MICHAEL JORDAN - THE ENTITLED VICTIM

Americans are predictable: money is the arbiter of success, (It is very simple money is aristocracy, the more you got the higher up you are - a millionaire is a mere Sir and a billionaire is a Prince); they cheer a winner regardless of his or her behavior; they support a victim regardless of the circumstances; they just worship entertainers, - of any variety but particularly those involved with a ball of any sort and they are entranced by the drama of the courtroom, having a touching belief in the justice system. These cultural characteristics have taken over from more humble tokens like log cabins, mother’s milk, Davy Crocket hats and apple pie as the bedrocks of the American value system. Often a notable can encompass more than one of these  characteristics and can then set the world on fire. Witness Donald Trump an unashamed boor and braggart but a billionaire winner none the less. That coupled with his entertainment skills and he is off to the races - Presidential races that is. 

Top entertainers in sport have an incredible following and it is fair to say are the most admired of all the American icons.  Good or bad off the field they capture the imagination and admiration while the public never give up on them. Witness the sudden return to form of somewhat scandal tarnished Tiger Woods in a golf event last weekend. The ticket sales went up dramatically. Now if one these champions with a ball appear in a legal drama the nation sits back spellbound day after day watching each play in the court of another sort. Just remember how the nation paused while the O. J. Simpson trial played out while each infringement of a National Football League Player garners all the attention in the world. Nothing engrosses a celebrity hungry society as much as a tragedy to an all conquering hero such as the affliction that baseball great Lou Gehrig had. In tribute he then had his lethal neuronal disease named after him. A victim not only evokes empathy, sympathy and compensation but is somehow admired for bearing his cross and this too is seen as emblematic of the Great American psyche today. 

I WANNA BE LIKE MIKE

The above are examples of top dogs that had encompassed a few of the attributes that epitomize the great American society. What if one champion exhibited them all? Enter Michael Jordan the most accomplished sportsman/entertainer in Jay H. Ell’s lifetime. Now that is saying something because there have been the likes of Pele, Federer, Nicolas and Gretzky. 

Now none of these displayed the all round talent, skill and determination of the famous Chicago Bull, MJ, who is as internationally well known as anyone. It is that much harder to stand out in a sport that relies on teamwork than a pastime that you either compete as an individual or where your own performance is not dependent on anyone else. Jordan was not only the greatest star n his own right he took a team to the dizziest heights that only had one other luminary and elevated the play of everyone else. To just cite one example, Dennis Rodman who was an absolutely unpredictable individualist who danced to his own drummer and MJ integrated him into the team building him up to be the rebound king. Jordan would take the responsibility for all key plays and although everyone knew the ball was coming to him he still converted. Then when everyone read his game and double and even triple teamed him he changed his style totally - no more knifing his way to the hoop, either drawing the foul or scoring - rather shooting from the three point line and or drawing defenders and passing to players that had been left unmarked in the pursuit of him.

All in all the Bulls won 6 championships in the 1990’s. There would have been more had there not been the punctuation in the maestro’s career after the first three when Mike went off to play baseball. In addition, Gerry Reinsdorff, the greedy Bull’s owner, knew he had sold all the tickets for a new stadium so he would no pay all that money to keep that Dream Team intact after their sixth Championship. In short Mike was a phenom and left at the top of his game. He played for another year or two elsewhere but the light had gone out. His legacy was ensured. He was known as “Air Jordan” and “His Airness” but more significantly MJ, his initials, are better recognized than JFK or LBJ by today’s generation. The NBA website acknowledges that he was the greatest basketball player of all time and in Jay H. Ell’s opinion the greatest sportsman in history. 

MIKE THE BUSINESSMAN

After he had finally stopped playing he went into business. It made sense that he invested in a basketball team but the basis of his massive fortune became public as a result of litigation, that he initiated and that played out in Federal Court Chicago last week. But more of what that is all about later. 

MJ is the only sports billionaire. His investment in a basketball team is said to be worth about $500 million and he has an annual income of well over a $100 million a year that comes from branding his name. A decade after he had called it quits he obtains over $80 million a year from Nike. Nike of course collect billions from sales from MJ’s named sneakers. This franchise is growing and growing. “His Aireness” makes millions from every other company that he is connected with. This includes Hanes underwear and a memorabilia company, Upper Deck. This explains why MJ is never prepared to sign autographs - he was reportedly under contract not to do so. So 12 years after shedding his Nike sneakers he limits his signature and it fetches higher and higher amounts. 

JORDAN’S LITIGATION

With all this as a background we proceed to the litigation that took place in the Dirksen Federal Court in Chicago last week. MJ sued, Safeway, the holding company of a grocery store, Dominick’s, that had gone bankrupt, for $10 million dollars. The basis of his claim was that Dominick’s had sent out a flier congratulating him on his election to the Hall of Fame in 2009. The flier also offered two dollars off on a meat product on presentation of the flier. Two customers took advantage. Jordan maintained that his number and likeness had been illegally used. (MJ who fancies himself as American aristocracy had a request denied by the Judge that he enter the court via a special security entrance). 

Jordan on the witness stand admitted that he was doing just fine but he argued that the use of his name was worth $10 million. His counsel argued that his name brand had to be protected. Safeway, the defendants who had owned the now defunct grocery store produced experts that maintained that at most the compensation for this flier should have been a $150,000. So the great MJ the greatest sportsman of the twentieth century was a victim. Someone had used his name congratulating him in a flier and had as a result had $4 worth of coupons redeemed . MJ believed that as his name had been unlawfully abused he was entitled to $10 million.

The sickening part of it all is that the jury, made up of the likes of you and Jay H. Ell, instead of telling this megalomaniac to go jump into Lake Michigan awarded him $9 million dollars! It seems that MJ, the winner both as an entertainer and a businessman, was a victim as well being a central character in a drama played out in court. Do the jurors believe that these awards to a billionaire are not without cost to the man in the street? Does the pompous MJ warrant having the cost of groceries increased because he has delusions of grandeur? If he could have shown that Dominick’s had profited by this gesture he would have well been entitled to a share. But that was not the case.

“His Airness’s" argument that this is not about the money - ostensibly it is about him being used and being made a victim - is hollow. Nobody even knew about the whole incident till MJ made it public. It is blatant greed. Whenever anyone says it is not about money it is about money unless they actually don’t get any money. 

 So the leading billionaire entertainer and a winner too in business, successfully persuaded his peers, that is us, that he had been victimized and was entitled to win the lottery. In addition he used the opportunity to punt his restaurant but more significantly to obtain tens of millions of free advertising for his brand in addition to the nine million he didn’t really want. Besides there was the message to all potential sponsors of his worth as determined by his peers, (the buyers) - this not in a poll, but in a court of law. 

THE ALTERNATIVE?

Could the outcome have been any different. Now if MJ would have ignored the whole tepid event no one would have been any the wiser. The little congratulatory flier from the dying store would have just floated away into nothingness. It was not accompanied by media headlines, “His Airness taken for a ride” or “MJ’s brand abused” . So Air Jordan could have let it fly away.

