Gnarled and Twisted…

I love this gnarled, twisted tree trunk. It’s “growing” in the front yard of my friends, Dick and Kit Duane, in Berkeley. Dick and I were law school classmates there 57 years ago. They bought the house 47 years ago, raised their children there, played music, made plans, drank wine, cooked meals and read poetry there. The tree is old growth by any standard of time, just as we are old growth by the standards of the Social Security Life Expectancy chart.

Kit wants to have the tree taken out. She has a point; it could fall on the house when one of those fast-moving Pacific storms rips through the Golden Gate and blasts the Berkeley flats, but I’m betting on the tree. It’s seen a lot of those storms.

Dick and I can’t remember the specifics of how our friendship began. We were in the same law school section, one of three, in a class of 750. He was recently out of the Navy and I was fresh from the Marine Corps but early on we uncovered a mutual interest in swimming. I had no talent…still don’t…despite millions of laps in thousands of pools around the world. He, on the other hand, was a competitive swimmer at Cal… but everything about him was relaxed. He never minded doing 3 laps for every 1 of mine, and I was grateful he didn’t mention it. We both needed a release from those mind-numbing hours in the law library and found it in our noon workouts at the UC pool and browsing stops at Cody’s Books on Telegraph Avenue.

There is probably something deeply psychological about my affection for the Duane’s gnarly twisted tree. It’s like my gnarly wrinkled hand in some ways. Both show the effect of time in lumps, veins and scars on surfaces that were once  smooth and elastic. When I suggested to Marilynn that we take a photo of our hands for this article she didn’t want any part of it. I love her hands, but she tells me that women are sensitive about their hands and rarely does a “woman of a certain age” allow her hands to be photographed. I love her vanity. It means she still cares about showing the world the best side of herself. Me? Not so much.

Nevertheless, last weekend M and I watched an interview with Angie Dickinson, a woman famous for her physical beauty who, at 87, was astonishingly unselfconscious about her gray hair, wrinkles, and hands. I found her confidence reassuring. After a lifetime of living shouldn’t we all be able to present ourselves proudly, and confidently “as is?”

Dick and I took much different paths after law school. Things have changed since we were there, but the curriculum and vector in those days was toward an elite private law practice. I followed the vector by way of Loeb & Loeb in Los Angeles and lasted nine months. Dick, who spent a law school summer in Georgia doing civil rights work before graduation, spent a couple of years doing poverty law in DC and San Francisco before returning to Berkeley to start his own small general practice. I remember Professor John Jackson, our Contracts teacher, taking time to extoll the virtues of small private community based practice. It seemed so contrary to Boalt’s big firm bias, but that’s what Dick chose and I know after all these years that he loved it and never thought of looking back.

Friendship, like love, is a mix of intangibles. Several of my most enduring friendships were formed in law school, though most of these were with classmates who didn’t follow traditional paths. Like friendships formed anywhere, law school was simply the nexus that brought together a cohort of people with similar characteristics, interests, and experience. We were all achievers in one way or another, competitive and curious in others. Some moved on according to someone else’s plan and some worked out their own.

The cement in my friendship with Dick is probably that we were slightly out of synch with the curriculum and our classmates. We maintained those friendships too, but ours didn’t depend on a shared professional experience. We were focused elsewhere. We both loved the outdoors. He was a serious rock climber (including El Capitan and some first ascents) and I spent most of my adult life skiing and living in ski areas. He’s an avid reader and lover of poetry. So am I, and we both play the guitar, though neither of us is very good. On top of that, Kit was a book editor and both couples have spent serious chunks of time traveling and living abroad. It’s all added up to a great recipe for friendship.

Steep rock faces and snowy steep chutes are behind the two of us now. His granddaughter is on her way to becoming a world-class rock climber and my grandsons are serious freestyle and backcountry skiers. We’ve had a hand in paying it forward for them and are enjoying the ride as they figure out their futures…but the best part for us now is our enduring friendship, memories of shared experience, and talk about what’s next. Neither of us is through…just adapting to changed circumstances.

Dick and Kit in Provence last year.

