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Friday, March 12, 2004

My appointment with my New Jersey Urologist was for 2:45 pm. on March 11, I took an early bus out because I wanted to pick out a piece of obsidian for my friend Grace-Ann, and I showed up at the office in plenty of time: "I'm early!" I beamed. Three jaws fell to their knees: "It's tomorrow!"

I don't wear a watch, I should start wearing a calendar, get the broad strokes right.

Thinking the 11th was Wednesday, I had made an appointment with my old boss and his wife for what I thought was the 12th. So, all of a sudden, I found myself with a double whammy, a trip to New Jersey and a night out on the town. It had taken me hours to get back into the city on Wednesday night, there was horrendous traffic, plus an accident involving nine cars and two buses, the bus I was on had to head back out north to get an alternate way in, on and on. Should I plan for disaster and warn Mrs. Ex-Boss I might, just might, be late? I decided not to -- Why "put it out there?" It all worked out perfectly, and I was half an hour early for my evening appointment.

The point of seeing my Urologist was to discuss, eye to eye, what my options might be right now. I have a long-term JJ stent catheter in place in my left ureter for, let's see, seven years now. Must be some kind of record. The kidney is dead. It's been dead for years now. It's referred to by the cat-scan people as an "endgame kidney". Oh, joy!

Having done my lay person research on the net, it appears to me the consensus among specialists the world over is the impossibility to control, contain or eradicate opportunistic, chronic and acute, infections in patients with long-term in-dwelling stents, and that a high proportion of such patients actually die from these infections, rather than from whatever it was that had made it necessary to place the stent in the first place.

My two-week old baby bunny question was this. If the kidney is dead, presumably nothing is draining through the stent (although admittedly some noisome necrotic matter might be, which we can't know for sure ahead of time), so, since the very purpose of a stent is not operative, could we not just take it out, instead of replacing it? This way, I might just get rid of my persistent urinary tract infection.

The clear answer is "Yes". The problem is, there is no way of guessing what might happen next, and one of the things that might just happen next is a really massive infection. It's not hard for me to go out to New Jersey when I am normally stable and able, as I was this week, but it would be impossible with a fever, say of 105F, or even if in terrible pain. It's medically unsound to just pull out the stent and see what happens without having some sort of back-up plan, in case something bad happens after the stent removal.

So, we are revisiting the possibility of a change of Urologist, to someone more geographically convenient to where I live. I am not at all happy about having another total stranger go up my Kazoo.

I love my Urologist. He is the answer to my dreams. Nobody is perfect, but he comes closest. He respects my wishes, he talks to me frankly and openly, as if I were a real human being, he is a great stent man. I saw one, two, three, four, five, Urologists before him, I fired them all, I'd almost rather die than be handled by any one of those again.

On the way to catch the bus back to New York, I kept seeing real estate signs "Apartment for Rent". Should I move out to New Jersey? It's tempting. Great little place, with a gem store. Large cemetery. Good funeral parlor. Large Women's Community Center. Clean, jolly little hospital (I've been operated there, a few years ago, it's squeaky clean and friendly, your stay there feels more like a visit to a spa).

I must needs ponder deeply on all of this!

My old boss had invited me to attend a program at the New School run by the World Policy Institute. Last night's panel discussion was "Is Terrorism Forever?"

Very interesting, very thoughtful, thought-provoking, smart and well done, all in one short hour or so.

Random things I heard (I purposely won't attribute them because this would require me to go into more detail than I want to right now).

There was a moderator; to his left there was a law professor, who gave us an overview of the definition of terrorism, and where it is, and a lesson in careful choice of words; and to his right, there was a special projects partner responsible for Middle Eastern and North African affairs in an outfit located in Switzerland which specializes in studying terrorism ("I can definitely say it is not connected to the CIA ", he said laughingly to someone who asked, in the most convoluted, unclear verbiage possible, whether it was).

So, random facts:

Terrorism is a method of obtaining leverage to obtain political advantages. It is like someone trying to get through a cacophony of sounds to obtain the attention of someone who can give them what they want. It has been with humanity from the very beginning of time. The first terrorist act documented is God, in the Bible, slaying every first-born Egyptian child in order to get Pharaoh to release the Israelites from bondage. (I really enjoyed that particular reference!)

Terrorism is committed, wherever it is committed, with a principal aim of obtaining something locally. That is why most people are disinterested: by and large, it is happening in places they don't live in, to people they don't know, in places they never go to, where they have no family or friends, it just does not affect them directly. Few people even think about it enough, for instance, to avoid going to Bali on vacation, or Spain, or Morocco, or Turkey. The only Americans directly affected are the 19-year old kids patrolling Kabul or Mosul, and they are definitely directly affected, but it doesn't affect all of us at the same time. You get the picture.

The difference with Bin Laden is that he was the first one to think and act globally. He declared the war "worldwide". Still, his goals are local. The WTC was not about America, its focus was the suicide bombers; the WTC, the victims, etc., they were just "incidental" in his mind. Like extras in a Hollywood production. The focus was the martyrs, those who were going to heaven to get their reward of 74 young virgins. They never actually thought the buildings would come down, but by golly, when they did, WOW! They had outdone, outreached, themselves, it was God's intervention, God is great!

