Worst Mass Shooting in US History

I got up Sunday morning and the CNN headlines stated: "50 dead, 53 injured.....".  What appears to have been a single shooter entered an Orlando nightclub last night  at about 2AM and shot 92 people with an assault rifle.  I saw Dr. Michael Cheatham  of Orlando Regional Medical Center say that a mass casualty incident was declared and an additional 6 trauma surgeons and a pediatric trauma surgeon were brought in.  The FBI is investigating it as an act of terror or a hate crime.  The shooter was a 29 year old man who had been investigated by the FBI for possible ties to Islamic extremism.  He had been working as a security guard for a company who provides services to the federal government.  He was licensed to purchase firearms.  He purchased two firearms shortly before the shooting - a Sig Sauer MCX Carbine 0.223 cal on June 4 and a Glock 19  9mm pistol on June 9 from the same gun shop.  Some reports suggest he was also carrying a Walther P22 .22LR pistol, purchase date unknown.  Prior to this incident the worst mass shooting incident was the Virginia Tech incident in 2007 that killed 32 people.  

At the time of the attack the shooter called 911 and pledged allegiance to ISIS and mentioned the Boston bombers.  President Obama came on the networks at 2PM and referred to the incident:  "This was an act of terror or hate."  He pointed out that this was an attack on all Americans and he encouraged solidarity.  In an earlier commentary (posted above) he discussed solutions.  He used the example of highway traffic fatalities and how they were approached from a scientific and public health standpoint.  Vehicle safety improved.  Driver behaviors especially driving while intoxicated was confronted.  Although he did not mention it, the drinking age in the United States was increased to age 21 largely by political leverage using federal highway money granted to individual states.  He pointed out that these same public health measures cannot be used in the case of firearm violence because Congress has blocked research on firearm deaths and violence. He discussed a situation that he had just encountered, where people being tracked by the FBI for frequenting ISIL web sites could be put on the no-fly list but they could not be prohibited from purchasing firearms. That legislation is blocked by a gun lobby with a primary thesis that some members of the government want to take away Second Amendment rights and firearms from law-abiding citizens.   The President points out that nothing could be further from the truth and cited the fact that more firearms have been sold during his administration that practically any other time of the Republic.  I think the manufacturing statistics might back up that claim at least based on a chart I created during the first half of his administration.  Further information corroborating this statement is available at the document Firearms Commerce in the United States 2015 on the ATF website.  There is plenty of data there to corroborate both the President's remarks and the potential financial conflict of interest of the firearms lobby.  I am sure that the gun advocates will be the first to say they deserve credit for gun commerce rather than the President.  My speculation is that they would deflect the conflict of issue by either wrapping themselves in the Second Amendment or as advocates for all of the law-abiding gun owners.

I think that most physicians agree with a public health approach to gun violence and would like to see more data and strategies.  The existing data shows that gun availability is the single largest determinant when it comes to firearm deaths either due to suicide or homicide.  It accounts for the greatest correlation with adverse outcomes from gun violence.  By comparison psychiatric diagnosis does not.

The President's comments on the further political aspects of gun control legislation in the US especially people being investigated by the FBI, like the perpetrator was on two occasions cannot be prohibited from obtaining firearms.  That speaks directly to the pro-gun argument that all we have to do is focus on existing laws and get the guns out of the hands of the bad guys.  This law potentially puts guns directly into the hands of the bad guys and nothing is being done about it.  The Obama video was posted 10 days prior to the Orlando attack.

I won't belabor the points I have already made in a series of posts on this blog.  We are still seeing the same microanalysis and political opportunism that has become a routine part of mass shootings.  We are still seeing the lack of solutions like we have seen in the past.  The way it looks I can continue to post on the issue on out into the future it will probably be a problem long after I am gone.  I heard a gun advocate on public radio this morning and what he said after this incident was not only depressing and disingenuous, but it typifies a rigid illogical stance that no place in science, medicine, or the 21st century.  It illustrates why the gun lobby has Congress enact laws to stifle funding for epidemiological work on gun mortality and morbidity.   I suppose at this point it is just a question of when we hit the tipping point.  When will the majority of Americans start to reject this illogical philosophy?

If the gun advocates hit the street with this hard line attitude after the scope of a mass shooting like we witnessed in Orlando - I shudder to think of what the eventual human cost is going to be.




George Dawson, MD, DFAPA




Attribution:

Embedded video per PBS and the instruction on their site.  Original video was from June 2, 2016

Blame Gun Extremists – Not Parents

 

   

 The Crumbley verdict is in and in the usual manner – the media is either celebrating it or bothered by it.  The bothered response is more muted this time – probably because Americans have been conditioned to see national court cases as vindication or rejection of whatever moral position they seem to have on the issue. Without reading the court transcript – media reports suggest that the prosecution in the case portrayed Jennifer Crumbley as a distracted mother who did not pay adequate attention to her son – 15-year-old Ethan Crumbley’s mental status.  If she had - he would not have had access to the 9mm semiautomatic handgun that he used in the Oxford school shootings.  On November 30, 2021 – he shot and killed 4 students and wounded 7.  The jury agreed with the prosecution despite Ms. Crumbley’s statement: "You never would think you'd have to protect your child from harming somebody else. That’s what blew my mind. That was the hardest I had to stomach is that my child harmed and killed other people."  She was found guilty of 4 counts of involuntary manslaughter and the sentence is pending. 