Two Degrees of Separation…

I didn’t know Albert Finney, but when he died two days ago, I felt the loss personally. I’d admired him as an actor since first seeing him as the randy Tom Jones (1963) and again as Audrey Hepburn’s husband in Two for the Road (above) in 1967. He was nominated for an Oscar five times, but never took one home. He was an actor’s actor, but it wasn’t his acting chops that made me feel his loss.

Finney and I were only a year apart in age. Wikipedia doesn’t mention it, but I know he was an avid horse racing fan who followed the ponies from Saratoga to the Triple Crown and on to Santa Anita in the fall. In a tangential way, it was his interest in racing that provided our connection.

Mr. Finney was friends with Karen and Mickey Taylor. Two friends of mine. Two degrees of separation. The Taylors purchased Seattle Slew for $17,500 in 1975. Slew went on to win the Triple Crown and made the Taylors very wealthy. I knew them because they were customers of mine at Piccolo, the little Italian café my wife, Abby, and I owned.

Running a small restaurant is a labor of love – especially in a seasonal resort like Sun Valley. I made the pasta and bread. Abby ran the kitchen. Our small operation was either wildly busy or empty depending on the season. Christmas holidays were especially chaotic, and one Christmas week Mickey and Karen stopped in for lunch. The café seated 44 but there were probably 50 eating lunch on that particular day. Abby and the kitchen staff were cranking out the pasta dishes and I was up front seating customers, making espresso drinks, and busing tables.

At a particularly chaotic moment, with all the tables finishing at once, I felt a tap on my shoulder and turned to see a grinning Albert Finney. “Hello, Jack. I’m Albert. It looks like you could use some help. Let me give you a hand cleaning up these tables.” I was nonplussed. I didn’t even realize he was in the restaurant, but for the next 30 minutes Albert Finney and I were the busboys at Piccolo. He couldn’t have been nicer or more natural, and that’s the reason I was personally touched when I heard of his passing on Thursday.

Sun Valley was founded by Averill Harriman in 1936 and always had celebrity appeal, but it was years behind Aspen and Vail in becoming a “scene.” When Abby and I moved there in 70’s it was very sleepy. In 1987 when we opened the restaurant it was becoming more popular but still a one-story, log cabin kind of town and quiet escape for some celebrities. Jamie Lee Curtis used to bring us loaves of bread from the La Brea Bakery in LA, and Edie Baskin (Baskin & Robbins/SNL writer) brought us fresh mozzarella from Dean and DeLuca in New York.

Piccolo was a place celebrities with a local connection could come for a dish of pasta and not be bothered. Carole King, Scott Glenn, Adam West, and Jack Hemingway were lunch regulars while Jamie Lee and husband Christopher Guest, Brooke Shields, and Peter Cetera were often there for dinner. It was a few years later that the one-story log cabins were replaced with two-story banks, galleries, and glitzy boutiques. Change is a given, but I feel fortunate to have been part of it before the change.

Albert Finney’s passing reminds me of those times. I left Ketchum after 25 years. Piccolo has closed its doors and I’ve lost touch with Karen and Mickey. Even so, Abby and all three of my children are there and it remains a special place for me. Tomorrow I’m planning to settle in with a cocktail and watch a couple of Albert’s films – maybe Murder on the Orient Express or Annie – just to keep this memory fresh. My day busing tables with him is the perfect reminder that in this time of megalomania even a rich and famous celebrity can be modest, friendly, and helpful.

RIP Albert Finney (1936 – 2019)

Drugs of Choice?

I yearn for a simpler time when doctors carried black bags and made house calls, baseball players stayed with the same team their entire career, and serious drugs were recommended and prescribed only by physicians.

I doubt that we’ll ever see the first two again, but we might live to see the day when America joins the rest of the world’s developed countries and stops hawking dangerous drugs on prime-time TV.

For the past week I’ve been watching, and one of the subtle take-aways is that most of these drug ads are targeted at older viewers – the news (CNN, Fox News, MSNBC) or television magazines (GMA, Today, or CBS This Morning). Implicit is the recognition that younger viewers are getting their news online.

