The NYT has a good review of boutique or concierge medicine. I was surprised by how relatively low the concierge fees are -- $1000 to $2000/year (For a reasonably wealthy person this is not much money.) One the other hand, if one also gets insurance payments for the visits and services a 600 person panel this can make for a pretty decent income.
I don't see patients any longer, but personally I preferred taking care of the non-wealthy. Still, one could mix a 'concierge practice' with 1-2 days a week of charity care (forget the insurance companies for the non-wealthy, too much hastle).
Saturday, October 29, 2005
Friday, October 28, 2005
Gwynne Dyer's erratic web site has a set of new articles
Dyer, historian, essayist, and big thinker has added another four or five articles to his web site.
I wish, I wish he'd learn what a feed is.
I wish, I wish he'd learn what a feed is.
Implications of the dyslexia gene
The long anticipated is upon us.
Be the Best You can Be: A gene for dyslexia
At last. If this holds up the implications are vast. We will be able to clearly identify one subtype of a common learning disorder. We'll be able to identify variations in the associated phenotype, and match therapies to the gene. We will gain vast insights into the bizarre miracle of reading (note to intelligent design folks -- the evolution of reading is much more interesting than the evolution of the retina).
This gene modulates the "migration of neurons", it is presumably one of a class of genes that determines the very structure of the human brain. Alter these genes, alter that which makes a human.
Wonderful news.
Less wonderful if it becomes part of a prenatal profile that may lead to abortions. This is a future we knew was coming.
The next big thing in telemedicine: doctor visits in virtual worlds
The New York Times has an article in the travel section on vactions to virtual worlds (mirrorshades allowed):
This is soo interesting.
Update 10/30: The answer to "how long" is not very. In a comment on this posting James reports:
A Virtual Holiday in the Virtual Sun - New York TimesSo how long will it be before someone sets up a virtual doctor's office? A place to go and receive medical advice. How long before someone then sets up a legal office to adjudicate disputes? How long before the first subpoena is delivered to Second Life requesting the physician's realworld identity to initiate a lawsuit? How long before they realize the physician was a high school dropout? Or a very savvy cyberdoc who's identity can't be traced?
...On FairChang Island, for instance, one of the 1,000-plus 'regions' of Second Life (each covering 16 virtual acres), a simple mouse-click allows members to purchase virtual sailboats that can be sailed around the waters of the virtual world. Prices start at less than a penny, and the money goes to the 'resident' who created the item. Payments are made using a virtual currency called 'Linden dollars' that can be bought and sold freely with real money on eBay and other sites.
In contrast to most virtual worlds, Linden Lab doesn't mind having its currency bought and sold, and even grants Second Life members ownership of the intellectual property rights to whatever they create in the world. But to create anything of permanence, members must 'own' a plot of virtual land (on which they must then pay monthly fees).
A robust economy has sprung up as a result, with one of the most profitable areas being the virtual real estate business. Large tracts of land can be 'purchased' at auction in Second Life, often for more than $100 an acre, then subdivided and sold at a profit.
This is soo interesting.
Update 10/30: The answer to "how long" is not very. In a comment on this posting James reports:
... I went to a talk last year where John Lester from Mass General talked about the virtual support group he has running in the second life virtual world...John isn't a physician, but clearly the game is afoot. Thanks James!
How to be a successful quack
I came to this one via skeptico. I loved the insights on waiting rooms and avoiding insurance compensation (dentists, who are clearly not quacks, have been lucky to avoid the insurance quagmire that trapped physicians). The only recommendation I'd add is to avoid therapies that have obvious toxic side-effects. Never use a herbal remedy that actually has noticeable activity. Don't do chiropracty on the neck.
Overall a wonderful guide to success in quackery: A Photon in the Darkness: How to Succeed at Quackery (Without Even Trying). There are lessons aplenty there.
Overall a wonderful guide to success in quackery: A Photon in the Darkness: How to Succeed at Quackery (Without Even Trying). There are lessons aplenty there.
Thursday, October 27, 2005
A 2002 article that detailed Google's direction.
August 2009: How Google beat Amazon and Ebay to the Semantic Web (Ftrain.com) was written in 2002. Fascinating bit of prescience, particularly if you're a knowledge-engineer sort (odd community). I'm adding this author to my bloglines list.