Then the jury, that is us, had an opportunity to inject some reality into this unashamed greed. They were asked to choose between two conflicting theories. On the one hand it could be argued that how could MJ’s brand suffer if no one even knew of the alleged slight. Likewise the defendants had gained no profit from the exercise so how could there be monetary damages? At most according to the defendant’s experts the damage suffered was about a $150,000. The other theory put forward by Jordan, a real expert on himself and who values himself really highly, said the "loss" was $10 million. Mumbo jumbo arguments were used to get to this number in relation to the Dominick case. It is all very well if firms that get billions in sales award him $80 million a year but “His Airness" was asking $10 million for the sale of two pieces of meat. The jury cruelly lobbed off a million and only awarded $9 million never - the- less, in so doing, laid down what they thought societal values should be. In Jay H. Ell’s opinion he should have been awarded a cent. He had suffered no real damage all he was doing was pumping up his own self importance and claiming even though there had been no real damages because he was MJ the victim he was entitled to it.

The belief too that no harm is done by making a rich grocery holding company pay out $9 million is a myth. What will happen is that the consumer will pay a little extra for each item as the company’s bottom line never suffers. But victim Jordan claimed that winner Jordan would donate all the money to charity so good is coming out of it. Be that as it may it would have been far more impressive if “His Airness” shelled out his own money. As for us when we pay an extra few cents for a loaf of bread we have to know its going to a good cause.

AT THE END OF THE DAY

Jay H. Ell is of the old school he believes that society deserves better. Those who are blessed to be winners in every field should be role models not unashamed uncaring megalomaniacs who are winners at any cost. They have a responsibility to those who are giving them these outrageous sums of money for their G-D given talent, however hard they work. MJ should take a leaf out of Federer’s book. He should listen to his acceptance speech delivered  after winning the Connecticut Tennis Open for the seventh time. There was no false modesty, “His service worked well today” and in addition plenty of humility. His team and family were acknowledged for their contribution and sacrifice and every one down to the ballboys were thanked. Then unlike Michael he patiently signed every exited young fan’s hat, tennis ball or photo. Then without any publicity Federer ususally donates a chunk of change to his Foundation which to date has provided finances to assist in the education of nearly a quarter a million children in Africa. In fairness to MJ he has a Celebrity Golf event once a year and he has raised over $7 million in the past 15 years.

MJ was the greatest ever and brought unforgettable entertainment to so many but apparently thats what he did for a living and should not be rewarded for it anymore than anyone else who does an honest days work. At the end of the day he is not really an icon who one can enthusiastically reminisce with one’s grandchildren as someone you would like them to emulate.

IRAN CONGRESSIONAL DEBATE OVER THE TOP

Everyone involved in the Iran congressional debate agrees that the Iranian nuclear threat should be curtailed. The question is how. Obama and the rest of the world clearly believe that the painstaking diplomatic efforts backed up by all sorts of military, nuclear and scientific support in reaching the final Joint Comprehensive Plan of Action, (JCPA) is the best shot. Bibi Netanyahu, under daily genocidal threats from the Ayatollah, doesn’t. To a certain extent where one comes down depends on the context that the debate is framed. (Blog: The Great Iranian Debate Divide). 

Broadly speaking there are those that believe that Iran is such an existential threat that negotiations themselves represent “selling out” to the theocracy. At the other end of the spectrum there are those who argue that the alternative to the JCPA is war. While Jay H. Ell is of the opinion that the deal is a mistake and has repeatedly blogged that Obama is misguided in his judgement on this issue, (Blog: Why the Iranian Deal), the politics and vitriolic rhetoric that have accompanied the debate as to whether the United States Congress should accept or reject the plan of action is quiet frankly dangerous, over the top and counterproductive.

CONSENSUS THAT THIS IS A DONE DEAL

At the end of the day it is agreed that whenever there is evidence that Iran is on the nuclear path the sites will be bombed to smithereens. That much is obvious and is inherent in Obama’s policy as well as how else could you explain his bombast that the alternative to no understanding is to go to war. So there is consensus on what would happen to Iranian nuclear facilities should there be evidence or intelligence that they are in the nuclear weapon way. All this should to a certain extent reassure the opponents of the plan, but needless to say it doesn’t. 

At the end of the day, too, this accord will survive and Congress will not override a Presidential veto. Jay H. Ell has blogged that the GOP really support it and if any further indication is needed as to their real attitude it was provided by their Senate leader, Mitch McConnell. At a speech to a Chamber of Commerce in Kentucky he confided that, “The President had every likelihood of success”. He further hoped for a “Respectful uplifting debate”. Not the fighting words expected to garner support to overturn a presidential veto. McConnell knows and wants this to be a done deal. The world is behind it and it cannot be undone. Over ninety percent of the American, military, nuclear and security experts agree that the nuclear agreement should be signed. McConnell can still have it both ways knock Obama and not have to take the responsibility of kiboshing the accord and then have to take the flack if it all turns sour. 

Also the American electorate, in general, favor the plan by 2 to 1 according to the latest WashingtonPost/ABC poll. Even moderates and Independents are 60 percent onsides while Republicans are equally divided. Not that it is that important to the broad mass of the electorate who rate Foreign Affairs low down on the totem poll.

So on the crucial issues - curtail the nuclear threat, if Iran sets on the path of creating a nuclear weapon it will be bombed and that the JCPA is a done deal - there is very little congressional dispute - it is all just for the record.  The electorate are generally disinterested but when polled favor it.  So why the hysteria and unprecedented lobbying on both sides? Also there are accusations flying around that Obama is genocidal sending the Jews to the oven and more recently that he is invoking the notorious anti semitic Protocols of Zion. 

The climate is being created that anyone for the agreement is an anti semite. This is lunacy and can only help the true anti semites who would be only to happy to welcome former Israeli Generals and security personnel as well as their American counterparts into their ranks. On the other hand Obama creating this as a test of loyalty to him and pressuring the Democrats off the charts is overkill as well.

NETANYAHU AND CONFLICTING JEWISH OPINION

While there is plenty of blame to go around Prime Minister Netanyahu has worked hard at being able to claim the number one spot in creating this hysteria. In an unprecedented intervention into another country’s internal affairs he connived with the Republicans to attack the “bad deal” that hadn’t even been announced yet. The argument that Churchill did the same is poppycock. While it is trite to say that Bibi is no Churchill, the real issue is that the British Bulldog did not come to Congress to oppose the Administration. He rather argued that the UK and the US had common cause to engage a common enemy that threatened our civilization and way of life .The GOP gleefully aided and abetted Bibi in his impertinence and then forty - seven GOP Senators followed up by sending a letter to the Ayatollah Khamenei, treasonously stabbing their own President in his back by telling the mad Mullah that Obama had no final say in the matter. The Ayatollah for once interpreted the missive correctly pointing out that the letter reflected the deceit and dysfunction of the American political system. 

