Nuclear Policy In The Trump Administration

 

A couple of weeks ago, the administration released its Nuclear Posture Review. All administrations like to put their stamp on policy. The last review was in 2010.

There are lots of things in this one to talk about, and many articles out there about them. I’ve been trying lately to stand back from the trees and look at the forest. So, as a former project manager, some of the first questions I come up with have to do with budgets and timelines. Things like resource availability and scheduling. I wrote that up for Physics Today.

Short version: Looks to me like they can’t do what they want with the resources they’ve got. Plus it will take a decade or more to build the nukes they want, so maybe diplomacy can achieve our ends faster.

 

Cross-posted at Nuclear Diner.



What Doesn’t Make You Stronger Can Kill You

Bit of self promotion here:  I’ve got a piece in today’s Boston Globe, on one of the hidden consequences of failing to deal with the antibiotic crisis.  In it, I focus on the use of antibiotics as prophylactics in surgery. Nowadays, it’s standard procedure for a wide range of operations to dose the patient with antibiotics shortly before she or he goes under the knife; doing so has been shown to signficantly reduce the risk of post-surgical infections.

I took off from a study that modeled the consequences of increased microbial resistance for ten common procedures, mostly surgeries, along with chemotherapy for a particular set of cancers.

The results of that study were predictable:  more resistance leads to more post-op infections and to more deaths.  If the situation gets really dire, if common causes of infection associated with surgery become increasingly untreatable then the calculation behind all kinds of medical interventions will change:

That’s what scares Dr. James Maguire, an infectious disease specialist at Brigham and Women’s Hospital. “I think some of the worst feelings we have are when we have a problem with a patient and there’s nothing we can do.” Infections following joint replacements are bad enough. They are, Maguire says, “catastrophic in terms of what happens to the patient.” Were the risk of infection to go up enough, he adds, “having seen what an infected joint replacement is all about I would think twice.”

That’s a response to an operation that may be vitally needed to reduce pain and increase mobility — but, as Maguire went on…

…while someone contemplating a joint replacement can choose to forgo the risk, if they need a new heart valve or a ventricular assist device, “that’s potentially life and death.” In such circumstances, “if your life depending on having the device, even with great risk you’d do it. But more would die.”

Behind such specific possible horror stories, this is for me a deeply cautionary tale about the way choices our society — our politics — makes have much deeper effects than our usual debate admits.  Antibiotics are not just responses to disease; their use penetrates medical practice, to the point that basic expectations we may have about what how we can move through the stages of our life can be dashed, without our ever really grasping why.

That is:  joint replacements are part of our medical and mental landscape now.  There are over 330,000 hip replacements performed each year in the US.  We know (some of us, venerable as we are, more than others) that our knees, elbows, shoulders and so on won’t always work as well as they do today.  We know, most of us I’m sure, folks who’ve had the op and are now playing tennis again or whatever, and we have in the back of our minds (those of us fortunate enough to believe we’ll still have adequate health care available over time) that if and when that bit falls apart in our own bodies, we can look for the same outcome.

Except, of course, if the risks of surgery shift significantly in the meantime.

The last point I make in the piece, somewhat more gently than here, is that should the way we age, the way we give birth and so on deteriorates because of unchecked microbial resistance, that will be a more-or-less hidden consequence of political failure.

That’s because dealing with the antibiotic crisis boils down to doing two things:  regulating economic activity and funding research.  The GOP doesn’t want to do either.  And, as usual, people will die as a result.

So, on that note of cheer, a link, again, to the piece.

Oh…and open thread too.

Image: Follower of Jan Sanders van Hemessen, An Operation for a Stone in the Head, date unknown (to me).



A thousand and one posts

Wow, that last post was my 1,000th post here at Balloon Juice. I was not expecting that when I first got started here.

I’ve been a Balloon Juice reader and primarily a lurker since before the Cole Conversion time. Over the summer of 2013, I saw a lot of good questions about the ACA and how it would effect our community. I got in touch with a front-pager I know in real life and asked if I could write a couple of posts to answer a couple of questions. He e-mailed John and John gave me the keys to this place. I figured that I would twenty to thirty thousand words in forty or fifty posts and then I would be done.

Over the past three years, I have eight hundred or more health insurance posts with about half a million words written.

That was a slight miscalculation.

I’ve rediscovered how much I like to write about a subject that I like. Every day I get to answer a question, explore something that I heard something about but now need to explain, or advocate for a slightly better world with tweaks to the current policy universe. I’ve been able to point people in the right direction when they are getting screwed over. We’ve been able to go through complicated choice structures to get community members taken care of when they know they need to do something but do not know what they have to do.

At the same time, my education has deepened as the community here and a second community of wonks, advocates and researchers. If I need to know about anti-trust law, I have a couple of world class experts who share their time with me. If I need to know more about Medicare, I can talk to people who are on it, I can talk with CMS techno-wonks, and national level advocates. If I need to learn more accounting, there are plenty of people who will share their knowledge and expertise with me.

I never thought I would have written here for more than a couple of months. But between all of you, the community and John’s amazing ability to let things flow, I am more energized than I ever thought I would be a thousand posts ago.



For A Good Time In Tucson…And Then Tn Charlottesville.

[Obligatory sound track]

Way late with this post, but if any of y’all happen to be in the Tucson, AZ area this weekend, I’ll be doing a bunch of stuff at the excellent Tucson Festival of Books.  It’s truly an all-in event; just an outrageous amount of book love crammed into two days.

