text:
Jack Balkin:
jackbalkin at yahoo.com
Bruce Ackerman
bruce.ackerman at yale.edu
Ian Ayres
ian.ayres at yale.edu
Corey Brettschneider
corey_brettschneider at brown.edu
Mary Dudziak
mary.l.dudziak at emory.edu
Joey Fishkin
joey.fishkin at gmail.com
Heather Gerken heather.gerken at yale.edu
Abbe Gluck abbe.gluck at yale.edu
Mark Graber
mgraber at law.umaryland.edu
Stephen Griffin
sgriffin at tulane.edu
Jonathan Hafetz
jonathan.hafetz at shu.edu
Jeremy Kessler
jkessler at law.columbia.edu
Andrew Koppelman
akoppelman at law.northwestern.edu
Marty Lederman
msl46 at law.georgetown.edu
Sanford Levinson
slevinson at law.utexas.edu
David Luban
david.luban at gmail.com
Gerard Magliocca
gmaglioc at iupui.edu
Jason Mazzone
mazzonej at illinois.edu
Linda McClain
lmcclain at bu.edu
John Mikhail
mikhail at law.georgetown.edu
Frank Pasquale
pasquale.frank at gmail.com
Nate Persily
npersily at gmail.com
Michael Stokes Paulsen
michaelstokespaulsen at gmail.com
Deborah Pearlstein
dpearlst at yu.edu
Rick Pildes
rick.pildes at nyu.edu
David Pozen
dpozen at law.columbia.edu
Richard Primus
raprimus at umich.edu
K. Sabeel Rahmansabeel.rahman at brooklaw.edu
Alice Ristroph
alice.ristroph at shu.edu
Neil Siegel
siegel at law.duke.edu
David Super
david.super at law.georgetown.edu
Brian Tamanaha
btamanaha at wulaw.wustl.edu
Nelson Tebbe
nelson.tebbe at brooklaw.edu
Mark Tushnet
mtushnet at law.harvard.edu
Adam Winkler
winkler at ucla.edu
Compendium of posts on Hobby Lobby and related cases
The Anti-Torture Memos: Balkinization Posts on Torture, Interrogation, Detention, War Powers, and OLC
The Anti-Torture Memos (arranged by topic)
Recent Posts
Parsing the Vice President's Careful Words
Monday, August 20, 2007
Parsing the Vice President's Careful Words
Marty Lederman
The Vice President's office sent Pat Leahy this letter today, asking for an extension of time to respond to the Senate Judiciary's subpoena for documents relating to the NSA's warrantless surveillance between 2001 and 2007.
How many times do we see this:
At a tense meeting last week with lawyers from a range of private groups active in the wiretapping issue, senior Justice Department officials refused to commit the administration to adhering to the limits laid out in the new legislation and left open the possibility that the president could once again use what they have said in other instances is his constitutional authority to act outside the regulations set by Congress.
The administration requires certain language in a law, gets it from Congress, then proceeds to state that it can ignore it if wants/needs/feels like it (all in the name of his Presidential/Constitutional/Dictatorial perorgative.
If they are this contemptuous of our Constitution, Congress, and the electorate, I would not be surprised to hear a future signing statement ignoring the 2008 presidential election because the results were found to be inconsistent with the president's constitutional duty to protect the country. It is becoming blatantly obvious that we have more to fear from this administration than from any other foreign or domestic enemy.
Pure speculation on my part, but an alternative to a "change in limitation (i.e., one party al Qaeda) changes the legal analysis."
I've speculated that the change in heart is the result of combining the AUMF with FISA. The government cites the Hamdi case in conjunction with this, and the Hamdi case was argued and decided in a 2004 timeframe.
In other words, it may be that the pre-March 2004 legal rationales do not refer to the AUMF or any other Congressional approval.
I agree that it's also good speculation that pre-March 2004, the surveillance included warrantless acquisition of purely domestic communications. Perhaps it does, to this day.
As a matter of being effective at stopping terrorism, I would think that purely domestic communications would be at least as important as international communications, and probably more important if the communications are for the purpose of coordination of attack timing and other logistics.
It struck me as a stupid limitation (stupid as in failing in a practical way), to say "we are limiting our 'agile' warrantless surveillance to international communications."
The line may have been thought useful to tamp down legal objections, or to avoid a political backlash if the government admitted it was engaged in unfettered spying -- although a substantial number of people have no problem with unfettered warrantless spying, holding that such activity is part of what it will take to address the terrorism scourge.
To your broader point, that of President Bush asking for, then praising Congress for enacting the PAA, I remain a cynic.
I think the point of the law is to fool the public into thinking the government follows the law. In fact, the exposure of the TSP was decried as illuminating for our terrorist enemy, that there might be surveillance outside of statutory boundaries. In other words, the problem was that the statutory law would lose its function of misleading the terrorists.
Seeing as how the terrorists mingle freely within the domestic public, it then becomes necessary to fool the public as well. For their own good, of course.
In our ongoing debate over my contention which you dispute that the Executive shares my position that Congress has no power to direct Exdecutive foreign intelligence gathering, I offer Professor Balkin's analysis.
Professor Balkin:
So think about what the VP's letter is suggesting -- that perhaps Congress can't legislate on the topic of the government's domestic electronic surveillance!
The Truong line of cases indicates that the line between domestic and foreign intelligence gathering for 4th Amendment purposes is determined by the target, not the geographical location of the intercept. The 4th Amendment does not require warrants for intelligence gathering in the US against agents of any nationality working for foreign powers.
Under this bright line rule, the TSP would be a foreign intelligence gathering operation even if the geographical location of its intercepts are in the US.
Consequently, because no provision of Article I provides Congress the power to direct or criminalize foreign intelligence gathering, the Senate Judiciary Committee has no legislative or criminal investigation interest in the TSP docs. At most, the Intelligence Committees would have oversight of the TSP to determine what Congress is funding and have reportedly received all requested information.
This is, I think, a fairly audacious assertion to be making at this late date. After all, just a few days ago the President himself insisted that Congress legislate forthwith on this very subject, and then showered praise on Congress for enacting the "Protect America Act," without suggesting any constitutional disability.
The President is simply being nice after Congress nearly completely surrendered on the issue.
-- The Truong line of cases indicates that the line between domestic and foreign intelligence gathering for 4th Amendment purposes is determined by the target, not the geographical location of the intercept. --
To which I would add, that the citizenship of the target is also irrelevant, when the object is foreign intelligence gathering. See Mr. Humphrey, another party in the Truong investigation.
And as numerous courts have noticed, the categories of "for foreign intelligence" and "to thwart criminal enterprise" are largely overlapping -- there is no "line between them." Under the rule of FISCR's "In re: Sealed Case," a law enforcement agency can't be prohibited from driving a primarily law enforcement investigation, just because a significant purpose of the investigation is foreign intelligence. As long as a significant purpose of surveillance is denominated "foreign intelligence," law enforcement is free to direct the surveillance activity, and it need not obtain a warrant in order to do so.
The issue becomes "what additional fact or factor must be present, in order for a criminal enterprise to also be a matter of foreign intelligence?"
I'm not intending to make a judgement call here, just paraphrasing the court cases as I see them.
Although the letter from OVP hints at Cheney's position that FISA is unconstitutional, and administration officials bravely assert the President's Article II powers in a meeting (as they have done in recent congressional testimony), I would be shocked if the administration stakes out this position squarely in any court case.
In fact, the entire DOJ strategy all along has been to make such arguments only where they cannot be resolved, but avoid making them where they could be settled -- in court. Administration lawyers deliberately avoid teeing up this question for judicial review, because if it were presented squarely to SCOTUS they would probably lose by at least 8-1.
Comey, for one, did not have access or knowledge about the existence of the 6 prior memoranda:
Comey's SJC written testimony asserts that he was unaware of the existence of any legal memoranda prior to March 10, 2004.
d. Did the response include any legal opinion or memorandum from the White House, or any other federal agency related to the classified program? If so, please identify what individual(s) or entities prepared and reviewed the legal opinion or memorandum.
I am not aware of any other such memorandum or legal opinion prior to March 10, 2004. Some time shortly after March 10, I received a memorandum from White House Counsel Gonzales.