King Netanyahu has not let up, not satisfied at making Israel a partisan issue in the US Congress and socking one to his nemesis Obama he has carried on as if the Jews in America and the rest of the world are part of his constituency and owe him undying loyalty. This when most of the Israelis don’t afford him blind loyalty so why he should expect it from the diaspora hebrews only he knows? In the wake of Congress’s upcoming vote on the matter he has implored the Jews of America, whom he claims to represent, to canvas and lobby against the deal. Three hundred and forty rabbis defied him and urged Congress to accept the deal. Twenty five Jewish Organization leaders urged acceptance in a full page advertisement in the New York Times. Doubtless there are another three hundred and forty rabbis that are against it that will surface very soon in the company of twenty five Jewish Organization leaders that are for it. But so what?

Now there are a plethora of lobbies in America including a number involved in “Jewish” issues. Chief among these are AIPAC and J Street. The former lobbying for the axing of the pact and the latter are for it. As a matter of a fact there are several other groups lobbying including The Center For American Progress and Plough Shear and the Black Churches to name a few. 

While Orthodox Jewry and the more influential Jewish lobbies are against the understanding, polls show that a majority of those who regard themselves as “Jewish” are in favor of the accord. Netanyahu has focussed attention on the Jews instructing them to not make a decision on its merits but rather to do so for what he defines as being in the Jews best interests. Implicit in that argument is if you don’t you follow Netanyahu you are betraying Israel and the Jews in general.

Netanyahu’s own retired top army brass and security intelligentsia are not ad idem with the Likud Prime Minister. Forty seven of the latter wrote to him urging him to support it. These included a Former Chief of Intelligence and Chief of the Israeli Security Agency, Scores of admirals and generals, the lead scientist at the Dimona Nuclear Reactor and members of Mossad joined in.  An unprecedented position paper, entitled IDF strategy, published by the Israeli Defense Force and authored by its Chief of Staff Lt. General Eiskenot barely mentions Iran. This missive surfacing at this time is being interpreted by Israeli cognoscenti as a not so subtle message from the military to Netanyahu that they disagree with him on Iran. (For what its worth Jay H. Ell disagrees with these military and security personnel because he sees the JCPA in a much broader context).

The question still remains for those that are screaming that supporters of the Iran deal are anti semites as to whether they include most of the Israeli military and security establishment and the majority of jews in America?

IRANIANS AND THE DEAL

The Iranians could do all these activists a big favor by nixing the agreement themselves. The Iranian parliament has solemnly given themselves 60 days to decide. Not that they really have any say at the end of the day but let them have fun. The Ayatollah has irreversible veto power. You cannot override his veto and live. Now it has been published by some guy who is said to be very close to the head Mullah that he is not happy with the pact. Khamenei refuses to even call it an agreement he only dignifies it with the term “text”. He stated that it has to be scrutinized through legal channels. One wonders what they have been doing for the past few years while the “text” was being negotiated and agreed upon. Then from Iran there are the regular outpourings of disgust at the American process ,the objections to the alleged insults to the Iranian people coupled with reassurances from Khamenei downwards that the Iranian Revolution will still continue, that is code for death to America and Israel. Incidentally other than the latter statement Jay H. Ell does not believe a word they say - all cultural he supposes as he has been told they just talk in hyperbole and mean the opposite of what they say . 

STOP IT!

It is time to hone down the rhetoric and stop defining this as The Dreyfus Trial or Kristallnaght. Someone needs to get a sense of proportion. This is about a tactic to control a common threat to nearly all of the world, including the Sunni Muslims. (Blog: Iran - Not About Trust But About Avoiding War). It has been acknowledged by all concerned that with or without the deal the Iranians will still scream death to America and Israel. One has to  believe that Netanyahu and Obama’s personal animus has plenty to do with this. Jay H. Ell already fears that the damage has been done. Is AIPAC or J Street trying to prove the anti semites right that the Zionists control the world? Mercifully not too many people in America are taking too much notice of the protagonists in this unseemly fight, both of whom claim it will be armageddon that will herald the end of the world if the other side triumphs. Just as well everyone around here is watching the Donald Trump reality show. The Donald is one of the apprentice contestants for President and in passing has mentioned that he is against the agreement. His priority however is deporting eleven million aliens, stopping the legals sending money home and changing the constitution so as to create more aliens to deport. He does acknowledge that if he becomes President it would be too late to reverse the Joint Comprehensive Plan of Action.

Maybe everyone should just listen to Mitch McConnell and have a "Respectful uplifting debate". 

GOP PRIMARY: THE LUNATICS ARE RUNNING THE ASYLUM

After the 2012 GOP Primary Race protracted debacle, where the GOP candidates chewed each other up making gaffe after gaffe and where it took the Establishment’s favorite Mitt Romney forever to “win” the nomination, it was Reince Priebus’s, the Chairman of the GOP National Committee,  strategy to have a shortened 2106 Primary with as few candidates and debates as possible. To effect this he ultimately handed the Party over to Fox News. (Blog: Fox News is the New GOP and Trump is the New Enemy). But before this could happen nearly every Republican in the world who thought that they had a ghost of a chance announced their candidacy. There were then all manner of unofficial “get togethers” and Conservative Jamborees long before the long delayed first Fox debate only about 410 days before the November 8, 2016 event.  In the beginning there was unity as they all ran against Hillary but that didn’t last too long. (Blog: The GOP Leadership Conference and My Fair Hillary”). Chaos has ensued among the inmates and now the lunatics have taken full control of the asylum.

ITS ALL  ABOUT THE DONALD - THE WARDEN OF THE ASYLUM

The pacemaker is The Donald who gives us a thrill a minute. His most recent sensation - it is hard to keep up - is the announcement of women that he thought he could nominate as Vice Presidential running mates.  Believe it or not Megyn Kelly was in the line up. This after calling her a lightweight and unprofessional implying she was hormonal and demanding an apology from her.  Another pick was Oprah which he then maintained he wasn’t serious about but he is serious about Cecile Richards the President of Planned Parenthood! Inter alia he has suggested Warren Buffet who has already declared support for Hillary Clinton. 

Now The Donald has instead of uniting the party against Hillary has split the wannabe Presidents into three groups: There are those that have attacked him such as Jeb, Scott Walker, Lindsey Graham, Rand Paul - with a vengeance - Carly Fiorona, incidentally one of Trump's potential VP woman picks, Rick Perry and the only stable one of the lot John Kasich, who was locked up by mistake as he got involved with the wrong company. Then we have the neutrals such as Mark Rubio who is far to busy to be diverted by the leader of the Republican Primary. Finally, there are the supporters such as Ted Cruz and Mike Huckabee who are onsides with The Don. 

All of the above are not exactly on the sunny side of dementia. Lindsey Graham smashing his cell phone in several different ways in response to Trump publicly broadcasting his private number, Huckabee telling Obama he was delivering Israel to the doors of the oven and Rand Paul doing impersonations of Trump on the campaign trail are some of the recent bizarre episodes of the patients.

