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Vietnam Welcomes America with Open Arms

December 7, 2014 by Llewellyn King 2 Comments

No grunt slogging through the jungles of Vietnam could imagine that in 2014, 41 years after the end of the Vietnam War, the Vietnamese would be welcoming back Americans as investors, tourists, advisers and protectors.

Next year is a big year in Vietnam. It is the 40th anniversary of the fall of Saigon, on April 30, 1975. It is also the 20th anniversary of the normalization of U.S. relations with Vietnam, a country where so much American and Vietnamese blood was spilled.

The Vietnam War started in the Eisenhower Administration, dragged down Lyndon Johnson’s presidency, and was ended in the Nixon Administration amid controversy that tore America apart and has informed its foreign policy ever since.

It will be remembered in the annals of war for the limits it revealed on mechanized fighting, and the challenge of asymmetrical fighting and wrong-headiness. But it also deserves mention in the annals of peace for the surprising speed in which the war has been put aside, especially in Vietnam, where the gory past has been buried and the future embraced.

Today’s Vietnam is a place where the United States is admired and emulated. And the Vietnamese want nothing so much as to be closer to Americans.

Twenty years ago when I traveled from Hanoi, south along the spine of the country, to Ho Chi Minh City, formerly Saigon, I was astounded by the way the war had been willfully forgotten: people I met did not want to talk about it.

Da Nang still was set about with hardened bunkers, Hue, which had been the national capital until 1945, was a sad ruin, but people were determinedly forward-looking. They wanted to know three things: how could they get American goods, how could sell their goods in the U.S. market, and what was the United States going to do about China?

A generation later, Vietnam is more passionate in its desire to get close to the United States. The government of Vietnam is making a new push for American investment, particularly in the privatization of infrastructure, which is still government-controlled and beset by inefficiency and corruption.

Vietnam Report, a business and data service, has just released a comprehensive white paper, prepared by Corr Analytics, a New York-based risk management consultancy, that paints an agreeable picture of investment opportunities, particularly in those industries that the Vietnamese government is anxious to hive off to the private sector. Of 432 projects identified by the government, Corr has honed in on what it believes to be the 31 best-investment targets. These range from opportunities — from a few million dollars to over $7 billion — in finance, infrastructure, manufacturing and petroleum.

The backstory is that Vietnam needs more than U.S. investment. As it struggles against China in the South China Sea, over territorial claims on small island groups that are thought to contain large hydrocarbon reserves, Vietnam wants the United States to be a visible friend.

There is even talk that the United States, might establish a naval base at Cam Rahn Bay, its legendary base and deep-water port during the Vietnam War. This, the argument goes, would compensate for the loss of the naval base at Subic Bay in the Philippines. Come back, Yanks.

Several analysts have told me that they believe Vietnam to be an excellent investment opportunity, but there are concerns. The government is nominally communist and there is only one party: the Communist Party. It is avowedly pro-business but faces human-rights issues, press-freedom issues, and the impartiality of the judiciary is questionable. Corruption is widespread and debilitating.

Yet Forbes magazine is looking to Vietnam as the new Asian investment haven. In the World Bank’s Ease of Doing Business rankings, according to Corr Analytics, Vietnam is ahead of major investment destinations such as China, India and Brazil. Vietnamese Prime Minister Nguyen Tan Dung has made it clear that his country is open for business – particularly American business.

Tourism is growing, especially at Vietnam’s superb beaches. Lauren Graham, who stars in the NBC drama “Parenthood,” has taken a bicycle trip with her father, a Washington lobbyist and fluent Vietnamese speaker.

Some who fought in Vietnam have joined the ranks of its boosters, like Tom Patterson, the famed Harvard professor, who is helping to develop a high-technology village near Nha Trang and Cam Rhan Bay, where he was once stationed.

The generational change also has made a difference. Much of the Vietnamese population was not born during the war. A new generation of Americans has been shaped by war in the Middle East not in Asia. — For the Hearst-New York Times Syndicate

 

Filed Under: King's Commentaries Tagged With: Cam Rahn Bay, China, communism, Corr Analytics, Dwight Eisenhower, Hanoi, Ho Chi Minh City, King Commentary, Lyndon Johnson, Nha Trang, Richard Nixon, Saigon, South China Sea, Subic Bay, the Philippines, U.S.-Vietnam relations, Vietnam, Vietnam War, WHC In Vietnam

