Tuesday, January 20, 2004

(Professor Mark Granovetter was kind enough to e-mail me a PDF of his article, The Strength of Weak Ties, to which I made reference on 1/16/2004.   When it is done downloading, I'll post any pertinent comments.  Take home points: it never hurts to ask for what you want.  And, go right to the source, if you can.)

Crapweasels, Streptoccus agalactiae, and other Annoyances

Streptoccus agalactiae

I've gotten a bit farther in Suskind's book, The Price of Loyalty.  The reason I bought this book is that I am concerned about the media reports that imply that Mr. Bush the 43rd started planning for an Iraq invasion as soon as he was elected.  I wanted to see what evidence was cited, because the statements in the media were vague on this critical point.   Although I haven't finished the book, I did find some of the detail that I was after.  On page 83, there is what appears to be a transcript from the briefing materials for a National Security Council meeting on February 1, 2001.  The transcript mentions the various attachments to the briefs, including "Tab C: Executive Summary: Political-Military Plan for Post-Saddam Iraq Crisis (interagency working paper) -- SECRET"

I say that this appears to be a transcript, because Mr. O'Neill has stated publicly that he was given a CD-ROM with images of all the papers that he had official contact with, during the course of his tenure as the Secretary of Treasury.  This CD-ROM was given to Mr. Suskind, who used the documents as material for the book.  Unfortunately, we do not get to see the rest of the document.   

What would it mean if Mr. Bush the 43rd had, by February 1 2001, already decide that he would invade Iraq?  If he made the decision before being elected, he really should have told the American People that  this was his plan, before the election.  A presidential candidate having a plan to send over 100,000 of our sons and daughters into harm's way is something that we have a right to be informed about.  If indeed he had this plan, during the campaign, and he did not tell us, this would -- in my view -- be a very serious ethical lapse.  Unfortunately, the limited information cited above is not sufficient for us to be certain.  The following exchange (from a Today Show interview) provides a little more light:
COURIC: So you see nothing wrong with that being at the top of the president's agenda...

Mr. O'NEILL: Absolutely nothing. You know, and one of the candidates...

COURIC: ...10 days after the inauguration?

Mr. O'NEILL: ...one of the candidates had said this confirms his worst suspicions. I'm amazed that anyone would think that our government on a continuing basis across the political administration doesn't do contingency planning and looking at circumstances. Saddam Hussein has been there forever. And so I was surprised, as I've said in the book, that Iraq was given such a high priority, but I was not surprised that we were doing a continuation of planning that had been going on and continuing looking at contingency options during the Clinton administration.

This mentions the topic of contingency planning.  I understand from various sources that our government has extant plans for invading almost every square inch of the planet.  That makes sense, even to a near-pacifist like me.  If, for example, a renegade band of zealots took a bunch of American medical students hostage on some Caribbean island, it would be good for the military to have a plan ready to pull of the shelf, so they could deploy quickly.  And since we are at peace more than we are at war, it makes sense for the officers to spend time drawing up such plans.  However, the specific mention of a "Plan for Post-Saddam Iraq Crisis," in the context as mentioned, suggests that this was more than a routine contingency plan. 

It will be many years before all of the pertinent documents are declassified.  Unless there is a major leak somewhere, we almost certainly will not know the whole truth before the next election.

This puts us (the American People) in a particular kind of situation.  The situation is this: we must make a very important  - life altering -- decision, when we vote in the next Presidential election.  We would like very much to know whether the current president was withholding crucial information about his plans, as this would (in my view) constitute a major ethical lapse.  However, we do not know for sure.  All we have is some partial information, not enough to draw a firm conclusion. 

So, the question is this: how do you go about the business of making major decisions, when you know you do not have all of the pertinent information?  This sort of thing happens all the time.  For example, a patient comes in to a hospital with high fever, headache, and a stiff neck.  The cause is probably meningitis.  You would like very much to know if it is bacterial meningitis, and if so, what bacterium is responsible, and what antibiotic is most likely to kill the bacteria.  You do a lumbar puncture, get some CSF, send it to the micro lab for culture and sensitivity.  The results will take about two days.  The patient could well be dead if you wait two days.  So, you look at a chart of recent cultures taken in that hospital, what organisms were found most often in similar situations, and what antibiotic was able to kill most of the organisms.  Then you start a one or more antibiotics to cover the most likely organisms, and cross your fingers.

Common Pathogens and Empiric Therapeutic Recommenations Based on Age in Patients with Bacterial Meningitis
Age Common bacterial pathogens Empiric antimicrobial therapy*
0 to 4 weeks Streptoccus agalactiae, Escherichia coli, Listeria monocytogenes, Klebsiella pneumoniae, Enterococcus species Ampicillin plus cefotaxime (Claforan), or ampicillin plus an aminoglycoside
4 to 12 weeks S. agalactiae, E. coli, L. monocytogenes, Haemophilus influenzae, Streptococcus pneumoniae, Neisseria meningitidis Ampicillin plus a third-generation cephalosporin£
3 months to 18 years H. influenzae, N. meningitidis, S. pneumoniae Third-generation cephalosporin£, or ampicillin plus chloramphenicol (Chloromycetin)
18 to 50 years S. pneumoniae, N. meningitidis Third-generation cephalosporin£ with or without ampicillin§
Older than 50 years S. pneumoniae, N. meningitidis, L. monocytogenes, aerobic gram-negative bacilli Ampicillin plus a third-generation cephalosporin
*-- Vancomycin (Vancocin) should be added to empiric therapeutic regimens when highly penicillin - or cephalosporin-resistant pneumococcal meningitis is suspected.
£ -- Cefotaxime or ceftriaxone (Rocephin).
§ -- Add ampicillin if meningitis caused by L. monocytogenes is suspected.

(From AR Tunkel, et. al. American Family Physician 56:5)

In this case, we do not have a chart that tells us the likelihood that a particular politician was lying about a particular topic.  So a straightforward statistical analysis is not possible.  I hate to say it, but in this situation, we are going to have to make our best guess, and vote accordingly.  Even so, there are some things to keep in mind, to help make sure the guess is valid. 

If you run a search on Suskind and O'Neill, you will find a whole bunch of commentary on the Suskind's book.  Many of the commentators will say things about O'Neill, such as claiming that he is a disgruntled former employee, upset with getting fired, so you can't believe anything he says.  This, of course, is an argumentum ad hominem, that is, an attack on the messenger, not the message itself.  This is not a valid line of reasoning.  A particularly egregious example is here: "I'm on record as believing that Paul O'Neill is a feckless crapweasel, and I stand by that....That Suskind takes journalistic liberties is not a new charge."  Who cares if Suskind takes journalistic liberties?  Of if Paul O'Neill is a crapweasel? (BTW, neither Google nor Wikipedia know what a crapweasel is.  As far as I can tell, the fist known citation is here.)  The point is that you gather whatever information you can, strip out all the baseless value judgments, consider your own likely biases, and try to be objective.  Open discourse (such as this) and careful research both are helpful in this process. Don't do all your research in sources that you tend to agree with; make a point of getting some divergent opinions.   Then make your best guess.