However what must be of great concern to the Establishment is that Ben Carson and Ted Cruz are polling second and third to Emperor Caligula, a. k. a. Trump. The three together have nearly 50% of the GOP electorate. That coupled with the fact that Jeb, who is entitled to the nomination by divine right, is heading for the padded cell and is giving them nightmares.

JEB IS NOT TAKING HIS ANTIPSYCHOTICS

Jeb after a tortuous, he calls it tortoise, period as to where he stood on his brother’s cuckoo decision to invade Iraq finally came down on boetie luvvie’s side. After making such inane comments such as saying the first President he met was his father, the moment he was born and the second President he came into contact with was his brother whom he met when he got home from the hospital, he finally clarified how he saw the Middle East. He initially said he would have gone into Iraq just like his brother. He then went home took his pills and said that knowing what we now know he obviously wouldn’t have. In the great debate last week wannabe 45 admitted that the Iraq war was a “mistake”. Since then he has been non - compliant as to his medications and stopped taking his prescriptions so the following has ensued:

 Bush, the Wannabe 45, maintains that Mission was Accomplished in 2003 on American security issues . One wonders whether he used Jon Stewart’s Daily Show graphics when trumpeting that sick joke of history. This appearance by Dubbaya on an aircraft carrier with the banner “Mission Accomplished” was to haunt Bush 43 as the war went on and on after that. The former Florida Governor opined that taking out Saddam “ turned to be a pretty good deal” . He now argues even in hindsight he would have gone into Iraq. Carrying on with his revisionist history, Wannabe 45 complimented his brother for the surge in 2007 in Iraq that did the trick. He maintained that in 2009 Obama and his Team of Rivals compatriot Secretary Hillary inherited a “fragile but secure” Iraq. 

Hillary and Obama then screwed it all up by getting out of Iraq and giving ISIS the whole Middle East on a plate. He forgets, but forgive him it is part of the condition, that Bush 43 signed into effect the “US - Iraq Status of Forces Agreement”. The latter guaranteed that all US forces would be out of by December 31, 2011. Obama incidentally tried to keep some troops but he couldn’t get agreement from Bush’s stooge Nouri al - Malaki, who all but handed the country to Iran. ( Incidentally in 2007 Senator Hillary called for Malaki's removal but Bush 43 stuck to his guns).Obama’s administration forced Nouri out in 2014 as he had done nothing to unite the Shia and Sunnis in Iraq and had worsened the situation dramatically.

Jay H. Ell supposes Bush wannabe 45 wants to be loyal to his brother as his blood is thicker than the blood of the nearly 5,000 American troops that died in this madcap venture not to mention  the hundreds of thousands of Iraqis. This demonstrates if not lunacy an unbelievable arrogance, callousness and lack of judgement that should preclude him from the Presidency. 

HOW CAN  ESTABLISHMENT JEB LOSE?

Jeb, after the circuses, reality shows and the media hype would be done, was as much considered the presumptive nominee of the Republicans as Hillary is of the Democrats. He has the Establishment behind him, he has a $120 million already in his war chest and everything would be done to facilitate his coronation. 

It needs to be clarified what it means to have the Establishment support. This represents  generations of money, influence, endless party officials who toe the head office’s line and party organization in every town, county and State in America that is responsible for  knocking on doors, going to nursing homes to get absentee votes and the like. Then add to the fact that he is a Bush. Prescott Bush, 41’s father, was the Establishment way back when. Bush 41 was head of the CIA, head of the Republican Party, Reagan’s Vice President for 8 years and then President. His total domination of the Establishment spans almost a half a century. At the end of the day the Establishment has ruled. They anointed Bush 43 a mediocre inarticulate,intellectually challenged and uninspiring Governor, (the supposed less intelligent brother), who was ultimately made President by a Supreme Court that had been largely appointed by that self same Establishment. 

Trump, who cannot be called challenged, recognizes the power of the Establishment. He has thrown down the gauntlet to the Establishment - “You don’t treat me fairly and I will run as an Independent”.

WHY ESTABLISHMENT JEB CAN LOSE

Having argued all that Jay H. Ell does not believe that Jeb with all his money and protehcsia can survive his support of his brother’s Iraqi war. It is bigger albatross around his neck than The Donald’s paranoia, (pathological), to all the demographic groups, especially women, that the Republicans need to win over to triumph in a national election. The Tea Party was founded as a revolution to the GOP Establishment at the time when Dubbaya 43 was President. This was largely a response to his alleged big government fiscal mismanagement including bail outs and the massive cost of the Iraqi war. The Iraqi war had another major casualty in that it destroyed any reasonable candidate the establishment could hence forth put forward. Colin Powell was a central sacrificial lamb as he was the only member with international crediblity in Dubbaya’s cabinet. He was given the job of selling the dummy intelligence to the United Nations so they would sanction the Iraq war. 

The formation of the Tea Party and Bush 43 are almost synonymous. The Tea Party have not gone away rather they have grown and grown and the Party hierarchy instead of fighting them have pandered to them and pretended they are really on the same side. This denial has landed them and the country in the mess they are in now.

As already indicated the anti Establishment support is already near fifty percent. While  this is early days it needs an heroic effort from Jeb to win the nomination. It is not going to be as easy as it was for Romney as one by one he knocked off the “Anyone but Romney” leaders of the polls. He was always the main contender against the leader du jour. Jeb does not appear to have the where with all to take this on and he was supposed to be the stronger brother.

The only momentum Jeb has got is that there is saying. "Never two without three". So it is obvious - Bush 41, Bush 43 and Bush 45.

SO WHAT NOW?

The opportunist Trump has changed the landscape as the Primaries lurch from one deranged moment to another. The billionaires are sitting on the sidelines waiting to know who to back. The Koch Brothers, the Adelsons, the Rove menage and the rest are all pondering how they are going to influence this ball game. Even if they find a candidate he or she still has to beat Hillary with or without her e mails. The bottom lines still remain - if you demean or ignore women’s priorities, you regard Hispanics as unwanted aliens, you make it more difficult for certain minorities to vote and you rant and discriminate against LBGT’s - you just cannot win anymore as there just are not enough elderly white males.

So blame this all on Ronald Reagan who closed all the mental institutions and discharged all the invalids in the hope that they would take their medications thereby allowing them to function as level headed members of society. It just didn't happen.

FOX NEWS IS THE NEW GOP AND TRUMP IS THE NEW ENEMY

Fox News has achieved the pinnacle of success. It, a media company, is now the ultimate arbiter of who the Republican candidates in the main debate in the Primary race will be and how many contenders will participate. Fox also sets the pre election agenda in so far as it frames the questions that are the content of the debates. They, thus, are able to pressure a candidate whom they don’t favor and feed into the strengths of those that they do. Even before this “takeover” they reached nearly every Republican voter and were without a doubt the glue that was keeping the disparate groups of the GOP together. So Fox News has deservedly taken over the mantle of being the new GOP. In so doing they took over the number one priority of the Republican establishment - stop Trump!