How to Steal the Sea, Chinese Style

December 1, 2014 by Llewellyn King 3 Comments

In history, countries have sought to increase their territory by bribery, chicanery, coercion and outright force of arms. But while many have sought to dominate the seas, from the Greek city states to the mighty British Empire, none has ever, in effect, tried to take over an ocean or a sea as its own.
But that is what China is actively doing in the ocean south of the mainland: the South China Sea. Bit by bit, it is establishing hegemony over this most important sea where the littoral states — China, Taiwan, the Philippines, Brunei, Malaysia, Indonesia, Singapore and Vietnam — have territorial claims.
The importance of the South China Sea is hard to overestimate. Some of the most vital international sea lanes traverse it; it is one of the great fishing areas; and the ocean bed, near land, has large reserves of oil and gas. No wonder everyone wants a piece of it — and China wants all of it.
Historically China has laid claim to a majority of the sea and adheres to a map or line — known as the nine-dash map, the U-shape line or the nine-dotted line — that cedes most of the ocean area and all of the island land to it. The nine-dash map is a provocation at best and a blueprint for annexation at worst.
The mechanism for China’s filching of one of the great seas of the world is control of the three island archipelagos, the Paracel, Spratly and Pratas islands, and several other smaller outcroppings, as well as the seamounts, called the Macclesfield Bank and the Scarborough Shoal. Between them, they consist of about 250 small islands, atolls, keys, shoals, sandbars and reefs. Very few of these are habitable or have indigenous people. Some are permanently submerged, and many are only exposed at low tide.
Yet if China can claim title to them, it can use them to extend its hegemony into the area around them. First, it can claim the standard 12 miles of territorial waters around each land mass and it also can claim an economic zone of influence of 200 miles from the most dubious “island.” Ergo, China can connect the dots and grab a large chunk of the South China Sea.
China is reclaiming land – actually building a new artificial island — in the disputed Spratly Islands. The two-mile-long island will have an airfield that, China’s foreign ministry claims, will be used for air-sea operations. The other claimants, think otherwise, especially Vietnam. The United States has called for China to halt the island project.
China has been both stealthy and obvious about its strategy. It has increased its trade with the claimants; and in some cases has made generous contributions to their infrastructure development, but not in the South China Sea. In its maritime provocations, China has been careful to use its coast guard, not its navy, as it extends its grasp on the archipelagos, and inches forward to total domination of anything that looks like land in the waters off its southern coast.
The Philippines has sought international legal redress under the United Nations Convention on the Law of the Sea, a treaty which the United States has not ratified, limiting its legal maneuvering, according to Barry Nolan of the Boston Forum, a policy analysis group that has studied the South China Sea crisis this year. China denies the legitimacy of international law in what is says is an internal matter.
To my mind, we are seeing is a new kind of imperialism from China, a gradual annexation of whatever it wants; quiet aggression, just short of war but relentless. This is China’s modus operandi in Southeast Asia, Africa and other places. It squeezes gently and then with greater strength, like a lethal constrictor snake.
Southeast Asian countries are arming, but China’s naval forces are growing faster. Also, it has the cash and the people to do what it wants. The U.S. “pivot to Asia” has done little to reassure China’s neighbors. Their nervousness is compounded by the ease with which Russia was able to annex Crimea and is proceeding into Eastern Ukraine unchecked. What’s to stop China grabbing some useless islands, and then a whole sea?
The ancient concept of oceans as commons is under threat. The Chinese dragon walks and swims. — For the Hearst-New York Times Syndicate


Filed Under: King's Commentaries Tagged With: Brunei, China, Indonesia, King Commentary, Macclesfield Bank, Malaysia, Paracel Islands, Scarborough Shoal, Singapore, South China Sea, Southeast Asia, Spratly Islands, Taiwan, the Philippines, United Nations Convention on the Law of the Sea, Vietnam, WHC In Vietnam

