To James B. Comey: J’accuse …!

 

James Comey , former F.B.I. Director, has written his memoir, “A Higher Loyalty: Truth, Lies and Leadership”, and we are all transported back to the days when he first met President Donald J. Trump.  The book was a front page story in leading newspapers and cable TV on Friday, April 13. From The New York Times:  “Visceral Details and Grim View of President in Comey Memoir”. TV interviews took place on Sunday while the White House launched a “war room “ to attack Comey and counter revelations in the memoir.  Trump, of course, sent a series of furious tweets about “Lyin Comey” in the days that followed.

Comey , who had been a federal prosecutor in New York before he headed the F.B.I. ,  describes in the book the time he helped take down the Gambino Crime family – The Mob. “ The silent circle of assent. The boss in complete control. The loyalty oaths. The us versus them world view. The lying about all things, large and small, in service to some code of loyalty that put the organization above morality and above the truth.”  Comey’s  draws an analogy between the Mafia boss and the current occupant of the Oval Office.  He writes, “The president is unethical and untethered to institutional values.  His leadership is transactional, ego driven and about personal loyalty.”

This blog was written in May, 2017, six months  after Donald J.Trump was elected to office in November 2016.  James Comey had held  two sensational  press conferences about Hillary Clinton’s emails.  The second came in October, just eleven days before the election!  Plus a final announcement the Sunday before election day on Tuesday. It is worth looking back at exactly how those days enfolded. The result was that Donald J. Trump became the 45th president of the United States of America.  We all have been witness to what that has meant to the country and the world.

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Prologue: As Director of the Federal Bureau of Investigation, James Comey  supervises 50 state field offices in large cities and San Juan, Puerto Rico.  His responsibilities are broad and significant.  He reports directly to the United States Attorney General at the Department of Justice.  His job is to oversee the development and completion of appropriate investigations. The next step is to give his findings to the U.S. Attorney General.  James Comey was appointed to his current position in 2013 by President Barack Obama. During the hard fought 2016 presidential campaign between Hillary Clinton and Donald Trump,   Director Comey became a controversial figure.

Act One:  As the  presidential campaign unfolded, it became known that Secretary Clinton had used a private server for emails,  following the practice of former Secretaries of State Madeline Albright and Colin Powell.  Bernie Sanders, her opponent in the Democratic primary, said in a debate, “The American people are sick and tired of your damn emails!”  This brought much laughter and a hug from Clinton who agreed and thanked him for his good natured response.  However, when Donald Trump became her opponent in 2015,  the email issue emerged as  one of his favorite attack lines, calling her “Crooked Hillary”  and inviting a chant of  “Lock her up!” from his supporters at the Republican convention and  rallies that followed.

The F.B.I. interest in Clinton’s emails began in July 2015 when the intelligence community learned that classified information had been found on certain e-mails. On July 10, the F.B. I. opened an investigation into Clinton’s handling of classified information.   The investigation lasted into the summer of 2016.  By the end of June, agents finally interviewed Clinton aides and Hillary, who was interviewed for over three hours on July 3.  On the morning of July 5, Comey called Attorney General Lynch and said he was going to hold a news conference.  He did not tell her what he planned to say.  As  his superior, she did not insist he tell her.

The F.B.I. summoned reporters to their headquarters in D.C. for the briefing from Director Comey.   A few blocks away, Hillary was about to give a speech.  At the Justice Department, prosecutors and F.B.I. agents watched anxiously.  All Cable TV stations carried Comey’s conference  live.  Comey strode into a large room in  the F. B. I. building and stood in front of two American flags and two royal blue F.B.I. flags.  At six foot  8, he was a commanding figure.  He read his remarks from a script in a firm, clear voice for fifteen minutes.  Comey said F.B.I. agents had reviewed 30,000 emails and found 110 that contained classified information.  He added that computer hackers may have compromised her emails. He criticized the State Department’s lax security culture and Secretary Clinton directly.  He called Clinton and her aides “extremely careless” in their handling of the emails. This became the most quoted phrase by TV and press reporters. Many listeners said later they expected him to announce criminal charges as Trump had been urging for months. That did not happen.  In the last two minutes, Comey explained that the agents had found no criminal “intent”.  Therefore, Comey said, “no charges are appropriate in this case.”