An expert's speculation on what life is like in Bush's place
It's rare to get the perspective of someone with this kind of perspective:
PS. I don't believe there will be any indictments from Fitzgerald's grand jury.
TPMCafe || What It's LikeBush must have many strengths, but his weaknesses seem to be profound. Maybe it does come from a life of wealth, and the world of the CEO. The CEO is not a democrat; s/he is at best a wise king, at worst a tinpot dictator. FDR, also a child of privilege was the wise king. Bush seems more the tinpot dictator, one who curries the praise of fools, shoots the messenger, and ruthlessly executes the disloyal. Is Rove no different?
... The exodus and incapacity were inevitable [from Bush's original team]; replacing Bush's stand-up guys and gals with suck-ups and sycophants was not. After he was re-elected, with the clouds of scandal still all `round, Bill Clinton lured John Podesta back to the White House. Podesta, who is as tough as a bar of iron, became deputy chief of staff, and then chief of staff. He was indispensable in maintaining the focus of both the President and his staff. When Abner Mikva left, Clinton recruited a new White House counsel, Charles Ruff, who was strong and steady, and put together the most impressive team of lawyers ever to grace the West Wing. When Mike McCurry stepped down, he was replaced by bulldog Joe Lockhart. Clinton also promoted Rahm Emanuel and Doug Sosnik, veteran campaigners, and convinced me to leave my beloved Austin to become Counselor to the President. Not because I was possessed of some special wisdom or insight, but because I knew him well and was not afraid to give him bad news.
Mr. Bush would do well to augment his current staff, a C-Team if ever there was one, with some stronger characters. But to read the Bush-Miers correspondence is to gain a disturbing insight into Mr. Bush's personality: he likes having his ass kissed. Ms. Miers' cards and letters to the then-Governor of Texas belong in the Brown-Nosers Hall of Fame. You can be sure the younger and less experienced Bush White House aides are even more obsequious. The last thing this President wants is the first thing he needs: someone to slap his spoiled, pampered, trust-funded, plutocratic, never-worked-a-day-in-his-life cheek and make him face the reality of his foul-ups.
And so they wait. And they sniff the royal throne. They tell the Beloved Leader he's the victim of a partisan plot (although how the Bush CIA, which referred the Plame case for prosecution, became ground zero of Democratic liberalism escapes me). They assure him all is well. But all is not well. People are looking over their shoulders. The smart ones have stopped taking notes in meetings. The very smart ones have stopped using email for all but the most pedestrian communications. And the smartest ones have already obtained outside counsel...
PS. I don't believe there will be any indictments from Fitzgerald's grand jury.
We could be worse. We could be chimps.
The more we learn about chimps (BBC NEWS | Science/Nature | Chimps fall down on friendship), the less "appealing" they seem. Violent, murderous, xenophobic, misogynistic, sadistic -- our closest living siblings make us seem relatively decent.
Wednesday, October 26, 2005
Visiting the first church of scientology and Hubbard's offices
When I was a youngling wandering southern california eons ago, one of my hobbies was visiting cults. From old photographs I can see I had a rather innocent and even vulnerable looking face, and cultists were always keen to recruit me. I found them quite fascinating, and over time I became familiar with the "marks" (troubled and lost youth typically), the true believers ("marks" who've joined up) and the handlers (those one level above the believers). I even met a few of the "operators" -- those who are in the cult for power or perks, not for belief. The latter were quite good at spotting my true nature, and would quickly turf me back to the street (my face was misleading).
Nowadays, 25 years later, I fear I no longer have a face that appeals to cultists. Fortunately a friend of mine, no younger than I, still does. So it came that he and I enjoyed a tour of the very first church of Scientology in Washington DC (1701 20th Street NW), and then took a unique guided tour of the unmarked building that was Scientology's first headquarters, around the block at 1812 19th Street Nw, Washington, DC 20009. This latter building is not marked in any way. I believe it is usually visited by Scientologists, but for some reason we were invited. Our hosts were gracious and personable, though I suspect that one of them (quite senior in the church) suspected my true nature. We did not deceive them and admitted to being physicians, but we were very quick to (honestly) state that we were not psychiatrists. In Scientology's doctrine psychiatrists are the closest thing to Satan, and while our guests might tolerate heretics Satan himself would be too much. It probably helped that both of us now work in health care software companies and no longer see patients.
