The Grumpy Doc – Page 4 – Grumpy opinions about everything.

The Agony of Presidental Elections

On July 6, 2024

Over the past several months I have become increasingly discouraged as I watch the sad spectacle of the presidential election play out in the newspapers and on the electronic media. It seems the candidates are more interested in serving themselves than in serving the people. Each is convinced that he is the only one who can save the country. While one is obsessed with regaining the power of the president, the other is reluctant to relinquish it.

This has left me wondering if there’s not a better way to elect the president. As everyone knows we elect a president for four years and then they can be reelected for an additional four years. But this was not always the way our electoral process has been structured.

A brief history of presidential terms

Perhaps second only to slavery, the office of president was one of the most controversial subjects at the 1787 Constitutional Convention. There were extensive debates about the structure of the office, the power of the chief executive, and even if it should be a single person. There was a proposal put forward by Edmund Randolph of Virginia for a three-person executive committee to head the government.

There were proposals for a short-term presidency of one or two years, arguing that more frequent elections would ensure the chief executive was more responsible to the people. There were also proposals for longer terms such as 7 or even 15 years. The intent of longer terms was to provide the president with independence from the influence of special interests and provide for more stable government.

There is a popular misconception that Alexander Hamilton favored a president for life. While he advocated for a strong presidency with certain aspects of a monarch, he also recognized the importance of a fixed term and the provision for impeachment to safeguard the country against abuse of power.

After it became clear to most delegates that George Washington would become the first president, the convention decided on a four-year term for the president. The constitution as originally adopted did not explicitly state that the president can be reelected, nor did it prohibit reelection. Not all delegates were in favor of allowing the president to be reelected because they felt it would result in too much power being consolidated the hands of the single person. As often happens in politics, no decision was made, and the Constitution as adopted was silent on reelection.

The issue of term length did not end with the ratification of the constitution. The first proposed constitutional amendment to change the length of the presidential term was introduced in 1808. Since then, multiple amendments have been proposed to extend the term to five, six, seven or even eight years. By the early 1900s the single six-year term had become the dominant idea being proposed. Amendments to change the term of the presidential office were introduced as late as the 1990s. Although persistent in their reappearance, none have ever had any realistic chance of being approved.

George Washington set the precedent of serving only two terms by retiring to Mount Vernon at the end of eight years in office. This pattern was followed until Franklin Roosevelt ran for a third and then a fourth term. After Roosevelt’s death, the 22nd Amendment to the Constitution was passed by Congress in 1947, and ratified in 1951, limiting the president to two total terms in office.

Other countries have different patterns for their chief executive’s term of office. Parliamentary countries have no set term. Elections can be called, and the chief executive removed from office whenever confidence in the government has fallen, and the public demands a change. Other countries such as Mexico, the Philippines and Chile have a single six-year term for president.

If we were to consider a single six-year term for the US president how would that change things. Let’s look at a few of the pros and cons.

The arguments in favor of a single six-year term

The president would be relieved of the burden of an almost constant reelection campaign. With a single term, a president can focus on policy and governance without being distracted by the next election cycle. This may lead to bolder, more decisive leadership, unencumbered by the need to cater to special interest groups. Those groups may be less inclined to make large political contributions knowing that they hold no future sway over the actions of the president.

There may be potential for greater continuity in policymaking. Presidents could be more inclined to tackle unpopular long-term challenges head-on, rather than deferring them to a second term or even to their successor. The president may be more likely to engage in bipartisan programs knowing that there is no need to appease party radicals during a reelection process. The president could be more likely to engage in long term planning rather than worry about what will look good in the polls in the short term. This may result in fewer political decisions made just to improve reelection chances.

Not having to run for reelection would also give the president more time to work for the country and the citizens. The time and the effort put into planning campaigns, making speeches, and attending reelection events could be spent improving the government and the country. If the president has more time to work closely with Congress, then there could be less gridlock in Washington. In sum, the single six-year term may allow the president to be the statesman they all claim to be.

The arguments against a single six-year term

A single six-year term could diminish the accountability of the president to the electorate. In a traditional two-term system, presidents are incentivized to deliver on their promises and perform effectively to secure re-election. With only one term to serve, there may be less pressure for a president to maintain high levels of performance throughout their tenure. This could result in complacency or a lack of motivation to pursue ambitious reforms, knowing there won’t be a chance for the electorate to hold them accountable.

A single six-year term could disrupt the balance of power between the executive and legislative branches. With the absence of a potential second term, presidents may become more inclined to bypass Congress and govern through executive orders and unilateral actions. This could lead to increased polarization and gridlock, as Congress may resist executive overreach, exacerbating tensions between branches of government.