 Now Fox News does not pretend too hard to be unbiased as they have been the unofficial organ of the Republican Party since their inception in 1996. Rupert Murdoch, the media giant, who does not hide his right wing affiliations, formed the cable channel as an antidote to what he reckoned were the politically liberal news channels out there. He appointed Roger Ailes as CEO of the new Fox News Channel. Ailes couldn’t hide his beliefs if he tried as he was media consultant to Richard Nixon, Ronald Reagan and George W. Bush.  He has had incredible success turning Fox into the number one TV news channel in America. However, it is ironic that Fox is most successful in the same skill as their newest worst friend Donald Trump - both have them are excellent at getting high viewer ratings. 

FOX NEWS - THE NEW GOP and THE OLD ESTABLISHMENT GOP

So Fox - the new GOP - and Ailes the new Chairman of the Party had two objectives with the first debate - discredit The Donald and promote some of the other more electable candidates. It is acknowledged that Trump’s presence was the reason that the viewership of this debate was quadruple the first Republican debate for the 2102 election. You see now that Fox is the new GOP it has responsibility to steady the ship and make it respectable and electable. This is proving a hard task for the channel who have been, for nearly twenty years, promoting the likes of Trump who up till very recently was Ailes’s oldest best friend. It is one thing being rabble rousers where anything goes and another bearing the burden of being at the helm. 

With the old Establishment GOP floundering around and being all things to all people and with the Establishment Chairman Reince Priebus ignoring the last past election post mortem which instructed the Republicans to be Hispanic friendly, stop supporting anti woman issues, make positive moves toward the African American community, to pay attention to the low income groups and lay off the LGBT group as the GOP millennials were singularly unimpressed, they were indeed in deep trouble as they had studiously opposed all the recommendations.

Jay H. Ell is sure that Fox GOP see the paradox in having to try to eliminate the very guy that they used and promoted to push themselves into this position of power. It goes without saying that the poster child for all these policies and Fox’s standard bearer was The Donald. On its face Fox News was the last entity on earth to clean up the Establishment GOP mess as they were part of the cause but forward unto the breech they soared. But the network, who Jon Stewart affectionally referred to as “bullshit mountain”, is not exhibiting any discomfort at the task - you have to do what you have to do - its not personal.

THE DEBATE: FOX NEWS TAKES ON THE DONALD

So debate number one burst onto the scene with all the bohaai imaginable. The tactic to show Trump in a bad light was to fire at him the hardest of questions and dish up lollypops to the rest. The debate was assured a record breaking audience because, as The Donald bragged, he is a rating machine. In the aftermath of the debate and in response to the treachery of his old friend Fox, he roared that he had done Fox a favor by appearing on their show and getting them a viewership and this is what he received in return.

The contest was off to a lightning start. The new FOX/GOP party was at war with the forces of evil and needed a pledge of loyalty from their potential standard bearers. So Fox straight out of the gate asked who would not support the eventual winner of the Primary in the Presidential election against the Democrats. This they did hoping it would put the only possible candidate for such treachery, The Donald, on the spot. Without the slightest hesitation, The Donald raised his hand up high. No shaming Trump into submission in front of his peers cause The Donald doesn’t shame as he has no shame and he has no peers. Fox had dared ask the question the Chairman of the Establishment GOP, Reince Priebus, had been too scared to ask because he was afraid of the answer. Donald had now set the tone of where he was at, they could all go and jump in the lake. Trump believes that he has the goods and that he could win the Primary and then the Presidency. Nothing could disabuse him from this fact. So gambit number one had failed badly and from that moment Fox would have to regroup later. 

The Donald had served notice that he would no more serve the Fox master anymore than he would the establishment GOP. He had the utmost confidence in himself and himself only. This moment may have heralded the beginning of the break up of the Republican Party.

THE DEBATE, WOMEN AND THE DONALD

From then on it was The Donald at his best or worst as the Fox team launched missiles at him. Megyn Kelly skewered into him about his sexist and misogynistic statements and the impact that this might have in a Presidential election against a likely woman contender such as Hillary. He laughed it all off saying his sexist comments were about Rosie O' Donnell. As Trump trumpeted later this retort elicited the greatest laugh of the evening but Megyn would not let go. Kelly said he had called women “fat pigs”, “slobs”, “dogs”and maintained that a contestant on his reality show “Would have been a pretty picture on her knees”. He was not politically correct he countered to roars of approval from the masses.

 He continued blowing this all off and followed up by attacking Kelly as being unprofessional tra la la. He upped the anti and crudely implied that Kelly’s attack was prompted by her hormonal state which brought some of the house down on poor old Donald. This sexist stuff being too much for some of his Conservative allies so he was disinvited to a weekend Conservative bunfest entitled “RedStates”. To this snub he just threw in some more chips publicizing all those tweets he received, one of which called Kelly a bimbo. On the issue of apologies he believed Megyn Kelly owed him one as she asked him a very inappropriate question!

Back to the debate where the hammering followed and he was questioned about his political affiliations as far back as 1987 when he was leaning towards being a Democrat, his immigrant position and was asked for proof that the Mexican Government were sending criminals here and then there was his string of bankruptcies. Trump wailed afterwords at the unfair treatment he had received. But as the Conservative commentator Charles Krauthammer responded, Trump maintains that he is tough and shouldn’t be moaning over tough questions.

It was very very interesting to note that on the next Sunday he was on every other channel except FOX/GOP explaining his benevolent policy towards women whom he employs by the ton. He would be the “best”, “phenomenal” towards women. He thinks that Jed Bush is totally wrong by complaining that a half a billion is too much to spend on women’s health he would spend much more…However, he refused to get into specifics when Mika asked him on Morning Joe about equal pay and equal access to loans for women. She wanted to know if he deviated from GOP policy on this but she would just have to wait till The Donald was ready to answer. 

THE DONALD, WHAT MAKES HIM TICK AND THE GOP DEMISE

Trump has already had his say on immigration which is a coarse paraphrasing of GOP policy. He is not in favor of gays and lesbians or their marriages. The only crucial demographic he hasn’t alienated thus far is the African American group but that will happen when he is questioned on voter registration. So what separates him from the Republican Party and gives him the current leadership in the Republican polls? In his own words - “They like his message” and the fact that he maintains that the leaders are incompetent and useless. 

So Donald is really just the agent that is finally bringing about the split of the GOP. He will run if he is not the Party’s nominee and take more than half the current GOP electorate with him. His supporters are the Tea Party crowd who the Establishment GOP have been ineffectively pandering too to date. The Donald calls as he sees it - the Hispanics are murderers and rapists and women who disagree with him are slobs, fat pigs, bimbos or hormonal. His three marriages were "traditional" - no gays and lesbians for him. 

The Republican crowd lap up the entertainment he provides. To some of them he represents strong leadership and he never but never apologizes. He also attacks anyone who disagrees with him. He does not show any hesitancy even if his positions are incomprehensible - in 2004 he was against the Iraq war but he believes “We should take ISIS out with boots on the ground”.