Does this Comey statement indicate that the DOJ Lawyers charged with reviewing the legality of the NSA-driven Surveillance Program were not given existing memoranda on the legality of The Program when they were conducting their analysis?
Is the conflict between the Comey Testimony and the newly disclosed existence of DOJ memoranda evidence of the "compartmentalization" that was hindering effective review, and the source of Ashcroft's March 10, 2004 complaint noted in the Mueller notes?
drational: I have to imagine that in that case Comey understood the Senate's question to refer to memos from *outside* DOJ. He could not have been unaware of his own OLC's previous memos on the subject.
Bart: This President has NEVER been nice...or decent, or ethical, or forthright, or compassionate, or statesmanlike in any way. He's a coward and liar by practice and temperament, and any apparent concessions he makes are born of fear rather than largesse.
b. Why was the review started? Was the review started at the request of any individual
or entity? If so, who or what entity?
I believe it was started at the initiative of Jack Goldsmith and Patrick Philbin.
[Does this mean that if the review was started by Goldsmith, he for sure had access to prior Yoo memos?]
Did any individual or entity from outside DoJ participate in the review? Were there
any individuals from the White House, the Department of Defense ("DoD"), or other
federal agency who participated in the review? If so please identify those individuals
and/or entities?
I believe Goldsmith and Philbin coordinated their effort with lawyers in the
intelligence community.
[So the review did not include help from the WHO or OVP? What else was off limits?]
Your take on the wording of Comey's response is probably correct, but I still wonder whether the program was so classified and compartmentalized that the analysis could not be performed appropriately....
Marty Lederman said...
Robert, Bart, Mark, et al.: Please, let's keep the conversation substantive, and on-topic. Thanks
To start, I apologize for confusing you with Professor Balkin in my second post. The hazard of jumping between thread by different professors.
As to topicality, my replies directly addressed the quoted contentions made in your lead post. If you have a different idea of staying "on topic" to which you would like me adhere, please clarify.
-- the letter from OVP hints at Cheney's position that FISA is unconstitutional --
I don't see a way to reach a conclusion either way, in the abstract.
If the case was a spy, e.g., Aldrich Ames, and the government had reason to suspect foreign intelligence ramifications (e.g., feeding Ames a specific fact and having it turn up at a foreign mole, etc.), then my prediction is that the court would find FISA unconstitutional to the extent it prohibited THAT surveillance without a court order.
I can imagine hypothetical fact patterns in the other direction, something tantamount to no basis whatsoever to suspect a foreign intelligence surveillance -- then the government bootstrapping evidence for a domestic criminal prosecution based on no warrant "foreign intelligence"-justified search. This wouldn't result in finding the statute unconstitutional, but would be a search without probable cause, and no warrant. Reasonable under the fourth? I suppose that depends on the court's attitude about the need for protective surveillance in this terrorist-infested country of ours.
Fraud guy: If they are this contemptuous of our Constitution, Congress, and the electorate, I would not be surprised to hear a future signing statement ignoring the 2008 presidential election because the results were found to be inconsistent with the president's constitutional duty to protect the country.
I have to agree that the underlying logic here is very troubling. If "the power to inquire extends no further than the power to legislate," then there is quite the potential for abuse.
Consider the way that the VP snubbed any attempt at oversight by the Information Security Oversight Office, claiming exemption by dint of a hybrid status. The ISOO is part of NARA, the same "independent" federal agency that administers the electoral college. The idea that the executive shouldn't be restricted by an independent agency was raised in another post about the Fed--I wonder how that changes if you plug in NARA?
Of course, we expect that the executive couldn't stay in power long even if they did assert such a thing (i.e. "we must stay for another term to win the war"), and we rely on the good faith of our politicians to move on and allow the next government to take power. Still, one has to wonder--given this administration's history of testing the limits to their actions and pushing the boundaries of permissible behavior--what procedures and traditions remain sacrosanct even for them. It's difficult to talk about lines in the sand that they won't cross, especially when they go out of their way to tell us that sand isn't binding on the movement of their feet.
I see drational's point about compartmentalization in tandem with JaO's and think it best to scotch efforts to account for all the administration's actions under a single legal theory.
We've been wrestling with conflicting indicators about how legalists within the White House, the DOJ and the Intelligence Community regard the Protect America Act. These include:
(1) the press for the new law,
(2) the refusal to drop Article II rationales in response to Bruce Fein and, now, in the Cheney letter,
(3) the possibility of using 105A without going through 105B,
(4) the odd timeline for vetting a surveillance program, and
(5) the motion before Judge Walker that treats 105B as the be-all and end-all of the Act (to stand Marty's phrase on its head).
If there's one theory behind all these elements, it's not a legal theory; it's a political view of executive power that uses legal theories opportunistically with the legal views of others variously anchored in institutional settings in mind. The less polite term for this is "power grab."
A mainstay of such attempts is the ability to go this way or that depending on how events unfold and others with political power react. Thus, one gets only so far positing a master plan. It directs us away from the power package, from a welter of tools left for another day.
One also gets only so far by looking for theoretical consistency on a legal level however abstract. Notice that Cheney's letter invokes anew the idea that he is a fourth branch. It was supposedly withdrawn when the OVP faced a funding cutoff. Yes and no.
We also kid ourselves in looking for a Rubicon whose crossing switches over into a new political reality. (The Rubicon actually meant something in Roman political culture.) If there's bad news ahead and history yet beyond it, the debates will fasten onto a variety of headwaters, mostly underground. A sewage system is a more fitting image.
If I had to put all of the connivances into a single brain, I would agree with JaO and choose Addington. Yet it's equally important to see that soldiers need different marching orders within a truer working picture.
Here compartmentalization comes into play. People need to be able to say different things at different times to further any grand strategy. And while obfuscation allows individuals not to be bound by things they've said, there are limits to what one can get away with, as Gonzales's stumblings show and as the decision not to allow White House officials so much as appear before Congress tacitly acknowledges.
I'd submit the motion before Judge Walker as a case in point. It could have been penned by persons who, if they knew at all about the 105A loophole, were convinced it would not be used. (SEC disclosure rules similarly allow companies not to divulge legal loopholes once legal is convinced they won't be used.) As supporting evidence for this we have Ashcroft's complaint to Gonzales that his people were being kept in the dark. For that matter, we know that Bush himself is kept from information he'd prefer not to see.
A public corporation will map out a business strategy in similar ways, dealing with competitors, public relations, potential lawsuits and disclosure rules, and its own legal and accounting departments. These are dealt with in different but overlapping ways in furtherance of business. In a world in which people can take the money and run, even the conventional bottom line is not always the true bottom line.
But, to keep it political, I think "radical," in Sidney Blumenthal's sense, is not a bad term for what's going on.
I have rethought my position somewhat after a discussion at digby, based in part at the usual capitulation of the Democrats to the wishes of the White House (and the uselessness of that capitulation that we are discussing here). I an drawing parallels to the fight to capture the egg of the sooty tern, and the destructive use of resources to capture the symbolic chieftanship which will just pass to another after the next contest. Bushco may acquiesce to the next Democratic occupant of the White House, because the spoils will still be divided, and the game will continue to the next round.
I think casual observer nails it in his post above, in that this is all political use and abuse of legal theory in order to obtain political ends. I serve in a compliance role in my company, and part of my job there is to review and state what is allowed by law. You get pressure to interpret the law to allow particular goals, but my idea of compliance is to find what the law/regulation requires and allows, and then work to that. It doesn't make me popular, but it does insure that we can market with a clear conscience and avoid legal issues (and I have yet to be reversed by our legal counsel on a decision).
Interesting that the OVP relies so heavily on Barenblatt, because reliance is so misplaced. The Barenblatt holding supported extremely broad Congressional investigatory authorities. Harlan's statement regarding their limitation was mere dicta.
"Key Notes" are for kids.
I think casual observer nails it in his post above
I think you meant occasional observer. It pays to keep in mind that George W. Bush is our first MBA president.
I'd be curious to know if you've ever run into an SEC disclosure issue centering on a contract term containing a loophole that an issuer secretly knows it could use and would use as a last resort if things went sour, but decides it doesn't have to disclose it in filings because it's unlikely ever to be used and because materiality is in part a function of probability.