My friend did tell an earlier younger host that we had, of course, often treated patietns with psychiatric medications, but fortunately she appeared not to hear.
So it is that I read of Hubbard's life, or at least the sanctified version thereof. It was a fascinating life. A brilliant, romantic, and precocious youth, a restless wanderer and adventurer, a college drop-out who churned out reams of pulp fiction (science fiction, adventure fiction, even romances -- all under varied pseudonyms). I could see many of the books in his offices and scan some of his 1950s writings (which were more direct and clear than his later writing). [Update 3/06: Alas, it's a life more fictional than I'd thought. Did Hubbard know what was fact and what was imagination? See more below.]
I think I could also tell when he developed whatI'd guess was his schizophrenia-like disorder, his unusual thinking patterns [1] about about age 20 -- a very typical age of onset.
There were many fascinating aspects of the tour. Despite the name of the church, there were no science texts in Hubbard's collection -- nothing on biology, geology, medicine, physics, astronomy, chemistry, electricity, etc. He evidently read history, a bit of philosophy, science fiction and mystical stories -- but not science. Most curiously he had a copy of one of Freud's popular books on psychoanalysis; not marked with any bloody ink and mixed in with his other texts. Nowhere was there mention or reference to any women in his life other than his mother.
There's a remarkable series of 'e-machines', and a fascinating letter mentioning that the first e-machine was the descendant of 40 preceding years of research in psychogalvanometry (there are no Google links to that term, and only a handful of obscure links to the 'psychogalvanometer'. I am amazed there's not more on what was apparently a fad from 1910 to 1950).
Reading the books and literature a few themes emerge, which I think capture the flavor of Hubbard's mind. First and foremost there's his well known hatred of psychiatrists. He refers to the German (psychology), the Viennese (psychoanalysis) and the Russian (psychiatry - most foul). The intensity of his hatred may have some delusional qualities, but he lived in the era of Soviet dissidents imprisoned in psych facilities, frontal lobotomies, etc. The connection he made between the Soviets and psychiatry is particularly interesting.
Throughout his life he revisits themes that have, to someone who's cared for schizophrenic patients, a familiar feeling. He believed that Niacin was a good treatment for substance abuse and radiation poisoning, apparently because it induced facial flushing that he connected with sauna-induced vasodilation. His early books focus on radiation exposure, cellular memory (single-celled organisms 'learn' and pass their learning on to their descendants), and multiple lives. There's some suggestion of an antipathy to Christianity but a sympathy for Buddism; yet the newer Scientology churches display a modified Christian cross.
I was most interested in his use of language, and in his concerns about the meaning of words (shades of his science fiction colleague AE Van Vogt, who later signed up with scientology). His use of 'flub' for "error" is characteristic. He seemed very bothered by words having multiple meanings, and preferred that a word have only a single precise meaning. A children's book on learning makes a somewhat odd transition from a general discussion on learning styles to an perseverant discussion of the dangers of words that could be misunderstood. His concern with the meaning of words, and with the power of words to cause physical harm or effects, has a magical and tortured quality. It is ironic in a man who was a stupendously prolific writer and typist (90 words a minute!).
It is a fascinating tour of an increasingly powerful church (or cult -- a nascent religion). I can believe they easily have 300,000 members, and if each contributes $5,000/year (courses and contributions) that's a tax-exempt cash flow of $1.5 billion/year. Enough money to buy many US senators and politicians. Impressive!
It will be very interesting to see how Scientology evolves.
Update 10/27:
[1] The more I thought about Hubbard's mental status, the less ready I am to give him a label as "simple" as "schitzophreniform disorder". Given his extraordinary bursts of productivity, I could as easily and as amateurishly "label" him as "mania with delusional components". There is clearly something odd about his fixed beliefs and obsessions, and particularly his themes of struggles with the "unconscious" and his focus on words and their slippery meanings. I get the impression of someone fighting to master a mind coming apart, and ending in some odd truce that worked quite well the rest of his life.
I'm not confident, however, that even a professional psychiatrist would know quite how to categorize Hubbard in our current ill-defined taxonomies of psychiatric disorders. It would be very interesting to know more about Hubbard's family history, and whether any particular disorders were prevalent in his parents, cousins, etc.
As my friend noted, the relationship between the delusional disorders, religiosity, and the propensity to create religions is complex, interesting, and intensely controversial.