Comey had broken established Justice Department rules of procedure.  His job was to give the F.B.I. investigation findings to Attorney General Loretta Lynch.  She would then decide if further action was warranted.  Donald Trump called the system “ rigged” and rejected Comey’s failure to bring criminal charges.  Comey followed it up with a meeting a few days later with angry Republicans in the House of Representatives. He assured them he would keep them abreast of any further revelations. Throughout the rest of the heated campaign, Trump wielded  Comey’s remarks as a constant refrain. Hillary had been “extremely careless” and could not be trusted as president.

Act Two.  October 28, 2016 was only eleven days before November 8, Election Day.  The polls showed Clinton with a clear lead. Almost all forecasters predicted she would have a strong victory in the Electoral College. Then,  James Comey called a second press conference to announce that thousands of emails from Anthony Weiner , husband of Clinton’s top aide had included  some involving Hillary Clinton.  Therefore, he was reopening the investigation into Clinton’s emails.  This BREAKING NEWS on all cable stations was immediately lableled a violation of a long standing  tradition in the political world: There could be no information or introduction of news that would roil the campaign within sixty days of the election.  This tradition, that had been followed for 50 years, was inscribed in writing by Attorney General Eric Holder during the Obama years.  It was FORBIDDEN  by Justice Department rules to do what James Comey did that day.

In the days that followed, it became known that Loretta Lynch and her deputies had urged Comey not to reopen the investigation into Clinton’s emails. Donald Trump chortled and embraced Comey after castigating him for months.  Hillary Clinton kept to her schedule of rallies and  speeches.  She even moved into red states  that appeared to be turning blue. The polls continued to show she was leading Trump in both Electoral College votes and the Popular Vote. But the margin  had narrowed.

Act Three:  On Sunday, November 6, two days before Election Day,  Director Comey sent a final letter to Congress.  He said his agents had worked their way through thousands of emails and “Based on our review, we have not changed our conclusion that we reached in July.”   James Comey did not vote on Election Day, records show. The first time he ever skipped a national election.  Hillary Clinton said, “Our analysis is that Comey’s letter, raising doubts that were groundless, baseless… stopped our momentum.”  She pointed to polling data that showed late deciding voters choosing Trump in large  numbers.

Epilogue:  We have learned since the election that James Comey and the F.B. I. were beginning their investigation of possible collusion between the Russians and the Trump Campaign in July, 2016 when he held his first News Conference about Hillary Clinton.   This investigation continues and has become a major news story during the First Hundred Days.  When asked why he didn’t say anything before the election about this, he answers that it was not completed at the time. Comey continues to stand by his news conferences and letters to Congress  about Clinton’s emails. He told Senate Judiciary members  he is “mildly nauseous”  at the idea he swayed votes and caused Hillary Clinton to be the loser in the election, making Donald Trump president! Each citizen can make his or her own judgment on that question. I have made mine as reflected in the title of this blog.

……………………………………………………………………………………………Joyce S. Anderson

 

 

 

 

 

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People Skills for M.D. Dummies!

 

 

In this high tech age, we are no longer surprised nor insulted by book titles like “Word Perfect for Dummies” or “Microsoft Works for Dummies”.  In fact, many of us are thrilled to have books that spell out the basics for entry into the mysteries of the computer world.

It seems there’s another area of life that needs a similar primer. It’s a world most of us know very well, the world of the doctor and the patient. There have been galactic leaps forward in medicine in recent years. Amazing new surgical techniques.  New treatments for heart attack and stroke victims that minimize potential damage.  New drugs for a myriad of diseases. Radiation and chemotherapy advances to fight cancer. Shortened hospital stays. Faster recovery time to restored health. For all of these advances, we are profoundly grateful.

However, there still remains a need to improve the people skills of many doctors practicing today. Comedians like to say, “When will they stop practicing and get it right?”  In terms of interpersonal communication, there is less humor and more truth in the question.  Certainly, not  all physicians are guilty of this problem. (This writer has been very fortunate to have been treated by physicians with the best people skills one could wish for. ) But enough qualify to warrant a refresher book. How about calling it “People Skills for M.D. Dummies” . Do you think it could be a best seller?

Here are a few first hand accounts:   Scene: Wedding Reception. Mother of the groom has big red blisters on her forehead, result of a poorly timed painful eruption of shingles. She’s being a good sport, says she’s “patriotic, red blisters, white glasses and blue eyes.”  One of the guests, a doctor, looks at her forehead without an invitation, and pronounces in an offhand manner, “Oh, you have shingles.  Some of my patients have pain from that for years.” Thanks a lot for that encouraging information.  And, who asked you?