If the president proves to be inept or not acting in the best interests of the people and the nation, six years is a long time for that person to be in office. The only option would be impeachment and we know from recent experience that impeachment is a long and painful process frequently generating more ill will than good results.

And in conclusion…

So, would a single six-year presidential term be a good thing or a bad thing? Would it help us get out of our current political mess?

Perhaps it would have no impact at all. Perhaps it’s not the length of the presidential term, the number of terms the president serves, or even how we elect the president. Perhaps the real problem lies with us. It doesn’t matter how we elect our president if we don’t do a better job deciding who the candidates will be. It’s been said many times that people get the government they deserve. We all complain about it and yet we continue voting for the same type of people year after year.

Of all the people to blame for the current political situation, the one in the mirror is the one to whom we should look first. Because, after all, that’s the only person we can control.

And that is my grumpy opinion.

Even More Fun With AI

By John Turley

On June 18, 2024

In Art, Commentary, Humor

Since I’m easily amused, I’m still playing with the AI image generator DALL-E. I wanted to take some time to show you just how easy this is to use. All these images were generated on the requests shown below. The only ones I’ve modified or edited are the ones in the series to demonstrate an edit. You will usually get two versions with each request. You can save either one or both. You can generate up to 50 images a day. I’ve hit my limit more than once.

I generated the image above using the following command. In a cartoon style, generate images of a man dressed as an artist, wearing a beret and a smock, and holding an artist palette and brush. On the easel, have a computer screen with a picture of the same man.

It only takes a little bit of change to get a completely different feel to your pictures. I created the image below basically by saying in a realistic style as opposed to in a cartoon style.

Generate an image in a realistic style of a man dressed as an artist with a smock and beret, holding a palette and a paintbrush and standing in front of an easel with a computer screen in a messy studio.

Now, let your imagination soar and see what you can come up with. I’m going to make up a few commands now and see what develops.

In a surrealistic style generate images of a young boy with pale green skin and feathers on his arms soaring with fantastical eagles over a fantasy landscape of canyons and forests.

In a realistic style, generate images of an African American woman in a sophisticated business suit and carrying a briefcase. Place her in a whimsical background with fantasy creatures, such as elves, fairies, and unicorns.

In a steampunk style, generate images of a doctor examining a patient with a stethoscope. Have the patient have a third eye in the middle of his forehead.

In an abstract style, generate images of a man and a woman sitting in chairs facing each other. Have the man smoking a cigar and have the woman with purple hair.

In a style reminiscent of the French impressionists, generate images of young people in colorful outfits, dancing on an outside patio.

In a cubist style generate images of baseball players.

DALL-E offers the capability to edit your pictures. However, as you’ll see from the series below it actually generates new pictures with slight variations based on your requests for edit.

In a cartoon style generate images of a young man walking down a sidewalk on a sunny day. Have him in a suburban neighborhood with trees and flowers and well tended lawns and houses.

Change the neighborhood to urban with cars parked on the street and the sky overcast.

So far, the changes seem to be fairly consistent and go along with the general style we requested. Let’s make a couple of big changes and see what happens.

Have him look disheveled and scruffy. Make the neighborhood run down with trash in the streets. Have him carry a whiskey bottle and a cigarette.

I think it’s right on with this one. It got the feel I was looking for.

Now for my last picture, I’m going to let my imagination run wild and try to come up with these strangest and most bizarre images I can imagine and see if DALL-E matches or exceeds my ideas.

In a dystopian style with a post-apocalyptic background, generate images of an emaciated Santa Claus jumping rope while talking to an Easter Bunny with vampire fangs and a leprechaun with claws. Add any other menacing characters you think may be appropriate.

I couldn’t decide which one I liked best, so I decided to use them both. I’m not sure what it says about me that I like these images.

I couldn’t resist trying one more edit. I asked DALL-E to generate the above image in cartoon style. It sent me this response: I encountered some issues while trying to generate the cartoon-style images. Please let me know if you would like to try a different request or if there’s anything else I can assist you with. Perhaps it thought cartoon style would attract children and the subject matter was a little too ghoulish for kids. After tweaking the prompt a couple of times, I got the following image:

Maybe they were right the first time.

Give it a try. I think you’ll have as much fun as I do.

Doctor’s orders!

New Myths Arise

By John Turley

On June 10, 2024

In Commentary, History

So why should we consider myths as anything but an anachronistic curiosity since we consider ourselves a rational and scientific society? Because the willingness to believe in myths is as strong today as it has ever been. While belief in Olympian gods, elves, and fairies has faded away new myths have arisen. Since the late 1800s, at least two new myths have spread in the United States.