Trump and his political style - Reality TV versus politics as usual

 Most of all Trump is the past master at Reality TV. This contrasts with the real political world where you have carefully nuanced positions and statements with months of preparation and where even statements let alone policies are run past focus groups. In the political universe you clearly think through every utterance as it could end up being a gaffe and put you on the defensive. Witness Jeb Bush’s statement that half a billion seemed a bit much to spend on women’s health. This put him on the defensive and appearing to be following the GOP mantra of being anti woman. 

Now compare this with Trump’s style. He refused to prepare for the debate as he wanted to be spontaneous, (This is why his closest advisor walked out on him). He wanted to blurt out whatever he thinks just like he does in real life. That is what reality TV is all about. What you come up with is what you stick with just like Trump does in real life. The Donald is never wrong just like in the real world. Now The Donald had a massive success in his reality show, “The Apprentice”, where his real life boorish boardroom behavior was on display and the viewers loved it. Trump comes at a time when the populace is sick and tired of politics as usual and the the do nothing politicians. On top of that The Donald is highly intelligent and intuitive. So he is changing the paradigm of political electioneering to suit his style. 

In addition he has name recognition, charisma, understands the entertainment business like no one else, is decisive, not politically correct nor a recognized political figure, just loves attention and most important his message jives with the Republican base and no body articulates it better than him.

The new GOP, Fox News better realize that Trump’s base is their base too - the Trumpits. Trump articulates it out loud and clear, no diluting the prejudice with him. If Fox truly is taking on its new role as the new GOP seriously Trump is their man and not their enemy. Also the more they attack him the more he is in the limelight and remains the main event.

THE DEBATE’S OUTCOMES

* Trump is here to stay. Jay H. Ell has already blogged that Trump must be taken seriously and that he is in this for the long run, (Blog: Trump Comes Up Trumps), and the debate proved just that. He has, however, effectively, one way or another axed any hope any Republican has of winning in 2016 against any Democratic candidate. The only hope the GOP and Fox have of regaining control of their party is if he gets bored and rationalizes getting out of the race. That is unlikely to happen while he is center stage. The only camper that is happy that he is occupying that position is Hillary as she just needs to go on her own little way without being constantly attacked about Benghazi and her e mails. In fact, John Sununu, the former Chief of Staff of George Bush 41 and a solid member of the establishment, stated that it was out there in the blogosphere that Trump’s friends, the Clintons, put him up to run so as to throw confusion into the Republican Party. Jay H. Ell is sure Baba would be thrilled if he could take credit for such a maneuver. 

* The GOP together with FOX news have created this monster. They only have themselves to blame. He is the logical outcome of their duplicity and failure to face the crises in their party head on. The GOP establishment must be relieved that FOX news has taken over the reigns of managing the 2016 Republican Primary and the subsequent election strategy for it really is too much for them.

* So objective number one to eliminate Trump just did not happen and hence the belated reconciliation. As for objective number two, allowing other candidates to shine, that failed as well. They all just bickered among themselves and wimped out. In the post debate spin room only The Donald had a meaningful presence where he set about to reassure the hungry media, if they needed reassuring, that he had won the debate. 

* If any further evidence is needed that the original plan was to axe The Donald just watch the fake focus group run after the debate where former Trump supporters supposedly are disgusted with the property magnate's performance. Hence we are onto Plan B and The Donald as the "New enemy" is reprieved for the moment.

* Jeb is exactly where he wants to be - out of the fray. Whether that helps him or not time will tell. He has over a $110,000,000 in his war chest and is hoping that his own prophesy, that for a Republican to win the Presidency he has to lose the Primary, is proved wrong. However, Ted Cruz, Mark Rubio and  Mike Huckabee are deliberately not attacking Trump because if he loses favor they would just love for his support to go to one of them. Jeb has no chance of garnering any of those voters and as Trump’s numbers creep up and up he has to fear that all those are votes that he is not likely to collect decreasing his chances more and more.

* Donald still has the last laugh as his numbers went up in three separate polls following the debate. What FOX/GOP has to learn Trump isn’t the normal candidate he is a creature of their making - any publicity is good publicity and if you suck all the oxygen out of the air there is none left for anyone else to breathe. 

* For Trump to become the ultimate standard bearer of the new GOP he realized pretty quickly that he better make up with FOX. He is a quick learner and was on Fox Tuesday morning coming to terms with the reality that you cannot declare war on everyone and still win.

* This whole cause celebre gives Hillary a pass to quietly carry on with her business. Rather she can feed off the feast. She can call Trump's sexist remarks "outrageous" and by extension expose the other hopefuls' shortcomings on women's issues.

* If Megyn Kelly, who is otherwise right of Genghis Khan, is reflecting the views of the GOP women then the Republican brand is even in more trouble than they recognize.

* This episode may be heralding the extinction of the GOP establishment's Republican Party. It will be interesting to see whether Fox reneges on the Establishment in the event that Trump's campaign has legs.

MEDICAL MALPRACTICE - AMERICA’S HIDDEN DISASTER

The 1000 pound gorilla in every medical office, procedure and treatment room, hospital bed and operating theater in the United States of America is the looming fear of being sued for medical malpractice. According to a Harvard Study virtually every American doctor is likely to be sued at least once in their careers and those in “risky” disciplines several times. As a result medical malpractice has defined the practice of medicine in this country, exponentially driven up costs, driven doctors out of practice, and furthermore has resulted in creating an artificial shortage of health care services.The operation of the flawed system of regulating medical negligence is totally dictated to by a few thousand malpractice lawyers who decide which cases they will take up and therefore what is and what is not potentially malpractice and who or who not should be compensated as a result of alleged doctor malfeasance. The net result is that the standard of care in medicine in the USA is defined by the malpractice lawyers.

There have been calls from public safety groups, all physician bodies, the Association of American Retired Persons, the Chamber of Commerce and schools of public health to at least run pilot projects of special health courts to address malpractice that have been ignored by the politicians. Michelle Mellow, a Harvard Public Health and Law Professor maintained that it would be hard to design a more inefficient compensation system or one which skewed incentives more away from public candor and good practices. The public are in favor of reform as a 2009 poll showed just prior to the enactment of Obamacare. Over 80%  of those polled believed that as any part of Health Care Reform Plan Congress needed to change the medical malpractice system. The opportunity to include it in the Affordable Health Care Act, (Obamacare) was ignored in spite attempts by wide ranging sections of society.

COST AND IMPACT OF MALPRACTICE ON MEDICAL PRACTICE

Several authorities including the American Medical Association have estimated the cost to the economy, directly and indirectly, at $200 billion annually. However, this does not take into account the insidious impact that malpractice has on medical practice and the price tag of health care. The training of health care workers takes place in a practice and hospital environment. Future doctors learn from those in the field whose fear is litigation and how they cope with that variable. The lists of investigations they must perform and what procedures they must and must not do, whether they feel comfortable or not to perform them as they are considered litigation risks for their discipline, are all part and parcel of the content of their education. The malpractice reality is so ingrained in American doctors that a costly defensive approach is unconscious and considered part of “standard of care”. Now Jay H. Ell knows precisely what he is opining about as he has practiced and or taught medicine in several countries. 