Jennifer Crumbley is of course right.  Professionals charged with assessing the potential for harming others cannot accomplish this task with any degree of certainty.  Should untrained parents be held to that standard, especially when they are emotionally involved with the children they are supposed to assess?  A summary of her court testimony is available from several sites at this point. It focuses on testimony and texts that suggest her son was having difficulty at school and that other people noticed he was moody and depressed. The parents were called in by school officials because they had noticed violent content in his drawings, but after a meeting they did not insist that he be removed from school.  I do not know the school professionals involved – but if there was that level of concern – why not insist that the parents take their son home and give them a clear plan of care?

With any criminal proceeding there are always a lot of discrepancies.  Jennifer Crumbley denied that her son was symptomatic (hearing voices and depressed).  She denied knowing anything about his preoccupation with violent thoughts.  Ethan Crumbley apparently intentionally injured birds and enjoyed doing that.  I do not know if the parents were aware of this or not. There was some debate about the family’s health insurance situation.  Coverage for Ethan lapsed when his father lost his job and his mother was trying to enroll him during the next enrollment period in her plan.  There is also the question of what is generally available for emergency psychiatric care for a 15 yr old.  I don't know if that was bought up during the hearings or not.  I can't speak to what is available in that specific area, but I can say that it is generally non-existent throughout much of the country.    

There is some opinion in the media right now that this trial is precedent setting in that it may translate to parents being held responsible for the crimes of their children. Although I am not a lawyer – to me the precedent seems to already have been set – parents are not responsible for the crimes of their children.  There have been other parents convicted in cases where their children were involved in school shootings.  In one case the mother of a 6-year-old who shot his teacher was sentenced to 21 months, but that was for illegally obtaining a firearm by denying a that she had a drug problem.  In the other case, a father of a shooter who killed 7 people was eventually charged with 7 counts of reckless conduct for assisting his son in obtaining a firearm license even when he had expressed thoughts about killing himself and others.

The critical events in the Crumbley case seem to be the parent purchasing the handgun for their son as a way to lift his spirits, not securing the gun when he was not under their direct supervision, and the two meetings at school on the day before and the day of the shooting. On the first of those days there was concern that he was researching ammunition on his phone during class.  He explained that he went shooting with his mother and that was a hobby.  The counselor called his mother who communicated by text and joked that he had to learn to not get caught.  On the day of the shooting, his parents were called in after he was seen watching a violent video in class, drawing guns and a bleeding body on a math worksheet and writing several nihilistic statements. The counselor was concerned that he might be suicidal. During the meeting the Dean of Students brought in Ethan’s back pack but nobody searched it.  The handgun was in the backpack.  He returned to school from that meeting with his backpack and started the shooting (2).  

In a related matter – there is a civil suit but the trail of that paperwork is difficult to follow.  The original suit against the school and staff was dropped but a subsequent suit against the counselor and Dean of Students was allowed to proceed. There was also a lawsuit against the Michigan State police.

From what I know about this case so far, it appears that Jennifer Crumbley’s trial was primarily an attack on her character. Combined with hindsight that is a powerful approach to find someone guilty of a crime.  I looked up the definition of involuntary manslaughter in the state of Michigan according to this reference it requires proving one of 2 theories:

1:  That the deaths were caused by grossly negligent actions of the defendant

2:  That the defendant neglected her duty as a parent to “exercise reasonable care to control their minor child so as to prevent the minor child from intentionally harming others or prevent the minor child from conducting themselves in a way that creates an unreasonable risk of bodily harm to others.”

There is a lot of room between "gross negligence" and "reasonable care." In this case the parents were responsive to school authorities and those responses at the time satisfied those authorities to the point that they allowed Ethan to return to school.  

Applicable laws in the State of Michigan state that handgun purchasers must be 18 years of age to purchase from a private seller and 21 years of age to purchase from a federal licensed firearms dealer (FFL).  The handgun purchase in this case occurred when Ethan Crumbley was 15 years of age.  Michigan will not have a safe storage law for firearms until February 13, 2024.  The law mandates that unattended firearms must be locked and unloaded and it defines crimes and penalties for problems that occur as a result of violations defined as behavior ranging from threats to deaths resulting from unauthorized access to that firearm.  Since the Oxford school shootings occurred in November 2021 – that law does not apply. 

The medical literature has a few studies that appear to address the issue of age-related firearm purchases and homicide and suicide.  The authors of one study (6) found no correlation between higher age requirements and homicide rates of 18-20 year olds; but discuss the reasons why that was the case.  Most of those reasons come back to the firearm density in the United States and how easy it is to access firearms through back channels.  Any casual inspection of those firearm density figures in the United States – shows an incredible number of firearms even relative to war zones across the globe. The United States ranks 9^th in gun homicides.  The 8 countries ranking higher all have significant amounts of gang and cartel related violence, some to the point that it is driving the current immigrant crisis at the southern border.  Five of those 8 countries have the highest crime index.  Four have the highest homicide rates.  The US has the gun homicide rate of lawless low and middle income (LMIC) countries.  