The Golden Age of America

Our political situation today has much to do with belief in the Myth of the Golden Age of America. I strongly believe that the United States has been and continues to be the best hope for personal freedom in the world today. But the idea that at some time in the recent past everything was wonderful for everyone is a myth. In this “Golden Age” to which some people wish to return, women, minorities, gays, and the disabled were clearly discriminated against.

One key contributor to the Golden Age Myth was the economic boom that followed World War II. The United States was a global industrial leader and the economy showed significant gains in jobs, wages, and consumer goods. The middle class was expanded, college education rose due to the GI Bill, and home ownership reached new levels. However, these advantages did not reach all members of our society.

Racial minorities continued to be actively discriminated against. Segregation, particularly under the Jim Crow laws in the South, limited economic, social, and political opportunities for our Black citizens.
Women’s roles and opportunities similarly were significantly constrained. Women were expected to take a domestic role over professional or personal aspirations. Even women who obtained advanced college degrees were expected to stay at home and raise their family or to take “appropriate” jobs such as secretaries, teachers, or nurses.

Reaction to the Golden Age Myth led to movements such as women’s liberation and the civil rights movement, both followed shortly by gay rights and the advocacy for the disabled. The Golden Age seems to have existed principally in popular television shows such as Ozzie and Harriet or Father Knows Best. In short, this “Golden Age” was not golden for everyone.

The Lost Cause

This myth arose in the South in the late 19th and early 20th centuries though it had its origins while the war still raged. According to the Myth of the Lost Cause, the Civil War had nothing to do with slavery. It had to do with the southern states fighting for their individual state rights and their prerogatives of self-government. They were fighting against northern aggression that was trying to destroy the southern way of life. Most Confederate soldiers were poor farmers who neither owned nor could afford slaves. They had to be convinced that they were fighting for their way of life against a malicious union army that was intent on invading their homes and forcing “northern ways” on them. The soldiers had to be distracted from the fact that they were fighting, suffering, and dying to protect the way of life of the wealthy slave owning aristocracy.

The evolution of legend was also involved in the creation of this myth. Robert E. Lee and Stonewall Jackson were idealized as true southern gentlemen struggling in a glorious but doomed battle against overwhelming odds.

Of course, it completely ignores the fact that the southern way of life and those state rights were predominantly based on slavery. A critical element in this myth is that slavery was good for the slaves. We continue to hear this stunning falsehood from politicians today as they try to describe slavery as a little more than job training.

Many historians today agree this myth is an intentional distortion of historical facts. The Lost Cause Myth reached its fully developed form in the years surrounding the turning of the 20th century and was intended to change the historical narrative of the South’s role in the Civil War by minimizing the central role of slavery in the origin of the conflict. This revisionism was part on the broader social effort used to justify segregation, Jim Crow laws, and white supremacy.

The Lost Cause is a compelling example of history being reshaped by myth and legend. It shows how over time people can come to accept those things that most support their personal beliefs despite evidence to the contrary. It continues to dominate much of our current debate about race relations, voting rights and social welfare policies. However, today open advocacy of the Lost Cause Myth is in the background and it is seldom mentioned by name though its tenents are reflected in the opinions and statements of many .

Why believe in myths?

So why do we have a widespread belief in these myths? There are several reasons people persist in a false belief even after it has been largely disproven.

The most obvious reason is that myths meet emotional needs. They can be deeply ingrained in a person’s identity, beliefs, and values. When the myth is tied to political or religious beliefs people will be resistant to change even in the face of contradictory evidence. Admitting a previous error of belief is, in some ways, viewed as a form of weakness.

There is also a condition called confirmation bias. People are inclined to seek out and accept without question things that confirm their pre-existing beliefs and opinions. They ignore anything that is not consistent with an already held position.

When presented with information that conflicts with previously held opinions, people can experience what is known as cognitive dissonance. This is the emotional distress that people feel when attempting to hold two contradictory ideas or when trying to reconcile new information that challenges their behaviors or previously held ideas. To reduce this distress people either ignore or in some cases violently reject anything that conflicts with what they previously believed.

Critical thinking skills involve objectively evaluating evidence, identifing inconsistencies, and appling reasoning skills. Critical thinking isn’t always a natural process. When I was in high school, we were expected to memorize facts and then duplicate them on tests. I don’t remember even hearing the term critical thinking until I was in graduate school. Even then, I’m not really sure I understood how important it is to develop a personal understanding of facts and events and how difficult it would be to aquire those skills.