Perhaps the government's motion before Judge Walker making light of 105A can be seen in some such way. I'm not sure, but I wonder.
occasional observer,
I apologize for the confusion; both you and casual have made excellent arguments here.
I have generally worked for non-traded, closely held corporations, and compliance issues I have been consulted on have centered on payment acceptance (Reg E, Z, TSR, and card association rules) including ID breach issues, not overarching corporate governance. That said, there are cases where judging the probability of occurrence strongly influences handling of disclosure notification procedures. I haven't read through the FISA changes to comment further.
This government of one man and not of laws became inevitable the day Andrew Jackson defied the Supreme Court and got away with it.
We need to amend the Constitution to give the Court the power to fire a president who disobeys one of its orders.
Oh, please! You think very many Democrats are willing to give the Court that ruled on Bush v. Gore the power to "fire" a President?!
BTW: every time I see Bruce Fein's name nowadays, it has to include "a Justice Department lawyer in the Reagan administration" -- how I wish the press would seek out comment from other Reagan Justice Department laywers to counter-balance -- but, does anyone think that Benedict Arnold was constantly referred to as "a decorated hero in the Capture of Fort Ticonderoga and the Battle of Saratoga" once he turned redcoat?
Professor Phillip Bobbitt provided a counterpoint argument in the NYT today which is worth reading.
From Bobbitt's letter:
The statutory change is unnecessary, I suppose, if you believe that there is in fact no real threat, that it's all hype by the White House to expand its powers — presumably to some other end — and that all we have to fear is fear itself. Doubtless, some people do believe this. If the editorialists and columnists in the news media make this assumption, they should frankly say so (and hold their breath until the next attack).
One good reason not to want popular politics to guide such decisions arises when the public is not well-informed. Partly this can be laid at the door of the incumbent president, the Great Miscommunicator. But mainly it lies with those people who don't bother giving reasons, don't explain or give arguments, who prefer to traduce the people with whom they disagree by attacks on their characters, which are presumed to be insufficiently stalwart.
Very illuminating. It seems that the poorly misguided people (including the head of the ABA) are not informed of why this is necessary. But it is not only the (minor) job of the President to explain why it should be necessary, but also the (major) job of the people who oppose it to explain why it is not. But when the whole argument is shrouded in fear ("the next attack") and secrecy ("national security interest") and the rush to pass enabling legislation (that was of no concern for months and years while what we know of the program was running) on the one side and best guess arguments based on previous behaviour by the administration on the other, of course you are going to have insufficient explanation.
Let's lay it all out, talk it out in public, and make a decision. Otherwise, to claim that we can't have legitimate and informed public opinion is specious at best. Not that it matters, especially when days after signing the legislation, the President advised that this oh so very important legislation may be ignored anyway if he sees fit. Law--outdated as soon as it is written; constitution--scrap of paper; democracy--lets spread it around.
One last thought. I have found that generally, laws are meant to be strategic, not tactical. Tactics change much more rapidly than strategies. If the President submits a law to Congress that he would like passed, and then shortly thereafter declares that it may be useless, it is because that he is trying to apply a tactical effect instead of a strategic doctrine. Which makes sense, as he is about as good at strategy as he was at running businesses.
Prof. Philip Bobbitt writes [in the N.Y. Times article]:
Once linear, analog, point-to-point communication has been replaced by the disaggregated packets of the Internet, two people talking to each other in Europe could find their conversations going through American switches....
And circuit-switched data too. SFW? That isn't the problem with the pre-amendment FISA. Interception could be done here (if convenient) for such calls and communications under the old FISA.
... It also became difficult to determine the true origin of any communication that was routed through the United States....
It's generally not as hard as one would think (and as the proponents of the new wiretap laws insist, as a reason for loosening the restrictions). And if it's a problem determining where a person is (due to anonymisers, NATing, etc., then it is just as much of a problem determining who a person is. Once you have that difficulty, is the solution to permit tapping of anyone and eveyone unless you 'know' they're a good guy (and even that doesn't solve the problems)....
... If a terrorism suspect in Pakistan is having conversations with someone on a computer with a New York Internet protocol address via a chat room run by an Internet service provider in London, where exactly is the intelligence being collected? If the answer is the United States simply because the servers are here, of what possible relevance could that be to the protection of the rights of Americans?
The real issue isn't where the tap is taking place. It's who you're allowed to tap w/o a court order. Had they fixed the (admittedly irrelevant) geographical clause concerning intercept location, but kept the rest of FISA, I would have been happier. I think the only reason for a geographical intercept location clause was that this might have been a compromise concerning the likelihood of intercepting domestic parties (and thus the amount of minimisation effort needed) when tapping here or abroad, back in 1978.
More Prof. Bobbitt:
One good reason not to want popular politics to guide such decisions arises when the public is not well-informed. Partly this can be laid at the door of the incumbent president, the Great Miscommunicator. But mainly it lies with those people who don't bother giving reasons, don't explain or give arguments, who prefer to traduce the people with whom they disagree by attacks on their characters, which are presumed to be insufficiently stalwart.
Isn't that last sentence mostly redundant of the second one?
But I'd note a bit of anti-democratic sentiment in the first sentence: "Trust us, we're from the gummint.... Now be a good sheeple and move along, move along."
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Linda C. McClain and Joanna L. Grossman, Gender Equality: Dimensions of Women's Equal Citizenship (Cambridge University Press, 2012)
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Jack M. Balkin, Living Originalism (Harvard University Press, 2011)
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Richard W. Garnett and Andrew Koppelman, First Amendment Stories, (Foundation Press 2011)
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text:
Meg emails to ask me "How much work is small-scale farming, anyway?" I want to farm and I'm planning on trying it out over the summer as an intern, but what I'm worried about is not being able to keep up with everyone else. I'm healthy and reasonably energetic, but everyone makes it sound so hard! Should I even try?"
Well first of all, I think Meg is doing exactly the right thing in trying it out. The best way to understand whether you are suited to small-scale agriculture is to get some experience, idealy on several different small farms that do the kinds of things you want to do. Interning, WWOOFing, taking hands-on classes are good ways to get a sense of the scope of things.
The reason I would advise several farms is that the workload is quite variable based on what crops you raise, and also on your personality. Different approaches have different rush periods and different quite periods, and different people do things differently. Trying several farmers and several kinds of farming will help you get a sense of what is needed.
For example, livestock raising requires more day-to-day attention – you can't go away for the weekend without finding someone to handle your chores, and realistically, it can be hard to find that someone. On the other hand, raising livestock can provide, in my experience, more remuneration with less effort than raising produce. In fact, our family does both, but it is helpful that given the right fence, livestock will harvest their own food – green beans just sit there until you pick them ;-).
Other factors matter too – do you live in or on the edge of an urban or suburban area? You may be managing a much smaller area with a greater profit margin due to the proximity of customers, but you'll also have more pressure on your fences and on issues of appearance – you'll need to keep up with things that those of us in rural areas can let go. If you live in the country, you have more freedom often to do things as you like, but it can be harder to make money.
What's your personality? Do you see a leaning post and think "I've got to get out there today and fix that", or do you think "That'll hold another week or two." Those who have to keep everything in fine repair and keep up with everything will do more work in some says, but will have the excitement of fewer sudden catastrophic systems failures, and spend less time looking for things in the general clutter, usually.
What tools do you want to use? How big or small do you want to go? What can you afford, and what scale are you imagining working on. A small urban farmer selling microgreens from a few beds and someone harvesting 12 acres of grapes will require very different tools – or, if operating with the same tools, will have very different workloads.
Also, is the workload even throughout the year? It rarely is in agriculture – if you milk cows, you'll be doing much the same work every day of the year in some measure (not all), but if you sell Christmas trees and wreaths and raise pastured poultry, you'll be operating on a very different schedule, with heavy workloads some parts of the year and comparative quiet in others. My own take on this is to aim for farm business products that spread out over the year, with a quiet period in early winter for rest.
