: “I think your friend has [a neurological disease]. He should have it checked out, if he hasn’t already.” It was because my dad had seen a certain pattern—of expression, and movement, and facial detail—so many times in the past, that he saw familiar signs, and knew from experience what the cause usually was. (He was right in this case.) Similarly, he could walk down the street, or through an airline terminal, and tell by people’s gait or breathing patterns who needed to have knee or hip surgery, who had just had that surgery, who was starting to have heart problems, et cetera. (I avoided asking him what he was observing about me.)

Recognizing patterns is the heart of most professional skills, and mental health professionals usually know less about an individual patient than all of us now know about Donald Trump. And on that basis, Dr. Bandy Lee of Yale and others associated with the World Mental Health Coalition have been sounding the alarm about Trump’s mental state (including with a special analysis of the Mueller report). Another organization of mental health professionals is the “Duty to Warn” movement.

But the diagnosis-at-a-distance issue wasn’t the real reason I avoided “medicalization.” The main reason I didn’t go down this road was my assessment that it wouldn’t make a difference. People who opposed Donald Trump already opposed him, and didn’t need some medical hypothesis to dislike his behavior. And people who supported him had already shown that they would continue to swallow anything, from “Grab ‘em by … ”  to “I like people who weren’t captured.” The Vichy Republicans of the campaign dutifully lined up behind the man they had denounced during the primaries, and the Republicans of the Senate have followed in that tradition.


But now we’ve had something we didn’t see so clearly during the campaign. These are episodes of what would be called outright lunacy, if they occurred in any other setting: An actually consequential rift with a small but important NATO ally, arising from the idea that the U.S. would “buy Greenland.” Trump’s self-description as “the Chosen One,” and his embrace of a supporter’s description of him as the “second coming of God” and the “King of Israel.” His logorrhea, drift, and fantastical claims in public rallies, and his flashes of belligerence at the slightest challenge in question sessions on the White House lawn. His utter lack of affect or empathy when personally meeting the most recent shooting victims, in Dayton and El Paso. His reduction of any event, whatsoever, into what people are saying about him.

Obviously I have no standing to say what medical pattern we are seeing, and where exactly it might lead. But just from life I know this:

  • If an airline learned that a pilot was talking publicly about being “the Chosen One” or “the King of Israel” (or Scotland or whatever), the airline would be looking carefully into whether this person should be in the cockpit.
  • If a hospital had a senior surgeon behaving as Trump now does, other doctors and nurses would be talking with administrators and lawyers before giving that surgeon the scalpel again.
  • If a public company knew that a CEO was making costly strategic decisions on personal impulse or from personal vanity or slight, and was doing so more and more frequently, the board would be starting to act. (See: Uber, management history of.)
  • If a university, museum, or other public institution had a leader who routinely insulted large parts of its constituency—racial or religious minorities, immigrants or international allies, women—the board would be starting to act.
  • If the U.S. Navy knew that one of its commanders was routinely lying about important operational details, plus lashing out under criticism, plus talking in “Chosen One” terms, the Navy would not want that person in charge of, say, a nuclear-missile submarine. (See: The Queeg saga in The Caine Mutiny, which would make ideal late-summer reading or viewing for members of the White House staff.)

Yet now such a  person is in charge not of one nuclear-missile submarine but all of them—and the bombers and ICBMs, and diplomatic military agreements, and the countless other ramifications of executive power.

If Donald Trump were in virtually any other position of responsibility, action would already be under way to remove him from that role. The board at . . .

Continue reading.

Written by LeisureGuy

24 August 2019 at 7:32 pm

Which countries dominate the world’s dinner tables?

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The article in the Economist states:

“THE DESTINY of nations,” wrote Jean Anthelme Brillat-Savarin, an 18th-century French gastronome, “depends on how they nourish themselves.” Today a nation’s stature depends on how well it nourishes the rest of the world, too. For proof of this, consider the rise of culinary diplomacy. In 2012 America’s State Department launched a “chef corps” tasked with promoting American cuisine abroad. Thailand’s government sends chefs overseas to peddle pad Thai and massaman curry through its Global Thai programme. South Korea pursues its own brand of “kimchi diplomacy”.

But which country’s cuisine is at the top of the global food chain? A new paper by Joel Waldfogel of the University of Minnesota provides an answer. Using restaurant listings from TripAdvisor, a travel-review website, and sales figures from Euromonitor, a market-research firm, Mr Waldfogel estimates world “trade” in cuisines for 52 countries. Whereas traditional trade is measured based on the value of goods and services that flow across a country’s borders, the author’s estimates of culinary exchange is based on the value of food found on restaurant tables. Domestic consumption of foreign cuisine is treated as an “import”, whereas foreign consumption of domestic cuisine is treated as an “export”. The balance determines which countries have the greatest influence on the world’s palate. . .

Continue reading. (Though the rest is behind a paywall if you’re not a subscriber.)

Written by LeisureGuy

24 August 2019 at 3:04 pm

Posted in Daily life, Food, Politics

In Men, It’s Parkinson’s. In Women, It’s Hysteria.

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David Armstrong reports in ProPublica:

Once it was called “hysterical” movement disorder, or simply “hysteria.” Later it was labeled “psychogenic.” Now it’s a “functional disorder.”

By any name, it’s one of the most puzzling afflictions — and problematic diagnoses — in medicine. It often has the same symptoms, like uncontrollable shaking and difficulty walking, that characterize brain diseases like Parkinson’s. But the condition is caused by stress or trauma and often treated by psychotherapy. And, in a disparity that is drawing increased scrutiny, most of those deemed to suffer from it — as high as 80% in some studies — are women.