Regardless, the next time a Vraylar or Eliquis ad interrupts your program, stay with it and listen to the sotto voce side effects while the happy family on the screen enjoys a hot air balloon ride or sail on the lake. In the meantime, here are Vraylar’s side effects:

  • extrapyramidal symptoms (muscle spasms, muscle rigidity, tremor, jerking movements)
  • agitation
  • indigestion
  • nausea
  • vomiting,
  • sleepiness,
  • restlessness,
  • weight gain
  • headache,
  • insomnia,
  • abdominal pain,
  • constipation,
  • toothache
  • anxiety,
  • diarrhea,
  • pain in the extremities,
  • dry mouth,
  • loss of appetite,
  • back pain
  • dizziness

Vraylar is just one example of the 27 drug ads I screened in the five days before writing this – all the while wondering why dangerous drugs were being advertised like Reese’s Pieces on TV? Curiously, these ads are all approved by the Food and Drug Administration (FDA) not the Federal Communications Commission (FCC) or Health and Human Services (HHS). What possible justification is there for allowing drugs that can only be obtained with a physician’s written prescription to be “sold” on TV?

Since 1962, the FDA has regulated pharmaceutical advertising with a mandate to ensure it is not false or misleading. What about dangerous, inappropriate, improper, unnecessary, and out of place?

Here’s the FDA mission statement:“The Food and Drug Administration is responsible for protecting the public health by ensuring the safety, efficacy, and security of human and veterinary drugs, biological products, and medical devices; and by ensuring the safety of our nation’s food supply, cosmetics, and products that emit radiation.” 

There is nothing in the mission statement about marketing prescription drugs, nor is there anything related in the FCC or HHS regulations. If these three agencies are charged with protecting the public’s health doesn’t it make sense to limit the advocacy of serious drugs with harmful side effects to the medical professionals charged with matching the right drugs with the needs of their patients? Let’s take away the temptation of those who are gullible or desperate enough to be seduced by the happy family scenes in TV ads.

In 1970 Congress voted to ban tobacco advertising in the interest of the nation’s public’s health. It makes sense that it should do the same with prescription drugs.

I believe in a market economy, but advertising has nothing to do with good medical practice? We know that pharmaceutical companies pay doctors to promote their drugs. That in itself is shameful – on both sides of the equation, but let’s not have patients telling doctors what drugs they want based on something they saw advertised on TV? America and New Zealand are the only two developed countries that allow the direct to consumer advertising of pharmaceuticals on television.

Here’s how it hit home for me; I got annoyed by the interruptions and began cataloging all the drugs that were advertised on the programs I watched over a five day period. I quit adding to the list when I had 27.

Like most television watchers, I’d rather skip the commercials, but there are lessons to be learned when you pay attention to the spaces in between. Big Pharma is big business and marketing is a key element in growing that business.

Here’s how important TV ads are for Big Pharma: In the past 3 years (October 2015 to October 2018) prescription brands spent an estimated $10.1 billion on TV advertising. Last year 76 prescription drug brands spent an estimated $2.96 billion, running 200 ads 534,000 times on national TV. In total, these ads generated 148.9 billion impressions. None of these ads included price information, although Johnson & Johnson announced this week that it will begin to include that information in upcoming ads. According to an industry watchdog group called BiopharmaDive, spending for pharmaceutical ads in 2012 was the 12th-largest ad category. Last year, it was sixth.

In 2013 the profit margin for pharmaceutical companies ranged from 10% to 42%, with an average of 18%.

Let’s put those billions to work reducing the cost of drugs.

TV advertising isn’t the biggest problem confronting American healthcare. Drug prices are out of control. Health insurance is a patchwork of confusing choices, and Medicare, the biggest purchaser of prescription drugs, is prohibited from negotiating with drug companies on the cost of drugs. And… there are millions of Americans still unable to afford health insurance. No system is going to be perfect but we can do better.

It’s undeniable that America is capable of providing the most up to date and sophisticated medical care in the world, but, according to a Commonwealth Fund report the US ranks last overall among 11 industrialized countries on measures of health system quality, efficiency, access to care, equity, and healthy lives. To do better we need to treat healthcare as a universal right and work to eliminate the inefficiencies, duplications, price gouging, and unpredictability of the complicated system we have now. It should be a priority. Check this space for more.