How much labor can you count on from others? Family, friends, other interested parties? Sometimes volunteer labor can be deeply helpful, in other cases, it can be more work than not. The help of your 17 year old daughter maybe invaluable, or it might be not worth the effort if she mostly spends her time whining and eye rolling. Who will help, and how and how engaged are they?
How much energy are you willing to devote to working "smart" rather than hard? When we first started our CSA, I was in my late 20s and cheerfully willing to bust my behind all day long to get tomatoes from our rocky, cold soils – and it didn't bother me that my CSA customers had been getting them from other farms for 2 weeks, because of our cold location. Over time, however, I realized that what I wanted was not to muscle my way through, but to adapt my farming to be more natural and less demanding – and the goats and herbs and vegetable seedlings I now sell are less work and more pleasure.
From my own experience, I find that farming is a lot of work – but much of it is so enjoyable that it doesn't feel that way once you adapt to it. I look forward to large chunks of the year's labors – and that's probably the most important factor in feeling like you aren't overwhelmed. That doesn't mean a goat kid never comes on a day when I'd rather be doing something else, or I don't have to spend a hot afternoon in the garden when I'd rather sit in the shade – of course, that's part of it. But overwhelmingly, if you enjoy what you do, working hard is not onerous – it is enjoyable.
I do not wish to pretend that sometimes it is very hard, as when a physically demanding job has to be done late in the night or in terrible weather. Sometimes awful things happen – we lost a seemingly healthy kid recently for no apparent reason, and that's the sort of disheartening thing that makes you want to give up. Sometimes it is frustrating, as when a run of problems hits, or when you realize you've been doing something the dumb way. There are plenty of moments when farming is very hard – much of it, however, is the same psychological hardness that comes from a disheartening period in any project, rather than sheer physical hardness.
It can be physically demanding and exhausting – but consider the fact that the average small farmer in the US is over 60 – it cannot be something that depends solely on physical strength. In the end, yes, there is physical work, but it is often possible to grow into that work, or to adapt that work to the strength and ability of your body.
What I love about it, what makes the endless work seem so tolerable is that it is always different – today I will spend my day making sure the does in heat get bred, a humorous and enjoyable project I always look forward to. A friend of mine visiting a few weeks ago commented "It looks like a frat-house here" – and frankly, breeding season provides a lot of amusement. We joke that we are spending our days watching "CNN" or "The Caprine Nookie Network." Besides routine chores and the spreading of manure on some of the last garden beds, there's not too much to do. This is the quiet season – we turn to domestic maintenence, to the spring cleaning that I never really do because by spring I'm busy starting seeds and taking cuttings. I'm enjoying seeing what is buried in the back closets (mostly, a few horrors have been found), and when I get tired, there's wood to carry, trees to prune and goats to rotate around.
By January I'll be sick of the quiet and longing to get my hands into some soil – I love to start seeds and nurture them along. in February the trays will be full and the plants will be poking up, the winter-stratified nursery beds covered with snow but gestating. We'll breed our second group of goats then for year round milk, and dream of the summer's kids. January and February will involve some cold days in the woods as well, cutting firewood from the downed trees of last year's hurricane – work I truly enjoy.
In March we'll tap our few maple trees and make syrup, and every windowsill and corner will be filled with plants. The delight of getting my fingers into the potting soil will have faded a bit, but still, every seedling is a hope of spring. We'll have chicks in the brooder and the hens will be laying like mad, and hopefully, we'll have cleaned out the winter barn, a project that takes several concerted days. We'll be managing the last of the stored winter produce as well, preserving what goes mealy or soft, cleaning out and getting ready for the new to come.
By April we'll be in the garden – we hope. Some years things start early, other years they run late. I'll be selling seedlings and spring plants and forcing bulbs. The first herbs will be up and ready for tending, and the fruiting bushes will need attention. The kids will begin coming in April, and our nights will be interrupted for a bit, but the joy of new babies compensates. April can be a mad rush with kidding and planting – but some years it is so cold and wet that we mostly chafe and whine and rotate too many seedlings around one more time, waiting for spring.
In May it all rushes upon us and for eight to ten weeks, we push from dawn to dusk, racing outside at first light and working our bodies as long as we can. We fall into bed exhausted from planting and tending, the first early harvests, and all the rest. The first crop of hay comes in, fences must be moved regularly, everything is busting out all over, including us. It is tiring but glorious, and every day the world is more beautiful and we feel luckier to be part of it.
June too is part of the rush and race, some years more, some years less, depending on when spring decided to come to the northeast. Add to all the sowing and planting and transplanting and sales the fact that in June comes the first harvest and first preservation of herbs and berries (we have harvested morels, rhubarb and raspberry leaves already, but these hardly count).
In July things slow a little, except for the endless weeding and mowing, and the thrust of preservation. We do not put up our own hay (most of my neighbors sell hay), so July is a quieter month for us than for many here. There's enough of a lull to even go away for a couple of days at the beginning of the month. Then comes the second round of babies and the fall garden rush which is always chancy – will hot dry days wither seedlings meant to feed us in winter? Still, there's plenty of preserving to do – cucumbers, blueberries, peaches, etc…
August is the peak preserving month for us most years, and the rush to get everything done that should have been in past months before our fall responsibilities start, since farming is not our only work. By August we are done with summer, sick of planting, tired of the green beans that keep producing, and the challenge is not to give up to th weeds or to be sick of the corn on the third go-round. Summer has lost a little of its luster now, and fall is eagerly anticipated. By August much of the herb harvest is done except for the root crops, and must be preserved and put away. The goat babies are headed to new homes, and it is never wise to underestimate how much time customers will take up.
September is a new day – the planting is over, the harvesting goes on with new intensity. It is time to get ready for winter and it is hard not to think about how much hay and firewood and squash you will need. September is a time for lists of things to do – and for us, for celebrations as the Jewish holidays come in autumn.
By October most years it is cool enough to fill the root cellar and we are rushing to get everything preserved and under cover before winter comes (not this year, with the weird warm temps). It is time to do the last butchering cycle for the poultry and sell the last goats and cull rabbits so that the barns aren't too crowded. Stacking firewood and loading in hay are big projects as well.
November is when we catch up, make gifts, begin breeding goats and managing stud service for others, moving fences for the last time and winterizing the barn. We always hope to get one more barn cleaning done in December before everything freezes and too much snow hits to allow us to get the wheelbarrows in and out. Everything must be winterized and the garden clean up, garlic planting and bulb planting drag us out on the last nice days.
December is time to face the house and ask "ok, what didn't I do all last year." In December and January we reorganize, paint and clean out, give away and get ready for the quiet.
There is of course, a permanent cycle – the daily chores, the daily maintenence of a home, the daily care of children, and this is something you can in some measure choose. A few chickens won't much inconvenience anyone, and only houseplants is easier still. In our case we have chosen a life that requires much daily attention – many children, many animals, and we find it delightful for the most part.
In the end, the workload depends in large measure on how you see it – I can understand how someone might view a day in the woods in winter with a crosscut saw, or a night in the barn in summer covered with goat placenta as a day of hard labor. To me, the saw and the birds and the sounds and the sights of the bony bare trees are pleasures. It feels good to move after a December of too many latkes and too much sitting before a fire. Is it work? I can't say when I'm having so much fun.
I can see how someone might find the mess and fuss of a night time kidding to be a disruption. To me, watching and waiting and seeing what will be born, tending my does in this time of birth, being ready to help if needed, even though I rarely am is a gift. When twins slip into the world, silvery, new and struggle up to nurse against a mother who washes them clean, I don't mind the state of my sweatshirt or the loss of sleep – instead, I feel fortunate that I've chosen this life and these joys. It is not work I think of in those nights, but pleasure.
The gift of it – the day to day things to do, the cyclical ones is that they come around again and i have a chance to stick my fingers in the ground and feel the cool earth warming, or that I stand on my porch with a load of laundry watching the pheobes build their nest on my porch and smelling springtime in the air, watching a small child carry a newborn chick, the swing of the scythe through grass, that I take eggs and milk, chard and homemade goat cheese and bring forth quiche, that my morning begins with a warm goat and a stream of milk hitting a metal bucket, the cutting of basil, the harvesting of tomatoes, even the sometimes endless pureeing and canning…. Most of the time the work and the joy are indistinguishable and it is hard and good – and the good is what matters.

