Autobiography

Assumptions

Assumptions

I don’t need no doctor

‘Cause I know what’s ailing me

I don’t need no doctor

‘Cause I know what’s ailing me

All I need is my baby

You don’t know I’m in misery

(Humble Pie)

Late in my career I went back to school for a Masters Degree in Medical Management. This was a paranoid backup plan I had worked out if Managed Care would one day put me out of business. At least I would then have the credentials to go into hospital management. It was a grueling enterprise that took five years because I still a clinical medical practice to take care of.

But if I learned anything at all by this endeavor, it was that all assumptions are:

False, Limiting, and Reversible.

It was a lesson I should have already empirically learned on the wards at the VA hospital when I had to take care of a man who had an unusual complication of long-term alcohol abuse in which the cerebellum in the brain becomes affected similar to how it scars the liver in alcoholic cirrhosis. This often-irreversible syndrome requires a great deal of alcohol consumption over decades.

Because the cerebellum controls balance, this man literally had the gait of a drunken sailor or a sea-sick landlubber, which made anyone who saw him, feel compelled to stand by for a catch in case he fell down. He looked like the protagonist in the Monty Python sketch, “The Ministry of Silly Walks.”

After the diagnosis was secured I was assigned to explain his problem. After a very lengthy, diligent explanation about how alcohol had damaged this part of his brain, which included drawings and visual schematics, he looked up at me when I was finished and said:

  • So, what kind of doctor do you think you are?
  • I’m not really a doctor yet. I’m still a medical student.
  • Well mister, you’ll never make it in this business, so maybe you should think about doing something else
  • Why do you say that? I’m only interested in helping you understand what’s wrong with you, so you can change your habits. This might prevent further trouble. Some of your balance issues might even improve if you stop drinking. If not, it can only get worse.

Of course, I had assumed he knew what I was talking about and that my carefully studied little lecture had made enough of an impact to inspire a trip down the road to total sobriety.

Nothing was further from the truth, because the opposite reaction had  caused him to completely lose any faith, trust, or confidence he might have had.

  • That’s just what I’m saying, pretty boy. You can’t possibly know what you’re talking about. Like I said, I been drinking hard for over thirty years.
  • Correct. That’s the point.
  • Not really. So, the point is you can’t be right, because this is the first time in thirty years something like this ever happened to me. So, it can’t be the booze. Now what’s really wrong with me?

What I really wanted to say was:

  • Well, perhaps you  can’t really cure being Irish.

Unbelievably, déjà vu came knocking thirty years later when our next-door neighbor in the Hamptons presented to the hospital with liver failure associated with ascites. This is a condition in which the liver is so scarred it cannot properly function, subsequently causing the abdominal cavity to fill up with clear yellow serous fluid. In being a serious sign that portends a very poor short-term prognosis, it can even make a man or woman look ten months pregnant.

Usually the kidneys shut down next or nearly unstoppable upper G.I. hemorrhaging occurs expressed as continuous vomiting of blood. This is a result of extremely high pressure in the varicose veins located in the lower esophagus that dilate because the liver doesn’t work; causing back-pressure into the spleen; which also enlarges.

His predicament was no surprise, as I would notice him regularly wandering around his yard, starting to drink his beers at ten a.m., which he conveniently parked in front of him on the home-made shelf provided by his expanded abdominal girth. Meanwhile, his wife, who had smoked her lungs to death, was inside their house attached to an oxygen tank.

As a perfect pair, the couple was a veritable monument to self-inflicted abuse.

When he was hospitalized with cirrhotic liver disease, I saw him briefly when I stopped by his bed for a courtesy call, but was taken aback when he asked me what was wrong. He said his doctor told him he had liver failure. When I reaffirmed that his problem was the result of years of drinking to excess, he dismissively parroted the man at the Boston V.A. by saying it could not possibly be true for the same precise reasons I heard many years before. He said he had consumed beer all day long for well over half a lifetime but this was the first time something like this had ever happened to him; ergo alcohol could not be the problem.

Saying nothing more than “good luck and get better”, I just walked away because I had seen that that movie once  and it wasn’t very good the first time around. In this case he wasn’t even Irish. He was just an ignoramus.

Enough said about assumptions.