Update 3/2/06: Rolling Stone has a wonderful story on Scientology. It adds a bit of detail to his biography (note- I went to Caltech):
Update 5/14/07: While tagging my scientology posts I came across this unpublished 2005 reference to a CT article on L Ron's creative biography. It reminded of Kim Jong-il's equally momentous list of achievements. I suspect the resemblance is not coincidental.
Nowadays, 25 years later, I fear I no longer have a face that appeals to cultists. Fortunately a friend of mine, no younger than I, still does. So it came that he and I enjoyed a tour of the very first church of Scientology in Washington DC (1701 20th Street NW), and then took a unique guided tour of the unmarked building that was Scientology's first headquarters, around the block at 1812 19th Street Nw, Washington, DC 20009. This latter building is not marked in any way. I believe it is usually visited by Scientologists, but for some reason we were invited. Our hosts were gracious and personable, though I suspect that one of them (quite senior in the church) suspected my true nature. We did not deceive them and admitted to being physicians, but we were very quick to (honestly) state that we were not psychiatrists. In Scientology's doctrine psychiatrists are the closest thing to Satan, and while our guests might tolerate heretics Satan himself would be too much. It probably helped that both of us now work in health care software companies and no longer see patients.
My friend did tell an earlier younger host that we had, of course, often treated patietns with psychiatric medications, but fortunately she appeared not to hear.
So it is that I read of Hubbard's life, or at least the sanctified version thereof. It was a fascinating life. A brilliant, romantic, and precocious youth, a restless wanderer and adventurer, a college drop-out who churned out reams of pulp fiction (science fiction, adventure fiction, even romances -- all under varied pseudonyms). I could see many of the books in his offices and scan some of his 1950s writings (which were more direct and clear than his later writing). [Update 3/06: Alas, it's a life more fictional than I'd thought. Did Hubbard know what was fact and what was imagination? See more below.]
I think I could also tell when he developed what
There were many fascinating aspects of the tour. Despite the name of the church, there were no science texts in Hubbard's collection -- nothing on biology, geology, medicine, physics, astronomy, chemistry, electricity, etc. He evidently read history, a bit of philosophy, science fiction and mystical stories -- but not science. Most curiously he had a copy of one of Freud's popular books on psychoanalysis; not marked with any bloody ink and mixed in with his other texts. Nowhere was there mention or reference to any women in his life other than his mother.
There's a remarkable series of 'e-machines', and a fascinating letter mentioning that the first e-machine was the descendant of 40 preceding years of research in psychogalvanometry (there are no Google links to that term, and only a handful of obscure links to the 'psychogalvanometer'. I am amazed there's not more on what was apparently a fad from 1910 to 1950).
Reading the books and literature a few themes emerge, which I think capture the flavor of Hubbard's mind. First and foremost there's his well known hatred of psychiatrists. He refers to the German (psychology), the Viennese (psychoanalysis) and the Russian (psychiatry - most foul). The intensity of his hatred may have some delusional qualities, but he lived in the era of Soviet dissidents imprisoned in psych facilities, frontal lobotomies, etc. The connection he made between the Soviets and psychiatry is particularly interesting.
Throughout his life he revisits themes that have, to someone who's cared for schizophrenic patients, a familiar feeling. He believed that Niacin was a good treatment for substance abuse and radiation poisoning, apparently because it induced facial flushing that he connected with sauna-induced vasodilation. His early books focus on radiation exposure, cellular memory (single-celled organisms 'learn' and pass their learning on to their descendants), and multiple lives. There's some suggestion of an antipathy to Christianity but a sympathy for Buddism; yet the newer Scientology churches display a modified Christian cross.
I was most interested in his use of language, and in his concerns about the meaning of words (shades of his science fiction colleague AE Van Vogt, who later signed up with scientology). His use of 'flub' for "error" is characteristic. He seemed very bothered by words having multiple meanings, and preferred that a word have only a single precise meaning. A children's book on learning makes a somewhat odd transition from a general discussion on learning styles to an perseverant discussion of the dangers of words that could be misunderstood. His concern with the meaning of words, and with the power of words to cause physical harm or effects, has a magical and tortured quality. It is ironic in a man who was a stupendously prolific writer and typist (90 words a minute!).