Scene, Office of an Ophthalmologist: Couple in their 80’s having their regular checkup.  As the doctor examines the husband, he says, “The left eye doesn’t look too good. You need to make an appointment for a zapping.”  Translation, after cataract removals, scars sometimes form. A laser zap usually corrects the problem. In this case, his lead in comment raised anxiety. Then, the doctor asked the wife, “Do you drive?”  She answered “Yes”. The couple then worried for two weeks until their next appointment.  Zapping went smoothly. His sight war restored to 20/25.

Have you ever been in a hospital when a new doctor, perhaps a resident or an intern, appears at your bedside? He’s holding your chart and says,  “Good morning, I’m Dr. X and how are you feeling today, Mary?”  Mary is sixty eight years old, holds a Master’s Degree and has three children older than the doctor. Call her Mrs. Evans. She has earned that title of respect with her years.

Or the response to a patient who deals with constant pain, when she related that the new medicine is giving her five or six good hours at the start of the day. Then the pain returns in force. Her neurologist replies, “Don’t look a gift horse in the mouth.” Is that supposed to help her get through the afternoon and the evening?

Finally, an unusual situation with a sighted woman who taught Braille transcription to others to produce books for the blind.  During her check up with her optholmologist, he said in a matter of fact manner,  ‘You have a condition where you could wake up blind one day.”  As she was reeling from his cool comment, he added, “Well,  Mrs. S.  You know Braille already.”  She came home in an understandable state of shock.  She never returned to his office again. And happily, it never happened.

Now, many of us thought the medical schools were giving courses these days in interpersonal relations as well as anatomy and biology.  Some of them are.  We had hoped that the new generation would learn that human interaction is at the heart of the doctor-patient relationship.  We even hoped some of the old dogs would learn some of the new tricks.  And some of them have. For the others, here’s a starter list until someone writes the book for M.D.  Dummies:

  1. Each patient is an individual with inherent dignity of being.
  2. The words you use and how you say them are very powerful. Think before you speak.
  3. Patients need time to absorb what you are saying. Hearing is not listening. Make sure your instructions are clear. Write them or ask the patient to write them. Ask for questions.
  4. Take a course in interpersonal relations if this is a new subject for you. They may be available at medical conferences or schools.
  5. Make sure that everyone who works in your office — receptionist, nurse, assistants take a course or have a seminar in your office for everyone. A patient doesn’t want to meet a “dragon lady’ at the front desk or on the telephone.
  6. Patients are often worried when they come to your office with a problem. Some are frightened. Never forget that. Your welcome matters. Your smile matters. Your job is to treat the entire person. Not just the rotator cuff or the intestine.
  7. We know you are usually pressed for time. Try to make each patient feel you are giving them quality time. It doesn’t take many extra minutes. It’s all in the eye contact, the concentration, the personal word. A touch of the hand. Try it. You may like it.
  8. Stay on top of your field. That’s why patients come to you. But never forget that your main endeavor is to heal the whole human being. How you communicate tells them who you are as well as how they are. That’s the key to the entire equation.
  9. Rent the movies “The Hospital” 1971 and “The Doctor”  1991. The former with George C. Scott is a sardonic look inside a big city hospital.  The latter follows William Hurt, an arrogant surgeon who is diagnosed with throat cancer and learns what it means to be a patient. It was based on the true life story of Dr. Ed Rosenbaum, described in his book , “A Taste of My Own Medicine”. This movie is an education in itself for any doctor.

A final story from the positive side of the ledger.  The memory of an obstetrician , a big gentle man who looked like a fullback and instilled confidence in a weary and frightened young woman having her first baby. At the end of sixteen hours of hard labor, when the baby was still not ready to emerge into the world, Dr. S. sat in a chair at her side and calmed her down just by being there. Sixty years ago, the father was not allowed to be with the mother through those long hours alone in a white tiled room with an occasional nurse coming in to check “progress”.  Dr. S. was there at the end when it was hardest.  He gave her something to ease the pain and delivered an 8 pound, 4 ounce son at two in the afternoon.  He will always be remembered with gratitude, respect and affection. He was a kind and caring human being as well as a skilled physician.  We need more men and women of his caliber in medicine today.