My mother put it differently whenever I did something that I assumed had seemed like a good idea at the time; but turned out just the opposite.

  • But mom. I thought…
  • So, you know what thought did, don’t you?
  • No mom, what?
  • A man thought he had to fart.

Anyone who studies medicine comes to know it as a discipline in which two great truths are axiomatic:

A: Never make assumptions.

B: Never, say never.

Especially never assume that a patient knows what you are talking about or understands anything you are saying without soliciting your own personal validated feedback. One must ask at the end of the visit:

  • Did you understand what we discussed and do you have any other questions?

As far as patients are concerned, they believe that too many doctors speak a foreign language, but are often afraid or too intimidated to ask for an understandable translation. They just nod their heads like dumb jack-asses, or worse, talk through the explanations without listening, then go home to tell family or friends.

  • The doctor didn’t spend any time with me at all. And he didn’t tell me anything either. He’s an incompetent boob.

That is, assuming the doctor really takes the time to speak plainly, or unless the patient has taken it upon himself to become an overnight Internet expert about his own personal health; in which case, he does not need a doctor anyway.

So, there it is. Just another one of life’s many negative feed-back loops.

The father is Jim Beam

 

intranet.tdmu.edu.ua

 

 

Advertisements

1960s: The Decade of Assassinations

Assassinations 

If America finally died at Kent State, it had been slowly tortured and already beaten in the decade before it finally went down. The 1960s could easily be referred to the decade when the National sport of political assassinations replaced the National pastime of baseball.

Despite the fact of numerous investigations into the assassination of the Kennedy brothers, Martin Luther King and Marilyn Monroe, there will always be doubt as to their elusory links and to who was the responsible party. Official investigative panels must think the American public is naively stupid to believe that in each murder, the gunman was a lone, crazed malcontent who acted out of single-minded hatred; or that Monroe’s association with the Kennedy men was innocent celebrity cameo.

In their careers, the Kennedy brothers had made enough enemies, burned enough bridges, or double-crossed enough powerful men to have been killed six times over. They were also trio of egalitarian, womanizing, arrogant and condescending hypocrites who suffered the deadly sin of Hubris.

Unfortunately for them they may have been innocent in a naïve way because they learned it at home from their crooked bootlegging father, Joe. Once in power two of these brothers were also determined to erase the history of their father’s close ties to organized crime and to create a future legacy of white washed lily pure family history.

I had a patient who was a CIA operative and who was one of the last agents to leave Havana when Castro came into power. He was also on the beach at the Bay of Pigs when John Kennedy failed to bring in the previously promised and desperately necessary ground fire and air support to aid the landing parties. In relating the fact of this betrayal, he told me how frustrating it had been to see the U.S. aircraft carriers and gun-ships sitting off on the horizon as the Cuba Libre troops were mowed down on the beach.

He also stated that there was a highly-placed mole in some U.S. governmental organization that had alerted Castro to the time and place of the assault.To make matters worse, JFK blamed the fiasco entirely on the agency itself and then tried to dismantle it after the fact. This man then subsequently hated John Kennedy with a passion.

Failing an invasion, there is documented evidence that the President’s office may have recruited the CIA to kill Castro in an eventually failed assassination attempt. They wanted him to smoke a poisoned cigar. my patient stated that the idea was patently stupid.

Kennedy was also hated by the mob boss of South Florida, Sam Traffacante, who wanted to get back his confiscated Havana casinos and nightclubs.

Lyndon Johnson had no love either. He was a politically ambitious conniving snake, whose world was caving in because of the Bobby Baker and Billy Sol Estes scandals; and feared being dropped from the 1964 Presidential ticket. His sole ambition in life was to become the U.S. President; so being a heart-beat away would make him a close second; as well as exempt from scrutiny of his own scandalous financial dealings; including the diversion of military contracts to Texas.

Then lurking far in the distant past was the fact that Bobby Kennedy in his early pre-Attorney General career had sidelined an attempt by Aristotle Onasis to gain U.S. seaport access for his oil tankers.

The Kennedy’s connections to organized crime are well outlined in the book “Double Cross” written by the mafia boss Sam Giancana’s nephew. Old father Joe had been a great asset to the criminal world during prohibition because he supplied their stills with vitally needed sugar. He was also able to freely import Scotch under the diplomatic immunity conferred on him by being Ambassador to England for which services he was owed a favor.