The cultural effects of gun extremism are never discussed as being a cause of gun violence in the United States.  Over the past 50 years, gun extremists have pushed for increasing accessibility to firearms by shall issue laws, stand your ground laws, fewer restrictions, and loopholes that allow back door access to firearms. In the process, common sense gun laws that were developed in the 19^th century, like city ordinances that forbade carrying guns in town have fallen by the wayside.  Some gun extremists are pushing to eliminate domestic violence charges as a disqualifier for gun possession. In that landscape there is a subcultural effect that (for some) guns are a legitimate way to express anger or dissatisfaction in school or the workplace. Nobody is standing up against that myth.  If anything, the gun extremists are rationalizing it as mental illness or not enough guns (arm the teachers) rather than far, far too many guns.

That is what I think about when I think about the Jennifer Crumbley verdict. In many ways she was set up to take a fall for 50 years of gun extremism. Certainly, her son should have never had a handgun.  But do other parents buy firearms for their children?  They certainly pose them with guns on Christmas cards. When I was a kid 50 years ago – no kid had one and it was the law. There was a good reason for it and that reason was not discovered until the 21^st century.  Teenagers may look like adults but they do not have the brain development or judgment of adults. Combining that with a general culture of gun extremism and a subculture of mass shootings is a recipe for disaster. Until we recognize the cultural effects and how guns became part of the culture wars – we will not be able to stop this violence and loss of life.  

Parents may have become the next casualty.

 

George Dawson, MD, DFAPA

Photo Credit to my colleague Eduardo A. Colon, MD

References:

1:  El-Bawab N.  Jennifer Crumbley says she wishes son had 'killed us instead' as she took stand in manslaughter trial.  February 1, 2024.  https://abcnews.go.com/US/jennifer-crumbley-takes-stand-manslaughter-trial-tied-sons/story

2:  Snell R.  Oxford school shooting victim's family sues Michigan State Police in latest legal challenge.  October 5, 2023  https://www.detroitnews.com/story/news/local/michigan/2023/10/05/oxford-school-shooting-victims-family-sues-michigan-state-police/71074873007/

3:  Stack MK.  What Is This Mother Really Guilty Of?  New York Times.  Febnruary 1, 2024. https://www.nytimes.com/2024/02/01/opinion/mother-homicide-court-crumbley.html

4:  Strom S. Michigan Involuntary Manslaughter Law.  FindLaw.  February 7, 2024. https://www.findlaw.com/state/michigan-law/michigan-involuntary-manslaughter-law.html

5:  Associated Press.  Timeline: Key moments surrounding the 2021 Michigan high school shooting as mother of shooter is found guilty.  https://www.nbcchicago.com/news/local/timeline-key-moments-surrounding-the-2021-michigan-high-school-shooting-as-mother-of-shooter-is-found-guilty/3348384/

6:  Moe CA, Haviland MJ, Bowen AG, Rowhani-Rahbar A, Rivara FP. Association of Minimum Age Laws for Handgun Purchase and Possession With Homicides Perpetrated by Young Adults Aged 18 to 20 Years. JAMA Pediatr. 2020 Nov 1;174(11):1056-1062. doi: 10.1001/jamapediatrics.2020.3182. Erratum in: JAMA Pediatr. 2020 Nov 1;174(11):1119. PMID: 32870238; PMCID: PMC7489426.

No Way To Run A Democracy.....

 

 

CBS news came out with an analysis this morning that most Republican mid-term election candidates are election deniers.  That is 308 out of 597 total.  They agree with former President Trump that he actually won the 2020 election, despite the fact that there is absolutely no evidence to support that claim.  The evidence is lacking even when analyzed by Republicans and judges and attorneys who are Republican appointees. When that claim is reported in the news these days it is characterized as a lie. Even apart from the news media, the January 6^th Committee has presented direct evidence that this claim was inaccurate and had no supporting evidence and that it also formed the basis for the coordinated attack on the Capitol and an attempt by former President Trump and his associates to overthrow the newly elected government of the United States.

What should be most concerning for any citizen of the United States is that attempted insurrection. There is a good chance that if the current crop of Republican candidates – most of whom are overt election deniers become the majority in the House that former President Trump and his associates will not be held accountable for this action. That is unprecedented in any democracy and it flaunts the rule of law and political convention of the United States. If the insurrection had succeeded – the United States as we know it would cease to exist. Democracy instead would be replaced by a Republican party of moral and gun extremists.

Instead of focusing on preserving the Republic – voters seem focused on the economy and inflation – as though any group of politicians has a more favorable history in that area. Over the course of my lifetime, we have had worse inflation, much worse unemployment, 10 recessions, 2 economic crises that nearly collapsed the world economy, and 30 yr fixed mortgage rates at least twice as high as they are now.  The people who saved the economy were professional economists from the Federal Reserve who are appointed and not elected officials. Elected officials consistently have the opportunity to pass legislation to reduce financial market risk due to speculation, but they seem to lose interest every time one of these crises has passed.  In this case both inflation and the possible recession can be explained by historical events (pandemic, Russian invasion of Ukraine) affecting the supply side and driving up prices. Rising interest rates to decrease demand and reduce inflation have made increased the cost of borrowing and that comes following a long period of artificially low interest rates that included low interest rates for savings accounts. In some cases, money market and bond funds were paying negative interest.  