In the meantime, amuse yourself with this Viagra spoof:

Present at the Creation…

My “office” these days is a scarred up antique table at Folio, Seattle’s membership non-profit for people who love books. Out my window this morning is a quintessential Northwest scene with the January sun reflecting off the Bainbridge Island ferry’s trailing wake and the dark blue waters of Elliott Bay. Further west are the peninsula’s foothills and the sharpened peaks of the Olympic mountains. So, while the rest of the country is being cold-soaked by a Polar Vortex, I’m in one of my favorite settings, surrounded by books and the natural beauty of the Northwest.

Founded by David Brewster, a serial literary entrepreneur, Folio is located one floor above Pike Place Market, where it functions as a library, event space, work area for writers, and book lover’s sanctuary. Since opening its door three years ago, Folio has assembled a rich collection of books through the donation of private library collections supplemented by the purchase of noteworthy current releases.

When new books arrive at Folio it’s common to find duplicates of books already in the collection, and in that case some are sold, some donated to school libraries, and others placed on a cart outside the door and given away. These give aways change on a daily basis and I never pass the cart without looking to see what’s on it.

Today, on my way to lunch, one title caught my eye – Acheson Country – a memoir by David Acheson of his father, Dean Acheson, former Secretary of State and all-around American statesman. I might have ignored it had it not been for the fact that the senior Acheson was the commencement speaker at my law school graduation in 1965.

On that long ago afternoon in Berkeley, the former diplomat and advisor to presidents gave a graduation address that was memorable not for the advice it contained but for the aura surrounding its speaker. There, in the hot California sun, Mr. Acheson was, as my father might have said, “bandbox” perfect. The expression is dated now, but maybe not inappropriate in this case. The reference is to the container or “bandbox” used to store and preserve the condition of a clergymen’s vestments in earlier times. In the vernacular, according to the Oxford Dictionary, it is used to “convey the smartness or neatness of someone’s appearance.”

That expression from bygone days perfectly describes the Dean Acheson I observed that day. His neatly trimmed trademark mustache, bespoke steel-gray suit, starched white shirt, pinched regimental tie, and spit-shined shoes reinforced the impression that I was in the presence of one of the 20th century’s greatest statesmen. My father and mother, who attended the graduation, both rock-ribbed Republicans, were equally in awe of Mr. Acheson as they listened to him in the courtyard at Boalt Hall.

Yesterday, reading the memoir’s foreword by historian David McCullough, took me back to that day and gave me an opportunity to revisit the major figures and events of America’s most critical decades in the last century and to measure their contributions against those of today’s leaders.

Dean Acheson’s biography reveals a scholarly but pragmatic man, a Groton and Yale patrician who forged a unique bond with Harry Truman, the quintessential common man. Together, they, with the help of others crafted the institutions and policies that maintained the world order for 70 years until recent disruptions upset that balance. His post-WWII foreign policy accomplishments included the establishment of the World Bank, International Monetary Fund, Truman Doctrine, Marshall Plan, United Nations, and the creation of NATO. And, it was he who, during the early 1950s strongly defended State Department employees whose loyalty and patriotism were under attack by Senator Joseph McCarthy. He remained an important advisor to Truman when the US entered the Korean War and participated in the controversial decision to fire General Douglas MacArthur during that conflict.

Mr. Acheson left government service in 1953 and entered private practice in Washington where he remained a trusted advisor to presidents Kennedy and Johnson. In 1964 he was awarded the Presidential Medal of Freedom and in 1970 the Pulitzer Prize for History for his memoir, Present at the Creation: My Years in the State Department. His son’s memoir is an important reminder of the importance of character, diplomacy, and historical perspective. His was a pivotal time in American history, and the contrast with today’s leaders is stark. Dean Acheson, George Marshall, George Kennan, Henry Cabot Lodge II, and Clark Clifford were all public servants who dedicated years to public service.

As world powers jockey for position in the 21st century, it’s clear that America has fallen from grace and is struggling to find its place in the world order. The Trump administration does not appear to have a comprehensive world view. Foreign affairs is a chess game that requires a grasp of history, culture, politics, economics, and military strategy. Donald Trump is purely transactional. His guiding star is his own self-interest. He gathers ideas by watching Fox News, denigrates his intelligence and national security advisors, and doesn’t read, understand or value the lessons of history that should be guiding him in the global chess match. Is it any wonder he is being played so easily by a former KGB functionary? Why else would he want to pull out of NATO or shred the Paris Climate Accords, Trans Pacific Partnership, Non-Proliferation and Iran Nuclear Treaties? These are the organizations and institutions that hold the world together and keep war at bay.