It is a fascinating tour of an increasingly powerful church (or cult -- a nascent religion). I can believe they easily have 300,000 members, and if each contributes $5,000/year (courses and contributions) that's a tax-exempt cash flow of $1.5 billion/year. Enough money to buy many US senators and politicians. Impressive!
It will be very interesting to see how Scientology evolves.
Update 10/27:
[1] The more I thought about Hubbard's mental status, the less ready I am to give him a label as "simple" as "schitzophreniform disorder". Given his extraordinary bursts of productivity, I could as easily and as amateurishly "label" him as "mania with delusional components". There is clearly something odd about his fixed beliefs and obsessions, and particularly his themes of struggles with the "unconscious" and his focus on words and their slippery meanings. I get the impression of someone fighting to master a mind coming apart, and ending in some odd truce that worked quite well the rest of his life.
I'm not confident, however, that even a professional psychiatrist would know quite how to categorize Hubbard in our current ill-defined taxonomies of psychiatric disorders. It would be very interesting to know more about Hubbard's family history, and whether any particular disorders were prevalent in his parents, cousins, etc.
As my friend noted, the relationship between the delusional disorders, religiosity, and the propensity to create religions is complex, interesting, and intensely controversial.
Update 3/2/06: Rolling Stone has a wonderful story on Scientology. It adds a bit of detail to his biography (note- I went to Caltech):
Wow. I bet JPL doesn't put that bit in their official history.... After the war, Hubbard made his way to Pasadena, California, a scientific boomtown of the 1940s, where he met John Whiteside Parsons, a society figure and a founder of CalTech's Jet Propulsion Laboratory. A sci-fi buff, Parsons was also a follower of the English occultist Aleister Crowley. Parsons befriended Hubbard and invited him to move onto his estate. In one of the stranger chapters in Hubbard's life, recorded in detail by several biographers, the soon-to-be founder of Dianetics became Parsons' assistant -- helping him with a variety of black-magic and sex rituals, including one in which Parsons attempted to conjure a literal "whore of Babalon [sic]," with Hubbard serving as apprentice.
Charming and charismatic, Hubbard succeeded in wooing away Parsons' mistress, Sara Northrup, whom he would later marry. Soon afterward, he fell out with Parsons over a business venture...
Update 5/14/07: While tagging my scientology posts I came across this unpublished 2005 reference to a CT article on L Ron's creative biography. It reminded of Kim Jong-il's equally momentous list of achievements. I suspect the resemblance is not coincidental.
Sunday, October 23, 2005
Summary of the Scowcroft interview
Apparently when you're 80 years old, you feel free to be blunt at certain times. DeLong quotes another blogger with many excerpts of a very long rant from a senior old-guard Republican.
Don't donate your used PC -- it's not worth anything
I once went to some effort to recondition and setup a used PC for a family that didn't have one. Even as I set it up, I knew this was dumb. They couldn't afford a network connection, they didn't have a printer and couldn't afford a new one, and they didn't have the background or resources to maintain the high quality computer I gave them. Since they couldn't affort to pay to dispose of it, I was just creating more toxic waste. (I'd said I'd come get it ... but that was dumb too.)
As in the twin cities, so to in Africa. Even if all those donated PCs were in terrific shape, most of them would soon be worthless. PCs are annoying resource intensive life sucking leaches that cost far too much to maintain and keep healthy. And here I'm speaking of a Mac. Wintel macchines are far worse.
Stop donating computer hardware. It's a waste. Spend the time and effort lobbying for decreased tariffs and support increased trade. Support acts that can decrease poverty. Donate to CARE.ORG. Donate high quality t-shirts. Just don't send computer gear.
As in the twin cities, so to in Africa. Even if all those donated PCs were in terrific shape, most of them would soon be worthless. PCs are annoying resource intensive life sucking leaches that cost far too much to maintain and keep healthy. And here I'm speaking of a Mac. Wintel macchines are far worse.
Stop donating computer hardware. It's a waste. Spend the time and effort lobbying for decreased tariffs and support increased trade. Support acts that can decrease poverty. Donate to CARE.ORG. Donate high quality t-shirts. Just don't send computer gear.
Digital Rights Management and the DMCA shall make criminals of us all
By providing half a solution, then stopping, Apple leads a reasonably honest soul to the twilight zone: Gordon's Tech: Controlling Apple AirTunes with SlimServer, or how I was turned to the Darkseid. Beware, if you walk the 'media server' road you too will be led to the rebel alliance ...