I present the following graph as economic evidence. It is not exhaustive but it illustrates my point. I thought about adding a timeline of Federal Reserve Chairs but ran out of time. The national debt increases substantially under all presidents. The recessions are the shaded areas. Major crises in the economy occurred with the Savings and Loan Crisis (1982-1989), Long Term Capital Management liquidation (1998) and the Subprime Mortgage Crisis of 2007-2010.  The graph extends to August of 2022 with unemployment at 3.5% and Sticky Price Consumer Price Index of 6.39%.   Republican politicians are saying this is the highest inflation rate in 40 years.  What they are not saying is that it is also the highest rate of corporate profits in 70 years and the Federal Reserve has made interest rate increases that are already taking effect in the housing market. (click to enlarge)

I say that the voters seem focused on the economy because it is hard to get valid news about voter preferences from major networks focused on either balancing one party against the other (when no such symmetry exists) or acting essentially like the public relations department of the Republican party. Viewers used to be able to turn on the news and watch reliable journalists deliver the facts, but now they have a choice to listen to a broadcaster who parrots their political ideology. The facts take a distant second place.  There is no clearer example than election denial and all of its ugly correlates like voter suppression and political violence. 

There is only one party that has multiple members endorsing both of those options.  To listen to some of those candidates today – they make it seem like the opposition party has similar problems. There were no Democrats advocating for the violent overthrow of the US government.  There were no Democrats addressing violent groups and suggesting that they “stand by”.  There were no Democrats writing and passing permitless carry gun laws at a time when gun homicides and suicides are high and school shootings continue unabated.  There were no Democrats passing laws that allow heavily armed men wearing body armor and carrying assault weapons to gather in proximity to a legislative body and intimidate them. There is no symmetry between parties on the issue of political violence, gun violence, and the orderly transitions between elections. 

I could continue but realize that this scarcely read blog and the lateness of this post will probably not change much. I will end by posting what I consider the top issues to be in order of importance. I have posted before that I am a long time small “i” independent but in the current Constitutional Crisis I don’t have much of a choice and I have already voted. The vote I cast last week required 2 forms of ID, my address had to be confirmed in an electronic database and I had to sign a registry and one of the two envelopes containing my paper ballot.  That sealed paperwork was directly observed and signed off by an election worker.  This is what I voted on:

1:  Preservation of American Democracy. No insurrection against the government can stand and none of the conspirators should go unpunished.  Any party claiming to be the Law and Order party should understand this.  That party is trying to make crime an issue and it is hard to say if the media or the GOP is the reason for this focus - but the reality is that there has not been an increase in violent crime and there has been a 30 year trend in a positive direction. 

2:  Voter Rights. The Big Lie about the 2020 election was a variation of the big lie about election problems in the United States.  That lie is used to restrict access to voters and make it more difficult for citizens to cast their ballot. Lower income Americans are disproportionately affected.  A variation on that theme is intimidating voters and election officials. That is an ongoing process and it is encouraged by politicians spreading the Big Lie about both the election process and the integrity of the voting process. There is no evidence that either has been compromised. 

3:  Civil Rights.  The unprecedented attack on Roe at the level of the Supreme Court is really the culmination of Republican activism dating back to the Carter administration. At the time a Republican activist convinced fundamental Christians that they should be politically interested in the abortion issue and it was used to attempt to protect school segregation. They created one of the most divisive issues in American politics to advance their interests and made it seem like it was a religious issue.  This is a doubling down of moral extremism.  In other words moral superiority to cover an essentially immoral act.  There are not many positions that are more cynical.

4: Gun Regulation. Gun carnage continues unabated and the GOP and their justices in the Supreme Court have no reservations about allowing it to continue.  Republicans everywhere are rationalizing it as a problem with mental illness, when the prevalence of mental illness is the same across all countries and only the United States has mass shooters shooting children on a regular basis, gun homicide as a leading cause of death in children and young black men, and extremely high levels of gun homicides and suicides.  There are currently 25 states that allow permitless concealed carry of firearms.  All of this from a politicized reading of the archaic language of the Second Amendment. That alone would probably not be enough.  It also takes the fear tactic that the "government", "liberals", etc are "coming for your guns."  The reality is that there are so many weapons in the country - finding them and rounding them up would be an impossible task for anyone. And of course - nobody is interested in doing that. 

5:  Strengthening NATO.  The Biden administration has handled the crisis in Europe and rebuilding the NATO alliance expertly and they are not getting nearly enough credit. A secondary goal should be containing terrorism with our allies that comes in all forms including state terrorism that we are witnessing from Russia, North Korea, and Iran. It is likely there would be a much different outcome under a Trump administration.

5:  Nuclear non-proliferation: Every possible effort must be made to ensure that nuclear weapons are not used again.  There is too much loose talk about how limited tactical nuclear weapons would release less radiation and that a small local nuclear war would be "winnable" by somebody. Climate change should be a wake up call illustrating that even small changes in the environment can lead to catastrophic global changes. The detonation of nuclear weapons will not determine winners and losers. Mankind will lose and civilization will end.  