Teachers now make an effort to teach critical thinking skills. But it can be difficult for students to translate those skills into their life outside the classroom. Perhaps many of them may think of critical thinking the way they think of algebra, something they must do in school but won’t ever use in their everyday life. A well-informed citizenship requires all of us to encourage critical thinking practices. We need to ensure that our young people are reading and listening and using those skills outside the classroom. It’s easy to say, but venturing out of our comfort zone can take strength and purpose for all of us.

We can quickly fall into the habit of listening to or reading only a narrow range of opinions from a limited number of sources. It is particularly easy when those sources don’t challenge us to think or to analyze. It is too easy to reject new information rather than trying to evaluate and reconcile it with our previously held beliefs.

Obviously, these reasons are not mutually exclusive and are melded into a continuum of reasons for the rejection of fact in favor of myth.

Both the Lost Cause Myth and the Golden Age Myth arose much quicker and for a more limited purpose than did the classic myths. In this way the evolution of these myths has much in common with the concepts of propaganda. In my next post I will be looking at the difference between lies and myths and how both relate to propaganda and how it has evolved in modern times.

The Power of Myth and Legend

By John Turley

On May 30, 2024

In Commentary, History

A brief history of myths and legends

This is the first in a series of posts on myths, legends, lies, and propaganda. Above are illustrated Thor, Paul Bunyon, and Zeus. Instinctively we know Thor and Zeus are myths and Paul Bunyan is a legend. But how do we know that?

Let’s start with the Merriam-Webster definitions.
Myth: “a usually traditional story of ostensibly historical events that serves to unfold part of the world view of a people or explain a practice, belief, or natural phenomenon”. Legend: “a story that comes from the past, especially one that is popularly regarded as historical but not verifiable. Legends are also traditional but unfounded stories that explain the reason for a current custom, belief, or fact of nature.”

As with many dictionary definitions, these are broad and give the general concept without developing any detail. One important element is included in the definition of both; they are based on traditional stories that have evolved through shared historical experiences and understandings. They are generally not created as a single fully developed narrative. Almost all cultures have a tradition of myth and legend. For example, the “creation” myth is surprisingly similar among diverse societies.

So, how do we differentiate between the two?

Myths are primarily religious or spiritual in nature and evolve to help people understand the mysteries of the physical universe. They typically involve supernatural beings represented as “gods”. For example, early people did not understand that the rotation of the earth caused night and day. As a way of dealing with this they created the myth of a god driving a flaming chariot across the sky.

Legends, on the other hand, are usually based on a historical person or are, perhaps, a synthesis of several people into a single legendary figure. They are less about the supernatural or divine but more about human heroes who accomplished extraordinary deeds. Legends evolve over time with the hero frequently accomplishing great feats that reflect the concerns of the population at the time. The legends are intended to inspire and to contribute to societal cohesion. The legend can have variations in many areas over many years. The classic example of this is the King Arthur legend which comes in many forms in different countries spanning several centuries. Daniel Boone and Davy Crockett are examples of historic Americans who have evolved into near legendary status.

As you might expect, myths and legends can overlap and can even melt into one another. They can also be incorporated into propaganda and can be used to support false narratives of history and society. For the rest of this post, I’m going to principally look at myths because of their similarity to legends and because sometimes it may be less clear that the origins of some belief may be steeped in mythology or legend.

More About Myths

Myths serve a variety of purposes. They are used to explain natural events that are not well understood. A variety of “gods” were created to help people feel they had a sense of control in a world that seemed very dangerous to them. They helped people feel there is a purpose to existence.

Myths also help shape cultural and social identities. They give people a sense of shared history and reflect community values and customs. The myths frequently contain ethical and moral lessons. Myths help create unity in times of difficulty and can be a source of inspiration. Myths can also be used as an object lesson about what could happen to those who don’t respect community values.

In preliterate societies, myths performed a service of historical or cultural preservation, particularly as it relates to behavior and beliefs. Myths frequently use symbolic language and narrative to enhance societal cohesion. They reinforce a feeling of belonging within the group.

Myths can have an emotional appeal and are more engaging than a dry listing of facts. They can often provide a simple answer to complex problems. Societies find comfort in the stability that an underlying myth can provide even if there is no empirical evidence to support it. Myths can become so embedded in a society’s religion, art, and literature that some people often have trouble separating the myth from the reality of the world around them.

The belief in myths is not always consistent among groups and cultures. In some societies, myths are taken literally while in others they are taken allegorically. The belief in myths has changed over time as societies have evolved knowledge and scientific understanding. But they all share an attempt to transform the metaphysical to the literal.