Whether someone has Parkinson’s or a functional disorder can be difficult to determine. But the two labels result not only in different treatments but in different perceptions of the patient. A diagnosis of Parkinson’s is likely to create sympathy, but a functional diagnosis can stigmatize patients and cast doubt on the legitimacy of their illness. Four in 10 patients do not get better or are actually worse off after receiving such a diagnosis and find themselves in a “therapeutic wasteland,” according to a 2017 review of the literature by academic experts.

“This is the crisis,” said University of Cincinnati neurologist Alberto Espay, the author of guidelines on diagnosing functional movement disorders. “It shouldn’t be stigmatized but it is. No. 1, patients are wondering if it is real. ‘Does my doctor think I am crazy?’ Secondly, doctors can approach it in a way that implies this is a waste of their time.”

A study published last year in a leading neurological journal stoked the growing controversy. Of patients diagnosed with functional symptoms, 68% were women. This finding, the authors wrote, “suggests that female sex may be an independent risk factor for the development” of functional symptoms.

The study prompted a furious letter to the journal’s editor from Dr. Laura Boylan, a New York City neurologist. She argued that the study’s results might demonstrate instead that symptoms thought to be psychogenic were actually the result of Parkinson’s, and that doctors were slow to identify the brain disease in women. “Disparities in healthcare for women are well established,” she wrote, adding, “Women commonly encounter dismissal in the medical context.”

For Boylan, the issue was more than a professional debate. It was personal. She had been diagnosed with Parkinson’s-like symptoms that her doctors, all top caregivers at some of the world’s leading medical institutions, largely believed to be psychogenic or side effects of medication. Most of her doctors were men, but two were women. Boylan, herself a brilliant neurologist, disagreed vehemently with them. She attributed her problems to a physiological cause, a tiny cyst in her brain, and grew despondent when other neurologists doubted her theory. She gave up her medical practice, became housebound and contemplated suicide. Even today, her case remains a mystery.


The first sign that something was wrong came in 2008.

At the time, Boylan was busy with a successful career that included work as a teacher, researcher and clinician. She was an assistant professor of neurology at the New York University School of Medicine; the director of the behavioral neurology clinic for the VA in New York City; and an attending physician at a hospital in Pennsylvania. She was married to another neurologist, Daniel Labovitz, who is a professor at the Albert Einstein College of Medicine and practices at Montefiore Medical Center in the Bronx.

It was while driving at night on a Pennsylvania highway that Boylan experienced a vivid hallucination. She saw a cartoonish chipmunk on the steering wheel, smiling and waving at her. Another time, two blue men with red hats appeared on either side of her. She knew the images were not real, but she couldn’t make them go away.

Her doctors at the time blamed the hallucinations on side effects of psychiatric medicine Boylan took for her long-diagnosed bipolar disorder. Her bipolar condition would later add another element of uncertainty to the debate over her Parkinson’s-like symptoms. Studies show that people with preexisting psychiatric disorders are more likely to develop Parkinson’s — or have a functional disorder with similar symptoms. Boylan said she sees a psychiatrist for the bipolar disorder, but it’s “just not a big deal in my life.”

Over time, her health continued to worsen. In early 2011, . . .

Continue reading.

Written by LeisureGuy

24 August 2019 at 12:10 pm

Six-minute lithium battery recharge for phones and cars on way

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Amazing. Mike Scialom writes in Cambridge Independent:

Echion Technologies, the Sawston-based battery specialist spun out of Cambridge University, is preparing to commercialise technology which has been trialled to allow charging times for both mobiles and electric cars to drop to six minutes.

The development could revolutionise the electric transport era, allowing electric car owners to recharge at any garage over a cup of coffee rather than having to stay close enough to recharge overnight at home.

The restrictions are being lifted thanks to technology which involves replacing graphite with a new material, possibly a compound – but Dr Jean De La Verpilliere isn’t saying what.

Echion is the brainchild of Dr De La Verpilliere. Two years ago, while studying for a PhD in nanoscience at the University of Cambridge, he created a material that could be used in lithium batteries. In 2017 – the final year of his phD – he founded Echion, with a focus and expertise on high performance materials innovations for lithium, or Li-ion, batteries. Echion “engages with chemicals and battery cell manufacturers to integrate its materials solutions into next-generation products”. Currently, materials are simply ‘dropped in’ to lithium battery infrastructure.

One of the materials is graphite, which Echion has replaced with its own material. . .

Continue reading.

Written by LeisureGuy

24 August 2019 at 11:52 am

Pink power juice with green foam

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It’s great! I use my immersion blender and its beaker. Put into the beaker:

1 cup frozen cranberries
1/2 cup fresh mint leaves
2 tablespoons plus 2 teaspoons erythritol
water to cover

Blend that, then add enough water to bring the total to 2 cups, stir, and enjoy.

Erythritol is good. It doesn’t cause gas or bloating, doesn’t raise blood glucose or trigger insulin, has no side effects, and is just about zero calories. Use it instead of granulated sugar, teaspoon for teaspoon.

Since I’m consuming the whole cranberry and not just extracted juice, I’m  thus getting fiber and the bioflavonoids that are in the skin, making this a very healthful drink indeed.

Next I’m going to try frozen cherries and lemon juice with water to make 2 cups.

Update: Here’s the source of the recipe:

More on erythritol:

and more on fruit juices:

Written by LeisureGuy

24 August 2019 at 11:49 am

World’s Lightest Solid!

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Written by LeisureGuy

24 August 2019 at 11:15 am

Posted in Science, Technology

Avocado and cholesterol

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Written by LeisureGuy

24 August 2019 at 10:31 am

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