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My own motes in this maelstrom come at 10 a.m. and 4 p.m. both days.  On Saturday, I’ll be participating in a couple of panels, “Genius: Lives in Science” in the morning and “How We Got Here: Histories of Science” in the afternoon.  Sunday morning I’ll be doing a workshop/Q & A on science writing — how that will go will depend on who shows up and what they want to talk about — and in the afternoon we’ll be on to “Our Nearest Neighbors In The Solar System,” a chance to talk Planet Nine, Kuiper Belt Objects, those funky moons that orbit the Pluto-Charon system…and maybe just a bit about our should-be, could-be, never-was friend, Vulcan.

Some come by if you can.  And check out everything else going on — or rather, as that’s more than any one person could manage, check out what you like.

Also — an author’s plea.  If you happen to have read The Hunt for Vulcan (so nice I linked it twice) do tell your friends, and if you’re feeling extra generous, pop up a review on Amazon, or whatever social media venue floats your boat.

Also, also:  for anyone in the Charlottesville, VA vicinity next week, I’ll be talking at the Virginia Festival of the Book as part of a panel on “Mysteries of the Cosmos.”  That’ll be on Friday, March 18 at 4 p.m.  That’s another great celebration of writing, reading and the wondrousness of words; it too has an amazing line up of authors, with only yours-truly mucking up the joint; and a spring weekend spent in sight of the Blue Ridge is never wasted.

And just to broaden out the thread — how about talking about what you’re reading now.  For me, I just finished work in a genre I don’t usually read much: N. K. Jemisin’s Inheritance Trilogywhich I enjoyed a lot, and to which I turned after being truly wowed by her The Fifth Season — a novel of geophysics, race, love and vengeance. I’m not sure what the next novel will be just yet.

My non-fiction jones is being fed by a dual read of Andrea Wulf’s The Invention of Nature:  Alexander Humboldt’s New World and Humboldt’s own Personal Narrative of Travels to the Equinoctial Regions of Americaand a nightly, just-before-bed dip into Susan Howe’s My Emily Dickinson — which is just wonderful, a poet diving into another poet’s life and work in a bravura demonstration of criticism as high art.

What’s on your pile?

Image: Simon Luttichuijs, Vanitas still life with skull, books, prints and paintings by Rembrandt and Jan Lievens, with a reflection of the painter at workbetw. 1635-1640.



Authors in Our Midst: Bullets

I see if I want an afternoon distraction I’m going to have to post it myself.

BULLETS e-cover

This is a quick Authors in Our Midst. I received an email this week reminding me that one of our authors is offering a free download this week.

BULLETS – mystery thriller by Elijah Drive

Professional poker player Jon “Big Slick” Elder was minding his own business in a diner when an Arizona sheriff walked in and killed the man sitting next to him, a Mexican day laborer accused of murder. The law officer then arrested Slick simply because the sheriff didn’t like the color of Slick’s skin.

Slick knew that the stranger who had been sitting next to him at the diner was no murderer because, in addition to cards, Slick also kills people for money. The poor man didn’t have the look, but Slick does, and with the help of a beautiful assistant district attorney, a Navajo state trooper and a homegrown federal agent, Slick sets out to prove the dead man’s innocence. What he discovers, as he digs deeper, is a deadly mystery that threatens not only him, but his newfound friends as well. But Slick hates to have anyone… ANYONE… toss him his shoes and tell him to get out of town.

If you need something to read this week, there you have it! Again if you missed it, here are the first three posts: ONE, TWO and THREE

Consider this a book and open thread. See if we can avoid any hint of politics. Unless it’s a political thriller.



Authors In Our Midst: The Dog Thief and Unreasonable Doubt

I am very excited about the response to my request for submissions from authors in our midst. If you missed it, here are the first and second installments. There was enough of a response that I think I’ll do two authors in each post, for variety – if one genre doesn’t appeal to you, another might. I’ll probably post twice a month, more if I have time.

I’ve asked the authors to chime in, in the comments, to give a bit of their journey, how they came to write their works, what inspires them. I hope you’ll play along and ask them questions. Think of it as your very own writer’s workshop/author meet and greet.

First up: Jill Kearney, The Dog Thief (available here)*

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This book seriously sounds like it could be a Balloon-Juicer’s favorite:  Read more



Authors In Our Midst: The Cabin

JMA12-001-019_THE-CABIN_BOOK-COVER

I thought the first post of Balloon-Juice writers was successful enough to do another. I think after taking suggestions, a weekly or twice monthly post will be manageable and fun. I’ll only post one or two authors in each post. If you’d like to be featured, please email me and I’ll post on a first come basis.

Just to avoid any complications, I’ll only post at the author’s request.

So hit comments, ask questions, share favorite reads and if you’re an author share your work, talk about your publishing adventures, share any tips or advice, answer questions.

The week’s submission is from Munira – The Cabin, by Judith Munira

Building the cabin Photo by Hédi Mizouni

Building the cabin
Photo by Hédi Mizouni

When Judith Avinger drove out of Bellingham, Washington, in her white Honda, on her way to a new life in Quebec, Canada, she knew, of course, that she was going to a different country, and to a province with a different language, but she also felt she was looking for something else, something elusive, something she couldn’t define. What she found was a new family, a spiritual path, a new name (Munira) and the vision of a cabin in the forest, a cabin she eventually built in the Eastern Townships of Quebec.

The Cabin is the story of how she dreamed that cabin into existence. But it’s also the story of her deep connection to the people and places she left behind and her trips back and forth between the east and the west coasts. She began writing this memoir the day she left Bellingham, recording each day’s adventures in her journal. Nearly 20 years later, it is finally finished.

To see the original authors in the first authors in our midst post, click here. Also check out the comments are there were quite a few author links there, too.