While the evolution and perpetuation of myths was of great value to early societies, continued reliance on myths as a source of knowledge often hampered scientific development. Throughout history, there have been persecutions of people who proposed new scientific knowledge or philosophical opinions that varied from society’s foundational myths.

We tend to think of myths as having arisen in the mystic past. We think of them as entertaining stories with little relation to our lives. However, myths continue to evolve, and new myths are continually created. In my next post, New Myths Arise, I’ll talk about two myths particular to the United States that have risen within the last 150 years and still have a continuing impact on our society.

It’s Time For National Service

By John Turley

On May 23, 2024

In Commentary

The performance of our active-duty military, national guard, and reserves was commendable during the wars in Iraq and Afghanistan. These young men and women continue providing exemplary service to our country. The public has rallied behind them to support them and to thank them for their efforts. This old Vietnam veteran is thrilled to see the public response to our young service people.

There is one thing that concerns me though. The ranks of our armed forces continue to be drawn from an ever-smaller percentage of our population. I cannot adequately express how proud I am of the young people who have chosen to voluntarily serve our country. Unfortunately, these patriotic young people do not represent our population as a whole and recruiting goals frequently are unmet. One of the few exceptions is the Marine Corps, in which most of you know I proudly served. But it is small and has high Esprit de Corps and appeals to those looking for a challenge.

Personally, I feel it was the greatest privilege of my life to serve as a member of our Armed Services and protect our country and our way of life. I firmly believe those who now serve share this conviction.

However, most of our citizens now are not directly impacted either by personal military service, other types of public service, or by the service of family members. I would like to see the benefits of public service extended to all members of our population, even those for whom military service may not be appropriate.

Perhaps we should consider a program of universal national service. Such a program might begin with a two-year national service obligation that would begin at age 18 but could be delayed for education or other appropriate reasons.

Universal national service could include not only the military, but also such existing programs as the Peace Corps and AmeriCorps/Vista. We might also consider bringing back older programs such as the Civilian Conservation Corps to work on infrastructure. There could be options for service in teaching, law enforcement, firefighting, or emergency medical services. This type of public service could not only help fill nation-wide shortages but could also lead to long-term careers in these fields as well. Delay of service obligations could be available for those in training to serve as military officers, or in training to be teachers or in medical fields that require advanced education and who agree to work in underserved areas following completion of their training.

I don’t pretend to know the details of putting such a program in place. I’m sure it would be very complex and expensive to initiate. But I think there would be many benefits ranging from reduced unemployment to job training to education. But most importantly it would enhance a sense of pride in being Americans, give personal satisfaction in improving the lives of our fellow citizens and strength our of our sense of community. All of this while contributing to the common good.

There’s an old saying, “Freedom is not free”. We now have only a small part of our population that pays the price of freedom for the rest of us. We owe them a debt that cannot be repaid. Isn’t time for everyone to help share the burden and enjoy the pride of protecting and maintaining our freedom, keeping our nation strong and providing for those who need our help?

And that is my grumpy opinion.

More Fun With AI

By John Turley

On May 17, 2024

In Commentary

In my previous post Fun With AI, I talked about how much I enjoy DALL-E, the ChatGPT image generator. But that’s only a small part of ChatGPT, although it is the most fun part.

So, what is ChatGPT? I’ll let ChatGPT explain in its own words: “ChatGPT is an advanced artificial intelligence language model developed by OpenAI, based on the GPT (Generative Pre-trained Transformer) architecture. It processes and generates text by predicting the likelihood of a word sequence, enabling it to perform a wide range of tasks, from holding conversations to writing articles and answering queries. Its training involved analyzing vast amounts of text data, which helps it understand context and nuances in language.”

I hope that’s clearer to you than it is to me. But what I do know is it’s been very helpful to me. I’m just going to go over a few of the things for which I use ChatGPT.

I first started using ChatGPT as a research assistant. I asked it to find me articles about specific topics and suggest references and lines of inquiry. It’s not a substitute for detailed individual research but it is a head start in the right direction. Although you do have to check some of its research because it occasionally gets it wrong or cites outdated material.

One of the things where I have found ChatGPT to be very good is finding quotations on multiple topics. Sometimes it can be difficult to locate specific applicable quotes. (Does anyone else remember Bartlett’s Familiar Quotations?) Again, you must double check the results. Occasionally it will attribute the quote to someone who was referencing the original author.

I’ve also found ChatGPT to be useful in generating title ideas. I’ll ask it to give me 10 suggested titles on a specific subject. While I’ve not used any of the titles exactly, they have formed the basis for developing my own specific titles.