The Cruelty of the Holidays

November 23, 2014 by Llewellyn King Leave a Comment

T.S. Eliot may have had it wrong: The cruelest months are November and December, when the holidays are upon us, not April. For those who are broken – broken in all the ways that people can be broken — the holidays are a special hell.
The bedridden, the incarcerated, the mourners, the maimed from accidents, disease or wars, the heartbroken – either those who have had their hearts broken by lovers or others, or those who have had no one in their lives — endure the holidays in anguish, hurting even more than the permanent hurt that has become their lives.
You may find the broken in the corners at parties, sitting glumly at the table. But the real suffering is unseen; the real sufferers cannot make it to the table – or dare not for fear that the outing will cost them later. The brave face can mask the deepest hurt. They are the permanently sick. Those who will be sick today, sick tomorrow and sick in the next holiday season as they were in the last.
There are people who suffer constant illness in all the myriad ways that a body can be afflicted or fail. No afflicted cohort is more deserving of understanding than another; none has a greater call for science to redouble its efforts for a cure than another.
But the effort to find cures is woefully skewed by the institutions of medicine, by the pharmaceutical companies and by those diseases that have celebrity champions, informing the public and the politics of research institutions. Yes, there is always politics and so there are winners and losers. Celebrities can help: Elizabeth Taylor did so for AIDS, Jerry Lewis for Multiple Sclerosis, and Michael J. Fox is doing so for Parkinson’s disease.
I write and broadcast about one disease in particular, Myalgic Encephalomyelitis (ME), also called Chronic Fatigue Syndrome. It is a disease largely orphaned by the medical community which has no test for it — cannot say with assurance that a patient has it until months of debility validate that it is ME. In medical parlance, there are no biological markers. What is known is that it is almost certainly a disease of the immune system, and that there is no cure. It also has no celebrity benefactors and no lobby in Washington.
I think of it as a terrorist disease, which takes its patents hostage and confines them in an alternative world of muscle pain, headaches, diarrhea, dizziness, brain fog and almost permanent collapse. Some are adversely affected by light, others by sound.
One sufferer says that having ME is like being an engine without fuel: Your tank is empty and you hurt in new and refined ways almost daily. Sufferers go through long periods of disability where they cannot function at all. “I thought I was already in my coffin,” another told me.
The joys are few and sometimes from little things, like a pet or nature observations. One sufferer, Elisabeth Tova Bailey, wrote a wonderful book, “The Sound of a Wild Snail Eating.” It is about the habits of a snail in a terrarium next to her bed, during two years of sustained collapse.
This is a disease that steals lives, chains them up in dungeons of despair where loneliness and suffering reach “excruciating proportions,” according to my colleague, Deborah Waroff, whose life was snatched by this disease 25 years ago. Together Waroff and I established a YouTube channel on ME, mecfsalert.
The loved ones, and the caregivers – if there are any — are enslaved by this disease, seeing those they care about in a place where neither love nor medicine can reach them. Literally and figuratively, they must fluff the pillows once again and mouth the empty words — lies really — of encouragement that we all utter in the face of hopelessness. Those who live on their own, often in poverty and sloth they cannot ameliorate for themselves, suffer what one woman told me was such sustained loneliness that she prayed nightly for death.
Thanksgiving, Christmas, Hanukkah, Kwanzaa and New Year's Eve are on the way. Sadly, while the rest of us are suffused with joy, the permanently ill take stock and find their lives are terribly wanting and isolated on the holidays. — For the Hearst-New York Times Syndicate

Filed Under: King's Commentaries Tagged With: AIDS, Christmas, Chronic Fatigue Syndrome, Hanukkah, holidays, Kwanzaa, Multiple Sclerosis, myalgic encephalomyelitis, Parkinson's disease, Thanksgiving

The Media-Pollster Axis Stole the Election

November 16, 2014 by Llewellyn King Leave a Comment

Politics is the hot ticket in journalism these days. Young reporters long to cover Capitol Hill, when once they longed for the exotic life of the foreign correspondent. “Timbuktu or bust” has become “Washington or fail.” Journalism's stars today are those who can reel off the precincts of Iowa or the hobbies of senators, not the wonders of rural Sri Lanka.

Yet the passion for politics that has seized the Washington press corps and those who want to join it across the country has not been reflected in the public – not, at any rate, by the abysmally low national turnout of 36. 3 percent on Nov. 4, arguably one of the most important midterm elections in a long time.

It was the lowest voter turnout in 72 years: a seeming monument to voter apathy. Certainly not the sign of a seething, unhappy electorate which believes the bums should be thrown out because the country is on the wrong track. That may be so, but you wouldn't know it from the voter turnout.

The voter turnout wasn't large enough for anyone to claim that the country has veered to the right, or that the victors have a mandate. Yet we know President Obama is held in low esteem, although not as low as the risible contempt in which Congress is held.

If the voters didn't come out in large enough numbers to give us a clear reading, how do we know that Obama is on the ropes and that Congress is despised? We know it, without doubt, from the innumerable opinion polls which are now part of the journalistic toolbox.

There is no doubt about the public mood. So why didn't the public vote when there was so much journalistic enthusiasm for the election; when an amazing amount of television time, especially on cable, was given to politics; and when radio goes at politics 24-7?

The paradox may be journalism and its commitment to opinion polls, largely funded by the media. If you know who is going to win the match, why buy a ticket?

The passion in journalism for politics has made politics a victim, robbed it of surprise and tension. I voted without passion because I had a very complete picture of the outcome before I did my civic duty. It was like reading an otherwise gripping who-done-it, when I already knew it was the butler.

The metadata people, like Nate Silver, aren't helping either.

When newspapers are cutting their staffs and budgets are tight, why is political coverage and polling out of Washington thriving? First, it is cheaper to create news than find it. With polls, you scoop the election result. Second, there is a large pot of money for “political issues” advertising that has given rises to a raft of new outlets, forcing old-line media to double down.

Washington politics is no longer a franchise of The Washington Post and The New York Times. It has its own trade press, led by the upstart and well-funded Politico, a big news predator in a school of hungry fish. There is The Hill, Roll Call, National Journal, RealClearPolitics and more than a dozen others, like The Cook Political Report and Talking Points Memo.