subset: commoncrawl


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One EOPC-funded project was distributed across the University and focused on the role of faculty in promoting the retention and graduation of African American students.
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"Recognizing our Progress Along the Path": The 20th Anniversary of the Formation of The Equal Opportunity Planning Committee
Prior to the formal announcement of the formation of EOPC, the University administration had to decide on the best structure for implementing Penn State's Equal Opportunity Plan.
Seen here with civil rights activist Desmond Tutu, Penn State President Bryce Jordan formally announced the inauguration of EOPC on August 17, 1983.
Press release that announced the formation of EOPC.
Only a long-term commitment to the principles of affirmative action and equal opportunity will ensure a secure and just future for the citizens of the state and nation.
EOPC's orginal focus was on recruiting and graduating African American students, especially those who were Pennsylvania residents.
The Equal Opportunity Plan called for concrete actions at the highest levels of the University administration.
From its inception, one of EOPC's main strategies was to fund proposals from members of the University community that would contribute to Penn State's equal opportunity goals.
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Approximate Measurements
Artwork Panel: 52.4cm x 99cm ≈ 20½" x 39"
Silk/Brocade: 61.5cm x 155cm ≈ 24¼" x 61"
Width at Wooden Knobs: 70.5cm ≈ 27¾"Information about caring for your wall scroll
Close up view of the artwork mounted to this silk brocade wall scroll
This warrior's name is or Guan Gong (at least that is what his friends call him). He was born with the name Guan Yu, but he earned the name "Gong" which is used to refer to a most respected person (You could also translate "Gong" as "Duke" in old English).
Much as Confucius is seen in China as the Saint of Philosophy, Guan Gong is known as the Saint of War.
He is known for not only for his status as a great warrior, but also being full of wisdom and knowledge.
He is the essence of what Chinese people call or "yong" which means brave, courageous, and not afraid of difficulty.
Note: Along with the title, date, and artist's signature, this artwork contains a Chinese poem of sorts about Guan Gong's high esteem and abilities in both civil and military matters.
Please note that the xuan paper used for the painting on this wall scroll may have some embedded fibers, husks, or specks. This is not a defect, but a natural part of this handmade paper.
Here is Sandy holding a different wall scroll by Jin Bin. This one is actually about 122cm or 48" long (smaller than most of the Jin Bin wall scrolls we sell). Even in this smaller size, it shows you how big these handmade wall scrolls are.
This is a very detailed painting that is mounted to a silk wall scroll. A lot of work went into this. It actually takes the artist about a half day to complete.
You won't be disappointed if you become the owner of this work of art. I guarantee it personally or your money back.
The artist's name is (Qing Jing-Bin). He was born in Guanxi Province (southern China). His specialty is paintings of mythological and historical figures of ancient China.
This item was listed or modified
Mar 11th, 2014
Gary's random little things about China:
When crossing a street, or merely making your way down the road, there is a certain law of physics that comes into play: When two forces meet, one must yield.
Here is the general yielding scheme in China:
Cars yield to big buses and trucks.
Bicycles and cars mingle and narrowly avoid each other. When push comes to shove, the bicyclist knows he will lose the fight. But the car driver knows that the bicycle will scratch his car when he runs it over, and will only yield on that premise.
Cars will not yield to, but are required to avoid pedestrians. When you hit a pedestrian at low speed, it does very little damage, and unlike a bicycle, will almost never scratch your car. Therefore pedestrians are given a smaller margin.
Note: Regardless of green or red stop lights, it is against the law to come to a complete stop when making a right hand turn in China (no matter how many pedestrians are in the way). The rule is "honk and avoid, then continue on your way".
Motor scooters yield to no one, not even when they are being driven on a pedestrian-filled sidewalk. Motor scooters zip around like they have nothing to lose - this may be true, as smaller motor scooters require no license of any kind and are very cheap.
If you are driving on the wrong side of the road, or going the wrong way on a one-way street, you do not have to yield to anyone, no matter what kind of vehicle you are operating.
Cars will yield (not by choice) to pedestrians crossing the street in numbers greater than 10 (it is best in China to invite 9 of your friends for an outing if you plan to cross a lot of streets).
In lieu of yielding, drivers are required to honk at pedestrians. I swear to God, this is the law! It's a safety issue: If you are passing a pedestrian that is walking on the side of the road, you are required by law to honk at them to let them know you are there.
Note: All streets in Chinese cities, sound like a New York traffic jam 24 hours per day with all this "safety honking".
I have not been able to find a traffic law that states you must yield to ambulances. And in practice, very few drivers do.
When two large vehicles come face to face on a narrow roadway, and neither can pass, neither will yield. They will sit there, honking at each other for a while. After several cars are lined up behind them, they will decide that they should have yielded earlier, and start to back up. This is to the great dismay of all the cars behind them who will honk in unison. This could go on for an hour or more. It ends when a police officer arrives, tells both drivers what idiots they are, issues tickets to both of them, and then systematically makes the situation worse by insisting that all the smaller cars turn around (rather than back up) by making 162-point turns in the small roadway. Eventually, two of the cars will hit each other, for which both drivers will be cited and fined on the spot.
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It's a fact -- people are absolutely enamored with the mob. This fascination goes way back to the earliest parts of the 20th century, but came to the fore in 1969, when Mario Puzo released his quintessential mafia book The Godfather. By the time the book was made into a movie in the early 1970s, America's (and the world's) love with the Italian-American underground was fully cemented, and we've never looked back. Especially in the realm of cinema, we are inundated with mafia and mobster movies. We just can't get enough.
Gaming is a different beast than cinema, of course, but with games like The Godfather, the mobster gaming sub-genre seems to be coming into its own. Mafia II itself is the long-awaited sequel to the game Mafia, released way back in 2002. The game focuses on a character named Vito, who rises from rags to riches through the illicit underworld of the fictional city, Empire Bay. The game has fifteen chapters to complete, and plenty of unlockables and collectibles to find, including elusive Playboy Magazines and Wanted Posters. And naturally, our guide's got you fully covered.
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HIV Frontlines: An Interview With Ben Young, M.D., Ph.D.
July 12, 2007
Welcome to HIV Frontlines, a new series from TheBodyPRO.com. In this series, we'll talk to a range of health care professionals who have both provided HIV care and trained health care workers in resource-poor areas throughout the world. From China to Ukraine to Rwanda, these inspiring clinicians are doing their part to make a difference in regions of the world where access to HIV treatment and care is only a shadow of what is generally available in the United States. Through these interviews, we'll get a glimpse of the realities of practicing HIV care in some of the world's poorest areas.
Today we're talking to Dr. Benjamin Young, who is actually one of The Body PRO's faculty. He participates in conference coverage and answers questions in our Ask Your Colleague forum. Dr. Young is an assistant clinical professor of medicine at the University of Colorado and a consultant physician for Denver ID Consultants at Rose Medical Center in Denver, Colorado. He has recently returned from St. Petersburg, Russia, where he has been helping train health care providers. Welcome Dr. Young. I guess my first question is: How did you end up working in St. Petersburg?
Do you know if they are still looking for health care professionals?
I guess the general answer is, from time to time, they look for additional health care providers.
Do you know where they get their funding?
Funding for AIHA comes from various organizations, and is really dependent on the country that we're working in. So, for example, in Ukraine, the funding comes from places like the Global Fund [to Fight Against AIDS, Tuberculosis and Malaria] and the [William J.] Clinton Foundation. By contrast, in the Russian Federation, the primary funding source is USAID ... and surprisingly, in a sense, from the Bush administration.
When did you first go to St. Petersburg?
I went to St. Petersburg first at the end of last summer [2006]. Again, as part of what was the first program to try to help train Russian HIV doctors about tuberculosis medicine, and simultaneously train tuberculosis doctors about HIV medicine.
St. Petersburg is a really interesting city. It's a city of incredible history and culture. It is, in my view, the birthplace of the Bolshevik Revolution. It's the home of the czars, and has many of the icons of Russian history and Russian wealth. Superimposed on that, of course, is this incredibly growing HIV epidemic, with unexpectedly large numbers of patients with incredible difficulty accessing the care infrastructure.