I also use ChatGPT in my genealogy work. Occasionally when researching old records, I’ll find documents that are written in foreign languages or church records written in Latin. Previously I’d used Google translate but found that to be somewhat onerous. ChatGPT translation is quick and easy. I just cut and paste the text into ChatGPT and ask for a translation. You don’t even need to tell it the original language.

I also use ChatGPT as an editing aid. I ask it to review my articles for grammar, readability, and content. ChatGPT has let me know that I frequently use too many adverbs and don’t always get in enough commas. This is a simple process. I take my completed article and paste it in the ChatGPT and ask it to give me an edit.

There are other features that I haven’t used in ChatGPT because I don’t really understand them. One of them is helping with search engine optimization. Apparently, this is a way of ensuring that people searching for topics on the internet can find your website instead of others. While I haven’t taken time to investigate this, I guess I could just ask ChatGPT to explain it to me.

ChatGPT also has a strong program for developing interactive content. This hasn’t been something I’ve been interested in, so I haven’t explored it.

It has the capability to analyze and summarize large amounts of data. I’m hoping to use this at some point to help me with census analysis in my genealogy work. I just haven’t taken the time to develop that ability yet.

I found ChatGPT to be especially useful when I work on this blog. I spend a lot less time on Google. I get more focused searches with ChatGPT, but I do need to be more careful in reviewing the results. The image generation function has expanded my ability to illustrate my blogs. I don’t have to go searching for images in the public domain or worry about licensing fees. I just generate my own images.

There have been a lot of concerns recently about the “dark side” of artificial intelligence. There are plenty of articles in the popular press and I’m not going to dwell on it here. (ChatGPT can generate you a list of as many articles as you would like.)

I just want to express one concern that I have. I worry that it may make me lazy. I may decide not to do my own research, not to read and analyze the available information, and not to spend the time organizing and writing my articles.

I may just tell ChatGPT to generate an article about the use of ChatGPT for writing a blog. Or maybe I already did!?!

Just because I have so much fun with the image generator, I want to share a few of the other images I generated to illustrate this post.

Stand Strong: Protect Yourself From Falls

By John Turley

On May 11, 2024

In Commentary, Medicine

Not too long ago I decided to spend my lunch break from the clinic by taking a walk around downtown. It was a beautiful day. It was warm, the sun was shining, and the sky was bright blue. I just started my walk when I thought I heard tires squealing behind me. I looked over my shoulder and as soon as I did, I felt my foot catch on a piece of broken concrete, and I went down hard. Fortunately, I fell right in front of my office and even more fortunately I work for the ambulance authority. Within minutes I was surrounded by paramedics and a nurse practitioner who made sure I was well taken care of. My CELLULAR watch also helped save the day. I’ll talk more about my experience later in this post but now I’d like to talk about falling in general.

Those of us of a certain age have gotten used to having every visit to any type of medical appointment include the question: “Have you fallen recently?” Even though I know the reason for this, it still annoys me. They always assume older folks are going to fall. (I think I’ve told you before, I preferred to use the term older folks or even old geezers for that matter but, I refused to be labeled as elderly.)

It’s been estimated that over 25% of older adults fall each year but probably less than half of those will report the incident to their health care provider. Once you’ve fallen your risk doubles that you will fall again. As we advance in age, falls become the leading cause of both fatal and non-fatal injuries.

Chronic medical conditions such as diabetes and heart disease can increase our risk of falling by affecting our blood pressure and causing dizziness. Some of the medications we take can have the same side effects. Also, older folks are less likely to eat or drink adequately leaving them more susceptible to dehydration and fainting. If these things are happening to you, it’s important to let your doctor know so together you come up with a plan to protect yourself.

Environmental factors also play a critical role in falls. Common hazards include loose rugs, wet floors, uneven surfaces, curbs, icy sidewalks, and dropped objects. As I found out, what would have been a simple stumble with a quick recovery when I was younger became a hard fall.

So why is that? As we age arthritis can cause stiffness in our joints which slows our reaction time. Loss of muscle mass and with it decreased core strength make it harder for us to maintain and regain our balance. Changing eyesight makes it difficult to tell where objects are in relationship to one another. As we get older, we tend to shuffle or drag our feet when we walk making us more susceptible to the uneven surfaces. I know that’s one of my major problems.

There are many resources people can use to reduce their risk of falling. I’m sure you all know about them: strength exercises, flexibility and balance classes, and regular stretching can be very helpful. There are many websites that tell you how to fall-proof your home and workspace. And of course, everyone should get a regular checkup to make sure that they don’t have undiagnosed health problems.