It is these new entrants, with their access to instant electronic delivery, that have led the change and fueled the frenzy. They are in danger of becoming the game instead of covering it. They have become more interested in what the polls say than what the politicians say.

On Capitol Hill, members of Congress are in bunker mode. They are afraid to say anything or look a bit tired, distressed or unkempt because these ill-considered words and unflattering images will be flashed across the Internet – there to be retrieved at any time, for all time.

There is a joke around Washington that if a member of Congress breaks wind, Politico will have the story. In this new world, every trifle is recorded and archived. Is this the way to foster statecraft in a dangerous and unforgiving world? Let's poll that question, shall we? — For the Hearst-New York Times Syndicate

Filed Under: King's Commentaries Tagged With: King Commentary, Nate Silver, National Journal, Politico, Politics, President Obama, Roll Call, Talking Points Memo, The Cook Political Report, The Hill, The New York Times, The Washington Post, U.S. midterm elections, U.S.Congress, Washington D.C.

The Need To Redistribute Income Is Real

April 28, 2014 by Llewellyn King 2 Comments

If you want to get people riled up, whisper "redistribution."
 
Well, sorry about this, but that is what we need. We need to re-establish what might be called "the comfortable class." Those are the people we used to call the middle class until the politicians, with a helping hand from the media, characterized everyone who worked as middle class.
 
When we had a working class and a middle class, the working class could aspire to join the middle class, and the middle class could aspire to join the upper middle class, which might also be thought of as the managerial or professional class.
 
The professional class is still mostly intact; it includes doctors, dentists, corporate lawyers and some scientists. But the rest of us, unless we are protected by government employment, are standing on the edge of a precipice, and some are already on the way down.
 
There are many problems with our social structure today, not the least of which is that many forms of work have been endangered or have disappeared. Look around you.
 
You do not have to look far to see whole swaths of employment that have disappeared; either moved overseas or have fallen prey to the predations of the computer. I treasure my electronic reading device, but every time I switch it on, a parade of ghosts passes before me: book designers, papermakers, printers, bookbinders, warehousemen, drivers, sales assistants and store cleaners. Well, they are just the book people who the clever device has rendered obsolete.
 
Then there is the whole issue of the future of retail in general, and shopping centers in particular. A young person told me recently that the mall was for hanging out, but shopping should be done on the Web. Retailing has always been poorly paid but, even there, the middle class had a foothold with its managers, marketing specialists and all those aspiring sales assistants.
 
A new book is all the rage in circles that care about such things, and it is causing economists to rethink the inequality that wage-fear has made possible; the fact that the minimum-wage and low-wage structure now prevails in many states and is spreading.
 
The book is "Capital in the Twenty-First Century" by Thomas Piketty. It lays out how money is being concentrated in fewer and fewer hands with more of it belonging not to those who earned it, but to those who inherited it. With sound, but not spectacular investment, the owner of a few billion dollars will almost certainly pass even greater wealth on to his or her heirs in a never-ending column of money, creating the greatest concentration of wealth in history.
 
Yet there is nothing pushing up our earnings.
 
Instead, there are many forces pushing them down — from the inability of the unions to adjust to the times to the constant endeavor by states, such as Texas, to suck high-wage jobs out of other states and beggar the workers. Employers do not want to pay more than necessary and, of course, there is computerization.
 
Lower wages mean less spending, more low-wage jobs, fewer people in the middle class, fewer "comfortable" people.
 
Martin Wolf, the esteemed columnist of the Financial Times, points out that where redistribution is practiced as a continual part of the political process, as in Scandinavia, there is generally universal prosperity and a measurable middle class, enjoying a lot of social services. In Latin America, where you have an oligarchy of the kind forming here, there is little prosperity and consequent human suffering.
 
In history, there have been savage periods of redistribution. Henry VIII seized the abbeys because that was where the wealth was; Oliver Cromwell had the same idea. The French overdid it terribly in 1789, the Russians in 1917. And the British ran taxes up to 90 percent of income after World War II with predictable, devastating results.
 
Societies work best when they are flexible without rigidities; the rise of incalculable billions in the hands of the very few while general incomes are falling creates a cruel and dangerous rigidity. Worse, concentrated wealth overwhelms democracy.
 
Whisper it: "redistribution."  – For the Hearst-New York Times Syndicate
 

Filed Under: King's Commentaries Tagged With: income redistribution, Martin Wolf, middle class, Thomas Piketty

The Strange Case of the NIH and an Elusive Disease

March 3, 2014 by Llewellyn King 40 Comments

The federal government has a mostly open dialogue with those it serves and those who serve it. This happens pretty well across government agencies, from the Pentagon to the Department of Transportation to the Department of Agriculture.
 