How do you characterize these patients? What's the source of infection?
Traditionally, the Western view of the Eastern European epidemic is that of injection drug use. That's a fair characterization of the earlier epidemic in the Russian Federation, where the majority of cases were among injection drug users, and the minority among patients who acquired HIV sexually.
Interestingly, most recently, the majority of new cases in the Russian Federation are heterosexually acquired. For the last two years, for example, in excess of 60 percent of new cases are among heterosexuals, and a smaller number of cases among injection drug users.
Are these heterosexual women or men?
The heterosexual transmission appears to be roughly 50-50. So it's an epidemic that, in many ways, demographically looks a lot like the epidemic in Southern Africa, where the majority of cases are among heterosexual men.
I'm curious about the male heterosexual numbers. Is it because there are other sexually transmitted diseases, or other cofactors that make them more vulnerable? Why would these numbers differ so much from the United States?
I look at this as the United States being the exception rather than the rule. The rule being that for the majority of countries and the majority of cases around the world, HIV is transmitted heterosexually. What we see in the Russian Federation, for example, is this very interesting crossover of the -- or the emergence of the -- heterosexual epidemic and, proportionately speaking, the decrease in the impact of injection drug use on the epidemic.
So if we go back and look at statistics from the period prior to 2000, between 80 and 90 percent of new cases in Moscow, for example, were as a result of injection drug use, and only 5 or 10 percent as a result of heterosexual sex.
In the last two years, over 60 percent of new cases were among heterosexuals, and only 25 percent of cases among injection drug users. We have just seen two different epidemics, in a way, and the emergence of an, unfortunately, self-sustaining epidemic among people who identify themselves as heterosexuals.
Submersed in all of this is a rapidly growing epidemic, numerically smaller but a growing epidemic, nonetheless, among men who have sex with men.
What's the average age of this population?
Most of them are young adults, like that in the United States, in many ways. There are a lot of cases among people who are certainly less than 35. I think the largest proportion of patients newly diagnosed in Russia were among men between the ages of 25 and 30, followed closely by women of the same age group. So the majority of cases are among young adults between, let's say, 20 and 30 years old.
What's your typical day like when you're in St. Petersburg?
What we are involved with are multi-city training programs, in the sense that what we do, or what our Russian colleagues do, is they bring together physicians, nurses and social workers from various cities into one particular city or one training center.
There's an AIDS education training center in St. Petersburg, and a parallel center in Moscow. In these centers, physicians and health care providers, roughly between 30 and 40, come together for a weeklong training program.
The day typically starts very early, and in the Russian winter, it's very dark then. We get, as a group, usually transported to the AIDS center. These AIDS centers are, of course, on the campuses of the AIDS clinics or AIDS hospitals in the city, as well.
Then we do a variety of training and learning exercises that range from didactic lectures to role plays to case reviews to patient interviews. It's really a multidisciplinary program, often in partnership with Russian experts who are also serving to train the Russian colleagues.
Mixed in with this, depending on time and so on, are ad hoc complication and second opinions for difficult cases within the centers themselves. So it's an opportunity both to interact with health care providers from across the very large country of Russia, as well as to hear about and meet some of the more challenging cases within city centers.
This continues all day?
Yes. These are all-day programs, with a short break for lunch and generally horrible coffee, instant coffee -- which is mandatory, given the 10-hour time change from Denver to Russia.
How many people attend the training?
Somewhere between 25 and 40 individuals attend. Often the physicians at the local centers -- from the St. Petersburg Botkin Hospital, or the Moscow City AIDS Center, for example -- will be drop-in attendees at these meetings, as well. So the census will vary from day to day. What I think is really quite interesting, again, is the participation of people at multiple levels of training, and multiple disciplines, all in the same place.
How would you characterize their knowledge base, compared to American physicians?
The Russian physicians are amazing bookworms. They know data like no others. That stands in contrast, however, to their practical knowledge base, particularly when it comes to antiretroviral therapy.
That situation isn't really surprising, in a way. The Russian education system is very data rich, and my impression is that Russian physicians are able to memorize algorithms and tables and protocols in ways that I can only envy. But because antiretroviral therapy has only recently become available, and because programs for HIV, systematic HIV care, are relatively new in the country, practical, hands-on knowledge, especially in the smaller cities, is lacking, particularly when it comes to the management of antiretroviral therapies.
You have your training, and there are also Russian trainers.
And the Russian trainers have been trained by physicians out of the country?
Sometimes they have trained out of country. More often they are the first physicians in the country to have people on therapy.
At some point during the day do you actually see patients?
Yes, absolutely.
The patient is actually brought to the teaching center. The teaching center is really just a room separated from the actual clinic space, sometimes upstairs or down the hall.
The patients provide an incredible learning resource, on one hand. Conversely, I think, for the patients, this really provides an opportunity for them to interact with other global health care providers, in a sense, to get a second, third and fifteenth opinion on their care.
What sort of cases are they seeing that are challenging?
The single largest problem area that I see, and certainly something that differs tremendously from that in the United States, is that a very large proportion of patients in Eastern Europe, in both Ukraine and Russia, are TB [tuberculosis] co-infected patients.
The official statistics say something in the neighborhood of 50 percent of HIV-infected patients have active tuberculosis. These are the patients who frequently wind up in hospital and provide the most challenging management issues, because one has to treat tuberculosis aggressively, and before the initiation of antiretroviral therapy. A significant proportion of the HIV-related deaths that occur in the Russian Federation are due to tuberculosis complications. So this is really the number one priority in terms of the medical management of patients.
In terms of disease status, at what point in their HIV infection are these coinfected patients?
They have very advanced HIV. There's a bit of a debate among patients who might present with, let's say, more conventional tuberculosis, and the debate as to whether someone who has what we call cavitary tuberculosis is an AIDS-defining illness. In Russia, following the fall of the Soviet Union, there was a concomitant collapse of the public health system and a simultaneous rise of epidemic tuberculosis exposure. This has led, of course, to a population of people, many of whom have been exposed to TB.
The translation of this is that there is a silent tuberculosis epidemic in the general population. It becomes manifest in HIV patients much later in the natural history of the disease. The reality is that the majority of patients that I interact with are patients who are presenting with tuberculosis as their first symptom of HIV disease, and often with CD4 counts that are below 100.
If you ever wanted to know what it's like to be an illiterate, or a toddler, all an American has to do is to go to Russia, because the alphabet is entirely different. When I first arrived there, I was functionally illiterate, and really couldn't do anything without the assistance of translators. From a medical perspective, everything was translated. Both the printed or computer-based materials are all translated into Russian. All the lectures are translated from Russian to English and vice versa. So it's an existence where you hear yourself speak in English and then a half second later, hear the same words in Russian. Everything that is spoken back to you, of course, is spoken in Russian and then translated into English. So it's like spending a week listening in echoes.
That's an interesting way of putting it! What HIV monitoring tests are available in St. Petersburg?
Well, again, the answer to this varies from city to city. The best centers for HIV care in Russia are in St. Petersburg and in Moscow, and a few other cities, including Orenburg and Irkutsk, for example. The availability of diagnostic testing for HIV, again, is very city dependent. For example, in St. Petersburg and Moscow, the two best centers, viral load testing and CD4 counts are widely available. But because of financial constraints, viral load testing is not done with the same frequency as it is in the United States.
Just to put it into context, a CD4 count in Russia costs roughly $20 U.S. By contrast, a viral load test costs about $125. In an environment of limited resources, viral load testings are really thought of as a luxury for many patient settings.
I take it there are no resistance tests?
Again, it varies from center to center. The Moscow City center and the St. Petersburg centers actually have resistance tests coming online, and so a few patients are able to avail themselves of these tests.
And what medications are available in Russia?
Russia is an interesting story. Russia is a country that is a signatory, as I understand it, to the World Trade Organization. Within the context of the United Nations, the Global Fund, and so on, it's a middle class country. What this means is that Russia doesn't buy generic HIV medications from India or Brazil or South Africa. It rather buys the same branded products that are available in the United States in Western Europe. So what this means is that the same brands, largely, that we see in the United States are available in Russia. There are very considerable difficulties, in terms of the continuity of that access, because of the importation stream.