Apparently, the favor was called in and delivered when the Presidential election was handed to the Kennedys on a mob promise to father Joe; having been effected by the ever so ethical mayor of Chicago, John Daly, stuffing the ballot boxes in Cook County, Illinois. This was why it was so poetically and justly pathetic to see John Daly Junior adamantly plea the case of election fraud in Florida when George Bush II was elected over Albert Gore.

Payback can often take a long time, but it is always still a real bitch.

Part of the original deal between the mob and the Kennedy boys was that Frank Sinatra would be the mob’s ambassador as well as its liaison to the White House and that certain special favors would periodically be required of the Kennedy Administration for the big assist at the voting booths. Keep in mind that Nixon had won the popular vote in Illinois and that Cook County only reported the next day when the number of necessary electoral votes to win became known.

However, once in power the Kennedys decided to expunge their father’s past. They not only reneged on the deal but then decided to turn around and break the spine of organized crime in America; thus, hoping to bury their sordid past connections forever. They believed their power placed them above the law of the common man and that the sins of their father should no longer be visited upon them.

Among other things, Bobby Kennedy had the mob boss of New Orleans, Carlos Marcello plucked off the street and unofficially ‘deported’ by dropping him into a jungle in South America. After he miraculously made it safely back o civilization, Marcello angrily castigated Bobby for his cowardice and corruptly brazen use of his office to avoid the customary legal channels of deportation.He was also royally pissed off that his family had no clue as to what had happened to him because if he had at least been plopped down in Sicily instead of in Honduras, this would have been an acceptable and more honorable chess move.

The Kennedys then quietly began to snub Sinatra by making it clear directly that his presence was no longer required at the White House. Bobby then went one step further in bringing mob bosses in front of Congress when he launched his campaign to finally eliminate organized crime in America.

He jeeringly and repeatedly derided Sam Giancana in a nationally televised public display where he stated that Mr. Giancana (Gin-cahna, in Boston brogue) was “giggling like a little girl.”

  • Are you giggling Mr. Gin-cahna. Are you giggling? Is that you giggling? I thought only little girls giggled, Mr. Gin-cahna.

Even as the U.S. Attorney General, discretion would have suggested this to be an insane allegorical accusation.

Add to all this the fact that J. Edgar Hoover, who liked to play the horses, especially the trotters, would regularly meet Sam Giancana on a park bench in Washington D.C. to get his periodic list of sure winners. Some historians believe that not only did John Kennedy want to emasculate the CIA, but he also felt J. Edgar Hoover’s tenure and power was too much for one individual to hold. Hoover also despised having to cow tow to Robert Kennedy as Attorney general.

Richard Nixon felt the same way about Hoover when he became President but recanted his call for Hoover to step aside after Hoover showed Nixon his own FBI file.

Finally, does it not seem strange that Marilyn Monroe, who had three-way sex with Giancana and Sinatra at Lake Tahoe, at some other ill-defined point in the process, then became a paramour to both Kennedy brothers? After Sinatra’s snub the mob simply sent in their moll to get whatever information they felt they needed. Happy Birthday, Mr. President!

Sam Giancana’s nephew sates that the mob planned J.F.K.’s assassination. Giancana wanted to eliminate Bobby instead, but Marcello said that:

  • When the dog bites you, you don’t cut off the tail. You cut off the head because the head has the teeth. Otherwise the dog can come back and bite you again.

He also had a sign outside his office that stated: “Two people can keep a secret only if one is dead.”

Who knows if the CIA or the FBI or the Free Cubans or any rouge element of the same were also involved. Strong evidence supports the premises that one or all were co-conspirators because the stakes were too high and the cover up was too slick. Then once J.F.K. was gone and Bobby resurfaced to run for President, there was little choice but to finish off the job because if not, then the players would have to face a brand-new snarling, dangerously angry, more viciously powerful, and vengeful dog to boot.

That is, unless you happen to believe that Aristotle Onassis, as he admitted to his mistress Maria Callas, paid radical elements of the Arab terrorist world to kill his old nemesis, Bobby, after which he then took the ultimate trophy bride, Bobby’s now sufficiently post bereavement sister in law, Jackie, whom Bobby was already tired of screwing anyway.