So it is troubling that the National Institutes of Health, an arm of the Department of Health and Human Services, appears to have no communication with a critical but ignored patient cohort: those suffering from Myalgic Encephalomyelitis, also known as Chronic Fatigue Syndrome, and often referred to only as ME/CFS. The NIH does not appear to hear the cries of the petitioners at its door; it seems to be interested only in classifying and defining the disease.
 
According to the Centers for Disease Control, ME/CFS afflicts 1 million people in the United States, and 17 million people around the world. While those numbers of victims are disputed, their suffering is not; they are ill in a terrible way.
 
ME/CFS takes healthy — often athletic — people and casts them into a shadow world of physical incapacity, mental fog, loneliness and relentless dependence on others. The suffering is measured in years and decades. Suicide is common.
 
It is a disease of the immune system, but what triggers it is unknown. Physicians who treat ME/CFS have told me that they would rather have cancer than this disease. One epidemiologist said, “With cancer, you are cured or you die. ME/CFS just goes on and on. You live the life of a zombie.”
 
From a physician devoted to treating and researching ME/CFS, this is not only a terrible admission, but also a de facto indictment of the national effort to find a cure, or even a therapy, for alleviating the suffering.
 
One of the problems affecting ME/CFS treatment is diagnosis. There are no biological labels, known as markers, that enable doctors to easily identify ME/CFS; it cannot be picked up in a blood tests or a urine sample. It is a ghostly manifestation, and doctors fall back on what is known as wastebasket diagnosis. In its simplest form, this means testing for a lot of diseases and if it does not turn out to be one of them, it could be ME/CFS.
 
But one case definition has satisfied the ME/CFS community in recent years, and it is endorsed by specialists in the field. Established in 2001, it is called the Canadian Consensus Criteria.
 
Yet, incomprehensibly, the NIH is spending some of the paltry $6 million devoted to ME/CFS, on a study to come up with a new case definition for the disease; something that no one wants and which could do real harm.
 
To do this work, the NIH selected the Institute of Medicine (IOM), which has no expertise in ME/CFS and which had drawn opprobrium with its clumsy attempt to do a case definition of Gulf War Syndrome.
 
The NIH, which has failed to explain itself in plain English, has ignited incandescent rage in the patient community and from patient advocates. In a unique outpouring of objection, 50 of the world's top doctors and clinicians wrote to Secretary of Health and Human Services Kathleen Sibelius, pleading with her not to muddy the waters and to stay with the definition which is working well. The NIH went ahead with the IOM contract.
 
So lacking is government support, moral as well as financial, that the research community, including dedicated physicians such as Andreas Kogelnik of Mountain View, Calif., Daniel Peterson of Incline Village, Nev., and Derek Enlander of New York City, feel they have to raise funds privately to continue their work. Even celebrity virus hunter Ian Lipkin of Columbia University has abandoned hope of getting his seminal work funded by the NIH and has joined the researchers who have had to hold out begging bowls to the public to do their research.
 
Judging by social media, the entire patient community is in a state of metaphorical war with the NIH.
 
There is a cry from and on behalf of the pitiable sick for action, sympathy and even courtesy from the bureaucrats in Bethesda, where the NIH is headquartered. The Hippocratic Oath says, “first do no harm.” When people are in pain and despair, inaction is palpable harm.
 
A congressional hearing is needed to investigate decision-making in the NIH, find out about its budget request to the Office of Management and Budget, and to demand that it listen to those who suffer and those who are trying to help them. — For the Hearst-New York Times Syndicate

Filed Under: King's Commentaries Tagged With: Centers for Disease Control, Department of Health and Human Services, HHS, Institute of Medicine, Kathleen Sibelius, ME/CFS, Myalgic Encelphalomyelitis, National Institutes of Health

David and Goliath, or, the Sick and the Bureaucracy

December 6, 2013 by Llewellyn King 10 Comments

Malcolm Gladwell, the New Yorker writer, has grown rich with a series of books exploring the sociological dimensions of success and failure. In his latest, “David and Goliath: Underdogs, Misfits and the Art of Battling Giants,” Gladwell celebrates the many Davids who triumphed over the odds because they were nimble and resourceful.
 
If he wants to observe a classic David-versus-Goliath rumble, Gladwell might want to go to Washington on Tuesday (Dec. 10). He will see a frail woman go up against the federal government with a humble petition and a small following of mostly very sick people.
 
Her name is Susan Kreutzer and she suffers from the debilitating and mysterious disease Chronic Fatigue Syndrome (CFS), also known as Myalgic Encephalomyelitis, which is the name patients favor.
 
Kreutzer and others will begin their demonstration at 9a.m. outside the headquarters of the Department of Health and Human Services on Independence Avenue, where she will hand over a petition. Then she will move up the street to Capitol Hill to demonstrate and hand-deliver petitions to members of Congress. She will end her day of petitioning her government outside the White House.
 