6:  Climate Activism:  As climate change gets more and more obvious the party that denied it was happening clearly has no solutions.  The infrastructure bill passed by the Biden administration was a major step in the right direction but even that is not enough. More changes need to follow to reduce carbon dioxide emissions and remove permanent environmental contaminants from the environment.

7:  Social programs.  There are Republican legislators who want to cancel Social Security and Medicare or euphemistically review it every 5 years and decide whether or not to cancel it.  Every person who has paid into those programs needs to be assured that they will get the agreed upon benefits.  Republicans use socialist rhetoric to impress upon their followers that the “socialists” want to take over the government and restrict their freedom.  In fact, social democracies are some of the fairest systems in the world and the United States has had social programs for a long time. Social programs in a democratic republic have nothing to so with a socialist government.

8:  Public health Initiatives: COVID-19 denialism was a major factor in unnecessary mortality and morbidity from that pandemic and there is no doubt who the most significant players in that denialism were. As the climate deteriorates and mankind is in closer proximity to millions of novel viruses in the wild – we need to infrastructure to assess those threats and either contain them or treat the outbreaks. We need people who understand science as a process and what needs to happen in this area.  Instead we have Republican politicians bragging about ignoring public health measures.

9:  A Coherent Immigration Policy:  Building walls and playing games with the lives of undocumented immigrants is not a coherent policy. It will take more comprehensive planning and aid to countries in Central and South America.  In addition the United States has a lower percentage of foreign born citizens than many European countries and Canada as well as a labor shortage so that increasing the number of legal immigrants each year can potentially decrease the number of people seeking political asylum. 

10:  Simplified Tax Policy:  Taxes are always a political football. Promise of no new taxes and tax cuts are not realistic, especially considering the current national debt.  A better plan is to make taxes more transparent and easier to complete. Business taxes should not be eliminated and should be consistent year-to-year and not a disincentive to doing business in the United States.

That is what I voted on.  It does not come down to a single issue for me.  It does not come down to voting for myths rather than reality.

But it does come down to a single party.

 

George Dawson, MD, DFAPA

Extremely relevant late breaking stories relevant to the above post:

1: Election deniers in Minnesota are training some election judges. Link - there are widespread efforts with various levels of organization by election deniers to interfere with the election process. This is a story from 2 days ago.

2:  What Fortune 500 Companies Said After Jan. 6 vs. What They Did.  Link - major US corporations said they would suspend political donations to election deniers and insurrectionists following January 6 - but those donations have resumed to the tune of $13 million.

3:  A message from Billie Eilish on the importance of voting. She describes the top issues highlighted above and I hope her followers and fans are able to follow through with her advice:  https://www.instagram.com/p/Ckj-ihtLw3G/?utm_source=ig_web_copy_link

4:  Charles Blow.  Dancing Near the Edge of a Lost Democracy.  New York Times November 6, 2022   https://www.nytimes.com/2022/11/06/opinion/midterms-democracy.html

"America is one bad election away from being a memory."

5:  Putin ally Yevgeny Prigozhin admits interfering in US elections.

https://www.theguardian.com/world/2022/nov/07/putin-ally-yevgeny-prigozhin-admits-interfering-in-us-elections

They are obviously not interfering in the direction of more democracy.

6:  Bill Maher's analysis on the even of the election. Certainly hope he is wrong but if he isn't these are a few more reasons:

Democracy's Deathbed | Real Time with Bill Maher (HBO)

https://www.youtube.com/watch?v=HKVBvooZ2c8

7:  Office of Intelligence and Analysis Operations in Portland April 20, 2021

https://www.wyden.senate.gov/imo/media/doc/I&A%20and%20OGC%20Portland%20Reports.pdf

Remember all of the reports about Antifa - the secret left wing terrorist organization that was supposed to be fighting the police and causing general unrest in the riots following George Floyd's death.  At the time is was pretty clear it was a myth to rationalize right wing militias showing up heavily armed to maintain law and order.  This mildly redacted report shows how US intelligence failed to show that any such organization existed.

8:  Democratic upset in U.S. midterms could roil markets, options mavens say

https://www.yahoo.com/finance/news/democratic-upset-u-midterms-could-060916343.html

Nothing like last minute pro-GOP economic propaganda.  Three things:

1.  The current polls are based on the 1% of people using land lines who agree to take the poll.  With that level of sampling don't be too surprised if polls are wrong as they have been in the past.  There is no "upset" in that context only inaccurate polls.

2.  Why would the average voter be remotely interested in what "options mavens" have to say. Anyone who has followed financial news knows that it is often created to move markets in a favorable way and not to favor the casual investor or little guy. 

3.  See more objective data from the St. Louis FRED below.

9:  The Recent Rise of U.S. National Wealth

https://research.stlouisfed.org/publications/economic-synopses/2022/10/19/the-recent-rise-of-u-s-national-wealth?

Written by professional economists and not politicians.  Was this expansion due to another tech bubble?

"If this rise is driven by another asset bubble instead of the reasons mentioned above, then this trend is likely to cause another recession. Unfortunately, it is difficult to identify an asset bubble until after it has burst."