Today, the US Secretary of State is an ambitious, smug former Congressman from Kansas who’s attached himself to Donald Trump’s too long, too big, too black overcoat’s coattails and now smiles and prostrates himself with murderous dictators like Saudi’s Mohamed Bin Salman and Turkey’s Recep Erdogan. I don’t want to be pessimistic, but, in light of our present predicament, if Dean Acheson was “present at the creation“ will we have to write that we were present at the destruction? I hope not, but I’m not sure.

As I write this I’m reminded of the many outstanding US Foreign Service officers I’ve known, especially Angela Dickey, who was interim Consul General in Ho Chi Minh City when I was there. I know she shares my concern for the shredding of Foreign Service professionals at the State Department.

At the moment I’m pinning my hopes on another patrician public servant, Robert Swan Mueller III,  a graduate of St. Paul’s School, Princeton University, and the University of Virginia Law School who also earned a Master’s in international studies from NYU and served as a Marine Corps officer in Vietnam. His public service includes time as a US Attorney, Assistant Attorney General, and twelve-years as Director of the FBI. While at the Justice Department he oversaw the investigation and prosecution of those responsible for the bombing of Pan Am 103 where 270 lives, including three friends of mine, were lost.

I’m glad to have serendipitously run across Acheson Country, where my memory was refreshed and faith restored. Dean Gooderham Acheson was a giant among giants, and even though my connection was only a glimpse of the man late in his monumentally important career, I feel honored to have been present and to have heard him speak. I’m sure his words were inspiring, but what I remember most is the imposing figure who made me feel I was in the company of greatness. I think Robert Mueller can stand beside Acheson as an American hero and patriot. It’s possible that future generations will praise him for turning the American ship away from its destructive course and someone like me will read his daughter’s recollections – maybe it will even be called Mueller Country.

“Always remember that the future comes one day at a time.”

Dean Acheson

Survival…

On Sunday, the Seattle Times had a front-page article about crime, drugs, trash and human excrement in SODO (Seattle’s stadium/industrial area) from an influx of RV dwellers who park there because police have given up trying to control the area. The last time M and I saw these conditions was during a garbage worker strike in Johannesburg, South Africa.

Then, this morning, our friend Laura called to tell us a midnight marauder had broken into and ransacked her son’s car, reclined the seat and slept in it. This was in a quiet residential neighborhood. Was it ballsy or just desperate? I sympathized with Laura and her son but felt sad for the perp at the same time.

And, tonight, coming out of our local market, we were met by a young woman selling Real Change, the non-profit Seattle newspaper sold by homeless or near homeless vendors. Sellers pay $.60 for each paper and resell them for $2. Our girl was smiling and grateful when I gave her $3, and though it was nothing to us it meant a meal for her. I should have given her more. I will next time.

Are these examples of the new normal? 

Today is the 32nd day of the longest government shutdown in our country’s history. 800,000 federal employees are either furloughed and/or working without pay. Most are struggling to find a survival strategy until this nightmare is over… but government workers are not the only Americans thinking about survival.

Those of us who are privileged need to stop fooling ourselves.

Marilynn and I are in a couple’s book group, and our most recent selection, Jessica Bruder’s Nomadland: Surviving America in the Twenty-First Century, is a study in how a growing segment of older Americans is coping with their survival.

Nomadland chronicles the lives of a growing band of older, mostly white, Americans who have been downsized out of jobs, lost their homes to foreclosure, can’t afford an apartment, were ruined financially by a medical expenses, or lost a wage-earner spouse who left them with nothing but a small monthly Social Security check. Their survival strategy is to embrace the “vandweller” lifestyle–living in small older RV’s, working seasonal jobs as campground hosts or “Camperforce” workers at Amazon distribution centers, moving from part time job to part time job as they travel around the country.