Kreutzer has no idea how many, if any, demonstrators will join her, but she assures me she has the required permits to demonstrate. Another time, only six demonstrators turned out,, but they unfurled a huge banner and stood on he street telling the oft-ignored story of their suffering to anyone who would listen.
 
Telling your story in Washington without a big-bucks lobbying firm or celebrity friends is not an easy assignment. Not only is there the high chance of being ignored but there is also the chance of being discounted as one of the apocalyptic “end of days” proselytizers, or those who believe the CIA has it in for them and who habitually assemble at the White House and elsewhere. In other words, it is easy to be dismissed as a “crazy.”
 
But Kreutzer, who will have a warm-up demonstration on Dec. 9 in San Francisco at the HHS offices there, believes in the strength of small voices, of a murmur in the cacophony of Washington petitioning. “I feel I have to do this,” she said.
 
This year, the victims of CFS are particularly upset with HHS and its dependent agency the National Institutes of Health. They are fuming at the decision of NIH to seek a new clinical definition of their disease, supplanting the Canadian Consensus Criteria, which has been the diagnostic gold standard for researchers who are deeply committed to finding a cure for a disease that affects as many as 1 million Americans and another 17 million people worldwide.
 
It is a disease that simply confiscates normal life and substitutes an existence in purgatory, where victims can be confined for decades until death. Sometimes they will be so sick they must lie in darkened rooms for months or years; sometimes they can function for a few hours a day, usually followed by collapse. Dysphasia — word confusion — increases. Lovers leave, spouses despair and the well of family compassion runs dry.
 
The first and major complaint of all those in researching the disease and those suffering from it is that NIH spends a trifling $6 million on this circle of hell that could have been invented by Dante.
 
The second and immediate source of anger laced with despair is that NIH has, apparently arbitrarily, decided to have the clinical definition of the disease reclassified by the Institute of Medicine and has diverted a precious $1 million to this purpose. Thirty-six leading researchers and physicians from the United States, risking retribution in funding, protested the move but were ignored. They were joined by colleagues from abroad, bringing the blue-ribbon protesters to 50.
 
Still nobody knows why the move to reclassify the disease. One school of thought is that NIH would like to abandon the current and well-accepted diagnostic criteria, known as the Canadian Consensus Criteria, in order to treat the disease as more of a mental one rather than a physical one.
 
I approached HHS for a comment and for a word with Dr. Howard Koh, the assistant secretary in charge, but have received no response.
 
Will this David, Susan Kreutzer, fell this Goliath, HHS? — For the Hearst-New York Times Syndicate
 

Filed Under: King's Commentaries, Uncategorized Tagged With: Canadian Consensus Criteria, Chronic Fatigue Syndrome, Department of Health and Human Services, Dr. Howard Koh, Institute of Medicine, Myalgic Encelphalomyelitis, National Institutes of Health

Washington Post: Family Adieu

August 12, 2013 by Llewellyn King Leave a Comment

Part of the problem with dragging the news business into the 21st century is that newspaper people are so damned conservative. That's right, conservative.
 
Most journalists who work in print may be liberal, but we are conservative about our own trade. We like it the way it has always been. Gruff editors hammered into us how it should be, and we have passed the hammer.
 
While magazines experimented with new ways of presenting their wares and developing new voices, especially in the 1920s, newspapers clung to the past. Horizontal layout – the headlines running across the page rather than sitting astride vertical columns – was considered radical enough.
 
Even the sensational papers of William Randolph Hearst and Joseph Pulitzer were sensational within bounds. They pushed the limits of content and veracity, but the concept of the newspaper was unchanged. The carved-in-stone rules of the trade were not challenged — like the one that says headlines must have verbs, and another that says the first line of a headline cannot end with a conjunction or a preposition.
 
The most revolutionary of American newspapers was probably The New York Herald Tribune. In its last decade, even as it was dying a decades-long death from extraordinarily poor management, it became a laboratory for new journalism with certifiable newspaper geniuses like David Laventhol, Eugenia Sheppard, Red Smith, Tom Wolfe, Jimmy Breslin and Clay Felker. Working at the paper was like working for Orson Welles' Mercury Theater: great stuff was going on.
 
The Washington Post has had its share of dazzling reporters and columnists – and benefited from some of its Herald Tribune hires, including Laventhol, who created its much-imitated Style section. I was lucky to have worked for both papers.
 
The Post has shone in the coverage of politics, interpretative foreign stories and big investigative stories. Watergate gets the kudos, but there was good, even great, investigative work before and after that.
 
The Graham family presided over the Post in its golden period from 1954, when it bought its morning rival, The Washington Times-Herald, to 2000 to the present. It never achieved the global recognition that The New York Times enjoys, but it was a close second — and on many days, the Post was clearly the better newspaper.
 