This is a beginning list for the Dummies book.  Please add a few ideas of your own. If you are a doctor or a patient or both, you are probably an expert on the subject.

…………………………………………………………………………Joyce S. Anderson

 

 

 

 

 

 

 

 

 

 

March Madness: Donald J. Trump Style!

 

Basket Ball always accelerates in March as college teams are matched to choose the best in the nation.  This year, the White House created their own chaotic version of March Madness with shocking events. Trump fired Secretary of State Rex Tillerson with a six a.m. tweet as Tillerson returned from a grueling tour of Africa at four a.m. to D.C.  Trump had already fired Rob Porter, the aide who handed top security information to the president in the Oval Office.  Next was  Hope Hicks his trusted, close confidant for years in the White House.   Headlines and cable interviews followed Stormy Daniels, the former porn star and her lawyer.  She had been paid over $130,000  to stay quiet about her affair with the president a week before the 2016 election.   Trump also fired Lt. General H. R. Mc Master, National Security Adviser who had replaced General Mike Flynn in the key position  after serving for 24 days.   Flynn, who then was indicted by special counsel, Robert Mueller III , pled guilty and began cooperating with the Russia investigation.

Trump chose Mike Pompeo, the current C.I.A. director, to be his new secretary of state and John Bolton, former ambassador to the United Nations to be the next national security adviser. Both men have been ardent “hawks” in the past and are vehemently opposed to the 2015 Iran deal.  Bolton was a controversial figure at the United nations, once declaring about the tall U. N.building, “if ten stories disappeared, it wouldn’t make a bit of difference.”   The position of secretary of state must pass senate confirmation.  The national security adviser’s position does not require senate confirmation.  John Bolton was a strong supporter of the Iraq war and remains adamant that it was the right choice. His Senate hearing should be one to watch closely.

On March 29, The New York Times reported that Trump had fired Veterans Affairs Secretary David Shulkin and nominated his personal physician, the White House doctor, Ronny Jackson, to replace him.   Trump praised Jackson, a rear admiral in the Navy , who had also been Obama’s physician as  “highly trained and qualified”.  However, this choice immediately raised questions from reporters and and political analysts since the VA is the second largest government agency with over 350,000 employees. The secretary is primarily a very challenging management position.  Jackson has no management experience.  Shulkin in an Op Ed in the Times explained that he had been working with members of the VA to avoid privatization of the agency. He stressed that there were advocates of privatization in the administration and that led to his being fired.  He wrote, “I am convinced that privatization is a political issue aimed at rewarding select people and companies with profits , even if it undermines care for veterans.”

Current controversy swirls about Secretary Scott Pruitt of the Environmental Protection Agency ( EPA) and Secretary Ben Carson of Housing and Urban Affairs (HUD).  Rumors persist they may be the next to be fired by Trump.  Pruitt has spent enormous sums on increasing his protection staff to 20 people , building a secure phone booth, and deluxe air travel at enormous expenses. Carson made headlines with a $35,000 dining room set for his office suite.  He has recently eliminated the words “free from discrimination” and “inclusive’ from HUD’s mission statement. It has been reported that the Trump administration is trying to roll back enforcement of fair housing laws and slowing down officials who have been pursuing civil rights cases.

Easter weekend brought March to a close. Sunday was April first. The president skipped the annual Easter Egg Hunt at the White House.  He flew to Florida to play golf and invited some guests “three Fox News hosts led by Sean Hannity , an ex con and a pillow salesman” described on CNN cable news. On March 23,  David Sanger had written in The New York Times, about the  March firings of significant members of the White House team. “Just a month ago, the prevailing wisdom in Washington was that the triumvirate of General McMaster, Secretary of State Rex Tillerson, and Defense Secretary Jim Mattis, was the only restraining influence on Mr. Trump’s confrontational urges.  Now, only Mr. Mattis is left and there are increasing questions about how long he will last.”

On April l, The Times Magazine had a picture of General Mattis on the cover, “The Last Man Standing”.  Inside the article, there is a picture of  President Trump  at his first cabinet meeting last January with Rex Tillerson on his right and Jim Mattis on his left.  Trump is speaking, animatedly with both hands in the familiar spread finger manner. Tillerson and Mattis appear very grave, as if they are anticipating the difficult year to come.

………………………………………………………………………………………………….Joyce S. Anderson