They have learned to adapt to a subsistence level of personal comfort and to survive by sharing tips on jobs, mechanical repairs, RV improvements, parking places, and how to avoid police harassment with their vandweller compatriots. These modern nomads live by forming friendships, coping strategies and support systems based on shared experiences. I find their vandweller lifestyle both sad and inspiring, unimaginable and creative, unacceptable and another iteration of the new normal.

Ms. Bruder followed them, formed friendships, and camped with them for three years. She ended up admiring their grit and creativity and her book tells their story. Read it!

From the Gold Watch to the Pink Slip

In my adult lifetime I have seen America…

  • Drift from a thriving economy where companies bargained with employee unions and both sides prospered to organized attacks on unions and the enactment of state right-to-work laws that strongly favor employers.
  • I’ve seen good manufacturing jobs give way to automation without a national plan for retraining.
  • I’ve seen the funding for public education gutted by ballot referendums like California’s Proposition 13.
  • I watched as traditional employee-centered companies surrendered to Wall Street’s shareholder value model resulting in layoffs for well-paid older workers and the hiring of, less expensive younger replacements, where the savings were funneled to skyrocketing executive salaries.
  • I watched as my defined benefit pension plan, like so many others, was “stolen” and replaced by a much less to generous 401k.
  • I’ve seen company paid insurance plans given up in exchange for a patchwork of state directed insurance offerings through Medicaid and the Affordable Care Act.
  • M and I grew up in strong, healthy middle-class families but lived to see our children’s two-income families struggle because Congress chooses to reward a few gold-plated 1% families.

What is the effect of these changes in my lifetime?

For decades, the US was recognized as having the world’s highest standard of living. That is no longer true. In 2014, adjusted for income inequality (UN Human Development Index which measures health, education, and per capita income) the US ranked 27th(tied with Poland).

According to 2017 US Census Bureau figures, 39.7 million Americans are living in poverty, 18.5 million of them in “deep poverty” (more than 50% below the poverty line) and an estimated 100 million “near” poverty. Every day we read about the increase in homelessness. Every night 40,057 veterans and 1,500,000 children are sleeping on American streets without shelter.

Today, nearly 70% of Americans consider themselves middle-class, but according to a Pew Research Center report the real number is just over 50%. Another recent study revealed that 78% of all full time American workers live paycheck to paycheck. (CNBC) Watch the news tonight and listen to the stories of furloughed federal employees who can’t pay their rent or mortgage and have to stand in line at food banks to get groceries for their families. That’s what happens when you live paycheck to paycheck and the government stops paying you.

What about healthcare? Out of 33 developed countries, the US is the only one without universal health coverage. US healthcare costs are $8,745 per capita, highest in the world, and despite having the most expensive health care system, the United States ranks last overall among 11 industrialized countries on measures of health system quality, efficiency, access to care, equity, and healthy lives, according to a Commonwealth Fund report (2014).

Let’s get real!

Given the statistics, American “exceptionalism” is a thing of the past though most Americans still believe in America’s promise. Building a wall on our southern border is not going to help deliver on that promise or benefit anyone but Don the Builder. That one rich man can hold 800,000 unpaid workers hostage in order to secure funding for a vanity project is obscene.

Today it was announced that funding for SNAP (Supplemental Nutritional Assistance Program) is in jeopardy for March. Congress and Mr. Trump are still getting paid but food, in addition to paychecks, is being withheld by OUR government.

Let’s take the government back! Several plans have been offered to reopen the government. There is only one issue and one resister. Funding for “border security” can be isolated and negotiated separately. We need courageous leadership and the resister-in-chief is not providing it. It’s time for this to end.

In the meantime, Chef Jose Andres and his peripatetic World Central Kitchen, famous for providing free meals in disaster situations like Puerto Rico, and the recent California fires, has served 20,000 free meals and given bags of free groceries to furloughed US government employees on Pennsylvania Avenue in the last two weeks. Chef Andres’ location, it should be noted, is not far from the White House where the resister-in-chief so proudly served 300 Big Mac “hamberders” (that he “paid for himself,” yes, he really tweeted that) to the national champion Clemson Tiger football team last week. Really? Is this what inspirational leadership looks like?

Do you have a survival strategy? It’s become clear that we all need one.