The current state of economics.

10:  Election workers brace for a torrent of threats: ‘I KNOW WHERE YOU SLEEP’:

https://www.yahoo.com/news/election-workers-brace-threats-know-155038219.html

And let's be honest - these threats are the direct result of the Big Lie, The Insurrection, and the fueling continued political violence by the GOP.  There are no Democrats threatening election workers.

11:  Voting Machine Problems in Arizona Fuel Right-Wing Fraud Claims

https://www.yahoo.com/news/voting-machine-problems-arizona-fuel-195213577.html

Trump spreads voter fraud claims on this election day, despite Republican official stating that there is no problem.

12:  John Oliver on Election Subversion:

https://www.youtube.com/watch?v=Y0LA7Ff2hgs

13:  The gasoline price gambit:

Here is a link to a graph I just made on 12/6/2022 on crude oil prices per barrel versus gasoline prices per gallon.   The explanation of price volatility is in this post.  Don't let any politician from either party use these prices swings to suggest that somebody other than oil speculators and production companies are responsible.

https://gdpsychtech.blogspot.com/2022/12/graphs-from-fred.html

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The Times They Are A-Changin’ – or Are they?

I was walking around last week at dusk on a couple of nights. For the first time I decided to listen to some music as I walked. I would never do this if I was cycling because you need to hear the tire noise of approaching vehicles and I was using noise cancellation headphones tied into my music library. I also decided to use shuffle mode and that is also unusual – I typically repeat tracks until I get tired of them and that often takes a long time. For some reason, my phone kept playing Dylan songs. It reminded me of how I really did not like Dylan when I was young and listening to Hendrix and the Who. My interest peaked when he got the Noble Prize for Literature. It peaked again when I heard him interviewed and he talked about how easy it was to write music when he was younger. The music just seemed to flow and all he had to do was write it down. It was how mathematicians were described in Nasar’s biography of John Nash. Young mathematicians typically produced most of the ideas that advanced the field.

A lot of the songs were melancholy tunes about relationships gone bad.  Some were lessons in how not to be codependent. I was acutely aware of being an old man dressed in black listening to this music and free associating to similar events in my life from long ago. Before it got too maudlin - The Times They Are A-Changin’ came on:

Come gather 'round people

Wherever you roam
And admit that the waters
Around you have grown
And accept it that soon
You'll be drenched to the bone
If your time to you is worth savin'
And you better start swimmin'
Or you'll sink like a stone
For the times they are a-changin'

I could have sworn that what I heard walking around in the dark was a direct reference to the United States in that song. But looking it up later - it was not there. The song snapped me out of interpersonal reflection and into the current threat to American democracy.  For the past several days I had been responding to social media posts about the disconnect between what appears to be going on in national presidential politics and the reality of the situation. Just that day I responded to a poster questioning why Christians appear to be in lock step with a candidate who does not appear to have similar values and how Biden has done very well in the White House but seems to be struggling in the polls against a candidate with a known poor record who orchestrated an insurrection against the US government? A candidate who has been charged with 91 felonies. Even more mysteriously, the entire Republican party with rare exceptions is supporting Trump and most want his endorsement in local and state elections. How can a candidate with that many flaws still be in contention at this point and dominating a party that was originally abolitionist and got Lincoln elected as their first President before the start of the Civil War?  It does not make any sense and I will look at the hypotheticals below.  I tried to put as many as possible into the graphic at the head of this post – but only the coarsest details are possible:

1:  A general lack of critical thinking:

It has been a long time since I took a high school English class, but from what I recall even back in those days there was very little emphasis on rhetoric. Critical thinking generally involved the decoding the author’s intent, detection of symbolism and defending an opinion on a theme: “Do you find Lord of the Flies to be optimistic or pessimistic and why?”  Rhetoric was largely confined to debate teams that a small percentage of students participated in.

It has never been more important for the average citizen to be informed and aware of what might be rhetorical distortions. There used to be some level of assistance from professionally edited news, but that is no longer reliably available. Today it is possible to get all your news from a site that you agree with on ideological grounds – no matter how far from reality that site gets. Apart from these echo chambers on the Internet, the main street news offers minimal assistance.  You might find stories about the polarized electorate with no discussion of what that means or if one side is more polarized than the other.  Threats and overt violence were introduced into the political scene with no comment that this is almost an entirely right-wing phenomenon that is often tied in with gun rights and bragging about who owns the most guns. The right wing owns both moral and gun extremism in the US and yet there no criticism of this in mainstream media. Most importantly, political violence against specific groups should be unacceptable in the US and it is increasingly apparent.

2:  President Biden is too old: 

This seems to be a popular trope in both campaign propaganda and as material for comedians.  Bill Maher for example, will often detail the accomplishments of the Biden administration as being some of the most significant in decades only to incorporate polling questions about his age and conclude he should step down and let someone else run. No suggestions about who that should be and judging from the declared candidates there is no one of suitable name recognition or accomplishment who could run and expect to get support equal to Trump’s locked in MAGA constituency. If you look at my graphic – any candidate the Democrats advance will not have the amount of leverage with the voters based on the factors listed.