The Washington Post Company, which is controlled by the Graham family and which owned the newspaper, is less of a success story.
 
While other publishing companies grew and prospered, The Washington Post Co. was less successful: After its acquisition of Newsweek in 1961, it faltered as a dynamic news entity, even though the newspaper was hugely profitable.
 
It failed to become a major player in television, athough it owned stations, failed to expand its magazine franchise and missed out on cable TV, which has been so important to the growth of old-line publishers Scripps Howard and Hearst.
 
The company bought and sold many properties on the fringes of its core business, but with little success, except for Kaplan Inc., which was very profitable until the student loan imbroglio.
 
Four years ago the Internet, like an invasive species, began choking the life out of the Post. It didn't know how to respond. It failed to create a credible Web site and watched two English newspapers, The Guardian and the Mail, build up huge Web presences in the United States. Helplessly, it also watched an upstart company, Politico, staffed with Post veterans, take hunks out of its political franchise. As recently as last year, the Post could not establish whether it needed a pay wall.
 
Now the Graham family, headed by Washington Post Co. chairman and chief executive officer Donald Graham, has done something very brave in the egotistical world of publishing. It has admitted: We don't know what to do.
 
Jeff Bezos, the inordinately wealthy founder of Amazon, has bought the paper. Does he know what to do? Nobody knows.
 
Nothing Bezos has done suggests that he either understands or reveres newspapers. But he can afford to be radical and he is not bound by newspaperdom's reverence for the way we used to do it; our conservatism. — For the Hearst-New York Times Syndicate

Filed Under: King's Commentaries Tagged With: Amazon, Donald Graham, Hearst, Jeff Bezos, Scripps Howard, the Graham family, The New York Herald Tribune, The New York Times, The Washington Post, The Washington Post Company, The Washington Times-Herald

A Young Man, a Big Disease and a Big Idea

June 17, 2013 by Llewellyn King 14 Comments

 
We expect big ideas to come from young people in computers, social networking and music. In medicine, less so.
 
So meet Ryan Prior, age 23, of Atlanta, Ga. He suffers from a little understood but ghastly disease of the immune system known in the United States as Chronic Fatigue Syndrome (CFS), and in the rest of the world as Myalgic Encephalomyelitis (ME).
 
The disease is mostly incurable; affects men and women, but more women than men are recorded; and the Centers for Disease Control (CDC) in Atlanta says there are 1 million victims in the United States and 17 million worldwide.
 
Its impact is horrific; confiscating lives, wrecking homes, sundering love affairs and grinding down caregivers and families. For the most part, the sick are sick until they die. Some are bedridden for years. Advocacy groups say suicide is high. I have received many letters from patients who say they can't take the pain, the helplessness and the stigma any longer, and beg for a quick release.
 
Despite all this, the disease gets short shrift from the National Institutes of Health and the CDC, although patients say they get a better hearing at the Food and Drug Administration.
 
Enter the over-achieving young patient, Ryan Prior. His story begins on Oct. 22, 2006. Like many victims he knows exactly when he was felled, when normal life had to be abandoned. He entered a dark world where good times are marked in hours; where bad times are days, weeks or months in darkened, silent rooms.
 
Prior was student president at Warner Robins High School in Warner Robins, Ga. (about 90 miles south of Atlanta), captain of the cross-country team and was taking three advanced placement courses. “My goal was to attend Duke University or West Point with the ultimate goal of becoming an Army Ranger,” he said.
 
By Nov. 15, 2006, Prior had to quit school. Under a Georgia plan for educating sick students, “my physics teacher taught me heat transfer while I was lying on the couch,” he said. But he slept through calculus.
 
Ryan still hoped to make it as an athlete. During a brief respite, he was back on his soccer varsity squad. But it was a disaster. He had been put on a drug that provided a short energy boost. “I went to a practice and played for about five minutes. I did OK for the first minute. After five minutes, I realized I had to stagger off the field as soon as possible. If I didn't get off voluntarily, I knew I would have to be carried off soon after.”
 
After seeing 15 doctors, who knew little or nothing about the disease, Prior found one who has helped him. Now, he says, he functions 90 percent of the time if he takes 15 to 20 pills a day and avoids overdoing it. Ultimately, he graduated Phi Beta Kappa from the University of Georgia.
 
But it's the almost complete ignorance of CFS by most doctors that has set Prior on his big idea project. He is making a documentary film about the disease with young filmmakers, and with a $12,000 budget. He hopes the film will lead to $50,000 in funding to create “an eight-week summer fellowship program” for medical students, between their first and second years, to study with recognized experts in CFS. They would, according to Prior, provide each student with a stipend of $5,000 for the eight weeks.
 