The significant aspect of this is that Americans tend to be in denial of the fact that we have our own local terrorists. For most Americans, terrorists are "them" , "out there", we must keep them from coming "into this country". (Notice how Americans never say "into our country" -- I wonder why not?)

The reality is there are plenty of homegrown terrorist groups in America, who are never referred to as terrorists. The Oklahoma bombing would be a prime example. The Puerto Rican bombings in the early 70's would be another. The ongoing killing of abortion doctors and the bombing of women's health clinics are a blatant, ongoing example, because these acts of violence are never referred to as acts of terrorism, but just as "pro-life activities of [insert description] groups".

Just remember one of the characteristics of terrorism is that it should scare the bejesus out of you sufficiently to guarantee that you will change your opinions and your behavior.

When it came time for Q and A, someone asked about nuclear weapons and the possibility some radical terrorist group might obtain some WMD's. The answer was simple. Modern day nuclear bombs are the most sophisticated devices invented by man, humongously complex, full of incompatible elements, they are not so easy to make, to obtain ready-made, or to set off. Few people actually have them in stock to be bought "off the shelf", as it were. There are apparently a few examples of Al Qaeda operatives who bought nuclear bombs (at a hefty price) from the Russian mafia, took them home and gleefully "Opened the box to reveal a mass of useless nuclear waste materials". The equivalent of the suckers on the street, who buy cut-rate mobile phones from con artists and find out when they get them home that they are just holding a plastic molded casing without any sort of wiring inside. Caveat emptor, all over again and forever.

The real description for WMD's might be weapons of mass distraction, because their desirability is limited almost entirely to the realm of deterrence, or blackmail to obtain something in exchange, or extortion. A country like North Korea, for instance, doesn't really have the money available to develop their own weapons, and it knows that if it did have one such device and it used it, it would be annihilated in very short order, probably before sundown, and that is not North Korea's goal. Nor is it that of any other state or nation on earth.

A question was put how best to eradicate "radical Islam". The short answer was, you can't eradicate them by tracking them down and killing them. Suicide bombers lead to a form of cult of death, which you cannot terrify out of existence. The only way out is when their supporting cultures and societies, instead of turning them into heroes and martyrs, condemns them for what they are, terrorists. This will come about only by evolution from within moderate Islam, and, therefore, we should be clear we are not at war against Islam, but against radical islamists, and we should support moderate Islam and encourage them. How? We should learn more about them, not be willing to have them remain strangers and outsiders, we can only engage in dialogue when we know each other better and can learn to trust each other.

Someone asked whether the war on terrorism justified the loss of civil rights. The answer was we should recognize we are in a state of war. Those of us who lived through World War II remember how everyone had to carry an ID card at all times during those years. It's a small price to pay if it can help sort out who's who. It's also a small price to pay to have to take off our shoes at the airport. Since 9/11, the Arab Americans have borne the brunt of the burden, in terms of loss of civil rights, but we should not be overly surprised if at some point we were to be required to share that burden equitably.

Someone asked what else could be done to make us safer?

"Fire Tom Ridge!" Without hesitation. [Laughter]

That's it in a nutshell. It was just one short hour.

* * * * *

Madrid: almost 200 dead, over 1400 wounded, some critically.

The Spanish authorities say it's ETA's MO. Maybe, but with a difference this time: they usually target the military, the political, the police, etc., and avoid excessive civil casualies by phoning in warnings ahead of time. This time, there were no warnings, civilians were specifically targeted for maximal casualties, and ETA has not yet claimed responsibility. In the meanwhile, Al Qaeda has claimed responsibility, but this is not proven to the Spaniards' satisfaction.

The French have already had some antiterrorist personnel on the ground, working with the Spanish, since they have some cooperative systems in place on a regular basis, and they have flown down some of their ... I don't know how best to put it ... "arabic-speaking antiterrorist specialists". I hope that says it without putting an offensive twist to it.

The police had collected a whole lot of backpacks which they stored in a room and were sorting through when a phone rang in one of them. They opened that particular backpack and found one whole explosive device, which they were able to dismantle safely. They are now trying to make that cellphone talk.

They also have two cars, one of which was filled with unexploded bombs, the other had seven trigger devices and some sort of evidence of an Arab connection. They are trying to make those cars talk too. One of them had been stolen a few days ago.

The ETA have been committing terrorist acts in Spain and southwest France for the last thirty years. Somehow, their attacks have escalated in viciousness since the dismantling of their so-called "political" branch some while back. Is there a connection? Or is there a connection with a small Al Qaeda splinter group?

* * * * *

I must finish on a small joke, courtesy of Jerry Paxman of BBC Newsnight.

"This from Gregory Hicks. A snail goes to the police station. He's terribly beaten up. The policeman asks who did it. "A tortoise," says the snail. "Can you describe the tortoise?" the cop asks. "How big was he? What colour?"

"I don't know, " says the snail, "It all happened so fast."
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