Now, I want to tell you about the one thing that I thought was very important for me in my fall. I’ve always been a gadget guy. A few years ago, I decided to get an Apple Watch. I like the idea of being able to get a weather report, check my e-mail, check my texts, check my calendar, and answer the phone all from my wrist. And, because I am a gadget guy, I got the one with cellular capability. I never really expected to make use of it, I just thought it seemed neat.

As competitive as the smart watch market is, I’m sure they all have similar capabilities. I’m not an expert on any of the others, but I do know about the Apple Watch, and I’d like to tell you about it. The watch comes with a fall alert and SOS system. If you fall like I did, you immediately get a notice on your phone that says it looks like you’ve had a hard fall, to which you can either respond “yes send help”, or “no I’m fine”. If you respond yes, it sends your GPS coordinates to 911. If you respond no, it asks if you’re sure, to which you again respond that you are sure and then that’s the end of it. If you do not respond at all or the watch detects you aren’t moving, it waits a few seconds and then sends your GPS coordinates to 911. I know a lot of people are concerned about technology tracking them. Well, I’m glad it does.

And now back to being a gadget guy. This is where the cellular option paid off for me. The SOS fall protection system only works when your phone and watch are in range of one another. You can only make calls from your watch when they were in range as well. Unless, you have a cellular capable watch which works independently.

I know most people think they won’t go anywhere with their watch without their phone. Well, that’s what I thought. But that day, I inadvertently left my phone on my desk. And when I fell, I couldn’t get up. I told my watch not to send my information to 911 because I was right in front of the ambulance authority. I called into the office and very quickly had all the help I could ever want. But if I had not had a cellular capable watch I would either have had to crawl into the office or lay there on the sidewalk until somebody stopped to help me. Which someone did almost immediately. So, there are Good Samaritans in Charleston.

So, my bottom-line recommendation to you is to get a smart watch, whatever type you prefer, and make sure it has cellular capability. Don’t do anything including housework, yard work, or even taking a walk at lunch that may have any risk of a fall without having your smart watch with you. As I found out, the risk of falling is greater than you think. I wish I were getting compensation for pitching this technology.

Who Do I Vote For?

By John Turley

On May 8, 2024

In Commentary

This morning, I was looking over the sample ballot for next Tuesday’s primary election. I miss the days when there were candidates I could get excited about. Candidates for whom I really wanted to vote.

Now I find myself trying to decide who is the LOC, the Least Objectionable Candidate. I worry that if I vote for the LOC and that person is elected, I will come to regret it. I worry even more that if I don’t vote at all, a more objectionable candidate, who may be even worse, will be elected.

How have we come to this state where most of the candidates are people for whom I would not happily vote? I’m afraid I must take part of the blame. I haven’t taken the time or the effort to locate, encourage, and support candidates whose values and ideas I share. I’ve let others, with whom I share few beliefs or values, but who are willing to work much harder, set the agenda and define the candidates. I know I’m going to have to live with the consequences of my inattention in the short term. But I have made the decision that going forward I won’t passively watch the electoral process unfold only to complain about it later.

The Triumph of Ignorance

By John Turley

On April 30, 2024

In Commentary, Medicine

“There are two ways to be fooled. One is to believe what is not true; the other is to refuse to believe what is true.” – Søren Kierkegaard

Saturday morning, I was reading in the newspaper about the resurgence of measles in West Virginia. I find it appalling that this disease should be returning, given that we have safe and effective vaccinations. What is next, polio, smallpox, or even plague? It is only through the unexpected veto by our governor that the ill-advised bill passed by our legislature to make all vaccinations virtually optional did not become law.

Some people may wonder why vaccinations are important. There are two principal reasons to ensure that a large portion of the population is vaccinated against communicable diseases. The first is that it reduces the individual vulnerability to disease. The person who is vaccinated is protected. But there is also a second, sometimes not well-understood, reason. That is herd immunity.

Communicable diseases require a large susceptible population to spread. When a significant portion of the population has been vaccinated the disease does not have the core of potential victims to allow spreading. This means that the vaccinated are protecting the non-vaccinated. However, it does require a large portion of the population to be vaccinated. The idea is that herd immunity will protect those who are unable to be vaccinated either due to age, allergies, or other medical conditions that would prohibit vaccination. Herd immunity is never going to protect a large proportion of the population who just choose not to be vaccinated. For example, about 90 -95% of the population needs to be vaccinated against measles to provide herd immunity.

So why do people who otherwise can be vaccinated choose not to be?

There are, of course, those who have true religious objections to vaccination. These people have long standing, deeply held convictions. Their opinions derive from study, prayer and reflection based on the tenants of their faith. They did not have a sudden anti-vaccine epiphany after listening to the poorly informed rantings of a demagogic politician.