One of the biggest concerns of Russian physicians is the long-term availability of therapies, and their concern that if they start a patient on therapy today, in a month or two, those same medications might not be available.
How do you address your approach to HIV care when you deal with patients in Russia, and when you train people? Do you have to adjust a lot?
I think the first overriding principle for American physicians, working abroad, is the need to be very sensitive to both the, let's say, the professional culture, and the practice habits of the local doctors. In other words, it's a collaborative learning and training process, a collaborative care process. I think too often there's a tendency to invoke medical imperialism and a scenario that is not often welcomed by either local physicians or local government.
That said, it's heartening to know that the Russian Ministry of Health treatment guidelines are becoming more or less in sync with international treatment guidelines. So, at least in principle, Russian physicians practice a standard of care which resembles that of our country.
It's important, however, to understand that there are significant difficulties in terms of specific patient populations and those specific patient populations in Russia really represent the majority of patients. So these include issues related to, as we mentioned, tuberculosis. Other very significant issues are related to care for injection drug users. There is, for example, no substitution therapy, or methadone therapy, available in Russia. So the entire issue of how we take care of our narcotic dependency in Russia is very much more challenged than that in the United States. There are really significant issues with stigma and the virtual criminalization of an HIV diagnosis in Russia, so that patients are reluctant to get tested and reluctant to access care.
Remember that this is a system where the hospitals are run by the state. There are often uniformed policemen in the lobbies of the hospitals. In a country where the perception, the stigma, is that HIV means that you are an injection drug user, if you're an injection drug user you're a criminal. So the notion of HIV means, or at least is perceived, as one where you might be a criminal. The act of walking into the clinic means you have to walk past the state level police.
I have seen some of your photographs. The hospitals are difficult to find, I would think, if you don't know they exist. They don't have signs.
Absolutely. It's really quite interesting. In cities that have literally tens of thousands of HIV patients, all of the HIV hospitals and HIV clinics are unmarked. They do this on purpose, in large part because of the degree of stigma. So often the entrances to these clinics and facilities exist what seemingly looks like down a back alley, and certainly without significant signage. It speaks to the level of stigma and challenges that patients face, in terms of access and care.
It's largely an unacknowledged issue. But in terms of, let's say, cultural stigma, homosexuality is really not accepted in Russia. There are the very nascent beginnings of gay rights political movement, as well as rights for HIV-infected individuals. But these are not widely accepted. The educated person on the street in Russia will utter things about injection drug users, or gays, or HIV-infected patients that I think we have largely abandoned in the United States 20 years ago. The level of stigma in the general population is quite profound, even among the educated intelligentsia.
In terms of mother-to-child transmission, what's the standard prevention used in Russia?
Prevention of mother-to-child transmission, or PMTCT, I think, is actually one of the bright points in the Russian HIV health care system. I have worked very closely with Vladimir Musatov, who is the director of the AIDS program in a placed called Botkin Hospital. Botkin is the world's largest infectious disease hospital, and has its own separate obstetrics hospital for infectious disease patients.
As I understand the statistics, something in the neighborhood of 400 or 500 HIV-positive pregnancies were cared for in that hospital last year and the year before. Prior to the arrival of antiretroviral therapies, roughly 25 to 30 percent of these women would deliver HIV-positive babies. In the last couple of years, that rate has gone from 30 percent down to 2 percent. I think it really shows what one can do with investment and access to care, and universal testing. Musatov has been able to save literally hundreds of children from what is undoubtedly a death sentence.
What medications are being used? The Russian Federation doctors largely adhere to a hybrid of international treatment guidelines. So the typical treatment would involve the use of AZT [zidovudine] and 3TC [lamivudine], branded Combivir, and typically with a boosted protease inhibitor, ritonavir [Norvir] plus saquinavir [Invirase], and alternatively, with nevirapine [Viramune].
Can the women continue on treatment? Is it available to them?
This is an interesting topic. In general terms, no. The women generally don't stay on therapy, with the exception of those who have more advanced disease and meet criteria for continuous therapy. So there's a bit of a split, or two different groups, of patients presenting with HIV: those patients with very advanced disease, and then there are the pregnant women who present with earlier stage infection. The women with higher CD4 counts generally don't stay on continuous therapy, despite the fact that they now have newborn children.
I guess one thing we didn't mention is the treatment of opportunistic infections. Are there medications for that? And are there knowledgeable people?
I think, in general terms, the answer is yes. Russia has fairly good access to the medicines that we use for most opportunistic infections. Certainly, the medications for treatment of pneumocystis and cytomegalovirus are available in the major centers.
I think, again, the interesting thing is that the major opportunistic infection in Russia is tuberculosis, followed by hepatitis C. The issues with the latter, hepatitis C, is it's viewed as a marker of injection drug use. Active injection drug users are largely thought of as people who are simply not capable of being adherent, and therefore therapy is often not even offered to these patients.
But to your question: Again, opportunistic infections are seen, primarily tuberculosis, and with a lesser number of pneumocystis and cytomegalovirus cases.
Has doing this work changed the way you practice medicine in the United States?
Yes, absolutely, in many and often unexpected ways. I think for those of us who were doing HIV care before the advent of successful therapy, we were exposed to an awful lot of disease and suffering. In the last 10 years we have really, in many ways, from a day-to-day perspective, forgotten about that. Working in Russia, working in Eastern Europe provides a constant reminder that HIV, even in middle class countries, is causing disease and morbidity to literally tens of thousands, if not hundreds of thousands, of individuals, all of whose lives could be improved by the simple access to antiretroviral therapies.
So it's a way to reignite and catalyze this notion of advocacy and bring to it, to everyday reality, a sense of urgency, of making sure that people have access to care, both here in the United States and abroad.
More importantly, it's certainly provided a learning vehicle, a teaching vehicle, not just for my Russian colleagues, but really, bidirectionally, in that I have learned a lot about tuberculosis that I'd never had exposure to in over a decade of work here in the United States.
Probably the most important is the reverse lesson, in a sense, to my patients. They are always very interested in hearing about what's going on from my travels. The very simple statement that there are people out there dying because they don't have access to any medicine provides a motivating, if not inspiring, reason for my patients to continue to be as adherent as possible to their medications.
In the end, I think, all of us feel that all of us here in the United States, on this side of the Atlantic, feel very fortunate for the access to the resources that we have. I think that fundamentally changed the way that I approach my patients, and the way that my patients think about their access to health care.
What percentage of people with HIV has access to meds in Russia?
Well, again, the statistics are often a bit fuzzy in terms of their accuracy. In St. Petersburg there are roughly 30,000 individuals known to have HIV, that is to say, registered with the federal government. Of those, fewer than 2,000 have access to continuous care. I think that that's the situation that my St. Petersburg colleagues will say needs to change.
Part of the difficulty is because of stigma. Part of the difficulty is because of the numbers of antiretroviral medications that are currently available. Part of the issue is the notion that injection drug users can't adhere and therefore are not really included in the nominator of the population that is theoretically eligible for antiretroviral therapy. So it's a situation that is in flux. There are ongoing and significant difficulties that are faced by the large majority of patients in the Russian Federation, in terms of access to care.
How many times have you been to Russia now?
I've been to Russia three times in the last six or seven months. I think I'm going on my now fifth trip to Ukraine. So I've taken quite a few trips over the last two and a half years.
How has it changed the way you see your job? It seems like you're doing this more and more often.
I think this is one of these things where I'm both a glutton for jet lag, I suppose; but really, I'm addicted to travel at the personal level. The ability to fuse that wanderlust with this incredible sense of being able to help not just one patient, but whole communities of patients is incredibly fulfilling, and something that I hope to be able to continue doing for a long time. I live in a very fortunate business environment, and am very proud of the people I work with here in Denver. We have decided that these kinds of programs and trips -- where we leave the office to help others -- at frankly, considerable cost and workload to my partners, who stay behind, is an important mission for us, both professionally and personally.
Well, thank you, Ben. It's really inspiring to hear from you. And we look forward to hearing from you again, when you come back from Ukraine.
Thanks, Bonnie. I'd love to tell you about the next trip to Ukraine.