So what is it about medical malpractice that helps make American medicine different and far more expensive than in other countries? The principle behind the regulation and sanctions for medical negligence has to be one that everyone agrees with. In addition surely those who have suffered loss as a result deserved to be compensated. Now no - one would disagree with any of this so the question is what is the problem? How do other countries deal with the same problem and why does America deal it almost solely in the arena of ordinary civil courts?

ADJUDICATION OF “MEDICAL NEGLIGENCE” 

So the objective of every country is to set up an infrastructure to adjudicate medical negligence and even ethical behavior, (The American Tort System doesn’t attempt to go into the ethical arena), that is fair to the patients, health care providers, does not artificially drive up costs, create health care coverage problems nor impact on the standard of care provided and rather has the effect of improving health care to all patients in general and the aggrieved patient, in particular.

It is fair to point out that in no country has a system been perfected. However, there is a crucial difference between the system used in America and the rest of countries that they are culturally akin to. 

 British System based on Roman - Dutch Law

The British model is almost universally used in the countries America that would culturally ally itself with. They use as an entirely different model to mediate what is central in American medical practice law,  the “Standard of Care”. The British system creates entities to mediate in professional areas of special expertise such as medicine . By so doing the law recognizes that there is a unique body of knowledge and skills in the discipline of medicine and therefore the standards of care and ethical behavior would best be determined by a body of experts from that discipline. There is also both legal and lay representation on what are called “quasi judicial” bodies. 

These have the right to impose penalties when a doctor is found guilty which range from a warning to having their license to practice suspended. A large number of situations brought to their attention are do not go to a trial as an attempt is made to resolve issues informally. Doctors are asked for an explanation of the circumstances and their answers are often accepted. These courts recognize too that sometimes differing treatments can all be within the standard of care. While the “experts” they call upon are recognizable to the profession, there is a problem in what type of recognized expert to appoint - is the emphasis on a practicing physician or an academic?

The crucial factor in this system is that the Civil courts accept that it is the medical profession that is best able to adjudicate what is in fact the standard of care. The ordinary courts will not reverse a decision of the medical quasi judicial body because they disagree with it unless the decision is so outrageous that no reasonable person could have come to it. 

The legal system also allows for plaintiffs to sue for damages in the ordinary courts. However, the bar as to who is a medical expert is far higher than in the USA. Also the court’s yardstick to evaluate the doctor’s behavior is that he or she  followed a “reasonable” standard for that discipline and had the appropriate training to effect the care under dispute. It stands to reason that there will be more than one reasonable standard of care in many situations. Malpractice civil cases are uncommon in these countries.

American Malpractice Law

Malpractice law in America is no different from any other civil litigation. Put another way there are no mechanism put into place to ensure that some of those adjudicating the medical management, namely the jury, have any knowledge or training in medicine. Also the Plaintiff has to prove negligence as opposed to the doctor proving that he or she provided a reasonable standard of care. As in all legal cases the system is adversarial and leaves little room to conclude that the Plaintiff’s “expert” and the defendant both could have had reasonable approaches. Implicit in the American system is that if the Defendant is proved negligent the outcome of the medical management would have been different and this is in fact the basis of their case. (This is not an argument in a quasi judicial system except in obvious cases where the wrong leg may have been cut off)!

The medical “experts” can virtually be anyone and not necessarily recognized as leaders in the profession as in the quasi judicial system. Some are professional witnesses testifying in malpractice case after case. In fact it is a highly lucrative endeavor paying far more than medical practice. The standard going rate for reading documentation is about $500 an hour and court testimony and depositions are double that. 

Medical litigation is extremely costly and not affordable to the vast majority of people so consequently it is undertaken on a contingency basis. by “trial” lawyers who receive about 35 percent of the award. In fact it is estimated of the final amount awarded by the jury 54 percent of the money goes to the winning legal team and administrative expenses. 

To understand more about the dysfunction of the system a discussion on the trial lawyers and the impact they have on malpractice litigation in this country is warranted.

THE MALPRACTICE TRIAL LAWYERS SET STANDARDS OF MEDICINE

The whole multibillion operation is operated at the behest of a few thousand trial lawyers who donate heavily to the Democratic Party. As the way things work around here the Dems will not tolerate any health care reform that will get rid of the current insidious malpractice of malpractice litigation.

As malpractice litigation is so expensive these trial lawyers are basically the gatekeepers as to what suits get taken up or not. Put another way a few thousand lawyers decide which cases go to trial and therefore are the arbiters of the standard of care of medicine in America making a dysfunctional system even more dysfunctional. Obviously as the lawyers are not in this for charity or society they are going to choose those incidents that have the potential for the highest payouts. 

The sad perception of doctors is that these lawyers are not much interested in the standard of care but rather situations than can result in the largest pay off. In order to achieve this objective the belief is that they are on the look out not for the most egregious episodes of malpractice but rather they seek events that can elicit the million dollar pay outs. In order to effect this they need a bad outcome such as a death that can conjure up millions, ideally a male young enough to have  a number of working years ahead and whose passing inevitably engenders a large financial loss and emotional pain. Even better is a baby who had a whole life ahead and whose loss is incalculable. 

The lawyers do not publish theIr modus operandi but they obviously have to canvas “business”. Besides their banal television adverts some have contacts in hospital that tip them off as to  potential “clients”. A death in the Emergency Room, a complication following an operation or any mishap that the omnipotent medical profession has effected all have to be illustrations of malpractice or why would they have happened?

So how do these relatively few guys make enough money to shut out malpractice reform as effectively as the NRA are able to kybosh gun reform? Again they are not about to advertise their operations but Jay H. Ell has some anecdotal information that affords some insight.  Let us say that a trial lawyer has 20 files that are to be finalized in a year. Just two of these have to result in a million dollar pay out. That gives him $700,000. Over 90% of suits are said to be settled as either the doctor cannot take the pressure or the insurance company, that has the final say, weighs up their potential expenditure and then dishes out round about $200,000 which is reckoned as a “token” sum. Even if only five of the 20 cases result in $200,000 awards, the lawyer has garnered another $350,000 income giving him or her an annual income of over a million dollars.  These numbers are not considered excessive neither are they universal but do give one some idea as to why the trial lawyers as a group have the financial clout to effect what the NRA are doing - shutting legislation out. So let us look at the real figures of someone whose malpractice practice became public knowledge due to his prominence - John Edwards.

JOHN EDWARDS - A SUCCESSFUL MALPRACTICE LAWYER.

John Edwards, who subsequently became a Senator and a Presidential candidate was said to be just one of the malpractice lawyers who drove out all the neurosurgeons, obstetricians and psychiatrists in North Carolina. The situation became bad enough for the American Medical Association in 2004 to label the medical status in that state a “crisis”.  Edwards won 31 multi million malpractice awards. His two specialities were blaming obstetricians for cerebral palsy babies and psychiatrists for patient suicides. With regard to the former his science was absolutely faulty as it has been shown that the cause of that brain defect has nothing to do with the delivery of the child. His most celebrated case with an award for $23 million which he received from an obstetrician, gynecological clinic, anesthesiologist and hospital for a baby born with cerebral palsy. His style in baby cases was to speak to the jurors as the unborn baby trying to get out. (Yes, it was that obscene). Edwards credited some of his success due to running his gig past focus groups which cost $300 a sitting - “… a small investment compared to $5 million won in a case”, he confided. Edwards’s share in these medical malpractice cases was said to be in excess of $60 million.