Saturday, October 22, 2005
Leon Kass: presidential advisor on the forgotten place of women
Leon Kass is Bush's bioethics advisor. DeLong and Kieran Healy quote Kass's philosophy of the woman's place. Really, he says, it all went wrong when the Pill was developed ...
This is the president's advisor. These guys are a parody of themselves. At this rate I'll soon be expecting Bush to find a way to stay on after his term runs out ...
This is the president's advisor. These guys are a parody of themselves. At this rate I'll soon be expecting Bush to find a way to stay on after his term runs out ...
Colonel Wilkerson on the cabal running American foreign policy
Colonel Wilkerson is a military academic who followed Colin Powel into government. He lectures here on US foreign policy (ft.com). He rambles a bit. He liked George Bush I and accepted the Clintonians with grudging respect. He acknowledges must US presidents are far from brilliant. Then he gets down to the brassy tacks (emphases mine):
And you’re talking about the potential for, I think, real dangerous times if we don’t get our act together. Now, let me get a little more specific. This is where I’m sure the journalists will get their pens out. Almost everyone since the ’47 act, with the exception, I think, of Eisenhower, has in some way or another, perterbated, flummoxed, twisted, drew evolutionary trends with, whatever, the national security decision-making process....
... The complexity of crises that confront governments today is just unprecedented. Let me say that again.
The complexity of the crises that confront governments today are just unprecedented. At the same time, especially in America, but I submit to you that in Japan, in China and in a number of other countries soon to be probably the European Union, it’s just as bad, if not in some ways worse.
The complexity of governing is unprecedented. You simply cannot deal with all the challenges that government has to deal with, meet all the demands that government has to meet in the modern age, in the 21st century, without admitting that it is hugely complex. That doesn’t mean you have to add a Department of Homeland Security with 70,000 disparate entities thrown under somebody in order to handle them. But it does mean that your bureaucracy has got to be staffed with good people and they’ve got to work together and they’ve got to work under leadership they trust and leadership that, on basic issues, they agree with.
And that if they don’t agree, they can dissent and dissent and dissent. And if their dissent is such that they feel so passionate about it, they can resign and know why they’re resigning. That is not the case today. And when I say that is not the case today, I stop on 26 January 2005.
I don’t know what the case is today. I wish I did. But the case that I saw for 4 plus years was a case that I have never seen in my studies of aberration, bastardizations, [inaudible], changes to the national security [inaudible] process. What I saw was a cabal between the Vice President of the United States, Richard Cheney, and the Secretary of Defense and [inaudible] on critical issues that made decisions that the bureaucracy did not know were being made.
And then when the bureaucracy was presented with those decisions and carried them out, it was presented in such a disjointed incredible way that the bureaucracy often didn’t know what it was doing as it moved to carry them out.
Read George Packer’s book The Assassin’s [inaudible] if you haven’t already. George Packer, a New Yorker, reporter for The New Yorker, has got it right. I just finished it and I usually put marginalia in a book but, let me tell you, I had to get extra pages to write on.
And I wish, I wish I had been able to help George Packer write that book. In some places I could have given him a hell of a lot more specifics than he’s got. But if you want to read how the Cheney Rumsfeld cabal flummoxed the process, read that book. And, of course, there are other names in there, Under Secretary of Defense Douglas [jf - Feith], whom most of you probably know Tommy Frank said was stupidest blankety blank man in the world. He was. Let me testify to that. He was. Seldom in my life have I met a dumber man.
And yet, and yet, after the Secretary of State agrees to a $400 billion department, rather than a $30 billion department, having control, at least in the immediate post-war period in Iraq, this man is put in charge. Not only is he put in charge, he is given carte blanche to tell the State Department to go screw themselves in a closet somewhere. That’s not making excuses for the State Department.
That’s telling you how decisions were made and telling you how things got accomplished. Read George’s book...
...They’ve [jf - defense contractors] got every Congressman, every Senator, they got it covered. Now, it’s not to say that they aren’t smart businessmen. They are, and women. They are. But it’s something we should be looking at, something we should be looking at. So you’ve got this collegiality there between the Secretary of Defense and the Vice President. And then you’ve got a President who is not versed in international relations. And not too much interested in them either.
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