Prior has compiled a list of nine doctors or clinics preeminent in the field who he believes would accept the fellows. The end result: a flow of young doctors with a knowledge of CFS and new ideas.
 
I can attest that this is desperately needed. As far as I have been able to determine there are many states, including West Virginia and Rhode Island, where there are no doctors with specialized knowledge of the disease. One woman travels from Delaware to Manhattan for treatment with Dr. Derek Enlander, and many have moved Nevada to be near Dr. Dan Peterson in Incline Village and the Whittemore-Peterson Clinic in Reno.
 
If Prior's plan works, it may lead to a much larger training effort in the United States and across the world.
 
“The message is simple: American history has progressed in a logical line from women's rights, through civil rights, then to gay rights,” Prior says, adding, “Medical history has a similar process of ridicule, repression and ultimate acceptance: MS, AIDS, and now we want CFS to be the next step.”
 

Filed Under: King's Commentaries Tagged With: Centers for Disease Control, Chronic Fatigue Syndrome, Food and Drug Administration, myalgic encephalomyelitis, National Institutes of Health

How to Move the Nuclear Project Forward

May 13, 2013 by Llewellyn King Leave a Comment

Nuclear power ought to have everything going for it. It has worked extremely well for more than 60 years — a fact that will be celebrated at the Nuclear Energy Institute’s annual meeting in Washington this week.

Yet there is a somber sense about civil nuclear power in the United States that its race is run; that, as in other things, the United States has lost control of a technology it invented.

Consider: There are more than 70 reactors under construction worldwide, but only five of those are in the United States. They are in Georgia, South Carolina and Tennessee. Even so, costs are rising and rest of the electric utility industry is resolutely committed to natural gas, which is cheap these days.

Once nuclear power plants are up and running, they tend do so seamlessly for decades, often operating above their original design output. It is clean power, unaffected by fuel prices, doing no damage to the air and very little to the earth, except in the mining of uranium or in immediate contact with the used radioactive fuel, when it is finally disposed of — an issue made thorny by two presidents, Jimmy Carter and Barack Obama.

Carter banned nuclear reprocessing just as it was about to be commercialized, and Obama nixed the Yucca Mountain waste repository in Nevada. The trigger for his devastating decision was the opposition of Senate Majority Leader Harry Reid (D-Nev.), thought to be acting on behalf of the gaming interests of Las Vegas. Talk about wheels of fortune — a great technology endangered by legions of slot machines.

Overlooked when the nuclear titans gather in Washington will be two of nuclear’s greatest achievements: the nuclear Navy and the transformation of medicine. The Navy is largest maritime war machine in history with its aircraft carriers that can stay on station for more than a year and submarines that can go under the icecaps and stay submerged for months.

The utility industry seeks stability in all things, ergo it is not scientifically entrepreneurial. It embraces risk reluctantly. It accepts new technology when it is delivered with limited or shared risk.

It was that way with nuclear power, where the risk was shared with the government and sometimes the vendors. Likewise, with the development of today’s aero-derivative gas turbines, the military did the work and took the risk.

In this atmosphere it is easy to forget that nuclear is not a mature technology, but that it belongs at the frontiers of science. Today’s nuclear power plant is analogous to the black rotary phone — there is room for improvement.

But as there is no competition between electricity supplying entities, the impetus must come from elsewhere: government and incentivized private companies. Some like the General Atomics Corp. in San Diego, Calif., have reaped huge benefits by exploring the scientific frontier. While they are known mostly for the Predator drone, General Atomics' work on nuclear fusion has provided the building blocks for magnetic resonance imaging and tissue welding among dozens of medical advances and has enabled the company to use fusion science to develop the electromagnetic catapults for launching aircraft from carriers. If you get to ride a levitating train, it may be because it is suspended by electromagnetic forces pioneered in nuclear research by General Atomics.

Nuclear waste – the industry hates that term because of potential energy left in spent fuel — is the sad story of nuclear: too much yesterday (ideas codified and frozen 60 years ago), not enough tomorrow.

When aviation science has been stuck in the past, it has leaped forward by offering prizes to unleash invention: the first flight across the English Channel, the first Atlantic crossing, and now the first commercial foray into space, were inspired by prizes.

The good burghers of the nuclear industry might with their government allies think of cobbling together a really big prize that will change the thinking about how we deal with used nuclear fuel. At present, there are only two options: reducing the volume by cutting it up, leaching the useful stuff out and making glass out of the rest, and burying that or everything in a place like Yucca Mountain.

Generally in life and science, when there are only two options, there is a deficit of thinking. — For the Hearst-New York Times Syndicate

 

 

Filed Under: King's Commentaries Tagged With: General Atomics Corporation, nuclear energy, Nuclear Energy Institute, Sen. Harry Reid, U.S. Navy, Yucca Mountain

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