Dr, VanderVeer one of Edward’s harshest critics has plenty of stories relating to the devastation that Edwards left in his wake including patients dying as a result of no neurosurgeon being available and doctors leaving because of increased malpractice insurance. He concluded that that the “little people” Mr. Edwards claimed to have helped had cost thousands of patients their health care.

One gets some insight into the vast sums of money obtained by so few and the inevitable impact on the political process by getting a glimpse into the world of this former Presidential hopeful. He has returned back to law after his political career was terminated by a succession of scandals and legal woes. One wonders where he would do the least harm, politics or law?

THE GROWING DEFICIT OF OBSTETRIC CARE SERVICES 

One example of the devastation of malpractice litigation is the impact that it has had on maternal fetal care where hospitals have closed down their delivery units and over half the counties in the USA have no obstetrician. In certain states the annual malpractice insurance for an obsterician is $200,000 a year. Obstetrics is a very high risk discipline and in most states doctors are liable up to 18 years after the birth of a child.

One in seven Obstetrician/Gynecologists are dropping obstetrics from their services. The Association of Obstetrics and Gynecology forecast a shortage of between 9000 and 14000 doctors in this area within the next few decades.

In the recent past family physicians have been a supplemental factor in the delivering of babies especially in rural areas and or where there are no obstetricians. However. principally, because of malpractice costs and fears, the number so doing has decreased dramatically and some have even forecast the death knell of this service by this discipline. In 2010 only 10% of Family Physicians were involved in Obstetric Care.Residency requirements in Family Practice have been altered to meet this reality and now there are two tracks - one to give the trainee an experience and the other to train them in the skills and knowledge needed to effect obstetric care. 

So it is not an exaggeration to see that malpractice is a key factor in the current medical crises by driving up costs, creating shortages in certain areas of medicine and driving out doctors from practicing.

JAY H ELL 

Jay H. Ell became a predictable statistic when he became a defendant in his first malpractice case last month. It resulted from an incident 8 years previously because this is how long these episodes drag on. Without going into too many details as the litigation hobbled along for three weeks in court, the substance of his alleged negligence was an ER patient, who had chronic anxiety, was diagnosed and treated as having a panic attack and a small pneumonia . He was then admitted to the hospital. The patient suddenly worsened and died. The post mortem was conducted by the most renowned and experienced pathologist in Illinois, Dr. Blum. He conclusively maintained that the patient succumbed from a sudden arrhythmic death due to cardiac ischemia. He had conducted 10,000 post mortems, 3,000 of which showed the same picture as this patient, because the commonest cause of an unexpected sudden death is a cardiac arrhythmia. He specifically could see no pathology to support a death by respiratory causes. He further stated that nothing could have been done about this death.

The plaintiff’s theory was based on the fact that the patients perceived “difficulty with breathing” was not due to a panic but rather the beginning of respiratory failure which was allegedly ignored by the defendant, Jay H. Ell, and in fact the respiratory failure was worsened by him by sedating the patient for his anxiety. This in spite of the fact that there was no evidence of respiratory failure during the stay and both he and the nurse testified to the fact that this death was sudden and unexpected as shown by the coroner.

Now of the 13 Jurors that sat 10 supported Jay H. Ell. These jurors related why the other three  had “held out”. One had unashamedly stated that it was time to show these corporations a thing or two while another argued that the medical profession needed to be sent a message. These two were accused of being biased by the others but to no avail. A third was “unhappy” at the documentation as he was an engineer and was used to precision.

Now the death of this patient conceivably met all the requirements for a big pay out and initially the Plaintiff was prepared to accept $4 million settlement. The deceased ostensibly had a number of working years ahead of him and the outcome was as bad as one can get. It was worth a shot. Now any one in medicine will tell you that one of the most important academic learning exercise is the clinical pathological conference when the clinical aspects of a case are presented and then finally the pathologist who conducted the post mortem weighs in with the ultimate answer as the naked dead truth is front of his or her eyes. Now from a purely medical perspective this tragic circumstance should not have seen the light of day and the expense, unproductive activity, three weeks of jurors’ and court time and emotional toll this experience engendered would have been prevented. Jay H. Ell  was on the face of it vindicated but it is not much fun to hear hired guns, who are obviously talking palpable rubbish, and who were not present, accuse you of systematically killing a patient.

A saving grace in this whole sordid mess was the band of dedicated lawyers who use their knowledge and understanding of medicine to defend the organizations and health care providers rather than cash in. Jay H. Ell was blessed to be represented by them.

NO CASE FOR LITIGATION

Jay H. Ell would just like to juxtapose his experience with a vignette presented to him by a friend contemporaneously with his ordeal. The latter had a lesion removed from his lung that had been found during a routine procedure. The operation produced some side effects that needed further management. He proceeded to another institution for treatment and they reviewed his slides and pathology and found that the initial thoracic surgeon had missed a carcinoma. In fact the surgeon argued that he hadn’t even attempted to access whether or not there was a malignancy. The patient needed a second operation where the cancer tissue was fully removed.

 He then went to see a several malpractice lawyers none of whom were interested although the second institution had volunteered that the management was disgraceful. One can see why there was no interest - the victim was alive and kicking. What harm had resulted from the negligence? He had lost a relatively short amount of work time, had had some additional pain and suffering and had additional medical costs, but it all added up to a string of beans. The complainant said he was not after money but this doctor needed to be stopped. There is no routine formal unbiased structure to effect this. You can complain to the State licensing board but understaffed as they are they just generally pursue those who are placed in the data bank.

FINALLY

 An incident stands out in Jay H. Ell’s memory when as a medical student he attended the quasi judicial trial of a dedicated senior anesthesiologist who had given the wrong pint of blood in an operation. Everyone agreed that should never have happened. The circumstances were hectic and the surgeon was screaming that the patient was bleeding to death. It just so happened that there was a patient in the hospital with the same name and they brought her blood instead. Both the nurse and the doctor checked the pint and obviously in the drama only checked the name. 

The pro forma testifying expert was a famed academic and Head of the Department of Anesthesiology at a distinguished hospital and Medical School. He maintained that the signs the patient had experienced were consistent with a transfusion reaction due to differing blood types. He continued that the reason he was so sure was that, unfortunately, there had been accidents to which he was witness. So in the case of the defendant anesthesiologist the occurrence was egregious negligence but for the leader in the field it was an unfortunate accident. The trashing of the doctor that these investigations inevitably entail left the defendant depressed and humiliated and to quote his son, a life long friend, he never recovered. 

There by the Grace of G-d go all of us……. .