There are many who mistrust the medical system. There were some cases in the past where unethical studies were conducted on unsuspecting populations. Given the rigorous oversight of medical research now, this no longer happens. Information about research into vaccinations and their safety and efficacy can be found on websites for the Centers for Disease Control and Prevention and the World Health Organization among others. (Website references are provided at the end of this post.)

There are others who object to vaccination on the basis of personal autonomy. They believe their right to refuse vaccination outweighs any consideration of the health concerns of the frail members of our community. This is certainly not reflective of the spirit of charity towards all that I was raised with.

What concerns me most are those who refuse to believe reputable medical authorities, government agencies, and mainline news services. They prefer to get their information from anonymous websites or from conspiracy theory websites that still give credence to such sources as the now-discredited 1999 study linking the MMR vaccine to autism. They completely ignore the fact that 10 of the 11 reported co-authors disavowed any part in the published conclusions. They also ignore the fact that the principal author was found guilty of fraud for personal gain as he was employed by the manufacturer of rival drugs. They also ignore the fact that he lost his medical license over his falsifications in this study. Yet, he is still cited in anti-vaccine literature as an expert source.

Equally disturbing is the fact that vaccine resistance has become a part of political identification. Certain reactionary political groups have, for some unfathomable reason, decided that refusing vaccination is a badge of their political allegiance. They seem to care more about maintaining their political purity than they care about science, public health, or even the welfare of their family and friends. Politicizing public health is dangerous for all of us. I’m not sure how we overcome this. It is easy to find the truth and verify it through fact-based studies, yet people refuse to do it.

I encourage everyone to work hard to ensure that our political leaders do not remove vaccination mandates for school children. For those of us of my age, we already have immunity through vaccination or prior exposure to the disease. It is our grandchildren and their children and their children’s children who will suffer through the return of these deadly diseases.

SOURCES:
World Health Organization: https://www.who.int/health-topics/vaccines-and-immunization#tab=tab_1

CDC: https://www.cdc.gov/vaccines/index.html https://www.cdc.gov/vaccines/hcp/vis/index.html

WV DHHR: https://oeps.wv.gov/immunizations/Pages/default.aspx
Immunise.org: https://www.vaccineinformation.org/

Fun with AI

By John Turley

On April 27, 2024

In Humor

Depending on what you read, Artificial Intelligence will either be the greatest advancement in the history of humanity or it will be the end of civilization as we know it. I’m not sure if it will be either of those, but I do know I’ve been having a lot of fun with it. I’ve been using chatGPT, a popular form of AI for a little over a year. I first used it to help me research blog ideas and, for the first time, I used it to edit my most recent post. The text feature is what we most often think about when considering chatGPT, and I’ll talk about that in a future post, but today I want to tell you about DALL-E, a feature available on the enhanced version.

DALL-E is an AI powered image generator that creates original images based on user input. I have always thought the banner illustration for this blog was boring and wanted to create a new one. I tried using stock images but you always run into copyright and fee problems. When I discovered DALL-E, I realized it was the answer to my problem. I just didn’t know how much fun it would be.

My first attempt was to simply enter the command: “Generate images for the home page of a blog titled The Grumpy Doc”. These were the responses I got.

I thought they looked pretty good, but obviously I don’t have a beard so I tried a few more. I entered for him to have gray hair and glasses and be clean shaven. I got what looked like a gray haired 14 year-old with a lab coat and a stethoscope. When I said make him look older, it gave him a gray beard. When I said make the beard go away, it turned it brown. I went through a variety of commands for images in a realistic style and a cartoon style with many various other instructions. The more detailed the instructions you give it, the better images you will get. One caveat, it will not generate images of actual people or of copyrighted material. I probably generated almost 100 images for this project. Here are few of those images.

DALL-E has some trouble depicting human emotion. It doesn’t seem to distinguish between grumpy, angry and just plain mean.

When I asked DALL-E for a whimsical or sly smile, I got this down right goofy look.

Being a hefty guy myself, I asked for The Grumpy Doc to be a little heavier:

Please, no wisecracks about how that looks just like me or you may be in my next blog.

Sometimes the images just don’t make sense. In the image below you will see a stethoscope tube that doesn’t connect to any thing, book titles in no known language and a dial with unrecognizable symbols. Look at some of the above images and you will find many of the same types of mistakes. It is almost like a built-in game.

When asking for text or a title you have to check closely. Sometimes it is fine; other times there are subtle mistakes. One of the pictures above has one of those. See if you can find it. Other times you get something like this:

The one human emotion that DALL-E seems to be fine with is confusion or indecision.

Now what’s that all about?