But backing up – is 80 years old – too old?  I saw President Biden on the bike and I saw him fall. It was clearly a mistake that people make when they are not used to toe clip pedals. The part that most people seem to ignore is that he got up with no problems. That is not the mark of a feeble old man and neither is the current schedule he has been keeping. More to the point – he has an awareness of how things need to run in the Executive Branch, how information needs to be managed, how consultation with staff is a critical function, and how to manage alliances.  There is minimal evidence that his predecessor has that level of awareness.  

There is certainly no current evidence that Biden cannot do the job given his list of accomplishments and some high-profile incidents – most notably his performance at the last State of the Union address. Ageism is certainly a prominent cultural bias in the US.  If I were a foreign actor wanting to manipulate the American electorate – I would use it, especially if I knew the opposition party could easily be convinced to use it.  The current group of Republicans could be expected to jump on it even though some of their members of Congress are older than Biden.

3:  The Republican base has been manipulated and brain washed by culture war tropes: 

This is undoubtedly a factor at some level.  I have written on this blog about how the GOP has become a party of gun and moral extremists – not out of some strict Constitutional interpretation or religious belief, but out of political expediency. It is easy to manufacture some ideological position to elicit emotional responses from some voters and get them to believe they are in a morally or Constitutionally superior position. Fortunately, that is not how democracy works but it is how the current crop of Republicans want it to work. In the meantime, public safety, education, and women’s health have all been compromised. On the day I am typing this a Constitutional Amendment for reproductive rights was passed in Ohio blocking attempts to pass restrictive abortion laws. Whether this can be a rallying point against moral extremism is an open question at this point.

4:  Fragmentation among Democrats: 

There is some concern that progressives within the party have gone too far in areas of social consciousness particularly social justice issues involving race and the LGBT community. The concern is amplified by the Republican’s rhetorical use of the term woke as a pejorative. That has allowed them to indiscriminately use the term to criticize health care, educational, social, and economic policies as being too woke (translation politically correct) and simultaneously suggest that most Americans would not find it to be acceptable. That can range from books in a high school library that were read by several older generations to college admission policies to protests about excessive use of force by the police.

The current war between Israel and Hamas is a similar flashpoint. One analysis suggests that progressives see the world though a simple lens of colonizers and victims. That has been spun into Israel starting a genocidal war in Gaza or even the US starting or backing such a war. In the most extreme case, social media was abuzz with young people supporting a letter allegedly written by a famous terrorist, blaming the United States for terrorist attacks. That has also led to protests and threats to Jewish college students in the United States. All of that misses the point that violence is being incited against US citizens who happen to be Jewish and that Hamas clearly started the war and clearly stated their ongoing goal is to destroy Israel and kill their citizens.

5:  Activation of far right white supremacist and antisemitic groups:  

There is no doubt that fringe groups that were essentially silenced for many years were activated during the Trump administration and actively support him. In my own neighborhood there was widespread dissemination of white supremacist literature for tens of miles in all directions.  That has never happened in the Midwest during my lifetime. Further investigation linked the same group spreading that literature to antisemitism.  Investigation by local officials and law enforcement did not identify the specific perpetrators and no charges were ever filed.

6:  Activation of antisemitism in younger generations: 

The facts are not disputed and various theories have been proposed. The history is forgotten explanation seems to have a lot of traction.  At least it seems to have garnered the most speculation. In other words, with less exposure to Holocaust survivors and the history of World War II, younger generations are unlikely to believe the actual historical events – a clearly documented genocide against the Jewish people. That seems to minimize any role of activated antisemitic hate groups and social media. Many of these groups are now at the point that they show up in public demonstrations and are attempting to recruit new members from suburban neighborhoods. The wave of antisemitism in the younger generation has had far reaching effects on college campuses, in some cases to the point that departments and administrations failed to condemn the recent terrorist attack against Israel or an obvious problem of antisemitism on their campuses. This generation uses TikTok as a preferred social media site. In a recent press release they described removing tens of thousands of antisemitic posts.  Just how long that posting has occurred is unknown.

I think it is also useful to recall that political violence directed at minority groups is a well-known tactic of fascist and totalitarian states.  In the early days of the Internet online discussions often became heated to the point that accusations of Naziism were often made.  This led to Godwin’s Rule or as an online discussion grows longer (regardless of topic or scope), the probability of a comparison to Nazis or Adolf Hitler approaches 1.  That is basically nerd speak to say that analogies to Nazis based on Internet discussions is probably absurd. What I have seen lately suggests to me that we are beyond the absurd stage when people are injured and living in fear.  If it walks and talks  like a Nazi….

 7:  The social media propaganda machine:  

Social media seems to always be in the news. The common topic is how it is a malignant force in the lives of teenagers and children. There is concern that you can get “addicted” to rapidly scrolling and clicking on too many sites. People talk about the dopaminergic effects of this activity – like the neuroscience is known. Even though we had a foreign government actively interfering in the last Presidential election through social media and email hacks – nobody seems focused on that happening again. US Intelligence agencies predicted that it would happen again and it would probably be more vigorous than the last time. It is also more difficult to detect because the foreign actors are all using servers within the United States. Several agencies are responsible for detecting and monitoring this activity – but 1 year out none of them are reporting on what they see or what kind of misinformation is being posted. You don’t have to be a secret agent to think about who these foreign actors are. Russia was clearly involved in the last Presidential election and given the situation in Ukraine – they would clearly prefer Trump over Biden.  Putin has actively encouraged Russian hackers at all levels including those who steal money from average Americans.  Trump has made it clear that he would not support Ukraine and he clearly had a negative impact on NATO.  Biden has been able to reverse most of that damage and unify NATO.  Iran, China, and North Korea also have an interest in a Trump presidency.  These countries either have a direct interest in supporting Trump based on his probable policies or just weakening the US by more divisiveness in the electorate.