Martin Luther King was in a different bind. He was on the wrong side of the FBI, an organization who believed that he was a communist and felt that a grass roots street revolution could not be tolerated. The Watts riot of 1965 would have paled in comparison with what they feared might happen if King could continue his crusade. Blackmailing King by releasing tapes of him banging his girlfriend in a motel room would not have been enough to derail his accelerating popularity.

Marilyn Monroe also had to go because she either knew too much or her role as a spy became too compromising. Who killed her is anyone’s guess. She had played with everyone’s matches before she finally got burned; or rather had her passionate flames  doused by a barbiturate enema.

But for the Kennedys, no matter how you slice it, when your list of enemies includes the FBI, the CIA, Fidel Castro, Richard Nixon, LBJ,  Free Cuban expatriates, and three of the most powerful mob bosses in America it would be very difficult to find a friend, much less even a loyal body guard.

Then, there is the final irony.

After Castro took over Cuba, Santo Trafficante went there in an effort to resurrect one of his gambling casinos. Castro put him in jail. Carlos Marcello sent Jack Ruby to Havana to negotiate Santos release from prison. Castro agreed after the three men then set up a Caribbean heroin drug traffic operation. No. There was no conspiracy to kill Kennedy. It just happens to be a small world.

What I do not really understand however is why there is so much doubt that the assassination of John F. Kennedy was a conspiracy and that the dots were purposefully never connected. Just watch the Zapruder film.

Kennedy takes the first bullet, that going into his back then exits through his trachea and hits John Connelly. Both men react. Kennedy falls slightly forward and to his left while bringing both hands forward with his fists clenched and then up toward his throat. Connelly at the same time turns hard to his right as the bullet goes into his back.

Jacqueline quizzically looks toward JFK and begins to move to assist him, at which time the President’s head is forcefully blown back or sideways by a second shot that coming from the front or the side, rips through his head and blows his brains out the back of his skull. Entry wounds cause a little hole. Not splatter.

This is the point where Mrs. Kennedy panics and tries to crawl out the back of the car.

One can look at mountains of evidence, re-creations, and tedious explanations from both sides of the theory and form opinions either way, but the film is real and the film tells it all. Then there is the testimony of mob hitman James Filer who admitted that he shot Kennedy from the fence behind the grassy knoll.

By adding insult to injury, a mob stooge, Jack Ruby, known to be a soldier employed by Carlos Marcello, then kills Lee Harvey Oswald, a man undoubtedly involved and naively recruited to have been history’s greatest patsy. We are then supposed to swallow the propaganda line that Ruby was so upset about losing his ‘beloved president’ that he simply could not help himself. How perfectly maudlin.

The History Channel airs an astute series on the assassination of John F. Kennedy. In the final capitulation one commentator states that if it true the murder was covered up at the highest levels of government, then it is also true we do not live in a democracy, but rather the case that we live in a hierarchy.

One does not even have to link this concept to a political assassination. If we actually lived in a democracy, then even an unemployed blue-collar Pittsburgh steelworker or a Detroit autoworker would have an equal chance to be elected President.

Or even worse, perhaps this country was spared the frightening possibility of reverting to governance by monarchy. Think about twenty-four sequential years of a Jack-Bobby-Teddy Presidency, and because the family breeds like Irish Jack rabbits, following this with endless generations of Kennedy political animals running amok in Washington.

This may have been foremost in the mind of one of LBJ’s daughters, who in being far less than jubilant after his Vice-Presidential nomination in 1959, was told by her father that they had not come to the nominating convention to pout. She quipped back that they had not come to the convention to be the Vice President either.

Funny thing then about the death taking place in Dallas, no?

 

kennedy-shot

 

 

 

If you really want to hit a moving target, you must triangulate it. Two shots successfully hit from two different directions. The third one hit the pavement.

Final score: Guns two. Brains nothing

 

 

Or if you don’t like triangles, perhaps a perfect Pentagon fits the bill.

  • CIA
  • FBI
  • Mafia
  • Cuba Libre
  • Ambitious Vice President. The man who would be king.
Zapruder clips http://pages.prodigy.net/whiskey99/fig21.jpg