Editor's Note: All photographs were taken by Dr. Young and have been reprinted with his permission.
This article was provided by TheBodyPRO.


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tokle wrote:cairnswk wrote:tokle wrote:cairnswk wrote:tokle wrote:Looks interesting, but I have a request;
The title; could you write it out properly, in Cyrillic?
Since it's already in Russian, and sort of semi-cyrillic letters, it wouldn't take much to it properly.
To those of us who understand it, it just looks horrible like that.
And to those of us who don't understand it, it wouldn't make much of a difference anyway, would it?
I understand the faux-cyrillic you are doing at the bottom, though, but not in the title line.
You want this...tokle?
thanks for taking me seriously.
Sorry, but your answer tells me nothing...i cannot read yes or no from that.
If no, please put up what you want.
How about just Mосква?
Deal !


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Vt Senate committee passes immigrant license bill
Full senate vote expected next week
Vt Senate committee passes immigrant license bill
Full senate vote expected next week
MONTPELIER, Vt. —
A Vermont Senate committee has passed a bill that would allow immigrant farmworkers to get state driver's licenses.
The Senate Transportation Committee moved the bill out by a vote of 4-1 on Friday.
Vermont dairy farms employ an estimated 1,500 Mexican farmworkers, many of whom are in this country illegally. They say they are isolated in rural areas and have to get rides from their employer or volunteers or sometimes pay for transportation to the grocery store or doctor.
The bill would allow them to get driver's licenses provided that they have the proper documentation and then take the tests to get a permit, and then a license.
The full Senate is expected to consider the bill next week.


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Metallic Colours
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Wagons don't often catch my eye but this one did. I think Renault has nailed the look. It's beautifully designed. The glossy black front grille, 18-inch alloy wheels, GT badges and well-rounded rear look athletic and stylish.Read more
An athletic point-to-point tourer with resolved ride and handling balance, a comfortable and spacious interior and a decent amount of safety and convenience features for the money.Read more
Before you buy a compact SUV, think about a conventional wagon like the Renault Megane GT. It looks great, is well equipped, and nicely screwed together. It's also keenly priced, boasts a solid suite of safety tech and, most of all, is heaps of fun to drive.Read more
*Recommended drive away price shown is from the 2017 MEGANE Wagon Zen with non-metallic paint to the 2017 MEGANE Wagon GT with metallic paint and is valid for vehicles ordered between 02/10/2017 and 03/01/2018 and delivered by 31/01/2018 or while stocks last. Offer excludes fleet and government buyers. Renault reserves the right to vary, extend or withdraw this offer.
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The last time that Velvet jackets seriously disturbed the High Street was in the 90s, when inspired by movies like Swingers and clubs like Smashing, dressing up like Noel Coward (and don't forget that neck scarf) became a must for both gay and straight men.
It seems now that velvet jackets are making a return to the High Street now. They have apparently been doing the round on the catwalk for a while and now everyone from Mango through to M&S are offering rather striking Velvet jackets.
The big question is, to borrow from Trent from Swingers, are you money enough to wear one? In the past velvet seems to have been kept for special occasions, parties, big nights out.
It now seems that the new jackets, which mix different fabrics and effects with velvet and also available in a variety of colours, are designed to be worn a lot more often.
If you want to read more Fashionising has a great article here with loads of catwalk pics
Anyhow, if you are attempted here are a few to consider.


text:
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We would also like the site to become an information portal for those outside the area. The site contains useful information for visitors to the area or those relocating to Joplin.
Joplin.com is meant to be useful and informative for you. We welcome any suggestions on how to improve this site. Please email those to email@example.com.


text:
By Romeo Agresti
Juventus have contacted Borussia Dortmund to enquire about the availability of prolific striker Robert Lewandowski, Goal.com can reveal.
The Serie A champions have made the Poland international their primary target on the transfer market and are looking to orchestrate a deal as soon as possible in order to beat any potential rivals to the 24-year-old's signature.
Juve have sent BVB a fax in order to find out their asking price and now await the Bundesliga titleholders' response.
Dortmund are keen to hold on to Lewandowski but the striker's refusal to extend his current deal, which is set to expire in 2014, could prompt them to cash in on the attacker at the end of the 2012-13 campaign.
The Bianconeri are willing to spent €25 million [£20.3m] on Lewandowski but face stiff competition from Manchester United and Manchester City in the race for the prolific hitman's services.


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Re: Obama doubles down on ethanol
What do you wanna bet somewhere in Iowa is a corn farmer that's all pissed off about the "takers"?
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The Obama administration proposed a 9 percent increase in the so-called renewable fuels standard from 2012, in line with a 2007 law. Half of the 1.35 billion-gallon increase would go to corn ethanol and half to "advanced" biofuels that produce half the greenhouse gases of first-generation ethanol. ...
Last fall, the administration denied a request from several governors from livestock and oil-producing states for a partial or total waiver of the requirement to use ethanol. Corn prices soared during the drought as ethanol makers, livestock producers, and grain exporters competed for a smaller supply.
So stupid and/or evil, by which I mean so Fucking stupid and/or evil.
To begin with, "modern" agriculture is petroleum-based. So we're essentially processing oil through corn fields to create gasoline. How much sense does that make?
And then there's coupling food supplies (and prices) to our insane automobile economy. What could go wrong?
[bangs head on desk]
What do you wanna bet somewhere in Iowa is a corn farmer that's all pissed off about the "takers"?
Ethanol is welfare for Big Agribusiness. So of course, it is a boondoggle, increases food prices, and will be expanded.
Of course the political problem with all subsidies is that once established they are very difficult to end. Corn ethanol was a boondoggle from the beginning, which means it must be a beloved program in DC.
The funny thing is that if there was enough ethanol production, which is just alcohol and so doesn't need to be distilled from corn, there might be something to it. In its current mixture, it reduces the combustion and adds water. That means more pollutants from incomplete burn and less power. In pure form, it burns cleaner and has more power. That's why it's used heavily in auto racing. Theoretically, smaller engines could produce equal power, leading to less consumption. (Neglecting that Americans need ever more power. A new Camry can be had with 286 hp. 20 years ago those were high-end sports car numbers, and far more than anyone owning a Camry will ever need or probably be able to safely use.)
Note that we don't see ethanol cars on the road, just cars burning a blend containing up to 15% ethanol. In the BMW, i jump all the way to 91 octane because that's the only blend that doesn't contain ethanol, and for older cars ethanol is very hard on the engine and fuel system.
There is a fundamental disconnect in America on the issue of cars. We want better economy, but also incredibly safe cars - especially from large SUVs. This has led to large vehicles being mandated by safety laws, as well as every more electronic doo-dads in cars, and a quiet horsepower war that puts the 60's to shame. All that's wrapped up in CAFE, which might be the most convoluted and self-defeating piece of environmental legislation ever created.
The answer is simple and it's the same as the Chapman motto on building a race care. "Simplify and add lightness." Current gas engine technology (and certainly diesel) paired with smaller, simpler, lighter cars would easily exceed the mpg of current hybrids. But Americans (who actually hate driving, and prove it by their choice of cars) would not stand for that, and neither would government regulations.
President Obama has his head in a dark place on this matter. Given his lack of a technical education, he should consult wiser heads. Few, if any, can be found in Congress. Could the national laboratory system (not the DOE) be consulted for an intelligent appraisal?
to be getting the hell outta that administration.
What a reputation breaker it can be, being in any administration.
I wonder if the comments that he had minimal impact on curbing carbon emissions, but is getting praise for presiding over making the US more energy independent, all with methods which damage the environment or cost highly in carbon emissions. Wonder if this bothers Chu....


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- 6365
Bua with guests North Atlantic Drift
Chicago's bua, winner of Irish Music Awards' 2009 "Top Traditional Group" recently made a Toronto stop on their current tour of North America to play a double bill with Toronto's Irish/Scottish trio, North Atlantic Drift.
This exciting quartet comprised of some of the most talented young musicians in the US playing Irish traditional music with "a precision and intensity that is rarely heard on this side of the Atlantic" brought the Melody Bar to it's feet.
See for yourself:


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