 8:  Uncritical voters:  

I heard Iowa voters asked about why they are voting for Trump and why he is so popular in their state.  I heard the following responses:

 “He is a businessman.”

 “He says what is on his mind.”

 “I don’t care what he has said or done – I am voting for him.”

These responses and his previous performance – all indicate that many Trump voters are not focused on any policy.  It would probably be difficult because most of the policies that Trump seems focused on at this point have to do with revenge against his perceived enemies.  That is typically a low bar – they are people who either disagree with him or want accountability.  That leads me to a previously stated conclusion I made that a lot of Trump’s base are nihilists who just want to burn the system down. It is difficult to find more nihilistic behavior than orchestrating an insurrection against the US government and refusing the peaceful transfer of power.

Given the above analysis – I think the negative sentiment about President Biden is primarily the product of foreign actors manipulating the American electorate. That also explains the disconnect between many of the demographic features of Trump voters and their candidate.

I do not want to put all of this on young voters.  There are clearly older voters who demonstrate similar levels of cluelessness, probably borne out of long-standing biases.  It is up to voters of all ages to not believe what you see in social media echo chambers, clear propaganda from hate groups, and similar attitudes that may have existed in your culture for generations. We cannot turn the United States over to a man and a party of extremists who have proven time again that they have no vision for the country or where it is headed. In Congress the Republican majority has clearly demonstrated that they cannot govern. We cannot be influenced by groups seeking to divide Americans and destroy the values that this country was founded on.

We all must start swimmin’ to save American democracy.

 

George Dawson, MD, DFAPA

References:

1:  Hotez, Peter. "On Antiscience and Antisemitism." Perspectives in Biology and Medicine, vol. 66 no. 3, 2023, p. 420-436. Project MUSE, https://doi.org/10.1353/pbm.2023.a902035.

2:  Scherer, Nancy & Miller, Banks. (2009). The Federalist Society's Influence on the Federal Judiciary. Political Research Quarterly - Polit Res Quart 62. 366-378. https://doi.org//10.1177/1065912908317030. 

Graphic Credit: I made this graphic 

Supplementary 1:  Why I wrote this post - this post is not an analysis of the psychiatric status of either candidate.  I am on record on this blog that the role of assessing the President's fitness to work in that office is supposed to be assumed by lay people working with him or her.  Many people working with Trump have provided scathing critiques of what they observed. I have not seen any from the Biden administration. 

This post was written basically as an exploration of how a candidate who seems so intellectually, emotionally, and temperamentally unfit for the office (as determined by multiple independent assessments by non-mental health professionals) has such a draw with the electorate. It seems mystifying until you look at the diagram and realize that more of the factors that leverage the electorate are stacked against Biden rather than Trump. In fact - replacing Biden in the graphic results in minimal gains. If I had to speculate on the biggest effect I would see it as all of the factors impinging on the social media on Trump's side.  

For the record, I am not a life long Democrat and in fact ran as an Independent in 2000 for the US Senate from Minnesota. As a life long skeptic of both major parties, that was an eye opening experience. I am currently highly motivated to write about political extremism that I see from Republicans and the fact that it is only getting worse.  Giving Trump the job again when we already know what happened the last time is a clear mistake.  Allowing the Republican Party to maintain a nongoverning, culture wars, nihilistic response is also a massive mistake for the Republic.   

 

Supplementary 2:

Will add some examples to highlight the graphic as the I see them on a day to day basis:

Taylor Lorenz - excellent example that I saw today on TMZ is this interview.  Before this the TMZ crew showed Biden's attempt at humor with a birthday cake and they continue this into the interview like he is trying to win young voters with jokes.  Ms. Lorenz of course jumps on the opportunity to point out that Biden has not been focused on what Millennials or Gen Z want.  She cites an example of student loan forgiveness was not a focus apparently forgetting that his $430B student loan forgiveness plan was shot down by the right wing Supreme Court.  All three justices appointed by Trump (Gorsuch, Kavanaugh, Barrett) voted against the plan in a 6-3 vote (Biden v. Nebraska).  Instead she praises Trump for being "authentic."  With brilliant analyses like that Biden does not stand a chance. 

Adam Kinzinger - seems like a rare positive force in American politics today.  I saw him on Real Time with Bill Maher last week where he clearly stated that there was only one pro-democracy political party in the US and it was the Democrats. The former Republican Congressman clearly described why fanaticism is a negative coercive force in politics and that is why it needs to be eliminated. He also founded the Country First PAC as a way to distance himself from right wing extremists and conspiracy theories. 

Gen. Mark Milley - questioned about President Biden's performance by 60 minutes.